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Erschienen in: European Radiology 9/2017

16.02.2017 | Head and Neck

Dynamic contrast-enhanced MR imaging pharmacokinetic parameters as predictors of treatment response of brain metastases in patients with lung cancer

verfasst von: Grégory Kuchcinski, Emilie Le Rhun, Alexis B. Cortot, Elodie Drumez, Romain Duhal, Maxime Lalisse, Julien Dumont, Renaud Lopes, Jean-Pierre Pruvo, Xavier Leclerc, Christine Delmaire

Erschienen in: European Radiology | Ausgabe 9/2017

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Abstract

Objectives

To determine the diagnostic accuracy of pharmacokinetic parameters measured by dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in predicting the response of brain metastases to antineoplastic therapy in patients with lung cancer.

Methods

Forty-four consecutive patients with lung cancer, harbouring 123 newly diagnosed brain metastases prospectively underwent conventional 3-T MRI at baseline (within 1 month before treatment), during the early (7–10 weeks) and midterm (5–7 months) post-treatment period. An additional DCE MRI sequence was performed during baseline and early post-treatment MRI to evaluate baseline pharmacokinetic parameters (K trans, k ep, v e, v p) and their early variation (∆K trans, ∆k ep, ∆v e, ∆v p). The objective response was judged by the volume variation of each metastasis from baseline to midterm MRI. ROC curve analysis determined the best DCE MRI parameter to predict the objective response.

Results

Baseline DCE MRI parameters were not associated with the objective response. Early ∆K trans, ∆v e and ∆v p were significantly associated with the objective response (p = 0.02, p = 0.001 and p = 0.02, respectively). The best predictor of objective response was ∆v e with an area under the curve of 0.93 [95% CI = 0.87, 0.99].

Conclusions

DCE MRI and early ∆v e may be a useful tool to predict the objective response of brain metastases in patients with lung cancer.

