フククラ　ヨシヒコ   Yoshihiko Fukukura   福倉　良彦    所属   川崎医科大学  医学部 臨床医学　機能・代謝画像診断学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Extracellular volume fraction with MRI: As an alternative predictive biomarker to dynamic contrast-enhanced MRI for chemotherapy response of pancreatic ductal adenocarcinoma.
掲載誌名	正式名：European journal of radiology ISSNコード：18727727/0720048X
掲載区分	国外
巻・号・頁	145,pp.110036-74
著者・共著者	Fukukura Y, Kumagae Y, Fujisaki Y, Nakamura S, Dominik Nickel M, Imai H, Yoshiura T
発行年月	2021/12
概要	PURPOSE: To assess the feasibility of extracellular volume (ECV) fraction determined with equilibrium contrast-enhanced MRI for prediction of treatment response to chemotherapy in pancreatic ductal adenocarcinoma (PDAC) in comparison with dynamic contrast-enhanced MRI (DCE-MRI), and to clarify the association between ECV fraction and DCE-MRI-derived pharmacokinetic parameters. METHODS: This retrospective study included 58 consecutive patients with histologically confirmed PDAC who underwent DCE-MRI before systemic chemotherapy. Tumor pharmacokinetic parameters, including the volume transfer coefficient (K(trans)), rate constant (k(ep)), and extracellular extravascular volume fraction (v(e)) of DCE-MRI, and ECV fraction determined with equilibrium contrast-enhanced MRI were compared between the response and non-response groups. The correlation of tumor ECV fraction with each DCE-MRI-derived pharmacokinetic parameter was examined using Spearman's rank correlation coefficient. RESULTS: Tumor K(trans), v(e), and ECV fraction were significantly higher in the response group than in the non-response group (all, P < 0.001), whereas no significant difference was found in k(ep) (P = 0.119). Tumor ECV fraction showed the highest area under receiver operating characteristic curve of 0.918, with a sensitivity of 89.3%, specificity of 90.0%, and accuracy of 89.7% (cut off, >37.6%). The ECV fraction showed a significant positive correlation with K(trans) (Spearman's coefficient = 0.66, P < 0.001) and v(e) (Spearman's coefficient = 0.79, P < 0.001). CONCLUSIONS: ECV fraction determined with equilibrium contrast-enhanced MRI was as useful as DCE-MRI-derived pharmacokinetic parameters for predicting treatment response to chemotherapy in patients with PDAC.