Monitoring cytotoxic tumour treatment response by diffusion magnetic resonance imaging and proton spectroscopy

Exposure of tumours to anti-cancer drugs, gene or radiation therapy consistently leads to an increase in water diffusion in the cases expressing favourable treatment response. The diffusion change coincides cytotoxic cell eradication and precedes volume reduction in drug or gene therapy-treated experimental tumours. Interestingly, the recent studies from human brain tumour patients undergoing chemotherapy show similar behaviour of diffusion, suggesting important application for MRI in patient management. In this review observations from diffusion MRI and MRS in the tumours during cytotoxic treatment are summarized and the cellular mechanisms affecting molecular mobility are discussed in the light of tissue microenvironmental and microdynamic changes.