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European Radiology
Published in: European Radiology 5/2016

Open Access 01-05-2016 | Magnetic Resonance

Diffusion-weighted MR imaging of metastatic abdominal and pelvic tumours is sensitive to early changes induced by a VEGF inhibitor using alternative diffusion attenuation models

Authors: Matthew R. Orton, Christina Messiou, David Collins, Veronica A. Morgan, Jean Tessier, Helen Young, Nandita deSouza, Martin O. Leach

Published in: European Radiology | Issue 5/2016

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Abstract

Objectives

To assess the utility of diffusion weighted imaging for monitoring early treatment effects associated with a VEGF inhibitor.

Materials and methods

Twenty-nine patients with metastatic abdominal and pelvic tumours were recruited and imaged with DW-MRI: twice at baseline, and after 7 and 28 days of treatment with cediranib. Tumour measures were derived using mono-exponential, bi-exponential and stretched-exponential models, and parameter repeatability and treatment effects seen after 7 and 28 days were assessed. Correlations with volume changes and DCE-MRI metrics were also assessed.

Results

Diffusion coefficient repeatabilities from all models were < 6 %; f and D* (bi-exponential) were 22 % and 44 %; α (stretched-exponential) was 4.2 %. Significant increases in the diffusion coefficients from all models were observed at day 28 but not day 7. Significant decreases in D* and f.D* were observed at day 7 and in f at day 28; significant increases in α were observed at both time-points. Weak correlations between DW-MRI changes and volume changes and DCE-MRI changes were observed.

Conclusion

DW-MRI is sensitive to early and late treatment changes caused by a VEGF inhibitor using non-mono-exponential models. Evidence of over-fitting using the bi-exponential model suggests that the stretched-exponential model is best suited to monitor such changes.

Key points

• Non-mono-exponential diffusion models widen sensitivity to a broader class of tissue properties.
• A stretched-exponential model robustly detects changes after 7 days of VEGF-inhibitor treatment.
• There are very weak correlations between DWI-IVIM perfusion and similar DCE-MRI measures.
• Diffusion-weighted MRI is a highly informative technique for assessing novel tumour therapies.
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Metadata
Title
Diffusion-weighted MR imaging of metastatic abdominal and pelvic tumours is sensitive to early changes induced by a VEGF inhibitor using alternative diffusion attenuation models
Authors
Matthew R. Orton
Christina Messiou
David Collins
Veronica A. Morgan
Jean Tessier
Helen Young
Nandita deSouza
Martin O. Leach
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3933-7

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