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利用动态对比增强磁共振成像预测头颈部鳞状细胞癌的放化疗反应。

Prediction of response to chemoradiation therapy in squamous cell carcinomas of the head and neck using dynamic contrast-enhanced MR imaging.

机构信息

Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

AJNR Am J Neuroradiol. 2010 Feb;31(2):262-8. doi: 10.3174/ajnr.A1817. Epub 2009 Oct 1.

Abstract

BACKGROUND AND PURPOSE

Tumor microenvironment, including blood flow and permeability, may provide crucial information regarding response to chemoradiation therapy. Thus, the objective of this study was to investigate the efficacy of pretreatment DCE-MR imaging for prediction of response to chemoradiation therapy in HNSCC.

MATERIALS AND METHODS

DCE-MR imaging studies were performed on 33 patients with newly diagnosed HNSCC before neoadjuvant chemoradiation therapy by using a 1.5T (n = 24) or a 3T (n = 9) magnet. The data were analyzed by using SSM for estimation of K(trans), v(e), and tau(i). Response to treatment was determined on completion of chemoradiation as CR, with no evidence of disease (clinically or pathologically), or PR, with pathologically proved residual tumor.

RESULTS

The average pretreatment K(trans) value of the CR group (0.64 +/- 0.11 minutes(-1), n = 24) was significantly higher (P = .001) than that of the PR (0.21 +/- 0.05 minutes(-1), n = 9) group. No significant difference was found in other pharmacokinetic model parameters: v(e) and tau(i), between the 2 groups. Although the PR group had larger metastatic nodal volume than the CR group, it was not significantly different (P = .276).

CONCLUSIONS

These results indicate that pretreatment DCE-MR imaging can be potentially used for prediction of response to chemoradiation therapy of HNSCC.

摘要

背景与目的

肿瘤微环境,包括血流和通透性,可能为放化疗反应提供重要信息。因此,本研究的目的是探讨 DCE-MR 成像在预测头颈部鳞癌(HNSCC)放化疗反应中的作用。

材料与方法

33 例新诊断的 HNSCC 患者在新辅助放化疗前进行了 DCE-MR 成像检查,使用 1.5T(n=24)或 3T(n=9)磁共振成像仪。采用 SSM 分析数据以估计 Ktrans、v e 和 tau i。治疗结束时根据无病状态(临床或病理)评估为完全缓解(CR)或部分缓解(PR)。

结果

CR 组(n=24)的平均预处理 Ktrans 值(0.64±0.11 分钟-1)显著高于 PR 组(0.21±0.05 分钟-1)(P=0.001)。两组间其他药代动力学模型参数(v e 和 tau i)无显著差异。尽管 PR 组的转移性淋巴结体积大于 CR 组,但无显著差异(P=0.276)。

结论

这些结果表明,DCE-MR 成像可用于预测 HNSCC 放化疗反应。

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