Predicting response of colorectal hepatic metastasis: Value of pretreatment apparent diffusion coefficients
Predicting response of colorectal hepatic metastasis: Value of pretreatment apparent diffusion coefficients
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DOI：
10.2214/ajr.06.0601
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发表时间：
2007-04-01
影响因子：
5
通讯作者：
Husband, Janet E.
中科院分区：
文献类型：
--
作者：
Koh, Dow-Mu;Scurr, Erica;Husband, Janet E.
OBJECTIVE.本研究的目的是确定结直肠癌肝转移灶的治疗前表观扩散系数（ADC）是否可以预测对化疗的反应，并比较化疗前后转移灶的ADC。对象和方法。对20例直径大于1 cm的结直肠癌转移性肝病灶患者在化疗前后进行了3个B值的弥散加权成像前瞻性评价。使用B值为0、150和500 s/mm（2）的图像（ADC 0 -500）和B值为150和500 s/mm（2）的图像（ADC 150 -500）计算定量ADC图。在转移性病灶周围绘制感兴趣区域，并在肝脏上随机绘制。根据实体瘤疗效评价标准，比较化疗前后转移灶的平均ADC 0 -500和平均ADC 150 -500。对25例有反应和15例无反应的转移性病灶进行了评价。无反应病灶的治疗前平均ADC 0 -500和平均ADC 150 -500显著高于有反应病灶（Mann-Whitney U检验，p < 0.002）。转移灶体积缩小百分比与治疗前平均ADC 150 -500之间存在线性回归关系（r（2）= 0.34，p = 0.02）。化疗后，缓解病灶的平均ADC 0 -500和ADC 150 -500显著增加（Wilcoxon符号秩，p = 0.025）。无反应转移灶（Wilcoxon符号秩，p > 0.5）或正常肝实质（Wilcoxon符号秩，p > 0.4）中未观察到显著变化。结直肠癌肝转移灶治疗前平均ADC 0 -500和平均ADC 150 -500高预示化疗反应差。在对化疗有反应的转移性病灶中观察到平均ADC 0 -500和ADC 150 -500显著增加。这些发现可能对个体化治疗的发展有影响。
OBJECTIVE. The purposes of this study were to determine whether the pretreatment apparent diffusion coefficients (ADCs) of hepatic metastatic lesions from colorectal cancer are predictive of response to chemotherapy and to compare the ADCs of metastatic lesions before and after chemotherapy.SUBJECTS AND METHODS. Twenty patients with potentially operable hepatic lesions larger than 1 cm in diameter metastatic from colorectal carcinoma were prospectively evaluated with diffusion-weighted imaging at three b values before and after chemotherapy. Quantitative ADC maps were calculated with images with b values of 0, 150, and 500 s/mm(2) (ADC0-500) and with images with b values of 150 and 500 s/mm(2) (ADC150-500). Regions of interest were drawn around metastatic lesions and randomly over liver. The mean ADC0-500 and mean ADC150-500 of metastatic lesions before and after chemotherapy were compared according to response defined by Response Evaluation Criteria in Solid Tumors criteria.RESULTS. Twenty-five responding and 15 nonresponding metastatic lesions were evaluated. Nonresponding lesions had a significantly higher pretreatment mean ADC0-500 and mean ADC150-500 than did responding lesions (Mann-Whitney U test, p < 0.002). There was a linear regression relation (r(2) = 0.34, p = 0.02) between percentage size reduction of metastatic lesions and pretreatment mean ADC150-500. After chemotherapy, responding lesions had a significant increase in mean ADC0-500 and ADC150-500 (Wilcoxon's signed rank, p = 0.025). No significant change was observed in nonresponding metastatic lesions (Wilcoxon's signed rank, p > 0.5) or in normal liver parenchyma (Wilcoxon's signed rank, p > 0.4).CONCLUSION. High pretreatment mean ADC0-500 and mean ADC150-500 of colorectal hepatic metastatic lesions were predictive of poor response to chemotherapy. A significant increase in mean ADC0-500 and ADC150-500 was observed in metastatic lesions that responded to chemotherapy. These findings may have implications for development of individualized therapy.