Water-Exchange-Modified Kinetic Parameters from Dynamic Contrast-Enhanced MRI as Prognostic Biomarkers of Survival in Advanced Hepatocellular Carcinoma Treated with Antiangiogenic Monotherapy.
Water-Exchange-Modified Kinetic Parameters from Dynamic Contrast-Enhanced MRI as Prognostic Biomarkers of Survival in Advanced Hepatocellular Carcinoma Treated with Antiangiogenic Monotherapy.
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DOI：
10.1371/journal.pone.0136725
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Yoshida H
中科院分区：
文献类型：
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作者：
Lee SH;Hayano K;Zhu AX;Sahani DV;Yoshida H
目的探讨动态增强磁共振(DCE-MRI)水交换(WX)动力学参数在抗血管生成单药治疗中晚期肝细胞癌(HCC)治疗前的应用价值。20例晚期肝细胞癌患者接受了DCE-MRI检查，随后接受了舒尼替尼治疗。采用5种不同的WX动力学模型：Tofts-Kty模型(WX-TK)、扩展TK模型(WX-ETK)、二室交换模型、绝热近似组织均质模型(WX-AATH)和分布参数模型(WX-DP)对晚期肝癌的DCE-MRI数据进行分析。计算肝总血流量、动脉血流量分数(γ)、动脉血流量(BFA)、门脉血流量、血容量、平均通过时间、通透性表面积乘积、间质体积分数(Vi)、提取分数、平均细胞内水分子寿命(τC)和细胞内体积分数(VC)。在采用留一法交叉验证进行受试者操作特征分析后，使用Kaplan-Meier分析对每个模型的个体参数进行1年生存率(1YS)判别，并采用单因素COX回归分析结合排列检验来评估个体参数与总生存率(OS)的关系。WX-TK模型派生的γ(P=0.022)和VI(P=0.010)、WX-ETK模型派生的τC(P=0.023)和v C(P=0.042)是1YS有统计学意义的预后生物标志物。WX-DP模型衍生的BFA增加(P=0.025)，WX-TK、WX-ETK、WX-AATH和WX-DP模型衍生的vC减少(分别为P=0.034，P=0.038，P=0.028，P=0.041)。WX-ETK模型衍生的vC是舒尼替尼治疗晚期肝癌的一个有效的预后生物标志物。
To find prognostic biomarkers in pretreatment dynamic contrast-enhanced MRI (DCE-MRI) water-exchange-modified (WX) kinetic parameters for advanced hepatocellular carcinoma (HCC) treated with antiangiogenic monotherapy. Twenty patients with advanced HCC underwent DCE-MRI and were subsequently treated with sunitinib. Pretreatment DCE-MRI data on advanced HCC were analyzed using five different WX kinetic models: the Tofts-Kety (WX-TK), extended TK (WX-ETK), two compartment exchange, adiabatic approximation to tissue homogeneity (WX-AATH), and distributed parameter (WX-DP) models. The total hepatic blood flow, arterial flow fraction (γ), arterial blood flow (BF A), portal blood flow, blood volume, mean transit time, permeability-surface area product, fractional interstitial volume (v I), extraction fraction, mean intracellular water molecule lifetime (τ C), and fractional intracellular volume (v C) were calculated. After receiver operating characteristic analysis with leave-one-out cross-validation, individual parameters for each model were assessed in terms of 1-year-survival (1YS) discrimination using Kaplan-Meier analysis, and association with overall survival (OS) using univariate Cox regression analysis with permutation testing. The WX-TK-model-derived γ (P = 0.022) and v I (P = 0.010), and WX-ETK-model-derived τ C (P = 0.023) and v C (P = 0.042) were statistically significant prognostic biomarkers for 1YS. Increase in the WX-DP-model-derived BF A (P = 0.025) and decrease in the WX-TK, WX-ETK, WX-AATH, and WX-DP-model-derived v C (P = 0.034, P = 0.038, P = 0.028, P = 0.041, respectively) were significantly associated with an increase in OS. The WX-ETK-model-derived v C was an effective prognostic biomarker for advanced HCC treated with sunitinib.