Value of rFOV-DWI in predicting clinical efficacy of locally advanced pancreatic cancer

doi:10.3877/cma.j.issn.2095-3232.2022.02.006

Abstract

Abstract:

Objective

To evaluate the effect of reduced field-of-view diffusion-weighted imaging (rFOV-DWI) in predicting the clinical efficacy of locally advanced pancreatic cancer.

Methods

41 patients with locally advanced pancreatic cancer treated in the First Affiliated Hospital of Naval Medical University from January 2015 to July 2017 were enrolled in this prospective study. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 28 patients were male and 13 female, aged from 44 to 80 with a median age of 64 years. All 41 patients received radiotherapy, and 32 cases were treated with orally chemotherapeutic drug S-1. 3.0T MRI was performed within 1 week before treatment to detect the signal intensity of lesions. Survival analysis was conducted by Kaplan-Meier method and Log-rank test. Prognostic factors were screened by Cox proportional hazards regression model. The prediction efficiency was analyzed using prediction error curve. The evaluation indexes included integrated Brier score (IBS) and C-index.

Results

In 3.0T rFOV-DWI, typical planes of the locally advanced pancreatic cancer were manifested with slightly low signal intensity on T1WI, slightly high signal intensity on T2WI, low enhancement in the arterial stage and high signal intensity on rFOV-DWI. The median signal intensity of the region of interest was 537(357-943). The median overall survival and disease-free survival were 11.7 and 7.2 months, respectively. Survival analysis demonstrated that the progression-free survival of patients with pancreatic tail cancer was significantly better than that of their counterparts with pancreatic head cancer (χ²=5.165, P<0.05). Cox regression model showed that signal intensity and oral intake of S-1 were the independent protective factors for the overall survival of patients (HR=0.995, 0.161; P<0.05). The combination of these two yielded the highest efficiency in predicting the overall survival, with an IBS of 0.152 and C-index of 0.673.

Conclusions

The stronger the signal intensity of rFOV-DWI in patients with locally advanced pancreatic cancer, the better the overall survival of patients treated with oral intake of S-1.

Key words: Pancreatic neoplasms, Magnetic resonance imaging, Diffusion-weighted imaging, Prognosis

Yu Zhang, Kailian Zheng, Yuxiao Li. Value of rFOV-DWI in predicting clinical efficacy of locally advanced pancreatic cancer[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2022, 11(02): 139-143.

