摘要
目的基于磁共振体素内不相干运动-弥散加权成像(IVIM-DWI)技术评估中晚期肺癌化疗疗效,以指导临床制订早期化疗方案。方法回顾性纳入该院2020年1月至2022年12月经病理证实的中晚期肺癌患者24例,对所有患者行磁共振IVIM-DWI扫描,获取肿瘤最大层面表观扩散系数(ADC)、灌注相关扩散系数(Dstar)、单纯扩散系数(D)及灌注分数(f)值等参数。比较化疗前、后,以及化疗有效组与化疗无效组间各参数的差异;绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),分析参数评估肺癌化疗疗效的效能。结果肺癌患者化疗前Dstar、f值均明显高于化疗后[(32394.3±220.3)μm^(2)/s vs.(35517.4±256.2)μm^(2)/s,0.39±0.10 vs.0.41±0.09,P<0.05],化疗前后ADC、D无明显差异(P>0.05);化疗有效组Dstar、f值明显低于化疗无效组[(25138.2±167.2)μm^(2)/s vs.(36844.7±178.3)μm^(2)/s,0.42±0.10 vs.0.43±0.06,P<0.05],两组ADC、D无明显差异(P>0.05);f值及Dstar评估中晚期肺癌化疗疗效的AUC分别为0.707、0.769。结论IVIM-DWI的f值、Dstar可有效评估中晚期肺癌化疗效果。
Objective To evaluate the efficacy of chemotherapy for advanced lung cancer based on magnetic resonance intravoxel incoherent motion-diffusion weighted imaging(IVIM-DWI)technology and provide guidance for the development of early chemotherapy regimens in clinical practice.Methods A total of 24 patients with advanced lung cancer,confirmed by pathology in this hospital from January 2020 to December 2022,were retrospectively included.Magnetic resonance IVIM-DWI scans were performed on all patients,and the parameters such as apparent diffusion coefficient(ADC),perfusion-related diffusion coefficient(Dstar),simple diffusion coefficient(D),and perfusion fraction(f)of tumor were obtained.The parameters were compared between before and after chemotherapy,as well as between the chemotherapy effective group and chemotherapy ineffective group.The receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was calculated to analyze the effectiveness of each parameter in evaluating the efficacy of lung cancer.Results The Dstar and f value of lung cancer patients before chemotherapy were significantly higher than those after chemotherapy[(32394.3±220.3)μm^(2)/s vs.(35517.4±256.2)μm^(2)/s,0.39±0.10 vs.0.41±0.09,P<0.05].There was no statistically significant difference in ADC and D value between before and after chemotherapy(P>0.05).The Dstar and f value in the chemotherapy effective group were significantly lower than those in the chemotherapy ineffective group[(25138.2±167.2)μm^(2)/s vs.(36844.7±178.3)μm^(2)/s,0.42±0.10 vs.0.43±0.06,P<0.05],while there was no statistically significant difference in ADC and D value between the two groups(P>0.05).The AUC values of f and Dstar,which wereused to assess the efficacy of chemotherapy for advanced lung cancer,were 0.707 and 0.769,respectively.Conclusion The f value and Dstar of IVIM-DWI can effectively evaluate the efficacy of chemotherapy in advanced lung cancer.
作者
陈德全
谢艳君
官彬
王祝
何骥
杨理丹
阙昌友
沈国洪
CHEN Dequan;XIE Yanjun;GUAN Bin;WANG Zhu;HE Ji;YANG Lidan;QUE Changyou;SHEN Guohong(Department of Radiology,Hechuan District People’s Hospital,Chongqing 401520,China)
出处
《重庆医学》
CAS
2023年第16期2494-2498,2506,共6页
Chongqing medicine
基金
重庆市合川区科技局科技计划项目(合川-2019-28)。
关键词
肺癌
化学治疗
体素内不相干运动
弥散加权成像
疗效
lung carcinoma
chemotherapy
intravoxel incoherent motion
diffusion weighted imaging
efficacy
