Baseline 3D-ADC outperforms 2D-ADC in predicting response to treatment in patients with colorectal liver metastases

Daniel Fadaei Fouladi, Manijeh Zarghampour, Pallavi Pandey, Ankur Pandey, Farnaz Najmi Varzaneh, Mounes Aliyari Ghasabeh, Pegah Khoshpouri, Ihab R. Kamel

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To examine the value of baseline 3D-ADC and to predict short-term response to treatment in patients with hepatic colorectal metastases (CLMs). Methods: Liver MR images of 546 patients with CLMs (2008–2015) were reviewed retrospectively and 68 patients fulfilled inclusion criteria. Patients had received systemic chemotherapy (n = 17), hepatic trans-arterial chemoembolization or TACE (n = 34), and 90Y radioembolization (n = 17). Baseline (pre-treatment) 3D-ADC (volumetric) of metastatic lesions was calculated employing prototype software. RECIST 1.1 was used to assess short-term response to treatment. Prediction of response to treatment by baseline 3D-ADC and 2D-ADC (ROI-based) was also compared in all patients. Results: Partial response to treatment (minimum 30% decrease in tumor largest transverse diameter) was seen in 35.3% of patients; 41.2% with systemic chemotherapy, 32.4% with TACE, and 35.3% with 90Y radioembolization (p = 0.82). Median baseline 3D-ADC was significantly lower in responding than in nonresponding lesions. Area under the curve (AUC) of 3D-ADC was 0.90 in 90Y radioembolization patients, 0.88 in TACE patients, and 0.77 in systemic chemotherapy patients (p < 0.01). Optimal prediction was observed with the 10th percentile of ADC (1006 × 10−6 mm2/s), yielding sensitivity and specificity of 77.4% and 91.3%, respectively. 3D-ADC outperformed 2D-ADC in predicting response to treatment (AUC; 0.86 vs. 0.71; p < 0.001). Conclusion: Baseline 3D-ADC is a highly specific biomarker in predicting partial short-term response to treatment in hepatic CLMs. Key Points: • Baseline 3D-ADC is a highly specific biomarker in predicting response to different treatments in hepatic CLMs. • The prediction level of baseline ADC is better for90Y radioembolization than for systemic chemotherapy/TACE in hepatic CLMs. • 3D-ADC outperforms 2D-ADC in predicting short-term response to treatment in hepatic CLMs.

Original languageEnglish (US)
Pages (from-to)291-300
Number of pages10
JournalEuropean radiology
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2020

Keywords

  • Colorectal neoplasms
  • Diffusion magnetic resonance imaging
  • Liver neoplasms
  • RECIST

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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