Diffusion‐weighted magnetic resonance imaging allows monitoring of anticancer treatment effects in patients with soft‐tissue sarcomas

Dudeck, Oliver; Zeile, Martin; Pink, Daniel; Pech, Maciej; Tunn, Per‐Ulf; Reichardt, Peter; Ludwig, Wolf‐Dieter; Hamm, Bernd

doi:10.1002/jmri.21358

Cited by 139 publications

(101 citation statements)

References 22 publications

(26 reference statements)

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“…Several authors have shown the importance of DWI with ADC mapping to assess posttreatment response in osteosarcomas (14-16), but to our knowledge, few studies have reported its use in assessing response in soft-tissue sarcomas (17)(18)(19), although DWI has been used for detecting tumor recurrence and for characterizing soft-tissue tumors (19,27,31). Since changes at the cellular level are likely to occur before morphologic changes in tumor size occur, DWI is considered useful in detecting treatment response sooner than conventional imaging (18).…”

Section: Discussionmentioning

confidence: 99%

“…Since changes at the cellular level are likely to occur before morphologic changes in tumor size occur, DWI is considered useful in detecting treatment response sooner than conventional imaging (18). DWI changes have been shown to correlate…”

Section: Discussionmentioning

confidence: 99%

“…Hence, the functional MR imaging techniques of DWI and DCE imaging may offer a more accurate assessment of histologic response, as suggested for other organ systems (9-13), and for osteosarcoma (5,6,(14)(15)(16). However, limited reports exist regarding the use of DWI (17)(18)(19) and DCE imaging for Abbreviations: ADC = apparent diffusion coefficient DCE = dynamic contrast enhanced DWI = diffusion-weighted imaging…”

Section: Study Populationmentioning

confidence: 99%

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Multiparametric Assessment of Treatment Response in High-Grade Soft-Tissue Sarcomas with Anatomic and Functional MR Imaging Sequences

Soldatos¹,

Ahlawat²,

Montgomery³

et al. 2016

Radiology

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).q RSNA, 2015 Purpose:To determine the added value of quantitative diffusionweighted and dynamic contrast material-enhanced imaging to conventional magnetic resonance (MR) imaging for assessment of the response of soft-tissue sarcomas to neoadjuvant therapy. Materials and Methods:MR imaging examinations in 23 patients with soft-tissue sarcomas who had undergone neoadjuvant therapy were reviewed by two readers during three sessions: conventional imaging (T1-weighted, fluid-sensitive, static postcontrast T1-weighted), conventional with diffusion-weighted imaging, and conventional with diffusion-weighted and dynamic contrast-enhanced imaging. For each session, readers recorded imaging features and determined treatment response. Interobserver agreement was assessed and receiver operating characteristic analysis was performed to evaluate the accuracy of each session for determining response by using results of the histologic analysis as the reference standard. Good response was defined as less than or equal to 5% residual viable tumor. Results:Of the 23 sarcomas, four (17.4%) showed good histologic response (three of four with .95% granulation tissue and ,5% necrosis, one of four with 95% necrosis and ,5% viable tumor) and 19 (82.6%) showed poor response (viable tumor range, 10%-100%). Interobserver agreement was substantial or excellent for imaging features in all sequences (k = 0.789-1.000). Receiver operating characteristic analysis showed an increase in diagnostic performance with the addition of diffusion-weighted and dynamic contrast-enhanced MR imaging for prediction of response compared with that for conventional imaging alone (areas under the curve, 0.500, 0.676, 0. Conclusion:Adding functional sequences to the conventional MR imaging protocol increases the sensitivity of MR imaging for determining treatment response in soft-tissue sarcomas.q RSNA, 2015

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

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Multiparametric Assessment of Treatment Response in High-Grade Soft-Tissue Sarcomas with Anatomic and Functional MR Imaging Sequences

Soldatos¹,

Ahlawat²,

Montgomery³

et al. 2016

Radiology

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“…The tumor border was delineated manually, and the area was automatically calculated by using ImageJ. Given the irregular contour and shape of the tumors, the tumor volume V was calculated according to the following equation: V = s · (a 1 + a 2 + a 3 + ... + a n ), where s is the section interval and a 1 through a n are the areas of sections (21). Relative tumor volume (RTV) at different time points …”

Section: In Vivo Experiments In Pigsmentioning

confidence: 99%

Intrabiliary RF Heat-enhanced Local Chemotherapy of a Cholangiocarcinoma Cell Line: Monitoring with Dual-Modality Imaging—Preclinical Study

