Correlation of diffusion weighted MR imaging with the prognosis of local advanced gastric carcinoma after neoadjuvant chemotherapy
10.3760/cma.j.issn.1671-0274.2015.03.006
- VernacularTitle:磁共振扩散加权成像表观扩散系数值与局部进展期胃癌新辅助化疗预后的关系
- Author:
Lei TANG
1
;
Yingshi SUN
;
Ziyu LI
;
Xiaopeng ZHANG
;
Kun CAO
;
Xiaoting LI
;
Fei SHAN
;
Ziran LI
;
Jiafu JI
Author Information
1. 100142,北京市肿瘤防治研究所 恶性肿瘤发病机制及转化研究教育部重点实验室 北京大学肿瘤医院医学影像科
- Keywords:
Stomach neoplasms;
Neoadjuvant chemotherapy;
Magnetic resonance imaging;
Diffusion-weighted;
Prognosis
- From:
Chinese Journal of Gastrointestinal Surgery
2015;(3):221-226
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the correlation of the apparent diffusion coefficient (ADC) on diffusion-weighted MRI (DWI) with the prognosis of locally advanced gastric carcinoma after neoadjuvant chemotherapy (NACT). Methods Patients with locally advanced gastric carcinoma undergoing NACT in our hospital from November 2010 to September 2011 were enrolled in this prospective study. MRI examinations were performed before and after NACT. ADCs of the whole lesion (ADCentire) and high signal area on DWI (ADCmin) were calculated, and the cancer thickness on T2-weighted images was measured. All the patients were divided into long-term survival group and poor prognosis group, according to the 3-year survival status. The pre-therapy baseline values and early percentage changes (%△) of the above parameters were compared between the two groups. Receiver operating characteristics (ROC) curves were employed to compare the performance of the above parameters in the discrimination of different prognosis groups. Results A total of 24 patients were enrolled in the study. There were 14 patients of long-term survival group and 10 patients of poor prognosis group. No statistical difference in baseline ADCmin and ADCentire was shown between long-term survival group and poor prognosis group [ADCmin: (1.17±0.23)×10-3 mm2/s vs. (1.23±0.27) ×10-3 mm2/s, P>0.05; ADCentire: (1.43±0.20)×10-3 mm2/s vs. (1.50±0.24)×10-3 mm2/s, P>0.05]. The %△ADCmin and %△ADCentire were both higher in long-term survival group than those in poor prognosis group (%△ADCmin: 21% vs. 5%, P=0.06; %△ADCentire: 23% vs. 1%, P=0.02). Through ROC curves, the AUCs for pre-therapy cancer thickness, ADCmin and ADCentire were 0.693, 0.543 and 0.600 respectively, and AUCs for %△thickness, %△ADCmin and %△ADCentire were 0.532, 0.729 and 0.779 respectively, in the differentiation of prognosis. Using %△ADC≥15% to predict long-term survival, the positive predictive value (PPV) for %△ADCmin was 81.8% and %△ADCentire was 83.3%. Using %△ADC≤10% to predict poor prognosis, the PPV for %△ADCmin was 63.6% and%△ADCentire was 70.0%. Conclusions The change of ADC after NACT of gastric carcinoma is correlated with long-term prognosis. The significantly increased ADC is prone to signify long-term survival. ADCentire is better than ADCmin in the prognosis prediction.
