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ORIGINAL ARTICLE
Year : 2017  |  Volume : 13  |  Issue : 5  |  Page : 748-755

Optimization of b-values in diffusion-weighted imaging for esophageal cancer: Measuring the longitudinal length of gross tumor volume and evaluating chemoradiotherapeutic efficacy


1 Department of Radiology, The 1st Affiliated Hospital of PLA General Hospital, Beijing, China
2 Department of Radiology, The 95th Hospital of PLA, Putian, China
3 Department of Radiology, Chinese PLA General Hospital, Beijing, China

Correspondence Address:
Tianran Li
Department of Radiology, The 1st Affiliated Hospital of PLA General Hospital, No. 51 Fucheng Road, Haidian, Beijing 100048
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcrt.JCRT_630_17

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Purpose: To study the optimization of b-values of magnetic resonance-diffusion-weighted (MR-DWI) in evaluating the chemoradiotherapeutic efficacy for esophageal squamous cell carcinoma (ESCC) and measuring the longitudinal length of gross tumor volume (GTV) of ESCC. Materials and Methods: Eighteen patients with biopsy-proven ESCC were undergoing concurrent chemoradiotherapy (CCRT). Conventional magnetic resonance imaging (MRI) combined with DWI using b-values of 600 s/mm2, 800 s/mm2, and 1000 s/mm2 was performed before CCRT and after the 1st, 3rd, 5th, and 10th weeks. The apparent diffusion coefficient (ADC) values of ESCC were derived from DWI using multiple b-values. The correlations between ADC values and apoptosis positive rates of ESCC cells obtained from the endoscope biopsy were statistically analyzed. Thirty-eight patients with confirmed ESCC who underwent radical surgery were analyzed. Longitudinal length of GTV of ESCC was measured using endoscopy, esophageal barium fluoroscopy, computed tomography (CT), and T2-weighted MRI and DWI using different b-values (b = 400, 600, and 800 s/mm2) before surgery and were compared with pathologic lesion length. Results: The ADC values of DWI images with different b-values are positively correlated with ESCC cell apoptosis positive ratios, the relation is significant, especially in the group of b = 1000 s/mm2 (P < 0.01). The measured length of esophageal lesions from short to long was MR-DWI b = 800 s/mm2, endoscopy, real tumor, MR-DWI b = 600 s/mm2, esophageal barium fluoroscopy, CT, and MR-DWI b = 400 s/mm2. Conclusion: MR-DWI b = 800 s/mm2 and b = 1000 s/mm2 are in favor of observing the chemoradiotherapeutic efficacy with time variation and evaluating the chemoradiotherapeutic efficacy, respectively. MR-DWI b = 600 s/mm2 could be used as a supplementary means in measuring the length of ESCC.


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