The Value Of Apparent Diffusion Coefficient Values In The Evaluation Of The Efficacy Of Radiotherapy And Chemotherapy For Esophageal Cancer

Objective:To explore the apparent diffusion coefficient values in the evaluation of the radiotherapy and chemotherapy efficacy and prognosis assessment for esophageal cancer,and then to guide clinical treatment.Methods:30 cases of pathologically confirmed esophageal cancer patients in Cancer Hospital of Shanxi Medical University were collected from 2014.10 to 2016.3, those who were underwent the conventional MRI examination,the images could show the tumor clearly,and these patients would be treated with radiotherapy and chemotherapy. All patients were underwent conventional MRI and DWI scan before and after radiotherapy and chemotherapy, and the ADC images were obtained.According to the RECIST standard, 30 patients were divided into remission group(CR, PR) and non remission group(SD, PD),among which there were 16 cases(16/30, 53%) in the remission group, and 14 cases(14/30, 47%) in the non remission group. Length, thickness and ADC values of each group lesions’ maximum level were measured before and after the radiotherapy and chemotherapy of the esophageal lesions, then we calculated each group’s difference of length, thickness and ADC values before and after the treatment and their rate of change,by the end,compared these differences of two groups.Data were analyzed by paired sample t test and two independent sample t test statistical methods. Using the ROC curve to analyze the differences of ADC values and their rate of change before and after radiotherapy and chemotherapy to obtain the ADC optimal threshold values and the corresponding sensitivity and specificity.Results:1. The difference of the values of the lesion’s length, thickness and ADC values before and after radiotherapy and chemotherapy of the patients with esophageal cancer were statistical significance(P < 0.05), the lesions’ length and thickness before treatment were greater than after treatment, the lesions’ ADC values were increased after treatment.2.There were no statistical significant difference in the length, thickness and ADC values of the lesions between the remission group and the non remission group of the patients with esophageal cancer before underwent radiotherapy and chemotherapy.(P >0.05).3.These values including the lesions’ length difference and their rate of change,thickness difference and their rate of change before and after radiotherapy and chemotherapy for esophageal cancer between the remission group and the non remission group were not significantly different(P > 0.05). ADC values’ difference and their rate of change before and after radiotherapy and chemotherapy for esophageal cancer between the two groups were significantly different(P<0.05).Using ROC curve to analyze the ADC values’ difference and their rate of change could conclude that if the ADC values’ difference reaches 0.552×10-3mm2/s, it could be diagnosed that the esophageal cancer remitted after radiotherapy and chemotherapy, its sensitivity was 87.5%and specificity was78.6%; if the ADC values’ change of rate reaches 0.559, it could also be diagnosed that the esophageal cancer remitted after radiotherapy and chemotherapy, its sensitivity was87.5%and specificity was 85.7%.Conclusion:DWI examination and the measurement of ADC values have important clinical value in the evaluation of the efficacy of radiotherapy and chemotherapy for esophageal cancer:(1) It showed that radiotherapy and chemotherapy had a positive effect on esophagealcancer by the measurement and comparison of the lesions’ length, thickness and ADC values.(2) DWI examination and ADC values can evaluate the effect of esophageal cancer patients with radiotherapy and chemotherapy treatment by analyzing the ADC values’ difference and their rate of change before and after radiotherapy and chemotherapy for esophageal cancer between the remission group and the non remission group.