Paudyal Ramesh, LoCastro Eve, Reyngold Marsha, Do Richard Kinh, Konar Amaresha Shridhar, Oh Jung Hun, Dave Abhay, Yu Kenneth, Goodman Karyn A, Shukla-Dave Amita
Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Cancers (Basel). 2021 Aug 26;13(17):4319. doi: 10.3390/cancers13174319.
The present study aims to monitor longitudinal changes in simulated tumor interstitial fluid pressure (IFP) and velocity (IFV) values using dynamic contrast-enhanced (DCE)-MRI-based computational fluid modeling (CFM) in pancreatic ductal adenocarcinoma (PDAC) patients. Nine PDAC patients underwent MRI, including DCE-MRI, on a 3-Tesla MRI scanner at pre-treatment (TX (0)), after the first fraction of stereotactic body radiotherapy (SBRT, (D1-TX)), and six weeks post-TX (D2-TX). The partial differential equation of IFP formulated from the continuity equation, incorporating the Starling Principle of fluid exchange, Darcy velocity, and volume transfer constant (K), was solved in COMSOL Multiphysics software to generate IFP and IFV maps. Tumor volume (V), K, IFP, and IFV values were compared (Wilcoxon and Spearman) between the time- points. D2-TX K values were significantly different from pre-TX and D1-TX ( < 0.05). The D1-TX and pre-TX mean IFV values exhibited a borderline significant difference ( = 0.08). The IFP values varying <3.0% between the three time-points were not significantly different ( > 0.05). V and IFP values were strongly positively correlated at pre-TX (ρ = 0.90, = 0.005), while IFV exhibited a strong negative correlation at D1-TX (ρ = -0.74, = 0.045). V, K, IFP, and IFV hold promise as imaging biomarkers of early response to therapy in PDAC.
本研究旨在利用基于动态对比增强（DCE）-MRI的计算流体动力学建模（CFM）监测胰腺导管腺癌（PDAC）患者模拟肿瘤间质液压力（IFP）和流速（IFV）值的纵向变化。9例PDAC患者在3特斯拉MRI扫描仪上于治疗前（TX(0)）、立体定向体部放疗（SBRT）第一部分治疗后（D1-TX）以及TX后六周（D2-TX）接受了MRI检查，包括DCE-MRI。在COMSOL Multiphysics软件中求解了根据连续性方程制定的IFP偏微分方程，该方程纳入了流体交换的斯塔林原理、达西流速和体积转移常数（K），以生成IFP和IFV图。比较了各时间点之间的肿瘤体积（V）、K、IFP和IFV值（Wilcoxon和Spearman检验）。D2-TX时的K值与TX前和D1-TX时显著不同（<0.05）。D1-TX和TX前的平均IFV值显示出临界显著差异（=0.08）。三个时间点之间IFP值变化<3.0%，差异不显著（>0.05）。TX前V和IFP值呈强正相关（ρ=0.90，=0.005），而D1-TX时IFV呈强负相关（ρ=-0.74，=0.045）。V、K、IFP和IFV有望作为PDAC治疗早期反应的影像学生物标志物。
