Dynamic Contrast-Enhanced MRI for Assessing Histopathological Growth Patterns and Prognosis in Colorectal Liver Metastases.

IF 3.5 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Xiaoli Yin, Peng Liu, Chaoya Zhang, Chen Pan, Yueyue Lu, Zhiying Wang, Baihe Luo, Bai Du, Aoran Yang, Qijun Wu, Chengli Gu, Yu Shi
{"title":"Dynamic Contrast-Enhanced MRI for Assessing Histopathological Growth Patterns and Prognosis in Colorectal Liver Metastases.","authors":"Xiaoli Yin, Peng Liu, Chaoya Zhang, Chen Pan, Yueyue Lu, Zhiying Wang, Baihe Luo, Bai Du, Aoran Yang, Qijun Wu, Chengli Gu, Yu Shi","doi":"10.1002/jmri.70060","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The desmoplastic histopathological growth pattern (dHGP) of colorectal liver metastases (CRLM) is associated with prolonged survival and favorable anti-angiogenic chemotherapy response. However, reliable preoperative identification of dHGP using MRI remains challenging.</p><p><strong>Purpose: </strong>To develop a dynamic contrast-enhanced MRI (DCE-MRI)-based model for assessing dHGP probability, facilitating candidate selection for anti-angiogenic neoadjuvant chemotherapy, and prognostic evaluation.</p><p><strong>Study type: </strong>Retrospective, dual-center study.</p><p><strong>Subjects: </strong>286 patients (114 female; 133 with dHGP) with pathologically confirmed CRLM (≥ 10 mm).</p><p><strong>Field strength/sequence: </strong>3.0 T, T1-weighted imaging using 3D gradient sequence (precontrast, arterial, portal venous and delayed phases).</p><p><strong>Assessment: </strong>Three abdominal radiologists independently reviewed DCE-MRI features, including peritumoral rim enhancement at different phases for dHGP assessment. Disease-free survival (DFS), overall survival (OS), and treatment response to bevacizumab were also assessed.</p><p><strong>Statistical tests: </strong>Univariable and multivariable logistic regression, area under the receiver operating characteristic curve (AUC), DeLong test, Kaplan-Meier analysis, and log-rank test.</p><p><strong>Results: </strong>Peritumoral rim enhancement on arterial (odds ratio [OR] = 4.65, [95% CI: 2.20-9.84]), portal venous (OR = 7.46, [95% CI: 3.12-17.84]), and delayed phases (OR = 3.55, [95% CI: 1.84-6.88]) was significantly and independently associated with dHGP. A peritumoral rim enhancement-based probability model achieved AUCs of 0.86 (95% CI: 0.81-0.90) and 0.82 (95% CI: 0.70-0.91) for diagnosing dHGP in development and external validation cohorts, respectively. Peritumoral rim enhancement was independently associated with longer survival (DFS: adjusted hazard ratio [HR] = 0.34, [95% CI: 0.25-0.47]; OS: HR = 0.46, [95% CI: 0.34-0.63]) in all patients. Among patients receiving bevacizumab-containing neoadjuvant chemotherapy (n = 90), peritumoral rim enhancement was significantly associated with longer DFS (HR = 0.24, [95% CI: 0.12-0.49]) and OS (HR = 0.24, [95% CI: 0.11-0.50]).</p><p><strong>Data conclusion: </strong>Peritumoral rim enhancement on DCE-MRI shows a strong association with dHGP, indicates favorable survival, and may identify candidates for anti-angiogenic chemotherapy.</p><p><strong>Evidence level: </strong>3.</p><p><strong>Technical efficacy: </strong>Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.70060","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The desmoplastic histopathological growth pattern (dHGP) of colorectal liver metastases (CRLM) is associated with prolonged survival and favorable anti-angiogenic chemotherapy response. However, reliable preoperative identification of dHGP using MRI remains challenging.

Purpose: To develop a dynamic contrast-enhanced MRI (DCE-MRI)-based model for assessing dHGP probability, facilitating candidate selection for anti-angiogenic neoadjuvant chemotherapy, and prognostic evaluation.

Study type: Retrospective, dual-center study.

Subjects: 286 patients (114 female; 133 with dHGP) with pathologically confirmed CRLM (≥ 10 mm).

