Motivation: Neoadjuvant chemotherapy (NCT) benefits select locally advanced rectal cancer (LARC) patients, with those achieving clinical complete response (cCR) potentially avoiding surgery. Goal(s): To evaluate the efficacy of dynamic contrast-enhanced MRI (DCE-MRI) parameters and MRI tumor regression grade (MR-TRG) in predicting pathologic complete response (pCR) after NCT. Approach: Retrospective analysis of 81 rectal cancer patients, assessing DCE-MRI parameters and MR-TRG. Results: Ktrans and kep were significantly lower, while ve was higher in pCR patients, with AUCs of 0.763, 0.868, and 0.698, respectively. MR-TRG showed high specificity but limited sensitivity. Impact: This study highlights DCE-MRI's potential in noninvasively predicting complete response in rectal cancer, supporting personalized, less invasive management and enabling organ preservation strategies in responsive patients following neoadjuvant chemotherapy.
Fan et al. (Tue,) studied this question.