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07.06.2016 | Magnetic Resonance

Diffusion-weighted magnetic resonance imaging predicts survival in patients with liver-predominant metastatic colorectal cancer shortly after selective internal radiation therapy

verfasst von: Frederic Carsten Schmeel, Birgit Simon, Amir Sabet, Julian Alexander Luetkens, Frank Träber, Leonard Christopher Schmeel, Samer Ezziddin, Hans Heinz Schild, Dariusch Reza Hadizadeh

Erschienen in: European Radiology | Ausgabe 3/2017

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Abstract

Objectives

To investigate whether quantifications of apparent diffusion coefficient (ADC) on diffusion-weighted imaging (DWI) can predict overall survival (OS) in patients with liver-predominant metastatic colorectal cancer (CRC) following selective internal radiation therapy with ⁹⁰Yttrium-microspheres (SIRT).

Methods

Forty-four patients underwent DWI 19 ± 16 days before and 36 ± 10 days after SIRT. Tumour-size and intratumoral minimal ADC (minADC) values were measured for 132 liver metastases on baseline and follow-up DWI. Optimal functional imaging response to treatment was determined by receiver operating characteristics and defined as ≥22 % increase in post-therapeutic minADC. Survival analysis was performed with the Kaplan-Meier method and Cox-regression comparing various variables with potential impact on OS.

Results

Median OS was 8 months. The following parameters were significantly associated with median OS: optimal functional imaging response (18 vs. 5 months; p < 0.001), hepatic tumour burden <50 % (8 vs. 5 months; p = 0.018), Eastern Cooperative Oncology Group performance scale <1 (10 vs. 4 months; p = 0.012) and progressive disease according to Response and Evaluation Criteria in Solid Tumours (8 vs. 3 months; p = 0.001). On multivariate analysis, optimal functional imaging response and hepatic tumour burden remained independent predictors of OS.

Conclusion

Functional imaging response assessment using minADC changes on DWI may predict survival in CRC shortly after SIRT.

Key points

• Relative minADC changes may predict survival in liver-predominant metastatic colorectal cancer following SIRT

• Intratumoral minADC changes by ≥22 % were best to predict an improved overall survival

• Functional imaging response assessment is feasible before anatomic tumour-size changes occur

• minADC changes might guide future therapy management in sequential lobar radioembolization approaches

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Titel: Diffusion-weighted magnetic resonance imaging predicts survival in patients with liver-predominant metastatic colorectal cancer shortly after selective internal radiation therapy
verfasst von: Frederic Carsten Schmeel
Birgit Simon
Amir Sabet
Julian Alexander Luetkens
Frank Träber
Leonard Christopher Schmeel
Samer Ezziddin
Hans Heinz Schild
Dariusch Reza Hadizadeh
Publikationsdatum: 07.06.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 3/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4430-3

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Diffusion-weighted magnetic resonance imaging predicts survival in patients with liver-predominant metastatic colorectal cancer shortly after selective internal radiation therapy

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Objectives

Methods

Results

Conclusion

Key points

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