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Zhang B, Bian B, Zhang Y, Zhang L, Zhang R, Wang J. The Apparent Diffusion Coefficient of Diffusion-Weighted Whole-Body Magnetic Resonance Imaging Affects the Survival of Multiple Myeloma Independently. Front Oncol 2022; 12:780078. [PMID: 35311101 PMCID: PMC8931198 DOI: 10.3389/fonc.2022.780078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/07/2022] [Indexed: 02/03/2023] Open
Abstract
Background Diffusion-weighted whole-body MRI (DW-MRI) is increasingly used to evaluate bone diseases of multiple myeloma (MM), but there is lack of quantitative indicator for DW-MRI to reflect the prognosis of MM. Apparent diffusion coefficient (ADC) values in DW-MRI has potential correlations between some indexes of MM, but the influence of ADC on MM survival needs to be further verified. Methods A total of 381 newly diagnosed MM patients were enrolled in the study to analyze the effect of ADC values in DW-MRI on progression-free survival (PFS) and overall survival (OS). The Kaplan–Meier method was used to perform univariate survival analysis, and the Cox proportional hazards model was used for multivariate analysis. In addition to the ADC value, genetic and serological indexes were also included. Results The survivals were observed in univariate ADC stratification with median PFS of 52.0, 45.0, 34.0, and 26.0 months (the unit of ADC value was 10−3 mm2/s; the ADC ranges were ADC < 0.4886, 0.4886 ≤ ADC < 0.6545, 0.6545 ≤ ADC < 0.7750, and ADC ≥ 0.7750; 95% CI, 43.759–62.241, 46.336–53.664, 39.753–46.247, and 27.812–32.188). The OS were 81.0, 61.0, 47.0, and 36.0 months (p < 0.001; 95% CI, 71.356–82.644, 67.630–70.370, 57.031–60.969, and 36.107–43.893). In Cox proportional hazards model, the ADC value was considered to be an independent risk factor affecting PFS and OS of MM (both p < 0.001). Conclusions This study supports that ADC in DW-MRI may independently stratify MM patients and better predict their prognosis. The combined use of DW-MRI and other parameters allows more accurate evaluation of MM survival. Trial Registration http://www.chictr.org.cn/showproj.aspx?proj=49012, ChiCTR2000029587.
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Affiliation(s)
- Bei Zhang
- Department of Radiology, First Hospital of Jilin University, Changchun, China
| | - Bingyang Bian
- Department of Radiology, First Hospital of Jilin University, Changchun, China
| | - Yanjiao Zhang
- Department of Radiology, First Hospital of Jilin University, Changchun, China
| | - Li Zhang
- Department of Radiology, First Hospital of Jilin University, Changchun, China
| | - Rongkui Zhang
- Department of Hematology, First Hospital of Jilin University, Changchun, China
| | - Jiping Wang
- Department of Radiology, First Hospital of Jilin University, Changchun, China
- *Correspondence: Jiping Wang,
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Doblas S, Almeida GS, Blé FX, Garteiser P, Hoff BA, McIntyre DJ, Wachsmuth L, Chenevert TL, Faber C, Griffiths JR, Jacobs AH, Morris DM, O’Connor JP, Robinson SP, Van Beers BE, Waterton JC. Apparent diffusion coefficient is highly reproducible on preclinical imaging systems: Evidence from a seven-center multivendor study. J Magn Reson Imaging 2015; 42:1759-64. [PMID: 26012876 PMCID: PMC5968828 DOI: 10.1002/jmri.24955] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/08/2015] [Accepted: 05/11/2015] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To evaluate between-site agreement of apparent diffusion coefficient (ADC) measurements in preclinical magnetic resonance imaging (MRI) systems. MATERIALS AND METHODS A miniaturized thermally stable ice-water phantom was devised. ADC (mean and interquartile range) was measured over several days, on 4.7T, 7T, and 9.4T Bruker, Agilent, and Magnex small-animal MRI systems using a common protocol across seven sites. Day-to-day repeatability was expressed as percent variation of mean ADC between acquisitions. Cross-site reproducibility was expressed as 1.96 × standard deviation of percent deviation of ADC values. RESULTS ADC measurements were equivalent across all seven sites with a cross-site ADC reproducibility of 6.3%. Mean day-to-day repeatability of ADC measurements was 2.3%, and no site was identified as presenting different measurements than others (analysis of variance [ANOVA] P = 0.02, post-hoc test n.s.). Between-slice ADC variability was negligible and similar between sites (P = 0.15). Mean within-region-of-interest ADC variability was 5.5%, with one site presenting a significantly greater variation than the others (P = 0.0013). CONCLUSION Absolute ADC values in preclinical studies are comparable between sites and equipment, provided standardized protocols are employed.
