To explore and evaluate the potential value of dynamic contrast-enhanced (DCE) magnetic reso-nance imaging (MRI) for the prediction of pathologic response to neoadjuvant chemoradiotherapy (nCRT) in oesoph-ageal cancer .Methods :Twenty-seven patients underwent DCE -MRI before ,during (week 2-3) and after nCRT , but before surgery (pre/per/post ,respectively) .Histopathologic tumour regression grade (TRG) was assessed af-ter oesophagectomy .Tumour area-under -the -concentration time curve (AUC) ,time -to -peak (TTP) and slope were calculated .The ability of these DCE -parameters to distinguish good responders (GR ,TRG 1-2) from poor responders (noGR ,TRG P 3) ,and pathologic complete responders (pCR) from no-pCR was assessed .Re-sults :Thirteen patients (48 .1% ) showed GR of which eight patients (33 .3% ) pCR .Analysis of AUC change throughout treatment ,AUCper-pre ,was most predictive for GR ,at a threshold of 22 .7% resulting in a sensitivity of 92% ,specificity of 77% ,PPV of 79% ,and a NPV of 91% .AUCpost-pre was most predictive for pCR ,at a threshold of-24 .6% resulting in a sensitivity of 83% ,specificity of 88% ,PPV of 71% ,and a NPV of 93% .TTP and slope were not associated with pathologic response .Conclusions :This study demonstrates that changes in AUC throughout treatment are promising for prediction of histopathologic response to nCRT for oesophageal cancer .%目的:探讨和评价动态对比增强磁共振成像(DCE-MRI)在用于预测新辅助放化疗(nCRT)食管癌病理反应的潜在价值.方法:收集食管癌患者27例分别于nCRT前、nCRT 2~3周期间、及nCRT后进行DCE-M RI检查.术后评估肿瘤病理反应分级(T RG),计算肿瘤浓度时间曲线下面积(AUC)、峰值时间(TTP)及斜率.根据不同的DCE参数制定和分析好的反应(GR)和差反应(noGR),及完全病理反应(pCR)和不完全病理反应(nopCR)发生情况.结果:27例中13例(48.1%)显示GR,其中9例(33.3%)pCR.AUC在治疗中的变化显示,AUC per-pre最能预测GR.在22.7%的临界值时,灵敏度92%,特异度77%,阳性预测值(PPV)79%,阴性预测值(NPA)91%.而AUCpost-pre最能预测pCR,在-24.6%的临界值时,灵敏度83%,特异度88%,PPV71%,NPV93%.TTP和斜率都与病理反应无相关性.结论:在食管癌治疗过程中,AUC的变化有望预测新辅助放化疗食管癌的组织病理反应.
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