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Apparent diffusion coefficient by diffusion-weighted magnetic resonance imaging as a sole biomarker for staging and prognosis of gastric cancer

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Chinese Journal of Cancer Research 2017年第2期29卷 118-126页

作者： Francesco Giganti Alessandro Ambrosi Damiano Chiari elena Orsenigo Antonio Esposito elena mazza Luca Albarello Carlo Staudacher Alessandro Del Maschio Francesco De Cobelli Department of Radiology and Experimental Imaging Center San Raffaele Scientific Institute Milan Italy Vita-Salute San Raffaele University Milan Italy Department of Surgery San Raffaele Scientific Institute Milan Italy Department of Oncology San Raffaele Scientific Institute Milan Italy Pathology Unit San Raffaele Scientific Institute Milan Italy

Objective： To investigate the role of apparent diffusion coefficient （ADC） from diffusion-weighted magnetic resonance imaging （DW-MRI） when applied to the 7th TNM classification in the staging and prognosis of gastric cancer （GC）. Methods： Between October 2009 and May 2014, a total of 89 patients with non-metastatic, biopsy proven GC underwent 1.5T DW-MRI, and then treated with radical surgery. Tumor ADC was measured retrospectively and compared with final histology following the 7th TNM staging （local invasion, nodal involvement and according to the different groups -- stage Ⅰ, Ⅱ and Ⅲ）. Kaplan-Meier curves were also generated. The follow-up period is updated to May 2016. Results： Median follow-up period was 33 months and 45/89 （51%） deaths from GC were observed. ADC was significantly different both for local invasion and nodal involvement （P〈0.001）. Considering final histology as the reference standard, a preoperative ADC cut-offof 1.80×10-3 mm^2/s could distinguish between stages I and Ⅱ and an ADC value of ≤1.36-10-3 mm^2/s was associated with stage Ⅲ（P〈0.001）. Kaplan-Meier curves demonstrated that the survival rates for the three prognostic groups were significantly different according to final histology and ADC cut-offs （P〈0.001）. Conclusions： ADC is different according to local invasion, nodal involvement and the 7th TNM stage groups for GC, representing a potential, additional prognostic biomarker. The addition of DW-MRI could aid in the staging and risk stratification of GC.

关键词： Apparent diffusion coefficient diffusion-weighted magnetic resonance imaging gastric cancer prognosis TNM staging

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