Prognostic value of intra-voxel incoherent motion-diffusion weighted imaging quantitative parameters in predicting prognosis of patients with KRAS mutation non-small cell lung cancer undergoing first-line concurrent chemoradiotherapy
- VernacularTitle:磁共振体素内不相干运动-弥散加权成像定量参数预测KRAS突变非小细胞肺癌患者一线同步放化疗预后的价值
- Author:
Zhihong SHANG
1
;
Linkun YUE
;
Dan WANG
Author Information
- Keywords: non-small cell lung cancer; Kirsten rat sarcoma viral oncogene homolog; intra-voxel incoherent motion-diffusion weighted imaging; first-line concurrent chemoradiotherapy; prog-nosis; mutation; apparent diffusion coefficient; influencing factors
- From: Journal of Clinical Medicine in Practice 2025;29(14):28-33
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the prognostic value of quantitative parameters of intra-voxel incoherent motion-diffusion weighted imaging(IVIM-DWI)in predicting the prognosis of patients with Kirsten rats arcomaviral oncogene homolog(KRAS)mutation non-small cell lung cancer(NSCLC)undergoing first-line concurrent chemoradiotherapy.Methods A total of 139 patients with KRAS-mutated NSCLC were selected as the research subjects,and all of them received first-line concurrent chemoradiotherapy.Based on follow-up results(with all-cause mortality within one year defined as the endpoint event),patients were divided into favorable prognosis group and poor prognosis group.General data and IVIM-DWI quantitative parameters[apparent diffusion coefficient(ADC),diffusion coefficient(D),pseudo-diffusion coefficient(D*)and perfusion fraction(f)]were compared be-tween the two groups.Cox regression analysis was employed to identify factors influencing poor prognosis in patients with KRAS-mutated NSCLC.Receiver operating characteristic(ROC)curves were plotted to evaluate the prognostic predictive value of IVIM-DWI quantitative parameters.Kaplan-Meier(K-M)survival curves and the Log-rank test were used to analyze the relationships between IVIM-DWI quantitative parameters and prognosis in patients with KRAS-mutated NSCLC.Results Among the 139 patients,four were lost during follow-up,resulting in a survival rate of 69.63％(94/135).The favorable prognosis group comprised 94 patients,while the poor prognosis group included 41 pa-tients.There were statistically significant differences in the types of KRAS mutations,the best thera-peutic effect after treatment,and smoking history between the two groups(P＜0.05).After adjus-ting for confounding factors,ADC,D,D* and f values were identified as influencing factors for poor prognosis in patients with KRAS-mutated NSCLC(P＜0.05).The area under the curve(AUC)for the combined prediction of prognosis using ADC,D,D* and f values was 0.933,which was higher than the AUC for each parameter alone.Patients with low ADC,D,D* and f values exhibited sig-nificantly lower survival rates compared to those with high values(P＜0.05).Conclusion IVIM-DWI quantitative parameters,including ADC,D,D* and f values,are influencing factors for the prognosis of first-line concurrent chemoradiotherapy in patients with KRAS-mutated NSCLC.The combined predictive performance of these parameters is high,offering guidance for clinical diagnosis and treatment and potentially improving disease prognosis.
