Dynamic contrast‐enhanced MRI: Use in predicting pathological complete response to neoadjuvant chemoradiation in locally advanced rectal cancer. Issue 3 (5th February 2015)

• Record Type: Journal Article
• Authors: Tong, Tong; Sun, Yiqun; Gollub, Marc J.; Peng, Weijun; Cai, Sanjun; Zhang, Zhen; Gu, Yajia
• Is Part Of: Journal of magnetic resonance imaging. Volume 42:Issue 3(2015)
• Page Start: 673
• Page End: 680
• Publication Date: 2015-02-05
• Subjects: Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.24835
• Languages: English
• ISSNs: 1053-1807

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jmri24835-sec-0001" sec-type="section"> <title>Purpose</title> <p>To determine the ability of dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) to predict pathological complete response (pCR) before preoperative chemoradiotherapy (CRT) in locally advanced rectal cancer.</p> </sec> <sec id="jmri24835-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p>In a prospective clinical trial, 38 enrolled patients underwent pre‐ and post‐CRT DCE‐MRI at 3.0T. The tumor length and the following perfusion parameters (K<sup>trans</sup>, k<sub>ep</sub>, v<sub>e</sub>) were measured for the tumor and compared between the pCR group and the non‐pCR group, as well as before and after CRT. For categorical variable comparison, the Kruskal‐Wallis test was used. <italic>P</italic> < 0.05 was considered significant.</p> </sec> <sec id="jmri24835-sec-0003" sec-type="section"> <title>Results</title> <p>No difference in tumor length was found between the pCR and non‐pCR group pre‐ and post‐CRT (<italic>P</italic> = 0.26 (0.15, 0.45), 0.35 (0.21, 0.52), respectively). Before CRT, the mean tumor K<sup>trans</sup> in the pCR group was significantly higher than in the non‐pCR group (<italic>P</italic> = 0.01). A K<sup>trans</sup> of 0.66 emerged as the best cutoff for distinguishing pCR from non‐pCR. Regarding k<sub>ep</sub> and v<sub>e</sub>, significant differences were also observed between the pCR and non‐pCR groups (<italic>P</italic> = 0.02, 0.01, respectively). The mean K<sup>trans</sup>, k<sub>ep</sub>, and v<sub>e</sub> values post‐CRT were lower in the pCR group than in the non‐pCR group, although there was no significant difference (<italic>P</italic> = 0.10 (0.04, 0.16), 0.11 (0.07, 0.26), 0.10 (0.06, 0.23), respectively).</p> </sec> <sec id="jmri24835-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Before neoadjuvant chemoradiotherapy in rectal cancer, DCE‐MRI can distinguish between complete and incomplete response using a K<sup>trans</sup> threshold of 0.66 with a sensitivity of 100%. J. Magn. Reson. Imaging 2015;42:673–680.</p> </sec> </abstract>