The apparent diffusion coefficient is a useful biomarker in predicting treatment response in patients with locally advanced rectal cancer

Santos, Mayra Evelia Jiménez de los; Reyes-Pérez, Juan Armando; Sandoval-Nava, Rosa Martha; Villalobos-Juárez, José Luis; Villaseñor‐Navarro, Yolanda; Vela-Sarmiento, Itzel; Sollozo-Dupont, Isabel

doi:10.1177/2058460120957295

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…ADC values may reflect cellularity, tissue perfusion, and necrosis (39,40). Both minimum and mean ADC values predicted treatment response in patients with locally advanced rectal cancer before neoadjuvant chemoradiation treatment (41). A recent meta-analysis showed that alterations between pre-and post-treatment ADC can identify responders to TACE in HCC (42).…”

Section: Discussionmentioning

confidence: 99%

Local ablation of hepatocellular carcinoma by interstitial brachytherapy: prediction of outcome by diffusion-weighted imaging

et al. 2022

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Background Interstitial brachytherapy (iBT) has become a viable treatment option in the therapy of early and intermediate stage hepatocellular carcinoma (HCC). Prognostic imaging tools to predict patient outcome are missing. Purpose To assess the predictive value of baseline diffusion-weighted imaging in HCC before iBT with regard to local tumor control and overall survival (OS). Material and Methods We retrospectively identified 107 patients who underwent iBT for HCC from 2011 to 2018 from our database. Apparent diffusion coefficient (ADC) values for each treated lesion were analyzed in region of interest measurements. Additionally, explorative combined ratios adjusting total measured lesion area and mean measured lesion area per patient by ADC values were calculated. Measurements underwent a univariate and multivariate Cox regression analysis. The log rank test was then used to verify prognostic cutoff levels for median survival time. Results A total of 189 lesions in 81 patients were measured. Median survival of patients was 46.0 months. Neither ADC parameter was indicative of local tumor control. Lesion size >5 cm was associated with lower local tumor control (hazard ratio [HR]=4.292, 95% confidence interval [CI]=1.285–14.331; P = 0.018). Average measured lesion area divided by ADCmin (ADCarea mean, min) was identified to independently predict OS (HR=1.994, 95% CI=1.172–3.392; P = 0.011). A cutoff based on the variable's median (0.29 × 10–4 AU) identified patients with poor outcome (OS 36 vs. 61 months) for lower ADCarea mean, min values as verified by the log-rank test ( P = 0.040). Conclusion Pre-treatment ADCarea mean, min may serve as an independent predictor of OS in patients with HCC undergoing iBT.

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Section: Discussionmentioning

confidence: 99%

Local ablation of hepatocellular carcinoma by interstitial brachytherapy: prediction of outcome by diffusion-weighted imaging

et al. 2022

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“…ADC values obtained at DWI have been con rmed to be related to tumor cellularity, with lower ADC values associated with increased tumor cellularity [9]. However, these studies on the use of ADC values for treatment response evaluation are inconsistent [10][11][12][13][14]. These con icting results may partly be because the ADC values calculated from DWI are based on a mono-exponential decay model, which hypothesizes the free motion of water molecules following a Gaussian distribution [15].…”

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confidence: 99%

Combination of intravoxel incoherent motion histogram parameters and clinical characteristics for predicting response to neoadjuvant chemoradiation in Rectal Cancer