Key Points

DCE MRI could predict the response of brain metastases from lung cancer
∆v e was the best predictor of response
DCE MRI could be used to individualize patients’ follow-up
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Literatur
1.
Zurück zum Zitat Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J et al (2013) Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 49:1374–1403CrossRefPubMed Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J et al (2013) Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 49:1374–1403CrossRefPubMed
2.
Zurück zum Zitat Goncalves PH, Peterson SL, Vigneau FD et al (2016) Risk of brain metastases in patients with nonmetastatic lung cancer: analysis of the Metropolitan Detroit Surveillance, Epidemiology, and End Results (SEER) data. Cancer 122:1921–1927CrossRefPubMedPubMedCentral Goncalves PH, Peterson SL, Vigneau FD et al (2016) Risk of brain metastases in patients with nonmetastatic lung cancer: analysis of the Metropolitan Detroit Surveillance, Epidemiology, and End Results (SEER) data. Cancer 122:1921–1927CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Peters S, Bexelius C, Munk V, Leighl N (2016) The impact of brain metastasis on quality of life, resource utilization and survival in patients with non-small-cell lung cancer. Cancer Treat Rev 45:139–162CrossRefPubMed Peters S, Bexelius C, Munk V, Leighl N (2016) The impact of brain metastasis on quality of life, resource utilization and survival in patients with non-small-cell lung cancer. Cancer Treat Rev 45:139–162CrossRefPubMed
4.
Zurück zum Zitat Soffietti R, Cornu P, Delattre JY et al (2006) EFNS Guidelines on diagnosis and treatment of brain metastases: report of an EFNS Task Force. Eur J Neurol 13:674–681CrossRefPubMed Soffietti R, Cornu P, Delattre JY et al (2006) EFNS Guidelines on diagnosis and treatment of brain metastases: report of an EFNS Task Force. Eur J Neurol 13:674–681CrossRefPubMed
5.
Zurück zum Zitat Novello S, Barlesi F, Califano R et al (2016) Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 27:v1–v27CrossRefPubMed Novello S, Barlesi F, Califano R et al (2016) Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 27:v1–v27CrossRefPubMed
6.
Zurück zum Zitat Lin NU, Lee EQ, Aoyama H et al (2015) Response assessment criteria for brain metastases: proposal from the RANO group. Lancet Oncol 16:e270–e278CrossRefPubMed Lin NU, Lee EQ, Aoyama H et al (2015) Response assessment criteria for brain metastases: proposal from the RANO group. Lancet Oncol 16:e270–e278CrossRefPubMed
7.
Zurück zum Zitat Jakubovic R, Zhou S, Heyn C et al (2016) The predictive capacity of apparent diffusion coefficient (ADC) in response assessment of brain metastases following radiation. Clin Exp Metastasis 33:277–284CrossRefPubMed Jakubovic R, Zhou S, Heyn C et al (2016) The predictive capacity of apparent diffusion coefficient (ADC) in response assessment of brain metastases following radiation. Clin Exp Metastasis 33:277–284CrossRefPubMed
8.
Zurück zum Zitat Essig M, Waschkies M, Wenz F, Debus J, Hentrich HR, Knopp MV (2003) Assessment of brain metastases with dynamic susceptibility-weighted contrast-enhanced MR imaging: initial results. Radiology 228:193–199CrossRefPubMed Essig M, Waschkies M, Wenz F, Debus J, Hentrich HR, Knopp MV (2003) Assessment of brain metastases with dynamic susceptibility-weighted contrast-enhanced MR imaging: initial results. Radiology 228:193–199CrossRefPubMed
9.
Zurück zum Zitat Chernov MF, Hayashi M, Izawa M et al (2009) Dynamics of metabolic changes in intracranial metastases and distant normal-appearing brain tissue after stereotactic radiosurgery: a serial proton magnetic resonance spectroscopy study. Neuroradiol J 22:58–71CrossRefPubMed Chernov MF, Hayashi M, Izawa M et al (2009) Dynamics of metabolic changes in intracranial metastases and distant normal-appearing brain tissue after stereotactic radiosurgery: a serial proton magnetic resonance spectroscopy study. Neuroradiol J 22:58–71CrossRefPubMed
10.
Zurück zum Zitat Jain R (2013) Measurements of tumor vascular leakiness using DCE in brain tumors: clinical applications. NMR Biomed 26:1042–1049CrossRefPubMed Jain R (2013) Measurements of tumor vascular leakiness using DCE in brain tumors: clinical applications. NMR Biomed 26:1042–1049CrossRefPubMed
11.
