Predictive value of quantitative dynamic contrast?enhanced magnetic resonance imaging for the efficacy of neoadjuvant chemotherapy in locally advanced gastric cancer
10.3760／cma.j.issn.0253?3766.2019.10.008
- VernacularTitle:定量动态增强磁共振成像技术对局部进展期胃癌新辅助化疗疗效的预测价值
- Author:
Yongjian ZHU
1
;
Ying LI
;
Jun JIANG
;
Wen ZHANG
;
Liyan XUE
;
Aiping ZHOU
;
Liming JIANG
Author Information
1. 国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院影像诊断科100021
- Keywords:
Gastric neoplasms;
Magnetic resonance imaging;
Dynamic contrast?enhancement;
Neoadjuvant chemotherapy;
Efficacy
- From:
Chinese Journal of Oncology
2019;41(10):765-770
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of dynamic contrast?enhanced magnetic resonance imaging ( DCE?MRI) quantitative parameters for the efficacy of neoadjuvant chemotherapy in locally advanced gastric cancer. Methods Sixty?five patients with locally advanced gastric cancer (LAGC) confirmed by gastroscopy and received neoadjuvant chemotherapy ( NCT ) were enrolled in this study. Quantitative DCE?MRI was performed before NCT, and the quantitative parameters were measured, including volume transfer constant (Ktrans ), rate constant ( Kep ), volume fraction of extravascular extracellular space (Ve) and volume fraction of plasma (Vp). After NCT, all patients received radical gastrectomy. According to postoperative pathological tumor regression grade, patients were divided into response group and non? response group, and the differences of DCE quantitative parameters between the two groups were compared. ROC curve was utilized to analyze the predictive efficacy of DCE quantitative parameters for NCT response of LAGC, and multivariate logistic regression analysis was performed to analyze the predictive efficacy of combined parameters. Results Thirty?seven patients were in response group and 28 patients were in non?response group. The pretreatment Ktrans in the response group were [ 0.216 min－1 ( 0.130 min－1, 0.252 min－1)], significantly higher than [0.091 min－1(0.069 min－1, 0.146 min－1 )] of non?response group (P＜0.001), and Ve in the response group were [0.354 ( 0.228, 0.463)], significantly higher than [ 0.200 (0.177, 0.253)] of non?response group (P＜0.001). ROC analysis showed the AUCS of Ktrans and Ve in predicting NCT efficacy were 0.881 and 0.756, respectively. Multiple logistic regression analysis showed that the combination of the two parameters could improve the AUC to 0.921, with the sensitivity and specificity of 86.5% and 89.3%, respectively. Conclusion DCE?MRI quantitative parameters could help to predict the NCT response of LAGC, and the combination of parameters could improve the predictive efficacy.
