scholarly journals Assessing Response to Radiation Therapy Treatment of Bone Metastases: Short-Term Followup of Radiation Therapy Treatment of Bone Metastases with Diffusion-Weighted Magnetic Resonance Imaging

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Salvatore Cappabianca ◽  
Raffaella Capasso ◽  
Fabrizio Urraro ◽  
Andrea Izzo ◽  
Antonio Raucci ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Radiation Therapy ◽  
Magnetic Resonance ◽  
Bone Metastases ◽  
Residual Tumor ◽  
Response To Therapy ◽  
Resonance Imaging ◽  
Diffusion Weighted ◽  
Magnetic Resonance Imaging Mri ◽  
Therapy Treatment

This study examined the usefulness of diffusion-weighted (DW) Magnetic Resonance Imaging (MRI) in monitoring bone metastases response to radiation therapy in 15 oligometastatic patients. For each metastasis, both mean apparent diffusion coefficient (ADC) changes and high b-value DW metastasis/muscle signal intensity ratio (SIR) variations were evaluated at 30 ± 5 days and 60 ± 7 days after the end of treatment. On baseline DW-MRI, all bone metastases were hyperintense and had signal intensities higher than normal bone marrow on calculated ADC maps. At follow-up evaluations, 4 patterns of response were identified: (I) decreased high b-value DW SIR associated with increased mean ADC (83.3% of cases); (II) increased mean ADC with no change of high b-value DW SIR (10% of cases); (III) decreased both high b-value DW SIR and mean ADC (3.3% of cases); (IV) a reduction in mean ADC associated with an increase in high b-value DW SIR compared to pretreatment values (3.3% of cases). Patterns (I) and (II) suggested a good response to therapy; pattern (III) was classified as indeterminate, while pattern (IV) was suggestive of disease progression. This pattern approach may represent a useful tool in the differentiation between treatment-induced necrosis and highly cellular residual tumor.

scholarly journals Diffusion-weighted magnetic resonance imaging in cystic renal masses

2017 ◽  
Vol 11 (1-2) ◽  
pp. 8 ◽  
Author(s):  
Fikret Balyemez ◽  
Ahmet Aslan ◽  
Ibrahim Inan ◽  
Ercan Ayaz ◽  
Vildan Karagöz ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Renal Cysts ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Renal Masses ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Magnetic Resonance Imaging Mri

Introduction: We aimed to introduce the diagnostic value of diffusion-weighted (DWI) magnetic resonance imaging (MRI) for distinguishing benign and malignant renal cystic masses.Methods: Abdominal DWI-MRIs of patients with Bosniak categories 2F, 3, and 4 cystic renal masses were evaluated retrospectively. Cystic masses were assigned as benign or malignant according to histopathological or followup MRI findings and compared with apparent diffusion coefficient (ADC) values.Results: There were 30 patients (18 males and 12 females, mean age was 59.23 ± 12.08 years [range 38‒83 years]) with cystic renal masses (eight Bosniak category 2F, 12 Bosniak category 3, 10 Bosniak category 4). Among them, 14 cysts were diagnosed as benign and 16 as malignant by followup imaging or histopathological findings. For the malignant lesions, the mean ADC values were lower than for benign lesions (p=0.001). An ADC value of ≤2.28 x10-6 mm2/s or less had a sensitivity of 75% and a specificity of 92.86% for detecting malignancy.Conclusions: ADC can improve the diagnostic performance of MRI in the evaluation of complex renal cysts when used together with conventional MRI sequences.

scholarly journals NIMG-33. CHANGES IN MAGNETIC RESONANCE IMAGING AFTER PROTON BOOST THERAPY FOR GLIOBLASTOMA WITH AND WITHOUT TUMOR TREATING FIELDS THERAPY

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii155-ii155
Author(s):  
Hanna Goett ◽  
Alexandra Jensen ◽  
Tobias Struffert ◽  
Eberhard Uhl ◽  
Marco Stein
Keyword(s):  
Magnetic Resonance Imaging ◽  
Radiation Therapy ◽  
Magnetic Resonance ◽  
Contrast Enhancement ◽  
Median Overall Survival ◽  
Progressive Disease ◽  
Tumor Resection ◽  
Resonance Imaging ◽  
Tumor Treating Fields ◽  
Magnetic Resonance Imaging Mri

