Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.
Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
Radiat Oncol. 2020 Apr 15;15(1):79. doi: 10.1186/s13014-020-01526-2.
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may provide biomarkers of the outcome of locally-advanced cervical carcinoma (LACC). There is, however, no agreement on how DCE-MR recordings should be analyzed. Previously, we have analyzed DCE-MRI data of LACC using non-model-based strategies. In the current study, we analyzed DCE-MRI data of LACC using the Tofts pharmacokinetic model, and the biomarkers derived from this analysis were compared with those derived from the non-model-based analyses.
Eighty LACC patients given cisplatin-based chemoradiotherapy with curative intent were included in the study. Treatment outcome was recorded as disease-free survival (DFS) and overall survival (OS). DCE-MRI series were analyzed voxelwise to produce K and v frequency distributions, and ROC analysis was used to identify the parameters of the frequency distributions having the greatest potential as biomarkers. The prognostic power of these parameters was compared with that of the non-model-based parameters LETV (low-enhancing tumor volume) and TVIS (tumor volume with increasing signal).
Poor DFS and OS were associated with low values of K, whereas there was no association between treatment outcome and v. The K parameters having the greatest prognostic value were p35-K (the K value at the 35 percentile of a frequency distribution) and RV-K (the tumor subvolume with K values below 0.13 min). Multivariate analysis including clinical parameters and p35-K or RV-K revealed that RV-K was the only independent prognostic factor of DFS and OS. There were significant correlations between RV-K and LETV and between RV-K and TVIS, and the prognostic power of RV-K was similar to that of LETV and TVIS.
Biomarkers of the outcome of LACC can be provided by analyzing DCE-MRI series using the Tofts pharmacokinetic model. However, these biomarkers do not appear to have greater prognostic value than biomarkers determined by non-model-based analyses.
动态对比增强磁共振成像（DCE-MRI）可能为局部晚期宫颈癌（LACC）的治疗结果提供生物标志物。然而，目前对于 DCE-MR 记录的分析方法尚未达成共识。先前，我们使用基于非模型的策略分析了 LACC 的 DCE-MRI 数据。在本研究中，我们使用 Tofts 药代动力学模型分析了 LACC 的 DCE-MRI 数据，并将从这种分析中得出的生物标志物与从非模型分析中得出的生物标志物进行了比较。
本研究纳入了 80 例接受顺铂为基础的放化疗治疗的 LACC 患者。治疗结果记录为无病生存率（DFS）和总生存率（OS）。对 DCE-MRI 系列进行体素分析，以生成 K 和 v 频率分布，并使用 ROC 分析来确定作为生物标志物具有最大潜力的频率分布参数。将这些参数的预后能力与非模型参数 LETV（低增强肿瘤体积）和 TVIS（信号增强肿瘤体积）进行比较。
DFS 和 OS 较差与 K 值较低相关，而治疗结果与 v 之间没有相关性。具有最大预后价值的 K 参数是 p35-K（频率分布的第 35 百分位数的 K 值）和 RV-K（K 值低于 0.13 min 的肿瘤亚体积）。包括临床参数和 p35-K 或 RV-K 的多变量分析表明，RV-K 是 DFS 和 OS 的唯一独立预后因素。RV-K 与 LETV 之间以及 RV-K 与 TVIS 之间存在显著相关性，且 RV-K 的预后能力与 LETV 和 TVIS 相似。
使用 Tofts 药代动力学模型分析 DCE-MRI 系列可以提供 LACC 治疗结果的生物标志物。然而，这些生物标志物似乎没有比基于非模型的分析确定的生物标志物具有更大的预后价值。
