Dynamic contrast enhanced MRI of pulmonary adenocarcinomas for early risk stratification: higher contrast uptake associated with response and better prognosis

BMC Medical Imaging

Research

Julia Saupe¹  Claus Peter Heussel¹  Stephan Rheinheimer²  Gudula Heussel³  Hans-Ulrich Kauczor⁴  Stella Erdmann⁵  Heiko Golpon⁶  Jens Vogel-Claussen⁷  Julien Dinkel⁸  Petros Christopoulos⁹  Michael Thomas⁹ 

[1] Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126, Heidelberg, Germany;Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany;Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany;German Center for Lung Research (DZL), Giessen, Germany;Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126, Heidelberg, Germany;Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany;Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany;Radiology, Asklepios Hospital Munich, Robert-Koch-Allee 2, 82131, Gauting, Germany;Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126, Heidelberg, Germany;Thoracic Oncology, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126, Heidelberg, Germany;German Center for Lung Research (DZL), Giessen, Germany;Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany;Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany;German Center for Lung Research (DZL), Giessen, Germany;Medical Biometry, Institute of Medical Biometry, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany;German Center for Lung Research (DZL), Giessen, Germany;Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany;Department of Respiratory Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany;German Center for Lung Research (DZL), Giessen, Germany;Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany;Diagnostic and Interventional Radiology and Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany;Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany;German Center for Lung Research (DZL), Giessen, Germany;Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany;Radiology, Asklepios Hospital Munich, Robert-Koch-Allee 2, 82131, Gauting, Germany;German Center for Lung Research (DZL), Giessen, Germany;Translational Lung Research Center Heidelberg (TLRC), University of Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany;Thoracic Oncology, Thoraxklinik at University of Heidelberg, Röntgenstrasse 1, 69126, Heidelberg, Germany;German Center for Lung Research (DZL), Giessen, Germany;

关键词: Non-small-cell lung carcinoma;    Early response;    Treatment outcome;    Response evaluation criteria in solid tumors;    Magnetic resonance imaging;    Perfusion;    Protein-tyrosine kinases;    Platinum;    Survival analysis;    Progression-free survival;   

DOI  :  10.1186/s12880-022-00943-x

 received in 2022-02-23, accepted in 2022-11-28,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundTo explore the prognostic value of serial dynamic contrast-enhanced (DCE) MRI in patients with advanced pulmonary adenocarcinoma undergoing first-line therapy with either tyrosine-kinase inhibitors (TKI) or platinum-based chemotherapy (PBC).MethodsPatients underwent baseline (day 0, n = 98), and post-therapeutic DCE MRI (PBC: day + 1, n = 52); TKI: day + 7, n = 46) at 1.5T. Perfusion curves were acquired at 10, 40, and 70 s after contrast application and analysed semiquantitatively. Treatment response was evaluated at 6 weeks by CT (RECIST 1.1); progression-free survival (PFS) and overall survival  were analysed with respect to clinical and perfusion parameters. Relative uptake was defined as signal difference between contrast and non-contrast images, divided by the non-contrast signal. Predictors of survival were selected using Cox regression analysis. Median follow-up was 825 days.ResultsIn pre-therapeutic and early post-therapeutic MRI, treatment responders (n = 27) showed significantly higher relative contrast uptake within the tumor at 70 safter application as compared to non-responders (n = 71, p ≤ 0.02), response defined as PR by RECIST 1.1 at 6 weeks. There was no significant change of perfusion at early MRI after treatment. In multivariate regression analysis of selected parameters, the strongest association with PFS were relative uptake at 40 s in the early post-treatment MRI and pre-treatment clinical data (presence of liver metastases, ECOG performance status).ConclusionHigher contrast uptake within the tumor at pre-treatment and early post-treatment MRI was associated with treatment response and better prognosis. DCE MRI of pulmonary adenocarcinoma may provide important prognostic information.

【 授权许可】

CC BY   
© The Author(s) 2022

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