Kuchcinski Grégory, Le Rhun Emilie, Cortot Alexis B, Drumez Elodie, Duhal Romain, Lalisse Maxime, Dumont Julien, Lopes Renaud, Pruvo Jean-Pierre, Leclerc Xavier, Delmaire Christine
Department of Neuroradiology, University of Lille, CHU Lille, Rue Emile Laine, F-59000, Lille, France.
Department of Neurosurgery, University of Lille, CHU Lille, F-59000, Lille, France.
Eur Radiol. 2017 Sep;27(9):3733-3743. doi: 10.1007/s00330-017-4756-5. Epub 2017 Feb 16.
To determine the diagnostic accuracy of pharmacokinetic parameters measured by dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in predicting the response of brain metastases to antineoplastic therapy in patients with lung cancer.
Forty-four consecutive patients with lung cancer, harbouring 123 newly diagnosed brain metastases prospectively underwent conventional 3-T MRI at baseline (within 1 month before treatment), during the early (7-10 weeks) and midterm (5-7 months) post-treatment period. An additional DCE MRI sequence was performed during baseline and early post-treatment MRI to evaluate baseline pharmacokinetic parameters (K , k , v , v ) and their early variation (∆K , ∆k , ∆v , ∆v ). The objective response was judged by the volume variation of each metastasis from baseline to midterm MRI. ROC curve analysis determined the best DCE MRI parameter to predict the objective response.
Baseline DCE MRI parameters were not associated with the objective response. Early ∆K , ∆v and ∆v were significantly associated with the objective response (p = 0.02, p = 0.001 and p = 0.02, respectively). The best predictor of objective response was ∆v with an area under the curve of 0.93 [95% CI = 0.87, 0.99].
DCE MRI and early ∆v may be a useful tool to predict the objective response of brain metastases in patients with lung cancer.
• DCE MRI could predict the response of brain metastases from lung cancer • ∆v was the best predictor of response • DCE MRI could be used to individualize patients' follow-up.
确定动态对比增强（DCE）磁共振成像（MRI）测量的药代动力学参数在预测肺癌患者脑转移瘤对抗肿瘤治疗反应方面的诊断准确性。
44例连续的肺癌患者，共123个新诊断的脑转移瘤，在基线期（治疗前1个月内）、治疗后早期（7 - 10周）和中期（5 - 7个月）前瞻性地接受了常规3T MRI检查。在基线期和治疗后早期MRI期间额外进行了DCE MRI序列检查，以评估基线药代动力学参数（K、k、v、v）及其早期变化（∆K、∆k、∆v、∆v）。通过每个转移瘤从基线期到中期MRI的体积变化来判断客观反应。ROC曲线分析确定预测客观反应的最佳DCE MRI参数。
基线DCE MRI参数与客观反应无关。早期∆K、∆v和∆v与客观反应显著相关（分别为p = 0.02、p = 0.001和p = 0.02）。客观反应的最佳预测指标是∆v，曲线下面积为0.93 [95% CI = 0.87, 0.99]。
DCE MRI和早期∆v可能是预测肺癌患者脑转移瘤客观反应的有用工具。
• DCE MRI可预测肺癌脑转移瘤的反应 • ∆v是反应的最佳预测指标 • DCE MRI可用于个体化患者的随访
