扩散加权成像及体素内不相干运动在预测局部进展期直肠癌新辅助放化疗后病理完全缓解方面的研究进展
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摘要
新辅助放化疗联合全直肠系膜切除术是目前局部进展期直肠癌的标准治疗方案。新辅助放化疗后达到病理完全缓解(pC R)的患者可采取局部切除或"观察与等待"策略。准确预测pCR对于指导患者的个体化治疗至关重要。扩散加权成像与体素内不相干运动已用于预测局部进展期直肠癌新辅助放化疗后pCR。本文就相关研究进展进行综述。
Neoadjuvant chemoradiotherapy( NCRT) combined with total mesorectal excision is currently the standard therapeutic regimen for locally advanced rectal cancer( LARC). Patients achieving pathological complete response( pCR) after NCRT can be offered local excision or " wait and see" strategy. Accurately predicting pCR is of great importance to guide the individualized treatment of patients. Diffusion weighted imaging and intravoxel incoherent motion have been used to predict pCR after NCRT in LARC patients. In this paper,the related researches were reviewed.
Neoadjuvant chemoradiotherapy( NCRT) combined with total mesorectal excision is currently the standard therapeutic regimen for locally advanced rectal cancer( LARC). Patients achieving pathological complete response( pCR) after NCRT can be offered local excision or " wait and see" strategy. Accurately predicting pCR is of great importance to guide the individualized treatment of patients. Diffusion weighted imaging and intravoxel incoherent motion have been used to predict pCR after NCRT in LARC patients. In this paper,the related researches were reviewed.
引文
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[13]张晓燕,李晓婷,史燕杰,等.高分辨率MR T2WI联合DWI评价直肠癌新辅助治疗后病理学完全缓解[J].中国介入影像与治疗学,2017,14(3):164-168.DOI:10.13929/j.1672-8475.201612020.Zhang XY,Li XT,Shi YJ,et al.High resolution MR T2WIcombined with DWI in evaluation of pathological complete response after neoadjuvant therapy in rectal cancer[J].Chinese Journal of Interventional Imaging and Therapy,2017,14(3):164-168.DOI:10.13929/j.1672-8475.201612020.
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[16]Chen YG,Chen MQ,Guo YY,et al.Apparent diffusion coefficient predicts pathology complete response of rectal cancer treated with neoadjuvant chemoradiotherapy[J].PLo S One,2016,11(4):e0153944.DOI:10.1371/journal.pone.0153944.
[17]Kim SH,Lee JY,Lee JM,et al.Apparent diffusion coefficient for evaluating tumour response to neoadjuvant chemoradiation therapy for locally advanced rectal cancer[J].Eur Radiol,2011,21(5):987-995.DOI:10.1007/s00330-010-1989-y.
[18]Genovesi D,Filippone A,Ausili Cèfaro G,et al.Diffusion-weighted magnetic resonance for prediction of response after neoadjuvant chemoradiation therapy for locally advanced rectal cancer:preliminary results of a monoinstitutional prospective study[J].Eur J Surg Oncol,2013,39(10):1071-1078.DOI:10.1016/j.ejso.2013.07.090.
[19]Bassaneze T,Gon9alves JE,Faria JF,et al.Quantitative aspects of diffusion-weighted magnetic resonance imaging in rectal cancer response to neoadjuvant therapy[J].Radiol Oncol,2017,51(3):270-276.DOI:10.1515/raon-2017-0025.
[20]Choi MH,Oh SN,Rha SE,et al.Diffusion-weighted imaging:Apparent diffusion coefficient histogram analysis for detecting pathologic complete response to chemoradiotherapy in locally advanced rectal cancer[J].J Magn Reson Imaging,2016,44(1):212-220.DOI:10.1002/jmri.25117.
[21]Intven M,Reerink O,Philippens ME.Diffusion-weighted MRI in locally advanced rectal cancer:pathological response prediction after neo-adjuvant radiochemotherapy[J].Strahlenther Onkol,2013,189(2):117-122.DOI:10.1007/s00066-012-0270-5.
