title: Diffusion MRI: a new strategy for assessment of cancer therapeutic efficacy.
abstract: 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.
authors.affiliation: 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
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Chenevert
authors.forename: Charles R
authors.initials: CR
authors.lastname: Meyer
authors.forename: Bradford A
authors.initials: BA
authors.lastname: Moffat
authors.forename: Alnawaz
authors.initials: A
authors.lastname: Rehemtulla
authors.forename: Suresh K
authors.initials: SK
authors.lastname: Mukherji
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Gebarski
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Quint
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Robertson
authors.forename: Theodore S
authors.initials: TS
authors.lastname: Lawrence
authors.forename: Larry
authors.initials: L
authors.lastname: Junck
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Taylor
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Johnson
authors.forename: Qian
authors.initials: Q
authors.lastname: Dong
authors.forename: Karin M
authors.initials: KM
authors.lastname: Muraszko
authors.forename: James A
authors.initials: JA
authors.lastname: Brunberg
authors.forename: Brian D
authors.initials: BD
authors.lastname: Ross
mesh_terms: 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
chemical_list: D014867:Water