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Tumor modifications recorded with IVIM and DCE-MRI after Neoadjuvant radiotherapy.
LALLEMAND, François; LEROI, Natacha; Bahri, Mohamed Ali et al.
2019In Radiotherapy and Oncology, 133 (Supplement 1), p. 284 - S285
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Keywords :
IVIM; DCE; MRI; neoadjuvant
Abstract :
[en] Purpose or Objective Neoadjuvant radiotherapy (NeoRT) improves tumor local control and facilitates tumor resection in many cancers. We hypothesized anti-cancer treatments (i.e. radiotherapy) modify tumor microenvironment and could potentially impact distant metastases occurrence. Previously, we developed a pre-clinical model demonstrating an impact of NeoRT schedule and the timing of surgery on metastatic spreading (Leroi et al. Oncotarget 2015). Here, we aim to identify by fMRI noninvasive markers reflecting NeoRT related tumor microenvironment modifications that could predict the best timing for performing surgery and avoiding tumor spreading. Material and Methods To briefly delineate the NeoRT model, MDA-MB 231 tumor cells implanted in the flank of SCID mice were locally irradiated with 2x5Gy when tumor reached 100mm3 and then surgically removed at different time points. We performed fMRI, Diffusion Weighted (DW) and Dynamic Contract enhancement (DCE) – MRI, before RT and every 2 days between RT and surgery. We acquired 8 slices of 1 mm thickness and 0.5 mm gap with an “in plane voxel resolution” of 0.5 mm. For DW-MRI, we performed FSEMS (Fast Spin Echo MultiSlice) sequences, with 9 different Bvalue (from 40 to 1000) and B0. We performed IVIM (IntraVoxel Incoherent Motion) analysis to obtain information on intravascular diffusion, related to perfusion (F: perfusion factor) and subsequently tumor vessels perfusion. For DCE-MRI, we performed a T1 mapping with multiple TR and DCE acquisition with 200 repetitions of 3 sec each and gadolinium IV injection after 10 repetitions. We performed semi-quantitative analysis. We validated tumor perfusion by immunochemistry with injection of FITC-dextran IV 3 min before surgery and CD31 labelling. Human Ki67 was used for lung metastases labelling and quantification. Results After the tumor irradiation, we observed a significant and transient increase at day 6 (60% of the basal value (n=6, p<0,05)) of F and D* parameters related to perfusion. The other parameters of the DW-MRI, ADC and D presented no modifications. The sham irradiated tumors used as control showed no modifications of all fMRI parameters. At the same timing, 6 days post-radiotherapy, DCE-MRI significantly demonstrated a WhashinSlope (n=13, p<0,05) increase. Immunochemistry confirmed the increase of tumor perfusion when surgery is performed at day 6. The sham irradiated tumors never demonstrated such changes. Finally, when surgery is performed on tumor increased perfusion measured by fMRI, it demonstrated a burst of lung metastasis compared to the other timings. Conclusion We showed a significant difference in perfusion-related parameters with fMRI and immunochemistry at a specific time point after NeoRT. These modifications are correlated with an increase of metastasis spreading related to surgery procedure. These results open new perspectives in the personalized medicine and MRI guided surgery timing after NeoRT.
Research center :
GIGA CRC (Cyclotron Research Center) In vivo Imaging-Aging & Memory - ULiège
Disciplines :
Oncology
Author, co-author :
LALLEMAND, François  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de radiothérapie
LEROI, Natacha ;  Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Institut de Cancérologie
Bahri, Mohamed Ali  ;  Université de Liège - ULiège > CRC In vivo Imaging-Aging & Memory
Balteau, Evelyne ;  Université de Liège - ULiège > CRC In vivo Im.-Neuroimaging, data acquisition & processing
Noël, Agnès ;  Université de Liège - ULiège > Département des sciences cliniques > Labo de biologie des tumeurs et du développement
Coucke, Philippe  ;  Université de Liège - ULiège > Département des sciences cliniques > Radiothérapie
Plenevaux, Alain  ;  Université de Liège - ULiège > CRC In vivo Imaging-Preclinical Imaging
Martinive, Philippe ;  Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Département des sciences biomédicales et précliniques
Language :
English
Title :
Tumor modifications recorded with IVIM and DCE-MRI after Neoadjuvant radiotherapy.
Publication date :
April 2019
Event name :
ESTRO 38
Event organizer :
The European SocieTy for Radiotherapy and Oncology
Event place :
Milan, Italy
Event date :
26 avril au 30 avril
Audience :
International
Journal title :
Radiotherapy and Oncology
ISSN :
0167-8140
eISSN :
1879-0887
Publisher :
Elsevier, Netherlands
Special issue title :
ESTRO 38
Volume :
133
Issue :
Supplement 1
Pages :
S284 - S285
Peer reviewed :
Peer Reviewed verified by ORBi
Funders :
Fédération Wallonie Bruxelles. Fonds de la Recherche Scientifique - F.R.S.-FNRS
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