Skip to main content
SpringerLink
Log in

Early prediction of anticancer effects with diffusion-weighted MR imaging in patients with colorectal liver metastases following selective internal radiotherapy

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective:

To prospectively evaluate diffusion-weighted imaging (DWI) for early prediction of tumour response in patients with colorectal liver metastases following selective internal radiotherapy (SIRT).

Methods:

We evaluated 41 metastases in 21 patients, age 62.9 ± 9.9 years. All patients underwent magnetic resonance imaging (MRI) including breath-hold echoplanar DWI sequences. Imaging was performed before therapy (baseline MRI), 2 days after SIRT (early MRI) as well as 6 weeks later (follow-up MRI). Tumour volume (TV) and intratumoural apparent diffusion coefficient (ADC) were measured independently by two radiologists at all time points.

Results:

Metastases were categorised as responding lesions (RL; n = 33) or non-responding lesions (NRL; n = 8) according to changes in TV after 6 weeks. We found an inverse correlation of changes in TV and ADC at follow-up MRI with a Pearson’s correlation coefficient of r = −0.66 (p < 0.0001). On early MRI, no significant changes in TV were found for either RL or NRL. Conversely, ADC decreased significantly in RL by 10.7 ± 8.4% (p < 0.0001). ADC increased in NRL by 9.6 ± 20.8%, which was not statistically significant (p = 0.40).

Conclusion:

DWI was capable of predicting therapy effects of SIRT in patients with colorectal hepatic metastases as early as 2 days following treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1a–j
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Welsh JS, Kennedy AS, Thomadsen B (2006) Selective Internal Radiation Therapy (SIRT) for liver metastases secondary to colorectal adenocarcinoma. Int J Radiat Oncol Biol Phys 66:S62–S73

    CAS  PubMed  Google Scholar 

  2. Lewandowski RJ, Thurston KG, Goin JE, Wong CY, Gates VL, Van Buskirk M, Geschwind JF, Salem R (2005) 90Y microsphere (TheraSphere) treatment for unresectable colorectal cancer metastases of the liver: response to treatment at targeted doses of 135–150 Gy as measured by [18F]fluorodeoxyglucose positron emission tomography and computed tomographic imaging. J Vasc Interv Radiol 16:1641–1651

    PubMed  Google Scholar 

  3. Salem R, Lewandowski RJ, Atassi B, Gordon SC, Gates VL, Barakat O, Sergie Z, Wong CY, Thurston KG (2005) Treatment of unresectable hepatocellular carcinoma with use of 90Y microspheres (TheraSphere): safety, tumor response, and survival. J Vasc Interv Radiol 16:1627–1639

    PubMed  Google Scholar 

  4. Van Hazel G, Blackwell A, Anderson J, Price D, Moroz P, Bower G, Cardaci G, Gray B (2004) Randomised phase 2 trial of SIR-Spheres plus fluorouracil/leucovorin chemotherapy versus fluorouracil/leucovorin chemotherapy alone in advanced colorectal cancer. J Surg Oncol 88:78–85

    Article  PubMed  Google Scholar 

  5. Koh DM, Padhani AR (2006) Diffusion-weighted MRI: a new functional clinical technique for tumour imaging. Br J Radiol 79:633–635

    Article  PubMed  Google Scholar 

  6. Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635

    Article  PubMed  Google Scholar 

  7. Chenevert TL, Meyer CR, Moffat BA, Rehemtulla A, Mukherji SK, Gebarski SS, Quint DJ, Robertson PL, Lawrence TS, Junck L, Taylor JM, Johnson TD, Dong Q, Muraszko KM, Brunberg JA, Ross BD (2002) Diffusion MRI: a new strategy for assessment of cancer therapeutic efficacy. Mol Imaging 1:336–343

    Article  PubMed  Google Scholar 

  8. Taouli B, Koh DM (2010) Diffusion-weighted MR imaging of the liver. Radiology 254:47–66

    Article  PubMed  Google Scholar 

  9. Ross BD, Moffat BA, Lawrence TS, Mukherji SK, Gebarski SS, Quint DJ, Johnson TD, Junck L, Robertson PL, Muraszko KM, Dong Q, Meyer CR, Bland PH, McConville P, Geng H, Rehemtulla A, Chenevert TL (2003) Evaluation of cancer therapy using diffusion magnetic resonance imaging. Mol Cancer Ther 2:581–587

