Carlo Nicola de Cecco MD, Presenter: Nothing to Disclose

Maria Ciolina MD, Abstract Co-Author: Nothing to Disclose

Balaji Ganeshan PhD, Abstract Co-Author: Scientific Director, TexRAD Limited

Marco Rengo MD, Abstract Co-Author: Nothing to Disclose

Luca Saba MD, Abstract Co-Author: Nothing to Disclose

Andrea Laghi MD, Abstract Co-Author: Speaker, Bracco Group Speaker, Bayer AG Speaker, General Electric Company Speaker, Koninklijke Philips NV

To determine the performance of texture analysis (TA), diffusion weighted imaging (DWI), and perfusion MR (pMR) in predicting tumoral response in patients treated with neoadjuvant chemoradiotherapy (CRT).

The patient population consisted of 12 patients with rectal cancer, who underwent pre-treatment 3T MRI. Texture analysis (kurtosis), apparent diffusion coefficient (ADC) and pMR parameters (IAUGC, Ktrans, Ve, Kep) were quantified using commercial research software algorithms. After CRT, all patients underwent complete surgical resection and the surgical specimen served as the gold standard. Receiver operating characteristic (ROC) curve analysis was performed to assess the discriminatory power of texture parameters to predict complete response.

Pathological complete response (pCR), partial response (PR) and no response (NR) were found in 6, 3 and 3 patients, respectively. Baseline kurtosis was significantly lower in pCR in comparison with PR+NR (p=.01). Among ADC and pMR parameters, only Ve was significantly lower in the pCR compared to PR/NR (p=.01). A significant negative correlation between kurtosis and ADC (r=-0.650, p=0.022) was observed. The areas under the curve (AUC) to discriminate patients with pCR from patients with PR/NR were 0.861 for kurtosis, 0.694 for IAUGC, 0.569 for Ktrans, 0.861 for Ve, 0.668 for Kep and 0.556 for ADC. The discriminatory power was significant for kurtosis (p=0.001) and Ve (p=0.003). The optimal cutoff for the identification of pCR was ≤0.192 for kurtosis (100% sensitivity, 67% specificity) and ≤0.311 for Ve (83% sensitivity, 83% specificity).

Baseline TA and pMRI parameters have the potential to act as imaging biomarkers of tumoral response to neoadjuvant chemoradiotherapy.

The identification of new imaging biomarkers for early assessment of neoadjuvant treatment response could be helpful in refining rectal cancer patient management, providing a better targeting of preoperative therapy.

de Cecco, C, Ciolina, M, Ganeshan, B, Rengo, M, Saba, L, Laghi, A, Performance of Texture Analysis, Diffusion Weighted Imaging and Perfusion Imaging in Predicting Tumoral Response to Neoadjuvant Chemoradiotherapy in Rectal Cancer Patients Studied with 3T MR.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018210.html