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Fig. 2 | Cancer Imaging

Fig. 2

From: Diffusion-weighted MRI improves response assessment after definitive radiotherapy in patients with NSCLC

Fig. 2

Presentation of the disease process before treatment and in the course of the three follow-ups. a-f shows the MRI sequences inverted DWI (b-value = 800 s/mm2) and T2-TSE in a transversal plane. G-L shows the corresponding CTs in lung and soft tissue window. The time points 6 and 12 months are divided into two anatomical regions (right lower lobe and right centrally). The tumor response after 3 months can be assessed in the DWI (b) as accurately as in the CT (h). After 6 months, severe radiation pneumonitis develops. Their extent can be determined both by MRI (c) and CT (i). Within pneumonitis it is difficult to make a statement on tumor response on CT (i). In the DWI (c), however, one can not detect any suspicious signal in the right lower lobe at this time. In addition, the DWI (d), in contrast to the CT (j) already delineates a suspicious signal on the right hilum. After 12 months, the findings after 6 months for pneumonitis in the right lower lobe and the suspicious lesion on the right hilum are reaffirmed. The extent of pneumonitis shows a good correlation between MRI (e) and CT (k) even after 12 months. The suspicious diffusion restriction in the right hilum (f) can still be clearly seen, whereas in CT (l) a delineation is much more difficult. After the study, the patient developed a right hilar recurrence

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