Yang,

Lin,

et al. 2024

Preprint

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Objective To explore the value of histogram parameters derived from intravoxel incoherent motion (IVIM) for predicting response to neoadjuvant chemoradiation (nCRT) in patients with rectal cancer. Methods 112 patients diagnosed with rectal cancer who underwent IVIM-DWI before nCRT were enrolled in this study, and true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and microvascular volume fraction (f) calculated from IVIM, together with the histogram parameters were recorded. The patients were divided into the pathological complete response (pCR) group and the non-pCR group according to the tumor regression grade (TRG) system. We also divided the patients into low T stage (yp T0-2) and high T stage (ypT3-4) according to the pathologic T stage (ypT stage). Univariate logistic regression analysis was implemented to select independent risk factors, including clinical characteristics and IVIM histogram parameters, and the models for Clinical, Histogram, and Combined Clinical and Histogram were generated respectively by using multivariable binary logistic regression analysis for predicting pCR. The area under the Receiver operating characteristic (ROC) curve (AUCs) were used to compare the diagnostic performance among the three models. Results The values of D_ kurtosis, f_mean, and f_ median were significantly higher in the pCR group (n = 24) compared with the non-pCR group. The value of D*_ entropy was significantly lower in the pCR group compared with the non-pCR group. The values of D_ kurtosis, f_mean, and f_ median were significantly higher in the low T stage group (n=37) compared with the high T stage group. The value of D*_ entropy was significantly lower in the low T stage group compared with the high T stage group (all p < 0.05). ROC curves demonstrated that the Combined Clinical and Histogram model had the best diagnostic performance in predicting the pCR patients with optimal AUCs, sensitivity, specificity, and accuracy (0.916, 83.33%, 85.23%, and 84.82%, respectively). Conclusions IVIM histogram parameters which combined with clinical characteristics showed promising prospects in predicting the pCR patients before surgery.

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Whole lesion histogram analysis of apparent diffusion coefficient predicts therapy response in locally advanced rectal cancer

Santos¹,

Reyes-Pérez²,

Osorio³

et al. 2022

WJG

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BACKGROUND Whole-tumor apparent diffusion coefficient (ADC) histogram analysis is relevant to predicting the neoadjuvant chemoradiation therapy (nCRT) response in patients with locally advanced rectal cancer (LARC). AIM To evaluate the performance of ADC histogram-derived parameters for predicting the outcomes of patients with LARC. METHODS This is a single-center, retrospective study, which included 48 patients with LARC. All patients underwent a pre-treatment magnetic resonance imaging (MRI) scan for primary tumor staging and a second restaging MRI for response evaluation. The sample was distributed as follows: 18 responder patients (R) and 30 non-responders (non-R). Eight parameters derived from the whole-lesion histogram analysis (ADCmean, skewness, kurtosis, and ADC10 th , 25 th , 50 th , 75 th , 90 th percentiles), as well as the ADCmean from the hot spot region of interest (ROI), were calculated for each patient before and after treatment. Then all data were compared between R and non-R using the Mann-Whitney U test. Two measures of diagnostic accuracy were applied: the receiver operating characteristic curve and the diagnostic odds ratio (DOR). We also reported intra- and interobserver variability by calculating the intraclass correlation coefficient (ICC). RESULTS Post-nCRT kurtosis, as well as post-nCRT skewness, were significantly lower in R than in non-R (both P < 0.001, respectively). We also found that, after treatment, R had a larger loss of both kurtosis and skewness than non-R (∆%kurtosis and ∆skewness, P < 0.001). Other parameters that demonstrated changes between groups were post-nCRT ADC10 th , ∆%ADC10 th , ∆%ADCmean, and ROI ∆%ADCmean. However, the best diagnostic performance was achieved by ∆%kurtosis at a threshold of 11.85% (Area under the receiver operating characteristic curve [AUC] = 0.991, DOR = 376), followed by post-nCRT kurtosis = 0.78 × 10 -3 mm 2 /s (AUC = 0.985, DOR = 375.3), ∆skewness = 0.16 (AUC = 0.885, DOR = 192.2) and post-nCRT skewness = 1.59 × 10 -3 mm 2 /s (AUC = 0.815, DOR = 168.6). Finally, intraclass correlation coefficient analysis showed excellent intraobserver and interobserver agreement, ensuring the implementation of histogram analysis into routine clinical practice. CONCLUSION Whole-tumor ADC histogram parameters, particularly kurtosis and skewness, are relevant biomarkers for predicting the nCRT response in LARC. Both parameters appear to be more reliable than ADCmean from one-slice ROI.

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The apparent diffusion coefficient is a useful biomarker in predicting treatment response in patients with locally advanced rectal cancer

Cited by 3 publications

References 42 publications

Local ablation of hepatocellular carcinoma by interstitial brachytherapy: prediction of outcome by diffusion-weighted imaging

Local ablation of hepatocellular carcinoma by interstitial brachytherapy: prediction of outcome by diffusion-weighted imaging

Combination of intravoxel incoherent motion histogram parameters and clinical characteristics for predicting response to neoadjuvant chemoradiation in Rectal Cancer

Whole lesion histogram analysis of apparent diffusion coefficient predicts therapy response in locally advanced rectal cancer

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