Biomarkers for site-specific response to neoadjuvant chemotherapy in epithelial ovarian cancer: relating MRI changes to tumour cell load and necrosis.
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ICR Authors
Authors
Winfield, JM
Wakefield, JC
Brenton, JD
AbdulJabbar, K
Savio, A
Freeman, S
Pace, E
Lutchman-Singh, K
Vroobel, KM
Yuan, Y
Banerjee, S
Porta, N
Ahmed Raza, SE
deSouza, NM
Wakefield, JC
Brenton, JD
AbdulJabbar, K
Savio, A
Freeman, S
Pace, E
Lutchman-Singh, K
Vroobel, KM
Yuan, Y
Banerjee, S
Porta, N
Ahmed Raza, SE
deSouza, NM
Document Type
Journal Article
Date
2021-03-16
Date Accepted
2020-11-25
Date Available
Abstract
BACKGROUND: Diffusion-weighted magnetic resonance imaging (DW-MRI) potentially interrogates site-specific response to neoadjuvant chemotherapy (NAC) in epithelial ovarian cancer (EOC). METHODS: Participants with newly diagnosed EOC due for platinum-based chemotherapy and interval debulking surgery were recruited prospectively in a multicentre study (n = 47 participants). Apparent diffusion coefficient (ADC) and solid tumour volume (up to 10 lesions per participant) were obtained from DW-MRI before and after NAC (including double-baseline for repeatability assessment in n = 19). Anatomically matched lesions were analysed after surgical excision (65 lesions obtained from 25 participants). A trained algorithm determined tumour cell fraction, percentage tumour and percentage necrosis on histology. Whole-lesion post-NAC ADC and pre/post-NAC ADC changes were compared with histological metrics (residual tumour/necrosis) for each tumour site (ovarian, omental, peritoneal, lymph node). RESULTS: Tumour volume reduced at all sites after NAC. ADC increased between pre- and post-NAC measurements. Post-NAC ADC correlated negatively with tumour cell fraction. Pre/post-NAC changes in ADC correlated positively with percentage necrosis. Significant correlations were driven by peritoneal lesions. CONCLUSIONS: Following NAC in EOC, the ADC (measured using DW-MRI) increases differentially at disease sites despite similar tumour shrinkage, making its utility site-specific. After NAC, ADC correlates negatively with tumour cell fraction; change in ADC correlates positively with percentage necrosis. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT01505829.
Citation
British journal of cancer, 2021
Source Title
Publisher
SPRINGERNATURE
ISSN
0007-0920
eISSN
1532-1827
Research Team
Clinical Trials & Statistics Unit
Computational Pathology & Integrated Genomics
Magnetic Resonance
Computational Pathology & Integrated Genomics
Magnetic Resonance