Assessment of pathological complete response to preoperative chemoradiotherapy by means of multiple mathematical models of diffusion-weighted MRI in locally advanced rectal cancer: A prospective single-center study
Assessment of pathological complete response to preoperative chemoradiotherapy by means of multiple mathematical models of diffusion-weighted MRI in locally advanced rectal cancer: A prospective single-center study
复制标题
利用弥散加权 MRI 的多个数学模型评估局部晚期直肠癌术前放化疗的病理完全缓解：一项前瞻性单中心研究
DOI：
10.1002/jmri.25567
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发表时间：
2017
影响因子：
4.4
通讯作者：
Sun YS
中科院分区：
文献类型：
--
作者：
Zhu HB;Zhang XY;Zhou XH;Li XT;Liu YL;Wang S;Sun YS
PurposeTo assess stretched-exponential，mono-exponential and intravoxel incoherent motion（IVIM）models of diffusion-weighted MRI（DWI）in predicting pathological complete response（pCR）to neoadjuvant chemoradiotherapy（CRT）in rectal cancer patients.Materials and MethodsThis prospective study results 98 continued patients with local advanced rectal cancer who experienced 3 Tesla MR examination before，during and after CRT.测量表观扩散系数（ADC）、IVIM衍生参数（D、f和D*）和拉伸指数模型衍生参数（DDC和α）。比较pCR和非pCR之间CRT期间和之后的参数及其相应变化。进行受试者工作特征曲线分析以评价诊断性能。计算变异系数和组内相关系数，以评估可靠性和agreement.Results19例患者达到pCR，而79没有。pCR组的ADC和α（ADC 2和α2）及其终点变化（Δ ADC 2和Δα2）均高于非pCR组。α 2与ADC 2的AUC相似（P= 0.339），Δα 2与Δ ADC 2的AUC相似（P= 0.263），ADC与α基本一致，α的CV最小（5.0-7.0%）。α可能更有用，因为它比IVIM导出的参数具有更好的诊断性能，比ADC具有更好的可靠性。证据等级：1技术有效性：2 J期。MAGN. RESON.影像2017;46：175-183
PurposeTo assess stretched‐exponential, mono‐exponential and intravoxel incoherent motion (IVIM) models of diffusion‐weighted MRI(DWI) in predicting pathological complete response (pCR) to neoadjuvant chemoradiotherapy (CRT) in rectal cancer patients.Materials and MethodsThis prospective study recruited 98 consecutive patients with locally advanced rectal cancer who underwent 3 Tesla MR examination before, during and after CRT. The apparent diffusion coefficient (ADC), IVIM‐derived parameters (D, f, and D*), and stretched‐exponential model‐derived parameters (DDC and α) were measured. The parameters and their corresponding changes during and after CRT were compared between pCR and non‐pCR. Receiver‐operating characteristic curve analysis was performed to evaluate the diagnostic performance. Coefficient of variations and intraclass correlation coefficient were calculated to assess reliability and agreement.ResultsNineteen patients achieved pCR while 79 did not. The pCR group had higher ADC and α (ADC2and α2), and their changes (ΔADC2, and Δα2) at the endpoint than non‐pCR group. α2and ADC2yielded similar AUCs (P= 0.339), Δα2and ΔADC2yielded similar AUCs (P= 0.263) ADC and α presented substantial agreement, and α presented the minimum CV (5.0–7.0%).ConclusionADC and α were useful for assessing pCR after CRT. α might be more useful because it demonstrated better diagnostic performance than IVIM‐derived parameters and better reliability than ADC.Level of Evidence:1Technical Efficacy:Stage 2J. MAGN. RESON. IMAGING 2017;46:175–183