The Role of Diffusion-weighted Imaging in Patients with Gastric Wall Thickening

Author(s): Yilmaz Onal, Cesur Samanci*.

Journal Name: Current Medical Imaging
Formerly: Current Medical Imaging Reviews

Volume 15 , Issue 10 , 2019

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Graphical Abstract:


Abstract:

Background: Gastric cancer is the second leading cause of cancer death worldwide.

Aims: In the benign and malign gastric pathologies, we measured the Apparent Diffusion Coefficient (ADC) value from the thickened section of the stomach wall. We assessed the diagnostic value of ADC and we wanted to see whether this value could be used to diagnose gastric pathologies.

Study Design: This study has a prospective study design.

Methods: A total of 90 patients, 27 with malign gastric pathologies 63 with benign gastric pathologies with Gastric Wall (GW) thickening in multidector CT, were evaluated by T2 weighted axial MR imaging and Diffusion-Weighted Imaging (DWI). Measurements were made both from the thickened wall and from the normal GW. Also, a new method called GW/spine ADC ratio was performed in image analysis. The value found after ADC measurement from the GW was proportioned to the spinal cord ADC value in the same section.

Results: The ADC values measured from the pathological wall in patients with gastric malignancy (1.115 ± 0.156 x10-3 mm2/s) were significantly lower than the healthy wall measurements (1.621 ± 0.292 × 10-3 mm2/s) and benign gastric diseases (1.790± 0.359 x10-3 mm2/s). GW/spine ADC ratio was also lower in gastric malignancy group.

Conclusion: ADC measurement in DWI can be used to distinguish between benign and malign gastric pathologies.

Keywords: Gastric wall thickening, gastric cancer, diffusion-weighted imaging, apparent diffusion coefficient, gastric pathologies, ulceration.

