Department of Diagnostic Radiology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University, Changsha, 410013, Hunan, P.R. China.
Department of Radiotherapy, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University, Changsha, 410013, Hunan, P.R. China.
Sci Rep. 2017 Aug 17;7(1):8496. doi: 10.1038/s41598-017-09227-9.
To investigate the usefulness of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in discriminating the pathological complete response (pCR) to neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC), 42 patients underwent preoperative IVIM-DWI before (pre-nCRT) and after nCRT (post-nCRT). The values of pre-nCRT and post-nCRT IVIM-DWI parameters (ADC, D, D* and f), together with the percentage changes (∆% parametric value) induced by nCRT, were compared between the pCR (tumour regression grade [TRG] 4) and non-pCR (TRG 0, 1, 2 or 3) groups and between the GR (TRG 3 or 4) and PR (TRG 0, 1 or 2) groups based on the Dworak TRG system. After nCRT, the ADC and D values for LARC increased significantly (all P < 0.05). The TRG score revealed a positive correlation with pref (r = 0.357, P = 0.020), postD (r = 0.551, P < 0.001) and Δ%D (r = 0.605, P < 0.001). The pCR group (n = 10) had higher preD*, pref, postD, ∆%ADC and ∆%D values than the non-pCR group (n = 32) (all P < 0.05). The GR group (n = 15) exhibited higher postD, ∆%ADC and ∆%D values than the PR group (n = 27) (all P < 0.05). Based on ROC analysis, ∆%D had a higher area under the curve value than ∆%ADC (P = 0.009) in discriminating the pCR from non-pCR groups. In conclusion, IVIM-DWI may be helpful in identifying the pCR to nCRT for LARC and is more accurate than traditional DWI.
为了研究体素内不相干运动扩散加权成像（IVIM-DWI）在鉴别局部晚期直肠癌（LARC）新辅助放化疗（nCRT）病理完全缓解（pCR）中的作用，42 例患者在术前（pre-nCRT）和 nCRT 后（post-nCRT）进行了 IVIM-DWI。比较了 pCR（肿瘤消退分级[TRG]4）和非 pCR（TRG 0、1、2 或 3）组以及完全缓解（TRG 3 或 4）和部分缓解（TRG 0、1 或 2）组之间的 pre-nCRT 和 post-nCRT IVIM-DWI 参数（ADC、D、D和 f）值，以及 nCRT 引起的百分比变化（∆%参数值），并基于 Dworak TRG 系统进行分析。nCRT 后，LARC 的 ADC 和 D 值显著升高（均 P<0.05）。TRG 评分与 pref（r=0.357，P=0.020）、postD（r=0.551，P<0.001）和 ∆%D（r=0.605，P<0.001）呈正相关。pCR 组（n=10）的 preD、pref、postD、∆%ADC 和 ∆%D 值均高于非 pCR 组（n=32）（均 P<0.05）。GR 组（n=15）的 postD、∆%ADC 和 ∆%D 值均高于 PR 组（n=27）（均 P<0.05）。基于 ROC 分析，∆%D 在鉴别 pCR 和非 pCR 组方面的曲线下面积值高于 ∆%ADC（P=0.009）。总之，IVIM-DWI 有助于识别 LARC 的 nCRT 病理完全缓解，且比传统 DWI 更准确。
