TY - JOUR
T1 - The evaluation of esophageal adenocarcinoma using dynamic contrast-enhanced magnetic resonance imaging
AU - Chang, Eugene Y.
AU - Li, Xin
AU - Jerosch-Herold, Michael
AU - Priest, Ryan A.
AU - Enestvedt, C. Kristian
AU - Xu, Jingang
AU - Springer, Charles S.
AU - Jobe, Blair A.
N1 - Funding Information:
Acknowledgement Financial support is provided by SAGES Research Grant (EYC), Medical Research Foundation of Oregon Early Clinical Investigator Grant (EYC), OHSU GCRC Mentored Medical Student Clinical Research Award (RAP), and NIH grants RO1 NS40801 and RO1 EB00422 (CSS).
PY - 2008/1
Y1 - 2008/1
N2 - 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.
AB - 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.
KW - Dynamic contrast-enhanced magnetic resonance imaging
KW - Esophageal adenocarcinoma
KW - Neoadjuvant chemoradiation
UR - http://www.scopus.com/inward/record.url?scp=38149009615&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=38149009615&partnerID=8YFLogxK
U2 - 10.1007/s11605-007-0253-5
DO - 10.1007/s11605-007-0253-5
M3 - Article
C2 - 17768665
AN - SCOPUS:38149009615
SN - 1091-255X
VL - 12
SP - 166
EP - 175
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 1
ER -