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Dynamic contrast‐enhanced MRI to evaluate the therapeutic response to neoadjuvant chemoradiation therapy in locally advanced rectal cancer
Author(s) -
Kim Seung Ho,
Lee Jeong Min,
Gupta Sandeep N.,
Han Joon Koo,
Choi Byung Ihn
Publication year - 2014
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24387
Subject(s) - medicine , colorectal cancer , perfusion , nuclear medicine , dynamic contrast , dynamic contrast enhanced mri , radiation therapy , chemoradiotherapy , radiology , magnetic resonance imaging , cancer
Purpose To evaluate the usefulness of perfusion parameters derived from dynamic contrast‐enhanced MR imaging (DCE‐MRI) for assessing the therapeutic response to neoadjuvant chemoradiation therapy (CRT) for locally advanced rectal cancer (LARC). Materials and Methods Fifty patients with LARC (≥T3 or lymph‐node metastasis) who underwent CRT and subsequent surgery, were included in this study. All patients underwent pre‐ and post‐CRT DCE‐MRI on a 1.5 Tesla unit. By using a postprocessing software, the following perfusion parameters (K trans , k ep , v e ) were measured for tumor. Those perfusion parameters were compared not only between the T‐downstaged group and the nondownstaged group, but also before and after CRT in each group. Results After CRT, the mean K trans (min −1 ) significantly decreased from 1.24 ± 0.53 to 0.76 ± 0.45 in the T‐downstaged group (n = 24) ( P = 0.0007), whereas it did not significantly decrease in the nondownstaged group (n = 26) (from 1.02 ± 0.53 to 0.87 ± 0.48, P = 0.24). The percentage difference between pre‐ and post‐CRT K trans in the T‐downstaged group was significantly higher than that in the nondownstaged group (43%, 16%, respectively, P = 0.0092). However, none of the other parameters showed significant differences. Conclusion A large decrease in the mean K trans after CRT was associated with a good therapeutic response to CRT for LARC. J. Magn. Reson. Imaging 2014;40:730–737 . © 2013 Wiley Periodicals, Inc .