Colorectal cancer liver metastases: Apparent diffusion coefficient for prediction of histopathologic response grade after neoadjuvant systemic chemotherapy

2020 ◽  
Author(s):  
M Bode ◽  
A BARABASCH ◽  
C KUHL
Keyword(s):  
Colorectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Liver Metastases ◽  
Systemic Chemotherapy ◽  
Colorectal Cancer Liver Metastases ◽  
Histopathologic Response ◽  
Apparent Diffusion

scholarly journals The role of quantitative diffusion-weighted imaging in characterization of hypovascular liver lesions: A prospective comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247301
Author(s):  
Jelena Djokić Kovač ◽  
Marko Daković ◽  
Aleksandra Janković ◽  
Milica Mitrović ◽  
Vladimir Dugalić ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Liver Metastases ◽  
Diffusion Weighted Imaging ◽  
Intraclass Correlation ◽  
Intravoxel Incoherent Motion ◽  
Liver Lesions ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Apparent Diffusion

Background The utility of intravoxel incoherent motion (IVIM) related parameters in differentiation of hypovascular liver lesions is still unknown. Purpose The purpose of this study was to evaluate the value of IVIM related parameters in comparison to apparent diffusion coefficient (ADC) for differentiation among intrahepatic mass-forming cholangiocarcinoma (IMC), and hypovascular liver metastases (HLM). Methods Seventy-four prospectively enrolled patients (21 IMC, and 53 HLM) underwent 1.5T magnetic resonance examination with IVIM diffusion-weighted imaging using seven b values (0–800 s/mm2). Two independent readers performed quantitative analysis of IVIM-related parameters and ADC. Interobserver reliability was tested using a intraclass correlation coefficient. ADC, true diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and perfusion fraction (ƒ) were compared among the lesions using Kruskal-Wallis H test. The diagnostic accuracy of each parameter was assessed by receiver operating characteristic (ROC) curve analysis. Results The interobserver agreement was good for ADC (0.802), and excellent for D, D*, and ƒ (0.911, 0.927, and 0.942, respectively). ADC, and D values were significantly different among IMC and HLM (both p < 0.05), while there was no significant difference among these lesions for ƒ and D* (p = 0.101, and p = 0.612, respectively). ROC analysis showed higher diagnostic performance of D in comparison to ADC (AUC = 0.879 vs 0.821). Conclusion IVIM-derived parameters in particular D, in addition to ADC, could help in differentiation between most common hypovascular malignant liver lesions, intrahepatic mass—forming cholangiocarcinoma and hypovascular liver metastases.

scholarly journals Updates of colorectal cancer liver metastases therapy: review on DEBIRI

2020 ◽  
Vol 7 (1) ◽  
pp. HEP16 ◽  
Author(s):  
Giammaria Fiorentini ◽  
Donatella Sarti ◽  
Roberto Nani ◽  
Camillo Aliberti ◽  
Caterina Fiorentini ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Systemic Chemotherapy ◽  
Tumor Response ◽  
Public Health Issue ◽  
Advanced Stage ◽  
Stage At Diagnosis ◽  
Colorectal Cancer Liver Metastases ◽  
Safety And Efficacy ◽  
Metastatic Sites

Colorectal cancer is a worldwide public health issue, presenting an advanced stage at diagnosis in more than 20% of patients. Liver metastases are the most common metastatic sites and are not indicated for resection in 80% of cases. Unresectable colorectal cancer liver metastases that are refractory to systemic chemotherapy may benefit from transarterial chembolization with irinotecan-loaded beads (DEBIRI). Several studies show the safety and efficacy of DEBIRI for the treatment of colorectal cancer liver metastases. The development of transarterial chembolization and the introduction of new embolics have contributed to better outcomes of DEBIRI. This article reviews the current literature on DEBIRI reporting its use, efficacy in terms of tumor response and survival and side effects.

scholarly journals Assessment of the percentage of apparent diffusion coefficient value changes as an early indicator of the response of colorectal hepatic metastases to chemotherapy

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Nada Gamal El-Husseiny ◽  
Sayed Mohamed Mehana ◽  
Sherif Farouk El Zawawy
Keyword(s):  
Colorectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Hepatic Metastasis ◽  
Percentage Increase ◽  
Early Assessment ◽  
Response To Chemotherapy ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Adc Values

Abstract Background Colorectal cancer is considered one of the most common causes of cancer-related deaths worldwide. We aim to evaluate the efficacy of DWI-MRI in predicting response to chemotherapy in this cohort. The study included 30 lesions in 20 biopsy proven-colorectal cancer patients with hepatic metastasis larger than 1 cm. All patients underwent both triphasic CT with intravenous contrast, pre-chemotherapy MRI (axial T2 and DW sequences) which was repeated 21 days following chemotherapy. A follow-up CT was done 2 months later. The response of the lesions was evaluated using the RESCIST criteria. On MRI, the lesions corresponding to the ones chosen on CT were identified and the apparent diffusion coefficient (ADC) values of pre- and post-chemotherapy images were recorded and correlated with the CT results. Results In the study, 17 (56.7%) of the lesions showed response to chemotherapy while 13 (43.3%) were non-responding. There was no significant difference in pretreatment ADC values between responding and non-responding lesions (p = 0.14). The mean percentage increase in ADC values in responding lesions was 42% compared to 18% in non-responding lesions (p < 0.001). Lesions that showed less than 18% increase were all found to be non-responsive Conclusion DWI-MRI has an emerging role in early assessment of early treatment response that can be detected before morphological response for patients with hepatic metastasis from colorectal cancer. Based on our study, the use of 25 % as the cutoff point of percent difference in ADC for detection of non-responding lesions proved to be successful only 21 days after the 1st chemotherapy cycle.

