Tumor Volume Reduction Rate Measured by Magnetic Resonance Volumetry Correlated With Pathologic Tumor Response of Preoperative Chemoradiotherapy for Rectal Cancer

Yeo, Seung‐Gu; Kim, Dae Yong; Kim, Tae Hyun; Jung, Kyung Hae; Hong, Yong Sang; Chang, Hee Jin; Park, Ji Won; Lim, Sun Mi; Choi, Hyo Seong; Jeong, Seung‐Yong

doi:10.1016/j.ijrobp.2009.07.1682

Cited by 81 publications

(66 citation statements)

References 33 publications

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“…categorized into two groups (unfavourable <80%, and favourable ≥80 %) using previously published definitions [15].…”

Section: Mri Image Analysesmentioning

confidence: 99%

“…A number of different methods have been proposed for assessing response of rectal cancer to CRT on MRI. These include post-treatment T staging (ymrT), volume reduction between baseline and posttreatment, [15] and modified Response Evaluation Criteria in Solid Tumors (RECIST) measurement [16]. In addition to these assessment criteria, the MERCURY study group has developed an MRI-based tumor regression grading (ymrTRG) system by applying the principles of histopathology ypTRG [17,18] and showed that MRI assessment of ypTRG following preoperative therapy predicted survival [17].…”

Section: Introductionmentioning

confidence: 99%

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Timing of surgery following neoadjuvant chemoradiotherapy in locally advanced rectal cancer – A comparison of magnetic resonance imaging at two time points and histopathological responses

West

Dimitrov

Moyses

et al. 2016

European Journal of Surgical Oncology (EJSO)

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Purpose: There is wide inter-institutional variation in the interval between neoadjuvant chemoradiotherapy (NACRT) and surgery for locally advanced rectal cancer. We aimed to assess the association of magnetic resonance imaging (MRI) at 9 and 14 weeks post-NACRT;T-staging (ymrT) and post-NACRT tumour regression grading (ymrTRG) with histopathological outcomes; histopathological T-stage (ypT) and histopathological tumour regression grading (ypTRG) in order to inform decision-making about timing of surgery. Patients and Methods:We prospectively studied 35 consecutive patients (26 males) with MRI-defined resection margin threatened rectal cancer who had completed standardized NACRT. Patients underwent a MRI at Weeks 9 and 14 post-NACRT, and surgery at Week 15. Two readers independently assessed MRIs for ymrT, ymrTRG and volume change. ymrT and ymrTRG were analysed against histopathological ypT and ypTRG as predictors by logistic regression modelling and receiver operating characteristic (ROC) curve analyses.

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“…categorized into two groups (unfavourable <80%, and favourable ≥80 %) using previously published definitions [15].…”

Section: Mri Image Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Timing of surgery following neoadjuvant chemoradiotherapy in locally advanced rectal cancer – A comparison of magnetic resonance imaging at two time points and histopathological responses

West

Dimitrov

Moyses

et al. 2016

European Journal of Surgical Oncology (EJSO)

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“…The accurate assessment of tumor volume reduction and downstaging might enable of a local excision or a nonsurgical approach to be considered in patients who have a good probability of anal sphincter preservation or a good tumor response after preoperative CRT (11,12). Researchers have reported that the tumor volume reduction rate is significantly correlated with the downstaging of locally advanced rectal cancer following preoperative CRT (13). Furthermore, MR volumetry has been shown to be potentially effective in predicting the early response of rectal cancer (14).…”

mentioning

confidence: 99%

Comparison of diffusion‐weighted MRI and MR volumetry in the evaluation of early treatment outcomes after preoperative chemoradiotherapy for locally advanced rectal cancer

