scholarly journals Pretreatment apparent diffusion coefficient cannot predict histopathological features and response to neoadjuvant radiochemotherapy in rectal cancer. A Meta-Analysis

2021 ◽  
Author(s):  
Alexey Surov ◽  
Maciej Pech ◽  
Maciej Powerski ◽  
Katja Woidacki ◽  
Andreas Wienke
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Treatment Response ◽  
Meta Analysis ◽  
Neoadjuvant Radiochemotherapy ◽  
Ki 67 ◽  
Kras Status ◽  
Apparent Diffusion ◽  
Adc Values

Aim: Our purpose was to perform a systemic literature review and meta-analysis regarding use of apparent diffusion coefficient (ADC) for prediction of histopathological features in rectal cancer (RC) and to proof if ADC can predict treatment response to neoadjivant radiochemotherapy in RC. Methods: MEDLINE library, Cochrane and SCOPUS database were screened for associations between ADC and histopathology and/or treatment response in RC up to June 2020. Authors, year of publication, study design, number of patients, mean value and standard deviation of ADC were acquired. The methodological quality of the collected studies was checked according to the QUADAS 2 instrument. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used to account the heterogeneity between the studies. Mean ADC values including 95% confidence intervals were calculated. Results: Overall, 37 items (2015 patients) were included. ADC values of tumors with different T and N stages and grades overlapped strongly. ADC cannot distinguish RC with high and low CEA level. Regarding KRAS status, ADC cannot discriminate mutated and wild type RC. ADC did not correlate significantly with expression of VEGF and HIF 1a. ADC correlates with Ki 67, calculated correlation coefficient: -0.52. The ADC values in responders and non-responders overlapped significantly. Conclusion: ADC correlates moderately with expression of Ki 67 in RC. ADC cannot discriminate tumor stages, grades and KRAS status in RC. ADC cannot predict therapy response to neoadjuvant radiochemotherapy in RC.

scholarly journals Apparent diffusion coefficient cannot discriminate metastatic and non-metastatic lymph nodes in rectal cancer: a meta-analysis

2021 ◽  
Author(s):  
Alexey Surov ◽  
Hans-Jonas Meyer ◽  
Maciej Pech ◽  
Maciej Powerski ◽  
Jasan Omari ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Lymph Nodes ◽  
Meta Analysis ◽  
Adc Value ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Apparent Diffusion ◽  
Adc Values

Abstract Background Our aim was to provide data regarding use of diffusion-weighted imaging (DWI) for distinguishing metastatic and non-metastatic lymph nodes (LN) in rectal cancer. Methods MEDLINE library, EMBASE, and SCOPUS database were screened for associations between DWI and metastatic and non-metastatic LN in rectal cancer up to February 2021. Overall, 9 studies were included into the analysis. Number, mean value, and standard deviation of DWI parameters including apparent diffusion coefficient (ADC) values of metastatic and non-metastatic LN were extracted from the literature. The methodological quality of the studies was investigated according to the QUADAS-2 assessment. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian, and Laird random-effects models with inverse-variance weights were used to account the heterogeneity between the studies. Mean DWI values including 95% confidence intervals were calculated for metastatic and non-metastatic LN. Results ADC values were reported for 1376 LN, 623 (45.3%) metastatic LN, and 754 (54.7%) non-metastatic LN. The calculated mean ADC value (× 10−3 mm2/s) of metastatic LN was 1.05, 95%CI (0.94, 1.15). The calculated mean ADC value of the non-metastatic LN was 1.17, 95%CI (1.01, 1.33). The calculated sensitivity and specificity were 0.81, 95%CI (0.74, 0.89) and 0.67, 95%CI (0.54, 0.79). Conclusion No reliable ADC threshold can be recommended for distinguishing of metastatic and non-metastatic LN in rectal cancer.

scholarly journals Value of Apparent Diffusion Coefficient for Assessing Preoperative T Staging of Low Rectal Cancer and Whether This Is Correlated With Ki-67 Expression

