Diffusion-weighted MRI in rectal cancer: Apparent diffusion coefficient as a potential noninvasive marker of tumor aggressiveness

L. Curvo Semedo, D.M. Lambregts, M. Maas, G.L. Beets, F. Caseiro Alves, R.G. Beets Tan

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

PURPOSE: To assess the value of diffusion-weighted MR imaging (DWI) as a potential noninvasive marker of tumor aggressiveness in rectal cancer, by analyzing the relationship between tumoral apparent diffusion coefficient (ADC) values and MRI and histological prognostic parameters. MATERIALS AND METHODS: Fifty rectal cancer patients underwent primary staging MRI including DWI before surgery and neo-adjuvant therapy. In 47, surgery was preceded by short-course radiation therapy (n = 28) or long-course chemoradiation therapy (n = 19). Mean tumor ADC was measured and compared between subgroups based on pretreatment CEA levels, MRI parameters (mesorectal fascia - MRF - status; T-stage; N-stage) and histological parameters (differentiation grade: poorly differentiated, poorly moderately differentiated, moderately differentiated, moderately well differentiated, well-differentiated; lymphangiovascular invasion). RESULTS: Mean tumor ADCs differ between MRF-free versus MRF-invaded tumors (P = 0.013), the groups of cN0 versus cN+ cancers (P = 0.011), and between the several groups of histological differentiation grades (P = 0.025). There was no significant difference in mean ADCs between the various groups of CEA levels, the T stage, and the presence of lymphangiovascular invasion. CONCLUSION: Lower ADC values were associated with a more aggressive tumor profile. Significant correlations were found between mean ADC values and radiological MRF status, N stage and differentiation grade. ADC has the potential to become an imaging biomarker of tumor aggressiveness profile. J. Magn. Reson. Imaging 2012;. (c) 2012 Wiley Periodicals, Inc.
Original languageEnglish
Pages (from-to)1365-1371
Number of pages7
JournalJournal of Magnetic Resonance Imaging
Volume35
Issue number6
DOIs
Publication statusPublished - Jun 2012

Keywords

  • MRI
  • diffusion-weighted imaging
  • apparent diffusion coefficient
  • rectal cancer
  • prognosis
  • biomarker
  • LOCAL RECURRENCE
  • PROGNOSTIC-FACTORS
  • RADIATION-THERAPY
  • RESECTION MARGIN
  • CHEMORADIATION
  • PREDICTION
  • CARCINOMA
  • CHEMOTHERAPY
  • SURVIVAL
  • RADIOTHERAPY

Cite this