Frederic Carsten Schmeel1, Birgit Simon2, Amir Sabet3,4, Julian Alexander Luetkens2, Frank Träber2, Leonard Christopher Schmeel2, Samer Ezziddin3,5, Hans Heinz Schild2, Dariusch Reza Hadizadeh2. 1. Department of Radiology, University Hospital Bonn, Rheinische-Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany. Carsten.Schmeel@ukb.uni-bonn.de. 2. Department of Radiology, University Hospital Bonn, Rheinische-Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany. 3. Department of Nuclear Medicine, University Hospital Bonn, Rheinische-Friedrich-Wilhelms-Universität Bonn, Bonn, Germany. 4. Department of Nuclear Medicine, University Hospital Essen, Universität Duisburg-Essen, Essen, Germany. 5. Department of Nuclear Medicine, University Hospital Saarland, Universität des Saarlandes, Homburg, Germany.
Abstract
OBJECTIVES: To investigate whether quantifications of apparent diffusion coefficient (ADC) on diffusion-weighted imaging (DWI) can predict overall survival (OS) in patients with liver-predominant metastatic colorectal cancer (CRC) following selective internal radiation therapy with 90Yttrium-microspheres (SIRT). METHODS: Forty-four patients underwent DWI 19 ± 16 days before and 36 ± 10 days after SIRT. Tumour-size and intratumoral minimal ADC (minADC) values were measured for 132 liver metastases on baseline and follow-up DWI. Optimal functional imaging response to treatment was determined by receiver operating characteristics and defined as ≥22 % increase in post-therapeutic minADC. Survival analysis was performed with the Kaplan-Meier method and Cox-regression comparing various variables with potential impact on OS. RESULTS: Median OS was 8 months. The following parameters were significantly associated with median OS: optimal functional imaging response (18 vs. 5 months; p < 0.001), hepatic tumour burden <50 % (8 vs. 5 months; p = 0.018), Eastern Cooperative Oncology Group performance scale <1 (10 vs. 4 months; p = 0.012) and progressive disease according to Response and Evaluation Criteria in Solid Tumours (8 vs. 3 months; p = 0.001). On multivariate analysis, optimal functional imaging response and hepatic tumour burden remained independent predictors of OS. CONCLUSION: Functional imaging response assessment using minADC changes on DWI may predict survival in CRC shortly after SIRT. KEY POINTS: • Relative minADC changes may predict survival in liver-predominant metastatic colorectal cancer following SIRT • Intratumoral minADC changes by ≥22 % were best to predict an improved overall survival • Functional imaging response assessment is feasible before anatomic tumour-size changes occur • minADC changes might guide future therapy management in sequential lobar radioembolization approaches.
OBJECTIVES: To investigate whether quantifications of apparent diffusion coefficient (ADC) on diffusion-weighted imaging (DWI) can predict overall survival (OS) in patients with liver-predominant metastatic colorectal cancer (CRC) following selective internal radiation therapy with 90Yttrium-microspheres (SIRT). METHODS: Forty-four patients underwent DWI 19 ± 16 days before and 36 ± 10 days after SIRT. Tumour-size and intratumoral minimal ADC (minADC) values were measured for 132 liver metastases on baseline and follow-up DWI. Optimal functional imaging response to treatment was determined by receiver operating characteristics and defined as ≥22 % increase in post-therapeutic minADC. Survival analysis was performed with the Kaplan-Meier method and Cox-regression comparing various variables with potential impact on OS. RESULTS: Median OS was 8 months. The following parameters were significantly associated with median OS: optimal functional imaging response (18 vs. 5 months; p < 0.001), hepatic tumour burden <50 % (8 vs. 5 months; p = 0.018), Eastern Cooperative Oncology Group performance scale <1 (10 vs. 4 months; p = 0.012) and progressive disease according to Response and Evaluation Criteria in Solid Tumours (8 vs. 3 months; p = 0.001). On multivariate analysis, optimal functional imaging response and hepatic tumour burden remained independent predictors of OS. CONCLUSION: Functional imaging response assessment using minADC changes on DWI may predict survival in CRC shortly after SIRT. KEY POINTS: • Relative minADC changes may predict survival in liver-predominant metastatic colorectal cancer following SIRT • Intratumoral minADC changes by ≥22 % were best to predict an improved overall survival • Functional imaging response assessment is feasible before anatomic tumour-size changes occur • minADC changes might guide future therapy management in sequential lobar radioembolization approaches.
