Diffusion-Weighted and Dynamic Contrast-Enhanced MRI Derived Imaging Metrics for Stereotactic Body Radiotherapy of Pancreatic Ductal Adenocarcinoma: Preliminary Findings
Diffusion-Weighted and Dynamic Contrast-Enhanced MRI Derived Imaging Metrics for Stereotactic Body Radiotherapy of Pancreatic Ductal Adenocarcinoma: Preliminary Findings
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DOI：
10.18383/j.tom.2020.00015
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发表时间：
2020-06-01
期刊：
影响因子：
1.9
通讯作者：
Shukla-Dave, Amita
中科院分区：
文献类型：
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作者：
Do, Richard Kinh;Reyngold, Marsha;Shukla-Dave, Amita
我们旨在评估胰腺导管腺癌患者在治疗前（TX [0]）、立体定向体部放疗第一部分后即刻（D1-TX[1]）和TX后6周（Post-TX[2]）通过弥散加权（DW-）和动态对比增强磁共振成像（DCE）-MRI获得的定量成像度量值的纵向变化。10例入组患者（n = 10）在3.0 T扫描仪上接受了DW和DCE-MRI检查。表观扩散系数ADC（mm（2）/s）采用单指数模型从DW成像数据中推导得出。用快门速度模型拟合组织松弛速率R-1 t时程数据，该模型提供了体积传递常数K-transs（min（-1））、血管外细胞外体积分数v（e）和细胞内水质子平均寿命tau（i）（秒）的估计值。Wilcoxon秩和检验比较了磁共振检查之间ADC、K-transs、v（e）和tau（i）值的平均值、标准差、偏度、峰度和相对百分比（r，%）变化（Delta）。rADC（Delta 2-0）值显著大于rADC（Delta 1-0）值（P = .009）。rK（反式）Delta（2-0）值显著低于rK（反式）Delta（1-0）值（P = 0.048）。rv（e Delta 2-1）和rv（e Delta 2-0）值存在显著差异（P = 0.016）。r tau（i Delta 2-1）值显著低于r tau（i Delta 2-0）值（P = .008）。对于组比较，TX前ADC的平均值和峰度（P = 0.18和P = 0.14）、K-transs值的偏度和峰度（两者均为P = 0.14）显示局部控制（n = 2）和早期失败（n = 4）患者之间存在显著差异。DW和DCE-MRI衍生的定量指标可能是有用的生物标志物，以评估胰腺导管腺癌患者立体定向体部放疗的纵向变化。
We aimed to assess longitudinal changes in quantitative imaging metric values obtained from diffusion-weighted (DW-) and dynamic contrast-enhanced magnetic resonance imaging (DCE)-MRI at pre-treatment (TX [0]), immediately after the first fraction of stereotactic body radiotherapy (D1-TX[1]), and 6 weeks post-TX (Post-TX[2]) in patients with pancreatic ductal adenocarcinoma. Ten enrolled patients (n = 10) underwent DW and DCE-MRI examinations on a 3.0 T scanner. The apparent diffusion coefficient, ADC (mm(2)/s), was derived from DW imaging data using a monoexponential model. The tissue relaxation rate, R-1t, time-course data were fitted with a shutter-speed model, which provides estimates of the volume transfer constant, K-trans (min(-1)), extravascular extracellular volume fraction, v(e), and mean lifetime of intracellular water protons, tau(i) (seconds). Wilcoxon rank-sum test compared the mean values, standard deviation, skewness, kurtosis, and relative percentage (r, %) changes (Delta) in ADC, K-trans, v(e), and tau(i) values between the magnetic resonance examinations. rADC(Delta 2-0) values were significantly greater than rADC(Delta 1-0) values (P = .009). rK(trans) Delta(2-0) values were significantly lower than rK(trans) Delta(1-0) values (P = .048). rv(e Delta 2-1) and rv(e Delta 2-0) values were significantly different (P = .016). r tau(i Delta 2-1) values were significantly lower than r tau(i Delta 2-0) values (P = .008). For group comparison, the pre-TX mean and kurtosis of ADC (P = .18 and P = .14), skewness and kurtosis of K-trans values (P = .14 for both) showed a leaning toward significant difference between patients who experienced local control (n = 2) and failed early (n = 4). DW- and DCE-MRI-derived quantitative metrics could be useful biomarkers to evaluate longitudinal changes to stereotactic body radiotherapy in patients with pancreatic ductal adenocarcinoma.