DCE-MRI time–intensity curve visual inspection to assess pathological response after neoadjuvant therapy in locally advanced rectal cancer

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate the potential of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to discriminate responder from non-responder patients after preoperative chemoradiotherapy (pCRT) in locally advanced rectal cancer (LARC). Materials and methods: One hundred and fifty-eight consecutive patients were enrolled in this prospective study. We compared morphological MRI (mMRI) using T2-weighted images about tumor presence and invasiveness, and functional DCE-MRI using time–intensity curve (TIC) visual inspection (qMRI), classifying TIC shape into three types: type 1, persistent enhancement; type 2, high enhancement with plateau; type 3, high enhancement with wash-out. Clinical TNM was obtained before and after CRT by radiological consensus of two expert radiologists. Pathological tumor–nodes–metastasis classification and tumor regression grade (TRG) were confirmed as the golden standard. Non-parametric test, sensitivity, specificity, and positive and negative predictive values were calculated. Results: Ninety-eight patients (62%) were classified as responders (TRG ≤ 2), while 60 (38%) were classified as non-responders. Sensitivity, specificity, and accuracy were 52, 78, and 62% for mMRI, and 81, 85, and 82% for qMRI, respectively. Conclusions: TIC visual inspection may be one of the potential biomarkers over morphological analysis using DCE-MRI data to assess pathological response after pCRT in LARC.

Original languageEnglish
JournalJapanese Journal of Radiology
DOIs
Publication statusPublished - 2018

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Neoadjuvant Therapy
Rectal Neoplasms
Magnetic Resonance Imaging
Chemoradiotherapy
Sensitivity and Specificity
Neoplasms
Biomarkers
Prospective Studies

Keywords

  • DCE-MRI
  • Functional assessment
  • Neoadjuvant therapy
  • Rectal cancer
  • Tumor response

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{bb3722778a064207acd3e2b5eab42564,
title = "DCE-MRI time–intensity curve visual inspection to assess pathological response after neoadjuvant therapy in locally advanced rectal cancer",
abstract = "Purpose: To investigate the potential of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to discriminate responder from non-responder patients after preoperative chemoradiotherapy (pCRT) in locally advanced rectal cancer (LARC). Materials and methods: One hundred and fifty-eight consecutive patients were enrolled in this prospective study. We compared morphological MRI (mMRI) using T2-weighted images about tumor presence and invasiveness, and functional DCE-MRI using time–intensity curve (TIC) visual inspection (qMRI), classifying TIC shape into three types: type 1, persistent enhancement; type 2, high enhancement with plateau; type 3, high enhancement with wash-out. Clinical TNM was obtained before and after CRT by radiological consensus of two expert radiologists. Pathological tumor–nodes–metastasis classification and tumor regression grade (TRG) were confirmed as the golden standard. Non-parametric test, sensitivity, specificity, and positive and negative predictive values were calculated. Results: Ninety-eight patients (62{\%}) were classified as responders (TRG ≤ 2), while 60 (38{\%}) were classified as non-responders. Sensitivity, specificity, and accuracy were 52, 78, and 62{\%} for mMRI, and 81, 85, and 82{\%} for qMRI, respectively. Conclusions: TIC visual inspection may be one of the potential biomarkers over morphological analysis using DCE-MRI data to assess pathological response after pCRT in LARC.",
keywords = "DCE-MRI, Functional assessment, Neoadjuvant therapy, Rectal cancer, Tumor response",
author = "Antonella Petrillo and Roberta Fusco and Mario Petrillo and Vincenza Granata and Francesco Bianco and {Di Marzo}, Massimiliano and Paolo Delrio and Fabiana Tatangelo and Gerardo Botti and Biagio Pecori and Antonio Avallone",
year = "2018",
doi = "10.1007/s11604-018-0760-1",
language = "English",
journal = "Japanese Journal of Radiology",
issn = "1867-1071",
publisher = "Springer Japan",

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TY - JOUR

T1 - DCE-MRI time–intensity curve visual inspection to assess pathological response after neoadjuvant therapy in locally advanced rectal cancer

AU - Petrillo, Antonella

AU - Fusco, Roberta

AU - Petrillo, Mario

AU - Granata, Vincenza

AU - Bianco, Francesco

AU - Di Marzo, Massimiliano

AU - Delrio, Paolo

AU - Tatangelo, Fabiana

AU - Botti, Gerardo

AU - Pecori, Biagio

AU - Avallone, Antonio

PY - 2018

Y1 - 2018

N2 - Purpose: To investigate the potential of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to discriminate responder from non-responder patients after preoperative chemoradiotherapy (pCRT) in locally advanced rectal cancer (LARC). Materials and methods: One hundred and fifty-eight consecutive patients were enrolled in this prospective study. We compared morphological MRI (mMRI) using T2-weighted images about tumor presence and invasiveness, and functional DCE-MRI using time–intensity curve (TIC) visual inspection (qMRI), classifying TIC shape into three types: type 1, persistent enhancement; type 2, high enhancement with plateau; type 3, high enhancement with wash-out. Clinical TNM was obtained before and after CRT by radiological consensus of two expert radiologists. Pathological tumor–nodes–metastasis classification and tumor regression grade (TRG) were confirmed as the golden standard. Non-parametric test, sensitivity, specificity, and positive and negative predictive values were calculated. Results: Ninety-eight patients (62%) were classified as responders (TRG ≤ 2), while 60 (38%) were classified as non-responders. Sensitivity, specificity, and accuracy were 52, 78, and 62% for mMRI, and 81, 85, and 82% for qMRI, respectively. Conclusions: TIC visual inspection may be one of the potential biomarkers over morphological analysis using DCE-MRI data to assess pathological response after pCRT in LARC.

AB - Purpose: To investigate the potential of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to discriminate responder from non-responder patients after preoperative chemoradiotherapy (pCRT) in locally advanced rectal cancer (LARC). Materials and methods: One hundred and fifty-eight consecutive patients were enrolled in this prospective study. We compared morphological MRI (mMRI) using T2-weighted images about tumor presence and invasiveness, and functional DCE-MRI using time–intensity curve (TIC) visual inspection (qMRI), classifying TIC shape into three types: type 1, persistent enhancement; type 2, high enhancement with plateau; type 3, high enhancement with wash-out. Clinical TNM was obtained before and after CRT by radiological consensus of two expert radiologists. Pathological tumor–nodes–metastasis classification and tumor regression grade (TRG) were confirmed as the golden standard. Non-parametric test, sensitivity, specificity, and positive and negative predictive values were calculated. Results: Ninety-eight patients (62%) were classified as responders (TRG ≤ 2), while 60 (38%) were classified as non-responders. Sensitivity, specificity, and accuracy were 52, 78, and 62% for mMRI, and 81, 85, and 82% for qMRI, respectively. Conclusions: TIC visual inspection may be one of the potential biomarkers over morphological analysis using DCE-MRI data to assess pathological response after pCRT in LARC.

KW - DCE-MRI

KW - Functional assessment

KW - Neoadjuvant therapy

KW - Rectal cancer

KW - Tumor response

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