[22]Xie H,Sun T,Chen M,et al.Effectiveness of the apparent diffusion coefficient for predicting the response to chemoradiation therapy in locally advanced rectal cancer:a systematic review and meta-analysis[J].Medicine(Baltimore),2015,94(6):e517.DOI:10.1097/MD.0000000000000517.
[23]De Felice F,Magnante AL,Musio D,et al.Diffusion-weighted magnetic resonance imaging in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy[J].Eur J Surg Oncol,2017,43(7):1324-1329.DOI:10.1016/j.ejso.2017.03.010.
[24]Blazic IM,Lilic GB,Gajic MM.Quantitative assessment of rectal cancer response to neoadjuvant combined chemotherapy and radiation therapy:comparison of three methods of positioning region of interest for ADC measurements at diffusion-weighted MR imaging[J].Radiology,2017,282(2):615.DOI:10.1148/radiol.2017164040.
[25]Iima M,Le Bihan D.Clinical intravoxel incoherent motion and diffusion MR imaging:past,present,and future[J].Radiology,2016,278(1):13-32.DOI:10.1148/radiol.2015150244.
[26]Le Bihan D,Breton E,Lallemand D,et al.Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging[J].Radiology,1988,168(2):497-505.DOI:10.1148/radiology.168.2.3393671.
[27]Le Bihan D,Turner R.The capillary network:a link between IVIM and classical perfusion[J].Magn Reson Med,1992,27(1):171-178.DOI:10.1002/mrm.1910270116.
[28]白毓,罗鸣,张鹏.磁共振IVIM-DWI及DCE-MRI在直肠癌诊断中的应用价值[J].解放军医药杂志,2017,29(7):89-92,96.DOI:10.3969/j.issn.2095-140X.2017.07.024.Bai Y,Luo M,Zhang P.Values of magnetic resonance IVIM-DWIand DCE-MRI in diagnosis of rectal cancer[J].Medical&Pharmaceutical Journal of Chinese People's Liberation Army,2017,29(7):89-92,96.DOI:10.3969/j.issn.2095-140X.2017.07.024.
[29]Lu W,Jing H,Ju-Mei Z,et al.Intravoxel incoherent motion diffusion-weighted imaging for discriminating the pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer[J].Sci Rep,2017,7(1):8496.DOI:10.1038/s41598-017-09227-9.
[30]信超,孙轶群,毛健,等.体素内不相干运动扩散加权成像在预测局部进展期直肠癌新辅助放化疗疗效中的初步研究[J].中国癌症杂志,2017,27(12):985-991.DOI:10.19401/j.cnki.1007-3639.2017.12.012.Xin C,Sun YQ,Mao J,et al.A pilot study of intravoxelincoherent motion sequence for prediction of responce to neoadjuvant chemoradiotherapy in locally advanced rectal cancer[J].China Oncology,2017,27(12):985-991.DOI:10.19401/j.cnki.1007-3639.2017.12.012.
[31]Zhu HB,Zhang XY,Zhou XH,et al.Assessment of pathological complete response to preoperative chemoradiotherapy by means of multiple mathematical models of diffusion-weighted MRI in locally advanced rectal cancer:a prospective single-center study[J].J Magn Reson Imaging,2017,46(1):175-183.DOI:10.1002/jmri.25567.
[32]Ganeshan B,Miles KA.Quantifying tumour heterogeneity with CT[J].Cancer Imaging,2013(13):140-149.DOI:10.1102/1470-7330.2013.0015.
[33]Lubner MG,Smith AD,Sandrasegaran K,et al.CT texture analysis:definitions,applications,biologic correlates,and challenges[J].Radiographics,2017,37(5):1483-1503.DOI:10.1148/rg.2017170056.
[34]刘思野,文露,侯静,等.治疗前IVIM-DWI参数图纹理特征对直肠癌新辅助放化疗病理反应的预测价值[J].磁共振成像,2018,9(7):518-524.DOI:10.12015/issn.1674-8034.2018.07.007.Liu SY,Wen L,Hou J,et al.Texture features derived from intravoxel incoherent motion diffusion-weighted imaging for predicting the pathological response to chemoradiotherapy in rectal cancer[J].Chinese Journal of Magnetic Resonance Imaging,2018,9(7):518-524.DOI:10.12015/issn.1674-8034.2018.07.007.
