Diffusion-weighted and dynamic contrast-enhanced magnetic resonance imaging after radiation therapy for bone metastases in patients with hepatocellular carcinoma

Abstract

The objectives of this study were to assess changes in apparent diffusion coefficient (ADC) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) parameters after radiation therapy (RT) for bone metastases from hepatocellular carcinoma (HCC) and to evaluate their prognostic value. This prospective study was approved by the Institutional Review Board. Fourteen patients with HCC underwent RT (30 Gy in 10 fractions once daily) for bone metastases. The ADC and DCE-MRI parameters and the volume of the target lesions were measured before (baseline) and one month after RT (post-RT). The Wilcoxon signed-rank test was used to compare the parameters between the baseline and post-RT MRI. The parameters were compared between patients with or without disease progression in RT fields using the Mann–Whitney test. Intraclass correlation coefficients were used to evaluate the interobserver agreement. The medians of the ADC, rate constant [kep], and volume fraction of the extravascular extracellular matrix [ve] in the baseline and post-RT MRI were 0.67 (range 0.61–0.72) and 0.75 (range 0.63–1.43) (× 10–3 mm2/s) (P = 0.027), 836.33 (range 301.41–1082.32) and 335.80 (range 21.86–741.87) (× 10–3/min) (P = 0.002), and 161.54 (range 128.38–410.13) and 273.99 (range 181.39–1216.95) (× 10–3) (P = 0.027), respectively. The medians of the percent change in the ADC of post-RT MRI in patients with progressive disease and patients without progressive disease were − 1.35 (range − 6.16 to 6.79) and + 46.71 (range 7.71–112.81) (%) (P = 0.011), respectively. The interobserver agreements for all MRI parameters were excellent (intraclass correlation coefficients > 0.8). In conclusion, the ADC, kep, and ve of bone metastases changed significantly after RT. The percentage change in the ADC was closely related to local tumor progression.

State-of-the-Art Imaging Techniques in Metastatic Spinal Cord Compression

“…The findings concur with a retrospective study by Chu et al (2013), which also showed that reduction in plasma volume was the strongest predictor of treatment response [146]. Regarding DWI, Lee et al (2021) found that the percentage change in ADC pre-and post-radiotherapy for bone metastasis from hepatocellular carcinoma was closely related to local tumour progression with a lower value predicting progressive disease [147]. Similarly, another study by Byun et al (2002) showed that decreased DWI signal intensity of the bone marrow within metastatic spinal disease was indicative of successful radiation therapy [148].…”

A Cohort Study to Evaluate the Efficacy and Value of CT Perfusion Imaging in Patients with Metastatic Osteosarcoma after Chemotherapy

“…PS has no significant change, which may be due to the formation of a large number of arteriovenous collateral circulation in malignant tumor, blood directly from the artery to the vein without capillary exchange, so the change of PS is not significant [ 39 ]. Lee et al performed perfusion imaging in 25 patients with upper respiratory tract squamous cell carcinoma before and after induction chemotherapy [ 40 ]. The results also showed that the tumor BF and BV decreased significantly after treatment.…”

Multimodal Imaging-Based Potential Visualization of the Tumor Microenvironment in Bone Metastasis

“…The latter characteristic could permit MRI with DCE to contribute to evaluation of the response to antiangiogenic therapies [ 20 ]. DWI and DCE parameters of BM changed significantly in patients with HCC after radiation therapy (RT) [ 44 ]. In addition, the percent change in apparent diffusion coefficient (ADC) was related to therapeutic responses and local tumor progression after RT in BM.…”