| PartⅠ Apparent diffusion coefficient single-slice histogram analysis of the early response to chemotherapy in lung cancerAim: To investigate the usefulness of apparent diffuse coefficient(ADC)values derived from diffusion-weighted imaging(DWI)using the single-slice histogram analysis to evaluate the response to chemotherapy in lung cancer.Methods: Twenty-two patients with advanced lung cancer who underwent chemotherapy were included.DWI was obtained before and during chemotherapy and single-slice histogram analysis of ADC values was performed.We recorded peak ADC value(ADCpeak)and lowest ADC value(ADClowest)of the histograms before and during chemotherapy.We assessed the response after chemotherapy of three months on computed tomography and compared the differences of ADC histogram parameters between responders and nonresponders.These parameters and corresponding changes were compared using Student’s t or Mann–Whitney U tests.Results: 13 patients were classified as responders and 9 patients were classified as nonresponders after chemotherapy of three months.After one week of chemotherapy,the longest diameters of target lesions did not differ significantly from pretreatment values both in responders and non-responders(P=0.141,and P=0.899,respectively).There was no significant difference in baseline ADClowest and ADCpeak between responders and nonresponders(P=0.855,P=0.606,respectively).After chemotherapy,13 responders had significant increases in ADClowest and ADCpeak compared with pre-treatment value(P<0.001).9 nonresponders had significant increase in ADClowest(P =0.027),while there was no significant increase in ADCpeak(P =0.065).Changes in ADCpeak were significantly larger in responders than that in nonresponders(P =0.024).Changes in ADClowest were larger without statistical significance after treatment in responders than that in nonresponders(P =0.178).Conclusion: ADC values derived from the single-slice histogram analysis may provide a useful and clinically feasible tool to monitor the early response to chemotherapy in patients with lung cancer.PartⅡ Assessment of Early Response to Chemotherapy in Lung Cancer using semi-quantitative analysis of dynamic contrast-enhanced MRIAim: To assess the early treatment response to chemotherapy in patients with lung cancer using semi-quantitative analysis of dynamic contrast-enhanced MRI.Materials and Methods: Twenty-two patients with lung cancer underwent DCE-MRI before chemotherapy and 1 week after the start of the first course of chemotherapy.Semi-quantitative parameters(PEI,SER,MSI,and TTP)derived from DCE-MRI were generated using the post-processing platform.These parameters and corresponding changes were compared between responders and nonresponders after treatment using Mann–Whitney U tests.Results: After one week of chemotherapy,the longest diameters of target lesions did not differ significantly from pretreatment values both in responders and non-responders(P=0.141,and P=0.899,respectively).Thirteen responders had significant increase in PEI,SER and MSI compared with pretreatment value(P<0.05),and had no significant decrease in TTP(P>0.05).Nine nonresponders had no significant changes compared with pretreatment value(P>0.05).Changes in PEI were significantly larger in the responder group than that in the nonresponder group(P<0.05).Changes in SER,MSI and TTP were without statistical significance after treatment in the responder group than that in the nonresponder group(P>0.05).Conclusion: DCE MRI may be useful for assess the early response to chemotherapy in patients with lung cancer,but larger,more definitive studies are neededPart Ⅲ Assessment of Early Response to Chemotherapy in Lung Cancer using quantitative analysis of dynamic contrast-enhanced MRIAim: The purpose of the study was to evaluate the early treatment response to chemotherapy in patients with lung cancer using quantitative analysis of dynamic contrast-enhanced(DCE)magnetic resonance imaging(MRI).Materials and Methods: Twenty-two patients with lung cancer underwent DCE-MRI before chemotherapy and 1 week after the start of the first course of chemotherapy.Pharmacokinetic parameters(Ktrans,Kep,and Ve)derived from DCE MRI were generated using the post-processing platform.These parameters and corresponding changes were compared between responders and non-responders after treatment using Student’s t or Mann–Whitney U tests.Diagnostic efficiency of kinetic parameters in differentiating responders from non-responders after one week of chemotherapy was also investigated.Results: After one week of chemotherapy,the longest diameters of target lesions did not differ significantly from pretreatment values both in responders and non-responders(P=0.141,and P=0.899,respectively).Thirteen responders after one week of chemotherapy had a significant decrease in Ktrans and Ve compared with pretreatment value(P<0.05),and had no significant changes in Kep(P>0.05).Nine non-responders had no significant changes in Ktrans,Kep,and Ve compared with pretreatment value(P>0.05).Changes in Ktrans(ΔKtrans)were significantly larger in responders than that in non-responders(P<0.05).Changes in Ve and Kep(ΔVe andΔKep)were without statistical significance after treatment between responders and non-responders(P>0.05).The cutoff value of ΔKtrans in best predicting tumor’s chemotherapeutic response was 0.032min-1 and the corresponding AUC(area under the curve),sensitivity,specificity,and accuracy were 0.821,84.62%,77.78%,and 81.82%,respectively.Conclusion: DCE MRI may be useful for evaluating the early response to chemotherapy in patients with lung cancer.ΔKtrans might offer the potential for exploitation as a biomarker. |
PDF Full Text Request