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BioMed Research International
Volume 2013 (2013), Article ID 740195, 5 pages
http://dx.doi.org/10.1155/2013/740195
Clinical Study

Diffusion-Weighted Magnetic Resonance Application in Response Prediction before, during, and after Neoadjuvant Radiochemotherapy in Primary Rectal Cancer Carcinoma

1Department of Radiotherapy, Policlinico Umberto I “Sapienza” University of Rome, Viale Regina Elena 326, 00161 Rome, Italy
2Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I “Sapienza” University of Rome, Polo Pontino, Corso della Repubblica 79, 04100 Latina, Italy
3Department of Surgical Sciences, Policlinico Umberto I “Sapienza” University of Rome, Viale Regina Elena 326, 00161 Rome, Italy
4Spencer-Lorillard Foundation, Viale Regina Elena 291, 00161 Rome, Italy

Received 16 May 2013; Accepted 24 June 2013

Academic Editor: Aleksandra Nikolic

Copyright © 2013 Daniela Musio et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Our interest was to monitor treatment response using ADC value to predict response of rectal tumour to preoperative radiochemotherapy. Materials and Methods. Twenty-two patients were treated with long course of radiochemotherapy, followed by surgery. Patients were examined by diffusion-weighted imaging MRI at three-time points (prior, during, and after radiochemotherapy) and were classified as responders and nonresponders. Results. A statistical significant correlation was found between preradiochemotherapy ADC values and during treatment ADC values, in responders ( , value ). An increase in ADC value during treatment was predictive of at least a partial response. Discussion. Response of tumour to neoadjuvant therapy cannot be easily evaluated, and such capability might be of great importance in clinical practice, because the number of irradiated and operated patients may be superior to the number of who will really benefit from this multimodal treatment. A reliable prediction of the final clinical TN stage would allow radiotherapist to adapt multidisciplinary approach to a less invasive management, sparing surgical procedure in responder patients or even allowing an early surgery in nonresponders, which would significantly reduce radiochemotherapy related toxicity. Conclusion. Early evaluation of response during neoadjuvant radiochemotherapy treatment shows great promise to predict tumour response.