2020 ◽  
Vol 71 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Weiqun Ao ◽  
Xiangdong Bao ◽  
Guoqun Mao ◽  
Guangzhao Yang ◽  
Jian Wang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Low Rectal Cancer ◽  
Biological Behavior ◽  
Proliferation Index ◽  
Ki 67 ◽  
Adc Value ◽  
Apparent Diffusion ◽  
Adc Values

Purpose: To explore the value of the apparent diffusion coefficient (ADC) in assessing preoperative T staging of low rectal cancer and the correlation between ADC value and Ki-67 expression. Methods: Data on 77 patients with a proven pathology of low rectal cancer were retrospectively analyzed. All patients underwent a magnetic resonance imaging scan 1 week prior to operation, and the mean ADC value was measured. All tumors were fully removed, and pathologic staging was determined. The Ki-67 expression was determined using immunohistochemical methods in all patients. The correlation between Ki-67 expression and ADC features was studied. Results: A total of 77 patients with low rectal cancer were included in the study. The pathology type was adenocarcinoma. The numbers of patients with pathological stages T1, T2, T3, and T4 were 9, 23, 32, and 13, respectively. The ADC value of all tumors ranged from 0.60 to 1.20 mm2/s. The average Ki-67 proliferation index was 55.3% ± 20.2%. A significant difference was observed between the preoperative ADC value and pathological T staging of low rectal cancer ( P < .01). The more advanced the T stage, the lower the detected ADC values were. A negative correlation was noted between the preoperative ADC value and Ki-67 proliferation index of rectal cancer ( r = −0.71, P < .01). When the Ki-67 proliferation index increased, lower ADC values were detected. Conclusion: The ADC values can provide useful information on preoperative tumor staging and may facilitate evaluation of the biological behavior of low rectal cancer. The ADC values should be considered a sensitive image biomarker of rectal cancer.

scholarly journals The apparent diffusion coefficient is a useful biomarker in predicting treatment response in patients with locally advanced rectal cancer

2020 ◽  
Vol 9 (9) ◽  
pp. 205846012095729
Author(s):  
Mayra Evelia Jiménez de los Santos ◽  
Juan Armando Reyes-Pérez ◽  
Rosa Martha Sandoval-Nava ◽  
José Luis Villalobos-Juárez ◽  
Yolanda Villaseñor-Navarro ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Treatment Response ◽  
Roc Analysis ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Apparent Diffusion ◽  
Adc Values

Background Apparent diffusion coefficient (ADC) values achieve promising results in treatment response prediction in patients with several types of cancers. Purpose To determine whether ADC values predict neoadjuvant chemoradiation treatment (nCRT) response in patients with locally advanced rectal cancer (LARC). Material and Methods Forty-four patients with LARC who underwent magnetic resonance imaging scans before and after nCRT followed by delayed surgery were enrolled retrospectively. The sample was distributed as follows: responders (R), n = 8; and non-responders (Non-R), n = 36. Three markers of treatment response were considered: post-nCRT measures; ΔADC; and Δ%ADC. Statistical analysis included a Wilcoxon test, a Mann–Whitney U test, and a receiver operating characteristic (ROC) analysis in order to evaluate the diagnostic accuracy for each ADC value marker to differentiate between R and Non-R. Results Both minimum and mean ADC values were significantly higher after nCRT in the R group, while non-significant differences between basal and control ADC values were found in the non-R group. In addition, ΔADC and Δ%ADC exhibited increased values after nCRT in R when compared with non-R. ROC analysis revealed the following diagnostic performance parameters: post-nCRT: ADCmin = 1.05 × 10−3 mm2/s (sensitivity 61.1% and specificity 66.7%), ADCmean = 1.50 × 10−3 mm2/s (sensitivity 72.2% and specificity 83.3%), ΔADC: ADCmin = 0.35 (sensitivity 66.7% and specificity 83.3%), ADCmean = 0.50 (sensitivity 72% and specificity 83%); and Δ%ADC: ADCmin = 44% (sensitivity 66.7% and specificity 83.3%) and ADCmean = 60% (sensitivity 83% and specificity 99%). Conclusion Our findings suggest that post-treatment rectal tumor ADC values, as well changes between pre- and post-treatment values, may be biomarkers for predicting treatment response in patients with LARC who underwent nCRT.

