动态对比增强磁共振成像：评估局部晚期食管癌患者治疗的新方法。
Dynamic contrast-enhanced magnetic resonance imaging: A novel approach to assessing treatment in locally advanced esophageal cancer patients.
机构信息
Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Baiziting Road, Nanjing, P. R. China.
Department of Radiation Oncology, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Baiziting Road, Nanjing, P. R. China.
出版信息
Niger J Clin Pract. 2021 Dec;24(12):1800-1807. doi: 10.4103/njcp.njcp_78_21.
AIMS
This study aims to investigate the potential application of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to predict concurrent chemoradiation (CRT) in locally advanced esophageal carcinoma.
PATIENTS AND METHODS
This study involved 33 patients with locally advanced esophageal cancer and treated with CRT. The patients underwent DCE-MRI before CRT (pre) and 3 weeks after starting CRT (mid). The patients were categorized into two groups: complete response (CR) and non-complete response (non-CR) after 3 months of treatment. The quantitative parameters of DCE-MRI (K, Kep, and Ve), the changes and ratios of parameters (ΔK, ΔKep, ΔVe, rΔK, rΔKep, and rΔVe), and the relative ratio in the tumor area and a normal tube wall (rK, rKep, and rVe) were calculated and compared between two timeframes in two groups, respectively. Moreover, the receiver operating characteristics (ROC) statistical analysis was used to assess the above parameters.
RESULTS
We divided 33 patients into two groups: 22 in the CR group and 11 in the non-CR group. During the mid-CRT phase in the CR group, both K and Kep rapidly decreased, while only Kep decreased in the non-CR group. The pre-K and pre-Kep in the CR group were substantially higher compared to the non-CR group. Moreover, the rK was also apparently observed as higher at pre-CRT in the CR group compared to the non-CR group. The ROC analysis demonstrated that the pre-K could be the best parameter to evaluate the treatment performance (AUC = 0.74).
CONCLUSION
Pre-K could be a promising parameter to forecast how patients with locally advanced esophageal cancer will respond to CRT.
目的
本研究旨在探讨动态对比增强磁共振成像（DCE-MRI）在预测局部晚期食管癌同步放化疗（CRT）中的潜在应用。
方法
本研究纳入了 33 例接受 CRT 治疗的局部晚期食管癌患者。患者在 CRT 前（pre）和开始 CRT 后 3 周（mid）进行 DCE-MRI 检查。患者在治疗 3 个月后分为完全缓解（CR）和非完全缓解（non-CR）两组。分别计算并比较两组两个时间点的 DCE-MRI 定量参数（K、Kep 和 Ve）、参数变化率（ΔK、ΔKep、ΔVe、rΔK、rΔKep 和 rΔVe）和肿瘤区与正常管壁的相对比值（rK、rKep 和 rVe）。此外，还使用受试者工作特征（ROC）统计分析评估了上述参数。
结果
我们将 33 例患者分为两组：CR 组 22 例，non-CR 组 11 例。在 CR 组的 mid-CRT 阶段，K 和 Kep 迅速下降，而 non-CR 组仅 Kep 下降。CR 组的 pre-K 和 pre-Kep 明显高于 non-CR 组。此外，CR 组的 rK 在 pre-CRT 时也明显较高。ROC 分析表明，pre-K 可能是评估治疗效果的最佳参数（AUC = 0.74）。
结论
pre-K 可能是预测局部晚期食管癌患者对 CRT 反应的有前途的参数。
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