Abstract BACKGROUND Tumor treating fields (TTFields) are an approved glioblastoma (GBM) treatment modality that demonstrated a significant improved median overall survival in newly diagnosed GBM patients. Data about morphologic changes in serial magnetic resonance imaging (MRI) for patients with a combination therapy of TTFields and proton boost therapy does not exist. METHODS Twenty-two patients were included in this study. All patients were treated with initial tumor resection followed by combined chemo- and radiation therapy. Radiation therapy was performed with 50.0 Gy photons and a proton boost with 10 Gy equivalent (Gy(RBE)). 11 patients were additionally treated with TTFields. RESULTS A new increase in contrast enhancement and/or a progress in the T2 FLAIR hyperintensity was observed in 54.5% (N=12) at 3 months and in 31.8% (N=7) at 6 months. No differences were observed between patients with and without TTFields therapy at 3 months [63.6% (N=7) vs. 45.5% (N=5); P=0.392] and at 6 months [27.3 (N=3) vs. 36.3% (N=4); P=0.647). By the RANO criteria a progressive disease (PD) was observed in 6 patients (27.3%) at 3 months and in 7 patients (31.8%) at 6 months. Pseudoprogression (PP) was observed in in 36.4% (N=8) at months and in 27.3% (N=6) at 6 months. Neither for PD at 3 months [36.4% (N=4) vs. 18.2% (N=2); P=0.338] or at 6 months [36.4% (N=4) vs. 27.3% (N=3); P=0.647), nor for PP at 3 months [45.5% (N=5) vs. 27.2% (N=3); P=0.375] or at 6 months [18.2% (N=2) vs. 36.4% (N=4); P=0.338] differences for patients with and without TTFields therapy were found. CONCLUSION Increased contrast enhancement and/or increased T2 FLAIR MRI hyperintensity after proton boost therapy are common. Furthermore, the rates for new contrast enhancement, PD, and PP after photon therapy with and without additional TTFields therapy are comparable.

Management of Malignant Pineal Germ Cell Tumors with Residual Mature Teratoma

Neurosurgery ◽  
2001 ◽  
Vol 48 (3) ◽  
pp. 518-523 ◽  
Author(s):  
Jonathan A. Friedman ◽  
James J. Lynch ◽  
Jan C. Buckner ◽  
Bernd W. Scheithauer ◽  
Corey Raffel
Keyword(s):  
Magnetic Resonance Imaging ◽  
Radiation Therapy ◽  
Magnetic Resonance ◽  
Germ Cell ◽  
Neoadjuvant Therapy ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Response To Therapy ◽  
External Beam Radiation ◽  
Resonance Imaging

Abstract OBJECTIVE The treatment of intracranial mixed germ cell tumors presents a unique challenge, since eradication of malignant tumor by radiation and/or chemotherapy may spare the benign tumor component. We reviewed our surgical experience with residual malignant pineal germ cell tumors after neoadjuvant therapy. METHODS Between 1987 and 1997, 16 patients with malignant intracranial germ cell tumors were treated at the Mayo Clinic with a protocol of neoadjuvant chemotherapy and radiation therapy. After the diagnosis was confirmed by histopathological examination, all patients were treated with four cycles of etoposide and cisplatin as well as external beam radiation therapy (range, 3030–5940 cGy). Six patients had an incomplete response to therapy, as demonstrated by observation of residual tumor on magnetic resonance imaging scans. Initial pathology in these six patients was germinoma in four and combinations of yolk sac tumor, embryonal carcinoma, malignant teratoma, and germinoma in two. Two patients had synchronous pineal and suprasellar tumors, with leptomeningeal dissemination. Tumor markers were elevated in four of the six patients at presentation. RESULTS All patients with residual pineal tumors underwent surgical resection via an infratentorial, supracerebellar approach. Pathological examination revealed mature teratoma in five patients and amorphous debris in one patient. No patient had recurrent malignancy. Significant neurological morbidity occurred in one patient, with no mortality. At a mean follow-up of 23 months, no recurrence on magnetic resonance imaging has been documented. CONCLUSION Residual pineal tumor occurring after treatment of malignant intracranial germ cell tumor with neoadjuvant therapy is likely to be mature teratoma. Operative resection of these benign recurrences is safe and effective.

scholarly journals Magnetic Resonance Imaging of Rectal Cancer

2019 ◽  
Vol 02 (01) ◽  
pp. 018-032
Author(s):  
Ekta Maheshwari ◽  
Gitanjali Bajaj ◽  
Kedar Jambhekar ◽  
Tarun Pandey ◽  
Roopa Ram
Keyword(s):  
Magnetic Resonance Imaging ◽  
Rectal Cancer ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Imaging Techniques ◽  
Postoperative Recurrence ◽  
Response To Therapy ◽  
Resonance Imaging ◽  
Primary Rectal Cancer ◽  
Magnetic Resonance Imaging Mri

AbstractHigh-resolution magnetic resonance imaging (MRI) plays a pivotal role in the pretreatment assessment of primary rectal cancer. The success of this technique depends on obtaining good-quality high-resolution T2-weighted images of the primary tumor, orthogonal to rectal lumen. The goal of magnetic resonance staging is to identify patients who will benefit from neoadjuvant therapy prior to surgery to minimize postoperative recurrence and planning of optimal surgical approach. MRI also facilitates optimal identification of important prognostic factors, which improves both treatment selection and posttreatment follow-up. The objective of this article is to review the existing literature and provide a concise update on various aspects of rectal cancer imaging, discuss the current role of advanced imaging techniques such as diffusion-weighted and perfusion imaging in the evaluation of rectal cancer, and to assess response to therapy.

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