Could perfusion heterogeneity at dynamic contrast-enhanced MRI be used to predict rectal cancer sensitivity to chemoradiotherapy?
To evaluate whether perfusion heterogeneity of rectal cancer prior to chemoradiotherapy (CRT) using histogram analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) quantitative parameters can predict response to treatment. Twenty-one patients with histologically proven rectal...
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| Veröffentlicht in: | Clinical radiology 2018-10, Vol.73 (10), p.911.e1-911.e7 |
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| container_title | Clinical radiology |
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| creator | Palmisano, A. Esposito, A. Rancoita, P.M.V. Di Chiara, A. Passoni, P. Slim, N. Campolongo, M. Albarello, L. Fiorino, C. Rosati, R. Del Maschio, A. De Cobelli, F. |
| description | To evaluate whether perfusion heterogeneity of rectal cancer prior to chemoradiotherapy (CRT) using histogram analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) quantitative parameters can predict response to treatment.
Twenty-one patients with histologically proven rectal adenocarcinoma were enrolled prospectively. All patients underwent 1.5 T DCE-MRI before CRT. Tumour volumes were drawn on Ktrans and Ve maps, using T2-weighted (W) images as reference, and the following first-order texture parameters of Ve and Ktrans values were extracted: 25th, 50th, 75th percentile, mean, standard deviation, skewness, and kurtosis. After CRT, patients underwent surgery and according with Rödel's tumour regression grade (TRG), they were classified as poor responders “non-GR” (TRG 0–2) and good responders “GR” (TRG 3–4). Differences between GR and non-GR in DCE-MRI first-order texture parameters were evaluated using the Mann–Whitney test, and their role in the prediction of response was investigated using receiver operating characteristic (ROC) curve analysis.
Sixteen (76%) patients were classified as GR and five (24%) were non-GR. Skewness and kurtosis of Ve was significantly higher in non-GR (4.886±1.320 and 36.402±24.486, respectively) than in GR patients (1.809±1.280, p=0.003 and 6.268±8.130, p= 0.011). Ve skewness |
| doi_str_mv | 10.1016/j.crad.2018.06.007 |
| format | Article |
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Twenty-one patients with histologically proven rectal adenocarcinoma were enrolled prospectively. All patients underwent 1.5 T DCE-MRI before CRT. Tumour volumes were drawn on Ktrans and Ve maps, using T2-weighted (W) images as reference, and the following first-order texture parameters of Ve and Ktrans values were extracted: 25th, 50th, 75th percentile, mean, standard deviation, skewness, and kurtosis. After CRT, patients underwent surgery and according with Rödel's tumour regression grade (TRG), they were classified as poor responders “non-GR” (TRG 0–2) and good responders “GR” (TRG 3–4). Differences between GR and non-GR in DCE-MRI first-order texture parameters were evaluated using the Mann–Whitney test, and their role in the prediction of response was investigated using receiver operating characteristic (ROC) curve analysis.
Sixteen (76%) patients were classified as GR and five (24%) were non-GR. Skewness and kurtosis of Ve was significantly higher in non-GR (4.886±1.320 and 36.402±24.486, respectively) than in GR patients (1.809±1.280, p=0.003 and 6.268±8.130, p= 0.011). Ve skewness <3.635 was able to predict GR with an area under the ROC curve (AUC) of 0.988, sensitivity 93.8%, specificity 80%, and accuracy 90.5%. Ve kurtosis <21.095 was able to predict response with an AUC of 0.963, sensitivity 93.8%, specificity 80%, and accuracy 90.5%. Other parameters were not different between groups or predictors of response.
Ve skewness and kurtosis seem to be promising in the prediction of response to CRT in rectal cancer patients.
•Rectal cancer's perfusion heterogeneity at DCE-MRI assessed pre-CRT may give information about tumor chemioradiosensitivity.•Skewness and kurtosis of Ve are significantly higher in poor responders than in good responders (p=0.003 and p=0.011).•Poor and good responders resulted not significantly different in term of heterogeneity of ktrans values' distribution.</description><identifier>ISSN: 0009-9260</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1016/j.crad.2018.06.007</identifier><identifier>PMID: 30029837</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Chemoradiotherapy ; Contrast Media ; Female ; Humans ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Neoadjuvant Therapy ; Prospective Studies ; Rectal Neoplasms - pathology ; Rectal Neoplasms - therapy ; Retrospective Studies ; ROC Curve ; Treatment Outcome</subject><ispartof>Clinical radiology, 2018-10, Vol.73 (10), p.911.e1-911.e7</ispartof><rights>2018 The Royal College of Radiologists</rights><rights>Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-7f185b9866ae09e54ae7d6a4a0b1edd864a96b53a7bdd835f96f98c180a438fb3</citedby><cites>FETCH-LOGICAL-c356t-7f185b9866ae09e54ae7d6a4a0b1edd864a96b53a7bdd835f96f98c180a438fb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0009926018302447$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30029837$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Palmisano, A.</creatorcontrib><creatorcontrib>Esposito, A.</creatorcontrib><creatorcontrib>Rancoita, P.M.V.</creatorcontrib><creatorcontrib>Di Chiara, A.</creatorcontrib><creatorcontrib>Passoni, P.</creatorcontrib><creatorcontrib>Slim, N.</creatorcontrib><creatorcontrib>Campolongo, M.</creatorcontrib><creatorcontrib>Albarello, L.</creatorcontrib><creatorcontrib>Fiorino, C.</creatorcontrib><creatorcontrib>Rosati, R.</creatorcontrib><creatorcontrib>Del Maschio, A.</creatorcontrib><creatorcontrib>De Cobelli, F.</creatorcontrib><title>Could perfusion heterogeneity at dynamic contrast-enhanced MRI be used to predict rectal cancer sensitivity to chemoradiotherapy?</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>To evaluate whether perfusion heterogeneity of rectal cancer prior to chemoradiotherapy (CRT) using histogram analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) quantitative parameters can predict response to treatment.
