对比增强能谱乳腺X线摄影的临床应用及进展
|
摘要
乳腺癌是目前女性发病率最高的恶性肿瘤。早期发现乳腺病变并进行良恶性鉴别,直接影响临床治疗决策,并关系到乳腺癌患者预后。乳腺肿瘤通常血管富集,对比增强能谱乳腺X线摄影(CESM)技术基于碘剂的K边缘效应,通过静脉注射对比剂后对乳腺组织同时进行高、低能量X线摄片,经处理后获得直接反映碘对比剂在腺体内分布情况的减影图像,消除了腺体重叠干扰,显示病灶血供状态,从而可更敏感地发现隐藏于腺体中的小病灶,准确评估病变形态、范围,并进行定性诊断。本文对CESM在乳腺癌临床诊断中的应用和进展进行综述。
Breast cancer is the most common cancer in female population. Early detection of breast lesions and proper differentiation will directly impact on clinical treatment strategy and is related with prognosis. Breast tumors are usually rich in vascularity. Contrast-enhanced spectral mammography(CESM), based on K-edge effect of iodine, can acquire images of iodine contrast distribution in breasts through special computing and subtraction of images with both low-and high-energy X-ray exposures after intravenous induction of iodinated contrast media. It can eliminate the disturbance caused by overlapping breast tissues and demonstrate blood supply of the lesions, thus is sensitive to small lesion, more accurate in tumor delineating and able to help diagnosing. The current clinical applications and progresses of CESM were reviewed in this article.
Breast cancer is the most common cancer in female population. Early detection of breast lesions and proper differentiation will directly impact on clinical treatment strategy and is related with prognosis. Breast tumors are usually rich in vascularity. Contrast-enhanced spectral mammography(CESM), based on K-edge effect of iodine, can acquire images of iodine contrast distribution in breasts through special computing and subtraction of images with both low-and high-energy X-ray exposures after intravenous induction of iodinated contrast media. It can eliminate the disturbance caused by overlapping breast tissues and demonstrate blood supply of the lesions, thus is sensitive to small lesion, more accurate in tumor delineating and able to help diagnosing. The current clinical applications and progresses of CESM were reviewed in this article.
引文
[1] Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin, 2017,67(1):7-30.
[2] Chen W, Sun K, Zheng R, et al. Cancer incidence and mortality in China, 2014. Chin J Cancer Res, 2018,30(1):1-12.
[3] Ronca R, Benkheil M, Mitola S, et al. Regulators and clinical implications. Med Res Rev, 2017,37(6):1231-1274.
[4] De Palma M, Biziato D, Petrova TV. Microenvironmental regulation of tumour angiogenesis. Nat Rev Cancer, 2017,17(8):457-474.
[5] Puong S, Bouchevreau X, Patoureaux F, et al. Dual-energy contrast enhanced digital mammography using a new approach for breast tissue canceling. Proceedings of SPIE, 2007:6510,doi: 10.1117/12.710133.
[6] Daniaux M, De Zordo T, Santner W, et al. Dual-energy contrast-enhanced spectral mammography (CESM). Arch Gynecol Obstet, 2015,292(4):739-747.
[7] Dromain C, Thibault F, Muller S, et al. Dual-energy contrast-enhanced digital mammography: Initial clinical results. Eur Radiol, 2011,21(3):565-574.
[8] Jeukens CR, Lalji UC, Meijer E, et al. Radiation exposure of contrast-enhanced spectral mammography compared with full-field digital mammography. Invest Radiol, 2014,49(10):659-665.
[9] Badr S, Laurent N, Regis C, et al. Dual-energy contrast-enhanced digital mammography in routine clinical practice in 2013. Diagn Interv Imaging, 2014,95(3):245-258.
[10] Fallenberg EM, Dromain C, Diekmann F, et al. Contrast-enhanced spectral mammography: Does mammography provide additional clinical benefits or can some radiation exposure be avoided? Breast Cancer Res Treat, 2014,146(2):371-381.
