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动态磁共振成像对非小细胞肺癌患者放化疗后的预后价值

Prognostic value of dynamic MR imaging for non-small-cell lung cancer patients after chemoradiotherapy.

作者信息

Ohno Yoshiharu, Nogami Munenobu, Higashino Takanori, Takenaka Daisuke, Matsumoto Sumiaki, Hatabu Hiroto, Sugimura Kazuro

机构信息

Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.

出版信息

J Magn Reson Imaging. 2005 Jun;21(6):775-83. doi: 10.1002/jmri.20297.

Abstract

PURPOSE

To determine the prognostic value of dynamic MRI for non-small-cell lung cancer (NSCLC) patients after chemoradiotherapy.

MATERIALS AND METHODS

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.

RESULTS

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).

CONCLUSION

Dynamic MRI has potential prognostic value for NSCLC patients after chemoradiotherapy.

摘要

目的

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。

材料与方法

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。

结果

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)。

结论

动态MRI对NSCLC患者放化疗后具有潜在的预后价值。

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