胶质母细胞瘤术后表观弥散系数预测放射治疗疗效和无进展生存期的研究  

ADC changes of glioblastomas after surgery:Possible prediction of radiotherapy response and TTP

作　　者：曲金荣[1] 李少武[2] 艾林[2] 蒋田仔[3] 王奇峰[3] 戴建平[2] 江涛[4] 

机构地区：[1]河南省肿瘤医院放射科,郑州450003 [2]首都医科大学北京天坛医院神经影像中心 [3]中国科学研究院自动化研究所 [4]首都医科大学北京天坛医院神经外科胶质瘤中心

出　　处：《中国神经精神疾病杂志》2009年第6期331-335,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：十一五国家科技支撑计划重点项目(编号:2007BAI05B08);973项目:(编号:2004CB318107)

摘　　要：目的早期预测肿瘤放射治疗的反应和无进展生存期(Time-to-progression,TTP)对胶质母细胞瘤术后辅助治疗方案的优化至关重要。本研究对胶质母细胞瘤术后放射治疗前、放射治疗中弥散加权成像的变化与放射治疗的疗效TTP进行对照研究,评价表观弥散系数(apparent diffusion coefficient,ADC)在预测其疗效和TTP中的作用。方法回顾性分析19例术后证实为胶质母细胞瘤患者弥散成像的变化与放射治疗疗效、TTP。测量放射治疗前1周内、放射治疗中(放射剂量达30Gy)残存肿瘤及瘤周组织的ADC值,根据放射治疗结束后4周与放射治疗前的MR图像显示肿瘤大小的变化将放射治疗疗效分为4组:CR(complete resolution),PR(partial response),SD(stable disease),PD(progressive disease),对ADC与放射治疗疗效和TTP进行对照研究。结果CR组残存肿瘤的ADC值放射治疗中明显高于治疗前,而PD组残存肿瘤的ADC值放射治疗前后没有明显变化。PD组瘤周组织的ADC值放射治疗中明显增高。残存肿瘤放射治疗中与治疗前ADC的变化和TTP之间的相关系数是0.099,P值是0.622,瘤周组织ADC的变化与TTP之间的相关系数是0.352,P值是0.036。结论胶质母细胞瘤术后残存肿瘤及瘤周组织的ADC值能预测其放射治疗的疗效和TTP。Objective Diffusion-weighted images （DWIs） have been used to study glioma. Optimizing gliobiastoma treatment after surgery requires prediction of radiotherapy （RT） response and TIP. Our hypothesis was that apparent diffusion coefficient （ADC） could provide additional useful information in this prediction. Methods Nineteen glioblastoma after surgery were examined by diffusion-weighted imaging before RT and at 30 Gy middle RT. We determined ADC values on DWIs both in the residual tumoral tissue and peritumoral tissue before RT and at 30 Gy middle RT. RT responses were classified as follows： complete resolution （ CR）, partial response （ PR）, stable disease （ SD）, and progressive disease （PD） by comparison of pretreatment and postchemoradiotherapy scans. We also evaluated the correlation between the ADC and treatment response of 4 weeks after the complement of RT and TIP. Results In CR group, the ADC of the residual tumors was greater at 30 Gy middle RT than before RT. On contrast, in PD group, ADC at 30 Gy middle RT was not different form that at before RT in PD group. However, the ADC of peritumoral tissue significantly increased at 30 Gy middle RT compared with that at before RT in PD. The correlation was 0. 099 between the changes of tumoral ADC and TI＇P （ P = 0. 622）, 0. 352 between the changes of infiltrating tumoral ADC and TFP （P = 0. 036）, respectively. Conclnsions ADC changes in tumoral and peritumoral tissue may predict the response and TTP of glioblastomas after surgery to RT.

关 键 词：核磁共振 弥散加权成像 胶质母细胞瘤 放射治疗 TTP 

分 类 号：R739.4[医药卫生—肿瘤]