Diffusion-weighted MRI in rectal cancer: Apparent diffusion coefficient as a potential noninvasive marker of tumor aggressiveness
Diffusion-weighted MRI in rectal cancer: Apparent diffusion coefficient as a potential noninvasive marker of tumor aggressiveness
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DOI：
10.1002/jmri.23589
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发表时间：
2012-06-01
影响因子：
4.4
通讯作者：
Beets-Tan, Regina G. H.
中科院分区：
文献类型：
--
作者：
Curvo-Semedo, Luis;Lambregts, Doenja M. J.;Beets-Tan, Regina G. H.
目的：通过分析肿瘤表观扩散系数（ADC）值与MRI及组织学预后参数的关系，探讨弥散加权磁共振成像（DWI）作为直肠癌肿瘤侵袭性的潜在无创标志物的价值。材料与方法：50例直肠癌患者术前行包括DWI在内的初级分期MRI及新辅助治疗。在47例患者中，手术前进行了短期放疗（n = 28）或长期放化疗（n = 19）。根据预处理CEA水平、MRI参数（直肠系膜筋膜- MRF状态、t期、n期）和组织学参数（分化等级：低分化、中分化、中分化、中分化、高分化、淋巴血管侵袭）测量亚组间平均肿瘤ADC并进行比较。结果：肿瘤平均adc在无mrf肿瘤组和浸润mrf肿瘤组（P = 0.013）、cN0肿瘤组和cN+肿瘤组（P = 0.011）以及不同组织学分化等级组（P = 0.025）之间存在差异。不同CEA水平、T分期和有无淋巴管浸润组的adc平均值无显著差异。结论：较低的ADC值与更具侵袭性的肿瘤相关。平均ADC值与放射学MRF状态、N分期和分化等级之间存在显著相关性。ADC有潜力成为肿瘤侵袭性的成像生物标志物。j .增效。的原因。成像2012;。(c) 2012 Wiley期刊有限公司
Purpose: To assess the value of diffusion-weighted MR imaging (DWI) as a potential noninvasive marker of tumor aggressiveness in rectal cancer, by analyzing the relationship between tumoral apparent diffusion coefficient (ADC) values and MRI and histological prognostic parameters. Materials and Methods: Fifty rectal cancer patients underwent primary staging MRI including DWI before surgery and neo-adjuvant therapy. In 47, surgery was preceded by short-course radiation therapy (n = 28) or long-course chemoradiation therapy (n = 19). Mean tumor ADC was measured and compared between subgroups based on pretreatment CEA levels, MRI parameters (mesorectal fascia - MRF - status; T-stage; N-stage) and histological parameters (differentiation grade: poorly differentiated, poorly moderately differentiated, moderately differentiated, moderately well differentiated, well-differentiated; lymphangiovascular invasion). Results: Mean tumor ADCs differ between MRF-free versus MRF-invaded tumors (P = 0.013), the groups of cN0 versus cN+ cancers (P = 0.011), and between the several groups of histological differentiation grades (P = 0.025). There was no significant difference in mean ADCs between the various groups of CEA levels, the T stage, and the presence of lymphangiovascular invasion. Conclusion: Lower ADC values were associated with a more aggressive tumor profile. Significant correlations were found between mean ADC values and radiological MRF status, N stage and differentiation grade. ADC has the potential to become an imaging biomarker of tumor aggressiveness profile. J. Magn. Reson. Imaging 2012;. (c) 2012 Wiley Periodicals, Inc.