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Diffusion-weighted MRI predicts the histologic response for neoadjuvant therapy in patients with pancreatic cancer: a prospective study (DIFFERENT trial).

扩散加权 MRI 预测胰腺癌患者新辅助治疗的组织学反应: 一项前瞻性研究 (不同试验)。

  • 影响因子:2.30
  • DOI:10.1007/s00423-020-01857-4
  • 作者列表:"Okada KI","Kawai M","Hirono S","Kojima F","Tanioka K","Terada M","Miyazawa M","Kitahata Y","Iwahashi Y","Ueno M","Hayami S","Murata SI","Shimokawa T","Yamaue H
  • 发表时间:2020-01-28
Abstract

PURPOSE:Pre-operative prediction of histological response to neoadjuvant therapy aids decisions regarding surgical management of borderline resectable pancreatic cancer (BRPC). We elucidate correlation between pre-/post-treatment whole-tumor apparent diffusion coefficient (ADC) value and rate of tumor cell destruction. We newly verify whether post-treatment ADC value at the site of vascular contact predicts R0 resectability of BRPC. METHODS:We prospectively reviewed 28 patients with BRPC who underwent diffusion-weighted magnetic resonance imaging before neoadjuvant chemotherapy and surgery. Correlation between the percentage of tumor cell destruction and various parameters was analyzed. Strong parameters were assessed for their ability to predict therapeutic histological response and R0 resectability. RESULTS:Pre-/post-treatment whole-tumor ADC value correlated with tumor cell destruction rate by all parameters (R = 0.630/0.714, P  50% was determined at 1.40 × 10-3 mm2/s. It predicts histological response with 100% sensitivity, 81% specificity, and 89% accuracy. It predicts R0 with 88% sensitivity, 70% specificity, and 75% accuracy. CONCLUSIONS:Post-treatment whole-tumor ADC value may be a predictor of R0 resectability in patients with BRPC. Tumor cell destruction rate is indicated by the difference between pre-/post-treatment ADC values. This difference is strongly affected by the pre-treatment ADC value. The cutoff value of ADC at the site of vascular contact could not discriminate R0 resectability.

摘要

目的: 术前预测新辅助治疗的组织学反应有助于决定临界可切除胰腺癌 (BRPC) 的手术治疗。我们阐明了治疗前/后全肿瘤表观扩散系数 (ADC) 值与肿瘤细胞破坏率之间的相关性。我们新验证血管接触部位的治疗后 ADC 值是否预测 BRPC 的基本传染数可切除性。 方法: 我们前瞻性回顾了 28 例在新辅助化疗和手术前接受磁共振弥散加权成像的 BRPC 患者。分析肿瘤细胞破坏百分比与各参数的相关性。强参数评估其预测治疗组织学反应和基本传染数可切除性的能力。 结果: 治疗前/后全瘤 ADC 值与各参数肿瘤细胞破坏率相关 (r = 0.630/0.714, p   50% 测定为 1.40 × 10-3平方毫米/s。它以 100% 的敏感性、 81% 的特异性和 89% 的准确性预测组织学反应。它以 88% 的敏感性、 70% 的特异性和 75% 的准确性预测基本传染数。 结论: 治疗后的全瘤 ADC 值可能是 BRPC 患者基本传染数可切除性的预测因子。肿瘤细胞破坏率由治疗前/后 ADC 值之间的差值表示。这种差异受到治疗前 ADC 值的强烈影响。ADC 在血管接触部位的截断值不能区分基本传染数可切除性。

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翻译标题与摘要 下载文献
影响因子:2.30
发表时间:2020-01-28
DOI:10.1007/s00423-020-01857-4
作者列表:["Okada KI","Kawai M","Hirono S","Kojima F","Tanioka K","Terada M","Miyazawa M","Kitahata Y","Iwahashi Y","Ueno M","Hayami S","Murata SI","Shimokawa T","Yamaue H"]

METHODS:PURPOSE:Pre-operative prediction of histological response to neoadjuvant therapy aids decisions regarding surgical management of borderline resectable pancreatic cancer (BRPC). We elucidate correlation between pre-/post-treatment whole-tumor apparent diffusion coefficient (ADC) value and rate of tumor cell destruction. We newly verify whether post-treatment ADC value at the site of vascular contact predicts R0 resectability of BRPC. METHODS:We prospectively reviewed 28 patients with BRPC who underwent diffusion-weighted magnetic resonance imaging before neoadjuvant chemotherapy and surgery. Correlation between the percentage of tumor cell destruction and various parameters was analyzed. Strong parameters were assessed for their ability to predict therapeutic histological response and R0 resectability. RESULTS:Pre-/post-treatment whole-tumor ADC value correlated with tumor cell destruction rate by all parameters (R = 0.630/0.714, P  50% was determined at 1.40 × 10-3 mm2/s. It predicts histological response with 100% sensitivity, 81% specificity, and 89% accuracy. It predicts R0 with 88% sensitivity, 70% specificity, and 75% accuracy. CONCLUSIONS:Post-treatment whole-tumor ADC value may be a predictor of R0 resectability in patients with BRPC. Tumor cell destruction rate is indicated by the difference between pre-/post-treatment ADC values. This difference is strongly affected by the pre-treatment ADC value. The cutoff value of ADC at the site of vascular contact could not discriminate R0 resectability.

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