Dynamic contrast-enhanced and intravoxel incoherent motion magnetic resonance imaging to assess early response of microwave ablation in lung tumors.

OBJECT: To explore the potential of dynamic contrast-enhanced MRI (DCE-MRI) and intravoxel incoherent motion MRI (IVIM-MRI) in predicting the short-term efficacy of microwave ablation (MWA) in lung tumors.

METHODS

Thirty-nine patients with 47 lesions were enrolled in this study, who underwent percutaneous MWA treatment from May 2023 to July 2024. All patients underwent DCE-MRI and IVIM-MRI scanning before and after MWA procedure within 24 h. All patients underwent computed tomography (CT) examinations at 3 and 6 months after MWA. According to the CT findings during the 6-month follow-up period, all patients were classified into the local control group and the recurrence group. The pre- and post-treatment DCE-MRI parameters (Ktrans, Kep, Ve, Vp) and IVIM-MRI parameters (D, f, D*, ADC), and their percentage change (Δ) were calculated and compared between two groups. Within each group, all DCE-MRI and IVIM-MRI parameters were compared pairwise (pre vs. post). The diagnostic performance was tested using receiver operating characteristic (ROC) curves.

RESULTS

Among the total of thirty-nine patients with 47 lesions, twenty-five patients with 31 lesions were classified into local control group, and fourteen patients with 16 lesions were classified into recurrence group. DCE-MRI parameters (Ktrans, Kep, Ve, Vp) and IVIM-MRI parameters (D, D*, ADC) showed a significant difference between pre-treatment and post-treatment in both groups (P < 0.05). Post-D, post-ADC, ΔD and ΔADC showed a statistically significant difference between the local control group and the recurrence group (P = 0.027, 0.018, 0.037 and 0.005, respectively). ROC analysis showed the area under the curve (AUC) values of post-D, post-ADC, ΔD and ΔADC were 0.716, 0.700, 0.688 and 0.750, respectively.

CONCLUSIONS

The parameters of IVIM-MRI (D, ADC) after MWA within 24 h may be a potential early biomarker for evaluating the treatment efficacy of MWA in lung tumors.