The prognostic value of dynamic contrast-enhanced MRI contrast agent transfer constant K trans in cervical cancer is explained by plasma flow rather than vessel permeability.

Autor: Dickie BR; Division of Molecular and Clinical Cancer Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester M20 4BX, UK.; Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, UK., Rose CJ; Centre for Imaging Sciences, Division of Informatics, Imaging, and Data Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PG, UK., Kershaw LE; Division of Molecular and Clinical Cancer Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester M20 4BX, UK.; Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, UK., Withey SB; RRPPS, University Hospitals Birmingham NHS Foundation Trust, Birmingham B30 3HP, UK., Carrington BM; Department of Diagnostic Radiology, The Christie NHS Foundation Trust, Manchester M20 4BX, UK., Davidson SE; Department of Diagnostic Radiology, The Christie NHS Foundation Trust, Manchester M20 4BX, UK., Hutchison G; Department of Radiology, Royal Bolton NHS Foundation Trust, Farnworth BL4 0JR, UK., West CML; Division of Molecular and Clinical Cancer Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester M20 4BX, UK.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2017 May 23; Vol. 116 (11), pp. 1436-1443. Date of Electronic Publication: 2017 Apr 27.
DOI: 10.1038/bjc.2017.121
Abstrakt: Background: The microvascular contrast agent transfer constant K trans has shown prognostic value in cervical cancer patients treated with chemoradiotherapy. This study aims to determine whether this is explained by the contribution to K trans of plasma flow (F p ), vessel permeability surface-area product (PS), or a combination of both.
Methods: Pre-treatment dynamic contrast-enhanced MRI (DCE-MRI) data from 36 patients were analysed using the two-compartment exchange model. Estimates of F p , PS, K trans , and fractional plasma and interstitial volumes (v p and v e ) were made and used in univariate and multivariate survival analyses adjusting for clinicopathologic variables tumour stage, nodal status, histological subtype, patient age, tumour volume, and treatment type (chemoradiotherapy vs radiotherapy alone).
Results: In univariate analyses, F p (HR=0.25, P=0.0095) and K trans (HR=0.20, P=0.032) were significantly associated with disease-free survival while PS, v p and v e were not. In multivariate analyses adjusting for clinicopathologic variables, F p and K trans significantly increased the accuracy of survival predictions (P=0.0089).
Conclusions: The prognostic value of K trans in cervical cancer patients treated with chemoradiotherapy is explained by microvascular plasma flow (F p ) rather than vessel permeability surface-area product (PS).
Databáze: MEDLINE
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