Quantitative intravoxel incoherent motion parameters derived from whole‐tumor volume for assessing pathological complete response to neoadjuvant chemotherapy in locally advanced rectal cancer

Journal of Magnetic Resonance Imaging - Tập 48 Số 1 - Trang 248-258 - 2018
Qiaoyu Xu1, Yanyan Xu1, Hongliang Sun1, Queenie Chan2, Kaining Shi3, Aiping Song4, Wu Wang1
1Department of Radiology, China-Japan Friendship Hospital, Beijing, China
2Philips Healthcare, Shatin, New Territories, Hong Kong, China
3Philips Healthcare, Beijing, China
4Department of Pathology, China-Japan Friendship Hospital, Beijing, China

Tóm tắt

BackgroundMany locally advanced rectal cancer (LARC) patients can benefit from neoadjuvant chemotherapy (NACT), with some achieving a pathological complete response (pCR). However, there is limited research reporting on the value of intravoxel incoherent motion (IVIM) in monitoring pCR in patients with LARC.PurposeTo identify whether IVIM parameters derived from whole‐tumor volume (WTV) before and after NACT could accurately assess pCR in patients with LARC.Study TypeProspective patient control study.PopulationFifty‐one patients with LARC before and after NACT, prior to surgery.Field Strength/SequenceIVIM‐diffusion imaging at 3T.AssessmentApparent diffusion coefficient (ADC), slow diffusion coefficient (D), fast diffusion coefficient (D*), and perfusion‐related diffusion fraction (f) values were obtained on diffusion‐weighted magnetic resonance images (DW‐MRI) using WTV methods and calculated using a biexponential model before and after NACT.Statistical TestsDWI‐derived ADC and IVIM‐derived parameters and their percentage changes (ΔADC%, ΔD%, ΔD*%, and Δf%) were compared using independent‐samples t‐test and Mann–Whitney U‐test between the pCR and non‐pCR groups. The diagnostic performance of IVIM parameters and their percentage changes were evaluated using receiver operating characteristic curves.ResultsCompared with the non‐pCR group, the pCR group exhibited significantly lower pre‐ADCmean (P = 0.003) and pre‐D values (P = 0.024), and significantly higher post‐f (P = 0.002), ΔADCmean% (P = 0.002), ΔD% (P = 0.001), and Δf% values (P = 0.017). Receiver operating characteristic curves showed that the pre‐D value had the best specificity (95.12%) and accuracy (86.27%) in predicting the pCR status, and ΔD% had the highest area under the curve (0.832) in assessing the pCR response to NACT.Data ConclusionsThe IVIM‐derived D value is a promising tool in predicting the pCR status before therapy. The percentage changes in D values after therapy may help assess the pCR status prior to surgery.Level of Evidence: 2Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2017.

Từ khóa


Tài liệu tham khảo

10.3322/caac.21262

10.1097/DCR.0000000000000127

10.1097/SLA.0b013e3181f3f1b1

10.1097/DCR.0b013e31828e5a72

10.1016/j.gassur.2004.10.010

10.1007/s10350-004-0713-x

10.4240/wjgs.v7.i11.306

10.1097/MD.0000000000005059

10.1046/j.1463-1318.2002.00300.x

10.1097/01.sla.0000141194.27992.32

10.1016/j.ejso.2015.09.008

10.1016/j.semradonc.2011.02.010

10.1200/JCO.2011.37.7176

10.1016/j.ijrobp.2013.12.012

10.1016/j.gassur.2006.09.005

10.1111/j.1463-1318.2008.01593.x

10.1148/radiol.13122833

10.1016/S0140-6736(00)04040-X

10.1002/jmri.25117

10.1148/radiol.2532090027

Hu F, 2017, The value of diffusion kurtosis imaging in assessing pathological complete response to neoadjuvant chemoradiation therapy in rectal cancer: a comparison with conventional diffusion‐weighted imaging, Oncotarget

10.1007/s00330-010-1989-y

Engin G, 2012, Can diffusion‐weighted MRI determine complete responders after neoadjuvant chemoradiation for locally advanced rectal cancer?, Diagn Interv Radiol, 574

10.1148/radiol.11102467

10.1007/s00330-013-2936-5

10.1016/j.ijrobp.2010.12.063

10.1148/radiol.2015150244

10.1016/j.radonc.2014.03.006

10.1148/radiology.168.2.3393671

10.1002/jmri.25075

Lu W, 2017, Intravoxel incoherent motion diffusion‐weighted imaging for discriminating the pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer, Sci Rep‐UK, 7

10.1002/jmri.25567

10.1148/radiol.2016150702

10.1148/radiology.211.1.r99ap35215

10.1245/s10434-010-0985-4

2010, World Health Organization Classification of Tumours of the Digestive System, 134

10.1007/s003840050072

10.1016/j.ijrobp.2009.03.010

10.1200/JCO.2013.51.7904

10.1016/j.ejso.2013.07.090

10.1002/jmri.22749

10.1148/radiol.13130444

10.1148/radiol.13122506

10.1007/s00330-012-2604-1

10.1245/s10434-011-1607-5

10.1148/radiol.11102135

10.1148/radiol.2473070414

10.1148/radiol.12112478

10.1002/mrm.22565

10.1007/s00234-013-1154-9

10.1097/RCT.0b013e31826bdbbd

10.1038/bjc.1995.514

10.3906/sag-1609-59

10.1097/MD.0000000000000658

10.1016/j.ejca.2013.12.007

Thông tin
Thông tin xuất bản

Journal of Magnetic Resonance Imaging

Tập 48 Số 1

248-258

Thông tin tác giả