Measuring repeatability of dynamic contrast-enhanced MRI biomarkers improves evaluation of biological response to radiotherapy in lung cancer

Nivetha Sridharan ^1,2, Ahmed Salem ^3,4, Ross A Little ³

¹Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK. nivetha.sridharan@icr.ac.uk.
²Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK. nivetha.sridharan@icr.ac.uk.
³Division of Cancer Sciences, University of Manchester, Manchester, UK.
⁴Faculty of Medicine, The Hashemite University, Zarqa, Jordan.
⁵Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK.
⁶Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK.
⁷Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK.
⁸Bioxydyn Ltd, Manchester, UK.
⁹Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
¹⁰Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK.
¹¹Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK. james.oconnor@icr.ac.uk.
¹²Division of Cancer Sciences, University of Manchester, Manchester, UK. james.oconnor@icr.ac.uk.
¹³Radiology Department, The Christie NHS Foundation Trust, Manchester, UK. james.oconnor@icr.ac.uk.

⁰Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK. nivetha.sridharan@icr.ac.uk.

European Radiology +

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August 9, 2024

View abstract on PubMed

Summary

Dynamic contrast-enhanced MRI biomarkers K<sup>trans</sup> and tumor volume are repeatable in non-small cell lung cancer (NSCLC) patients. These metrics identify early biological responses at both cohort and individual lesion levels, aiding future therapeutic studies.

Area Of Science

Oncology
Radiology
Medical Imaging

Background

Non-small cell lung cancer (NSCLC) treatment response assessment often relies on conventional imaging, which may not capture early biological changes.
Quantitative imaging biomarkers offer potential for more sensitive detection of treatment effects.

Purpose Of The Study

To assess the repeatability of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) biomarkers in NSCLC patients.
To utilize repeatability statistics to identify individual target lesions exhibiting early biological response to therapy.

Main Methods

A prospective, single-centre DCE-MRI study was conducted on NSCLC patients before and during radiotherapy.
Key biomarkers measured included volume transfer constant (K<sup>trans</sup>), extravascular extracellular space volume fraction (v<sub>e</sub>), plasma volume fraction (v<sub>p</sub>), and tumor volume.
Repeatability was quantified using within-subject coefficient of variation (wCV) and repeatability coefficient (RC).

Main Results

Fourteen patients with 22 evaluable lesions were included.
Biomarkers K<sup>trans</sup>, v<sub>e</sub>, and tumor volume demonstrated significant cohort-level treatment effects (p < 0.001).
K<sup>trans</sup> and tumor volume showed the highest number of individual lesions responding biologically, while v<sub>e</sub> did not show significant individual lesion changes.

Conclusions

DCE-MRI biomarkers, specifically K<sup>trans</sup> and tumor volume, are repeatable and can detect early treatment-induced changes in NSCLC.
Individual lesion-level analysis provides additional information beyond cohort statistics, aiding in the selection of parameters for future studies.
Repeatability coefficient measurements enhance the assessment of early biological response to therapy at the lesion-specific level.

Keywords:

Biomarkers Lung neoplasms Magnetic resonance imaging Statistics