Background: This study aimed to examine whether the coefficient of variation (CV) in the hepatobiliary-phase (HBP) of Gd-EOB-DTPA-MRI could be an independent predictive factor for tumor progression. Methods: Patients who underwent Gd-EOB-DTPA-MRI before Atezolizumab/bevacizumab therapy at six affiliated institutions between 2018 and 2022 were included. CV for each patient was calculated as the mean value for up to five tumors larger than 10 mm, and CV of the whole tumor was calculated using LIFEx software. The tumor response was evaluated within 6–10 weeks. The primary endpoint was to investigate the predictive factors, including CV, related to tumor progression using logistic regression analysis. The secondary endpoints were tumor response rate and progression-free survival (PFS) based on CV. Results: Of the 46 enrolled patients, 13 (28.3%) underwent early progressive disease. Multivariate analysis revealed that a high CV (≥0.22) was an independent predictive factor for tumor progression (p= 0.043). Patients with a high CV had significantly frequent PD than those with a low CV (43.5 vs. 13.0%,p= 0.047). Patients with a high CV tended to have shorter PFS than those with a low CV (3.5 vs. 6.7 months,p= 0.071). Conclusion: Quantitative analysis using CV in the HBP of Gd-EOB-DTPA-MRI may be useful for predicting tumor progression for atezolizumab/bevacizumab therapy.
背景：本研究旨在探讨钆塞酸二钠增强磁共振成像肝胆期信号强度的变异系数是否能作为肿瘤进展的独立预测因素。方法：纳入2018年至2022年间在六家附属机构接受阿特珠单抗/贝伐珠单抗治疗前进行钆塞酸二钠增强磁共振成像检查的患者。每位患者的变异系数通过计算直径大于10毫米的肿瘤（最多五个）的平均值得出，并使用LIFEx软件计算整体肿瘤的变异系数。在治疗开始后6-10周内评估肿瘤反应。主要终点是通过逻辑回归分析探讨包括变异系数在内的与肿瘤进展相关的预测因素。次要终点是基于变异系数的肿瘤反应率和无进展生存期。结果：在46例入组患者中，13例（28.3%）出现早期疾病进展。多变量分析显示，高变异系数（≥0.22）是肿瘤进展的独立预测因素（p=0.043）。高变异系数患者的疾病进展率显著高于低变异系数患者（43.5%对13.0%，p=0.047）。高变异系数患者的无进展生存期有短于低变异系数患者的趋势（3.5个月对6.7个月，p=0.071）。结论：在钆塞酸二钠增强磁共振成像肝胆期使用变异系数进行定量分析，可能有助于预测阿特珠单抗/贝伐珠单抗治疗中的肿瘤进展。
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