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Figures/Tables 5

References 20

[1]	Zhang Y, Zhu X, Liu R, et al. Combination of pre-treatment DWI-signal intensity and S-1 treatment: a predictor of survival in patients with locally advanced pancreatic cancer receiving stereotactic body radiation therapy and sequential S-1[J]. Transl Oncol, 2018, 11(2):399-405.
[2]	李晶，马超，边云, 等. 小视野高分辨DWI对胰腺实性病变的鉴别诊断价值[J]. 中华胰腺病杂志, 2017, 17(6):394-399.
[3]	Ma C, Li YJ, Pan CS, et al. High resolution diffusion weighted magnetic resonance imaging of the pancreas using reduced field of view single-shot echo-planar imaging at 3 T[J]. Magn Reson Imaging, 2014, 32(2):125-131.
[4]	Kim H, Lee JM, Yoon JH, et al. Reduced field-of-view diffusion-weighted magnetic resonance imaging of the pancreas: comparison with conventional single-shot echo-planar imaging[J]. Korean J Radiol, 2015, 16(6):1216-1225.
[5]	Mannelli L, Monti S, Corrias G, et al. Comparison of navigator triggering reduced field of view and large field of view diffusion weighted imaging of the pancreas[J]. J Comput Assist Tomogr, 2019, 43(1):143-148.
[6]	张瑜，陈炜，王湘莲, 等. ADCtot值对射波刀联合替吉奥治疗局部进展期胰腺癌患者总生存期的预测价值[J]. 中华胰腺病杂志, 2018, 18(6):375-379.
[7]	Trajkovic-Arsic M, Heid I, Steiger K, et al. Apparent diffusion coefficient (ADC) predicts therapy response in pancreatic ductal adenocarcinoma[J]. Sci Rep, 2017, 7(1):17038.
[8]	Park MJ, Kim YK, Choi SY, et al. Preoperative detection of small pancreatic carcinoma: value of adding diffusion-weighted imaging to conventional MR imaging for improving confidence level[J]. Radiology, 2014, 273(2):433-443.
[9]	姚秀忠，曾蒙苏，饶圣祥, 等. 3.0T MR灌注加权成像和扩散加权成像在胰腺肿块诊断中应用[J]. 中华放射学杂志, 2011, 45(7):646-652.
[10]	Schoennagel BP, Habermann CR, Roesch M, et al. Diffusion-weighted imaging of the healthy pancreas: apparent diffusion coefficient values of the normal head, body, and tail calculated from different sets of b-values[J]. J Magn Reson Imaging, 2011, 34(4):861-865.
[11]	Klauss M, Lemke A, Grünberg K, et al. Intravoxel incoherent motion MRI for the differentiation between mass forming chronic pancreatitis and pancreatic carcinoma[J]. Invest Radiol, 2011, 46(1):57-63.
[12]	Niwa T, Ueno M, Ohkawa S, et al. Advanced pancreatic cancer. the use of the apparent diffusion coefficient to predict response to chemotherapy[J]. Br J Radiol, 2009, 82(973):28-34.
[13]	Dzik-Jurasz A, Domenig C, George M, et al. Diffusion MRI for prediction of response of rectal cancer to chemoradiation[J]. Lancet, 2002, 360(9329):307-308.
[14]	Koh DM, Scurr E, Collins D, et al. Predicting response of colorectal hepatic metastasis: value of pretreatment apparent diffusion coefficients[J]. AJR Am J Roentgenol, 2007, 188(4):1001-1008.
[15]	Cui Y, Zhang XP, Sun YS, et al. Apparent diffusion coefficient: potential imaging biomarker for prediction and early detection of response to chemotherapy in hepatic metastases[J]. Radiology, 2008, 248(3):894-900.
[16]	Ma C, Li J, Boukar MB, et al. Optimized ROI size on ADC measurements of normal pancreas, pancreatic cancer and mass-forming chronic pancreatitis[J]. Oncotarget, 2017, 8(58):99085-99092.
[17]	Ma C, Guo X, Liu L, et al . Effect of region of interest size on ADC measurements in pancreatic adenocarcinoma[J]. Cancer Imaging, 2017, 17(1):13.
[18]	Zhou X, Ma C, Wang Z, et al. Effect of region of interest on ADC and interobserver variability in thyroid nodules[J]. BMC Med Imaging, 2019, 19(1):55.
[19]	Cai PQ, Wu YP, An X, et al. Simple measurements on diffusion-wighted MR imaging for assessment of complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer[J]. Eur Radiol, 2014, 24(11):2962-2970.
[20]	马超，刘莉，李晶, 等. 3.0T磁共振扩散加权成像信号强度对胰腺导管腺癌的诊断价值究[J]. 中华胰腺病杂志, 2015, 15(6):361-364.

变量	b	Wald χ²	P	HR	95%CI
口服替吉奥	-1.829	12.145	<0.001	0.161	0.057~0.449
SI	-0.005	07.911	<0.005	0.995	0.992~0.999

变量	b	Wald χ²	P	HR	95%CI
口服替吉奥	-1.829	12.145	<0.001	0.161	0.057~0.449
SI	-0.005	07.911	<0.005	0.995	0.992~0.999

变量	b	Wald χ²	P	HR	95%CI
病灶部位	1.359	6.803	0.009	3.892	1.402~10.808
CA19-9	0.001	6.196	0.013	1.001	1.000~1.0020

变量	b	Wald χ²	P	HR	95%CI
病灶部位	1.359	6.803	0.009	3.892	1.402~10.808
CA19-9	0.001	6.196	0.013	1.001	1.000~1.0020

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