[1]苏宝安,许之晨,李艾恩. 3.0T MR弥散加权成像评价中晚期食管鳞癌放化疗的早期疗效[J].中国医学物理学杂志,2018,35(12):1452-1456.[doi:DOI:10.3969/j.issn.1005-202X.2018.12.016]
　SU Baoan,XU Zhichen,LI Aien. Evaluation of the early therapeutic effect of radiotherapy and chemotherapy for advanced esophageal squamous cell carcinoma by 3.0T MR diffusion weighted imaging[J].Chinese Journal of Medical Physics,2018,35(12):1452-1456.[doi:DOI:10.3969/j.issn.1005-202X.2018.12.016]
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 3.0T MR弥散加权成像评价中晚期食管鳞癌放化疗的早期疗效()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
35卷
期数:
2018年第12期
页码:
1452-1456
栏目:
医学影像物理
出版日期:
2018-12-24

文章信息/Info

Title:
 Evaluation of the early therapeutic effect of radiotherapy and chemotherapy for advanced esophageal squamous cell carcinoma by 3.0T MR diffusion weighted imaging
文章编号:
1005-202X（2018）12-1452-05
作者:
 苏宝安; 许之晨; 李艾恩
 泉州市第一医院放疗科， 福建 泉州 362000
Author(s):
 SU Baoan;  XU Zhichen;  LI Aien
 Department of Radiotherapy, the First People’s Hospital of Quanzhou City, Quanzhou 362000, China
关键词:
 ; 【关键词】磁共振; 弥散加权成像; 食管鳞癌/药物治疗; 食管鳞癌/放射治疗; 早期疗效
Keywords:
 ; Keywords: magnetic resonance;  diffusion-weighted imaging;  esophageal squamous carcinoma/drug therapy;  esophageal squamous carcinoma/radiotherapy;  early therapeutic effect
分类号:
R445.2；R735.1
DOI:
DOI:10.3969/j.issn.1005-202X.2018.12.016
文献标志码:
A
摘要:
 【摘 要】 目的：探讨3.0 T磁共振（MR）弥散加权成像（DWI）在评价中晚期食管鳞癌放化疗早期疗效的应用价值。 方法：收集2016年6月~2017年12月在泉州市第一医院拟行根治性放化疗的53例中晚期食管癌患者，于治疗前后不同时间点行常规MR平扫及DWI检查。根据近期疗效评价结果分为有效组和无效组，比较两组治疗前后肿瘤ADC值、△ADC及肿瘤最大径变化，对ADC值变化率评价食管癌放化疗早期疗效进行ROC曲线分析。 结果：本组53例患者，有效41例，无效12例。有效组与无效组在治疗1周末、治疗2周末及治疗结束时ADC值均逐渐增高（P<0.05），且有效组在上述各时点的△ADC均显著高于无效组（P<0.05）。两组在治疗1周末肿瘤最大径与治疗前比较差异无统计学意义（P>0.05），治疗2周末及治疗结束时较治疗前均明显减小（P<0.05）。ROC曲线分析显示，治疗1周末ROC曲线下面积最大（0.785），以该时刻ADC值变化率（15.5%）为阈值，评价放化疗近期疗效是否有效的敏感性为86.5%、特异性为69.8%、阳性预测值为89.4%、阴性预测值为63.4%。 结论：MR-DWI对评价食管磷癌放化疗早期疗效有重要价值，治疗1周末的ADC值变化率可作为优选疗效预测时间点。
Abstract:
 Abstract: Objective To investigate the value of 3.0T magnetic resonance (MR) diffusion weighted imaging (DWI) in evaluating the early therapeutic effect of radiotherapy and chemotherapy for advanced esophageal squamous cell carcinoma. Methods A total of 53 patients with advanced esophageal cancer who were scheduled for radical radiotherapy and chemotherapy in the First People’s Hospital of Quanzhou City from June 2016 to December 2017 were selected. Routine plain MR scan and DWI examination were performed at different time points before and after treatment. According to the short-term therapeutic effect, the patients were assigned into effective group and ineffective group. The changes of apparent diffusion coefficient (ADC) values, △ADC and the maximum diameter of the tumor before and after treatment were compared between two groups. The change rate of ADC value in evaluation of early therapeutic effect of radiotherapy and chemotherapy for esophageal cancer was analyzed by receiver operating characteristic curve (ROC) curve. Results Forty-one cases were assigned into effective group and 12 cases in ineffective group. ADC values of effective group and ineffective group gradually increased after 1 week of treatment, after 2 weeks of treatment and at the end of treatment (P<0.05), and △ADC was significantly higher in effective group than in ineffective group at above time points (P<0.05). There was no significant differences of the maximum diameter of the tumor in two groups before treatment and after 1 week of treatment (P>0.05), but the diameter was significantly decreased after 2 weeks of treatment and at the end of treatment (P<0.05). ROC curve analysis showed that the area under ROC curve was the largest after 1 week of treatment (0.785). With the change rate of ADC at this time point (15.5%) as the threshold, the sensitivity, specificity, positive predictive value and negative predictive value for evaluating the short-term therapeutic effect of radiotherapy and chemotherapy were 86.5%, 69.8%, 89.4% and 63.4%, respectively. Conclusion MR-DWI is of great value in evaluating the early therapeutic effect of radiotherapy and chemotherapy for esophageal squamous cell carcinoma. The change rate of ADC value after 1 week of treatment can be used as the optimal time point for predicting the therapeutic effect.

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备注/Memo

备注/Memo:
 【收稿日期】2018-07-11
【作者简介】苏宝安，副主任医师，研究方向：恶性肿瘤放射治疗，E-mail: 3393436965@qq.com
更新日期/Last Update: 2018-12-26