Feedback

Treatment Assessment of pNET and NELM after Everolimus by Quantitative MRI Parameters

ORCID
0000-0001-6465-4597
Affiliation
Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany
Ingenerf, Maria;
Affiliation
Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany
Kiesl, Sophia;
Affiliation
Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany
Winkelmann, Michael;
ORCID
0000-0001-8087-3722
Affiliation
ENETS Centre of Excellence, Interdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System at The University Hospital of Munich (GEPNET-KUM), 81377 Munich, Germany
Auernhammer, Christoph J.;
ORCID
0000-0003-0832-5662
Affiliation
Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany
Rübenthaler, Johannes;
Affiliation
Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany
Grawe, Freba;
ORCID
0000-0002-3471-4701
Affiliation
Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany
Fabritius, Matthias P.;
Affiliation
Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany
Ricke, Jens;
Affiliation
Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany
Schmid-Tannwald, Christine

Assessment of treatment response to targeted therapies such as everolimus is difficult, especially in slow-growing tumors such as NETs. In this retrospective study, 17 patients with pancreatic neuroendocrine tumors (pNETs) and hepatic metastases (NELMs) (42 target lesions) who received everolimus were analyzed. Intralesional signal intensities (SI) of non-contrast T1w, T2w and DCE imaging, and apparent diffusion coefficients (ADCmean and ADCmin) of DWI, were measured on baseline and first follow-up MRI after everolimus initiation. Response assessment was categorized according to progression-free survival (PFS), with responders (R) showing a PFS of ≥11 months. ADCmin of NELMs decreased in Rs whereas it increased in non-responders (NR). Percentual changes of ADCmin and ADCmean differed significantly between response groups ( p < 0.03). By contrast, ADC of the pNETs tended to increase in Rs, while there was no change in NRs. Tumor-to-liver (T/L) ratio of T1 SI of NELMs increased in Rs and decreased in NRs, and percentual changes differed significantly between response groups ( p < 0.02). T1 SI of the pNETs tended to decrease in Rs and increase in Ns. The quotient of pretherapeutic and posttherapeutic ADCmin values (DADCmin) and length of everolimus treatment showed significant association with PFS in univariable Cox analysis. In conclusion, quantitative MRI, especially DWI, seems to allow treatment assessment of pNETs with NELMs under everolimus. Interestingly, the responding NELMs showed decreasing ADC values, and there might be an opposite effect on ADC and T1 SI between NELMs and pNETs.

Cite

Citation style:
Could not load citation form.

Rights

License Holder: © 2022 by the authors.

Use and reproduction: