Diffusion-weighted imaging in rectal cancer: current applications and future perspectives

Schurink, Niels W; Lambregts, Doenja M J; Beets‐Tan, Regina G. H.

doi:10.1259/bjr.20180655

Cited by 117 publications

(94 citation statements)

References 127 publications

(239 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ADC mean measures the magnitude of water molecular diffusion within the tissue. Decreased ADC mean values of tumor are due to increased nuclear size, cytoplasmic proteins, and cytoplasmic viscosity 30 . Tumors with a higher Ki‐67 labeling index, which are characterized by higher proliferative activities and increased cell density, lead to restricted diffusion of water and decreased ADC mean values.…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Amide Proton Transfer MRI and Diffusion‐Weighted Imaging in Assessing p53 and Ki‐67 Expression of Rectal Adenocarcinoma

Chen

Yan

et al. 2020

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Background The evaluation of prognostic factors in rectal carcinoma patients has important clinical significance. P53 status and the Ki‐67 index have served as prognostic factors in rectal carcinoma. Amide proton transfer (APT) imaging has shown great potential in tumor diagnosis. However, few studies reported the value of APT imaging in evaluating p53 and Ki‐67 status of rectal carcinoma. Purpose To investigate the feasibility of amide proton transfer MRI in assessing p53 and Ki‐67 expression of rectal adenocarcinoma, and compare it with conventional diffusion‐weighted imaging (DWI). Study Type Retrospective. Population Forty‐three patients with rectal adenocarcinoma (age: 34–85 years). Field Strength/Sequence 3T/APT imaging using a 3D turbo spin echo (TSE)‐Dixon pulse sequence with chemical shift‐selective fat suppression, 2D DWI, and 2D T2‐weighted TSE. Assessment Mean tumor APT signal intensity (SImean) and apparent diffusion coefficient (ADCmean) were measured. Traditional tumor pathological analysis included WHO grades, pT (pathologic tumor) stages, and pN (pathologic node) stages. Expression levels of p53 and Ki‐67 were determined by immunohistochemical assay. Statistical Tests One‐way analysis of variance (ANOVA); Student's t‐test; Spearman's correlation coefficient; receiver operating characteristic (ROC) curve analysis. Results High‐grade tumors, more advanced stage tumors, and tumors with lymph node involvement had higher APT SImean values: high grade (n = 15) vs. low‐grade (n = 28), P < 0.001; pT2 (n = 10) vs. pT3 (n = 20) vs. pT4 (N = 13), P = 0.021; pN0 (n = 24) vs. pN1‐2 (n = 19), P = 0.019. ADCmean differences were found in tumors with different pT stage: pT2 (n = 10) vs. pT3 (n = 20) vs. pT4 (N = 13), P = 0.013, but not in tumors with different histologic grade: high grade (n = 15) vs. low‐grade (n = 28), P = 0.3536; or pN stage: pN0 (n = 24) vs. pN1‐2 (n = 19), P = 0.624. Tumor with p53 positive status had higher APT SImean than tumor with negative p53 status (2.363 ± 0.457 vs. 2.0150 ± 0.3552, P = 0.014). There was no difference in ADCmean with p53 status (1.058 ± 0.1163 10−3 mm2/s vs. 1.055 ± 0.128 10−3 mm2/s, P = 0.935). APT SImean and ADCmean were significantly different in tumors with low and high Ki‐67 status (1.7882 ± 0.11386 vs. 2.3975 ± 0.41586, P < 0.001; 1.1741 ± 0.093 10−3 mm2/s vs. 1.0157 ± 0.10459 10−3 mm2/s, P < 0.001, respectively). APT SImean exhibited a positive correlation with p53 labeling index and Ki‐67 labeling index (r = 0.3741, P = 0.0135; r = 0.7048; P < 0.001, respectively). ADCmean showed no correlation with p53 labeling index, but a negative correlation with Ki‐67 labeling index (r = −0.5543, P < 0.0001). ROC curves demonstrated that APT SImean had significantly higher diagnostic ability for differentiation of high Ki‐67 expression of rectal adenocarcinoma than ADCmean (81.2% vs. 78.12%, 90.91% vs. 63.64; P < 0.001 vs. P = 0.017), while no difference was found in predicting p53 status (92.86% vs. 71.4%, 53.33% vs. 66.7%; P < 0.001 vs. P = 0.0471). Data Conclusion APT...

