Neuroendocrine liver metastasis treated by using intraarterial therapy: volumetric functional imaging biomarkers of early tumor response and survival.
Neuroendocrine liver metastasis treated by using intraarterial therapy: volumetric functional imaging biomarkers of early tumor response and survival.
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DOI：
10.1148/radiol.12120495
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发表时间：
2013-02
期刊：
影响因子：
19.7
通讯作者：
Kamel IR
中科院分区：
文献类型：
--
作者：
Gowdra Halappa V;Corona-Villalobos CP;Bonekamp S;Li Z;Reyes D;Cosgrove D;Pawlik TM;Diaz LA;Bhagat N;Eng J;Geschwind JF;Kamel IR
确定弥散加权和造影剂增强磁共振（MR）成像的体积变化是否有助于评估神经内分泌肝转移瘤（NELM）对动脉内治疗（IAT）的早期肿瘤反应。该回顾性单中心综合影像学分析按照HIPAA进行，并获得机构审查委员会批准。患者放弃知情同意。回顾性分析了71例接受IAT治疗的NELM患者（39例男性;平均年龄62.3岁）。在治疗前和治疗后3 - 4周进行MR检查。分割索引病变，以提供表观扩散系数（ADC）和对比增强MR成像在肝动脉期（HAP）和门静脉期（PVP）的体积功能分析。肿瘤缓解定义为HAP期间体积ADC增加15%或更大，体积增强降低25%或更大，PVP期间体积增强降低50%或更大。患者总生存期是治疗开始后的主要终点。单变量分析包括Kaplan-Meier生存曲线。使用考克斯比例风险回归模型检测体积ADC和对比增强MR成像之间的相互作用，并计算风险比。所有患者在HAP（-25.3%，P <.0001）和PVP（-22.4%，P <.0001）期间的平均体积ADC显著增加（27%，P <.0001），平均体积增强显著降低。治疗后体积ADC增加15%或以上的患者（n = 49）比体积ADC增加小于15%的患者（n = 22）预后更好（对数秩检验，P <0.002）。动脉增强体积减少25%或更多（n = 40）或静脉增强体积减少50%或更多（n = 18）的患者比动脉增强体积减少小于25%（n = 31）或静脉增强体积减少小于50%（n = 53）的患者预后更好（对数秩检验，P <0.02）。容积功能磁共振成像标准可以作为早期反应的生物标志物，表明这些标准在未来的NELM临床试验中可能是重要的。
To determine if volumetric changes of diffusion-weighted and contrast material–enhanced magnetic resonance (MR) imaging can help assess early tumor response to intraarterial therapy (IAT) in neuroendocrine liver metastasis (NELM). This retrospective single-center comprehensive imaging analysis was performed in compliance with HIPAA and was institutional review board approved. Informed patient consent was waived. Seventy-one patients (39 men; mean age, 62.3 years) with NELM treated with IAT were analyzed retrospectively. MR studies were performed before and 3–4 weeks after therapy. The index lesion was segmented to provide volumetric functional analysis of apparent diffusion coefficient (ADC) and contrast-enhanced MR imaging in the hepatic arterial phase (HAP) and portal venous phase (PVP). Tumor response was defined as increase in volumetric ADC of 15% or greater and decrease in volumetric enhancement of 25% or greater during the HAP or of 50% or greater during the PVP. Patient overall survival was the primary end point after therapy initiation. Univariate analysis included Kaplan-Meier survival curves. The Cox proportional hazards regression model was used to detect interactions between volumetric ADC and contrast-enhanced MR imaging and to calculate the hazard ratio. There was significant increase in mean volumetric ADC (27%, P < .0001) and significant decrease in mean volumetric enhancement during the HAP (−25.3%, P < .0001) and the PVP (−22.4%, P < .0001) in all patients. Patients who had 15% or greater volumetric ADC increase (n = 49) after therapy had better prognosis than those who had less than 15% increase in volumetric ADC (n = 22) (log-rank test, P < .002). Patients who had 25% or greater decrease in volumetric arterial enhancement (n = 40) or 50% or greater decrease in venous enhancement (n = 18) had better prognosis than those who had less than 25% decrease in volumetric arterial enhancement (n = 31) or less than 50% decrease in venous enhancement (n = 53) (log-rank test, P < .02). Volumetric functional MR imaging criteria may act as biomarkers of early response, indicating that these criteria may be important to incorporate in future NELM clinical trials.
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DOI：
10.1016/j.jvir.2006.10.005
发表时间：
2007-01-01
影响因子：
2.9
作者：
Kamel, Ihab R.;Reyes, Diane K.;Geschwind, Jean-Francois H.
通讯作者：
Geschwind, Jean-Francois H.
影响因子：
29.4
作者：
Cadiot, G;Vuagnat, A;Mignon, M
通讯作者：
Mignon, M
影响因子：
3.3
作者：
Oberg, Kjell
通讯作者：
Oberg, Kjell
影响因子：
5
作者：
Liapi, Eleni;Geschwind, Jean-Francois;Kamel, Ihab R.
通讯作者：
Kamel, Ihab R.
影响因子：
2.9
作者：
Geschwind, JFH;Ramsey, DE;Choti, MA
通讯作者：
Choti, MA