Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer.
Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer.
复制标题
定量磁共振成像可以预测肝切除癌后个体未来的肝脏表现。
DOI：
10.1371/journal.pone.0238568
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
HepaT1ca Study Group
中科院分区：
文献类型：
--
作者：
Mole DJ;Fallowfield JA;Sherif AE;Kendall T;Semple S;Kelly M;Ridgway G;Connell JJ;McGonigle J;Banerjee R;Brady JM;Zheng X;Hughes M;Neyton L;McClintock J;Tucker G;Nailon H;Patel D;Wackett A;Steven M;Welsh F;Rees M;HepaT1ca Study Group
术后结果不佳的风险以及手术切除作为治疗方法的益处需要临床护理团队对原发性和继发性肝癌患者进行仔细评估。手术技术的进步改善了患者的预后，但确定哪些患者术后肝脏功能不佳的风险最大仍然是一个挑战。在此，我们报告了一项多中心观察性临床试验 (ClinicalTrials.gov NCT03213314) 的结果，该试验旨在通过使用定量多参数磁共振成像 (MRI) 评估肝脏健康状况，为肝癌手术的个性化术前风险评估提供信息。我们将未来肝脏残余 (FLR) 体积的估计与肝实质的校正 T1 (cT1) 结合起来，作为 143 名患者治疗前肝脏健康状况的代表。与 cT1 在正常范围内的患者相比，术前肝脏 cT1 升高（表明存在纤维炎症）的患者术后住院时间更长（6.5 天与 5 天；p = 0.0053）。结合 FLR 和 cT1 的综合评分预测术后 5 天内肝脏功能较差（AUROC = 0.78）。此外，该综合评分与切除后 3 个月内肝脏的再生性能相关。这项研究强调了定量 MRI 在识别术后肝功能不佳和住院时间较长的患者方面的实用性。这种方法有可能为个体化患者风险评估提供信息，作为肝癌手术临床决策过程的一部分。
The risk of poor post-operative outcome and the benefits of surgical resection as a curative therapy require careful assessment by the clinical care team for patients with primary and secondary liver cancer. Advances in surgical techniques have improved patient outcomes but identifying which individual patients are at greatest risk of poor post-operative liver performance remains a challenge. Here we report results from a multicentre observational clinical trial (ClinicalTrials.gov NCT03213314) which aimed to inform personalised pre-operative risk assessment in liver cancer surgery by evaluating liver health using quantitative multiparametric magnetic resonance imaging (MRI). We combined estimation of future liver remnant (FLR) volume with corrected T1 (cT1) of the liver parenchyma as a representation of liver health in 143 patients prior to treatment. Patients with an elevated preoperative liver cT1, indicative of fibroinflammation, had a longer post-operative hospital stay compared to those with a cT1 within the normal range (6.5 vs 5 days; p = 0.0053). A composite score combining FLR and cT1 predicted poor liver performance in the 5 days immediately following surgery (AUROC = 0.78). Furthermore, this composite score correlated with the regenerative performance of the liver in the 3 months following resection. This study highlights the utility of quantitative MRI for identifying patients at increased risk of poor post-operative liver performance and a longer stay in hospital. This approach has the potential to inform the assessment of individualised patient risk as part of the clinical decision-making process for liver cancer surgery.
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影响因子：
13.5
作者：
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影响因子：
3.2
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通讯作者：
Fong, YM