Abstract #0867

Diffusion-Weighted MRI Identifies Viable Tissue in Wilms Tumour: Application for Subtype Analysis and Response to Chemotherapy

Harriet Rogers¹, Patrick Hales¹, Kathy Pritchard-Jones², and Christopher Clark¹

¹Developmental Imaging and Biophysics, Institute of Child Health, University College London, London, United Kingdom, ²Developmental Biology and Cancer, Institute of Child Health, University College London, London, United Kingdom

In Wilms Tumour (WT) Blastemal subtype has the worst prognosis. Diffusion MRI (DWI) can distinguish some histological subtypes. Gadolinium-contrast-injected T₁ MRI (T_1gad) identifies necrotic tissue. Gadolinium is contra-indicated in renal failure. 27 patients received DWI, 20/27 received T_1gad. DWI was fitted with Intravoxel Incoherent Motion providing Dmaps. Viable and necrotic regions identified on T_1gad were transferred to corresponding Dmaps. ROC analysis determined a D threshold separating necrotic and viable tissue. ANOVAs showed viable regions separated Blastemal from other subtypes, whole lesions could not. DWI separates necrotic and viable tissue in WT potentially identifying subtypes, assessing chemotherapy, guiding biopsies and surgery.

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