期刊
EUROPEAN RADIOLOGY
卷 26, 期 5, 页码 1412-1419出版社
SPRINGER
DOI: 10.1007/s00330-015-3933-7
关键词
Diffusion magnetic resonance imaging; Cancer; Analysis, regression; Vascular endothelial growth factor; Magnetic resonance imaging, functional
资金
- AstraZeneca
- Cancer Research UK [16464] Funding Source: researchfish
- Engineering and Physical Sciences Research Council [GR/T20427/01] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10162] Funding Source: researchfish
To assess the utility of diffusion weighted imaging for monitoring early treatment effects associated with a VEGF inhibitor. Twenty-nine patients with metastatic abdominal and pelvic tumours were recruited and imaged with DW-MRI: twice at baseline, and after 7 and 28 days of treatment with cediranib. Tumour measures were derived using mono-exponential, bi-exponential and stretched-exponential models, and parameter repeatability and treatment effects seen after 7 and 28 days were assessed. Correlations with volume changes and DCE-MRI metrics were also assessed. Diffusion coefficient repeatabilities from all models were < 6 %; f and D* (bi-exponential) were 22 % and 44 %; alpha (stretched-exponential) was 4.2 %. Significant increases in the diffusion coefficients from all models were observed at day 28 but not day 7. Significant decreases in D* and f.D* were observed at day 7 and in f at day 28; significant increases in alpha were observed at both time-points. Weak correlations between DW-MRI changes and volume changes and DCE-MRI changes were observed. DW-MRI is sensitive to early and late treatment changes caused by a VEGF inhibitor using non-mono-exponential models. Evidence of over-fitting using the bi-exponential model suggests that the stretched-exponential model is best suited to monitor such changes. aEuro cent Non-mono-exponential diffusion models widen sensitivity to a broader class of tissue properties. aEuro cent A stretched-exponential model robustly detects changes after 7 days of VEGF-inhibitor treatment. aEuro cent There are very weak correlations between DWI-IVIM perfusion and similar DCE-MRI measures. aEuro cent Diffusion-weighted MRI is a highly informative technique for assessing novel tumour therapies.
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