文章：

氧增强R2*加权磁共振成像与扩散加权磁共振成像在预测头颈部鳞状细胞癌淋巴结患者放化疗后两年预后中的应用

Oxygen-Enhanced R2* Weighted MRI and Diffusion Weighted MRI of Head and Neck Squamous Cell Cancer Lymph Nodes in Prediction of 2-Year Outcome Following Chemoradiotherapy

原文发布日期：14 July 2025

DOI: 10.3390/cancers17142333

类型: Article

开放获取: 是

英文摘要：

Background: We evaluated the utility of HNSCC LN R2* relaxation times to infer the oxygenation status of LN non-invasively at baseline and when breathing air and 100% oxygen to predict chemoradiotherapeutic locoregional response at 2 years. Hypoxia within LNs has been associated with poorer outcomes following CRT. Deoxyhaemoglobin decreases MRI transverse relaxation time (T2*) (lengthening inverse, R2*). Methods: A total of 54 patients underwent 1.5T-MRI before CRT. Conventional MR sequences were supplemented with T2* sequences breathing both air and 100% oxygen; pathological nodes identified in consensus were volumetrically contoured to T2* parametric maps. Results: Patients followed-up with for >2 years were categorised by multidisciplinary consensus into post-therapy complete local response (CR; n = 32/54) and local nodal disease relapse (RD; n = 22/54). Our data demonstrated, by R2*, that nodes that sustained post-therapy CR are significantly more hypoxic compared with relapsing nodes and paradoxically demonstrate a significant increase in hypoxia on 100% oxygen. Pre-treatment LN short axis diameter, various qualitative descriptors of malignancy, and quantitative DWI were not useful in discriminating successful response to CRT. Conclusions: This study demonstrates that a significant differential response to 100% oxygen and higher baseline R2* LN measurements could be exploited in risk stratification prior to CRT, and future work could be directed towards understanding the contrast mechanisms of R2* imaging, underpinning the observed differences in the context of hypoxia.

摘要翻译： 

背景：本研究旨在评估头颈部鳞状细胞癌（HNSCC）淋巴结R2*弛豫时间在预测放化疗后2年局部区域疗效中的应用价值，通过无创方式推断基线状态及吸入空气与纯氧时淋巴结的氧合水平。淋巴结内缺氧与放化疗后不良预后相关。脱氧血红蛋白会降低MRI横向弛豫时间（T2*）（即延长其倒数R2*）。方法：共54例患者在放化疗前接受1.5T-MRI检查。在常规MR序列基础上，补充采集患者分别呼吸空气和纯氧时的T2*序列；经多学科共识确定的病理阳性淋巴结在T2*参数图上进行三维勾画。结果：对随访超过2年的患者，经多学科共识分为治疗后完全缓解组（CR；n=32/54）和局部淋巴结复发组（RD；n=22/54）。通过R2*数据显示，治疗后持续完全缓解的淋巴结相较于复发淋巴结缺氧程度显著更高，且反常地在吸入纯氧时表现出缺氧显著加剧。治疗前淋巴结短径、多种恶性定性描述指标及定量扩散加权成像参数均无法有效区分放化疗疗效。结论：本研究证明，淋巴结对纯氧的显著差异反应及较高的基线R2*测量值可用于放化疗前的风险分层，未来研究可致力于阐明R2*成像的对比机制，以解释缺氧背景下观察到的差异现象。

原文链接：

Oxygen-Enhanced R2* Weighted MRI and Diffusion Weighted MRI of Head and Neck Squamous Cell Cancer Lymph Nodes in Prediction of 2-Year Outcome Following Chemoradiotherapy