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Quantitative Diffusion-Weighted MRI of Neuroblastoma
Niklas Abele1,2, Soenke Langner1,3, Ute Felbor4,5
1Department of Radiology, Germany University of Greifswald, 17475 Greifswald, Germany.
Cancers
|April 13, 2023
Summary
Changes in apparent diffusion coefficient (ADC) values in neuroblastoma can predict treatment response early. An increase in ADC indicates a probable response, while a decrease suggests progression, even within 120 days of therapy initiation.
Area of Science:
- Pediatric Oncology
- Radiology
- Medical Imaging
Background:
- Neuroblastoma is a common pediatric solid tumor, often diagnosed at advanced stages.
- Contrast-enhanced MRI with diffusion-weighted imaging (DWI) is crucial for staging and monitoring treatment response.
- Apparent diffusion coefficient (ADC) values derived from DWI can reflect histological characteristics and treatment effects, often preceding volumetric changes.
Purpose of the Study:
- To evaluate early changes in ADC values in neuroblastoma patients undergoing therapy.
- To determine if these ADC changes are dependent on the therapy type.
- To assess the potential of ADC changes as a prognostic marker for neuroblastoma.
Main Methods:
- Retrospective analysis of 40 neuroblastoma cases (121 DWI scans) treated between 2007 and 2014.
- ADC values were calculated from regions of interest on MRI scans at different staging points (prestaging, intermediate, final, follow-up).
- Changes in ADC (ΔADC) were calculated relative to baseline or previous scans and analyzed based on disease course (progress, stable, regress).
Main Results:
- Significant differences were observed in mean ADC values between high-risk and intermediate-risk groups (INRG classification).
- Mean ΔADC values showed significant differences correlating with disease course (regress, stable, progress), both in absolute and percentage changes.
- Early changes in ADC (within 60-120 days) also significantly correlated with treatment response, with increasing ADC indicating response and decreasing ADC indicating progression.
Conclusions:
- Early changes in ADC values are a reliable indicator of treatment response in neuroblastoma, even within the first 120 days of therapy.
- Increasing ADC values predict a probable response to therapy, while decreasing values predict disease progression.
- ADC changes supplement conventional imaging criteria for therapy response assessment and can serve as a prognostic marker.
