Abstract
Although radiation therapy (RT) plays an important role in the palliation of localized bone metastases, there is no consensus on a reliable method for evaluating treatment response. Therefore, we retrospectively evaluated the potential of magnetic resonance imaging (MRI) using apparent diffusion coefficient (ADC) maps and conventional images in whole-tumor volumetric analysis of texture features for assessing treatment response after RT. For this purpose, 28 patients who received RT for osteolytic bone metastasis and underwent both pre- and post-RT MRI were enrolled. Volumetric ADC histograms and conventional parameters were compared. Cox regression analyses were used to determine whether the change ratio in these parameters was associated with local disease progression-free survival (LDPFS). The ADCmaximum, ADCmean, ADCmedian, ADCSD, maximum diameter, and volume of the target lesions after RT significantly increased. Change ratios of ADCmean < 1.41, tumor diameter ≥ 1.17, and tumor volume ≥ 1.55 were significant predictors of poor LDPFS. Whole-tumor volumetric ADC analysis might be utilized for monitoring patient response to RT and potentially useful in predicting clinical outcomes.
Highlights
The maximum diameter and volume of target lesions significantly increased after radiation therapy (RT)
Kurtosis values tended to decrease after treatment (−1.26 ± 3.51, p = 0.051)
Showedand a significant in ADCa values, in addition to our study showed a significant increase in values, in addition to maximum, and ADCmedian after treatment and their potential use in treatment response assessment
Summary
Therapeutic goals in patients with bone metastases are to delay progression, alleviate symptoms, improve quality of life, and obtain any possible survival benefit [3]. The important role of radiation therapy (RT) in the palliation of localized bone metastases is well acknowledged, with its intent to reduce tumor growth and improve symptom control [4]. To determine the optimal management to minimize radiation dose and prevent recurrence, it is important to evaluate the response to treatment [5]. Assessing the treatment response with conventional images is difficult because the healing process of bone metastases is slow to evolve and subtle [2,6]. There has been no consensus on a reliable method for evaluating the treatment response, making therapeutic decisions difficult [7,8]
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