Diffusion-Weighted Magnetic Resonance Application in Response Prediction before, during, and after Neoadjuvant Radiochemotherapy in Primary Rectal Cancer Carcinoma

Author:

Musio Daniela1,De Felice Francesca1,Magnante Anna Lisa1,Ciolina Maria2ORCID,De Cecco Carlo Nicola2ORCID,Rengo Marco2,Redler Adriano3,Laghi Andrea2,Raffetto Nicola1,Tombolini Vincenzo14

Affiliation:

1. Department of Radiotherapy, Policlinico Umberto I “Sapienza” University of Rome, Viale Regina Elena 326, 00161 Rome, Italy

2. Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I “Sapienza” University of Rome, Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy

3. Department of Surgical Sciences, Policlinico Umberto I “Sapienza” University of Rome, Viale Regina Elena 326, 00161 Rome, Italy

4. Spencer-Lorillard Foundation, Viale Regina Elena 291, 00161 Rome, Italy

Abstract

Introduction. Our interest was to monitor treatment response using ADC value to predict response of rectal tumour to preoperative radiochemotherapy.Materials and Methods. Twenty-two patients were treated with long course of radiochemotherapy, followed by surgery. Patients were examined by diffusion-weighted imaging MRI at three-time points (prior, during, and after radiochemotherapy) and were classified as responders and nonresponders.Results. A statistical significant correlation was found between preradiochemotherapy ADC values and during treatment ADC values, in responders (F=21.50,Pvalue<0.05). An increase in ADC value during treatment was predictive of at least a partial response.Discussion. Response of tumour to neoadjuvant therapy cannot be easily evaluated, and such capability might be of great importance in clinical practice, because the number of irradiated and operated patients may be superior to the number of who will really benefit from this multimodal treatment. A reliable prediction of the final clinical TN stage would allow radiotherapist to adapt multidisciplinary approach to a less invasive management, sparing surgical procedure in responder patients or even allowing an early surgery in nonresponders, which would significantly reduce radiochemotherapy related toxicity.Conclusion. Early evaluation of response during neoadjuvant radiochemotherapy treatment shows great promise to predict tumour response.

Publisher

Hindawi Limited

Subject

General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology,General Medicine

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