ArticlePhysics and imaging in radiation oncology2025
Apparent diffusion coefficient increases during short course radiotherapy in rectal tumours: Results from a multicentre longitudinal trial.
Article in Physics and imaging in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and purpose: The apparent diffusion coefficient (ADC) derived from diffusion-weighted imaging (DWI), a form of magnetic resonance imaging (MRI), has shown promise for predicting response to long course neoadjuvant chemoradiotherapy in rectal cancer. This study investigated whether ADC changes are detectable during short course radiotherapy in patients with rectal cancer. Materials and methods: Across 3 centres, this study included 138 patients with primary tumours, who received neoadjuvant short course radiotherapy (5 fractions of 5 Gy) on a 1.5 T MRI linear accelerator (MRI-linac), without any prior oncological treatments. DWI was acquired at each fraction prior to beam-on. ADC maps were calculated centrally using a mono-exponential model using b-values between 150-800 s/mm Results: A scaling factor of 0.93 was used to account for ADC variation between the DWI sequence groups. The median (range) slope of the ADC time-trends was 0.05 (-0.18, 0.42) 10 Conclusions: ADC changes during short course radiotherapy were detectable in 56% of the patients. Furthermore, the limited ADC variation across DWI sequences supports feasibility of multicentre investigations of MRI-linac based DWI. These findings encourage future research linking ADC to clinical outcomes in rectal cancer for potential treatment personalization.
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