Department of Radiology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin 150010, Heilongjiang, China.
Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin 150010, Heilongjiang, China.
Eur J Radiol. 2021 Oct;143:109887. doi: 10.1016/j.ejrad.2021.109887. Epub 2021 Aug 13.
To assess the value of the enhanced features on the hepatobiliary phase (HBP) of pre-treatment Gd-EOB-DTPA MRI in evaluating response to chemotherapy in colorectal liver metastases (CRLMs).
We retrospectively studied 65 patients with CRLMs who underwent Gd-EOB-DTPA enhanced MRI before chemotherapy from October 2015 to November 2017. The diagnosis of liver metastasis was established on the basis of imaging findings. Two radiologists evaluated the size, contrast-enhanced (CE) patterns of the maximum lesion on the HBP. According to the different CE patterns, we quantified area signal intensity (SI) by applying SI ratio (such as SI and SI). All of the above parameters were analyzed in terms of chemotherapy response.
Rim enhancement on the HBP was more frequent in the responding group of 28 patients (72%) than in the non-responding group of eight patients (31%). Additionally, there was a significant association between chemotherapy response and quantitative parameters: including diameter (P = 0.04), SI (P = 0.047) and SI (P = 0.012). The HBP CE pattern (P = 0.007) and SI (P = 0.022) were independent factors for chemotherapy response. The areas under the curve (AUCs) of the above-mentioned parameters were significant associated with response to chemotherapy, in which diameter, HBP CE patterns, SI, and SI were 0.638, 0.706, 0.712, and 0.673, respectively. Moreover, the combination of these parameters obtained the largest AUC of 0.821.
The CE patterns, in particular with rim enhancement, and SI ratio parameters on the HBP are useful indicators for early evaluation of therapeutic response after chemotherapy in patients with CRLMs.
评估 Gd-EOB-DTPA 磁共振成像（MRI）肝期增强（HBP）的强化特征在评估结直肠癌肝转移（CRLM）患者化疗反应中的价值。
我们回顾性研究了 2015 年 10 月至 2017 年 11 月期间 65 例接受 Gd-EOB-DTPA 增强 MRI 检查的 CRLM 患者。肝脏转移的诊断基于影像学发现。两位放射科医生评估了 HBP 上最大病变的大小、对比增强（CE）模式。根据不同的 CE 模式，我们通过应用 SI 比值（如 SI 和 SI）来量化面积信号强度（SI）。所有这些参数均根据化疗反应进行分析。
28 例（72%）反应组 HBP 上的边缘增强比 8 例（31%）无反应组更常见。此外，化疗反应与定量参数之间存在显著相关性：包括直径（P=0.04）、SI（P=0.047）和 SI（P=0.012）。HBP 的 CE 模式（P=0.007）和 SI（P=0.022）是化疗反应的独立因素。上述参数的曲线下面积（AUC）与化疗反应显著相关，其中直径、HBP CE 模式、SI 和 SI 的 AUC 分别为 0.638、0.706、0.712 和 0.673。此外，这些参数的组合获得了最大的 AUC 值 0.821。
HBP 的 CE 模式，特别是边缘增强模式，以及 SI 比值参数是评估 CRLM 患者化疗后早期治疗反应的有用指标。
