scholarly journals The role of MRI with diffusion-weighted imaging in restaging rectal cancers after neoadjuvant chemoradiotherapy

2016 ◽  
Vol 20 (1) ◽  
Author(s):  
Irem Bayram ◽  
Baris Bakir ◽  
Merve G.D. Kartal ◽  
Enver Kunduz ◽  
Onur Bayram ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Predictive Value ◽  
Diffusion Weighted Imaging ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Staging System ◽  
Tnm Staging ◽  
Kappa Statistics ◽  
Diffusion Weighted ◽  
Adc Values

Background: It is challenging to restage rectal cancer at MRI, in patients who have had neoadjuvant chemoradiotherapy.Objective: To investigate the accuracy of MRI with diffusion-weighted imaging (DWI) in the restaging of rectal cancer.Materials and methods: Pre- and post-neoadjuvant chemoradiotherapy MRI examinations of 35 patients diagnosed with locally advanced rectal cancer were evaluated and subsequently compared with post-operative pathology results.Results: The accuracy of MRI with DWI to determine the T-stage status was calculated as 54.28%. Kappa statistics revealed poor concordance with pathology results, with a κ value of 0.212 ± 0.114 (p = 0.028). The apparent diffusion coefficient (ADC) values measured after the neoadjuvant chemotherapy revealed a significant increase when compared with pre-treatment ADC values (p < 0.000001). MRI accuracy rate for lymph node involvement was calculated as 57.14% with a κ value of 0.001 (p = 0.989). MRI had 80% sensitivity and 100% specificity in determining mesorectal fascia involvement, with a calculated positive predictive value of 100% and a calculated negative predictive value of 96%. The accuracy of MRI in overall staging according to the TNM staging system was 28%.Conclusion: The accuracy of MRI in restaging rectal cancer is not yet sufficient and is not on par with the accuracy of MRI in the primary staging of the disease. This is attributed to post-treatment changes. Adding DWI to the protocol is promising, but more expanded data are required.

Prediction of Neoadjuvant Radiotherapy and Chemotherapy for Locally Advanced Rectal Cancer Based on 3.0T MRI Intravoxel Incoherent Motion Diffusion Weighted-Imaging with Fe3O4 Nanocontrast Agent

2019 ◽  
Vol 11 (12) ◽  
pp. 1676-1684
Author(s):  
Hongbo Hu ◽  
Huijie Jiang
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Diffusion Weighted Imaging ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Intravoxel Incoherent Motion ◽  
Diffusion Weighted ◽  
D Values

The purpose of this study was to preliminarily explore the feasibility of pre-treatment intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for predicting the efficacy of neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC). Fifty-four patients underwent preoperative IVIM-DWI before (pre-nCRT) and after nCRT (post-nCRT). The values of pre-nCRT and post-nCRT IVIM-DWI parameters (apparent diffusion coefficient standard (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f), together with the percentage changes (Δ% parametric value) induced by nCRT, were compared between pathological complete response (pCR) and non-pCR groups. After nCRT, the ADC and Dvalues for LARC increased significantly (all P <0.05). The TRG score revealed positive correlations with pre f (r = 0.357, P = 0.020), postD (r =0.551,P <0.001), and Δ%D (r =0.605, P <0.001). The pCR group (n =10) had higher preD *, pref, postD, Δ%ADC, and Δ%D values than the non-pCR group (n =32) (allP <0.05). The GR group (n =15) exhibited higher postD, %ADC, and %D values than the PR group (n =27) (allP <0.05). Based on ROC analysis, Δ%D had a higher area under the curve value than Δ%ADC (P =0.009) in discriminating the pCR and non-pCR groups. IVIM-DWI may be helpful in identifying pCR to nCRT for LARC and is more accurate than traditional DWI.

scholarly journals Integrated slice-specific dynamic shimming diffusion weighted imaging (DWI) for rectal Cancer detection and characterization

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jianxing Qiu ◽  
Jing Liu ◽  
Zhongxu Bi ◽  
Xiaowei Sun ◽  
Xin Wang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Image Quality ◽  
Diffusion Weighted Imaging ◽  
Rectal Tumor ◽  
B Values ◽  
Primary Rectal Cancer ◽  
Diffusion Weighted ◽  
Adc Values ◽  
Group 2 ◽  
Group 1

Abstract Purpose To compare integrated slice-specific dynamic shimming (iShim) diffusion weighted imaging (DWI) and single-shot echo-planar imaging (SS-EPI) DWI in image quality and pathological characterization of rectal cancer. Materials and methods A total of 193 consecutive rectal tumor patients were enrolled for retrospective analysis. Among them, 101 patients underwent iShim-DWI (b = 0, 800, and 1600 s/mm2) and 92 patients underwent SS-EPI-DWI (b = 0, and 1000 s/mm2). Qualitative analyses of both DWI techniques was performed by two independent readers; including adequate fat suppression, the presence of artifacts and image quality. Quantitative analysis was performed by calculating standard deviation (SD) of the gluteus maximus, signal intensity (SI) of lesion and residual normal rectal wall, apparent diffusion coefficient (ADC) values (generated by b values of 0, 800 and 1600 s/mm2 for iShim-DWI, and by b values of 0 and 1000 s/mm2 for SS-EPI-DWI) and image quality parameters, such as signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of primary rectal tumor. For the primary rectal cancer, two pathological groups were divided according to pathological results: Group 1 (well-differentiated) and Group 2 (poorly differentiated). Statistical analyses were performed with p < 0.05 as significant difference. Results Compared with SS-EPI-DWI, significantly higher scores of image quality were obtained in iShim-DWI cases (P < 0.001). The SDbackground was significantly reduced on b = 1600 s/mm2 images and ADC maps of iShim-DWI. Both SNR and CNR of b = 800 s/mm2 and b = 1600 s/mm2 images in iShim-DWI were higher than those of b = 1000 s/mm2 images in SS-EPI-DWI. In primary rectal cancer of iShim-DWI cohort, SIlesion was significantly higher than SIrectum in both b = 800 and 1600 s/mm2 images. ADC values were significantly lower in Group 2 (0.732 ± 0.08) × 10− 3 mm2/s) than those in Group 1 ((0.912 ± 0.21) × 10− 3 mm2/s). ROC analyses showed significance of ADC values and SIlesion between the two groups. Conclusion iShim-DWI with b values of 0, 800 and 1600 s/mm2 is a promising technique of high image quality in rectal tumor imaging, and has potential ability to differentiate rectal cancer from normal wall and predicting pathological characterization.

scholarly journals The potential predictive value of tumor budding for neoadjuvant chemoradiotherapy response in locally advanced rectal cancer

2018 ◽  
Vol 194 (11) ◽  
pp. 991-1006 ◽  
Author(s):  
Tarkan Jäger ◽  
Daniel Neureiter ◽  
Mohammad Fallaha ◽  
Philipp Schredl ◽  
Tobias Kiesslich ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Predictive Value ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Tumor Budding
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