Dynamic contrast-enhanced MRI to evaluate the therapeutic response to neoadjuvant chemoradiation therapy in locally advanced rectal cancer

Seung Ho Kim, Jeong Min Lee, Sandeep N. Gupta, Joon Koo Han, Byung Ihn Choi

Research output: Contribution to journalArticle

Abstract

Purpose To evaluate the usefulness of perfusion parameters derived from dynamic contrast-enhanced MR imaging (DCE-MRI) for assessing the therapeutic response to neoadjuvant chemoradiation therapy (CRT) for locally advanced rectal cancer (LARC). Materials and Methods Fifty patients with LARC (≥T3 or lymph-node metastasis) who underwent CRT and subsequent surgery, were included in this study. All patients underwent pre- and post-CRT DCE-MRI on a 1.5 Tesla unit. By using a postprocessing software, the following perfusion parameters (Ktrans, kep, ve) were measured for tumor. Those perfusion parameters were compared not only between the T-downstaged group and the nondownstaged group, but also before and after CRT in each group. Results After CRT, the mean Ktrans (min-1) significantly decreased from 1.24 ± 0.53 to 0.76 ± 0.45 in the T-downstaged group (n = 24) (P = 0.0007), whereas it did not significantly decrease in the nondownstaged group (n = 26) (from 1.02 ± 0.53 to 0.87 ± 0.48, P = 0.24). The percentage difference between pre- and post-CRT Ktrans in the T-downstaged group was significantly higher than that in the nondownstaged group (43%, 16%, respectively, P = 0.0092). However, none of the other parameters showed significant differences. Conclusion A large decrease in the mean Ktrans after CRT was associated with a good therapeutic response to CRT for LARC.

Original languageEnglish (US)
Pages (from-to)730-737
Number of pages8
JournalJournal of Magnetic Resonance Imaging
Volume40
Issue number3
DOIs
StatePublished - 2014
Externally publishedYes

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Neoadjuvant Therapy
Rectal Neoplasms
Therapeutics
Perfusion
Software
Lymph Nodes
Neoplasm Metastasis

Keywords

  • chemoradiation
  • dynamic contrast-enhanced magnetic resonance imaging
  • neoplasms
  • perfusion
  • rectum
  • therapeutic response

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Dynamic contrast-enhanced MRI to evaluate the therapeutic response to neoadjuvant chemoradiation therapy in locally advanced rectal cancer. / Kim, Seung Ho; Lee, Jeong Min; Gupta, Sandeep N.; Han, Joon Koo; Choi, Byung Ihn.

In: Journal of Magnetic Resonance Imaging, Vol. 40, No. 3, 2014, p. 730-737.

Research output: Contribution to journalArticle

Kim, Seung Ho ; Lee, Jeong Min ; Gupta, Sandeep N. ; Han, Joon Koo ; Choi, Byung Ihn. / Dynamic contrast-enhanced MRI to evaluate the therapeutic response to neoadjuvant chemoradiation therapy in locally advanced rectal cancer. In: Journal of Magnetic Resonance Imaging. 2014 ; Vol. 40, No. 3. pp. 730-737.
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abstract = "Purpose To evaluate the usefulness of perfusion parameters derived from dynamic contrast-enhanced MR imaging (DCE-MRI) for assessing the therapeutic response to neoadjuvant chemoradiation therapy (CRT) for locally advanced rectal cancer (LARC). Materials and Methods Fifty patients with LARC (≥T3 or lymph-node metastasis) who underwent CRT and subsequent surgery, were included in this study. All patients underwent pre- and post-CRT DCE-MRI on a 1.5 Tesla unit. By using a postprocessing software, the following perfusion parameters (Ktrans, kep, ve) were measured for tumor. Those perfusion parameters were compared not only between the T-downstaged group and the nondownstaged group, but also before and after CRT in each group. Results After CRT, the mean Ktrans (min-1) significantly decreased from 1.24 ± 0.53 to 0.76 ± 0.45 in the T-downstaged group (n = 24) (P = 0.0007), whereas it did not significantly decrease in the nondownstaged group (n = 26) (from 1.02 ± 0.53 to 0.87 ± 0.48, P = 0.24). The percentage difference between pre- and post-CRT Ktrans in the T-downstaged group was significantly higher than that in the nondownstaged group (43{\%}, 16{\%}, respectively, P = 0.0092). However, none of the other parameters showed significant differences. Conclusion A large decrease in the mean Ktrans after CRT was associated with a good therapeutic response to CRT for LARC.",
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N2 - Purpose To evaluate the usefulness of perfusion parameters derived from dynamic contrast-enhanced MR imaging (DCE-MRI) for assessing the therapeutic response to neoadjuvant chemoradiation therapy (CRT) for locally advanced rectal cancer (LARC). Materials and Methods Fifty patients with LARC (≥T3 or lymph-node metastasis) who underwent CRT and subsequent surgery, were included in this study. All patients underwent pre- and post-CRT DCE-MRI on a 1.5 Tesla unit. By using a postprocessing software, the following perfusion parameters (Ktrans, kep, ve) were measured for tumor. Those perfusion parameters were compared not only between the T-downstaged group and the nondownstaged group, but also before and after CRT in each group. Results After CRT, the mean Ktrans (min-1) significantly decreased from 1.24 ± 0.53 to 0.76 ± 0.45 in the T-downstaged group (n = 24) (P = 0.0007), whereas it did not significantly decrease in the nondownstaged group (n = 26) (from 1.02 ± 0.53 to 0.87 ± 0.48, P = 0.24). The percentage difference between pre- and post-CRT Ktrans in the T-downstaged group was significantly higher than that in the nondownstaged group (43%, 16%, respectively, P = 0.0092). However, none of the other parameters showed significant differences. Conclusion A large decrease in the mean Ktrans after CRT was associated with a good therapeutic response to CRT for LARC.

AB - Purpose To evaluate the usefulness of perfusion parameters derived from dynamic contrast-enhanced MR imaging (DCE-MRI) for assessing the therapeutic response to neoadjuvant chemoradiation therapy (CRT) for locally advanced rectal cancer (LARC). Materials and Methods Fifty patients with LARC (≥T3 or lymph-node metastasis) who underwent CRT and subsequent surgery, were included in this study. All patients underwent pre- and post-CRT DCE-MRI on a 1.5 Tesla unit. By using a postprocessing software, the following perfusion parameters (Ktrans, kep, ve) were measured for tumor. Those perfusion parameters were compared not only between the T-downstaged group and the nondownstaged group, but also before and after CRT in each group. Results After CRT, the mean Ktrans (min-1) significantly decreased from 1.24 ± 0.53 to 0.76 ± 0.45 in the T-downstaged group (n = 24) (P = 0.0007), whereas it did not significantly decrease in the nondownstaged group (n = 26) (from 1.02 ± 0.53 to 0.87 ± 0.48, P = 0.24). The percentage difference between pre- and post-CRT Ktrans in the T-downstaged group was significantly higher than that in the nondownstaged group (43%, 16%, respectively, P = 0.0092). However, none of the other parameters showed significant differences. Conclusion A large decrease in the mean Ktrans after CRT was associated with a good therapeutic response to CRT for LARC.

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