Limited accuracy of DCE-MRI in identification of pathological complete responders after chemoradiotherapy treatment for rectal cancer Journal Article
| Authors: | Gollub, M. J.; Tong, T.; Weiser, M.; Zheng, J.; Gonen, M.; Zakian, K. L. |
| Article Title: | Limited accuracy of DCE-MRI in identification of pathological complete responders after chemoradiotherapy treatment for rectal cancer |
| Abstract: | Objectives: To examine whether post-chemoradiotherapy (CRT) DCE-MRI can identify rectal cancer patients with pathologic complete response (pCR). Methods: From a rectal cancer surgery database 2007–2014, 61 consecutive patients that met the following inclusion criteria were selected for analysis: (1) stage II/III primary rectal adenocarcinoma; (2) received CRT; (3) underwent surgery (4); underwent rectal DCE-MRI on a 1.5-T MRI scanner. Two experienced radiologists, in consensus, drew regions of interest (ROI) on the sagittal DCE-MRI image in the tumour bed. These were exported from ImageJ to in-house Matlab code for modelling using the Tofts model. Ktrans, Kep and ve values were compared to pathological response. Results: Of the 61 initial patients, 37 had data considered adequate for fitting to obtain perfusion parameters. Among the 13 men and 24 women, median age 53 years, there were 8 pCR (22 %). Ktrans could not distinguish patients with pCR. For patients with 90 % or greater response, mean Ktrans and Kep values were statistically significant (p = 0.032 and 0.027, respectively). Using a cutoff value of Ktrans = 0.25 min−1, the AUC was 0.71. Conclusion: Ktrans could be used to identify patients with 90 % or more response to chemoradiotherapy for rectal cancer with an AUC of 0.7. Key Points: • Chemoradiotherapy for rectal cancer causes decreased blood flow and permeability in the tumour bed. • Lower values of blood flow and permeability correlate with good tumour response. • Ktransof 0.25min−1best identifies patients with ≥90 % response with AUC 0.71 © 2016, European Society of Radiology. |
| Keywords: | dce-mri; chemoradiotherapy; rectal cancer; complete response; ktrans |
| Journal Title: | European Radiology |
| Volume: | 27 |
| Issue: | 4 |
| ISSN: | 0938-7994 |
| Publisher: | Springer |
| Date Published: | 2017-04-01 |
| Start Page: | 1605 |
| End Page: | 1612 |
| Language: | English |
| DOI: | 10.1007/s00330-016-4493-1 |
| PROVIDER: | scopus |
| PUBMED: | 27436029 |
| PMCID: | PMC5570543 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 April 2017 -- Source: Scopus |
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