[11] James JR, Pavlicek W, Hanson JA, et al. Breast radiation dose with CESM compared with 2D FFDM and 3D tomosynthesis mammography. AJR Am J Roentgenol, 2017,208(2):362-372.
[12] Monsees BS. The Mammography Quality Standards Act: An overview of the regulations and guidance. Radiol Clin North Am, 2000,38(4):759-772.
[13] Lewin JM, Isaacs PK, Vance V, et al. Dual-energy contrast-enhanced digital subtraction mammography: Feasibility. Radiology, 2003,229(1):261-268.
[14] Lobbes MB, Lalji U, Houwers J, et al. Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme. Eur Radiol, 2014,24(7):1668-1676.
[15] Cheung YC, Lin YC, Wan YL, et al. Diagnostic performance of dual-energy contrast-enhanced subtracted mammography in dense breasts compared to mammography alone: Interobserver blind-reading analysis. Eur Radiol, 2014,24(10):2394-2403.
[16] Cheung YC, Juan YH, Lin YC, et al. Dual-energy contrast-enhanced spectral mammography: Enhancement analysis on BI-RADS 4 non-mass microcalcifications in screened women. PLoS One, 2016,11(9):e0162740.
[17] Lobbes MB, Lalji UC, Nelemans PJ, et al. The quality of tumor size assessment by contrast-enhanced spectral mammography and the benefit of additional breast MRI. J Cancer, 2015,6(2):144-150.
[18] ?uczyńska E, Heinze-Paluchowska S, Hendrick E, et al. Comparison between breast MRI and contrast-enhanced spectral mammography. Med Sci Monit, 2015,21:1358-1367.
[19] 张承中,王庆国,王建丰,等.对比增强能谱乳腺X线摄影在诊断乳腺癌中的可行性研究.放射学实践,2014,29(12):1420-1423.
[20] 姜婷婷,张盛箭,李瑞敏,等.对比增强能谱X线摄影对乳腺疾病的诊断价值.中华放射学杂志,2017,51(4):273-278.
[21] Barra FR, de Souza FF, Camelo REFA, et al. Accuracy of contrast-enhanced spectral mammography for estimating residual tumor size after neoadjuvant chemotherapy in patients with breast cancer: A feasibility study. Radiol Bras, 2017,50(4):224-230.
[22] Patel BK, Hilal T, Covington M, et al. Contrast-enhanced spectral mammography is comparable to MRI in the assessment of residual breast cancer following neoadjuvant systemic therapy. Ann Surg Oncol, 2018,25(5):1350-1356.
[23] Knogler T, Homolka P, Hoernig M, et al. Application of BI-RADS descriptors in contrast-enhanced dual-energy mammography: Comparison with MRI. Breast Care (Basel), 2017,12(4):212-216.
[24] Houben IPL, Van de Voorde P, Jeukens CRLPN, et al. Contrast-enhanced spectral mammography as work-up tool in patients recalled from breast cancer screening has low risks and might hold clinical benefits. Eur J Radiol, 2017,94:31-37.
[2] Chen W, Sun K, Zheng R, et al. Cancer incidence and mortality in China, 2014. Chin J Cancer Res, 2018,30(1):1-12.
[3] Ronca R, Benkheil M, Mitola S, et al. Regulators and clinical implications. Med Res Rev, 2017,37(6):1231-1274.
[4] De Palma M, Biziato D, Petrova TV. Microenvironmental regulation of tumour angiogenesis. Nat Rev Cancer, 2017,17(8):457-474.
[5] Puong S, Bouchevreau X, Patoureaux F, et al. Dual-energy contrast enhanced digital mammography using a new approach for breast tissue canceling. Proceedings of SPIE, 2007:6510,doi: 10.1117/12.710133.
[6] Daniaux M, De Zordo T, Santner W, et al. Dual-energy contrast-enhanced spectral mammography (CESM). Arch Gynecol Obstet, 2015,292(4):739-747.
