Diffusion-weighted MRI of lymphoma: prognostic utility and implications for PET/MRI?
Diffusion-weighted MRI of lymphoma: prognostic utility and implications for PET/MRI?
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DOI：
10.1007/s00259-012-2293-7
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发表时间：
2013-02-01
影响因子：
9.1
通讯作者：
Humphries, Paul D.
中科院分区：
文献类型：
--
作者：
Punwani, Shonit;Taylor, Stuart A.;Humphries, Paul D.
随着最近PET/MRI的引入，我们研究了扩散加权成像（DWI）是否可以补充PET来预测霍奇金淋巴瘤的局部治疗反应。本回顾性研究从医院数据库中选择39例组织学诊断为霍奇金淋巴瘤的患者，在长春新碱、依托泊苷、强的松龙和阿霉素（OEPA）治疗前后分别接受了全身MRI （DWI辅助）和PET/CT检查。定量测定预处理体积、MRI表观扩散系数（ADC）和PET最大标准化摄取值（SUVmax），评价OEPA两个周期后的局部反应。定量预处理成像生物标志物（疾病体积、ADC、SUVmax）使用Fisher精确检验和Mann Whitney统计比较反应充分和反应不充分的部位。基于人口统计学/临床特征、预处理疾病量和未添加ADC（模型1）和添加ADC（模型2）的SUVmax，我们推导并交叉验证了预测不良反应的多变量模型。使用完整数据集（训练）和交叉验证（测试）数据计算两种模型的ROC曲线下面积（AUC）。反应充分的位点的中位预处理ADC (1.0 x 10(-3)mm（2)s(-1)）明显低于反应不充分的位点(1.26 x 10(-3)mm(2)s(-1))；P < 0.01)。患者人口学/临床参数、预处理SUVmax或预处理淋巴结体积在反应不足和充分的部位之间没有显著差异。模型1的训练和测试数据预测反应不足的roc - auc分别为0.90和0.53，模型2的roc - auc分别为0.84和0.71。DWI与PET互补用于预测部位特异性化疗中期反应。
With the recent introduction of PET/MRI, we investigated whether diffusion-weighted imaging (DWI) can complement PET for predicting local treatment response in Hodgkin lymphoma.This retrospective study included 39 patients selected from a hospital database with a histological diagnosis of Hodgkin lymphoma undergoing whole-body MRI (supplemented by DWI) and PET/CT before and after two cycles of vincristine, etoposide, prednisolone and doxorubicin (OEPA). The pretreatment volume, MRI apparent diffusion coefficient (ADC) and PET maximum standardized uptake value (SUVmax) of the largest nodal mass were determined quantitatively for evaluation of the local response following two cycles of OEPA. Quantitative pretreatment imaging biomarkers (disease volume, ADC, SUVmax) were compared between sites with an adequate and those with an inadequate response using Fisher's exact test and Mann Whitney statistics. Multivariate models predictive of an inadequate response based on demographic/clinical features, pretreatment disease volume and SUVmax without (model 1) and with (model 2) the addition of ADC were derived and crossvalidated. The ROC area under curve (AUC) was calculated for both models using the full dataset (training) and the crossvalidation (test) data.Sites with an adequate response had a significantly lower median pretreatment ADC (1.0 x 10(-3)mm(2)s(-1)) than those with an inadequate response (1.26 x 10(-3)mm(2)s(-1); p < 0.01). There were no significant differences in patient demographic/clinical parameters, pretreatment SUVmax or pretreatment nodal volume between sites with inadequate and adequate response. The ROC-AUCs for prediction of an inadequate response for the training and test data for model 1 were 0.90 and 0.53, and for model 2 were 0.84 and 0.71, respectively.DWI complements PET for prediction of site-specific interim response to chemotherapy.