磁力共振成像 (MRI) 瘤回归响应新辅助化疗单独没有辐射用于直肠腺癌
Yu Shen1, Xiaoling Gong1, Yazhou He1
1From the Colorectal Cancer Center, Department of General Surgery (Y.S., W.M., M.W., M.Q., Z.W.), and Department of Radiology (X.G., H.Z.), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang St, Chengdu 86610000, China; and Department of Epidemiology and Medical Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China (Y.H.).
Radiology
|August 27, 2024
概括
对直肠癌的新辅助化疗 (NCT) 可以通过MRI准确评估. 扩散加权成像修改MR瘤回归等级 (DWImodMR-TRG) 在NCT后预测完整反应时显示出最高的准确性.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 新辅助化疗 (NCT) 越来越多地用于局部晚期直肠癌 (LARC).
- 核磁共振成像在NCT后评估治疗反应的有效性尚未完全确立.
- 准确的反应评估对于治疗计划和患者的结果至关重要.
研究的目的:
- 评估各种基于MRI的模型在预测LARC患者NCT后病理完整反应 (pCR) 的准确性.
- 为了比较不同MRI评估方法的性能,包括MR瘤回归等级 (MR-TRG) 和扩散权重成像 (DWI).
- 为了确定DWI是否可以提高MRI对治疗反应的预测准确性.
主要方法:
- 两项前性试验的回顾性分析,涉及用NCT (capecitabine和oxaliplatin) 治疗LARC患者.
- 三位放射科医生独立评估了瘤反应,使用MR-TRG,DWI,DWI修饰的MR-TRG (DWImodMR-TRG),MRI完整反应和放射性新辅助反应得分.
- 手术后的病理评估作为计算灵敏度,特异性,正负预测值和AUC的参考标准.
- 使用DeLong测试进行了AUCs的比较.
主要成果:
- 224名LARC患者被纳入分析.
- 所有评估的MRI模型 (MR-TRG,DWI,DWImodMR-TRG,MRI完整反应,放射性新辅助反应得分) 都与pCR相关.
- DWImodMR-TRG表现出最高的准确性,AUC为0.90,特异性为89%,负预测值为93%.
结论:
- 基于MRI的模型在预测NCT后LARC患者的病理完整反应方面是准确的.
- 整合扩散加权成像显著提高了基于MRI的评估的预测性能.
- 在新辅助化疗后,DWImodMR-TRG是一种非常准确的方法,用于评估新辅助化疗后LARC的治疗反应.
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