Ji Wenbing, Wang Jian, Zhou Rongzhen, Wang Minke, Wang Weizhen, Pang Peipei, Kong Min, Zhou Chao
Department of Radiology, Taizhou Hospital of Zhejiang Province, Taizhou, China.
Advanced Application Team, GE Healthcare, Shanghai, China.
Front Oncol. 2021 May 18;11:604480. doi: 10.3389/fonc.2021.604480. eCollection 2021.
Esophageal squamous cell carcinoma (ESCC) is an aggressive type of cancer, associated with poor prognosis. The development of an accurate and non-invasive method to evaluate the pathologic response of patients with ESCC to chemoradiotherapy remains a critical issue. Therefore, the aim of this study was to assess the importance of vascular permeability and texture parameters in predicting the response to neoadjuvant chemoradiotherapy (NACRT) in patients with ESCC.
This prospective analysis included patients with T1-T2 stage of ESCC, without either lymphatic or metastasis, and distant metastasis. All patients underwent surgery having received two rounds of NACRT. All patients underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) twice, i.e., before the first NACRT and after the second NACRT. Patients were assessed for treatment response at 30 days after the second NACRT. Patients were divided into the complete response (CR) and partial response (PR) groups based on their responses to NACRT. Vascular permeability and texture parameters were extracted from the DCE-MRI scans. After assessing the diagnostic performance of individual parameters, a combined model with vascular permeability and texture parameters was generated to predict the response to NACRT.
In this study, the CR and PR groups included 16 patients each. The volume transfer constant (Ktrans), extracellular extravascular volume fraction (ve), and entropy values, as well as changes to each of these parameters, extracted from the second DCE-MRI scans, showed significant differences between the CR and PR groups. The area under the curve (AUC) of Ktrans, ve, and entropy values showed good diagnostic ability (0.813, 0.789, and 0.707, respectively). A logistic regression model combining Ktrans, ve, and entropy had significant diagnostic ability (AUC=0.977).
The use of a combined model with vascular permeability and texture parameters can improve post-NACRT prognostication in patients with ESCC.
食管鳞状细胞癌（ESCC）是一种侵袭性癌症，预后较差。开发一种准确且非侵入性的方法来评估ESCC患者对放化疗的病理反应仍然是一个关键问题。因此，本研究的目的是评估血管通透性和纹理参数在预测ESCC患者对新辅助放化疗（NACRT）反应中的重要性。
这项前瞻性分析纳入了T1 - T2期的ESCC患者，这些患者无淋巴转移和远处转移。所有患者在接受两轮NACRT后接受手术。所有患者在第一次NACRT前和第二次NACRT后各进行了两次动态对比增强磁共振成像（DCE - MRI）检查。在第二次NACRT后30天评估患者的治疗反应。根据患者对NACRT的反应将其分为完全缓解（CR）组和部分缓解（PR）组。从DCE - MRI扫描中提取血管通透性和纹理参数。在评估各个参数的诊断性能后，生成了一个包含血管通透性和纹理参数的联合模型来预测对NACRT的反应。
在本研究中，CR组和PR组各有16例患者。从第二次DCE - MRI扫描中提取的容积转移常数（Ktrans）、细胞外血管外容积分数（ve）和熵值，以及这些参数各自的变化，在CR组和PR组之间显示出显著差异。Ktrans、ve和熵值的曲线下面积（AUC）显示出良好的诊断能力（分别为0.813、0.789和0.
