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Predictive value of mono-exponential and multiple mathematical models in locally advanced rectal cancer response to neoadjuvant chemoradiotherapy.
Zhou, Mi; Chen, Mengyuan; Chen, Meining; Yan, Xu; Yang, Guang; Huang, Hongyun.
Afiliación
  • Zhou M; sichuan provincial orthopedics hospital, Chengdu, China.
  • Chen M; Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
  • Chen M; Siemens Healthineers (China), Pudong, China.
  • Yan X; Siemens Healthineers (China), Pudong, China.
  • Yang G; East China Normal University, Shanghai, China.
  • Huang H; Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. HHY730418@163.com.
Abdom Radiol (NY) ; 2024 Sep 14.
Article en En | MEDLINE | ID: mdl-39276193
ABSTRACT

PURPOSE:

This prospective study aimed to assess the predictive value of mono-exponential and multiple mathematical diffusion-weighted imaging (DWI) models in determining the response to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC).

METHODS:

The study included 103 LARC patients scheduled for preoperative chemoradiotherapy between December 2021 and June 2023 Magnetic resonance imaging (MRI) scans were performed using a 3.0-T MR scanner, encompassing sagittal, axial, and oblique coronal T2-weighted images without fat saturation, along with DWI perpendicular to the rectum's long axis. Various DWI parameters, including apparent diffusion coefficient (ADC), stretched exponential model (SEM), continuous-time random-walk model (CTRW), and fractional-order calculus model (FROC), were measured. The pathologic complete response (pCR) rate and tumor downstaging (T-downstage) rate were determined.

RESULTS:

After nCRT, SEM-α, SEM-DDC, CTRW-α, CTRW-ß, CTRW-D, FROC-ß, and ADC values were significantly higher in the pCR group compared to the non-pCR group (all P < 0.05). SEM-DDC, CTRW-α, CTRW-D, FROC-ß, FROC-µ, and ADC values were significantly higher in the T-downstage group (ypT0-1) than in the non-T-downstage group (ypT2-4) (P < 0.05). The combination of CTRW (α + ß + D) exhibited the best diagnostic performance for assessing pCR after nCRT (AUC = 0.840, P < 0.001). Pre-nCRT CTRW (α + ß) demonstrated a predictive AUC of 0.652 (95%CI 0.552-0.743), 90.3% sensitivity, and 43.1% specificity for pCR. Regarding T-downstage assessment after nCRT, the combination of CTRW (α + D) yielded the best diagnostic performance (AUC = 0.877, P = 0.048).

CONCLUSION:

In LARC patients, imaging markers derived from CTRW show promise in predicting tumor response before nCRT and assessing pCR after nCRT.
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Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: Abdom Radiol (NY) Año: 2024 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: Abdom Radiol (NY) Año: 2024 Tipo del documento: Article