PURPOSE: To investigate dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of advanced nonsmall-cell lung cancer (NSCLC) patients treated with the antiangiogenic agent bevacizumab combined with gemcitabine and cisplatin as first-line treatment. MATERIALS AND METHODS: All patients were enrolled for MRI and computed tomography (CT) before and after the first three courses of bevacizumab combination chemotherapy. Pharmacokinetic parameters (K(trans), k(ep), v(e), v(p)) derived from DCE MRI were computed for the main mass. Parametric histogram analysis was obtained to evaluate changes of the internal tumor composition and for correlation with tumor response measured on CT. RESULTS: After three cycles of treatment, 11 patients showed decreased tumor size and a decreased value of all MR-derived pharmacokinetic parameters. Among these parameters, there was a significant decrease of mean and standard deviation of the K(trans) histogram as well as a decrease of mean of the k(ep) histogram (P < 0.05). Tumors with larger mean values of rate constant k(ep) (P < 0.0001) and smaller standard deviation of volume of extravascular extracellular space fraction v(e) (P < 0.0001) on histograms before chemotherapy were considered predictors for treatment response. CONCLUSION:DCE MRI enables a functional analysis of the treatment response of NSCLC. MRI parametric histogram has the potential to predict early treatment response of combined bevacizumab, gemcitabine, and cisplatin.
RCT Entities:
PURPOSE: To investigate dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of advanced nonsmall-cell lung cancer (NSCLC) patients treated with the antiangiogenic agent bevacizumab combined with gemcitabine and cisplatin as first-line treatment. MATERIALS AND METHODS: All patients were enrolled for MRI and computed tomography (CT) before and after the first three courses of bevacizumab combination chemotherapy. Pharmacokinetic parameters (K(trans), k(ep), v(e), v(p)) derived from DCE MRI were computed for the main mass. Parametric histogram analysis was obtained to evaluate changes of the internal tumor composition and for correlation with tumor response measured on CT. RESULTS: After three cycles of treatment, 11 patients showed decreased tumor size and a decreased value of all MR-derived pharmacokinetic parameters. Among these parameters, there was a significant decrease of mean and standard deviation of the K(trans) histogram as well as a decrease of mean of the k(ep) histogram (P < 0.05). Tumors with larger mean values of rate constant k(ep) (P < 0.0001) and smaller standard deviation of volume of extravascular extracellular space fraction v(e) (P < 0.0001) on histograms before chemotherapy were considered predictors for treatment response. CONCLUSION:DCE MRI enables a functional analysis of the treatment response of NSCLC. MRI parametric histogram has the potential to predict early treatment response of combined bevacizumab, gemcitabine, and cisplatin.
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