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Diffusion-weighted magnetic resonance imaging for predicting the response of rectal cancer to neoadjuvant concurrent chemoradiation

查看全文 作　　者：Gang [1,2]Cai;Ye [2,3]Xu;Ji [4,2]Zhu;Wei-Lie [2,3]Gu;Shuai [2,5]Zhang;Xue-Jun [4,2]Ma;San-Jun [2,3]Cai;Zhen [4,2]Zhang 高影响力作者 机构地区：[1]Department of Radiation Oncology,Fudan University Shanghai Cancer Center;[2]Department of Oncology,Shanghai Medical College,Fudan University;[3]Department of Colorectal Surgery,Fudan University Shanghai Cancer Center;[4]Department of Endoscopic Center,Zhongshan Hospital,Fudan University;[5]Department of Radiology,Fudan University Shanghai Cancer Cente高影响力机构 出　　处：《World Journal of Gastroenterology》索引2013年第19卷第33期,共8页高影响力期刊 摘　　要：AIM:To evaluate the clinical value of diffusion-weighted magnetic resonance imaging(DW-MRI)in predicting the response of rectal cancer to neoadjuvant chemoradiation.METHODS:This prospective study was approved by our institutional review board,and informed consent was obtained from each patient.Fifteen patients(median age 56 years)with locally advanced rectal cancer were treated in our hospital from June 2006 to December 2007.All patients were stageⅢB-C according to the results of MRI and endorectal ultrasound examinations.All patients underwent pelvic irradiation with 45 Gy/25 fx per 35 days.The concurrent chemotherapy regimen consisted of capecitabine 625mg/m2,bid(Monday-Friday),and oxaliplatin 50 mg/m2,weekly.The patients underwent surgery 5-8 wk after the completion of neoadjuvant therapy.T downstaging was defined as the downstaging of the tumor from cT3to ypT0-2 or from cT4 to ypT0-3.Good regression was defined as TRG 3-4,and poor regression was defined as TRG 0-2.Diffusion-weighted magnetic resonance images were obtained prior to and weekly during the course of neoadjuvant chemoradiation,and the apparent diffusion coefficient(ADC)values were calculated from the acquired tumor images.RESULTS:Comparison with the mean pretreatment tumor ADC revealed an increase in the mean tumor ADC during the course of neoadjuvant chemoradiation,especially at the 2ndweek(P=0.004).We found a strong negative correlation between the mean pretreatment tumor ADC and tumor regression after neoadjuvant chemoradiation(P=0.021).In the T downstage and tumor regression groups,we found a significant increase in the mean ADC at the 2ndweek of neoadjuvant therapy(P=0.011;0.004).CONCLUSION:DW-MRI might be a valuable clinical tool to help predict or assess the response of rectal cancer to neoadjuvant chemoradiation at an early timepoint. 关 键 词：LOCALLY advanced RECTAL cancer NEOADJUVANT CHEMORADIATION DIFFUSION-WEIGHTED magnetic resonance imaging APPARENT diffusion coefficient
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