Diffusion-weighted imaging in evaluating the efficacy of concurrent chemoradiotherapy in the treatment of non-small cell lung cancer

Abstract

Objective:

To explore the predictive value of diffusion-weighted imaging (DWI) in evaluating the short-term efficacy of concurrent chemoradiotherapy (CCRT) in the treatment of patients with non-small cell lung cancer (NSCLC).

Methods:

A total of 192 patients with NSCLC were selected and treated with CCRT. Dynamic contrast-enhanced magnetic resonance imaging combined with DWI was performed on all patients before and after CCRT treatment. Correspondingly, apparent diffusion coefficient (ADC) values were recorded before treatment (ADC_pre), during treatment (ADC_mid), and after treatment (ADC_post). Tumor response was evaluated as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic power of quantitative DWI parameters in predicting the short-term efficacy of CCRT for patients with NSCLC.

Results:

There were 21 patients with CR, 82 with PR, 77 with SD, and 12 with PD. The ADC_pre was negatively correlated with tumor regression rate, whereas ADC_mid, ADC_post, and their respective change rates ∆ADC_mid and ∆ADC_post were positively related to tumor regression rate. The ROC curve analysis suggested ADC_pre = 1.38 × 10⁻³ mm²/s, ∆ADC_mid = 14.14%, and ∆ADC_post = 20.39% as thresholds to predict the short-term efficacy of CCRT, with corresponding areas under the curve of 0.637, 0.743, and 0.752, respectively.

Conclusions:

These findings indicate that DWI provides promising predictive value in evaluating the short-term efficacy of CCRT in the treatment of patients with NSCLC.