当前位置: X-MOL 学术Radiother. Oncol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
A prospective, multi-centre trial of multi-parametric MRI as a biomarker in anal carcinoma
Radiotherapy and Oncology ( IF 4.9 ) Pub Date : 2020-03-01 , DOI: 10.1016/j.radonc.2019.10.001
Michael Jones 1 , George Hruby 2 , Catherine Coolens 3 , Brandon Driscoll 3 , Peter Stanwell 4 , Mahesh Kumar 5 , Anne Capp 5 , Swetha Sridharan 5 , Jameen Arm 6 , Sarah Gallagher 5 , Carl Holder 7 , Christopher Oldmeadow 7 , Jarad Martin 8
Affiliation  

BACKGROUND AND PURPOSE To investigate the role of multi-parametric magnetic resonance imaging (MP-MRI) as a biomarker for squamous cell carcinoma of the anal canal (SCCAC). MATERIALS AND METHODS From January 2013 to January 2017, 25 patients with non-metastatic SCCAC were enrolled in a multi-centre prospective clinical trial, of whom 20 completed protocol treatment. MP-MRIs, incorporating diffusion weighted magnetic resonance imaging (DW-MRI) and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) sequences, were performed before (baseline), during the second and fourth weeks of chemo-radiotherapy (CRT), and 8 weeks following treatment completion. Histogram analysis of multi-parametric maps generated maximum, mean, median, minimum, skewness, kurtosis, and standard deviation metrics. Exact logistic regression and ROC AUC analyses were performed for each metric at every timepoint. An elastic net LASSO logistic regression was also performed using all measures at each timepoint. RESULTS With a median follow up of 17.1 months, 3/20 patients had a local recurrence, and 5/20 had any recurrence. Several apparent diffusion coefficient (ADC) metrics extracted from DW-MRIs correlated with local recurrence and demonstrated excellent discrimination: baseline skewness (p = 0.04, ROC AUC 0.90) and standard deviation (SD) (p = 0.02, ROC AUC 0.90), week 2 skewness (p = 0.02, ROC AUC 0.91) and SD (p = 0.01, ROC AUC 0.94), week 4 kurtosis (p = 0.01, AUC 0.92) and SD (p = 0.01, ROC AUC 0.96). Changes in minimum ADC between baseline and week 2 (p = 0.02, ROC AUC 0.94) and baseline and week 4 (p = 0.02, ROC AUC 0.94) were prognostic for local recurrence. For prediction of any recurrence, ADC minimum (p = 0.02, ROC AUC 0.87) and SD (p = 0.01, ROC AUC 0.85) at baseline, and ADC maximum (p = 0.03, ROC AUC 0.77) and SD (p = 0.02, ROC AUC 0.81) at week 4 were significant. On LASSO logistic regression, ADC minimum and SD at baseline were retained for any recurrence. The only significant finding for DCE-MRI was a correlation of k-trans min at the second follow-up with local recurrence (p = 0.05, AUC 0.84). CONCLUSION Several ADC parameters at various time points correlate with recurrence suggesting DW-MRI is a potential biomarker for SCCAC.

中文翻译:

多参数 MRI 作为肛门癌生物标志物的前瞻性、多中心试验

背景和目的 研究多参数磁共振成像 (MP-MRI) 作为肛管鳞状细胞癌 (SCCAC) 生物标志物的作用。材料与方法 2013 年 1 月至 2017 年 1 月,25 例非转移性 SCCAC 患者参加了一项多中心前瞻性临床试验,其中 20 例完成了方案治疗。MP-MRI 结合弥散加权磁共振成像 (DW-MRI) 和动态对比增强磁共振成像 (DCE-MRI) 序列,在放化疗 (CRT) 的第二周和第四周之前(基线)进行,和治疗完成后 8 周。多参数图的直方图分析生成最大值、平均值、中值、最小值、偏度、峰度和标准偏差度量。在每个时间点对每个指标进行精确的逻辑回归和 ROC AUC 分析。还在每个时间点使用所有测量值进行弹性网络 LASSO 逻辑回归。结果 中位随访时间为 17.1 个月,3/20 患者出现局部复发,5/20 出现任何复发。从 DW-MRI 中提取的几个表观扩散系数 (ADC) 指标与局部复发相关并显示出极好的辨别力:基线偏度(p = 0.04,ROC AUC 0.90)和标准偏差(SD)(p = 0.02,ROC AUC 0.90),周2 偏度(p = 0.02,ROC AUC 0.91)和 SD(p = 0.01,ROC AUC 0.94),第 4 周峰度(p = 0.01,AUC 0.92)和 SD(p = 0.01,ROC AUC 0.96)。基线和第 2 周(p = 0.02,ROC AUC 0.94)和基线和第 4 周(p = 0.02,ROC AUC 0. 94) 是局部复发的预后因素。对于任何复发的预测,基线时的 ADC 最小值(p = 0.02,ROC AUC 0.87)和 SD(p = 0.01,ROC AUC 0.85),以及 ADC 最大值(p = 0.03,ROC AUC 0.77)和 SD(p = 0.02,第 4 周的 ROC AUC 0.81) 是显着的。在 LASSO 逻辑回归中,ADC 最小值和基线 SD 保留用于任何复发。DCE-MRI 的唯一重要发现是第二次随访时 k-trans min 与局部复发的相关性(p = 0.05,AUC 0.84)。结论 不同时间点的几个 ADC 参数与复发相关,表明 DW-MRI 是 SCCAC 的潜在生物标志物。在 LASSO 逻辑回归中,ADC 最小值和基线 SD 保留用于任何复发。DCE-MRI 的唯一重要发现是第二次随访时 k-trans min 与局部复发的相关性(p = 0.05,AUC 0.84)。结论 不同时间点的几个 ADC 参数与复发相关,表明 DW-MRI 是 SCCAC 的潜在生物标志物。在 LASSO 逻辑回归中,ADC 最小值和基线 SD 保留用于任何复发。DCE-MRI 的唯一重要发现是第二次随访时 k-trans min 与局部复发的相关性(p = 0.05,AUC 0.84)。结论 不同时间点的几个 ADC 参数与复发相关,表明 DW-MRI 是 SCCAC 的潜在生物标志物。
更新日期:2020-03-01
down
wechat
bug