Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan.
Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan.
Eur J Radiol. 2021 Dec;145:110036. doi: 10.1016/j.ejrad.2021.110036. Epub 2021 Nov 16.
To assess the feasibility of extracellular volume (ECV) fraction determined with equilibrium contrast-enhanced MRI for prediction of treatment response to chemotherapy in pancreatic ductal adenocarcinoma (PDAC) in comparison with dynamic contrast-enhanced MRI (DCE-MRI), and to clarify the association between ECV fraction and DCE-MRI-derived pharmacokinetic parameters.
This retrospective study included 58 consecutive patients with histologically confirmed PDAC who underwent DCE-MRI before systemic chemotherapy. Tumor pharmacokinetic parameters, including the volume transfer coefficient (K), rate constant (k), and extracellular extravascular volume fraction (v) of DCE-MRI, and ECV fraction determined with equilibrium contrast-enhanced MRI were compared between the response and non-response groups. The correlation of tumor ECV fraction with each DCE-MRI-derived pharmacokinetic parameter was examined using Spearman's rank correlation coefficient.
Tumor K, v, and ECV fraction were significantly higher in the response group than in the non-response group (all, P < 0.001), whereas no significant difference was found in k (P = 0.119). Tumor ECV fraction showed the highest area under receiver operating characteristic curve of 0.918, with a sensitivity of 89.3%, specificity of 90.0%, and accuracy of 89.7% (cut off, >37.6%). The ECV fraction showed a significant positive correlation with K (Spearman's coefficient = 0.66, P < 0.001) and v (Spearman's coefficient = 0.79, P < 0.001).
ECV fraction determined with equilibrium contrast-enhanced MRI was as useful as DCE-MRI-derived pharmacokinetic parameters for predicting treatment response to chemotherapy in patients with PDAC.
评估平衡对比增强 MRI 测定的细胞外容积（ECV）分数预测胰腺导管腺癌（PDAC）化疗反应的可行性，并与动态对比增强 MRI（DCE-MRI）进行比较，阐明 ECV 分数与 DCE-MRI 衍生的药代动力学参数之间的关系。
本回顾性研究纳入了 58 例经组织学证实的 PDAC 患者，这些患者在全身化疗前接受了 DCE-MRI。比较了 DCE-MRI 衍生的肿瘤药代动力学参数，包括容积转移系数（K）、速率常数（k）、DCE-MRI 的细胞外细胞外容积分数（v）和平衡对比增强 MRI 测定的 ECV 分数，在反应组和非反应组之间。使用 Spearman 秩相关系数检查肿瘤 ECV 分数与每个 DCE-MRI 衍生药代动力学参数的相关性。
反应组肿瘤 K、v 和 ECV 分数均显著高于非反应组（均 P<0.001），而 k 无显著差异（P=0.119）。肿瘤 ECV 分数的受试者工作特征曲线下面积最高，为 0.918，灵敏度为 89.3%，特异性为 90.0%，准确性为 89.7%（截断值>37.6%）。ECV 分数与 K（Spearman 系数=0.66，P<0.001）和 v（Spearman 系数=0.79，P<0.001）呈显著正相关。
平衡对比增强 MRI 测定的 ECV 分数与 DCE-MRI 衍生的药代动力学参数一样，可用于预测 PDAC 患者化疗反应。
