Changes in Water Mobility Measured by Diffusion MRI Predict Response of Metastatic Breast Cancer to Chemotherapy

Abstract

The goal of oncology is the individualization of patient care to optimize therapeutic responses and minimize toxicities. Achieving this will require noninvasive, quantifiable, and early markers of tumor response. Preclinical data from xenografted tumors using a variety of antitumor therapies have shown that magnetic resonance imaging (MRI)-measured mobility of tissue water (apparent diffusion coefficient of water, or ADCw) is a biomarker presaging cell death in the tumor. This communication tests the hypothesis that changes in water mobility will quantitatively presage tumor responses in patients with metastatic liver lesions from breast cancer. A total of 13 patients with metastatic breast cancer and 60 measurable liver lesions were monitored by diffusion MRI after initiation of new courses of chemotherapy. MR images were obtained prior to, and at 4, 11, and 39 days following the initiation of therapy for determination of volumes and ADCw values. The data indicate that diffusion MRI can predict response by 4 or 11 days after commencement of therapy, depending on the analytic method. The highest concordance was observed in tumor lesions that were less than 8 cm3 in volume at presentation. These results suggest that diffusion MRI can be useful to predict the response of liver metastases to effective chemotherapy.

Change in diffusion weighted MRI during liver cancer radiotherapy: Preliminary observations

“…Our preliminary experience in primary and metastastic liver cancers suggests early increases in tumour mean ADC are correlated with eventual response to radiation treatment and is in keeping with the results of others [3,10,12,13]. When compared to baseline, the greatest early increase in tumour mean ADC was seen during the first week of RT.…”

“…Other authors have seen increases in ADC as early as 4Á11 days post start of anti-cancer treatments [10,11,13]. Theilman et al investigated the relationship between lesion sizes at baseline with response predicted by changes in mean ADC [10]. There was a trend towards smaller lesions having larger changes in ADC, similar to our findings.…”

“…When compared to baseline, the greatest early increase in tumour mean ADC was seen during the first week of RT. Other authors have seen increases in ADC as early as 4Á11 days post start of anti-cancer treatments [10,11,13]. Theilman et al investigated the relationship between lesion sizes at baseline with response predicted by changes in mean ADC [10].…”

Diffusion-weighted MRI in early assessment of tumour response to radiotherapy in high-risk prostate cancer

“…[15][16][17][18] It is reported that following radiotherapy, ADCs may rapidly decrease over several hours owing to cell swelling, followed by an increase over several days with concurrent cell death. 19,20 When compared with baseline, the greatest early increase in tumour mean ADC values was seen during the first week of radiotherapy.…”

Navigator respiratory‐triggered diffusion‐weighted imaging in the follow‐up after hepatic radiofrequency ablation—initial results

“…The usefulness of DWI has been demonstrated both in detection and in characterization of focal hepatic lesions (1,3,4). The value of DWI for monitoring the response to different types of tumor treatment is currently being investigated extensively (5)(6)(7)(8)(9).…”