Value of perfusion parameters from golden-angle radial sparse parallel dynamic contrast-enhanced magnetic resonance imaging in predicting pathological complete response after neoadjuvant chemoradiotherapy for locally advanced rectal cancer

IF 1.4 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Diagnostic and interventional radiology Pub Date : 2024-07-08 Epub Date: 2024-03-26 DOI:10.4274/dir.2024.232460

Yu-Ning Pan, Meng-Yin Gu, Quan-Liang Mao, Yu-Guo Wei, Lin Zhang, Guang-Yu Tang

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Abstract

Purpose: Non-invasive methods for predicting pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) can provide distinct leverage in the management of patients with locally advanced rectal cancer (LARC). This study aimed to investigate whether including the golden-angle radial sparse parallel (GRASP) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) perfusion parameter (K_trans), in addition to tumor regression grading (TRG) and apparent diffusion coefficient (ADC) values, can improve the predictive ability for pCR.

Methods: Patients with LARC who underwent nCRT and subsequent surgery were included. The imaging parameters were compared between patients with and without pCR. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive ability of these parameters for pCR.

Results: A total of 111 patients were included in the study. A pCR was obtained in 32 patients (28.8%). MRI-based TRG (mrTRG) showed a negative correlation with pCR (r = -0.61, P < 0.001), and the average ADC value showed a positive correlation with pCR (r = 0.62, P < 0.001). Before nCRT, K_trans in the pCR group was significantly higher than in the non-pCR group (1.30 ± 0.24 vs. 0.88 ± 0.34, P < 0.001), but no difference was identified after nCRT. Following ROC curve analysis, the area under the curve (AUC) of mrTRG (level 1-2), average ADC value, and K_trans value for predicting pCR were 0.738 [95% confidence interval (CI): 0.65-0.82], 0.78 (95% CI: 0.69-0.86), and 0.84 (95% CI: 0.77-0.92), respectively. The model combining the three parameters had significantly higher predictive ability for pCR (AUC: 0.94, 95% CI: 0.88-0.98).

Conclusion: The use of a combination of the GRASP DCE-MRI K_trans with mrTRG and ADC can lead to a better pCR predictive performance.

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黄金角径向稀疏平行动态对比增强磁共振成像的灌注参数在预测局部晚期直肠癌新辅助化疗后病理完全反应中的价值。

目的：预测新辅助化放疗（nCRT）后病理完全反应（pCR）的无创方法可为局部晚期直肠癌（LARC）患者的治疗提供独特的杠杆作用。本研究旨在探讨在肿瘤回归分级（TRG）和表观弥散系数（ADC）值之外，加入黄金角径向稀疏平行（GRASP）动态对比增强磁共振成像（DCE-MRI）灌注参数（Ktrans）是否能提高pCR的预测能力：方法：纳入接受 nCRT 和后续手术的 LARC 患者。方法：纳入接受 nCRT 和后续手术的 LARC 患者，比较有 pCR 和无 pCR 患者的成像参数。采用接收者操作特征（ROC）曲线分析评估这些参数对 pCR 的预测能力：研究共纳入了 111 例患者。32例患者（28.8%）获得了pCR。基于 MRI 的 TRG（mrTRG）与 pCR 呈负相关（r = -0.61，P < 0.001），平均 ADC 值与 pCR 呈正相关（r = 0.62，P < 0.001）。nCRT前，pCR组的Ktrans明显高于非pCR组（1.30 ± 0.24 vs. 0.88 ± 0.34，P < 0.001），但nCRT后未发现差异。根据 ROC 曲线分析，mrTRG（1-2 级）、ADC 平均值和 Ktrans 值预测 pCR 的曲线下面积（AUC）分别为 0.738 [95% 置信区间 (CI)：0.65-0.82]、0.78 (95% CI：0.69-0.86) 和 0.84 (95% CI：0.77-0.92)。综合三个参数的模型对 pCR 的预测能力明显更高（AUC：0.94，95% CI：0.88-0.98）：结论：将 GRASP DCE-MRI Ktrans 与 mrTRG 和 ADC 结合使用可获得更好的 pCR 预测效果。

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Diagnostic and interventional radiology Medicine-Radiology, Nuclear Medicine and Imaging

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期刊介绍： Diagnostic and Interventional Radiology (Diagn Interv Radiol) is the open access, online-only official publication of Turkish Society of Radiology. It is published bimonthly and the journal’s publication language is English. The journal is a medium for original articles, reviews, pictorial essays, technical notes related to all fields of diagnostic and interventional radiology.