title: Dynamic contrast-enhanced MR imaging pharmacokinetic parameters as predictors of treatment response of brain metastases in patients with lung cancer.
abstract: OBJECTIVE
  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 (Ktrans, kep, ve, vp) and their early variation (∆Ktrans, ∆kep, ∆ve, ∆vp). 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 ∆Ktrans, ∆veand ∆vpwere significantly associated with the objective response (p = 0.02, p = 0.001 and p = 0.02, respectively). The best predictor of objective response was ∆vewith an area under the curve of 0.93 [95% CI = 0.87, 0.99].
  
  
  CONCLUSIONS
  DCE MRI and early ∆vemay be a useful tool to predict the objective response of brain metastases in patients with lung cancer.
  
  
  CONCLUSIONS
  • DCE MRI could predict the response of brain metastases from lung cancer • ∆vewas the best predictor of response • DCE MRI could be used to individualize patients' follow-up.
authors.affiliation: Department of Neuroradiology, University of Lille, CHU Lille, Rue Emile Laine, F-59000, Lille, France. gregory.kuchcinski@univ-lille2.fr.
authors.forename: Grégory
authors.identifier: http://orcid.org/0000-0001-8206-198X
authors.initials: G
authors.lastname: Kuchcinski
authors.affiliation: Department of Neurosurgery, University of Lille, CHU Lille, F-59000, Lille, France.|Department of Medical Oncology, Oscar Lambret Center, F-59000, Lille, France.|Inserm U1192-PRISM-Laboratoire de Protéomique, Réponse Inflammatoire, Spectrométrie de Masse, F-59000, Lille, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Le Rhun
authors.affiliation: Department of Thoracic Oncology, University of Lille, CHU Lille, F-59000, Lille, France.
authors.forename: Alexis B
authors.initials: AB
authors.lastname: Cortot
authors.affiliation: Department of Biostatistics, University of Lille, CHU Lille, EA 2694-Santé publique: épidémiologie et qualité des soins, F-59000, Lille, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Drumez
authors.affiliation: Department of Neuroradiology, University of Lille, CHU Lille, Rue Emile Laine, F-59000, Lille, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Duhal
authors.affiliation: Department of Neuroradiology, University of Lille, CHU Lille, Rue Emile Laine, F-59000, Lille, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Lalisse
authors.affiliation: Department of Neuroradiology, University of Lille, CHU Lille, Rue Emile Laine, F-59000, Lille, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Dumont
authors.affiliation: Department of Neuroradiology, University of Lille, CHU Lille, Rue Emile Laine, F-59000, Lille, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: Lopes
authors.affiliation: Department of Neuroradiology, University of Lille, CHU Lille, Rue Emile Laine, F-59000, Lille, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pruvo
authors.affiliation: Department of Neuroradiology, University of Lille, CHU Lille, Rue Emile Laine, F-59000, Lille, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Leclerc
authors.affiliation: Department of Neuroradiology, University of Lille, CHU Lille, Rue Emile Laine, F-59000, Lille, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Delmaire
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000556:secondary; D003287:Contrast Media / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D000970:Antineoplastic Agents; D003287:Contrast Media
keywords: Blood-brain barrier; Brain neoplasms; Lung neoplasms; Magnetic resonance imaging; Perfusion