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Published on: April 18, 2015
Dynamic contrast-enhanced MRI for advanced esophageal cancer response assessment after concurrent chemoradiotherapy
Na-Na Sun1, Chang Liu1, Xiao-Lin Ge2
1Departments of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Purpose:
We aimed to evaluate the treatment response of patients with esophageal cancer after concurrent chemoradiation therapy (CRT) using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).
Methods:
This retrospective study included 59 patients with histologically confirmed esophageal squamous cell carcinoma. The patients underwent DCE-MRI before and 4 weeks after CRT. Patients with complete response were defined as the CR group; partial response, stable disease, and progressive disease patients were defined as the non-CR group. DCE-MRI parameters (Ktrans, Ve, and Kep) were measured and compared between pre- and post-CRT in the CR and non-CR groups, respectively. Pre-CRT and post-CRT parameters were used to calculate the absolute change and the ratio of change. DCE-MRI parameters were compared between the CR and non-CR groups. Receiver operating characteristic (ROC) curves were used to verify diagnostic performance.
Results:
Patients with higher T-stage esophageal cancer might present with poorer response. After CRT, the Ktrans and Kep values significantly decreased in the CR group, whereas only Kep value decreased in the non-CR group. The post-Ktrans and post-Kep values were observed to be significantly lower in the CR group than in the non-CR group. The absolute change and ratio of change of both Ktrans and Kep were higher in the CR group than in the non-CR group. Based on ROC analysis, the ratio of change in Ktrans was the best parameter to assess treatment response (AUC= 0.840).
Conclusion:
DCE-MRI parameters are valuable in predicting and assessing concurrent CRT response for advanced esophageal cancer.
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