Diffusion-weighted MR imaging in liver metastases of colorectal cancer: reproducibility and biological validation
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Before diffusion-weighted imaging (DWI) can be implemented in standard clinical practice for response monitoring, data on reproducibility are needed to assess which differences outside the range of normal variation can be detected in an individual patient. In this study we assessed the reproducibility of the apparent diffusion coefficient (ADC) values in colorectal liver metastases. To provide a biological basis for these values, their relation with histopathology was assessed.
DWI was performed twice in 1 week in patients scheduled for metastasectomy of colorectal liver metastases. Correlation between ADC values and apoptosis marker p53, anti-apoptotic protein BCL-2, proliferation marker Ki67 and serum vascular endothelial growth factor (VEGF) concentration were assessed.
A good reproducibility coefficient of the mean ADC (coefficient of reproducibility 0.20 × 10−3 mm2/s) was observed in colorectal liver metastases (n = 21). The ADC value was related to the proliferation index and BCL-2 expression of the metastases. Furthermore, in metastases recently treated with systemic therapy, the ADC was significantly higher (1.27 × 10−3 mm2/s vs 1.05 × 10−3 mm2/s, P = 0.02).
The good reproducibility, correlation with histopathology and implied sensitivity for systemic treatment-induced anti-tumour effects suggest that DWI might be an excellent tool to monitor response in metastatic colorectal cancer.
• ADC values are becoming important oncological biomarkers
• DWI provides reproducibile ADC values in colorectal liver metastases
• The coefficient of reproducibility of the mean ADC is 0.20 × 10 −3 mm 2 /s
• ADC values correlate with proliferation index and are related to BCL-2 expression
- Diffusion-weighted MR imaging in liver metastases of colorectal cancer: reproducibility and biological validation
Volume 23, Issue 3 , pp 748-756
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- Diffusion weighted magnetic resonance imaging
- Liver metastases
- Histopathological validation
- Response monitoring
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- Author Affiliations
- 1. Department of Medical Oncology 452, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
- 2. Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- 4. Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- 5. Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- 7. Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- 3. Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- 6. Department of Laboratory Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands