Dynamic Contrast-Enhanced Magnetic Resonance Imaging: A Novel Approach to Assessing Treatment in Locally Advanced Esophageal Cancer Patients

Aims: This study aims to investigate the potential application of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to predict concurrent chemoradiation (CRT) in locally advanced esophageal carcinoma. Patients and Methods: This study involved 33 patients with locally advanced esophageal cancer and treated with CRT. The patients underwent DCE-MRI before CRT (pre) and 3 weeks after starting CRT (mid). The patients were categorized into two groups: complete response (CR) and non-complete response (non-CR) after 3 months of treatment. The quantitative parameters of DCE-MRI (K-trans, Kep, and Ve), the changes and ratios of parameters (delta K-trans, delta Kep,& nbsp; delta Ve, r delta K-trans, r delta Kep, and r delta Ve), and the relative ratio in the tumor area and a normal tube wall (rK(trans), rKep, and rVe) were calculated and compared between two timeframes in two groups, respectively. Moreover, the receiver operating characteristics (ROC) statistical analysis was used to assess the above parameters. Results: We divided 33 patients into two groups: 22 in the CR group and 11 in the non-CR group. During the mid-CRT phase in the CR group, both Ktrans and Kep rapidly decreased, while only Kep decreased in the non-CR group. The pre-K-trans and pre-Kep in the CR group were substantially higher compared to the non-CR group. Moreover, the rK(trans )was also apparently observed as higher at pre-CRT in the CR group compared to the non-CR group. The ROC analysis demonstrated that the pre-K-trans could be the best parameter to evaluate the treatment performance (AUC = 0.74). Conclusion: Pre-K-trans could be a promising parameter to forecast how patients with locally advanced esophageal cancer will respond to CRT.