[1]
Ba-Ssalamah A, Prokop M, Uffmann M, Pokieser P, Teleky B, Lechner G. Dedicated multidetector CT of the stomach: spectrum of diseases. Radiographics 2003; 23(3): 625-44.
[http://dx.doi.org/10.1148/rg.233025127] [PMID: 12740465]
[2]
Kim SJ, Lee JM, Kim H, Yoon JH, Han JK, Choi BI. Role of diffusion-weighted magnetic resonance imaging in the diagnosis of gallbladder cancer. J Magn Reson Imaging 2013; 38(1): 127-37.
[http://dx.doi.org/10.1002/jmri.23956] [PMID: 23281048]
[3]
Tam HH, Collins DJ, Wallace T, Brown G, Riddell A, Koh DM. Segmental liver hyperintensity in malignant biliary obstruction on diffusion weighted MRI: associated MRI findings and relationship with serum alanine aminotransferase levels. Br J Radiol 2012; 85(1009): 22-8.
[http://dx.doi.org/10.1259/bjr/24852804] [PMID: 21224301]
[4]
Wang Y, Chen ZE, Nikolaidis P, et al. Diffusion-weighted magnetic resonance imaging of pancreatic adenocarcinomas: association with histopathology and tumor grade. J Magn Reson Imaging 2011; 33(1): 136-42.
[http://dx.doi.org/10.1002/jmri.22414] [PMID: 21182131]
[5]
Bittencourt LK, Barentsz JO, de Miranda LC, Gasparetto EL. Prostate MRI: diffusion-weighted imaging at 1.5T correlates better with prostatectomy gleason grades than TRUS-guided biopsies in peripheral zone tumours. Eur Radiol 2012; 22(2): 468-75.
[http://dx.doi.org/10.1007/s00330-011-2269-1] [PMID: 21913058]
[6]
Piana G, Trinquart L, Meskine N, Barrau V, Beers BV, Vilgrain V. New MR imaging criteria with a diffusion-weighted sequence for the diagnosis of hepatocellular carcinoma in chronic liver diseases. J Hepatol 2011; 55(1): 126-32.
[http://dx.doi.org/10.1016/j.jhep.2010.10.023] [PMID: 21145857]
[7]
Alacalı M. Mide kanseri, mide kanseri taramaları ve mide kanserinden korunma. Ankara Med J 2012; 12(4): 195-8.
[8]
Sala E, Priest AN, Kataoka M, et al. Apparent diffusion coefficient and vascular signal fraction measurements with magnetic resonance imaging: feasibility in metastatic ovarian cancer at 3 Tesla: technical development. Eur Radiol 2010; 20(2): 491-6.
[http://dx.doi.org/10.1007/s00330-009-1543-y] [PMID: 19657643]
[9]
Fornasa F, Pinali L, Gasparini A, Toniolli E, Montemezzi S. Diffusion-weighted magnetic resonance imaging in focal breast lesions: analysis of 78 cases with pathological correlation. Radiol Med (Torino) 2011; 116(2): 264-75.
[http://dx.doi.org/10.1007/s11547-010-0602-4] [PMID: 21076884]
[10]
Miller FH, Hammond N, Siddiqi AJ, et al. Utility of diffusion-weighted MRI in distinguishing benign and malignant hepatic lesions. J Magn Reson Imaging 2010; 32(1): 138-47.
[http://dx.doi.org/10.1002/jmri.22235] [PMID: 20578020]
[11]
Hayashida Y, Yakushiji T, Awai K, et al. Monitoring therapeutic responses of primary bone tumors by diffusion-weighted image: Initial results. Eur Radiol 2006; 16(12): 2637-43.
[http://dx.doi.org/10.1007/s00330-006-0342-y] [PMID: 16909220]
[12]
Guo Y, Cai YQ, Cai ZL, et al. Differentiation of clinically benign and malignant breast lesions using diffusion-weighted imaging. J Magn Reson Imaging 2002; 16(2): 172-8.
[http://dx.doi.org/10.1002/jmri.10140] [PMID: 12203765]
[13]
Squillaci E, Manenti G, Cova M, et al. Correlation of diffusion-weighted MR imaging with cellularity of renal tumours. Anticancer Res 2004; 24(6): 4175-9.
[PMID: 15736469]
[14]
Manenti G, Di Roma M, Mancino S, et al. Malignant renal neoplasms: correlation between ADC values and cellularity in diffusion weighted magnetic resonance imaging at 3 T. Radiol Med (Torino) 2008; 113(2): 199-213.
[http://dx.doi.org/10.1007/s11547-008-0246-9] [PMID: 18386122]
[15]
Yoshikawa MI, Ohsumi S, Sugata S, et al. Relation between cancer cellularity and apparent diffusion coefficient values using diffusion-weighted magnetic resonance imaging in breast cancer. Radiat Med 2008; 26(4): 222-6.
[http://dx.doi.org/10.1007/s11604-007-0218-3] [PMID: 18509722]
[16]
Taouli B, Vilgrain V, Dumont E, Daire JL, Fan B, Menu Y. Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients. Radiology 2003; 226(1): 71-8.
[http://dx.doi.org/10.1148/radiol.2261011904] [PMID: 12511671]
[17]
Parikh T, Drew SJ, Lee VS, et al. Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging. Radiology 2008; 246(3): 812-22.
[http://dx.doi.org/10.1148/radiol.2463070432] [PMID: 18223123]
[18]