    CAS  PubMed  Google Scholar 

  10. Dudeck O, Zeile M, Pink D, Pech M, Tunn PU, Reichardt P, Ludwig WD, Hamm B (2008) Diffusion-weighted magnetic resonance imaging allows monitoring of anticancer treatment effects in patients with soft-tissue sarcomas. J Magn Reson Imaging 27:1109–1113

    Article  PubMed  Google Scholar 

  11. Bruegel M, Holzapfel K, Gaa J, Woertler K, Waldt S, Kiefer B, Stemmer A, Ganter C, Rummeny EJ (2008) Characterization of focal liver lesions by ADC measurements using a respiratory triggered diffusion-weighted single-shot echo-planar MR imaging technique. Eur Radiol 18:477–485

    Article  PubMed  Google Scholar 

  12. Gourtsoyianni S, Papanikolaou N, Yarmenitis S, Maris T, Karantanas A, Gourtsoyiannis N (2008) Respiratory gated diffusion-weighted imaging of the liver: value of apparent diffusion coefficient measurements in the differentiation between most commonly encountered benign and malignant focal liver lesions. Eur Radiol 18:486–492

    Article  PubMed  Google Scholar 

  13. Parikh T, Drew SJ, Lee VS, Wong S, Hecht EM, Babb JS, Taouli B (2008) Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging. Radiology 246:812–822

    Article  PubMed  Google Scholar 

  14. Deng J, Miller FH, Rhee TK, Sato KT, Mulcahy MF, Kulik LM, Salem R, Omary RA, Larson AC (2006) Diffusion-weighted MR imaging for determination of hepatocellular carcinoma response to yttrium-90 radioembolization. J Vasc Interv Radiol 17:1195–1200

    Article  PubMed  Google Scholar 

  15. Kamel IR, Bluemke DA, Ramsey D, Abusedera M, Torbenson M, Eng J, Szarf G, Geschwind JF (2003) Role of diffusion-weighted imaging in estimating tumor necrosis after chemoembolization of hepatocellular carcinoma. AJR Am J Roentgenol 181:708–710

    PubMed  Google Scholar 

  16. Koh DM, Scurr E, Collins DJ, Pirgon A, Kanber B, Karanjia N, Brown G, Leach MO, Husband JE (2006) Colorectal hepatic metastases: quantitative measurements using single-shot echo-planar diffusion-weighted MR imaging. Eur Radiol 16:1898–1905

    Article  CAS  PubMed  Google Scholar 

  17. Marugami N, Tanaka T, Kitano S, Hirohashi S, Nishiofuku H, Takahashi A, Sakaguchi H, Matsuoka M, Otsuji T, Takahama J, Higashiura W, Kichikawa K (2009) Early detection of therapeutic response to hepatic arterial infusion chemotherapy of liver metastases from colorectal cancer using diffusion-weighted MR imaging. Cardiovasc Intervent Radiol 32:638–646

    Article  PubMed  Google Scholar 

  18. Rhee TK, Naik NK, Deng J, Atassi B, Mulcahy MF, Kulik LM, Ryu RK, Miller FH, Larson AC, Salem R, Omary RA (2008) Tumor response after yttrium-90 radioembolization for hepatocellular carcinoma: comparison of diffusion-weighted functional MR imaging with anatomic MR imaging. J Vasc Interv Radiol 19:1180–1186

    Article  PubMed  Google Scholar 

  19. Theilmann RJ, Borders R, Trouard TP, Xia G, Outwater E, Ranger-Moore J, Gillies RJ, Stopeck A (2004) Changes in water mobility measured by diffusion MRI predict response of metastatic breast cancer to chemotherapy. Neoplasia 6:831–837

    Article  PubMed  Google Scholar 

  20. Yuan Z, Ye XD, Dong S, Xu LC, Xu XY, Liu SY, Xiao XS (2009) Role of magnetic resonance diffusion-weighted imaging in evaluating response after chemoembolization of hepatocellular carcinoma. Eur J Radiol. doi:10.1016/j.ejrad.2009.05.040

  21. Koh DM, Scurr E, Collins D, Kanber B, Norman A, Leach MO, Husband JE (2007) Predicting response of colorectal hepatic metastasis: value of pretreatment apparent diffusion coefficients. AJR Am J Roentgenol 188:1001–1008

