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. 2021 Aug 26;16(1):1265-1275.
doi: 10.1515/med-2021-0260. eCollection 2021.

Predictive effect of DCE-MRI and DWI in brain metastases from NSCLC

Chengyu Ye  1   2 , Quanbing Lin  1 , Zhang Jin  1 , Cuiping Zheng  3 , Shenglin Ma  4
Affiliations

Predictive effect of DCE-MRI and DWI in brain metastases from NSCLC

Chengyu Ye et al. Open Med (Wars). .

Abstract

Non-small cell lung cancer (NSCLC), a commonly diagnosed lung cancer, is characterized by a high incidence of metastatic spread to the brain, which adversely impacts prognosis. The present study aimed to assess the value of combined dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in predicting the treatment outcomes of whole-brain radiotherapy (WBRT) and gefitinib in brain metastases from non-small cell lung cancer (NSCLC) from the perspectives of response rate and short- and long-term efficacy. These results suggested that the indicators measured by DCE-MRI combined with DWI can be used as key imaging-derived markers that predicted the efficacy of WBRT combined with gefitinib in NSCLC patients with brain metastases. Specifically, patients with higher ΔADCmid and ΔADCpost values showed better treatment outcomes. ROC curve analysis indicated ADCpost, ΔADCpost, ΔADCpost (%), and tumor regression rate as the best predictors of efficacy of WBRT combined with gefitinib in these patients. The short-term and long-term effects noted were also significant. Taken together, the findings of this study reveal that tumor regression rate, ADCpost, ΔADCpost, and ΔADCpost (%) can be used as important imaging indicators that predict the therapeutic effect of WBRT combined with gefitinib in NSCLC patients with brain metastases.

Keywords: brain metastasis; diffusion-weighted imaging; dynamic contrast-enhanced MRI; gefitinib; non-small cell lung cancer; whole-brain radiotherapy.

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Conflict of interest statement

Conflict of interest: Authors state no conflict of interest.

Figures

Figure 1
Figure 1
DCE-MRI, DWI, and ADC before treatment. Note: The depicted patient was male, 61 years old, with no smoking history, diagnosed with brain metastasis of squamous adenocarcinoma. (a) DCE-MRI image, showing a ring enhancement lesion about 4.3 cm in the right temporal lobe, with significantly low signal in the center (where the arrow points); (b) DWI image, showing significantly low signal in the center of the lesion, equal or high mixed signal at the edge, and equal signal in peritumor edema; (c) ADC image, showing accelerated diffusion of the lesion center and unrestricted diffusion of surrounding edema.
Figure 2
Figure 2
ROC curve analysis of ADC value. Note: (a) Δdpost, (b) ADCpost, (c) ΔADCpost, and (d) ΔADCpost (%).
See this image and copyright information in PMC

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