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European Radiology
Published in: European Radiology 1/2013

01-01-2013 | Oncology

T2 weighted signal intensity evolution may predict pathological complete response after treatment for rectal cancer

Authors: Ewelina Kluza, Esther D. Rozeboom, Monique Maas, Milou Martens, Doenja M. J. Lambregts, Jos Slenter, Geerard L. Beets, Regina G. H. Beets-Tan

Published in: European Radiology | Issue 1/2013

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Abstract

Objectives

To determine the diagnostic value of T2-weighted signal intensity evolution in the tumour for detection of complete response to neoadjuvant chemoradiotherapy in patients with rectal cancer.

Methods

Thirty-nine patients diagnosed with locally advanced adenocarcinoma and treated with chemoradiotherapy (CRT), followed by surgery, underwent magnetic resonance imaging (MRI) before and after CRT on 1.5-T MRI using T2-weighted fast spin-echo (FSE) imaging. The relative T2-weighted signal intensity (rT2wSI) distribution in the tumour and post-CRT residual tissue was characterised by means of the descriptive statistical parameters, such as the mean, 95th percentile and standard deviation (SD). Receiver operating characteristic curves were used to determine the diagnostic potential of the CRT-induced alterations (Δ) in rT2wSI descriptives. The tumour regression grade (TRG) served as a histopathological reference standard.

Results

CRT induced a significant decrease of approximately 50% in all rT2wSI descriptives in complete responders (TRG1). This drop was significantly larger than for incomplete response groups (TRG2–TRG4). The ΔrT2wSI descriptives produced a high diagnostic performance for identification of complete responders, e.g. Δ95th percentile, ΔSD and Δmean resulted in accuracy of 92%, 90% and 82%, respectively.

Conclusions

Quantitative assessment of the CRT-induced changes in the tumour T2-weighted signal intensity provides high diagnostic performance for selection of complete responders.

Key Points

• T2 weighted MRI helps predict response after chemoradiotherapy for rectal cancer.
• Residual tumour and chemoradiotherapy-induced fibrosis have different T2 relaxation properties.
• T2-weighted signal intensity evolution is a promising non-invasive marker of therapeutic response.
• A pathologically complete response is associated with the largest signal intensity drop.
Appendix
Available only for authorised users
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Metadata
Title
T2 weighted signal intensity evolution may predict pathological complete response after treatment for rectal cancer
Authors
Ewelina Kluza
Esther D. Rozeboom
Monique Maas
Milou Martens
Doenja M. J. Lambregts
Jos Slenter
Geerard L. Beets
Regina G. H. Beets-Tan
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
European Radiology / Issue 1/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2578-z

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