show abstract

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Amide Proton Transfer MRI and Diffusion‐Weighted Imaging in Assessing p53 and Ki‐67 Expression of Rectal Adenocarcinoma

Chen

Yan

et al. 2020

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“…DWI, as a noninvasive imaging technique based on the Brownian movement of water molecules, has been used in the diagnosis of early rectal cancer [18]. The DWI-derived ADC is a quantitative parameter that can reflect histological changes in intratumoral characteristics after N-CRT [30].…”

Section: Discussionmentioning

confidence: 99%

“…In clinical settings, these two b -value combinations are considered acceptable and reasonable. However, it was reported that ADC values varied greatly with different b -value combinations [18, 19]. There were limited articles about the impact of ADC values measured through ADC map using two different b -value combinations on assessment of response to N-CRT.…”

Section: Introductionmentioning

confidence: 99%

Optimized Parameters of Diffusion-Weighted MRI for Prediction of the Response to Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer

Jia

Pang

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

Aim To identify the optimal diffusion-weighted MRI-derived parameters for predicting the response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Methods This prospective study enrolled 92 patients who underwent neoadjuvant chemoradiotherapy. Diffusion-weighted MRI sequences with two b-value combinations of b (0, 800) and b (0, 1000) were acquired before the start of neoadjuvant chemoradiotherapy and surgery. The pathological tumor regression grade was obtained according to the Mandard criteria, recommended by the seventh edition of the American Joint Committee on Cancer, to act as the reference standard. Pathological good responders (pathological tumor regression grade 1-2) were compared with poor responders (pathological tumor regression grade 3–5). Results The good responder group contained 37 (40.2%) patients and the poor responder group 55 (59.8%) patients. Both before and after neoadjuvant chemoradiotherapy, the mean ADC value for b = 1000 was significantly higher than that for b = 800. In the two patient groups, the post-ADC value and ΔADC for b = 800 were significantly lower than those for b = 1000, but percentages of ADC increase for b = 800 and b = 1000 showed no significant difference. Conclusions The percentage of ADC increase, as an optimized predictor unaffected by different b-values, may have a significant role in differentiating those patients with a good response to N-CRT from those with a poor response.

show abstract

“…Two studies did show some potential for kurtosis imaging to predict response (18,19). However, due to the lack of standardization and lack of strong evidence both IVIM and kurtosis imaging are currently only explored in a research setting (20). DCE-MRI is a method which measures the inflow of intravenously injected contrast agents into the tumor and leakage of contrast into the extracellular space on T1W-MRI and provides direct information of the tissue perfusion.…”

Section: Baseline Imagingmentioning

confidence: 99%

Modern MR Imaging Technology in Rectal Cancer; There Is More Than Meets the Eye

Haak

Maas

2020

Front. Oncol.

View full text Add to dashboard Cite

MR imaging (MRI) is now part of the standard work up of patients with rectal cancer. Restaging MRI has been traditionally used to plan the surgical approach. Its role has recently increased and been adopted as a valuable tool to assist the clinical selection of clinical (near) complete responders for organ preserving treatment. Recently several studies have addressed new imaging biomarkers that combined with morphological provides a comprehensive picture of the tumor. Diffusion-weighted MRI (DWI) has entered the clinics and proven useful for response assessment after chemoradiotherapy. Other functional (quantitative) MRI technologies are on the horizon including artificial intelligence modeling. This narrative review provides an overview of recent advances in rectal cancer (re)staging by imaging with a specific focus on response prediction and evaluation of neoadjuvant treatment response. Furthermore, directions are given for future research.

show abstract

Diffusion-weighted imaging in rectal cancer: current applications and future perspectives

Cited by 117 publications

References 127 publications

Comparative Analysis of Amide Proton Transfer MRI and Diffusion‐Weighted Imaging in Assessing p53 and Ki‐67 Expression of Rectal Adenocarcinoma

Comparative Analysis of Amide Proton Transfer MRI and Diffusion‐Weighted Imaging in Assessing p53 and Ki‐67 Expression of Rectal Adenocarcinoma

Optimized Parameters of Diffusion-Weighted MRI for Prediction of the Response to Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer

Modern MR Imaging Technology in Rectal Cancer; There Is More Than Meets the Eye

Contact Info

Product

Resources

About