O04DIFFUSION WEIGHTED MRI DISCRIMINATES PRIMARY CANCER TYPE AND OUTCOME IN BRAIN METASTASES
| Autor: | Rasheed Zakaria, M. Bhojak, Vanessa Sluming, M. Radon, Kumar Das, Michael D. Jenkinson |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Cancer Research
medicine.medical_specialty Pathology business.industry medicine.medical_treatment Hazard ratio medicine.disease Radiosurgery Log-rank test White matter body regions Abstracts medicine.anatomical_structure Oncology medicine Adenocarcinoma Effective diffusion coefficient Neurology (clinical) Radiology business Brain metastasis Diffusion MRI |
| Popis: | INTRODUCTION: Diffusion weighted MRI (DWI) is a powerful technique for non-invasive assessment of many solid cancers. We investigated whether pre-operative DWI characteristics of cerebral metastases correlate with patient outcomes. METHOD: Retrospective analysis of 76 metastases with DWI performed pre-operatively at 1.5T. Apparent Diffusion Coefficient (ADC) maps were generated and measurements were taken from the tumour, peritumoral region, across the brain-tumour interface (ADC transition coefficient or (ATC)) and in normal white matter. Outcome measures were overall survival (OS) and time to local recurrence (PFS). Tissue was assessed to determine cellularity. RESULTS: ADC changes in the tumour and peritumoral region differed between metastases of different primaries. Metastases with higher tumour ADC values were associated with longer OS and PFS. This was also demonstrated in the most common brain metastasis, lung adenocarcinoma (n = 36). Tumours with a sharp change in ADC across their boundary (high ATC) had a significantly shorter OS, 6.8 months (95% CI 5.3 - 8.4) as compared to those with a low ATC and hence diffuse boundary (11.2 months, 95% CI 8.3 - 14.0, Log rank Chi-Square = 4.19, p = 0.041). The ATC was the only imaging metric which independently predicted overall survival in multivariate analysis (hazard ratio 0.54, 95% CI 0.3 - 0.97, p = 0.04). Cellularity was positively related to ATC and inversely related to tumour ADC. CONCLUSION: DWI demonstrates changes in the tumour, tumour edge and peritumoral region which are not visible on routine MRI. ADC maps could be used to predict patient outcomes more accurately and plan surgical margins or stereotactic radiosurgery fields. |
| Databáze: | OpenAIRE |
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