Application of intravoxel incoherent motion sequence in evaluating and predicting response to neoadjuvant chemotherapy in esophageal squamous cell carcinoma
10.3760/cma.j.issn.1005-1201.2018.08.003
- VernacularTitle: 体素内不相干运动成像在食管鳞癌新辅助化疗疗效评估及预测中的应用
- Author:
Tao SONG
1
;
Hongkai ZHANG
;
Hailiang LI
;
Jianjun QIN
;
Wen FENG
;
Yan ZHAO
;
Jinrong QU
Author Information
1. Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms;
Magnetic resonance imaging;
Intravoxel incoherent motion;
Neoadjuvant chemotherapy
- From:
Chinese Journal of Radiology
2018;52(8):581-586
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess intravoxel incoherent motion(IVIM) in evaluating and predicting response to neoadjuvant chemotherapy(NAC) in esophageal squamous cell carcinoma(ESCC).
Methods:Forty-seven patients with ESCC diagnosed by pathological findings on biopsy from September 2015 to March 2017 were prospectively collected. All patients were examined before and after NAC using routine MRI scan and IVIM. The standard apparent diffusion coefficient (ADCstandard), diffusion coefficient (D), perfusion coefficient (D*) and perfusion score (f) were measured. The patients were divided into complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) according to the 1.1 version of the response evaluation criteria in solid tumors (RECIST). Thirty-one patients underwent surgery after NAC, and the patients were divided into TRG 0-3 according to tumor regression grade (TRG). The differences of parameter values before and after NAC between different groups were analyzed using Student's t test (normal distribution) and Wilcoxon rank sum tests (non-normal distribution). The parameters with statistical significance were evaluated by the receiver operating characteristics (ROC) curves.
Results:The ADCstandard values before and after NAC were (1.97±0.51) ×10-3, (2.42±0.52)×10-3 mm2/s. The D values before and after NAC were (1.30±0.30)×10-3, (1.63±0.35)×10-3 mm2/s. The ADCstandard and D values after NAC were significantly higher than those before NAC, and the differences were statistically significant (t=-6.35, -5.25 respectively, both P<0.01). There were no statistical differences on D* and f between before and after NAC (P>0.05). The patients were divided into PR group (29 cases) and SD group (18 cases) after NAC, without CR and PD patients. The ADCstandard, D and f values of PR group were significantly lower than those of the SD group before NAC (t=-3.11, -2.53 and -2.10 respectively, all P<0.05). The ADCstandard, D, D* and f values after NAC revealed no significant difference between PR and SD groups. Thirty-one patients received operation after NAC, which were divided into TRG 2 group (14 cases) and TRG 3 group (17 cases) according to TRG standard, without TRG 0 and TRG 1 patients. All the parameter values before NAC revealed no significant difference between TRG 2 and TRG 3 groups. The D values after NAC in TRG 2 and TRG 3 groups were (1.81±0.31)×10-3, (1.46±0.39)×10-3 mm2/s respectively, and the significant difference was found between two groups (t=2.76, P<0.05). The efficiency of efficacy evaluation for NAC was the highest at D value of 1.68×10-3 mm2/s, with sensitivity and specificity being 85.7% and 70.6%, respectively.
Conclusion:IVIM can be used as a new imaging method to evaluate and predict the efficacy of NAC for ESCC, among which the parameter D was the most valuable.
