Chest
Original ResearchDynamic Contrast-Enhanced MRI of Malignant Pleural Mesothelioma: A Feasibility Study of Noninvasive Assessment, Therapeutic Follow-up, and Possible Predictor of Improved Outcome
Section snippets
Patients and Diagnostic Evaluation
A total of 19 patients (17 men and 2 women; age range, 53 to 77 years; mean, 62.5 years) received a diagnosis of stage II (n = 9) or stage IV (n = 10) MPM, and subsequently were included in a prospective clinical trial with single-agent chemotherapy. All reported patients were enrolled under an investigational protocol that was approved by the investigational review board of the university clinics. Written informed consent was obtained from all patients. DCE-MRI was performed as an exploratory
Results
Pretherapeutic pharmacokinetic quantification of the tumor area presented heterogeneous color maps with different contrast-enhancement patterns showing by characteristic signal-intensity time curves (Fig 1). The color-coded maps were very helpful to successfully guide semiautomated ROI analysis, separating normal from malignant tissue.
Subjects were classified as clinical nonresponders or responders. Nonresponders (n = 15) were characterized by short median survival (460 days). In contrast,
Discussion
This pilot feasibility study successfully demonstrates that parametric mapping based on DCE-MRI in MPM depicts not only the lesion and its extent but can map out the heterogeneity of microcirculation within the full thoracic extent of MPM. The pharmacokinetic parameters (Amp, kep, kel) enabled differentiation of normal and tumor tissue. In addition, the kinetic parameter kep may provide prognostic information with regard to therapeutic response.
MPM has been causally related to asbestos exposure
ACKNOWLEDGMENT
We acknowledge the extensive review and comments by Peter L. Choyke, MD, from the National Cancer Institute Molecular Imaging Program.
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