Apparent diffusion coefficient for evaluating tumour response to neoadjuvant chemoradiation therapy for locally advanced rectal cancer
Apparent diffusion coefficient for evaluating tumour response to neoadjuvant chemoradiation therapy for locally advanced rectal cancer
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DOI：
10.1007/s00330-010-1989-y
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发表时间：
2011-05-01
影响因子：
5.9
通讯作者：
Choi, Byung Ihn
中科院分区：
文献类型：
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作者：
Kim, Seung Ho;Lee, Jae Young;Choi, Byung Ihn
为了确定局部进展期直肠癌（LARC）新辅助放化疗（CRT）前后表观扩散系数（ADC）的变化是否比单独分析CRT前后ADC更准确地预测病理完全缓解（pCR）。76例LARC患者（>= T3或淋巴结阳性）接受了CRT前后的1.5 T弥散加权成像。盲态放射科医师测量肿瘤ADC。这三个措施进行了比较，就CR和非CR。为了计算测定pCR的准确度，受试者工作特征曲线（ROC）分析应用于这三个措施。（1.43 +/- 0.10）（x10（-3）mm（2）/s）和百分比变化CR组（n = 11）的患者（70.0 +/- 23.5%）显著高于非CR组（n = 65）（分别为1.14 +/- 0.18，30.2 +/-21.7%）（均P < 0.0001）。pCR的CRT前ADC（0.85 +/- 0.10）与非pCR（0.88 +/- 0.14）无显著差异（P = 0.4094）。CRT后ADC显示确定pCR的相对准确度与百分比变化相当（P = 0.788）。但是，前者的总体准确性（87%）高于后者（75%）（P = 0.049）。单独分析CRT后ADC可以可靠地区分LARC中的pCR与非pCR。
To determine whether change in the apparent diffusion coefficient (ADC) before and after neoadjuvant chemoradiation therapy (CRT) for locally advanced rectal cancer (LARC) would more accurately predict pathological complete response (pCR) than analysing the pre- or post-CRT ADC individually.76 patients with LARC (>= T3 or lymph node-positive) underwent pre- and post-CRT, 1.5-T diffusion-weighted imaging. A blinded radiologist measured the tumour ADCs. The three measures were compared with regard to CR and non-CR. To calculate accuracy for determining pCR, receiver-operating characteristic curve (ROC) analysis was applied to the three measures.The post-CRT ADC (1.43 +/- 0.10) (x10(-3) mm(2)/s) and the percentage change (70.0 +/- 23.5%) in the CR (n = 11) were significantly higher than those in the non-CR (n = 65) (1.14 +/- 0.18, 30.2 +/- 21.7%, respectively)(both, P < 0.0001). The pre-CRT ADC (0.85 +/- 0.10) of the pCR did not differ significantly from that of the non-pCR (0.88 +/- 0.14)(P = 0.4094). The post-CRT ADC showed comparable relative accuracy for determining pCR to that of the percentage change (P = 0.788). However, overall accuracy of the former (87%) was higher than that of the latter (75%) (P = 0.049).Analyzing post-CRT ADC alone can reliably differentiate pCR from non-pCR in LARC.