Twenty-one patients with histologically proven rectal adenocarcinoma were enrolled prospectively. All patients underwent 1.5 T DCE-MRI before CRT. Tumour volumes were drawn on Ktrans and Ve maps, using T2-weighted (W) images as reference, and the following first-order texture parameters of Ve and Ktrans values were extracted: 25th, 50th, 75th percentile, mean, standard deviation, skewness, and kurtosis. After CRT, patients underwent surgery and according with Rödel's tumour regression grade (TRG), they were classified as poor responders “non-GR” (TRG 0–2) and good responders “GR” (TRG 3–4). Differences between GR and non-GR in DCE-MRI first-order texture parameters were evaluated using the Mann–Whitney test, and their role in the prediction of response was investigated using receiver operating characteristic (ROC) curve analysis.
Sixteen (76%) patients were classified as GR and five (24%) were non-GR. Skewness and kurtosis of Ve was significantly higher in non-GR (4.886±1.320 and 36.402±24.486, respectively) than in GR patients (1.809±1.280, p=0.003 and 6.268±8.130, p= 0.011). Ve skewness <3.635 was able to predict GR with an area under the ROC curve (AUC) of 0.988, sensitivity 93.8%, specificity 80%, and accuracy 90.5%. Ve kurtosis <21.095 was able to predict response with an AUC of 0.963, sensitivity 93.8%, specificity 80%, and accuracy 90.5%. Other parameters were not different between groups or predictors of response.
Ve skewness and kurtosis seem to be promising in the prediction of response to CRT in rectal cancer patients.
•Rectal cancer's perfusion heterogeneity at DCE-MRI assessed pre-CRT may give information about tumor chemioradiosensitivity.•Skewness and kurtosis of Ve are significantly higher in poor responders than in good responders (p=0.003 and p=0.011).•Poor and good responders resulted not significantly different in term of heterogeneity of ktrans values' distribution.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Chemoradiotherapy</subject><subject>Contrast Media</subject><subject>Female</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy</subject><subject>Prospective Studies</subject><subject>Rectal Neoplasms - pathology</subject><subject>Rectal Neoplasms - therapy</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Treatment Outcome</subject><issn>0009-9260</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEGL1TAQx4Mo7nP1C3iQHL20Tpo2bUAQeay6sIuwrOAtpMnUl0fb1CRdeEe_uSlv9binmYHf_Jn5EfKWQcmAiQ_H0gRtywpYV4IoAdpnZMe4aIqqkj-fkx0AyEJWAi7IqxiP21hX9UtywQEq2fF2R_7s_TpaumAY1uj8TA-YMPhfOKNLJ6oTtadZT85Q4-cUdEwFzgc9G7T09u6a9kjXmPvk6RLQOpNoQJP0SM0GBRpxji65hy0tQ-aAk89XO58OGPRy-vSavBj0GPHNY70kP75c3e-_FTffv17vP98UhjciFe3AuqaXnRAaQWJTa2yt0LWGnqG1nai1FH3DddvniTeDFIPsDOtA17wben5J3p9zl-B_rxiTmlw0OI56Rr9GVUHLOW-zroxWZ9QEH2PAQS3BTTqcFAO1qVdHtalXm3oFQmX1eendY_7aT2j_r_xznYGPZwDzlw8Og4rG4WbSbcqU9e6p_L-YEJgv</recordid><startdate>201810</startdate><enddate>201810</enddate><creator>Palmisano, A.</creator><creator>Esposito, A.</creator><creator>Rancoita, P.M.V.</creator><creator>Di Chiara, A.</creator><creator>Passoni, P.</creator><creator>Slim, N.</creator><creator>Campolongo, M.</creator><creator>Albarello, L.</creator><creator>Fiorino, C.</creator><creator>Rosati, R.</creator><creator>Del Maschio, A.</creator><creator>De Cobelli, F.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201810</creationdate><title>Could perfusion heterogeneity at dynamic contrast-enhanced MRI be used to predict rectal cancer sensitivity to chemoradiotherapy?</title><author>Palmisano, A. ; Esposito, A. ; Rancoita, P.M.V. ; Di Chiara, A. ; Passoni, P. ; Slim, N. ; Campolongo, M. ; Albarello, L. ; Fiorino, C. ; Rosati, R. ; Del Maschio, A. ; De Cobelli, F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-7f185b9866ae09e54ae7d6a4a0b1edd864a96b53a7bdd835f96f98c180a438fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Chemoradiotherapy</topic><topic>Contrast Media</topic><topic>Female</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy</topic><topic>Prospective Studies</topic><topic>Rectal Neoplasms - pathology</topic><topic>Rectal Neoplasms - therapy</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Palmisano, A.