Does GRASP affect DCE-MRI quantitative parameters and texture analysis in patients with esophageal cancer receiving preoperative neoadjuvant chemotherapy?

Abstract

Purpose To compare pharmacokinetic parameters and texture features from two dynamic contrast-enhanced (DCE) MR images [golden-angle radial sparse parallel (GRASP) and view-sharing with golden-angle radial profile (VS-GR) reconstruction], and explore their value in assessing response to neoadjuvant chemotherapy (nCT) in esophageal cancer (EC). Methods The study prospectively enrolled 30 EC patients receiving nCT before surgery. DCE-MRI scanning was performed before nCT and within 1 week before surgery. Chemotherapy response was assessed according to RECIST 1.1 and Tumor Regression Grade (TRG). Mann-Whitney U test was utilized for comparing GRASP and VS-GR reconstruction, and the receiver operating characteristic (ROC) was performed for each significant feature to assess its accuracy in predicting response. Results Among the 30 patients included in this cohort (28 men; average age of 58 ± 8 years), response by RECIST 1.1 demonstrated 18 responders and 12 non-responders. For TRG, no case showed TRG1, 1 patient was TRG2, 3 patients were TRG3, 8 patients were TRG4, and 18 patients were TRG5. A total of 72 pharmacokinetic parameters and texture features were extracted from each tumor. Of those, 29 pre-nCT features and 24 post-nCT features showed statistically significant difference between GRASP and VS-GR reconstruction. One pre-nCT texture feature and 37 post-nCT pharmacokinetic parameters and texture features on VS-GR showed statistically significant differences between responder and non-responders. Both preand post-nCT pharmacokinetic parameters and texture features with GRASP reconstruction showed good performance in response groups (AUC > 0.70, P < 0.05), and only post-nCT pharmacokinetic parameters and texture features with VS-GR reconstruction showed good performance in response groups (AUC > 0.70, P < 0.05). Conclusion GRASP can improve pharmacokinetic parameters and texture features from DCE-MR imaging. Both pre-and post-nCT pharmacokinetic parameters and texture features with GRASP and only post-nCT those with VS-GR reconstruction showed the ability to assess the response to nCT in EC. Keywords Magnetic resonance imaging • Esophageal cancer • Treatment outcome • Chemotherapy • Neoadjuvant therapy Abbreviations DCE-MRI Dynamic contrast-enhanced magnetic resonance imaging GRASP Golden-angle radial sparse parallel VS-GR View-sharing with golden-angle radial profile nCT Neoadjuvant chemotherapy EC Esophageal cancer TRG Tumor Regression Grade AIF Arterial input function ROC The receiver operating characteristic ROI Regions of interest AUC Area under receiver operating characteristic curve Yanan Lu and Ling Ma contributed equally to this work.

The value of GRASP on DCE-MRI for assessing response to neoadjuvant chemotherapy in patients with esophageal cancer

“…All studies were performed between September 2015 and March 2017. The inclusion criteria were following [17]: 1) Patients were confirmed with stage II-III EC by esophagoscopy pathologically [18, 19], 2) 2 cycles of nCT before surgery were performed, 3) Imaging and clinical response evaluation were performed at 2 weeks after completing all the treatment. (Fig.…”

“…Radial VIBE sequence parameters were following: TR: 3.98 ms TE: 1.91 ms, flip angle: 12°, acquisition matrix: 300 × 300, FOV: 300 mm × 300 mm × 146 mm, slice thickness: 3 mm, reconstructed image voxel size: 1.0 × 1.0 × 3.0 mm 3 , radial views: 1659, scanning time: 309 s. A total of 68 period images were collected, and each period included 72 images. 10-15 mL Gadopentetate Dimeglumine Injection (0.2 ml/kg of body weight, Omniscan, GE Healthcare) was injected at a rate of 2.5 mL/s, followed by equal volume of normal saline solution to flush the tube at 20 s after the beginning of scanning by a MR-compatible automated high-pressure injector (Spectris Solaris EP, Medrad) [17].…”