摘要
目的旨在评估磁共振功能成像分析肿瘤异质性在直肠癌放化疗(CRT)疗效评估中的作用。方法2020年1月至2021年11月期间,选择在惠州市中心人民医院接受CRT前磁共振功能成像检查以评估60例局部晚期直肠癌(LARC)患者作为研究对象。从整体肿瘤的直方图中获得表观扩散系数(ADC)、体素内不相干运动(Dslow、Dfast和f)和拉伸指数模型[分布扩散系数(DDC)和α]。比较病理完全缓解(pCR)和非p CR患者CRT前的直方图指标和预后因素。构建受试者操作特征曲线(ROC曲线)以评估这些参数的诊断性能。结果CRT治疗后,13例(21.7%)患者归类为p CR组,而其他47例患者被归类为非p CR组(78.3%)。与p CR组相比,非p CR组在肿瘤体积、TRG和p T分期方面存在显著差异(P<0.05)。p CR组的ADC均值、标准差以及第10、25、50、75、90和95个百分点显著低于非p CR组(P<0.05)。p CR组DDC的平均值、偏度、峰度和第25、50、75、90和95百分位数低于非p CR组(P<0.05)。在ADC中,其平均值(AUC=0.890,P<0.001,95%CI=0.806~0.974)的诊断性能最高。在DDC中,其平均值(AUC=0.866,P<0.001,95%CI=0.771~0.960)的AUC值最高。ADC平均值与肿瘤体积结合预测p CR具有最高的诊断性能,其AUC为0.932,敏感度为100%,特异度为81%。结论使用整体肿瘤的ADC平均值与肿瘤体积相结合能有效预测LARC对CRT的反应。
Obective Overall tumor asment,such as histogram analysis,was a commom means to obtain tunor hetenogeneity information that may afect the treatment response.The purpose of this study was to evaluate the role of functional magnetie resonance imaging(MRI)in analyzing tunor heterngeneity in evaluating the effcacy of radiothernpy and chemotherapy(CRT)for rectal cancer.Methods From January 2020 to November 2021,60 patients with locally advanced rectal cancer(LARC)who underwent MRI examination before CRT in our hospital were selected a the research subjects.The apparent difusion cofficient(ADC),intra-voxel incoherent motion(Dslow,Dfast and F)and stretch index model(DDC and a)were obtained from the histogram of the whole tumor.Histogran indexes and prognostic factors before CRT were compared between patients with complete pathological remissio(pCR)and those without pCR.The receiver operating characteristie curve(ROC curve)was constructed to evaluate the diagnostic performance of these parameters.Results After CRT treatment,13 patients(21.7%)were lasifed as pCR group,while the other 47 patienits were casified 8 non-pCR group(78.3%).Cormpared with the pCR group,the non-pCR group had significant differences in tumor volume,TRG and pT stages(P<0.05).The mean,standard deviation and the 10th,25th,50th,75th,90h and 95th percentile of ADC in pCR goup were sigificanly lower than those in non-pCR group(P<0.05).The mean,skewness,kurtosis and 25th,50th,75th,90h and 95th percentile of DDC in pCR group were lower than those in non-pCR group(P<0.05).In ADC,its avenage value(AUC=0.890,P<0.001,95%CI=0.806-0.974)had the highest diagnostic performance.In DDC,is avenage(AUC=0.866,P<0.001,95%C1=0.771-0.960)has the highest AUC value.Average ADC combined with tumor volume had the highest diagnostie performance in predicting pCR,with AUC of 0.932,sensitivity of 100%and speifcity of 81%.Conclusion The whole-tumor ADC mean combined with the tumor volume can ffectively predict the response of LARC to CRT.
作者
段艳华
余煜栋
邓小燕
Duan Yanhuan;Yu Yudong;Deng Xiaoyan(Depatment of Medical Imaging,Huishou Central People's Hospital,Huishou 516000,Guangdong,China)
出处
《肿瘤代谢与营养电子杂志》
2024年第6期790-796,共7页
Electronic Journal of Metabolism and Nutrition of Cancer
基金
广东省卫生健康委员会科研项目(20210353)。
关键词
磁共振成像
肿瘤异质性
直肠癌
放化疗
表观扩散系数
直方图分析
体素内不相干运动
拉伸指数模型
Magnetie resonance imaging
Tunor heterogeneity
Rectal cancer
Radiotherapy and chemotherapy
Apparent difusion offcient
Histogram analysis
Inoberent motion in voxel
Tensile index model
