软组织肉瘤区域热疗期间的无创磁共振热成像：与反应及直接测温的相关性

Noninvasive magnetic resonance thermography of soft tissue sarcomas during regional hyperthermia: correlation with response and direct thermometry.

作者信息

Gellermann Johanna, Hildebrandt Bert, Issels Rolf, Ganter Hildegard, Wlodarczyk Waldemar, Budach Volker, Felix Roland, Tunn Per-Ulf, Reichardt Peter, Wust Peter

机构信息

Clinic for Radiation Medicine, University Hospital Charite, Campus Virchow Klinikum, Berlin, Germany.

出版信息

Cancer. 2006 Sep 15;107(6):1373-82. doi: 10.1002/cncr.22114.

DOI:10.1002/cncr.22114

PMID:16902986

Abstract

BACKGROUND

The objective of this study was to evaluate noninvasive magnetic resonance (MR) thermography for the monitoring of regional hyperthermia (RHT) in patients with soft tissue sarcomas of the lower extremities and pelvis.

METHODS

Noninvasive MR monitoring during RHT was performed in 9 patients who had high-risk soft tissue sarcomas of the lower extremities or pelvis during neoadjuvant chemotherapy plus RHT in the scope of the European Organization for Research and Treatment of Cancer 62961/European Society for Hyperthermic Oncology RHT-95 study. Anatomic and temperature-sensitive data sets were acquired every 10 minutes before and during RHT (using gradient-echo-sequences with variable echo times). MR temperature distributions were derived from the phase differences by using the proton-resonance frequency shift method. A phase convolution setting phase shifts to zero in the fat tissue was performed as a drift correction. The mean MR temperatures in the tumor and muscles and the index temperatures (e.g., T90, which covers 90% of the target volume) and thermal doses were determined and compared with pathohistologic responses and direct temperature measurements if available.

RESULTS

Thirty of 72 MR-thermography data sets (>40% of heat sessions) were evaluable. A significant correlation was observed between pathohistologic response (defined as a necrosis rate >or=90%) and standardized thermal parameters, such as thermal dose cumulative equivalent minutes at 43 degrees C to 90% of the target volume (T90) (P = .050), mean T90 (P = .048), or T50 (P = .050). The correlation of 13 conventional temperature measurements performed in selected patients and sessions invasively in the tumor or noninvasively in rectum and bladder revealed an excellent correlation with MR temperatures (R2 = .96).

CONCLUSIONS

Noninvasive MR thermography of soft tissue sarcoma was feasible and suitable for validating the quality of heating during RHT.

摘要

背景

本研究的目的是评估无创磁共振（MR）热成像技术在监测下肢和骨盆软组织肉瘤患者区域热疗（RHT）中的应用。

方法

在欧洲癌症研究与治疗组织62961/欧洲热疗肿瘤学会RHT - 95研究范围内，对9例患有下肢或骨盆高危软组织肉瘤的患者在新辅助化疗加RHT期间进行了无创MR监测。在RHT之前和期间每隔10分钟采集解剖学和温度敏感数据集（使用具有可变回波时间的梯度回波序列）。通过质子共振频率偏移方法从相位差中得出MR温度分布。进行相位卷积以使脂肪组织中的相位移至零作为漂移校正。确定肿瘤和肌肉中的平均MR温度、指数温度（例如，覆盖目标体积90%的T90）和热剂量，并与病理组织学反应以及直接温度测量值（如可获得）进行比较。

结果

72个MR热成像数据集中的30个（>40%的热疗疗程）可评估。观察到病理组织学反应（定义为坏死率≥90%）与标准化热参数之间存在显著相关性，如43℃至目标体积90%的热剂量累积等效分钟数（T90）（P = 0.050）、平均T90（P = 0.048）或T50（P = 0.050）。在选定患者和疗程中对肿瘤进行有创或在直肠和膀胱进行无创的13次常规温度测量与MR温度显示出极好的相关性（R2 = 0.96）。