College of Electronic and Information Engineering, Tongji University, Shanghai, China.
Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, Changhai Road 168, Shanghai, 200434, China.
BMC Cancer. 2024 Sep 18;24(1):1160. doi: 10.1186/s12885-024-12934-y.
To investigate the values of apparent diffusion coefficient (ADC) for the treatment response evaluation in pancreatic cancer (PC) patients receiving neoadjuvant therapy (NAT).
This study included 103 NAT patients with histologically proven PC. ADC maps were generated using monoexponential diffusion-weighted imaging (b values: 50, 800 s/mm). Tumors' minimum, maximum, and mean ADCs were measured and compared pre- and post-NAT. Variations in ADC values measured between pre- and post-NAT completion for NAT methods (chemotherapy, chemoradiotherapy), tumor locations (head/neck, body/tail), tumor regression grade (TRG) levels (0-2, 3), N stages (N0, N1/N2) and tumor resection margin status (R0, R1), were further analyzed.
The minimum, maximum, and mean ADC values all increased dramatically after NAT, rising from 23.4 to 25.4% (all p < 0.001): mean (average: 1.626 × 10 mm/s vs. 1.315 × 10 mm/s), minimum (median: 1.274 × 10 mm/s vs. 1.034 × 10 mm/s), and maximum (average: 1.981 × 10 mm/s vs. 1.580 × 10 mm/s). The ADCs between the subgroups of all the criteria under investigation did not differ significantly for the minimum, maximum, or mean values pre- or post-NAT (P = 0.08 to 1.00). In the patients with borderline resectable PC (n = 47), the rate of tumor size changes after NAT was correlated with the pre-NAT mean ADC values (Spearman's coefficient: 0.288, P = 0.049).
The ADC values of PC increased significantly following NAT; however, the percentage increases failed to provide any predictive value for the resection margin status or TRG levels.
探讨在接受新辅助治疗（NAT）的胰腺癌（PC）患者中，表观扩散系数（ADC）值对治疗反应评估的价值。
本研究纳入了 103 例经组织学证实的 PC 接受 NAT 的患者。使用单指数扩散加权成像（b 值：50、800 s/mm）生成 ADC 图。测量并比较治疗前后肿瘤的最小、最大和平均 ADC 值。进一步分析治疗方法（化疗、放化疗）、肿瘤位置（头/颈、体/尾）、肿瘤消退分级（TRG）水平（0-2、3）、N 分期（N0、N1/N2）和肿瘤切除边缘状态（R0、R1）对 ADC 值变化的影响。
NAT 后，最小、最大和平均 ADC 值均显著升高，分别从 23.4%升至 25.4%（均 P<0.001）：平均（平均：1.626×10 mm/s 比 1.315×10 mm/s）、最小（中位数：1.274×10 mm/s 比 1.034×10 mm/s）和最大（平均：1.981×10 mm/s 比 1.580×10 mm/s）。在所有研究标准的亚组中，治疗前后的 ADC 值在最小、最大或平均方面均无显著差异（P=0.08 至 1.00）。在边界可切除 PC 患者（n=47）中，NAT 后肿瘤大小变化率与治疗前平均 ADC 值相关（Spearman 系数：0.288，P=0.049）。
PC 的 ADC 值在接受 NAT 后显著升高；然而，百分比的增加并不能为切缘状态或 TRG 水平提供任何预测价值。
