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Pharmacokinetic analysis of DCE-MRI data of locally advanced cervical carcinoma with the Brix model.
- Source :
-
Acta oncologica (Stockholm, Sweden) [Acta Oncol] 2019 Jun; Vol. 58 (6), pp. 828-837. Date of Electronic Publication: 2019 Feb 27. - Publication Year :
- 2019
-
Abstract
- Background: There is significant evidence that DCE-MRI may have the potential to provide clinically useful biomarkers of the outcome of locally advanced cervical carcinoma. However, there is no consensus on how to analyze DCE-MRI data to arrive at the most powerful biomarkers. The purpose of this study was to analyze DCE-MRI data of cervical cancer patients by using the Brix pharmacokinetic model and to compare the biomarkers derived from the Brix analysis with biomarkers determined by non-model-based analysis [i.e., low-enhancing tumor volume (LETV) and tumor volume with increasing signal (TVIS)] of the same patient cohort. Material and methods: DCE-MRI recordings of 80 patients (FIGO stage IB-IVA) treated with concurrent cisplatin-based chemoradiotherapy were analyzed voxel-by-voxel, and frequency distributions of the three parameters of the Brix model ( A <subscript>Brix</subscript> , k <subscript>ep</subscript> , and k <subscript>el</subscript> ) were determined. Moreover, risk volumes were calculated from the Brix parameters and termed RV- A <subscript>Brix</subscript> , RV- k <subscript>ep</subscript> , and RV- k <subscript>el</subscript> , where the RVs represent the tumor volume with voxel values below a threshold value determined by ROC analysis. Disease-free survival (DFS) and overall survival (OS) were used as measures of treatment outcome. Results: Significant associations between the median value or any other percentile value of A <subscript>Brix</subscript> , k <subscript>ep</subscript> , or k <subscript>el</subscript> and treatment outcome were not found. However, RV- A <subscript>Brix</subscript> , RV- k <subscript>ep</subscript> , and RV- k <subscript>el</subscript> correlated with DFS and OS. Multivariate analysis revealed that the prognostic power of RV- A <subscript>Brix</subscript> , RV- k <subscript>ep</subscript> , and RV- k <subscript>el</subscript> was independent of well-established clinical prognostic factors. RV- A <subscript>Brix</subscript> , RV- k <subscript>ep</subscript> , and RV- k <subscript>el</subscript> correlated with each other as well as with LETV and TVIS. Conclusion: Strong biomarkers of the outcome of locally advanced cervical carcinoma can be provided by subjecting DCE-MRI series to pharmacokinetic analysis using the Brix model. The prognostic power of these biomarkers is not necessarily superior to that of biomarkers identified by non-model-based analyses.
- Subjects :
- Adenocarcinoma metabolism
Adenocarcinoma therapy
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell metabolism
Carcinoma, Squamous Cell therapy
Chemoradiotherapy mortality
Female
Follow-Up Studies
Humans
Image Processing, Computer-Assisted methods
Middle Aged
Neoplasm Recurrence, Local metabolism
Neoplasm Recurrence, Local therapy
Prognosis
Survival Rate
Tissue Distribution
Uterine Cervical Neoplasms metabolism
Uterine Cervical Neoplasms therapy
Young Adult
Adenocarcinoma pathology
Carcinoma, Squamous Cell pathology
Contrast Media pharmacokinetics
Magnetic Resonance Imaging methods
Models, Statistical
Neoplasm Recurrence, Local pathology
Uterine Cervical Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1651-226X
- Volume :
- 58
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Acta oncologica (Stockholm, Sweden)
- Publication Type :
- Academic Journal
- Accession number :
- 30810443
- Full Text :
- https://doi.org/10.1080/0284186X.2019.1580386