DCE-MRI Perfusion and Permeability Parameters as predictors of tumor response to CCRT in Patients with locally advanced NSCLC

Abstract

In this prospective study, 36 patients with stage III non-small cell lung cancers (NSCLC), who underwent dynamic contrast-enhanced MRI (DCE-MRI) before concurrent chemo-radiotherapy (CCRT) were enrolled. Pharmacokinetic analysis was carried out after non-rigid motion registration. The perfusion parameters [including Blood Flow (BF), Blood Volume (BV), Mean Transit Time (MTT)] and permeability parameters [including endothelial transfer constant (Ktrans), reflux rate (Kep), fractional extravascular extracellular space volume (Ve), fractional plasma volume (Vp)] were calculated, and their relationship with tumor regression was evaluated. The value of these parameters on predicting responders were calculated by receiver operating characteristic (ROC) curve. Multivariate logistic regression analysis was conducted to find the independent variables. Tumor regression rate is negatively correlated with Ve and its standard variation Ve_SD and positively correlated with Ktrans and Kep. Significant differences between responders and non-responders existed in Ktrans, Kep, Ve, Ve_SD, MTT, BV_SD and MTT_SD (P < 0.05). ROC indicated that Ve < 0.24 gave the largest area under curve of 0.865 to predict responders. Multivariate logistic regression analysis also showed Ve was a significant predictor. Baseline perfusion and permeability parameters calculated from DCE-MRI were seen to be a viable tool for predicting the early treatment response after CCRT of NSCLC.

Dynamic Contrast-Enhanced MR Imaging of Nonenhancing T2 High-Signal-Intensity Lesions in Baseline and Posttreatment Glioblastoma: Temporal Change and Prognostic Value

“…Although brain tumors are different from other tumors due to their unique BBB structure, previous studies of malignant tumors outside the brain, such as cervical cancer, colorectal cancer, and lung cancer, have demonstrated that increased permeability or angiogenesis was related to a favorable tumor response. [11][12][13] Therefore, there is a possibility that increased permeability at certain time points might be related to a favorable treatment response.…”

Development of Kinetic Modeling to Assess Multi-functional Vascular Response to Low Dose Radiation in Leukemia

“…Changes in these underlying parameters occur early in the progression of malignant disease, making ν ec and K trans useful as potential biomarkers and for assessing drug or oxygen delivery. Both K trans and ν ec have been clinically used as predictive markers of disease and treatment response, demonstrating their relevance in prognosis and treatment evaluation [2][3][4]30].Limited work has been done with microscopy to perform tissue compartment modeling to identify vascular permeability [12,22]. Moreover, to our knowledge there have been no successful attempts to fit time-lapsed microscopy data of local plasma and tissue concentrations to perform compartment modeling and obtain K trans and ν ec for the local vasculature.…”

Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Advanced Cervical Carcinoma: The Advantage of Perfusion Parameters From the Peripheral Region in Predicting the Early Response to Radiotherapy

“…The application of automatically extracted personalized AIFs is limited because of various factors, such as motion artifacts and temporal resolutions. 21 Therefore, we used a manual selection of individual AIFs with an ROI placed on internal iliac artery on transverse plane at the peak arterial enhancement phase. Second, Tofts mode was selected to calculate the perfusion parameters because that this model gave good fits to data and the signal-tonoise ratio was sufficiently high that parametric images were not influenced significantly by noise.…”