Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Room 143, Baltimore, MD, 21287, USA.
Eur Radiol. 2020 Jan;30(1):291-300. doi: 10.1007/s00330-019-06289-3. Epub 2019 Jun 17.
To examine the value of baseline 3D-ADC and to predict short-term response to treatment in patients with hepatic colorectal metastases (CLMs).
Liver MR images of 546 patients with CLMs (2008-2015) were reviewed retrospectively and 68 patients fulfilled inclusion criteria. Patients had received systemic chemotherapy (n = 17), hepatic trans-arterial chemoembolization or TACE (n = 34), and Y radioembolization (n = 17). Baseline (pre-treatment) 3D-ADC (volumetric) of metastatic lesions was calculated employing prototype software. RECIST 1.1 was used to assess short-term response to treatment. Prediction of response to treatment by baseline 3D-ADC and 2D-ADC (ROI-based) was also compared in all patients.
Partial response to treatment (minimum 30% decrease in tumor largest transverse diameter) was seen in 35.3% of patients; 41.2% with systemic chemotherapy, 32.4% with TACE, and 35.3% with Y radioembolization (p = 0.82). Median baseline 3D-ADC was significantly lower in responding than in nonresponding lesions. Area under the curve (AUC) of 3D-ADC was 0.90 in Y radioembolization patients, 0.88 in TACE patients, and 0.77 in systemic chemotherapy patients (p < 0.01). Optimal prediction was observed with the 10th percentile of ADC (1006 × 10 mm/s), yielding sensitivity and specificity of 77.4% and 91.3%, respectively. 3D-ADC outperformed 2D-ADC in predicting response to treatment (AUC; 0.86 vs. 0.71; p < 0.001).
Baseline 3D-ADC is a highly specific biomarker in predicting partial short-term response to treatment in hepatic CLMs.
• Baseline 3D-ADC is a highly specific biomarker in predicting response to different treatments in hepatic CLMs. • The prediction level of baseline ADC is better forY radioembolization than for systemic chemotherapy/TACE in hepatic CLMs. • 3D-ADC outperforms 2D-ADC in predicting short-term response to treatment in hepatic CLMs.
探讨基线 3D-ADC 值在预测结直肠癌肝转移（CLMs）患者短期治疗反应中的价值。
回顾性分析 2008 年至 2015 年 546 例 CLMs 患者的肝脏磁共振成像（MRI）资料，其中 68 例患者符合纳入标准。患者接受全身化疗（n=17）、肝动脉化疗栓塞（TACE）（n=34）和 Y 放射性栓塞（n=17）治疗。采用原型软件计算转移瘤的基线（治疗前）3D-ADC（体积）。采用 RECIST 1.1 评估短期治疗反应。比较所有患者基线 3D-ADC 和 2D-ADC（基于 ROI）对治疗反应的预测价值。
治疗后部分缓解（肿瘤最大横径至少减少 30%）患者占 35.3%；接受全身化疗者中为 41.2%，TACE 者中为 32.4%，Y 放射性栓塞者中为 35.3%（p=0.82）。与无反应病变相比，反应性病变的基线 3D-ADC 值显著降低。Y 放射性栓塞患者的 3D-ADC 曲线下面积（AUC）为 0.90，TACE 患者为 0.88，全身化疗患者为 0.77（p<0.01）。最佳预测值为 ADC 的第 10 百分位数（1006×10mm/s），其敏感性和特异性分别为 77.4%和 91.3%。3D-ADC 在预测治疗反应方面优于 2D-ADC（AUC：0.86 比 0.71；p<0.001）。
基线 3D-ADC 是预测结直肠癌肝转移短期治疗反应的高度特异性生物标志物。
基线 3D-ADC 是预测结直肠癌肝转移不同治疗方法反应的高度特异性生物标志物。
在结直肠癌肝转移中，基线 ADC 预测 Y 放射性栓塞的效果优于全身化疗/TACE。
3D-ADC 在预测结直肠癌肝转移的短期治疗反应方面优于 2D-ADC。
