Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany.
Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany; Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
Acad Radiol. 2021 Nov;28 Suppl 1:S73-S80. doi: 10.1016/j.acra.2020.09.006. Epub 2020 Sep 30.
The aim of this meta-analysis was to evaluate the suitability of apparent diffusion coefficient (ADC) as a predictor of response to systemic chemotherapy in patients with metastatic colorectal carcinoma (CRC).
MEDLINE library, SCOPUS database, and EMBASE database were screened for relationships between pretreatment ADC values of hepatic CRC metastases and response to systemic chemotherapy. Overall, five eligible studies were identified. The following data were extracted: authors, year of publication, study design, number of patients, mean value ADC and standard-deviation, measure method, b-values, and Tesla-strength. The methodological quality of every study was checked according to the Quality Assessment of Diagnostic Studies-2 instrument. The meta-analysis was undertaken by employing RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used to account for heterogeneity. Mean ADC values including 95% confidence intervals were calculated.
Five studies (n = 114 patients) were included. The pretreatment mean ADC in the responder group was 1.15 × 10 mm/s (1.03, 1.28) and 1.37 × 10 mm/s (1.3, 1.44) in the nonresponder group. An ADC baseline threshold of 1.2 × 10 mm/s, below which no nonresponder was found, can distinguish both groups.
The results indicate ADC can serve as a predictor of response to chemotherapy for CRC patients.
本荟萃分析旨在评估表观扩散系数（ADC）作为预测转移性结直肠癌（CRC）患者对全身化疗反应的适宜性。
在 MEDLINE 库、SCOPUS 数据库和 EMBASE 数据库中筛选了肝 CRC 转移灶的预处理 ADC 值与全身化疗反应之间的关系。共确定了五项符合条件的研究。提取的数据包括：作者、出版年份、研究设计、患者数量、平均 ADC 值和标准差、测量方法、b 值和特斯拉强度。根据诊断研究质量评估-2 工具检查了每项研究的方法学质量。采用 RevMan 5.3 软件进行荟萃分析。采用逆方差加权的 DerSimonian 和 Laird 随机效应模型来解释异质性。计算包括 95%置信区间的平均 ADC 值。
共纳入五项研究（n=114 例患者）。应答组的预处理平均 ADC 值为 1.15×10 mm/s（1.03，1.28），无应答组为 1.37×10 mm/s（1.3，1.44）。ADC 基线阈值为 1.2×10 mm/s，低于该值的患者均为无应答者，可区分两组。
结果表明 ADC 可作为 CRC 患者化疗反应的预测指标。
