在直肠癌放射治疗期间预测早期反应,使用磁共振图像引导线性加速器的顺序扩散加权成像
Johanna A Hundvin1,2, Jonas Habrich3, Cihan Gani4
1Cancer Clinic, Haukeland University Hospital, Bergen, Norway.
Physics and imaging in radiation oncology
|October 27, 2025
概括
序列扩散权重的MRI可以预测局部晚期直肠癌 (LARC) 中的化学放射治疗反应. 结合基线和治疗中的明显扩散系数 (ADC) 测量,可以提供治疗响应者的早期分层.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 对化疗放射治疗 (CRT) 的反应变化使局部晚期直肠癌 (LARC) 的治疗变得复杂.
- 准确预测治疗反应对于优化LARC管理至关重要.
研究的目的:
- 调查顺序性,在治疗中的扩散权重 (DW) 磁共振 (MR) 图像的预测潜力,以便在接受CRT的LARC患者中及时分层反应.
- 为了评估明显扩散系数 (ADC) 变化对预测治疗结果的有效性.
主要方法:
- 在15名LARC患者的基线和MR指导CRT期间获得了DWMR图像.
- 根据病理回归,瘤反应被归类为好或坏.
- 使用线性混合效应模型分析了平均瘤ADC的变化,并与体积变化进行了比较.
- 接收机运行特征 (ROC) 分析与曲线下的面积 (AUC) 用于时间点调查.
主要成果:
- 与响应较差的患者相比,响应良好的患者在整个治疗过程中显示出显著更高的基线ADC和更大的ADC变化 (p=0.03).
- 表面扩散系数 (ADC) 的变化提供了0.73-0.85的AUC,在五个分数后观察到最的斜率.
- 结合基线ADC和斜率改善了响应差异化,达到AUC高达0.90.
- 基于体积的分层仅在15/25分数后才可行.
结论:
- 序列扩散权重MRI,特别是明显扩散系数 (ADC) 测量,可以在LARC中早期预测化疗疗效应.
- 结合基线和治疗中的ADC数据,显著提高了分层响应者的能力.
- 建议在更大的队列中进行进一步验证,以确认这些有希望的发现.
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