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1DCE-MRI in hepatocellular carcinoma-clinical and therapeutic image biomarker显示文摘Dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)enables tumor vascular physiology to be assessed.Within the tumor tissue,contrast agents(gadolinium chelates)extravasate from intravascular into the extravascular extracellular space(EES),which results in a signal increase on T1-weighted MRI.The rate of contrast agents extravasation to EES in the tumor tissue is determined by vessel leakiness and blood flow.Thus,the signal measured on DCE-MRI represents a combination of permeability and perfusion.The semi-quantitative analysis is based on the calculation of heuristic parameters that can be extracted from signal intensity-time curves.These enhancing curves can also be deconvoluted by mathematical modeling to extract quantitative parameters that may reflect tumor perfusion,vascular volume,vessel permeability and angiogenesis.Because hepatocellular carcinoma(HCC)is a hypervascular tumor,many emerging therapies focused on the inhibition of angiogenesis.DCE-MRI combined with a pharmacokinetic model allows us to produce highly reproducible and reliable parametric maps of quantitative parameters in HCC.Successful therapies change quantitative parameters of DCE-MRI,which may be used as early indicators of tumor response to anti-angiogenesis agents that modulate tumor vasculature.In the setting of clinical trials,DCE-MRI may provide relevant clinical information on the pharmacodynamic and biologic effects of novel drugs,monitor treatment response and predict survival outcome in HCC patients.Bang-Bin Chen Tiffany Ting-Fang Shih 2014World Journal of Gastroenterology2014,20,12:15
2Dual-input two-compartment pharmacokinetic model of dynamic contrast-enhanced magnetic resonance imaging in hepatocellular carcinoma显示文摘AIM: To investigate the feasibility of a dual-input two-compartment tracer kinetic model for evaluating tumorous microvascular properties in advanced hepatocellular carcinoma(HCC). METHODS: From January 2014 to April 2015, we prospectively measured and analyzed pharmacokinetic parameters [transfer constant(K_(trans)), plasma flow(F_p), permeability surface area product(PS), efflux rate constant(k_(ep)), extravascular extracellular space volume ratio(V_e), blood plasma volume ratio(V_p), and hepatic perfusion index(HPI)] using dual-input two-compartment tracer kinetic models [a dual-input extended Tofts model and a dual-input 2-compartment exchange model(2CXM)] in 28 consecutive HCC patients. A well-known consensus that HCC is a hypervascular tumor supplied by the hepatic artery and the portal vein was used as a reference standard. A paired Student's t-test and a nonparametric paired Wilcoxon rank sum test were used to compare the equivalent pharmacokinetic parameters derived from the two models, and Pearson correlation analysis was also applied to observe the correlations among all equivalent parameters. The tumor size and pharmacokinetic parameters were tested by Pearson correlation analysis, while correlations among stage, tumor size and all pharmacokinetic parameters were assessed by Spearman correlation analysis. RESULTS: The F_p value was greater than the PS value(F_P = 1.07 m L/m L per minute, PS = 0.19 m L/m L per minute) in the dual-input 2CXM; HPI was 0.66 and 0.63 in the dual-input extended Tofts model and the dualinput 2CXM, respectively. There were no significant differences in the K_(ep), V_p, or HPI between the dual-input extended Tofts model and the dual-input 2CXM(P = 0.524, 0.569, and 0.622, respectively). All equivalent pharmacokinetic parameters, except for V_e, were correlated in the two dual-input two-compartment pharmacokinetic models; both Fp and PS in the dualinput 2CXM were correlated with K_(trans) derived from the dual-input extended Tofts model(P = 0.002, r = 0.566; P = 0.002, r = 0.570); K_(ep), V_p, and HPI between the two kinetic models were positively correlated(P = 0.001, r = 0.594; P = 0.0001, r = 0.686; P = 0.04, r = 0.391, respectively). In the dual input extended Tofts model, V_e was significantly less than that in the dual input 2CXM(P = 0.004), and no significant correlation was seen between the two tracer kinetic models(P = 0.156, r = 0.276). Neither tumor size nor tumor stage was significantly correlated with any of the pharmacokinetic parameters obtained from the two models(P > 0.05).CONCLUSION: A dual-input two-compartment pharmacokinetic model(a dual-input extended Tofts model and a dual-input 2CXM) can be used in assessing the microvascular physiopathological properties before the treatment of advanced HCC. The dual-input extended Tofts model may be more stable in measuring the V_e; however, the dual-input 2CXM may be more detailed and accurate in measuring microvascular permeability.Jian-Feng Yang Zhen-Hua Zhao Yu Zhang Li Zhao Li-Ming Yang Min-Ming Zhang Bo-Yin Wang Ting Wang Bao-Chun Lu 2016World Journal of Gastroenterology2016,22,13:3
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