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Dynamic contrast-enhanced MRI for treatment response assessment in patients with oesophageal cancer receiving neoadjuvant chemoradiotherapy.

Sophie E Heethuis ,
Peter S N van Rossum ,
Irene M Lips ,
Lucas Goense ,
Francine E Voncken ,
Onne Reerink ,
Richard van Hillegersberg ,
Jelle P Ruurda ,
Marielle E Philippens ,
Marco van Vulpen ,
Gert J Meijer ,
Jan J W Lagendijk ,
Astrid L H M W van Lier

Abstract

MATERIAL AND METHODS

Twenty-six patients underwent DCE-MRI before, during (week 2-3) and after nCRT, but before surgery (pre/per/post, respectively). Histopathologic tumour regression grade (TRG) was assessed after oesophagectomy. Tumour area-under-the-concentration time curve (AUC), time-to-peak (TTP) and slope were calculated. The ability of these DCE-parameters to distinguish good responders (GR, TRG 1-2) from poor responders (noGR, TRG⩾3), and pathologic complete responders (pCR) from no-pCR was assessed.

CONCLUSIONS

This study demonstrates that changes in AUC throughout treatment are promising for prediction of histopathologic response to nCRT for oesophageal cancer.

RESULTS

Twelve patients (48%) showed GR of which 8 patients (32%) pCR. Analysis of AUC change throughout treatment, AUCper-pre, was most predictive for GR, at a threshold of 22.7% resulting in a sensitivity of 92%, specificity of 77%, PPV of 79%, and a NPV of 91%. AUCpost-pre was most predictive for pCR, at a threshold of -24.6% resulting in a sensitivity of 83%, specificity of 88%, PPV of 71%, and a NPV of 93%. TTP and slope were not associated with pathologic response.

PURPOSE

To explore and evaluate the potential value of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for the prediction of pathologic response to neoadjuvant chemoradiotherapy (nCRT) in oesophageal cancer.

More about this publication

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

Volume 120
Issue nr. 1
Pages 128-35
Publication date 01-07-2016

Full text links

Publisher website (DOI) 10.1016/j.radonc.2016.05.009
Europe PubMed Central 27296409
Pubmed 27296409

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