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Predicting Treatment Response of Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Using Amide Proton Transfer MRI Combined With Diffusion-Weighted Imaging

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机构: [1]Department of Radiology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China, [2]Department of Pathology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
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关键词: Amide proton transfer diffusion-weighted imaging neoadjuvant chemoradiotherapy locally advanced rectal cancer (LARC) treatment response

摘要:
Objective To evaluate amide proton weighted (APTw) MRI combined with diffusion-weighted imaging (DWI) in predicting neoadjuvant chemoradiotherapy (NCRT) response in patients with locally advanced rectal cancer (LARC). Methods 53 patients with LARC were enrolled in this retrospective study. MR examination including APTw MRI and DWI was performed before and after NCRT. APTw SI, ADC value, tumor size, CEA level before and after NCRT were assessed. The difference of the above parameters between before and after NCRT was calculated. The tumor regression grading (TRG) was assessed by American Joint Committee on Cancer's Cancer Staging Manual AJCC 8th score. The Shapiro-Wilk test, paired t-test and Wilcoxon Signed Ranks test, two-sample t-test, Mann-Whitney U test and multivariate analysis were used for statistical analysis. Results Of the 53 patients, 19 had good responses (TRG 0-1), 34 had poor responses (TRG 2-3). After NCRT, all the rectal tumors demonstrated decreased APT values, increased ADC values, reduced tumor volumes and CEA levels (all p < 0.001). Good responders demonstrated higher pre-APT values, higher Delta APT values, lower pre- ADC values and higher Delta tumor volumes than poor responders. Pre-APT combined with pre-ADC achieved the best diagnostic performance, with AUC of 0.895 (sensitivity of 85.29%, specificity of 89.47%, p < 0.001) in predicting good response to NCRT. Conclusion The combination of APTw and DWI may serve as a noninvasive biomarker for evaluating and identifying response to NCRT in LARC patients.

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出版当年[2020]版:
大类 | 2 区 医学
小类 | 3 区 肿瘤学
最新[2025]版:
大类 | 3 区 医学
小类 | 4 区 肿瘤学
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出版当年[2019]版:
Q2 ONCOLOGY
最新[2023]版:
Q2 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版] 出版后一年[2020版]

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第一作者机构: [1]Department of Radiology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China,
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