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Tesi etd-11202019-214012


Thesis type
Tesi di specializzazione (5 anni)
Author
LANDI, ELENA
URN
etd-11202019-214012
Title
"Response evaluation of locally advanced rectal cancer after chemoradiotherapy:added value of ADC at 3T MR imagig"
Struttura
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
RADIODIAGNOSTICA
Supervisors
relatore Prof. Caramella, Davide
relatore Dott. Boraschi, Piero
Parole chiave
  • locally advanced rectal cancer
  • adc
Data inizio appello
14/12/2019;
Consultabilità
Secretata d'ufficio
Data di rilascio
14/12/2089
Riassunto analitico
Purpose
To evaluate the usefulness of the apparent diffusion coefficient (ADC) value at 3T-device in response assessment of locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (n-CRT).

Materials and Methods
Thirty-seven patients affected by locally advanced rectal cancer underwent 3.0T MRI before and after n-CRT. After the preliminary acquisition of high resolution T2 weighted sequences, diffusion weighted MR images were performed using a spin-echo echo-planar sequence with multiple b-values (150, 500, 1000, 1500 sec/mm2) and an ADC map was obtained. Fitted ADC values were calculated for each rectal lesion before and after n-CRT, by drawing a hand-made ROI around the tumor outline. All patients underwent surgery and the pathologic staging (classified according to TNM and to TRG) represented the reference standard. Pre-treatment ADC value (p-ADC), ADC value obtained after n-CRT (n-ADC) and the difference between p-ADC and n-ADC (ΔADC) were correlated with both the TNM and the TRG staging systems, in each patient.

Results
The ADC value obtained in the post n-CRT examination was statistically related both to TRG and TNM stages at histopathology (p=0,0027; p=0,0165). Otherwise the ΔADC and the p-ADC values were not related to the pathologic staging.

Conclusions
DW-MRI, using ADC map and value, can be useful to assess the efficacy of n-CRT in LARC; in fact post- n-CRT ADC value improves the MR capability in the evaluation of n-CRT response assessment.
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