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Biomarkers for site-specific response to neoadjuvant chemotherapy in epithelial ovarian cancer : relating MRI changes to tumour cell load and necrosis
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Winfield, Jessica M., Wakefield, Jennifer C., Brenton, James D., AbdulJabbar, Khalid, Savio, Antonella, Freeman, Susan, Pace, Erika, Lutchman-Singh, Kerryn , Vroobel, Katherine M., Yuan, Yinyin, Banerjee, Susana, Porta, Nuria, Raza, Shan-e-Ahmed and deSouza, Nandita M. (2021) Biomarkers for site-specific response to neoadjuvant chemotherapy in epithelial ovarian cancer : relating MRI changes to tumour cell load and necrosis. British Journal of Cancer, 124 . pp. 1130-1137. doi:10.1038/s41416-020-01217-5 ISSN 0007-0920.
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Official URL: https://doi.org/10.1038/s41416-020-01217-5
Abstract
Background
Diffusion-weighted magnetic resonance imaging (DW-MRI) potentially interrogates site-specific response to neoadjuvant chemotherapy (NAC) in epithelial ovarian cancer (EOC).
Methods
Participants with newly diagnosed EOC due for platinum-based chemotherapy and interval debulking surgery were recruited prospectively in a multicentre study (n = 47 participants). Apparent diffusion coefficient (ADC) and solid tumour volume (up to 10 lesions per participant) were obtained from DW-MRI before and after NAC (including double-baseline for repeatability assessment in n = 19). Anatomically matched lesions were analysed after surgical excision (65 lesions obtained from 25 participants). A trained algorithm determined tumour cell fraction, percentage tumour and percentage necrosis on histology. Whole-lesion post-NAC ADC and pre/post-NAC ADC changes were compared with histological metrics (residual tumour/necrosis) for each tumour site (ovarian, omental, peritoneal, lymph node).
Results
Tumour volume reduced at all sites after NAC. ADC increased between pre- and post-NAC measurements. Post-NAC ADC correlated negatively with tumour cell fraction. Pre/post-NAC changes in ADC correlated positively with percentage necrosis. Significant correlations were driven by peritoneal lesions.
Conclusions
Following NAC in EOC, the ADC (measured using DW-MRI) increases differentially at disease sites despite similar tumour shrinkage, making its utility site-specific. After NAC, ADC correlates negatively with tumour cell fraction; change in ADC correlates positively with percentage necrosis.
Item Type: | Journal Article | ||||||||||||||||||
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Subjects: | R Medicine > RC Internal medicine R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) |
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Divisions: | Faculty of Science, Engineering and Medicine > Science > Computer Science | ||||||||||||||||||
Library of Congress Subject Headings (LCSH): | Cancer -- Magnetic resonance imaging, Magnetic resonance imaging, Ovaries -- Cancer -- Chemotherapy -- Evaluation, Ovaries -- Cancer -- Treatment, Ovaries -- Tumors | ||||||||||||||||||
Journal or Publication Title: | British Journal of Cancer | ||||||||||||||||||
Publisher: | Nature Publishing Group | ||||||||||||||||||
ISSN: | 0007-0920 | ||||||||||||||||||
Official Date: | 16 March 2021 | ||||||||||||||||||
Dates: |
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Volume: | 124 | ||||||||||||||||||
Page Range: | pp. 1130-1137 | ||||||||||||||||||
DOI: | 10.1038/s41416-020-01217-5 | ||||||||||||||||||
Status: | Peer Reviewed | ||||||||||||||||||
Publication Status: | Published | ||||||||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||||||||
Date of first compliant deposit: | 5 January 2021 | ||||||||||||||||||
Date of first compliant Open Access: | 8 January 2021 | ||||||||||||||||||
RIOXX Funder/Project Grant: |
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