Diffusion-weighted imaging in cancer: physical foundations and applications of restriction spectrum imaging.
Diffusion-weighted imaging in cancer: physical foundations and applications of restriction spectrum imaging.
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DOI：
10.1158/0008-5472.can-13-3534
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发表时间：
2014-09-01
期刊：
影响因子：
11.2
通讯作者：
Dale AM
中科院分区：
文献类型：
--
作者：
White NS;McDonald C;Farid N;Kuperman J;Karow D;Schenker-Ahmed NM;Bartsch H;Rakow-Penner R;Holland D;Shabaik A;Bjørnerud A;Hope T;Hattangadi-Gluth J;Liss M;Parsons JK;Chen CC;Raman S;Margolis D;Reiter RE;Marks L;Kesari S;Mundt AJ;Kane CJ;Carter BS;Bradley WG;Dale AM
扩散加权成像（DWI）自21世纪初以来一直处于癌症成像的最前沿。在其应用于临床肿瘤学之前，由于其在脑梗死诊断中的实用性，这种强大的技术已经获得了广泛的认可。在这一初步成功之后，DWI检测固有组织对比度的能力开始在肿瘤学领域得到利用。虽然最初的肿瘤学应用，肿瘤检测和表征，评估治疗反应，预测生存主要是在神经肿瘤学领域，DWI的范围已经扩大到包括前列腺，乳腺和肝脏的肿瘤成像。尽管其日益成功和应用，DWI信号的潜在物理基础的误解存在于研究人员和临床医生。在这篇综述中，我们提供了一个详细的解释扩散对比度的生物物理基础，强调受阻和限制扩散之间的差异，并阐明如何在组织中的扩散参数来自通过扩散模型的测量。我们描述了一种先进的DWI建模技术，称为限制谱成像（RSI）。该技术提供了一种更直接的肿瘤细胞体内测量，因为它能够根据其内在扩散特性区分组织内可分离的水池。以RSI为例，我们强调了高级DWI技术解决神经肿瘤学关键临床挑战的能力，包括改善肿瘤的显著性，区分治疗的实际反应和假反应，以及描绘瘤周水肿区域的白色物质束。我们还讨论了如何RSI，结合新的方法来校正固有的空间失真的扩散MRI扫描，可以使更精确的空间靶向病变，放射肿瘤学和手术计划的影响。
Diffusion weighted imaging (DWI) has been at the forefront of cancer imaging since the early 2000’s. Prior to its application in clinical oncology, this powerful technique had already achieved widespread recognition due to its utility in the diagnosis of cerebral infarction. Following this initial success, the ability of DWI to detect inherent tissue contrast began to be exploited in the field of oncology. Although the initial oncologic applications for tumor detection and characterization, assessing treatment response, and predicting survival were primarily in the field of neuro-oncology, the scope of DWI has since broadened to include oncologic imaging of the prostate gland, breast, and liver. Despite its growing success and application, misconceptions as to the underlying physical basis of the DWI signal exist among researchers and clinicians alike. In this review, we provide a detailed explanation of the biophysical basis of diffusion contrast, emphasizing the difference between hindered and restricted diffusion, and elucidating how diffusion parameters in tissue are derived from the measurements via the diffusion model. We describe one advanced DWI modeling technique, called Restriction Spectrum Imaging (RSI). This technique offers a more direct in vivo measure of tumor cells, due to its ability to distinguish separable pools of water within tissue based on their intrinsic diffusion characteristics. Using RSI as an example, we then highlight the ability of advanced DWI techniques to address key clinical challenges in neuro-oncology, including improved tumor conspicuity, distinguishing actual response to therapy from pseudoresponse, and delineation of white matter tracts in regions of peritumoral edema. We also discuss how RSI, combined with new methods for correction of spatial distortions inherent diffusion MRI scans, may enable more precise spatial targeting of lesions, with implications for radiation oncology, and surgical planning.