动态对比增强磁共振成像（DCE-MRI）和体素内不相干运动扩散加权成像（IVIM-DWI）在骨肉瘤新辅助化疗患者中的预测价值
Predictive value of DCE-MRI and IVIM-DWI in osteosarcoma patients with neoadjuvant chemotherapy.
作者信息
Xia Xibin, Wen Lu, Zhou Feng, Li Junjun, Lu Qiang, Liu Jun, Yu Xiaoping
机构信息
Department of Diagnostic Radiology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
Department of Orthopedics and Soft Tissue, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
出版信息
Front Oncol. 2022 Oct 14;12:967450. doi: 10.3389/fonc.2022.967450. eCollection 2022.
OBJECTIVE
To investigate the predictive value of dynamic contrast enhanced MRI (DCE-MRI) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for clinical outcomes of osteosarcoma patients with neoadjuvant chemotherapy.
METHODS
The present prospective single-arm cohort study enrolled 163 patients of osteosarcoma during July 2017 to July 2022. All patients received the same treatment strategy of neoadjuvant chemotherapy. Both DCE-MRI and IVIM-DWI were conducted for the patients before the chemotherapy, as well as after one or two chemotherapy treatment cycles. The imaging parameters of contrast agent transfer rate between blood and tissue ( ), contrast agent back-flux rate constant ( ), extravascular extracellular fractional volume ( ), as well as pure diffusion coefficient ( value), pseudo-diffusion coefficient ( value), apparent diffusion coefficient () and the perfusion fraction ( value) were recorded. RECIST standard [complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD)] was used as the main clinical outcome.
RESULTS
After two treatment cycles, 112 (68.71%) cases were with CR and PR, 31 (19.02%) cases were with SD and 20 cases (12.27%) were with PD. After 1~2 treatment cycles, patients with CR/PR showed significantly markedly lower , , values, while higher , and values compared with SD or PD patients. Alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were positively correlated with values of , , and , while negative correlation was observed between ALP and values of , and , as well as between LDH and and after the whole treatment. and values after two treatment cycles showed the best predictive value for diagnosis of PD. The values of , , as well as ALP and LDH were all risk factors for PD after neoadjuvant chemotherapy.
CONCLUSION
DCE-MRI and IVIM-DWI have the potential to predict clinical outcomes of osteosarcoma patients with neoadjuvant chemotherapy.
目的
探讨动态对比增强磁共振成像（DCE-MRI）和体素内不相干运动扩散加权成像（IVIM-DWI）对接受新辅助化疗的骨肉瘤患者临床结局的预测价值。
方法
本前瞻性单臂队列研究纳入了2017年7月至2022年7月期间的163例骨肉瘤患者。所有患者均接受相同的新辅助化疗治疗策略。在化疗前以及一个或两个化疗周期后，对患者进行DCE-MRI和IVIM-DWI检查。记录血液与组织间造影剂转移率（ ）、造影剂回流速率常数（ ）、血管外细胞外容积分数（ ）以及纯扩散系数（ 值）、伪扩散系数（ 值）、表观扩散系数（ ）和灌注分数（ 值）等成像参数。采用实体瘤疗效评价标准（RECIST标准）[完全缓解（CR）、部分缓解（PR）、疾病稳定（SD）、疾病进展（PD）]作为主要临床结局。
结果
两个治疗周期后，112例（68.71%）患者达到CR和PR，31例（19.02%）患者为SD，20例（12.27%）患者为PD。在1~2个治疗周期后，CR/PR患者的 、 、 值显著低于SD或PD患者，而 、 和 值则更高。碱性磷酸酶（ALP）和乳酸脱氢酶（LDH）与 、 、 值呈正相关，而在整个治疗后，ALP与 、 、 值之间以及LDH与 和 值之间呈负相关。两个治疗周期后的 和 值对PD诊断具有最佳预测价值。 、 、 值以及ALP和LDH均为新辅助化疗后PD的危险因素。
结论
DCE-MRI和IVIM-DWI有潜力预测接受新辅助化疗的骨肉瘤患者的临床结局。
Zotero 插件