Diffusion-weighted imaging in rectal cancer: current applications and future perspectives

Niels W. Schurink, Doenja M. J. Lambregts*, Regina G. H. Beets-Tan

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

58 Citations (Web of Science)

Abstract

This review summarizes current applications and clinical utility of diffusion-weighted imaging (DWI) for rectal cancer and in addition provides a brief overview of more recent developments (including intravoxel incoherent motion imaging, diffusion kurtosis imaging, and novel postprocessing tools) that are still in more early stages of research. More than 140 papers have been published in the last decade, during which period the use of DWI have slowly moved from mainly qualitative (visual) image interpretation to increasingly advanced methods of quantitative analysis. So far, the largest body of evidence exists for assessment of tumour response to neoadjuvant treatment. In this setting, particularly the benefit of DWI for visual assessment of residual tumour in post-radiation fibrosis has been established and is now increasingly adopted in clinics. Quantitative DWI analysis (mainly the apparent diffusion coefficient) has potential, both for response prediction as well as for tumour prognostication, but protocols require standardization and results need to be prospectively confirmed on larger scale. The role of DWI for further clinical tumour and nodal staging is less well-defined, although there could be a benefit for DWI to help detect lymph nodes. Novel methods of DWI analysis and post-processing are still being developed and optimized; the clinical potential of these tools remains to be established in the upcoming years.

Original languageEnglish
Article number20180655
Number of pages17
JournalBritish Journal of Radiology
Volume92
Issue number1096
DOIs
Publication statusPublished - 5 Mar 2019

Keywords

  • NEOADJUVANT CHEMORADIATION THERAPY
  • PATHOLOGICAL COMPLETE RESPONSE
  • COEFFICIENT HISTOGRAM ANALYSIS
  • MAGNETIC-RESONANCE
  • LYMPH-NODES
  • PREOPERATIVE CHEMORADIOTHERAPY
  • RADIATION-THERAPY
  • TUMOR RESPONSE
  • MR-VOLUMETRY
  • COMBINED CHEMOTHERAPY

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