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01.11.2010 | Magnetic Resonance

Early prediction of anticancer effects with diffusion-weighted MR imaging in patients with colorectal liver metastases following selective internal radiotherapy

verfasst von: Oliver Dudeck, Martin Zeile, Christian Wybranski, Alice Schulmeister, Frank Fischbach, Maciej Pech, Gero Wieners, Ricarda Rühl, Oliver Grosser, Holger Amthauer, Jens Ricke

Erschienen in: European Radiology | Ausgabe 11/2010

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Abstract

Objective:

To prospectively evaluate diffusion-weighted imaging (DWI) for early prediction of tumour response in patients with colorectal liver metastases following selective internal radiotherapy (SIRT).

Methods:

We evaluated 41 metastases in 21 patients, age 62.9 ± 9.9 years. All patients underwent magnetic resonance imaging (MRI) including breath-hold echoplanar DWI sequences. Imaging was performed before therapy (baseline MRI), 2 days after SIRT (early MRI) as well as 6 weeks later (follow-up MRI). Tumour volume (TV) and intratumoural apparent diffusion coefficient (ADC) were measured independently by two radiologists at all time points.

Results:

Metastases were categorised as responding lesions (RL; n = 33) or non-responding lesions (NRL; n = 8) according to changes in TV after 6 weeks. We found an inverse correlation of changes in TV and ADC at follow-up MRI with a Pearson’s correlation coefficient of r = −0.66 (p < 0.0001). On early MRI, no significant changes in TV were found for either RL or NRL. Conversely, ADC decreased significantly in RL by 10.7 ± 8.4% (p < 0.0001). ADC increased in NRL by 9.6 ± 20.8%, which was not statistically significant (p = 0.40).

Conclusion:

DWI was capable of predicting therapy effects of SIRT in patients with colorectal hepatic metastases as early as 2 days following treatment.

Welsh JS, Kennedy AS, Thomadsen B (2006) Selective Internal Radiation Therapy (SIRT) for liver metastases secondary to colorectal adenocarcinoma. Int J Radiat Oncol Biol Phys 66:S62–S73PubMed

Lewandowski RJ, Thurston KG, Goin JE, Wong CY, Gates VL, Van Buskirk M, Geschwind JF, Salem R (2005) ⁹⁰Y microsphere (TheraSphere) treatment for unresectable colorectal cancer metastases of the liver: response to treatment at targeted doses of 135–150 Gy as measured by [18F]fluorodeoxyglucose positron emission tomography and computed tomographic imaging. J Vasc Interv Radiol 16:1641–1651PubMed

Salem R, Lewandowski RJ, Atassi B, Gordon SC, Gates VL, Barakat O, Sergie Z, Wong CY, Thurston KG (2005) Treatment of unresectable hepatocellular carcinoma with use of ⁹⁰Y microspheres (TheraSphere): safety, tumor response, and survival. J Vasc Interv Radiol 16:1627–1639PubMed

Van Hazel G, Blackwell A, Anderson J, Price D, Moroz P, Bower G, Cardaci G, Gray B (2004) Randomised phase 2 trial of SIR-Spheres plus fluorouracil/leucovorin chemotherapy versus fluorouracil/leucovorin chemotherapy alone in advanced colorectal cancer. J Surg Oncol 88:78–85CrossRefPubMed

Koh DM, Padhani AR (2006) Diffusion-weighted MRI: a new functional clinical technique for tumour imaging. Br J Radiol 79:633–635CrossRefPubMed

Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635CrossRefPubMed

Chenevert TL, Meyer CR, Moffat BA, Rehemtulla A, Mukherji SK, Gebarski SS, Quint DJ, Robertson PL, Lawrence TS, Junck L, Taylor JM, Johnson TD, Dong Q, Muraszko KM, Brunberg JA, Ross BD (2002) Diffusion MRI: a new strategy for assessment of cancer therapeutic efficacy. Mol Imaging 1:336–343CrossRefPubMed

Taouli B, Koh DM (2010) Diffusion-weighted MR imaging of the liver. Radiology 254:47–66CrossRefPubMed

Ross BD, Moffat BA, Lawrence TS, Mukherji SK, Gebarski SS, Quint DJ, Johnson TD, Junck L, Robertson PL, Muraszko KM, Dong Q, Meyer CR, Bland PH, McConville P, Geng H, Rehemtulla A, Chenevert TL (2003) Evaluation of cancer therapy using diffusion magnetic resonance imaging. Mol Cancer Ther 2:581–587PubMed

10.

