Tarallo Nicola, Angeretti Maria Gloria, Bracchi Elena, Xhepa Genti, Molinelli Valeria, Tagliaferri Chiara, Antognoni Paolo, Novario Raffaele, Sessa Fausto, Fugazzola Carlo
Università degli Studi dell'Insubria - Circolo Hospital and Macchi Foundation, Italy.
Pol J Radiol. 2018 Dec 17;83:e600-e609. doi: 10.5114/pjr.2018.81156. eCollection 2018.
To assess the diagnostic performance of diffusion-weighted imaging (DWI) for the discrimination of complete responder (CR) from the non-complete responder (n-CR) in patients with locally advanced rectal cancer (LARC) undergoing chemotherapy and radiation (CRT).
Between December 2009 and January 2014, 32 patients (33 lesions: one patient had two synchronous lesions) were enrolled in this retrospective study. All patients underwent a pre- and post-CRT conventional MRI study completed with DWI. For both data sets (T2-weighted and DWI), the pre- and post-CRT tumour volume (V; V) and the tumour volume reduction ratio (ΔV%) were determined as well as pre- and post-CRT apparent diffusion coefficient (ADC) and ADC change (ΔADC%). Histopathological findings were the standard of reference. Receiver operating characteristic (ROC) curves were generated to compare performance of T2-weighted and DWI volumetry, as well as ADC.
The area under the ROC curve (AUC) revealed a good accuracy of pre- and post-CRT values of V (0.86; 0.91) and V (0.82; 1.00) as well as those of ΔV% (0.84) and ΔV% (1.00) for the CR assessment, with no statistical difference. The AUC of pre- and post-CRT ADC (0.53; 0.54) and that of ΔADC% (0.58) were significantly lower.
Both post-CRT V and ΔV% (AUC = 1) are very accurate for the assessment of the CR, in spite of no significant differences in comparison to the conventional post-CRT V (AUC = 0.91) and ΔV% (AUC = 0.84). On the contrary, both ADC and ΔADC% values are not reliable.
评估弥散加权成像（DWI）在鉴别接受化疗和放疗（CRT）的局部晚期直肠癌（LARC）患者中完全缓解者（CR）与非完全缓解者（n-CR）方面的诊断性能。
2009年12月至2014年1月，32例患者（33个病灶：1例患者有两个同步病灶）纳入本回顾性研究。所有患者在CRT前后均接受了常规MRI检查并完成了DWI检查。对于两个数据集（T2加权和DWI），测定了CRT前后的肿瘤体积（V；V）、肿瘤体积缩小率（ΔV%）以及CRT前后的表观扩散系数（ADC）和ADC变化（ΔADC%）。组织病理学结果为参考标准。绘制受试者操作特征（ROC）曲线以比较T2加权和DWI体积测量以及ADC的性能。
ROC曲线下面积（AUC）显示，CRT前后的V值（0.86；0.91）、V值（0.82；1.00）以及ΔV%（0.84）和ΔV%（1.00）在CR评估方面具有良好的准确性，无统计学差异。CRT前后ADC的AUC（0.53；0.54）和ΔADC%的AUC（0.58）显著较低。
尽管与常规的CRT后V值（AUC = 0.91）和ΔV%（AUC = 0.84）相比无显著差异，但CRT后的V值和ΔV%（AUC = 1）在评估CR方面非常准确。相反，ADC和ΔADC%值不可靠。
