Diffusion magnetic resonance imaging: A molecular imaging tool caught between hope, hype and the real world of “personalized oncology”

Abstract

“Personalized oncology” is a multi-disciplinary science, which requires inputs from various streams for optimal patient management. Humongous progress in the treatment modalities available and the increasing need to provide functional information in addition to the morphological data; has led to leaping progress in the field of imaging. Magnetic resonance imaging has undergone tremendous progress with various newer MR techniques providing vital functional information and is becoming the cornerstone of “radiomics/radiogenomics”. Diffusion-weighted imaging is one such technique which capitalizes on the tendency of water protons to diffuse randomly in a given system. This technique has revolutionized oncological imaging, by giving vital qualitative and quantitative information regarding tumor biology which helps in detection, characterization and post treatment surveillance of the lesions and challenging the notion that “one size fits all”. It has been applied at various sites with different clinical experience. We hereby present a brief review of this novel functional imaging tool, with its application in “personalized oncology”.

Background, current role, and potential applications of radiogenomics

“…In DWI, advanced techniques such as intravoxel incoherent motion (IVIM), stretched exponential DWI, and DW kurtosis imaging (DKI) are being investigated and show promise to provide additional robust imaging biomarkers that can be incorporated in radiogenomic studies. 125 Other MRI techniques that can potentially provide imaging biomarkers for radiogenomic research include spectroscopy, proton, 126 phosphorus, 127 lipid, 128,129 sodium imaging, [130][131][132][133][134] chemical exchange saturation transfer (CEST) imaging, 135,136 BOLD, [137][138][139] or arterial spin labeling MRI. [140][141][142] In this respect, radiogenomics is still in its infancy and data are still scarce.…”

Imaging and the completion of the omics paradigm in breast cancer

“…In DWI advanced techniques such as intravoxel incoherent motion, stretched exponential DWI, and DW kurtosis imaging are being investigated and hold promise for providing additional robust imaging biomarkers that can be incorporated in radiogenomic studies [30]. In addition, other MRI techniques that may be used for radiogenomic research include spectroscopy (proton, phosphorus, lipid), sodium imaging [50], CEST imaging [24], BOLD [21], and arterial spin labeling MRI [43].…”

Diffusion Weighted Imaging (DWI) Classification and Apparent Diffusion Coefficient (ADC) Value Tendency Based on Cerebral Glioma Grading in Patients at Dr. Soetomo General Academic Hospital in 2016-2020

“…DWI can also improve the specificity and sensitivity of conventional MRI images. 6 The use of DWI, especially in the head and neck area, is to look for the presence of primary tumors and nodal metastases, predict and monitor therapy response, and distinguish between residual or recurrent tumors and changes after radiation therapy. 7 The degree to which signal intensity decreases within a given ROI is reflected in ADC values.…”