Dynamic contrast-enhanced MRI for treatment response assessment in patients with oesophageal cancer receiving neoadjuvant chemoradiotherapy.

Autor: Heethuis SE; Department of Radiotherapy, University Medical Center Utrecht, Netherlands. Electronic address: s.e.heethuis@umcutrecht.nl., van Rossum PS; Department of Radiotherapy, University Medical Center Utrecht, Netherlands; Department of Surgery, University Medical Center Utrecht, Netherlands., Lips IM; Department of Radiotherapy, University Medical Center Utrecht, Netherlands., Goense L; Department of Radiotherapy, University Medical Center Utrecht, Netherlands; Department of Surgery, University Medical Center Utrecht, Netherlands., Voncken FE; Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands., Reerink O; Department of Radiotherapy, University Medical Center Utrecht, Netherlands., van Hillegersberg R; Department of Surgery, University Medical Center Utrecht, Netherlands., Ruurda JP; Department of Surgery, University Medical Center Utrecht, Netherlands., Philippens ME; Department of Radiotherapy, University Medical Center Utrecht, Netherlands., van Vulpen M; Department of Radiotherapy, University Medical Center Utrecht, Netherlands., Meijer GJ; Department of Radiotherapy, University Medical Center Utrecht, Netherlands., Lagendijk JJ; Department of Radiotherapy, University Medical Center Utrecht, Netherlands., van Lier AL; Department of Radiotherapy, University Medical Center Utrecht, Netherlands.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2016 Jul; Vol. 120 (1), pp. 128-35. Date of Electronic Publication: 2016 Jun 10.
DOI: 10.1016/j.radonc.2016.05.009
Abstrakt: Purpose: To explore and evaluate the potential value of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for the prediction of pathologic response to neoadjuvant chemoradiotherapy (nCRT) in oesophageal cancer.
Material and Methods: Twenty-six patients underwent DCE-MRI before, during (week 2-3) and after nCRT, but before surgery (pre/per/post, respectively). Histopathologic tumour regression grade (TRG) was assessed after oesophagectomy. Tumour area-under-the-concentration time curve (AUC), time-to-peak (TTP) and slope were calculated. The ability of these DCE-parameters to distinguish good responders (GR, TRG 1-2) from poor responders (noGR, TRG⩾3), and pathologic complete responders (pCR) from no-pCR was assessed.
Results: Twelve patients (48%) showed GR of which 8 patients (32%) pCR. Analysis of AUC change throughout treatment, AUCper-pre, was most predictive for GR, at a threshold of 22.7% resulting in a sensitivity of 92%, specificity of 77%, PPV of 79%, and a NPV of 91%. AUCpost-pre was most predictive for pCR, at a threshold of -24.6% resulting in a sensitivity of 83%, specificity of 88%, PPV of 71%, and a NPV of 93%. TTP and slope were not associated with pathologic response.
Conclusions: This study demonstrates that changes in AUC throughout treatment are promising for prediction of histopathologic response to nCRT for oesophageal cancer.
(Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: