Abstract
Purpose: To evaluate the clinical value of diffusion-weighted magnetic resonance imaging (DW-MRI) to monitor response of primary carcinoma of the rectum to preoperative chemoradiation by measuring tumor apparent diffusion coefficient (ADC). Materials and methods: Diffusion data of nine patients undergoing preoperative combined chemoradiation for clinical staged T3, N 0–2, M 0 carcinoma of the rectum were analyzed. Diffusion-weighted echo-planar MR images were obtained prior to and at specified intervals during chemoradiation and ADCs calculated from acquired tumor images. Results: Comparison of mean ADC and cumulative radiation dose showed a significant decrease of mean ADC at the 2nd ( P=0.028), 3rd ( P=0.012), and 4th ( P=0.008) weeks of treatment. Cytotoxic edema and fibrosis were considered as reasons for ADC decrease. Conclusion: This study demonstrated tumor ADC changes via detection of therapy-induced alterations in tumor water mobility. Our results indicate that diffusion-weighted imaging may be a valuable clinical tool to diagnose the early stage of radiation-induced fibrosis.
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