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Comparison of diffusion-weighted MRI and MR volumetry in the evaluation of early treatment outcomes after preoperative chemoradiotherapy for locally advanced rectal cancer

Authors
 서진석 ; 신상준 ; 임준석 ; 금기창 ; 김경아 ; 김기황 ; 김남규 ; 김명진 ; 김영철 
Citation
 Journal of Magnetic Resonance Imaging, Vol.34(3) : 570~576, 2011 
Journal Title
 Journal of Magnetic Resonance Imaging 
ISSN
 1053-1807 
Issue Date
2011
Abstract
PURPOSE: To compare diffusion-weighted imaging (DWI) and magnetic resonance (MR) volumetry for predicting treatment outcomes of locally advanced rectal cancers with preoperative chemoradiotherapy (CRT). MATERIALS AND METHODS: This prospective study was approved by our Institutional Review Board. Thirty-four patients underwent three MR examinations: pre-CRT (before CRT), early CRT (2 weeks after CRT initiation), and post-CRT (before surgery). The tumor apparent diffusion coefficient (ADC), ADC increase rate, and volume reduction rate were compared between responders and nonresponders using three reference standards: downstaging, modified Response Evaluation Criteria in Solid Tumors (mRECIST), and tumor regression grade (TRG). For DWI and volumetry, differences between responders and nonresponders were assessed by receiver operating characteristic analysis. RESULTS: The median early tumor volume reduction rate of responders, subgrouped by downstaging and mRECIST (47.97% and 53.97%, respectively), was significantly higher than that of nonresponders (20.94% and 20.36%; P = 0.0024 and 0.0001, respectively), but there were no significant differences in pre-CRT ADC and early ADC increase rate using all references. When using the downstaging and mRECIST, the diagnostic performance of early tumor volume reduction rate (Az = 0.81 and 0.94, respectively) was higher than that of pre-CRT ADC (Az = 0.55 and 0.62; P = 0.033 and 0.007) and early ADC increase rate (Az = 0.58 and 0.64; P = 0.055 and 0.01) for predicting the treatment outcome. For TRG, there were no significant differences between DWI and volumetry. CONCLUSION: Early tumor volume reduction rate at the second week after CRT initiation may be a better indicator than DWI based on the mean ADC measurements for predicting CRT treatment outcome.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/93861
DOI
10.1002/jmri.22696
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Surgery
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Radiology
1. 연구논문 > 1. College of Medicine > Dept. of Radiation Oncology
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Link
 http://dx.doi.org/10.1002/jmri.22696
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