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Perfusion MRI for the prediction of treatment response after preoperative chemoradiotherapy in locally advanced rectal cancer

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

A Gastrointestinal to this article was published on 24 November 2012

Abstract

Objectives

To evaluate the utility of perfusion MRI as a potential biomarker for predicting response to chemoradiotherapy (CRT) in locally advanced rectal cancer.

Methods

Thirty-nine patients with primary rectal carcinoma who were scheduled for preoperative CRT were prospectively recruited. Perfusion MRI was performed with a 3.0-T MRI system in all patients before therapy, at the end of the 2nd week of therapy, and before surgery. The K trans (volume transfer constant) and V e (extracellular extravascular space fraction) were calculated.

Results

Before CRT, the mean tumour K trans in the downstaged group was significantly higher than that in the non-downstaged group (P = 0.0178), but there was no significant difference between tumour regression grade (TRG) responders and TRG non-responders (P = 0.1392). Repeated-measures analysis of variance (ANOVA) showed significant differences for evolution of K trans values both between downstaged and non-downstaged groups (P = 0.0215) and between TRG responders and TRG non-responders (P = 0.0001). Regarding V e, no significant differences were observed both between downstaged and non-downstaged groups (P = 0.689) or between TRG responders and TRG non-responders (P = 0.887).

Conclusion

Perfusion MRI of rectal cancer can be useful for assessing tumoural K trans changes by CRT. Tumours with high pre-CRT K trans values tended to respond favourably to CRT, particularly in terms of downstaging criteria.

Key Points

• Perfusion MRI can now assess therapeutic response of tumours to therapy.

• Tumours with high initial K trans values responded favourably to chemoradiotherapy.

• Perfusion MRI of rectal cancer may help with decisions about management.

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Acknowledgments

This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health Welfare, Republic of Korea (A070001).

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Authors and Affiliations

  1. Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, Seoul, Republic of Korea

    Joon Seok Lim, Song-Ee Baek, Myeong-Jin Kim, Jinsuk Suh & Ki Whang Kim

  2. Molecular Imaging & Therapy Branch, National Cancer Center, Goyangsi, Republic of Korea

    Daehong Kim

  3. Department of Medical Information, Jungwon University, Goesan-eup, Republic of Korea

    Sungmin Myoung

  4. Department of Pathology, Yonsei University Health System, Seoul, Republic of Korea

    Junjeong Choi

  5. Department of Internal Medicine, Yonsei University Health System, Seoul, Republic of Korea

    Sang Joon Shin

  6. Department of Surgery, Yonsei University Health System, Seoul, Republic of Korea

    Nam Kyu Kim

  7. Department of Radiation Oncology, Yonsei University Health System, Seodaemun-ku, Shinchon-dong 134, Seoul, 120-752, Republic of Korea

    Ki Chang Keum

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  1. Joon Seok Lim
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  2. Daehong Kim
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  9. Jinsuk Suh
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Corresponding author

Correspondence to Ki Chang Keum.

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Lim, J.S., Kim, D., Baek, SE. et al. Perfusion MRI for the prediction of treatment response after preoperative chemoradiotherapy in locally advanced rectal cancer. Eur Radiol 22, 1693–1700 (2012). https://doi.org/10.1007/s00330-012-2416-3

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  • DOI: https://doi.org/10.1007/s00330-012-2416-3

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