Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
J Ultrasound Med. 2021 Jan;40(1):81-89. doi: 10.1002/jum.15378. Epub 2020 Jul 10.
The aim of this study was to assess the application value of shear wave elastography in the evaluation of tumor downstaging for locally advanced rectal cancer after neoadjuvant chemoradiotherapy.
A retrospective analysis was conducted using data from patients with locally advanced rectal cancer treated in our hospital who received endorectal ultrasound (ERUS) and shear wave elastographic examinations before and after chemoradiotherapy. The cases were grouped according to the postoperative pathologic tumor-staging scores. The lesions were divided into 2 groups: 1 showing and the other not showing tumor downstaging. The efficacy of ERUS in diagnosis of tumor downstaging was calculated. The differences in the mean and maximum values of the Young modulus of the lesions before and after chemoradiotherapy between the groups were calculated and compared. Receiver operating characteristic curves were constructed by using the differences in the 2 kinds of values of the Young modulus.
The mean and maximum values of the Young modulus before and after chemoradiotherapy were significantly different (P < .05). The differences in the mean and maximum values of the Young modulus of rectal lesions between groups were statistically significant (P < .05). The results of the receiver operating characteristic curve showed that a difference in the mean value at 34.7 kPa was the optimal diagnostic threshold. Compared with ERUS, this standard showed a significant difference in diagnosis of tumor downstaging (P < .05).
Shear wave elastography is an effective ultrasound elastographic technique to assist ERUS in evaluating lesions after chemoradiotherapy in rectal cancer. It can improve the diagnostic efficacy of tumor downstaging and provide effective imaging conclusions for clinical decision making.
本研究旨在评估剪切波弹性成像在评价新辅助放化疗后局部进展期直肠癌肿瘤降期中的应用价值。
回顾性分析我院经直肠腔内超声（ERUS）和剪切波弹性成像检查的局部进展期直肠癌患者的资料，根据术后病理肿瘤分期评分将病例分组。将病灶分为降期组和未降期组。计算 ERUS 诊断肿瘤降期的效能，计算病灶治疗前后杨氏模量的均值和最大值的差异，并比较组间差异。构建杨氏模量两种值差异的受试者工作特征曲线。
放化疗前后杨氏模量的均值和最大值差异均有统计学意义（P < .05）。放化疗前后直肠病灶杨氏模量的均值和最大值差异均有统计学意义（P < .05）。受试者工作特征曲线结果显示，杨氏模量均值 34.7 kPa 的差异为最佳诊断阈值。与 ERUS 相比，该标准在肿瘤降期诊断方面具有显著差异（P < .05）。
剪切波弹性成像技术是一种有效的超声弹性成像技术，可辅助 ERUS 评估直肠癌放化疗后病灶，提高肿瘤降期诊断效能，为临床决策提供有效的影像学结论。
