Premium
Response assessment of stereotactic body radiation therapy using dynamic contrast‐enhanced integrated MR‐PET in non‐small cell lung cancer patients
Author(s) -
Huang YuSen,
Chen Jenny LingYu,
Hsu FengMing,
Huang JeiYie,
Ko WeiChun,
Chen YiChang,
Jaw FuShan,
Yen RuohFang,
Chang YeunChung
Publication year - 2018
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25758
Subject(s) - medicine , nuclear medicine , lung cancer , standardized uptake value , magnetic resonance imaging , positron emission tomography , univariate analysis , radiosurgery , lung , radiation therapy , radiology , multivariate analysis
Purpose To evaluate the response in patients undergoing SBRT using dynamic contrast‐enhanced (DCE) integrated magnetic resonance positron emission tomography (MR‐PET). Stereotactic body radiation therapy (SBRT) is efficacious as a front‐line local treatment for non‐small cell lung cancer (NSCLC). Materials and Methods We prospectively enrolled 19 lung tumors in 17 nonmetastatic NSCLC patients who were receiving SBRT as a primary treatment. They underwent DCE‐integrated 3T MR‐PET before and 6 weeks after SBRT. The following image parameters were analyzed: tumor size, standardized uptake value (SUV), apparent diffusion coefficient, K trans , k ep , v e , v p , and iAUC 60 . Chest computed tomography (CT) was performed at 3 months after SBRT. Results SBRT treatment led to tumor changes including significant decreases in the SUV max (–61%, P < 0.001), K trans mean (–72%, P = 0.005), K trans standard deviation (SD; –85%, P = 0.046), k ep mean (–53%, P = 0.014), k ep SD (–63%, P = 0.001), and v p SD (–58%, P = 0.002). The PET SUV max was correlated with the MR k ep mean ( P = 0.002) and k ep SD ( P < 0.001). The percentage reduction in K trans mean ( P < 0.001) and k ep mean ( P = 0.034) at 6 weeks post‐SBRT were significantly correlated with the percentage reduction in tumor size, as measured using CT at 3 months after SBRT. Univariate analyses revealed a trend toward disease progression when the initial SUV max > 10 ( P = 0.083). Conclusion In patients with NSCLC who are receiving SBRT, DCE‐integrated MR‐PET can be used to evaluate the response after SBRT and to predict the local treatment outcome. Level of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:191–199.