Assessment of esophageal carcinoma undergoing concurrent chemoradiotherapy with quantitative dynamic contrast-enhanced magnetic resonance imaging

The aim of the present study was to investigate whether quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can predict an early response in primary esophageal carcinoma patients undergoing concurrent chemoradiotherapy. A total of 25 patients with who were pathologically confirmed stage II-III esophageal carcinoma underwent quantitative DCE-MRI prior to chemoradiotherapy, and at 3 weeks post-treatment, the quantitative parameters [K-trans (volume transfer constant; the rate at which contrast agent distributes from the plasma to the EES), K-ep (rate contrast; the rate at which the contrast agent that has diffused to the EES returns to the plasma) and V-e (the contrast agent percentage in the space of the extracellular fluid)] were analyzed respectively. The 25 cases were categorized as a complete response (CR) or a partial response (PR). An independent samples Mann-Whitney U test was used to compare the quantitative parameters between CR and PR. A receiver operating characteristic curve (ROC) was used to determine the best predictor. In total, 17 patients were in the CR group and 8 patients were in the PR group. Pretreatment Ktrans, K-ep and V-e values were 0.54 +/- 0.17/min, 1.12 +/- 0.46/min and 0.37 +/- 0.14, respectively, in the CR group, and 0.40 +/- 0.21/min, 1.07 +/- 0.37/min and 0.40 +/- 0.22, respectively, in the PR group. There was a significant difference between the two groups for K-trans, but there were no significant differences between the two groups for K-ep and V-e. The K-trans, K-ep and V-e values at 3 weeks post-treatment were 0.33 +/- 0.11/min, 0.86 +/- 0.31/min and 0.66 +/- 0.05, respectively, in the CR group, and 0.62 +/- 0.22/min, 1.19 +/- 0.39/min and 0.45 +/- 0.19, respectively, in the PR group. The corresponding U values were -3.319, -1.719 and -2.628, respectively, and the P-values were 0.006, 0.119 and 0.021, respectively. The areas under the ROC curve of K-trans prior to chemoradiotherapy, and of K-trans and K-ep at 3 weeks post-treatment were 0.648, 0.741 and 0.796, respectively. In conclusion, DCE-MRI can predict an early response in primary esophageal carcinoma following 3 weeks of concurrent chemoradiotherapy. K-trans prior to chemoradiotherapy, and K-trans and K-ep at 3 weeks post-treatment are sensitive prediction parameters.