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

Abstract

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.

Multi‐parametric MRI (mpMRI) for treatment response assessment of radiation therapy

“…220 In another study using both DCE-MRI and DWI, K trans and k ep acquired in the middle of the RT course captured significant differences between different responsive groups, but ADC only indicated such difference in pretreatment results. 221 Another study reported that a90% percentile change in CA concentration AUC could predict pathologic complete response after neoadjuvant chemo-RT. 222 In a T1 mapping study assessing cardiac toxicity after esophagus chemo-RT, pre-CA T1 value of myocardium increased 6 months after treatment, which was earlier than late CA enhancement results that demonstrated significant results 18 months after treatment.…”

“…In a study of esophageal squamous cell carcinoma (SCC) chemo‐RT, DWI ADC was used to identify significant survival rate difference 220 . In another study using both DCE‐MRI and DWI, K trans and k ep acquired in the middle of the RT course captured significant differences between different responsive groups, but ADC only indicated such difference in pre‐treatment results 221 . Another study reported that a90% percentile change in CA concentration AUC could predict pathologic complete response after neoadjuvant chemo‐RT 222 .…”

Longitudinal Correlations Between Intravoxel Incoherent Motion (IVIM) and Dynamic Contrast-Enhanced (DCE) MRI During Radiotherapy in Prostate Cancer Patients

“…A common way to measure perfusion is by using dynamic contrast enhanced (DCE-) MRI ( 2 , 4 , 5 ). In addition to prognosis, DCE has been shown to have value for mid-treatment response assessment in cervix ( 6 ), esophageal ( 7 ), and head-and-neck cancer ( 8 – 10 ).…”

DCE-MRI radiomics models predicting the expression of radioresistant-related factors of LRP-1 and survivin in locally advanced rectal cancer

“…DCE-MRI parameters can also reflect tumor angiogenesis and, therefore, provide essential information about the prognosis and effect of treatment for LARC (17). Moreover, in various oncology fields, several researchers have recommended using DCE-MRI to assess response to radiotherapy (18,19). Li et al (20) showed that radiomics features based on breast DCE-MRI could identify the status of some pathological markers (HER2 and Ki-67).…”