利用金角径向采样动态增强磁共振成像预测胃癌患者腹腔游离癌细胞
Prediction of peritoneal free cancer cells in gastric cancer patients by golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging
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影响因子:4.9
分区:医学2区 / 生化与分子生物学2区 生物工程与应用微生物2区 医学：研究与实验2区
发表日期:2024 Jun 05
作者:
Xueqing Yin, Xinzhong Ruan, Yongmeng Zhu, Yongfang Yin, Rui Huang, Chao Liang
DOI:
10.1631/jzus.B2300929
摘要
腹腔游离癌细胞对胃癌的疾病进展和患者预后具有负面影响。本研究旨在探讨使用金角径向采样动态增强磁共振成像（GRASP DCE-MRI）预测胃癌患者腹腔游离癌细胞的可行性。所有入组患者依次分为分析组和验证组。对接受手术的胃癌患者进行术前磁共振成像（MRI）扫描和灌注成像，并采集腹腔冲洗液标本进行检查。根据腹腔灌洗细胞学（PLC）结果，将患者分为阴性和阳性灌洗液组。收集的资料包括临床信息和MR参数。构建列线图预测模型以预测腹腔灌洗液的阳性率，并利用验证组数据验证模型的有效性。结果显示，GRASP DCE-MRI预测的PLC阳性病例比例与实际PLC检测无统计学差异。MR肿瘤分期、肿瘤厚度及灌注参数Tofts-Ketty模型的转移常数（Ktrans）是预测阳性腹腔灌洗液的独立变量。列线图模型在建模组和验证组的一致性指数（C-index）分别为0.785和0.742。GRASP DCE-MRI可以有效预测胃癌患者中的腹腔游离癌细胞。利用这些预测指标构建的列线图模型或有助于临床医生更好地评估胃癌患者腹腔游离癌细胞的风险。
Abstract
Peritoneal free cancer cells can negatively impact disease progression and patient outcomes in gastric cancer. This study aimed to investigate the feasibility of using golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging (GRASP DCE-MRI) to predict the presence of peritoneal free cancer cells in gastric cancer patients.All enrolled patients were consecutively divided into analysis and validation groups. Preoperative magnetic resonance imaging (MRI) scans and perfusion were performed in patients with gastric cancer undergoing surgery, and peritoneal lavage specimens were collected for examination. Based on the peritoneal lavage cytology (PLC) results, patients were divided into negative and positive lavage fluid groups. The data collected included clinical and MR information. A nomogram prediction model was constructed to predict the positive rate of peritoneal lavage fluid, and the validity of the model was verified based on data from the verification group.There was no statistical difference between the proportion of PLC-positive cases predicted by GRASP DCE-MR and the actual PLC test. MR tumor stage, tumor thickness, and perfusion parameter Tofts-Ketty model volume transfer constant (Ktrans) were independent predictors of positive peritoneal lavage fluid. The nomogram model featured a concordance index (C-index) of 0.785 and 0.742 for the modeling and validation groups, respectively.GRASP DCE-MR could effectively predict peritoneal free cancer cells in gastric cancer patients. The nomogram model constructed using these predictors may help clinicians to better predict the risk of peritoneal free cancer cells being present in gastric cancer patients.