Abstract
Purpose: To compare diffusion-weighted imaging (DWI) and magnetic resonance (MR) volumetry for predicting treatment outcomes of locally advanced rectal cancers with preoperative chemoradiotherapy (CRT). Materials and Methods: This prospective study was approved by our Institutional Review Board. Thirty-four patients underwent three MR examinations: pre-CRT (before CRT), early CRT (2 weeks after CRT initiation), and post-CRT (before surgery). The tumor apparent diffusion coefficient (ADC), ADC increase rate, and volume reduction rate were compared between responders and nonresponders using three reference standards: downstaging, modified Response Evaluation Criteria in Solid Tumors (mRECIST), and tumor regression grade (TRG). For DWI and volumetry, differences between responders and nonresponders were assessed by receiver operating characteristic analysis. Results: The median early tumor volume reduction rate of responders, subgrouped by downstaging and mRECIST (47.97% and 53.97%, respectively), was significantly higher than that of nonresponders (20.94% and 20.36%; P = 0.0024 and 0.0001, respectively), but there were no significant differences in pre-CRT ADC and early ADC increase rate using all references. When using the downstaging and mRECIST, the diagnostic performance of early tumor volume reduction rate (Az = 0.81 and 0.94, respectively) was higher than that of pre-CRT ADC (Az = 0.55 and 0.62; P = 0.033 and 0.007) and early ADC increase rate (Az = 0.58 and 0.64; P = 0.055 and 0.01) for predicting the treatment outcome. For TRG, there were no significant differences between DWI and volumetry. Conclusion: Early tumor volume reduction rate at the second week after CRT initiation may be a better indicator than DWI based on the mean ADC measurements for predicting CRT treatment outcome.
| Original language | English |
|---|---|
| Pages (from-to) | 570-576 |
| Number of pages | 7 |
| Journal | Journal of Magnetic Resonance Imaging |
| Volume | 34 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2011 Sep 1 |
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All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging
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Comparison of diffusion-weighted MRI and MR volumetry in the evaluation of early treatment outcomes after preoperative chemoradiotherapy for locally advanced rectal cancer. / Kim, Young Chul; Lim, Joon Seok; Keum, Ki Chang; Kim, Kyung Ah; Myoung, Sungmin; Shin, Sang Joon; Kim, Myeong Jin; Kim, Nam Kyu; Suh, Jinsuk; Kim, Ki Whang.
In: Journal of Magnetic Resonance Imaging, Vol. 34, No. 3, 01.09.2011, p. 570-576.Research output: Contribution to journal › Article
TY - JOUR
T1 - Comparison of diffusion-weighted MRI and MR volumetry in the evaluation of early treatment outcomes after preoperative chemoradiotherapy for locally advanced rectal cancer
AU - Kim, Young Chul
AU - Lim, Joon Seok
AU - Keum, Ki Chang
AU - Kim, Kyung Ah
AU - Myoung, Sungmin
AU - Shin, Sang Joon
AU - Kim, Myeong Jin
AU - Kim, Nam Kyu
AU - Suh, Jinsuk
AU - Kim, Ki Whang
PY - 2011/9/1
Y1 - 2011/9/1
N2 - Purpose: To compare diffusion-weighted imaging (DWI) and magnetic resonance (MR) volumetry for predicting treatment outcomes of locally advanced rectal cancers with preoperative chemoradiotherapy (CRT). Materials and Methods: This prospective study was approved by our Institutional Review Board. Thirty-four patients underwent three MR examinations: pre-CRT (before CRT), early CRT (2 weeks after CRT initiation), and post-CRT (before surgery). The tumor apparent diffusion coefficient (ADC), ADC increase rate, and volume reduction rate were compared between responders and nonresponders using three reference standards: downstaging, modified Response Evaluation Criteria in Solid Tumors (mRECIST), and tumor regression grade (TRG). For DWI and volumetry, differences between responders and nonresponders were assessed by receiver operating characteristic analysis. Results: The median early tumor volume reduction rate of responders, subgrouped by downstaging and mRECIST (47.97% and 53.97%, respectively), was significantly higher than that of nonresponders (20.94% and 20.36%; P = 0.0024 and 0.0001, respectively), but there were no significant differences in pre-CRT ADC and early ADC increase rate using all references. When using the downstaging and mRECIST, the diagnostic performance of early tumor volume reduction rate (Az = 0.81 and 0.94, respectively) was higher than that of pre-CRT ADC (Az = 0.55 and 0.62; P = 0.033 and 0.007) and early ADC increase rate (Az = 0.58 and 0.64; P = 0.055 and 0.01) for predicting the treatment outcome. For TRG, there were no significant differences between DWI and volumetry. Conclusion: Early tumor volume reduction rate at the second week after CRT initiation may be a better indicator than DWI based on the mean ADC measurements for predicting CRT treatment outcome.
AB - Purpose: To compare diffusion-weighted imaging (DWI) and magnetic resonance (MR) volumetry for predicting treatment outcomes of locally advanced rectal cancers with preoperative chemoradiotherapy (CRT). Materials and Methods: This prospective study was approved by our Institutional Review Board. Thirty-four patients underwent three MR examinations: pre-CRT (before CRT), early CRT (2 weeks after CRT initiation), and post-CRT (before surgery). The tumor apparent diffusion coefficient (ADC), ADC increase rate, and volume reduction rate were compared between responders and nonresponders using three reference standards: downstaging, modified Response Evaluation Criteria in Solid Tumors (mRECIST), and tumor regression grade (TRG). For DWI and volumetry, differences between responders and nonresponders were assessed by receiver operating characteristic analysis. Results: The median early tumor volume reduction rate of responders, subgrouped by downstaging and mRECIST (47.97% and 53.97%, respectively), was significantly higher than that of nonresponders (20.94% and 20.36%; P = 0.0024 and 0.0001, respectively), but there were no significant differences in pre-CRT ADC and early ADC increase rate using all references. When using the downstaging and mRECIST, the diagnostic performance of early tumor volume reduction rate (Az = 0.81 and 0.94, respectively) was higher than that of pre-CRT ADC (Az = 0.55 and 0.62; P = 0.033 and 0.007) and early ADC increase rate (Az = 0.58 and 0.64; P = 0.055 and 0.01) for predicting the treatment outcome. For TRG, there were no significant differences between DWI and volumetry. Conclusion: Early tumor volume reduction rate at the second week after CRT initiation may be a better indicator than DWI based on the mean ADC measurements for predicting CRT treatment outcome.
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U2 - 10.1002/jmri.22696
DO - 10.1002/jmri.22696
M3 - Article
C2 - 21751285
AN - SCOPUS:80051933393
VL - 34
SP - 570
EP - 576
JO - Journal of Magnetic Resonance Imaging
JF - Journal of Magnetic Resonance Imaging
SN - 1053-1807
IS - 3
ER -