Study demonstrates that MRI and DWI of patient samples with primary central nervous system lymphoma can be used to predict and monitor disease progression through the use of ADC histogram analysis of Ki-67 expression.
Scientists have long been aware that lymphoma occurs when multiple genetic changes take place in the white blood cells. This causes the white blood cells to grow out of control and no longer respond to central signaling—which would stop them from overgrowing and aid in natural cell death. However, many other factors driving lymphoma diagnosis have not been fully illuminated.
“Primary central nervous system lymphoma (PCNSL) is a rare subgroup of non-Hodgkin lymphoma confined to the central nervous system, with more than 90% of cases classified as Diffuse Large B-cell Lymphoma [1, 2].”
In a paper published in Oncotarget, researchers from the United States’ Texas, Missouri, and Pennsylvania, used apparent diffusion coefficient (ADC) mapping to produce a computed representation of the PCNSL tumor microenvironment, while hypothesizing that this will aid in predicting the degree, quality, and condition of the cell masses.
Apparent Diffusion Coefficient
ADC is a measurement of the magnitude of diffusion within a tissue—commonly calculated in the clinic using magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI). Biomarkers are distinctly important and tangible indicators of actions, or reactions, taking place in the body. Ki-67 is a protein and cellular biomarker that is associated with tumor malignancy and proliferation that can be represented through ADC mapping.
Researchers in this study say that although the tumor debulking treatments that are currently emerging show promising results, the recurrence rate of PCNSL still remains high. They explained that this must be due to the protective blood-brain barrier that restricts treatment agents from penetrating. The goal of this comprehensive and retrospective study was aimed at evaluating the relationship between ADC calculations taken from Ki-67 expression in tumor samples and the overall survival and progression-free survival of patients with PCNSL.
Their sample size of patients with PCNSL was relatively small, so the team included another patient sample in their study of patients living with HIV (PLWH). HIV has been identified as a leading factor in the rise of PCNSL.
“Patients living with HIV (PLWH) represent an important population to include in investigations related to PCNSL, as the association with the Epstein Barr virus highlights PCNSL in PLWH is a distinct entity from sporadic cases [3, 4].”
This research highlights that MRI should be explored for use in for more than neuroimaging; the most common adaptation for MRI. The researchers found that MRI and DWI are tools that can be used to investigate other diseases including PCNSL, and to acquire ADC values that may serve as a potential noninvasive method of predicting and monitoring tumor response to treatment.
“Quantitative ADC histogram analysis should be strongly considered as part of the imaging protocol in the evaluation of immunocompetent patients with PCNSL.”
Click here to read the full scientific paper, published in Oncotarget.
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