Intravoxel Incoherent Motion MRI of Rectal Cancer: Correlation of Diffusion and Perfusion Characteristics With Prognostic Tumor Markers

Sun, Hongzan; Xu, Yanyan; Song, Aiping; Shi, Kun; Wu, Wei

doi:10.2214/ajr.17.18342

Cited by 53 publications

(55 citation statements)

References 49 publications

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“…Some studies looked at more advanced DWI parameters derived from IVIM imaging (discussed in more detail in section on "Recent advances" below). 102,108 Higher IVIM perfusion related parameters were associated with poorer TN-stage, differentiation grade, lymphovascular invasion and extramural venous invasion.…”

Section: Dwi For Follow Up After Treatmentmentioning

confidence: 94%

“…Around half of these reports found significant correlations between DWI-derived parameters and clinical or histopathology outcomes. 96,[102][103][104][105][106][107][108][109][110][111] Of those studies that found significant results, the majority reported low ADC values for the unfavourable outcome groups (e.g. higher TN-stage, lower differentiation grade, MRF+ stage and extranodal tumour deposits), and high ADC values for the more favourable outcome groups, suggesting that tumours with a more dense cellular structure (low ADC) tend to show a more aggressive growth pattern.…”

Section: Dwi For Follow Up After Treatmentmentioning

confidence: 99%

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Diffusion-weighted imaging in rectal cancer: current applications and future perspectives

Schurink

Lambregts

Beets‐Tan

2019

The British Journal of Radiology

117

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This paper aims to give an overview of the various clinical applications of DWI and discuss their potential role for rectal cancer imaging. PRiMARy RectAl cANceR stAgiNg Rectal tumour detection The main goal of MRI for rectal cancer is staging rather than tumour detection, since typically the presence of tumour has already been established by endoscopy or CT-colonography. 2 It is probably therefore that only a few studies have focused on DWI for the primary detection of rectal cancer. 3-10 Nevertheless, published reports have shown consistently good results for DWI to detect rectal tumours. In a recent meta-analysis, albeit focusing on colorectal tumours in general and not specifically on rectal cancer, pooled sensitivity, specificity and area under the curve (AUC) were 95%, 93% and 0.98, respectively. 11

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Section: Dwi For Follow Up After Treatmentmentioning

confidence: 94%

Section: Dwi For Follow Up After Treatmentmentioning

confidence: 99%

Diffusion-weighted imaging in rectal cancer: current applications and future perspectives

Schurink

Lambregts

Beets‐Tan

2019

The British Journal of Radiology

117

View full text Add to dashboard Cite

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“…D was more likely to be related to cellular microstructure than to tumor cellularity[ 11 ], and D* actually reflected blood flow and was affected by flow velocity and vascular geometry[ 34 ]. IVIM-DWI–derived parameters were also useful for describing rectal tumor aggressiveness and prognosis[ 31 ]. D* and f tended to increase with greater tumor differentiation, and D and D* decreased with advanced tumor stages.…”

Section: Colorectal Tumorsmentioning

confidence: 99%

“…The f is the partial volume of the whole capillary vascular fraction[ 9 ] and the proportion of the arterial blood is greater than the venous component for f at low b values[ 35 ]. This phenomenon is reflected in well-differentiated tumors and poorly differentiated tumors: the capillary vascular network is relatively mature in the former, and there is poor structure of luminal vessels leading to low perfusion of the microcirculation in the latter[ 31 ]. This could be confirmed by the correlation between the D*, f and MVD in colorectal tumors[ 13 ].…”

Section: Colorectal Tumorsmentioning

confidence: 99%

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Could intravoxel incoherent motion diffusion-weighted magnetic resonance imaging be feasible and beneficial to the evaluation of gastrointestinal tumors histopathology and the therapeutic response?

