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Quantitative Aspects of Diffusion-weighted Magnetic Resonance Imaging in Rectal Cancer Response to Neoadjuvant Therapy.
Bassaneze, Thiago; Gonçalves, José Eduardo; Faria, Juliano Ferreira; Palma, Rogério Tadeu; Waisberg, Jaques.
Afiliação
  • Bassaneze T; Department of Gastrointestinal Surgery, State Public Servant Hospital of São Paulo, São Paulo, Brazil.
  • Gonçalves JE; Department of Gastrointestinal Surgery, State Public Servant Hospital of São Paulo, São Paulo, Brazil.
  • Faria JF; Department of Diagnostic Imaging, Federal University of São Paulo, São Paulo, Brazil.
  • Palma RT; Department of Gastrointestinal Surgery, State Public Servant Hospital of São Paulo, São Paulo, Brazil.
  • Waisberg J; Department of Gastrointestinal Surgery, ABC Medical School, Santo André, Brazil.
Radiol Oncol ; 51(3): 270-276, 2017 Sep.
Article em En | MEDLINE | ID: mdl-28959163
BACKGROUND: The aim of the study was to evaluate the added value of the apparent diffusion coefficient (ADC) of diffusion-weighted magnetic resonance imaging (DW-MRI) in patients with rectal cancer who received neoadjuvant chemoradiotherapy (CRT). The use of DW-MRI for response evaluation in rectal cancer still remains a widely investigated issue, as the accurate detection of pathologic complete response (pCR) is critical in making therapeutic decisions. PATIENTS AND METHODS: Thirty-three patients with locally advanced rectal cancer were evaluated retrospectively by MRI in addition to diffusion-weighted images (DWI) and its ADC pre- and post-neoadjuvant CRT. These patients subsequently underwent curative-intent surgery. Tumor staging by MRI and ADC value were compared with histopathological findings of the surgical specimen. RESULTS: MRI in addition to DWI had a sensitivity of 96.1%, specificity of 71.4%, positive predictive value of 92.5%, and negative predictive value of 83.3% in the detection of pCR. The pre-CRT ADC alone could not reliably predict the pCR group. Post-CRT ADC cutoff value of 1.49 x 10-3 mm2/s had the highest accuracy and allowed a 16.7% increase in negative predictive value and 3.9% increase in sensitivity. Patients with pCR to neoadjuvant treatment differed from the other groups in their absolute values of post-CRT ADC (p < 0.01). CONCLUSIONS: The use of post-CRT ADC increased the diagnostic performance of MRI in addition to DWI in predicting the final pathologic staging of rectal carcinoma.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Revista: Radiol Oncol Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Polônia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Revista: Radiol Oncol Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Polônia