The value of intravoxel incoherent motion and diffusion kurtosis imaging in the assessment of tumor regression grade and T stages after neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer.
Eur J Radiol
; 136: 109504, 2021 Mar.
Article
em En
| MEDLINE
| ID: mdl-33421885
ABSTRACT
PURPOSE:
To evaluate the role of IVIM and diffusion kurtosis imaging (DKI) in identifying pathologic complete response (pCR) and T stages after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC).METHOD:
Forty-two patients with biopsy-proven rectal adenocarcinoma, who underwent both pre-and post-CRT MRI with IVIM and DKI sequences on a 3â¯T scanner, were enrolled prospectively. According to the pathologic ypTNM stages and tumor regression grade (TRG), patients were grouped into pCR (TRG0) and non-pCR (TRG1-3) groups and low T stage (ypT0-2) and high T stage (ypT3-4) groups. IVIM parameters (the slow diffusion coefficient [D], fast diffusion coefficient [D*], perfusion fraction [f]), DKI parameters (mean diffusivity [MD] and mean kurtosis [MK]), and mono-exponential ADC were calculated and analyzed between groups.RESULTS:
The pCR group had significantly higher post-CRT ADC, D*, f, and MD values than non-pCR group, and higher percent changes in the ADC, f, and MD values (all Pâ¯<â¯0.05). The post-CRT MD values yielded the highest AUC (0.788) with higher sensitivity than post-ADC values (82.9 % vs. 77.1 %, respectively). Post-CRT ADC and MD values and the percent changes in the ADC and MD values were also negatively correlated with TRG (all Pâ¯<â¯0.05). Besides, negative correlations were found among the pre-CRT MD, post-CRT ADC, D, f, and MD values and the ypT stages (all Pâ¯<â¯0.05).CONCLUSIONS:
Both IVIM and DKI parameters could provide more information when evaluating pCR and T stages after nCRT. In particular, the diagnostic performance of the MD values was more valuable than ADC values in being able to determine pCR.Palavras-chave
Texto completo:
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Temas:
ECOS
/
Aspectos_gerais
Bases de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
/
Terapia Neoadjuvante
Limite:
Humans
Idioma:
En
Revista:
Eur J Radiol
Ano de publicação:
2021
Tipo de documento:
Article