Functional diffusion map: A noninvasive MR1 biomarker for early stratification of clinical brain tumor response
Functional diffusion map: A noninvasive MR1 biomarker for early stratification of clinical brain tumor response
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DOI：
10.1073/pnas.0501532102
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发表时间：
2005-04-12
影响因子：
11.1
通讯作者：
Ross, BD
中科院分区：
文献类型：
--
作者：
Moffat, BA;Chenevert, TL;Ross, BD
脑癌患者放疗和化疗疗效的评估传统上是通过测量治疗后几个月肿瘤大小的变化来完成的。在分次治疗的早期阶段使用非侵入性成像来确定特定治疗是否有效的能力将提供优化个体患者管理并避免不必要的全身毒性、费用和治疗延迟的机会。我们研究了通过使用扩散MRI量化的肿瘤组织中水的布朗运动的变化是否可以用作早期预测脑癌患者治疗反应的生物标志物。20例脑肿瘤患者在开始治疗前接受标准和弥散MRI检查。在开始化疗和/或放疗后3周获得额外的图像。将图像与治疗前扫描进行配准，计算肿瘤水扩散值的变化，并显示为功能扩散图（FDM），以与临床反应相关。在治疗过程中成像的20名患者中，6名被分类为具有部分响应，6名被分类为稳定疾病，8名被分类为进行性疾病。发现fDM可预测治疗开始后3周的患者反应，表明肿瘤扩散值的早期变化可用作后续体积肿瘤反应的预后指标。总体而言，FDM分析提供了一种预测脑肿瘤患者治疗反应的早期生物标志物。
Assessment of radiation and chemotherapy efficacy for brain cancer patients is traditionally accomplished by measuring changes in tumor size several months after therapy has been administered. The ability to use noninvasive imaging during the early stages of fractionated therapy to determine whether a particular treatment will be effective would provide an opportunity to optimize individual patient management and avoid unnecessary systemic toxicity, expense, and treatment delays. We investigated whether changes in the Brownian motion of water within tumor tissue as quantified by using diffusion MRI could be used as a biomarker for early prediction of treatment response in brain cancer patients. Twenty brain tumor patients were examined by standard and diffusion MRI before initiation of treatment. Additional images were acquired 3 weeks after initiation of chemo- and/or radiotherapy. Images were coregistered to pretreatment scans, and changes in tumor water diffusion values were calculated and displayed as a functional diffusion map (fDM) for correlation with clinical response. Of the 20 patients imaged during the course of therapy, 6 were classified as having a partial response, 6 as stable disease, and 8 as progressive disease. The fDMs were found to predict patient response at 3 weeks from the start of treatment, revealing that early changes in tumor diffusion values could be used as a prognostic indicator of subsequent volumetric tumor response. Overall, fDM analysis provided an early biomarker for predicting treatment response in brain tumor patients.