title: MRI for Assessing Response to Neoadjuvant Therapy in Locally Advanced Rectal Cancer Using DCE-MR and DW-MR Data Sets: A Preliminary Report.
abstract: To evaluate MRI for neoadjuvant therapy response assessment in locally advanced rectal cancer (LARC) using dynamic contrast enhanced-MRI (DCE-MRI) and diffusion weighted imaging (DWI), we have compared magnetic resonance volumetry based on DCE-MRI (V(DCE)) and on DWI (V(DWI)) scans with conventional T2-weighted volumetry (V(C)) in LARC patients after neoadjuvant therapy. Twenty-nine patients with LARC underwent MR examination before and after neoadjuvant therapy. A manual segmentation was performed on DCE-MR postcontrast images, on DWI (b-value 800 s/mm(2)), and on conventional T2-weighted images by two radiologists. DCE-MRI, DWI, and T2-weigthed volumetric changes before and after treatment were evaluated. Nonparametric sample tests, interobserver agreement, and receiver operating characteristic curve (ROC) were performed. Diagnostic performance linked to DCE-MRI volumetric change was superior to T2-w and DW-MRI volumetric changes performance (specificity 86%, sensitivity 93%, and accuracy 93%). Area Under ROC (AUC) of V(DCE) was greater than AUCs of V(C) and V(DWI) resulting in an increase of 15.6% and 11.1%, respectively. Interobserver agreement between two radiologists was 0.977, 0.864, and 0.756 for V(C), V(DCE), and V(DWI), respectively. V(DCE) seems to be a promising tool for therapy response assessment in LARC. Further studies on large series of patients are needed to refine technique and evaluate its potential value.
authors.affiliation: Division of Radiology, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, Istituto Nazionale Tumori-IRCCS "Fondazione Giovanni Pascale", Via Mariano Semmola, 80131 Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Petrillo
authors.affiliation: Division of Radiology, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, Istituto Nazionale Tumori-IRCCS "Fondazione Giovanni Pascale", Via Mariano Semmola, 80131 Naples, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Fusco
authors.affiliation: Division of Radiology, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, Istituto Nazionale Tumori-IRCCS "Fondazione Giovanni Pascale", Via Mariano Semmola, 80131 Naples, Italy.
authors.forename: Orlando
authors.initials: O
authors.lastname: Catalano
authors.affiliation: Department of Electrical Engineering and Information Technologies, University of Naples Federico II, Via Claudio 21, 80125 Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Sansone
authors.affiliation: Division of Gastrointestinal Medical Oncology, Department of Abdominal Oncology, Istituto Nazionale Tumori-IRCCS "Fondazione Giovanni Pascale", Via Mariano Semmola, 80131 Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Avallone
authors.affiliation: Division of Gastrointestinal Surgical Oncology, Department of Abdominal Oncology, Istituto Nazionale Tumori-IRCCS "Fondazione Giovanni Pascale", Via Mariano Semmola, 80131 Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Delrio
authors.affiliation: Divion of Radiotherapy, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, Istituto Nazionale Tumori-IRCCS "Fondazione Giovanni Pascale", Via Mariano Semmola, 80131 Naples, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Pecori
authors.affiliation: Division of Diagnostic Pathology, Department of Diagnostic and Laboratory Pathology, Istituto Nazionale Tumori-IRCCS "Fondazione Giovanni Pascale", Via Mariano Semmola, 80131 Naples, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Tatangelo
authors.affiliation: Division of Radiology, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, Istituto Nazionale Tumori-IRCCS "Fondazione Giovanni Pascale", Via Mariano Semmola, 80131 Naples, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Petrillo
mesh_terms: D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*