Histogram analysis of DCE-MRI for chemoradiotherapy response evaluation in locally advanced esophageal squamous cell carcinoma

  • Na-Na Sun
  • Xiao-Lin Ge
  • Xi-Sheng LiuEmail author
  • Lu-Lu Xu
Magnetic Resonance Imaging



The aim of the study was to predict and assess treatment response by histogram analysis of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to patients with locally advanced esophageal squamous cell carcinoma receiving chemoradiotherapy (CRT).

Materials and methods

Seventy-two patients with locally advanced esophageal squamous cell carcinoma who underwent DCE-MRI before and after chemoradiotherapy were enrolled and divided into the complete response (CR) group and the non-CR group based on RECIST. The histogram parameters (10th percentile, 90th percentile, median, mean, standard deviation, skewness, and kurtosis) of pre-CRT and post-CRT were compared using a paired Student’s t test in the CR and non-CR groups, respectively. The histogram parameter differences between the CR and the non-CR groups were compared using an unpaired Student’s t test. A receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance.


The histogram parameters of Ktrans values were observed to have significantly decreased after chemoradiotherapy in the CR group. The CR responders showed significantly higher median, mean, and 10th and 90th percentile of pre-Ktrans values than those of the non-CR group. The histogram analysis indicated the decreased heterogeneity in the CR group after CRT. Esophageal cancer with higher pre-Ktrans and lower post-Ktrans values indicated a good treatment response to CRT. Pre-Ktrans-10th showed the best diagnostic performance in predicting the chemoradiotherapy response.


The histogram parameters of Ktrans are useful in the assessment and prediction of the chemoradiotherapy response in patients with advanced esophageal squamous cell carcinoma. DCE-MRI could serve as an adjunctive imaging technique for treatment planning.


Dynamic contrast-enhanced MRI Esophageal cancer Chemoradiotherapy response Histogram analysis 



This study was not funded by any financial support.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Italian Society of Medical Radiology 2019

Authors and Affiliations

  • Na-Na Sun
    • 1
  • Xiao-Lin Ge
    • 2
  • Xi-Sheng Liu
    • 1
    Email author
  • Lu-Lu Xu
    • 1
  1. 1.Department of RadiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
  2. 2.Department of RadiotherapyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina

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