Diffusion-Related MRI Parameters for Assessing Early Treatment Response of Liver Metastases to Cytotoxic Therapy in Colorectal Cancer

Joo, Ijin; Kim, Tae-Yong; Han, Sae‐Won; Kim, Yong Jae; Lee, Jeong Min; Han, Joon Koo

doi:10.2214/ajr.15.15683

Cited by 38 publications

(32 citation statements)

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“…In many tissues, a second exponential is included, giving the IVIM model, which allows inference of vascular fraction and tissue perfusion properties. Such measures are becoming increasingly important in oncology to differentiate tumour type or grade (Yamada et al 1999 , Chandarana et al 2011 ), or where the focus of a treatment may be anti-angiogenic or reducing tumour vascularity (Kim et al 2016 , Yang et al 2016 ). In using models with additional parameters, however, there is the potential for over-fitting, or having strongly covariant parameters that do not supply additional information.…”

Section: Discussionmentioning

confidence: 99%

Extended T2-IVIM model for correction of TE dependence of pseudo-diffusion volume fraction in clinical diffusion-weighted magnetic resonance imaging

et al. 2016

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The bi-exponential intravoxel-incoherent-motion (IVIM) model for diffusion-weighted MRI (DWI) fails to account for differential T2s in the model compartments, resulting in overestimation of pseudodiffusion fraction f. An extended model, T2-IVIM, allows removal of the confounding echo-time (TE) dependence of f, and provides direct compartment T2 estimates. Two consented healthy volunteer cohorts (n = 5, 6) underwent DWI comprising multiple TE/b-value combinations (Protocol 1: TE = 62–102 ms, b = 0–250 mm−2s, 30 combinations. Protocol 2: 8 b-values 0–800 mm−2s at TE = 62 ms, with 3 additional b-values 0–50 mm−2s at TE = 80, 100 ms; scanned twice). Data from liver ROIs were fitted with IVIM at individual TEs, and with the T2-IVIM model using all data. Repeat-measures coefficients of variation were assessed for Protocol 2. Conventional IVIM modelling at individual TEs (Protocol 1) demonstrated apparent f increasing with longer TE: 22.4 ± 7% (TE = 62 ms) to 30.7 ± 11% (TE = 102 ms); T2-IVIM model fitting accounted for all data variation. Fitting of Protocol 2 data using T2-IVIM yielded reduced f estimates (IVIM: 27.9 ± 6%, T2-IVIM: 18.3 ± 7%), as well as T2 = 42.1 ± 7 ms, 77.6 ± 30 ms for true and pseudodiffusion compartments, respectively. A reduced Protocol 2 dataset yielded comparable results in a clinical time frame (11 min). The confounding dependence of IVIM f on TE can be accounted for using additional b/TE images and the extended T2-IVIM model.

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Section: Discussionmentioning

confidence: 99%

Extended T2-IVIM model for correction of TE dependence of pseudo-diffusion volume fraction in clinical diffusion-weighted magnetic resonance imaging

et al. 2016

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“…Different from the aforementioned imaging studies, IVIM‐DWI can provide quantitative assessment of both perfusion and diffusion information of the liver parenchyma without the need for an exogenous contrast agent, and therefore, can have important clinical implications in the management of patients at risk for SOS or the monitoring of treatment efficacy in the prevention or improvement of SOS. In clinical practice, liver MRI with DWI is often performed in patients who have received preoperative chemotherapy for CRLM, to assess tumor response, and determine surgical planning . Of note is that these patients are an important risk group for hepatic SOS, a parenchymal disease frequently associated with oxaliplatin‐based chemotherapy .…”

Section: Discussionmentioning

confidence: 99%

Assessment of hepatic sinusoidal obstruction syndrome with intravoxel incoherent motion diffusion‐weighted imaging: An experimental study in a rat model

