dc.contributor.author | Rata, M | |
dc.contributor.author | Khan, K | |
dc.contributor.author | Collins, DJ | |
dc.contributor.author | Koh, D-M | |
dc.contributor.author | Tunariu, N | |
dc.contributor.author | Bali, MA | |
dc.contributor.author | d'Arcy, J | |
dc.contributor.author | Winfield, JM | |
dc.contributor.author | Picchia, S | |
dc.contributor.author | Valeri, N | |
dc.contributor.author | Chau, I | |
dc.contributor.author | Cunningham, D | |
dc.contributor.author | Fassan, M | |
dc.contributor.author | Leach, MO | |
dc.contributor.author | Orton, MR | |
dc.date.accessioned | 2022-02-23T09:55:39Z | |
dc.date.available | 2022-02-23T09:55:39Z | |
dc.date.issued | 2021-12-19 | |
dc.identifier.citation | Cancer imaging : the official publication of the International Cancer Imaging Society, 2021, 21 (1), pp. 67 - ? | |
dc.identifier.issn | 1740-5025 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/5031 | |
dc.identifier.eissn | 1470-7330 | |
dc.identifier.eissn | 1470-7330 | |
dc.identifier.doi | 10.1186/s40644-021-00436-0 | |
dc.identifier.doi | 10.1186/s40644-021-00436-0 | |
dc.description.abstract | BACKGROUND: Diffusion weighted imaging (DWI) with intravoxel incoherent motion (IVIM) modelling can inform on tissue perfusion without exogenous contrast administration. Dynamic-contrast-enhanced (DCE) MRI can also characterise tissue perfusion, but requires a bolus injection of a Gadolinium-based contrast agent. This study compares the use of DCE-MRI and IVIM-DWI methods in assessing response to anti-angiogenic treatment in patients with colorectal liver metastases in a cohort with confirmed treatment response. METHODS: This prospective imaging study enrolled 25 participants with colorectal liver metastases to receive Regorafenib treatment. A target metastasis > 2 cm in each patient was imaged before and at 15 days after treatment on a 1.5T MR scanner using slice-matched IVIM-DWI and DCE-MRI protocols. MRI data were motion-corrected and tumour volumes of interest drawn on b=900 s/mm2 diffusion-weighted images were transferred to DCE-MRI data for further analysis. The median value of four IVIM-DWI parameters [diffusion coefficient D (10-3 mm2/s), perfusion fraction f (ml/ml), pseudodiffusion coefficient D* (10-3 mm2/s), and their product fD* (mm2/s)] and three DCE-MRI parameters [volume transfer constant Ktrans (min-1), enhancement fraction EF (%), and their product KEF (min-1)] were recorded at each visit, before and after treatment. Changes in pre- and post-treatment measurements of all MR parameters were assessed using Wilcoxon signed-rank tests (P<0.05 was considered significant). DCE-MRI and IVIM-DWI parameter correlations were evaluated with Spearman rank tests. Functional MR parameters were also compared against Response Evaluation Criteria In Solid Tumours v.1.1 (RECIST) evaluations. RESULTS: Significant treatment-induced reductions of DCE-MRI parameters across the cohort were observed for EF (91.2 to 50.8%, P<0.001), KEF (0.095 to 0.045 min-1, P<0.001) and Ktrans (0.109 to 0.078 min-1, P=0.002). For IVIM-DWI, only D (a non-perfusion parameter) increased significantly post treatment (0.83 to 0.97 × 10-3 mm2/s, P<0.001), while perfusion-related parameters showed no change. No strong correlations were found between DCE-MRI and IVIM-DWI parameters. A moderate correlation was found, after treatment, between Ktrans and D* (r=0.60; P=0.002) and fD* (r=0.67; P<0.001). When compared to RECIST v.1.1 evaluations, KEF and D correctly identified most clinical responders, whilst non-responders were incorrectly identified. CONCLUSION: IVIM-DWI perfusion-related parameters showed limited sensitivity to the anti-angiogenic effects of Regorafenib treatment in colorectal liver metastases and showed low correlation with DCE-MRI parameters, despite profound and significant post-treatment reductions in DCE-MRI measurements. TRIAL REGISTRATION: NCT03010722 clinicaltrials.gov; registration date 6th January 2015. | |
dc.format | Electronic | |
dc.format.extent | 67 - ? | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | BMC | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | Humans | |
dc.subject | Colorectal Neoplasms | |
dc.subject | Liver Neoplasms | |
dc.subject | Magnetic Resonance Imaging | |
dc.subject | Prospective Studies | |
dc.title | DCE-MRI is more sensitive than IVIM-DWI for assessing anti-angiogenic treatment-induced changes in colorectal liver metastases. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2021-11-24 | |
rioxxterms.version | VoR | |
rioxxterms.versionofrecord | 10.1186/s40644-021-00436-0 | |
rioxxterms.licenseref.uri | https://creativecommons.org/licenses/by/4.0 | |
rioxxterms.licenseref.startdate | 2021-12-19 | |
dc.relation.isPartOf | Cancer imaging : the official publication of the International Cancer Imaging Society | |
pubs.issue | 1 | |
pubs.notes | Not known | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham) | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)/Medicine (RMH Smith Cunningham) (hon.) | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Radiotherapy Physics Modelling | |
pubs.organisational-group | /ICR/Primary Group/Royal Marsden Clinical Units | |
pubs.publication-status | Published | |
pubs.volume | 21 | |
pubs.embargo.terms | Not known | |
icr.researchteam | Medicine (RMH Smith Cunningham) | |
icr.researchteam | Radiotherapy Physics Modelling | |
dc.contributor.icrauthor | Collins, David | |
dc.contributor.icrauthor | Valeri, Nicola | |