Monitoring cytotoxic tumour treatment response by diffusion magnetic resonance imaging and proton spectroscopy

Abstract

Exposure of tumours to anti-cancer drugs, gene or radiation therapy consistently leads to an increase in water diffusion in the cases expressing favourable treatment response. The diffusion change coincides cytotoxic cell eradication and precedes volume reduction in drug or gene therapy-treated experimental tumours. Interestingly, the recent studies from human brain tumour patients undergoing chemotherapy show similar behaviour of diffusion, suggesting important application for MRI in patient management. In this review observations from diffusion MRI and MRS in the tumours during cytotoxic treatment are summarized and the cellular mechanisms affecting molecular mobility are discussed in the light of tissue microenvironmental and microdynamic changes.

Noninvasive estimation of tumour viability in a xenograft model of human neuroblastoma with proton magnetic resonance spectroscopy (1H MRS)

“…Proton magnetic resonance spectroscopy is emerging as a highly useful tool for this purpose (Hakumaki et al, 2002;Kauppinen, 2002). In the present work, we evaluated the relevance of MLs and Chocontaining compounds detected in vivo by 1 H MRS in a xenograft model of human neuroblastoma.…”

Identification and characterisation of childhood cerebellar tumours by in vivo proton MRS

“…Potential roles have been identified in pre-surgical diagnosis of tumour type and grade (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), monitoring of treatment response (20), and evaluation of tumour recurrence (21). However, optimised MRS analysis is required to enable the widespread clinical use of the technique.…”

Using magnetic resonance imaging and spectroscopy in cancer diagnostics and monitoring

“…9,13 This is partially due to the fact that diffusion contrast sensitizes MR images, among others, to tumor cellularity and microenvironment. [13][14][15] DWI has demonstrated heterogeneity in the apparent diffusion coefficient (ADC) within solid tumors (for an ADC image, see Fig. 2C) in numerous organs.…”

“…18 This is understood by the restrictions imposed by cell structures, high intracellular-to-extracellular volume ratio and elevated macromolecule content in tumor per unit volume. 13 The converse is also true, i.e., lowered cell density results in elevated ADC. 17 Evidence is also emerging that DWI performed prior to treatment can predict progression of some cancers.…”