Baseline and early 3D-CUBE volume reconstruction of locally advanced rectal cancer to predict tumor response after neoadjuvant chemotherapy

Article type: Research Article

Authors: Wang, Xin-Hua^a | Liu, Zheng-Jun^a | Xu, Jian-Bo^a | Li, Fang-Qian^a | Li, Wen-Li^a | Cao, Wu-Teng^{a; *} | Zhou, Zhi-Yang^{a; b; *}

Affiliations: [a] Department of Radiology, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Guangzhou, China | [b] Guangzhou Universal Medical Imaging Diagnostic Center, Guangzhou, China

Correspondence: [*] Corresponding authors: Wu-teng Cao and Zhi-yang Zhou, Department of Radiology, The Sixth Affiliated Hospital, Sun Yat-sen University, No.26, Yuancun Er Heng Road, Tianhe, Guangzhou, China, 510655. E-mails: caowteng@outlook.com (W. Cao) and zhouzyang@hotmail.com (Z. Zhou).

Abstract: PURPOSE:To explore whether volumetric measurements of 3D-CUBE sequences based on baseline and early treatment time can predict neoadjuvent chemotherapy (NCT) efficacy of locally advanced rectal cancer (LARC). MATERIAL AND METHOD:73 patients with LARC were enrolled from February 2014 to January 2018. All patients underwent MRIs during the baseline period before NCT (BL-NCT) and the first month of NCT (FM-NCT), and tumor volume (TV) was measured using 3D-CUBE, and tumor volume reduction (TVR) and tumor volume reduction rate (TVRR) were calculated. In addition, tumor invasion depth, tumor maximal length, range of tumor involvement in the circumference of intestinal lumen and distance from inferior part of tumor to the anal verge were measured using baseline high-spatial-resolution T2-weighted MRIs. All patients were categorized into sensitive and insensitive groups based on post-surgical pathology after completion of the full courses of NCT. The receiver operating characteristic (ROC) curve was used to analyze the value of different MRI parameters in predicting efficacy of NCT. RESULTS:Statistically significant differences in TV of BL-NCT, TVR and TVRR from BL-NCT to FM-NCT were detected between sensitive and insensitive groups (P < 0.05, respectively). The areas under the curves (AUC) of ROC of TVR and TVRR in predicting efficacy of NCT (0.890 [95% CI, 0.795∼0.951], 0.839 [95% CI, 0.735∼0.915]) were significantly better than that of TV (0.660 [95% CI, 0.540∼0.767]) (P < 0.05, respectively). CONCLUSION:Reconstruction of 3D-CUBE volume in the first month of NCT is necessary, and both TVR and TVRR can be used as early predictors of NCT efficacy.

Keywords: Magnetic resonance imaging, 3D-CUBE sequence, rectal cancer, neoadjuvant chemotherapy

DOI: 10.3233/XST-190594

Journal: Journal of X-Ray Science and Technology, vol. 28, no. 2, pp. 231-241, 2020