Bony metastases: assessing response to therapy with whole-body diffusion MRI
1Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK. anwar.padhani@stricklandscanner.org.uk
Abstract:
There are no universally accepted methods for assessing tumour response in skeletal sites with metastatic disease; response is assessed by a combination of imaging tests, serum and urine biochemical markers and symptoms assessments. Whole-body diffusion magnetic resonance imaging excels at bone marrow assessments at diagnosis and for therapy evaluations. It can potentially address unmet clinical and pharmaceutical needs for a reliable measure of tumour response. Signal intensity on high b-value images and apparent diffusion coefficient values can be related to underlying biophysical properties of skeletal metastases. Four patterns of change in response to therapy are described this review. Therapy response criteria need to be tested in prospective clinical studies that incorporate conventional measures of patient benefit.
Insights
Whole-body diffusion MRI offers a promising method for evaluating bone metastasis treatment response. This technique may provide a reliable measure of tumor changes, addressing current clinical needs.
Area of Science:
- Oncology
- Radiology
- Biophysics
Background:
- Assessing tumor response in skeletal metastases lacks standardized methods, relying on varied imaging, biochemical markers, and symptom assessments.
- Current evaluation methods present challenges in reliably measuring treatment efficacy for bone metastases.
Purpose of the Study:
- To explore the potential of whole-body diffusion magnetic resonance imaging (WB-DWI) as a reliable tool for assessing tumor response in skeletal metastases.
- To review the application of WB-DWI in therapy evaluation and its ability to address unmet clinical needs.
Main Methods:
- Utilizing whole-body diffusion magnetic resonance imaging (WB-DWI) for bone marrow assessments at diagnosis and during therapy.
- Analyzing signal intensity on high b-value images and apparent diffusion coefficient (ADC) values to correlate with skeletal metastases' biophysical properties.
Main Results:
- WB-DWI shows promise for bone marrow assessments and therapy evaluations in skeletal metastases.
- Signal intensity and ADC values on WB-DWI can reflect underlying biophysical changes in response to therapy.
- Four distinct patterns of change indicating therapy response have been identified.
Conclusions:
- Whole-body diffusion MRI is a potential solution for reliable tumor response assessment in skeletal metastases.
- Further prospective clinical studies are needed to validate WB-DWI response criteria against conventional patient benefit measures.
