Diffusion Weighted Magnetic Resonance Imaging Predicts the Pathological Response to Pre-surgical Treatment in Esophageal Carcinoma

Abstract

Background : The purpose of this study was to investigate the usefulness of the apparent diffusion coefficient (ADC) in diffusion weighted magnetic resonance imaging (DWI) for evaluation of the pathological effect to preoperative therapies including chemotherapy and chemoradiotherapy for esophageal cancer. Subjects & Methods : Seventy patients with esophageal cancer who received surgery after preoperative therapy were included in this study. DWI was performed before and after preoperative therapy in all patients. The correlation between ADC and postoperative pathological effect was assessed. Results : The ADCs after preoperative therapy were significantly higher in the pathological responders than those in the non-responders(1.61 vs. 1.11, P<0.0001). The increase rate of ADCs was significantly higher in the pathological responders than those in the non-responders (62% vs. 13%, P<0.0001). The ADC discriminated the pathological responders with the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 96%, 91%, 86%, 98%, and 93%, respectively. Conclusion : DWI is useful to evaluate the pathological effect of the preoperative therapy for esophageal cancer.