Abstract：As an important component of functional magnetic resonance imaging, diffusion-weighted magnetic resonance imaging (DWI) can provide qualitative and quantitative information for tumor evaluation and distinguish esophageal lesions and mediastinal lymph node metastasis. DWI-computed tomography fusion images facilitate the delineation of target volume. During radiotherapy or concurrent chemoradiotherapy for esophageal carcinoma, monitoring the changes in apparent diffusion coefficient value helps to predict the early treatment outcomes and prognosis;DWI compensates for the shortcomings of radiography alone in the evaluation of short-term treatment outcomes. This paper reviews the application of DWI in the diagnosis, delineation of target volume, assessment of treatment outcomes, and prognostic prediction in radiotherapy for esophageal carcinoma.
Li Guanghu,Qian Liting. Application of diffusion-weighted magnetic resonance imaging in radiotherapy for esophageal carcinoma[J]. Chinese Journal of Radiation Oncology, 2017, 26(2): 239-242.
[1] Siegel RL,Miller KD,Jemal A.Cancer statistics,2015[J].CA Cancer J Clin,2015,65(1):5-29.DOI:10.3322/caac.21254. [2] 陈万青,张思维,曾红梅,等.中国2010年恶性肿瘤发病与死亡[J].中国肿瘤,2014,23(1):1-10.DOI:10.11735/j.issn.1004-0242.2014.01.A001. Chen WQ,Zhang SW,Xiao HM,et al. The incidence and mortality of malignant tumors in China in 2010[J].Chin Cancer,2014,23(1):1-10.DOI:10.11735/j.issn.1004-0242.2014.01.A001. [3] Sillah K,Williams LR,Laasch HU,et al. Computed tomography overestimation of esophageal tumor length:implications for radiotherapy planning[J].World J Gastrointest Oncol,2010,2(4):197-204.DOI:10.4251/wjgo.v2.i4.197. [4] Yamada I,Izumi Y,Kawano T,et al. Esophageal carcinoma:evaluation with high-resolution three-dimensional constructive interference in steady state MR imaging in vitro[J].J Mag Res Imag,2006,24(6):1326-1332.DOI:10.1002/jmri.20741. [5] 汪宁,张晓鹏,唐磊,等.食管肿瘤扩散加权成像序列参数优化及相关影像病理对照研究[J].中国医学影像技术,2005,21(12):1826-1829.DOI:10.3321/j.issn:1003-3289.2005.12.010. Wang N,Zhang XP,Tang L,et al. Parameters optimization of diffusion weighted imaging sequence of esophageal cancer and related imaging pathologic correlation[J].Chin J Med Imag Technol,2005,21(12):1826-1829.DOI:10.3321/j.issn:1003-3289.2005.12.010. [6] 田华,王澜,韩春,等.磁共振弥散加权成像在食管癌精确放疗中的应用价值[J].中华放射肿瘤学杂志,2012,21(3):223-226.DOI:10.3760/cma.j.issn.1004-4221.2012.03.009. Tian H,Wang L,Han C,et al. Application value of diffusion weighted magnetic resonance imaging in precise radiotherapy of esophageal carcinoma[J].Chin J Radiat Oncol,2012,21(3):223-226.DOI:10.3760/cma.j.issn.1004-4221.2012.03.009. [7] 侯栋梁,时高峰,高献书,等.磁共振弥散加权成像在食管癌大体肿瘤靶区勾画中的应用价值[J].中华放射肿瘤学杂志,2012,21(4):343-347.DOI:10.3760/cma.j.issn.1004-4221.2012.04.016. Hou DL,Shi GF,Gao XS,et al. The application value of magnetic resonance diffusion weighted imaging in gross tumor target delineation of esophageal cancer[J].Chin J Radit Oncol,2012,21(4):343-347.DOI:10.3760/cma.j.issn.1004-4221.2012.04.016. [8] Shuto K,Saito H,Ohira G,et al. Diffusion-weighted MR imaging for postoperative nodal recurrence of esophageal squamous cell cancer in comparison with FDG-PET[J].Gan To Kagaku Ryoho,2009,36(12):2468-2470. [9] 张倩倩,徐亮,申洪明,等.CT及DWI评价食管癌术前淋巴结转移及N分期对比研究[J].实用放射学杂志,2013,29(7):1075-1078.DOI:10.3969/j.issn.1002-1671.2013.07.012. Zhang QQ,Xu L,Shen HM,et al. Comparison of CT and DWI in preoperative evaluation of lymph node metastasis and N staging of esophageal cancer patients[J].J Pract Radiol,2013,29(7):1075-1078.DOI:10.3969/j.issn.1002-1671.2013.07.012. [10] Sakurada A,Takahara T,Kwee TC,et al. Diagnostic performance of diffusion-weighted magnetic resonance imaging in esophageal cancer[J].Eur Radiol,2009,19(6):1461-1469.DOI:10.1007/s00330-008-1291-4. [11] 陈兆秋,李万湖,刘立恒,等.CT-MRI图像融合体外控制点模体的研制及临床应用的初步结果[J].