Füsun TAŞKIN, Veli Süha ÖZTÜRK, İbrahim Halil ERDOĞDU, Filiz ABACIGİL, Recep ÖZGÜR, Yasemin DURUM POLAT

Meme MRG Bulguları Meme Kanserinin Moleküler Alt Tiplerini Öngörebilir mi?

Amaç: Meme kanserinde dinamik kontrastlı manyetik rezonans görüntüleme MRG ile saptanan morfolojik ve kinetik bulgularla, difüzyon ağırlıklı görüntüleme ile elde edilen apparent diffusion coefficient ADC değerlerinin tümör histopatolojik alt tipleri ile ilişkisini araştırmak.Gereç ve Yöntemler: 258 kadın hastaya ait 271 meme lezyonunun MRG bulguları geriye dönük olarak değerlendirildi. Konvansiyonel MRG’de lezyon morfolojisi ve kontrastlanma özellikleri değerlendirilirken, difüzyon ağırlıklı MRG’de ADC ölçümleri yapıldı. Morfolojik, kinetik özellikler ve ortalama ADC değerleri ile tümör boyutu, histolojik grade, aksiller lenf nodu tutulumu, ki-67 indeksi ve histolojik subtipler arasındaki ilişki analiz edildi.Bulgular: Kitlelerde düzgün kenar, tümör içi nekroz varlığı ve halkasal kontrastlanma bulgularıyla triple negatif tip; spiküle kenar luminal A tip, aksilla lenf nodu tutulumu ile human epidermal growth factor reseptör 2 pozitif HER2+ tip arasında ilişki saptandı. Yüksek histolojik grade en fazla TN %45,7 ve HER2 + %47,1 tümörlerde saptandı p=0.000 . Ortalama ADC değeri 1001x10-6mm2/sn olarak ölçüldü. Triple negatif TN tümörlerde ortalama ADC değeri diğer subtiplerden daha yüksekti. Ancak, ADC değeri moleküler subtipler arasında önemli farklılık göstermedi p=0,396 . Östrojen ve progesteron reseptörü pozitif ER/PR+ subgrubun ADC değerleri HER2+ ve TN grupla karşılaştırıldığında iki grup aralarında anlamlı farklılık saptanmadı p=0,556 . Ki-67 proliferasyon indeksi ve ortalama ADC değerleri arasında korelasyon saptanmadı p=0,207 .Sonuç: Dinamik kontrastlı meme MRG morfoloji bulguları özellikle bazı moleküler alt tipleri işaret ederken, DAG ile saptanan ADC değerlerinin moleküler alt tip belirlemede iddialı olmadığı söylenebilir

Anahtar Kelimeler:

Difüzyon ağırlıklı MRG, Meme kanseri, ADC, Moleküler subtip

Can Breast MRI Findings Predict Molecular Subtypes of Breast Cancer?

Objective: To investigate the association between the morphologic and kinetic results obtained with the dynamic contrast-enhanced magnetic resonance imaging MRI , and the apparent diffusion coefficient ADC values obtained using diffusion-weighted imaging DWI in breast cancer with the histopathologic subtypes of tumors.Material and Methods: The MRI results of 271 breast lesions of 258 patients were retrospectively evaluated. Lesion morphology and contrast-enhancement characteristics were evaluated using conventional MRI, and ADC measurements were performed with DWI. Results: An association was detected between regular margins in the masses, the presence of intratumoral necrosis, and annular contrast enhancement with triple-negative type TN , spiculated margin luminal A type. Higher histological grade was mostly detected in TN 45.7% , and human epidermal growth factor receptor 2 positive HER2+ tumors 47.1% p

Keywords:

Diffusion-weighted MRI, Breast cancer, ADC, Molecular subtype,

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