Correlation of ADC With Pathological Treatment Response for Radiation Therapy of Pancreatic Cancer

Dalah, Entesar Zawam; Erickson, Beth; Oshima, Kiyoko; Schött, D.; Hall, William A.; Paulson, E.S.; Tai, A.; Knechtges, Paul; Li, X. Allen

doi:10.1016/j.tranon.2018.01.018

Cited by 39 publications

(16 citation statements)

References 19 publications

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“…There are differences in tumor margin, enhancement pattern, portal enhancement ratio, and duct dilatation among PNETs 11–13. Diffusion-weighted imaging (DWI) or the apparent diffusion-coefficient (ADC) map obtained from DWI is an effective imaging method in assessment of tumors or pathological treatment response to chemoradiation 14,15. Lotfalizadeh et al16 found that mean ADC and diffusion coefficient (D) became significantly lower as tumor grade of PNETs increased.…”

Section: Introductionmentioning

confidence: 99%

<p>Pancreatic neuroendocrine tumor: prediction of the tumor grade using magnetic resonance imaging findings and texture analysis with 3-T magnetic resonance</p>

Guo¹,

Ren²,

Chen³

et al. 2019

CMAR

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Purpose The purpose of this study was to evaluate the performance of magnetic resonance imaging (MRI) findings and texture parameters for prediction of the histopathologic grade of pancreatic neuroendocrine tumors (PNETs) with 3-T magnetic resonance. Patients and methods PNETs are classified into Grade 1 (G1), Grade 2 (G2), and Grade 3 (G3) tumors based on the Ki-67 proliferation index and the mitotic activity. A total of 77 patients with pathologically confirmed PNETs met the inclusion criteria. Texture analysis (TA) was applied to T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) maps. Patient demographics, MRI findings, and texture parameters were compared among three different histopathologic subtypes by using Fisher’s exact tests or Kruskal–Wallis test. Then, logistic regression analysis was adopted to predict tumor grades. ROC curves and AUCs were calculated to assess the diagnostic performance of MRI findings and texture parameters in prediction of tumor grades. Results There were 31 G1, 29 G2, and 17 G3 patients. Compared with G1, G2/G3 tumors showed higher frequencies of an ill-defined margin, a predominantly solid tumor type, local invasion or metastases, hypo-enhancement at the arterial phase, and restriction diffusion. Four T2-based (inverse difference moment, energy, correlation, and differenceEntropy) and five DWI-based (correlation, contrast, inverse difference moment, maxintensity, and entropy) TA parameters exhibited statistical significance among PNETs ( P <0.001). The AUCs of six predicting models on T2WI and DWI ranged from 0.703–0.989. Conclusion Our data indicate that MRI findings, including tumor margin, texture, local invasion or metastases, tumor enhancement, and diffusion restriction, as well as texture parameters can aid the prediction of PNETs grading.

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Section: Introductionmentioning

confidence: 99%

<p>Pancreatic neuroendocrine tumor: prediction of the tumor grade using magnetic resonance imaging findings and texture analysis with 3-T magnetic resonance</p>

Guo¹,

Ren²,

Chen³

et al. 2019

CMAR

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“…Although there have been various studies on the potential of changes in ADC values for monitoring treatment response, to the best of our knowledge, there have been no studies on the potential for predicting clinical outcomes in bone metastases. Several studies demonstrated that changes between pre- and post-treatment ADC parameters were correlated with treatment response and clinical outcome in malignant brain tumors [ 31 , 32 ] and pancreatic cancer [ 33 ]. Accordingly, it seems reasonable to assume that there may be associations between changes in ADC parameters after RT and local disease progression in bone metastases.…”

Section: Discussionmentioning

confidence: 99%

Which Parameter Influences Local Disease-Free Survival after Radiation Therapy Due to Osteolytic Metastasis? A Retrospective Study with Pre- and Post-Radiation Therapy MRI including Diffusion-Weighted Images

