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Standardized Index of Shape (SIS): a quantitative DCE-MRI parameter to discriminate responders by non-responders after neoadjuvant therapy in LARC

  • Gastrointestinal
  • Published:
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Abstract

Objectives

To investigate the potential of DCE-MRI to discriminate responders from non-responders after neoadjuvant chemo-radiotherapy (CRT) for locally advanced rectal cancer (LARC). We investigated several shape parameters for the time-intensity curve (TIC) in order to identify the best combination of parameters between two linear parameter classifiers.

Methods

Seventy-four consecutive patients with LARC were enrolled in a prospective study approved by our ethics committee. Each patient gave written informed consent. After surgery, pathological TNM and tumour regression grade (TRG) were estimated. DCE-MRI semi-quantitative analysis (sqMRI) was performed to identify the best parameter or parameter combination to discriminate responders from non-responders in response monitoring to CRT. Percentage changes of TIC shape descriptors from the baseline to the presurgical scan were assessed and correlated with TRG. Receiver operating characteristic analysis and linear classifier were applied.

Results

Forty-six patients (62.2 %) were classified as responders, while 28 subjects (37.8 %) were considered as non-responders. sqMRI reached a sensitivity of 93.5 % and a specificity of 82.1 % combining the percentage change in Maximum Signal Difference (ΔMSD) and Wash-out Slope (ΔWOS), the Standardized Index of Shape (SIS).

Conclusions

SIS obtains the best result in discriminating responders from non-responders after CRT in LARC, with a cut-off value of −3.0 %.

Key Points

• DCE-MRI shape descriptors are investigated to assess preoperative CRT response in LARC.

• Identification of the best TIC shape descriptors combination through a linear classifier.

• Identification of a single MRI index to predict neoadjuvant treatment response.

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Acknowledgments

The scientific guarantor of this publication is Dr. Antonella Petrillo. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Approval from the institutional animal care committee was not required because there are no animal subjects in this study. No study subjects or cohorts have been previously reported. Methodology: Prospective, diagnostic study, performed at one institution.

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Authors and Affiliations

  1. Division of Radiology, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, Via Mariano Semmola, 80131, Naples, Italy

    Antonella Petrillo, Roberta Fusco, Mario Petrillo & Vincenza Granata

  2. Department of Biomedical, Electronics and Telecommunications Engineering, University “Federico II” of Naples, via Claudio no.21, 80132, Naples, Italy

    Mario Sansone

  3. Division of Gastrointestinal Medical Oncology, Department of Abdominal Oncology, “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, Via Mariano Semmola, 80131, Naples, Italy

    Antonio Avallone

  4. Division of Gastrointestinal Surgical Oncology, Department of Abdominal Oncology, “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, Via Mariano Semmola, 80131, Naples, Italy

    Paolo Delrio

  5. Divion of Radiotherapy, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, Via Mariano Semmola, 80131, Naples, Italy

    Biagio Pecori

  6. Division of Diagnostic Pathology, Department of Diagnostic and Laboratory Pathology, “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, Via Mariano Semmola, 80131, Naples, Italy

    Fabiana Tatangelo

  7. “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, Via Mariano Semmola, 80131, Naples, Italy

    Gennaro Ciliberto

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  1. Antonella Petrillo
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  2. Roberta Fusco
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Corresponding author

Correspondence to Antonella Petrillo.

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Petrillo, A., Fusco, R., Petrillo, M. et al. Standardized Index of Shape (SIS): a quantitative DCE-MRI parameter to discriminate responders by non-responders after neoadjuvant therapy in LARC. Eur Radiol 25, 1935–1945 (2015). https://doi.org/10.1007/s00330-014-3581-3

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  • DOI: https://doi.org/10.1007/s00330-014-3581-3

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