Predicting Response of Colorectal Hepatic Metastasis: Value of Pretreatment Apparent Diffusion Coefficients

Koh, Dow‐Mu; Scurr, Erica; Collins, David; Kanber, Baris; Norman, A.; Leach, Martin O.; Husband, Janet E.

doi:10.2214/ajr.06.0601

Cited by 324 publications

(240 citation statements)

References 29 publications

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“…The ADC and/or D histogram(s) display(s) functional differences in tumor tissue due to the microstructural heterogeneity as seen in a previous study 34. Thus, the distribution of tumor ADC values represented by a histogram may be important in assessing tumor response in HNSCC.…”

Section: Discussionmentioning

confidence: 84%

Intravoxel incoherent motion diffusion‐weighted MRI during chemoradiation therapy to characterize and monitor treatment response in human papillomavirus head and neck squamous cell carcinoma

Paudyal

Riaz

et al. 2016

Magnetic Resonance Imaging

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PurposeCharacterize and monitor treatment response in human papillomavirus (HPV) head and neck squamous cell carcinoma (HNSCC) using intra‐treatment (intra‐TX) imaging metrics derived from intravoxel incoherent motion (IVIM) diffusion‐weighted magnetic resonance imaging (DW‐MRI).Materials and MethodsThirty‐four (30 HPV positive [+] and 4 HPV negative [‐]) HNSCC patients underwent a total of 136 MRI including multi‐b value DW‐MRI (pretreatment [pre‐TX] and intra‐TX weeks 1, 2, and 3) at 3.0 Tesla. All patients were treated with chemo‐radiation therapy. Monoexponential (yielding apparent diffusion coefficient [ADC]) and bi‐exponential (yielding perfusion fraction [f], diffusion [D], and pseudo‐diffusion [D*] coefficients) fits were performed on a region of interest and voxel‐by‐voxel basis, on metastatic neck nodes. Response was assessed using RECISTv1.1. The relative percentage change in D, f, and D* between the pre‐ and intra‐TX weeks were used for hierarchical clustering. A Wilcoxon rank‐sum test was performed to assess the difference in metrics within and between the complete response (CR) and non‐CR groups.ResultsThe delta (Δ) change in volume (V)1wk‐0wk for the CR group differed significantly (P = 0.016) from the non‐CR group, while not for V2wk‐0wk and V3wk‐0wk (P > 0.05). The mean increase in ΔD3wk‐0wk for the CR group was significantly higher (P = 0.017) than the non‐CR group. ADC and D showed an increasing trend at each intra‐TX week when compared with pre‐TX in CR group (P < 0.003). Hierarchical clustering demonstrated the existence of clusters in HPV + patients.ConclusionAfter appropriate validation in a larger population, these IVIM imaging metrics may be useful for individualized treatment in HNSCC patients. Level of Evidence: 2J. Magn. Reson. Imaging 2017;45:1013–1023

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Section: Discussionmentioning

confidence: 84%

Intravoxel incoherent motion diffusion‐weighted MRI during chemoradiation therapy to characterize and monitor treatment response in human papillomavirus head and neck squamous cell carcinoma

Paudyal

Riaz

et al. 2016

Magnetic Resonance Imaging

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“…Diffusing water spins within a voxel experience phase dispersion, causing signal attenuation that is dependent on the (12,17,18,47,50), and for liver tumor treatment response (6,11,14,20,(51)(52)(53)(54).…”

Section: Discussionmentioning

confidence: 99%

“…Potential applications of PACE DWI include patients who are not able to hold their breath sufficiently and patients in whom better image quality (higher SNR and/or spatial resolution) is needed. These include for example patients with severe renal dysfunction who cannot receive Gadolinium chelates, at risk of nephrogenic systemic fibrosis (21)(22)(23)(24) and for assessment of tumor treatment response (6,11,14). In our study, we did not modify the spatial resolution, but we did use a higher number of averages with the PACE DWI sequence, thus the improved SNR.…”

Section: Discussionmentioning

confidence: 99%

“…THERE IS A GROWING interest in using liver diffusionweighted imaging (DWI) for lesion detection and characterization, prediction of treatment response and assessment of chronic liver disease, by means of apparent diffusion coefficient (ADC) measurement (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The interest in DWI is motivated by the recently described risk of nephrogenic systemic fibrosis (21)(22)(23)(24), which makes DWI an attractive alternate method to Gadolinium-enhanced sequences.…”

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confidence: 99%

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Diffusion‐weighted imaging of the liver: Comparison of navigator triggered and breathhold acquisitions

