Dynamic contrast-enhanced MRI in advanced nonsmall-cell lung cancer patients treated with first-line bevacizumab, gemcitabine, and cisplatin
Yeun-Chung Chang MD, PhD
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Search for more papers by this authorChong-Jen Yu MD, PhD
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Search for more papers by this authorChung-Ming Chen PhD
Graduate Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorFu-Chang Hu MS, ScD
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Department of Medical Research and National Center of Excellence for General Clinical Trial and Research, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorHao-Hsiang Hsu MS
Graduate Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorWen-Yih I Tseng MD, PhD
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Search for more papers by this authorTiffany Ting-Fang Shih MD
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Search for more papers by this authorPan-Chyr Yang MD, PhD
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
James Chih-Hsin Yang MD, PhD
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
Graduate Institute of Oncology and Cancer Research Center, National Taiwan University, Taipei, Taiwan
Graduate Institute of Oncology and Cancer Research Center, National Taiwan University, #7 Chung- Shan South Road, Taipei 100, TaiwanSearch for more papers by this authorYeun-Chung Chang MD, PhD
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Search for more papers by this authorChong-Jen Yu MD, PhD
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Search for more papers by this authorChung-Ming Chen PhD
Graduate Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorFu-Chang Hu MS, ScD
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Department of Medical Research and National Center of Excellence for General Clinical Trial and Research, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorHao-Hsiang Hsu MS
Graduate Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorWen-Yih I Tseng MD, PhD
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Search for more papers by this authorTiffany Ting-Fang Shih MD
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Search for more papers by this authorPan-Chyr Yang MD, PhD
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
James Chih-Hsin Yang MD, PhD
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
Graduate Institute of Oncology and Cancer Research Center, National Taiwan University, Taipei, Taiwan
Graduate Institute of Oncology and Cancer Research Center, National Taiwan University, #7 Chung- Shan South Road, Taipei 100, TaiwanSearch for more papers by this authorAbstract
Purpose:
To investigate dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of advanced nonsmall-cell lung cancer (NSCLC) patients treated with the antiangiogenic agent bevacizumab combined with gemcitabine and cisplatin as first-line treatment.
Materials and Methods:
All patients were enrolled for MRI and computed tomography (CT) before and after the first three courses of bevacizumab combination chemotherapy. Pharmacokinetic parameters (Ktrans, kep, ve, vp) derived from DCE MRI were computed for the main mass. Parametric histogram analysis was obtained to evaluate changes of the internal tumor composition and for correlation with tumor response measured on CT.
Results:
After three cycles of treatment, 11 patients showed decreased tumor size and a decreased value of all MR-derived pharmacokinetic parameters. Among these parameters, there was a significant decrease of mean and standard deviation of the Ktrans histogram as well as a decrease of mean of the kep histogram (P < 0.05). Tumors with larger mean values of rate constant kep (P < 0.0001) and smaller standard deviation of volume of extravascular extracellular space fraction ve (P < 0.0001) on histograms before chemotherapy were considered predictors for treatment response.
Conclusion:
DCE MRI enables a functional analysis of the treatment response of NSCLC. MRI parametric histogram has the potential to predict early treatment response of combined bevacizumab, gemcitabine, and cisplatin. J. Magn. Reson. Imaging 2012;36:387–396. ©2012 Wiley Periodicals, Inc.
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