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Diffusion-weighted magnetic resonance imaging for tumour response assessment: why, when and how?

Afaq A, Andreou A, Koh DM - Cancer Imaging (2010)

Bottom Line: The technique is quick to perform without the need for administration of exogenous contrast medium, and enables the apparent diffusion coefficient (ADC) of tissues to be quantified.Studies have shown that ADC increases in response to a variety of treatments including chemotherapy, radiotherapy, minimally invasive therapies and novel therapeutics.In this article, we review the rationale of applying DWI for tumour assessment, the evidence for ADC measurements in relation to specific treatments and some of the practical considerations for using ADC to evaluate treatment response.

View Article: PubMed Central - PubMed

Affiliation: Royal Marsden Hospital, Downs Road, Sutton, UK.

ABSTRACT
Diffusion-weighted magnetic resonance imaging (DWI) is increasingly being used to assess tumour response to a variety of anticancer treatments. The technique is quick to perform without the need for administration of exogenous contrast medium, and enables the apparent diffusion coefficient (ADC) of tissues to be quantified. Studies have shown that ADC increases in response to a variety of treatments including chemotherapy, radiotherapy, minimally invasive therapies and novel therapeutics. In this article, we review the rationale of applying DWI for tumour assessment, the evidence for ADC measurements in relation to specific treatments and some of the practical considerations for using ADC to evaluate treatment response.

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Related in: MedlinePlus

Schematic diagram showing ADC changes with anticancer treatment. Graphs show frequency plots of ADC values in tumours before (solid black line) and after (dotted black line) therapy. Inserts depict a cluster of tumour cells, which demonstrate cellular lysis and apoptosis following treatment, thus increasing the mobility of water protons in that microenvironment. Note that successful therapy results in a shift of the ADC frequency plot (dotted line) towards the right as a result of increasing ADC values.
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Figure 1: Schematic diagram showing ADC changes with anticancer treatment. Graphs show frequency plots of ADC values in tumours before (solid black line) and after (dotted black line) therapy. Inserts depict a cluster of tumour cells, which demonstrate cellular lysis and apoptosis following treatment, thus increasing the mobility of water protons in that microenvironment. Note that successful therapy results in a shift of the ADC frequency plot (dotted line) towards the right as a result of increasing ADC values.

Mentions: When tumours are treated by a range of anticancer therapies (e.g. chemotherapy, radiotherapy, radiofrequency ablation, cryoablation, embolization and targeted novel therapies), treatment-induced cell death by apoptosis, necrosis and cell lysis will lead to an increase in the mobility of water in the tissue microenvironment. This increase in water diffusion translates to an increase in the measured tissue ADC (Fig. 1). Thus, by quantifying tumour ADC before and after anticancer therapies, tumour response or lack of response to treatment can be determined. Studies in animals and humans in a variety of tumour types have shown that successful anticancer therapy results in an increase in the measured tumour ADC. ADC increase in tumour tissues after treatment has been shown to correlate with pathological changes including necrosis and apoptosis[14].Figure 1


Diffusion-weighted magnetic resonance imaging for tumour response assessment: why, when and how?

Afaq A, Andreou A, Koh DM - Cancer Imaging (2010)

Schematic diagram showing ADC changes with anticancer treatment. Graphs show frequency plots of ADC values in tumours before (solid black line) and after (dotted black line) therapy. Inserts depict a cluster of tumour cells, which demonstrate cellular lysis and apoptosis following treatment, thus increasing the mobility of water protons in that microenvironment. Note that successful therapy results in a shift of the ADC frequency plot (dotted line) towards the right as a result of increasing ADC values.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2967137&req=5

Figure 1: Schematic diagram showing ADC changes with anticancer treatment. Graphs show frequency plots of ADC values in tumours before (solid black line) and after (dotted black line) therapy. Inserts depict a cluster of tumour cells, which demonstrate cellular lysis and apoptosis following treatment, thus increasing the mobility of water protons in that microenvironment. Note that successful therapy results in a shift of the ADC frequency plot (dotted line) towards the right as a result of increasing ADC values.
Mentions: When tumours are treated by a range of anticancer therapies (e.g. chemotherapy, radiotherapy, radiofrequency ablation, cryoablation, embolization and targeted novel therapies), treatment-induced cell death by apoptosis, necrosis and cell lysis will lead to an increase in the mobility of water in the tissue microenvironment. This increase in water diffusion translates to an increase in the measured tissue ADC (Fig. 1). Thus, by quantifying tumour ADC before and after anticancer therapies, tumour response or lack of response to treatment can be determined. Studies in animals and humans in a variety of tumour types have shown that successful anticancer therapy results in an increase in the measured tumour ADC. ADC increase in tumour tissues after treatment has been shown to correlate with pathological changes including necrosis and apoptosis[14].Figure 1

Bottom Line: The technique is quick to perform without the need for administration of exogenous contrast medium, and enables the apparent diffusion coefficient (ADC) of tissues to be quantified.Studies have shown that ADC increases in response to a variety of treatments including chemotherapy, radiotherapy, minimally invasive therapies and novel therapeutics.In this article, we review the rationale of applying DWI for tumour assessment, the evidence for ADC measurements in relation to specific treatments and some of the practical considerations for using ADC to evaluate treatment response.

View Article: PubMed Central - PubMed

Affiliation: Royal Marsden Hospital, Downs Road, Sutton, UK.

ABSTRACT
Diffusion-weighted magnetic resonance imaging (DWI) is increasingly being used to assess tumour response to a variety of anticancer treatments. The technique is quick to perform without the need for administration of exogenous contrast medium, and enables the apparent diffusion coefficient (ADC) of tissues to be quantified. Studies have shown that ADC increases in response to a variety of treatments including chemotherapy, radiotherapy, minimally invasive therapies and novel therapeutics. In this article, we review the rationale of applying DWI for tumour assessment, the evidence for ADC measurements in relation to specific treatments and some of the practical considerations for using ADC to evaluate treatment response.

Show MeSH
Related in: MedlinePlus