中国临床医学影像杂志,2009,20(5):379-380.DOI:10.3969/j.issn.1008-1062.2009.05.026. Chen ZQ,Li WH,Liu LH,et al. Preliminary results of the development and clinical application of CT-MRI image fusion in vitro control point model[J].J Chin Clin Med Imag,2009,20(5):379-380.DOI:10.3969/j.issn.1008-1062.2009.05.026. [12] 侯栋梁,房彤,刘辉,等.CT/MR图像融合在食管癌精确放疗大体肿瘤靶区勾画中的应用价值[J].中华放射医学与防护杂志,2014,34(2):129-132.DOI:10.3760/cma.j.issn.0254-5098.2014.02.013. Hou DL,Shi GF,Gao XS,et al. Improved longitudinal length accuracy of gross tumor volume delineation with diffusion weighted magnetic resonance imaging for esophageal squamous cell carcinoma[J].Radiat Oncol,2013,8:169-173.DOI:10.1186/1748-717X-8-169. [13] Kyriazi S,Collins DJ,Messiou C,et al. Metastatic ovarian and primary peritoneal cancer:assessing chemotherapy response with diffusion-weighted MR imaging-value of histogram analysis of apparent diffusion coefficients[J].Radiology,2011,261(1):182-192.DOI:10.1148/radiol.11110577. [14] Aoyagi T,Shuto K,Okazumi S,et al. Apparent diffusion coefficient correlation with oesophageal tumour stroma and angiogenesis[J].Eur Radiol,2012,22(6):1172-1177.DOI:10.1007/s00330-011-2359-0. [15] Aoyagi T,Shuto K,Okazumi S,et al. Apparent diffusion coefficient values measured by diffusion-weighted imaging predict chemoradiotherapeutic effect for advanced esophageal cancer[J].Dig Surg,2011,28(4):252-257.DOI:10.1159/000328770. [16] Sun Y S,Cui Y,Tang L,et al. Early evaluation of cancer response by a new functional biomarker:apparent diffusion coefficient[J].Am J Roentgenol,2011,197(1):W23-W29.DOI:10.2214/AJR.10.4912. [17] 刘辉,时高峰,邵娴,等.磁共振弥散加权成像在早期评估食管癌放疗疗效的应用价值[J].河北医药,2013,35(22):3403-3404.DOI:10.3969/j.issn.1002-7386.2013.22.018. Liu H,Shi GF,Shao X,et al. The application value of MR diffusion weighted imaging in early assessment of esophageal cancer radiotherapy[J].Hebei Med J,2013,35(22):3403-3404.DOI:10.3969/j.issn.1002-7386.2013.22.018. [18] 王澜,韩春,祝淑钗,等.磁共振弥散加权成像在食管癌放疗疗效评价中的应用价值探讨[J].中华放射医学与防护杂志,2014,34(2):120-124.DOI:10.3760/cma.j.issn.0254-5098.2014.02.011. Wang L,Han C,Zhu S,et al. Investigation of using diffusion-weighted magnetic resonance imaging to evaluate the therapeutic effect of esophageal carcinoma treatment[J]. Oncol Res Treat,2014,37(3):112-116.DOI:10.1159/000360210. [19] 盖娟娟,宋利强,韩珊,等.3.0T磁共振弥散加权成像评价食管癌同步放化疗疗效[J].实用临床医药杂志,2014,18(7):154-156.DOI:10.7619/jcmp.201407055. Gai JJ,Song LQ,Han S,et al. Evaluation of concurrent radiotherapy and chemotherapy in esophageal cancer with 3.0T magnetic resonance diffusion weighted imaging[J].J Clin Med Pract,2014,18(7):154-156.DOI:10.7619/jcmp.201407055. [20] 陈伟,周胜利,苗重昌,等.DWI在食管癌同期放化疗早期疗效评价中的初步研究[J].中华放射肿瘤学杂志,2014,23(4):312-316.DOI:10.3760/cma.j.issn.1004-4221.2014.04.010. Chen W,Zhou SL,Miao ZC,et al. Preliminary study on the evaluation of the efficacy of DWI in the early stage of esophageal cancer with concurrent radiotherapy and chemotherapy[J].Chin J Radiat Oncol,2014,23(4):312-316.DOI:10.3760/cma.j.issn.1004-4221.2014.04.010. [21] Imanishi S,Shuto K,Aoyagi T,et al. Diffusion-weighted magnetic resonance imaging for predicting and detecting the early response to chemoradiotherapy of advanced esophageal squamous cell carcinoma[J].Dig Surg,2013,30(3):240-248.DOI:10.1159/000351435. [22] Kwee RM,Dik AK,Sosef MN,et al. Interobserver reproducibility of diffusion-weighted MRI in monitoring tumor response to neoadjuvant therapy in esophageal cancer[J/OL].PLoS One,2014,9(4):e92211.DOI:10.1371/journal.pone.0092211.
2017, Vol. 26 