Dudeck O, Zeile M, Pink D, Pech M, Tunn PU, Reichardt P, Ludwig WD, Hamm B (2008) Diffusion-weighted magnetic resonance imaging allows monitoring of anticancer treatment effects in patients with soft-tissue sarcomas. J Magn Reson Imaging 27:1109–1113CrossRefPubMed

11.

Bruegel M, Holzapfel K, Gaa J, Woertler K, Waldt S, Kiefer B, Stemmer A, Ganter C, Rummeny EJ (2008) Characterization of focal liver lesions by ADC measurements using a respiratory triggered diffusion-weighted single-shot echo-planar MR imaging technique. Eur Radiol 18:477–485CrossRefPubMed

12.

Gourtsoyianni S, Papanikolaou N, Yarmenitis S, Maris T, Karantanas A, Gourtsoyiannis N (2008) Respiratory gated diffusion-weighted imaging of the liver: value of apparent diffusion coefficient measurements in the differentiation between most commonly encountered benign and malignant focal liver lesions. Eur Radiol 18:486–492CrossRefPubMed

13.

Parikh T, Drew SJ, Lee VS, Wong S, Hecht EM, Babb JS, Taouli B (2008) Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging. Radiology 246:812–822CrossRefPubMed

14.

Deng J, Miller FH, Rhee TK, Sato KT, Mulcahy MF, Kulik LM, Salem R, Omary RA, Larson AC (2006) Diffusion-weighted MR imaging for determination of hepatocellular carcinoma response to yttrium-90 radioembolization. J Vasc Interv Radiol 17:1195–1200CrossRefPubMed

15.

Kamel IR, Bluemke DA, Ramsey D, Abusedera M, Torbenson M, Eng J, Szarf G, Geschwind JF (2003) Role of diffusion-weighted imaging in estimating tumor necrosis after chemoembolization of hepatocellular carcinoma. AJR Am J Roentgenol 181:708–710PubMed

16.

Koh DM, Scurr E, Collins DJ, Pirgon A, Kanber B, Karanjia N, Brown G, Leach MO, Husband JE (2006) Colorectal hepatic metastases: quantitative measurements using single-shot echo-planar diffusion-weighted MR imaging. Eur Radiol 16:1898–1905CrossRefPubMed

17.

Marugami N, Tanaka T, Kitano S, Hirohashi S, Nishiofuku H, Takahashi A, Sakaguchi H, Matsuoka M, Otsuji T, Takahama J, Higashiura W, Kichikawa K (2009) Early detection of therapeutic response to hepatic arterial infusion chemotherapy of liver metastases from colorectal cancer using diffusion-weighted MR imaging. Cardiovasc Intervent Radiol 32:638–646CrossRefPubMed

18.

Rhee TK, Naik NK, Deng J, Atassi B, Mulcahy MF, Kulik LM, Ryu RK, Miller FH, Larson AC, Salem R, Omary RA (2008) Tumor response after yttrium-90 radioembolization for hepatocellular carcinoma: comparison of diffusion-weighted functional MR imaging with anatomic MR imaging. J Vasc Interv Radiol 19:1180–1186CrossRefPubMed

19.

Theilmann RJ, Borders R, Trouard TP, Xia G, Outwater E, Ranger-Moore J, Gillies RJ, Stopeck A (2004) Changes in water mobility measured by diffusion MRI predict response of metastatic breast cancer to chemotherapy. Neoplasia 6:831–837CrossRefPubMed

20.

Yuan Z, Ye XD, Dong S, Xu LC, Xu XY, Liu SY, Xiao XS (2009) Role of magnetic resonance diffusion-weighted imaging in evaluating response after chemoembolization of hepatocellular carcinoma. Eur J Radiol. doi:10.1016/j.ejrad.2009.05.040

21.

