Abstract
Patients with oesophageal cancer without metastases are currently treated with five weeks of chemotherapy and radiation followed by surgery. Postoperatively, no tumour is found by the pathologist in 29% of patients. In these patients, not performing surgery is considered. A good clinical selection of complete responders prior to surgery is essential, and this thesis examines the role can be in this for diffusion-weighted MRI (DW-MRI).
DW-MRI has a high sensitivity to the selection of patients with residual tumour after chemoradiation. In addition, DW-MRI resulted in a higher sensitivity than the (currently widely used) technique FDG-PET/CT. Previous studies also described a high chance of false negatives in endoscopies performed by a gastrointestinal-liver-doctor. This implies that patients with residual tumour may be incorrectly not operated on. Therefore, the additional value of DW-MRI in endoscopy/EUS after chemoradiation was examined which led to higher detection of patients with residual tumour.
In conclusion, a promising role for DW-MRI was found for selecting complete responders after chemoradiation, which contributes to the implementation of organ-saving treatment for patients with oesophageal cancer.
DW-MRI has a high sensitivity to the selection of patients with residual tumour after chemoradiation. In addition, DW-MRI resulted in a higher sensitivity than the (currently widely used) technique FDG-PET/CT. Previous studies also described a high chance of false negatives in endoscopies performed by a gastrointestinal-liver-doctor. This implies that patients with residual tumour may be incorrectly not operated on. Therefore, the additional value of DW-MRI in endoscopy/EUS after chemoradiation was examined which led to higher detection of patients with residual tumour.
In conclusion, a promising role for DW-MRI was found for selecting complete responders after chemoradiation, which contributes to the implementation of organ-saving treatment for patients with oesophageal cancer.
Original language | English |
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Award date | 9 Dec 2020 |
Place of Publication | Maastricht |
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Print ISBNs | 9789464211269 |
DOIs | |
Publication status | Published - 2020 |
Keywords
- oesophageal cancer
- MRI
- personalised treatment
- selection