肝脏间质近距离放疗治疗肾细胞癌：ADC 值测量不能预测总体生存率。
Interstitial Brachytherapy of the Liver for Renal Cell Carcinoma: ADC Measurements Do Not Predict Overall Survival.
机构信息
University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany.
出版信息
In Vivo. 2022 Nov-Dec;36(6):2945-2951. doi: 10.21873/invivo.13037.
BACKGROUND/AIM: To assess the influence of pre-treatment apparent diffusion coefficient (ADC) measurements on outcomes in patients undergoing interstitial brachytherapy (iBT) for liver metastases from renal cell carcinoma.
PATIENTS AND METHODS
Patients undergoing iBT for renal cell carcinoma (RCC) liver metastases were retrospectively identified. Patients were eligible for inclusion if they had a pre-treatment magnetic resonance imaging (MRI) with diffusion weighted imaging (DWI) sequences. For each lesion, a region of interest (ROI) was placed along the contours of the entire lesion across all slices. For each ROI, ADC minimum, mean and maximum as well as the lesion area were noted, and the average was calculated for each lesion. ADC measurements were correlated with overall survival.
RESULTS
The analysis included 17 patients. Median overall survival was 36 months. Neither ADC measurement was significantly associated with overall survival. ADC min (HR=1.00, 95%CI=1.00-1.00, p=0.600), ADC max (HR=1.001, 95%CI=0.998-1.003, p=0.490), ADC mean (HR=0.999, 95%CI=0.996-1.003, p=0.638).
CONCLUSION
ADC is not able to differentiate between groups with good and bad overall survival in patients undergoing iBT for RCC liver metastases.
背景/目的：评估接受肾细胞癌（RCC）肝转移间质内近距离放射治疗（iBT）患者的治疗前表观扩散系数（ADC）测量值对治疗结局的影响。
患者与方法
回顾性确定了接受 iBT 治疗 RCC 肝转移的患者。符合纳入标准的患者需具备治疗前磁共振成像（MRI）弥散加权成像（DWI）序列。对于每个病变，在所有层面上沿病变的整个轮廓放置感兴趣区域（ROI）。对于每个 ROI，记录 ADC 最小值、平均值和最大值以及病变面积，并计算每个病变的平均值。ADC 测量值与总生存率相关。
结果
该分析共纳入 17 例患者。中位总生存期为 36 个月。没有任何 ADC 测量值与总生存率显著相关。ADC min（HR=1.00，95%CI=1.00-1.00，p=0.600）、ADC max（HR=1.001，95%CI=0.998-1.003，p=0.490）、ADC mean（HR=0.999，95%CI=0.996-1.003，p=0.638）。
结论
在接受 RCC 肝转移 iBT 治疗的患者中，ADC 无法区分总体生存率良好和不良的组间差异。
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