Amide proton transfer imaging to predict tumor response to neoadjuvant chemotherapy in locally advanced rectal cancer
Amide proton transfer imaging to predict tumor response to neoadjuvant chemotherapy in locally advanced rectal cancer
复制标题
酰胺质子转移显像预测局部晚期直肠癌新辅助化疗的疗效
DOI：
10.1111/jgh.14315
复制
发表时间：
2019-01-01
影响因子：
4.1
通讯作者：
Honda, Hiroshi
中科院分区：
文献类型：
--
作者：
Nishie, Akihiro;Asayama, Yoshiki;Honda, Hiroshi
背景与目的利用酰胺质子转移（APT）成像技术可以对蛋白质和多肽的含量进行估计。先前的研究表明APT成像预测肿瘤恶性程度的有用性。我们确定APT成像是否可以预测局部晚期直肠癌（LARC）患者对新辅助化疗（NAC）的肿瘤反应。方法17例LARC患者在治疗前均接受过磁共振检查，包括APT成像和NAC（至少2个疗程）。APT加权成像（WI）信号强度（SI）（%）定义为偏移量为3.5 ppm时的磁化传递率不对称（MTRAsym）。对每个肿瘤的变性和坏死程度进行组织学评价，然后将其分类为5个组织学等级之一（0，无; 1a，小于1/3; 1b，1/3至2/3; 2，大于2/3; 3，全部）。我们通过Student t检验比较了0/1a/1b级（低反应组）和2/3级（高反应组）肿瘤的平均APTWI SI。我们使用受试者工作特征曲线来确定APTWI SI用于预测肿瘤反应的诊断性能。结果低反应组的平均APTWI SI（n = 12; 3.05 ± 1.61%）显著高于高反应组（n = 5; 1.14 ± 1.13%）（P = 0.029）。使用APTWI SI预测肿瘤反应的曲线下面积为0.87。当≥ 2.75%作为低反应状态的指标时，APTWI SI的敏感性为75%，特异性为100%。结论治疗前APT显像可预测LARC患者对NAC的反应。
Background and Aim The amount of proteins and peptides can be estimated with amide proton transfer (APT) imaging. Previous studies demonstrated the usefulness of APT imaging to predict tumor malignancy. We determined whether APT imaging can predict the tumor response to neoadjuvant chemotherapy (NAC) in patients with locally advanced rectal cancer (LARC). Methods Seventeen patients with LARC who underwent a pretherapeutic magnetic resonance examination including APT imaging and NAC (at least two courses) were enrolled. The APT-weighted imaging (WI) signal intensity (SI) (%) was defined as magnetization transfer ratio asymmetry (MTRasym) at the offset of 3.5 ppm. Each tumor was histologically evaluated for the degree of degeneration and necrosis and then classified as one of five histological Grades (0, none; 1a, less than 1/3; 1b, 1/3 to 2/3; 2, more than 2/3; 3, all). We compared the mean APTWI SIs of the tumors between the Grade 0/1a/1b (low-response group) and Grade 2/3 (high-response group) by Student's t-test. We used receiver operating characteristics curves to determine the diagnostic performance of the APTWI SI for predicting the tumor response. Results The mean APTWI SI of the low-response group (n = 12; 3.05 +/- 1.61%) was significantly higher than that of the high-response group (n = 5; 1.14 +/- 1.13%) (P = 0.029). The area under the curve for predicting the tumor response using the APTWI SI was 0.87. When >= 2.75% was used as an indicator of low-response status, 75% sensitivity and 100% specificity of the APTWI SI were obtained. Conclusion Pretherapeutic APT imaging can predict the tumor response to NAC in patients with LARC.