Diagnostic Performance of Vascular Permeability and Texture Parameters for Evaluating the Response to Neoadjuvant Chemoradiotherapy in Patients With Esophageal Squamous Cell Carcinoma

Wenbing Ji; Jian Wang; Rongzhen Zhou; Minke Wang; Weizhen Wang; Peipei Pang; Min Kong; Chao Zhou

doi:10.3389/fonc.2021.604480

Diagnostic Performance of Vascular Permeability and Texture Parameters for Evaluating the Response to Neoadjuvant Chemoradiotherapy in Patients With Esophageal Squamous Cell Carcinoma

Front Oncol. 2021 May 18:11:604480. doi: 10.3389/fonc.2021.604480. eCollection 2021.

Authors

Wenbing Ji¹, Jian Wang¹, Rongzhen Zhou¹, Minke Wang¹, Weizhen Wang¹, Peipei Pang², Min Kong³, Chao Zhou⁴

Affiliations

¹ Department of Radiology, Taizhou Hospital of Zhejiang Province, Taizhou, China.
² Advanced Application Team, GE Healthcare, Shanghai, China.
³ Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province, Taizhou, China.
⁴ Department of Radiotherapy, Taizhou Hospital of Zhejiang Province, Taizhou, China.

Abstract

Background: Esophageal squamous cell carcinoma (ESCC) is an aggressive type of cancer, associated with poor prognosis. The development of an accurate and non-invasive method to evaluate the pathologic response of patients with ESCC to chemoradiotherapy remains a critical issue. Therefore, the aim of this study was to assess the importance of vascular permeability and texture parameters in predicting the response to neoadjuvant chemoradiotherapy (NACRT) in patients with ESCC.

Methods: This prospective analysis included patients with T1-T2 stage of ESCC, without either lymphatic or metastasis, and distant metastasis. All patients underwent surgery having received two rounds of NACRT. All patients underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) twice, i.e., before the first NACRT and after the second NACRT. Patients were assessed for treatment response at 30 days after the second NACRT. Patients were divided into the complete response (CR) and partial response (PR) groups based on their responses to NACRT. Vascular permeability and texture parameters were extracted from the DCE-MRI scans. After assessing the diagnostic performance of individual parameters, a combined model with vascular permeability and texture parameters was generated to predict the response to NACRT.

Results: In this study, the CR and PR groups included 16 patients each. The volume transfer constant (Ktrans), extracellular extravascular volume fraction (ve), and entropy values, as well as changes to each of these parameters, extracted from the second DCE-MRI scans, showed significant differences between the CR and PR groups. The area under the curve (AUC) of Ktrans, ve, and entropy values showed good diagnostic ability (0.813, 0.789, and 0.707, respectively). A logistic regression model combining Ktrans, ve, and entropy had significant diagnostic ability (AUC=0.977).

Conclusions: The use of a combined model with vascular permeability and texture parameters can improve post-NACRT prognostication in patients with ESCC.

Keywords: dynamic contrast-enhanced magnetic resonance imaging; esophageal squamous cell carcinoma; neoadjuvant chemoradiotherapy; texture parameter; vascular permeability.