Remy Klaassen1, Oliver J Gurney-Champion2, Marc R W Engelbrecht3, Jaap Stoker3, Johanna W Wilmink4, Marc G Besselink5, Arjan Bel6, Geertjan van Tienhoven6, Hanneke W M van Laarhoven4, Aart J Nederveen3. 1. Cancer Center Amsterdam, Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands; Cancer Center Amsterdam, LEXOR (Laboratory for Experimental Oncology and Radiobiology), Academic Medical Center, Amsterdam, The Netherlands. Electronic address: r.klaassen@amc.uva.nl. 2. Department of Radiology & Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands; Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands. 3. Department of Radiology & Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands. 4. Cancer Center Amsterdam, Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands. 5. Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. 6. Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands.
Abstract
PURPOSE: To compare 6 diffusion-weighted imaging (DWI) MRI models for response evaluation in patients with pancreatic ductal adenocarcinoma (PDAC). MATERIALS AND METHODS: DWI images were acquired at 3T for b = 0-600 s/mm2 in fourteen patients with advanced PDAC during 2 separate pretreatment sessions and 9 patients with (borderline) resectable PDAC pre and post neoadjuvant chemoradiation. Data was fitted with a mono-exponential (ADC), double mono-exponential to b = 0 and 100 s/mm2 (ADCfast), and b = 100 and 600 s/mm2 (ADCslow), IVIM model with D* free (D, f, D*) and fixed (D, f), tri-exponent (D, f1, f2), and stretched exponent model (DDC, α). Goodness of fit (adjusted R2), tumor to normal tissue contrast, repeatability (coefficient of variation), and parameter correlations (Spearman's rho) were assessed for the repeated measures. Treatment induced changes were assessed and compared to the repeatability. RESULTS: The mono-exponential model had the lowest goodness of fit in both tumor (R2 = 0.94) and normal-appearing pancreas (R2 = 0.88). Tumour to normal tissue contrast was higher for the 'non-diffusion' parameters (ADCfast, f, D*, f1, f2, α), with better repeatability for the diffusion parameters (ADC, ADCslow, D, DDC). Diffusion parameters were strongly correlated between the models (rho ≥0.81) and showed a general treatment associated increase. All models were able to identify individual treatment effects, showing a change greater than the repeatability in 5 out of 9 patients for at least one of the parameters. CONCLUSIONS: Individual treatment evaluation is possible with all investigated DWI models, with treatment associated changes exceeding the repeatability. The double monoexponential fit with ADCfast and ADCslow is able to discriminate between non-diffusion and diffusion related effects, is measured fast and can be performed on most commercial scanners, making it an attractive alternative for the more advanced multiparametric models in radiotherapy treatment evaluation.
PURPOSE: To compare 6 diffusion-weighted imaging (DWI) MRI models for response evaluation in patients with pancreatic ductal adenocarcinoma (PDAC). MATERIALS AND METHODS: DWI images were acquired at 3T for b = 0-600 s/mm2 in fourteen patients with advanced PDAC during 2 separate pretreatment sessions and 9 patients with (borderline) resectable PDAC pre and post neoadjuvant chemoradiation. Data was fitted with a mono-exponential (ADC), double mono-exponential to b = 0 and 100 s/mm2 (ADCfast), and b = 100 and 600 s/mm2 (ADCslow), IVIM model with D* free (D, f, D*) and fixed (D, f), tri-exponent (D, f1, f2), and stretched exponent model (DDC, α). Goodness of fit (adjusted R2), tumor to normal tissue contrast, repeatability (coefficient of variation), and parameter correlations (Spearman's rho) were assessed for the repeated measures. Treatment induced changes were assessed and compared to the repeatability. RESULTS: The mono-exponential model had the lowest goodness of fit in both tumor (R2 = 0.94) and normal-appearing pancreas (R2 = 0.88). Tumour to normal tissue contrast was higher for the 'non-diffusion' parameters (ADCfast, f, D*, f1, f2, α), with better repeatability for the diffusion parameters (ADC, ADCslow, D, DDC). Diffusion parameters were strongly correlated between the models (rho ≥0.81) and showed a general treatment associated increase. All models were able to identify individual treatment effects, showing a change greater than the repeatability in 5 out of 9 patients for at least one of the parameters. CONCLUSIONS: Individual treatment evaluation is possible with all investigated DWI models, with treatment associated changes exceeding the repeatability. The double monoexponential fit with ADCfast and ADCslow is able to discriminate between non-diffusion and diffusion related effects, is measured fast and can be performed on most commercial scanners, making it an attractive alternative for the more advanced multiparametric models in radiotherapy treatment evaluation.
Authors: Thomas F Stoop; Eran van Veldhuisen; L Bengt van Rijssen; Remy Klaassen; Oliver J Gurney-Champion; Ignace H de Hingh; Olivier R Busch; Hanneke W M van Laarhoven; Krijn P van Lienden; Jaap Stoker; Johanna W Wilmink; C Yung Nio; Aart J Nederveen; Marc R W Engelbrecht; Marc G Besselink Journal: Langenbecks Arch Surg Date: 2022-10-15 Impact factor: 2.895
Authors: Marian A Troelstra; Julia J Witjes; Anne-Marieke van Dijk; Anne L Mak; Oliver Gurney-Champion; Jurgen H Runge; Diona Zwirs; Daniela Stols-Gonçalves; Aelko H Zwinderman; Marije Ten Wolde; Houshang Monajemi; Sandjai Ramsoekh; Ralph Sinkus; Otto M van Delden; Ulrich H Beuers; Joanne Verheij; Max Nieuwdorp; Aart J Nederveen; Adriaan G Holleboom Journal: J Magn Reson Imaging Date: 2021-05-15 Impact factor: 5.119
Authors: Oliver J Gurney-Champion; David J Collins; Andreas Wetscherek; Mihaela Rata; Remy Klaassen; Hanneke W M van Laarhoven; Kevin J Harrington; Uwe Oelfke; Matthew R Orton Journal: Phys Med Biol Date: 2019-05-17 Impact factor: 3.609
Authors: Miriam Klauß; Wolfram Stiller; Philipp Mayer; Franziska Fritz; Marco Koell; Stephan Skornitzke; Frank Bergmann; Matthias M Gaida; Thilo Hackert; Klaus Maier-Hein; Frederik B Laun; Hans-Ulrich Kauczor; Lars Grenacher Journal: Cancer Imaging Date: 2021-01-19 Impact factor: 3.909
Authors: Oliver J Gurney-Champion; Faisal Mahmood; Marcel van Schie; Robert Julian; Ben George; Marielle E P Philippens; Uulke A van der Heide; Daniela Thorwarth; Kathrine R Redalen Journal: Radiother Oncol Date: 2020-02-27 Impact factor: 6.280
Authors: Remy Klaassen; Anne Steins; Oliver J Gurney-Champion; Maarten F Bijlsma; Geertjan van Tienhoven; Marc R W Engelbrecht; Casper H J van Eijck; Mustafa Suker; Johanna W Wilmink; Marc G Besselink; Olivier R Busch; Onno J de Boer; Marc J van de Vijver; Gerrit K J Hooijer; Joanne Verheij; Jaap Stoker; Aart J Nederveen; Hanneke W M van Laarhoven Journal: Mol Oncol Date: 2020-06-23 Impact factor: 6.603