功能MRI定量评估局部进展期直肠癌新辅助放化疗后病理完全缓解研究进展
Progress of quantitative prediction of the pathologic complete response after neoadjuvant chemoradiotherapy for locally advanced rectal cancer with functional MRI
杨澳 1周鹏2
作者信息
- 1. 电子科技大学医学院,成都 610051;四川省肿瘤临床医学研究中心,四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学附属肿瘤医院影像科,成都 610041
- 2. 四川省肿瘤临床医学研究中心,四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学附属肿瘤医院影像科,成都 610041
- 折叠
摘要
新辅助放化疗(neoadjuvant chemoradiotherapy,nCRT)可降低局部进展期直肠癌(locally advanced rectal cancer,LARC)患者的局部复发率,提高保肛率.部分患者在nCRT后可达到病理完全缓解(pathologic complete response,pCR),这类患者采取"等待观察"策略,可避免手术导致的相关并发症.功能磁共振成像(functional magnetic resonance imaging,fMRI)从细胞水平反映肿瘤微环境结构及功能的改变,较常规MRI可更为准确地评估LARC患者对nCRT的反应.本文围绕扩散加权成像(diffusion-weighted imaging,DWI)及其衍生序列和灌注成像定量评估LARC患者nCRT后pCR研究进展予以综述,比较了DWI、体素内不相干运动(intravoxel incoherent motion,IVIM)、拉伸指数模型(stretched exponential model,SEM)、扩散峰度成像(diffusion kurtosis imaging,DKI)、动态对比增强磁共振成像(dynamic contrast-enhanced MRI,DCE-MRI)和基于人工智能的预测模型在当前研究中的优势与不足,并为未来的研究方向提供了线索和思路,旨在为准确识别pCR的LARC患者提供较为可靠的定量指标.
Abstract
Neoadjuvant chemoradiotherapy (nCRT) could reduce the local recurrence rate and improve the anus-preserving rate in patients with locally advanced rectal cancer (LARC). Some patients can achieve pathologic complete response (pCR) after nCRT,who will be take "watch and wait" strategy,and the patients could be avoid the complications caused by surgery. Functional magnetic resonance imaging (fMRI) can more accurately assess patients' response to nCRT than conventional MRI by reflecting changes in the structure and function of the tumor microenvironment at the cellular level. In this paper,we review the research progress on the quantitative evaluation of pCR after nCRT by diffusion-weighted imaging (DWI) and its derived sequences and perfusion imaging in patients with LARC,compare the advantages and disadvantages of DWI,intravoxel incoherent motion (IVIM),stretched exponential model (SEM),diffusion kurtosis imaging (DKI),dynamic contrast-enhanced MRI (DCE-MRI),and artificial intelligence-based prediction models in the current research,and provide clues and ideas for future research directions,aiming to provide relative reliable quantitative indicators for accurately identifying patients with LARC who achieve pCR.
关键词
局部进展期直肠癌/新辅助放化疗/病理完全缓解/功能磁共振成像/磁共振成像Key words
locally advanced rectal cancer/neoadjuvant chemoradiotherapy/pathologic complete response/functional magnetic resonance imaging/magnetic resonance imaging引用本文复制引用
基金项目
四川省科技计划(2022YFSY0006)
四川省科技计划(2021YFG0125)
出版年
2024
国家科技期刊平台
NSTL
万方数据