Apparent diffusion coefficient modifications in assessing gastro-oesophageal cancer response to neoadjuvant treatment: comparison with tumour regression grade at histology

Cobelli, Francesco De; Giganti, Francesco; Orsenigo, E.; Cellina, Michaela; Esposito, Antonio; Agostini, Giulia; Albarello, Luca; Mazza, Elena; Ambrosi, Alessandro; Socci, C.; Staudacher, C.; Maschio, Alessandro Del

doi:10.1007/s00330-013-2807-0

Cited by 91 publications

(85 citation statements)

References 35 publications

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“…In accordance with the literature [23], we performed a T2-weighted study, with and without fat suppression, followed by DWI (b = 0-600 s/mm 2 ), and a dynamic T1-weighted study with fat suppression during intravenous injection of gadobutrol (Gadovist Ò , 1 mmol/ mL; Bayer Schering Pharma, Berlin, Germany) at 0.1 mL per kilogram of body weight with an automatic injector (Spectris MR, Medrad Europe, Maastricht, The Netherlands) at a rate of 2 mL/s. The total imaging time was approximately 40 min.…”

Section: Patientssupporting

confidence: 90%

Preoperative locoregional staging of gastric cancer: is there a place for magnetic resonance imaging? Prospective comparison with EUS and multidetector computed tomography

et al. 2015

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Background The aim of this study was to prospectively compare the diagnostic performance of magnetic resonance imaging (MRI), multidetector computed tomography (MDCT) and endoscopic ultrasonography (EUS) in the preoperative locoregional staging of gastric cancer. Methods This study had Institutional Review Board approval, and informed consent was obtained from all patients. Fifty-two patients with biopsy-proven gastric cancer underwent preoperative 1.5-T MRI, 64-channel MDCT and EUS. All images were analysed blind, and the results were compared with histopathological findings according to the seventh edition of the TNM classification. After the population had been divided on the basis of the local invasion (T1-3 vs T4a-b) and nodal involvement (N0 vs N?), sensitivity, specificity, positive and negative predictive value, and accuracy were calculated and diagnostic performance measures were assessed using the McNemar test. Results For T staging, EUS showed higher sensitivity (94 %) than MDCT and MRI (65 and 76 %; p = 0.02 and p = 0.08). MDCT and MRI had significantly higher specificity (91 and 89 %) than EUS (60 %) (p = 0.0009 and p = 0.003). Adding MRI to MDCT or EUS did not result in significant differences for sensitivity. For N staging, EUS showed higher sensitivity (92 %) than MRI and MDCT (69 and 73 %; p = 0.01 and p = 0.02). MDCT showed better specificity (81 %) than EUS and MRI (58 and 73 %; p = 0.03 and p = 0.15). Conclusions Our prospective study confirmed the leading role of EUS and MDCT in the staging of gastric cancer and did not prove, at present, the value of the clinical use of MRI.

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Section: Patientssupporting

confidence: 90%

Preoperative locoregional staging of gastric cancer: is there a place for magnetic resonance imaging? Prospective comparison with EUS and multidetector computed tomography

et al. 2015

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“…Until recently, DWI or DWIBS with a 1.5-Tesla scanner was considered to be unsuitable for imaging of abdominal organs due to respiratory movement (16)(17)(18). However, the protocol of acquiring images has improved with the use of a respiratory trigger (6).…”

Section: Discussionmentioning

confidence: 99%

Diffusion-weighted whole-body imaging with background body signal suppression/T2-weighted image fusion of gastrointestinal cancers