Lee¹,

Yoon²,

Lee³

et al. 2021

JCM

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Although radiation therapy (RT) plays an important role in the palliation of localized bone metastases, there is no consensus on a reliable method for evaluating treatment response. Therefore, we retrospectively evaluated the potential of magnetic resonance imaging (MRI) using apparent diffusion coefficient (ADC) maps and conventional images in whole-tumor volumetric analysis of texture features for assessing treatment response after RT. For this purpose, 28 patients who received RT for osteolytic bone metastasis and underwent both pre- and post-RT MRI were enrolled. Volumetric ADC histograms and conventional parameters were compared. Cox regression analyses were used to determine whether the change ratio in these parameters was associated with local disease progression-free survival (LDPFS). The ADCmaximum, ADCmean, ADCmedian, ADCSD, maximum diameter, and volume of the target lesions after RT significantly increased. Change ratios of ADCmean < 1.41, tumor diameter ≥ 1.17, and tumor volume ≥ 1.55 were significant predictors of poor LDPFS. Whole-tumor volumetric ADC analysis might be utilized for monitoring patient response to RT and potentially useful in predicting clinical outcomes.

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“…Moreover, at 4 weeks after treatment, the responders revealed a significantly larger percentage increase in the median ADC (10.4%) value of the solid tumor than the nonresponders (−1.15%), which is consistent with literature published on esophageal, rectal, pancreatic, and prostate cancers and myeloma. 19 , 38 , 39 , 40 Such an early indicator of response would clearly be helpful for optimizing treatment management of MPM as patients who are unlikely to respond could be offered other emerging treatments at an earlier time point. Nevertheless, there was no significant change in the TTV in either the responders or nonresponders at 4 weeks after treatment, nor was there a significant correlation between the percentage TTV change at 4 weeks with CT mRECIST tumor measurements at 12 weeks post-treatment.…”

Section: Discussionmentioning

confidence: 99%

Early Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations

Curcean

Cheng

Picchia

et al. 2021

JTO Clinical and Research Reports

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Introduction We compared the magnetic resonance imaging total tumor volume (TTV) and median apparent diffusion coefficient (ADC) of malignant pleural mesothelioma (MPM) before and at 4 weeks after chemotherapy, to evaluate whether these are potential early markers of treatment response. Methods Diffusion-weighted magnetic resonance imaging was performed in 23 patients with MPM before and after 4 weeks of chemotherapy. The TTV was measured by semiautomatic segmentation (GrowCut) and transferred onto ADC maps to record the median ADC. Test-retest repeatability of TTV and ADC was evaluated in eight patients. TTV and median ADC changes were compared between responders and nonresponders, defined using modified Response Evaluation Criteria In Solid Tumors on computed tomography (CT) at 12 weeks after treatment. TTV and median ADC were also correlated with CT size measurement and disease survival. Results The test-retest 95% limits of agreement for TTV were −13.9% to 16.2% and for median ADC −1.2% to 3.3%. A significant increase in median ADC in responders was observed at 4 weeks after treatment ( p = 0.02). Correlation was found between CT tumor size change at 12 weeks and median ADC changes at 4 weeks post-treatment ( r = −0.560, p = 0.006). An increase in median ADC greater than 5.1% at 4 weeks has 100% sensitivity and 90% specificity for responders (area under the curve = 0.933, p < 0.001). There was also moderate correlation between median tumor ADC at baseline and overall survival ( r = 0.45, p = 0.03). Conclusions Diffusion-weighted magnetic resonance imaging measurements of TTV and median ADC in MPM have good measurement repeatability. Increase in ADC at 4 weeks post-treatment has the potential to be an early response biomarker.

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Correlation of ADC With Pathological Treatment Response for Radiation Therapy of Pancreatic Cancer

Cited by 39 publications

References 19 publications

<p>Pancreatic neuroendocrine tumor: prediction of the tumor grade using magnetic resonance imaging findings and texture analysis with 3-T magnetic resonance</p>

<p>Pancreatic neuroendocrine tumor: prediction of the tumor grade using magnetic resonance imaging findings and texture analysis with 3-T magnetic resonance</p>

Which Parameter Influences Local Disease-Free Survival after Radiation Therapy Due to Osteolytic Metastasis? A Retrospective Study with Pre- and Post-Radiation Therapy MRI including Diffusion-Weighted Images

Early Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations

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