Dynamic contrast-enhanced MRI as a predictor of tumour response to radiotherapy

Zahra, M.; Hollingsworth, Kieren G.; Sala, Evis; Lomas, David J.; Tan, Li Tee

doi:10.1016/s1470-2045(06)71012-9

Cited by 236 publications

(203 citation statements)

References 61 publications

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“…Several studies have assessed the predictive role of pretreatment tumor enhancement, quantified as the initial slope or the peak enhancement, especially in gynecologic cancer. Most reports have shown that tumors with better enhancement are associated with better tumor regression and local control (19). This correlation is attributed to less hypoxia-related resistance in better perfused tumors.…”

Section: Discussionmentioning

confidence: 98%

“…Serial T1-weighted imaging samples the blood signal at intervals of a few seconds for up to several minutes after injection (18). The temporal changes in signal intensity obtained by dynamic enhanced MRI are related to the underlying permeability and perfusion of the tumor microenvironment and to the interstitial pressures within the tumor, all of which are known to influence treatment response (19).…”

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confidence: 99%

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Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Dirix¹,

Vandecaveye²,

Keyzer³

et al. 2009

J Nucl Med

191

109

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The purpose of this work was to evaluate the potential of functional imaging with 18 F-FDG PET, 18 F-fluoromisonidazole PET, diffusion-weighted MRI, and dynamic contrast-enhanced MRI to provide an appropriate and reliable biologic target for dose painting in radiotherapy for head and neck squamous cell carcinoma (HNSCC). Methods: Fifteen patients with locally advanced HNSCC, treated with concomitant chemoradiotherapy, were prospectively enrolled in a bioimaging protocol. Sequential PET ( 18 F-FDG and 18 F-fluoromisonidazole) and MRI (T1, T2, dynamic enhanced, and diffusion-weighted sequences) were performed before, during, and after radiotherapy. Results: Median follow-up was 30.7 mo (range, 6.3-56.3 mo); in 7 patients, disease recurred. Disease-free survival correlated negatively with the maximum tissue-to-blood 18 F-fluoromisonidazole ratio (T/B max ) on the baseline 18 F-fluoromisonidazole scan (P 5 0.04), with the size of the initial hypoxic volume (P 5 0.04), and with T/B max on the 18 F-fluoromisonidazole scan during treatment (P 5 0.02). All locoregional recurrences were within the 18 F-FDGavid regions on baseline 18 F-FDG PET; 3 recurrences mapped outside the hypoxic volume on baseline 18 F-fluoromisonidazole PET. Lesions (primary tumor and lymph nodes) where a locoregional recurrence developed during follow-up had significantly lower apparent diffusion coefficients on diffusion-weighted MRI during week 4 of radiotherapy (0.0013 vs. 0.0018 mm 2 /s, P 5 0.01) and at 3 wk after treatment (0.0014 vs. 0.0018 mm 2 /s, P 5 0.01) and a significantly higher initial slope on baseline dynamic enhanced MRI (26.2 vs. 17.5/s, P 5 0.03) than did lesions that remained controlled. Conclusion: These results confirm the added value of 18 F-FDG PET and 18 F-fluoromisonidazole PET for radiotherapy planning of HNSCC and suggest the potential of diffusion-weighted and dynamic enhanced MRI for dose painting and early response assessment.

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Dirix¹,

Vandecaveye²,

Keyzer³

et al. 2009

J Nucl Med

191

109

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“…Then the pixelwise k ep value can be mapped by substituting the retrieved TSF of each pixel from the real DCE-MRI dataset into Eq. [6].…”

Section: Theorymentioning

confidence: 99%

“…DYNAMIC CONTRAST-ENHANCED (DCE) magnetic resonance imaging (MRI) has become a valuable noninvasive method that enables the investigation of microcirculation environment of tissues to characterize tumors and evaluate treatment response (1)(2)(3)(4)(5)(6). Pharmacokinetic models (7)(8)(9)(10) for T 1 -weighted (T 1 w) DCE-MRI have been widely used to obtain physiologically relevant parameters.…”

mentioning

confidence: 99%

Heuristic linear mapping of physiological parameters in dynamic contrast‐enhanced MRI without T₁ measurement and contrast agent concentration

