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Treatment response monitoring in patients with gastrointestinal stromal tumor using diffusion‐weighted imaging: preliminary results in comparison with positron emission tomography/computed tomography
Author(s) -
Gong NanJie,
Wong ChunSing,
Chu YiuChing,
Gu Jing
Publication year - 2013
Publication title -
nmr in biomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.278
H-Index - 114
eISSN - 1099-1492
pISSN - 0952-3480
DOI - 10.1002/nbm.2834
Subject(s) - nuclear medicine , medicine , positron emission tomography , standardized uptake value , effective diffusion coefficient , receiver operating characteristic , diffusion mri , radiology , magnetic resonance imaging
We compared the parameters derived from diffusion‐weighted imaging (DWI) and positron emission tomography/computed tomography (PET/CT) for treatment response evaluation and response prediction in patients with gastrointestinal stromal tumor (GIST). Seven patients with histologically proven metastatic disease were enrolled. DWI and PET/CT data were collected from all patients at diagnosis and from six at follow‐up. All 37 lesions were identifiable in DWI with a sensitivity of 100%. To achieve higher accuracy, we used the apparent diffusion coefficient (ADC) of liver and background noise as thresholds for the measurement of the ADCs of lesions. Significant inverse correlations were found between ADC mean_thr (ADC mean with thresholds) and SUV mean (mean standardized uptake value) ( R 2 = 0.523, p < 0.001 at diagnosis, and R 2 = 0.916, p < 0.001 at follow‐up), between ADC mean_thr and SUV max (maximum SUV) ( R 2 = 0.529, p < 0.001 at diagnosis, and R 2 = 0.761, p < 0.001 at follow‐up), between ΔADC mean_thr (percentage change in ADC mean_thr ) and ΔSUV mean (percentage change in SUV mean ) ( R 2 = 0.384, p < 0.001), and between ΔADC mean_thr and ΔSUV max (percentage change in SUV max ) ( R 2 = 0.500, p < 0.001). In lesion‐based analysis, pre‐treatment ADC mean_thr outperformed SUV mean and SUV max in treatment response prediction, with an area under the receiver operating characteristic curve of 0.706. These results show that DWI can provide a quantitative assessment comparable with PET/CT in GIST lesion characterization, treatment response evaluation and response prediction. Copyright © 2012 John Wiley & Sons, Ltd.