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Published on: December 15, 2014
Diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for monitoring
Anwar R Padhani1, Aftab Alam Khan
1Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, Middlesex, UK. anwar.padhani@stricklandscanner.org.uk
Abstract:
There is an increasing awareness that anatomical approaches based on measurements of tumor size have significant limitations for assessing therapy response. Functional imaging techniques are increasing being used to monitor response to therapies with novel mechanisms of action, often predicting the success of therapy before conventional measurements have changed. Dynamic contrast-enhanced and diffusion magnetic resonance imaging (MRI) are the most advanced in their evidence base, and in this manuscript we focus on them as response parameters. Technology, data gathering methods, and current limitations for these techniques are addressed. With few exceptions, most studies shows that successful treatment is reflected by increases in tumor water diffusion values visible as increased apparent diffusion coefficient values. Most response assessment studies also show that successful treatment results in decreases in tumor vascularization and microvessel permeability.
Insights
Functional imaging, including dynamic contrast-enhanced and diffusion MRI, offers superior tumor therapy response assessment over anatomical measurements. These advanced MRI techniques predict treatment success by detecting changes in tumor diffusion and vascularization earlier than traditional methods.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Anatomical tumor size measurements have limitations in assessing therapy response.
- Functional imaging techniques are increasingly vital for monitoring novel cancer therapies.
- Dynamic contrast-enhanced and diffusion MRI are advanced functional imaging modalities.
Purpose of the Study:
- To review functional imaging techniques, specifically dynamic contrast-enhanced and diffusion MRI, as parameters for therapy response assessment.
- To discuss the technology, data acquisition, and limitations of these MRI techniques.
- To highlight the predictive value of functional imaging in therapy response.
Main Methods:
- Focus on dynamic contrast-enhanced MRI and diffusion MRI.
- Review technological aspects and data gathering methods for these techniques.
- Analyze current limitations and evidence base for MRI in response assessment.
Main Results:
- Successful treatment correlates with increased tumor water diffusion (apparent diffusion coefficient values).
- Effective therapy typically results in decreased tumor vascularization.
- Decreased microvessel permeability is observed with successful treatment.
Conclusions:
- Functional MRI techniques provide earlier and more sensitive assessment of tumor therapy response compared to anatomical measurements.
- Diffusion MRI and dynamic contrast-enhanced MRI show significant potential in predicting treatment outcomes.
- Further research and standardization of these techniques are crucial for clinical implementation.
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