Tomizawa

Shinozaki

Fugo

et al. 2016

Molecular and Clinical Oncology

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Abstract. Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) yields positive results for cancer against the surrounding tissues. The combination of DWIBS and T2-weighted images (DWIBS/T2) in the diagnosis of gastrointestinal tract cancers was retrospectively analyzed in the present study. Patients were subjected to magnetic resonance imaging after cancer was diagnosed through specimens obtained via biopsy or endoscopic mucosal resection. Sixteen patients were assessed between July, 2012 and June, 2013 and the correlation between detection with DWIBS/T2 and T staging was analyzed. Regarding patients who underwent surgery, the correlation between detection with DWIBS/T2 and the diameter or depth of invasion was analyzed. All cancers that had advanced to >T2 stage were detectable by DWIBS/T2, whereas all cancers staged as T2) or invading beyond the muscularis propria. IntroductionEndoscopy is the gold standard for diagnosing cancers of the gastrointestinal tract, including the esophagus, stomach, colon and rectum (1,2). However, endoscopy is not suitable for evaluating the depth of invasion and extent of cancer, as it only allows observation of the lumen. Endoscopic ultrasonography (EUS) and contrast-enhanced computed tomography (CE-CT) are performed to assess the structure of the primary lesion, the depth of invasion into the surrounding tissues and distant metastasis (3,4). Assessing the depth of invasion may occasionally be difficult due to the weak contrast of the cancer against the surrounding tissues. Therefore, an imaging modality with a strong signal and contrast would facilitate the assessment of the depth of tumor invasion.Magnetic resonance imaging (MRI) is not as popular as CT due to blurring and low spatial resolution (5). However, MRI may be a promising method if a strong soft tissue contrast in the abdomen can be achieved. Diffusion-weighted wholebody imaging with background body signal suppression (DWIBS) images are acquired using multiple-signal averaging, pre-pulse fat suppression and heavy diffusion weighting during free breathing (6). DWIBS is based on diffusion-weighted imaging (DWI) that visualizes and assesses the random movement of water at the molecular level (Brownian motion) (7,8). An advantage of DWIBS is that it provides a strong contrast of cancerous against surrounding non-cancerous tissues, which is useful for the detection, staging and monitoring of the response to therapy (9). A major limitation of DWIBS is that anatomical analysis may be difficult at times (10,11).

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“…The study has also confirmed that the quantitative parameters of DCE-MRI (K trans and Kep) can be used to supervise the early clinical effects of EC, which may lead to more objective and timely assessment of treatment [37]. De Cobelli et al [38] used DWI to assess gastroesophageal tumor response to neoadjuvant treatment and found that there was a negative correlation between changes in the apparent diffusion coefficient (ΔADC) and tumor regression grade. There is also research suggesting that DWI could assess the therapeutic effect of EC treatment with 3D-CRT, and hyperintense lesions on DWI are a poor prognosis factor after RT [39].…”

Section: Discussionmentioning

confidence: 86%

Quantitative Multiparametric MRI May Augment the Response to Radiotherapy in Mid-Treatment Assessment of Patients with Esophageal Carcinoma

Xie

Pang³

et al. 2019

Oncol Res Treat

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Objective: The purpose of this study was to assess the mid-treatment response to radiotherapy (RT) using dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with esophageal cancer (EC). Methods: 42 patients with squamous EC were prepared for DCE-MRI and DWI scans both before treatment (NRT) and after the fifth radiotherapy (5th RT). The patients were classified into two groups (complete response [CR] and partial response [PR]) according to tumor regression after treatment. The quantitative parameters of DCE-MRI (K^trans, Kep, Ve, and ADC) were measured. A receiver operating characteristic curve (ROC) was used to detect the efficiency of the above parameters. Results: After 1 month of RT, 29 patients were classified as CR and 11 patients were classified as PR. In the NRT group, the p values of K^trans, Kep, Ve, and ADC were 0.004, 0.078, 0.0008, and <0.0001, respectively. After the 5th RT, the p values of the above parameters were <0.001, 0.005, 0.108, and 0.365, respectively. In the NRT group, the areas under the ROC curves of K^trans, Ve, and ADC were 0.790, 0.617, and 0.737; the sensitivity values were 89.3, 92.5, and 90.0%; the specificity values were 69.4, 27.5, and 50.0%. In the 5th RT group, the areas under the ROC curves of K^trans and Kep were 0.816 and 0.804; the sensitivity values were 71.2 and 95.0%; the specificity values were 81.6 and 50.0%. Conclusion: DCE-MRI combined with DWI is effective in the early prediction of radiotherapeutic response of EC after the 5th RT other than after the traditional final treatment.

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Apparent diffusion coefficient modifications in assessing gastro-oesophageal cancer response to neoadjuvant treatment: comparison with tumour regression grade at histology

Cited by 91 publications

References 35 publications

Preoperative locoregional staging of gastric cancer: is there a place for magnetic resonance imaging? Prospective comparison with EUS and multidetector computed tomography

Preoperative locoregional staging of gastric cancer: is there a place for magnetic resonance imaging? Prospective comparison with EUS and multidetector computed tomography

Diffusion-weighted whole-body imaging with background body signal suppression/T2-weighted image fusion of gastrointestinal cancers

Quantitative Multiparametric MRI May Augment the Response to Radiotherapy in Mid-Treatment Assessment of Patients with Esophageal Carcinoma

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