磁共振弥散加权成像对索拉菲尼治疗肝细胞癌的疗效评估(英文)

研究目的:应用磁共振弥散加权成像(DWI)监测荷瘤裸鼠肝细胞性肝癌表观弥散系数(ADC)的变化,探讨ADC对索拉菲尼治疗肝细胞性肝癌的疗效预测。创新要点:探讨磁共振DWI对索拉菲尼治疗肝癌疗效的早期评估,期望能够指导临床合理用药。研究方法:荷瘤裸鼠分成两组(治疗组和对照组)共40只,使用GE 3.0T磁共振成像系统和小动物线圈,分别于服药前后1、10、14和18天(40 mg/kg,一天两次)进行T1加权成像(T1WI)、T2加权成像(T2WI)和DWI扫描。在弥散加权图像上进行ADC测量,对比不同区域和不同时间点的差异。重要结论:索拉菲尼治疗10天后,伴随肝癌肿瘤的缩小,肿瘤内部ADC值明显上升,病理切片显示治疗组瘤体中心小血管闭塞,凋亡细胞可见,此时瘤体内坏死细胞并未大量显现,说明ADC值的改变可以反映索拉菲尼的疗效。

Early changes in apparent diffusion coefficient as an indicator of response to sorafenib in hepatocellular carcinoma

Objective

The relationship between apparent diffusion coefficient (ADC) and chemotherapy has been established. However, whether ADC could be considered as a measure for monitoring response to sorafenib in hepatocellular carcinoma (HCC) has not been demonstrated. This study was to investigate the ADC changes of advanced HCC under sorafenib treatment. Methods: Athymic mice with HepG2 xenografts were allocated to two groups: control and sorafenib (40 mg/kg, bid). T2 and diffusion images were acquired at each time point (0, 10, 14, and 18 d post-therapy). Tumor volume and changes in ADC were calculated.

Results

Tumor volumes on Days 10, 14, and 18 after treatment showed significant decreases in the sorafenib-treated group compared with the control. Pretreatment ADC values were not significantly different between the control and treated groups. A slow increase in ADC in the peripheral zone of tumors appeared in the treated group, which was significantly higher compared with the control group on Days 10, 14, and 18. In the central part of tumors on Day 10 after treatment, an increase in ADC appeared in the treated and control groups, the ADC of the control group being significantly lower compared with the treated tumors. From Day 10 to Day 14, the ADC map showed a progressive decrease in the central region of tumors in the treated and control groups. However, this change is more significant in the treated groups.

Conclusions

Early changes in mean ADC correlated with sorafenib treatment in HCC, which are promising indicators for predicting sorafenib response in this carcinoma.