MR imaging in the evaluation of tumor response after neoadjuvant chemoradiotherapy for patients with rectal cancers

doi:10.3877/cma.j.issn.2095-3224.2016.04.005

Abstract

Abstract:

Multidisciplinary management of rectal cancer has evolved significantly, leading to the particular importance of neoadjuvant therapy. Concurrently improving the resectability, neoadjuvant therapy may lead to an effective tumor down-staging of locally advanced rectal cancer in varying degrees. It is significant to assess tumor response after neadjuvant therapy for altering the subsequent treatment options that are considered. Magnetic resonance imaging is the recommended imaging technique for local staging of rectal cancer before surgery, and the role which plays in evaluation of response to neoadjuvant therapy is still under study. The value of conventional MR depends on morphological changes in assessment of therapeutic effect. Nevertheless, there are still some limitations. Functional MR combines information of detailed anatomy with that of tumor biology, providing comprehensive status on tumor morphological features, quantitative indicators and their changes as a result of treatment. It has the potential to assess the response to neoadjuvant therapy more accurately.

Key words: Rectal neoplasms, Magnetic resonance imaging, Neoadjuvant chemoradiotherapy, Response

Chongda Zhang, Hongmei Zhang. MR imaging in the evaluation of tumor response after neoadjuvant chemoradiotherapy for patients with rectal cancers[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2016, 05(04): 303-308.

