Clinical Applications for Diffusion Magnetic Resonance Imaging in Radiotherapy

Tsien, Christina; Cao, Yue; Chenevert, Thomas L.

doi:10.1016/j.semradonc.2014.02.004

Cited by 81 publications

(67 citation statements)

References 57 publications

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“…The ability of diffusion-weighted MR imaging in improving target volume delineation, early tumor response assessment, and differentiation between normal posttreatment changes suggests an important clinical role in radiotherapy (22). It would be interesting to compare the impact of diffusion-weighted MR imaging on the treatment outcome.…”

Section: Discussionmentioning

confidence: 99%

“…The effect on prognosis might be stronger than many other factors investigated before, including stage or 18 F-FDG uptake. Despite the lower prevalence of human HPV-related oropharyngeal cancer in Asia (22,23), the results would be more robust if information about the HPV status could be included in this analysis. Future studies must use more imaging studies and information of HPV status and adjust for potential confounders in the analysis.…”

Section: Discussionmentioning

confidence: 99%

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Risk Stratification of Metastatic Neck Nodes by CT and PET in Patients with Head and Neck Cancer Receiving Definitive Radiotherapy

et al. 2015

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The aim of this study was to investigate the prognostic impact of CT and 18 F-FDG PET/CT on the outcome of metastatic neck node (MNN) in patients with head and neck cancer receiving definitive radiotherapy or chemoradiotherapy. Methods: This patient-based study included 91 patients diagnosed with pharyngeal cancers with MNN (N1, 15; N2, 70; N3, 6). All had pretreatment CT and PET/CT before definitive chemoradiotherapy/radiotherapy. Parameters of MNNs for each patient, including maximal diameter, nodal volume, radiologic central necrosis, maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG), were retrieved for the analysis. Nodal relapse-free survival (NRFS) and survivals were calculated using the Kaplan-Meier method. Independent predictors were identified using Cox regression analysis. Results: After a median follow-up of 18 mo, 64 patients remained nodal relapse-free, and 27 experienced neck recurrence. Multivariate analysis showed that the application of 40% of the maximal uptake of nodal TLG (N-TLG40%) 38 g or greater (P 5 0.03; hazard ratio, 2.63; 95% confidence interval, 1.10-6.30) and radiologic necrosis on CT scan (P 5 0.001; hazard ratio, 10.99; 95% confidence interval, 2.56-47.62) were 2 adverse features for NRFS. Patients who had an N-TLG40% 38 g or greater and central radiologic necrosis had a significantly inferior 2-y NRFS (53% vs. 77% and 45% vs. 95%, respectively). Conclusion: The outcome of MNNs in patients with head and neck cancer receiving chemoradiotherapy/radiotherapy can be predicted according to radiologic necrosis and N-TLG40% value. The 2 adverse features should be validated in future trials. In this way, patients can be treated alternatively or aggressively.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Stratification of Metastatic Neck Nodes by CT and PET in Patients with Head and Neck Cancer Receiving Definitive Radiotherapy

et al. 2015

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“…Diffusion MRI sequences have been shown to predict response to RT [86,87] earlier than gross tumor size changes or metabolic changes based on FDG PET-CT [88]. Both the baseline apparent diffusion coefficient (ADC) and changes in ADC, specifically increase in ADC after RT, correlate with tumor control and patient outcome after radiotherapy [89][90][91][92][93][94].…”

