A Feasibility Study of Parametric Response Map Analysis of Diffusion-Weighted Magnetic Resonance Imaging Scans of Head and Neck Cancer Patients for Providing Early Detection of Therapeutic Efficacy
A Feasibility Study of Parametric Response Map Analysis of Diffusion-Weighted Magnetic Resonance Imaging Scans of Head and Neck Cancer Patients for Providing Early Detection of Therapeutic Efficacy
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DOI：
10.1593/tlo.09175
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发表时间：
2009-09-01
影响因子：
5
通讯作者：
Ross, Brian D.
中科院分区：
文献类型：
--
作者：
Galban, Craig J.;Mukherji, Suresh K.;Ross, Brian D.
参数反应图（PRM）被评估为监测头颈部鳞状细胞癌（HNSCC）患者治疗诱导的组织改变的早期替代生物标志物。扩散加权磁共振成像（DW-MRI）对15例HNSCC患者在基线和治疗开始后3周进行非手术器官保存治疗（nopt），同时进行放化疗。使用可变形图像配准算法对序列表观扩散系数（ADC）图进行空间对齐，以测量显示ADC （PRMADC）显著变化的肿瘤体积。通过监测全肿瘤平均ADC和PRM指标的百分比变化，对dwi量化的治疗前和治疗中ADC图进行分析。在6个月时，通过与肿瘤控制的相关性来评估肿瘤体积百分比变化、平均ADC和PRMADC作为治疗反应生物标志物的预后价值。像素上的差异作为PRMADC分析的一部分揭示了水流动性增加的区域。对肿瘤ADC直方图的分析也显示，在预后良好的患者中，平均ADC早在治疗后3周就有所增加。然而，在6个月时，发现平均ADC的百分比变化与肿瘤控制无关。相比之下，在病理结果不同的患者中，PRMADC和肿瘤体积百分比变化存在显著差异。本研究的观察发现，当PRMADC评估弥散MRI时，有可能提供头颈癌nopt期间的预后和空间信息。
The parametric response map (PRM) was evaluated as an early surrogate biomarker for monitoring treatment-induced tissue alterations in patients with head and neck squamous cell carcinoma (HNSCC). Diffusion-weighted magnetic resonance imaging (DW-MRI) was performed on 15 patients with HNSCC at baseline and 3 weeks after treatment initiation of a nonsurgical organ preservation therapy (NSOPT) using concurrent radiation and chemotherapy. PRM was applied on serial apparent diffusion coefficient (ADC) maps that were spatially aligned using a deformable image registration algorithm to measure the tumor volume exhibiting significant changes in ADC (PRMADC). Pretherapy and midtherapy ADC maps, quantified from the DWIs, were analyzed by monitoring the percent change in whole-tumor mean ADC and the PRM metric. The prognostic values of percentage change in tumor volume and mean ADC and PRMADC as a treatment response biomarker were assessed by correlating with tumor control at 6 months. Pixel-wise differences as part of PRMADC analysis revealed regions where water mobility increased. Analysis of the tumor ADC histograms also showed increases in mean ADC as early as 3 weeks into therapy in patients with a favorable outcome. Nevertheless, the percentage change in mean ADC was found to not correlate with tumor control at 6 months. In contrast, significant differences in PRMADC and percentage change in tumor volume were observed between patients with pathologically different outcomes. Observations from this study have found that diffusion MRI, when assessed by PRMADC, has the potential to provide both prognostic and spatial information during NSOPT of head and neck cancer.