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Quantitative intravoxel incoherent motion parameters derived from whole-tumor volume for assessing pathological complete response to neoadjuvant chemotherapy in locally advanced rectal cancer.
- Source :
-
Journal of magnetic resonance imaging : JMRI [J Magn Reson Imaging] 2018 Jul; Vol. 48 (1), pp. 248-258. Date of Electronic Publication: 2017 Dec 27. - Publication Year :
- 2018
-
Abstract
- Background: Many locally advanced rectal cancer (LARC) patients can benefit from neoadjuvant chemotherapy (NACT), with some achieving a pathological complete response (pCR). However, there is limited research reporting on the value of intravoxel incoherent motion (IVIM) in monitoring pCR in patients with LARC.<br />Purpose: To identify whether IVIM parameters derived from whole-tumor volume (WTV) before and after NACT could accurately assess pCR in patients with LARC.<br />Study Type: Prospective patient control study.<br />Population: Fifty-one patients with LARC before and after NACT, prior to surgery.<br />Field Strength/sequence: IVIM-diffusion imaging at 3T.<br />Assessment: Apparent diffusion coefficient (ADC), slow diffusion coefficient (D), fast diffusion coefficient (D*), and perfusion-related diffusion fraction (f) values were obtained on diffusion-weighted magnetic resonance images (DW-MRI) using WTV methods and calculated using a biexponential model before and after NACT.<br />Statistical Tests: DWI-derived ADC and IVIM-derived parameters and their percentage changes (ΔADC%, ΔD%, ΔD*%, and Δf%) were compared using independent-samples t-test and Mann-Whitney U-test between the pCR and non-pCR groups. The diagnostic performance of IVIM parameters and their percentage changes were evaluated using receiver operating characteristic curves.<br />Results: Compared with the non-pCR group, the pCR group exhibited significantly lower pre-ADC <subscript>mean</subscript> (P = 0.003) and pre-D values (P = 0.024), and significantly higher post-f (P = 0.002), ΔADC <subscript>mean</subscript> % (P = 0.002), ΔD% (P = 0.001), and Δf% values (P = 0.017). Receiver operating characteristic curves showed that the pre-D value had the best specificity (95.12%) and accuracy (86.27%) in predicting the pCR status, and ΔD% had the highest area under the curve (0.832) in assessing the pCR response to NACT.<br />Data Conclusions: The IVIM-derived D value is a promising tool in predicting the pCR status before therapy. The percentage changes in D values after therapy may help assess the pCR status prior to surgery.<br />Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017.<br /> (© 2017 International Society for Magnetic Resonance in Medicine.)
- Subjects :
- Adult
Aged
Female
Humans
Image Interpretation, Computer-Assisted methods
Image Processing, Computer-Assisted methods
Male
Middle Aged
Motion
Prospective Studies
ROC Curve
Tumor Burden
Chemotherapy, Adjuvant
Diffusion Magnetic Resonance Imaging
Neoadjuvant Therapy
Rectal Neoplasms diagnostic imaging
Rectal Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1522-2586
- Volume :
- 48
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of magnetic resonance imaging : JMRI
- Publication Type :
- Academic Journal
- Accession number :
- 29281151
- Full Text :
- https://doi.org/10.1002/jmri.25931