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H. Yin
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P1.03 - Poster Session with Presenters Present (ID 455)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.03-013 - Diagnosis, Assessment and Prediction of Early Response to Chemotherapy by Using Diffusion-Weighted MRI in Lung Cancer (ID 5479)
14:30 - 14:30 | Author(s): H. Yin
- Abstract
Background:
Radiographic screening, diagnosing, staging, and assessing procedures with ironizing radiation-based tests are currently most widely used for lung cancer. However, one of the major harms of these imaging tests is the potential for radiation-induced carcinogenesis. Whether radiographic screening, diagnosing, staging, and assessing procedures increase cancer incidence and death in patients exposed to radiation of medical sources is ignored in the context of indefinite answer. We aimed to evaluate the ability of radiation-free diffusion-weighted magnetic resonance imaging (DW-MRI) to diagnose, assess and detect early response to chemotherapy in lung cancer patients.
Methods:
This study was approved by the institutional review board, and written informed consent was obtained from all subjects. Ninety patients with lung cancer as confirmed by pathologic examination (25 women, 65 men; mean age, 57 years) who underwent chemotherapy were enrolled between November 2014 and October 2015. All patients underwent MRI and computed tomography (CT), as the reference test, at baseline and after the second course of chemotherapy. The apparent diffusion coefficient (ADC) of each lung carcinoma was calculated from images. Ki-67 scores and tumor markers in the serum, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE) and squamous cell carcinoma antigen (SCC), were determined. ADC values were compared among different histopathologic types and between pretreatment and posttreatment. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of ADC and its combination with tumor markers. The relationship between the baseline ADC values with Ki-67 scores and final tumor size reduction were analyzed by using the Pearson correlation coefficient. This study is registered with Clinical Trials.gov (NCT02320617).
Results:
Before treatment, there were significant differences between NSCLC and SCLC (P=0.000), adenocarcinoma and SCLC (P=0.000), and squamous cell carcinoma and SCLC (P=0.002). ADC values and Ki-67 score showed negative correlation (r=−0.408, P=0.000). In ROC analysis, area under curve (AUC) of ADC in combination with CEA, SCC and NSE was 0.772, 0.821 and 0.761, respectively. ADC values were significantly different between pretreatment and posttreatment (P=0.001), and partial response (PR) and stable disease (SD) groups. ADC at baseline was negatively correlated with tumor size reduction (r=−0.434, P=0.017). As well, AUC of ADC after treatment to discriminate PR and SD groups was 0.804.
Conclusion:
Our findings extended the previous findings by that ADC in DW-MRI could: (1) discriminate different histopathologic types; (2) evaluate the malignancy; (3) predict and monitor the early response to chemotherapy. Radiation-free DW-MRI seems to be a promising tool for management of lung cancer.
