|
Early
Detection of Response to Radiation Therapy in Patients With Brain Malignancies
Using Conventional and High b-Value Diffusion-Weighted Magnetic Resonance
Imaging
Mardor
Y, Pfeffer R, Spiegelmann R, Roth Y, Maier SE, Nissim O, Berger R, Glicksman A,
Baram J, Orenstein A, Cohen JS, Tichler T
Advanced
Technology Center, Neurosurgery Department, Oncology Institute, and Plastic
Surgery Department, Sheba Medical Center, Tel-Hashomer, Sackler School of
Medicine and the School of Physics and Astronomy, Tel-Aviv University, Ramat-Aviv,
Israel
Purpose.
To study the feasibility of using diffusion-weighted magnetic resonance imaging
(DWMRI), which is sensitive to the diffusion of water molecules in tissues, for
detection of early tumor response to radiation therapy; and to evaluate the
additional information obtained from high DWMRI, which is more sensitive to
low-mobility water molecules (such as intracellular or bound water), in
increasing the sensitivity to response.
Patients
and Methods.
Standard MRI and DWMRI were acquired before and at regular intervals after
initiating radiation therapy for 10 malignant brain lesions in eight patients.
Results.
One week posttherapy, three of six responding lesions showed an increase in the
conventional DWMRI parameters.
Another three responding lesions showed no change.
Four nonresponding lesions showed a decrease or no change.
The early change in the diffusion parameters was enhanced by using high DWMRI.
When high DWMRI was used, all responding lesions showed increase in the
diffusion parameter and all nonresponding lesions showed no change or decrease.
Response was determined by standard MRI 7 weeks posttherapy.
The changes in the diffusion parameters measured 1 week after initiating
treatment were correlated with later tumor response or no response (P <.006).
This correlation was increased to P <.0006 when high DWMRI was used.
Conclusion.
The significant correlation between changes in diffusion parameters 1 week after
initiating treatment and later tumor response or no response suggests the
feasibility of using DWMRI for early, noninvasive prediction of tumor response.
The ability to predict response may enable early termination of treatment in
nonresponding patients, prevent additional toxicity, and allow for early changes
in treatment.
PMID:
12637476 [PubMed - in process]
Source:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12637476&dopt=Abstract
|
