Diffusion-weighted MRI improves response assessment after definitive radiotherapy in patients with NSCLC
Abstract Background Computed tomography (CT) is the standard procedure for follow-up of non-small-cell lung cancer (NSCLC) after radiochemotherapy. CT has difficulties differentiating between tumor, atelectasis and radiation induced lung toxicity (RILT). Diffusion-weighted imaging (DWI) may enable a...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | Cancer Imaging |
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| Online Access: | https://doi.org/10.1186/s40644-021-00384-9 |
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| author | Jagoda Philippe Fleckenstein Jochen Sonnhoff Mathias Schneider Günther Ruebe Christian Buecker Arno Stroeder Jonas |
| author_facet | Jagoda Philippe Fleckenstein Jochen Sonnhoff Mathias Schneider Günther Ruebe Christian Buecker Arno Stroeder Jonas |
| author_sort | Jagoda Philippe |
| collection | DOAJ |
| description | Abstract Background Computed tomography (CT) is the standard procedure for follow-up of non-small-cell lung cancer (NSCLC) after radiochemotherapy. CT has difficulties differentiating between tumor, atelectasis and radiation induced lung toxicity (RILT). Diffusion-weighted imaging (DWI) may enable a more accurate detection of vital tumor tissue. The aim of this study was to determine the diagnostic value of MRI versus CT in the follow-up of NSCLC. Methods Twelve patients with NSCLC stages I-III scheduled for radiochemotherapy were enrolled in this prospective study. CT with i.v. contrast agent and non enhanced MRI were performed before and 3, 6 and 12 months after treatment. Standardized ROIs were used to determine the apparent diffusion weighted coefficient (ADC) within the tumor. Tumor size was assessed by the longest longitudinal diameter (LD) and tumor volume on DWI and CT. RILT was assessed on a 4-point-score in breath-triggered T2-TSE and CT. Results There was no significant difference regarding LD and tumor volume between MRI and CT (p ≥ 0.6221, respectively p ≥ 0.25). Evaluation of RILT showed a very high correlation between MRI and CT at 3 (r = 0.8750) and 12 months (r = 0.903). Assessment of the ADC values suggested that patients with a good tumor response have higher ADC values than non-responders. Conclusions DWI is equivalent to CT for tumor volume determination in patients with NSCLC during follow up. The extent of RILT can be reliably determined by MRI. DWI could become a beneficial method to assess tumor response more accurately. ADC values may be useful as a prognostic marker. |
| first_indexed | 2024-12-16T15:37:07Z |
| format | Article |
| id | doaj.art-2d4e7b76387a4d559b85abfaa425007b |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-12-16T15:37:07Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj.art-2d4e7b76387a4d559b85abfaa425007b2022-12-21T22:26:09ZengBMCCancer Imaging1470-73302021-01-0121111110.1186/s40644-021-00384-9Diffusion-weighted MRI improves response assessment after definitive radiotherapy in patients with NSCLCJagoda Philippe0Fleckenstein Jochen1Sonnhoff Mathias2Schneider Günther3Ruebe Christian4Buecker Arno5Stroeder Jonas6Clinic for Diagnostic and Interventional Radiology, Saarland University Medical CenterDepartment of Radiotherapy and Radiation Oncology, Saarland University Medical CenterDepartment of Radiotherapy and Radiation Oncology, Saarland University Medical CenterClinic for Diagnostic and Interventional Radiology, Saarland University Medical CenterDepartment of Radiotherapy and Radiation Oncology, Saarland University Medical CenterClinic for Diagnostic and Interventional Radiology, Saarland University Medical CenterClinic for Diagnostic and Interventional Radiology, Saarland University Medical CenterAbstract Background Computed tomography (CT) is the standard procedure for follow-up of non-small-cell lung cancer (NSCLC) after radiochemotherapy. CT has difficulties differentiating between tumor, atelectasis and radiation induced lung toxicity (RILT). Diffusion-weighted imaging (DWI) may enable a more accurate detection of vital tumor tissue. The aim of this study was to determine the diagnostic value of MRI versus CT in the follow-up of NSCLC. Methods Twelve patients with NSCLC stages I-III scheduled for radiochemotherapy were enrolled in this prospective study. CT with i.v. contrast agent and non enhanced MRI were performed before and 3, 6 and 12 months after treatment. Standardized ROIs were used to determine the apparent diffusion weighted coefficient (ADC) within the tumor. Tumor size was assessed by the longest longitudinal diameter (LD) and tumor volume on DWI and CT. RILT was assessed on a 4-point-score in breath-triggered T2-TSE and CT. Results There was no significant difference regarding LD and tumor volume between MRI and CT (p ≥ 0.6221, respectively p ≥ 0.25). Evaluation of RILT showed a very high correlation between MRI and CT at 3 (r = 0.8750) and 12 months (r = 0.903). Assessment of the ADC values suggested that patients with a good tumor response have higher ADC values than non-responders. Conclusions DWI is equivalent to CT for tumor volume determination in patients with NSCLC during follow up. The extent of RILT can be reliably determined by MRI. DWI could become a beneficial method to assess tumor response more accurately. ADC values may be useful as a prognostic marker.https://doi.org/10.1186/s40644-021-00384-9TomographySpiral computedMagnetic resonance imagingFunctional magnetic resonance imagingRadiotherapyImage-guided |
| spellingShingle | Jagoda Philippe Fleckenstein Jochen Sonnhoff Mathias Schneider Günther Ruebe Christian Buecker Arno Stroeder Jonas Diffusion-weighted MRI improves response assessment after definitive radiotherapy in patients with NSCLC Cancer Imaging Tomography Spiral computed Magnetic resonance imaging Functional magnetic resonance imaging Radiotherapy Image-guided |
| title | Diffusion-weighted MRI improves response assessment after definitive radiotherapy in patients with NSCLC |
| title_full | Diffusion-weighted MRI improves response assessment after definitive radiotherapy in patients with NSCLC |
| title_fullStr | Diffusion-weighted MRI improves response assessment after definitive radiotherapy in patients with NSCLC |
| title_full_unstemmed | Diffusion-weighted MRI improves response assessment after definitive radiotherapy in patients with NSCLC |
| title_short | Diffusion-weighted MRI improves response assessment after definitive radiotherapy in patients with NSCLC |
| title_sort | diffusion weighted mri improves response assessment after definitive radiotherapy in patients with nsclc |
| topic | Tomography Spiral computed Magnetic resonance imaging Functional magnetic resonance imaging Radiotherapy Image-guided |
| url | https://doi.org/10.1186/s40644-021-00384-9 |
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