scholarly journals Apparent diffusion coefficient can predict therapy response of hepatocellular carcinoma to transcatheter arterial chemoembolization

2021 ◽  
Author(s):  
Ralph Drewes ◽  
Constanze Heinze ◽  
Maciej Pech ◽  
Maciej Powerski ◽  
Katja Woidacki ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Transcatheter Arterial Chemoembolization ◽  
Meta Analysis ◽  
Therapy Response ◽  
Adc Value ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Arterial Chemoembolization

Aim: The goal of this meta-analysis was to assess the apparent diffusion coefficient (ADC) as a pre- and posttreatment (ΔADC) predictive imaging biomarker of response to transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods: SCOPUS database, EMBASE database and MEDLINE library were scanned for connections between pre- and posttreatment ADC values of HCC and response to TACE. Six studies qualified for inclusion. The following parameters were collected: authors, publication year, study design, number of patients, drugs for TACE, mean ADC value, standard deviation, measure method, b-values and Tesla-strength. The QUADAS-2 instrument was employed to check the methodological quality of each study. The meta-analysis was performed by utilizing RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance were used to regard heterogeneity. Mean ADC values and 95% confidence intervals were computed. Results: Six studies (n=271 patients with 293 HCC nodules) were included. The pretreatment mean ADC in the responder group was 1.20 x 10-3 mm2/s (0.98, 1.42) and 1.14 x 10-3 mm2/s (0.89, 1.39) in the non-responder group. The analysis of post TACE ADC value changes (ΔADC) revealed a threshold of ≥ 20% to identify treatment responders. No suitable pretreatment ADC threshold to predict therapy response or discriminate between responders and non-responders before therapy could be discovered. Conclusion: ΔADC can facilitate early objective response evaluation through post-therapeutic ADC alterations ≥ 20%. Pretreatment ADC cannot predict response to TACE.

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.

scholarly journals Early detection treatment response for head and neck carcinomas using intravoxel incoherent motion-magnetic resonance imaging: a meta-analysis

2020 ◽  
pp. 20190507
Author(s):  
Qingxu Song ◽  
Fang Li ◽  
Xin Chen ◽  
Jianbo Wang ◽  
Hong Liu ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Diagnostic Accuracy ◽  
Head And Neck ◽  
Treatment Response ◽  
Meta Analysis ◽  
Intravoxel Incoherent Motion ◽  
Perfusion Fraction ◽  
Apparent Diffusion ◽  
Pre Treatment

Objectives: To evaluate the diagnostic accuracy of intravoxel incoherent motion-MRI (IVIM-MRI) for predicting the treatment response in head and neck squamous cell carcinomas (HNSCC) patients. Methods: A comprehensive literature search was performed to identify original articles on diagnostic performance of IVIM in predicting treatment response in HNSCC patients receiving chemoradiotherapy. The IVIM parameters studied were diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient. Summary estimates of diagnostic accuracy were obtained by using a random-effects model. Of 65 studies screened, 8 studies with 347 patients were finally included. Results: The pooled sensitivities and specificities were 76% [95% confidence interval (CI) 69–82%] and 81% (95% CI 70–89%) for pre-treatment D, and 70% (95% CI 58–80%) and 82% (95% CI 66–92%) for △D, respectively. In addition, the sensitivities and specificities ranged from 41.7 to 94% and 67 to 100% for pre-treatment f, and from 55.7 to 76.5% and 72.2 to 93.3% for pre-treatment apparent diffusion coefficient, respectively. Conclusions: The diffusion-related coefficients pre-treatment D and △D demonstrated good accuracy in predicting early treatment response in HNSCC patients. However, because of the variability in reference test and other limitations of included literature, further investigation is needed before implementing any IVIM strategy into clinical practice.

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