Purpose: To evaluate the efficacy of diffusion-weighted imaging (DWI) on 3 Tesla (T) MR imaging to predict the tumor response to neoadjuvant chemoradiation therapy (CRT) in patients with locally advanced rectal cancer.

Materials And Methods: Thirty-five patients who underwent neoadjuvant CRT and subsequent surgical resection were included. Tumor volume was measured on T2-weighted MR images before and after neoadjuvant CRT and the percentage of tumor volume reduction was calculated. The apparent diffusion coefficient (ADC) value was measured on the DWI before and after neoadjuvant CRT, and the change of ADC (Δ ADC) was calculated. The histopathologic response was categorized either as a responder to CRT or as a nonresponder. The relationship between the ADC parameters and the percentage of tumor volume reduction or histopathologic response was then evaluated.

Results: There was a significant correlation between tumor volume reduction and pre-CRT ADC and Δ ADC, respectively (r = -0.352, r = 0.615). Pre-CRT ADC of the histopathologic responders was significantly lower than that of the histopathologic nonresponders (P = 0.034). Δ ADC of the histopathologic responders was significantly higher than that of the histopathologic nonresponders (P < 0.005).

Conclusion: DWI on 3T MR imaging may be a promising technique for helping to predict and monitor the treatment response to neoadjuvant CRT in patients with locally advanced rectal cancer.

Download full-text PDF

Source
http://dx.doi.org/10.1002/jmri.22749DOI Listing

Publication Analysis

Top Keywords

neoadjuvant crt
16
tumor volume
16
response neoadjuvant
12
locally advanced
12
advanced rectal
12
volume reduction
12
neoadjuvant chemoradiation
8
chemoradiation therapy
8
rectal cancer
8
tesla imaging
8

Similar Publications

Despite optimal local control obtained with neoadjuvant chemoradiotherapy (CRT), data on overall survival (OS) and disease-free survival (DFS) of local advanced rectal cancer patients are still equivocal. This meta-analysis aimed to estimate the pathological complete response (pCR), regression rate, DFS, and OS probabilities of rectal cancer patients treated with a second chemotherapy drug added to fluoropyrimidine and long-term radiotherapy. Computerized bibliographic searches of MEDLINE, PUBMED, Web of Science and the Cochrane Central Register of Controlled Trials databases (1970-2023) were supplemented with hand searches of reference lists.

View Article and Find Full Text PDF

A Comprehensive Approach to Neoadjuvant Treatment of Locally Advanced Rectal Cancer.

Cancers (Basel)

January 2025

Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.

At the end of the past century, the introduction of Total Mesorectal Excision (TME), preceded by either short-course radiotherapy (SCRT) or chemoradiation (CRT), established the new standard of care for locally advanced rectal cancer (LARC). Recently, significant advancements were achieved for both dMMR/MSI and pMMR/MSS LARC patients. For the 2-3% of dMMR/MSI LARCs, ablative immunotherapy emerged as a curative approach, offering the possibility of avoiding chemotherapy (CT), radiotherapy, and surgery altogether.

View Article and Find Full Text PDF

Whether preoperative chemoradiotherapy (CRT) or perioperative chemotherapy is superior for localized esophageal or gastro-esophageal junction (GEJ) cancers has been a topic of long-standing debate. For years, standard of care in the United States for localized esophageal or GEJ adenocarcinoma (EAC) has been physician's choice between the 2 strategies. More recently, adjuvant immunotherapy has also been introduced into the treatment approach for those who received neoadjuvant CRT.

View Article and Find Full Text PDF

Background: The study aimed at assessing whether long-term survival outcomes were different based on tumor location in pancreatic ductal adenocarcinoma (PDAC) patients who underwent pancreatectomy following neoadjuvant chemoradiotherapy (CRT).

Methods: Following CRT, resection rate was 60.5% (286/473) and the resected patients had pancreatic head (n = 218), body (n = 34) and tail (n = 34) tumors.

View Article and Find Full Text PDF

Quality of life and functional outcomes in patients with locally advanced rectal cancer receiving total neoadjuvant therapy versus concurrent chemoradiotherapy: An analysis of the XXX trial.

Int J Radiat Oncol Biol Phys

January 2025

State Key Laboratory of Molecular Oncology and Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China; Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Shenzhen, China. Electronic address:

Objective: To explore differences in the effects of total neoadjuvant therapy (TNT) and preoperative concurrent chemoradiotherapy (CRT) on quality of life and functional outcomes in patients with locally advanced rectal cancer.

Methods: In the study, 591 patients with distal or middle-third, clinical primary tumor stage cT3-4 and/or regional lymph node-positive rectal cancer were randomly assigned (1:1) to receive short-term radiotherapy (25 Gy in five fractions) followed by 4 cycles of CAPOX (TNT group, n=297) or standard concurrent chemoradiotherapy (50 Gy in 25 fractions concurrently with oral capecitabine) (CRT group, n=294) before surgery. After a 6-year follow-up, the surviving patients were sent surveys, including the EORTC QLQ-C30, EORTC QLQ-CR29, and Wexner incontinence score questionnaires.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!