Type:
Educational Exhibit
Keywords:
Outcomes, Neoplasia, Cancer, Treatment effects, Chemotherapy, MR-Diffusion/Perfusion, MR, Oncology, MR physics
Authors:
A. Amlani, S. J. Withey, K. Owczarczyk, D. Prezzi, V. Goh; London/UK
DOI:
10.1594/ecr2018/C-2040
Background
Dynamic contrast enhanced MRI (DCE-MRI) permits assessment of the vascular status of tumours and adjacent tissue [1].
The technique not only has the potential to be used at the diagnostic stage to differentiate between tumour types [2],
but it can also be used to assess the relationships between the microvascular function of tumours pre and post therapy [1].
An ROI is drawn over the tumours and several parameters can be derived.
DCE-MRI parameters range from simple semiquantitative data obtained from time-signal intensity plots [3] ranging to quantitative analysis derived from pharmacokinetic models [3].
Routine quantitative model-based parameters derived include the volume transfer rate constant (Ktrans),
relative extravascular extracellular space (Ve),
and the efflux rate constant (Kep) [3].
Although their relative utility in assessing tumours has been discussed extensively [1],
the role of these parameters,
in particular Ve,
in predicting response to chemo/radiotherapy remains unclear.
Ve refers to the extracellular,
extravascular volume and whilst consensus guidelines suggest it should be measured as a secondary endpoint in pharmacodynamic assessment of tumour response [16],
most focus is on Ktrans.
We undertook a systematic review of the literature to clarify the role of Ve in predicting response to chemo/radiotherapy in malignant disease.