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Prognostic utility of diffusion-weighted MRI in oesophageal cancer: is apparent diffusion coefficient a potential marker of tumour aggressiveness?
- Source :
- Europe PubMed Central
- Publication Year :
- 2015
- Publisher :
- Springer Science and Business Media LLC, 2015.
-
Abstract
- To investigate the role of the apparent diffusion coefficient (ADC) as a potential prognostic biomarker in the evaluation of the aggressiveness of oesophageal cancer.Between November 2009 and December 2013, 43 patients with evidence of oesophageal or oesophago-gastric junction cancer were referred to our institution and prospectively entered in our database. The final study population consisted of 23 patients (18 men; 5 women; mean age, 64.62 ± 10.91 years) who underwent diffusion-weighted Magnetic Resonance before surgical intervention. Specifically, 14 were directly treated with surgery and 9 were addressed to chemo/radiotherapy beforehand. Two radiologists independently measured mean tumour ADC and inter-observer agreement (Spearman's and intraclass correlation coefficient [ICC]) was assessed. In the univariate analysis, overall survival curves related to pathological ADC, pT, pN, tumour location and histotype were fitted using the Kaplan-Meier method. Survival curves were then compared using the log-rank test.Inter-observer reproducibility was very good (Spearman's rho = 0.95; ICC = 0.94). At a total median follow-up of 19 months (2-49 months), 4 patients had died. The median follow-up was 18.50 months (5-49 months) for the surgery-only group (1/4 events, 25 %) and 24 months (2-34 months) for the chemo/radiotherapy group (3/4 events, 75 %). Survival time at 48 months for the overall population was 59 % (±0.11), while for the surgery-only group and the chemo/radiotherapy group was 90 % (±0.09) and 61 % (±0.34), respectively. In the univariate analysis, ADC values below or equal to 1.4 × 10(-3) mm(2)/s were associated with a negative prognosis both in the total population (P = 0.016) and in the surgery-only group (P 0.001).Despite the biggest limitation of our study (i.e. the small study population), we were able to show that pathological ADC could be considered a prognostic factor for oesophageal cancer. DWI might be introduced into clinical practice as a promising and reliable technique in the diagnostic pathway of this tumour.
- Subjects :
- Male
medicine.medical_specialty
Esophageal Neoplasms
Biopsy
medicine.medical_treatment
Population
Contrast Media
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Biomarkers, Tumor
Organometallic Compounds
medicine
Humans
Effective diffusion coefficient
Radiology, Nuclear Medicine and imaging
Prospective Studies
Prospective cohort study
education
Survival analysis
Neoadjuvant therapy
Aged
Neoplasm Staging
Univariate analysis
education.field_of_study
business.industry
Reproducibility of Results
Cancer
General Medicine
Middle Aged
Prognosis
medicine.disease
Diffusion Magnetic Resonance Imaging
030220 oncology & carcinogenesis
Disease Progression
Population study
Female
Radiology
Neoplasm Grading
business
Subjects
Details
- ISSN :
- 18266983 and 00338362
- Volume :
- 121
- Database :
- OpenAIRE
- Journal :
- La radiologia medica
- Accession number :
- edsair.doi.dedup.....52509b1dc2a0642cadc96ce27d12865f