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Value of apparent diffusion coefficient prior to neoadjuvant therapy is a predictor of histologic response in patients with borderline resectable pancreatic carcinoma
Author(s) -
Okada Kenichi,
Hirono Seiko,
Kawai Manabu,
Miyazawa Motoki,
Shimizu Atsushi,
Kitahata Yuji,
Ueno Masaki,
Hayami Shinya,
Kojima Fumiyoshi,
Yamaue Hiroki
Publication year - 2017
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.430
Subject(s) - medicine , effective diffusion coefficient , neoadjuvant therapy , magnetic resonance imaging , standardized uptake value , diffusion mri , positron emission tomography , chemoradiotherapy , nuclear medicine , radiology , diffusion weighted magnetic resonance imaging , radiation therapy , cancer , breast cancer
Background The parameters to predict histological response to neoadjuvant therapy remain controversial in borderline resectable pancreatic carcinoma ( BRPC ). Methods Twenty‐four patients who underwent diffusion‐weighted magnetic resonance imaging ( DW ‐ MRI ) prior to expected neoadjuvant chemo/chemoradiotherapy and surgery were reviewed retrospectively. Analyses for correlation between percent tumor cell destruction and the following was performed to investigate the parameter and cut off value: tumor size, whole tumor apparent diffusion coefficient ( ADC ) value of DW ‐ MRI , maximum standardized uptake value of 18 F‐fluorodeoxyglucose positron emission tomography, carbohydrate antigen 19‐9, and their change ratios. The selected parameter was assessed for prediction ability of the histological response to neoadjuvant chemo/chemoradiotherapy and R0 curability. Results Pre‐treatment ADC value was correlated with tumor cell destruction rate among all parameters ( R = 0.625, P = 0.001). The ADC cut‐off value for discriminating between nonresponders (grade I) and responders (grade II a and more) after treatment was determined as 1.20 × 10 −3 mm 2 /s and the sensitivity, 100%; specificity, 75%; accuracy, 83% for responder, and the sensitivity, 100%; specificity, 63%; accuracy, 71% for R0 curability. Conclusions Pre‐treatment ADC value appeared to be a predictor of R0 curability in BRPC patients because of effective histological response to neoadjuvant therapy, and there was a significant correlation between the baseline ADC value and histological tumor cell destruction rate.