Kim

Lim

Keum

et al. 2011

Magnetic Resonance Imaging

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Purpose: To compare diffusion-weighted imaging (DWI) and magnetic resonance (MR) volumetry for predicting treatment outcomes of locally advanced rectal cancers with preoperative chemoradiotherapy (CRT). Materials and Methods:This prospective study was approved by our Institutional Review Board. Thirty-four patients underwent three MR examinations: pre-CRT (before CRT), early CRT (2 weeks after CRT initiation), and post-CRT (before surgery). The tumor apparent diffusion coefficient (ADC), ADC increase rate, and volume reduction rate were compared between responders and nonresponders using three reference standards: downstaging, modified Response Evaluation Criteria in Solid Tumors (mRECIST), and tumor regression grade (TRG). For DWI and volumetry, differences between responders and nonresponders were assessed by receiver operating characteristic analysis.Results: The median early tumor volume reduction rate of responders, subgrouped by downstaging and mRECIST (47.97% and 53.97%, respectively), was significantly higher than that of nonresponders (20.94% and 20.36%; P ¼ 0.0024 and 0.0001, respectively), but there were no significant differences in pre-CRT ADC and early ADC increase rate using all references. When using the downstaging and mRECIST, the diagnostic performance of early tumor volume reduction rate (Az ¼ 0.81 and 0.94, respectively) was higher than that of pre-CRT ADC (Az ¼ 0.55 and 0.62; P ¼ 0.033 and 0.007) and early ADC increase rate (Az ¼ 0.58 and 0.64; P ¼ 0.055 and 0.01) for predicting the treatment outcome. For TRG, there were no significant differences between DWI and volumetry.Conclusion: Early tumor volume reduction rate at the second week after CRT initiation may be a better indicator than DWI based on the mean ADC measurements for predicting CRT treatment outcome.

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“…The extent of response is expressed in various ways, including T or N down-classification, downstaging, tumor regression grade, or development of a pathologically complete response (pCR) [21]. Approximately 20% of patients experience pCR [22].…”

Section: Role Of Radiotherapy In Rectal Cancermentioning

confidence: 99%

“…Clinicopathological factors associated with the CRT response to rectal cancer include the levels of serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9, and fibrinogen; the histological grade and mucinous histology; tumor size, volume, circumference, and movability; the hemoglobin level and blood lymphocyte counts; the clinical T or N stage; and the distance from the tumor to the anal verge [21,[45][46][47][48][49][50][51][52][53][54][55][56][57]. Of these factors, the serum CEA level has been the most relevant [48][49][50].…”

Section: Predictive Markers Clinicopathological Factorsmentioning

confidence: 99%

Clinical utility of pretreatment prediction of chemoradiotherapy response in rectal cancer: a review

Yoo

Yeo

2017

EPMA Journal

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Approximately 20% of all patients with locally advanced rectal cancer experience pathologically complete responses following neoadjuvant chemoradiotherapy (CRT) and standard surgery. The utility of radical surgery for patients exhibiting good CRT responses has been challenged. Organsparing strategies for selected patients exhibiting complete clinical responses include local excision or no immediate surgery. The subjects of this tailored management are patients whose presenting disease corresponds to current indications of neoadjuvant CRT, and their post-CRT tumor response is assessed by clinical and radiological examinations. However, a model predictive of the CRT response, applied before any treatment commenced, would be valuable to facilitate such a personalized approach. This would increase organ preservation, particularly in patients for whom upfront CRT is not generally prescribed. Molecular biomarkers hold the greatest promise for development of a pretreatment predictive model of CRT response. A combination of clinicopathological, radiological, and molecular markers will be necessary to render the model robust. Molecular research will also contribute to the development of drugs that can overcome the radioresistance of rectal tumors. Current treatments for rectal cancer are based on the expected prognosis given the presenting disease extent. In the future, treatment schemes may be modified by including the predicted CRT response evaluated at presentation.

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Tumor Volume Reduction Rate Measured by Magnetic Resonance Volumetry Correlated With Pathologic Tumor Response of Preoperative Chemoradiotherapy for Rectal Cancer

Cited by 81 publications

References 33 publications

Timing of surgery following neoadjuvant chemoradiotherapy in locally advanced rectal cancer – A comparison of magnetic resonance imaging at two time points and histopathological responses

Timing of surgery following neoadjuvant chemoradiotherapy in locally advanced rectal cancer – A comparison of magnetic resonance imaging at two time points and histopathological responses

Comparison of diffusion‐weighted MRI and MR volumetry in the evaluation of early treatment outcomes after preoperative chemoradiotherapy for locally advanced rectal cancer

Clinical utility of pretreatment prediction of chemoradiotherapy response in rectal cancer: a review

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