Andreas M Hötker1,2, Lisa Tarlinton3, Yousef Mazaheri4, Kaitlin M Woo5, Mithat Gönen5, Leonard B Saltz6, Karyn A Goodman7, Julio Garcia-Aguilar8, Marc J Gollub3. 1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA. Andreas.Hoetker@uni-mainz.de. 2. Department of Diagnostic and Interventional Radiology, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Germany. Andreas.Hoetker@uni-mainz.de. 3. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA. 4. Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. 5. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. 6. Department of Medicine, Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. 7. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. 8. Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Abstract
PURPOSE: To compare morphological and functional MRI metrics and determine which ones perform best in assessing response to neoadjuvant chemoradiotherapy (CRT) in rectal cancer. MATERIALS AND METHODS: This retrospective study included 24 uniformly-treated patients with biopsy-proven rectal adenocarcinoma who underwent MRI, including diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) sequences, before and after completion of CRT. On all MRI exams, two experienced readers independently measured longest and perpendicular tumour diameters, tumour volume, tumour regression grade (TRG) and tumour signal intensity ratio on T2-weighted imaging, as well as tumour volume and apparent diffusion coefficient on DW-MRI and tumour volume and transfer constant Ktrans on DCE-MRI. These metrics were correlated with histopathological percent tumour regression in the resected specimen (%TR). Inter-reader agreement was assessed using the concordance correlation coefficient (CCC). RESULTS: For both readers, post-treatment DW-MRI and DCE-MRI volumetric tumour assessments were significantly associated with %TR; DCE-MRI volumetry showed better inter-reader agreement (CCC=0.700) than DW-MRI volumetry (CCC=0.292). For one reader, mrTRG, post-treatment T2 tumour volumetry and assessments of volume change made with T2, DW-MRI and DCE-MRI were also significantly associated with %TR. CONCLUSION: Tumour volumetry on post-treatment DCE-MRI and DW-MRI correlated well with %TR, with DCE-MRI volumetry demonstrating better inter-reader agreement. KEY POINTS: • Volumetry on post-treatment DCE-/DW-MRI sequences correlated well with histopathological tumour regression. • DCE-MRI volumetry demonstrated good inter-reader agreement. • Inter-reader agreement was higher for DCE-MRI volumetry than for DW-MRI volumetry. • DCE-MRI volumetry merits further investigation as a metric for evaluating treatment response.
PURPOSE: To compare morphological and functional MRI metrics and determine which ones perform best in assessing response to neoadjuvant chemoradiotherapy (CRT) in rectal cancer. MATERIALS AND METHODS: This retrospective study included 24 uniformly-treated patients with biopsy-proven rectal adenocarcinoma who underwent MRI, including diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) sequences, before and after completion of CRT. On all MRI exams, two experienced readers independently measured longest and perpendicular tumour diameters, tumour volume, tumour regression grade (TRG) and tumour signal intensity ratio on T2-weighted imaging, as well as tumour volume and apparent diffusion coefficient on DW-MRI and tumour volume and transfer constant Ktrans on DCE-MRI. These metrics were correlated with histopathological percent tumour regression in the resected specimen (%TR). Inter-reader agreement was assessed using the concordance correlation coefficient (CCC). RESULTS: For both readers, post-treatment DW-MRI and DCE-MRI volumetric tumour assessments were significantly associated with %TR; DCE-MRI volumetry showed better inter-reader agreement (CCC=0.700) than DW-MRI volumetry (CCC=0.292). For one reader, mrTRG, post-treatment T2 tumour volumetry and assessments of volume change made with T2, DW-MRI and DCE-MRI were also significantly associated with %TR. CONCLUSION: Tumour volumetry on post-treatment DCE-MRI and DW-MRI correlated well with %TR, with DCE-MRI volumetry demonstrating better inter-reader agreement. KEY POINTS: • Volumetry on post-treatment DCE-/DW-MRI sequences correlated well with histopathological tumour regression. • DCE-MRI volumetry demonstrated good inter-reader agreement. • Inter-reader agreement was higher for DCE-MRI volumetry than for DW-MRI volumetry. • DCE-MRI volumetry merits further investigation as a metric for evaluating treatment response.
Entities:
Keywords:
Diffusion MRI; Dynamic contrast-enhanced MRI; Magnetic resonance imaging; Neoadjuvant treatment; Rectal cancer
Authors: M J Gollub; D H Gultekin; O Akin; R K Do; J L Fuqua; M Gonen; D Kuk; M Weiser; L Saltz; D Schrag; K Goodman; P Paty; J Guillem; G M Nash; L Temple; J Shia; L H Schwartz Journal: Eur Radiol Date: 2011-11-20 Impact factor: 5.315
Authors: A F Devries; J Griebel; C Kremser; W Judmaier; T Gneiting; A Kreczy; D Ofner; K P Pfeiffer; G Brix; P Lukas Journal: Cancer Res Date: 2001-03-15 Impact factor: 12.701
Authors: David D B Bates; Maria El Homsi; Kevin J Chang; Neeraj Lalwani; Natally Horvat; Shannon P Sheedy Journal: Clin Colorectal Cancer Date: 2021-11-14 Impact factor: 4.481
Authors: Marc J Gollub; Ivana Blazic; David D B Bates; Naomi Campbell; Andrea Knezevic; Mithat Gonen; Patricio Lynn; Martin R Weiser; Julio Garcia-Aguilar; Andreas M Hötker; Andrea Cercek; Leonard Saltz Journal: Eur Radiol Date: 2018-10-02 Impact factor: 5.315
Authors: Marc J Gollub; Ivana Blazic; Seth Felder; Andrea Knezevic; Mithat Gonen; Julio Garcia-Aguilar; P Phillip Paty; J Joshua Smith Journal: Eur Radiol Date: 2018-09-21 Impact factor: 5.315