Magnetic resonance imaging T2WI and DWI sequences in evaluating the therapeutic effect of neoadjuvant chemoradiotherapy for advanced rectal cancer
10.3969/j.issn.1005-202X.2025.06.014
- VernacularTitle:磁共振T2WI及DWI序列评估进展期直肠癌新辅助放化疗效果
- Author:
Ai CHENG
1
;
Yanhong DONG
1
;
Hui HUANG
1
;
Wanqing LI
1
;
Dacong ZHAO
1
Author Information
1. 达州市中西医结合医院医学影像中心,四川 达州 635000
- Publication Type:Journal Article
- Keywords:
advanced rectal cancer;
neoadjuvant chemoradiotherapy;
magnetic resonance imaging;
T2-weighted imaging;
diffusion-weighted imaging
- From:
Chinese Journal of Medical Physics
2025;42(6):801-805
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of magnetic resonance imaging(MRI)T2-weighted imaging(T2WI)and diffusion-weighted imaging(DWI)sequences in evaluating the therapeutic effect of neoadjuvant chemoradiotherapy(nCRT)for advanced rectal cancer.Methods A retrospective analysis was conducted on 124 patients with advanced rectal cancer who received nCRT from November 2020 to November 2023 in Dazhou Integrated TCM&Western Medicine Hospital.All patients underwent radical resection of rectal cancer at 6-8 weeks after the end of nCRT.MRI scans were performed before nCRT and at 6-8 weeks after the end of nCRT.The differences in tumor long and short diameters,signal intensity in tumor(SIT),apparent diffusion coefficient(ADC)and other parameters were measured,and the MRI tumor regression grade was analyzed.Surgery was performed at 3 days after the second examination.The patients were divided into grade 0-1 group and grade 2-3 group according to the postoperative pathological tumor regression grade.The differences of MRI parameters before and after treatment were compared between groups.The consistency of T2WI sequence and DWI sequence in the diagnosis of tumor regression grade after nCRT was analyzed.ROC curve was used to analyze the value of MRI parameters in evaluating the therapeutic effect of nCRT.Results The differences of tumor long diameter,short diameter,SIT and ADC measured by twice MRI examination in grade 0-1 group were increased as compared with grade 2-3 group(P<0.05).MRI detected MRI tumor regression grade 1 in 28 cases(22.58%),grade 2 in 30 cases(24.19%),grade 3 in 31 cases(25.00%),grade 4 in 25 cases(20.16%)and grade 5 in 10 cases(8.06%).Consistency analysis showed that MRI had a sensitivity,specificity,accuracy rate and Kappa value of 92.45%,87.32%,89.51%and 0.788 in evaluating postoperative tumor regression grade.ROC analysis revealed that the AUC of MRI parameters such as differences in tumor long diameter,short diameter,SIT and ADC measured by twice MRI examinations in evaluating the nCRT efficacy ranged from 0.827 to 0.921,and the AUC of combined evaluation was 0.928(P<0.05).Conclusion The combined evaluation of MRI T2WI and DWI sequences can be served as an effective tool for evaluating the therapeutic effect of nCRT for advanced rectal cancer.
