Chemotherapy Response Monitoring of Colorectal Liver Metastases by Dynamic Gd-DTPA–Enhanced MRI Perfusion Parameters and <sup>18</sup>F-FDG PET Metabolic Rate

Vriens, Dennis; Laarhoven, Hanneke W. M. van; Asten, Jack J.A. van; Krabbe, Paul F M; Visser, Eric P.; Heerschap, Arend; Punt, Cornelis J.A.; Geus‐Oei, Lioe‐Fee de; Oyen, Wim J.G.

doi:10.2967/jnumed.109.064790

Cited by 29 publications

(37 citation statements)

References 26 publications

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“…DCE-MRI is a relatively novel MRI technology that combines morphology and changes in hemodynamics, and can quantitatively evaluate tumor differentiation in a more accurate way (19). Therefore, the aim of the present study was to explore the clinical application of DCE-MRI in the preoperative diagnosis of rectal cancer and its correlation with tumor differentiation.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in rectal cancer and its correlation with tumor differentiation

Chen

et al. 2016

Molecular and Clinical Oncology

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Abstract. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a novel imaging modality that can be used to reflect the microcirculation, although its value in diagnosing rectal cancer is unknown. The present study aimed to explore the clinical application of DCE-MRI in the preoperative diagnosis of rectal cancer, and its correlation with tumor differentiation. To achieve this, 40 pathologically confirmed patients with rectal cancer and 15 controls were scanned using DCE-MRI. The Tofts model was applied to obtain the perfusion parameters, including the plasma to extravascular volume transfer (Ktrans), the extravascular to plasma volume transfer (Kep), the extravascular fluid volume (Ve) and the initial area under the enhancement curve (iAUC). Receiver-operating characteristic (ROC) curves were plotted to determine the diagnostic value. The results demonstrated that the time-signal intensity curve of the rectal cancer lesion exhibited an outflow pattern. The Ktrans, Kep, Ve, and iAUC values were higher in the cancer patients compared with controls (P<0.05). The intraclass correlation coefficients of Ktrans, Kep, Ve and iAUC, as measured by two independent radiologists, were 0.991, 0.988, 0.972 and 0.984, respectively (all P<0.001), indicating a good consistency. The areas under the ROC curves for Ktrans and iAUC were both >0.9, resulting in a sensitivity and specificity of 100% and 93.3% for Ktrans, and of 92.5%, and 93.3% or 100%, for iAUC, respectively. In the 40 rectal cancer cases, there was a moderate correlation between Ktrans and iAUC, and pathological differentiation (0.365 years old, and rectal cancer occurs rarely in patients who are under 40 years of age; in addition, men are predominantly affected (2). Probable risk factors include age, male gender, colon polyps, a history of colorectal cancer, a history of inflammatory bowel disease, hereditary syndromes, lifestyle factors (diet, alcohol, obesity, sedentary lifestyle and smoking), and a history of diabetes mellitus (1). Rectal cancer is usually managed using a combination of surgery, chemotherapy, targeted therapy and radiation therapy (3). The five-year survival rates following surgical resection are 85-95% for stage I, 60-80% for stage II, and 30-60% for stage III cancer. With the aging of the Chinese society and a Westernization of the diet, the incidence of rectal cancer in China is increasing (4). Therefore, finding novel means to efficiently detect and diagnose rectal cancer are required.Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a relatively novel imaging modality that demonstrates the capillary blood flows (5,6). In DCE-MRI, the distribution of the contrast agent is repeatedly evaluate...