Zurück zum Zitat Tofts PS, Brix G, Buckley DL et al (1999) Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging 10:223–232CrossRefPubMed Tofts PS, Brix G, Buckley DL et al (1999) Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging 10:223–232CrossRefPubMed
12.
Zurück zum Zitat Piludu F, Marzi S, Pace A et al (2015) Early biomarkers from dynamic contrast-enhanced magnetic resonance imaging to predict the response to antiangiogenic therapy in high-grade gliomas. Neuroradiology 57:1269–1280CrossRefPubMed Piludu F, Marzi S, Pace A et al (2015) Early biomarkers from dynamic contrast-enhanced magnetic resonance imaging to predict the response to antiangiogenic therapy in high-grade gliomas. Neuroradiology 57:1269–1280CrossRefPubMed
13.
Zurück zum Zitat Yun TJ, Park CK, Kim TM et al (2015) Glioblastoma treated with concurrent radiation therapy and temozolomide chemotherapy: differentiation of true progression from pseudoprogression with quantitative dynamic contrast-enhanced MR imaging. Radiology 274:830–840CrossRefPubMed Yun TJ, Park CK, Kim TM et al (2015) Glioblastoma treated with concurrent radiation therapy and temozolomide chemotherapy: differentiation of true progression from pseudoprogression with quantitative dynamic contrast-enhanced MR imaging. Radiology 274:830–840CrossRefPubMed
14.
Zurück zum Zitat Tudorica A, Oh KY, Chui SY et al (2016) Early prediction and evaluation of breast cancer response to neoadjuvant chemotherapy using quantitative DCE-MRI. Transl Oncol 9:8–17CrossRefPubMedPubMedCentral Tudorica A, Oh KY, Chui SY et al (2016) Early prediction and evaluation of breast cancer response to neoadjuvant chemotherapy using quantitative DCE-MRI. Transl Oncol 9:8–17CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Fusco R, Sansone M, Petrillo M et al (2016) Multiparametric MRI for prostate cancer detection: preliminary results on quantitative analysis of dynamic contrast enhanced imaging, diffusion-weighted imaging and spectroscopy imaging. Magn Reson Imaging 34:839–845CrossRefPubMed Fusco R, Sansone M, Petrillo M et al (2016) Multiparametric MRI for prostate cancer detection: preliminary results on quantitative analysis of dynamic contrast enhanced imaging, diffusion-weighted imaging and spectroscopy imaging. Magn Reson Imaging 34:839–845CrossRefPubMed
16.
Zurück zum Zitat Jakubovic R, Sahgal A, Soliman H et al (2014) Magnetic resonance imaging-based tumour perfusion parameters are biomarkers predicting response after radiation to brain metastases. Clin Oncol (R Coll Radiol) 6555:00264–00267 Jakubovic R, Sahgal A, Soliman H et al (2014) Magnetic resonance imaging-based tumour perfusion parameters are biomarkers predicting response after radiation to brain metastases. Clin Oncol (R Coll Radiol) 6555:00264–00267
17.
Zurück zum Zitat Almeida-Freitas DB, Pinho MC, Otaduy MC, Braga HF, Meira-Freitas D, da Costa Leite C (2014) Assessment of irradiated brain metastases using dynamic contrast-enhanced magnetic resonance imaging. Neuroradiology 56:437–443PubMed Almeida-Freitas DB, Pinho MC, Otaduy MC, Braga HF, Meira-Freitas D, da Costa Leite C (2014) Assessment of irradiated brain metastases using dynamic contrast-enhanced magnetic resonance imaging. Neuroradiology 56:437–443PubMed
18.
Zurück zum Zitat Lin NU, Lee EQ, Aoyama H et al (2013) Challenges relating to solid tumour brain metastases in clinical trials, part 1: patient population, response, and progression. A report from the RANO group. Lancet Oncol 14:e396–e406CrossRefPubMed Lin NU, Lee EQ, Aoyama H et al (2013) Challenges relating to solid tumour brain metastases in clinical trials, part 1: patient population, response, and progression. A report from the RANO group. Lancet Oncol 14:e396–e406CrossRefPubMed
19.
Zurück zum Zitat Fleiss JL (1986) Reliability of measurement. In: The design and analysis of clinical experiments. Wiley, Hoboken, pp 1–32 Fleiss JL (1986) Reliability of measurement. In: The design and analysis of clinical experiments. Wiley, Hoboken, pp 1–32
20.
Zurück zum Zitat Sperduto PW, Kased N, Roberge D et al (2012) Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol 30:419–425CrossRefPubMed Sperduto PW, Kased N, Roberge D et al (2012) Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol 30:419–425CrossRefPubMed
21.
Zurück zum Zitat Schoenfeld D (1982) Partial residuals for the proportional hazards regression model. Biometrika 69:239–241CrossRef Schoenfeld D (1982) Partial residuals for the proportional hazards regression model. Biometrika 69:239–241CrossRef
