Francesco Giganti MD, Presenter: Nothing to Disclose

Luca Albarello, Abstract Co-Author: Nothing to Disclose

Alessandro Ambrosi, Abstract Co-Author: Nothing to Disclose

Carlo Staudacher MD, Abstract Co-Author: Nothing to Disclose

Alessandro Del Maschio MD, Abstract Co-Author: Nothing to Disclose

Francesco Aldo De Cobelli MD, Abstract Co-Author: Nothing to Disclose

Treatment options for gastric cancer (GC) range from endoscopic mucosal resection to radical surgery at its most invasive. These are used alone or in combination with neo-adjuvant therapy (NT). Despite multiple strategies, prognosis still remains poor regardless. The aim of our study was to investigate the role of apparent diffusion coefficient (ADC) as a potential biomarker in the evaluation of the aggressiveness of GC.

Approval for this study was obtained from our Institutional Ethics Committee and written informed consent was obtained from each Patient. From October 2009 to December 2013, 99 Patients (66 men - 33 women; mean age 67.45 ± 11.41 years) with biopsy-proven disease (24 Siewert II–III and 75 gastric cancers) were examined with a 1.5T MR system including T1, T2 and DWI (b values 0-600 s/mm2) sequences. ADC measurements were obtained from regions of interest traced on T2 and DW images and automatically copied on the ADC map. 70/99 Patients (70.7%) were directly treated with surgery while 29/99 Patients (29.3%) were submitted to NT beforehand. All participants were followed up for a median of 18 months. Pathological ADC, tumor location, pT, pN, surgical approach and histotype were investigated by univariate and multivariate analysis using Cox regression model and Kaplan-Meier curves.

At the end of the follow up, 66 (66.6%) patients were alive and 33 (33.4%) had died. Median overall survival was 36 ± 4 months. Considering all the variables, we observed that ADC values below 1.5 x 10-3 mm2/s could predict a negative prognosis both in the total population (n=99, p<0.01) and in the two subgroups (n=70, p<0.01, and n=29, p<0.01). Moreover, pT, pN and surgical approach were significant prognostic factors in all groups (p<0.05) along with histotype (p<0.05, both in the total and surgical population) and tumor location (p<0.05, only in the surgical population).

Our preliminary study suggests the potential role of ADC as a quantitative biomarker reflecting the aggressiveness of GC. ADC may provide useful information on life expectancy and might be added to the current validated prognostic parameters for pre-operative risk stratification.

ADC may provide useful information on life expectancy and might be added to the current validated prognostic parameters for pre-operative risk stratification.

Giganti, F, Albarello, L, Ambrosi, A, Staudacher, C, Del Maschio, A, De Cobelli, F, New Insights in the Management and Prognosis of Gastric Cancer: The Innovative Role of Pre-treatment Apparent Diffusion Coefficient.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007036.html