Early Assessment of Colorectal Cancer Patients with Liver Metastases Treated with Antiangiogenic Drugs: The Role of Intravoxel Incoherent Motion in Diffusion-Weighted Imaging | Zendy

Vincenza Granata | Zendy; Roberta Fusco | Zendy; Orlando Catalano | Zendy; Salvatore Filice | Zendy; Daniela Amato | Zendy; Guglielmo Nasti | Zendy; Antonio Avallone | Zendy; Francesco Izzo | Zendy; Antonella Petrillo | Zendy

Open Access

Early Assessment of Colorectal Cancer Patients with Liver Metastases Treated with Antiangiogenic Drugs: The Role of Intravoxel Incoherent Motion in Diffusion-Weighted Imaging

Author(s) -

Vincenza Granata,

Roberta Fusco,

Orlando Catalano,

Salvatore Filice,

Daniela Amato,

Guglielmo Nasti,

Antonio Avallone,

Francesco Izzo,

Antonella Petrillo

Publication year - 2015

Publication title -

plos one

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.99

H-Index - 332

ISSN - 1932-6203

DOI - 10.1371/journal.pone.0142876

Subject(s) - intravoxel incoherent motion , medicine , colorectal cancer , diffusion mri , nuclear medicine , effective diffusion coefficient , receiver operating characteristic , perfusion , irinotecan , radiology , magnetic resonance imaging , bevacizumab , response evaluation criteria in solid tumors , area under the curve , chemotherapy , cancer , progressive disease

Purpose To assess the feasibility and effectiveness of quantitative intravoxel incoherent motion (IVIM) of Diffusion-weighted imaging (DWI) in the assessment of liver metastases treated with targeted chemotherapy agents. Methods 12 patients with unresectable liver metastases from colorectal cancer were enrolled and received neoadjuvant FOLFIRI (5-fluorouracil, leucovorin, irinotecan) plus bevacizumab therapy. DWI was performed for 36 metastases at baseline and after 14 days from starting the treatment. In addition to the basic IVIM metrics, the product between pseudo-diffusivity and perfusion fraction was considered as a descriptor roughly analogous to the flow. Median diffusion parameters of Region of Interest (ROI) were used as representative values for each lesion. Normalized parameters in comparison with the median value of spleen were also collected. The percentual change of the diffusion parameters was calculated. The response to chemotherapy was evaluated according the Response Evaluation Criteria in Solid Tumors (RECIST) as calculated on whole-body CT scan obtained three months after treatment. Mann Whitney test and Receiver operating characteristic (ROC) analysis were performed. Results 24 lesions were categorized as responding and 12 as not responding. There was no statistically significant difference among absolute and normalized diffusion parameters between the pretreatment and the post-treatment findings. Instead, the perfusion fraction (f p ) values showed a statistical difference between responder and non-responder lesions: sensitivity and specificity of f p variation was 62% and 93%, respectively. Conclusions IVIM parameters represent a valuable tool in the evaluation of the anti-angiogenic therapy in patients with liver metastases from colorectal cancer. A percentage change of f p represents the most effective DWI marker in the assessment of tumor response.

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