scholarly journals T2-weighted, apparent diffusion coefficient and 18F-FDG PET histogram analysis of rectal cancer after preoperative chemoradiotherapy

2021 ◽  
Vol 25 (5) ◽  
pp. 569-577
Author(s):  
F. Crimì ◽  
R. Stramare ◽  
G. Spolverato ◽  
V. Aldegheri ◽  
A. Barison ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Locally Advanced ◽  
Preoperative Chemoradiotherapy ◽  
Histogram Analysis ◽  
Tumor Regression Grade ◽  
Complete Regression ◽  
Standardized Uptake Values ◽  
Apparent Diffusion

Abstract Background The aim of our study was to investigate the correlation among T2-weighted (T2w) images, apparent diffusion coefficient (ADC) maps, 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) images, histogram analysis and the pathological response in locally advanced rectal cancer (LARC) after preoperative chemoradiotherapy (pCRT). Methods Patients with LARC were prospectively enrolled between February 2015 and August 2018 and underwent PET/magnetic resonance imaging (MRI). MRI included T2w and diffusion-weighted imaging (DWI)-sequences. ADC maps and PET images were matched to the T2w images. Voxel-based standardized uptake values (SUVs,) ADC and T2w-signal-intensity values were collected from the volumes of interest (VOIs) and mean, skewness and kurtosis were calculated. Spearman’s correlation coefficient was applied to evaluate the correlation among the variables and tumor regression grade (TRG), T stage, N stage and fibrosis. Results Twenty-two patients with biopsy-proven LARC in the low or mid rectum were enrolled [17 males, mean age was 69 years (range 49–85 years)]. Seven patients experienced complete regression (TRG1). A significant positive correlation was found between SUV mean values (ρ = 0.480; p = 0.037) and TRG. No other significant correlations were found. Conclusions Histogram analysis of SUV values is a predictor of TRG in LARC.

Changes in apparent diffusion coefficient evaluated with diffusion-weighted MRI to predict complete pathologic response after neoadjuvant therapy for rectal cancer: Literature review and meta-analysis.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 503-503
Author(s):  
Vincenzo Desiato ◽  
Alan S Rosman ◽  
Elliot Newman ◽  
Russell S. Berman ◽  
H. Leon Pachter ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Imaging Techniques ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Pathologic Response ◽  
Operating Characteristics ◽  
Diffusion Weighted ◽  
Apparent Diffusion

503 Background: A complete pathological response (pCR) is observed in 9-38% of all patients undergoing neo-adjuvant chemo-radiation therapy (CRT) for locally advanced rectal cancer (ARC). Imaging techniques that can reliably assess CRT results may enhance identification of those pCR patients for which surgery may potentially be avoided. Recently, several studies have suggested that diffusion-weighted magnetic resonance imaging (DW-MRI) may predict pathologic response by measuring tumor apparent diffusion coefficient (ADC). ADC can be measured before (pre-ADC) and/or after CRT (post-ADC). Both pre- and post-ADC, as well as the variation between pre- and post-ADC (Δ-ADC) can be used to assess pCR. We aimed to assess the reliability of ADC at predicting pCR in ARC patients treated with CRT. To determine the most effective ADC timing to evaluate pCR. Methods: A systematic review of available literature was conducted to compare all the studies of DW-MRI for identification of pCR after CRT for ARC. For each parameter (pre-ADC, post-ADC and D-ADC) we pooled sensitivity and specificity and calculated the area (AUC) under the summary receiver operating characteristics (sROC) curve. Results: We found 10 prospective and 8 retrospective studies examining correlation of ADC and CRT results. Overall, pCR rate was 25%. Pooled sensitivity, specificity, and AUC were: 0.743, 0.755, and 0.841 for pre-ADC; 0.745, 0.706, and 0.782 for post-ADC; and 0.832, 0.806, and 0.895 for D-ADC. Conclusions: Our meta-analysis confirms that at least 25% of patients with ARC experiences pCR after CRT. DW-MRI is a promising technique for assessment of CRT results and D-ADC appears to be the most effective parameter for prediction of pCR.

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