title: The value of diffusion kurtosis magnetic resonance imaging for assessing treatment response of neoadjuvant chemoradiotherapy in locally advanced rectal cancer.
abstract: OBJECTIVE
  To evaluate the feasibility and value of diffusion kurtosis (DK) imaging in assessing treatment response to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC).
  
  
  METHODS
  Forty-one patients were included. All patients underwent pre- and post-CRT DCE-MRI on a 3.0-Tesla MRI scanner. Imaging indices (Dapp, Kappand ADC values) were measured. Change value (∆X) and change ratio (r∆X) were calculated. Pathological tumour regression grade scores (Mandard) were the standard reference (good responders: pTRG 1-2; poor responders: pTRG 3-5). Diagnostic performance was compared using ROC analysis.
  
  
  RESULTS
  For the pre-CRT measurements, pre-Dapp-10thwas significantly lower in the good responder group than that of the poor responder group (p = 0.036). For assessing treatment response to neoadjuvant CRT, pre-Dapp-10thresulted in AUCs of 0.753 (p = 0.036) with a sensitivity of 66.67 % and a specificity of 77.78 %. The r∆Dapphad a relatively high AUC (0.859) and high sensitivity (100 %) compared with other image indices.
  
  
  CONCLUSIONS
  DKI is feasible for selecting good responders for neoadjuvant CRT for LARC.
  
  
  CONCLUSIONS
  • LARC responded well after neoadjuvant chemoradiotherapy with lower pre-Dapp-10th. • LARC responded well with greater increases in mean ADC and Dapp. • The change ratio of Dapp(r∆Dapp) had a relatively better diagnostic performance.
authors.affiliation: Department of Radiology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd, Nanjing, 210029, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Radiology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd, Nanjing, 210029, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Radiology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd, Nanjing, 210029, China.
authors.forename: Jia-Cheng
authors.initials: JC
authors.lastname: Song
authors.affiliation: Department of Radiology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd, Nanjing, 210029, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Radiology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd, Nanjing, 210029, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Dai
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Dong-Ya
authors.initials: DY
authors.lastname: Huang
authors.affiliation: Department of Radiology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd, Nanjing, 210029, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Pathology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Radiology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd, Nanjing, 210029, China. shihb@njmu.edu.cn.
authors.forename: Hai-Bin
authors.initials: HB
authors.lastname: Shi
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D012372:ROC Curve; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
keywords: ADC; D app; Diffusion kurtosis imaging; Locally advanced rectal cancer; Neoadjuvant chemoradiotherapy