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Affiliation(s)
- Sabrina Doblas
- Laboratory of imaging biomarkers, UMR 1149 – CRI, Inserm, Paris Diderot University, Paris, France
| | - Gilberto S. Almeida
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | | | - Philippe Garteiser
- Laboratory of imaging biomarkers, UMR 1149 – CRI, Inserm, Paris Diderot University, Paris, France
| | - Benjamin A. Hoff
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Lydia Wachsmuth
- Department of Clinical Radiology, Münster University Hospital, Westfälische Wilhelms-Universität, Münster, Germany
| | | | - Cornelius Faber
- Department of Clinical Radiology, Münster University Hospital, Westfälische Wilhelms-Universität, Münster, Germany
| | | | - Andreas H. Jacobs
- European Institute for Molecular Imaging, Westfälische Wilhelms-Universität, Münster, Germany
| | - David M. Morris
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | | | - Simon P. Robinson
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - Bernard E. Van Beers
- Laboratory of imaging biomarkers, UMR 1149 – CRI, Inserm, Paris Diderot University, Paris, France
| | - John C. Waterton
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
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Jalali S, Chung C, Foltz W, Burrell K, Singh S, Hill R, Zadeh G. MRI biomarkers identify the differential response of glioblastoma multiforme to anti-angiogenic therapy. Neuro Oncol 2014; 16:868-79. [PMID: 24759636 DOI: 10.1093/neuonc/nou040] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Although anti-angiogenic therapy (AATx) holds great promise for treatment of malignant gliomas, its therapeutic efficacy is not well understood and can potentially increase the aggressive recurrence of gliomas. It is essential to establish sensitive, noninvasive biomarkers that can detect failure of AATx and tumor recurrence early so that timely adaptive therapy can be instituted. We investigated the efficacy of MRI biomarkers that can detect response to different classes of AATxs used alone or in combination with radiation. METHODS Murine intracranial glioma xenografts (NOD/SCID) were treated with sunitinib, VEGF-trap or B20 (a bevacizumab equivalent) alone or in combination with radiation. MRI images were acquired longitudinally before and after treatment, and various MRI parameters (apparent diffusion coefficient, T1w + contrast, dynamic contrast-enhanced [DCE], initial area under the contrast enhancement curve, and cerebral blood flow) were correlated to tumor cell proliferation, overall tumor growth, and tumor vascularity. RESULTS Combinatorial therapies reduced tumor growth rate more efficiently than monotherapies. Apparent diffusion coefficient was an accurate measure of tumor cell density. Vascular endothelial growth factor (VEGF)-trap or B20, but not sunitinib, resulted in significant reduction or complete loss of contrast enhancement. This reduction was not due to a reduction in tumor growth or microvascular density, but rather was explained by a reduction in vessel permeability and perfusion. We established that contrast enhancement does not accurately reflect tumor volume or vascular density; however, DCE-derived parameters can be used as efficient noninvasive biomarkers of response to AATx. CONCLUSIONS MRI parameters following therapy vary based on class of AATx. Validation of clinically relevant MRI parameters for individual AATx agents is necessary before incorporation into routine practice.
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Affiliation(s)
- Shahrzad Jalali
- Brain Tumor Research Center, Hospital for Sick Children, Toronto, Canada (S.J., K.B., S.S., G.Z.); Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada (C.C., W.F.); Department of Radiation Oncology, University of Toronto, Toronto, Canada (W.F., R.H.); Ontario Cancer Institute, Princess Margaret Cancer Centre, and Department of Medical Biophysics, University of Toronto, Toronto, Canada (R.H.); Division of Neurosurgery, University of Toronto and Toronto Western Hospital, University Health Network, Toronto, Canada (G.Z.)
| | - Caroline Chung
- Brain Tumor Research Center, Hospital for Sick Children, Toronto, Canada (S.J., K.B., S.S., G.Z.); Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada (C.C., W.F.); Department of Radiation Oncology, University of Toronto, Toronto, Canada (W.F., R.H.); Ontario Cancer Institute, Princess Margaret Cancer Centre, and Department of Medical Biophysics, University of Toronto, Toronto, Canada (R.H.); Division of Neurosurgery, University of Toronto and Toronto Western Hospital, University Health Network, Toronto, Canada (G.Z.)
| | - Warren Foltz
- Brain Tumor Research Center, Hospital for Sick Children, Toronto, Canada (S.J., K.B., S.S., G.Z.); Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada (C.C., W.F.); Department of Radiation Oncology, University of Toronto, Toronto, Canada (W.F., R.H.); Ontario Cancer Institute, Princess Margaret Cancer Centre, and Department of Medical Biophysics, University of Toronto, Toronto, Canada (R.H.); Division of Neurosurgery, University of Toronto and Toronto Western Hospital, University Health Network, Toronto, Canada (G.Z.)
