OPENING SESSION - ismrm

Monday AM
14:24 91. Apparent Diffusion Coefficient Predicts Biochemical Response in Neuroendocrine
Liver Metastases Treated Using Targeted Radiolabelled Therapy
Dow-Mu Koh 1 , Keiko Miyazaki 2 , Matthew Orton 2 , Toni Wallace 1 , David J. Collins 2 ,
Martin O. Leach 2 , Val Lewington 3
1 Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom; 2 CRUK-
EPSRC Cancer Imaging Centre, Institute of Cancer Research, Sutton, Surrey, United Kingdom; 3 Department of
Nuclear Medicine, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom
We investigated diffusion-weighted MR imaging (DW-MRI) for assessing treatment response of liver metastases of neuroendocrine
origin to targeted radiolabelled therapy 90Y-DOTATOC. The quantitative apparent diffusion coefficient (ADC) appears to be a
promising response and prognostic biomarker. Responders were found to have a lower pre-treatment value compared with nonresponders;
and also demonstrated a significant increase in ADC at 2 months after the first cycle of treatment. Response defined by
ADC changes also showed good agreement with biochemical response.
14:36 92. Diffusion-Weighted MR Imaging of Pulmonary Lesions: Effectiveness of Apparent
Diffusion Coefficient Quantification and Lesion-To-Spinal Cord Signal Intensity Ratio in the
Lesion Characterization
Nevzat Karabulut 1 , Vefa Çakmak 1
1 Radiology, Pamukkale University, School of Medicine, Denizli, Turkey
Diffusion-weighted imaging (DWI) of lung is a useful adjunct to conventional chest MR imaging sequences improving lesion
characterization. Differentiation of malignant tumors from benign lesions can be achieved using apparent diffusion coefficient (ADC)
quantification and lesion-to-spinal cord signal intensity ratio (LSR). Due to increased cellularity and less extracellular space impeding
the water diffusion, malignant tumors tend to have reduced ADC and increased LSR. Our results show that ADC quantification is
more accurate than LSR for the differentiation of lung lesions. Because DWI is a non-invasive technique improving lesion
characterization, it should be incorporated into routine chest MR imaging protocols.
14:48 93. Improving IVIM Derived F-Maps of Pancreatic Tumors with Automatic Duct and
Vessel Segmentation
Thomas Joseph Re 1,2 , Mirium Klauss 3 , Andreas Lemke 4 , Frederik B. Laun 2 , Dirk Simon 5 ,
Riccardo Manfredi 1 , Roberto Pozzi Mucelli 1 , Stefan Delorme 2 , Bram Stieltjes 2
1 Radiology, University of Verona, Verona, Italy; 2 Radiology, DKFZ, Heidelberg, BW, Germany; 3 Radiology,
University of Heidelberg, Heidelberg, BW, Germany; 4 MS Computer Assisted Clinical Medicine, University of
Heidelberg; 5 Software Development for Integrated Diagnostics and Therapy, DKFZ, Heidelberg, BW, Germany
Maps of IVIM model derived perfusion fraction f (f-maps) of the pancreas show potential for the identification of pancreatic
adenocarcinoma lesions which appear hypointense in these images. Unfortunately, since bile and pancreatic ducts also appear as
hypointense in f-maps, their presence adjacent to tumors can lead to tumor delineation errors. A novel approach which automatically
segmented vessels and ducts in the f-maps based on integrated diffusion coefficient D data was tested in 43 patients and proved to be
superior to both the ADC or f-map for tumor delineation.
15:00 94. Higher Pre-Treatment Apparent Diffusion Coefficient Predicts Poorer Disease
Survival in Patients with Colorectal Hepatic Metastasis
Henry Ho Ching Tam 1 , David J. Collins 2 , Gina Brown 1 , Ian Chau 3 , David Cunningham 3 ,
Martin O. Leach 2 ,
Dow-Mu Koh 1
1 Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom; 2 CRUK-
EPSRC Cancer Imaging Centre, Institute of Cancer Research, Sutton, Surrey, United Kingdom; 3 Department of
Medical Oncology (Gastrointestinal), Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom
We report the use of DW-MRI for assessing response to chemotherapy and long-term outcome in patients with colorectal hepatic
metastasis. Non-responders were found to have a higher pre-treatment apparent diffusion coefficient (ADC). High pre-treatment ADC
was also associated with a shorter progression free survival time, independent of response to chemotherapy and other prognostic
factors. This study demonstrates the potential of DW-MRI as a biologically relevant response and prognostic biomarker.
15:12 95. Value of Diffusion Weighted Imaging (DWI) as an Early Imaging Biomarker for
Prediction of Therapy Effect in Patients with Colorectal Metastases Following Selective
Internal Radiotherapy (SIRT)
Martin Zeile 1 , Christian Wybranski 1 , David Loewenthal 1 , Maciej Pech 1 , Frank
Fischbach 1 , Ricarda Ruehl 1 , Holger Amthauer 1 , Jens Ricke 1 , Oliver Dudeck 1
1 Clinic for Radiology and Nuclear Medicine, University Clinic Magdeburg, Magdeburg, 39120, Germany
Clinical studies revealed the potential of diffusion weighted imaging (DWI) as a biomarker for predicting tumor response. 41
colorectal liver metastases in 18 patients who underwent SIRT were examined before, 1 to 3 days after and 6 weeks following
radioembolization by MRI including DWI. Lesions were categorized in responding (RL) and non-responding (NRL) according to
change in tumor volume after 6 weeks. On early MRI, NRL showed no change in apparent diffusion coefficient (ADC), while a