专题论文

弥散加权磁共振成像技术在恶性肿瘤早期疗效评价及N分期的应用

  • 唐蛟 ,
  • 赵宇 ,
  • 刘志刚 ,
  • 王晖
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  • 湖南省肿瘤医院胸部放疗科;中南大学湘雅医学院附属肿瘤医院, 长沙410013
唐蛟,硕士研究生,研究方向为肿瘤放射治疗学,电子信箱:tangjiaofly@163.com;

收稿日期: 2014-08-13

  修回日期: 2014-09-15

  网络出版日期: 2014-11-14

基金资助

国家临床重点专科建设项目单位基金项目(国卫办医函2013/544号);湖南省肿瘤医院科研平台基金项目(PT2013-05)

Application of Diffusion Weighted Magnetic Resonance Imaging in Early Therapeutic Evaluation of Malignant Tumor Treatment and Accurate Lymph Node Staging

  • TANG Jiao ,
  • ZHAO Yu ,
  • LIU Zhigang ,
  • WANG Hui
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  • Department of Radiation, Oncology of Hunan Cancer Hospital; The Affiliated Cancer Hospital of Xiangya School of Medcine, Central South University, Changsha 410013, China

Received date: 2014-08-13

  Revised date: 2014-09-15

  Online published: 2014-11-14

摘要

近10 年来,功能磁共振成像被广泛应用于研究恶性肿瘤治疗疗效早期评价以及良恶性淋巴结的鉴别.弥散加权磁共振成像(diffusion weighted imaging,DWI)技术是功能磁共振成像的一种,是目前唯一应用于临床的可测量人体内水分子扩散运动的方法.它通过测量活体组织内的水分子弥散运动,从而为早期评价患者对治疗的反应、良恶性淋巴结的鉴别提供重要信息.本文综述了功能磁共振尤其是弥散加权磁共振成像在恶性肿瘤早期疗效评价及淋巴结良恶性鉴别的研究进展,认为弥散加权磁共振成像技术作为一种无创性的功能成像检查方法,通过其高分辨率以及功能成像的特点在以上两方面已经显示出较PET/CT 更大的优势,具有相当大的发展前景.

本文引用格式

唐蛟 , 赵宇 , 刘志刚 , 王晖 . 弥散加权磁共振成像技术在恶性肿瘤早期疗效评价及N分期的应用[J]. 科技导报, 2014 , 32(30) : 35 -39 . DOI: 10.3981/j.issn.1000-7857.2014.30.005

Abstract

Over the past decade, functional magnetic resonance imaging (fMRI) has been widely used to study the early therapeutic evaluation of malignant tumor treatment and identification of benign and malignant lymph nodes. Diffusion weighted magnetic resonance imaging (DWI) technology is one of the fMRI technologies, which issensitive to the microscopic motion of water molecules and allows for noninvasive characterization of biological tissues based on their water diffusion properties. The degree of restriction of water diffusion in biological tissues is related to tissue cellularities and the integrity of cell membranes. Thus, DWI may demonstrate early changes in cancers at the cellular level, such as the breakdown of cancer cells or the distortion of the microenvironment. This paper reviews published articles concerning both the early therapeutice valuation and identification of benign and malignant lymph nodes. As a noninvasive screening method with its high resolution and functional imaging features, DWI has shown superiority compared with PET/ CT, bearing considerable development prospects.

