Feasibility analysis of the parametric response map as an early predictor of treatment efficacy in head and neck cancer.
Feasibility analysis of the parametric response map as an early predictor of treatment efficacy in head and neck cancer.
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DOI：
10.3174/ajnr.a4296
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发表时间：
2015-04
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影响因子：
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通讯作者：
Mukherji SK
中科院分区：
文献类型：
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作者：
Baer AH;Hoff BA;Srinivasan A;Galbán CJ;Mukherji SK
通过使用动态对比增强MR成像来估计体积传递常数、60秒时对比增强时间曲线下归一化面积和分数血浆体积的变化可能有助于预测肿瘤对放化疗的反应。我们假设，参数反应图，一个体素的定量动态对比增强MR成像图的体素分析，预测头颈癌患者的生存。10例局部晚期头颈部鳞状细胞癌患者接受了明确的同步放化疗治疗。对于每例患者，在治疗开始前和治疗开始后2周收集动态对比增强MR成像数据。通过参数响应图和全肿瘤平均百分比变化分析原发肿瘤体积内灌注参数随时间的变化。结局定义为总生存期。确定了最能预测结果的灌注参数和指标。采用对数秩检验和Kaplan-Meier生存曲线估计总生存期。在参数反应图分析中，体积转移常数和60秒时对比增强时间曲线下面积可预测生存率（体积转移常数，P = 0.002; 60秒时对比增强时间曲线下面积标准化，P = 0.02）和百分比变化分析（体积转移常数，P = 0.04; 60秒时对比增强时间曲线下面积，P = 0.02）。血浆容量在两项分析中均不能预测生存率。MR灌注生物标志物的参数反应映射可能指导预测治疗失败患者的治疗调整。需要更大规模的研究来确定这些灌注参数中的参数响应图分析或百分比信号变化是否是生存的更强预测因子。
Estimating changes in the volume transfer constant, normalized area under the contrast-enhancement time curve at 60 seconds, and fractional blood plasma volume by using dynamic contrast-enhanced MR imaging may be useful in predicting tumor response to chemoradiation. We hypothesized that the parametric response map, a voxel-by-voxel analysis of quantitative dynamic contrast-enhanced MR imaging maps, predicts survival in patients with head and neck cancer. Ten patients with locoregionally advanced head and neck squamous cell carcinoma underwent definitive concurrent chemoradiation therapy. For each patient, dynamic contrast-enhanced MR imaging data were collected before and 2 weeks after treatment initiation. Change in perfusion parameters within the primary tumor volume with time was analyzed by parametric response mapping and by whole-tumor mean percentage change. Outcome was defined as overall survival. The perfusion parameter and metric most predictive of outcome were identified. Overall survival was estimated by the log-rank test and Kaplan-Meier survival curve. The volume transfer constant and normalized area under the contrast-enhancement time curve at 60 seconds were predictive of survival both in parametric response map analysis (volume transfer constant, P = .002; normalized area under the contrast-enhancement time curve at 60 seconds, P = .02) and in the percentage change analysis (volume transfer constant, P = .04; normalized area under the contrast-enhancement time curve at 60 seconds, P = .02). Blood plasma volume predicted survival in neither analysis. Parametric response mapping of MR perfusion biomarkers could potentially guide treatment modification in patients with predicted treatment failure. Larger studies are needed to determine whether parametric response map analysis or percentage signal change in these perfusion parameters is the stronger predictor of survival.