Dynamic contrast-enhanced CT-derived extracellular volume fraction for predicting postoperative oncologic outcomes in pancreatic ductal adenocarcinoma

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-06-18 DOI:10.1016/j.ejrad.2025.112246

Hideyuki Fukui , Yasunari Fukuda , Hiromitsu Onishi , Takashi Ota , Atsushi Nakamoto , Toru Honda , Ryo Aihara , Yukihiro Enchi , Daisaku Yamada , Shogo Kobayashi , Hidetoshi Eguchi , Mitsuaki Tatsumi , Noriyuki Tomiyama

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引用次数: 0

Abstract

Objective

To evaluate the prognostic value of the extracellular volume fraction (fECV) derived from contrast-enhanced computed tomography (CE-CT) for recurrence-free survival (RFS) and overall survival (OS) rates after pancreatic ductal adenocarcinoma (PDAC) surgery.

Methods

This retrospective study evaluated 71 patients diagnosed with PDAC postsurgery who underwent CE-CT with precontrast and equilibrium phases before neoadjuvant chemotherapy (35 males, 36 females; mean age, 70.3 years; 95 % CI, 68.1–72.6; SD, 9.8; range, 45–89 years), were enrolled. Noncancerous pancreatic parenchyma and pancreatic tumors were automatically segmented from nonenhanced and equilibrium-phase images, excluding focal lesions, major-vessel, and ducts. Uni- and multivariate analyses (Cox proportional hazards model) were performed to evaluate fECV [=(100 − hematocrit) × (ΔPancreas/ΔAorta] in the nonaffected pancreas and tumor, with age, sex, chemotherapeutic scheme, tumor marker/location/size, stage, histological type, RFS, and OS as factors. Time-dependent receiver-operating characteristic curves showed the optimal fECV cutoff values for predicting RFS and OS.

Results

Adjuvant chemotherapy regimen, histological type, and fECV of noncancerous pancreatic parenchyma were independent prognostic factors of OS (p < 0.001, 0.049, and 0.018, respectively), and TNM stage (IB) was an independent predictor of RFS (p = 0.025). RFS and OS were worse in patients with noncancerous pancreatic tissue with higher fECV than in those with lower fECV (optimal cutoffs: 40.32 % for RFS, p = 0.036; 43.65 % for OS, p < 0.001).

Conclusion

The fECV of noncancerous pancreatic parenchyma from CE-CT was a significant predictor of survival outcomes in PDAC.

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动态增强ct衍生的细胞外体积分数预测胰腺导管腺癌术后肿瘤预后

目的评价对比增强计算机断层扫描（CE-CT）所得细胞外体积分数（fECV）对胰腺导管腺癌（PDAC）手术后无复发生存率（RFS）和总生存率（OS）的预后价值。方法回顾性研究71例术后诊断为PDAC的患者，在新辅助化疗前进行造影前和平衡期的CE-CT检查(男性35例，女性36例；平均年龄70.3岁；95% ci, 68.1-72.6；SD, 9.8;年龄范围45-89岁)。非癌性胰腺实质和胰腺肿瘤从非增强和平衡期图像中自动分割，排除局灶性病变、主要血管和导管。采用单因素和多因素分析（Cox比例风险模型），以年龄、性别、化疗方案、肿瘤标志物/位置/大小、分期、组织学类型、RFS和OS为因素，评估未受影响胰腺和肿瘤中的fECV[=(100−hematocrit) × （ΔPancreas/ΔAorta）]。随时间变化的接收机工作特性曲线显示了预测RFS和OS的最佳fECV截止值。结果辅助化疗方案、组织学类型、非癌性胰腺实质fECV是影响OS预后的独立因素(p <；分别为0.001、0.049和0.018)，TNM分期（IB）是RFS的独立预测因子（p = 0.025）。fECV较高的非癌性胰腺组织患者的RFS和OS较fECV较低的患者更差(RFS的最佳截止值：40.32%,p = 0.036；43.65%为OS， p <；0.001)。结论CE-CT非癌性胰腺实质的fECV是预测PDAC患者生存结局的重要指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.