title: Dynamic contrast-enhanced MRI in advanced nonsmall-cell lung cancer patients treated with first-line bevacizumab, gemcitabine, and cisplatin.
abstract: OBJECTIVE
  To investigate dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of advanced nonsmall-cell lung cancer (NSCLC) patients treated with the antiangiogenic agent bevacizumab combined with gemcitabine and cisplatin as first-line treatment.
  
  
  METHODS
  All patients were enrolled for MRI and computed tomography (CT) before and after the first three courses of bevacizumab combination chemotherapy. Pharmacokinetic parameters (K(trans), k(ep), v(e), v(p)) derived from DCE MRI were computed for the main mass. Parametric histogram analysis was obtained to evaluate changes of the internal tumor composition and for correlation with tumor response measured on CT.
  
  
  RESULTS
  After three cycles of treatment, 11 patients showed decreased tumor size and a decreased value of all MR-derived pharmacokinetic parameters. Among these parameters, there was a significant decrease of mean and standard deviation of the K(trans) histogram as well as a decrease of mean of the k(ep) histogram (P < 0.05). Tumors with larger mean values of rate constant k(ep) (P < 0.0001) and smaller standard deviation of volume of extravascular extracellular space fraction v(e) (P < 0.0001) on histograms before chemotherapy were considered predictors for treatment response.
  
  
  CONCLUSIONS
  DCE MRI enables a functional analysis of the treatment response of NSCLC. MRI parametric histogram has the potential to predict early treatment response of combined bevacizumab, gemcitabine, and cisplatin.
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yeun-Chung
authors.initials: YC
authors.lastname: Chang
authors.forename: Chong-Jen
authors.initials: CJ
authors.lastname: Yu
authors.forename: Chung-Ming
authors.initials: CM
authors.lastname: Chen
authors.forename: Fu-Chang
authors.initials: FC
authors.lastname: Hu
authors.forename: Hao-Hsiang
authors.initials: HH
authors.lastname: Hsu
authors.forename: Wen-Yih I
authors.initials: WY
authors.lastname: Tseng
authors.forename: Tiffany
authors.initials: T
authors.lastname: Ting-Fang Shih
authors.forename: Pan-Chyr
authors.initials: PC
authors.lastname: Yang
authors.forename: James
authors.initials: J
authors.lastname: Chih-Hsin Yang
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology*; D002945:Cisplatin / Q000008:administration & dosage; D003287:Contrast Media; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D003287:Contrast Media; D003841:Deoxycytidine; D000068258:Bevacizumab; C064925:gadodiamide; D019786:Gadolinium DTPA; D002945:Cisplatin; D000093542:Gemcitabine