Guo Wei, Luo Dehong, Chen Xinyi, Lin Meng, Li Lin, Zhao Yanfeng, Yang Liang, Hu Lei, Zhao Xinming, Zhou Chunwu
Department of Diagnostic Radiology, Peking Union Medical College, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing,China.
Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Oncotarget. 2017 May 16;8(20):33836-33843. doi: 10.18632/oncotarget.12952.
This study is to investigate the use of dynamic contrast-enhanced magnetic resonance imaging in predicting early response to CRT (chemo-radiotherapy) in patients with larynx and hypopharynx carcinoma from primary tumors.
Sixty-two patients with larynx and hypopharynx carcinoma underwent two DCE-MRI studies: a baseline exam before any treatmentanda post-treatment exam 3 weeks after CRT. At the end of treatment, patients were classified as responders, or non-responders according to the Response Evaluation Criteria in Solid Tumors criteria (RECIST). The time intensity curves (TIC) were extracted and processed to obtain time to peak (TTP), maximum slope of increase (MSI), maximum slope of decrease (MSD) and positive enhancement integral (PEI), and the semi-quantitative MRI parameters were compared and analyzed between the two groups.
Fifty-four and 8 patients were included the responder and non-responder groups. It was observed that the MSI, MSD, and PEI were significantly lower post-treatment than pre-treatment(P < 0.05). The pretreatment MSI, MSD, and PEI parameters of responders were significantly higher than those of non-responders (P< 0.05). The post-treatment MSI, MSD, and PEI parameters of responders were significantly lower than those of non-responders (P< 0.05). Based on ROC curve analysis, at a threshold of 154.81 for pretreatment MSI, the corresponding AUC, sensitivity, and specificity were 0.882, 89.3% and 73.5%, respectively.
The semi-quantitative DCE-MRI may aid in the prediction of early response to CRT in patients with larynx and hypopharynx carcinoma.
本研究旨在探讨动态对比增强磁共振成像在预测喉癌和下咽癌患者原发肿瘤对同步放化疗（CRT）早期反应中的应用。
62例喉癌和下咽癌患者接受了两次动态对比增强磁共振成像（DCE-MRI）检查：一次是在任何治疗前的基线检查，另一次是在同步放化疗后3周的治疗后检查。治疗结束时，根据实体瘤疗效评价标准（RECIST）将患者分为反应者或无反应者。提取并处理时间-强度曲线（TIC）以获得达峰时间（TTP）、最大上升斜率（MSI）、最大下降斜率（MSD）和正性增强积分（PEI），并比较和分析两组之间的半定量磁共振成像参数。
反应者组和无反应者组分别纳入54例和8例患者。观察到治疗后MSI、MSD和PEI均显著低于治疗前（P<0.05）。反应者的治疗前MSI、MSD和PEI参数显著高于无反应者（P<0.05）。反应者的治疗后MSI、MSD和PEI参数显著低于无反应者（P<0.05）。基于ROC曲线分析，治疗前MSI阈值为154.81时，相应的AUC、敏感性和特异性分别为0.882、89.3%和73.5%。
半定量DCE-MRI可能有助于预测喉癌和下咽癌患者对同步放化疗的早期反应。
