Value of DWI-MRI and 18F-FDG PET/CT in Assessing Response to Neoadjuvant Radiotherapy for Localized ESCC
Objective Explore the value of diffusion weighted magnetic resonance imaging(DWI-MRI)and fluorodeoxyglucose F18 positron emission tomography/X-ray computed tomography(18F-FDG PET/CT)in evaluating the response to neoadjuvant chemotherapy in locally advanced esophageal squamous cell carcinoma(ESCC).Methods 90 patients with locally advanced ESCC admitted to Daqing Longnan Hospital from April 2019 to April 2023 were selected for the study.They were divided into a good response group of 41 patients and a poor response group of 49 patients based on their response to neoadjuvant radiotherapy and chemotherapy.Compare the differences in DWI-MRI parameters(pre treatment ADC value,post treatment ADC value,and ADC value change rate),18F-FDG PET/CT parameters(pre treatment SUVmax value,post treatment SUVmax lower than poor response group,SUVmax value change rate)between two groups(good response group and poor response group),and analyze the correlation between DWI-MRI parameters,18F-FDG PET/CT parameters,and local advanced ESCC response to neoadjuvant radiotherapy and chemotherapy through binary logistic regression analysis.Analyze the DWI-MRI parameters through ROC curves The value of 18F-FDG PET/CT parameters in evaluating the response of locally advanced ESCC to neoadjuvant radiotherapy and chemotherapy.Results There was no statistically significant difference in ADC values between the two groups before treatment(P＞0.05),but the ADC values and rate of change in ADC values after treatment in the well responsive group were higher than those in the poorly responsive group(P＜0.05).There was no statistically significant difference in SUVmax values between the two groups before treatment(P＞0.05),but after treatment,the SUVmax in the well responded group was lower than that in the poorly responded group,and the rate of change in SUVmax values was higher than that in the poorly responded group(P＜0.05).See Table 3.Binary logistic regression analysis showed that post treatment ADC value,post treatment SUVmax value,and SUVmax value change rate were relevant factors for the response of locally advanced ESCC to neoadjuvant radiotherapy and chemotherapy(P＜0.05).ROC analysis showed that after treatment,the ADC value,SUVmax value,and SUVmax value change rate were 0.746,0.814,and 0.733 for evaluating the AUC of locally advanced ESCC in response to neoadjuvant radiotherapy and chemotherapy,respectively.Combined data evaluation showed that the AUC of locally advanced ESCC in response to neoadjuvant radiotherapy and chemotherapy was 0.903,with a sensitivity of 75.6％and a specificity of 93.9％.Conclusion DWI-MRI and 18F-FDG PET/CT can both serve as effective indicators for evaluating neoadjuvant chemoradiotherapy response in locally advanced ESCC,and their combined evaluation is more effective.
Esophageal Squamous Cell CarcinomaLocal Late StageNeoadjuvant Radiotherapy and ChemotherapyReactionFluorodeoxyglucose F18Positron Emission Tomography/X-ray Computed TomographyDiffusion Weighted Magnetic Resonance ImagingValue
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