Diagnostic performance of MRI for assessment of response to neoadjuvant chemoradiotherapy in oesophageal cancer

作者：Sophie E. Vollenbrock, Francine E.M. Voncken, Jolanda M. van Dieren, Doenja M. J. Lambregts, Monique Maas, Gert Jacobus Meijer, Lucas Goense, Stella Mook, Koen Johan Hartemink, Pétur Snæbjörnsson, Leon C. ter Beek, Marcel Verheij, Berthe M.P. Aleman, Regina G. H. Beets‐Tan, Annemarieke Bartels‐Rutten · 发表于：British journal of surgery · 年份：2019 · DOI：10.1002/bjs.11094 · 被引用次数：44 · 研究领域：Esophageal Cancer Research and Treatment、Head and Neck Cancer Studies、MRI in cancer diagnosis

BACKGROUND: Patients with a pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) for oesophageal cancer may benefit from non-surgical management. The aim of this study was to determine the diagnostic performance of visual response assessment of the primary tumour after nCRT on T2-weighted (T2W) and diffusion-weighted (DW) MRI. METHODS: Patients with locally advanced oesophageal cancer who underwent T2W- and DW-MRI (1·5 T) before and after nCRT in two hospitals, between July 2013 and September 2017, were included in this prospective study. Three radiologists evaluated T2W images retrospectively using a five-point score for the assessment of residual tumour in a blinded manner and immediately rescored after adding DW-MRI. Histopathology of the resection specimen was used as the reference standard; ypT0 represented a pCR. Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve (AUC) and interobserver agreement were calculated. RESULTS: Twelve of 51 patients (24 per cent) had a pCR. The sensitivity and specificity of T2W-MRI for detection of residual tumour ranged from 90 to 100 and 8 to 25 per cent respectively. Respective values for T2W + DW-MRI were 90-97 and 42-50 per cent. AUCs for the three readers were 0·65, 0·66 and 0·68 on T2W-MRI, and 0·71, 0·70 and 0·70 on T2W + DW-MRI (P = 0·441, P = 0·611 and P = 0·828 for readers 1, 2 and 3 respectively). The κ value for interobserver agreement improved from 0·24-0·55 on T2W-...