This study is testing new imaging and analysis methods to improve how doctors predict treatment response in rectal cancer patients receiving chemoradiotherapy. Current MRI scans sometimes miss complete tumor response, which can lead to unnecessary surgery. To address this, researchers will use a special MRI technique called hyperpolarized carbon-13 MRI, along with blood and tissue analysis (metabolomics) and advanced image feature analysis (radiomics). These tools can track how cancer cells use energy and how metabolism changes during treatment.
The study will follow 30 rectal cancer patients at Chang Gung Memorial Hospital over 3 years. Patients will undergo standard MRI, colonoscopy, and advanced metabolic imaging before and after treatment. Results will compare patients whose tumors completely respond to therapy with those who do not. The goal is to see if metabolic changes detected by hyperpolarized MRI and metabolomics can predict treatment outcomes earlier and more accurately. This may help doctors avoid unnecessary surgery and provide more personalized care for rectal cancer patients.
Inclusion Criteria:
Exclusion Criteria:
2. Contraindication to MRI study (e.g., claustrophobia or non-removable devices or implants that are incompatible with MRI). 3. Intercurrent illness that will affect the compliance of the patient during the MRI study (e.g., active infection, symptomatic congestive heart failure, uncontrollable angina, arrhythmia, psychiatric disorders, dyspnea, or diarrhea). 4. Severe hepatic dysfunction (alkaline phosphatase/aspartate aminotransferase/alanine aminotransferase >20 × upper limit of normal [ULN] or bilirubin > 10 × ULN). 5. Severe renal impairment (eGFR <30 ml/min/1.73m2).
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Patients whose rectal cancer shows no residual tumor cells after neoadjuvant chemoradiotherapy, confirmed by pathology.
Patients whose rectal cancer still shows residual tumor cells after neoadjuvant chemoradiotherapy, confirmed by pathology.
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