Curcean Sebastian, Cheng Lin, Picchia Simona, Tunariu Nina, Collins David, Blackledge Matthew, Popat Sanjay, O'Brien Mary, Minchom Anna, Leach Martin O, Koh Dow-Mu
Department of Radiation Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Department of Radiation Oncology, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania.
JTO Clin Res Rep. 2021 Nov 2;2(12):100253. doi: 10.1016/j.jtocrr.2021.100253. eCollection 2021 Dec.
We compared the magnetic resonance imaging total tumor volume (TTV) and median apparent diffusion coefficient (ADC) of malignant pleural mesothelioma (MPM) before and at 4 weeks after chemotherapy, to evaluate whether these are potential early markers of treatment response.
Diffusion-weighted magnetic resonance imaging was performed in 23 patients with MPM before and after 4 weeks of chemotherapy. The TTV was measured by semiautomatic segmentation (GrowCut) and transferred onto ADC maps to record the median ADC. Test-retest repeatability of TTV and ADC was evaluated in eight patients. TTV and median ADC changes were compared between responders and nonresponders, defined using modified Response Evaluation Criteria In Solid Tumors on computed tomography (CT) at 12 weeks after treatment. TTV and median ADC were also correlated with CT size measurement and disease survival.
The test-retest 95% limits of agreement for TTV were -13.9% to 16.2% and for median ADC -1.2% to 3.3%. A significant increase in median ADC in responders was observed at 4 weeks after treatment ( = 0.02). Correlation was found between CT tumor size change at 12 weeks and median ADC changes at 4 weeks post-treatment ( = -0.560, = 0.006). An increase in median ADC greater than 5.1% at 4 weeks has 100% sensitivity and 90% specificity for responders (area under the curve = 0.933, < 0.001). There was also moderate correlation between median tumor ADC at baseline and overall survival ( = 0.45, = 0.03).
Diffusion-weighted magnetic resonance imaging measurements of TTV and median ADC in MPM have good measurement repeatability. Increase in ADC at 4 weeks post-treatment has the potential to be an early response biomarker.
我们比较了恶性胸膜间皮瘤（MPM）化疗前及化疗4周后的磁共振成像总肿瘤体积（TTV）和中位表观扩散系数（ADC），以评估它们是否为治疗反应的潜在早期标志物。
对23例MPM患者在化疗前及化疗4周后进行扩散加权磁共振成像。通过半自动分割（GrowCut）测量TTV，并将其转移至ADC图上以记录中位ADC。在8例患者中评估TTV和ADC的重测重复性。根据治疗12周后计算机断层扫描（CT）上使用改良实体瘤疗效评价标准定义的缓解者和非缓解者，比较TTV和中位ADC的变化。TTV和中位ADC还与CT尺寸测量及疾病生存期相关。
TTV的重测95%一致性界限为-13.9%至16.2%，中位ADC的重测95%一致性界限为-1.2%至3.3%。治疗4周后观察到缓解者的中位ADC显著增加（P = 0.02）。发现治疗12周时CT肿瘤大小变化与治疗后4周中位ADC变化之间存在相关性（r = -0.560，P = 0.006）。4周时中位ADC增加大于5.1%对缓解者的敏感性为100%，特异性为90%（曲线下面积 = 0.933，P < 0.001）。基线时肿瘤中位ADC与总生存期之间也存在中度相关性（r = 0.45，P = 0.03）。
MPM中TTV和中位ADC的扩散加权磁共振成像测量具有良好的测量重复性。治疗后4周ADC增加有可能成为早期反应生物标志物。
