Journal
EUROPEAN RADIOLOGY
Volume 31, Issue 4, Pages 1863-1871Publisher
SPRINGER
DOI: 10.1007/s00330-020-07296-5
Keywords
Lymphoma; Magnetic resonance imaging; Biomarkers; Prognosis; Survival
Funding
- Capital's Funds for Health Improvement and Research [2018-2-1074]
- National Natural Science Foundation of China [81971614]
- Beijing Municipal Administration of Hospital's Ascent Plan [DFL20180802]
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The study found that K(trans) and changes in K(trans) measured by DCE-MRI were reliable biomarkers for predicting chemotherapy responses in PCNSL patients. These factors may also influence patients' progression-free survival.
Objectives To evaluate the utility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting the response of chemotherapy and clinical outcomes in primary central-nervous-system lymphoma (PCNSL) patients. Methods DCE-MRI in 56 patients enrolled in a prospective study was performed at baseline and 30 days after treatment from 2016 to 2019. Multivariate logistic regression analyses were performed to assess risk factors for tumor responses. The predictive values of related parameters derived from DCE were analyzed via receiver operating characteristic (ROC) curve analysis. To evaluate prognostic factors, the Kaplan-Meier survival analysis with log-rank tests and Cox regression tests were analyzed. Results K(trans)andV(e)were higher in the non-response group than in the response group (p< 0.05). TheK(trans)and the percentage ofK(trans)decreased after 30 days of treatment were independent predictors of chemotherapy responses (p= 0.034 andp= 0.019). ROC analysis indicated that the cut-off point ofK(trans)for predicting chemotherapeutic responses was 0.353 min(-1)(AUC, 0.941; 95% CI, 0.87-1;p< 0.001) and percentage ofK(trans)decreased after 30 days of treatment was 15.2% (AUC, 0.858; 95% CI, 0.742-0.970;p< 0.001). The greater decrease inK(trans)correlated with a longer progression-free survival (PFS) (chi(2)= 13.203,p< 0.001). The higherK(trans)was an independent predictor for shorter PFS (hazard ratio, 10.182; 95% CI, 2.510-41.300;p= 0.001). Conclusions K(trans)andK(trans)change measured by DCE-MRI were reliable biomarkers for predicting chemotherapy responses in PCNSL patients.
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