Michele Anzidei1, Alessandro Napoli2, Beatrice Sacconi2,3, Fabrizio Boni2, Vincenzo Noce2, Michele Di Martino2, Luca Saba4, Carlo Catalano2. 1. Department of Radiological, Oncological and Anatomopathological Sciences, Radiology, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. michele.anzidei@gmail.com. 2. Department of Radiological, Oncological and Anatomopathological Sciences, Radiology, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. 3. Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Viale Regina Elena 291, Rome, Italy. 4. Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato, Cagliari, Italy.
Abstract
PURPOSE: To assess the correlation between functional MRI, including ADC values obtained from DWI and DCE, and clinical outcome in patients with bone metastases treated with MRgFUS. METHODS AND MATERIALS: Twenty-three patients with symptomatic bone metastases underwent MRgFUS treatment (ExAblate 2100 system InSightec) for pain palliation. All patients underwent clinical and imaging follow-up examinations at 1, 3 and 6 months after treatment. Visual Analog Scale (VAS) score was used to evaluate treatment efficacy in terms of pain palliation while ADC maps obtained by DWI sequences, and DCE data were used for quantitative assessment of treatment response at imaging. Spearman Correlation Coefficient Test was calculated to assess the correlation between VAS, ADC and DCE data. RESULTS: All treatments were performed successfully without adverse events. On the basis of VAS score, 16 (69.6 %) patients were classified as complete clinical responders, 6 (26.1 %) as partial responders and only one (4.3 %) was classified as a non-responder. The mean VAS score decreased from 7.09 ± 1.8 at baseline to 2.65 ± 1.36 at 1 month, 1.04 ± 1.91 at 3 months and 1.09 ± 1.99 at 6 months (p < 0.001). Baseline mean ADC value of treated lesions was 1.05 ± 0.15 mm2/s, increasing along follow-up period (1.57 ± 0.27 mm2/s 1st month; 1.49 ± 0.3 mm2/s 3rd month; 1.45 ± 0.32 mm2/s 6th month, p < 0.001). Non perfused volume (NPV) was 46.4 at 1 month, 45.2 at 3 months and 43.8 at 6 months. Spearman Coefficient demonstrated a statistically significant negative correlation between VAS and ADC values (ρ = -0.684; p = 0.03), but no significant correlation between VAS and NPV (ρ = 0.02216, p = 0.9305). Among other DCE data, Ktrans significantly changed in complete responders (3 months Ktrans = 2.14/min; -ΔKt = 52.65 % p < 0.01) and was not significantly different in partial responders (3 months Ktrans 0.042/min; ΔKt = 11.39 % p > 0.01). CONCLUSION: In patients with painful bone metastases treated with MRgFUS, ADC and Ktrans variation observed in the ablated lesions correlate with VAS values and may play a role as objective imaging marker of treatment response.
PURPOSE: To assess the correlation between functional MRI, including ADC values obtained from DWI and DCE, and clinical outcome in patients with bone metastases treated with MRgFUS. METHODS AND MATERIALS: Twenty-three patients with symptomatic bone metastases underwent MRgFUS treatment (ExAblate 2100 system InSightec) for pain palliation. All patients underwent clinical and imaging follow-up examinations at 1, 3 and 6 months after treatment. Visual Analog Scale (VAS) score was used to evaluate treatment efficacy in terms of pain palliation while ADC maps obtained by DWI sequences, and DCE data were used for quantitative assessment of treatment response at imaging. Spearman Correlation Coefficient Test was calculated to assess the correlation between VAS, ADC and DCE data. RESULTS: All treatments were performed successfully without adverse events. On the basis of VAS score, 16 (69.6 %) patients were classified as complete clinical responders, 6 (26.1 %) as partial responders and only one (4.3 %) was classified as a non-responder. The mean VAS score decreased from 7.09 ± 1.8 at baseline to 2.65 ± 1.36 at 1 month, 1.04 ± 1.91 at 3 months and 1.09 ± 1.99 at 6 months (p < 0.001). Baseline mean ADC value of treated lesions was 1.05 ± 0.15 mm2/s, increasing along follow-up period (1.57 ± 0.27 mm2/s 1st month; 1.49 ± 0.3 mm2/s 3rd month; 1.45 ± 0.32 mm2/s 6th month, p < 0.001). Non perfused volume (NPV) was 46.4 at 1 month, 45.2 at 3 months and 43.8 at 6 months. Spearman Coefficient demonstrated a statistically significant negative correlation between VAS and ADC values (ρ = -0.684; p = 0.03), but no significant correlation between VAS and NPV (ρ = 0.02216, p = 0.9305). Among other DCE data, Ktrans significantly changed in complete responders (3 months Ktrans = 2.14/min; -ΔKt = 52.65 % p < 0.01) and was not significantly different in partial responders (3 months Ktrans 0.042/min; ΔKt = 11.39 % p > 0.01). CONCLUSION: In patients with painful bone metastases treated with MRgFUS, ADC and Ktrans variation observed in the ablated lesions correlate with VAS values and may play a role as objective imaging marker of treatment response.
Authors: Ivan Jambor; Anna Kuisma; Susan Ramadan; Riikka Huovinen; Minna Sandell; Sami Kajander; Jukka Kemppainen; Esa Kauppila; Joakim Auren; Harri Merisaari; Jani Saunavaara; Tommi Noponen; Heikki Minn; Hannu J Aronen; Marko Seppänen Journal: Acta Oncol Date: 2015-04-02 Impact factor: 4.089
Authors: Andreas Biffar; Steven Sourbron; Gerwin Schmidt; Michael Ingrisch; Olaf Dietrich; Maximilian F Reiser; Andrea Baur-Melnyk Journal: Magn Reson Med Date: 2010-07 Impact factor: 4.668
Authors: V Vassiliou; D Andreopoulos; S Frangos; N Tselis; E Giannopoulou; S Lutz Journal: Clin Oncol (R Coll Radiol) Date: 2011-04-29 Impact factor: 4.126
Authors: Daniela Musio; Francesca De Felice; Anna Lisa Magnante; Maria Ciolina; Carlo Nicola De Cecco; Marco Rengo; Adriano Redler; Andrea Laghi; Nicola Raffetto; Vincenzo Tombolini Journal: Biomed Res Int Date: 2013-07-10 Impact factor: 3.411
Authors: Madhurima R Chetan; Paul C Lyon; Feng Wu; Rachel Phillips; David Cranston; Martin J Gillies; Stana Bojanic Journal: Radiol Case Rep Date: 2019-08-01
Authors: Sharon L Giles; Matthew R D Brown; Ian Rivens; Martin Deppe; Merel Huisman; Young-Sun Kim; Paul Farquhar-Smith; John E Williams; Gail R Ter Haar; Nandita M deSouza Journal: J Vasc Interv Radiol Date: 2019-05-14 Impact factor: 3.464
Authors: Joe D Baal; William C Chen; Ulysis Baal; Sagar Wagle; Jed H Baal; Thomas M Link; Matthew D Bucknor Journal: Skeletal Radiol Date: 2021-05-21 Impact factor: 2.199
Authors: Sharon L Giles; Jessica M Winfield; David J Collins; Ian Rivens; John Civale; Gail R Ter Haar; Nandita M deSouza Journal: Eur Radiol Exp Date: 2018-05-10