Published online May 28, 2020. doi: 10.3748/wjg.v26.i20.2657
Peer-review started: January 14, 2020
First decision: February 29, 2020
Revised: April 30, 2020
Accepted: May 13, 2020
Article in press: May 13, 2020
Published online: May 28, 2020
The management of rectal cancer patients is mainly based on the use of the magnetic resonance imaging (MRI) technique as a diagnostic tool for both staging and restaging. After treatment, to date, the evaluation of complete response is based on the histopathology assessment by using different tumor regression grade features (e.g., Dworak or Mandard classifications). While from the radiological point of view, the main attention for the prediction of a complete response after chemo-radiotherapy (CRT) focuses on MRI and the potential role of diffusion-weighted images and perfusion imaging represented by dynamic-contrast enhanced MRI (DCE-MRI). The main aim is to find a reliable tool to predict tumor response in comparison to histopathologic findings.
DCE-MRI is considered an important tool in the assessment of rectal adenocarcinoma because it permits to obtain important information about tumor vascularization quantitatively.
This study investigated the diagnostic role of DCE-MRI, in patients with rectal carcinoma who underwent chemoradiation therapy, as a complementary functional diagnostic tool in the assessment of the response of patients with rectal cancer after CRT, in comparison with standard histopathological analysis.
This is an analysis of the evaluation of the response of patients with biopsy-proven rectal adenocarcinoma after chemoradiation therapy, who underwent DCE-MRI.
Semiquantitative perfusion parameters demonstrated higher values in the tumor tissue than in the healthy tissue. More important, after chemoradiation therapy, those patients that responded to therapy showed lower perfusion values in residual tumor tissue than those who did not respond.
Dynamic contrast MRI represents a complementary diagnostic tool in identifying vascularity characteristics of local advanced rectal cancer, before and after chemoradiation treatment.
To strengthen our results, further studies should include a wider cohort of patients, by using pathological correlation as a gold standard.