[35]Freiman M,Voss SD,Mulkern RV,et al.Reliable assessment of perfusivity and diffusivity from diffusion imaging of the body[J].Med Image Comput Comput Assist Interv,2012,15(Pt 1):1-9.
[36]李爱银,宋歌声,王大伟,等.体素内不相干运动磁共振功能成像在直肠癌评估中的应用进展[J].中国医学影像技术,2017,33(11):1732-1735.DOI:10.13929/j.1003-3289.201704095.Li AY,Song GS,Wang DW,et al.Application progresses of intra-voxel incoherent motion in evaluation of rectal cancer[J].Chinese Journal of Medical Imaging Technology,2017,33(11):1732-1735.DOI:10.13929/j.1003-3289.201704095.
[2]Attenberger UI,Pilz LR,Morelli JN,et al.Multi-parametric MRIof rectal cancer-Do quantitative functional MR measurements correlate with radiologic and pathologic tumor stages?[J].Eur JRadiol,2014,83(7):1036-1043.DOI:10.1016/j.ejrad.2014.03.012.
[3]Maas M,Nelemans PJ,Valentini V,et al.Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer:a pooled analysis of individual patient data[J].Lancet Oncol,2010,11(9):835-844.DOI:10.1016/S1470-2045(10)70172-8.
[4]Ferrari L,Fichera A.Neoadjuvant chemoradiation therapy and pathological complete response in rectal cancer[J].Gastroenterol Rep(Oxf),2015,3(4):277-288.DOI:10.1093/gastro/gov039.
[5]Padhani AR,Liu G,Koh DM,et al.Diffusion-weighted magnetic resonance imaging as a cancer biomarker:consensus and recommendations[J].Neoplasia,2009,11(2):102-125.
[6]Koh TS,Bisdas S,Koh DM,et al.Fundamentals of tracer kinetics for dynamic contrast-enhanced MRI[J].J Magn Reson Imaging,2011,34(6):1262-1276.DOI:10.1002/jmri.22795.
[7]Brix G,Semmler W,Port R,et al.Pharmacokinetic parameters in CNS Gd-DTPA enhanced MR imaging[J].J Comput Assist Tomogr,1991,15(4):621-628.
[8]Lambregts DM,Vandecaveye V,Barbaro B,et al.Diffusionweighted MRI for selection of complete responders after chemoradiation for locally advanced rectal cancer:a multicenter study[J].Ann Surg Oncol,2011,18(8):2224-2231.DOI:10.1245/s10434-011-1607-5.
[9]Barbaro B,Fiorucci C,Tebala C,et al.Locally advanced rectal cancer:MR imaging in prediction of response after preoperative chemotherapy and radiation therapy[J].Radiology,2009,250(3):730-739.DOI:10.1148/radiol.2503080310.
[10]余以珊,岳金波,于金明.功能磁共振成像对直肠癌新辅助放化疗疗效预测的价值[J].中华胃肠外科杂志,2017,20(5):491-494.DOI:10.3760/cma.j.issn.1671-0274.2017.05.002.Yu YS,Yue JB,Yu JM.Value of functional magnetic resonance imaging in predicting outcomes of neoadjuvant chemoradiotherapy in rectal cancer[J].Chinese Journal of Gastrointestinal Surgery,2017,20(5):491-494.DOI:10.3760/cma.j.issn.1671-0274.2017.05.002.
[11]Kim SH,Lee JM,Hong SH,et al.Locally advanced rectal cancer:added value of diffusion-weighted MR imaging in the evaluation of tumor response to neoadjuvant chemo-and radiation therapy[J].Radiology,2009,253(1):116-125.DOI:10.1148/radiol.2532090027.
[12]Wu LM,Zhu J,Hu J,et al.Is there a benefit in using magnetic resonance imaging in the prediction of preoperative neoadjuvant therapy response in locally advanced rectal cancer?[J].Int JColorectal Dis,2013,28(9):1225-1238.DOI:10.1007/s00384-013-1676-y.
