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Uveal melanoma: quantitative evaluation of diffusion-weighted MR imaging in the response assessment after proton-beam therapy, long-term follow-up

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Abstract

Purpose

The purpose of this prospective study was to investigate the proton-beam-induced changes in apparent diffusion coefficient (ADC) values of ocular melanoma treated with proton-beam therapy (PBT) in patients undergoing long-term magnetic resonance imaging (MRI) follow-up and to assess whether variations in ADC constitute a reliable biomarker for predicting and detecting the response of ocular melanoma to PBT.

Methods

Seventeen patients with ocular melanoma treated with PBT were enrolled. All patients underwent conventional MRI and diffusion-weighted imaging (DWI) at baseline and 1, 3, 6, and 18 months after the beginning of therapy. Tumor volumes and ADC values of ocular lesions were measured at each examination. Tumor volumes and mean ADC measurements of the five examination series were compared; correlation of ADC values and tumor regression was estimated.

Results

Mean ADC values of ocular melanomas significantly increased already 1 month after therapy whereas tumor volume significantly decreased only 6 months after therapy. Pretreatment ADC value of ocular melanomas and early change in ADC value 1 month after therapy significantly correlated with tumor regression.

Conclusions

In ocular melanoma treated with PBT, ADC variations precede volume changes. Both pretreatment ADC and early change in ADC value may predict treatment response, thus expanding the role of DWI from diagnostic to prognostic.

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Authors and Affiliations

  1. Radiodiagnostic and Radiotherapy Unit, University Hospital “Policlinico-Vittorio Emanuele”, Via Santa Sofia 78, 95123, Catania, Italy

    Pietro Valerio Foti, Giuseppe Privitera, Corrado Spatola, Luigi Raffaele, Vincenzo Salamone, Renato Farina, Stefano Palmucci, Andrea Musumeci, Pietro Milone & Giovanni Carlo Ettorre

  2. Department of Ophthalmology, University of Catania, Catania, Italy

    Antonio Longo, Michele Reibaldi, Andrea Russo & Teresio Avitabile

  3. Department G.F. Ingrassia, Institute of Pathology, University of Catania, Catania, Italy

    Rosario Caltabiano

  4. Unità di BioMedicina Molecolare Genomica e dei Sistemi Complessi, Genetica, Biologia Computazionale, Department G.F. Ingrassia, University of Catania, Catania, Italy

    Marco Ragusa

  5. Dipartimento di Oftalmologia, Università Politecnica delle Marche, Ancona, Italy

    Cesare Mariotti

Authors
  1. Pietro Valerio Foti
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  2. Antonio Longo
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Correspondence to Pietro Valerio Foti.

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The authors declare that they have no conflict of interest. All authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence their work.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Foti, P.V., Longo, A., Reibaldi, M. et al. Uveal melanoma: quantitative evaluation of diffusion-weighted MR imaging in the response assessment after proton-beam therapy, long-term follow-up. Radiol med 122, 131–139 (2017). https://doi.org/10.1007/s11547-016-0697-3

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  • DOI: https://doi.org/10.1007/s11547-016-0697-3

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