22.
Zurück zum Zitat Nduom EK, Yang C, Merrill MJ, Zhuang Z, Lonser RR (2013) Characterization of the blood-brain barrier of metastatic and primary malignant neoplasms. J Neurosurg 119:427–433CrossRefPubMedPubMedCentral Nduom EK, Yang C, Merrill MJ, Zhuang Z, Lonser RR (2013) Characterization of the blood-brain barrier of metastatic and primary malignant neoplasms. J Neurosurg 119:427–433CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Ludemann L, Grieger WN, Wurm R, Wust P, Zimmer C (2005) Quantitative measurement of leakage volume and permeability in gliomas, meningiomas and brain metastases with dynamic contrast-enhanced MRI. Magn Reson Imaging 23:833–841CrossRefPubMed Ludemann L, Grieger WN, Wurm R, Wust P, Zimmer C (2005) Quantitative measurement of leakage volume and permeability in gliomas, meningiomas and brain metastases with dynamic contrast-enhanced MRI. Magn Reson Imaging 23:833–841CrossRefPubMed
24.
Zurück zum Zitat Mills SJ, Soh C, Rose CJ et al (2010) Candidate biomarkers of extravascular extracellular space: a direct comparison of apparent diffusion coefficient and dynamic contrast-enhanced MR imaging-derived measurement of the volume of the extravascular extracellular space in glioblastoma multiforme. AJNR Am J Neuroradiol 31:549–553CrossRefPubMed Mills SJ, Soh C, Rose CJ et al (2010) Candidate biomarkers of extravascular extracellular space: a direct comparison of apparent diffusion coefficient and dynamic contrast-enhanced MR imaging-derived measurement of the volume of the extravascular extracellular space in glioblastoma multiforme. AJNR Am J Neuroradiol 31:549–553CrossRefPubMed
25.
Zurück zum Zitat Yankeelov TE, Lepage M, Chakravarthy A et al (2007) Integration of quantitative DCE-MRI and ADC mapping to monitor treatment response in human breast cancer: initial results. Magn Reson Imaging 25:1–13CrossRefPubMed Yankeelov TE, Lepage M, Chakravarthy A et al (2007) Integration of quantitative DCE-MRI and ADC mapping to monitor treatment response in human breast cancer: initial results. Magn Reson Imaging 25:1–13CrossRefPubMed
26.
Zurück zum Zitat Batchelor TT, Sorensen AG, di Tomaso E et al (2007) AZD2171, a pan-VEGF receptor tyrosine kinase inhibitor, normalizes tumor vasculature and alleviates edema in glioblastoma patients. Cancer Cell 11:83–95CrossRefPubMedPubMedCentral Batchelor TT, Sorensen AG, di Tomaso E et al (2007) AZD2171, a pan-VEGF receptor tyrosine kinase inhibitor, normalizes tumor vasculature and alleviates edema in glioblastoma patients. Cancer Cell 11:83–95CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Farrar CT, Kamoun WS, Ley CD et al (2011) Sensitivity of MRI tumor biomarkers to VEGFR inhibitor therapy in an orthotopic mouse glioma model. PLoS One 6:e17228CrossRefPubMedPubMedCentral Farrar CT, Kamoun WS, Ley CD et al (2011) Sensitivity of MRI tumor biomarkers to VEGFR inhibitor therapy in an orthotopic mouse glioma model. PLoS One 6:e17228CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Chung C, Jalali S, Foltz W et al (2013) Imaging biomarker dynamics in an intracranial murine glioma study of radiation and antiangiogenic therapy. Int J Radiat Oncol Biol Phys 85:805–812CrossRefPubMed Chung C, Jalali S, Foltz W et al (2013) Imaging biomarker dynamics in an intracranial murine glioma study of radiation and antiangiogenic therapy. Int J Radiat Oncol Biol Phys 85:805–812CrossRefPubMed
29.
Zurück zum Zitat Kamoun WS, Ley CD, Farrar CT et al (2009) Edema control by cediranib, a vascular endothelial growth factor receptor-targeted kinase inhibitor, prolongs survival despite persistent brain tumor growth in mice. J Clin Oncol 27:2542–2552CrossRefPubMedPubMedCentral Kamoun WS, Ley CD, Farrar CT et al (2009) Edema control by cediranib, a vascular endothelial growth factor receptor-targeted kinase inhibitor, prolongs survival despite persistent brain tumor growth in mice. J Clin Oncol 27:2542–2552CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Fortin D (2012) The blood-brain barrier: its influence in the treatment of brain tumors metastases. Curr Cancer Drug Targets 12:247–259CrossRefPubMed Fortin D (2012) The blood-brain barrier: its influence in the treatment of brain tumors metastases. Curr Cancer Drug Targets 12:247–259CrossRefPubMed
31.
