Journal
EUROPEAN JOURNAL OF RADIOLOGY
Volume 45, Issue 3, Pages 214-222Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/S0720-048X(02)00231-0
Keywords
diffusion-weighted magnetic resonance imaging; chemoradiation; carcinoma of the rectum; apparent diffusion coefficient
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Purpose: To evaluate the clinical value of diffusion-weighted magnetic resonance imaging (DW-MRI) to monitor response of primary carcinoma of the rectum to preoperative chemoradiation by measuring tumor apparent diffusion coefficient (ADC). Materials and methods: Diffusion data of nine patients undergoing preoperative combined chemoradiation for clinical staged T3, N0-2, M-0 carcinoma of the rectum were analyzed. Diffusion-weighted echo-planar MR images were obtained prior to and at specified intervals during chemoradiation and ADCs calculated from acquired tumor images. Results: Comparison of mean ADC and cumulative radiation dose showed a significant decrease of mean ADC at the 2nd (P = 0.028), 3rd (P = 0.012), and 4th (P = 0.008) weeks of treatment. Cytotoxic edema and fibrosis were considered as reasons for ADC decrease. Conclusion: This study demonstrated tumor ADC changes via detection of therapy-induced alterations in tumor water mobility. Our results indicate that diffusion-weighted imaging may be a valuable clinical tool to diagnose the early stage of radiation-induced fibrosis. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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