Dynamic contrast-enhanced MRI in malignant pleural mesothelioma: prediction of outcome based on DCE-MRI measurements in patients undergoing cytotoxic chemotherapy

BMC Cancer

Viljem Kovač¹  Katarina Šurlan Popovič²  Sotirios Bisdas³  Martina Vivoda Tomšič⁴  Peter Korošec⁵ 

[1] Faculty of Medicine, University of Ljubljana, Korytkova ulica 2, 1000, Ljubljana, Slovenia;Department of Radiotherapy, Institute of Oncology Ljubljana, Zaloška cesta 2, 1000, Ljubljana, Slovenia;Faculty of Medicine, University of Ljubljana, Korytkova ulica 2, 1000, Ljubljana, Slovenia;Institute of Radiology, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia;Lysholm Department of Neuroradiology, National Hospital of Neurology and Neurosurgery, UCLH, London, UK;University Clinic of Pulmonary and Allergic Diseases Golnik, Golnik 36, 4204, Golnik, Slovenia;Faculty of Medicine, University of Ljubljana, Korytkova ulica 2, 1000, Ljubljana, Slovenia;University Clinic of Pulmonary and Allergic Diseases Golnik, Golnik 36, 4204, Golnik, Slovenia;Faculty of Pharmacy, University of Ljubljana, Aškerčeva cesta 7, 1000, Ljubljana, Slovenia;

关键词: Mesothelioma diagnostic imaging;    Mesothelioma drug therapy;    Magnetic resonance imaging;    Perfusion;    Prognosis;    Cisplatin;    Survival;    Progression free survival;   

DOI  :  10.1186/s12885-022-09277-x

来源: Springer

【 摘 要 】

BackgroundThe malignant pleural mesothelioma (MPM) response rate to chemotherapy is low. The identification of imaging biomarkers that could help guide the most effective therapy approach for individual patients is highly desirable. Our aim was to investigate the dynamic contrast-enhanced (DCE) MR parameters as predictors for progression-free (PFS) and overall survival (OS) in patients with MPM treated with cisplatin-based chemotherapy.MethodsThirty-two consecutive patients with MPM were enrolled in this prospective study. Pretreatment and intratreatment DCE-MRI were scheduled in each patient. The DCE parameters were analyzed using the extended Tofts (ET) and the adiabatic approximation tissue homogeneity (AATH) model. Comparison analysis, logistic regression and ROC analysis were used to identify the predictors for the patient’s outcome.ResultsPatients with higher pretreatment ET and AATH-calculated Ktrans and ve values had longer OS (P≤.006). Patients with a more prominent reduction in ET-calculated Ktrans and kep values during the early phase of chemotherapy had longer PFS (P =.008). No parameter was identified to predict PFS. Pre-treatment ET-calculated Ktrans was found to be an independent predictive marker for longer OS (P=.02) demonstrating the most favourable discrimination performance compared to other DCE parameters with an estimated sensitivity of 89% and specificity of 78% (AUC 0.9, 95% CI 0.74-0.98, cut off > 0.08 min-1).ConclusionsIn the present study, higher pre-treatment ET-calculated Ktrans values were associated with longer OS. The results suggest that DCE-MRI might provide additional information for identifying MPM patients that may respond to chemotherapy.

【 授权许可】

CC BY