Authors: Andrew S Kennedy; David Ball; Steven J Cohen; Michael Cohn; Douglas M Coldwell; Alain Drooz; Eduardo Ehrenwald; Samir Kanani; Steven C Rose; Charles W Nutting; Fred M Moeslein; Michael A Savin; Sabine Schirm; Samuel G Putnam; Navesh K Sharma; Eric A Wang Journal: J Gastrointest Oncol Date: 2015-04
Authors: Andrea M Abbott; Richard Kim; Sarah E Hoffe; Bulent Arslan; Ben Biebel; Junsung Choi; Ghassan El-Haddad; Bela Kis; Jennifer Sweeney; Kenneth L Meredith; Khaldoun Almhanna; Jonathan Strosberg; David Shibata; William J Fulp; Ravi Shridhar Journal: Clin Colorectal Cancer Date: 2015-02-16 Impact factor: 4.481
Authors: Francesco De Cobelli; Francesco Giganti; Elena Orsenigo; Michaela Cellina; Antonio Esposito; Giulia Agostini; Luca Albarello; Elena Mazza; Alessandro Ambrosi; Carlo Socci; Carlo Staudacher; Alessandro Del Maschio Journal: Eur Radiol Date: 2013-04-16 Impact factor: 5.315
Authors: M A D Vente; M Wondergem; I van der Tweel; M A A J van den Bosch; B A Zonnenberg; M G E H Lam; A D van Het Schip; J F W Nijsen Journal: Eur Radiol Date: 2008-11-07 Impact factor: 5.315
Authors: I M E Desar; C M L van Herpen; H W M van Laarhoven; J O Barentsz; W J G Oyen; W T A van der Graaf Journal: Cancer Treat Rev Date: 2009-01-10 Impact factor: 12.111
Authors: Ricarda Rühl; Max Seidensticker; Nils Peters; Konrad Mohnike; Jan Bornschein; Kerstin Schütte; Holger Amthauer; Peter Malfertheiner; Maciej Pech; Jens Ricke Journal: Dig Dis Date: 2009-06-22 Impact factor: 2.404
Authors: Linda Heijmen; Edwin E G W ter Voert; Wim J G Oyen; Cornelis J A Punt; Dick Johan van Spronsen; Arend Heerschap; Lioe-Fee de Geus-Oei; Hanneke W M van Laarhoven Journal: PLoS One Date: 2015-04-01 Impact factor: 3.240
Authors: Frederic Carsten Schmeel; Birgit Simon; Julian Alexander Luetkens; Frank Träber; Carsten Meyer; Leonard Christopher Schmeel; Amir Sabet; Samer Ezziddin; Hans Heinz Schild; Dariusch Reza Hadizadeh Journal: J Cancer Res Clin Oncol Date: 2017-03-19 Impact factor: 4.553
Authors: Anton Faron; Claus C Pieper; Frederic C Schmeel; Alois M Sprinkart; Daniel L R Kuetting; Rolf Fimmers; Jonel Trebicka; Hans H Schild; Carsten Meyer; Daniel Thomas; Julian A Luetkens Journal: Eur Radiol Date: 2019-01-28 Impact factor: 5.315
Authors: Martin Vallières; Monica Serban; Ibtissam Benzyane; Zaki Ahmed; Shu Xing; Issam El Naqa; Ives R Levesque; Jan Seuntjens; Carolyn R Freeman Journal: Phys Imaging Radiat Oncol Date: 2018-05-19