    Article  PubMed  Google Scholar 

  22. Salem R, Thurston KG, Carr BI, Goin JE, Geschwind JF (2002) Yttrium-90 microspheres: radiation therapy for unresectable liver cancer. J Vasc Interv Radiol 13:S223–S229

    Article  PubMed  Google Scholar 

  23. Moffat BA, Chenevert TL, Lawrence TS, Meyer CR, Johnson TD, Dong Q, Tsien C, Mukherji S, Quint DJ, Gebarski SS, Robertson PL, Junck LR, Rehemtulla A, Ross BD (2005) Functional diffusion map: a noninvasive MRI biomarker for early stratification of clinical brain tumor response. Proc Natl Acad Sci USA 102:5524–5529

    Article  CAS  PubMed  Google Scholar 

  24. Moffat BA, Hall DE, Stojanovska J, McConville PJ, Moody JB, Chenevert TL, Rehemtulla A, Ross BD (2004) Diffusion imaging for evaluation of tumor therapies in preclinical animal models. Magma 17:249–259

    Article  CAS  PubMed  Google Scholar 

  25. Cui Y, Zhang XP, Sun YS, Tang L, Shen L (2008) Apparent diffusion coefficient: potential imaging biomarker for prediction and early detection of response to chemotherapy in hepatic metastases. Radiology 248:894–900

    Article  PubMed  Google Scholar 

  26. Thoeny HC, De Keyzer F, Chen F, Ni Y, Landuyt W, Verbeken EK, Bosmans H, Marchal G, Hermans R (2005) Diffusion-weighted MR imaging in monitoring the effect of a vascular targeting agent on rhabdomyosarcoma in rats. Radiology 234:756–764

    Article  PubMed  Google Scholar 

  27. Thoeny HC, De Keyzer F, Vandecaveye V, Chen F, Sun X, Bosmans H, Hermans R, Verbeken EK, Boesch C, Marchal G, Landuyt W, Ni Y (2005) Effect of vascular targeting agent in rat tumor model: dynamic contrast-enhanced versus diffusion-weighted MR imaging. Radiology 237:492–499

    Article  PubMed  Google Scholar 

  28. Jordan BF, Runquist M, Raghunand N, Baker A, Williams R, Kirkpatrick L, Powis G, Gillies RJ (2005) Dynamic contrast-enhanced and diffusion MRI show rapid and dramatic changes in tumor microenvironment in response to inhibition of HIF-1alpha using PX-478. Neoplasia 7:475–485

    Article  CAS  PubMed  Google Scholar 

  29. van Rijswijk CS, Kunz P, Hogendoorn PC, Taminiau AH, Doornbos J, Bloem JL (2002) Diffusion-weighted MRI in the characterization of soft-tissue tumors. J Magn Reson Imaging 15:302–307

    Article  PubMed  Google Scholar 

  30. Latour LL, Svoboda K, Mitra PP, Sotak CH (1994) Time-dependent diffusion of water in a biological model system. Proc Natl Acad Sci USA 91:1229–1233

    Article  CAS  PubMed  Google Scholar 

  31. Padhani AR, Liu G, Koh DM, Chenevert TL, Thoeny HC, Takahara T, Dzik-Jurasz A, Ross BD, Van Cauteren M, Collins D, Hammoud DA, Rustin GJ, Taouli B, Choyke PL (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany

    Oliver Dudeck, Martin Zeile, Christian Wybranski, Alice Schulmeister, Frank Fischbach, Maciej Pech, Gero Wieners, Ricarda Rühl, Oliver Grosser, Holger Amthauer & Jens Ricke

Authors
  1. Oliver Dudeck
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin Zeile
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christian Wybranski
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alice Schulmeister
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Frank Fischbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maciej Pech
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gero Wieners
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ricarda Rühl
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Oliver Grosser
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Holger Amthauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Jens Ricke
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Oliver Dudeck.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dudeck, O., Zeile, M., Wybranski, C. et al. Early prediction of anticancer effects with diffusion-weighted MR imaging in patients with colorectal liver metastases following selective internal radiotherapy. Eur Radiol 20, 2699–2706 (2010). https://doi.org/10.1007/s00330-010-1846-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-010-1846-z

Keywords

Search

Navigation