Clinical Value of 3.0 T Magnetic Resonance Diffusion-weighted Imaging in Evaluating Neoadjuvant Chemoradiotherapy in Rectal Cancer
Objective To investigate the predictive value of 3.0 T magnetic resonance(MR)diffusion-weighted imaging(DWI)on the efficacy of neoadjuvant chemoradiotherapy(nCRT)in locally advanced rectal cancer(LARC).Methods 60 LARC patients admitted to the First Affiliated Hospital of Anhui Medical University between January 2022 and December 2023 were collected as samples.Patients completed magnetic resonance imaging(MRI)(routine scan+DWI).Patients were divided into T-down and T-off stages according to the pre-treatment and postoperative pathological stage.The difference of apparent diffusion coefficient(ADC),ADC value(ΔADC)and ADC value rate(％)was compared between the two groups before and after nCRT,and the predictive value of pre-treatment ADC value on nCRT was analyzed by the receiver operating characteristic curve(ROC)for nCRT.Results Among 60 patients,there were 35 cases(58.3％)in the T downstaging group[including 12 cases(20.0％)of pCR]and 25 cases(41.7％)in the T non-downstaging group.The ADC value of patients before nCRT treatment was(0.84+0.19)×10-3 mm2/s,and the ADC value after treatment was(1.25±0.22)×10-3mm2/s.The difference was statistically significant(P＜0.05).There was a significant difference in the ADC value before and after nCRT in the T downstaging group and the T non-downstaging group(P＜0.05).The ADC value of the T downstaging group before treatment was lower than that of the T non-downstaging group while the ADC value of the T downstaging group after treatment was higher than that of the T non-downstaging group.Compared with the T non-downstaging group,the ADC value change and ADC value change rate(％)before and after nCRT were increased in the T downstaging group(P＜0.05).The ADC value of pCR patients before nCRT was lower than that of the T downstaging group while the ADC value after nCRT was higher than that of the T downstaging group(P＜0.05).Conclusion MR-DWI quantitative parameter ADC has a certain value in predicting the nCRT efficacy of rectal cancer.A low ADC value before treatment may indicate better treatment response.
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