经动脉化疗栓塞术（TACE）治疗神经内分泌肝转移（NELM）：基线磁共振成像（MRI）上容积性动脉强化（VAE）的预测价值

Transarterial chemoembolization (TACE) for neuroendocrine liver metastasis (NELM): Predictive value of volumetric arterial enhancement (VAE) on baseline MRI.

作者信息

Desmaison Chloé, Niccoli Patricia, Oziel Taieb Sandrine, Faure Marjorie, Ewald Jacques, Izaaryene Jean, Piana Gilles

机构信息

Institut Paoli Calmettes, Department of Radiology, 232, boulevard Sainte Marguerite, 13009 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles Livon, 13007 Marseille, France.

Institut Paoli Calmettes, Department of Oncology, 232, boulevard Sainte Marguerite, 13009 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles Livon, 13007 Marseille, France.

出版信息

Bull Cancer. 2023 Mar;110(3):308-319. doi: 10.1016/j.bulcan.2022.12.007. Epub 2023 Jan 31.

DOI:10.1016/j.bulcan.2022.12.007

PMID:36732142

Abstract

BACKGROUND

Neuroendocrine tumors (NETs) belong to a rare family of tumors whose incidence has increased significantly over the past 50 years.

PURPOSE

To evaluate the prognostic value of volumetric arterial enhancement (VAE) on baseline magnetic resonance imaging (MRI) for patients with neuroendocrine liver metastasis (NELM) treated using transarterial chemoembolization (TACE).

MATERIAL AND METHODS

Between October 2012 and December 2018, VAE in 37 patients was measured with a semi-automatic volume of Interest (VOI) on subtracted T1 sequence in the arterial phase. Patients underwent 1-3 sectoral lipiodol TACE. Radiologic response using modified Response Evaluation Criteria in Solid Tumors (mRECIST) at the treatment cycle end and progression free survival were determined.

RESULTS

Median age was 68.0 (60.0; 73.0). Twenty-three patients (62%) had a partial response, 10 (27%) had stable disease, four (11%) had progressive disease. VAE was a significant (P<0.05) predictor of radiologic response. Median progression free survival was 13 months (IC 95: 8; 16). In univariate analysis, significant predictors of local progression were alkaline phosphatase (AP) (P=0.035), Ki-67 index (P=0.014), and VAE (P<0.01). VAE over 500ms and Ki-67 index over 3%were risk factors of progression (P=<0.01) in multivariate analysis.

CONCLUSION

VAE before TACE could be predictive of radiologic response and could be related to oncologic outcomes in patients with NELM.

摘要

背景

神经内分泌肿瘤（NETs）属于一类罕见的肿瘤，在过去50年中其发病率显著增加。

目的

评估基线磁共振成像（MRI）上的容积动脉强化（VAE）对接受经动脉化疗栓塞（TACE）治疗的神经内分泌肝转移（NELM）患者的预后价值。

材料与方法

2012年10月至2018年12月期间，对37例患者在动脉期的减影T1序列上使用半自动感兴趣容积（VOI）测量VAE。患者接受1-3次节段性碘油TACE。确定治疗周期结束时使用改良实体瘤疗效评价标准（mRECIST）的放射学反应和无进展生存期。

结果

中位年龄为68.0（60.0；73.0）。23例患者（62%）有部分缓解，10例（27%）病情稳定，4例（11%）病情进展。VAE是放射学反应的显著（P<0.05）预测因子。中位无进展生存期为13个月（95%置信区间：8；16）。在单因素分析中，局部进展的显著预测因子是碱性磷酸酶（AP）（P=0.035）、Ki-67指数（P=0.014）和VAE（P<0.01）。在多因素分析中，VAE超过500ms和Ki-67指数超过3%是进展的危险因素（P<0.01）。