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Quantitative synthetic MRI for predicting locally advanced rectal cancer response to neoadjuvant chemoradiotherapy

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate the value of pre-treatment quantitative synthetic MRI (SyMRI) for predicting a good response to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer.

Methods

This prospective study enrolled 63 patients with locally advanced rectal cancer scheduled to undergo preoperative chemoradiotherapy from January 2019 to June 2021. T1 relaxation time (T1), T2 relaxation time (T2), proton density (PD) from synthetic MRI, and apparent diffusion coefficient (ADC) from diffusion-weighted imaging (DWI) were measured. Independent-sample t-test, the Mann–Whitney U test, the Delong test, and receiver operating characteristic curve (ROC) analyses were used to predict the pathologic complete response (pCR) and T-downstaging.

Results

Among the 63 patients, 19 (30%) achieved pCR and 44 (70%) did not, and 24 (38%) achieved T-downstaging, while 44 (62%) did not. The mean T1 and T2 values were significantly lower in the pCR group compared with those in the non-pCR group and in the T-downstage group compared with those in the non-T-downstage group (all p < 0.05). There were no significant differences in the PD and ADC values between the two groups. There were no significant differences between the mean values of T1 and T2 for predicting pCR after CRT (AUC, 0.767 vs. 0.831, p = 0.37). There were no significant differences between the AUC values of T1 and T2 values for the assessment of post-CRT T-downstaging (AUC, 0.746 vs. 0.820, p = 0.506).

Conclusions

In patients with locally advanced rectal cancer, the synthetic MRI–derived T1 relaxation time and T2 relaxation time values are promising imaging markers for predicting a good response to neoadjuvant chemoradiotherapy.

Key Points

• Mean T1 and T2 values were significantly lower in the pathologic complete response group and the T-downstage group.

• There were no significant differences in the proton density and apparent diffusion coefficient values between the two groups.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under the receiver operating characteristic curve

DWI:

Diffusion-weighted imaging

LARC:

Locally advanced rectal cancer

MAGIC:

Magnetic resonance image compilation

nCRT:

Neoadjuvant chemoradiotherapy

pCR:

Pathologic complete response

PD:

Proton density

SyMRI:

Synthetic MRI

TRG:

Tumor regression grading

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Acknowledgements

We thank to Qian Long and Zhong Rui for their support.

Funding

This study was supported by the National Natural Science Foundation of China (Grant No. 81902638).

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Authors and Affiliations

  1. Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, 651 Dongfeng East Road, Guangzhou, 510060, People’s Republic of China

    Shanshan Lian, Huiming Liu, Tiebao Meng, Lidi Ma, Weilong Zeng & Chuanmiao Xie

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  1. Shanshan Lian
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  2. Huiming Liu
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Corresponding author

Correspondence to Chuanmiao Xie.

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The scientific guarantor of this publication is Chuanmiao Xie, MD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Each enrolled patient was asked to sign an informed consent form.

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Institutional Review Board approval was obtained.

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• prospective

• diagnostic study

• performed at one institution

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Lian, S., Liu, H., Meng, T. et al. Quantitative synthetic MRI for predicting locally advanced rectal cancer response to neoadjuvant chemoradiotherapy. Eur Radiol 33, 1737–1745 (2023). https://doi.org/10.1007/s00330-022-09191-7

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  • DOI: https://doi.org/10.1007/s00330-022-09191-7

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