Chenevert Thomas L, Meyer Charles R, Moffat Bradford A, Rehemtulla Alnawaz, Mukherji Suresh K, Gebarski Stephen S, Quint Douglas J, Robertson Patricia L, Lawrence Theodore S, Junck Larry, Taylor Jeremy M, Johnson Timothy D, Dong Qian, Muraszko Karin M, Brunberg James A, Ross Brian D
Department of Radiology, Center for Molecular Imaging, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0030, USA.
Mol Imaging. 2002 Oct;1(4):336-43. doi: 10.1162/15353500200221482.
The use of anatomical imaging in clinical oncology practice traditionally relies on comparison of patient scans acquired before and following completion of therapeutic intervention. Therapeutic success is typically determined from inspection of gross anatomical images to assess changes in tumor size. Imaging could provide significant additional insight into therapeutic impact if a specific parameter or combination of parameters could be identified which reflect tissue changes at the cellular or physiologic level. This would provide an early indicator or treatment response/outcome in an individual patient before completion of therapy. Moreover, response of a tumor to therapeutic intervention may be heterogeneous. The use of imaging could assist in delineating therapeutic-induced spatial heterogeneity within a tumor mass by providing information related to specific regions that are resistant or responsive to treatment. Largely untapped potential resides in exploratory methods such as diffusion MRI, which is a nonvolumetric intravoxel measure of tumor response based upon water molecular mobility. Alterations in water mobility reflect changes in tissue structure at the cellular level. While the clinical utility of diffusion MRI for oncologic practice is still under active investigation, this overview on the use of diffusion MRI for the evaluation of brain tumors will serve to introduce how this approach may be applied in the future for the management of patients with solid tumors.
在临床肿瘤学实践中，解剖成像的应用传统上依赖于对治疗干预完成前后获取的患者扫描图像进行比较。治疗成功与否通常通过检查大体解剖图像来评估肿瘤大小的变化来确定。如果能够识别出反映细胞或生理水平组织变化的特定参数或参数组合，成像可以提供有关治疗效果的重要额外见解。这将在治疗完成前为个体患者提供早期治疗反应/结果指标。此外，肿瘤对治疗干预的反应可能是异质性的。通过提供与对治疗有抗性或反应性的特定区域相关的信息，成像的使用可以帮助描绘肿瘤块内治疗诱导的空间异质性。很大程度上尚未开发的潜力存在于诸如扩散磁共振成像等探索性方法中，扩散磁共振成像是基于水分子流动性的肿瘤反应的非体积体素测量。水分子流动性的改变反映了细胞水平组织结构的变化。虽然扩散磁共振成像在肿瘤学实践中的临床效用仍在积极研究中，但本关于扩散磁共振成像用于脑肿瘤评估的概述将有助于介绍这种方法未来如何应用于实体瘤患者的管理。
