Diffusion-weighted magnetic resonance imaging for monitoring diffusion changes in rectal carcinoma during combined, preoperative chemoradiation: preliminary results of a prospective study

Hein, Patrick A.; Kremser, Christian; Judmaier, Werner; Griebel, Jürgen; Pfeiffer, Karl-Peter; Kreczy, Alfons; Hug, Eugen B.; Lukáš, Peter; DeVries, Alexander

doi:10.1016/s0720-048x(02)00231-0

Cited by 154 publications

(98 citation statements)

References 22 publications

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“…On a patient-bypatient basis, fDM had a sensitivity and a specificity of 100%. This current study significantly extends earlier work accomplished in rodent brain tumors (13,20,21,(23)(24)(25)28) and the preliminary clinical observations in patients with brain and other cancer types (28)(29)(30)(31)(32). The advancement reported in this study was achieved by using coregistered MRI datasets along with thresholding allowing for quantification of change in treatment-induced tumor diffusion values.…”

Section: Discussionsupporting

confidence: 85%

“…However, clinical utility of this approach has been hampered because of tumor heterogeneity and suboptimal methods of digital image analysis (28)(29)(30)(31)(32). Furthermore, although these preliminary studies have shown correlations between ADC change and tumor response, a definitive study demonstrating the ability of diffusion MRI to predict response has not been reported.…”

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confidence: 99%

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Functional diffusion map: A noninvasive MRI biomarker for early stratification of clinical brain tumor response

Moffat

Chenevert

Lawrence

et al. 2005

Proc. Natl. Acad. Sci. U.S.A.

592

477

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Assessment of radiation and chemotherapy efficacy for brain cancer patients is traditionally accomplished by measuring changes in tumor size several months after therapy has been administered. The ability to use noninvasive imaging during the early stages of fractionated therapy to determine whether a particular treatment will be effective would provide an opportunity to optimize individual patient management and avoid unnecessary systemic toxicity, expense, and treatment delays. We investigated whether changes in the Brownian motion of water within tumor tissue as quantified by using diffusion MRI could be used as a biomarker for early prediction of treatment response in brain cancer patients. Twenty brain tumor patients were examined by standard and diffusion MRI before initiation of treatment. Additional images were acquired 3 weeks after initiation of chemo-and͞or radiotherapy. Images were coregistered to pretreatment scans, and changes in tumor water diffusion values were calculated and displayed as a functional diffusion map (fDM) for correlation with clinical response. Of the 20 patients imaged during the course of therapy, 6 were classified as having a partial response, 6 as stable disease, and 8 as progressive disease. The fDMs were found to predict patient response at 3 weeks from the start of treatment, revealing that early changes in tumor diffusion values could be used as a prognostic indicator of subsequent volumetric tumor response. Overall, fDM analysis provided an early biomarker for predicting treatment response in brain tumor patients. diffusion MRI ͉ therapeutic response

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Section: Discussionsupporting

confidence: 85%

mentioning

confidence: 99%

Functional diffusion map: A noninvasive MRI biomarker for early stratification of clinical brain tumor response

Moffat

Chenevert

Lawrence

et al. 2005

Proc. Natl. Acad. Sci. U.S.A.

592

477

View full text Add to dashboard Cite

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“…In recent years, there have only been a few, small, preliminary studies of the use of DW-MRI for evaluating pCR to neoadjuvant CRT (27)(28)(29). In a recent, retrospective, multicenter trial, the added value of DW-MRI in the evaluation of pCR to neoadjuvant CRT was investigated in patients with 120 locally advanced rectal cancer.…”

Section: Z=462)mentioning

confidence: 99%

Can diffusion-weighted MRI determine complete responders after neoadjuvant chemoradiation for locally advanced rectal cancer?

Engin

Sharifov²,

Güral³

et al. 2012

Diagn Interv Radiol

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N eoadjuvant chemoradiotheraphy (CRT) improves tumor downstaging, pathological complete response (pCR), and local control (1, 2). pCR rates of 13%-30% have been reported in phase II and phase III trials following 5-fluorouracil-based preoperative CRT (3, 4). Currently, management of patients with clinical complete response (cCR) remains controversial (5-8).A recent meta-analysis including 218 phase I/II or retrospective studies and 28 phase III trials of adjuvant CRT reported that T3 rectal cancer is associated with high local recurrence rates after nonsurgical treatment (9). In addition, similiar results were recently shown from a study using a "wait-and-see" policy after CRT (10).Accurate imaging methods are needed to evaluate CRT responses, and post-CRT magnetic resonance imaging (MRI) is frequently used for this purpose. However, the method has low accuracy in predicting the pathological stage of the tumor and can often overstage T1 and T2 tumors due to the limited capability of MRI to differentiate viable tumor, residual fibrotic nontumoral tissue, and a desmoplastic reaction. Understaging of irradiated rectal cancer can affect treatment planning, including the surgical strategy, and thus affects the tumor recurrence rate and prognosis (11).Diffusion-weighted (DW)-MRI is a functional imaging technique that yields qualitative and quantitative information and provides unique insights regarding tumor cellularity, integrity of cell membranes, and microcirculation.

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“…With the introduction of higher field-strength MR scanners and the parallel imaging technique for rectal MRI, diffusionweighted imaging (DWI) has been shown to have several potential benefits for the assessment of tumour localisation and staging [11,12]. The usefulness of DWI at 1.5 T in measuring treatment response has been measured in several clinical studies [13][14][15]. Recently, 3.0 T MR scanners have become commercially available [16][17][18]; the increase in signal-to-noise ratio (SNR) provided by these machines offers increased DWI quality and improvements to apparent diffusion coefficient (ADC) maps.…”

mentioning

confidence: 99%

Value of diffusion-weighted imaging in the detection of viable tumour after neoadjuvant chemoradiation therapy in patients with locally advanced rectal cancer: comparison withT₂weighted and PET/CT imaging

Song¹,

Kim²,

Lee³

et al. 2012

BJR

112

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Diffusion-weighted magnetic resonance imaging for monitoring diffusion changes in rectal carcinoma during combined, preoperative chemoradiation: preliminary results of a prospective study

Cited by 154 publications

References 22 publications

Functional diffusion map: A noninvasive MRI biomarker for early stratification of clinical brain tumor response

Functional diffusion map: A noninvasive MRI biomarker for early stratification of clinical brain tumor response

Can diffusion-weighted MRI determine complete responders after neoadjuvant chemoradiation for locally advanced rectal cancer?

Value of diffusion-weighted imaging in the detection of viable tumour after neoadjuvant chemoradiation therapy in patients with locally advanced rectal cancer: comparison withT₂weighted and PET/CT imaging

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Diffusion-weighted magnetic resonance imaging for monitoring diffusion changes in rectal carcinoma during combined, preoperative chemoradiation: preliminary results of a prospective study

Cited by 154 publications

References 22 publications

Functional diffusion map: A noninvasive MRI biomarker for early stratification of clinical brain tumor response

Functional diffusion map: A noninvasive MRI biomarker for early stratification of clinical brain tumor response

Can diffusion-weighted MRI determine complete responders after neoadjuvant chemoradiation for locally advanced rectal cancer?

Value of diffusion-weighted imaging in the detection of viable tumour after neoadjuvant chemoradiation therapy in patients with locally advanced rectal cancer: comparison withT2weighted and PET/CT imaging

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Value of diffusion-weighted imaging in the detection of viable tumour after neoadjuvant chemoradiation therapy in patients with locally advanced rectal cancer: comparison withT₂weighted and PET/CT imaging