Rectal cancer: Assessment of response to neoadjuvant chemoradiation by dynamic contrast-enhanced MRI

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Item Type:	Article
Title:	Rectal cancer: Assessment of response to neoadjuvant chemoradiation by dynamic contrast-enhanced MRI
Creators Name:	Oberholzer, K., Menig, M., Pohlmann, A., Junginger, T., Heintz, A., Kreft, A., Hansen, T., Schneider, A., Lollert, A., Schmidberger, H. and Christoph, D.
Abstract:	PURPOSE: To assess pretreatment functional and morphological tumor characteristics with magnetic resonance imaging (MRI) in advanced rectal carcinoma and to identify factors predicting response to neoadjuvant chemoradiation. MATERIALS AND METHODS: In a prospective study, 95 patients with rectal carcinoma underwent dynamic contrast-enhanced MRI before and after chemoradiation. Quantitative parameters were derived from a pharmacokinetic two-compartment model. Tumors were also characterized with regard to mucinous status at pretreatment high-resolution MRI as nonmucinous or mucinous. Response to treatment was defined as a downshift in the local tumor stage. RESULTS: The parameter k21 (contrast medium exchange rate) was higher at pretreatment MRI in nonmucinous compared with mucinous carcinomas (P < 0.001). The effect of chemoradiation on dynamic MR parameters was higher in nonmucinous carcinomas than in the mucinous subtype (P < 0.001). A higher rate of response to treatment was linked with nonmucinous morphology (P < 0.001). Multivariate analysis revealed an association between mucinous tumor morphology and poor response (odds ratio [95% confidence interval]: 0.113 [0.032-0.395], P < 0.001) as well as an association between a high 75th percentile of k21 and a higher response rate (odds ratio: 1.043 [1.001-1.086], P = 0.019). CONCLUSION: Functional and morphological parameters of pretreatment MRI can assess tumor characteristics associated with the effectiveness of chemoradiation before treatment initiation.
Keywords:	Rectal Cancer, Mucinous Carcinoma, DCE-MRI, Pharmacokinetic Model, Chemoradiation, Pathologic Response
Source:	Journal of Magnetic Resonance Imaging
ISSN:	1053-1807
Publisher:	Wiley-Blackwell
Volume:	38
Number:	1
Page Range:	119-126
Date:	July 2013
Official Publication:	https://doi.org/10.1002/jmri.23952
PubMed:	View item in PubMed

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