Taouli

Sandberg

Stemmer

et al. 2009

Magnetic Resonance Imaging

150

122

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Purpose: To compare a free breathing navigator triggered single shot echoplanar imaging (SS EPI) diffusion-weighted imaging (DWI) sequence with prospective acquisition correction (PACE) with a breathhold (BH) DWI sequence for liver imaging. Materials and Methods:Thirty-four patients were evaluated with PACE-DWI and BH DWI of the liver using bvalues of 0, 50, and 500 s/mm 2 . There were 29 focal liver lesions in 18 patients. Qualitative evaluation was performed on a 3-point scale (1-3) by two independent observers (maximum score 9). Quantitative evaluation included estimated SNR (signal to noise ratio), lesion-to-liver contrast ratio, liver and lesion apparent diffusion coefficients (ADCs), and coefficient of variation (CV) of ADC in liver parenchyma and focal liver lesions (estimate of noise contamination in ADC).Results: PACE-DWI showed significantly better image quality, higher SNR and lesion-to-liver contrast ratio when compared with BH DWI. ADCs of liver and focal lesions with both sequences were significantly correlated (r ϭ 0.838 for liver parenchyma, and 0.904 for lesions, P Ͻ 0.0001), but lower with the BH sequence (P Ͻ 0.02). There was higher noise contamination in ADC measurement obtained with BH DWI (with a significantly higher SD and CV of ADC). Conclusion:The use of a navigator echo to trigger SS EPI DWI improves image quality and liver to lesion contrast, and enables a more precise ADC quantification compared with BH DWI acquisition. THERE IS A GROWING interest in using liver diffusionweighted imaging (DWI) for lesion detection and characterization, prediction of treatment response and assessment of chronic liver disease, by means of apparent diffusion coefficient (ADC) measurement (1-20). The interest in DWI is motivated by the recently described risk of nephrogenic systemic fibrosis (21-24), which makes DWI an attractive alternate method to Gadolinium-enhanced sequences. Most prior studies have used breathhold (BH) single shot echoplanar imaging (SS EPI) to acquire diffusion-weighted images, using various sets of b-values. SS EPI sequences are very fast, however, suffer from limited image quality, mostly related to limited signal to noise ratio (SNR) especially at higher b-values, and limited spatial resolution, which constitute an obstacle for its widespread use in clinical practice. Techniques such as parallel imaging (25,26) and pulse triggering (27) have been proposed to improve SS EPI image quality and precision of ADC measurement.There are several recent reports on the use of respiratory triggered acquisitions for liver DWI (15,16,[28][29][30][31]. However, only two studies have specifically compared different diffusion acquisition schemes for liver imaging (28,30). The first study (28) included a population of patients with liver lesions, and compared image quality and ADC of free breathing versus BH DWI. The second study included healthy volunteers, and compared BH, free breathing and respiratory triggered DWI (without navigator echoes) (30). There are, however, no reports on the use of a...

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“…Therefore, DWI provides a greater possibility of early assessment of the tumor when compared with imaging-based analysis of tumor blood flow and tumor conditions. Studies have described a number of useful ADCs for the evaluation of the response to treatment for HCC and liver metastases [15][16][17][18][19][20]. However, assessment of ADC values following ion beam therapy has not been reported previously for patients with HCC.…”

Section: Introductionmentioning

confidence: 99%

Preliminary study of apparent diffusion coefficient assessment after ion beam therapy for hepatocellular carcinoma

Kanamoto

Miyati

Terashima

et al. 2016

Radiol Phys Technol

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We evaluated the state of hepatocellular carcinoma (HCC) and the liver after ion beam therapy by analyzing the apparent diffusion coefficient (ADC). In this retrospective study, we evaluated 13 HCC lesions in 10 patients who underwent magnetic resonance imaging before and after therapy. Diffusion-weighted imaging was performed with use of b values of 0, 150, and 800 s/mm 2 . The ADC was determined for the tumor, irradiated liver, and normal liver. The maximum size of the tumor was measured, and reduction in tumor size was determined as a ratio of the maximum size of the diameter of the tumor. We compared the ADC before and after the therapy with the reduction in tumor size ratio. The reduction in tumor size ratio was compared with the ADCs of the tumors. The ADC of the tumor and the irradiated liver were significantly higher after therapy than before therapy. The ADC of the normal liver was not significantly different before and after therapy. The reduction ratio increased significantly (R = 0.73, P = 0.006) after therapy at the second follow-up when compared with after therapy at the first follow-up. No correlation was found between the reduction ratio and the ADC of the tumor in each follow-up. Inflammation of the liver occurs after treatment as a result of radiation doses from the ion beam, and the tumor reaches a state of necrosis. ADC value analysis provides a non-invasive assessment and yields focal information regarding the tumor and liver before and after ion beam therapy.

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Predicting Response of Colorectal Hepatic Metastasis: Value of Pretreatment Apparent Diffusion Coefficients

Cited by 324 publications

References 29 publications

Intravoxel incoherent motion diffusion‐weighted MRI during chemoradiation therapy to characterize and monitor treatment response in human papillomavirus head and neck squamous cell carcinoma

Intravoxel incoherent motion diffusion‐weighted MRI during chemoradiation therapy to characterize and monitor treatment response in human papillomavirus head and neck squamous cell carcinoma

Diffusion‐weighted imaging of the liver: Comparison of navigator triggered and breathhold acquisitions

Preliminary study of apparent diffusion coefficient assessment after ion beam therapy for hepatocellular carcinoma

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