非小细胞肺癌放化疗期间重复扩散加权磁共振成像的表观扩散系数（ADC）变化：一项初步研究。

Apparent diffusion coefficient (ADC) change on repeated diffusion-weighted magnetic resonance imaging during radiochemotherapy for non-small cell lung cancer: A pilot study.

作者信息

Weiss Elisabeth, Ford John C, Olsen Kathryn M, Karki Kishor, Saraiya Siddharth, Groves Robert, Hugo Geoffrey D

机构信息

Department of Radiation Oncology, Virginia Commonwealth University, 401 College Street, Richmond, VA 23298, USA.

Department of Radiation Oncology, Virginia Commonwealth University, 401 College Street, Richmond, VA 23298, USA; Department of Radiation Oncology, University of Miami, 1475 NW 12th Ave, Miami, FL 33136, USA.

出版信息

Lung Cancer. 2016 Jun;96:113-9. doi: 10.1016/j.lungcan.2016.04.001. Epub 2016 Apr 4.

DOI:10.1016/j.lungcan.2016.04.001

PMID:27133760

Abstract

OBJECTIVES

Serial diffusion-weighted magnetic resonance imaging (DW-MRI) during radiochemotherapy of non-small cell lung cancer (NSCLC) is analyzed to investigate the apparent diffusion coefficient (ADC) as a potential biomarker for tumor response.

METHODS

Ten patients underwent DW-MRI prior to and at three and six weeks during radiochemotherapy. Three methods of contouring primary tumors (PT) were performed to evaluate the impact of tumor heterogeneity on ADC values: PTT: whole tumor volume; PTT-N: PTT-necrosis; PTL: small volume of presumed active tumor with low ADC value. Pretreatment and during-treatment absolute ADC values and ADC value changes were analyzed for PT and involved lymph nodes (LN).

RESULTS

ADC values for PTT, PTT-N, PTL and LN increased by 8-14% (PT) and 15% (LN) at three weeks, and 19-26% and 23% at 6 weeks post initial treatment (p=0.04-0.002). Average percent ADC value increase was smaller than tumor volume regression (p=0.06-0.0005). Patients with overall survival <12 months had a lower increase of ADC values compared to longer surviving patients (p=0.008 for PTT).

CONCLUSIONS

Significant ADC value increases during radiochemotherapy for non-small cell lung cancer were observed. ADC value change during treatment appears to be an independent marker of patient outcome and warrants further investigation.

摘要

目的

分析非小细胞肺癌（NSCLC）放化疗期间的系列扩散加权磁共振成像（DW-MRI），以研究表观扩散系数（ADC）作为肿瘤反应潜在生物标志物的情况。

方法

10例患者在放化疗前、放化疗3周和6周时接受DW-MRI检查。采用三种勾勒原发性肿瘤（PT）轮廓的方法来评估肿瘤异质性对ADC值的影响：PTT：整个肿瘤体积；PTT-N：PTT-坏死；PTL：假定为低ADC值的小体积活性肿瘤。分析PT和受累淋巴结（LN）的治疗前和治疗期间的绝对ADC值及ADC值变化。

结果

PTT、PTT-N、PTL和LN的ADC值在治疗3周时增加了8%-14%（PT）和15%（LN），初始治疗后6周时增加了19%-26%和23%（p=0.04-0.002）。ADC值的平均增加百分比小于肿瘤体积缩小（p=0.06-0.0005）。总生存期<12个月的患者与生存期较长的患者相比，ADC值的增加较低（PTT的p=0.008）。