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Role of dynamic contrast-enhanced MRI in predicting severe acute radiation-induced rectal injury in patients with rectal cancer.
Chen, Yan; Ding, Li; Zhang, Zhi-Wen; Wu, Xue-Han; Que, Yu-Tao; Ma, Yu-Ru; Liu, Yi-Yan; Wen, Zi-Qiang; Yang, Xin-Yue; Lu, Bao-Lan; Bao, Yong; Niu, Shao-Qing; Yu, Shen-Ping.
Afiliação
  • Chen Y; Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
  • Ding L; Department of Pathology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
  • Zhang ZW; Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
  • Wu XH; Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
  • Que YT; Department of Radiology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518017, China.
  • Ma YR; Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
  • Liu YY; Department of Radiology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518017, China.
  • Wen ZQ; Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
  • Yang XY; Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
  • Lu BL; Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
  • Bao Y; Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.
  • Niu SQ; Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
  • Yu SP; Department of Radiotherapy, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
Eur Radiol ; 34(3): 1471-1480, 2024 Mar.
Article em En | MEDLINE | ID: mdl-37665390
ABSTRACT

OBJECTIVES:

To explore the potential of dynamic contrast-enhanced MRI (DCE-MRI) quantitative parameters in predicting severe acute radiation-induced rectal injury (RRI) in rectal cancer.

METHODS:

This retrospective study enrolled 49 patients with rectal cancer who underwent neoadjuvant chemoradiotherapy and rectal MRI including a DCE-MRI sequence from November 2014 to March 2021. Two radiologists independently measured DCE-MRI quantitative parameters, including the forward volume transfer constant (Ktrans), rate constant (kep), fractional extravascular extracellular space volume (ve), and the thickness of the rectal wall farthest away from the tumor. These parameters were compared between mild and severe acute RRI groups based on histopathological assessment. Receiver operating characteristic curve analysis was performed to analyze statistically significant parameters.

RESULTS:

Forty-nine patients (mean age, 54 years ± 12 [standard deviation]; 37 men) were enrolled, including 25 patients with severe acute RRI. Ktrans was lower in severe acute RRI group than mild acute RRI group (0.032 min-1 vs 0.054 min-1; p = 0.008), but difference of other parameters (kep, ve and rectal wall thickness) was not significant between these two groups (all p > 0.05). The area under the receiver operating characteristic curve of Ktrans was 0.72 (95% confidence interval 0.57, 0.84). With a Ktrans cutoff value of 0.047 min-1, the sensitivity and specificity for severe acute RRI prediction were 80% and 54%, respectively.

CONCLUSION:

Ktrans demonstrated moderate diagnostic performance in predicting severe acute RRI. CLINICAL RELEVANCE STATEMENT Dynamic contrast-enhanced MRI can provide non-invasive and objective evidence for perioperative management and treatment strategies in rectal cancer patients with acute radiation-induced rectal injury. KEY POINTS • To our knowledge, this study is the first to evaluate the predictive value of contrast-enhanced MRI (DCE-MRI) quantitative parameters for severe acute radiation-induced rectal injury (RRI) in patients with rectal cancer. • Forward volume transfer constant (Ktrans), derived from DCE-MRI, exhibited moderate diagnostic performance (AUC = 0.72) in predicting severe acute RRI of rectal cancer, with a sensitivity of 80% and specificity of 54%. • DCE-MRI is a promising imaging marker for distinguishing the severity of acute RRI in patients with rectal cancer.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Meios de Contraste Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Male / Middle aged Idioma: En Revista: Eur Radiol Assunto da revista: RADIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Meios de Contraste Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Male / Middle aged Idioma: En Revista: Eur Radiol Assunto da revista: RADIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China