Abstract
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.
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Acknowledgments
This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health Welfare, Republic of Korea (A070001).
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Lim, J.S., Kim, D., Baek, SE. et al. Perfusion MRI for the prediction of treatment response after preoperative chemoradiotherapy in locally advanced rectal cancer. Eur Radiol 22, 1693–1700 (2012). https://doi.org/10.1007/s00330-012-2416-3
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DOI: https://doi.org/10.1007/s00330-012-2416-3