Synthetic Magnetic Resonance Imaging For The Evaluation Of Axillary Lymph Node Metastasis In Breast Cancer

PART 1 Breast lesions Synthetic MRI quantitative parameters for the evaluation of lymph node metastasisObjective: To study synthetic magnetic resonance imaging(sy MRI)quantitative parameters of breast lesions for the assessment of lymph node metastasis in breast cancer.Methods: Collection of Guilin Medical College affiliated hospital during May 2020 to March 2022 line sy MRI and pathologic findings of 53 patients with breast cancer(a total of 54 cases of breast lesions).All subjects underwent pre-contrast and post-contrast sy MRI examinations before a pathological biopsy.The T1,T2,PD values of breast lesions pre-contrast and post-contrast injection(T1-pre,T2-pre,and PD-pre;T1-post,T2-post,and PD-post)were estimated from sy MRI data by using sy MRI post-processing software.The relative change rate between pre-and post-contrast sacnning was calculated(ΔT1%,ΔT2%,ΔPD%).According to the pathological results,patients were divided into the lymph node metastasis group and the no-lymph node metastasis group.Independent sample t-test and Wilcoxon rank-sum test were used to analyze whether the data were significantly different(P<0.05),and comparing with the performance characteristics of dynamic contrast-enhanced imaging MRI(DCE-MRI)(morphology,edge,internal reinforcement,time signal intensity curve)and apparent diffusion coefficient(ADC),and had a statistically significant parameters into binary logistic regression analysis to establish the prediction model,and compare diagnostic performance of different prediction model.Results: In 54 cases of breast lesions(22 cases of axillary lymph node metastases and 32 cases of no-axillary lymph node metastases),the differences of PD-pre and PD-post of sy MRI and the edge of DCE-MRI in two groups have statistically significant(P<0.05),and there was no statistically significant difference of ADC values(P>0.05).The sy MRI model(model B: PD-pre,PD-post)diagnostic performance is superior to the DCE-MRI model(model A:edge)(AUC were 0.693,0.670,respectively),the multi-parameter combination model(model C: PD-pre,PD-post,edge)diagnosis efficiency highest(AUC was0.798).Conclusions: PD-pre and PD-post value of breast lesions obtained using sy MRI have diagnostic value in predicting axillary lymph node metastasis in patients with breast cancer,its prediction value is superior to the DCE-MRI,and the diagnosis efficiency of combined application is highest.PART 2 Synthetic MRI quantitative parameters for the evaluation of lymph node metastasisObjective: To study synthetic magnetic resonance imaging(sy MRI)quantitative parameters for the assessment of axillary lymph node metastasis in patients with breast cancer.Methods : Collection of Guilin Medical College affiliated hospital during May 2020 to March 2022 line sy MRI and pathologic findings of 31 axillary lymph nodes of patients with breast cancer.All subjects underwent pre-contrast and post-contrast sy MRI examinations before a pathological biopsy.The T1,T2,PD values of lymph nodes pre-contrast and post-contrast injection(T1-pre,T2-pre,and PD-pre;T1-post,T2-post,and PD-post)were estimated from sy MRI data by using sy MRI post-processing software.The relative change rate between pre-and post-contrast sacnning was calculated(ΔT1%,ΔT2%,ΔPD%).According to the pathological results,patients were divided into the metastasis group and the no-metastasis group.Independent sample t-test and Wilcoxon rank-sum test were used to analyze whether the data were significantly different(P<0.05),and comparing with the short diameter,long diameter,the ratio of the short-long diameter,morphological performance and enhancement mode of lymph nodes.Results: In 31 cases of axillary lymph nodes(12 cases of metastases and 19 cases of no-metastases),the differences of T2-post,ΔT1%,ΔT2%,short diameter,long diameter,the ratio of the short-long diameter and enhancement mode in two group have statistically significant(P<0.05),the area under curve were 0.882,0.719,0.732,1,0.871,0.956,1.The morphological performance of lymph nodes was no statistically significant difference between this two groups(P>0.05).The AUC of the diagnosis model of T2-post,ΔT1% andΔT2% combined application can reach 0.895.Conclusions: The T2-post,ΔT1%,ΔT2% of axillary lymph node obtained using sy MRI can be used for assessment of lymph node metastasis,and the diagnosis efficiency of combined application is highest,it is better than the long diameter of lymph nodes,slightly lower than the short diameter,the ratio of the short-long diameter and enhancement mode.