Yuan

Chow

King

et al. 2011

Magnetic Resonance Imaging

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Purpose: To present a novel heuristic linear mapping method to individually estimate physiological parameters for Tofts model without T 1 measurement and contrast agent concentration. Materials and Methods:A linear relationship was used for k ep mapping through a heuristic time intensity curve (TIC) shape factor (TSF). K trans maps were subsequently estimated using k ep maps and another approximate linear model derived from the Tofts model. Twenty-seven patients with head-and-neck squamous cell carcinoma received dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Physiological parameters maps were obtained using this heuristic linear mapping method and compared to the maps obtained by the normal nonlinear least-square fitting with T 1 measurement.Results: High linearity (R 2 >0.95) between k ep and TSF was found in all patients for k ep <5/min. This linearity is robust for TSF timepoint selection. The k ep maps generated by this linear fitting were highly consistent with those by the normal nonlinear approach (P > 0.05). The K trans maps were consistent with the normally derived maps in pattern distribution but the absolute value might be scaled due to the assumption of the reference K trans value.Conclusion: This novel method generates reliable and consistent physiological parameter maps with significantly lower computation complexity than the multiparameter nonlinear fitting. The DCE-MRI scan time can be greatly shortened without T 1 mapping.

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“…Tumor images acquired by DCE-MRI have, therefore, been subjected to kinetic modeling in attempts to derive surrogate parameters related to tumor oxygenation status (10). In some clinical studies, correlations have been found between DCE-MRI-de-rived parameters and tumor oxygenation (11,12) or outcome of radiation therapy (13,14). However, the correlations are in general too weak to be clinically useful, perhaps because the surrogate parameters used in these studies are not adequate measures of tumor hypoxia.…”

mentioning

confidence: 99%

Limitations of dynamic contrast‐enhanced MRI in monitoring radiation‐induced changes in the fraction of radiobiologically hypoxic cells in human melanoma xenografts

Benjaminsen

Melås

Mathiesen

et al. 2008

Magnetic Resonance Imaging

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Purpose:To investigate the potential of gadopentetate dimeglumine (Gd-DTPA)-based dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in detecting radiation-induced changes in the fraction of radiobiologically hypoxic cells in A-07 human melanoma xenografts. Materials and Methods:A-07 tumors were randomly assigned to an unirradiated control group or a group given a single radiation dose of 20 Gy. DCE-MRI and measurement of fraction of hypoxic cells were performed immediately before and 24 h after the radiation exposure. Tumor images of E ⅐ F (E is the initial extraction fraction of Gd-DTPA and F is blood perfusion) and ( is proportional to extracellular volume fraction) were produced by subjecting DCE-MRI series to Kety analysis. Fraction of hypoxic cells was measured by using a radiobiological assay based on the paired survival curve method.Results: Fraction of radiobiologically hypoxic cells was higher in irradiated tumors (26.2 Ϯ 5.8%) than in unirradiated tumors (7.5 Ϯ 2.7%) by a factor of 3.5 Ϯ 1.5 (P ϭ 0.0093), whereas only minor radiation-induced changes in E ⅐ F and could be detected.Conclusion: DCE-MRI does not seem to offer insight into the changes in fraction of radiobiologically hypoxic cells occurring in A-07 tumors within 24 h after irradiation with 20 Gy.

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Dynamic contrast-enhanced MRI as a predictor of tumour response to radiotherapy

Cited by 236 publications

References 61 publications

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Heuristic linear mapping of physiological parameters in dynamic contrast‐enhanced MRI without T₁ measurement and contrast agent concentration

Limitations of dynamic contrast‐enhanced MRI in monitoring radiation‐induced changes in the fraction of radiobiologically hypoxic cells in human melanoma xenografts

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Dynamic contrast-enhanced MRI as a predictor of tumour response to radiotherapy

Cited by 236 publications

References 61 publications

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with18F-FDG PET,18F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with18F-FDG PET,18F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Heuristic linear mapping of physiological parameters in dynamic contrast‐enhanced MRI without T1 measurement and contrast agent concentration

Limitations of dynamic contrast‐enhanced MRI in monitoring radiation‐induced changes in the fraction of radiobiologically hypoxic cells in human melanoma xenografts

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Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Heuristic linear mapping of physiological parameters in dynamic contrast‐enhanced MRI without T₁ measurement and contrast agent concentration