More accurate diagnostics for prediction of treatment responses in locally advanced rectal cancer is warranted. We employed a simplified approach to the intravoxel incoherent motion imaging method to estimate the tumour perfusion fraction from diffusion-weighted MRI. The perfusion fraction was predictive of the histologic tumour response after chemoradiotherapy (p = 0.02), and in combination with tumour volume this parameter was also predictive of five-year progression-free survival of the patients (p = 0.002). This simplified approach does not require substantial extra scan time in a routine diagnostic scanning, and may offer a clinically feasible approach to stratifying patients to individualised treatment.
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