</creatorcontrib><creatorcontrib>Esposito, A.</creatorcontrib><creatorcontrib>Rancoita, P.M.V.</creatorcontrib><creatorcontrib>Di Chiara, A.</creatorcontrib><creatorcontrib>Passoni, P.</creatorcontrib><creatorcontrib>Slim, N.</creatorcontrib><creatorcontrib>Campolongo, M.</creatorcontrib><creatorcontrib>Albarello, L.</creatorcontrib><creatorcontrib>Fiorino, C.</creatorcontrib><creatorcontrib>Rosati, R.</creatorcontrib><creatorcontrib>Del Maschio, A.</creatorcontrib><creatorcontrib>De Cobelli, F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Palmisano, A.</au><au>Esposito, A.</au><au>Rancoita, P.M.V.</au><au>Di Chiara, A.</au><au>Passoni, P.</au><au>Slim, N.</au><au>Campolongo, M.</au><au>Albarello, L.</au><au>Fiorino, C.</au><au>Rosati, R.</au><au>Del Maschio, A.</au><au>De Cobelli, F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Could perfusion heterogeneity at dynamic contrast-enhanced MRI be used to predict rectal cancer sensitivity to chemoradiotherapy?</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2018-10</date><risdate>2018</risdate><volume>73</volume><issue>10</issue><spage>911.e1</spage><epage>911.e7</epage><pages>911.e1-911.e7</pages><issn>0009-9260</issn><eissn>1365-229X</eissn><abstract>To evaluate whether perfusion heterogeneity of rectal cancer prior to chemoradiotherapy (CRT) using histogram analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) quantitative parameters can predict response to treatment.
Twenty-one patients with histologically proven rectal adenocarcinoma were enrolled prospectively. All patients underwent 1.5 T DCE-MRI before CRT. Tumour volumes were drawn on Ktrans and Ve maps, using T2-weighted (W) images as reference, and the following first-order texture parameters of Ve and Ktrans values were extracted: 25th, 50th, 75th percentile, mean, standard deviation, skewness, and kurtosis. After CRT, patients underwent surgery and according with Rödel's tumour regression grade (TRG), they were classified as poor responders “non-GR” (TRG 0–2) and good responders “GR” (TRG 3–4). Differences between GR and non-GR in DCE-MRI first-order texture parameters were evaluated using the Mann–Whitney test, and their role in the prediction of response was investigated using receiver operating characteristic (ROC) curve analysis.
Sixteen (76%) patients were classified as GR and five (24%) were non-GR. Skewness and kurtosis of Ve was significantly higher in non-GR (4.886±1.320 and 36.402±24.486, respectively) than in GR patients (1.809±1.280, p=0.003 and 6.268±8.130, p= 0.011). Ve skewness <3.635 was able to predict GR with an area under the ROC curve (AUC) of 0.988, sensitivity 93.8%, specificity 80%, and accuracy 90.5%. Ve kurtosis <21.095 was able to predict response with an AUC of 0.963, sensitivity 93.8%, specificity 80%, and accuracy 90.5%. Other parameters were not different between groups or predictors of response.
Ve skewness and kurtosis seem to be promising in the prediction of response to CRT in rectal cancer patients.
•Rectal cancer's perfusion heterogeneity at DCE-MRI assessed pre-CRT may give information about tumor chemioradiosensitivity.•Skewness and kurtosis of Ve are significantly higher in poor responders than in good responders (p=0.003 and p=0.011).•Poor and good responders resulted not significantly different in term of heterogeneity of ktrans values' distribution.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30029837</pmid><doi>10.1016/j.crad.2018.06.007</doi></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Chemoradiotherapy Contrast Media Female Humans Magnetic Resonance Imaging - methods Male Middle Aged Neoadjuvant Therapy Prospective Studies Rectal Neoplasms - pathology Rectal Neoplasms - therapy Retrospective Studies ROC Curve Treatment Outcome |
| title | Could perfusion heterogeneity at dynamic contrast-enhanced MRI be used to predict rectal cancer sensitivity to chemoradiotherapy? |
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