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Erschienen in:
01.08.2012 | Gastrointestinal
Perfusion MRI for the prediction of treatment response after preoperative chemoradiotherapy in locally advanced rectal cancer
Erschienen in: European Radiology | Ausgabe 8/2012
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Objectives
To evaluate the utility of perfusion MRI as a potential biomarker for predicting response to chemoradiotherapy (CRT) in locally advanced rectal cancer.
Methods
Thirty-nine patients with primary rectal carcinoma who were scheduled for preoperative CRT were prospectively recruited. Perfusion MRI was performed with a 3.0-T MRI system in all patients before therapy, at the end of the 2nd week of therapy, and before surgery. The K
trans (volume transfer constant) and V
e (extracellular extravascular space fraction) were calculated.
Results
Before CRT, the mean tumour K
trans in the downstaged group was significantly higher than that in the non-downstaged group (P = 0.0178), but there was no significant difference between tumour regression grade (TRG) responders and TRG non-responders (P = 0.1392). Repeated-measures analysis of variance (ANOVA) showed significant differences for evolution of K
trans values both between downstaged and non-downstaged groups (P = 0.0215) and between TRG responders and TRG non-responders (P = 0.0001). Regarding V
e, no significant differences were observed both between downstaged and non-downstaged groups (P = 0.689) or between TRG responders and TRG non-responders (P = 0.887).
Conclusion
Perfusion MRI of rectal cancer can be useful for assessing tumoural K
trans changes by CRT. Tumours with high pre-CRT K
trans values tended to respond favourably to CRT, particularly in terms of downstaging criteria.
Key Points
• Perfusion MRI can now assess therapeutic response of tumours to therapy.
• Tumours with high initial
K
trans
values responded favourably to chemoradiotherapy.
• Perfusion MRI of rectal cancer may help with decisions about management.