| Objective:By observe the changes of ADC value of brain metastasis from lung cancer in traditional Chinese medicine combined with chemotherapy before and after treatment,lesions early ADC change regulation were analyzed for effective group and ineffective group,evaluation application value of MRI diffusion weighted imaging(DWI)as an early,noninvasive and repeatable functional imaging method for early traditional Chinese medicine combined with chemotherapy curative effect of tumor of brain metastases of lung cancer.Methods:We collected 30 patients of brain metastasis from lung cancer which confirmed by clinical and pathological images.Conventional and enhanced MRI and diffusion weighted magnetic resonance imaging(DWI)were taken respectively in patients with traditional Chinese medicine combined with chemotherapy 1 weeks before treatment,1 cycles after treatment,and 2 cycles after treatment.The maximum diameter of lesions in each period were taken through conventional and contrast enhanced MRI images,The changes of lesion volume before and after treatment were compared,according to the Criteria for evaluation of efficacy of solid tumors(RECIST),which can be divided into effective group and ineffective group.The DWI image(b=0,1000s/mm)sent to the PHILPS workstation and production ADC map,measure ADC values,using independent samples t test statistical method to compare the ADC values of effective group and ineffective group before treatment,understanding whether the ADC value can predict effect for tumor treatment of lung cancer with brain metastasis.The formula of ADC changes rate in effective group and ineffective group after 1 cycles of treatment:?ADC%=(ADC after-ADC before/ADCbefore×100%,)for treatment after the 1 cycle of effective group and ineffective group ADC%in contrast with the independent sample t test method,to understand whether it has statistical significance.In addition,the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficiency of ADC value after 1 cycles,and the optimal threshold of ADC change rate was obtained.The data were analyzed by SPSS20.0 software.Results:30 cases of patients with a total of 43 lesions with brain metastases from lung cancer,the maximum diameter of lesions before treatment is(2,780±0.15)cm,the maximum diameter of lesions after 1 cycles of treatment is(2.69±0.14)cm,the maximum diameter of lesions before treatment and after 1 cycles of treatment were compared,the difference was not statistically significant(t=1.725,P=0.092),suggestive of lung cancer metastases in early comprehensive treatment volume had no obvious change.After 2 cycles of treatment,the maximum diameter of the lesions was(2.24±0.13)cm,the difference was statistically significant(t=1.420,P?0.000)compared with the maximum diameter of the lesions before treatment(2.78±0.15)cm.Effective 22 cases(effective group),invalid in 21 cases(invalid group),suggesting that the lesions in the treatment of the 2 cycles after the volume began to shrink.The average ADC value of tumor before treatment within a week in effective group was(0.97±0.05)×10-3mm2/s,and the invalid group average value of ADC was(1.17±0.06)×10-3mm2/s,there was no significant difference between the effective group and ineffective group(t=2.42,p=0.083),indicating that the treatment before the ADC value was not predictive of the therapeutic response.The average value of ADC in the effective group before treatment was(0.97±0.05)×10-3mm2/s,and the average ADC value was(1.21±0.04)×10-3mm2/s after treatment,and the difference between the two groups was statistically significant(t=-8.76,p=0.000).The results showed that the ADC value of the effective group was significantly higher after the treatment of the 1 cycle.The average value of ADC in the invalid group before treatment was(1.17±0.07)×10-3mm2/s,and the average ADC value after treatment in the invalid group was(1.20±0.08)×10-3mm2/s,the difference was not statistically significant(t=-0.98,p=0.33),it illustrate that the lesions ADC value in invalid group after 1 cycles may increase or decrease.Calculated ?ADC%according to the formula:(ADC before—ADC after/ADC before×100%,)The change rate of ADC value of effective group increased obviously,?ADC(%)=(28.23?3.97)%,However,the change rate of ADC value in the ineffective group had a slight increase or a decrease of ADC value,?ADC(%)=(2.5±2.27)%.Using independent sample t test statistical method,the effective group and the ineffective group ?ADC(%)has statistical difference(t=5.537,p=0.029).The results showed that the variation rate of ADC in the effective groups after 1 cycle treatment was significantly higher than that in the ineffective group.Then using the receiver operating characteristic(ROC)curve to evaluate the 1 cycle variation rate of ADC diagnostic efficiency in the treatment of 1 cycles of ADC increased to 12.9%as the threshold,the detection of brain metastases of lung cancer treatment sensitivity 81,8%,specificity of 85.7%,area under the ROC curve(AUC)was 0.898,95%confidence interval 0.805?0.992,that has a high diagnostic efficiency,and has high reliability.Conclusion:1.Diffusion weighted magnetic resonance imaging(DWI-MRI)can be used as an early,noninvasive and repeatable functional imaging method,which can reflect the microscopic pathological of the tumor in early treatment,and can predict the early effect of chemotherapy combined with traditional Chinese medicine in the treatment of tumor of brain metastases of lung cancer?2.The value of ADC in the first 1 weeks of treatment of lung cancer with brain metastases can not be used as an indicator to predict the efficacy of radiotherapy combined with traditional Chinese Medicine.3.Brain metastasis from lung cancer treatment in the 1 cycle of chemotherapy combined with traditional Chinese medicine,the rate change of ADC value has high diagnostic efficiency in predict treatment,with 1 cycles of treatment ADC increased 12.9%as the threshold,the sensitivity of predictive therapy effective was 81,8%,the specificity was 85.7%?... |
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