Tomoyoshi Aoyagi MD, Presenter: Nothing to Disclose

Kiyohiko Shuto MD, PhD, Abstract Co-Author: Nothing to Disclose

Hideaki Shimada MD, PhD, Abstract Co-Author: Nothing to Disclose

Hisahiro Matsubara MD, PhD, Abstract Co-Author: Nothing to Disclose

Toshiki Kazama MD, PhD, Abstract Co-Author: Nothing to Disclose

Shinichi Okazumi MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate the effect of chemoradiotherapy (CRT) for advanced esophageal cancer using diffusion-weighted magnetic resonance imaging (DWI) measuring tumor apparent diffusion coefficient (ADC) value.

Patient Population 68 consecutive patients of esophageal squamous cell cancer participated in this prospective study. 21 patients underwent CRT treatment. Chemoradiotherapy A total dose of radiotherapy was 40Gy with concurrent cisplatin and 5-fluorouracil administration. Imaging Protocol and Analysis DW images were acquired using a 1.5T whole body scanner equipped with a phased-array body coil. A single shot spin-echo type of echo-planar sequence that provided diffusion weighting in the direction of slice selection was used to obtain DW images. The corresponding b-value to diffusion-sensitizing gradients were b=0, 1000 s/mm2. DWI was performed in all of 68 patients. 21 underwent DWI only before CRT, and 17 of 21 underwent both before and after CRT. Using ADC map, the ADCs were measured at whole esophageal cancer. In CRT treated patients, we evaluated the ADC value between pre-CRT and post-CRT (N=17), and compared CRT effect (N=21) with the value of pre-CRT. Patients were divided into two groups, responder or non-responder. The therapeutic effect was assessed according to WHO criteria using contrast enhanced MDCT and esophagography after the treatment.

Comparing the ADC values between pre-CRT and post-CRT, the ADC value has increased after CRT with significantly difference (pre, 0.988 x 10-3mm2/s vs. post, 1.689 x 10-3mm2/s, respectively, P<0.0001). ADC value of esophageal cancer was significantly higher in responder group than in non-responder group with significantly difference (1.064x10-3mm2/s vs. 0.817x10-3mm2/s, respectively, P=0.0248).

The responder group had significantly high ADC value in comparison with non-responder group. This non-invasive modality could be a valid clinical tool to predict the effect of CRT for advanced esophageal squamous cell cancer.

DWI is a non-invasive and valid clinical imaging method and is recommended for predicting the response of chemoradiotherapy of advanced esophageal squamous cell carcinoma.

Aoyagi, T, Shuto, K, Shimada, H, Matsubara, H, Kazama, T, Okazumi, S, Evaluation of Chemoradiation Effect for Advanced Esophageal Cancer Using Diffusion-weighted Magnetic Resonance Imaging.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5005497.html