Abstract
PurposeTo explore the role of intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging in evaluating human epidermal growth factor receptor 2 (HER2) status of gastric cancers preoperatively.ResultsThe apparent diffusion coefficient (ADC) and pure diffusion coefficient (D) values correlated positively with HER2 scores of gastric cancers significantly (r = 0.276, P = 0.048; r = 0.481, P < 0.001, respectively). The ADC and D values of HER2 positive gastric cancers were significantly higher than those of HER2 negative tumors (P = 0.033, 0.007, respectively). With a cut-off value of 1.321 and 1.123 × 10−3 mm2/sec, the ADC and D values could distinguish HER2 positive gastric cancers from HER2 negative ones with an area under the curve of 0.733 and 0.762, respectively (P = 0.023, 0.011, respectively).Materials and methodsFifty-three patients with gastric cancers underwent IVIM MR imaging preoperatively. The values of ADC, D, pseudo diffusion coefficient (D*) and perfusion related fraction (f) of the lesions were obtained. Partial correlation test including tumor volume was performed to analyze correlations between IVIM values and HER2 scores excluding the impact of tumor size. IVIM parameters of gastric cancers with different HER2 status were compared using independent samples t test. Diagnostic performance of IVIM parameters in distinguishing HER2 positive gastric cancers from negative ones was tested with receiver operating characteristic analysis.ConclusionsWe confirmed the feasibility of IVIM MR imaging in preoperative assessment of HER2 status of gastric cancers, which might make up the shortfall of biopsy and facilitate personalized treatment for patients with gastric cancers.
Highlights
Gastric cancer is one of the most common digestive malignancies worldwide and many patients were diagnosed at advanced stage [1]
We confirmed the feasibility of intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging in preoperative assessment of Human epidermal growth factor receptor 2 (HER2) status of gastric cancers, which might make up the shortfall of biopsy and facilitate personalized treatment for patients with gastric cancers
ToGA trial indicated that the combination of chemotherapy plus trastuzumab proved superior to chemotherapy alone with an extend survival from 11.8 to 16.0 months among patients with higher HER2 expression [3]
Summary
Gastric cancer is one of the most common digestive malignancies worldwide and many patients were diagnosed at advanced stage [1]. An excessive amount of HER2-containing heterodimers will be formed which enhances the signaling responses to growth factors. With a complex signaling network, the overexpression of HER2 leads to activations associated with cell proliferation, differentiation and survival [4,5,6]. HER2 overexpression is an important biomarker for treatment with trastuzumab in patients with gastric and gastroesophageal junction cancers [3]. ToGA trial indicated that the combination of chemotherapy plus trastuzumab proved superior to chemotherapy alone with an extend survival from 11.8 to 16.0 months among patients with higher HER2 expression [3]. An accurate assessment of HER2 status is critical to optimize the therapeutic effect
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