Changes in apparent diffusion coefficient and pathological response in colorectal liver metastases after preoperative chemotherapy

被引:3
作者
Eriksson, Sam [1 ,2 ]
Bengtsson, Johan [2 ,3 ]
Toren, William [1 ]
Latt, Jimmy [2 ]
Andersson, Roland [1 ]
Sturesson, Christian [1 ,4 ,5 ]
机构
[1] Lund Univ, Skane Univ Hosp, Dept Clin Sci Lund, Surg, S-22185 Lund, Sweden
[2] Skane Univ Hosp, Ctr Med Imaging & Physiol, Lund, Sweden
[3] Lund Univ, Skane Univ Hosp, Dept Clin Sci Lund, Diagnost Radiol, Lund, Sweden
[4] Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden
[5] Karolinska Univ Hosp, Stockholm, Sweden
关键词
Colorectal liver metastases; preoperative chemotherapy; magnetic resonance diffusion; liver; pathology; surgery; IMAGING BIOMARKER; FIELD-STRENGTH; WEIGHTED MRI; TUMOR; RESECTION; CONTRAINDICATION; REPRODUCIBILITY; PROGRESSION; ADC;
D O I
10.1177/02841851221074496
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Background The pathological response to preoperative chemotherapy of colorectal liver metastases (CRLMs) is predictive of long-term prognosis after liver resection. Accurate preoperative assessment of chemotherapy response could enable treatment optimization. Purpose To investigate whether changes in lesion-apparent diffusion coefficient (ADC) measured with diffusion-weighted magnetic resonance imaging (MRI) can be used to assess pathological treatment response in patients with CRLMs undergoing preoperative chemotherapy. Material and Methods Patients who underwent liver resection for CRLMs after preoperative chemotherapy between January 2011 and December 2019 were retrospectively included if they had undergone MRI before and after preoperative chemotherapy on the same 1.5-T MRI scanner with diffusion-weighted imaging with b-values 50, 400, and 800 s/mm(2). The pathological chemotherapy response was assessed using the tumor regression grade (TRG) by AJCC/CAP. Lesions were divided into two groups: pathological responding (TRG 0-2) and non-responding (TRG 3). The change in lesion ADC after preoperative chemotherapy was compared between responding and non-responding lesions. Results A total of 27 patients with 49 CRLMs were included, and 24/49 lesions showed a pathological chemotherapy response. After chemotherapy, ADC increased in both pathological responding (pretreatment ADC: 1.26 [95% confidence interval (CI)=1.06-1.37] vs. post-treatment ADC: 1.33 [95% CI=1.13-1.56] x 10(-3) mm(2)/s; P = 0.026) and non-responding lesions (1.12 [95% CI=0.980-1.21] vs. 1.20 [95% CI=1.09-1.43] x 10(-3) mm(2)/s; P = 0.018). There was no difference in median relative difference in ADC after chemotherapy between pathological responding and non-responding lesions (15.8 [95% CI=1.42-26.3] vs. 7.17 [95% CI=-4.31 to 31.2]%; P = 0.795). Conclusion Changes in CRLM ADCs did not differ between pathological responding and non-responding lesions.
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页码:51 / 57
页数:7
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