Koh DM, Scurr E, Collins D, Kanber B, Norman A, Leach MO, Husband JE (2007) Predicting response of colorectal hepatic metastasis: value of pretreatment apparent diffusion coefficients. AJR Am J Roentgenol 188:1001–1008CrossRefPubMed

22.

Salem R, Thurston KG, Carr BI, Goin JE, Geschwind JF (2002) Yttrium-90 microspheres: radiation therapy for unresectable liver cancer. J Vasc Interv Radiol 13:S223–S229CrossRefPubMed

23.

Moffat BA, Chenevert TL, Lawrence TS, Meyer CR, Johnson TD, Dong Q, Tsien C, Mukherji S, Quint DJ, Gebarski SS, Robertson PL, Junck LR, Rehemtulla A, Ross BD (2005) Functional diffusion map: a noninvasive MRI biomarker for early stratification of clinical brain tumor response. Proc Natl Acad Sci USA 102:5524–5529CrossRefPubMed

24.

Moffat BA, Hall DE, Stojanovska J, McConville PJ, Moody JB, Chenevert TL, Rehemtulla A, Ross BD (2004) Diffusion imaging for evaluation of tumor therapies in preclinical animal models. Magma 17:249–259CrossRefPubMed

25.

Cui Y, Zhang XP, Sun YS, Tang L, Shen L (2008) Apparent diffusion coefficient: potential imaging biomarker for prediction and early detection of response to chemotherapy in hepatic metastases. Radiology 248:894–900CrossRefPubMed

26.

Thoeny HC, De Keyzer F, Chen F, Ni Y, Landuyt W, Verbeken EK, Bosmans H, Marchal G, Hermans R (2005) Diffusion-weighted MR imaging in monitoring the effect of a vascular targeting agent on rhabdomyosarcoma in rats. Radiology 234:756–764CrossRefPubMed

27.

Thoeny HC, De Keyzer F, Vandecaveye V, Chen F, Sun X, Bosmans H, Hermans R, Verbeken EK, Boesch C, Marchal G, Landuyt W, Ni Y (2005) Effect of vascular targeting agent in rat tumor model: dynamic contrast-enhanced versus diffusion-weighted MR imaging. Radiology 237:492–499CrossRefPubMed

28.

Jordan BF, Runquist M, Raghunand N, Baker A, Williams R, Kirkpatrick L, Powis G, Gillies RJ (2005) Dynamic contrast-enhanced and diffusion MRI show rapid and dramatic changes in tumor microenvironment in response to inhibition of HIF-1alpha using PX-478. Neoplasia 7:475–485CrossRefPubMed

29.

van Rijswijk CS, Kunz P, Hogendoorn PC, Taminiau AH, Doornbos J, Bloem JL (2002) Diffusion-weighted MRI in the characterization of soft-tissue tumors. J Magn Reson Imaging 15:302–307CrossRefPubMed

30.

Latour LL, Svoboda K, Mitra PP, Sotak CH (1994) Time-dependent diffusion of water in a biological model system. Proc Natl Acad Sci USA 91:1229–1233CrossRefPubMed

31.

Padhani AR, Liu G, Koh DM, Chenevert TL, Thoeny HC, Takahara T, Dzik-Jurasz A, Ross BD, Van Cauteren M, Collins D, Hammoud DA, Rustin GJ, Taouli B, Choyke PL (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125PubMed

Titel: Early prediction of anticancer effects with diffusion-weighted MR imaging in patients with colorectal liver metastases following selective internal radiotherapy
verfasst von: Oliver Dudeck
Martin Zeile
Christian Wybranski
Alice Schulmeister
Frank Fischbach
Maciej Pech
Gero Wieners
Ricarda Rühl
Oliver Grosser
Holger Amthauer
Jens Ricke
Publikationsdatum: 01.11.2010
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 11/2010
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-010-1846-z

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Early prediction of anticancer effects with diffusion-weighted MR imaging in patients with colorectal liver metastases following selective internal radiotherapy