Locally advanced rectal cancer: post-chemoradiotherapy ADC histogram analysis for predicting a complete response

被引:47
作者
Cho, Seung Hyun [1 ]
Kim, Gab Chul [1 ]
Jang, Yun-Jin [2 ]
Ryeom, Hunkyu [2 ]
Kim, Hye Jung [1 ]
Shin, Kyung-Min [1 ]
Park, Jun Seok [3 ]
Choi, Gyu-Seog [3 ]
Kim, See Hyung [4 ]
机构
[1] Kyungpook Natl Univ, Dept Radiol, Med Ctr, Sch Med, Daegu 702210, South Korea
[2] Kyungpook Natl Univ, Dept Radiol, Kyungpook Natl Univ Hosp, Sch Med, Daegu 702210, South Korea
[3] Kyungpook Natl Univ, Colorectal Canc Ctr, Med Ctr, Sch Med, Daegu 702210, South Korea
[4] Keimyung Univ, Dept Radiol, Dongsan Hosp, Coll Med, Daegu, South Korea
关键词
Rectal cancer; chemoradiation; magnetic resonance imaging (MRI); apparent diffusion coefficient (ADC); histogram; APPARENT DIFFUSION-COEFFICIENT; NEOADJUVANT CHEMORADIATION THERAPY; WEIGHTED MRI; RADIATION-THERAPY; TUMOR RESPONSE; PREOPERATIVE CHEMORADIOTHERAPY; VOLUMETRY; RADIOCHEMOTHERAPY; MANAGEMENT; STANDARD;
D O I
10.1177/0284185114550193
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 value of diffusion-weighted imaging (DWI) for reliable differentiation between pathologic complete response (pCR) and residual tumor is still unclear. Recently, a few studies reported that histogram analysis can be helpful to monitor the therapeutic response in various cancer research. Purpose: To investigate whether post-chemoradiotherapy (CRT) apparent diffusion coefficient (ADC) histogram analysis can be helpful to predict a pCR in locally advanced rectal cancer (LARC). Material and Methods: Fifty patients who underwent preoperative CRT followed by surgery were enrolled in this retrospective study, non-pCR (n = 41) and pCR (n = 9), respectively. ADC histogram analysis encompassing the whole tumor was performed on two post-CRT ADC(600) and ADC(1000) (b factors 0, 600 vs. 0, 1000 s/mm(2)) maps. Mean, minimum, maximum, SD, mode, 10th, 25th, 50th, 75th, 90th percentile ADCs, skewness, and kurtosis were derived. Diagnostic performance for predicting pCR was evaluated and compared. Results: On both maps, 10th and 25th ADCs showed better diagnostic performance than that using mean ADC. Tenth percentile ADCs revealed the best diagnostic performance on both ADC(600) (A(Z) 0.841, sensitivity 100%, specificity 70.7%) and ADC(1000) (A(Z) 0.821, sensitivity 77.8%, specificity 87.8%) maps. In comparison between 10th percentile and mean ADC, the specificity was significantly improved on both ADC(600) (70.7% vs. 53.7%; P = 0.031) and ADC(1000) (87.8% vs. 73.2%; P = 0.039) maps. Conclusion: Post-CRT ADC histogram analysis is helpful for predicting pCR in LARC, especially, in improving the specificity, compared with mean ADC.
引用
收藏
页码:1042 / 1050
页数:9
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