title: Assessment of response to anti-angiogenic targeted therapy in pulmonary metastatic renal cell carcinoma: R2* value as a predictive biomarker.
abstract: OBJECTIVE
  To evaluate the utility of MR R2*-mapping and the optimal time-point for assessing the response of pulmonary metastatic renal cell carcinoma (mRCC) to anti-angiogenic targeted therapy (aATT).
  
  
  METHODS
  The exploration-sample group and the validation-sample group consisted of 22 and 16 patients. The parameters of MR R2*-mapping, including the R2* value at each time-point (R2*base, R2*1cycand R2*2cyc) and change between different time-points (R2*(1cyc-base)/base, R2*(2cyc-base)/baseand R2*(2cyc-1cyc)/1cyc), were evaluated with a receiver-operating-characteristic analysis, and a cut-off value derived from the clinical outcome was applied to the Kaplan-Meier method to assess the value of R2* mapping and Response-Evaluation-Criteria in Solid Tumours (RECIST) during treatment evaluation.
  
  
  RESULTS
  The inter-, intra-observer agreements and inter-scan consistency were excellent (p > 0.80). For the exploration-sample group, the areas under the curve for the parameters of MR R2* mapping were 0.55, 0.60, 0.83, 0.64, 0.88 and 0.83 for R2*base, R2*1cyc, R2*2cyc, R2*(1cyc-base)/base, R2*(2cyc-base)/baseand R2*(2cyc-1cyc)/1cyc.For the validation-sample, R2*(2cyc-base)/basebetter predicted progression-free survival (p = 0.03) than RECIST and other R2* mapping parameters with a lower p value.
  
  
  CONCLUSIONS
  Assessing aATT outcome based on changes in the R2* value between baseline and second treatment is more accurate than assessment at other time-points and assessment based on the RECIST.
  
  
  CONCLUSIONS
  • The inter-scan consistency of R2*-mapping in pulmonary mRCC are excellent. • The intra-/inter-observer agreement of R2* mapping in pulmonary mRCC are excellent. • Using changes in R2* value between baseline/after second-treatment is better than RECIST. • The choice of baseline/after second treatment is better than other time-points.
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1630, Dongfang Road, Pudong, Shanghai, 200120, China.
authors.forename: Guangyu
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1630, Dongfang Road, Pudong, Shanghai, 200120, China.
authors.forename: Guiqin
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Urinary Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1630, Dongfang Road, Pudong, Shanghai, 200120, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Kong
authors.affiliation: GE Healthcare, Shanghai, China.
authors.forename: Jianxun
authors.initials: J
authors.lastname: Qu
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1630, Dongfang Road, Pudong, Shanghai, 200120, China.
authors.forename: Shiteng
authors.initials: S
authors.lastname: Suo
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1630, Dongfang Road, Pudong, Shanghai, 200120, China. liu.mia@qq.com.
authors.forename: Xiaosheng
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1630, Dongfang Road, Pudong, Shanghai, 200120, China. renjixujr@163.com.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Urinary Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1630, Dongfang Road, Pudong, Shanghai, 200120, China. med-zhangjin@vip.sina.com.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives / Q000627:therapeutic use; D015588:Observer Variation; D010671:Phenylurea Compounds / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D012372:ROC Curve; D015203:Reproducibility of Results; D066066:Response Evaluation Criteria in Solid Tumors; D012189:Retrospective Studies; D000077157:Sorafenib; D000077210:Sunitinib; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D007211:Indoles; D010671:Phenylurea Compounds; D011758:Pyrroles; D009536:Niacinamide; D000077157:Sorafenib; D000077210:Sunitinib
keywords: Anti-angiogenic targeted therapy; Magnetic Resonance Imaging; Metastasis; Outcome Assessment; Renal cell carcinoma