scholarly journals Analysis of the early response to chemotherapy in lung cancer using apparent diffusion coefficient single-slice histogram

2018 ◽  
Vol 17 (4) ◽  
pp. 681 ◽  
Author(s):  
Jianxing Xu ◽  
Jiangang Zheng ◽  
Zhengyang Zhou ◽  
Xiao Han
2019 ◽  
Vol 18 ◽  
pp. 153303381984294 ◽  
Author(s):  
Genji Bai ◽  
Yating Wang ◽  
Yan Zhu ◽  
Lili Guo

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sebastian Johannes Müller ◽  
Eya Khadhraoui ◽  
Nicole E. Neef ◽  
Christian Heiner Riedel ◽  
Marielle Ernst

Abstract Background Brain metastases are particularly common in patients with small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), with NSCLC showing a less  aggressive clinical course and lower chemo- and radio sensitivity compared to SCLC. Early adequate therapy is highly desirable and depends on a reliable classification of tumor type. The apparent diffusion coefficient is a noninvasive neuroimaging marker with the potential to differentiate between major histological subtypes. Here we determine the sensitivity and specificity of the apparent diffusion coefficient to distinguish between NSCLC and SCLC. Methods We enrolled all NSCLC and SCLC patients diagnosed between 2008 and 2019 at the University Medical Center Göttingen. Cranial MR scans were visually inspected for brain metastases and the ratio of the apparent diffusion coefficient (ADC) was calculated by dividing the ADC measured within the solid part of a metastasis by a reference ADC extracted from an equivalent region in unaffected tissue on the contralateral hemisphere. Results Out of 411 enrolled patients, we detected 129 patients (83 NSCLC, 46 SCLC) with sufficiently large brain metastases with histologically classified lung cancer and no hemorrhage. We analyzed 185 brain metastases, 84 of SCLC and 101 of NSCLC. SCLC brain metastases showed an ADC ratio of 0.68 ± 0.12 SD, and NSCLC brain metastases showed an ADC ratio of 1.47 ± 0.31 SD. Receiver operating curve statistics differentiated brain metastases of NSCLC from SCLC with an area under the curve of 0.99 and a 95% CI of 0.98 to 1, p < 0.001. Youden's J cut-point is 0.97 at a sensitivity of 0.989 and a specificity of 0.988. Conclusions In patients with lung cancer and brain metastases with solid tumor parts, ADC ratio enables an ad hoc differentiation of SCLC and NSCLC, easily achieved during routine neuroradiological examination. Non-invasive MR imaging enables an early-individualized management of brain metastases from lung cancer. Trial registration: The study was registered in the German Clinical Trials Register (DRKS00023016).


2021 ◽  
pp. 197140092110490
Author(s):  
Mustafa Bozdağ ◽  
Ali Er ◽  
Sümeyye Ekmekçi

Purpose A fast, reliable and non-invasive method is required in differentiating brain metastases (BMs) originating from lung cancer (LC) and breast cancer (BC). The aims of this study were to assess the role of histogram analysis of apparent diffusion coefficient (ADC) maps in differentiating BMs originated from LC and BC, and then to investigate further the association of ADC histogram parameters with Ki-67 index in BMs. Methods A total of 55 patients (LC, N = 40; BC, N = 15) with BMs histopathologically confirmed were enrolled in the study. The LC group was divided into small-cell lung cancer (SCLC; N = 15) and non-small-cell lung cancer (NSCLC; N = 25) groups. ADC histogram parameters (ADCmax, ADCmean, ADCmin, ADCmedian, ADC10, ADC25, ADC75 and ADC90, skewness, kurtosis and entropy) were derived from ADC maps. Mann–Whitney U-test, independent samples t-test, receiver operating characteristic (ROC) analysis and Spearman correlation analysis were used for statistical assessment. Results ADC histogram parameters did not show significant differences between LC and BC groups ( p > 0.05). Subgroup analysis showed that various ADC histogram parameters were found to be statistically lower in the SCLC group compared to the NSCLC and BC groups ( p < 0.05). ROC analysis showed that ADCmean and ADC10 for differentiating SCLC BMs from NSCLC, and ADC25 for differentiating SCLC BMs from BC achieved optimal diagnostic performances. Various histogram parameters were found to be significantly correlated with Ki-67 ( p < 0.05). Conclusion Histogram analysis of ADC maps may reflect tumoural proliferation potential in BMs and can be useful in differentiating SCLC BMs from NSCLC and BC BMs.


2020 ◽  
pp. 028418512095195
Author(s):  
Ji Hyun Hong ◽  
Won-Hee Jee ◽  
Sunyoung Whang ◽  
Chan-Kwon Jung ◽  
Yang-Guk Chung ◽  
...  

Background Making the preoperative diagnosis of soft-tissue lymphoma is important because the treatments for lymphoma and sarcoma are different. Purpose To determine the reliability and accuracy of single-slice and whole-tumor apparent diffusion coefficient (ADC) histogram analysis when differentiating soft-tissue lymphoma from undifferentiated sarcoma. Material and Methods Patients with confirmed soft-tissue lymphoma or undifferentiated sarcoma who underwent 3-T magnetic resonance imaging (MRI), including diffusion-weighted imaging, were included. Single-slice and whole-tumor ADC histogram analyses were performed using software. Mean, standard deviation (SD), 5th and 95th percentiles, skewness, and kurtosis were compared between groups, and a receiver operating characteristic curve with area under the curve (AUC) was obtained. Results Thirteen patients with soft-tissue lymphoma and 12 patients with undifferentiated sarcoma were included. ADC histogram analysis of single-slice and whole-tumor, mean, SD, and 5th and 95th percentiles was significantly lower in lymphoma than in undifferentiated sarcoma. Whole-tumor analysis kurtosis was significantly higher in lymphoma than in undifferentiated sarcoma. All AUCs were high in single-slice and whole-tumor analysis: 0.987 vs. 1.000 in mean; 0.821 vs. 0.782 in SD; 0.949 vs. 0.949 in 5th percentile; and 1.000 vs. 1.000 in 95th percentile without significant difference. AUC of kurtosis in whole-tumor ADC histogram analysis was 0.750. Conclusion Single-slice and whole-tumor ADC histogram analysis seems to be reliable and accurate for differentiating soft-tissue lymphoma from undifferentiated sarcoma.


Author(s):  
Nada Gamal El-Husseiny ◽  
Sayed Mohamed Mehana ◽  
Sherif Farouk El Zawawy

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.


Sign in / Sign up

Export Citation Format

Share Document