Zurück zum Zitat Deeken JF, Loscher W (2007) The blood-brain barrier and cancer: transporters, treatment, and Trojan horses. Clin Cancer Res 13:1663–1674CrossRefPubMed Deeken JF, Loscher W (2007) The blood-brain barrier and cancer: transporters, treatment, and Trojan horses. Clin Cancer Res 13:1663–1674CrossRefPubMed
32.
Zurück zum Zitat Connell JJ, Chatain G, Cornelissen B et al (2013) Selective permeabilization of the blood-brain barrier at sites of metastasis. J Natl Cancer Inst 105:1634–1643CrossRefPubMedPubMedCentral Connell JJ, Chatain G, Cornelissen B et al (2013) Selective permeabilization of the blood-brain barrier at sites of metastasis. J Natl Cancer Inst 105:1634–1643CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Park EJ, Zhang YZ, Vykhodtseva N, McDannold N (2012) Ultrasound-mediated blood-brain/blood-tumor barrier disruption improves outcomes with trastuzumab in a breast cancer brain metastasis model. J Control Release 3659:00693–00691 Park EJ, Zhang YZ, Vykhodtseva N, McDannold N (2012) Ultrasound-mediated blood-brain/blood-tumor barrier disruption improves outcomes with trastuzumab in a breast cancer brain metastasis model. J Control Release 3659:00693–00691
34.
Zurück zum Zitat Thorsen F, Fite B, Mahakian LM et al (2013) Multimodal imaging enables early detection and characterization of changes in tumor permeability of brain metastases. J Control Release 172:812–822CrossRefPubMedPubMedCentral Thorsen F, Fite B, Mahakian LM et al (2013) Multimodal imaging enables early detection and characterization of changes in tumor permeability of brain metastases. J Control Release 172:812–822CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Lockman PR, Mittapalli RK, Taskar KS et al (2010) Heterogeneous blood-tumor barrier permeability determines drug efficacy in experimental brain metastases of breast cancer. Clin Cancer Res 16:5664–5678CrossRefPubMedPubMedCentral Lockman PR, Mittapalli RK, Taskar KS et al (2010) Heterogeneous blood-tumor barrier permeability determines drug efficacy in experimental brain metastases of breast cancer. Clin Cancer Res 16:5664–5678CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Patel TR, McHugh BJ, Bi WL, Minja FJ, Knisely JP, Chiang VL (2011) A comprehensive review of MR imaging changes following radiosurgery to 500 brain metastases. AJNR Am J Neuroradiol 32:1885–1892CrossRefPubMed Patel TR, McHugh BJ, Bi WL, Minja FJ, Knisely JP, Chiang VL (2011) A comprehensive review of MR imaging changes following radiosurgery to 500 brain metastases. AJNR Am J Neuroradiol 32:1885–1892CrossRefPubMed
37.
Zurück zum Zitat Cohen JV, Alomari AK, Vortmeyer AO et al (2016) Melanoma brain metastasis pseudoprogression after pembrolizumab treatment. Cancer Immunol Res 4:179–182CrossRefPubMed Cohen JV, Alomari AK, Vortmeyer AO et al (2016) Melanoma brain metastasis pseudoprogression after pembrolizumab treatment. Cancer Immunol Res 4:179–182CrossRefPubMed
38.
Zurück zum Zitat Drisis S, Metens T, Ignatiadis M, Stathopoulos K, Chao SL, Lemort M (2016) Quantitative DCE-MRI for prediction of pathological complete response following neoadjuvant treatment for locally advanced breast cancer: the impact of breast cancer subtypes on the diagnostic accuracy. Eur Radiol 26:1474–1484CrossRefPubMed Drisis S, Metens T, Ignatiadis M, Stathopoulos K, Chao SL, Lemort M (2016) Quantitative DCE-MRI for prediction of pathological complete response following neoadjuvant treatment for locally advanced breast cancer: the impact of breast cancer subtypes on the diagnostic accuracy. Eur Radiol 26:1474–1484CrossRefPubMed
39.
Zurück zum Zitat Andrews DW, Scott CB, Sperduto PW et al (2004) Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 363:1665–1672CrossRefPubMed Andrews DW, Scott CB, Sperduto PW et al (2004) Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 363:1665–1672CrossRefPubMed
Metadaten
Titel
Dynamic contrast-enhanced MR imaging pharmacokinetic parameters as predictors of treatment response of brain metastases in patients with lung cancer
verfasst von
Grégory Kuchcinski
Emilie Le Rhun
Alexis B. Cortot
Elodie Drumez
Romain Duhal
Maxime Lalisse
Julien Dumont
Renaud Lopes
Jean-Pierre Pruvo
Xavier Leclerc
Christine Delmaire
Publikationsdatum
16.02.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 9/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4756-5

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