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Intravoxel incoherent motion as a tool to detect early microstructural changes in meningiomas treated with proton therapy

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Purpose

To assess early microstructural changes of meningiomas treated with proton therapy through quantitative analysis of intravoxel incoherent motion (IVIM) and diffusion-weighted imaging (DWI) parameters.

Methods

Seventeen subjects with meningiomas that were eligible for proton therapy treatment were retrospectively enrolled. Each subject underwent a magnetic resonance imaging (MRI) including DWI sequences and IVIM assessments at baseline, immediately before the 1st (t0), 10th (t10), 20th (t20), and 30th (t30) treatment fraction and at follow-up. Manual tumor contours were drawn on T2-weighted images by two expert neuroradiologists and then rigidly registered to DWI images. Median values of the apparent diffusion coefficient (ADC), true diffusion (D), pseudo-diffusion (D*), and perfusion fraction (f) were extracted at all timepoints. Statistical analysis was performed using the pairwise Wilcoxon test.

Results

Statistically significant differences from baseline to follow-up were found for ADC, D, and D* values, with a progressive increase in ADC and D in conjunction with a progressive decrease in D*. MRI during treatment showed statistically significant differences in D values between t0 and t20 (p = 0.03) and t0 and t30 (p = 0.02), and for ADC values between t0 and t20 (p = 0.04), t10 and t20 (p = 0.02), and t10 and t30 (p = 0.035). Subjects that showed a volume reduction greater than 15% of the baseline tumor size at follow-up showed early D changes, whereas ADC changes were not statistically significant.

Conclusion

IVIM appears to be a useful tool for detecting early microstructural changes within meningiomas treated with proton therapy and may potentially be able to predict tumor response.

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Author information

Author notes

  1. Andrea Franconeri and Simone Sacco contributed equally to this work.

Authors and Affiliations

  1. Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

    Andrea Franconeri, Maria Vittoria Raciti, Alessia Maggi, Shaun Ivan Muzic & Lorenzo Preda

  2. UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA

    Simone Sacco

  3. Diagnostic Imaging Unit, National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy

    Andrea Franconeri, Simone Sacco, Maria Vittoria Raciti, Alessia Maggi, Sara Imparato, Lisa Farina, Ana Bacila & Lorenzo Preda

  4. Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy

    Lisa Farina & Ana Bacila

  5. Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy

    Chiara Paganelli, Giulia Buizza & Guido Baroni

  6. Bioengineering Unit, National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy

    Chiara Paganelli, Giulia Buizza, Giulia Fontana & Guido Baroni

  7. Radiotherapy Unit, National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy

    Giulia Riva, Alberto Iannalfi & Ester Orlandi

  8. Radiology Institute, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi, Pavia, Italy

    Andrea Franconeri, Maria Vittoria Raciti, Alessia Maggi, Shaun Ivan Muzic & Lorenzo Preda

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  1. Andrea Franconeri
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Correspondence to Andrea Franconeri.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Franconeri, A., Sacco, S., Raciti, M.V. et al. Intravoxel incoherent motion as a tool to detect early microstructural changes in meningiomas treated with proton therapy. Neuroradiology 63, 1053–1060 (2021). https://doi.org/10.1007/s00234-020-02630-6

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  • DOI: https://doi.org/10.1007/s00234-020-02630-6

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