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

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 we...

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Autores principales: Ingenerf, Maria, Kiesl, Sophia, Winkelmann, Michael, Auernhammer, Christoph J., Rübenthaler, Johannes, Grawe, Freba, Fabritius, Matthias P., Ricke, Jens, Schmid-Tannwald, Christine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9599819/
https://www.ncbi.nlm.nih.gov/pubmed/36289880
http://dx.doi.org/10.3390/biomedicines10102618
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author Ingenerf, Maria
Kiesl, Sophia
Winkelmann, Michael
Auernhammer, Christoph J.
Rübenthaler, Johannes
Grawe, Freba
Fabritius, Matthias P.
Ricke, Jens
Schmid-Tannwald, Christine
author_facet Ingenerf, Maria
Kiesl, Sophia
Winkelmann, Michael
Auernhammer, Christoph J.
Rübenthaler, Johannes
Grawe, Freba
Fabritius, Matthias P.
Ricke, Jens
Schmid-Tannwald, Christine
author_sort Ingenerf, Maria
collection PubMed
description 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.
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spelling pubmed-95998192022-10-27 Treatment Assessment of pNET and NELM after Everolimus by Quantitative MRI Parameters Ingenerf, Maria Kiesl, Sophia Winkelmann, Michael Auernhammer, Christoph J. Rübenthaler, Johannes Grawe, Freba Fabritius, Matthias P. Ricke, Jens Schmid-Tannwald, Christine Biomedicines Article 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. MDPI 2022-10-18 /pmc/articles/PMC9599819/ /pubmed/36289880 http://dx.doi.org/10.3390/biomedicines10102618 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ingenerf, Maria
Kiesl, Sophia
Winkelmann, Michael
Auernhammer, Christoph J.
Rübenthaler, Johannes
Grawe, Freba
Fabritius, Matthias P.
Ricke, Jens
Schmid-Tannwald, Christine
Treatment Assessment of pNET and NELM after Everolimus by Quantitative MRI Parameters
title Treatment Assessment of pNET and NELM after Everolimus by Quantitative MRI Parameters
title_full Treatment Assessment of pNET and NELM after Everolimus by Quantitative MRI Parameters
title_fullStr Treatment Assessment of pNET and NELM after Everolimus by Quantitative MRI Parameters
title_full_unstemmed Treatment Assessment of pNET and NELM after Everolimus by Quantitative MRI Parameters
title_short Treatment Assessment of pNET and NELM after Everolimus by Quantitative MRI Parameters
title_sort treatment assessment of pnet and nelm after everolimus by quantitative mri parameters
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9599819/
https://www.ncbi.nlm.nih.gov/pubmed/36289880
http://dx.doi.org/10.3390/biomedicines10102618
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