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The value of diffusion kurtosis magnetic resonance imaging for assessing treatment response of neoadjuvant chemoradiotherapy in locally advanced rectal cancer

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

Abstract

Objectives

To evaluate the feasibility and value of diffusion kurtosis (DK) imaging in assessing treatment response to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC).

Methods

Forty-one patients were included. All patients underwent pre- and post-CRT DCE-MRI on a 3.0-Tesla MRI scanner. Imaging indices (D app , K app and ADC values) were measured. Change value (∆X) and change ratio (r∆X) were calculated. Pathological tumour regression grade scores (Mandard) were the standard reference (good responders: pTRG 1-2; poor responders: pTRG 3-5). Diagnostic performance was compared using ROC analysis.

Results

For the pre-CRT measurements, pre-D app-10th was significantly lower in the good responder group than that of the poor responder group (p = 0.036). For assessing treatment response to neoadjuvant CRT, pre-D app-10th resulted in AUCs of 0.753 (p = 0.036) with a sensitivity of 66.67 % and a specificity of 77.78 %. The r∆D app had a relatively high AUC (0.859) and high sensitivity (100 %) compared with other image indices.

Conclusions

DKI is feasible for selecting good responders for neoadjuvant CRT for LARC.

Key Points

• LARC responded well after neoadjuvant chemoradiotherapy with lower pre-D app-10th .

• LARC responded well with greater increases in mean ADC and D app .

• The change ratio of D app (r∆D app ) had a relatively better diagnostic performance.

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Abbreviations

ADC:

Apparent diffusion coefficient

CRT:

Chemoradiotherapy

D app :

Apparent diffusion for Gaussian distribution

DKI:

Diffusion kurtosis imaging

K app :

Apparent kurtosis coefficient

LARC:

Locally advanced rectal cancer

mrTRG:

MRI tumour regression grade

pTRG:

Pathological tumour regression grade

ROC:

Receiver operating characteristic

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Acknowledgments

The scientific guarantor of this publication is Hai-Bin Shi. 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. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd, Nanjing, 210029, China

    Jing Yu, Qing Xu, Jia-Cheng Song, Yan Li, Xin Dai, Ling Zhang & Hai-Bin Shi

  2. Department of General Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Dong-Ya Huang

  3. Department of Pathology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Yang Li

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  1. Jing Yu
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Yu, J., Xu, Q., Song, JC. et al. The value of diffusion kurtosis magnetic resonance imaging for assessing treatment response of neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Eur Radiol 27, 1848–1857 (2017). https://doi.org/10.1007/s00330-016-4529-6

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