多参数磁共振成像(mp-MRI)对NSCLC非手术疗效的评估和预测价值

Multi-parameter magnetic resonance imaging(mp-MRI)for non-operative efficacy evaluation and prediction of non-small cell lung cancer

目的探讨多参数磁共振成像对非小细胞肺癌非手术疗效的评估和预测价值。方法49例非手术NSCLC病例在治疗前、治疗1个疗程、治疗2个疗程行mp-MRI扫描。分析ADC改变与靶病灶最长径之和变化的相关性。按照RECIST1.1标准将病例分有效组和无效组,计算第1疗程SLD、ADC值、ADC值变化率、ADC值变化量及四组参数联合对第2疗程NSCLC疗效的ROC曲线下面积。结果第1疗程ADC值改变与第2疗程SLD变化之间呈正相关。第1疗程SLD较治疗前无统计学差异(t值0.177、P值0.859),第2疗程SLD改变较治疗前有显著统计学差异(t值7.410、P值<0.0001)。四组参数联合预测NSCLC疗效效能明显提高AUC为0.789。结论mp-MRI中SLD联合ADC值改变对NSCLC非手术疗效评价和预测效能较高,可以用于NSCLC非手术疗效的评估及预测。

Objective To investigate the evaluation and predictive value of mp-MRI for non-surgical efficacy of non-small cell lung cancer.Methods 49 cases of non-surgical NSCLC underwent mp-MRI scans before,and 1 course and 2 courses after treatment.The correlation between the change of ADC and the change of the sum of the longest diameter of the target lesion was analyzed.According to the RECIST1.1 standard,the cases were divided into the effective group and the ineffective group.The value of SLD and ADC,and the change rate and amount of ADC were calculated in the first course of treatment,and the area under the ROC curve of the four parameters combined for the second course of NSCLC was calculated.Results There was a positive correlation between the change of ADC value in the first course of treatment and the change of SLD in the second course of treatment.The SLD in the first course of treatment showed no difference with before treatment(t=0.177,P=0.859),and the SLD change in the second course of treatment was more significant than before treatment(t=7.410,P<0.001).The four groups of parameters combined to predict the efficacy of NSCLC significantly improved the AUC to 0.789.Conclusion The SLD combined with ADC value change in mp-MRI has a high efficiency in evaluating and predicting the non-surgical efficacy of NSCLC,and it can be used for the evaluation and prediction of non-surgical efficacy of NSCLC.