Apparent Diffusion Coefficient Can Predict Response to Chemotherapy of Liver Metastases in Colorectal Cancer

Drewes, Ralph; Pech, Maciej; Powerski, Maciej; Omari, Jazan; Heinze, Constanze; Damm, Robert; Wienke, Andreas; Surov, Alexey

doi:10.1016/j.acra.2020.09.006

Cited by 14 publications

(14 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Zheng et al found that the apparent diffusion coefficient had a high predictive value for the response to chemotherapy in gastrointestinal cancer patients with liver metastases ( 20 ). Another study showed that the apparent diffusion coefficient was related to the response to chemotherapy in CRC patients ( 21 ). These results support those of the present study, but the focus of this study was different from those studies.…”

Section: Discussionmentioning

confidence: 99%

Apparent diffusion coefficient is a good marker in predicting the prognosis in colorectal cancer liver metastases: a diagnostic study

Zheng¹,

Lu²,

Zhang³

et al. 2022

J Gastrointest Oncol

View full text Add to dashboard Cite

Background: Colorectal cancer (CRC) is one of the most common malignant tumors. Up to 10% CRC patients can have liver metastases at the first diagnosis. At present, clinical diagnosis of CRC liver metastasis (CRCLM) is mostly based on imaging, and there is a certain false-positive rate and false-negative rate.Improving the diagnostic accuracy of imaging for CRCLM is highly significant. Apparent diffusion coefficients showed high predicting value in other cancers. The aim of the present study was to explore the diagnostic value of apparent diffusion coefficients based on magnetic resonance diffusion weighted imaging for CRCLM.Methods: Fifty patients with CRCLM admitted to Hebei Yanda Hospital from January 2018 to December 2018 were retrospectively collected, and the data of 50 patients with benign liver nodules were collected at the same time. The diagnostic value of apparent diffusion coefficients on liver metastatic cancer was analyzed using receiver operating characteristic curve. The correlation between apparent diffusion coefficients and clinical pathological features of patients with CRCLM was also analyzed. The diagnosis of liver metastatic cancer was based on pathological biopsy. Three-year follow up after surgery was conducted in clinic or via phone.Results: Compared with the benign liver nodule group, the apparent diffusion coefficients of patients in the CRCLM group were significantly decreased [(1.14±0.26 vs. 2.06±0.57)×10−3 mm 2 /s, P<0.001]. The apparent diffusion coefficient was of high value in differentiating between benign liver nodules and liver metastatic cancer. The area under the curve was 0.927 [95% confidence interval (CI): 0.879-0.975, P<0.001]. Compared with patients with highly differentiated tumors, the apparent diffusion coefficients of patients with moderately and poorly differentiated tumors were significantly reduced [(1.08±0.26 vs. 1.29±0.22)×10−3 mm 2 /s, P=0.010]. Compared with patients who survived 3 years after operation, the apparent diffusion coefficients of patients who died were significantly lower [(1.05±0.26 vs. 1.23±0.23)×10−3 mm 2 /s, P=0.011]. The apparent diffusion coefficients of liver nodules in patients with CRCLM is a good marker in predicting postoperative 3-year survival, and the area under the curve was 0.728 (95% CI: 0.580-0.876, P=0.006). Conclusions:The apparent diffusion coefficient can sever as a marker in diagnosing CRCLM and predicting prognosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Apparent diffusion coefficient is a good marker in predicting the prognosis in colorectal cancer liver metastases: a diagnostic study

Zheng¹,

Lu²,

Zhang³

et al. 2022

J Gastrointest Oncol

View full text Add to dashboard Cite

show abstract

“…This is in line with earlier studies comparing RECIST or similar size-based criteria. 11 , 30 , 31 , 32 , 33 There is no significant association of ADC and morphologic MRI criteria for response, and to our knowledge this has not been studied before. Lower ADC represents higher cellularity and thus possibly a more responding lesion.…”

Section: Discussionmentioning

confidence: 85%

“…11,12 Low pre-treatment ADC was not statistically associated with OS or PFS in our study, in line with findings by Tam et al, 34 but contrary to the study by Heijmen et al, where low baseline ADC was associated with shorter OS and PFS in patients receiving chemotherapy. 35 Baseline low ADC is counterintuitive for shorter OS and PFS, as low ADC has consequently shown association with better responses, 11,[30][31][32][33] a strong positive predictor for better PFS and OS. 14 Low ADC values after NAC also indicated better treatment response according to RECIST, but not according to morphologic MRI criteria.…”

