Maria Ciolina1, Damiano Caruso1, Domenico De Santis1, Marta Zerunian1, Marco Rengo1, Norma Alfieri2, Daniela Musio3, Francesca De Felice3, Antonio Ciardi4, Vincenzo Tombolini3, Andrea Laghi5. 1. Department of Surgical and Medical Sciences and Translational Medicine, "Sapienza" University of Rome, Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy. 2. Department of Radiological Sciences, Oncology and Pathology, UOC Radiologia, Policlinico Umberto I Hospital, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy. 3. Department of Radiological Sciences, Oncology and Pathology, UOC Radioterapia, Policlinico Umberto I Hospital, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy. 4. Department of Radiological Sciences, Oncology and Pathology, UOC Anatomia-Patologica, Policlinico Umberto I Hospital, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy. 5. Department of Surgical and Medical Sciences and Translational Medicine, "Sapienza" University of Rome, Radiology Unit - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy. andrea.laghi@uniroma1.it.
Abstract
PURPOSE: To correlate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters to tumor grading and to assess their reliability in predicting pathological complete response (pCR) before neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC). MATERIALS AND METHODS: Forty patients (24 male; mean age, 67.3 ± 8.1 years) with histologically proven LARC who had undergone 3-Tesla DCE-MRI before (MRI_1) and after CRT (MRI_2) between August 2015 and February 2016 were included in this retrospective study. DCE-MRI parameters at MRI_1 and MRI_2 were extracted by two board certified radiologists in consensus reading with Olea Sphere 2.3 software using the extended Tofts model. Based on DCE-MRI results, patients were divided in complete responders (CR) and non-complete responders (nCR) and the perfusion parameters were correlated to tumor grading and pCR. RESULTS: Wash-out and Kep at MRI_1 showed significant correlation with LARC grading (P = 0.004 and 0.01, respectively). Ve showed a significant increase between MRI_1 (0.47 ± 0.27) and MRI_2 (0.63 ± 0.23; P = 0.007). Ktrans measured at MRI_1 was significantly higher in CR (0.66 ± 0.48) compared to nCR (0.53 ± 0.34, P = 0.02). CONCLUSION: Wash-out and Kep measured before CRT correlate with LARC grading. Ve changes during CRT, while Ktrans measured before CRT may predict the response to therapy. Therefore, DCE-MRI parameters can predict tumor aggressiveness and CRT efficacy, playing a role as imaging biomarkers in patients with LARC.
PURPOSE: To correlate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters to tumor grading and to assess their reliability in predicting pathological complete response (pCR) before neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC). MATERIALS AND METHODS: Forty patients (24 male; mean age, 67.3 ± 8.1 years) with histologically proven LARC who had undergone 3-Tesla DCE-MRI before (MRI_1) and after CRT (MRI_2) between August 2015 and February 2016 were included in this retrospective study. DCE-MRI parameters at MRI_1 and MRI_2 were extracted by two board certified radiologists in consensus reading with Olea Sphere 2.3 software using the extended Tofts model. Based on DCE-MRI results, patients were divided in complete responders (CR) and non-complete responders (nCR) and the perfusion parameters were correlated to tumor grading and pCR. RESULTS: Wash-out and Kep at MRI_1 showed significant correlation with LARC grading (P = 0.004 and 0.01, respectively). Ve showed a significant increase between MRI_1 (0.47 ± 0.27) and MRI_2 (0.63 ± 0.23; P = 0.007). Ktrans measured at MRI_1 was significantly higher in CR (0.66 ± 0.48) compared to nCR (0.53 ± 0.34, P = 0.02). CONCLUSION: Wash-out and Kep measured before CRT correlate with LARC grading. Ve changes during CRT, while Ktrans measured before CRT may predict the response to therapy. Therefore, DCE-MRI parameters can predict tumor aggressiveness and CRT efficacy, playing a role as imaging biomarkers in patients with LARC.
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Authors: Damiano Caruso; Marta Zerunian; Domenico De Santis; Tommaso Biondi; Pasquale Paolantonio; Marco Rengo; Davide Bellini; Riccardo Ferrari; Maria Ciolina; Elena Lucertini; Michela Polici; Elsa Iannicelli; Vincenzo Tombolini; Andrea Laghi Journal: Biomed Res Int Date: 2020-10-10 Impact factor: 3.411