Extracellular volume fraction can predict the treatment response and survival outcome of colorectal cancer liver metastases

Shenglin Li; Xinmei Yang; Ting Lu; Long Yuan; Yuting Zhang; Jun Zhao; Juan Deng; Caiqiang Xue; Qiu Sun; Xianwang Liu; Wenjuan Zhang; Junlin Zhou

doi:10.1016/j.ejrad.2024.111444

Extracellular volume fraction can predict the treatment response and survival outcome of colorectal cancer liver metastases

Eur J Radiol. 2024 Mar 25:175:111444. doi: 10.1016/j.ejrad.2024.111444. Online ahead of print.

Authors

Shenglin Li¹, Xinmei Yang², Ting Lu², Long Yuan², Yuting Zhang³, Jun Zhao³, Juan Deng², Caiqiang Xue², Qiu Sun⁴, Xianwang Liu², Wenjuan Zhang³, Junlin Zhou⁵

Affiliations

¹ Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China. Electronic address: lishl21@lzu.edu.cn.
² Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
³ Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China.
⁴ Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China.
⁵ Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No. 82, Chengguan District, Lanzhou 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China. Electronic address: ery_zhoujl@lzu.edu.cn.

PMID: 38531223
DOI: 10.1016/j.ejrad.2024.111444

Abstract

Objective: To assess the prognostic value of pre- and post-therapeutic changes in extracellular volume (ECV) fraction of liver metastases (LMs) for treatment response (TR) and survival outcomes in colorectal cancer liver metastases (CRLM).

Methods: 186 LMs were confirmed by pathology or follow-up (Training: 130; Test: 56). We analyzed the changes in ECV fraction of LMs before and after 2 cycles of chemotherapy combined with bevacizumab. After 12 cycles, we evaluated the TR on LMs based on the RECIST v1.1. Relative changes in ECV fraction and Hounsfield Units (HU), defined as ΔECV and ΔHU, were associated with progression-free survival (PFS), overall survival (OS), and TR. We identified TR predictors with multivariate logistic regression and PFS, OS risk factors with COX analysis.

Results: 186 LMs were classified as TR lesions (TR+: 84) and non-TR lesions (TR-:102). ΔECV, ΔHU_A-E, and texture could distinguish the TR of LMs in training and test set (P < 0.05). ΔECV [Odds ratio (OR): 1.03; 95% Confidence interval (CI): 1.02-1.05, P < 0.01] was an independent predictor of TR-. Area under the curve (AUC), sensitivity and specificity of TR model in training and test set were 0.87, 0.84, 90.14%, 90.32%, 72.88%, 64.00%, respectively. High CRD_score indicates that patients have shorter PFS [Hazard ratio (HR): 2.01; 95%CI: 1.02-3.98, P = 0.045)] and OS (HR: 1.89, 95%CI: 1.04-3.42, P = 0.038).

Conclusion: ΔECV can be used as an independent predictor of TR of CRLM chemotherapy combined with bevacizumab.

Keywords: Colorectal cancer; Metastasis; Molecular targeted therapy; Treatment outcome.