From the Department of Neurosurgery (Y.F., T.S., K.T., M.K., H.K., A.F., E.K.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
From the Department of Neurosurgery (Y.F., T.S., K.T., M.K., H.K., A.F., E.K.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
AJNR Am J Neuroradiol. 2019 Dec;40(12):2045-2051. doi: 10.3174/ajnr.A6300. Epub 2019 Nov 21.
Photodynamic therapy is a novel treatment that provides effective local control, but little is known about photodynamic therapy-induced changes on MR imaging. The aim of this study was to assess the utility of DWI and ADC in monitoring the response of malignant gliomas to photodynamic therapy.
Time-dependent changes in DWI and ADC values after photodynamic therapy were analyzed in a group that received photodynamic therapy in comparison with a group that did not.
Twenty-four patients were enrolled (photodynamic therapy, = 14; non-photodynamic therapy, = 10). In all patients who received photodynamic therapy, linear high signals on DWI in the irradiated area were detected adjacent to the resection cavity and were 5-7 mm in depth from 1 day posttreatment and disappeared in about 30 days without any neurologic deterioration. The non-photodynamic therapy group did not show this change. The photodynamic therapy group had significantly lower ADC values from 1 day posttreatment (< .001), which increased steadily and disappeared by 30 days. There was no decline or time-dependent change in ADC values in the non-photodynamic therapy group.
The acute response of malignant gliomas to photodynamic therapy was detected as linear high signals on DWI and as a decrease in ADC values. These findings were asymptomatic and transient. Although the photodynamic therapy-induced acute response on MR imaging disappeared after approximately 30 days, it may be helpful for confirming the photodynamic therapy-irradiated area.
光动力疗法是一种新的治疗方法，可提供有效的局部控制，但对光动力疗法引起的磁共振成像改变知之甚少。本研究旨在评估 DWI 和 ADC 在监测恶性胶质瘤对光动力疗法的反应中的作用。
分析了一组接受光动力疗法与未接受光动力疗法的患者治疗后 DWI 和 ADC 值的时间依赖性变化。
共纳入 24 例患者（光动力治疗组 n=14，非光动力治疗组 n=10）。所有接受光动力治疗的患者在治疗后 1 天，于放射野内均检测到与切除腔相邻的弥散加权成像（DWI）上的线性高信号，深度为 5-7mm，约 30 天内消失，且无神经功能恶化。非光动力治疗组无此变化。光动力治疗组从治疗后 1 天起 ADC 值明显降低（<0.001），并逐渐升高，30 天内消失。非光动力治疗组的 ADC 值无下降或时间依赖性变化。
恶性胶质瘤对光动力疗法的急性反应表现为 DWI 上的线性高信号和 ADC 值降低。这些发现是无症状和短暂的。尽管光动力治疗后磁共振成像上的急性反应在大约 30 天后消失，但它可能有助于确认光动力治疗照射区域。
