Abstract

ObjectiveTo investigate the intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) as a potential valuable marker to monitor the therapy responses of VX2 to radiofrequency ablation (RF Ablation).MethodsThe institutional animal care and use committee approved this study. In 10 VX2 tumor–bearing rabbits, IVIM-DWI examinations were performed with a 3.0T imaging unit by using 16 b values from 0 to 800 sec/mm2. The true diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) of tumors were compared between before and instantly after RF Ablation treatment. The differences of D, D* and f and conventional perfusion parameters (from perfusion CT and dynamic enhanced magnetic resonance imaging, DCE-MRI) in the coagulation necrosis area, residual unablated area, untreated area, and normal control had been calculated by compared t- test. The correlation between f or D* with perfusion weighted CT including blood flow, BF (milliliter per 100 mL/min), blood volume, BV (milliliter per 100 mL/min), and capillary permeability–surface area, PMB (as a fraction) or from DCE-MRI: transfer constant (Ktrans), extra-vascular extra-cellular volume fraction (Ve) and reflux constant (Kep) values had been analyzed by region-of-interest (ROI) methods to calculate Pearson’s correlation coefficients.ResultsIn the ablated necrosis areas, f and D* significantly decreased and D significantly increased, compared with residual unblazed areas or untreated control groups and normal control groups (P < 0.001). The IVIM-DWI derived f parameters showed significant increases in the residual unablated tumor area. There was no significant correlations between f or D* and conventional perfusion parameters.ConclusionsThe IVIM-DW derived f, D and D* parameters have the potential to indicate therapy response immediately after RF Ablation treatment, while no significant correlations with classical tumor perfusion metrics were derived from DCE-MRI and perfusion-CT measurements.

Highlights

  • Image-guided percutaneous ablative therapies using thermal energy sources, such as radiofrequency (RF) [1], microwave [2], laser-induced thermal therapy [3], and high-intensity focused ultrasound [4], are rapidly evolving as nonsurgical minimally invasive techniques for the treatment of malignant neoplasms

  • There was no significant correlations between f or D* and conventional perfusion parameters

  • The purpose of this study was to investigate the value of intravoxel incoherent motion (IVIM)-Diffusion-weighted imaging (DWI), DCE-MRI, and perfusion CT techniques in assessing the response of VX2 to RF Ablation therapy, with particular emphasis on the role of IVIM-DWI as a potential valuable imaging marker of therapy response

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Summary

Methods

In 10 VX2 tumor– bearing rabbits, IVIM-DWI examinations were performed with a 3.0T imaging unit by using 16 b values from 0 to 800 sec/mm. The differences of D, D* and f and conventional perfusion parameters (from perfusion CT and dynamic enhanced magnetic resonance imaging, DCEMRI) in the coagulation necrosis area, residual unablated area, untreated area, and normal control had been calculated by compared t- test. The correlation between f or D* with perfusion weighted CT including blood flow, BF (milliliter per 100 mL/min), blood volume, BV (milliliter per 100 mL/min), and capillary permeability–surface area, PMB (as a fraction) or from DCE-MRI: transfer constant (Ktrans), extra-vascular extra-cellular volume fraction (Ve) and reflux constant (Kep) values had been analyzed by region-of-interest (ROI) methods to calculate Pearson’s correlation coefficients

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