摘要
目的探讨DCE-MRI定量参数在前列腺癌雄激素阻断疗法(androgen deprivation therapy,ADT)疗效评价中的应用价值。方法分析经病理证实并行ADT治疗的15例前列腺癌患者治疗前、后的肿瘤体积及DCE-MRI的参数变化。15例患者分别于ADT治疗前、后行常规和动态增强MRI检查,将DCE-MRI数据导入Omni Kinetics Manual软件,应用Extended Tofts双室模型,测量癌灶治疗前、后的容积转运常数(Ktrans)、速率常数(Kep)、血管外细胞外容积分数(Ve)、血流量(BF)、血容量(BV),并对各参数进行统计学分析。结果 15例患者治疗后病变体积均明显缩小,差异有统计学意义(P <0. 001)。治疗后肿瘤组织的Ktrans、Kep、BF、BV值均降低,差异有统计学意义(P <0. 05)。对癌灶Ktrans、Kep、BF、BV治疗前后的差值与治疗前参数值及治疗前后体积变化进行相关分析:Ktrans差值与治疗前Ktrans值高度相关(r=0. 878),Kep差值与治疗前Kep值显著相关(r=0. 942),BF差值与治疗前BF值高度相关(r=0. 856),BV差值与治疗前BV值中度相关(r=0. 776); P均<0. 001。治疗前后各参数值变化与体积变化无相关性(P> 0. 05)。结论 DCE-MRI定量参数Ktrans、Kep、BF可用于前列腺癌ADT治疗后疗效评价,为个体化治疗及治疗方案的调整提供依据。
Objective To investigate the value of quantitative dynamic contrast-enhanced MRI （DCE-MRI） in monitoring response to androgen deprivation therapy （ADT） for patients with prostate cancer.Methods This study included 15 men with pathologically confirmed prostate cancer who received ADT treatment. All cases underwent routine MRI and DCE-MRI before and after ADT for prostate cancer. DCE-MRI data were imported into the Omni Kinetics Manual software to measure the values of volume transfer constant （K ^trans ）,rate constant （K ep ）, extracellular volume fraction （V e）, blood flow （BF） and blood volume （BV） using the Extended Tofts two-compartment Model; ROIs were drawn on cancerous regions pre- and post-ADT. All the values of quantitative parameters were analyzed statistically.Results The volume of prostate cancer of all cases was reduced remarkably after treatment （ P 〈0.001）. The values of K^trans, K ep , BF and BV of tumor tissues were decreased with statistically significant differences after treatment （ P 〈0.05）. Pearson correlation analysis showed that the d-value of K trans （pre-K^trans minus post-K ^trans ） was highly correlated with the value of pre-K ^trans （ r =0.878）, the d-value of K ep significantly correlated with the value of pre-K ep （ r =0.942）, the d-value of BF highly correlated with the value of pre-BF （ r =0.856）, and the d-value of BV moderately correlated with the value of pre-BV （ r =0.776）; P 〈0.001. The changes of MRI parameters and volume in tumor pre -and post- ADT were not correlated （ P 〉0.05）.Conclusion The values of Ktrans,K ep , BF and BV of prostate cancer reduced remarkably after ADT, and the changes of K^trans, K ep and BF pre- and post-ADT were significantly or highly correlated with the values of K ^trans , K ep and BF before, respectively. Therefore, the quantitative parameters K^ trans , K ep and BF in DCE-MRI can be used to assess treatment efficacy of prostate cancer after ADT, thereby providing the basis f
作者
王洁琼
FANG Jieqiong(Department of Radiology,Taikang Xianlin Drum Tower Hospital,Nanfing 210046,P.R.China)
出处
《医学影像学杂志》
2018年第10期1705-1708,共4页
Journal of Medical Imaging
关键词
前列腺癌
磁共振成像
动态增强
疗效评估
Prostate cancer
Magnetic resonance imaging
Dynamic contrast enhancement
Treatment efficacy evaluation
