T1-Weighted Dynamic Contrast-Enhanced MR Perfusion Imaging Characterizes Tumor Response to Radiation Therapy in Chordoma.
T1-Weighted Dynamic Contrast-Enhanced MR Perfusion Imaging Characterizes Tumor Response to Radiation Therapy in Chordoma.
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DOI：
10.3174/ajnr.a5383
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发表时间：
2017-11
期刊：
影响因子：
--
通讯作者：
Lyo J
中科院分区：
文献类型：
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作者：
Santos P;Peck KK;Arevalo-Perez J;Karimi S;Lis E;Yamada Y;Holodny AI;Lyo J
众所周知，脊索瘤在常规MRI上显示放射治疗后很少有变化。我们假设脊索瘤的动态增强(DCE)MR灌注成像参数在放射治疗后会发生显着变化。11名经病理证实的脊索瘤患者在放射治疗前后完成了DCE MR灌注成像。肿瘤的定量测量由两位主治神经放射科医生进行。用感兴趣区计算血管通透性(KTRANS)和血浆容量(Vp)，生成动态增强曲线。定量分析平均、最大Vp和KTrans，半定量分析平均浓度曲线，确定曲线下面积(AUC)。采用P<；0.05显着水平的Mann-Whitney U检验来评估放射治疗前后上述参数的差异。放疗后感兴趣区的Vp平均值(治疗前μ=0.82，治疗后μ=0.42)、Vp最大值(治疗前μ=3.56；治疗后μ=2.27)和KTRANS平均值(治疗前μ=0.046；治疗后μ=0.028)在放射治疗后显著降低，从而显示了评估肿瘤疗效的潜力。AUC值也有显著差异(p<；0.05)。Vp和Ktras在放射治疗后降低，提示这些DCE-MR灌注参数可能有助于监测脊索瘤的生长和对放射治疗的反应。此外，脊索瘤的特征性动态MR信号强度-时间曲线可能为脊索瘤与其他脊柱病变的鉴别提供了一种影像手段。
Chordomas notoriously demonstrate a paucity of changes following radiation therapy on conventional MRI. We hypothesize that dynamic contrast enhanced (DCE) MR perfusion imaging parameters of chordomas would change significantly following radiation therapy. Eleven pathology-proven chordoma patients who completed DCE MR perfusion imaging pre -and post-radiation therapy were enrolled. Quantitative tumor measurements were taken by two attending neuroradiologists. ROIs were used to calculate vascular permeability (Ktrans) and plasma volume (Vp), and generate dynamic contrast enhancement curves. Quantitative analysis was performed to determine mean and maximum Vp and Ktrans values, while semi-quantitative analysis on averaged concentration curves was used to determine the area under the curve (AUC). A Mann-Whitney U test at a significance level of p<0.05 was used to assess differences of above parameters between pre- and post-radiation therapy. Vp mean (pre-treatment μ=0.82, post-treatment μ=0.42), Vp maximum (pre- treatment μ=3.56; post- treatment μ=2.27), and Ktrans mean (pre- treatment μ=0.046; post- treatment μ=0.028) in the ROIs significantly decreased after radiation therapy (p<0.05), thereby demonstrating potential for assessing tumor response. AUC values also demonstrated significant differnces (p<0.05). Vp and Ktrans, decreased after radiation therapy, suggesting that these DCE-MR perfusion parameters may be useful for monitoring chordoma growth and response to radiation therapy. Additionally, the characteristic dynamic MR signal intensity time curve of chordoma may provide a radiographic means of distinguishing chordoma from other spinal lesions.