Tong Tong1, Yiqun Sun1, Marc J Gollub2, Weijun Peng1, Sanjun Cai3, Zhen Zhang4, Yajia Gu1. 1. Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China. 2. Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. 3. Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China. 4. Department of Radiotherapy, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
Abstract
PURPOSE: To determine the ability of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to predict pathological complete response (pCR) before preoperative chemoradiotherapy (CRT) in locally advanced rectal cancer. MATERIALS AND METHODS: In a prospective clinical trial, 38 enrolled patients underwent pre- and post-CRT DCE-MRI at 3.0T. The tumor length and the following perfusion parameters (K(trans) , kep , ve ) were measured for the tumor and compared between the pCR group and the non-pCR group, as well as before and after CRT. For categorical variable comparison, the Kruskal-Wallis test was used. P < 0.05 was considered significant. RESULTS: No difference in tumor length was found between the pCR and non-pCR group pre- and post-CRT (P = 0.26 (0.15,0.45), 0.35 (0.21,0.52), respectively). Before CRT, the mean tumor K(trans) in the pCR group was significantly higher than in the non-pCR group (P = 0.01). A K(trans) of 0.66 emerged as the best cutoff for distinguishing pCR from non-pCR. Regarding kep and ve , significant differences were also observed between the pCR and non-pCR groups (P = 0.02, 0.01, respectively). The mean K(trans) , kep , and ve values post-CRT were lower in the pCR group than in the non-pCR group, although there was no significant difference (P = 0.10 (0.04,0.16), 0.11 (0.07,0.26), 0.10 (0.06,0.23), respectively). CONCLUSION: Before neoadjuvant chemoradiotherapy in rectal cancer, DCE-MRI can distinguish between complete and incomplete response using a K(trans) threshold of 0.66 with a sensitivity of 100%.
PURPOSE: To determine the ability of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to predict pathological complete response (pCR) before preoperative chemoradiotherapy (CRT) in locally advanced rectal cancer. MATERIALS AND METHODS: In a prospective clinical trial, 38 enrolled patients underwent pre- and post-CRT DCE-MRI at 3.0T. The tumor length and the following perfusion parameters (K(trans) , kep , ve ) were measured for the tumor and compared between the pCR group and the non-pCR group, as well as before and after CRT. For categorical variable comparison, the Kruskal-Wallis test was used. P < 0.05 was considered significant. RESULTS: No difference in tumor length was found between the pCR and non-pCR group pre- and post-CRT (P = 0.26 (0.15,0.45), 0.35 (0.21,0.52), respectively). Before CRT, the mean tumor K(trans) in the pCR group was significantly higher than in the non-pCR group (P = 0.01). A K(trans) of 0.66 emerged as the best cutoff for distinguishing pCR from non-pCR. Regarding kep and ve , significant differences were also observed between the pCR and non-pCR groups (P = 0.02, 0.01, respectively). The mean K(trans) , kep , and ve values post-CRT were lower in the pCR group than in the non-pCR group, although there was no significant difference (P = 0.10 (0.04,0.16), 0.11 (0.07,0.26), 0.10 (0.06,0.23), respectively). CONCLUSION: Before neoadjuvant chemoradiotherapy in rectal cancer, DCE-MRI can distinguish between complete and incomplete response using a K(trans) threshold of 0.66 with a sensitivity of 100%.
Authors: Harrison Kim; Mina Mousa; Patrick Schexnailder; Robert Hergenrother; Mark Bolding; Bernard Ntsikoussalabongui; Vinoy Thomas; Desiree E Morgan Journal: Med Phys Date: 2017-08-12 Impact factor: 4.071
Authors: Sven Otto; Suad Aljohani; Riham Fliefel; Sara Ecke; Oliver Ristow; Egon Burian; Matthias Troeltzsch; Christoph Pautke; Michael Ehrenfeld Journal: Medicina (Kaunas) Date: 2021-05-09 Impact factor: 2.430