Radiology Department, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK.
Pediatr Radiol. 2011 Jan;41(1):99-106. doi: 10.1007/s00247-010-1741-4. Epub 2010 Jul 2.
Apparent diffusion coefficient (ADC) relates to tissue cellularity, and change in ADC during chemotherapy may be a promising tool for assessing oncological response.
To investigate the feasibility of measuring changes in ADC distribution in solid abdominal and pelvic paediatric tumours during chemotherapy, and to assess patterns of change.
Consecutive children were included in a prospective observational study. ADC maps were calculated at presentation and following chemotherapy from a diffusion-sensitised sequence. ADC distribution in the whole tumour, excluding areas of low or absent gadolinium-enhancement, was investigated. Change during chemotherapy was assessed for each patient individually. Histopathological slices from the resected specimens were reviewed.
There were seven children (nine tumours) included in the study. ADC in all except one deviated from a normal distribution. All tumours changed their ADC distribution during chemotherapy. Median ADC increased in all upper abdominal tumours, but more in tumours with histopathologically good or marked response to chemotherapy. Seven out of nine tumours attained a wider ADC distribution, the remaining two showed little chemotherapy response.
ADC distribution changes during chemotherapy in childhood abdominal tumours are measurable. Distinct patterns of shift can be observed and ADC change is therefore promising as a noninvasive biomarker for therapy response.
表观扩散系数（ADC）与组织细胞密度有关，化疗过程中 ADC 的变化可能是评估肿瘤反应的有前途的工具。
研究在化疗过程中测量实性腹部和盆腔儿科肿瘤 ADC 分布变化的可行性，并评估变化模式。
连续纳入前瞻性观察研究中的儿童。在化疗前和化疗后，从扩散敏感序列计算 ADC 图。研究了整个肿瘤（不包括低信号或无钆增强区域）的 ADC 分布。对每个患者单独评估化疗期间的变化。对切除标本的组织学切片进行了回顾。
本研究纳入了 7 名儿童（9 个肿瘤）。除一个肿瘤外，所有 ADC 均偏离正态分布。所有肿瘤在化疗过程中改变了 ADC 分布。所有上腹部肿瘤的 ADC 中位数均增加，但对化疗有良好或明显反应的肿瘤增加更多。9 个肿瘤中的 7 个获得了更广泛的 ADC 分布，其余 2 个肿瘤对化疗反应较小。
儿童腹部肿瘤化疗过程中 ADC 分布发生变化是可以测量的。可以观察到明显的转移模式，因此 ADC 变化有望成为治疗反应的非侵入性生物标志物。
