BACKGROUND Rectal carcinoma(RC),one of the most common malignancies globally,presents an increasing incidence and mortality year by year,especially among young people,which seriously affects the prognosis and quality ...BACKGROUND Rectal carcinoma(RC),one of the most common malignancies globally,presents an increasing incidence and mortality year by year,especially among young people,which seriously affects the prognosis and quality of life of patients.At present,dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)parameters and serum carbohydrate antigen 19-9(CA19-9)and CA125 Levels have been used in clinical practice to evaluate the T stage and differentiation of RC.However,the accuracy of these evaluation modalities still needs further research.This study explores the application and value of these methods in evaluating the T stage and differentiation degree of RC.AIM To analyze the diagnostic performance of DCE-MRI parameters combined with serum tumor markers(TMs)in assessing pathological processes and prognosis of RC patients.METHODS A retrospective analysis was performed on 104 RC patients treated at Yantai Yuhuangding Hospital from May 2018 to January 2022.Patients were categorized into stages T1,T2,T3,and T4,depending on their T stage and differentiation degree.In addition,they were assigned to low(L group)and moderate-high differentiation(M+H group)groups based on their differentiation degree.The levels of DCE-MRI parameters and serum CA19-9 and CA125 in different groups of patients were compared.In addition,the value of DCE-MRI parameters[volume transfer constant(Ktrans),rate constant(Kep),and extravascular extracellular volume fraction(Ve)in assessing the differentiation and T staging of RC patients was discussed.Furthermore,the usefulness of DCE-MRI parameters combined with serum CA19-9 and CA125 Levels in the evaluation of RC differentiation and T staging was analyzed.RESULTS Ktrans,Ve,CA19-9 and CA125 were higher in the high-stage group and L group than in the low-stage group and M+H Group,respectively(P<0.05).The areas under the curve(AUCs)of the Ktran and Ve parameters were 0.638 and 0.694 in the diagnosis of high and low stages,respectively,and 0.672 and 0.725 in diagnosing moderate-high and low differentiation,respectively.The AUC of DCE-MRI parameters(Ktrans+Ve)in the diagnosis of high and low stages was 0.742,and the AUC in diagnosing moderate-high and low differentiation was 0.769.The AUCs of CA19-9 and CA-125 were 0.773 and 0.802 in the diagnosis of high and low stages,respectively,and 0.834 and 0.796 in diagnosing moderate-high and low differentiation,respectively.Then,we combined DCE-MRI(Ktrans+Ve)parameters with CA19-9 and CA-125 and found that the AUC of DCE-MRI parameters plus serum TMs was 0.836 in the diagnosis of high and low stages and 0.946 in the diagnosis of moderate-high and low differentiation.According to the Delong test,the AUC of DCE-MRI parameters plus serum TMs increased significantly compared with serum TMs alone in the diagnosis of T stage and differentiation degree(P<0.001).CONCLUSION The levels of the DCE-MRI parameters Ktrans and Ve and the serum TMs CA19-9 and CA125 all increase with increasing T stage and decreasing differentiation degree of RC and can be used as indices to evaluate the differentiation degree of RC in clinical practice.Moreover,the combined evaluation of the above indices has a better effect and more obvious clinical value,providing important guiding importance for clinical condition judgment and treatment selection.展开更多
In many areas of oncology, dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) has proven to be a clinically useful, non-invasive functional imaging technique to quantify tumor vasculature and tumor perfusio...In many areas of oncology, dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) has proven to be a clinically useful, non-invasive functional imaging technique to quantify tumor vasculature and tumor perfusion characteristics. Tumor angiogenesis is an essential process for tumor growth, proliferation, and metastasis. Malignant lesions demonstrate rapid extravasation of contrast from the intravascular space to the capillary bed due to leaky capillaries associated with tumor neovascularity. DCE-MRI has the potential to provide information regarding blood flow, areas of hypoperfusion, and variations in endothelial permeability and microvessel density to aid treatment selection, enable frequent monitoring during treatment and assess response to targeted therapy following treatment. This review will discuss the current status of DCE-MRI in cancer imaging, with a focus on its use in imaging prostate malignancies as well as weaknesses that limit its widespread clinical use. The latest techniques for quantification of DCE-MRI parameters will be reviewed and compared.展开更多
