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Winfield JM, Papoutsaki MV, Ragheb H, Morris DM, Heerschap A, ter Voert EGW, Kuijer JPA, Pieters IC, Douglas NHM, Orton M, de souza NM. Development of a diffusion-weighted MRI protocol for multicentre abdominal imaging and evaluation of the effects of fasting on measurement of apparent diffusion coefficients (ADCs) in healthy liver. Br J Radiol 2015; 88:20140717. [PMID: 25790061 PMCID: PMC4628478 DOI: 10.1259/bjr.20140717] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 02/04/2015] [Accepted: 03/18/2015] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To assess the effect of fasting and eating on estimates of apparent diffusion coefficient (ADC) in the livers of healthy volunteers using a diffusion-weighted MRI protocol with b-values of 100, 500 and 900 s mm(-2) in a multicentre study at 1.5 T. METHODS 20 volunteers were scanned using 4 clinical 1.5-T MR scanners. Volunteers were scanned after fasting for at least 4 h and after eating a meal; the scans were repeated on a subsequent day. Median ADC estimates were calculated from all pixels in three slices near the centre of the liver. Analysis of variance (ANOVA) was used to assess the difference between ADC estimates in fasted and non-fasted states and between ADC estimates on different days. RESULTS ANOVA showed no difference between ADC estimates in fasted and non-fasted states (p = 0.8) nor between ADC estimates on different days (p = 0.8). The repeatability of the measurements was good, with coefficients of variation of 5.1% and 4.6% in fasted and non-fasted states, respectively. CONCLUSION There was no significant difference in ADC estimates between fasted and non-fasted measurements, indicating that the perfusion sensitivity of ADC estimates obtained from b-values of 100, 500 and 900 s mm(-2) is sufficiently low that changes in blood flow in the liver after eating are undetectable beyond the variability in the measurements. ADVANCES IN KNOWLEDGE Assessment of the effect of prandial state on ADC estimates is critical, in order to determine the appropriate patient preparation for biological validation in clinical trials.
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Affiliation(s)
- J M Winfield
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
- MRI Unit, Royal Marsden NHS Foundation Trust, Sutton, UK
| | - M-V Papoutsaki
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - H Ragheb
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - D M Morris
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - A Heerschap
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - E G W ter Voert
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - J P A Kuijer
- Department Physics and Medical Technology, VU University Medical Center, Amsterdam, Netherlands
| | - I C Pieters
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, Netherlands
| | - N H M Douglas
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - M Orton
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - N M de souza
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
- MRI Unit, Royal Marsden NHS Foundation Trust, Sutton, UK
| | - on behalf of the QuIC-ConCePT Consortium
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
- MRI Unit, Royal Marsden NHS Foundation Trust, Sutton, UK
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
- Department Physics and Medical Technology, VU University Medical Center, Amsterdam, Netherlands
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, Netherlands
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Desar IME, ter Voert EGW, Hambrock T, van Asten JJA, van Spronsen DJ, Mulders PFA, Heerschap A, van der Graaf WTA, van Laarhoven HWM, van Herpen CML. Functional MRI techniques demonstrate early vascular changes in renal cell cancer patients treated with sunitinib: a pilot study. Cancer Imaging 2012; 11:259-65. [PMID: 22245974 PMCID: PMC3266589 DOI: 10.1102/1470-7330.2011.0032] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: To assess the early vascular effects of sunitinib in patients with renal cell carcinoma (RCC) with diffusion-weighted magnetic resonance imaging (DWI), dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and T2* perfusion MRI. Patients and methods: In 10 patients with abdominal RCC lesions, DWI, DCE-MRI and T2* perfusion MRI measurements at 3 Tesla were performed at baseline, 3 and 10 days after start of sunitinib. VEGF-A plasma levels were measured on days 0, 3 and 10. Results: DWI showed a significant increase in the apparent diffusion coefficient (×10−6 s/mm2) from baseline (mean 1158, range 814–2003) to day 3 (mean 1306, range 1008–2097, P = 0.015) followed by a decrease to baseline levels at day 10 (mean 1132, range 719–2005, P = 0.001). No significant changes were found in mean DCE-MRI parameters. T2* perfusion MRI showed a significant decrease in relative tumor blood volume (rBV) and relative tumor blood flow (rBF) at day 3 (rBV P = 0.037, rBF P = 0.018) and day 10 (rBV P = 0.006, rBF P = 0.009). VEGF-A plasma levels significantly increased after 10 days, but did not correlate with MRI parameters. Conclusions: Sunitinib induces antiangiogenic effects as measured by DWI and T2*-perfusion MRI, 3 and 10 days after the start of the initial treatment. DCE-MRI did not show significant changes. In the near future, early functional MRI-based evaluation can play an important role in tailoring treatment to the individual patient with RCC. Further investigation is warranted.
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Affiliation(s)
- I M E Desar
- Department of Medical Oncology, Radboud University Nijmegen Medical Centre, The Netherlands.
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