MRI评价1例直肠癌新辅助放化疗结果,辅以肿瘤T2WI结构分析(临床病例)

封面

如何引用文章

详细

本文报告一名对新辅助化疗有良好反应的73岁下段壶腹直肠癌患者,采用积极动态随访策略(Watch & Wait策略)的临床病例。经过三年的定期随访,包括指状直肠检查、直肠镜检查和磁共振成像(MRI),表明肿瘤没有进展,得到了18F氟脱氧葡萄糖正电子发射断层摄影与计算机断层摄影的结果。结果显示直肠下段壶腹部有一个高代谢活动的部位(SUVmax 27.1),因此决定进行手术治疗。讨论手术范围时,考虑MRI资料,辅以T2WI分析结果,证实无疾病进展。患者接受了保留器官的经肛门肿瘤切除体积的治疗。手术准备的病理形态学检查确定了肠壁炎症改变和肿瘤的消失。本案例证明了标准调查体积在使用Watch & Wait策略时的有效性,以及使用T2WI分析来提高MRI评估肿瘤对放化疗反应的可靠性的可能性。

作者简介

Yana Dayneko

А. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre

Email: vorobeyana@gmail.com
ORCID iD: 0000-0002-4524-0839
SPIN 代码: 1841-7759

MD, Research Associate

俄罗斯联邦, 4 Korolev st., Obninsk, 249036

Tatiana Berezovskaya

А. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre

编辑信件的主要联系方式.
Email: berez@mrrc.obninsk.ru
ORCID iD: 0000-0002-3549-4499
SPIN 代码: 5837-3465

MD, Dr. Sci. (Med.) Professor, Chief Researcher

俄罗斯联邦, 4 Korolev st., Obninsk, 249036

Sofia Myalina

А. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre

Email: samyalina@mail.ru
ORCID iD: 0000-0001-6686-5419

MD, Junior Research Associate

俄罗斯联邦, 4 Korolev st., Obninsk, 249036

Ivan Orekhov

А. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre

Email: ivan.orekhov.vgma@gmail.com
ORCID iD: 0000-0001-6543-6356
SPIN 代码: 6040-8930

MD, Junior Research Associate

俄罗斯联邦, 4 Korolev st., Obninsk, 249036

Aleksey Nevolskikh

А. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre

Email: nevol@mrrc.obninsk.ru
ORCID iD: 0000-0001-5961-2958
SPIN 代码: 3787-6139

MD, Dr. Sci. (Med.)

俄罗斯联邦, 4 Korolev st., Obninsk, 249036

参考

  1. Fedyanin MYu, Artamonova EV, Barsukov YuA, et al. Practical recommendations for the drug treatment of rectal cancer. Malignant tumors: Practical recommendations of RUSSCO. Russian Society of Clinical Oncology; 2020. (In Russ). doi: 10.18027/2224-5057-2020-10-3s2-23
  2. Gillies RJ, Kinahan PE, Hricak H. Radiomics: images are more than pictures, they are data. Radiology. 2016;278(2):563–577. doi: 10.1148/radiol.2015151169
  3. Haralick RM, Shanmugam K, Dinstein I. Textural features for image classification. IEEE Transactions on Systems, Man, and Cybernetics. 1973;SMC-3(6):610–621. doi: 10.1109/TSMC.1973.4309314
  4. Berezovskaya TP, Dayneko YaA, Nevolskikh AA, et al. A system for evaluating the effectiveness of neoadjuvant chemo radiotherapy in patients with colorectal cancer based on a texture analysis of post-therapeutic T2-WI magnetic resonance imaging. REJR. 2020;10(3):92–101. doi: 10.21569/2222-7415-2020-10-3-92-101
  5. Lambregts DM, Rao SX, Sassen S, et al. MRI and Diffusion-weighted MRI volumetry for identification of complete tumor responders after preoperative chemoradiotherapy in patients with rectal cancer: a bi-institutional validation study. Ann Surg. 2015;262(6):1034–1039. doi: 10.1097/SLA.0000000000000909
  6. Lambin P, Rios-Velazquez R, Leijenaar S, et al. Radiomics: Extracting more information from medical images using advanced feature analysis. Eur J Cancer. 2012;48(4):441–446. doi: 10.1016/j.ejca.2011.11.036
  7. Horvat N, Veeraraghavan H, Pelossof RA, et al. Radiogenomics of rectal adenocarcinoma in the era of precision medicine: A pilot study of associations between qualitative and quantitative MRI imaging features and genetic mutations. Eur J Radiol. 2019;113:174–181. doi: 10.1016/j.ejrad.2019.02.022

补充文件

附件文件
动作
1. JATS XML
2. Fig. 4. Magnetic resonance imaging of the tumor of the lower ampullar rectum 3 years after neoadjuvant chemoradiation therapy: a ― T2-WI; b ― segmentation of the zone of interest for texture analysis (highlighted in green).

下载 (162KB)
3. 图 1。治疗前下段壶腹直肠癌磁共振成像mrT3a:a—Т2-WI;b―弥散加权成像(DWI)。肿瘤呈领圈状。

下载 (136KB)
4. 图 2。新辅助化疗后1个月下段壶腹直肠癌磁共振成像,ymrT1-0,TRG2:a—T2-WI;b—弥散加权成像(DWI)。肿瘤被 一个薄薄的纤维疤痕代替,没有扩散受限的迹象(箭头所示)。

下载 (153KB)
5. 图 3。18F-氟脱氧葡萄糖正电子发射断层扫描联合计算 机断层扫描:a—肿瘤水平的单模正电子发射断层扫描( 箭头所示);b—肿瘤水平的计算机断层扫描(箭头所示) ;c—下段壶腹直肠18F-氟脱氧葡萄糖过度固定的三维重 建(箭头所示)。

下载 (95KB)
6. 图 4。新辅助化疗3年后下段壶腹直肠肿瘤的磁共振成像:a ―T2-WI;b—对分割感兴趣的区域进行结构分析(绿色 突出显示)。

下载 (162KB)

版权所有 © Dayneko Y., Berezovskaya T., Myalina S., Orekhov I., Nevolskikh A., 2021

Creative Commons License
此作品已接受知识共享署名-非商业性使用-禁止演绎 4.0国际许可协议的许可。

##common.cookie##