Aims and objectives
The liver is one of the most common metastatic sites of colorectal cancer,
nearly 50% patients develop hepatic metastases during the disease.
Metastatic spread influences survival rate of those patients.
The diffusion-weighted imaging (DWI) is MRI sequence designed to detect random movement of water protons in the extracellular compartment.
Biophysical parameter expressing the flexibility of Brownian motion is the apparent diffusion coefficient (ADC).
ADC values for b parameter lower than 300s/mm2 are influenced by perfusion whereas ADC values for b greater than 300s/mm2 depend mainly...
Methods and materials
We analysed the MRI studies of 52 patients (18women,
34men,
aged 43-83).
The inclusion criteria of the study were a) colorectal adenocarcinoma confirmed by histological examination,
b) presence of metastatic lesions in the liver diagnosed by multiphase contrast-enhanced CT and/or dynamic contrast-enhanced MR (without liver biopsy),
c) number of metastatic foci in the liver between 1 and 5 and size of the foci between 10 and 50mm,
d) disqualification from surgical treatment,
d) progression during or after chemotherapy,
e) qualification to RFA treatment,
f) no...
Results
The total number of analysed lesions was 110 (on average 2 per patient),
83 of them were completely ablated and in 27 residual disease was observed.
Out of this group,
52 lesions (a single one with the highest ADC value in case of multiple lesions) were included into Kaplan-Meier analysis.
9 cases out of 52 were censored (17.3%).
In ADC maps for b value of 0-15s/mm2,
24 lesions presented with ADC values above 2.49mm2/s with 1 censored case in this group.
In ADC maps for...
Conclusion
The study showed significant differences in survival rate depending on diffusion influenced ADC values of metastatic lesions.
The high ADC values correspond probably with necrosis in highly malignant lesions,
the survival rates in patients with such findings were significantly lower.
References
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