Prediction of the response of ocular adnexal lymphoma to chemotherapy using combined pretreatment dynamic contrast-enhanced and diffusion-weighted MRI

Acta Radiol. 2016 Dec;57(12):1490-1496. doi: 10.1177/0284185116631181. Epub 2016 Jul 20.

Abstract

Background There are no established biomarkers predictive of the efficacy of treatment for ocular adnexal lymphoma (OAL). Purpose To evaluate the effectiveness of pretreatment dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) in predicting the response of OAL to chemotherapy. Material and Methods Twenty-one patients, who were pathologically diagnosed with OAL, were retrospectively analyzed. According to the National Comprehensive Cancer Network (NCCN) response evaluation criteria for non-Hodgkin's lymphoma, patients were divided into responders (n = 14) and non-responders (n = 7). The volume transfer constant (Ktrans), rate constant (Kep), extracellular extravascular volume fraction (Ve), and apparent diffusion coefficient (ADC) were computed. Two independent-sample tests were applied for statistical analysis. For significantly different parameters, receiver-operator characteristics curve analysis was performed. Results The Ktrans value (min-1), Kep value (min-1), and ADC value (10-3 mm2/s) were 0.76 ± 0.36 vs. 0.47 ± 0.18 (mean ± SD), 4.43 ± 1.29 vs. 3.14 ± 1.37, and 0.51 ± 0.12 vs. 0.66 ± 0.15, respectively, in the responders and non-responders groups. Significant differences were found between the two groups regarding these parameters ( P < 0.05). However, no significant difference was observed in Ve (min-1) between the groups ( P > 0.05). Ktrans, Kep, and ADC had a moderately predictive sensitivity or specificity. When Ktrans and ADC or the three parameters were combined, a considerably higher sensitivity (85.7%) and specificity (85.7%) with a significant discriminative accuracy (area under the curve = 0.929; P = 0.002) was found. Conclusion Ktrans, Kep, and ADC could potentially predict OAL response to chemotherapy. A combination of these DWI and DCE-MRI quantitative parameters might increase sensitivity and specificity.

Keywords: Diffusion-weighted imaging (DWI); dynamic contrast-enhanced imaging (DCE-MRI); lymphoma; magnetic resonance imaging (MRI).

MeSH terms

  • Adult
  • Aged
  • Contrast Media*
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Humans
  • Image Enhancement / methods*
  • Lymphoma, Non-Hodgkin / diagnostic imaging*
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Male
  • Middle Aged
  • Orbital Neoplasms / diagnostic imaging*
  • Orbital Neoplasms / drug therapy*
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity
  • Treatment Outcome

Substances

  • Contrast Media