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The role of perfusion effects in monitoring of chemoradiotherapy of rectal carcinoma using diffusion-weighted imaging

Purpose: The aim of this study was to characterize and understand the therapy-induced changes in diffusion parameters in rectal carcinoma under chemoradiotherapy (CRT). The current literature shows conflicting results in this regard. We applied the intravoxel incoherent motion model, which allows fo...

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Hauptverfasser: Ganten, Maria-Katharina (VerfasserIn) , Schüßler, Maximilian (VerfasserIn) , Bäuerle, Tobias (VerfasserIn) , Münter, Marc (VerfasserIn) , Schlemmer, Heinz-Peter (VerfasserIn) , Jensen, Alexandra (VerfasserIn) , Brand, Karsten (VerfasserIn) , Dueck, Margret (VerfasserIn) , Dinkel, Julien (VerfasserIn) , Kopp-Schneider, Annette (VerfasserIn) , Maier-Hein, Klaus H. (VerfasserIn) , Stieltjes, Bram (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2013 Dec 11
In: Cancer imaging
Year: 2013, Jahrgang: 13, Heft: 4, Pages: 548-556
ISSN:1470-7330
DOI:10.1102/1470-7330.2013.0045
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1102/1470-7330.2013.0045
Verlag, lizenzpflichtig, Volltext: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864228/
Volltext
Verfasserangaben:Maria-Katharina Ganten, Maximilian Schuessler, Tobias Bäuerle, Marc Muenter, Heinz-Peter Schlemmer, Alexandra Jensen, Karsten Brand, Margret Dueck, Julien Dinkel, Annette Kopp-Schneider, Klaus Fritzsche, Bram Stieltjes
Beschreibung
Zusammenfassung:Purpose: The aim of this study was to characterize and understand the therapy-induced changes in diffusion parameters in rectal carcinoma under chemoradiotherapy (CRT). The current literature shows conflicting results in this regard. We applied the intravoxel incoherent motion model, which allows for the differentiation between diffusion (D) and perfusion (f) effects, to further elucidate potential underlying causes for these divergent reports. Materials and methods: Eighteen patients with primary rectal carcinoma undergoing preoperative CRT were examined before, during, and after neoadjuvant CRT using diffusion-weighted imaging. Using the intravoxel incoherent motion approach, f and D were extracted and compared with postoperative tumor downstaging and volume. Results: Initial diffusion-derived parameters were within a narrow range (D1 = 0.94 ± 0.12 × 10−3 mm2/s). At follow-up, D rose significantly (D2 = 1.18 ± 0.13 × 10−3 mm2/s; P < 0.0001) and continued to increase significantly after CRT (D3 = 1.24 ± 0.14 × 10−3 mm2/s; P < 0.0001). The perfusion fraction f did not change significantly (f1 = 9.4 ± 2.0%, f2 = 9.4 ± 1.7%, f3 = 9.5 ± 2.7%). Mean volume (V) decreased significantly (V1 = 16,992 ± 13,083 mm3; V2 = 12,793 ± 8317 mm3, V3 = 9718 ± 6154 mm3). T-downstaging (10:18 patients) showed no significant correlation with diffusion-derived parameters. Conclusions: Conflicting results in the literature considering apparent diffusion coefficient (ADC) changes in rectal carcinoma under CRT for patients showing T-downstaging are unlikely to be due to perfusion effects. Our data support the view that under effective therapy, an increase in D/ADC can be observed.
Beschreibung:Gesehen am 03.03.2020
Beschreibung:Online Resource
ISSN:1470-7330
DOI:10.1102/1470-7330.2013.0045

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