Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2024 Sep 15;58(3):366-375. doi: 10.2478/raon-2024-0044. eCollection 2024 Sep 1.
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can assess tumour vascularity, which depends on the process of angiogenesis and affects tumour response to treatment. Our study explored the associations between DCE-MRI parameters and the expression of plasma angiogenic factors in human papilloma virus (HPV)-negative oropharyngeal cancer, as well as their predictive value for response to concurrent chemoradiotherapy (cCRT).
Twenty-five patients with locally advanced HPV-negative oropharyngeal carcinoma were prospectively enrolled in the study. DCE-MRI and blood plasma sampling were conducted before cCRT, after receiving a radiation dose of 20 Gy, and after the completion of cCRT. Perfusion parameters k, k, V, initial area under the curve (iAUC) and plasma expression levels of angiogenic factors (vascular endothelial growth factor [VEGF], connective tissue growth factor [CTGF], platelet-derived growth factor [PDGF]-AB, angiogenin [ANG], endostatin [END] and thrombospondin-1 [THBS1]) were measured at each time-point. Patients were stratified into responders and non-responders based on clinical evaluation. Differences and correlations between measures were used to generate prognostic models for response prediction.
Higher perfusion parameter k and higher plasma VEGF levels successfully discriminated responders from non-responders across all measured time-points, whereas higher iAUC and higher plasma PDGF-AB levels were also discriminative at selected time points. Using early intra-treatment measurements of k and VEGF, a predictive model was created with cut-off values of 0.259 min for k and 62.5 pg/mL for plasma VEGF.
Early intra-treatment DCE-MRI parameter k and plasma VEGF levels may be valuable early predictors of response to cCRT in HPV-negative oropharyngeal cancer.
动态对比增强磁共振成像（DCE-MRI）可评估肿瘤血管生成，这取决于血管生成过程，影响肿瘤对治疗的反应。本研究探讨了人乳头瘤病毒（HPV）阴性口咽癌中 DCE-MRI 参数与血浆血管生成因子表达之间的关系，以及它们对同期放化疗（cCRT）反应的预测价值。
前瞻性纳入 25 例局部晚期 HPV 阴性口咽癌患者。在 cCRT 前、接受 20Gy 放射剂量后和 cCRT 完成后进行 DCE-MRI 和血血浆取样。在每个时间点测量灌注参数 k、k、V、初始曲线下面积（iAUC）和血管生成因子（血管内皮生长因子 [VEGF]、结缔组织生长因子 [CTGF]、血小板衍生生长因子 [PDGF-AB]、血管生成素 [ANG]、内皮抑素 [END] 和血栓素-1 [THBS1]）的血浆表达水平。根据临床评估将患者分为反应者和非反应者。使用差异和相关性来生成用于反应预测的预后模型。
在所有测量的时间点，较高的灌注参数 k 和较高的血浆 VEGF 水平成功区分了反应者和非反应者，而较高的 iAUC 和较高的血浆 PDGF-AB 水平在选定的时间点也具有区分能力。使用治疗期间早期的 k 和 VEGF 测量值，创建了一个预测模型，其 k 的截断值为 0.259 min，血浆 VEGF 的截断值为 62.5 pg/mL。
早期治疗中的 DCE-MRI 参数 k 和血浆 VEGF 水平可能是 HPV 阴性口咽癌 cCRT 反应的有价值的早期预测指标。
