胰腺癌新辅助治疗基于RECIST指南的肿瘤大小测量：MRI是否和CT一样有效？
Tumor size measurements of pancreatic cancer with neoadjuvant therapy based on RECIST guidelines: is MRI as effective as CT?
发表日期：2023 Jan 18
作者：
Panpan Yang, Kuanzheng Mao, Yisha Gao, Zhen Wang, Jun Wang, Yufei Chen, Chao Ma, Yun Bian, Chengwei Shao, Jianping Lu
来源：
CANCER IMAGING
摘要：
在进行新辅助治疗（NAT）的胰腺癌（PC）患者中，比较使用CT和MRI测量肿瘤大小。本研究包括125名组织学确认的接受NAT的PC患者。使用Bland-Altman分析和组内相关系数（ICCs）比较NAT前后CT和MRI的肿瘤大小。进一步分析MRI和CT在不同因素（包括NAT方法（化疗、化疗放疗）、肿瘤位置（头/颈、体/尾）、肿瘤回归分级（TRG）水平（0-2、3）、N分期（N0、N1/N2）和肿瘤切除缘状态（R0、R1））下估计肿瘤大小的变异性。使用McNemar检验根据RECIST 1.1标准比较基于CT和MRI测量的NAT评估的功效。在NAT前后，CT和MRI的中位数肿瘤大小没有显著差异（分别为P = 0.44和0.39）。MRI和CT在肿瘤大小方面有出色的一致性，NAT前后的平均大小差异和协议极限（LOAs）分别为1.5[-9.6至12.7]毫米和0.9[-12.6至14.5]毫米（ICC为0.93和0.91）。对于所有调查的因素，CT和MRI之间的肿瘤大小具有良好或出色的相关性（ICC为0.76至0.95）。在CT和MRI测量下，NAT的效果评估没有显著差异（P = 1.0）。MRI和CT在评估NAT前后PC肿瘤大小方面表现相似。 ©2023年作者。
To compare tumor size measurements using CT and MRI in pancreatic cancer (PC) patients with neoadjuvant therapy (NAT).This study included 125 histologically confirmed PC patients who underwent NAT. The tumor sizes from CT and MRI before and after NAT were compared by using Bland-Altman analyses and intraclass correlation coefficients (ICCs). Variations in tumor size estimates between MRI and CT in relationship to different factors, including NAT methods (chemotherapy, chemoradiotherapy), tumor locations (head/neck, body/tail), tumor regression grade (TRG) levels (0-2, 3), N stages (N0, N1/N2) and tumor resection margin status (R0, R1), were further analysed. The McNemar test was used to compare the efficacy of NAT evaluations based on the CT and MRI measurements according to RECIST 1.1 criteria.There was no significant difference between the median tumor sizes from CT and MRI before and after NAT (P = 0.44 and 0.39, respectively). There was excellent agreement in tumor size between MRI and CT, with mean size differences and limits of agreement (LOAs) of 1.5 [-9.6 to 12.7] mm and 0.9 [-12.6 to 14.5] mm before NAT (ICC, 0.93) and after NAT (ICC, 0.91), respectively. For all the investigated factors, there was good or excellent correlation (ICC, 0.76 to 0.95) for tumor sizes between CT and MRI. There was no significant difference in the efficacy evaluation of NAT between CT and MRI measurements (P = 1.0).MRI and CT have similar performance in assessing PC tumor size before and after NAT.© 2023. The Author(s).