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Prognostic utility of diffusion-weighted MRI in oesophageal cancer: is apparent diffusion coefficient a potential marker of tumour aggressiveness?

  • ABDOMINAL RADIOLOGY
  • Published:
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Abstract

Purpose

To investigate the role of the apparent diffusion coefficient (ADC) as a potential prognostic biomarker in the evaluation of the aggressiveness of oesophageal cancer.

Materials and methods

Between November 2009 and December 2013, 43 patients with evidence of oesophageal or oesophago-gastric junction cancer were referred to our institution and prospectively entered in our database. The final study population consisted of 23 patients (18 men; 5 women; mean age, 64.62 ± 10.91 years) who underwent diffusion-weighted Magnetic Resonance before surgical intervention. Specifically, 14 were directly treated with surgery and 9 were addressed to chemo/radiotherapy beforehand. Two radiologists independently measured mean tumour ADC and inter-observer agreement (Spearman’s and intraclass correlation coefficient [ICC]) was assessed. In the univariate analysis, overall survival curves related to pathological ADC, pT, pN, tumour location and histotype were fitted using the Kaplan–Meier method. Survival curves were then compared using the log-rank test.

Results

Inter-observer reproducibility was very good (Spearman’s rho = 0.95; ICC = 0.94). At a total median follow-up of 19 months (2–49 months), 4 patients had died. The median follow-up was 18.50 months (5–49 months) for the surgery-only group (1/4 events, 25 %) and 24 months (2–34 months) for the chemo/radiotherapy group (3/4 events, 75 %). Survival time at 48 months for the overall population was 59 % (±0.11), while for the surgery-only group and the chemo/radiotherapy group was 90 % (±0.09) and 61 % (±0.34), respectively. In the univariate analysis, ADC values below or equal to 1.4 × 10−3 mm2/s were associated with a negative prognosis both in the total population (P = 0.016) and in the surgery-only group (P < 0.001).

Conclusion

Despite the biggest limitation of our study (i.e. the small study population), we were able to show that pathological ADC could be considered a prognostic factor for oesophageal cancer. DWI might be introduced into clinical practice as a promising and reliable technique in the diagnostic pathway of this tumour.

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Acknowledgments

The Authors are indebted to all the patients, families and health care assistants (nurses, radiographers) who greatly contributed to the achievement of this work.

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Authors and Affiliations

  1. Department of Radiology and Centre for Experimental Imaging, San Raffaele Scientific Institute, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy

    Francesco Giganti, Annalaura Salerno, Antonio Esposito, Alessandro Del Maschio & Francesco De Cobelli

  2. Vita-Salute San Raffaele University, Milan, Italy

    Alessandro Ambrosi

  3. Department of Surgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy

    Damiano Chiari, Elena Orsenigo & Carlo Staudacher

  4. Pathology Unit, San Raffaele Scientific Institute, Milan, Italy

    Luca Albarello

  5. Department of Oncology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy

    Elena Mazza

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  1. Francesco Giganti
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  2. Annalaura Salerno
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Correspondence to Francesco Giganti.

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All the authors declare that they have no conflict of interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Giganti, F., Salerno, A., Ambrosi, A. et al. Prognostic utility of diffusion-weighted MRI in oesophageal cancer: is apparent diffusion coefficient a potential marker of tumour aggressiveness?. Radiol med 121, 173–180 (2016). https://doi.org/10.1007/s11547-015-0585-2

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  • DOI: https://doi.org/10.1007/s11547-015-0585-2

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