基于术前MRI特征及定量参数列线图预测乳腺癌患者淋巴血管侵犯OA北大核心CSTPCD

Objective:To develop a nomogram based on preoperative magnetic resonance imaging(MRI)features and apparent diffusion coefficient(ADC)to predict lymphovascular invasion(LVI)in invasive breast cancer.Materials and Methods:A retrospective analysis was conducted on data from 141 patients with invasive breast cancer.Among them,66 patients from March 2019 to July 2021 were assigned to the training group,and 75 patients from July 2021 to December 2022 were assigned to the validation group.The evaluation included assessment of lesion MRI features(such as mass shape,margins,internal enhancement patterns,and peritumoral edema)and measurement of ADC.The differences in imaging features and mean,maximum,and minimum ADC values within the tumor and peritumoral regions between the LVI-positive and LVI-negative groups were analyzed using chi-square tests,independent sample t-tests,and Mann-Whitney U tests.Multivariate logistic regression analysis was employed to identify independent risk factors associated with LVI and to establish a nomogram model for predicting LVI.Results:LVI was significantly associated with tumor size,Ki-67 expression,and lymph node metastasis rate.Multivariable logistic regression analysis showed that tumor shape[P=0.014,odds ratio(OR):0.142(0.030-0.679)],internal enhancement patterns[P=0.046,OR:0.157(0.025-0.965)],maximum tumor diameter[P=0.037,OR:4.372(1.093-17.488)],DWI rim[P=0.024,OR:0.193(0.047-0.803)],and ADCration[P=0.010,OR:1.056(1.013-1.101)were independent predictors of LVI.Areas under the receiver operating characteristic curve of the comprehensive prediction model based on MRI features and peritumoral intratumoral ADC ratio in the training and validation groups were 0.867 and 0.872,the specificity were 88.6%and 84.6%,and the precision were 74.2%and 69.7%,respectively.Calibration curves demonstrated good agreement between predicted and actual values in the training and validation groups.Conclusions:LVI is correlated with various clinical and pathological prognostic factors and MRI imaging features.The comprehensive model based on preoperative MRI features and apparent diffusion coefficient demonstrates good predictive efficiency for LVI,that contribute to clinical decision-making in guiding surgery,developing individualized treatment plans,and assessing prognosis.