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Diffusion-weighted magnetic resonance imaging in the prediction and assessment of chemotherapy outcome in liver metastases

  • Magnetic Resonance Imaging
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La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

This study assessed the capability of magnetic resonance (MR) diffusion-weighted imaging (DwI) with measurement of apparent diffusion coefficient (ADC) in both predicting and evaluating the response to chemotherapy (CHT) of liver metastases by itself and along with preliminary dimensional assessment.

Methods and materials

Patients affected by liver metastases from cancers of the digestive tract and breast were prospectively enrolled and underwent computed tomography and MR-DwI before CHT (time 0) and 20–25 days after the beginning of the second cycle (time 3). Moreover, MR-DwI was performed 10–15 (time 1) and 20–25 days (time 2) after the beginning of the first cycle. Maximum diameter and mean ADC value (×10−3 mm2/s) of metastases were evaluated. Lesions were classified as progressive disease (PD), stable disease (SD) or partial response (PR) according to dimensional changes between time 0 and time 3, following RECIST 1.1 indications. Clinically, PD lesions were defined as nonresponding (NR), and SD and PR lesions as responding (R). Analysis of variance and ROC analyses were performed (significance at p < 0.05).

Results

Eighty-six metastases (33 patients) were classified as follows: 15 PD, 39 SD and 32 PR without significant differences in mean ADC values among the groups before CHT and at all corresponding times. The mean ADC values of SD and PR groups at times 1 (respectively 1.66 ± 0.36 and 1.59 ± 0.23), 2 (1.72 ± 0.42 and 1.68 ± 0.37) and 3 (1.86 ± 0.44 and 1.73 ± 0.39) were significantly higher than the corresponding values at time 0 (1.50 ± 0.30 and 1.39 ± 0.33). An accurate cutoff value of ADC increase or diameter decrease for the early identification of R or NR lesions was not found.

Conclusion

The pretreatment ADC value of a liver metastasis does not seem useful in predicting the CHT outcome. A trend towards early ADC increase, alone or occurring with dimensional decrease, may be a good indicator of a responding lesion.

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Acknowledgments

This work was funded by SIRM (Società Italiana Radiologia Medica).

Conflict of interest

Francesco Mungai, Filippo Pasquinelli, Lorenzo Nicola Mazzoni, Gianni Virgili, Alfonso Ragozzino, Emilio Quaia, Giovanni Morana, Andrea Giovagnoni, Luigi Grazioli and Stefano Colagrande declare no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Experimental and Clinical Biomedical Sciences, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Francesco Mungai & Stefano Colagrande

  2. Department of Radiology, Ospedale Santa Maria Nuova, Florence, Italy

    Filippo Pasquinelli

  3. Health Physics Section, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Lorenzo Nicola Mazzoni

  4. Department of Translational Medicine and Surgery, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Gianni Virgili

  5. Section of Radiodiagnostics, Ospedale SM Grazie, Pozzuoli, Naples, Italy

    Alfonso Ragozzino

  6. Department of Radiology, Cattinara Hospital, Trieste, Italy

    Emilio Quaia

  7. Department of Diagnostic Radiology, Ospedale Cà Foncello, Treviso, Italy

    Giovanni Morana

  8. Department of Radiology, University Politecnica delle Marche, Ancona, Italy

    Andrea Giovagnoni

  9. Department of Radiology, Spedali Civili, Brescia, Italy

    Luigi Grazioli

  10. Dipartimento di Scienze Biomediche Sperimentali e Cliniche, Struttura Complessa di Radiodiagnostica (SOD 2), Università di Firenze, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy

    Stefano Colagrande

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  1. Francesco Mungai
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  2. Filippo Pasquinelli
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  3. Lorenzo Nicola Mazzoni
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  4. Gianni Virgili
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  5. Alfonso Ragozzino
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  6. Emilio Quaia
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  7. Giovanni Morana
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  8. Andrea Giovagnoni
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  9. Luigi Grazioli
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  10. Stefano Colagrande
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Corresponding author

Correspondence to Stefano Colagrande.

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Mungai, F., Pasquinelli, F., Mazzoni, L.N. et al. Diffusion-weighted magnetic resonance imaging in the prediction and assessment of chemotherapy outcome in liver metastases. Radiol med 119, 625–633 (2014). https://doi.org/10.1007/s11547-013-0379-3

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  • DOI: https://doi.org/10.1007/s11547-013-0379-3

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