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基于黄金角度放射状采样动态对比增强磁共振成像预测胃癌患者腹腔游离癌细胞。

Prediction of peritoneal free cancer cells in gastric cancer patients by golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging.

机构信息

The First Affiliated Hospital of Ningbo University, Ningbo 315000, China.

Ningbo Medical Center Lihuili Hospital, Ningbo 315000, China.

出版信息

J Zhejiang Univ Sci B. 2024 Jun 5;25(7):617-627. doi: 10.1631/jzus.B2300929.

Abstract

OBJECTIVES

Peritoneal free cancer cells can negatively impact disease progression and patient outcomes in gastric cancer. This study aimed to investigate the feasibility of using golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging (GRASP DCE-MRI) to predict the presence of peritoneal free cancer cells in gastric cancer patients.

METHODS

All enrolled patients were consecutively divided into analysis and validation groups. Preoperative magnetic resonance imaging (MRI) scans and perfusion were performed in patients with gastric cancer undergoing surgery, and peritoneal lavage specimens were collected for examination. Based on the peritoneal lavage cytology (PLC) results, patients were divided into negative and positive lavage fluid groups. The data collected included clinical and MR information. A nomogram prediction model was constructed to predict the positive rate of peritoneal lavage fluid, and the validity of the model was verified based on data from the verification group.

RESULTS

There was no statistical difference between the proportion of PLC-positive cases predicted by GRASP DCE-MR and the actual PLC test. MR tumor stage, tumor thickness, and perfusion parameter Tofts-Ketty model volume transfer constant () were independent predictors of positive peritoneal lavage fluid. The nomogram model featured a concordance index (-index) of 0.785 and 0.742 for the modeling and validation groups, respectively.

CONCLUSIONS

GRASP DCE-MR could effectively predict peritoneal free cancer cells in gastric cancer patients. The nomogram model constructed using these predictors may help clinicians to better predict the risk of peritoneal free cancer cells being present in gastric cancer patients.

摘要

目的

腹膜游离癌细胞可能会对胃癌的疾病进展和患者预后产生负面影响。本研究旨在探讨使用黄金角度放射状采样动态对比增强磁共振成像(GRASP DCE-MRI)预测胃癌患者腹膜游离癌细胞存在的可行性。

方法

所有入组患者连续分为分析组和验证组。对接受手术的胃癌患者进行术前磁共振成像(MRI)扫描和灌注,采集腹腔灌洗标本进行检查。根据腹腔灌洗细胞学(PLC)结果,将患者分为阴性和阳性灌洗液组。收集的资料包括临床和 MR 信息。构建预测腹膜灌洗液阳性率的列线图预测模型,并基于验证组的数据验证模型的有效性。

结果

GRASP DCE-MR 预测的 PLC 阳性病例比例与实际 PLC 检测结果之间无统计学差异。MR 肿瘤分期、肿瘤厚度和灌注参数 Tofts-Ketty 模型容积转移常数()是阳性腹腔灌洗液的独立预测因子。模型组和验证组的列线图模型一致性指数(-指数)分别为 0.785 和 0.742。

结论

GRASP DCE-MRI 可有效预测胃癌患者腹膜游离癌细胞。使用这些预测因子构建的列线图模型可能有助于临床医生更好地预测胃癌患者腹膜游离癌细胞存在的风险。

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