首页|APT成像在宫颈癌同步根治性放化疗疗效评估中的价值

APT成像在宫颈癌同步根治性放化疗疗效评估中的价值

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目的 探讨酰胺质子转移(amide proton transfer,APT)成像在宫颈癌同步根治性放化疗(concurrent chemoradiotherapy,CCRT)疗效评估中的价值.材料和方法 回顾性分析经病理证实为宫颈癌的27例患者的临床及影像资料,根据实体瘤疗效评价标准对CCRT后的疗效进行评估,将完全缓解(complete remission,CR)和部分缓解(partial remission,PR)纳入缓解组,疾病稳定(disease stability,SD)和疾病进展(disease progression,PD)纳入非缓解组.对比分析CCRT前、后以及缓解组、非缓解组病灶区表观扩散系数(apparent diffusion coefficient,ADC)和APT值的差异,采用Pearson相关性分析方法分析ADC值、APT值与CCRT疗效之间的相关性.结果 27例宫颈癌患者CCRT后CR 3例(11.11%),PR 16例(59.26%),SD 8例(29.63%),局部控制率为 100%.与CCRT前相比,CCRT后病灶的ADC值升高[(0.89±0.06)×10-3 mm2/s vs.(1.07±0.07)×10-3 mm2/s,P<0.05],APT值降低(3.30%±0.05%vs.3.07%±0.07%,P<0.05).CCRT前,缓解组 ADC值、APT值比非缓解组均高,但差异无统计学意义(P>0.05);CCRT后,缓解组ADC值比非缓解组高[(1.10±0.06)×10-3mm2/s vs.(1.01±0.04)×10-3mm2/s,P<0.05],缓解组APT值比非缓解组低(3.05%±0.06%vs.3.12%±0.07%,P<0.05).宫颈癌患者CCRT后ADC值与疗效具有显著的负相关性(r=-0.61,95%CI:-0.82~-0.39,P<0.01);APT值与疗效具有显著的正相关性(r=0.50,95%CI:0.20~0.76,P=0.01).结论 宫颈癌CCRT疗效好,CCRT后APT值降低,且APT值与CCRT疗效具有明显的正相关性,APT值是反映宫颈癌CCRT疗效有效的影像标记物.
The value of APT imaging in evaluating the therapeutic efficacy of concurrent chemoradiotherapy for cervical cancer
Objective:To explore the value of amide proton transfer(APT)imaging in evaluating the efficacy of concurrent chemoradiotherapy(CCRT)for cervical cancer.Material and Methods:A retrospective analysis was conducted on 27 patients with cervical cancer confirmed by pathology.The efficacy of CCRT was evaluated based on the evaluation criteria for solid tumor efficacy.Complete remission(CR)and partial remission(PR)were included in the remission group,while disease stability(SD)and disease progression(PD)were included in the non-remission group.The values of apparent diffusion coefficient(ADC)and ATP of the lesion area were compared and analyzed before and after CCRT,as well as in the remission and non-remission groups.The correlation between ADC value,APT value,and CCRT efficacy were analyzed by using Pearson correlation analysis.Results:After CCRT,there were 3 cases of CR(11.11%),16 cases of PR(59.26%)and 8 cases of SD(29.63%)in 27 patients with cervical cancer.The local control rate was 100.00%.Compared with before CCRT,the ADC value of the lesion after CCRT increased[(0.89±0.06)×l0-3 mm2/s vs.(1.07±0.07)× 10-3 mm2/s,P<0.05]and the APT value decreased significantly(3.30%±0.05%vs.3.07%±0.07%,P<0.05).Before CCRT,the values of ADC and APT in the remission group were higher than those in the non-remission group,and the difference was not statistically significant(P>0.05);After CCRT,the ADC value of the remission group was higher than that of the non-remission group[(1.10±0.06)× 10-3 mm2/s vs.(1.01±0.04)×10-3 mm2/s,P<0.05],while the APT value of the remission group was lower than that of the non-remission group(3.05%±0.06%vs.3.12%±0.07%,P<0.05).There is a significant negative correlation between the ADC value after CCRT and the efficacy of CCRT(r=-0.61,95%CI:-0.82--0.39,P<0.01),while there is a significant positive correlation between APT value and CCRT efficacy(r=0.50,95%CI:0.20-0.76,P=0.01).Conclusions:CCRT for cervical cancer has a good therapeutic effect.The APT value is positively correlated with the CCRT effect and an effective imaging marker for reflecting the efficacy of CCRT in cervical cancer.

cervical cancermagnetic resonance imagingamide proton transfer imagingapparent diffusion coefficientchemoradiotherapyefficacy evaluation

史天亮、杨崇双、刘元早、罗应斌、杨昌义、旷光先、姚庆

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铜仁市人民医院放射科,铜仁 554300

铜仁市人民医院肿瘤科,铜仁 554300

宫颈癌 磁共振成像 酰胺质子转移成像 表观扩散系数 放化疗 疗效评估

贵州省卫生健康委员会科学技术基金

gzwkj2021-374

2024

磁共振成像
中国医院协会 首都医科大学附属北京天坛医院

磁共振成像

CSTPCD北大核心
影响因子:1.38
ISSN:1674-8034
年,卷(期):2024.15(1)
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