Locally Advanced Rectal Cancer: Added Value of Diffusion-weighted MR Imaging for Predicting Tumor Clearance of the Mesorectal Fascia after Neoadjuvant Chemotherapy and Radiation Therapy

Park, Min Jung; Kim, Seong Hyun; Lee, Soon Jin; Jang, Kyung Mi; Rhim, Hyunchul

doi:10.1148/radiol.11102135

Cited by 110 publications

(65 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both in chemoembolization and in radio frequency ablation of liver tumors, both primary and metastatic, FDG PET/CT and MRI (with the addition of fMRI) demonstrated better performances than CT, with high accuracy [75,76]. Similar results have been obtained in the evaluation of neoadjuvant chemoradiotherapy in colorectal cancer [77,78]. Although FDG PET/CT monitoring of therapy of lymphomas (Hodgkin and diffuse large B cell) has been included in the guidelines [42], more recent studies reported low and maybe suboptimal predictive value [79,80] in early therapy assessment, probably related to therapy schemes different from classic chemotherapy, with higher predictive value in end-therapy evaluation.…”

Section: Therapy Response Assessmentsupporting

confidence: 64%

Whole-body PET/MRI in oncology: current status and clinical applications

Pace

Nicolai

Aiello

et al. 2013

Clin Transl Imaging

View full text Add to dashboard Cite

In oncology, diagnostic imaging plays a major role in staging, therapy assessment and in the evaluation of tumor biology. Multimodality imaging, and more specifically positron emission tomography/computed tomography (PET/CT), has matured into an important imaging tool. The recent introduction of the integrated whole-body PET/ magnetic resonance imaging (MRI) represents the addition of a promising methodology in clinical practice. Combining the metabolic data of PET with the anatomical and functional information provided by MRI and fMRI may further improve the diagnostic value of each method alone. Although the literature is still limited, data indicate a potential advantage of PET/MRI over PET/CT in all the indications where MRI is superior to CT, as well as in the evaluation of tumor biology. Integrated PET/MRI might be performed in addition to the existing imaging modality in specific regions. Moreover, integrated PET/MRI is an alternative to PET/CT when a low radiation dose is required, i.e. in children and in repeated imaging. In the rapidly evolving field of diagnostic imaging, the role of a new modality should be accurately evaluated. Further studies are needed to test the diagnostic accuracy of PET/MRI in different oncology indications. Whether PET/MRI will replace PET/CT or be a complementary methodology and whether it represents true diagnostic progress remains to be evaluated, also taking into account economic considerations.

show abstract

Section: Therapy Response Assessmentsupporting

confidence: 64%

Whole-body PET/MRI in oncology: current status and clinical applications

Pace

Nicolai

Aiello

et al. 2013

Clin Transl Imaging

View full text Add to dashboard Cite

show abstract

“…However, diagnostic assessment by using either of these techniques is hampered by difficulties in differentiating residual tumor from radiationinduced fibrosis (14). In other studies, investigators have suggested that adding diffusion-weighted imaging (DWI) to conventional MR imaging can aid in this differentiation and thus improve the prediction of response after neoadjuvant therapy (15)(16)(17)(18)(19)(20)(21)(22)(23). However, the literature on use of the apparent diffusion coefficient (ADC) for assessment of rectal tumor response to CRT is inconsistent.…”

Section: Methodsmentioning

confidence: 99%

“…While it is a simple and practical approach, it is potentially limited by the inaccuracies introduced by the variations in ROI size and positioning (15,(22)(23)(24). In comparison to the single-section ROI method, whole-tumor obtained from single-section ROIs increased significantly after CRT (D for reader 1, P = .01; D for reader 2, P = .002; ADC for reader 1, P = .0006; ADC for reader 2, P = .0002) and were significantly higher in good versus poor responders to CRT (D for reader 1, P = .003; D for reader 2, P = .004; ADC for reader 1, P = .02; ADC for reader 2, P = .02; Tables E5, E6 [online]).…”

Section: Gastrointestinal Imaging: Histogram Metrics For Assessment Omentioning

confidence: 99%

Intravoxel Incoherent Motion–derived Histogram Metrics for Assessment of Response after Combined Chemotherapy and Radiation Therapy in Rectal Cancer: Initial Experience and Comparison between Single-Section and Volumetric Analyses