scholarly journals Prediction of Early Response to Chemotherapy in Breast Cancer Liver Metastases by Diffusion-Weighted MR Imaging

2019 ◽  
Vol 18 ◽  
pp. 153303381984294 ◽  
Author(s):  
Genji Bai ◽  
Yating Wang ◽  
Yan Zhu ◽  
Lili Guo
Keyword(s):  
Breast Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Liver Metastases ◽  
Early Response ◽  
Apparent Diffusion Coefficient Values ◽  
Apparent Diffusion Coefficient Value ◽  
Response To Chemotherapy ◽  
Apparent Diffusion ◽  
Breast Cancer Liver Metastases

Objective: To determine whether change in apparent diffusion coefficient value could predict early response to chemotherapy in breast cancer liver metastases. Materials and Methods: We retrospectively studied 42 patients (86 lesions) with breast cancer liver metastases who had undergone conventional magnetic resonance imaging and diffusion-weighted imaging (b = 0.700 s/mm2) before and after chemotherapy. Maximum diameter and mean apparent diffusion coefficient value (×10−3 mm2/s) of liver metastases from breast cancer were evaluated. The grouping reference was based on magnetic resonance imaging according to Response Evaluation Criteria in Solid Tumors (RECIST). Analysis of variance and receiver–operating characteristic analyses were performed. Results: Eighty-six metastases were classified as 40 responders and 46 nonresponders. A statistically significant correlation was found between prechemotherapy and postchemotherapy apparent diffusion coefficient values in responders, which were 0.9 ± 0.16 × 10−3 mm2/s, 1.05 ± 0.12 × 10−3 mm2/s, 1.26 ± 0.12 × 10−3 mm2/s, and 1.33 ± 0.87 × 10−3 mm2/s, respectively. No statistically significant difference was found between prechemotherapy and postchemotherapy apparent diffusion coefficient values in nonresponders. Differences were statistically significant between responders and nonresponders at prechemotherapy, 2 weeks after chemotherapy, and 4 weeks after chemotherapy ( P = 0.014, P = .001, and P = .000, respectively). Receiver operating characteristic curves showed that apparent diffusion coefficient values could predict treatment response early at 2 weeks after chemotherapy with 64.5% sensitivity and 91.8% specificity. Conclusion: The change in apparent diffusion coefficient value may be a sensitive indicator to predict early response to chemotherapy in breast cancer liver metastases.

scholarly journals Diagnostic performance of apparent diffusion coefficient values for the differentiation of intrahepatic cholangiocarcinoma from gastrointestinal adenocarcinoma liver metastases

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Temel Fatih Yilmaz ◽  
Mehmet Ali Gultekin ◽  
Hacı Mehmet Turk ◽  
Mehmet Besiroglu ◽  
Dilek Hacer Cesme ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Liver Metastases ◽  
Intrahepatic Cholangiocarcinoma ◽  
Predictive Value ◽  
Gastrointestinal System ◽  
Apparent Diffusion Coefficient Values ◽  
Study Results ◽  
Apparent Diffusion ◽  
Adc Values

Abstract Background We aimed to investigate whether there is a difference between intrahepatic cholangiocarcinoma (IHCC) and liver metastases of gastrointestinal system (GIS) adenocarcinoma in terms of apparent diffusion coefficient (ADC) values. Patients and methods From January 2018 to January 2020, we retrospectively examined 64 consecutive patients with liver metastases due to gastrointestinal system adenocarcinomas and 13 consecutive IHCC in our hospital’s medical records. After exclusions, fifty-three patients with 53 liver metastases and 10 IHCC were included in our study. We divided the patients into two groups as IHCC and liver metastases of GIS adenocarcinoma. For mean apparent diffusion coefficient (ADCmean) values, the region of interests (ROI) was placed in solid portions of the lesions. ADCmean values of groups were compared. Results The mean age of IHCC group was 62.50 ± 13.49 and mean age of metastases group was 61.15 ± 9.18. ADCmean values were significantly higher in the IHCC group compared to the metastatic group (p < 0.001). ROC curves method showed high diagnostic accuracy (AUC = 0.879) with cut-off value of < 1178 x 10-6 mm2/s for ADCmean (Sensitivity = 90.57, Specificity = 70.0, positive predictive value [PPV] = 94.1, negative predictive value [NPV] = 58.3) in differentiating adenocarcinoma metastases from IHCC. Conclusions The present study results suggest that ADC values have a potential role for differentiation between IHCC and GIS adenocarcinoma liver metastases which may be valuable for patient management.

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