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Apparent diffusion coefficient for lymph node characterization after chemoradiation therapy for locally advanced
Seung Ho Kim1, Kyeong Hwa Ryu2, Jung-Hee Yoon2
1Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea radiresi@gmail.com.
Acta Radiologica (Stockholm, Sweden : 1987)
|November 27, 2014
Summary
Apparent diffusion coefficient (ADC) and lymph node (LN) size show comparable diagnostic performance for characterizing LNs after neoadjuvant chemoradiation therapy (CRT). This finding aids in refining treatment plans based on post-therapy LN status.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Accurate lymph node (LN) status assessment is crucial for guiding treatment decisions after neoadjuvant chemoradiation therapy (CRT).
- Distinguishing between metastatic and non-metastatic LNs post-CRT is essential for patient management.
Purpose of the Study:
- To evaluate the diagnostic performance of apparent diffusion coefficient (ADC) for LN characterization following CRT.
- To compare the efficacy of ADC measurements against traditional LN size measurements for LN characterization.
Main Methods:
- Fifty-three patients undergoing CRT and surgery were analyzed using 1.5-T MRI.
- Apparent diffusion coefficient (ADC) values and sizes of regional LNs were measured post-CRT.
- Histopathological examination served as the reference standard, with ROC curve analysis performed to assess diagnostic performance.
Main Results:
- A total of 115 LNs (29 metastatic, 86 non-metastatic) were analyzed.
- Metastatic LNs exhibited significantly higher mean ADC values and larger mean sizes compared to non-metastatic LNs (P < 0.0001 for ADC, P = 0.0078 for size).
- The diagnostic performance, as indicated by the area under the ROC curve, was comparable between ADC and LN size (P = 0.4090).
Conclusions:
- Apparent diffusion coefficient (ADC) demonstrates a diagnostic performance for LN characterization after CRT that is comparable to LN size.
- ADC measurements offer a valuable tool in conjunction with size for assessing LN status post-CRT.
- These findings support the integration of ADC in imaging protocols for improved post-CRT nodal staging.
