The evaluation of esophageal adenocarcinoma using dynamic contrast-enhanced magnetic resonance imaging

Eugene Y. Chang, Xin Li, Michael Jerosch-Herold, Ryan A. Priest, C. Kristian Enestvedt, Jingang Xu, Charles S. Springer, Blair A. Jobe

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Although neoadjuvant chemoradiation eradicates esophageal adenocarcinoma in a substantial proportion of patients, conventional imaging techniques cannot accurately detect this response. Dynamic contrast-enhanced magnetic resonance imaging is an emerging approach that may be well suited to fill this role. This pilot study evaluates the ability of this method to discriminate adenocarcinoma from normal esophageal tissue. Patients with esophageal adenocarcinoma and control subjects underwent scanning. Patients treated with neoadjuvant therapy underwent pre- and postchemoradiation scans. Parameters were extracted for each pixel were K trans (equilibrium rate for transfer of contrast reagent across the vascular wall), v e (volume fraction of interstitial space), and τ i (mean intracellular water lifetime). Five esophageal adenocarcinoma patients and two tumor-free control subjects underwent scanning. The mean K trans value was 5.7 times greater in esophageal adenocarcinoma, and τ i is 2.0 times smaller, than in the control subjects. K trans decreased by 11.4-fold after chemoradiation. Parametric maps qualitatively demonstrate a difference in K trans. DCE MRI of the esophagus is feasible. K trans, a parameter that has demonstrated discriminative ability in other malignancies, also shows promise in differentiating esophageal adenocarcinoma from benign tissue. The determination of K trans represents an in vivo assay for endothelial permeability and thus may serve as a quantitative measure of response to induction chemoradiation.

Original languageEnglish (US)
Pages (from-to)166-175
Number of pages10
JournalJournal of Gastrointestinal Surgery
Volume12
Issue number1
DOIs
StatePublished - Jan 2008

Keywords

  • Dynamic contrast-enhanced magnetic resonance imaging
  • Esophageal adenocarcinoma
  • Neoadjuvant chemoradiation

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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