Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Changes in apparent diffusion coefficient and pathological response in colorectal liver metastases after preoperative chemotherapy

Eriksson, Sam LU ; Bengtsson, Johan LU orcid ; Torén, William LU ; Lätt, Jimmy LU ; Andersson, Roland LU and Sturesson, Christian LU (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)
Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
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
  • pmid:35084232
  • scopus:85124085618
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
2024-04-24 18:54:12
@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}},
}