Objective： To evaluate the feasibility of dynamic contrast-enhanced magnetic resonance imaging（DCEMRI） for predicting tumor response to radiotherapy in patients with suspected primary central nervous system（CNS） ...Objective： To evaluate the feasibility of dynamic contrast-enhanced magnetic resonance imaging（DCEMRI） for predicting tumor response to radiotherapy in patients with suspected primary central nervous system（CNS） germ cell tumors（GCTs）.Methods： DCE-MRI parameters of 35 patients with suspected primary CNS GCTs were obtained prior to diagnostic radiation, using the Tofts and Kermode model. Radiosensitivity was determined in tumors diagnosed 2 weeks after radiation by observing changes in tumor size and markers as a response to MRI. Taking radiosensitivity as the gold standard, the cut-off value of DCE-MRI parameters was measured by receiver operating characteristic（ROC） curve. Diagnostic accuracy of DCE-MRI parameters for predicting radiosensitivity was evaluated by ROC curve.Results： A significant elevation in transfer constant（K^trans） and extravascular extracellular space（Ve）（P=0.000）, as well as a significant reduction in rate constant（Kep）（P=0.000） was observed in tumors. K^trans, relative K^trans, and relative Kep of the responsive group were significantly higher than non-responsive groups. No significant difference was found in Kep, Ve, and relative Ve between the two groups. Relative K^trans showed the best diagnostic value in predicting radiosensitivity with a sensitivity of 100%, specificity of 91.7%, positive predictive value（PPV） of 95.8%, and negative predictive value（NPV） of 100%.Conclusions： Relative K^trans appeared promising in predicting tumor response to radiation therapy（RT）. It is implied that DCE-MRI pre-treatment is a requisite step in diagnostic procedures and a novel and reliable approach to guide clinical choice of RT.展开更多
In the study,108 patients with endometrial cancer were selected as the observation group,and 105 patients with benign endometrial lesions were selected as the control group.After DCE-MRI examination,it was found that ...In the study,108 patients with endometrial cancer were selected as the observation group,and 105 patients with benign endometrial lesions were selected as the control group.After DCE-MRI examination,it was found that the volume transfer constant(K^(trans)),rate constant(K_(e))and extracellular space volume ratio(V_(e))in the observation group were higher than those in the control group(P<0.05).The area under curve(AUC)of combined K^(trans),K_(e) and V_(e) values in the diagnosis of endometrial cancer was 0.841.The values of K^(trans),K_(e )and V_(e) were positively correlated with the clinical stage and the degree of muscular invasion,but negatively correlated with the degree of differentiation(P<0.05).The results of the study suggested that DCE-MRI quantitative parameters have a certain value in the differential diagnosis of endometrial cancer,which helped to further distinguish the degree of muscular invasion,clinical stage,and differentiation of endometrial cancer patients.展开更多
Background The degree of pathological microvascular proliferation is an important element in evaluation of the astrocytoma grade. This study was aimed to quantitatively assess the microvascular permeability of brain a...Background The degree of pathological microvascular proliferation is an important element in evaluation of the astrocytoma grade. This study was aimed to quantitatively assess the microvascular permeability of brain astrocytoma with the volume transfer constant （Ktrans） and volume of extravascular extracellular space per unit volume of tissue （Ve） from dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） and to evaluate the effectiveness of the Ktr^n＇ and Ve in the grading of astrocytoma. Methods The highest values of the Kt~~s and Ve of 67 patients with astrocytoma （27 with grade II, 12 with grade III, and 28 with grade IV） were obtained. The comparisons of the differences of the Ktrans and Ve between the different grades were conducted using the Mann-Whitney rank-sum tests. Spearman＇s rank correlation coefficients were determined between Ktrans values, Ve values and astrocytoma grades. Receiver operating characteristic （ROC） curve analyses were performed to determine the cut-off values for the Ktrans and Ve to distinguish between the different grades of astrocytoma. Results There were significant differences （P〈0.001） between the different grades in the Ktrans values and Ve values, except for grades III and IV. The Ktrans values and Ve values were both correlated with astrocytoma grades （both P〈0.001）. The ROC curve analyses showed that the cut-off values for the Ktrans and Ve provided the best combination of sensitivity and specificity in distinguishing between grade II and grade III or IV astrocytomas. Conclusions DCE-MRI can play an important role in assessing the microvascular permeability and the grading of brain astrocytoma.展开更多
