Change in diffusion weighted MRI during liver cancer radiotherapy: Preliminary observations

Eccles, C.; Haider, Ehsan; Haider, Masoom A.; Fung, Sharon; Lockwood, Gina; Dawson, Laura A.

doi:10.1080/02841860903099972

Cited by 74 publications

(57 citation statements)

References 22 publications

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“…In photon therapy, the liver threshold of photon exposure is defined as 30-35 Gy. However, even when the liver was irradiated with less than 35 Gy, the ADC values were reported to have increased significantly [16]. On the other hand, the ADC values at the time of the first follow-up were significantly different when we compared the irradiated liver and the normal liver, suggesting that the increases in ADC values were not necessarily consistent with the prescription dose for compared photon and ion beam.…”

Section: Discussionmentioning

confidence: 56%

“…By contrast, a high b value almost completely excludes the effects of in vivo perfusion. Several previous studies utilized 0 and another b value, which makes it difficult to analyze the different components of ADC in detail [15,16,[18][19][20]22]. To avoid the effect of perfusion, we used b values of 150 and 800 in this study.…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…Ippolito et al [83] reported that pCT enabled the assessment of HCC vascularity after RFA, providing quantitative information about the presence of arterial vessels within viable residual neoplastic tissues: in this study, a significant difference in perfusion, arterial perfusion (AP), and hepatic perfusion index (HPI) values was found between treated lesions with residual tumor and those successfully treated. Eccles et al [84] , and 0.298%, respectively. Many studies have been conducted on the application of functional imaging techniques for HCCs treated with TACE and TARE; the most significant results are reported in Table 3.…”

Section: Primary Liver Tumorsmentioning

confidence: 99%

Prognostication and response assessment in liver and pancreatic tumors: The new imaging

Robertis¹,

Martini²,

Demozzi³

et al. 2015

WJG

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Diffusion-weighted imaging (DWI), dynamic contrastenhanced magnetic resonance imaging (DCE-MRI) and perfusion computed tomography (CT) are technical improvements of morphologic imaging that can evaluate functional properties of hepato-bilio-pancreatic tumors during conventional MRI or CT examinations. Nevertheless, the term "functional imaging" is commonly used to describe molecular imaging techniques, as positron emission tomography (PET) CT/MRI, which still represent the most widely used methods for the evaluation of functional properties of solid neoplasms; unlike PET or single photon emission computed tomography, functional imaging techniques applied to conventional MRI/CT examinations do not require the administration of radiolabeled drugs or specific equipments. Moreover, DWI and DCE-MRI can be performed during the same session, thus providing a comprehensive "one-step" morphological and functional evaluation of hepato-bilio-pancreatic tumors. Literature data reveal that functional imaging techniques could be proposed for the evaluation of these tumors before treatment, given that they may improve staging and predict prognosis or clinical outcome. Microscopic changes within neoplastic tissues induced by treatments can be detected and quantified with functional imaging, therefore these techniques could be used also for posttreatment assessment, even at an early stage. or altered cellular membranes will present diffusion restriction, which is depicted as signal hyperintensity areas on high b-value DW images and hypointensity on the apparent diffusion coefficient (ADC) maps; ADC measurement can also quantify water molecules' diffusion. As dedifferentiation or therapies may induce microscopic changes in neoplastic tissues that could modify water molecules' diffusion, DWI can distinguish between different degrees of malignancy and can be also proposed for post-treatment monitoring. Moreover, DWI can be performed in a single session with DCE-MRI, thus providing a comprehensive "one-step" morphological and functional evaluation of hepatobilio-pancreatic tumors.Perfusion imaging techniques evaluate changes in signal intensity (DCE-MRI) or density (pCT) after contrast medium injection, being therefore able to assess microvascularization through the evaluation of the dynamics of contrast medium distribution from vessels to the neoplastic tissue. Perfusion parameters are therefore theoretically good candidates for the evaluation of microscopic vascular differences between lesions with different pathological grade and for the assessment of treatment response, especially after chemoembolization or during treatments with antiangiogenic drugs.This editorial analyzes up-to-date literature data regarding the application of functional imaging techniques, apart from molecular imaging, to hepatic and pancreatic tumors, with particular emphasis on correlations to pathological features, prognostic stratification and therapeutic response assessment. FUNCTIONAL IMAGING TECHNIQUES: TECHNICAL BASESIn 1965 Stejskal and Tanne...

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“…The feasibility of using ADC change as a surrogate for tumor response to RT was demonstrated by an imaging study of 11 patients treated with six-fraction conformal liver RT [3]. Median ADC in treated tumor VOI kept increasing with the time course of before, one week during, two weeks during and one month after RT.…”

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confidence: 99%

Imaging Tumor Response to Radiation Therapy in Liver

Wang¹

2012

J Nucl Med Radiat Ther

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Currently, there are increasing interests in imaging tumor response to radiation therapy (RT) of hepatic cancer. Early detection of tumor response may allow a change in the treatment before completion of the prescribed therapy and maximize therapeutic efficacy of the treatment. Most importantly, once early tumor response indicates achievement of final tumor control, withholding treatment will prevent radiationinduced diseases. Response Evaluation Criteria in Solid Tumors (RECIST) which evaluates tumor response based on change in tumor size is a clinically adopted approach to determine solid tumor responses. But it may take several weeks for RECIST criteria to suggest success or failure of a treatment, which may lead to severe radiation toxicity or tumor progression due to inadequate radiation delivery. Advances of medical imaging allow high-sensitivity and high-specificity assessment of tumor biological process and, therefore, may provide surrogates of tumor response before morphological change occurs.Liver metastases response to Yttrium-90 radioembolization for 42 patients with unresectable liver metastases was assessed by CT and 18F-FDG PET [1]. The study graded FDG uptake of treated lesions into four categories. In comparison with response detection rates of 6% using RECIST and 24% using combined RECIST and necrosis criteria, PET detected tumor response to treatment in a rate of 63%. It was 61-160 days later that CT detected response on the lobes that initially showed response only on PET. The results suggested PET captured tumor response much earlier. In a recent study, Yttrium-90 radioembolization of 58 patients with hepatic metastases from breast cancer was imaged by 18F-FDG PET/CT [2]. 18F-FDG PET was acquired before and 3 month after the treatment. Percentage change in maximal 18F-FDG SUV (SUV max ) relative to the baseline was evaluated. SUV max assessing responsers showed significantly longer survival (65 weeks) than nonresponsers with survival of 43 weeks. The study found the change in SUV max measured by 18F-FDG PET before and 3 month after treatment was the only independent predictor of survival of the therapy for patients with hepatic metastases of breast cancer. Compared with morphological imaging such as CT, 18F-FDG PET detects early tumor metabolic change in response to treatment; however, PET is limited for depiction of small tumors partially because of its low spatial resolution.Diffusion-weighted MR imaging (DWI) and derived Apparent diffusion coefficients (ADC) image mobility of water molecules and have shown potential to detect tumor necrosis and apoptosis resulting from cancer treatment. The feasibility of using ADC change as a surrogate for tumor response to RT was demonstrated by an imaging study of 11 patients treated with six-fraction conformal liver RT [3]. Median ADC in treated tumor VOI kept increasing with the time course of before, one week during, two weeks during and one month after RT. Early increases in mean ADC correlated with higher radiation dose and increased likelihood of...

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Change in diffusion weighted MRI during liver cancer radiotherapy: Preliminary observations

Cited by 74 publications

References 22 publications

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

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

Prognostication and response assessment in liver and pancreatic tumors: The new imaging

Imaging Tumor Response to Radiation Therapy in Liver

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