Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2016; 22(10): 3031-3037
Published online Mar 14, 2016. doi: 10.3748/wjg.v22.i10.3031
Predicting liver metastasis of gastrointestinal tract cancer by diffusion-weighted imaging of apparent diffusion coefficient values
De-Xian Zheng, Shu-Chun Meng, Qing-Jun Liu, Chuan-Ting Li, Xi-Dan Shang, Yu-Seng Zhu, Tian-Jun Bai, Shi-Ming Xu
De-Xian Zheng, Qing-Jun Liu, Tian-Jun Bai, Department of Radiology, Second People’s Hospital of Liaocheng City, Liaocheng 252600, Shandong Province, China
Shu-Chun Meng, Department of Radiology, Third People’s Hospital of Liaocheng city, Liaocheng 252600, Shandong Province, China
Chuan-Ting Li, Medical Imaging Institute of Shandong Province, Shandong Provincial Hospital, Jinan 250021, Shandong Province, China
Xi-Dan Shang, Yu-Seng Zhu, Department of Gastroenterology, Second People’s Hospital of Liaocheng city, Liaocheng 252600, Shandong Province, China
Shi-Ming Xu, Department of Radiology, People’s Hospital of Liaocheng city, Liaocheng 252600, Shandong Province, China
Author contributions: Zheng DX and Meng SC designed research; Zheng DX, Meng SC, Liu QJ and Li CT performed research; Meng SC, Liu QJ, Li CT, Shang XD and Zhu YS contributed new reagents/analytic tools; Zheng DX and Meng SC analyzed data; Zheng DX and Meng SC wrote the paper; All the authors contributed to this manuscript.
Institutional review board statement: This study was reviewed by and approved by the Department of Radiology, Second People’s Hospital of Liaocheng city, Shandong Province Institutional review board statement.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that there are no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shu-Chun Meng, Deputy Chief Physician, Department of Radiology, Third People’s Hospital of Liaocheng city, Shandong No. 62 Weiyu Road of Liaocheng city, 60 Weiyu Road, Liaocheng 252000, Shandong Province, China. zhengdexianx@sina.com
Telephone: +86-635-8385120
Received: October 24, 2015
Peer-review started: October 25, 2015
First decision: November 27, 2015
Revised: December 6, 2015
Accepted: December 30, 2015
Article in press: December 30, 2015
Published online: March 14, 2016
Abstract

AIM: To determine if efficacy of chemotherapy on liver metastasis of gastrointestinal tract cancer can be predicted by apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI).

METHODS: In total, 86 patients with liver metastasis of gastrointestinal tract cancer (156 metastatic lesions) diagnosed in our hospital were included in this study. The maximum diameters of these tumors were compared with each other before treatment, 2 wk after treatment, and 12 wk after treatment. Selected patients were classified as the effective group and the ineffective group, depending on the maximum diameter of the tumor after 12 wk of treatment; and the ADC values at different treatment times between the two groups were compared. Spearman rank correlation was used to analyze the relationship between ADC value and tumor diameter. Receiver operating characteristic curve (ROC curve) was used to analyze the ADC values before treatment to predict the patient’s sensitivity and specificity degree of efficacy to the chemotherapy.

RESULTS: There was no difference in age between the two groups and in maximum tumor diameter before treatment and 2 wk after treatment. However, after 12 wk of treatment, maximum tumor diameter in the effective group was significantly lower than that in the ineffective group (P < 0.05). Before treatment, ADC values in the ineffective group were significantly higher than those in the effective group (P < 0.05). There was no difference in ADC values between the effective and ineffective groups after 2 and 12 wk of treatment. However, ADC values were significantly higher after 2 and 12 wk of treatment compared to before treatment in the effective group (P < 0.05). Spearman rank correlation analysis showed that ADC value before treatment and the reduced percentage of the maximum tumor diameter after 12 wk of treatment were negatively correlated, while the increase in the percentage of the ADC value 12 wk after treatment and the decrease in the percentage of the maximum tumor diameter were significantly positively correlated. The results of the ROC curve showed that ADC value with a chemotherapy ineffective threshold value of 1.14 × 10-3 mm2/s before treatment had a sensitivity and specificity of 94.3% and 76.7%, respectively.

CONCLUSION: DWI ADC values can be used to predict the response of patients with liver metastasis of gastrointestinal tract cancer to chemotherapy with high sensitivity and relatively high specificity.

Keywords: Chemotherapy, Liver metastatic tumor, Magnetic resonance imaging, Gastrointestinal tract cancer

Core tip:A total of 86 patients with liver metastasis of gastrointestinal tract cancer were assigned to one of two groups, effective group and ineffective group, according to the maximum diameter of the tumor after treatment. The apparent diffusion coefficient (ADC) values at different treatment times between the two groups were compared. The results revealed that ADC values before treatment can be used to predict chemotherapy response to liver metastasis of gastrointestinal tract cancer, with high sensitivity and relatively high specificity.