文摘BACKGROUND Rectal carcinoma(RC),one of the most common malignancies globally,presents an increasing incidence and mortality year by year,especially among young people,which seriously affects the prognosis and quality of life of patients.At present,dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)parameters and serum carbohydrate antigen 19-9(CA19-9)and CA125 Levels have been used in clinical practice to evaluate the T stage and differentiation of RC.However,the accuracy of these evaluation modalities still needs further research.This study explores the application and value of these methods in evaluating the T stage and differentiation degree of RC.AIM To analyze the diagnostic performance of DCE-MRI parameters combined with serum tumor markers(TMs)in assessing pathological processes and prognosis of RC patients.METHODS A retrospective analysis was performed on 104 RC patients treated at Yantai Yuhuangding Hospital from May 2018 to January 2022.Patients were categorized into stages T1,T2,T3,and T4,depending on their T stage and differentiation degree.In addition,they were assigned to low(L group)and moderate-high differentiation(M+H group)groups based on their differentiation degree.The levels of DCE-MRI parameters and serum CA19-9 and CA125 in different groups of patients were compared.In addition,the value of DCE-MRI parameters[volume transfer constant(Ktrans),rate constant(Kep),and extravascular extracellular volume fraction(Ve)in assessing the differentiation and T staging of RC patients was discussed.Furthermore,the usefulness of DCE-MRI parameters combined with serum CA19-9 and CA125 Levels in the evaluation of RC differentiation and T staging was analyzed.RESULTS Ktrans,Ve,CA19-9 and CA125 were higher in the high-stage group and L group than in the low-stage group and M+H Group,respectively(P<0.05).The areas under the curve(AUCs)of the Ktran and Ve parameters were 0.638 and 0.694 in the diagnosis of high and low stages,respectively,and 0.672 and 0.725 in diagnosing moderate-high and low differentiation,respectively.The AUC of DCE-MRI parameters(Ktrans+Ve)in the diagnosis of high and low stages was 0.742,and the AUC in diagnosing moderate-high and low differentiation was 0.769.The AUCs of CA19-9 and CA-125 were 0.773 and 0.802 in the diagnosis of high and low stages,respectively,and 0.834 and 0.796 in diagnosing moderate-high and low differentiation,respectively.Then,we combined DCE-MRI(Ktrans+Ve)parameters with CA19-9 and CA-125 and found that the AUC of DCE-MRI parameters plus serum TMs was 0.836 in the diagnosis of high and low stages and 0.946 in the diagnosis of moderate-high and low differentiation.According to the Delong test,the AUC of DCE-MRI parameters plus serum TMs increased significantly compared with serum TMs alone in the diagnosis of T stage and differentiation degree(P<0.001).CONCLUSION The levels of the DCE-MRI parameters Ktrans and Ve and the serum TMs CA19-9 and CA125 all increase with increasing T stage and decreasing differentiation degree of RC and can be used as indices to evaluate the differentiation degree of RC in clinical practice.Moreover,the combined evaluation of the above indices has a better effect and more obvious clinical value,providing important guiding importance for clinical condition judgment and treatment selection.
文摘In many areas of oncology, dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) has proven to be a clinically useful, non-invasive functional imaging technique to quantify tumor vasculature and tumor perfusion characteristics. Tumor angiogenesis is an essential process for tumor growth, proliferation, and metastasis. Malignant lesions demonstrate rapid extravasation of contrast from the intravascular space to the capillary bed due to leaky capillaries associated with tumor neovascularity. DCE-MRI has the potential to provide information regarding blood flow, areas of hypoperfusion, and variations in endothelial permeability and microvessel density to aid treatment selection, enable frequent monitoring during treatment and assess response to targeted therapy following treatment. This review will discuss the current status of DCE-MRI in cancer imaging, with a focus on its use in imaging prostate malignancies as well as weaknesses that limit its widespread clinical use. The latest techniques for quantification of DCE-MRI parameters will be reviewed and compared.
