Early prediction of anticancer effects with diffusion-weighted MR imaging in patients with colorectal liver metastases following selective internal radiotherapy

Dudeck, Oliver; Zeile, Martin; Wybranski, Christian; Schulmeister, Alice; Fischbach, Frank; Pech, Maciej; Wieners, Gero; Rühl, Ricarda; Großer, Oliver S.; Amthauer, Holger; Ricke, Jens

doi:10.1007/s00330-010-1846-z

Cited by 52 publications

(39 citation statements)

References 31 publications

(33 reference statements)

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“…Consequently, it has been postulated that the mechanism of action for 90 Y radioembolization is flow-directed deposition of 90 Y microspheres into the vascular tumor bed and irradiation of the tumor by b 2 emissions of 90 Y while the normal liver parenchyma is largely spared, thus combining the effects of interstitial high-dose radiotherapy and arterial microembolization (2,24). Nevertheless, the results of this study were obtained exclusively in patients with colorectal liver metastases, which can display various degrees of tumor vascularization and deposition of 99m Tc-MAA and 90 Y microspheres (25). Angiogenesis is a complex but fundamental requirement for tumor growth, invasion, and spread of metastases allowing newly formed metastatic nodules to rapidly coopt existing host vessels (26,27).…”

Section: Discussionmentioning

confidence: 97%

Predictive Value of Intratumoral ^99mTc-Macroaggregated Albumin Uptake in Patients with Colorectal Liver Metastases Scheduled for Radioembolization with ⁹⁰Y-Microspheres

et al. 2013

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90 Y radioembolization is a promising therapy for patients with primary and secondary liver malignancies. Pretherapeutic assessment consists of hepatic angiography and 99m Tc-macroaggregated albumin ( 99m Tc-MAA) perfusion scintigraphy to estimate the liver-to-lung shunt and exclude extrahepatic 99m Tc-MAA deposition. However, the predictive value of intratumoral 99m Tc-MAA uptake remains unclear. Methods: One hundred four patients with chemotherapy-refractory liver-dominant metastatic colorectal cancer were treated with 90 Y radioembolization between December 2006 and December 2010. All of the patients underwent angiographic assessment and perfusion scintigraphy with 99m Tc-MAA before lobar 90 Y radioembolization. For inclusion, patients must have undergone pretherapeutic and follow-up MR imaging (6 wk and 3 mo after radioembolization, respectively). The degree of intratumoral 99m Tc-MAA uptake was rated, and liver metastases were classified according to changes in tumor diameter on both an individual and a patient basis using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Response at both time points, MAA uptake, and catheter position were then statistically analyzed in a linear and generalized linear mixed model at a significance level of 0.05 (P value). Results: Sixty-six patients with a total of 435 colorectal liver metastases (mean number of lesions 6 SD, 6.6 6 2.8; mean lesion size 6 SD, 33.8 6 21.2 mm; lesion size range, 10-154 mm) were included in this analysis. According to the patient-based analysis, 3 patients had partial response, 49 stable disease, and 6 progressive disease after 6 wk. After 3 mo, 5 patients showed partial response, 26 stable disease, and 17 progressive disease. There was no association of patient-based tumor response with overall 99m Tc-MAA uptake (P 5 0.172) or with catheter position (P 5 0.6456). Furthermore, an interaction effect of 99m Tc-MAA uptake and catheter position in relation to tumor response was not found (P 5 0.512). Moreover, in lesion-based analysis according to RECIST 1.1 there was no association of tumor response with degree of 99m Tc-MAA uptake, catheter position, or interaction of 99m Tc-MAA uptake and catheter position (P 5 0.339, 0.593, and 0.658, respectively). Conclusion: Response to 90 Y radioembolization was found to be independent of the degree of 99m Tc-MAA uptake. Therefore, therapy should not be withheld from patients with colorectal liver metastases lacking intratumoral 99m Tc-MAA accumulation. Radi oembolization with 90 Y is a promising catheterbased liver-directed modality approved by the Food and Drug Administration for the treatment of patients with hepatic metastases of colorectal carcinoma (1-4). For this interventional technique, 90 Y-embedded microspheres of glass or resin are infused directly into the hepatic arteries, where they become lodged within the tumor microvasculature and irradiate the tumor by b-emission (5).Perfusion scintigraphy with 99m Tc-labeled macroaggregated albumin ( 99m Tc-MAA) is mandatory before 90 Y radioem...

