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Complementary value of pre-treatment apparent diffusion coefficient in rectal cancer for predicting tumor recurrence

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Author(s)
Sung Jun MoonSeung Hyun ChoGab Chul KimWon Hwa KimHye Jung KimKyung-Min ShinSo Mi LeeGyu-Seog ChoiSee Hyung KimJun Seok Park
Keimyung Author(s)
Kim, See Hyung
Department
Dept. of Radiology (영상의학)
Journal Title
Abdominal Radiology
Issued Date
2016
Volume
41
Issue
7
Keyword
Rectal cancerPrognosisMagnetic resonance imaging (MRI)Diffusion-weighted image (DWI)Apparent diffusion coefficient (ADC)
Abstract
Purpose: To assess the complementary prognostic value
of pre-treatment tumor apparent diffusion coefficient
(ADC) for the prediction of tumor recurrence in patients
with rectal cancer.
Methods: From March 2012 to March 2013, a total of
128 patients with mid/lower rectal cancer who underwent
pre-treatment rectal MRI were enrolled in this retrospective
study. Two radiologists in consensus evaluated
conventional imaging features (Cimg) in pre-treatment
rectal MRI: tumor height from anal verge (£5 cm vs.
>5 cm), T stage (high vs. low), the presence or absence
of lymph node metastasis, mesorectal fascia invasion,
and extramural venous invasion. The mean tumor ADC
values (TumorADC) based on high b-value (0,
1000 9 10-3 mm2/s) diffusion weight images were
extracted. A multivariate Cox proportional hazard
(CPH) regression was performed to evaluate the association
of Cimg and TumorADC with the 3-year local
recurrence (LR) rate. Predictive performance of two
multivariate CPH models (Cimg only vs. Cimg + TumorADC)
was compared using Harrell’s c index (HCI).
Results: TumorADC (Adjusted HR, 7.830; 95% CI 3.937–
15.571) and high T stage (Adjusted HR, 8.039; 95% CI
2.405–26.874) were independently associated with the 3-
year LR rate. The CPH model generated with T
stage + TumorADC (HCI, 0.820; 95% CI 0.708–0.932)
showed significantly higher HCI than that with T stage
only (HCI, 0.742; 95% CI 0.594–0.889) (P = 0.009).
Conclusions: In patients with mid/lower rectal cancer,
integrating TumorADC to Cimg increases predictive performance
of the CPH model than that with Cimg alone
for the prediction of LR within 3 years after surgery.
Keimyung Author(s)(Kor)
김시형
Publisher
School of Medicine
Citation
Sung Jun Moon et al. (2016). Complementary value of pre-treatment apparent diffusion coefficient in rectal cancer for predicting tumor recurrence. Abdominal Radiology, 41(7), 1237–1244. doi: 10.1007/s00261-016-0648-4
Type
Article
ISSN
2366-004X
Source
https://link.springer.com/article/10.1007%2Fs00261-016-0648-4
DOI
10.1007/s00261-016-0648-4
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32714
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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