Section: Discussionmentioning

confidence: 99%

Treatment response of colorectal cancer liver metastases to neoadjuvant or conversion therapy: a prospective multicentre follow-up study using MRI, diffusion-weighted imaging and 1H-MR spectroscopy compared with histology (subgroup in the RAXO trial)

et al. 2021

View full text Add to dashboard Cite

Background: Colorectal cancer liver metastases respond to chemotherapy and targeted agents not only by shrinking, but also by morphologic and metabolic changes. The aim of this study was to evaluate the value of advanced magnetic resonance imaging (MRI) methods in predicting treatment response and survival. Patients and methods: We investigated contrast-enhanced MRI, apparent diffusion coefficient (ADC) in diffusionweighted imaging and 1 H-magnetic resonance spectroscopy ( 1 H-MRS) in detecting early morphologic and metabolic changes in borderline or resectable liver metastases, as a response to first-line neoadjuvant or conversion therapy in a prospective substudy of the RAXO trial (NCT01531621, EudraCT2011-003158-24). MRI findings were compared with histology of resected liver metastases and KaplaneMeier estimates of overall survival (OS). Results: In 2012-2018, 52 patients at four Finnish university hospitals were recruited. Forty-seven patients received neoadjuvant or conversion chemotherapy and 40 liver resections were carried out. Low ADC values (below median) of the representative liver metastases, at baseline and after systemic therapy, were associated with partial response according to RECIST criteria, but not with morphologic MRI changes or histology. Decreasing ADC values following systemic therapy were associated with improved OS compared to unchanged or increasing ADC, both in the liver resected subgroup (5-year OS rate 100% and 34%, respectively, P ¼ 0.022) and systemic therapy subgroup (5-year OS rate 62% and 23%, P ¼ 0.049). 1 H-MRS revealed steatohepatosis induced by systemic therapy. Conclusions: Low ADC values at baseline or during systemic therapy were associated with treatment response by RECIST but not with histology, morphologic or detectable metabolic changes. A decreasing ADC during systemic therapy is associated with improved OS both in all patients receiving systemic therapy and in the resected subgroup.

show abstract

“…ADC has been proven to have good diagnostic performance in the identification of benign and malignant lesions such as the brain, thyroid, pancreas, and uterus (38)(39)(40)(41)(42). In addition, ADC has also been confirmed in other studies to better predict the response evaluation of liver cancer, nasopharyngeal cancer, colon cancer with liver metastasis after treatment (43)(44)(45). Whether the ADC value can better distinguish benign and malignant ovarian or appendages is different in some previous studies (46,47).…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Performance of Maximum Uptake Value and Apparent Diffusion Coefficient in Differentiating Benign and Malignant Ovarian or Adnexal Masses: A Meta-Analysis

Liang

Zhang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

ObjectiveThe purpose of this meta-analysis was to provide evidence for using maximum uptake value (SUVmax) and apparent diffusion coefficient (ADC) to quantitatively differentiate benign and malignant ovarian or adnexal masses, and to indirectly compare their diagnostic performance.Material and MethodsThe association between SUVmax, ADC and ovarian or adnexal benign and malignant masses was searched in PubMed, Cochrane Library, and Embase databases until October 1, 2021. Two authors independently extracted the data. Studies included in the analysis were required to provide data for the construction of a 2 × 2 contingency table to evaluate the diagnostic performance of SUVmax or ADC in differentiating benign and malignant ovarian or adnexal masses. The quality of the enrolled studies was evaluated by Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) instrument, and the meta-analysis was conducted using Stata software version 14.0. Forest plots were generated according to the sensitivity and specificity of SUVmax and ADC, and meta-regression analysis was further used to assess heterogeneity between studies.ResultsA total of 14 studies were finally included in this meta-analysis by gradually excluding duplicate literatures, conference abstracts, guidelines, reviews, case reports, animal studies and so on. The pooled sensitivity and specificity of SUVmax for quantitative differentiation of benign and malignant ovarian or adnexal masses were 0.88 and 0.89, respectively, and the pooled sensitivity and specificity for ADC were 0.87 and 0.80, respectively.ConclusionQuantitative SUVmax and ADC values have good diagnostic performance in differentiating benign and malignant ovarian or adnexal masses, and SUVmax has higher accuracy than ADC. Future prospective studies with large sample sizes are needed for the analysis of the role of SUVmax and ADC in the differentiation of benign and malignant ovarian or adnexal masses.

show abstract

Apparent Diffusion Coefficient Can Predict Response to Chemotherapy of Liver Metastases in Colorectal Cancer

Cited by 14 publications

References 49 publications

Apparent diffusion coefficient is a good marker in predicting the prognosis in colorectal cancer liver metastases: a diagnostic study

Apparent diffusion coefficient is a good marker in predicting the prognosis in colorectal cancer liver metastases: a diagnostic study

Treatment response of colorectal cancer liver metastases to neoadjuvant or conversion therapy: a prospective multicentre follow-up study using MRI, diffusion-weighted imaging and 1H-MR spectroscopy compared with histology (subgroup in the RAXO trial)

The Diagnostic Performance of Maximum Uptake Value and Apparent Diffusion Coefficient in Differentiating Benign and Malignant Ovarian or Adnexal Masses: A Meta-Analysis

Contact Info

Product

Resources

About