Ohno Yoshiharu, Nogami Munenobu, Higashino Takanori, Takenaka Daisuke, Matsumoto Sumiaki, Hatabu Hiroto, Sugimura Kazuro
Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
J Magn Reson Imaging. 2005 Jun;21(6):775-83. doi: 10.1002/jmri.20297.
To determine the prognostic value of dynamic MRI for non-small-cell lung cancer (NSCLC) patients after chemoradiotherapy.
A total of 114 consecutive patients with NSCLC underwent dynamic MRI after chemoradiotherapy. The patients were divided into two groups (local control (n=22) and local failure (n=92)) according to the presence of local recurrence. From the signal intensity-time course curve in each subject, the maximum relative enhancement ratio and slope of enhancement were calculated, and compared between two groups by Student's t-test. To determine the feasible threshold values of both MR indexes for group differentiation, ROC-based positive tests were performed. Finally, the Kaplan-Meier survival curves of each group divided by the adapted threshold value were compared by log-rank test.
The maximum relative enhancement ratio and the slope of enhancement in the local control group were significantly lower than those in the local failure group (P<0.05). Using 0.08/sec as the threshold value of the slope of enhancement, the sensitivity and specificity for differentiation between the two groups were 90.9% and 91.3%, respectively. When the slope of enhancement was adopted for estimation of prognosis after therapy, the mean survival period of the slope of enhancement<or=0.08/sec group was significantly longer than that seen in the group with a slope of enhancement>0.08/sec (P<0.0001).
Dynamic MRI has potential prognostic value for NSCLC patients after chemoradiotherapy.
确定动态磁共振成像(MRI)对非小细胞肺癌(NSCLC)患者放化疗后的预后价值。
114例连续的NSCLC患者在放化疗后接受了动态MRI检查。根据局部复发情况将患者分为两组(局部控制组(n = 22)和局部失败组(n = 92))。从每个受试者的信号强度-时间曲线中,计算最大相对增强率和增强斜率,并通过Student t检验在两组之间进行比较。为了确定两种MR指标用于组间区分的可行阈值,进行了基于ROC的阳性试验。最后,通过对数秩检验比较以适应阈值划分的每组的Kaplan-Meier生存曲线。
局部控制组的最大相对增强率和增强斜率明显低于局部失败组(P <0.05)。以0.08 /秒作为增强斜率的阈值,两组间区分的敏感性和特异性分别为90.9%和91.3%。当采用增强斜率评估治疗后的预后时,增强斜率≤0.08 /秒组的平均生存期明显长于增强斜率> 0.08 /秒组(P <0.0001)。
动态MRI对NSCLC患者放化疗后具有潜在的预后价值。