标准化形状指数（动态对比增强磁共振成像）和标准化摄取值（正电子发射断层显像/X线计算机体层成像）：两种基于功能特征鉴别局部晚期直肠癌放化疗反应者的定量方法。

Standardized Index of Shape (DCE-MRI) and Standardized Uptake Value (PET/CT): Two quantitative approaches to discriminate chemo-radiotherapy locally advanced rectal cancer responders under a functional profile.

作者信息

Petrillo Antonella, Fusco Roberta, Petrillo Mario, Granata Vincenza, Delrio Paolo, Bianco Francesco, Pecori Biagio, Botti Gerardo, Tatangelo Fabiana, Caracò Corradina, Aloj Luigi, Avallone Antonio, Lastoria Secondo

机构信息

Radiology Unit, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, "Istituto Nazionale Tumori Fondazione Giovanni Pascale - IRCCS", 80131, Naples, Italy.

Gastrointestinal Surgical Oncology Unit, Department of Abdominal Oncology, "Istituto Nazionale Tumori Fondazione Giovanni Pascale - IRCCS", 80131, Naples, Italy.

出版信息

Oncotarget. 2017 Jan 31;8(5):8143-8153. doi: 10.18632/oncotarget.14106.

PURPOSE

To investigate dynamic contrast enhanced-MRI (DCE-MRI) in the preoperative chemo-radiotherapy (CRT) assessment for locally advanced rectal cancer (LARC) compared to18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT).

METHODS

75 consecutive patients with LARC were enrolled in a prospective study. DCE-MRI analysis was performed measuring SIS: linear combination of percentage change (Δ) of maximum signal difference (MSD) and wash-out slope (WOS). 18F-FDG PET/CT analysis was performed using SUV maximum (SUVmax). Tumor regression grade (TRG) were estimated after surgery. Non-parametric tests, receiver operating characteristic were evaluated.

RESULTS

55 patients (TRG1-2) were classified as responders while 20 subjects as non responders. ΔSIS reached sensitivity of 93%, specificity of 80% and accuracy of 89% (cut-off 6%) to differentiate responders by non responders, sensitivity of 93%, specificity of 69% and accuracy of 79% (cut-off 30%) to identify pathological complete response (pCR). Therapy assessment via ΔSUVmax reached sensitivity of 67%, specificity of 75% and accuracy of 70% (cut-off 60%) to differentiate responders by non responders and sensitivity of 80%, specificity of 31% and accuracy of 51% (cut-off 44%) to identify pCR.

CONCLUSIONS

CRT response assessment by DCE-MRI analysis shows a higher predictive ability than 18F-FDG PET/CT in LARC patients allowing to better discriminate significant and pCR.

目的

与18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）相比，研究动态对比增强磁共振成像（DCE-MRI）在局部晚期直肠癌（LARC）术前放化疗（CRT）评估中的应用。

方法

75例连续的LARC患者纳入一项前瞻性研究。进行DCE-MRI分析，测量SIS：最大信号差异（MSD）的百分比变化（Δ）和洗脱斜率（WOS）的线性组合。使用SUV最大值（SUVmax）进行18F-FDG PET/CT分析。术后评估肿瘤退缩分级（TRG）。评估非参数检验和受试者工作特征。

结果

55例患者（TRG1-2）被分类为反应者，20例为无反应者。ΔSIS区分反应者与无反应者的敏感性为93%，特异性为80%，准确性为89%（临界值6%），识别病理完全缓解（pCR）的敏感性为93%，特异性为69%，准确性为79%（临界值30%）。通过ΔSUVmax进行治疗评估，区分反应者与无反应者的敏感性为67%，特异性为75%，准确性为70%（临界值60%），识别pCR的敏感性为80%，特异性为31%，准确性为51%（临界值44%）。