title: Apparent diffusion coefficient values detected by diffusion-weighted imaging in the prognosis of patients with locally advanced esophageal squamous cell carcinoma receiving chemoradiation.
abstract: OBJECTIVE
  Previous studies have demonstrated that apparent diffusion coefficient (ADC) values measured by magnetic resonance imaging have prognostic value in patients with esophageal squamous cell carcinoma (ESCC). However, the role of ADC needs to be validated in a cohort of Chinese ESCC patients. This study assessed the role of ADC in predicting the outcome of patients with ESCC treated only by chemoradiation in the People's Republic of China.
  
  
  METHODS
  Seventy-three patients with local advanced ESCC were retrospectively analyzed in this study; none of the patients underwent surgery before or after chemoradiation. The ADC values of the primary tumors were determined by magnetic resonance imaging. The ADC values were then correlated with clinicopathological and other radiological parameters. Survival analysis was carried out to determine if ADC had an impact on survival of these patients.
  
  
  RESULTS
  The median ADC value of the esophageal cancer tissue was 1.256*10-3mm2/sec (range: 0.657-2.354*10-3mm2/sec, interquartile range 0.606*10-3mm2/sec). No clinicopathological or radiological parameters were associated with the ADC values except the sites of tumor tissues. ADC <1.076*10-3mm2/sec predicted significantly worse survival in patients with ESCC (12.9 months vs undefined,P=0.0108).
  
  
  CONCLUSIONS
  The ADC value is a potent prognostic factor which can be used to predict the outcome of patients with ESCC treated only by chemoradiation.
authors.affiliation: Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Shu
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Fuxi
authors.initials: F
authors.lastname: Zhen
authors.affiliation: Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Nana
authors.initials: N
authors.lastname: Sun
authors.affiliation: Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Jiayan
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Yuandong
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of General Internal Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Ge
authors.affiliation: Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
authors.forename: Xinchen
authors.initials: X
authors.lastname: Sun
keywords: ADC; chemotherapy; diffusion-weighted MRI; esophageal cancer; prognosis; radiation