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Abstract #2822

Washout on Delayed Post Contrast High Resolution Spoiled Gradient Echo MRI is a Sign of Residual Rectal Cancer after Neoadjuvant Therapy

Muhammad Umer Nisar1, Surbhi Raichandani2, Aniket Pratapneni3, Pejman Ghanouni1, Erqi Pollom3, and Vipul R. Sheth1
1Department of Radiology, Stanford University, Palo Alto, CA, United States, 2Department of Radiology, Emory University, Atlanta, GA, United States, 3Department of Radiation Oncology, Stanford University, Palo Alto, CA, United States

Synopsis

Keywords: Digestive, Treatment Response, rectal cancer, mrTRG

Motivation: Rectal cancer response assessment criteria utilize T2-weighted and diffusion-weighted images. High-resolution dynamic and delayed post-contrast images with gadolinium-based contrast are not used.

Goal(s): Assess the value of gadolinium washout on delayed post-contrast T1 weighted images to predict residual cancer.

Approach: In 34 patients with at least T2N0 rectal cancer pre-treatment, we compared the gadolinium washout on T1-weighted images during neoadjuvant therapy with the 1-year outcome after surgery or surveillance.

Results: The presence of gadolinium washout on delayed post-contrast images obtained 4-12 weeks after radiation and 4-12 weeks after completion of total neoadjuvant therapy has a 100% positive predictive value for residual rectal cancer.

Impact: Gadolinium washout may be useful in conjunction with T2-weighted and diffusion-weighted images for accurate assessment of rectal cancer treatment response.

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Keywords