Early Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations

Introduction: We compared the magnetic resonance imaging total tumor volume (TTV) and median apparent diffusion coefficient (ADC) of malignant pleural mesothelioma (MPM) before and at 4 weeks after chemotherapy, to evaluate whether these are potential early markers of treatment response. Methods: Di...

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Autores principales:	Sebastian Curcean, M.B.B.S., Lin Cheng, PhD, Simona Picchia, MD, Nina Tunariu, MD, David Collins, PhD, Matthew Blackledge, PhD, Sanjay Popat, MD, Mary O’Brien, MD, Anna Minchom, MD, Martin O. Leach, PhD, Dow-Mu Koh, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Diffusion-weighted imaging Malignant mesothelioma Treatment response Biomarker Modified RECIST Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/572e9a8380774a418ac096766e983c19
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spelling	oai:doaj.org-article:572e9a8380774a418ac096766e983c192021-11-24T04:34:37ZEarly Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations2666-364310.1016/j.jtocrr.2021.100253https://doaj.org/article/572e9a8380774a418ac096766e983c192021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666364321001120https://doaj.org/toc/2666-3643Introduction: We compared the magnetic resonance imaging total tumor volume (TTV) and median apparent diffusion coefficient (ADC) of malignant pleural mesothelioma (MPM) before and at 4 weeks after chemotherapy, to evaluate whether these are potential early markers of treatment response. Methods: Diffusion-weighted magnetic resonance imaging was performed in 23 patients with MPM before and after 4 weeks of chemotherapy. The TTV was measured by semiautomatic segmentation (GrowCut) and transferred onto ADC maps to record the median ADC. Test-retest repeatability of TTV and ADC was evaluated in eight patients. TTV and median ADC changes were compared between responders and nonresponders, defined using modified Response Evaluation Criteria In Solid Tumors on computed tomography (CT) at 12 weeks after treatment. TTV and median ADC were also correlated with CT size measurement and disease survival. Results: The test-retest 95% limits of agreement for TTV were −13.9% to 16.2% and for median ADC −1.2% to 3.3%. A significant increase in median ADC in responders was observed at 4 weeks after treatment (p = 0.02). Correlation was found between CT tumor size change at 12 weeks and median ADC changes at 4 weeks post-treatment (r = −0.560, p = 0.006). An increase in median ADC greater than 5.1% at 4 weeks has 100% sensitivity and 90% specificity for responders (area under the curve = 0.933, p < 0.001). There was also moderate correlation between median tumor ADC at baseline and overall survival (r = 0.45, p = 0.03). Conclusions: Diffusion-weighted magnetic resonance imaging measurements of TTV and median ADC in MPM have good measurement repeatability. Increase in ADC at 4 weeks post-treatment has the potential to be an early response biomarker.Sebastian Curcean, M.B.B.S.Lin Cheng, PhDSimona Picchia, MDNina Tunariu, MDDavid Collins, PhDMatthew Blackledge, PhDSanjay Popat, MDMary O’Brien, MDAnna Minchom, MDMartin O. Leach, PhDDow-Mu Koh, MDElsevierarticleDiffusion-weighted imagingMalignant mesotheliomaTreatment responseBiomarkerModified RECISTNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENJTO Clinical and Research Reports, Vol 2, Iss 12, Pp 100253- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diffusion-weighted imaging Malignant mesothelioma Treatment response Biomarker Modified RECIST Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Diffusion-weighted imaging Malignant mesothelioma Treatment response Biomarker Modified RECIST Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Sebastian Curcean, M.B.B.S. Lin Cheng, PhD Simona Picchia, MD Nina Tunariu, MD David Collins, PhD Matthew Blackledge, PhD Sanjay Popat, MD Mary O’Brien, MD Anna Minchom, MD Martin O. Leach, PhD Dow-Mu Koh, MD Early Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations
description	Introduction: We compared the magnetic resonance imaging total tumor volume (TTV) and median apparent diffusion coefficient (ADC) of malignant pleural mesothelioma (MPM) before and at 4 weeks after chemotherapy, to evaluate whether these are potential early markers of treatment response. Methods: Diffusion-weighted magnetic resonance imaging was performed in 23 patients with MPM before and after 4 weeks of chemotherapy. The TTV was measured by semiautomatic segmentation (GrowCut) and transferred onto ADC maps to record the median ADC. Test-retest repeatability of TTV and ADC was evaluated in eight patients. TTV and median ADC changes were compared between responders and nonresponders, defined using modified Response Evaluation Criteria In Solid Tumors on computed tomography (CT) at 12 weeks after treatment. TTV and median ADC were also correlated with CT size measurement and disease survival. Results: The test-retest 95% limits of agreement for TTV were −13.9% to 16.2% and for median ADC −1.2% to 3.3%. A significant increase in median ADC in responders was observed at 4 weeks after treatment (p = 0.02). Correlation was found between CT tumor size change at 12 weeks and median ADC changes at 4 weeks post-treatment (r = −0.560, p = 0.006). An increase in median ADC greater than 5.1% at 4 weeks has 100% sensitivity and 90% specificity for responders (area under the curve = 0.933, p < 0.001). There was also moderate correlation between median tumor ADC at baseline and overall survival (r = 0.45, p = 0.03). Conclusions: Diffusion-weighted magnetic resonance imaging measurements of TTV and median ADC in MPM have good measurement repeatability. Increase in ADC at 4 weeks post-treatment has the potential to be an early response biomarker.
format	article
author	Sebastian Curcean, M.B.B.S. Lin Cheng, PhD Simona Picchia, MD Nina Tunariu, MD David Collins, PhD Matthew Blackledge, PhD Sanjay Popat, MD Mary O’Brien, MD Anna Minchom, MD Martin O. Leach, PhD Dow-Mu Koh, MD
author_facet	Sebastian Curcean, M.B.B.S. Lin Cheng, PhD Simona Picchia, MD Nina Tunariu, MD David Collins, PhD Matthew Blackledge, PhD Sanjay Popat, MD Mary O’Brien, MD Anna Minchom, MD Martin O. Leach, PhD Dow-Mu Koh, MD
author_sort	Sebastian Curcean, M.B.B.S.
title	Early Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations
title_short	Early Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations
title_full	Early Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations
title_fullStr	Early Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations
title_full_unstemmed	Early Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations
title_sort	early response to chemotherapy in malignant pleural mesothelioma evaluated using diffusion-weighted magnetic resonance imaging: initial observations
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/572e9a8380774a418ac096766e983c19
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Early Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations

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