%0 Journal Article
%T Prediction of peritoneal free cancer cells in gastric cancer patients by golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging.
%A Yin X
%A Ruan X
%A Zhu Y
%A Yin Y
%A Huang R
%A Liang C
%J J Zhejiang Univ Sci B
%V 25
%N 7
%D 2024 Jun 5
%M 39011681
%F 5.552
%R 10.1631/jzus.B2300929
%X OBJECTIVE: Peritoneal free cancer cells can negatively impact disease progression and patient outcomes in gastric cancer. This study aimed to investigate the feasibility of using golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging (GRASP DCE-MRI) to predict the presence of peritoneal free cancer cells in gastric cancer patients.
METHODS: All enrolled patients were consecutively divided into analysis and validation groups. Preoperative magnetic resonance imaging (MRI) scans and perfusion were performed in patients with gastric cancer undergoing surgery, and peritoneal lavage specimens were collected for examination. Based on the peritoneal lavage cytology (PLC) results, patients were divided into negative and positive lavage fluid groups. The data collected included clinical and MR information. A nomogram prediction model was constructed to predict the positive rate of peritoneal lavage fluid, and the validity of the model was verified based on data from the verification group.
RESULTS: There was no statistical difference between the proportion of PLC-positive cases predicted by GRASP DCE-MR and the actual PLC test. MR tumor stage, tumor thickness, and perfusion parameter Tofts-Ketty model volume transfer constant (Ktrans) were independent predictors of positive peritoneal lavage fluid. The nomogram model featured a concordance index (C-index) of 0.785 and 0.742 for the modeling and validation groups, respectively.
CONCLUSIONS: GRASP DCE-MR could effectively predict peritoneal free cancer cells in gastric cancer patients. The nomogram model constructed using these predictors may help clinicians to better predict the risk of peritoneal free cancer cells being present in gastric cancer patients.
胃癌腹腔游离癌细胞可对疾病进展和患者预后产生不利影响。本研究旨在探讨金角径向采样动态增强磁共振成像(GRASP DCE-MRI)预测胃癌患者腹膜游离癌细胞存在的可行性。对胃癌患者进行术前磁共振成像(MRI)扫描和灌注后处理,并采集患者术前腹腔灌洗标本进行检测。根据患者入组顺序将其分为实验组及验证组,将实验组数据进行多元回归分析并筛选有意义的变量,建立预测腹膜灌洗液阳性率的nomogram预测模型,并根据验证组数据对模型的有效性进行验证。研究发现,GRASP DCE-MR预测的腹膜灌洗细胞学(PLC)阳性病例比例与实际的PLC检测结果无统计学差异。肿瘤T分期、肿瘤厚度和灌注参数容积转移常数(Ktrans)均是腹膜灌洗液阳性的独立预测因子。用这些预测因子构建的nomogram模型可以帮助临床医生更好地预测胃癌患者腹膜游离癌细胞存在的风险。.