Field strength/sequence: 3.0 T, T1-weighted imaging using 3D gradient sequence (precontrast, arterial, portal venous and delayed phases).

Assessment: Three abdominal radiologists independently reviewed DCE-MRI features, including peritumoral rim enhancement at different phases for dHGP assessment. Disease-free survival (DFS), overall survival (OS), and treatment response to bevacizumab were also assessed.

Statistical tests: Univariable and multivariable logistic regression, area under the receiver operating characteristic curve (AUC), DeLong test, Kaplan-Meier analysis, and log-rank test.

Results: Peritumoral rim enhancement on arterial (odds ratio [OR] = 4.65, [95% CI: 2.20-9.84]), portal venous (OR = 7.46, [95% CI: 3.12-17.84]), and delayed phases (OR = 3.55, [95% CI: 1.84-6.88]) was significantly and independently associated with dHGP. A peritumoral rim enhancement-based probability model achieved AUCs of 0.86 (95% CI: 0.81-0.90) and 0.82 (95% CI: 0.70-0.91) for diagnosing dHGP in development and external validation cohorts, respectively. Peritumoral rim enhancement was independently associated with longer survival (DFS: adjusted hazard ratio [HR] = 0.34, [95% CI: 0.25-0.47]; OS: HR = 0.46, [95% CI: 0.34-0.63]) in all patients. Among patients receiving bevacizumab-containing neoadjuvant chemotherapy (n = 90), peritumoral rim enhancement was significantly associated with longer DFS (HR = 0.24, [95% CI: 0.12-0.49]) and OS (HR = 0.24, [95% CI: 0.11-0.50]).

Data conclusion: Peritumoral rim enhancement on DCE-MRI shows a strong association with dHGP, indicates favorable survival, and may identify candidates for anti-angiogenic chemotherapy.

Evidence level: 3.

Technical efficacy: Stage 2.

动态增强MRI评估结直肠肝转移的组织病理学生长模式和预后。
背景:结直肠肝转移瘤(CRLM)的结缔组织病理学生长模式(dHGP)与延长生存期和良好的抗血管生成化疗反应相关。然而,术前使用MRI可靠地识别dHGP仍然具有挑战性。目的:建立一种基于动态对比增强MRI (DCE-MRI)的dHGP概率评估模型,促进抗血管生成新辅助化疗候选人的选择和预后评估。研究类型:回顾性双中心研究。研究对象:286例患者(女性114例;133例dHGP),病理证实的CRLM(≥10 mm)。场强/序列:3.0 T, 3D梯度序列t1加权成像(对比前、动脉、门静脉和延迟期)。评估:三名腹部放射科医生独立审查了DCE-MRI特征,包括不同阶段的肿瘤周围增强,用于dHGP评估。无病生存期(DFS)、总生存期(OS)和对贝伐单抗的治疗反应也进行了评估。统计检验:单变量和多变量logistic回归、受试者工作特征曲线下面积(AUC)、DeLong检验、Kaplan-Meier分析、log-rank检验。结果:肿瘤周围动脉(比值比[OR] = 4.65, [95% CI: 2.20-9.84])、门静脉(比值比[OR] = 7.46, [95% CI: 3.12-17.84])和延迟期(OR = 3.55, [95% CI: 1.84-6.88])增强与dHGP有显著且独立的相关性。基于肿瘤周围边缘增强的概率模型在发展和外部验证队列中诊断dHGP的auc分别为0.86 (95% CI: 0.81-0.90)和0.82 (95% CI: 0.70-0.91)。瘤周边缘增强与更长的生存期独立相关(DFS:校正风险比[HR] = 0.34, [95% CI: 0.25-0.47];OS: HR = 0.46, [95% CI: 0.34-0.63])。在接受含贝伐单抗新辅助化疗的患者(n = 90)中,瘤周边缘增强与更长的DFS (HR = 0.24, [95% CI: 0.12-0.49])和OS (HR = 0.24, [95% CI: 0.11-0.50])显著相关。数据结论:DCE-MRI的肿瘤周围增强显示与dHGP有很强的相关性,预示着有利的生存,并可能确定抗血管生成化疗的候选药物。证据等级:3。技术功效:第二阶段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
9.70
自引率
6.80%
发文量
494
审稿时长
2 months
期刊介绍: The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信