Abstract
ObjectiveTo investigate the reproducibility of diffusion-weighted magnetic resonance imaging (DW-MRI) in assessing tumor response early in the course of neoadjuvant chemoradiotherapy in patients with operable esophageal cancer.MethodsEleven male patients (mean age 54.8 years) with newly diagnosed esophageal cancer underwent DW-MRI before and 10 days after start of chemoradiotherapy. Reproducibility of apparent diffusion coefficient (ADC) measurements by manual (freehand) and semi-automated volumetric methods was assessed.ResultsInterobserver reproducibility for the assessment of mean tumor ADC by the manual measurement method was good, with an ICC of 0.69 (95% CI, 0.36 to 0.85; P = 0.001). Interobserver reproducibility for the assessment of mean tumor ADC by the semi-automated volumetric measurement method was very good, with an ICC of 0.96 (95% CI, 0.91 to 0.98; P<0.001).ConclusionSemi-automated volumetric ADC measurements have higher reproducibility than manual ADC measurements in assessing tumor response to chemoradiotherapy in patients with esophageal adenocarcinoma.
Highlights
Esophageal cancer is a disease with a poor prognosis and high mortality
In the Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study trial, as much as 39% of patients had no histopathological tumor regression [3]
The objective of the present study was to investigate the reproducibility of Diffusion-weighted magnetic resonance imaging (DW-MRI) in assessing tumor response early in the course of neoadjuvant chemoradiotherapy in patients with operable esophageal cancer
Summary
Esophageal cancer is a disease with a poor prognosis and high mortality. There were an estimated 482,000 new cases and 407,000 patients died of the disease worldwide in 2008 [1]. Not all patients benefit from preoperative chemoradiotherapy. Patients who respond favorably may benefit from additional preoperative treatment and surgery may be delayed or even refrained from. There is a need for a method which can differentiate responders from nonresponders early in the course of neoadjuvant treatment. Studies investigating the value of Fluorine 18 (18F) fluorodeoxyglucose positron emission tomography (18F FDG PET) in assessing response to neoadjuvant treatment show heterogeneous results [5]. The objective of the present study was to investigate the reproducibility of DW-MRI in assessing tumor response early in the course of neoadjuvant chemoradiotherapy in patients with operable esophageal cancer. We investigated the potential of DW-MRI in differentiating responders from nonresponders in a limited number of patients
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