基金supported by Beijing Natural Science Foundation(No.7122029)
文摘Objective： To evaluate the feasibility of dynamic contrast-enhanced magnetic resonance imaging（DCEMRI） for predicting tumor response to radiotherapy in patients with suspected primary central nervous system（CNS） germ cell tumors（GCTs）.Methods： DCE-MRI parameters of 35 patients with suspected primary CNS GCTs were obtained prior to diagnostic radiation, using the Tofts and Kermode model. Radiosensitivity was determined in tumors diagnosed 2 weeks after radiation by observing changes in tumor size and markers as a response to MRI. Taking radiosensitivity as the gold standard, the cut-off value of DCE-MRI parameters was measured by receiver operating characteristic（ROC） curve. Diagnostic accuracy of DCE-MRI parameters for predicting radiosensitivity was evaluated by ROC curve.Results： A significant elevation in transfer constant（K^trans） and extravascular extracellular space（Ve）（P=0.000）, as well as a significant reduction in rate constant（Kep）（P=0.000） was observed in tumors. K^trans, relative K^trans, and relative Kep of the responsive group were significantly higher than non-responsive groups. No significant difference was found in Kep, Ve, and relative Ve between the two groups. Relative K^trans showed the best diagnostic value in predicting radiosensitivity with a sensitivity of 100%, specificity of 91.7%, positive predictive value（PPV） of 95.8%, and negative predictive value（NPV） of 100%.Conclusions： Relative K^trans appeared promising in predicting tumor response to radiation therapy（RT）. It is implied that DCE-MRI pre-treatment is a requisite step in diagnostic procedures and a novel and reliable approach to guide clinical choice of RT.
文摘In the study,108 patients with endometrial cancer were selected as the observation group,and 105 patients with benign endometrial lesions were selected as the control group.After DCE-MRI examination,it was found that the volume transfer constant(K^(trans)),rate constant(K_(e))and extracellular space volume ratio(V_(e))in the observation group were higher than those in the control group(P<0.05).The area under curve(AUC)of combined K^(trans),K_(e) and V_(e) values in the diagnosis of endometrial cancer was 0.841.The values of K^(trans),K_(e )and V_(e) were positively correlated with the clinical stage and the degree of muscular invasion,but negatively correlated with the degree of differentiation(P<0.05).The results of the study suggested that DCE-MRI quantitative parameters have a certain value in the differential diagnosis of endometrial cancer,which helped to further distinguish the degree of muscular invasion,clinical stage,and differentiation of endometrial cancer patients.
文摘Background The degree of pathological microvascular proliferation is an important element in evaluation of the astrocytoma grade. This study was aimed to quantitatively assess the microvascular permeability of brain astrocytoma with the volume transfer constant （Ktrans） and volume of extravascular extracellular space per unit volume of tissue （Ve） from dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） and to evaluate the effectiveness of the Ktr^n＇ and Ve in the grading of astrocytoma. Methods The highest values of the Kt~~s and Ve of 67 patients with astrocytoma （27 with grade II, 12 with grade III, and 28 with grade IV） were obtained. The comparisons of the differences of the Ktrans and Ve between the different grades were conducted using the Mann-Whitney rank-sum tests. Spearman＇s rank correlation coefficients were determined between Ktrans values, Ve values and astrocytoma grades. Receiver operating characteristic （ROC） curve analyses were performed to determine the cut-off values for the Ktrans and Ve to distinguish between the different grades of astrocytoma. Results There were significant differences （P〈0.001） between the different grades in the Ktrans values and Ve values, except for grades III and IV. The Ktrans values and Ve values were both correlated with astrocytoma grades （both P〈0.001）. The ROC curve analyses showed that the cut-off values for the Ktrans and Ve provided the best combination of sensitivity and specificity in distinguishing between grade II and grade III or IV astrocytomas. Conclusions DCE-MRI can play an important role in assessing the microvascular permeability and the grading of brain astrocytoma.
