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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2021 June;65(2):178-86

DOI: 10.23736/S1824-4785.19.03153-4


language: English

Role of intravoxel incoherent motion parameters in gastroesophageal cancer: relationship with 18F-FDG-positron emission tomography, computed tomography perfusion and magnetic resonance perfusion imaging parameters

Khoschy SCHAWKAT 1, 2 , Bert-Ram SAH 1, 2, 3, Edwin E. TER VOERT 2, 3, Gaspar DELSO 3, Moritz WURNIG 1, 2, Anton S. BECKER 1, 2, Sebastian LEIBL 4, Paul M. SCHNEIDER 5, Cäcilia S. REINER 1, 2, Martin W. HUELLNER 2, 3, Patrick VEIT-HAIBACH 1, 2, 3, 6, 7

1 Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland; 2 University of Zurich, Zurich, Switzerland; 3 Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; 4 Department of Pathology, University Hospital Zurich, Zurich, Switzerland; 5 Center for Visceral, Thoracic and Specialized Tumor Surgery, Hirslanden Medical Center, Zurich, Switzerland; 6 University of Toronto, Toronto, ON, Canada; 7 Toronto Joint Department of Medical Imaging, University Hospital of Zurich, Toronto General Hospital, Zurich, Switzerland

BACKGROUND: Identification of pretherapeutic predictive markers in gastro-esophageal cancer is essential for individual-oriented treatment. This study evaluated the relationship of multimodality parameters derived from intravoxel incoherent motion method (IVIM), 18F-FDG-positron emission tomography (PET), computed tomography (CT) perfusion and dynamic contrast enhanced magnetic resonance imaging (MRI) in patients with gastro-esophageal cancer and investigated their histopathological correlation.
METHODS: Thirty-one consecutive patients (28 males; median age 63.9 years; range 37-84 years) with gastro-esophageal adenocarcinoma (N.=22) and esophageal squamous cell carcinoma (N.=9) were analyzed. IVIM parameters: pseudodiffusion (D*), perfusion fraction (fp), true diffusion (D) and the threshold b-value (bval); PET-parameters: SUVmax, metabolic tumor volume (MTV) and total lesion glycolysis (TLG); CT perfusion parameters: blood flow (BF), blood volume (BV) and mean transit time (MTT); and MR perfusion parameters: time to enhance, positive enhancement integral, time-to-peak (TTP), maximum-slope-of-increase, and maximum-slope-of-decrease were determined, and correlated to each other and to histopathology.
RESULTS: IVIM and PET parameters showed significant negative correlations: MTV and bval (rs =-0.643, P=0.002), TLG and bval (rs=-0.699, P<0.01) and TLG and fp (rs=-0.577, P=0.006). Positive correlation was found for TLG and D (rs=0.705, P=0.000). Negative correlation was found for bval and staging (rs=0.590, P=0.005). Positive correlation was found for positive enhancement interval and BV (rs=0.547, P=0.007), BF and regression index (rs=0.753, P=0.005) and for time-to-peak and staging (rs=0.557, P=0.005).
CONCLUSIONS: IVIM parameters (bval, fp, D) provide quantitative information and correlate with PET parameters (MTV, TLG) and staging. IVIM might be a useful tool for additional characterization of gastro-esophageal cancer.

KEY WORDS: Magnetic resonance imaging; Perfusion; Stomach neoplasms; Positron emission tomography computed tomography

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