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Assessment of treatment response after lung stereotactic body radiotherapy using diffusion weighted magnetic resonance imaging and positron emission tomography: A pilot study
Institution:1. Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan;2. Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan;1. Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California;2. Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California;4. Department of Radiology, Stanford University School of Medicine, Stanford, California;6. Department of Health Research & Policy, Stanford University School of Medicine, Stanford, California;3. Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California;5. Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California;1. Division of Radiation Oncology, University of Ottawa, Ottawa, Ontario, Canada;2. Ottawa Hospital Research Institute, Ottawa, Ontario, Canada;1. Central Alberta Cancer Centre, Red Deer, Canada;2. Cross Cancer Institute, Edmonton, Canada;3. Data Integration, Measurement & Reporting, Alberta Health Services, Canada;4. Tom Baker Cancer Centre, Calgary, Canada;5. Department of Oncology, University of Alberta, Canada;6. Department of Oncology, University of Calgary, Canada
Abstract:Background and purposeThere is no early predictor of treatment response after lung stereotactic body radiotherapy (SBRT). We conducted this pilot study to evaluate whether serial diffusion weighted magnetic resonance imaging (DW-MRI) or positron emission tomography (PET) could predict response after SBRT.Material and methodsEarly stage non-small cell lung cancer patients who received SBRT were eligible. DW-MRI and PET were undertaken pretreatment and every 3 months after SBRT in the first year. Patients with <1 year of follow-up were excluded from the analysis. The apparent diffusion coefficient (ADC) value and maximum standardized uptake value (SUVmax) of tumors were measured and compared between groups with or without local recurrence (LR).ResultsFifteen patients were enrolled and the data of 14 patients were analyzed. The median ADC value was significantly lower in patients with LR (n = 3) than in those without LR (n = 11) at 3 and 6 months (1.11 vs. 1.54 and 0.98 vs. 1.69 ×10?3 mm2/s]; p = 0.039 and 0.012, respectively) while there was no significant difference pretreatment and at 9 and 12 months after treatment. No significant difference was observed in the SUVmax at any time point.ConclusionsDW-MRI could be an early predictor of treatment response after lung SBRT.
Keywords:Stereotactic body radiotherapy  Lung cancer  Local recurrence  Diffusion-weighted MRI  PET
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