浙江医学2025，Vol.47Issue(20)：2176-2181,6.DOI:10.12056/j.issn.1006-2785.2025.47.20.2025-422
光谱CT联合MRI的多模态影像学模型在鉴别Luminal型乳腺癌中的价值
The value of spectral CT combined with MRI in differentiating Luminal and non-Luminal breast cancer
摘要
Abstract
Objective To investigate the value of integrated spectral CT and MRI in differentiating between Luminal and non-Luminal subtypes of breast cancer.Methods A retrospective cohort of 110 breast cancer patients treated at the First Affiliated Hospital of Zhejiang Chinese Medical University between February 2024 and April 2025 was enrolled.Based on immunohistochemical profiling,subjects were categorized into Luminal subtype(n=82)and non-Luminal subtype(n=28).All patients underwent preoperative spectral CT chest plain scans and MRI enhanced scansexaminations,and the effective atomic number value(Zeff),electron density(EDW),and CT value at 40 keV(40 keV MonoE)and 100 keV(100 keV MonoE)were recorded,and the spectral curve slope(K)was also derived.MRI images were examined,and the lesion margins,morphological characteristics,maximum tumor diameter,and apparent diffusion coefficient(ADC)values were recorded,the time-intensity curve was calculated and the patterns of TICs were also recorded too.Spectral CT and MRI parameters were compared between the two groups.Univariate and multivariate logistic regression analyses were applied to identify the independent predictors for Luminal subtype of breast cancer,and an integrated multimodal model was constructed.The discriminatory performance of the model was evaluated by generating ROC curves.Results Significant differences were observed between Luminal and non-Luminal patients in terms of age,menstrual history,maximum tumor diameter,ADC value,40 keV MonoE,100 keV MonoE,and EDW(all P＜0.05).Maximum tumor diameter,ADC value,and EDW were identified as independent predictors for discriminating between Luminal and non-Luminal subtypes.ROC analysis demonstrated that the multimodal model integrating spectral CT and MRI parameters exhibited superior diagnostic performance compared to either modality alone,with an AUC of 0.867,a sensitivity of 0.854,and a specificity of 0.714.Conclusion The multimodal imaging model integrating spectral CT and MRI shows potential for discriminating between Luminal and non-Luminal breast cancer subtypes and may provide valuable guidance for clinical diagnosis and treatment planning.关键词
乳腺肿瘤/光谱CT/MRI/Luminal型/非Luminal型Key words
Breast tumor/Spectral CT/MRI/Luminal subtype/Non-Luminal subtype引用本文复制引用
吴郑鑫,周兆良,杨盼盼,董书杉,王世威,张睿馨..光谱CT联合MRI的多模态影像学模型在鉴别Luminal型乳腺癌中的价值[J].浙江医学,2025,47(20):2176-2181,6.基金项目
浙江省中医药科技计划项目(2024ZL448) （2024ZL448）
浙江省医药卫生科技计划项目(2024KY131) （2024KY131）