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in rectal cancer and its correlation with tumor differentiation

Chen

et al. 2016

Molecular and Clinical Oncology

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“…For conventional contrast agents such as Gd-DTPA, a dual-input one-compartment model provides a good fit to data measured in liver tissue [47,51,53,56]. It produces values for the blood (or plasma) flow, arterial blood flow fraction, extracellular volume, and mean transit time.…”

Section: Discussionmentioning

confidence: 98%

“…Some authors assume that either the venous blood supply is negligible (which may be justified in some tumors [44,[49][50][51], or that the arterial blood supply can be ignored (in liver tissue [52]). If one of the supplies can be ignored, the data can be analyzed with a model-free deconvolution method to extract blood flow and uptake fraction [52].…”

Section: Discussionmentioning

confidence: 99%

Contrast agents as a biological marker in magnetic resonance imaging of the liver: conventional and new approaches

Sommer¹,

Sourbron

Huppertz

et al. 2011

Abdom Imaging

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Liver imaging is an important clinical area in everyday practice. The clinical meaning of different lesion types in the liver can be quite different. Therefore, the result of imaging studies of the liver can change therapeutic concepts fundamentally. Contrast agents are used in the majority of MR examinations of the liver parenchyma-despite the already good soft-tissue contrast in plain MRI. This can be explained by the advantages in lesion detection and characterization of contrast-enhanced MRI of the liver. Beyond the qualitative evaluation of contrast-enhanced liver MR examinations, quantification of parameters will be the demand of the future. This can be achieved by perfusion MRI, also called dynamic contrast-enhanced MRI (DCE-MRI) of the liver. Its basic principles and different clinical applications will be discussed in this article. Definite cut-off values to determine disease or therapeutic response will help to increase the objectivity and reliability of liver MRI in future. This is especially important in the oncological setting, where modern therapies cannot be assessed based on changes in size only.

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“…Vriens et al [128] reported a large reduction in DCE-MRI-derived perfusion parameters and glucose metabolic rate at 18 F-FDG PET/CT in CRC metastases treated with bevacizumab. The same author [129] reported also that cytotoxic chemotherapy did not alter DCE-MRI-derived properties of tumor vasculature. Coenegrachts et al [130] reported that a decrease of Kep allowed early identification of response after 6 wk of FOLFIRI and bevacizumab treatment.…”

Section: Liver Metastasesmentioning

confidence: 89%

“…De Bruyne et al [127] 19 DCE-MRI AUC decrease CRC metastases Bevacizumab Vriens et al [129] 23 DCE-MRI K trans decrease CRC metastases Cytotoxic therapy Coenegrachts et al [130] 10 DCE-MRI Kep increase CRC metastases Bevacizumab + FOLFIRI Deckers et al [126] 20 DWI ADC decrease CRC metastases Chemotherapy Niwa et al [133] 63 DWI ADC decrease PDAC Gemcitabine Cuneo et al [134] 12 DWI ADC increase PDAC Chemoradiation Yao et al [135] 39 pCT BF decrease PanNET Bevacizumab ± everolimus Miyazaki et al [132] [115,116] .…”

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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Chemotherapy Response Monitoring of Colorectal Liver Metastases by Dynamic Gd-DTPA–Enhanced MRI Perfusion Parameters and ¹⁸F-FDG PET Metabolic Rate

Cited by 29 publications

References 26 publications

Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in rectal cancer and its correlation with tumor differentiation

Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in rectal cancer and its correlation with tumor differentiation

Contrast agents as a biological marker in magnetic resonance imaging of the liver: conventional and new approaches

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

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Chemotherapy Response Monitoring of Colorectal Liver Metastases by Dynamic Gd-DTPA–Enhanced MRI Perfusion Parameters and 18F-FDG PET Metabolic Rate

Cited by 29 publications

References 26 publications

Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in rectal cancer and its correlation with tumor differentiation

Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in rectal cancer and its correlation with tumor differentiation

Contrast agents as a biological marker in magnetic resonance imaging of the liver: conventional and new approaches

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

Contact Info

Product

Resources

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Chemotherapy Response Monitoring of Colorectal Liver Metastases by Dynamic Gd-DTPA–Enhanced MRI Perfusion Parameters and ¹⁸F-FDG PET Metabolic Rate