Remy Klaassen1, Oliver J Gurney-Champion2, Johanna W Wilmink3, Marc G Besselink4, Marc R W Engelbrecht5, Jaap Stoker5, Aart J Nederveen5, Hanneke W M van Laarhoven3. 1. Cancer Center Amsterdam, Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands; Cancer Center Amsterdam, LEXOR (Laboratory for Experimental Oncology and Radiobiology), Academic Medical Center, Amsterdam, The Netherlands. Electronic address: r.klaassen@amc.uva.nl. 2. Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands. 3. Cancer Center Amsterdam, Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands. 4. Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. 5. Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Abstract
BACKGROUND: In current oncological practice of pancreatic ductal adenocarcinoma (PDAC), there is a great demand for response predictors and markers for early treatment evaluation. In this study, we investigated the repeatability and the interaction of dynamic contrast enhanced (DCE) and T2* MRI in patients with advanced PDAC to enable for such evaluation using these techniques. MATERIALS & METHODS: 15 PDAC patients underwent two DCE, T2* and anatomical 3 T MRI sessions before start of treatment. Parametric maps were calculated for the transfer constant (Ktrans), rate constant (kep), extracellular extravascular space (ve) and perfusion fraction (vp). Quantitative R2* (1/T2*) maps were obtained from the multi-echo T2* images. Differences between normal and cancerous pancreas were determined using a Wilcoxon matched pairs test. Repeatability was obtained using Bland-Altman analysis and relations between DCE and T2*/R2* were observed by Spearman correlation and voxel-wise binned plots of tumor voxels. RESULTS: PDAC Ktrans (p = 0.007), kep (p < 0.001), vp (p = 0.035) were lower and ve (p < 0.001) was higher compared to normal pancreas. The coefficient of variation between sessions was 21.8% for Ktrans, 9.9% for kep, 19.3% for ve, 18.2% for vp and 18.7% for R2*. Variation between patients ranged from 20.2% for kep to 43.6% for Ktrans. In the tumor both Ktrans (r = 0.56, p = 0.030) and ve (r = 0.54, p = 0.037) showed a positive correlation with T2*. Voxel wise analysis showed a steep increase in R2* for tumor voxels with lower Ktrans and ve. CONCLUSION: We showed good repeatability of DCE and T2* related MRI parameters in advanced PDAC patients. Furthermore, we have illustrated the relation of DCE Ktrans and ve with tissue T2* and R2* indicating substantial value of these parameters for detecting tumor hypoxia in future studies. The results from our study pave the way for further response evaluation studies and patient selection based on DCE and T2* parameters.
BACKGROUND: In current oncological practice of pancreatic ductal adenocarcinoma (PDAC), there is a great demand for response predictors and markers for early treatment evaluation. In this study, we investigated the repeatability and the interaction of dynamic contrast enhanced (DCE) and T2* MRI in patients with advanced PDAC to enable for such evaluation using these techniques. MATERIALS & METHODS: 15 PDACpatients underwent two DCE, T2* and anatomical 3 T MRI sessions before start of treatment. Parametric maps were calculated for the transfer constant (Ktrans), rate constant (kep), extracellular extravascular space (ve) and perfusion fraction (vp). Quantitative R2* (1/T2*) maps were obtained from the multi-echo T2* images. Differences between normal and cancerous pancreas were determined using a Wilcoxon matched pairs test. Repeatability was obtained using Bland-Altman analysis and relations between DCE and T2*/R2* were observed by Spearman correlation and voxel-wise binned plots of tumor voxels. RESULTS:PDACKtrans (p = 0.007), kep (p < 0.001), vp (p = 0.035) were lower and ve (p < 0.001) was higher compared to normal pancreas. The coefficient of variation between sessions was 21.8% for Ktrans, 9.9% for kep, 19.3% for ve, 18.2% for vp and 18.7% for R2*. Variation between patients ranged from 20.2% for kep to 43.6% for Ktrans. In the tumor both Ktrans (r = 0.56, p = 0.030) and ve (r = 0.54, p = 0.037) showed a positive correlation with T2*. Voxel wise analysis showed a steep increase in R2* for tumor voxels with lower Ktrans and ve. CONCLUSION: We showed good repeatability of DCE and T2* related MRI parameters in advanced PDACpatients. Furthermore, we have illustrated the relation of DCEKtrans and ve with tissue T2* and R2* indicating substantial value of these parameters for detecting tumor hypoxia in future studies. The results from our study pave the way for further response evaluation studies and patient selection based on DCE and T2* parameters.
Authors: Olya Stringfield; John A Arrington; Sandra K Johnston; Nicolas G Rognin; Noah C Peeri; Yoganand Balagurunathan; Pamela R Jackson; Kamala R Clark-Swanson; Kristin R Swanson; Kathleen M Egan; Robert A Gatenby; Natarajan Raghunand Journal: Tomography Date: 2019-03
Authors: Remy Klaassen; Anne Steins; Oliver J Gurney-Champion; Maarten F Bijlsma; Geertjan van Tienhoven; Marc R W Engelbrecht; Casper H J van Eijck; Mustafa Suker; Johanna W Wilmink; Marc G Besselink; Olivier R Busch; Onno J de Boer; Marc J van de Vijver; Gerrit K J Hooijer; Joanne Verheij; Jaap Stoker; Aart J Nederveen; Hanneke W M van Laarhoven Journal: Mol Oncol Date: 2020-06-23 Impact factor: 6.603
Authors: Stephan Ursprung; Andrew N Priest; Fulvio Zaccagna; Wendi Qian; Andrea Machin; Grant D Stewart; Anne Y Warren; Timothy Eisen; Sarah J Welsh; Ferdia A Gallagher; Tristan Barrett Journal: PLoS One Date: 2021-10-26 Impact factor: 3.240