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Apparent diffusion coefficient for evaluating tumour response to neoadjuvant chemoradiation therapy for locally advanced rectal cancer

  • Gastrointestinal
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Abstract

Objective

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.

Methods

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.

Results

The post-CRT ADC (1.43 ± 0.10) (×10−3 mm2/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).

Conclusion

Analyzing post-CRT ADC alone can reliably differentiate pCR from non-pCR in LARC

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Acknowledgement

We thank In Chan Song, PhD, for technical assistance with the data acquisition. This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea. (A070001)

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Authors and Affiliations

  1. Department of Radiology, Seoul National University College of Medicine, Yongon-dong 28, Chongno-gu, Seoul, 110-744, South Korea

    Seung Ho Kim, Jae Young Lee, Jeong Min Lee, Joon Koo Han & Byung Ihn Choi

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  1. Seung Ho Kim
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Correspondence to Jae Young Lee.

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Kim, S.H., Lee, J.Y., Lee, J.M. et al. Apparent diffusion coefficient for evaluating tumour response to neoadjuvant chemoradiation therapy for locally advanced rectal cancer. Eur Radiol 21, 987–995 (2011). https://doi.org/10.1007/s00330-010-1989-y

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  • DOI: https://doi.org/10.1007/s00330-010-1989-y

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