| | - Kelly Burrell
- Brain Tumor Research Center, Hospital for Sick Children, Toronto, Canada (S.J., K.B., S.S., G.Z.); Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada (C.C., W.F.); Department of Radiation Oncology, University of Toronto, Toronto, Canada (W.F., R.H.); Ontario Cancer Institute, Princess Margaret Cancer Centre, and Department of Medical Biophysics, University of Toronto, Toronto, Canada (R.H.); Division of Neurosurgery, University of Toronto and Toronto Western Hospital, University Health Network, Toronto, Canada (G.Z.)
| | - Sanjay Singh
- Brain Tumor Research Center, Hospital for Sick Children, Toronto, Canada (S.J., K.B., S.S., G.Z.); Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada (C.C., W.F.); Department of Radiation Oncology, University of Toronto, Toronto, Canada (W.F., R.H.); Ontario Cancer Institute, Princess Margaret Cancer Centre, and Department of Medical Biophysics, University of Toronto, Toronto, Canada (R.H.); Division of Neurosurgery, University of Toronto and Toronto Western Hospital, University Health Network, Toronto, Canada (G.Z.)
| | - Richard Hill
- Brain Tumor Research Center, Hospital for Sick Children, Toronto, Canada (S.J., K.B., S.S., G.Z.); Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada (C.C., W.F.); Department of Radiation Oncology, University of Toronto, Toronto, Canada (W.F., R.H.); Ontario Cancer Institute, Princess Margaret Cancer Centre, and Department of Medical Biophysics, University of Toronto, Toronto, Canada (R.H.); Division of Neurosurgery, University of Toronto and Toronto Western Hospital, University Health Network, Toronto, Canada (G.Z.)
| | - Gelareh Zadeh
- Brain Tumor Research Center, Hospital for Sick Children, Toronto, Canada (S.J., K.B., S.S., G.Z.); Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada (C.C., W.F.); Department of Radiation Oncology, University of Toronto, Toronto, Canada (W.F., R.H.); Ontario Cancer Institute, Princess Margaret Cancer Centre, and Department of Medical Biophysics, University of Toronto, Toronto, Canada (R.H.); Division of Neurosurgery, University of Toronto and Toronto Western Hospital, University Health Network, Toronto, Canada (G.Z.)
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Whisenant JG, Ayers GD, Loveless ME, Barnes SL, Colvin DC, Yankeelov TE. Assessing reproducibility of diffusion-weighted magnetic resonance imaging studies in a murine model of HER2+ breast cancer. Magn Reson Imaging 2014; 32:245-9. [PMID: 24433723 PMCID: PMC3939718 DOI: 10.1016/j.mri.2013.10.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 08/27/2013] [Accepted: 10/22/2013] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND PURPOSE The use of diffusion-weighted magnetic resonance imaging (DW-MRI) as a surrogate biomarker of response in preclinical studies is increasing. However, before a biomarker can be reliably employed to assess treatment response, the reproducibility of the technique must be established. There is a paucity of literature that quantifies the reproducibility of DW-MRI in preclinical studies; thus, the purpose of this study was to investigate DW-MRI reproducibility in a murine model of HER2+ breast cancer. MATERIALS AND METHODS Test-Retest DW-MRI scans separated by approximately six hours were acquired from eleven athymic female mice with HER2+ xenografts using a pulsed gradient spin echo diffusion-weighted sequence with three b values [150, 500, and 800s/mm(2)]. Reproducibility was assessed for the mean apparent diffusion coefficient (ADC) from tumor and muscle tissue regions. RESULTS The threshold to reflect a change in tumor physiology in a cohort of mice is defined by the 95% confidence interval (CI), which was±0.0972×10(-3)mm(2)/s (±11.8%) for mean tumor ADC. The repeatability coefficient defines this threshold for an individual mouse, which was±0.273×10(-3)mm(2)/s. The 95% CI and repeatability coefficient for mean ADC of muscle tissue were±0.0949×10(-3)mm(2)/s (±8.30%) and±0.266×10(-3)mm(2)/s, respectively. CONCLUSIONS Mean ADC of tumors is reproducible and appropriate for detecting treatment-induced changes on both an individual and mouse cohort basis.
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Affiliation(s)
- Jennifer G Whisenant
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232-2675; Department of Program in Chemical and Physical Biology, Vanderbilt University, Nashville, Tennessee 37232-2675
| | - Gregory D Ayers
- Department of Biostatistics, Vanderbilt University, Nashville, Tennessee 37232-2675
| | - Mary E Loveless
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232-2675
| | - Stephanie L Barnes
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232-2675; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee 37232-2675
| | - Daniel C Colvin
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232-2675; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee 37232-2675
| | - Thomas E Yankeelov
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232-2675; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee 37232-2675; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee 37232-2675; Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee 37232-2675; Department of Cancer Biology, Vanderbilt University, Nashville, Tennessee 37232-2675; Department of Program in Chemical and Physical Biology, Vanderbilt University, Nashville, Tennessee 37232-2675; Department of Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee 37232-2675.
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