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European Radiology
Published in: European Radiology 8/2013

01-08-2013 | Gastrointestinal

Apparent diffusion coefficient modifications in assessing gastro-oesophageal cancer response to neoadjuvant treatment: comparison with tumour regression grade at histology

Authors: Francesco De Cobelli, Francesco Giganti, Elena Orsenigo, Michaela Cellina, Antonio Esposito, Giulia Agostini, Luca Albarello, Elena Mazza, Alessandro Ambrosi, Carlo Socci, Carlo Staudacher, Alessandro Del Maschio

Published in: European Radiology | Issue 8/2013

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Abstract

Objectives

To assess changes in apparent diffusion coefficient (ΔADC) and volume (ΔV) after neoadjuvant treatment (NT), and tumour regression grade (TRG) in gastro-oesophageal cancers (GEC), and to discriminate responders from non-responders.

Methods

Thirty-two patients with biopsy-proven locally-advanced GEC underwent diffusion weighted magnetic resonance imaging (DWI) pre- and post-NT. Lesion ADC, volume, ΔADC and ΔV were calculated. TRG 1-2-3 patients were classified as R; TRG 4-5 as non-responders. ΔADC-TRG and ΔV-TRG correlations, pre-NT and post-NT ADC, ΔADC and ΔV cut-off values for responders and non-responders were calculated. Two readers measured mean tumour ADCs and interobserver variability was calculated. (Spearman’s and intraclass correlation coefficient [ICC]).

Results

The interobserver reproducibility was very good both for pre-NT (Spearman’s rho = 0.8160; ICC = 0.8993) and post-NT (Spearman’s rho = 0.8357; ICC = 0.8663). Responders showed lower pre-NT ADC (1.32 versus 1.63 × 10−3 mm2/s; P = 0.002) and higher post-NT ADC (2.22 versus 1.51 × 10−3 mm2/s; P = 0.001) than non-responders and ADC increased in responders (ΔADC, 85.45 versus −8.21 %; P = 0.00005). ΔADC inversely correlated with TRG (r = −0.71, P = 0.000004); no difference in ΔV between responders and non-responders (−50.92 % versus −14.12 %; P = 0.068) and no correlation ΔV-TRG (r = 0.02 P = 0.883) were observed.

Conclusions

The ADC can be used to assess gastro-oesophageal tumour response to neoadjuvant treatment as a reliable expression of tumour regression.

Key Points

• DWI is now being used to assess many cancers.
• Change in ADC measurements offer new information about oesophageal tumours.
• ADC changes are more reliable than dimensional criteria in assessing neoadjuvant treatment.
• Such ADC assessment could optimise management of locally advanced gastro-oesophageal cancers.
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Metadata
Title
Apparent diffusion coefficient modifications in assessing gastro-oesophageal cancer response to neoadjuvant treatment: comparison with tumour regression grade at histology
Authors
Francesco De Cobelli
Francesco Giganti
Elena Orsenigo
Michaela Cellina
Antonio Esposito
Giulia Agostini
Luca Albarello
Elena Mazza
Alessandro Ambrosi
Carlo Socci
Carlo Staudacher
Alessandro Del Maschio
Publication date
01-08-2013
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2807-0

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