Apparent diffusion coefficient histogram analysis for predicting neoadjuvant chemoradiotherapy response in patients...

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Locally advanced rectal cancer (LARC) requires effective treatment response prediction for neoadjuvant chemoradiotherapy (CRT).
• Accurate assessment of CRT response is crucial for tailoring treatment strategies and improving patient outcomes.

Purpose of the Study:

• To retrospectively evaluate the efficacy of apparent diffusion coefficient (ADC) histograms in predicting CRT response in LARC patients.
• To identify specific ADC histogram parameters that correlate with treatment response.

Main Methods:

• Retrospective analysis of 51 LARC patients who received neoadjuvant CRT and surgery.
• Evaluation of conventional MR and diffusion-weighted images before and after CRT using histogram analysis software.
• Receiver operating characteristic (ROC) analysis to determine ADC cutoff values for predicting CRT response.

Main Results:

• Significant changes in ADC histogram parameters (mean, percentiles, skewness, kurtosis) were observed in partial and complete responders after CRT.
• Skewness value from post-CRT ADC histogram demonstrated the highest diagnostic performance (AUC=0.851, P=.003) for identifying complete responders.
• A skewness cutoff of 0.210 achieved 100% sensitivity and 61.4% specificity for predicting complete CRT response.

Conclusions:

• ADC histogram analysis is a promising non-invasive tool for predicting neoadjuvant CRT response in LARC.
• Post-treatment ADC histogram features, particularly skewness, can effectively differentiate between varying levels of treatment response.
• This technique may aid in optimizing treatment decisions for LARC patients.