Extracellular volume fraction with MRI: As an alternative predictive biomarker to dynamic contrast-enhanced MRI for chemotherapy response of pancreatic ductal adenocarcinoma
Extracellular volume fraction with MRI: As an alternative predictive biomarker to dynamic contrast-enhanced MRI for chemotherapy response of pancreatic ductal adenocarcinoma
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DOI：
10.1016/j.ejrad.2021.110036
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发表时间：
2021-11-20
影响因子：
3.3
通讯作者：
Yoshiura, Takashi
中科院分区：
文献类型：
--
作者：
Fukukura, Yoshihiko;Kumagae, Yuichi;Yoshiura, Takashi
目的：评估平衡对比增强MRI与动态对比增强MRI（DCE-MRI）测定的细胞外容积（ECV）分数预测胰腺导管腺癌（PDAC）化疗疗效的可行性，并阐明ECV分数与DCE-MRI推导的药代动力学参数之间的关系。方法：这项回顾性研究纳入了58例连续的经组织学证实的PDAC患者，这些患者在全身化疗前接受了DCE-MRI。比较反应组和无反应组的肿瘤药代动力学参数，包括体积转移系数（K-transs）、速率常数（k（ep））和细胞外血管外体积分数（v（e）），以及平衡对比增强MRI测定的ECV分数。结果：反应组肿瘤K-transs、v（e）和ECV分数均显著高于无反应组（均P < 0.001），而k（ep）无显著差异（P = 0.119）。肿瘤ECV分数的受试者工作特征曲线下面积最高为0.918，敏感性为89.3%，特异性为90.0%，准确性为89.7%（临界值，>37.6%）。ECV分数与K-transs（斯皮尔曼系数= 0.66，P < 0.001）和v（e）（斯皮尔曼系数= 0.79，P < 0.001）呈显著正相关。
Purpose: To assess the feasibility of extracellular volume (ECV) fraction determined with equilibrium contrast-enhanced MRI for prediction of treatment response to chemotherapy in pancreatic ductal adenocarcinoma (PDAC) in comparison with dynamic contrast-enhanced MRI (DCE-MRI), and to clarify the association between ECV fraction and DCE-MRI-derived pharmacokinetic parameters.Methods: This retrospective study included 58 consecutive patients with histologically confirmed PDAC who underwent DCE-MRI before systemic chemotherapy. Tumor pharmacokinetic parameters, including the volume transfer coefficient (K-trans), rate constant (k(ep)), and extracellular extravascular volume fraction (v(e)) of DCE-MRI, and ECV fraction determined with equilibrium contrast-enhanced MRI were compared between the response and non-response groups. The correlation of tumor ECV fraction with each DCE-MRI-derived pharmacokinetic parameter was examined using Spearman's rank correlation coefficient.Results: Tumor K-trans, v(e), and ECV fraction were significantly higher in the response group than in the nonresponse group (all, P < 0.001), whereas no significant difference was found in k(ep) (P = 0.119). Tumor ECV fraction showed the highest area under receiver operating characteristic curve of 0.918, with a sensitivity of 89.3%, specificity of 90.0%, and accuracy of 89.7% (cut off, >37.6%). The ECV fraction showed a significant positive correlation with K-trans (Spearman's coefficient = 0.66, P < 0.001) and v(e) (Spearman's coefficient = 0.79, P < 0.001).Conclusions: ECV fraction determined with equilibrium contrast-enhanced MRI was as useful as DCE-MRI-derived pharmacokinetic parameters for predicting treatment response to chemotherapy in patients with PDAC.