Interstitial Brachytherapy of the Liver for Renal Cell Carcinoma: ADC Measurements Do Not Predict Overall Survival

Overview

Journal In Vivo

Specialty Oncology

Date 2022 Oct 29

PMID 36309358

Authors

Maximilian Thormann

Franziska Heitmann

Vanessa Wrobel

Christine March

Maciej Pech

Alexey Surov

Robert Damm

Jazan Omari

Affiliations

Soon will be listed here.

Abstract

Background/aim: To assess the influence of pre-treatment apparent diffusion coefficient (ADC) measurements on outcomes in patients undergoing interstitial brachytherapy (iBT) for liver metastases from renal cell carcinoma.

Patients And Methods: Patients undergoing iBT for renal cell carcinoma (RCC) liver metastases were retrospectively identified. Patients were eligible for inclusion if they had a pre-treatment magnetic resonance imaging (MRI) with diffusion weighted imaging (DWI) sequences. For each lesion, a region of interest (ROI) was placed along the contours of the entire lesion across all slices. For each ROI, ADC minimum, mean and maximum as well as the lesion area were noted, and the average was calculated for each lesion. ADC measurements were correlated with overall survival.

Results: The analysis included 17 patients. Median overall survival was 36 months. Neither ADC measurement was significantly associated with overall survival. ADC min (HR=1.00, 95%CI=1.00-1.00, p=0.600), ADC max (HR=1.001, 95%CI=0.998-1.003, p=0.490), ADC mean (HR=0.999, 95%CI=0.996-1.003, p=0.638).

Conclusion: ADC is not able to differentiate between groups with good and bad overall survival in patients undergoing iBT for RCC liver metastases.

Citing Articles

Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MRI improves diagnosis and efficacy evaluation of early-stage hepatocellular carcinoma.

Wang Y, Zhang J, Zhuang X, Jin Q, Liu L Am J Cancer Res. 2024; 14(10):4855-4867.

PMID: 39553216 PMC: 11560834. DOI: 10.62347/WYNK6968.

References

Dudani S, de Velasco G, Wells J, Gan C, Donskov F, Porta C . Evaluation of Clear Cell, Papillary, and Chromophobe Renal Cell Carcinoma Metastasis Sites and Association With Survival. JAMA Netw Open. 2021; 4(1):e2021869. PMC: 7821027. DOI: 10.1001/jamanetworkopen.2020.21869. View

Paschall A, Mirmomen S, Symons R, Pourmorteza A, Gautam R, Sahai A . Differentiating papillary type I RCC from clear cell RCC and oncocytoma: application of whole-lesion volumetric ADC measurement. Abdom Radiol (NY). 2018; 43(9):2424-2430. PMC: 8058623. DOI: 10.1007/s00261-017-1453-4. View

Chandrasekar T, Klaassen Z, Goldberg H, Kulkarni G, Hamilton R, Fleshner N . Metastatic renal cell carcinoma: Patterns and predictors of metastases-A contemporary population-based series. Urol Oncol. 2017; 35(11):661.e7-661.e14. DOI: 10.1016/j.urolonc.2017.06.060. View

Ricke J, Wust P, Stohlmann A, Beck A, Cho C, Pech M . CT-guided interstitial brachytherapy of liver malignancies alone or in combination with thermal ablation: phase I-II results of a novel technique. Int J Radiat Oncol Biol Phys. 2004; 58(5):1496-505. DOI: 10.1016/j.ijrobp.2003.09.024. View

Schmeel F, Simon B, Luetkens J, Traber F, Meyer C, Schmeel L . Prognostic value of pretreatment diffusion-weighted magnetic resonance imaging for outcome prediction of colorectal cancer liver metastases undergoing 90Y-microsphere radioembolization. J Cancer Res Clin Oncol. 2017; 143(8):1531-1541. DOI: 10.1007/s00432-017-2395-5. View

Zhou X, Ma C, Wang Z, Liu J, Rui Y, Li Y . Effect of region of interest on ADC and interobserver variability in thyroid nodules. BMC Med Imaging. 2019; 19(1):55. PMC: 6625060. DOI: 10.1186/s12880-019-0357-x. View