[13]张晓燕,李晓婷,史燕杰,等.高分辨率MR T2WI联合DWI评价直肠癌新辅助治疗后病理学完全缓解[J].中国介入影像与治疗学,2017,14(3):164-168.DOI:10.13929/j.1672-8475.201612020.Zhang XY,Li XT,Shi YJ,et al.High resolution MR T2WIcombined with DWI in evaluation of pathological complete response after neoadjuvant therapy in rectal cancer[J].Chinese Journal of Interventional Imaging and Therapy,2017,14(3):164-168.DOI:10.13929/j.1672-8475.201612020.
[14]Lambrecht M,Vandecaveye V,De Keyzer F,et al.Value of diffusion-weighted magnetic resonance imaging for prediction and early assessment of response to neoadjuvant radiochemotherapy in rectal cancer:preliminary results[J].Int J Radiat Oncol Biol Phys,2012,82(2):863-870.DOI:10.1016/j.ijrobp.2010.12.063.
[15]Foti PV,Privitera G,Piana S,et al.Locally advanced rectal cancer:Qualitative and quantitative evaluation of diffusion-weighted MR imaging in the response assessment after neoadjuvant chemoradiotherapy[J].Eur J Radiol Open,2016(3):145-152.DOI:10.1016/j.ejro.2016.06.003.
[16]Chen YG,Chen MQ,Guo YY,et al.Apparent diffusion coefficient predicts pathology complete response of rectal cancer treated with neoadjuvant chemoradiotherapy[J].PLo S One,2016,11(4):e0153944.DOI:10.1371/journal.pone.0153944.
[17]Kim SH,Lee JY,Lee JM,et al.Apparent diffusion coefficient for evaluating tumour response to neoadjuvant chemoradiation therapy for locally advanced rectal cancer[J].Eur Radiol,2011,21(5):987-995.DOI:10.1007/s00330-010-1989-y.
[18]Genovesi D,Filippone A,Ausili Cèfaro G,et al.Diffusion-weighted magnetic resonance for prediction of response after neoadjuvant chemoradiation therapy for locally advanced rectal cancer:preliminary results of a monoinstitutional prospective study[J].Eur J Surg Oncol,2013,39(10):1071-1078.DOI:10.1016/j.ejso.2013.07.090.
[19]Bassaneze T,Gon9alves JE,Faria JF,et al.Quantitative aspects of diffusion-weighted magnetic resonance imaging in rectal cancer response to neoadjuvant therapy[J].Radiol Oncol,2017,51(3):270-276.DOI:10.1515/raon-2017-0025.
[20]Choi MH,Oh SN,Rha SE,et al.Diffusion-weighted imaging:Apparent diffusion coefficient histogram analysis for detecting pathologic complete response to chemoradiotherapy in locally advanced rectal cancer[J].J Magn Reson Imaging,2016,44(1):212-220.DOI:10.1002/jmri.25117.
[21]Intven M,Reerink O,Philippens ME.Diffusion-weighted MRI in locally advanced rectal cancer:pathological response prediction after neo-adjuvant radiochemotherapy[J].Strahlenther Onkol,2013,189(2):117-122.DOI:10.1007/s00066-012-0270-5.
[22]Xie H,Sun T,Chen M,et al.Effectiveness of the apparent diffusion coefficient for predicting the response to chemoradiation therapy in locally advanced rectal cancer:a systematic review and meta-analysis[J].Medicine(Baltimore),2015,94(6):e517.DOI:10.1097/MD.0000000000000517.
[23]De Felice F,Magnante AL,Musio D,et al.Diffusion-weighted magnetic resonance imaging in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy[J].Eur J Surg Oncol,2017,43(7):1324-1329.DOI:10.1016/j.ejso.2017.03.010.
[24]Blazic IM,Lilic GB,Gajic MM.Quantitative assessment of rectal cancer response to neoadjuvant combined chemotherapy and radiation therapy:comparison of three methods of positioning region of interest for ADC measurements at diffusion-weighted MR imaging[J].Radiology,2017,282(2):615.DOI:10.1148/radiol.2017164040.
