Apparent diffusion coefficient (ADC) change on repeated diffusion-weighted magnetic resonance imaging during radiochemotherapy for non-small cell lung cancer: A pilot study

Elisabeth Weiss; John C Ford; Kathryn M Olsen; Kishor Karki; Siddharth Saraiya; Robert Groves; Geoffrey D Hugo

doi:10.1016/j.lungcan.2016.04.001

Apparent diffusion coefficient (ADC) change on repeated diffusion-weighted magnetic resonance imaging during radiochemotherapy for non-small cell lung cancer: A pilot study

Lung Cancer. 2016 Jun:96:113-9. doi: 10.1016/j.lungcan.2016.04.001. Epub 2016 Apr 4.

Authors

Elisabeth Weiss¹, John C Ford², Kathryn M Olsen³, Kishor Karki⁴, Siddharth Saraiya⁴, Robert Groves⁵, Geoffrey D Hugo⁴

Affiliations

¹ Department of Radiation Oncology, Virginia Commonwealth University, 401 College Street, Richmond, VA 23298, USA. Electronic address: elisabeth.weiss@vcuhealth.org.
² Department of Radiation Oncology, Virginia Commonwealth University, 401 College Street, Richmond, VA 23298, USA; Department of Radiation Oncology, University of Miami, 1475 NW 12th Ave, Miami, FL 33136, USA.
³ Department of Radiology, Virginia Commonwealth University, 1101 East Marshall Street, Richmond, VA 23298, USA; Department of Radiology, University of Colorado, 1380 Lawrence Street, Denver, CO 80204, USA.
⁴ Department of Radiation Oncology, Virginia Commonwealth University, 401 College Street, Richmond, VA 23298, USA.
⁵ Department of Radiology, Virginia Commonwealth University, 1101 East Marshall Street, Richmond, VA 23298, USA.

PMID: 27133760
DOI: 10.1016/j.lungcan.2016.04.001

Abstract

Objectives: Serial diffusion-weighted magnetic resonance imaging (DW-MRI) during radiochemotherapy of non-small cell lung cancer (NSCLC) is analyzed to investigate the apparent diffusion coefficient (ADC) as a potential biomarker for tumor response.

Methods: Ten patients underwent DW-MRI prior to and at three and six weeks during radiochemotherapy. Three methods of contouring primary tumors (PT) were performed to evaluate the impact of tumor heterogeneity on ADC values: PTT: whole tumor volume; PTT-N: PTT-necrosis; PTL: small volume of presumed active tumor with low ADC value. Pretreatment and during-treatment absolute ADC values and ADC value changes were analyzed for PT and involved lymph nodes (LN).

Results: ADC values for PTT, PTT-N, PTL and LN increased by 8-14% (PT) and 15% (LN) at three weeks, and 19-26% and 23% at 6 weeks post initial treatment (p=0.04-0.002). Average percent ADC value increase was smaller than tumor volume regression (p=0.06-0.0005). Patients with overall survival <12 months had a lower increase of ADC values compared to longer surviving patients (p=0.008 for PTT).

Conclusions: Significant ADC value increases during radiochemotherapy for non-small cell lung cancer were observed. ADC value change during treatment appears to be an independent marker of patient outcome and warrants further investigation.

Keywords: Diffusion-weighted MRI; Non small cell lung cancer; Radiotherapy; Response assessment.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Carcinoma, Non-Small-Cell Lung / diagnostic imaging*
Carcinoma, Non-Small-Cell Lung / pathology
Carcinoma, Non-Small-Cell Lung / therapy*
Chemoradiotherapy
Diffusion Magnetic Resonance Imaging / methods*
Female
Humans
Lung Neoplasms / diagnostic imaging*
Lung Neoplasms / pathology
Lung Neoplasms / therapy*
Male
Middle Aged
Neoplasm Staging
Pilot Projects
Reproducibility of Results
Tumor Burden / drug effects

Grants and funding

P30 CA016059/CA/NCI NIH HHS/United States