Lassel E, Rao R, Schwenke C, Schoenberg S, Michaely H . Diffusion-weighted imaging of focal renal lesions: a meta-analysis. Eur Radiol. 2013; 24(1):241-9. DOI: 10.1007/s00330-013-3004-x. View

Surov A, Meyer H, Wienke A . Correlation Between Minimum Apparent Diffusion Coefficient (ADC) and Tumor Cellularity: A Meta-analysis. Anticancer Res. 2017; 37(7):3807-3810. DOI: 10.21873/anticanres.11758. View

Thoeny H, De Keyzer F, Boesch C, Hermans R . Diffusion-weighted imaging of the parotid gland: Influence of the choice of b-values on the apparent diffusion coefficient value. J Magn Reson Imaging. 2004; 20(5):786-90. DOI: 10.1002/jmri.20196. View

10.

Dabestani S, Marconi L, Hofmann F, Stewart F, Lam T, Canfield S . Local treatments for metastases of renal cell carcinoma: a systematic review. Lancet Oncol. 2014; 15(12):e549-61. DOI: 10.1016/S1470-2045(14)70235-9. View

11.

Kim B, Song J, Choi E, Hwang S, Hwang H . Diffusion-Weighted Imaging of Upper Abdominal Organs Acquired with Multiple B-Value Combinations: Value of Normalization Using Spleen as the Reference Organ. Korean J Radiol. 2018; 19(3):389-396. PMC: 5904465. DOI: 10.3348/kjr.2018.19.3.389. View

12.

Kwiatkowski J, Schmidt B, Merkle P, Keller K . Perioperative brachytherapy as an additional therapeutic option in patients with renal cell carcinoma (RCC), either inoperable or after completed percutaneous radiotherapy. Anticancer Res. 1999; 19(2C):1597-9. View

13.

Alves A, Adam R, Majno P, Delvart V, Azoulay D, Castaing D . Hepatic resection for metastatic renal tumors: is it worthwhile?. Ann Surg Oncol. 2003; 10(6):705-10. DOI: 10.1245/aso.2003.07.024. View

14.

Hao Y, Pan C, Chen W, Li T, Zhu W, Qi J . Differentiation between malignant and benign thyroid nodules and stratification of papillary thyroid cancer with aggressive histological features: Whole-lesion diffusion-weighted imaging histogram analysis. J Magn Reson Imaging. 2016; 44(6):1546-1555. DOI: 10.1002/jmri.25290. View

15.

Padhani A, Liu G, Koh D, Chenevert T, Thoeny H, Takahara T . Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia. 2009; 11(2):102-25. PMC: 2631136. DOI: 10.1593/neo.81328. View

16.

Le Bihan D, Iima M . Diffusion Magnetic Resonance Imaging: What Water Tells Us about Biological Tissues. PLoS Biol. 2015; 13(7):e1002203. PMC: 4512706. DOI: 10.1371/journal.pbio.1002203. View

17.

Bianchi M, Sun M, Jeldres C, Shariat S, Trinh Q, Briganti A . Distribution of metastatic sites in renal cell carcinoma: a population-based analysis. Ann Oncol. 2011; 23(4):973-80. DOI: 10.1093/annonc/mdr362. View

18.

Gregory J, Dioguardi Burgio M, Corrias G, Vilgrain V, Ronot M . Evaluation of liver tumour response by imaging. JHEP Rep. 2020; 2(3):100100. PMC: 7267412. DOI: 10.1016/j.jhepr.2020.100100. View

19.

Hotker A, Mazaheri Y, Wibmer A, Zheng J, Moskowitz C, Tickoo S . Use of DWI in the Differentiation of Renal Cortical Tumors. AJR Am J Roentgenol. 2015; 206(1):100-5. PMC: 4826468. DOI: 10.2214/AJR.14.13923. View

20.

Drewes R, Pech M, Powerski M, Omari J, Heinze C, Damm R . Apparent Diffusion Coefficient Can Predict Response to Chemotherapy of Liver Metastases in Colorectal Cancer. Acad Radiol. 2020; 28 Suppl 1:S73-S80. DOI: 10.1016/j.acra.2020.09.006. View