Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109, USA.
Curr Pharm Biotechnol. 2010 Sep 1;11(6):701-8. doi: 10.2174/138920110792246627.
Recent clinical practice for the management for cancer patients has begun to change from a statistical "one-size fits all" approach to medicine to more individualized care. Pre-treatment biomarkers (i.e. genetically and histologically based) have a growing role in providing guidance related to the appropriate therapy and likelihood of response; they do not take into account heterogeneity within the tumor mass. Thus, a biomarker which could be utilized to measure actual tumor response early following treatment initiation would provide an important opportunity to evaluate treatment effects on an individual patient basis. Diffusion weighted magnetic resonance imaging (DW-MRI) offers the opportunity to monitor treatment-associated alterations in tumor microenvironment using quantification of changes in tumor water diffusion values as a surrogate imaging biomarker. Results obtained thus far using DW-MRI have shown that changes in tumor diffusion values can be detected early following treatment initiation which correlate with traditional outcome measures. Sensitive imaging biomarkers are providing for the first time a means of assessing 3 dimensional tumor response early in the treatment cycle. This review highlights the development of DW-MRI and its proposed usefulness in the clinical management of cancer patients. The utility of DW-MRI for assessing therapeutic-induced response is further evaluated on tumors residing in the brain, head and neck and bone.
最近，癌症患者管理的临床实践已开始从基于统计学的“一刀切”方法向更个体化的治疗方式转变。治疗前生物标志物（即基于遗传和组织学的标志物）在提供与适当治疗和反应可能性相关的指导方面发挥着越来越重要的作用；但它们并未考虑到肿瘤内的异质性。因此，一种可用于测量治疗开始后早期实际肿瘤反应的生物标志物将为个体患者基础上评估治疗效果提供重要机会。扩散加权磁共振成像（DW-MRI）提供了使用肿瘤水扩散值变化来量化肿瘤微环境变化作为替代成像生物标志物来监测治疗相关改变的机会。迄今为止，使用 DW-MRI 获得的结果表明，治疗开始后可以早期检测到肿瘤扩散值的变化，这些变化与传统的结果测量指标相关。敏感的成像生物标志物首次提供了一种在治疗周期早期评估三维肿瘤反应的手段。本综述强调了 DW-MRI 的发展及其在癌症患者临床管理中的潜在应用。DW-MRI 用于评估治疗诱导反应的效用进一步在脑、头颈部和骨骼中的肿瘤中进行了评估。
