Journal
RADIOLOGY
Volume 217, Issue 2, Pages 385-391Publisher
RADIOLOGICAL SOC NORTH AMERICA
DOI: 10.1148/radiology.217.2.r00nv02385
Keywords
magnetic resonance (MR), contrast enhancement; magnetic resonance (MR), inversion recovery; magnetic resonance (MR), perfusion study; pelvic organs, MR; pelvic organs, therapeutic radiology; rectum, neoplasms; rectum, therapeutic radiology
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PURPOSE: To measure microcirculatory changes during chemoirradiation and to correlate perfusion index (Pi) values with therapy outcome. MATERIALS AND METHODS: Perfusion data in 11 patients with cT3 (clinical staging, tumor invaded the perirectal tissue) rectal carcinoma who underwent preoperative chemoirradiation were analyzed. Perfusion data were acquired by using a T1 mapping sequence with a whole-body magnetic resonance (MR) imager. After contrast medium was intravenously infused at a constant rate, concentration-and-time curves were evaluated for arterial blood and tumor. All patients underwent MR imaging before and at constant intervals during chemoirradiation. Clinical stages before therapy were compared with surgical stages after therapy. RESULTS: Spatial and temporal resolution on dynamic fl maps were sufficient to reveal changes in contrast medium accumulation in the tumor. Comparison of PI values and radiation dose showed a significant increase in the ist (P = .003) and 2nd weeks (P = .01) of treatment; values subsequently returned to pretreatment levels or showed a renewed increase. High initial PI values correlated with greater lymph node downstaging (P = .042). CONCLUSION: Dynamic T1 mapping provides a suitable tool for monitoring tumor microcirculation during chemoirradiation and offers the potential for individual optimization of therapeutic procedures. Furthermore, these results indicate that the PI map may serve as a prognostic factor.
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