[7] Dromain C, Thibault F, Muller S, et al. Dual-energy contrast-enhanced digital mammography: Initial clinical results. Eur Radiol, 2011,21(3):565-574.
[8] Jeukens CR, Lalji UC, Meijer E, et al. Radiation exposure of contrast-enhanced spectral mammography compared with full-field digital mammography. Invest Radiol, 2014,49(10):659-665.
[9] Badr S, Laurent N, Regis C, et al. Dual-energy contrast-enhanced digital mammography in routine clinical practice in 2013. Diagn Interv Imaging, 2014,95(3):245-258.
[10] Fallenberg EM, Dromain C, Diekmann F, et al. Contrast-enhanced spectral mammography: Does mammography provide additional clinical benefits or can some radiation exposure be avoided? Breast Cancer Res Treat, 2014,146(2):371-381.
[11] James JR, Pavlicek W, Hanson JA, et al. Breast radiation dose with CESM compared with 2D FFDM and 3D tomosynthesis mammography. AJR Am J Roentgenol, 2017,208(2):362-372.
[12] Monsees BS. The Mammography Quality Standards Act: An overview of the regulations and guidance. Radiol Clin North Am, 2000,38(4):759-772.
[13] Lewin JM, Isaacs PK, Vance V, et al. Dual-energy contrast-enhanced digital subtraction mammography: Feasibility. Radiology, 2003,229(1):261-268.
[14] Lobbes MB, Lalji U, Houwers J, et al. Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme. Eur Radiol, 2014,24(7):1668-1676.
[15] Cheung YC, Lin YC, Wan YL, et al. Diagnostic performance of dual-energy contrast-enhanced subtracted mammography in dense breasts compared to mammography alone: Interobserver blind-reading analysis. Eur Radiol, 2014,24(10):2394-2403.
[16] Cheung YC, Juan YH, Lin YC, et al. Dual-energy contrast-enhanced spectral mammography: Enhancement analysis on BI-RADS 4 non-mass microcalcifications in screened women. PLoS One, 2016,11(9):e0162740.
[17] Lobbes MB, Lalji UC, Nelemans PJ, et al. The quality of tumor size assessment by contrast-enhanced spectral mammography and the benefit of additional breast MRI. J Cancer, 2015,6(2):144-150.
[18] ?uczyńska E, Heinze-Paluchowska S, Hendrick E, et al. Comparison between breast MRI and contrast-enhanced spectral mammography. Med Sci Monit, 2015,21:1358-1367.
[19] 张承中,王庆国,王建丰,等.对比增强能谱乳腺X线摄影在诊断乳腺癌中的可行性研究.放射学实践,2014,29(12):1420-1423.
[20] 姜婷婷,张盛箭,李瑞敏,等.对比增强能谱X线摄影对乳腺疾病的诊断价值.中华放射学杂志,2017,51(4):273-278.
[21] Barra FR, de Souza FF, Camelo REFA, et al. Accuracy of contrast-enhanced spectral mammography for estimating residual tumor size after neoadjuvant chemotherapy in patients with breast cancer: A feasibility study. Radiol Bras, 2017,50(4):224-230.
[22] Patel BK, Hilal T, Covington M, et al. Contrast-enhanced spectral mammography is comparable to MRI in the assessment of residual breast cancer following neoadjuvant systemic therapy. Ann Surg Oncol, 2018,25(5):1350-1356.
[23] Knogler T, Homolka P, Hoernig M, et al. Application of BI-RADS descriptors in contrast-enhanced dual-energy mammography: Comparison with MRI. Breast Care (Basel), 2017,12(4):212-216.
[24] Houben IPL, Van de Voorde P, Jeukens CRLPN, et al. Contrast-enhanced spectral mammography as work-up tool in patients recalled from breast cancer screening has low risks and might hold clinical benefits. Eur J Radiol, 2017,94:31-37.