Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;47(10):3394-3405.
doi: 10.1007/s00261-022-03623-0. Epub 2022 Aug 2.

Dynamic contrast-enhanced and diffusion-weighted MR imaging in early prediction of pathologic response to neoadjuvant chemotherapy in locally advanced gastric cancer

Jing Li  1 , Liang-Liang Yan  1 , Hong-Kai Zhang  1 , Yi Wang  2 , Shu-Ning Xu  3 , Hai-Liang Li #  4 , Jin-Rong Qu #  5
Affiliations

Dynamic contrast-enhanced and diffusion-weighted MR imaging in early prediction of pathologic response to neoadjuvant chemotherapy in locally advanced gastric cancer

Jing Li et al. Abdom Radiol (NY). 2022 Oct.

Abstract

Purpose: To investigate the efficacy of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the early prediction of the pathologic response to neoadjuvant chemotherapy (NAC) in patients with locally advanced gastric cancer (LAGC).

Methods: Fifty patients with LAGC who were treated with NAC followed by radical gastrectomy were enrolled. Uncontrasted and DCE-MRI were performed within 1 week before NAC. According to tumor regression grading (TRG), patients were labeled as responders (TRG = 0 + 1) and non-responders (TRG = 2 + 3). Apparent diffusion coefficients (ADC) and DCE-MRI kinetics (Ktrans, Ve, and Kep) were compared between the two groups. Logistic regression analysis was performed to screen independent factors to predict the NAC efficacy. The relationship between MRI parameters and TRG was studied by Spearman's correlation analysis. Receiver-operating characteristic curve analyses were applied to evaluate the efficacy.

Results: ADC, Ktrans, and Kep values were higher in responders than in non-responders (p < 0.05) and correlated with TRG (p < 0.05). The ADC and Kep values were independent markers for predicting TRG. The area under the curve, sensitivities, specificities of ADC, Ktrans, Kep, and ADC + Kep were 0.813, 0.699, 0.709, 0.886;73.64%, 65.54%, 63.21%, 70.37%; 86.47%, 54.97%, 79.47%, 95.65%; respectively. ADC + Kep demonstrated a higher efficacy than Ktrans and Kep (p = 0.012, 0.011), but without improvement compared with ADC (p > 0.05).

Conclusion: Both DWI and DCE-MRI can effectively predict the pathologic response to NAC in LAGC. A combination of ADC and Kep increased the efficacy, and ADC is the most valuable imaging parameter.

Keywords: Diffusion-weighted MR imaging; Dynamic contrast-enhanced MR imaging; Gastric cancer; Neoadjuvant chemotherapy; Treatment response.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Sung H, Ferlay J, Siegel RL et al. (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71:209–249. https://doi.org/ https://doi.org/10.3322/caac.21660 . - DOI - PubMed
    1. Gao K, Wu J (2019) National trend of gastric cancer mortality in China (2003–2015): a population-based study. Cancer Commun (Lond) 39(1):24. https://doi.org/ https://doi.org/10.1186/s40880-019-0372-x . - DOI
    1. Miller KD, Nogueira L, Mariotto AB et al. (2019) Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin 69:363–385. https://doi.org/ https://doi.org/10.3322/caac.21565 . - DOI - PubMed
    1. Cunningham D, Allum WH, Stenning SP et al. (2016) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20. https://doi.org/ https://doi.org/10.1056/NEJMoa055531 . - DOI
    1. Maria C Russell (2016) Comparison of neoadjuvant versus a surgery first approach for gastric and esophagogastric cancer. J Surg Oncol 114(3):296–303. https://doi.org/ https://doi.org/10.1002/jso.24293 . - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources