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A prospective study of diffusion-weighted magnetic resonance imaging as an early prognostic biomarker in chemoradiotherapy in squamous cell carcinomas of the anus.

Research output: Contribution to journalArticle

Rebecca Muirhead, Daniel Bulte, Rosie Cooke, Kwun-Ye Chu, Lisa Durrant, Vicky Goh, Clare Jacobs, Stasya Ng, Victoria Strauss, Pradeep Virdee, Cathy Qi, Maria Hawkins

Original languageEnglish
JournalClinical Oncology
Publication statusAccepted/In press - 22 Jul 2020


  • CLINONC-2020-135R1

    CLINONC_2020_135R1.docx, 829 KB, application/vnd.openxmlformats-officedocument.wordprocessingml.document


    Submitted manuscript


King's Authors


Purpose: The use of diffusion-weighted magnetic resonance imaging as a prognostic marker of treatment response would enable early individualisation of treatment. We aimed to quantify the changes in mean apparent-diffusioncoefficient (∆ADCMean) between a DW-MRI at diagnosis and on fraction 8-10 of chemoradiotherapy (CRT) as a biomarker for cellularity, and correlate these with ASCC recurrence. Methods and materials This prospective study recruited patients with localised anal cancer between October 2014 and November 2017. DW-MRI was performed at diagnosis and after fraction 8-10 of radical CRT. A region of interest (ROI) was delineated for all primary tumours and any lymph nodes >2 cm on highresolution T2 -weighted images and propagated to the ADC map. Routine clinical follow up was collected from NHS electronic systems. Results Twenty-three of 29 recruited patients underwent paired DW-MRI scans. 26 ROIs were delineated among the 23 evaluable patients. The median (range) tumour volume was 13.6 cm3 (2.8 cm3 to 84.9 cm3). Ten of 23 patients had lesions with ∆ADCMean ≤20%. With a median follow-up of 41.2 months, 4 patients either failed to have a complete response to CRT, or subsequently relapsed. Three of 4 patients with disease relapse had lesions demonstrating ∆ADCMean. Conclusion: We demonstrated a potential correlation between patients with ∆ADCMean <20% and disease relapse. Further investigation of the prognostic merit of DW-MRI change is needed in larger prospective cohorts.

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