[25]Iima M,Le Bihan D.Clinical intravoxel incoherent motion and diffusion MR imaging:past,present,and future[J].Radiology,2016,278(1):13-32.DOI:10.1148/radiol.2015150244.
[26]Le Bihan D,Breton E,Lallemand D,et al.Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging[J].Radiology,1988,168(2):497-505.DOI:10.1148/radiology.168.2.3393671.
[27]Le Bihan D,Turner R.The capillary network:a link between IVIM and classical perfusion[J].Magn Reson Med,1992,27(1):171-178.DOI:10.1002/mrm.1910270116.
[28]白毓,罗鸣,张鹏.磁共振IVIM-DWI及DCE-MRI在直肠癌诊断中的应用价值[J].解放军医药杂志,2017,29(7):89-92,96.DOI:10.3969/j.issn.2095-140X.2017.07.024.Bai Y,Luo M,Zhang P.Values of magnetic resonance IVIM-DWIand DCE-MRI in diagnosis of rectal cancer[J].Medical&Pharmaceutical Journal of Chinese People's Liberation Army,2017,29(7):89-92,96.DOI:10.3969/j.issn.2095-140X.2017.07.024.
[29]Lu W,Jing H,Ju-Mei Z,et al.Intravoxel incoherent motion diffusion-weighted imaging for discriminating the pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer[J].Sci Rep,2017,7(1):8496.DOI:10.1038/s41598-017-09227-9.
[30]信超,孙轶群,毛健,等.体素内不相干运动扩散加权成像在预测局部进展期直肠癌新辅助放化疗疗效中的初步研究[J].中国癌症杂志,2017,27(12):985-991.DOI:10.19401/j.cnki.1007-3639.2017.12.012.Xin C,Sun YQ,Mao J,et al.A pilot study of intravoxelincoherent motion sequence for prediction of responce to neoadjuvant chemoradiotherapy in locally advanced rectal cancer[J].China Oncology,2017,27(12):985-991.DOI:10.19401/j.cnki.1007-3639.2017.12.012.
[31]Zhu HB,Zhang XY,Zhou XH,et al.Assessment of pathological complete response to preoperative chemoradiotherapy by means of multiple mathematical models of diffusion-weighted MRI in locally advanced rectal cancer:a prospective single-center study[J].J Magn Reson Imaging,2017,46(1):175-183.DOI:10.1002/jmri.25567.
[32]Ganeshan B,Miles KA.Quantifying tumour heterogeneity with CT[J].Cancer Imaging,2013(13):140-149.DOI:10.1102/1470-7330.2013.0015.
[33]Lubner MG,Smith AD,Sandrasegaran K,et al.CT texture analysis:definitions,applications,biologic correlates,and challenges[J].Radiographics,2017,37(5):1483-1503.DOI:10.1148/rg.2017170056.
[34]刘思野,文露,侯静,等.治疗前IVIM-DWI参数图纹理特征对直肠癌新辅助放化疗病理反应的预测价值[J].磁共振成像,2018,9(7):518-524.DOI:10.12015/issn.1674-8034.2018.07.007.Liu SY,Wen L,Hou J,et al.Texture features derived from intravoxel incoherent motion diffusion-weighted imaging for predicting the pathological response to chemoradiotherapy in rectal cancer[J].Chinese Journal of Magnetic Resonance Imaging,2018,9(7):518-524.DOI:10.12015/issn.1674-8034.2018.07.007.
[35]Freiman M,Voss SD,Mulkern RV,et al.Reliable assessment of perfusivity and diffusivity from diffusion imaging of the body[J].Med Image Comput Comput Assist Interv,2012,15(Pt 1):1-9.
[36]李爱银,宋歌声,王大伟,等.体素内不相干运动磁共振功能成像在直肠癌评估中的应用进展[J].中国医学影像技术,2017,33(11):1732-1735.DOI:10.13929/j.1003-3289.201704095.Li AY,Song GS,Wang DW,et al.Application progresses of intra-voxel incoherent motion in evaluation of rectal cancer[J].Chinese Journal of Medical Imaging Technology,2017,33(11):1732-1735.DOI:10.13929/j.1003-3289.201704095.