Comparison of intravoxel incoherent motion and diffusion kurtosis imaging and 18- FDG PET/CT in response assessment in rectosigmoid carcinoma.

IF 2.3 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Abdominal Radiology Pub Date : 2024-11-25 DOI:10.1007/s00261-024-04689-8

Stuti Chandola, Abhishek Soni, Soham Banerjee, Hemanga K Bhattacharjee, Raju Sharma, Ankita Phulia, Sushmita Pathy, Chandan J Das

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引用次数: 0

Abstract

Objective: To evaluate the performance of intravoxel incoherent motion and diffusion kurtosis imaging (IVIM- DKI) in response assessment of rectosigmoid carcinoma to chemo-radiotherapy (CRT) and compare with 18-FDG PET/CT parameters.

Methods: A total of 30 patients of recto-sigmoid cancer on CRT underwent baseline staging and follow-up with IVIM - DKI. Out of this cohort, 20 patients underwent 18-FDG PET/CT. IVIM- DKI MRI and PET/CT parameters were noted from both pre and post-chemoradiotherapy (done at 6 weeks after completion) scans. Quantitative IVIM-DKI parameters, viz. apparent (ADC) and molecular (D) diffusion coefficient, perfusion coefficient (f), and kurtosis (K) were measured from non-necrotic areas and semi-quantitative PET parameters including SUV max, SUV ratio, metabolic tumor volume (MTV), total lesion glycolysis (TLG) were also measured. All these parameters correlated with the patient's response keeping RECIST 1.1 criteria as reference standard.

Results: A statistically significant increase in D and ADC with a significant decline in K was noted after therapy in the entire cohort. These changes were observed in both responders as well as non-responders. No significant differences were observed in the percentage changes of these parameters post therapy amongst both groups. Among 20 patients with follow-up PET/CT imaging, a significant decline in all parameters of primary lesion was seen post-therapy. Responders (n = 12) showed a significant decline in MTV and TLG from baseline after therapy, whereas non-responders did not show any such decline. Change in TLG (ɗ TLG), followed by ɗ MTV had the strongest correlation with a positive response. A ɗ TLG value of ≥ 54.19 carried a 79% sensitivity and 83% specificity in differentiating responders from non responders.

Conclusion: 18-FDG PET/CT is a more accurate single modality for assessing both response and tumor burden post therapy, while ADC and D from IVIM MRI are useful adjuncts to response assessment.

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体细胞内不连贯运动和弥散峰度成像与 18- FDG PET/CT 在直肠乙状结肠癌反应评估中的比较。

目的评估体细胞内非相干运动和弥散峰度成像（IVIM- DKI）在直乙状结肠癌化疗（CRT）反应评估中的性能，并与 18-FDG PET/CT 参数进行比较：共有 30 名接受 CRT 的直肠乙状结肠癌患者接受了 IVIM - DKI 的基线分期和随访。其中，20 名患者接受了 18-FDG PET/CT 检查。IVIM- DKI MRI 和 PET/CT 参数来自化疗前和化疗后（化疗结束后 6 周）的扫描。测量了非坏死区域的 IVIM-DKI 定量参数，即表观（ADC）和分子（D）扩散系数、灌注系数（f）和峰度（K），还测量了半定量 PET 参数，包括 SUV 最大值、SUV 比值、代谢肿瘤体积（MTV）、总病变糖酵解（TLG）。所有这些参数都与患者的反应相关，以 RECIST 1.1 标准作为参考标准：结果：所有患者在接受治疗后，D 和 ADC 均有统计学意义上的明显增加，而 K 则明显下降。这些变化在有反应者和无反应者中都能观察到。两组患者治疗后这些参数的百分比变化无明显差异。在 20 名接受 PET/CT 成像随访的患者中，发现原发病灶的所有参数在治疗后均显著下降。有反应者（12 人）的 MTV 和 TLG 在治疗后较基线有明显下降，而无反应者则无任何下降。TLG（郱 TLG）的变化与阳性反应的相关性最强，其次是 MTV 的变化。结论：18-FDG PET/CT 是评估治疗后反应和肿瘤负荷的更准确的单一模式，而 IVIM MRI 的 ADC 和 D 是反应评估的有用辅助手段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

8.30%

发文量

334

期刊介绍： Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits