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Multimodale, parametrische und genetische Brustbildgebung

Multimodal, multiparametric and genetic breast imaging

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Zusammenfassung

Klinisches/methodisches Problem

Die multiparametrische Magnetresonanztomographie (MRT) zielt auf die Darstellung, Beschreibung und Quantifizierung biologischer, physiologischer und pathologischer Prozesse auf zellulärer und molekularer Ebene ab und liefert wertvolle Informationen über die Schlüsselprozesse in der Krebsentstehung und -progression. „Omics“-Strategien (Genomics, Transcriptomics, Proteomics, Metabolomics) kommen heute in vielen Bereichen der Onkologie zum Einsatz.

Radiologische Standardverfahren

Die multiparametrische MRT der Brust umfasst derzeit die T2- und diffusionsgewichtete Bildgebung sowie die dynamische kontrastmittelverstärkte MRT (DCE-MRT).

Methodische Innovationen

Weitere Parameter, wie Protonen- Magnetresonanz Spektroskopie (MRS), „chemical exchange saturation transfer“ (CEST), die „blood oxygen level-dependent“ (BOLD), die hyperpolarisierte (HP) MRT oder die Lipid-MRS sind derzeit in Entwicklung und werden in der Brustkrebsdiagnostik evaluiert.

Bewertung

Radiogenomics ist eine neue Richtung in der medizinischen Wissenschaft, die durch signifikante Fortschritte in Bildgebungs- und Bildanalysemethoden sowie die Entwicklung von Techniken zur Extraktion und Korrelation verschiedenster Bildgebungsparameter mit „Omics“-Daten ermöglicht wurde. Radiogenomics hat das Ziel, Bildgebungscharakteristika (Phenotypen) mit Genexpressionsmustern, Genmutationen und weiteren genomassoziierten Eigenschaften zu korrelieren. Quantitative und qualitative Imaging-Biomarker erlauben Einblicke in die komplexe Tumorbiologie. Erste Ergebnisse legen nahe, dass Radiogemics eine wichtige Rolle in Diagnostik, Prognose und Behandlung von Brustkrebs spielen werden.

Empfehlung für die Praxis

Dieser Beitrag gibt einen Überblick über den derzeitigen Stand von Radiogenomics der Brust und zukünftige Anwendungen und Herausforderungen.

Abstract

Clinical/methodological issue

Multiparametric magnetic resonance imaging (MRI) aims to visualize and quantify biological, physiological and pathological processes at the cellular and molecular level and provides valuable information about key processes in cancer development and progression. “Omics” strategies (genomics, transcriptomics, proteomics, metabolomics) have many uses in oncology.

Standard radiological methods

Multiparametric MRI of the breast currently includes T2-weighted, diffusion-weighted and dynamic contrast-enhanced MRI (DCE-MRI)

Methodological innovations

Additional parameters such as proton magetic resonance spectroscopy (MRS), chemical exchange saturation transfer (CEST), blood oxygen level-dependent (BOLD), hyperpolarized (HP) MRI or lipid MRS are currently being developed and are being evaluated in breast cancer diagnostics.

Achievements

Radiogenomics is a new direction in medical science that has been made possible by significant advances in imaging and image analysis methods, as well as the development of techniques to extract and correlate various imaging parameters with “omics” data. The aim of radiogenomics is to correlate imaging characteristics (phenotypes) with gene expression patterns, gene mutations and other genome-associated properties and is the evolution of the correlation between radiology and pathology from the anatomical–histological to the molecular level. Quantitative and qualitative imaging biomarkers provide insights into the complex tumor biology. Initial results suggest that radiogemics will play an important role in the diagnosis, prognosis, and treatment of breast cancer.

Practical recommendations

This article provides an overview of the current state of radiogenomics of the breast and future applications and challenges.

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Danksagung

Ich möchte meiner Lektorin Erdmuthe Pinker für ihre unentbehrliche jahrelange Unterstützung danken.

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Authors and Affiliations

  1. Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, 7th Floor, Suite 707, 10065, New York, NY, USA

    Roberto LoGullo MD, Joao Horvat MD, Jeffrey Reiner MD & Katja Pinker MD PhD EBBI

  2. Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Structural Preclinical Imaging, Medical University Vienna, Wien, Österreich

    Katja Pinker MD PhD EBBI

Authors
  1. Roberto LoGullo MD
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  2. Joao Horvat MD
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  4. Katja Pinker MD PhD EBBI
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Corresponding author

Correspondence to Katja Pinker MD PhD EBBI.

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Interessenkonflikt

R. LoGullo, J. Horvat, J. Reiner und K. Pinker geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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LoGullo, R., Horvat, J., Reiner, J. et al. Multimodale, parametrische und genetische Brustbildgebung. Radiologe 61, 183–191 (2021). https://doi.org/10.1007/s00117-020-00801-3

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