Monitoring therapeutic responses of primary bone tumors by diffusion-weighted image: initial results

Abstract

The purpose of our study was to investigate whether quantitative diffusion-weighted images (DWI) were useful for monitoring the therapeutic response of primary bone tumors. We encountered 18 osteogenic and Ewing sarcomas. Magnetic resonance (MR) images were performed in all patients before and after therapy. We measured the apparent diffusion coefficient (ADC) values, contrast-to-noise ratio (CNR), and tumor volume of the bone tumors pre- and posttreatment. We determined change in ADC value, change in CNR on T2-weighted images (T2WI), change in CNR on gadopentetate dimeglumine (Gd)-T1-weighted images (Gd-T1WI), and change in tumor volume. The bone tumors were divided into two groups: group A was comprised of tumors with less than 90% necrosis after treatment and group B of tumors at least with 90%. Changes in ADC value, tumor volume, and CNR were compared between the groups. Change in the ADC value was statistically greater in group B than that in the group A (p = 0.003). There was no significant difference in the changes in CNR on T2WI (p = 0.683), in CNR on Gd-T1WI (p = 0.763), and tumor volume (p = 0.065). The ADC value on DWI is a promising tool for monitoring the therapeutic response of primary bone sarcomas.

Value of diffusion-weighted imaging for evaluating chemotherapy response in osteosarcoma: A meta-analysis

“…Using the predefined electric literature databases, we identified 80 potentially eligible articles, of which 72 were excluded due to duplication or after reviewing the article title and abstract. Subsequently, 3 articles were excluded after reviewing the whole article (23)(24)(25). Five articles with 106 patients who fulfilled all of the inclusion criteria were selected for the meta-analysis (Table I) (26)(27)(28)(29)(30).…”

Characterization of chondroblastic osteosarcoma: Gadolinium‐enhanced versus diffusion‐weighted MR imaging

“…As a result, we used the minimum and maximum ADC, not the mean of ADC values. For ROI measurements in the tumors, the method of ROI measurement was based on the methods described in our previous reports (14,18,19). Care was taken to include the solid-appearing portions of the tumors and to exclude obviously necrotic and/or cystic regions, as these regions were demonstrated as hyperintense on T2-weighted imaging and no enhancement on contrastenhanced T1-weighted images.…”

A Pilot Study of Diffusion-Weighted MRI in Patients Undergoing Neoadjuvant Chemoradiation for Pancreatic Cancer

“…These changes would be expected to be detectable prior to macroscopic changes in mass, size or morphology since removal of tumor macromolecular debris occurs relatively slowly. In fact, clinical studies have shown that dMRI can predict tumor response often several months prior to detectable radiographic changes [13][14][15][16][17][18]. Therefore, we decided to study the effectiveness of dMRI to predict response in patients with pancreatic cancer receiving neoadjuvant chemoradiation therapy.…”