Entesar Dalah, Beth Erickson, Kiyoko Oshima, Diane Schott, William A

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Correlation of ADC With Pathological Treatment Response for Radiation Therapy of Pancreatic Cancer Entesar Dalah, Beth Erickson, Kiyoko Oshima, Diane Schott, William A. Hall, Eric Paulson, An Tai, Paul Knechtges, X. Allen Li Translational Oncology Volume 11, Issue 2, Pages 391-398 (April 2018) DOI: 10.1016/j.tranon.2018.01.018 Copyright © 2018 The Authors Terms and Conditions

Figure 1 (A) An example of pathological assessment of surgical specimen (top); and (B) a scheme of the neoadjuvant chemoradiation(nCR) treatment management and MRI staging and restaging scan for resectable and borderline resectable pancreatic ductal adenocarcinoma patients (bottom). Translational Oncology 2018 11, 391-398DOI: (10.1016/j.tranon.2018.01.018) Copyright © 2018 The Authors Terms and Conditions

Figure 2 Slice-to-slice comparison of the pre-and post-nCR ADC maps. Change in spatial heterogeneity of ADC values before and after the nCR for a pancreatic head tumor with pathologically proven moderate response (G2) is shown. Translational Oncology 2018 11, 391-398DOI: (10.1016/j.tranon.2018.01.018) Copyright © 2018 The Authors Terms and Conditions

Figure 3 Gross tumor volume (GTV) delineation based on ADC map demonstrating general tumor shrinkage post-nCR. Translational Oncology 2018 11, 391-398DOI: (10.1016/j.tranon.2018.01.018) Copyright © 2018 The Authors Terms and Conditions

Figure 4 (A) Significant correlations (top) of pathological treatment response with the mean post-nCR ADC values and the stained pictures (bottom) of all three categories shown with G1 single cells or small clusters of residual cancer cells in extensive fibrosis, G2 residual cancer outgrown by fibrosis, and G3 extensive residual cancer. (B) Spatial post-nCR ADC value heterogeneity in relation to treatment response (cellularity as a result of failing regeneration) together with histogram data for all three-tumor response grading. Translational Oncology 2018 11, 391-398DOI: (10.1016/j.tranon.2018.01.018) Copyright © 2018 The Authors Terms and Conditions

Figure 5 The mean post-nCR ADC values (left) for the cellularity and fibrosis regions, as divided by nonlinear Gaussian regression fitting, for the G1, G2 and G3 responses. A sample ADC histogram with two Gaussian fitting curves is included (right). Translational Oncology 2018 11, 391-398DOI: (10.1016/j.tranon.2018.01.018) Copyright © 2018 The Authors Terms and Conditions