Sinha S, Lucas-Quesada FA, Sinha U, DeBruhl N, Bassett LW. In vivo diffusion-weighted MRI of the breast: potential for lesion characterization. J Magn Reson Imaging 2002; 15(6): 693-704.
[http://dx.doi.org/10.1002/jmri.10116] [PMID: 12112520]
[19]
Woodhams R, Matsunaga K, Iwabuchi K, et al. Diffusion-weighted imaging of malignant breast tumors: the usefulness of apparent diffusion coefficient (ADC) value and ADC map for the detection of malignant breast tumors and evaluation of cancer extension. J Comput Assist Tomogr 2005; 29(5): 644-9.
[http://dx.doi.org/10.1097/01.rct.0000171913.74086.1b] [PMID: 16163035]
[20]
Shen SH, Chiou YY, Wang JH, et al. Diffusion-weighted single-shot echo-planar imaging with parallel technique in assessment of endometrial cancer. AJR Am J Roentgenol 2008; 190(2): 481-8.
[http://dx.doi.org/10.2214/AJR.07.2155] [PMID: 18212236]
[21]
Koh DM, Scurr E, Collins DJ, et al. Colorectal hepatic metastases: quantitative measurements using single-shot echo-planar diffusion-weighted MR imaging. Eur Radiol 2006; 16(9): 1898-905.
[http://dx.doi.org/10.1007/s00330-006-0201-x] [PMID: 16691378]
[22]
Yoshikawa T, Kawamitsu H, Mitchell DG, et al. ADC measurement of abdominal organs and lesions using parallel imaging technique. AJR Am J Roentgenol 2006; 187(6): 1521-30.
[http://dx.doi.org/10.2214/AJR.05.0778] [PMID: 17114546]
[23]
Ichikawa T, Haradome H, Hachiya J, Nitatori T, Araki T. Diffusion-weighted MR imaging with a single-shot echoplanar sequence: detection and characterization of focal hepatic lesions. AJR Am J Roentgenol 1998; 170(2): 397-402.
[http://dx.doi.org/10.2214/ajr.170.2.9456953] [PMID: 9456953]
[24]
Ichikawa T, Haradome H, Hachiya J, Nitatori T, Araki T. Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen: preliminary clinical experience in 61 patients. Abdom Imaging 1999; 24(5): 456-61.
[http://dx.doi.org/10.1007/s002619900539] [PMID: 10475927]
[25]
Ichikawa T, Erturk SM, Motosugi U, et al. High-B-value diffusion-weighted MRI in colorectal cancer. AJR Am J Roentgenol 2006; 187(1): 181-4.
[http://dx.doi.org/10.2214/AJR.05.1005] [PMID: 16794174]
[26]
Naganawa S, Sato C, Kumada H, Ishigaki T, Miura S, Takizawa O. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix. Eur Radiol 2005; 15(1): 71-8.
[http://dx.doi.org/10.1007/s00330-004-2529-4] [PMID: 15538578]
[27]
Tang L, Sun YS, Li ZY, et al. Diffusion-weighted magnetic resonance imaging in the depiction of gastric cancer: initial experience. Abdom Radiol (NY) 2016; 41(1): 2-9.
[http://dx.doi.org/10.1007/s00261-015-0594-6] [PMID: 26830605]
[28]
Giganti F, Orsenigo E, Esposito A, et al. Prognostic role of diffusion-weighted MR imaging for resectable gastric cancer. Radiology 2015; 276(2): 444-52.
[http://dx.doi.org/10.1148/radiol.15141900] [PMID: 25816106]
[29]
Jang KM, Kim SH, Lee SJ, Lee MW, Choi D, Kim KM. Upper abdominal gadoxetic acid-enhanced and diffusion-weighted MRI for the detection of gastric cancer: Comparison with two-dimensional multidetector row CT. Clin Radiol 2014; 69(8): 827-35.
[http://dx.doi.org/10.1016/j.crad.2014.03.017] [PMID: 24837701]
[30]
Liu S, Wang H, Guan W, et al. Preoperative apparent diffusion coefficient value of gastric cancer by diffusion-weighted imaging: Correlations with postoperative TNM staging. J Magn Reson Imaging 2015; 42(3): 837-43.
[http://dx.doi.org/10.1002/jmri.24841] [PMID: 25581898]
[31]
Giganti F, Ambrosi A, Chiari D, et al. Apparent diffusion coefficient by diffusion-weighted magnetic resonance imaging as a sole biomarker for staging and prognosis of gastric cancer. Chin J Cancer Res 2017; 29(2): 118-26.
[http://dx.doi.org/10.21147/j.issn.1000-9604.2017.02.04] [PMID: 28536490]
[32]
Yankeelov TE, Lepage M, Chakravarthy A, et al. Integration of quantitative DCE-MRI and ADC mapping to monitor treatment response in human breast cancer: initial results. Magn Reson Imaging 2007; 25(1): 1-13.
[http://dx.doi.org/10.1016/j.mri.2006.09.006] [PMID: 17222711]
[33]
Theilmann RJ, Borders R, Trouard TP, et al. Changes in water mobility measured by diffusion MRI predict response of metastatic breast cancer to chemotherapy. Neoplasia 2004; 6(6): 831-7.
[http://dx.doi.org/10.1593/neo.03343] [PMID: 15720810]
[34]
Pickles MD, Gibbs P, Lowry M, Turnbull LW. Diffusion changes precede size reduction in neoadjuvant treatment of breast cancer. Magn Reson Imaging 2006; 24: 831-7.
