Assessment of pathological complete response to preoperative chemoradiotherapy by means of multiple mathematical models of diffusion-weighted MRI in locally advanced rectal cancer: A prospective single-center study.
J Magn Reson Imaging
; 46(1): 175-183, 2017 07.
Article
em En
| MEDLINE
| ID: mdl-27981667
ABSTRACT
PURPOSE:
To assess stretched-exponential, mono-exponential and intravoxel incoherent motion (IVIM) models of diffusion-weighted MRI(DWI) in predicting pathological complete response (pCR) to neoadjuvant chemoradiotherapy (CRT) in rectal cancer patients. MATERIALS ANDMETHODS:
This prospective study recruited 98 consecutive patients with locally advanced rectal cancer who underwent 3 Tesla MR examination before, during and after CRT. The apparent diffusion coefficient (ADC), IVIM-derived parameters (D, f, and D*), and stretched-exponential model-derived parameters (DDC and α) were measured. The parameters and their corresponding changes during and after CRT were compared between pCR and non-pCR. Receiver-operating characteristic curve analysis was performed to evaluate the diagnostic performance. Coefficient of variations and intraclass correlation coefficient were calculated to assess reliability and agreement.RESULTS:
Nineteen patients achieved pCR while 79 did not. The pCR group had higher ADC and α (ADC2 and α2 ), and their changes (ΔADC2 , and Δα2 ) at the endpoint than non-pCR group. α2 and ADC2 yielded similar AUCs (P = 0.339), Δα2 and ΔADC2 yielded similar AUCs (P = 0.263) ADC and α presented substantial agreement, and α presented the minimum CV (5.0-7.0%).CONCLUSION:
ADC and α were useful for assessing pCR after CRT. α might be more useful because it demonstrated better diagnostic performance than IVIM-derived parameters and better reliability than ADC. LEVEL OF EVIDENCE 1 Technical Efficacy Stage 2 J. MAGN. RESON. IMAGING 2017;46175-183.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
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Cuidados Pré-Operatórios
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Interpretação de Imagem Assistida por Computador
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Quimiorradioterapia
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Modelos Biológicos
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article