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在评估局部晚期食道状细胞癌中对新辅助疗法的RECIST反应时,MR的表现优于CT

Wenshi Li^1,2, Zhaoqi Wang^1,2, Zihan Wang^1,2

¹Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.

European radiology

|November 18, 2025

概括

磁共振成像 (MRI) 在评估局部晚期食道状细胞癌 (ESCC) 的新辅助疗法 (NAT) 反应方面明显优于对比增强的计算机断层扫描 (CT). 核磁共振能够准确地分层风险,以便进行个性化治疗计划.

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:

局部发达的食道状细胞癌 (ESCC) 需要有效的新辅助疗法 (NAT) 来改善患者的治疗结果.
准确评估NAT反应对于治疗规划和预测预后至关重要.
传统的成像方法,如对比增强计算机断层扫描 (CT),在评估治疗反应方面存在局限性.

研究的目的:

为了比较MRI和对比度增强CT在评估局部发达ESCC中NAT反应的疗效.
为了评估响应评估标准在固体瘤 (RECIST) 和MR瘤回归等级 (mrTRG) 的性能,使用这两种模式.
确定ESCC中NAT后响应评估的首选成像模式.

主要方法:

一项前性单中心研究包括122名局部发达ESCC的患者,他们接受了NAT前后的MRI和对比增强CT.
放射科医生独立评估了使用RECIST对CT和MRI以及mrTRG的治疗反应.
术后病理性瘤回归度 (pTRG) 作为比较的参考标准.

主要成果:

与CT (63.9%) 相比,MRI在区分完全响应 (CR) 和非CR方面表现出更高的准确性 (93.4%).
核磁共振显示与术后病理学高度一致 (κ=0.834),而CT显示没有显著一致 (κ=0.029).
mrTRG系统与pTRG高度相关 (CR/非CR的κ=0.917,GR/非GR的κ=0.710).

结论:

在使用RECIST标准评估局部先进ESCC的新辅助疗法响应方面,MRI优于CT.
mrTRG系统提供了精确的瘤回归分层,与病理发现有很好的相关性.
推MRI作为在ESCC管理中实施RECIST的首选成像方式.

关键词:

食管状细胞癌的癌症磁共振成像技术磁共振成像技术在固体瘤中响应评估标准.断层扫描 (X射线计算) 的使用治疗结果的结果.

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