Hong

Joo

Park

et al. 2019

Magnetic Resonance Imaging

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Background: Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) parameters may reflect perfusion and diffusion changes in hepatic sinusoidal obstruction syndrome (SOS). Purpose: To investigate the feasibility of IVIM-DWI in the noninvasive assessment of hepatic SOS in an experimental rat model. Study Type: Animal study. Population/Subjects: Forty-four rats were administered different doses (90 or 160 mg/kg) of monocrotaline by gavage either 48 or 72 hours before MRI to induce different degrees of hepatic SOS, and another 10 rats served as controls. Field Strength/Sequence: 3T scanner, IVIM-DWI using nine b values (0-800 sec/mm 2 ). Assessment: Histologically, rats were classified as having none (n = 10), mild (n = 8), moderate (n = 19), or severe SOS (n = 17). The apparent diffusion coefficient (ADC) and IVIM-derived parameters (D: true diffusion coefficient, D*: pseudodiffusion coefficient, and f: perfusion fraction) of the liver parenchyma were measured. Statistical Tests: IVIM-DWI parameters were compared according to histologic grades of SOS (none, mild, moderate, and severe), and receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic accuracy. Results: ADC, D, and f of the liver parenchyma were significantly different according to SOS severity groups (Ps < 0.01) and significantly decreased as SOS severity increased (rho = -0.323, -0.313, and -0.700; P = 0.017, 0.021, and <0.001, respectively). Means of f in none, mild, moderate, and severe SOS were 17.2%, 13.3%, 12.3%, and 11.1%, respectively. Among ADC and IVIM-derived parameters, f provided the highest area under the ROC curves for detecting ≥mild, ≥moderate, and severe SOS (0.991, 0.890, and 0.803, respectively). Data Conclusion: IVIM-DWI may be useful in the diagnosis and severity assessment of hepatic SOS. Level of Evidence: 2 Technical Efficacy Stage: 2

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“…Tumors could respond to therapy in ways other than size reduction such as modified tissue composition which can be assessed by functional imaging such as the DWI which can detect tissue microstructure alteration rather than macrostructure [5].…”

Section: Discussionmentioning

confidence: 99%

“…According to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, the size change is currently considered the bases of evaluation of therapeutic response after chemotherapy [3]. However, because therapy may result in modification in tissue composition despite constant tumor size; moreover, fatty liver infiltration after chemotherapy can affect the liver parenchyma impairing the assessment of lesions, functional techniques, such as dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI), which reveal alterations in tissue microstructure rather than macrostructure changes [4,5].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the percentage of apparent diffusion coefficient value changes as an early indicator of the response of colorectal hepatic metastases to chemotherapy

El-Husseiny

Mehana

Zawawy

2019

Egypt J Radiol Nucl Med

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Background: Colorectal cancer is considered one of the most common causes of cancer-related deaths worldwide. We aim to evaluate the efficacy of DWI-MRI in predicting response to chemotherapy in this cohort. The study included 30 lesions in 20 biopsy proven-colorectal cancer patients with hepatic metastasis larger than 1 cm. All patients underwent both triphasic CT with intravenous contrast, pre-chemotherapy MRI (axial T2 and DW sequences) which was repeated 21 days following chemotherapy. A follow-up CT was done 2 months later. The response of the lesions was evaluated using the RESCIST criteria. On MRI, the lesions corresponding to the ones chosen on CT were identified and the apparent diffusion coefficient (ADC) values of pre-and post-chemotherapy images were recorded and correlated with the CT results. Results: In the study, 17 (56.7%) of the lesions showed response to chemotherapy while 13 (43.3%) were nonresponding. There was no significant difference in pretreatment ADC values between responding and nonresponding lesions (p = 0.14). The mean percentage increase in ADC values in responding lesions was 42% compared to 18% in non-responding lesions (p < 0.001). Lesions that showed less than 18% increase were all found to be non-responsive Conclusion: DWI-MRI has an emerging role in early assessment of early treatment response that can be detected before morphological response for patients with hepatic metastasis from colorectal cancer. Based on our study, the use of 25 % as the cutoff point of percent difference in ADC for detection of non-responding lesions proved to be successful only 21 days after the 1st chemotherapy cycle.

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Diffusion-Related MRI Parameters for Assessing Early Treatment Response of Liver Metastases to Cytotoxic Therapy in Colorectal Cancer

Abstract: Diffusion-related MRI parameters are useful for the early prediction of therapeutic response after cytotoxic chemotherapy for liver metastasis from CRC.

Cited by 38 publications

References 30 publications

Extended T2-IVIM model for correction of TE dependence of pseudo-diffusion volume fraction in clinical diffusion-weighted magnetic resonance imaging

Extended T2-IVIM model for correction of TE dependence of pseudo-diffusion volume fraction in clinical diffusion-weighted magnetic resonance imaging

Assessment of hepatic sinusoidal obstruction syndrome with intravoxel incoherent motion diffusion‐weighted imaging: An experimental study in a rat model

Assessment of the percentage of apparent diffusion coefficient value changes as an early indicator of the response of colorectal hepatic metastases to chemotherapy

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