Zuo

Zhang

2018

WJR

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Gastrointestinal tumors (GTs) are among the most common tumors of the digestive system and are among the leading causes of cancer death worldwide. Functional magnetic resonance imaging (MRI) is crucial for assessment of histopathological changes and therapeutic responses of GTs before and after chemotherapy and radiotherapy. A new functional MRI technique, intravoxel incoherent motion (IVIM), could reveal more detailed useful information regarding many diseases. Currently, IVIM is widely used for various tumors because the derived parameters (diffusion coefficient, D; pseudo-perfusion diffusion coefficient, D*; and perfusion fraction, f) are thought to be important surrogate imaging biomarkers for gaining insights into tissue physiology. They can simultaneously reflect the microenvironment, microcirculation in the capillary network (perfusion) and diffusion in tumor tissues without contrast agent intravenous administration. The sensitivity and specificity of these parameters used in the evaluation of GTs vary, the results of IVIM in GTs are discrepant and the variability of IVIM measurements in response to chemotherapy and/or radiotherapy in these studies remains a source of controversy. Therefore, there are questions as to whether IVIM diffusion-weighted MRI is feasible and helpful in the evaluation of GTs, and whether it is worthy of expanded use.

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Comparison of Intravoxel incoherent motion imaging and multiecho dynamic contrast‐based MRI in rectal cancer

Bakke

Grøvik

Meltzer

et al. 2019

Magnetic Resonance Imaging

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Background Dynamic contrast‐based MRI and intravoxel incoherent motion imaging (IVIM) MRI are both methods showing promise as diagnostic and prognostic tools in rectal cancer. Both methods aim at measuring perfusion‐related parameters, but the relationship between them is unclear. Purpose To investigate the relationship between perfusion‐ and permeability‐related parameters obtained by IVIM‐MRI, T1‐weighted dynamic contrast‐enhanced (DCE)‐MRI and T2*‐weighted dynamic susceptibility contrast (DSC)‐MRI. Study Type Prospective. Subjects In all, 94 patients with histologically confirmed rectal cancer. Field Strength/Sequence Subjects underwent pretreatment 1.5T clinical procedure MRI, and in addition a study‐specific diffusion‐weighted sequence (b = 0, 25, 50, 100, 500, 1000, 1300 s/mm2) and a multiecho dynamic contrast‐based echo‐planer imaging sequence. Assessment Median tumor values were obtained from IVIM (perfusion fraction [f], pseudodiffusion [D*], diffusion [D]), from the extended Tofts model applied to DCE data (Ktrans, kep, vp, ve) and from model free deconvolution of DSC (blood flow [BF] and area under curve). A subgroup of the excised tumors underwent immunohistochemistry with quantification of microvessel density and vessel size. Statistical Test Spearman's rank correlation test. Results D* was correlated with BF (rs = 0.47, P < 0.001), and f was negatively correlated with kep (rs = –0.31, P = 0.002). BF was correlated with Ktrans (rs = 0.29, P = 0.004), but this correlation varied extensively when separating tumors into groups of low (rs = 0.62, P < 0.001) and high (rs = –0.06, P = 0.68) BF. Ktrans was negatively correlated with vessel size (rs = –0.82, P = 0.004) in the subgroup of tumors with high BF. Data Conclusion We found an association between D* from IVIM and BF estimated from DSC‐MRI. The relationship between IVIM and DCE‐MRI was less clear. Comparing parameters from DSC‐MRI and DCE‐MRI highlights the importance of the underlying biology for the interpretation of these parameters. Level of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:1114–1124.

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Intravoxel Incoherent Motion MRI of Rectal Cancer: Correlation of Diffusion and Perfusion Characteristics With Prognostic Tumor Markers

Cited by 53 publications

References 49 publications

Diffusion-weighted imaging in rectal cancer: current applications and future perspectives

Diffusion-weighted imaging in rectal cancer: current applications and future perspectives

Could intravoxel incoherent motion diffusion-weighted magnetic resonance imaging be feasible and beneficial to the evaluation of gastrointestinal tumors histopathology and the therapeutic response?

Comparison of Intravoxel incoherent motion imaging and multiecho dynamic contrast‐based MRI in rectal cancer

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