• Francesco Giganti, Francesco De Cobelli, Carla Canevari, Elena Orsenigo, Francesca Gallivanone, Antonio Esposito, Isabella Castiglioni, Alessandro Ambrosi, Luca Albarello, Elena Mazza, Luigi Gianolli, Carlo Staudacher, and Alessandro Del Maschio.
• Department of Radiology and Center for Experimental Imaging, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
• J Magn Reson Imaging. 2014 Nov 1; 40 (5): 1147-57.

PurposeTo assess whether changes in diffusion-weighted MRI (DW-MRI) and (18) F-fluoro-2-deoxyglucose positron emission tomography/computed tomography ((18) F-FDG PET/CT), correlate with treatment response to neoadjuvant therapy (NT), as expressed by tumor regression grade (TRG), from locally advanced gastric adenocarcinoma (GA).Materials And MethodsSeventeen patients underwent both DW-MRI and (18) F-FDG-PET/CT scans before and after the end of NT. Apparent diffusion coefficient (ADC) and mean standardized uptake value (SUV) corrected for partial volume effect (PVC-SUVBW-mean ) were evaluated and compared with histopathological TRG.ResultsPre- and post-NT and percentage changes for ADC and PVC-SUVBW-mean were assessed. Post-NT ADC and ΔADC showed a significant inverse correlation with TRG (r = -0.71; P = 0.0011 and r = -0.78; P = 0.00020, respectively) and significant differences in their mean values were found between responders (TRG 1-2-3) and nonresponders (TRG 4-5) (P = 0.0009; P = 0.000082, respectively). No correlations with TRG were found for pre-NT ADC and for all PVC-SUVBW-mean values as well as between ΔADC and Δ PVC-SUVBW-mean .ConclusionDW-MRI seems more accurate than (18) F-FDG-PET/CT and ADC modifications may represent a reproducible tool to assess tumor response for GA.© 2013 Wiley Periodicals, Inc.

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