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References 38

[1]	Chen W, Zheng R, Baade P D, et al. Cancer statistics in China, 2015 [J]. CA: a cancer journal for clinicians, 2016, 66(2):115-132.
[2]	梁晓，张红梅，叶枫, 等. 扩散加权成像在预测直肠癌术前放化疗疗效中的价值 [J].中华肿瘤杂志, 2016, 38(2):133-137.
[3]	Mckeown E, Nelson D W, Johnson E K, et al. Current approaches and challenges for monitoring treatment response in colon and rectal cancer [J]. J Cancer, 2014, 5(1):31-43.
[4]	Ferrari L, Fichera A. Neoadjuvant chemoradiation therapy and pathological complete response in rectal cancer [J]. Gastroenterology report, 2015, 3(4):277-288.
[5]	Hartley A, Ho K F, Mcconkey C, et al. Pathological complete response following pre-operative chemoradiotherapy in rectal cancer: analysis of phase II/III trials [J]. The British journal of radiology, 2005, 78(934):934-938.
[6]	Huh J W, Kim H C, Lee S J, et al. Diagnostic accuracy and prognostic impact of restaging by magnetic resonance imaging after preoperative chemoradiotherapy in patients with rectal cancer [J]. Radiotherapy and Oncology, 2014, 113(1):24-28.
[7]	Petrillo M, Fusco R, Catalano O, et al. MRI for Assessing Response to Neoadjuvant Therapy in Locally Advanced Rectal Cancer Using DCE-MR and DW-MR Data Sets: A Preliminary Report [J]. BioMed Res int, 2015:514740
[8]	Kluza E, Rozeboom E D, Maas M, et al. T2 weighted signal intensity evolution may predict pathological complete response after treatment for rectal cancer [J]. European radiology, 2013, 23(1):253-261.
[9]	Habr Gama A, Perez R O. Non‐operative management of rectal cancer after neoadjuvant chemoradiation[J]. British Journal of Surgery,2009, 96(2):125-127.
[10]	O′Neill B D, Brown G, Heald R J, et al. Non-operative treatment after neoadjuvant chemoradiotherapy for rectal cancer [J]. The lancet oncology, 2007, 8(7):625-633.
[11]	Jang K M, Kim S H, Choi D, et al. Pathological correlation with diffusion restriction on diffusion-weighted imaging in patients with pathological complete response after neoadjuvant chemoradiation therapy for locally advanced rectal cancer: preliminary results [J]. The British journal of radiology,2012, 85(1017):e566-572
[12]	Beets-Tan R G, Beets G L. MRI for assessing and predicting response to neoadjuvant treatment in rectal cancer [J]. Nature Reviews Gastroenterology & Hepatology, 2014, 11(8):480-488.
[13]	Chand M, Swift R I, Tekkis P P, et al. Extramural venous invasion is a potential imaging predictive biomarker of neoadjuvant treatment in rectal cancer [J]. British journal of cancer, 2014, 110(1):19-25.
[14]	Kim S H, Chang H J, Kim D Y, et al. What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy?[J]. Cancer Research and Treatment, 2015, 254. [Epub ahead of print]
[15]	Dworak O, Keilholz L, Hoffmann A. Pathological features of rectal cancer after preoperative radiochemotherapy [J]. International journal of colorectal disease, 1997, 12(1):19-23.
[16]	Lee J H, Jang H S, Kim J, et al. Prediction of pathologic staging with magnetic resonance imaging after preoperative chemoradiotherapy in rectal cancer: pooled analysis of KROG 10-01 and 11-02[J]. Radiotherapy and Oncology,2014,113(1):18-23.
[17]	van der Paardt M P, Zagers M B, Beets-Tan R G, et al. Patients who undergo preoperative chemoradiotherapy for locally advanced rectal cancer restaged by using diagnostic MR imaging: a systematic review and meta-analysis [J]. Radiology, 2013, 269(1):101-112.
[18]	Pierredon-Foulongne M, Nougaret S, Bibeau F, et al. Utility of reassessment after neoadjuvant therapy and difficulties in interpretation [J]. Diagnostic and interventional imaging, 2014, 95(5):495-503.
[19]	Battersby N J, Moran B, Yu S, et al. MR imaging for rectal cancer: the role in staging the primary and response to neoadjuvant therapy [J]. Expert review of gastroenterology & hepatology, 2014, 8(6):703-719.
[20]	黄忠明，初丽丽，赵日升, 等. 磁共振成像对直肠癌术前放化疗后再分期准确性的Meta分析 [J].中华胃肠外科杂志, 2014, 17(3):258-263.
[21]	Wen B, Zhang L, Wang C, et al. Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy [J]. Radiation Oncology, 2015, 10(1):124.
[22]	Barbaro B, Fiorucci C, Tebala C, et al. Locally Advanced Rectal Cancer: MR Imaging in Prediction of Response after Preoperative Chemotherapy and Radiation Therapy [J]. Radiology, 2009, 250(3):730-739.
[23]	Nougaret S, Fujii S, Addley H C, et al. Neoadjuvant chemotherapy evaluation by MRI volumetry in rectal cancer followed by chemoradiation and total mesorectal excision: Initial experience [J]. Journal of Magnetic Resonance Imaging, 2013, 38(3):726-732.
[24]	Ha H I, Kim A Y, Yu C S, et al. Locally advanced rectal cancer: diffusion-weighted MR tumour volumetry and the apparent diffusion coefficient for evaluating complete remission after preoperative chemoradiation therapy [J]. European radiology, 2013, 23(12):3345-3353.
[25]	Birlik B, Obuz F, Elibol F D, et al. Diffusion-weighted MRI and MR-volumetry-in the evaluation of tumor response after preoperative chemoradiotherapy in patients with locally advanced rectal cancer [J]. Magnetic resonance imaging, 2015, 33(2):201-212.
[26]	Kim Y C, Lim J S, Keum K C, et al. Comparison of diffusion-weighted MRI and MR volumetry in the evaluation of early treatment outcomes after preoperative chemoradiotherapy for locally advanced rectal cancer [J]. Journal of Magnetic Resonance Imaging, 2011, 34(3):570-576.
[27]	Curvo-Semedo L, Lambregts D M, Maas M, et al. Rectal cancer: assessment of complete response to preoperative combined radiation therapy with chemotherapy-conventional MR volumetry versus diffusion-weighted MR imaging [J]. Radiology, 2011, 260(3):734-743.
[28]	Tong T, Sun Y, Gollub M J, et al. Dynamic contrast‐enhanced MRI: Use in predicting pathological complete response to neoadjuvant chemoradiation in locally advanced rectal cancer [J]. Journal of Magnetic Resonance Imaging, 2015, 42(3):673-680.
[29]	Song I, Kim S H, Lee S J, et al. Value of diffusion-weighted imaging in the detection of viable tumour after neoadjuvant chemoradiation therapy in patients with locally advanced rectal cancer: comparison with T2 weighted and PET/CT imaging [J]. The British journal of radiology, 2012, 85(1013):577-586.
[30]	Kim S H, Lee J M, Hong S H, et al. Locally Advanced Rectal Cancer: Added Value of Diffusion-weighted MR Imaging in the Evaluation of Tumor Response to Neoadjuvant Chemo-and Radiation Therapy [J]. Radiology, 2009, 253(1):116-125.
[31]	Lambrecht M, Vandecaveye V, De Keyzer F, et al. Value of diffusion-weighted magnetic resonance imaging for prediction and early assessment of response to neoadjuvant radiochemotherapy in rectal cancer: preliminary results [J]. International Journal of Radiation Oncology • Biology • Physics, 2012, 82(2):863-870.
[32]	Blažić I, Maksimović R, Gajić M, et al. Apparent diffusion coefficient measurement covering complete tumor area better predicts rectal cancer response to neoadjuvant chemoradiotherapy [J]. Croatian medical journal, 2015, 56(5):460-469.
[33]	Lambregts D M, Beets G L, Maas M, et al. Tumour ADC measurements in rectal cancer: effect of ROI methods on ADC values and interobserver variability [J]. European radiology, 2011, 21(12):2567-2574.
[34]	Nougaret S, Vargas H A, Lakhman Y, et al. Intravoxel Incoherent Motion-derived Histogram Metrics for Assessment of Response after Combined Chemotherapy and Radiation Therapy in Rectal Cancer: Initial Experience and Comparison between Single-Section and Volumetric Analyses [J]. Radiology, 2016:150702.
[35]	童彤，孙轶群，蔡三军, 等. 动态对比增强MRI预测局部进展期直肠癌新辅助放化疗疗效的价值[J]. 中华放射学杂志, 2015(6):414-418.
[36]	周妮娜，陈敏，王文超, 等. 动态增强磁共振成像对直肠癌术前新辅助治疗疗效的评价 [J]. 磁共振成像, 2010, 1(2):103-109.
[37]	Cai P, Wu Y, An X, et al. Simple measurements on diffusion-weighted MR imaging for assessment of complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer [J]. European radiology, 2014, 24(11):2962-2970.
[38]	Fujii S, Nougaret S, Escal L, et al. MR imaging of locally advanced low rectal cancer: Relationships between imaging findings and the pathological tumor regression grade [J]. Journal of Magnetic Resonance Imaging, 2015, 42(2):421-426.

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