TY - JOUR
T1 - Dynamic contrast-enhanced MRI for treatment response assessment in patients with oesophageal cancer receiving neoadjuvant chemoradiotherapy
AU - Heethuis, Sophie E.
AU - van Rossum, Peter S N
AU - Lips, IM
AU - Goense, Lucas
AU - Voncken, Francine E.
AU - Reerink, Onne
AU - van Hillegersberg, Richard
AU - Ruurda, Jelle P.
AU - Philippens, Marielle E.
AU - van Vulpen, Marco
AU - Meijer, Gert J.
AU - Lagendijk, JJW
AU - van Lier, A.L.H.M.W.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Purpose To explore and evaluate the potential value of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for the prediction of pathologic response to neoadjuvant chemoradiotherapy (nCRT) in oesophageal cancer. Material and methods Twenty-six patients underwent DCE-MRI before, during (week 2–3) and after nCRT, but before surgery (pre/per/post, respectively). Histopathologic tumour regression grade (TRG) was assessed after oesophagectomy. Tumour area-under-the-concentration time curve (AUC), time-to-peak (TTP) and slope were calculated. The ability of these DCE-parameters to distinguish good responders (GR, TRG 1–2) from poor responders (noGR, TRG ⩾ 3), and pathologic complete responders (pCR) from no-pCR was assessed. Results Twelve patients (48%) showed GR of which 8 patients (32%) pCR. Analysis of AUC change throughout treatment, AUCper-pre, was most predictive for GR, at a threshold of 22.7% resulting in a sensitivity of 92%, specificity of 77%, PPV of 79%, and a NPV of 91%. AUCpost-pre was most predictive for pCR, at a threshold of −24.6% resulting in a sensitivity of 83%, specificity of 88%, PPV of 71%, and a NPV of 93%. TTP and slope were not associated with pathologic response. Conclusions This study demonstrates that changes in AUC throughout treatment are promising for prediction of histopathologic response to nCRT for oesophageal cancer.
AB - Purpose To explore and evaluate the potential value of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for the prediction of pathologic response to neoadjuvant chemoradiotherapy (nCRT) in oesophageal cancer. Material and methods Twenty-six patients underwent DCE-MRI before, during (week 2–3) and after nCRT, but before surgery (pre/per/post, respectively). Histopathologic tumour regression grade (TRG) was assessed after oesophagectomy. Tumour area-under-the-concentration time curve (AUC), time-to-peak (TTP) and slope were calculated. The ability of these DCE-parameters to distinguish good responders (GR, TRG 1–2) from poor responders (noGR, TRG ⩾ 3), and pathologic complete responders (pCR) from no-pCR was assessed. Results Twelve patients (48%) showed GR of which 8 patients (32%) pCR. Analysis of AUC change throughout treatment, AUCper-pre, was most predictive for GR, at a threshold of 22.7% resulting in a sensitivity of 92%, specificity of 77%, PPV of 79%, and a NPV of 91%. AUCpost-pre was most predictive for pCR, at a threshold of −24.6% resulting in a sensitivity of 83%, specificity of 88%, PPV of 71%, and a NPV of 93%. TTP and slope were not associated with pathologic response. Conclusions This study demonstrates that changes in AUC throughout treatment are promising for prediction of histopathologic response to nCRT for oesophageal cancer.
KW - Chemoradiotherapy
KW - Dynamic contrast-enhanced MRI
KW - Neoadjuvant therapy
KW - Oesophageal cancer
KW - Treatment Outcome
UR - https://www.scopus.com/pages/publications/84992090924
U2 - 10.1016/j.radonc.2016.05.009
DO - 10.1016/j.radonc.2016.05.009
M3 - Article
C2 - 27296409
AN - SCOPUS:84992090924
SN - 0167-8140
VL - 120
SP - 128
EP - 135
JO - Radiotherapy & Oncology
JF - Radiotherapy & Oncology
IS - 1
ER -