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World J Gastroenterol. Feb 21, 2014; 20(7): 1650-1656
Published online Feb 21, 2014. doi: 10.3748/wjg.v20.i7.1650
Role of imaging in predicting response to neoadjuvant chemotherapy in gastric cancer
Robert Michael Kwee, Thomas Christian Kwee
Robert Michael Kwee, Department of Radiology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
Thomas Christian Kwee, Department of Radiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
Author contributions: Kwee RM and Kwee TC contributed equally to this work; Kwee RM and Kwee TC analyzed the data; Kwee RM and Kwee TC wrote the paper.
Correspondence to: Robert Michael Kwee, MD, PhD, Department of Radiology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. rmkwee@gmail.com
Telephone: +31-43-3874910 Fax: +31-43-3876909
Received: October 29, 2013
Revised: December 19, 2013
Accepted: January 3, 2014
Published online: February 21, 2014
Processing time: 134 Days and 7.8 Hours
Abstract

With the proven overall benefit of neoadjuvant chemotherapy in patients with locally advanced gastric cancer, there has come a need to discriminate responders from non-responders. In this article, the current role of anatomical and molecular imaging in the prediction of response to neoadjuvant therapy in gastric cancer is outlined and future prospects are discussed.

Keywords: Gastric cancer; Neoadjuvant therapy; Chemotherapy; Response; Imaging

Core tip: Studies have shown that there is an association between tumor response at anatomical imaging evaluation and histopathological response and survival in patients with gastric cancer who are treated with neoadjuvant chemotherapy. However, as it takes time for gross tumor changes to become apparent, anatomical imaging may be of limited value in the early assessment of neoadjuvant chemotherapy efficacy. Studies performing early response assessment with use of 18F-fluoro-2-deoxy-D-glucose positron-emission tomography demonstrate controversial results. The usefulness of other molecular imaging modalities, among which diffusion-weighted-magnetic resonance imaging, remains to be investigated.