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Predicting response to neoadjuvant chemoradiation therapy in locally advanced rectal cancer: Diffusion-weighted 3 tesla MR imaging

Authors

  • Se Hee Jung MD,

    1. Department of Radiology, Chonnam National University Hospital, Dong-gu, Gwangju, South Korea
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  • Suk Hee Heo MD,

    1. Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun-eup, Hwasun-gun, Jeollanam-do, South Korea
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  • Jin Woong Kim MD,

    1. Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun-eup, Hwasun-gun, Jeollanam-do, South Korea
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  • Yong Yeon Jeong MD,

    Corresponding author
    1. Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun-eup, Hwasun-gun, Jeollanam-do, South Korea
    • Chonnam National University Hwasun Hospital, #160 Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do, 519-809, South Korea
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  • Sang Soo Shin MD,

    1. Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Dong-gu, Gwangju, South Korea
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  • Min-Gyu Soung PhD,

    1. Division of Applied Biology and Chemistry, College of Agriculture and Life Science, Chungnam National University, Daejeon South Korea
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  • Heong Rok Kim MD,

    1. Department of Surgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun-eup, Hwasun-gun, Jeollanam-do, South Korea
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  • Heoung Keun Kang MD

    1. Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun-eup, Hwasun-gun, Jeollanam-do, South Korea
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Abstract

Purpose:

To evaluate the efficacy of diffusion-weighted imaging (DWI) on 3 Tesla (T) MR imaging to predict the tumor response to neoadjuvant chemoradiation therapy (CRT) in patients with locally advanced rectal cancer.

Materials and Methods:

Thirty-five patients who underwent neoadjuvant CRT and subsequent surgical resection were included. Tumor volume was measured on T2-weighted MR images before and after neoadjuvant CRT and the percentage of tumor volume reduction was calculated. The apparent diffusion coefficient (ADC) value was measured on the DWI before and after neoadjuvant CRT, and the change of ADC (Δ ADC) was calculated. The histopathologic response was categorized either as a responder to CRT or as a nonresponder. The relationship between the ADC parameters and the percentage of tumor volume reduction or histopathologic response was then evaluated.

Results:

There was a significant correlation between tumor volume reduction and pre-CRT ADC and Δ ADC, respectively (r = −0.352, r = 0.615). Pre-CRT ADC of the histopathologic responders was significantly lower than that of the histopathologic nonresponders (P = 0.034). Δ ADC of the histopathologic responders was significantly higher than that of the histopathologic nonresponders (P < 0.005).

Conclusion:

DWI on 3T MR imaging may be a promising technique for helping to predict and monitor the treatment response to neoadjuvant CRT in patients with locally advanced rectal cancer. J. Magn. Reson. Imaging 2012;35:110-116. © 2011 Wiley Periodicals, Inc.

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