Locally Advanced Rectal Carcinoma Treated with Preoperative Chemotherapy and Radiation Therapy: Preliminary Analysis of Diffusion-weighted MR Imaging for Early Detection of Tumor Histopathologic Downstaging
Locally Advanced Rectal Carcinoma Treated with Preoperative Chemotherapy and Radiation Therapy: Preliminary Analysis of Diffusion-weighted MR Imaging for Early Detection of Tumor Histopathologic Downstaging
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DOI：
10.1148/radiol.2541082230
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发表时间：
2010-01-01
期刊：
影响因子：
19.7
通讯作者：
Zhang, Xiao-Yan
中科院分区：
文献类型：
--
作者：
Sun, Ying-Shi;Zhang, Xiao-Peng;Zhang, Xiao-Yan
目的：为了确定是否在表观扩散系数（ADC）的直肠癌化疗和放射治疗（CRT）开始后1周的变化与肿瘤组织病理学降级后，术前CRT.Materials和方法：这项前瞻性研究是由机构审查委员会批准，知情同意书获得所有患者。37例患者（平均年龄54.7岁; 13例女性，24例男性）接受术前CRT治疗的原发性直肠癌患者被招募参与本研究。所有患者在治疗前、治疗第1周末和第2周末以及手术前均使用1.5 T MR成像仪进行弥散加权（DW）磁共振（MR）成像。计算肿瘤ADC。线性混合效应模型应用于分析ADC和体积的变化after treatment.Results：患者被分配到肿瘤降级组（n = 17）或肿瘤nondownstaged组（n = 20）的基础上手术后的组织病理学检查结果。在CRT之前，降级组的平均肿瘤ADC值低于非降级组（1.07 x 10 - 3 mm 2/sec +/- 0.13 [标准差] vs 1.19 x 10 - 3 mm 2/sec +/- 0.15，F = 6.91，P= 0.013）。CRT治疗第1周结束时，平均肿瘤ADC值从1.07 x 10（-3）mm（2）/sec +/- 0.13显著增加至1.32 x 10（-3）mm（2）/sec +/- 0.16（F = 37.63，P
Purpose: To determine whether changes in apparent diffusion coefficients (ADCs) of rectal carcinoma obtained 1 week after the beginning of chemotherapy and radiation therapy (CRT) correlate with tumor histopathologic downstaging after preoperative CRT.Materials and Methods: This prospective study was approved by an institutional review board; informed consent was obtained from all patients. Thirty-seven patients (mean age, 54.7 years; 13 women, 24 men) with primary rectal carcinoma who were undergoing preoperative CRT were recruited for the study. Diffusion-weighted (DW) magnetic resonance (MR) imaging was performed with a 1.5-T MR imager in all patients before therapy, at the end of the 1st and 2nd week of therapy, and before surgery. Tumor ADCs were calculated. Linear mixed-effects modeling was applied to analyze change in ADCs and volumes following treatment.Results: Patients were assigned to the tumor downstaged group (n = 17) or the tumor nondownstaged group (n = 20) on the basis of histopathologic examination results following surgery. Before CRT, the mean tumor ADC in the downstaged group was lower than that in the nondownstaged group (1.07 x 10(-3) mm(2)/sec +/- 0.13 [standard deviation] vs 1.19 x 10(-3) mm(2)/sec +/- 0.15, F = 6.91, P=.013). At the end of the 1st week of CRT, the mean tumor ADC increased significantly from 1.07 x 10(-3)mm(2)/sec +/- 0.13 to 1.32 x 10(-3) mm(2)/sec +/- 0.16 (F = 37.63, P