弥散加权MRI引导下穿刺活检可定量评估肿瘤异质性和估计细胞负荷
Diffusion-weighted MRI-guided needle biopsies permit quantitative tumor heterogeneity assessment and cell load estimation
摘要：
肿瘤异质性和细胞负荷的定量信息可以帮助设计有效和精细的个性化治疗策略。我们最近表明，如果可以建立D和细胞密度之间的关系，则可以从扩散加权MRI（DWI）导出的扩散参数D推断出这样的信息。然而，这种关系不能先验地被假定为对于所有患者和肿瘤类型是恒定的。因此，为了帮助姑息治疗的临床决策，需要在没有肿瘤切除的情况下建立这种关系。它在这里表明，活检可能包含足够的信息，为此目的，如果活检的本地化选择系统阐述了本文。提出了一种基于超像素的方法，用于从DWI D图自动优化活检定位。DWI引导程序的性能通过广泛模拟活检进行评价。针吸活检产生足够的组织学信息，以建立D值和细胞密度之间的定量关系，前提是它们取自DWI中具有高、中和低D值的区域。从NSCLC患者肿瘤中证明了活检区域的自动定位。在这种情况下，即使两三次活检也能给出合理的估计。在不同条件下的针活检的模拟表明，DWI指导大大提高了估计结果。实体瘤的细胞结构和异质性可以通过DWI和少数针吸活检可靠地研究，这些针吸活检是在D值分离良好的区域采样的，不包括脂肪组织。该过程可以提供一种基于个性化信息嵌入癌症诊断和治疗中的临床工作流程辅助的方式。
英文摘要：
Quantitative information on tumor heterogeneity and cell load could assist in designing effective and refined personalized treatment strategies. It was recently shown by us that such information can be inferred from the diffusion parameter D derived from the diffusion-weighted MRI (DWI) if a relation between D and cell density can be established. However, such relation cannot a priori be assumed to be constant for all patients and tumor types. Hence to assist in clinical decisions in palliative settings, the relation needs to be established without tumor resection. It is here demonstrated that biopsies may contain sufficient information for this purpose if the localization of biopsies is chosen as systematically elaborated in this paper. A superpixel-based method for automated optimal localization of biopsies from the DWI D-map is proposed. The performance of the DWI-guided procedure is evaluated by extensive simulations of biopsies. Needle biopsies yield sufficient histological information to establish a quantitative relationship between D-value and cell density, provided they are taken from regions with high, intermediate, and low D-value in DWI. The automated localization of the biopsy regions is demonstrated from a NSCLC patient tumor. In this case, even two or three biopsies give a reasonable estimate. Simulations of needle biopsies under different conditions indicate that the DWI-guidance highly improves the estimation results. Tumor cellularity and heterogeneity in solid tumors may be reliably investigated from DWI and a few needle biopsies that are sampled in regions of well-separated D-values, excluding adipose tissue. This procedure could provide a way of embedding in the clinical workflow assistance in cancer diagnosis and treatment based on personalized information.
机构、总结、中文摘要均由AI分析而来，可能存在错误，请以论文正文为准。
