Apparent Diffusion Coefficient Values Measured by Diffusion-Weighted Imaging Predict Chemoradiotherapeutic Effect for Advanced Esophageal Cancer

Abstract

Background: The purpose of this study was to assess whether apparent diffusion coefficient (ADC) values of esophageal squamous cell carcinoma (ESCC) predict responses to chemoradiotherapy (CRT) and/or patient prognosis. Methods: Magnetic resonance images were acquired to construct the diffusion-weighted images, and the ADC values were calculated before CRT in 80 patients with ESCC. A high-ADC group responded better to CRT than did a low-ADC group (p < 0.01). We divided the 80 patients into two groups based on the operating characteristic analysis: one group comprised patients with ADC values higher than the average ADC of the esophageal cancer tissue (1.10 × 10^–3 mm²/s), and the other group comprised those whose ADC values were less than the average value. A Kaplan-Meier analysis showed that the survival rate in the high-ADC group was significantly better than that in the low-ADC group (p = 0.04). Conclusion: Our results indicate that the ADC value may be a useful marker to predict treatment response as well as survival for patients with ESCC.

Investigation of Using Diffusion-Weighted Magnetic Resonance Imaging to Evaluate the Therapeutic Effect of Esophageal Carcinoma Treatment

“…Both the univariate and multivariate Cox regression analyses further confirmed this finding. This finding seems to be inconsistent with the study result by Aoyagi et al [17]. They found that the pre-CRT ADC value was a useful marker to predict the therapeutic response and OS for patients with ESCC.…”

Diffusion-Weighted Magnetic Resonance Imaging for Predicting and Detecting the Early Response to Chemoradiotherapy of Advanced Esophageal Squamous Cell Carcinoma

“…CRT, in particular, can provide a higher treatment effect in comparison to chemotherapy; however, CRT occasionally induces severe advance events. Therefore, it is quite helpful if prediction of the treatment effect of CRT at an early phase can be carried out [6]. Cases that expect a response with early determination of the effects can set accomplishing treatment as the primary goal, while cases that do not expect a response can change the content of treatment and avoid unnecessary adverse events by discontinuing treatment and moving on to the best supportive care.…”

“…We reported that DWMRI is useful for gastrointestinal disease [4,5,6,7,8]. DWMRI holds promise for use as a cancer treatment response biomarker because it is sensitive to macromolecular and microstructural changes that can occur at the cellular level earlier than anatomical changes during therapy.…”

“…DWMRI holds promise for use as a cancer treatment response biomarker because it is sensitive to macromolecular and microstructural changes that can occur at the cellular level earlier than anatomical changes during therapy. The ADC values in DWMRI predict the prognosis of patients with esophageal squamous cell carcinoma and the treatment response [6]. However, accuracy is not 100%; therefore, a different view and method for predicting the therapeutic effect is required.…”

Whole Body MRI in the Staging of Esophageal Cancer - A Prospective Comparison with Whole Body ¹⁸F-FDG PET-CT

“…Strong correlation between ADC values and grade of malignancy has been reported over the last few years in many cancers, including esophageal cancer, in effect validating ADC values as a surrogate for SUV derived from PET [30] . A tantalizing prospect is the possibility of determining disease response with serial ADC values, acquired without risk to the patient, unlike PET-CT the frequency of use of which is limited by concerns over radiation exposure and also cost [31] . Additionally, although both ADC and SUV values correlate with tumor aggressiveness, they repre-sent completely different tumor metrics, and as such it is possible that indeterminate (for malignancy) value with one parameter might be matched with definitive value for the other.…”