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Section: Discussionmentioning

confidence: 97%

Predictive Value of Intratumoral ^99mTc-Macroaggregated Albumin Uptake in Patients with Colorectal Liver Metastases Scheduled for Radioembolization with ⁹⁰Y-Microspheres

et al. 2013

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“…[4][5][6][7] However, there are relatively few reports systematically examining the relationship between ADC changes and tumour response to treatment of PC.…”

Section: Advances In Knowledgementioning

confidence: 99%

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

Liu

Wu²,

Ouyang³

et al. 2014

BJR

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“…For these indications, a significant decrease of the FDG uptake has been observed, predicting the outcome of the patients in terms of disease free survival [81][82][83].…”

Section: Morphological Changesmentioning

confidence: 99%

New Imaging Techniques for 90Y Microsphere Radioembolization

Vouche¹,

Vanderlinden²,

Delatte³

et al. 2011

J Nucl Med Radiat Ther

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Adequate patient selection and treatment planning is crucial for a safe and cost-effective administration of selective internal radiotherapy (SIRT) of malignant liver disease using 90 Y-labelled microspheres. It requires the implementation of multimodality imaging, integrating metabolic, functional and structural characteristics. A multidisciplinary approach is a prerequisite for SIRT, bringing together the knowhow and expertise of radiologists, nuclear medicine physicians, medical physicists, imaging engineers, and radiotherapists. This review discusses the available radiologic (CT/MRI) and nuclear (SPECT/PET) imaging modalities and their specific utility in the different diagnostic phases related to SIRT: wholebody and intrahepatic pre-treatment disease staging, CT and MRI-based angiography, liver-lung shunt assessment, treatment simulation, predictive dosimetry, post-treatment imaging, and SIRT response assessment.

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Early prediction of anticancer effects with diffusion-weighted MR imaging in patients with colorectal liver metastases following selective internal radiotherapy

Abstract: DWI was capable of predicting therapy effects of SIRT in patients with colorectal hepatic metastases as early as 2 days following treatment.

Cited by 52 publications

References 31 publications

Predictive Value of Intratumoral ^99mTc-Macroaggregated Albumin Uptake in Patients with Colorectal Liver Metastases Scheduled for Radioembolization with ⁹⁰Y-Microspheres

Predictive Value of Intratumoral ^99mTc-Macroaggregated Albumin Uptake in Patients with Colorectal Liver Metastases Scheduled for Radioembolization with ⁹⁰Y-Microspheres

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

New Imaging Techniques for 90Y Microsphere Radioembolization

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Early prediction of anticancer effects with diffusion-weighted MR imaging in patients with colorectal liver metastases following selective internal radiotherapy

Abstract: DWI was capable of predicting therapy effects of SIRT in patients with colorectal hepatic metastases as early as 2 days following treatment.

Cited by 52 publications

References 31 publications

Predictive Value of Intratumoral 99mTc-Macroaggregated Albumin Uptake in Patients with Colorectal Liver Metastases Scheduled for Radioembolization with 90Y-Microspheres

Predictive Value of Intratumoral 99mTc-Macroaggregated Albumin Uptake in Patients with Colorectal Liver Metastases Scheduled for Radioembolization with 90Y-Microspheres

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

New Imaging Techniques for 90Y Microsphere Radioembolization

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Predictive Value of Intratumoral ^99mTc-Macroaggregated Albumin Uptake in Patients with Colorectal Liver Metastases Scheduled for Radioembolization with ⁹⁰Y-Microspheres

Predictive Value of Intratumoral ^99mTc-Macroaggregated Albumin Uptake in Patients with Colorectal Liver Metastases Scheduled for Radioembolization with ⁹⁰Y-Microspheres