Akciğer kanserinde tedaviye cevap belirlenmesinde difüzyon ağırlıklı görüntülemenin (DAG) ve görünür difüzyon katsayısı (ADC) ölçümlerinin katkısı

Yıl 2023, Cilt: 48 Sayı: 1, 187 - 193, 31.03.2023

Eser Bulut , Polat Koşucu , Tevfik Ozlu , Muge Kosucu , Halil Kavgacı , İsmet Miraç Çakır , Arzu Coskuner Bulut

https://doi.org/10.17826/cumj.1218117

Öz

Amaç: Bu çalışmada evre III-IV akciğer kanserinde kemoterapiye tümör yanıtının değerlendirilmesinde difüzyon ağırlıklı görüntülemenin (DAG) rolünü değerlendirmektir.
Gereç ve Yöntem: Evre III-IV akciğer kanseri tanılı 32 hastaya 3 kür kemoterapi öncesi ve sonrası 3T MRG ile toraks MRG ve DAG uygulandı. DAG, tek atımlık bir eko-düzlemsel dizi kullanılarak 50, 400 ve 800 s/mm'lik bir b faktörü ile elde edildi. Kemoterapi öncesi ve sonrası histopatolojik tipler, regresyon ve progresyon grupları temelinde ortalama görünür difüzyon katsayısı (mADC) değerleri ölçülerek istatistiksel olarak karşılaştırıldı.
Bulgular: 32 olgudan 7'si (%18,5) progresyon grubunda (PG), 25'i (%81,5) regresyon grubunda (RG) yer aldı. PG'deki mADC, kemoterapiden önce 1,06±0,43 x 10ˉ³ ve kemoterapiden sonra 0,85±0,24 x 10ˉ³ ölçüldü. RG'deki mADC, kemoterapiden önce 0,92±0,27 x 10ˉ³ ve kemoterapiden sonra 1,20±0,26 x 10ˉ³ ölçüldü. Kemoterapi öncesi ve sonrası PG ve RG’de mADC değerleri arasında istatistiksel olarak anlamlı fark vardı. PG'de küçük hücreli akciğer kanseri (KHAK) tümör tipinde, kemoterapi öncesi ve sonrası mADC değerlerinde istatistiksel olarak anlamlı fark yoktu. RG'de KHAK ve küçük hücreli dışı akciğer kanseri (KHDAK) tümör tiplerinde ve PG'de KHDAK tümör tipinde kemoterapi öncesi ve sonrası mADC değerlerinde istatistiksel olarak anlamlı fark vardı.
Sonuç: Malign akciğer tümörlerinde DAG ve ADC ölçümleri tedaviye yanıtı değerlendirmede kullanılabilir.

Anahtar Kelimeler

İnoperabl akciğer kanseri, tedavi yanıtı, difüzyon ağırlıklı manyetik rezonans görüntüleme

Contribution of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurements in determining response to treatment in lung cancer

Öz

Purpose: The purpose of this study was to evaluate the role of diffusion-weighted imaging (DWI) in evaluating tumor response to chemotherapy in stage III-IV lung cancer.
Materials and Methods: Chest and DWI were performed with 3T MRI before and after 3 courses of chemotherapy on 32 patients diagnosed with stage III-IV lung cancer. DWI were acquired with a b factor of 50, 400 and 800 s/mm using a single-shot echo-planar sequence. Histopathological types before and after chemotherapy were compared by measuring mean apparent diffusion coefficient (mADC) values on the basis of regression and progression groups.
Results: 32 cases, 7 (18.5%) were in the progression group (PG), and 25 (81.5%) were in the regression group (RG). mADC in the PG was 1.06±0.43 x 10ˉ³ before chemotherapy and 0.85±0.24 x 10ˉ³ after chemotherapy. mADC in the RG was 0.92±0.27 x 10ˉ³ before chemotherapy and 1.20±0.26 x 10ˉ³ after chemotherapy. There was a statistically significant difference between the mADC values in the PG and RG before and after chemotherapy. There was no statistically significant difference in mADC values before and after chemotherapy in small cell lung cancer (SCLC) tumor type in the PG . There was a statistically significant difference in mADC values before and after chemotherapy in SCLC and non-small cell lung cancer (NSCLC) tumor types in the RG and NSCLC tumor type in the PG
Conclusion: DWI and ADC measurements can be used in assessing response to treatment in malignant pulmonary tumors.

Anahtar Kelimeler

Inoperable lung cancer, treatment response, diffusion-weighted magnetic resonance imaging

Kaynakça

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