Pretreatment Prediction of Brain Tumors' Response to Radiation Therapy Using High b-Value Diffusion-Weighted MRI

Yael Mardor*, Yiftach Roth, Aharon Ocherashvilli, Roberto Spiegelmann, Thomas Tichler, Dianne Daniels, Stephan E. Maier, Ouzi Nissim, Zvi Ram, Jacob Baram, Arie Orenstein, Raphael Pfeffer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

152 Scopus citations


Diffusion-weighted magnetic resonance imaging (DWMRI) is sensitive to tissues' biophysical characteristics, including apparent diffusion coefficients (ADCs) and volume fractions of water in different populations. In this work, we evaluate the clinical efficacy of DWMRI and high diffusion-weighted magnetic resonance imaging (HDWMRI), acquired up to b = 4000 sec/mm2 to amplify sensitivity to water diffusion properties, In pretreatment prediction of brain tumors' response to radiotherapy. Twelve patients with 20 brain lesions were studied. Six ring-enhancing lesions were excluded due to their distinct diffusion characteristics. Conventional and DWMRI were acquired on a 0.5-T MRI. Response to therapy was determined from relative changes in tumor volumes calculated from contrast-enhanced T1-weighted MRI, acquired before and a mean of 46 days after beginning therapy. ADCs and a diffusion index, R D, reflecting tissue viability based on water diffusion were calculated from DWMRIs. Pretreatment values of ADC and RD were found to correlate significantly with later tumor response/nonresponse (r = 0.76, P < .002 and r = 0.77, P < .001). This correlation implies that tumors with low pretreatment diffusion values, indicating high viability, will respond better to radiotherapy than tumors with high diffusion values, indicating necrosis. These results demonstrate the feasibility of using DWMRI for pretreatment prediction of response to therapy in patients with brain tumors undergoing radiotherapy.

Original languageEnglish
Pages (from-to)136-142
Number of pages7
Issue number2
StatePublished - 2004
Externally publishedYes


FundersFunder number
Israel Ministry of Industry and Commerce
Tel-Aviv University
National Institutes of Health
National Institute of Neurological Disorders and StrokeR01NS039335
Israel Cancer Research Fund
Israel Science Foundation


    • Brain tumors
    • Diffusion-weighted MRI
    • High b-value
    • Radiation
    • Response to treatment


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