Apparent diffusion coefficient by diffusion-weighted magnetic resonance imaging as a sole biomarker for staging and prognosis of gastric cancer

Giganti, Francesco; Ambrosi, Alessandro; Chiari, Damiano; Orsenigo, E.; Esposito, Antonio; Mazza, Elena; Albarello, Luca; Staudacher, C.; Maschio, Alessandro Del; Cobelli, Francesco De

doi:10.21147/j.issn.1000-9604.2017.02.04

Cited by 18 publications

(16 citation statements)

References 35 publications

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“…35 Furthermore ADC values increase gradually with the degree of histologic tumor differentiation 32,37,132 and there is an inverse correlation between the ADC value and the T-and N-stage. 133,134 Its correlation with the Her2Neu status of gastric tumors has been described 135,136 and it could also be useful in response prediction to neoadjuvant treatment as discussed before. 133 Lastly, lower tumor ADC values are associated with a negative prognosis (i.e.…”

Section: Challenges and Future Perspectives In Gastric Cancer Stagingmentioning

confidence: 92%

“…overall survival) and could potentially serve as prognostic factor in the evaluation of aggressiveness of gastric cancer. 134,137,138 One of the challenges specifically for the use of ADC values of DW-MRI in clinical practice, is that there is no consensus how to calculate and interpret ADC values. ADC values are calculated based on a region of interest (ROI), but the approach of determination of this ROI varies greatly between studies.…”

Section: Challenges and Future Perspectives In Gastric Cancer Stagingmentioning

confidence: 99%

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Imaging strategies in the management of gastric cancer: current role and future potential of MRI

Borggreve

Goense

Brenkman

et al. 2019

The British Journal of Radiology

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Gastric cancer is the fifth most common malignancy in the world, with nearly one million new cases of gastric cancer diagnosed every year. 1 Curative treatment of gastric adenocarcinoma consists of partial or total resection of the stomach combined with lymphadenectomy. 2 Over the last years, multimodality treatment strategies such as neoadjuvant chemo(radio)therapy, perioperative chemotherapy and adjuvant chemotherapy have gained importance in the treatment of gastric cancer by improving the likelihood of a radical tumor resection, disease free survival and overall survival. 3-8 Unfortunately, the overall 5 year survival rate still remains poor (35-45%). 4,9 Accurate staging of gastric cancer allows for selection of the most appropriate therapy, minimizes unnecessary surgery and maximizes the likelihood of benefit from the selected treatment. After initial diagnosis by gastroscopy with tumor biopsy, diagnostic work-up can consist of endoscopic ultrasonography (EUS), computed tomography (CT) and 18 F-fluorodeoxyglucose positron emission tomography (18 F-FDG PET). However, these techniques all have their limitations. EUS is an invasive, highly operator-dependent technique and does not detect distant metastases. 10,11 CT exposes patients to ionizing radiation and has poor soft-tissue contrast. 18 F-FDG PET is impaired by the fact that not all gastric carcinomas are 18 F-FDG-avid (avidity ranging from 42-96%) and has a low spatial resolution. 12 Historically, the role of magnetic resonance imaging (MRI) in gastric cancer has been limited, since relatively long acquisition times and technical challenges of peristaltic motion and respiration artifacts resulted in poor imaging quality. 13,14 With the continuous technical improvements in MRI scanning, including fast imaging techniques, (respiratory) motion compensation techniques, use of anti peristaltic agents and the introduction of functional MRI

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Section: Challenges and Future Perspectives In Gastric Cancer Stagingmentioning

confidence: 92%

Section: Challenges and Future Perspectives In Gastric Cancer Stagingmentioning

confidence: 99%

Imaging strategies in the management of gastric cancer: current role and future potential of MRI

Borggreve

Goense

Brenkman

et al. 2019

The British Journal of Radiology

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“…A total of 299 articles were screened in the primary literature search. After removing the ineligible study in each step, 15 studies (six studies [ 46 – 51 ] for DWI and nine studies [ 21 , 38 – 41 , 52 – 55 ] for 18 F-FDG PET/CT were finally selected on basis of the inclusion and exclusion criteria. A flowchart depicting the study selection process is shown in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…The overall accuracy is higher when the reference standard is based on ADC (ADC < 1.189×10 –3 mm 2 /s) than when based on the short axis diameter (SAD) (SAD > 5.05 mm) [ 50 ]. A study by Giganti et al proved that ADC value significantly differed according to local invasion, nodal involvement and the AJCC Cancer Staging Manual, 7th Edition TNM stage groups for GC, indicating that the ADC was potentially useful in the staging and risk stratification of GC patients [ 46 ]. Although Hasbahceci et al [ 49 ] demonstrated that ADC value did not aid in distinguishing metastatic lymph nodes, this contrary conclusion was based on study of only 23 GC subjects and was not convincing.…”

