Quantitative aspects of diffusion-weighted magnetic resonance imaging in rectal cancer response to neoadjuvant therapy

Quantitative aspects of diffusion-weighted magnetic resonance imaging in rectal cancer response to neoadjuvant therapy

Author Bassaneze, Thiago Google Scholar
Goncalves, Jose Eduardo Google Scholar
Faria, Juliano Ferreira Autor UNIFESP Google Scholar
Palma, Rogerio Tadeu Google Scholar
Waisberg, Jaques Google Scholar
Abstract Background. The aim of the study was to evaluate the added value of the apparent diffusion coefficient (ADC) of diffusion-weighted magnetic resonance imaging (DW-MRI) in patients with rectal cancer who received neoadjuvant chemoradiotherapy (CRT). The use of DW-MRI for response evaluation in rectal cancer still remains a widely investigated issue, as the accurate detection of pathologic complete response (pCR) is critical in making therapeutic decisions. Patients and methods. Thirty-three patients with locally advanced rectal cancer were evaluated retrospectively by MRI in addition to diffusion-weighted images (DWI) and its ADC pre-and post-neoadjuvant CRT. These patients subsequently underwent curative-intent surgery. Tumor staging by MRI and ADC value were compared with histopathological findings of the surgical specimen. Results. MRI in addition to DWI had a sensitivity of 96.1%, specificity of 71.4%, positive predictive value of 92.5%, and negative predictive value of 83.3% in the detection of pCR. The pre-CRT ADC alone could not reliably predict the pCR group. Post-CRT ADC cutoff value of 1.49 x 10(-3) mm(2)/s had the highest accuracy and allowed a 16.7% increase in negative predictive value and 3.9% increase in sensitivity. Patients with pCR to neoadjuvant treatment differed from the other groups in their absolute values of post-CRT ADC (p < 0.01). Conclusions. The use of post-CRT ADC increased the diagnostic performance of MRI in addition to DWI in predicting the final pathologic staging of rectal carcinoma.
Keywords rectal cancer
neoadjuvant therapy
diffusion MRI
Language English
Date 2017
Published in Radiology And Oncology. Ljubljana, v. 51, n. 3, p. 270-276, 2017.
ISSN 1318-2099 (Sherpa/Romeo, impact factor)
Publisher Assoc Radiology & Oncology
Extent 270-276
Origin http://dx.doi.org/10.1515/raon-2017-0025
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000410929300004
URI http://repositorio.unifesp.br/handle/11600/51309

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