Körner Stefanie Korsgaard, Tolbod Lars Poulsen, Pedersen Bodil G, Boellaard Thierry, Milling Rikke Vilsbøll, Brandt Simone Buchardt, Agerbæk Mads, Dyrskjøt Lars, Bouchelouche Kirsten, Jensen Jørgen B
Department of Urology, Aarhus University Hospital, 8200 Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark.
J Clin Med. 2024 Aug 8;13(16):4652. doi: 10.3390/jcm13164652.
Accurate assessment of therapy response to chemotherapy could possibly offer a bladder-sparing approach in selected patients with localized muscle-invasive bladder cancer (MIBC). The aim of this study was to evaluate whether [O]HO PET/MRI can be used for assessment of complete local pathological response to preoperative chemotherapy in patients with MIBC. This prospective pilot study included 13 patients with MIBC treated with neoadjuvant or induction chemotherapy and subsequent radical cystectomy. Patients underwent a [O]HO PET/MRI scan before chemotherapy and another scan after chemotherapy before radical cystectomy. Volumes of interest were delineated on T2-weighted MRI and transferred to parametric images for dynamic analysis. Tumor blood flow (TBF) was estimated by [O]HO PET. Changes in TBF were compared with histopathology. The Wilcoxon matched-pairs signed-ranks test was used for comparing pre- and post-chemotherapy measurements. Mean TBF decreased by 49%. Mean TBF in complete responders (ypT0N0/ypTis) was not significantly different from non-complete responders (≥ypT1) ( = 0.52). Despite a measurable decrease in TBF after chemotherapy treatment, we were not able to estimate a TBF threshold for identifying complete responders to chemotherapy for MIBC patients. Further studies are needed to elucidate the potential of [O]HO PET/MRI in assessing therapy response in MIBC.
准确评估化疗的治疗反应可能为部分局部肌层浸润性膀胱癌（MIBC）患者提供保膀胱治疗方案。本研究旨在评估[O]HO PET/MRI是否可用于评估MIBC患者术前化疗后的局部病理完全缓解情况。这项前瞻性初步研究纳入了13例接受新辅助或诱导化疗及后续根治性膀胱切除术的MIBC患者。患者在化疗前及化疗后根治性膀胱切除术前行[O]HO PET/MRI扫描。在T2加权MRI上勾画感兴趣区，并将其转移至参数图像进行动态分析。通过[O]HO PET估计肿瘤血流（TBF）。将TBF的变化与组织病理学结果进行比较。采用Wilcoxon配对符号秩检验比较化疗前后的测量值。平均TBF下降了49%。完全缓解者（ypT0N0/ypTis）的平均TBF与非完全缓解者（≥ypT1）相比无显著差异（ = 0.52）。尽管化疗后TBF有可测量的下降，但我们无法确定用于识别MIBC患者化疗完全缓解者的TBF阈值。需要进一步研究以阐明[O]HO PET/MRI在评估MIBC治疗反应方面的潜力。
