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The Evaluation of Esophageal Adenocarcinoma Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Although neoadjuvant chemoradiation eradicates esophageal adenocarcinoma in a substantial proportion of patients, conventional imaging techniques cannot accurately detect this response. Dynamic contrast-enhanced magnetic resonance imaging is an emerging approach that may be well suited to fill this role. This pilot study evaluates the ability of this method to discriminate adenocarcinoma from normal esophageal tissue. Patients with esophageal adenocarcinoma and control subjects underwent scanning. Patients treated with neoadjuvant therapy underwent pre- and postchemoradiation scans. Parameters were extracted for each pixel were K trans (equilibrium rate for transfer of contrast reagent across the vascular wall), v e (volume fraction of interstitial space), and τ i (mean intracellular water lifetime). Five esophageal adenocarcinoma patients and two tumor-free control subjects underwent scanning. The mean K trans value was 5.7 times greater in esophageal adenocarcinoma, and τ i is 2.0 times smaller, than in the control subjects. K trans decreased by 11.4-fold after chemoradiation. Parametric maps qualitatively demonstrate a difference in K trans. DCE MRI of the esophagus is feasible. K trans, a parameter that has demonstrated discriminative ability in other malignancies, also shows promise in differentiating esophageal adenocarcinoma from benign tissue. The determination of K trans represents an in vivo assay for endothelial permeability and thus may serve as a quantitative measure of response to induction chemoradiation.

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Acknowledgement

Financial support is provided by SAGES Research Grant (EYC), Medical Research Foundation of Oregon Early Clinical Investigator Grant (EYC), OHSU GCRC Mentored Medical Student Clinical Research Award (RAP), and NIH grants RO1 NS40801 and RO1 EB00422 (CSS).

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Authors and Affiliations

  1. Department of Surgery, Oregon Health & Science University, Mail Code L223, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA

    Eugene Y. Chang, Ryan A. Priest, C. Kristian Enestvedt & Blair A. Jobe

  2. Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA

    Xin Li, Michael Jerosch-Herold, Jingang Xu & Charles S. Springer Jr.

  3. Department of Surgery, Portland VA Medical Center, Portland, OR, P3OC, USA

    Blair A. Jobe

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  1. Eugene Y. Chang
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  2. Xin Li
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Correspondence to Blair A. Jobe.

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Chang, E.Y., Li, X., Jerosch-Herold, M. et al. The Evaluation of Esophageal Adenocarcinoma Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging. J Gastrointest Surg 12, 166–175 (2008). https://doi.org/10.1007/s11605-007-0253-5

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  • DOI: https://doi.org/10.1007/s11605-007-0253-5

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