参考文献

[1] Eisenhauer E A, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1)[J]. European Journal of Cancer, 2009, 45(2): 228-247.
[2] 汪俊萍, 廖茜, 张云亭, 等. 良恶性淋巴结鉴别的影像学研究进展[J].医学综述, 2011, 17(6): 925-928. Wang Junping, Liao Qian, Zhang Yunting, et al. Advancement of differentiatial imaging of benigan and maglignant lymph nodes[J]. Medical Recapitulate, 2011, 17(6): 925-928.
[3] 邵娴, 刘辉, 时高峰. 磁共振弥散加权成像在早期评估食管癌放疗疗效的应用价值[J]. 河北医药, 2013, 35(22): 3403-3404. Shao Xian, Liu Hui, Shi Gaofeng. The value about diffusion weighted magnetic resonance imaging in the early assessment of efficacy of radiotherapy in esophageal cancer[J]. Hebei Medical Journal, 2013, 35 (22): 3403-3404.
[4] Lambregts D M, Beets G L, Maas M, et al. Tumour ADC measurements in rectal cancer: Effect of ROI methods on ADC values and interobserver variability[J]. European Radiology, 2011, 21(12): 2567-2574.
[5] Thoeny H C, De Keyzer F, Chen F, et al. Diffusion- weighted MR imaging in monitoring the effect of a vascular targeting agent on rhabdomyosarcoma in rats[J]. Radiology, 2005, 234(3): 756-764.
[6] Park S Y, Kim C K, Park B K, et al. Early changes in apparent diffusion coefficient from diffusion-weighted MR imaging during radiotherapy for prostate cancer[J]. International Journal of Radiation Oncology Biology Physics, 2012, 83(2): 749-755.
[7] Imanishi S, Shuto K, Aoyagi T, et al. Diffusion-weighted magnetic resonance imaging for predicting and detecting the early response to chemoradiotherapy of advanced esophageal squamous cell carcinoma[J]. Digestive Surgery, 2013, 30(3): 240-248.
[8] 时高峰, 高红梅, 刘辉, 等. 磁共振扩散成像技术对食管癌放疗后疗效评价的动态研究[C] //第五届中国肿瘤学术大会暨第七届海峡两岸肿瘤学术会议、国际肿瘤细胞与基因治疗学会会议、第二届中日肿瘤介入治疗学术会议, 中国石家庄, 2008. Shi Gaofeng, Gao Hongmei, Liu Hui, et al. MRI diffusion imaging dynamic assessing esophageal carcinoma preradiation therapy and after radiation therapy[C] //Fifth China Oncology Conference and the Seventh Cross- Strait Academic Conference Tumors, Tumor Cells and the International Society of Gene Therapy Meeting, the Second Sino- Japanese Interventional Treatment of Cancer Conference, Shi Jiazhuang, China, 2008.
[9] Makino H, Kato H, Furui T, et al. Predictive value of diffusion-weighted magnetic resonance imaging during chemoradiotherapy for uterine cervical cancer[J]. Journal of Obstetrics and Gynaecology Research, 2014, 40(4): 1098-1104.
[10] Cai G, Xu Y, Zhu J, et al. Diffusion-weighted magnetic resonance imaging for predicting the response of rectal cancer to neoadjuvant concurrent chemoradiation[J]. World Journal of Gastroenterology, 2013, 19(33): 5520-5527.
[11] De Paepe K, Bevernage C, De Keyzer F, et al. Whole-body diffusionweighted magnetic resonance imaging at 3 Tesla for early assessment of treatment response in non- Hodgkin lymphoma: A pilot study[J]. Cancer Imaging, 2013, 13(1): 53-62.
[12] Chen Y, Zhong J, Wu H, et al. The clinical application of whole-body diffusion-weighted imaging in the early assessment of chemotherapeutic effects in lymphoma: The initial experience[J]. Magnetic Resonance Imaging, 2012, 30(2): 165-170.
[13] Wu X, Nerisho S, Dastidar P, et al. Comparison of different MRI sequences in lesion detection and early response evaluation of diffuse large Bcell lymphoma- a whole- body MRI and diffusion- weighted imaging study[J]. NMR in Biomedicine, 2013, 26(9): 1186-1194.
[14] Ohno Y, Koyama H, Yoshikawa T, et al. Diffusion-weighted MRI versus 18F- FDG PET/CT: Performance as predictors of tumor treatment response and patient survival in patients with non-small cell lung cancer receiving chemoradiotherapy[J]. American Journal of Roentgenology, 2012, 198(1): 75-82.
[15] Zheng D, Chen Y, Chen Y, et al. Early assessment of induction chemotherapy response of nasopharyngeal carcinoma by pretreatment diffusion-weighted magnetic resonance imaging[J]. Journal of Computer Assisted Tomography, 2013, 37(5): 673-680.
