A Pilot Study of Diffusion-Weighted MRI in Patients Undergoing Neoadjuvant Chemoradiation for Pancreatic Cancer Kyle C. Cuneo, Thomas L. Chenevert, Edgar.

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A Pilot Study of Diffusion-Weighted MRI in Patients Undergoing Neoadjuvant Chemoradiation for Pancreatic Cancer Kyle C. Cuneo, Thomas L. Chenevert, Edgar Ben-Josef, Mary U. Feng, Joel K. Greenson, Hero K. Hussain, Diane M. Simeone, Matthew J. Schipper, Michelle A. Anderson, Mark M. Zalupski, Mahmoud Al-Hawary, Craig J. Galban, Alnawaz Rehemtulla, Felix Y. Feng, Theodore S. Lawrence, Brian D. Ross Translational Oncology Volume 7, Issue 5, Pages 644-649 (October 2014) DOI: 10.1016/j.tranon.2014.07.005 Copyright © 2014 Terms and Conditions

Figure 1 ADC maps obtained from patients on the study. The region of interest (tumor) is outlined. Representative tumors with a low (A, 119 x 10−5mm2/s) and high (B, 168 x 10−5mm2/s) mean ADC are shown. Translational Oncology 2014 7, 644-649DOI: (10.1016/j.tranon.2014.07.005) Copyright © 2014 Terms and Conditions

Figure 2 Relationship between pretreatment mean tumor ADC and subsequent histopathologic response after chemoradiation therapy. The percentage of tumor cell destruction was converted from the grading system described by Evans DB et al. (19) to a numerical scale. Pearson correlation coefficient was calculated to describe the relationship between ADC and percent tumor cell destruction. Translational Oncology 2014 7, 644-649DOI: (10.1016/j.tranon.2014.07.005) Copyright © 2014 Terms and Conditions

Figure 3 Pretreatment ADC histograms generated for each tumor with the corresponding amount of tumor cell destruction (percentage listed) seen after chemoradiation therapy and surgical resection. A shift towards a higher ADC value was associated with improved pathologic response to chemoradiation. Translational Oncology 2014 7, 644-649DOI: (10.1016/j.tranon.2014.07.005) Copyright © 2014 Terms and Conditions

Figure 4 Comparison of pretreatment ADC and change in size on CT scan in patients showing a pathologic response (>90% tumor cell destruction) and in nonresponding patients (>10% viable tumor). Mean pretreatment tumor ADC was significantly higher in responding patients compared to nonresponding patients. Whereas, tumor size did not change on CT imaging after treatment with neoadjuvant chemoradiation. Translational Oncology 2014 7, 644-649DOI: (10.1016/j.tranon.2014.07.005) Copyright © 2014 Terms and Conditions

Figure 5 One stainless steel and two nitinol (nickel titanium alloy) stents were placed in fixed diameter plastic cylinders to simulate a bile duct. Stents were scanned in a water phantom with T2 and diffusion weighted MRI sequences. High levels of artifact were seen in the diffusion sequence with the stainless steel stent but not with the nitinol containing stents. Translational Oncology 2014 7, 644-649DOI: (10.1016/j.tranon.2014.07.005) Copyright © 2014 Terms and Conditions