Prognostic value of dynamic MR imaging for non‐small‐cell lung cancer patients after chemoradiotherapy

Abstract

Purpose:To determine the prognostic value of dynamic MRI for non-small-cell lung cancer (NSCLC) patients after chemoradiotherapy. Materials and Methods:A total of 114 consecutive patients with NSCLC underwent dynamic MRI after chemoradiotherapy. The patients were divided into two groups (local control (n ϭ 22) and local failure (n ϭ 92)) according to the presence of local recurrence. From the signal intensity-time course curve in each subject, the maximum relative enhancement ratio and slope of enhancement were calculated, and compared between two groups by Student's ttest. To determine the feasible threshold values of both MR indexes for group differentiation, ROC-based positive tests were performed. Finally, the Kaplan-Meier survival curves of each group divided by the adapted threshold value were compared by log-rank test. Results:The maximum relative enhancement ratio and the slope of enhancement in the local control group were significantly lower than those in the local failure group (P Ͻ 0.05). Using 0.08/sec as the threshold value of the slope of enhancement, the sensitivity and specificity for differentiation between the two groups were 90.9% and 91.3%, respectively. When the slope of enhancement was adopted for estimation of prognosis after therapy, the mean survival period of the slope of enhancement Յ 0.08/sec group was significantly longer than that seen in the group with a slope of enhancement Ͼ 0.08/sec (P Ͻ 0.0001). Conclusion:Dynamic MRI has potential prognostic value for NSCLC patients after chemoradiotherapy.

Prediction of Disease-Free Survival in Patients with Squamous Cell Carcinomas of the Head and Neck Using Dynamic Contrast-Enhanced MR Imaging

“…[20][21][22][23] Loncaster et al 24 reported that patients with cervical cancer with high pretreatment contrast enhancement had significantly improved disease-free survival after radiation therapy. In a recent study, higher base- -line); however, the difference is not significant (P ϭ .599).…”

Dynamic perfusion MRI: Capability for evaluation of disease severity and progression of pulmonary arterial hypertension in patients with connective tissue disease

“…On the other hand, in each subject with body weight equal to or more than 70 kg, 5 mL of the same contrast media with 0.5 mmol/mL was administered via a cubital vein by means of the same automatic infusion system at a rate of 5 mL/sec, followed by 20 mL of saline solution at the same rate. The basic theory and application of contrast-enhanced dynamic perfusion MRI has been documented in previous reports (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). After careful instruction, patients practiced the breath-holding technique to reproduce a consistent degree of inspiration for each scan series before the MR studies.…”

“…Recently, a 3D dynamic contrast-enhanced MR perfusion imaging (3D dynamic perfusion MRI) method can qualitatively evaluate regional perfusion differences in the entire lung with high temporal and spatial resolutions (12)(13)(14). Moreover, when combined with the indicator dilution theory and fuzzy cluster analysis, this method can be used for quantitative assessment of regional pulmonary perfusion abnormalities in lung cancer, chronic obstructive lung disease, and PAH patients, prediction of postoperative lung function in lung cancer patients (15)(16)(17)(18)(19), and evaluation of disease severity in primary PAH patients (17,18).…”

DCEMRI monitoring of canine tumors during fractionated radiotherapy

“…Increased tumor enhancement during early therapy has been found to correlate with tumor regression [11] and to be a favorable prognostic factor for local control [9]. However, at the completion of therapy, patients who achieved local control had significantly lower tumor signal enhancement than patients with local failure [13,15]. It has been suggested that the different correlations between signal enhancement and treatment outcome represent different phases of the tumor physiological response to radiotherapy [13].…”

“…For other treatment sites, emphasis has often been on post treatment DCEMR imaging. In head and neck cancers, the enhancement post treatment correlated positively with treatment failure, residual tumor cells and tumor recurrence [12Á14], while signal enhancement and initial enhancement rate post treatment correlated positively with treatment failure in lung cancer [15].…”