Section: Discussionmentioning

confidence: 99%

Comparison of DWI and 18F-FDG PET/CT for assessing preoperative N-staging in gastric cancer: evidence from a meta-analysis

et al. 2017

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The diagnostic values of diffusion weighted imaging (DWI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for N-staging of gastric cancer (GC) were identified and compared. After a systematic search to identify relevant articles, meta-analysis was used to summarize the sensitivities, specificities, and areas under curves (AUCs) for DWI and PET/CT. To better understand the diagnostic utility of DWI and PET/CT for N-staging, the performance of multi-detector computed tomography (MDCT) was used as a reference. Fifteen studies were analyzed. The pooled sensitivity, specificity, and AUC with 95% confidence intervals of DWI were 0.79 (0.73–0.85), 0.69 (0.61–0.77), and 0.81 (0.77–0.84), respectively. For PET/CT, the corresponding values were 0.52 (0.39–0.64), 0.88 (0.61–0.97), and 0.66 (0.62–0.70), respectively. Comparison of the two techniques revealed DWI had higher sensitivity and AUC, but no difference in specificity. DWI exhibited higher sensitivity but lower specificity than MDCT, and 18F-FDG PET/CT had lower sensitivity and equivalent specificity. Overall, DWI performed better than 18F-FDG PET/CT for preoperative N-staging in GC. When the efficacy of MDCT was taken as a reference, DWI represented a complementary imaging technique, while 18F-FDG PET/CT had limited utility for preoperative N-staging.

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“…The first study [37] reports that an ADC of 1.8 × 10 -3 mm 2 /s may discriminate between stage I and stage II and that values ≤ 1.36 × 10 -3 mm 2 /s are associated with stage III. The second paper [51] shows that an ADC ≤ 1.5 × 10 -3 mm 2 /s is related to a negative outcome, along with T and N stages after surgery.…”

Section: Dw-mri and Imaging Biomarkersmentioning

confidence: 99%

Gastric cancer and imaging biomarkers: Part 1 – a critical review of DW-MRI and CE-MDCT findings

2018

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The current standard of care for gastric cancer imaging includes heterogeneity in image acquisition techniques and qualitative image interpretation. In addition to qualitative assessment, several imaging techniques, including diffusion-weighted magnetic resonance imaging (DW-MRI), contrast-enhanced multidetector computed tomography (CE-MDCT), dynamic-contrast enhanced MRI and 18F-fluorodeoxyglucose positron emission tomography, can allow quantitative analysis. However, so far there is no consensus regarding the application of functional imaging in the management of gastric cancer. The aim of this article is to specifically review two promising biomarkers for gastric cancer with reasonable spatial resolution: the apparent diffusion coefficient (ADC) from DW-MRI and textural features from CE-MDCT. We searched MEDLINE/ PubMed for manuscripts published from inception to 6 February 2018. Initially, we searched for (gastric cancer OR gastric tumour) AND diffusion weighted magnetic resonance imaging. Then, we searched for (gastric cancer OR gastric tumour) AND texture analysis AND computed tomography. We collated the results from the studies related to this query. There is evidence that: (1) the ADC is a promising biomarker for the evaluation of the aggressiveness (T and N stage), treatment response and prognosis of gastric cancer; (2) textural features are related to the degree of differentiation, Lauren classification, treatment response and prognosis of gastric cancer. We conclude that these imaging biomarkers hold promise as effective additional tools in the diagnostic pathway of gastric cancer and may facilitate the multidisciplinary work between the radiologist and clinician, and across different institutions, to provide a greater biological understanding of gastric cancer.Key Points • Quantitative imaging is the extraction of quantifiable features from medical images for the assessment of normal or pathological conditions and represents a promising area for gastric cancer. • Quantitative analysis from CE-MDCT and DW-MRI allows the extrapolation of multiple imaging biomarkers. • ADC from DW-MRI and CE- MDCT-based texture features are non-invasive, quantitative imaging biomarkers that hold promise in the evaluation of the aggressiveness, treatment response and prognosis of gastric cancer.

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Apparent diffusion coefficient by diffusion-weighted magnetic resonance imaging as a sole biomarker for staging and prognosis of gastric cancer

Cited by 18 publications

References 35 publications

Imaging strategies in the management of gastric cancer: current role and future potential of MRI

Imaging strategies in the management of gastric cancer: current role and future potential of MRI

Comparison of DWI and 18F-FDG PET/CT for assessing preoperative N-staging in gastric cancer: evidence from a meta-analysis

Gastric cancer and imaging biomarkers: Part 1 – a critical review of DW-MRI and CE-MDCT findings

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