[16] Barbaro B, Vitale R, Valentini V, et al. Diffusion-weighted magnetic resonance imaging in monitoring rectal cancer response to neoadjuvant chemoradiotherapy[J]. International Journal of Radiation Oncology Biology Physics, 2012, 83(2): 594-599.
[17] Musio D, De Felice F, Magnante A L, et al. Diffusion-weighted magnetic resonance application in response prediction before, during, and after neoadjuvant radiochemotherapy in primary rectal cancer carcinoma[J]. BioMed Research International, 2013, Article ID: 740195.1-5
[18] Craciunescu O I, Thrall D E, Vujaskovic Z, et al. Magnetic resonance imaging: A potential tool in assessing the addition of hyperthermia to neoadjuvant therapy in patients with locally advanced breast cancer[J]. International Journal of Hyperthermia, 2010, 26(7): 625-637.
[19] Chen J, Daniel B L, Diederich C J, et al. Monitoring prostate thermal therapy with diffusion- weighted MRI[J]. Magnetic Resonance in Medicine, 2008, 59(6): 1365-1372.
[20] Reichardt W, Juettner E, Uhl M, et al. Diffusion-weighted imaging as predictor of therapy response in an animal model of Ewing sarcoma[J]. Investigative Radiology, 2009, 44(5): 298-303.
[21] Ohira T, Okuma T, Matsuoka T, et al. FDG-MicroPET and diffusionweighted MR image evaluation of early changes after radiofrequency ablation in implanted VX2 tumors in rabbits[J]. Cardiovascular and Interventional Radiology, 2009, 32(1): 114-120.
[22] 徐继飞, 王凡. 磁共振成像在鼻咽癌放射治疗中的应用[J]. 国际肿瘤学杂志, 2012, 39(2): 127-130. Xu Jifei, Wang Fan. Applications of magnetic resonnance imaging in radiotherapy of nasopharyngeal carcinoma[J]. Journal of International Oncology, 2012, 39(2): 127-130.
[23] 司家文, 史宏璐, 刘哲, 等. 磁共振弥散加权成像在口腔鳞癌颈部淋 巴结转移中的初步应用[J]. 中国口腔颌面外科杂志, 2012, 10(4): 311-315. Si Jiawen, Shi Honglu, Liu Zhe, et al. Initial study of diffusionweighted magnetic resonance imaging for cervical lymph node metastases in patients with oral squamous cell carcinoma[J]. China Journal of Oral & Maxillofacial Surgery, 2012, 10(4): 311-315.
[24] Wu L M, Xu J R, Gu H Y, et al. Preoperative mediastinal and hilar nodal staging with diffusion- weighted magnetic resonance imaging and fluorodeoxyglucose positron emission tomography/computed tomography in patients with non- small- cell lung cancer: Which is better?[J]. Journal of Surgical Research, 2012, 178(1): 304-314.
[25] 金征宇, 薛华丹. 全身弥散加权成像肿瘤学临床应用图谱[M]. 北京:科学出版社, 2009. Jin Zhengyu, Xue Huadan. Atlas of whole body diffusion weighted imaging in oncological clinical application[M]. Beijing: Science Press, 2009.
[26] Tsuchida T, Morikawa M, Demura Y, et al. Imaging the early response to chemotherapy in advanced lung cancer with diffusion- weighted magneticresonance imagingcomparedtofluorine-18fluorodeoxyglucose positron emission tomography and computed tomography[J]. Journal of Magnetic Resonance Imaging, 2013, 38(1): 80-88.
[27] Weber M A, Bender K, von Gall C C, et al. Assessment of diffusionweighted MRI and 18F- fluoro- deoxyglucose PET/CT in monitoring early response to neoadjuvant chemotherapy in adenocarcinoma of the esophagogastric junction[J]. Journal of Gastrointestinal and Liver Diseases, 2013, 22(1): 45-52.
[28] Hagtvedt T, Seierstad T, Lund K V, et al. Diffusion-weighted MRI compared to FDG PET/CT for assessment of early treatment response in lymphoma[J]. Acta Radiologica, 2014, pii: 0284185114526087.
[29] Heijmen L, Verstappen M C, Ter Voert E E, et al. Tumour response prediction by diffusion-weighted MR imaging: ready for clinical use?[J]. Critical Reviews in Oncology Hematology, 2012, 83(2): 194-207.
[30] Thoeny H C, De Keyzer F, King A D. Diffusion-weighted MR imaging in the head and neck[J]. Radiology, 2012, 263(1): 19-32.
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