Assessment Of Early Response To Tyrosine Kinase Inhibitors In Non-small Cell Lung Cancer:Value Of Diffusion-Weighted And Dynamic Contrast-Enhanced MRI

Assessment of early response to tyrosine kinase inhibitors in non-small cell lung cancer:the value of ADC in diffusion-weighted MR imagingObjective:To investigate quantitative parameters of ADC value obtained from diffusion weighted MR imaging (DWI) as early response predictors in advanced NSCLC patients who received tyrosine kinase inhibitors targeted therapy.Method:19 patients with stage ⅢB or Ⅳ NSCLC prospectively recruited from May 2014 to December 2015 were treated with tyrosine kinase inhibitors and underwent CT scan before treatment(preT).DWI was performed at baseline and one week(postTl) and four weeks (postT2)after the initiation of treatment.Tumor response、ADC.value and their principals were analysed with SPSS 18.0.Paired t test analysis was performed to investigate the significance of the difference between the maximal diameter as well as the ADC value of the baseline and after the therapy。Spearman or Pearson test was conducted to explore the correlation between the ADC value at baseline as we-11 as at postTl and the tumor response at postTx.Repeated Measurements was applied to assessed the significance of the ADC value changement in the responders group and nonresponders group.Bland-Altman analysis was performed to confirm the reproduci-bility of measurements.Result:ADC value were significantly increased after one week(p=0.000),while the change of maximal diameter were no significant (p=0.216).ADC value as well as the maximal diameter at postT2 were significantly changed compared with at baseline(p were both 0.000).Significance of the correlation was detected between the ADC at baseline and the maximal diameter change at 4 weeks later(Pearson r2=-0.474, p=0.047),No other significance of the correlation was found between the ADC value and the tumor response(all p> 0.05).Compared with the last ADC value of the responders significant increase were found.Only the difference of the ADC value at post T2 between the two groups was found significant.The reproducibility of measurements was good confirmed by the Bland-Altman analysis.Conclusion:ADC of DCE-MRI, as early biomarkers, have the potential to evaluate and predict therapeutic responses to molecular targeted therapy in NSCLC.Assessment of early response to tyrosine kinase inhibitors in non-small cell lung cancer:the value of dynamic contrast-enhanced MR imagingObjective:To investigate quantitative parameters of Ktrans、kep and Ve obtained from dynamic contrast-enhanced MR imaging (DCE-MRI) as early response predictors in advanced NSCLC patients who received tyrosine kinase inhibitors targeted therapy.Method:19 patients with stage ⅢB or ⅣNSCLC prospectively recruited from May 2014 to December 2015 were treated with tyrosine kinase inhibitors and underwent CT scan before treatment(preT).DCE-MRI was performed at baseline and one(postTl) and four(postT2) weeks after the initiation of treatment.Tumor response-..quantitative pharmacokinetic parameters and their principals were analysed with SPSS 18.0.Wilcox-on signed rank test or Paired t test analysis was performed to investigate the significance of the difference between the maximal diameter as well as the pharmacokinetic parameters of the baseline and after the therapy.Spearman or Pearson test was conducted to explorer the correlation between the pharmacokinetic parameters at baseline as well as at postTl and the tumor response at postTx.Repeated Measurements was appl-ied to assessed the significance of the pharmacokinetic parameters alteration in the responders group or nonresponders group.Bland-Altman analysis was performed to confi-rm the reproducibility of measurements.Result:Ktrans value were significantly decreased after one week(p was 0.020),while the change of kep and Ve value and maximal diameter were no significant(all p> 0.05).Ktrans value as well as the maximal diameter at postT2 were significantly decreased compared with at postTl (p was 0.021 and 0.000 respectively),while the change of kep and Ve value were no significant.No significance of the correlation was found between the quantitative pharmacokinetic parameters and the tumor response(all p>0.05).Ktrans value of the responders were found significantly reduced when compared with the lastone (p was 0.024 and 0.027 respectively).At post T2,significance of the Ktrans value w-as found between the responders and non-responders(p was 0.026).Conclusion:Ktrans of DCE-MRI, as early biomarkers, have the potential to evaluate therapeutic responses to molecular targeted therapy in NSCLC.