Abstract 475P
Background
The purpose of the FDZL-MRinCLM study (NCT03088163) is to evaluate the feasibility of early parameter change assessed by diffusion kurtosis imaging of magnetic resonance (MR-DKI) in predicting clinical response to chemotherapy and investigate its prognostic value in patients with colorectal liver metastases (CLM).
Methods
From August 2016 to January 2020, 120 eligible CLM patients were consecutively enrolled in the study. Liver lesions were examined by MR-DKI at baseline and after one cycle of chemotherapy. The texture features were extracted from the D and K map using a prototype postprocessing software. The first 100 cases were utilized as the training set to develop the MR-DKI signature using the R package called “glmnet”, while the remaining 20 cases were used as the validation set. Patients were classified into high-risk and low-risk group according to the risk score, with the cut-off value which was calculated by utilizing ROC analyses. The primary endpoint was the DKI-predicted objective response rate (ORR) of liver metastases, and the secondary endpoints were the DKI-predicted progression-free survival (PFS) and overall survival (OS).
Results
A MRI-DKI signature was constructed using the coefficient value of 6 texture features undergoing the selection by binary logistic regression model with a lasso penalty in the training set. The risk score of each patient was calculated according to the formula (data not published). The AUCs for the signature to predict ORR was 0.818 (95%CI: 0.732-0.905) and 0.790 (95%CI: 0.551-1.029). The DKI-predicted ORRs were 9.5% (4/42) and 72.4% (42/58) in the high-risk and low-risk group, respectively (P<0.05). A worse PFS and OS were observed in high-risk group (all P < 0.05). In the validation set, the predicted ORRs of this signature reached 27.27% (3/11) and 77.78% (7/9) in high-risk and low-risk group, respectively (P=0.07), and worse PFS and OS trends were also shown in the high-risk group, although this was not statistically significant.
Conclusions
The MR-DKI signature could effectively predict the response of hepatic lesions of CLM to chemotherapy earlier than routine scanning.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.