Role of Apparent Diffusion Coefficients in Assessment of Response to Chemotherapy in Liver Metastasis Patients_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GUO Peng ¹ , WANG Yi ² , YE YingJiang ¹ , ZHANG Sen ²

1.Department of Gastroenterological Surgery, People’s Hospital, Peking University, Beijing 100044, China;;
2.Department of Radiology, People’s Hospital, Peking University, Beijing 100044, China;

Corresponding author：

Keywords：

Gastrointestinal tumor; Liver metastasis; Chemotherapy; Apparent diffusion coefficient; Diffusionweighted imaging

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Objective To evaluate the role of apparent diffusion coefficients (ADC) in assesment of response to chemotherapy in patients with gastrointestinal liver metastasis. MethodsTen patients with liver metastasis （8 from colorectal cancer， 1 from gastric cancer， 1 from esophageal cancer） at Peking University People’s Hospital from April 2006 to April 2007 were included. All of them received chemotherapy （FOLFOX6： 4 cases， XELOX： 3 cases, and FOLFIRI： 1 case in 8 cases of colorectal liver metastases; ECF: 1 case of gastric liver metastases; DCF: 1 case of esophageal liver metastasis）. ADC were calculated after MR duffusionweight imaging exmination (GE MEDICAL SYSTEMS HD EXCITE 1.5 T) 1 month pre-and post-chemotherapy, respectively. Tumour response to chemotherapy was assessed by RECIST criteria. ResultsTumors with low pretreatment ADC ( lt;9.04×10－4 mm2/s) responded better to chemotherapy than that with high ADC ( gt;9.04×10－4 mm2/s); pretreatment ADC of cases (6/10) were remarkable lower than those of cases (4/10)， P＝0.033. Increased ADC after onemonth chemotherapy in patients with liver metastasis predicted a better response. ConclusionsLow pretreatment ADC is predictive of better response to chemotherapy. An increased ADC after treatment predicts a better response to chemotherapy.

Citation： GUO Peng ,WANG Yi,YE YingJiang,ZHANG Sen. Role of Apparent Diffusion Coefficients in Assessment of Response to Chemotherapy in Liver Metastasis Patients. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(5): 475-478. doi: Copy

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21.	Harry VN, Semple SI, Gilbert FJ, et al. Diffusionweighted magnetic resonance imaging in the early detection of response to chemoradiation in cervical cancer [J]. Gynecol Oncol, 2008, 111(2): 213220.

1. Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010 [J].CA Cancer J Clin, 2010, 60(5): 277300.
2. Khatri VP, Petrelli NJ, Belghiti J. Extending the frontiers of surgical therapy for hepatic colorectal metastases: is there a limit? [J]. J Clin Oncol, 2005, 23（33）: 84908499.
3. Kemeny NE, Jarnagin WR, Capanu M, et al. Randomized phase Ⅱ trial of sdjuvant hepatic arterial Infusion and systemic chemotherapy with or without bevacizumab in patients with resected hepatic metastases from colorectal cancer [J]. J Clin Oncol, 2010, 29（7）: 884889.
4. Stillwell AP, Ho YH, Veitch C. Systematic review of prognostic factors related to overall survival in patients with stage Ⅳ colorectal cancer and unresectable metastases [J]. World J Surg, 2011, 35(3): 684692.
5. Masi G, Vasile E, Loupakis F, et al. Randomized trial of two induction chemotherapy regimens in metastatic colorectal cancer: an updated analysis [J]. J Natl Cancer Inst, 2011, 103(1): 2130.
6. Méndez Romero A, Verheij J, Dwarkasing RS, et al. Comparison of macroscopic pathology measurements with magnetic resonance Imaging and sssessment of microscopic pathology extension for colorectal liver metastases [J]. Int J Radiat Oncol Biol Phys, 2010 Dec 21.
7. Eiber M, Fingerle AA, Brügel M, et al. Detection and classification of focal liver lesions in patients with colorectal cancer: retrospective comparison of diffusionweighted MR imaging and multislice CT [J]. Eur J Radiol, 2011 Feb 11.
8. Wang Y, Ganger DR, Levitsky J, et al. Assessment of chronic hepatitis and fibrosis: comparison of MR elastography and diffusionweighted Imaging [J]. AJR Am J Roentgenol, 2011, 196(3): 553561.
9. Kubota K, Yamanishi T, Itoh S, et al. Role of diffusionweighted imaging in evaluating therapeutic efficacy after transcatheter arterial chemoembolization for hepatocellular carcinoma [J]. Oncol Rep, 2010, 24(3): 727732.
10. Jennings D, Hatton BN, Guo J, et al. Early esponse of proostate carcinoma xenografts to docetaxel chemotherapy monitored with diffusion MRI [J]. Neoplasia, 2002, 4(3): 255262.
11. Yankeelov TE, Lepage M, Chakravarthy A, et al. Integration of quantitative DCEMRI and ADC mapping to monitor treatment response in human breast cancer: initial results [J]. Magn Reson Imaging, 2007, 25(1): 113.
12. Hall DE, Moffat BA, Stojanovska J, et al. Therapeutic efficacy of DTI015 using diffusion magnetic resonance imaging as an early surrogate marker. Clin Cancer Res [J]. 2004, 10(23): 78527859.
13. Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada [J]. J Natl Cancer Inst, 2000, 92(3): 205216.
14. Mardor Y, Roth Y, Ocherashvilli A, et al. Pretreatment prediction of brain tumors’ response to radiation therapy using high bvalue diffusionweighted MRI [J]. Neoplasia, 2004, 6(2): 136142.
15. DeVries AF, Kremser C, Hein PA, et al. Tumor microcirculation and diffusion predict therapy outcome for primary rectal carcinoma [J]. Int J Radiation Oncology Biol Phys, 2003, 56(4): 958965.
16. Cui Y, Zhang XP, Sun YS, et al. Apparent diffusion coefficient: potential imaging biomarker for prediction and early detection of response to chemotherapy in hepatic metastases [J]. Radiology, 2008, 248(3): 894900.
17. Theilmann RJ, Borders R, Trouard TP, et al. Changes in water mobility measured by diffusion MRI predict response of metastatic breast cancer to chemotherapy [J]. Neoplasia, 2004, 6(6): 831837.
18. Pickles MD, Gibbs P, Lowry M, et al. Diffusion changes precede size reduction in neoadjuvant treatment of breast cancer [J]. Magn Reson Imaging, 2006, 24(7): 843847.
19. Schraml C, Schwenzer NF, Martirosian P, et al. Diffusionweighted MRI of advanced hepatocellular carcinoma during sorafenib treatment: initial results [J]. AJR Am J Roentgenol, 2009, 193(4): W301W307.
20. Marugami N, Tanaka T, Kitano S, et al. Early detection of therapeutic response to hepatic arterial infusion chemotherapy of liver metastases from colorectal cancer using diffusionweighted MR imaging [J]. Cardiovasc Intervent Radiol, 2009, 32(4): 638646.
21. Harry VN, Semple SI, Gilbert FJ, et al. Diffusionweighted magnetic resonance imaging in the early detection of response to chemoradiation in cervical cancer [J]. Gynecol Oncol, 2008, 111(2): 213220.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Role of Apparent Diffusion Coefficients in Assessment of Response to Chemotherapy in Liver Metastasis Patients

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