Prognostic value of dynamic MR imaging for non-small-cell lung cancer patients after chemoradiotherapy.
OBJECTIVE
To determine the prognostic value of dynamic MRI for non-small-cell lung cancer (NSCLC) patients after chemoradiotherapy.


METHODS
A total of 114 consecutive patients with NSCLC underwent dynamic MRI after chemoradiotherapy. The patients were divided into two groups (local control (n=22) and local failure (n=92)) according to the presence of local recurrence. From the signal intensity-time course curve in each subject, the maximum relative enhancement ratio and slope of enhancement were calculated, and compared between two groups by Student's t-test. To determine the feasible threshold values of both MR indexes for group differentiation, ROC-based positive tests were performed. Finally, the Kaplan-Meier survival curves of each group divided by the adapted threshold value were compared by log-rank test.


RESULTS
The maximum relative enhancement ratio and the slope of enhancement in the local control group were significantly lower than those in the local failure group (P<0.05). Using 0.08/sec as the threshold value of the slope of enhancement, the sensitivity and specificity for differentiation between the two groups were 90.9% and 91.3%, respectively. When the slope of enhancement was adopted for estimation of prognosis after therapy, the mean survival period of the slope of enhancement<or=0.08/sec group was significantly longer than that seen in the group with a slope of enhancement>0.08/sec (P<0.0001).


CONCLUSIONS
Dynamic MRI has potential prognostic value for NSCLC patients after chemoradiotherapy.
Ohno
Yoshiharu
Y
Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan. yosirad@kobe-u.ac.jp
Nogami
Munenobu
M
Higashino
Takanori
T
Takenaka
Daisuke
D
Matsumoto
Sumiaki
S
Hatabu
Hiroto
H
Sugimura
Kazuro
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016896:Treatment Outcome