Nougaret¹,

Vargas²,

Lakhman³

et al. 2016

Radiology

138

104

View full text Add to dashboard Cite

Results:Extreme values aside, results of histogram analysis of ADC and IVIM were equivalent to median values for tumor response assessment (P . .06). Prior to CRT, none of the median ADC and IVIM diffusion metrics correlated with subsequent tumor response (P . .36). Median D and ADC values derived from either whole-volume or single-section analysis increased significantly after CRT (P  .01) and were significantly higher in good versus poor responders (P  .02). Median IVIM f and D* values did not significantly change after CRT and were not associated with tumor response to CRT (P . .36). Interobserver agreement was excellent for whole-tumor volume analysis (range, 0.91-0.95) but was only moderate for singlesection ROI analysis (range, 0.50-0.63). Conclusion:Median D and ADC values obtained after CRT were useful for discrimination between good and poor responders. Histogram metrics did not add to the median values for assessment of tumor response. Volumetric analysis demonstrated better interobserver reproducibility when compared with single-section ROI analysis.q RSNA, 2016

show abstract

“…Studies show that MRI using diffusion-weighted imaging (DWI) can increase the accuracy in patients who had neo-ChRT. One of the reasons is that DWI provides information that reflects tissue cellularity and the integrity of cellular membranes and it is sensitive to intratumoral changes induced by chemoradiation therapy, so it is easier to discriminate between fibrosis and residual tumor [45,46,47,48,49,50,51]. Park et al [46] showed that the accuracy improved from 0.4 (0.69 in observer 2) to 0.89 (0.93 in observer 2).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of MRI for the Assessment of Mesorectal Fascia Involvement in Patients with Rectal Cancer: A Systematic Review and Meta-Analysis

Xie

Zhou

et al. 2014

Dig Surg

View full text Add to dashboard Cite

Aims: Defining the most appropriate definition of mesorectal fascia involvement (MRF+) by reviewing literature and using new inclusion criteria to re-evaluate the effectiveness of MRI in the assessment of MRF+ for rectal cancer. Methods: PubMed, Medline, Embase, and the Cochrane Library databases were electronically searched from 1999 to 2012. The bivariate random effects model was used to estimate the pooled outcomes of each subgroup. The definition of MRF+ in MRI and the influence of neoadjuvant chemoradiotherapy (neo-ChRT) were especially discussed. Results: Fourteen studies involving 1,600 patients were included. Different definitions of MRF+ (≤1, ≤2 and ≤5 mm) in MRI exhibited different pooled sensitivity (76, 79 and 92%), specificity (88, 66 and 48%) and diagnostic odds ratio (DOR) (22.4, 6.6 and 16.0). The definition of MRF+ at ≤1 mm showed the highest DOR. The specificity (88 vs. 93%, p = 0.026) and DOR (15.5 vs. 39.0, p = 0.001) were lower in patients who underwent neo-ChRT than those who did not while using ≤1 mm as the definition of MRF+. However, the sensitivity showed no significant difference (67 vs. 74%, p = 0.129). Conclusions: MRI is valuable for the assessment of MRF. The most appropriate definition of MRF+ in MRI is ≤1 mm. The effectiveness is higher in patients who did not undergo neo-ChRT.

show abstract

Locally Advanced Rectal Cancer: Added Value of Diffusion-weighted MR Imaging for Predicting Tumor Clearance of the Mesorectal Fascia after Neoadjuvant Chemotherapy and Radiation Therapy

Abstract: Adding DW imaging to T2-weighted imaging can improve the prediction of tumor clearance in the MRF after neoadjuvant CRT compared with T2-weighted imaging alone in patients with locally advanced rectal cancer.

Cited by 110 publications

References 33 publications

Whole-body PET/MRI in oncology: current status and clinical applications

Whole-body PET/MRI in oncology: current status and clinical applications

Intravoxel Incoherent Motion–derived Histogram Metrics for Assessment of Response after Combined Chemotherapy and Radiation Therapy in Rectal Cancer: Initial Experience and Comparison between Single-Section and Volumetric Analyses

Effectiveness of MRI for the Assessment of Mesorectal Fascia Involvement in Patients with Rectal Cancer: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About