Cui Yong, Zhang Xiao-Peng, Sun Ying-Shi, Tang Lei, Shen Lin
Department of Radiology, Peking University School of Oncology, Beijing Cancer Hospital and Institute, 52 Fu Cheng Road, Hai Dian District, Beijing 100036, People's Republic of China.
Radiology. 2008 Sep;248(3):894-900. doi: 10.1148/radiol.2483071407.
To evaluate the ability of the apparent diffusion coefficient (ADC) to help predict response to chemotherapy in patients with colorectal and gastric hepatic metastases.
Institutional review board approval was obtained; all patients provided informed consent. Standard magnetic resonance (MR) imaging and diffusion-weighted (DW) MR imaging were performed before and 3, 7, and 42 days after initiating chemotherapy for 87 hepatic metastases in 23 colorectal and gastric cancer patients (16 men, seven women; mean age, 55.7 years; range, 33-71 years). Lesions were classified as either responding or nonresponding, according to changes in size at the end of therapy. Linear mixed-effects modeling was applied to analyze change in ADCs and size following treatment. The Pearson correlation test was calculated between those ADC parameters and tumor response.
Thirty-eight responding and 49 nonresponding metastatic lesions were evaluated. Pretherapy mean ADCs in responding lesions were significantly lower than those of nonresponding lesions (P = .003). An early increase in ADCs (on day 3 or 7) was observed in responding lesions but not in nonresponding lesions (P = .002). Weak but significant correlations were found between final tumor size reduction and both pretreatment ADCs (P = .006) and early ADC changes (day 3, P = .004; day 7, P < .001).
ADC seems to be a promising tool for helping predict and monitor the early response to chemotherapy of hepatic metastases from colorectal and gastric carcinomas.
评估表观扩散系数（ADC）预测结直肠癌和胃癌肝转移患者化疗反应的能力。
获得机构审查委员会批准；所有患者均提供知情同意书。对23例结直肠癌和胃癌患者（16例男性，7例女性；平均年龄55.7岁；范围33 - 71岁）的87个肝转移灶在化疗开始前、化疗开始后3天、7天和42天进行标准磁共振（MR）成像和扩散加权（DW）MR成像。根据治疗结束时病灶大小的变化，将病灶分为反应性和非反应性。应用线性混合效应模型分析治疗后ADC值和大小的变化。计算这些ADC参数与肿瘤反应之间的Pearson相关性检验。
评估了38个反应性和49个非反应性转移病灶。反应性病灶治疗前的平均ADC值显著低于非反应性病灶（P = .003）。在反应性病灶中观察到ADC值早期升高（第3天或第7天），而非反应性病灶中未观察到（P = .002）。最终肿瘤大小缩小与治疗前ADC值（P = .006）以及早期ADC变化（第3天，P = .004；第7天，P < .001）之间存在弱但显著的相关性。
ADC似乎是预测和监测结直肠癌和胃癌肝转移化疗早期反应的一种有前景的工具。
