新辅助化疗可诱导卵巢癌患者肿瘤表观扩散系数值升高。
Neoadjuvant chemotherapy induces an elevation of tumour apparent diffusion coefficient values in patients with ovarian cancer.
机构信息
Department of Radiology, Tampere University Hospital, Tampere, Finland.
Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.
出版信息
BMC Cancer. 2023 Apr 1;23(1):299. doi: 10.1186/s12885-023-10760-2.
OBJECTIVES
Multiparametric magnetic resonance imaging (mMRI) is the modality of choice in the imaging of ovarian cancer (OC). We aimed to investigate the feasibility of different types of regions of interest (ROIs) in the measurement of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging in OC patients treated with neoadjuvant chemotherapy (NACT).
METHODS
We retrospectively enrolled 23 consecutive patients with advanced OC who had undergone NACT and mMRI. Seventeen of them had been imaged before and after NACT. Two observers independently measured the ADC values in both ovaries and in the metastatic mass by drawing on a single slice of (1) freehand large ROIs (L-ROIs) covering the solid parts of the whole tumour and (2) three small round ROIs (S-ROIs). The side of the primary ovarian tumour was defined. We evaluated the interobserver reproducibility and statistical significance of the change in tumoural pre- and post-NACT ADC values. Each patient's disease was defined as platinum-sensitive, semi-sensitive, or resistant. The patients were deemed either responders or non-responders.
RESULTS
The interobserver reproducibility of the L-ROI and S-ROI measurements ranged from good to excellent (ICC range: 0.71-0.99). The mean ADC values were significantly higher after NACT in the primary tumour (L-ROI p < 0.001, S-ROIs p < 0.01), and the increase after NACT was associated with sensitivity to platinum-based chemotherapy. The changes in the ADC values of the omental mass were associated with a response to NACT.
CONCLUSION
The mean ADC values of the primary tumour increased significantly after NACT in the OC patients, and the amount of increase in omental mass was associated with the response to platinum-based NACT. Our study indicates that quantitative analysis of ADC values with a single slice and a whole tumour ROI placement is a reproducible method that has a potential role in the evaluation of NACT response in patients with OC.
TRIAL REGISTRATION
Retrospectively registered (institutional permission code: 5302501; date of the permission: 31.7.2020).
目的
多参数磁共振成像（mmRI）是卵巢癌（OC）成像的首选方式。我们旨在研究在接受新辅助化疗（NACT）的 OC 患者中，扩散加权成像表观扩散系数（ADC）值测量中不同类型感兴趣区域（ROI）的可行性。
方法
我们回顾性纳入了 23 例接受 NACT 和 mMRI 的晚期 OC 连续患者。其中 17 例在 NACT 前后进行了成像。两名观察者分别在一张切片上通过绘制（1）自由手大 ROI（L-ROI）覆盖整个肿瘤的实性部分和（2）三个小圆形 ROI（S-ROI），独立测量双侧卵巢和转移瘤的 ADC 值。定义原发卵巢肿瘤的侧别。我们评估了肿瘤 ADC 值在 NACT 前后变化的观察者间可重复性和统计学意义。每位患者的疾病被定义为铂敏感、半敏感或耐药。患者被认为是有反应者或无反应者。
结果
L-ROI 和 S-ROI 测量的观察者间可重复性从良好到极好（ICC 范围：0.71-0.99）。原发肿瘤的 ADC 值在 NACT 后明显升高（L-ROI p<0.001，S-ROIs p<0.01），且 NACT 后的增加与基于铂类化疗的敏感性相关。网膜肿块 ADC 值的变化与 NACT 的反应相关。
结论
OC 患者 NACT 后原发肿瘤的平均 ADC 值明显升高，网膜肿块的增加量与基于铂类 NACT 的反应相关。我们的研究表明，使用单张切片和整个肿瘤 ROI 位置进行 ADC 值的定量分析是一种可重复的方法，在评估 OC 患者 NACT 反应方面具有潜在作用。
试验注册
回顾性注册（机构许可代码：5302501；许可日期：2020 年 7 月 31 日）。
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