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Perfusion MRI for the prediction of treatment response after preoperative chemoradiotherapy in locally advanced rectal cancer.

 Joon Seok Lim  ;  Daehong Kim  ;  Song-Ee Baek  ;  Sungmin Myoung  ;  Junjeong Choi  ;  Sang Joon Shin  ;  Myeong-Jin Kim  ;  Nam Kyu Kim  ;  Jinsuk Suh  ;  Ki Whang Kim  ;  Ki Chang Keum 
 EUROPEAN RADIOLOGY, Vol.22(8) : 1693-1700, 2012 
Journal Title
Issue Date
Adult ; Aged ; Biomarkers/metabolism ; Carcinoma/pathology* ; Carcinoma/therapy* ; Chemoradiotherapy/methods* ; Combined Modality Therapy/methods ; Contrast Media/pharmacology ; Female ; Humans ; Magnetic Resonance Angiography/methods* ; Male ; Middle Aged ; Perfusion ; Permeability ; Prospective Studies ; Rectal Neoplasms/pathology* ; Rectal Neoplasms/therapy* ; Treatment Outcome
Magnetic resonance imaging (MRI) ; Perfusion imaging ; Dynamic contrast-enhanced MRI ; Rectal cancer ; Chemoradiotherapy (CRT)
OBJECTIVES: To evaluate the utility of perfusion MRI as a potential biomarker for predicting response to chemoradiotherapy (CRT) in locally advanced rectal cancer.

METHODS: Thirty-nine patients with primary rectal carcinoma who were scheduled for preoperative CRT were prospectively recruited. Perfusion MRI was performed with a 3.0-T MRI system in all patients before therapy, at the end of the 2nd week of therapy, and before surgery. The K (trans) (volume transfer constant) and V (e) (extracellular extravascular space fraction) were calculated.

RESULTS: Before CRT, the mean tumour K (trans) in the downstaged group was significantly higher than that in the non-downstaged group (P = 0.0178), but there was no significant difference between tumour regression grade (TRG) responders and TRG non-responders (P = 0.1392). Repeated-measures analysis of variance (ANOVA) showed significant differences for evolution of K (trans) values both between downstaged and non-downstaged groups (P = 0.0215) and between TRG responders and TRG non-responders (P = 0.0001). Regarding V (e), no significant differences were observed both between downstaged and non-downstaged groups (P = 0.689) or between TRG responders and TRG non-responders (P = 0.887).

CONCLUSION: Perfusion MRI of rectal cancer can be useful for assessing tumoural K (trans) changes by CRT. Tumours with high pre-CRT K (trans) values tended to respond favourably to CRT, particularly in terms of downstaging criteria.

KEY POINTS: • Perfusion MRI can now assess therapeutic response of tumours to therapy. • Tumours with high initial K ( trans ) values responded favourably to chemoradiotherapy. • Perfusion MRI of rectal cancer may help with decisions about management.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Ki Whang(김기황)
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Baek, Song Ee(백송이) ORCID logo https://orcid.org/0000-0001-8146-2570
Suh, Jin Suck(서진석) ORCID logo https://orcid.org/0000-0001-9455-9240
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
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