[35]
Uhl M, Saueressig U, van Buiren M, et al. Osteosarcoma: preliminary results of in vivo assessment of tumor necrosis after chemotherapy with diffusion- and perfusion-weighted magnetic resonance imaging. Invest Radiol 2006; 41(8): 618-23.
[http://dx.doi.org/10.1097/01.rli.0000225398.17315.68] [PMID: 16829744]
[36]
Galons JP, Altbach MI, Paine-Murrieta GD, Taylor CW, Gillies RJ. Early increases in breast tumor xenograft water mobility in response to paclitaxel therapy detected by non-invasive diffusion magnetic resonance imaging. Neoplasia 1999; 1(2): 113-7.
[http://dx.doi.org/10.1038/sj.neo.7900009] [PMID: 10933044]
[37]
Lambrecht M, Vandecaveye V, De Keyzer F, et al. Value of diffusion-weighted magnetic resonance imaging for prediction and early assessment of response to neoadjuvant radiochemotherapy in rectal cancer: preliminary results. Int J Radiat Oncol Biol Phys 2012; 82(2): 863-70.
[http://dx.doi.org/10.1016/j.ijrobp.2010.12.063] [PMID: 21398048]
[38]
Thoeny HC, Ross BD. Predicting and monitoring cancer treatment response with diffusion-weighted MRI. J Magn Reson Imaging 2010; 32(1): 2-16.
[http://dx.doi.org/10.1002/jmri.22167] [PMID: 20575076]
[39]
Joye I, Deroose CM, Vandecaveye V, Haustermans K. The role of diffusion-weighted MRI and (18)F-FDG PET/CT in the prediction of pathologic complete response after radiochemotherapy for rectal cancer: a systematic review. Radiother Oncol 2014; 113(2): 158-65.
[http://dx.doi.org/10.1016/j.radonc.2014.11.026] [PMID: 25483833]
[40]
Intven M, Reerink O, Philippens ME. Diffusion-weighted MRI in locally advanced rectal cancer: pathological response prediction after neo-adjuvant radiochemotherapy. Strahlenther Onkol 2013; 189(2): 117-22.
[http://dx.doi.org/10.1007/s00066-012-0270-5] [PMID: 23283590]
[41]
Aoyagi T, Shuto K, Okazumi S, Shimada H, Kazama T, Matsubara H. Apparent diffusion coefficient values measured by diffusion-weighted imaging predict chemoradiotherapeutic effect for advanced esophageal cancer. Dig Surg 2011; 28(4): 252-7.
[http://dx.doi.org/10.1159/000328770] [PMID: 21654173]
[42]
De Cobelli F, Giganti F, Orsenigo E, et al. Apparent diffusion coefficient modifications in assessing gastro-oesophageal cancer response to neoadjuvant treatment: comparison with tumour regression grade at histology. Eur Radiol 2013; 23(8): 2165-74.
[http://dx.doi.org/10.1007/s00330-013-2807-0] [PMID: 23588582]
[43]
Kwee RM, Dik AK, Sosef MN, et al. Interobserver reproducibility of diffusion-weighted MRI in monitoring tumor response to neoadjuvant therapy in esophageal cancer. PLoS One 2014; 9(4) e92211
[http://dx.doi.org/10.1371/journal.pone.0092211] [PMID: 24704912]
[44]
Aoyagi T, Shuto K, Okazumi S, et al. Evaluation of the clinical staging of esophageal cancer by using diffusion-weighted imaging. Exp Ther Med 2010; 1: 847-51.
[http://dx.doi.org/10.3892/etm.2010.112]
[45]
Sun YS, Zhang XP, Tang L, et al. Locally advanced rectal carcinoma treated with preoperative chemotherapy and radiation therapy: preliminary analysis of diffusion-weighted MR imaging for early detection of tumor histopathologic downstaging. Radiology 2010; 254(1): 170-8.
[http://dx.doi.org/10.1148/radiol.2541082230] [PMID: 20019139]
[46]
Park SH, Moon WK, Cho N, et al. Comparison of diffusion-weighted MR imaging and FDG PET/CT to predict pathological complete response to neoadjuvant chemotherapy in patients with breast cancer. Eur Radiol 2012; 22(1): 18-25.
[http://dx.doi.org/10.1007/s00330-011-2236-x] [PMID: 21845462]
[47]
Zhong J, Zhao W, Ma W, et al. DWI as a quantitative biomarker in predicting chemotherapeutic efficacy at multitime points on gastric cancer lymph nodes metastases. Medicine (Baltimore) 2016; 95(13) e3236
[http://dx.doi.org/10.1097/MD.0000000000003236] [PMID: 27043694]
[48]
Onur MR, Ozturk F, Aygun C, Poyraz AK, Ogur E. Role of the apparent diffusion coefficient in the differential diagnosis of gastric wall thickening. J Magn Reson Imaging 2012; 36(3): 672-7.
[http://dx.doi.org/10.1002/jmri.23698] [PMID: 22570233]


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Article Details

VOLUME: 15
ISSUE: 10
Year: 2019
Page: [965 - 971]
Pages: 7
DOI: 10.2174/1573405614666181115120109
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