Zhang¹,

Le²,

Wu³

et al. 2014

Radiology

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Purpose:To determine whether magnetic resonance (MR) imaging heating guidewire-mediated radiofrequency (RF) hyperthermia could enhance the therapeutic effect of gemcitabine and 5-fluorouracil (5-FU) in a cholangiocarcinoma cell line and local deposit doses of chemotherapeutic drugs in swine common bile duct (CBD) walls. Materials and Methods:The animal protocol was approved by the institutional animal care and use committee. Green fluorescent proteinlabeled human cholangiocarcinoma cells and cholangiocarcinomas in 24 mice were treated with (a) combination therapy with chemotherapy (gemcitabine and 5-FU) plus RF hyperthermia, (b) chemotherapy only, (c) RF hyperthermia only, or (d) phosphate-buffered saline. Cell proliferation was quantified, and tumor changes over time were monitored with 14.0-T MR imaging and optical imaging.To enable further validation of technical feasibility, intrabiliary local delivery of gemcitabine and 5-FU was performed by using a microporous balloon with (eight pigs) or without (eight pigs) RF hyperthermia. Chemotherapy deposit doses in the bile duct walls were quantified by means of high-pressure liquid chromatography. The nonparametric Mann-Whitney U test and the paired-sample Wilcoxon signed rank test were used for data analysis. Results:Combination therapy induced lower mean levels of cell proliferation than chemotherapy only and RF hyperthermia only (0.39 6 0.13 [standard deviation] vs 0.87 6 0.10 and 1.03 6 0.13, P , .001). Combination therapy resulted in smaller relative tumor volume than chemotherapy only and RF hyperthermia only (0.65 6 0.03 vs 1.30 6 0.021 and 1.37 6 0.05, P = .001). Only in the combination therapy group did both MR imaging and optical imaging show substantial decreases in apparent diffusion coefficients and fluorescent signals in tumor masses immediately after the treatments. Chemotherapy quantification showed a higher average drug deposit dose in swine CBD walls with intrabiliary RF hyperthermia than without it (gemcitabine: 0.32 mg/g of tissue 6 0.033 vs 0.260 mg/g 6 0.030 and 5-FU: 0.660 mg/g 6 0.060 vs 0.52 mg/g 6 0.050, P , .05). Conclusion:The use of intrabiliary MR imaging heating guidewiremediated RF hyperthermia can enhance the chemotherapeutic effect on a human cholangiocarcinoma cell line and local drug deposition in swine CBD tissues.q RSNA, 2013

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“…DW imaging was performed in coronal or axial orientation by employing a spin echo echoplanar imaging (17). This resulted in significant signal attenuation of vessels, which is called black-blood image (18).…”

Section: Diffusion-weighted Imagingmentioning

confidence: 99%

Diffusion-Weighted Imaging and Proton Magnetic Resonance Spectroscopy Findings in Osteosarcoma Versus Normal Muscle

et al. 2017

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Objectives: The goal of our study was to assess diffusion-weighted (DW) imaging and proton magnetic resonance (MR) spectroscopy findings in osteosarcoma versus normal muscle at 3 Tesla (3 T) MR system. Patients and Methods:Nineteen patients highly suspicious for osteosarcoma and 12 normal young healthy adults were enrolled in this study. Two patients were excluded from the study due to incompatible histopathologic results. DW imaging and multivoxel proton MR spectroscopy at 3 T were performed for all participants. Surgical biopsy and histopathological examination were done for every patient after imaging. SPSS 20 was used for statistical analysis. Results:The minimum apparent diffusion coefficient (ADC) value of osteosarcoma (0.88 ± 0.28) in this study confirms the significant restriction of this tumor against the dark background of normal muscle in high b-value images. Fourteen (82%) of the available 17 patients had ADC values ≤ 1 × 10 -3 mm 2 /s. The maximum choline/creatine (Cho/Cr) ratio of osteosarcoma (1.94 ± 1.12) was statistically higher than the normal muscle (1.34 ± 0.11). Receiver operating curve (ROC) analysis (the area under the curve = 0.7) indicated a maximum Cho/Cr ratio of 1.37 as the cut point between the normal muscle and osteosarcoma, with a sensitivity, specificity and accuracy of 58.8%, 83.3%, and 69%, respectively. All patients with Cho/Cr ratios more than the cut point had ADC values ≤ 1 × 10 -3 mm 2 /s and all patients with ADC values higher than 1 × 10 -3 mm 2 /s had Cho/Cr ratios ≤ 1.37. Conclusions:It was concluded that DW imaging and proton MR spectroscopy are two effective noninvasive techniques in the evaluation of osteosarcoma.

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Diffusion‐weighted magnetic resonance imaging allows monitoring of anticancer treatment effects in patients with soft‐tissue sarcomas

Cited by 139 publications

References 22 publications

Multiparametric Assessment of Treatment Response in High-Grade Soft-Tissue Sarcomas with Anatomic and Functional MR Imaging Sequences

Multiparametric Assessment of Treatment Response in High-Grade Soft-Tissue Sarcomas with Anatomic and Functional MR Imaging Sequences

Intrabiliary RF Heat-enhanced Local Chemotherapy of a Cholangiocarcinoma Cell Line: Monitoring with Dual-Modality Imaging—Preclinical Study

Diffusion-Weighted Imaging and Proton Magnetic Resonance Spectroscopy Findings in Osteosarcoma Versus Normal Muscle

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