title: A literature review of the association between diffusion-weighted MRI derived apparent diffusion coefficient and tumour aggressiveness in pelvic cancer.
abstract: Diffusion-weighted magnetic resonance imaging (DW-MRI) is used extensively to improve tumour detection and localization because it offers excellent soft tissue contrast between malignant and non-malignant tissues. It also provides a quantitative biomarker; the apparent diffusion coefficient (ADC) can be derived from DW-MRI sequences using multiple diffusion weightings. ADC reflects the tumour microenvironment, e.g. cell membrane integrity and cellularity and has potential for reporting on tumour aggressiveness. This review focuses on the use of the DW-MRI derived imaging biomarker ADC to reflect tumour aggressiveness and its potential impact in managing pelvic cancer patients. The clinical studies which evaluate the role of ADC in pelvic tumours (prostate, bladder, rectal, ovary, cervix and uterus) are summarized and the evidence linking ADC values with tumour aggressiveness is evaluated.
authors.affiliation: European Organization for Research and Treatment of Cancer Headquarters, Brussels, Belgium.
authors.forename: V R
authors.initials: VR
authors.lastname: Bollineni
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Kramer
authors.affiliation: European Organization for Research and Treatment of Cancer Headquarters, Brussels, Belgium.
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.affiliation: European Organization for Research and Treatment of Cancer Headquarters, Brussels, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Melidis
authors.affiliation: CRUK Cancer Imaging Centre, MRI Unit, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK.
authors.forename: N M
authors.initials: NM
authors.lastname: deSouza
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D016889:Endometrial Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D010051:Ovarian Neoplasms / Q000473:pathology; D010386:Pelvic Neoplasms / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology; D012004:Rectal Neoplasms / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000473:pathology
keywords: Apparent diffusion coefficient; Bladder cancer; Cervical cancer; Diffusion-weighted MRI; Endometrial cancer and tumour aggressiveness; Ovarian cancer; Prostate cancer; Rectal cancer