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Role of diffusion-weighted imaging in response prediction and evaluation after high dose rate brachytherapy in patients with colorectal liver metastases

  • 0Department of Radiology, University Hospital, LMU Munich, Germany.
Radiology and Oncology +

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February 20, 2024

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February 20, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Diffusion-weighted imaging (DWI) effectively evaluates treatment response in liver metastases from colorectal cancer after high-dose-rate brachytherapy (HDR-BT). Combining DWI with contrast-enhanced T1-weighted imaging improves diagnostic accuracy for detecting local tumor recurrence.

Area Of Science

  • Radiology
  • Oncology
  • Medical Imaging

Background

  • Colorectal cancer liver metastases present a challenge for treatment response assessment.
  • High-dose-rate brachytherapy (HDR-BT) is a treatment modality for these metastases.
  • Accurate evaluation of treatment response is crucial for patient management.

Purpose Of The Study

  • To assess the role of diffusion-weighted imaging (DWI) in evaluating treatment response.
  • To compare the diagnostic performance of DWI alone versus DWI combined with contrast-enhanced MRI.
  • To determine the utility of DWI in differentiating responding from non-responding liver metastases.

Main Methods

  • Retrospective observational cohort study of 19 patients with colorectal cancer liver metastases treated with HDR-BT.
  • Pre- and post-interventional MRI including DWI and contrast-enhanced T1-weighted hepatobiliary phase (CE T1w hb) were analyzed.
  • Apparent diffusion coefficient (ADC) parameters (ADCmean, ADCmin) were evaluated qualitatively and quantitatively.
  • Sensitivity, specificity, PPV, and NPV were calculated for detecting local tumor recurrence.

Main Results

  • ADCmean significantly increased 3 months post-HDR-BT in both responding (R-Mets) and non-responding (NR-Mets) groups.
  • Intraindividual changes in ADCmean and ADCmin significantly increased only in R-Mets.
  • ADCmin was significantly higher in R-Mets compared to NR-Mets at first follow-up.
  • Combining DWI with CE T1w hb improved sensitivity, specificity, PPV, and NPV for detecting local recurrence compared to DWI alone.

Conclusions

  • DWI is valuable for qualitative and quantitative evaluation of treatment response after HDR-BT for liver metastases.
  • Quantitative ADC parameters, particularly ADCmin changes, can help differentiate responding from non-responding lesions.
  • The combination of DWI and CE T1w hb offers superior diagnostic performance for detecting local tumor recurrence.

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