Diffusion weighted imaging improves diagnostic ability of MRI for determining complete response to neoadjuvant therapy in locally advanced rectal cancer

European Journal of Radiology Open
Anuradha ChandramohanDipti Masih

Abstract

To assess the diagnostic performance, interobserver agreement and confidence level for determining response to neoadjuvant chemoradiotherapy (NACRT) using morphology based MR-tumour regression grade (MR TRG), diffusion weighted imaging (DWI) patterns and their combination in patients with locally advanced rectal cancer. This was a retrospective study including patients with locally advanced rectal cancer treated with NACRT and subsequent surgery. Two independent radiologists blinded to the histopathology reviewed staging and restaging MRI. Diagnostic performance of morphology based MR-TRG, DWI patterns and their combination for determining complete (CR) and incomplete (IR) response was assessed with pathological response as the reference. Likert's scale was used to assess the radiologist's level of confidence. Interobserver agreement was determined using Kappa statistics. The study included 251 patients (mean age of 47.9+/-14 (range 19-86) years, M:F = 164:87). Rate of pathological CR was 14.7 % (n = 37). Pattern based interpretation of DWI and combined approach (DWI + T2-HR) had superior diagnostic performance than morphology based assessment alone with area under curve (AUC) for T2HR, DWI and their combination being 0.531, 0....Continue Reading

References

Aug 31, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Uday B PatelGina Brown
Sep 22, 2012·AJR. American Journal of Roentgenology·Uday B PatelGina Brown
Sep 22, 2017·British Journal of Cancer·Francesco SclafaniIan Chau
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Dec 12, 2018·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Marit E van der SandeMonique Maas

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