Journal
EUROPEAN RADIOLOGY
Volume 27, Issue 5, Pages 1848-1857Publisher
SPRINGER
DOI: 10.1007/s00330-016-4529-6
Keywords
Locally advanced rectal cancer; Neoadjuvant chemoradiotherapy; Diffusion kurtosis imaging; D-app; ADC
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To evaluate the feasibility and value of diffusion kurtosis (DK) imaging in assessing treatment response to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC). Forty-one patients were included. All patients underwent pre- and post-CRT DCE-MRI on a 3.0-Tesla MRI scanner. Imaging indices (D (app) , K (app) and ADC values) were measured. Change value (a dagger X) and change ratio (ra dagger X) were calculated. Pathological tumour regression grade scores (Mandard) were the standard reference (good responders: pTRG 1-2; poor responders: pTRG 3-5). Diagnostic performance was compared using ROC analysis. For the pre-CRT measurements, pre-D (app-10th) was significantly lower in the good responder group than that of the poor responder group (p = 0.036). For assessing treatment response to neoadjuvant CRT, pre-D (app-10th) resulted in AUCs of 0.753 (p = 0.036) with a sensitivity of 66.67 % and a specificity of 77.78 %. The ra dagger D (app) had a relatively high AUC (0.859) and high sensitivity (100 %) compared with other image indices. DKI is feasible for selecting good responders for neoadjuvant CRT for LARC. aEuro cent LARC responded well after neoadjuvant chemoradiotherapy with lower pre-D (app-10th) . aEuro cent LARC responded well with greater increases in mean ADC and D (app) . aEuro cent The change ratio of D (app) (ra dagger D (app) ) had a relatively better diagnostic performance.
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