Changes in apparent diffusion coefficient and pathological response in colorectal liver metastases after preoperative chemotherapy
(2023) In Acta Radiologica 64(1). p.51-57- Abstract
Background: The pathological response to preoperative chemotherapy of colorectal liver metastases (CRLMs) is predictive of long-term prognosis after liver resection. Accurate preoperative assessment of chemotherapy response could enable treatment optimization. Purpose: To investigate whether changes in lesion-apparent diffusion coefficient (ADC) measured with diffusion-weighted magnetic resonance imaging (MRI) can be used to assess pathological treatment response in patients with CRLMs undergoing preoperative chemotherapy. Material and Methods: Patients who underwent liver resection for CRLMs after preoperative chemotherapy between January 2011 and December 2019 were retrospectively included if they had undergone MRI before and after... (More)
Background: The pathological response to preoperative chemotherapy of colorectal liver metastases (CRLMs) is predictive of long-term prognosis after liver resection. Accurate preoperative assessment of chemotherapy response could enable treatment optimization. Purpose: To investigate whether changes in lesion-apparent diffusion coefficient (ADC) measured with diffusion-weighted magnetic resonance imaging (MRI) can be used to assess pathological treatment response in patients with CRLMs undergoing preoperative chemotherapy. Material and Methods: Patients who underwent liver resection for CRLMs after preoperative chemotherapy between January 2011 and December 2019 were retrospectively included if they had undergone MRI before and after preoperative chemotherapy on the same 1.5-T MRI scanner with diffusion-weighted imaging with b-values 50, 400, and 800 s/mm2. The pathological chemotherapy response was assessed using the tumor regression grade (TRG) by AJCC/CAP. Lesions were divided into two groups: pathological responding (TRG 0–2) and non-responding (TRG 3). The change in lesion ADC after preoperative chemotherapy was compared between responding and non-responding lesions. Results: A total of 27 patients with 49 CRLMs were included, and 24/49 lesions showed a pathological chemotherapy response. After chemotherapy, ADC increased in both pathological responding (pretreatment ADC: 1.26 [95% confidence interval (CI)=1.06–1.37] vs. post-treatment ADC: 1.33 [95% CI=1.13–1.56] × 10−3 mm2/s; P = 0.026) and non-responding lesions (1.12 [95% CI=0.980–1.21] vs. 1.20 [95% CI=1.09–1.43] × 10−3 mm2/s; P = 0.018). There was no difference in median relative difference in ADC after chemotherapy between pathological responding and non-responding lesions (15.8 [95% CI=1.42–26.3] vs. 7.17 [95% CI=−4.31 to 31.2]%; P = 0.795). Conclusion: Changes in CRLM ADCs did not differ between pathological responding and non-responding lesions.
(Less)
- author
- Eriksson, Sam LU ; Bengtsson, Johan LU ; Torén, William LU ; Lätt, Jimmy LU ; Andersson, Roland LU and Sturesson, Christian LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Colorectal liver metastases, liver, magnetic resonance diffusion, pathology, preoperative chemotherapy, surgery
- in
- Acta Radiologica
- volume
- 64
- issue
- 1
- pages
- 51 - 57
- publisher
- SAGE Publications
- external identifiers
-
- scopus:85124085618
- pmid:35084232
- ISSN
- 0284-1851
- DOI
- 10.1177/02841851221074496
- language
- English
- LU publication?
- yes
- id
- c5b9adac-1343-4f0b-bfa3-588b28cf36b4
- date added to LUP
- 2022-04-06 11:45:56
- date last changed
- 2024-07-18 03:55:16
@article{c5b9adac-1343-4f0b-bfa3-588b28cf36b4, abstract = {{<p>Background: The pathological response to preoperative chemotherapy of colorectal liver metastases (CRLMs) is predictive of long-term prognosis after liver resection. Accurate preoperative assessment of chemotherapy response could enable treatment optimization. Purpose: To investigate whether changes in lesion-apparent diffusion coefficient (ADC) measured with diffusion-weighted magnetic resonance imaging (MRI) can be used to assess pathological treatment response in patients with CRLMs undergoing preoperative chemotherapy. Material and Methods: Patients who underwent liver resection for CRLMs after preoperative chemotherapy between January 2011 and December 2019 were retrospectively included if they had undergone MRI before and after preoperative chemotherapy on the same 1.5-T MRI scanner with diffusion-weighted imaging with b-values 50, 400, and 800 s/mm<sup>2</sup>. The pathological chemotherapy response was assessed using the tumor regression grade (TRG) by AJCC/CAP. Lesions were divided into two groups: pathological responding (TRG 0–2) and non-responding (TRG 3). The change in lesion ADC after preoperative chemotherapy was compared between responding and non-responding lesions. Results: A total of 27 patients with 49 CRLMs were included, and 24/49 lesions showed a pathological chemotherapy response. After chemotherapy, ADC increased in both pathological responding (pretreatment ADC: 1.26 [95% confidence interval (CI)=1.06–1.37] vs. post-treatment ADC: 1.33 [95% CI=1.13–1.56] × 10<sup>−3</sup> mm<sup>2</sup>/s; P = 0.026) and non-responding lesions (1.12 [95% CI=0.980–1.21] vs. 1.20 [95% CI=1.09–1.43] × 10<sup>−3</sup> mm<sup>2</sup>/s; P = 0.018). There was no difference in median relative difference in ADC after chemotherapy between pathological responding and non-responding lesions (15.8 [95% CI=1.42–26.3] vs. 7.17 [95% CI=−4.31 to 31.2]%; P = 0.795). Conclusion: Changes in CRLM ADCs did not differ between pathological responding and non-responding lesions.</p>}}, author = {{Eriksson, Sam and Bengtsson, Johan and Torén, William and Lätt, Jimmy and Andersson, Roland and Sturesson, Christian}}, issn = {{0284-1851}}, keywords = {{Colorectal liver metastases; liver; magnetic resonance diffusion; pathology; preoperative chemotherapy; surgery}}, language = {{eng}}, number = {{1}}, pages = {{51--57}}, publisher = {{SAGE Publications}}, series = {{Acta Radiologica}}, title = {{Changes in apparent diffusion coefficient and pathological response in colorectal liver metastases after preoperative chemotherapy}}, url = {{http://dx.doi.org/10.1177/02841851221074496}}, doi = {{10.1177/02841851221074496}}, volume = {{64}}, year = {{2023}}, }