Section: Adaptive Radiotherapymentioning

confidence: 99%

MRI-guided radiotherapy: Opening our eyes to the future

Kishan¹,

Lee²

2016

Integr Cancer Sci Therap

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When discussing local treatment modalities, physicians often quip that there can be no blind surgeons, suggesting that an inherent advantage to surgery is the ability to precisely visualize the target. Advances in radiation therapy (RT) technology over the years have significantly improved the radiation oncologists' abilities to precisely sculpt high-dose radiation to a variety of targets, simultaneously improving local control and toxicity profiles. However, even the most sophisticated methods of CT-based image-guided radiotherapy (IGRT) are hampered by limitations that can compromise target localization and motion management. Additionally, realtime adaptive radiotherapy (ART) programs, wherein radiation plans can be molded to fit the often malleable anatomy of tumors and organs-at-risk, have not yet been developed. For these reasons, MRI-guided RT is considered the next frontier of radiation oncology. However, the development of integrated MRI/RT-delivery platforms is complicated by several technical challenges that have precluded development of MRI-guided linear accelerators. By virtue of employing a low-field (0.35 T) MRI and three 60 Co sources, a newly available tri-60 Co teletherapy system (MRIdian System™, ViewRay™, Cleveland, OH, USA) has tackled these technical concerns and has thus become the first MRI-guided RT platform with FDA approval for medical use. In this Review, we describe the abilities of this device to accomplish the goals of MRI-guided RT-improved target localization, sophisticated motion management, and on-line ART-by exploring published feasibility, proof-of-principle, and proof-of-practice studies.

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“…Among the advances in multiparametric MR imaging, Diffusion-weighted imaging (DWI) has attracted particular attention (for a concise review see [45]). DWI measures the mobility of water within a tissue and is independent on the application of a contrast agent [46].…”

Section: Advances In Mr Imaging For Radiation Oncology Treatment Planmentioning

confidence: 99%

“…Low ADC values are associated with a poor prognosis [50]. The potential of DWI for integration in target volume definition is furthermore reflected by the fact that it is already in clinical use in radiotherapy of prostate [51,52] or rectal cancer [53], among others [45]. Although a biopsy controlled study in glioma showed that ADC mapping may insufficiently distinguish tumour from peritumoral tissue [54], a recent report introduced the low ADC subvolume, that is not fully covered by the 95 % isodose of prescribed radiation dose, as a significant negative predictor for PFS [55].…”

Section: Advances In Mr Imaging For Radiation Oncology Treatment Planmentioning

confidence: 99%

PET/MRI and brain tumors: focus on radiation oncology treatment planning

Oehlke

Grosu

2016

Clin Transl Imaging

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In brain tumors, imaging by magnetic resonance imaging (MRI) can very accurately visualize anatomy and morphology of healthy and malignant tissue, but neither contrast-enhancing areas in T1-weighted sequences, nor hyperintensities in T2/FLAIR sequences are specific for tumor tissue, especially when considering the manifold alterations resulting from previous treatment. Imaging the biology of tumor tissue by positron emission tomography (PET), therefore, is a highly interesting approach to improve the detection of macroscopic tumor which is the prerequisite for high-precision radiotherapy treatment planning. This review will focus on the benefits of amino acid tracers (L-[methyl-11 C]methionine (MET) and O-(2-[ 18 F]fluoroethyl)-L-tyrosine (FET)) in neurooncology and their implementation in radiation oncology. Furthermore, a brief overview of the current impact of 2-deoxy-2-(18F)fluoro-D-glucose (FDG), nucleic acid analogs, hypoxia tracers, and Somatostatin receptor (SSTR) analogs on radiotherapy planning in brain tumors is provided. Among advances in multiparametric MRI, Diffusionweighted imaging (DWI) has attracted particular attention since it can predict prognosis, as well as indicate response to treatment and has already been introduced into target volume definition for radiotherapy of various cancers (e.g., prostate and rectal cancer). Additionally, advances in MR spectroscopy (MRS) are mentioned. Finally, these findings will be discussed concerning their influence on current aspects of integrated PET/MR hybrid imaging.

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Clinical Applications for Diffusion Magnetic Resonance Imaging in Radiotherapy

Cited by 81 publications

References 57 publications

Risk Stratification of Metastatic Neck Nodes by CT and PET in Patients with Head and Neck Cancer Receiving Definitive Radiotherapy

Risk Stratification of Metastatic Neck Nodes by CT and PET in Patients with Head and Neck Cancer Receiving Definitive Radiotherapy

MRI-guided radiotherapy: Opening our eyes to the future

PET/MRI and brain tumors: focus on radiation oncology treatment planning

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