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基于动态对比增强磁共振成像(DCE-MRI)得出的容积转移常数(K)和弥散加权成像(DWI)表观扩散系数作为食管癌患者放化疗短期和长期疗效的预测指标

DCE-MRI-Derived Volume Transfer Constant (K) and DWI Apparent Diffusion Coefficient as Predictive Markers of Short- and Long-Term Efficacy of Chemoradiotherapy in Patients With Esophageal Cancer.

作者信息

Ye Zhi-Min, Dai Shu-Jun, Yan Feng-Qin, Wang Lei, Fang Jun, Fu Zhen-Fu, Wang Yue-Zhen

机构信息

1 Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Repbulic of China.

2 Department of Intense Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People's Republic of China.

出版信息

Technol Cancer Res Treat. 2018 Jan 1;17:1533034618765254. doi: 10.1177/1533034618765254.

Abstract

This study aimed to evaluate both the short- and long-term efficacies of chemoradiotherapy in relation to the treatment of esophageal cancer . This was achieved through the use of dynamic contrast-enhanced magnetic resonance imaging-derived volume transfer constant and diffusion weighted imaging-derived apparent diffusion coefficient . Patients with esophageal cancer were assigned into the sensitive and resistant groups based on respective efficacies in chemoradiotherapy. Dynamic contrast-enhanced magnetic resonance imaging and diffusion weighted imaging were used to measure volume transfer constant and apparent diffusion coefficient, while computed tomography was used to calculate tumor size reduction rate. Pearson correlation analyses were conducted to analyze correlation between volume transfer constant, apparent diffusion coefficient, and the tumor size reduction rate. Receiver operating characteristic curve was constructed to analyze the short-term efficacy of volume transfer constant and apparent diffusion coefficient, while Kaplan-Meier curve was employed for survival rate analysis. Cox proportional hazard model was used for the risk factors for prognosis of patients with esophageal cancer. Our results indicated reduced levels of volume transfer constant, while increased levels were observed in ADC, ADC, and ADC following chemoradiotherapy. A negative correlation was determined between ADC, ADC, and ADC, as well as in the tumor size reduction rate prior to chemoradiotherapy, whereas a positive correlation was uncovered postchemoradiotherapy. Volume transfer constant was positively correlated with tumor size reduction rate both before and after chemoradiotherapy. The 5-year survival rate of patients with esophageal cancer having high ADC, ADC, and ADC and volume transfer constant before chemoradiotherapy was greater than those with respectively lower values. According to the Cox proportional hazard model, ADC, clinical stage, degree of differentiation, and tumor stage were all confirmed as being independent risk factors in regard to the prognosis of patients with EC. The findings of this study provide evidence suggesting that volume transfer constant and apparent diffusion coefficient as being tools allowing for the evaluation of both the short- and long-term efficacies of chemoradiotherapy esophageal cancer treatment.

摘要

本研究旨在评估放化疗治疗食管癌的短期和长期疗效。这是通过使用动态对比增强磁共振成像衍生的容积转移常数和扩散加权成像衍生的表观扩散系数来实现的。根据放化疗的各自疗效,将食管癌患者分为敏感组和耐药组。使用动态对比增强磁共振成像和扩散加权成像来测量容积转移常数和表观扩散系数,同时使用计算机断层扫描来计算肿瘤缩小率。进行Pearson相关分析以分析容积转移常数、表观扩散系数与肿瘤缩小率之间的相关性。构建受试者工作特征曲线以分析容积转移常数和表观扩散系数的短期疗效,同时采用Kaplan-Meier曲线进行生存率分析。使用Cox比例风险模型分析食管癌患者预后的危险因素。我们的结果表明,放化疗后容积转移常数水平降低,而ADC、ADC和ADC水平升高。ADC、ADC和ADC与放化疗前的肿瘤缩小率呈负相关,而放化疗后呈正相关。放化疗前后容积转移常数与肿瘤缩小率均呈正相关。放化疗前ADC、ADC、ADC和容积转移常数高的食管癌患者的5年生存率高于相应值较低的患者。根据Cox比例风险模型,ADC、临床分期、分化程度和肿瘤分期均被确认为食管癌患者预后的独立危险因素。本研究结果提供了证据,表明容积转移常数和表观扩散系数可作为评估放化疗治疗食管癌短期和长期疗效的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b56/5900808/3f9f687dacb0/10.1177_1533034618765254-fig1.jpg

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