Diffusion MRI: a new strategy for assessment of cancer therapeutic efficacy.
The use of anatomical imaging in clinical oncology practice traditionally relies on comparison of patient scans acquired before and following completion of therapeutic intervention. Therapeutic success is typically determined from inspection of gross anatomical images to assess changes in tumor size. Imaging could provide significant additional insight into therapeutic impact if a specific parameter or combination of parameters could be identified which reflect tissue changes at the cellular or physiologic level. This would provide an early indicator or treatment response/outcome in an individual patient before completion of therapy. Moreover, response of a tumor to therapeutic intervention may be heterogeneous. The use of imaging could assist in delineating therapeutic-induced spatial heterogeneity within a tumor mass by providing information related to specific regions that are resistant or responsive to treatment. Largely untapped potential resides in exploratory methods such as diffusion MRI, which is a nonvolumetric intravoxel measure of tumor response based upon water molecular mobility. Alterations in water mobility reflect changes in tissue structure at the cellular level. While the clinical utility of diffusion MRI for oncologic practice is still under active investigation, this overview on the use of diffusion MRI for the evaluation of brain tumors will serve to introduce how this approach may be applied in the future for the management of patients with solid tumors.
Chenevert
Thomas L
TL
Department of Radiology, Center for Molecular Imaging, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0030, USA. tlchenev@umich.edu
Meyer
Charles R
CR
Moffat
Bradford A
BA
Rehemtulla
Alnawaz
A
Mukherji
Suresh K
SK
Gebarski
Stephen S
SS
Quint
Douglas J
DJ
Robertson
Patricia L
PL
Lawrence
Theodore S
TS
Junck
Larry
L
Taylor
Jeremy M
JM
Johnson
Timothy D
TD
Dong
Qian
Q
Muraszko
Karin M
KM
Brunberg
James A
JA
Ross
Brian D
BD
D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D004058:Diffusion; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009369:Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D014867:Water / Q000378:metabolism
D014867:Water