Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA.
Semin Oncol. 2011 Feb;38(1):16-25. doi: 10.1053/j.seminoncol.2010.11.007.
Current standard-of-care radiological methods for assessing the response of solid tumors to treatment are based on measuring changes in lesion size in a single dimension using high-resolution x-ray computed tomography (CT) or magnetic resonance imaging (MRI). Even if size measurements are adapted to record true volume changes more accurately, the effects of therapeutic drugs on tumor size may not occur for several cycles of treatment. Furthermore, current and future generations of anticancer drugs will be designed to affect highly specific cancer characteristics, and their effects may not be immediately cytotoxic. More sensitive and specific measures are required that can report on tumor status and treatment response early in the course of therapy. Several MRI techniques have matured to the point where they can offer quantitative information on tissue status and greater insight into specific biophysical and physiological characteristics of tumors. Here we review and provide illustrative examples of two MRI methods that have already been incorporated into clinical trials of treatment response in solid tumors: diffusion imaging and dynamic contrast-enhanced MRI. We also discuss the limitations and future research directions required for these techniques to gain greater acceptance and to have their maximum impact.
目前评估实体瘤对治疗反应的标准放射学方法基于使用高分辨率 X 射线计算机断层扫描（CT）或磁共振成像（MRI）在单一维度上测量病变大小的变化。即使大小测量经过调整以更准确地记录真实的体积变化，治疗药物对肿瘤大小的影响也可能不会在几个治疗周期内发生。此外，当前和未来几代抗癌药物将被设计用于影响高度特异性的癌症特征，其效果可能不会立即具有细胞毒性。需要更敏感和更特异的方法，可以在治疗过程的早期报告肿瘤状态和治疗反应。几种 MRI 技术已经成熟，可以提供关于组织状态的定量信息，并更深入地了解肿瘤的特定生物物理和生理特征。在这里，我们回顾并提供了两种已经纳入实体瘤治疗反应临床试验的 MRI 方法的示例：扩散成像和动态对比增强 MRI。我们还讨论了这些技术获得更大认可并发挥最大影响所需的局限性和未来研究方向。
