Cancer cells receding, replaced by healthy tissue.

Decoding Cancer: How New Imaging Tech Can Predict Treatment Success

Mira Elwood in Health & Wellness August 2025 • 3 min read.

"Revolutionary IVIM-DWI could transform cancer care by accurately predicting how rectal tumors respond to chemotherapy, paving the way for personalized treatment strategies."

For individuals battling locally advanced rectal cancer (LARC), neoadjuvant chemoradiotherapy (nCRT) followed by surgery has become a standard treatment approach. However, not everyone responds the same way, leading researchers to seek better methods of predicting treatment success. A new study published in Scientific Reports investigates how a cutting-edge imaging technique called intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) could help.

The core challenge lies in accurately identifying which patients will achieve a pathological complete response (pCR), meaning no detectable cancer cells remain after treatment. Those who achieve pCR typically have better long-term outcomes, and some may even be able to avoid surgery altogether. On the flip side, patients with a poor response might be spared the side effects of a treatment that won't work for them.

Traditional methods like MRI volumetric evaluation and T-downstaging often fall short because they primarily focus on changes in tumor size and structure, which can lag behind changes at the cellular level. More advanced imaging techniques like diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) have shown promise, but they have limitations, including inconsistent results and the need for contrast agents.

IVIM-DWI: A New Hope for Personalized Cancer Treatment

Cancer cells receding, replaced by healthy tissue.

IVIM-DWI is a modified version of DWI that goes a step further. While standard DWI measures the overall movement of water molecules in tissues, IVIM-DWI separates this movement into two components: the pure diffusion of water and the movement of water related to blood flow in tiny blood vessels (microcirculation). This distinction is crucial because cancer treatment affects both cellular structure and blood supply.

The study enrolled 42 patients with LARC, each undergoing IVIM-DWI before and after nCRT. Researchers then compared IVIM-DWI measurements with the actual pathological response observed after surgery. The key parameters measured were:

ADC (apparent diffusion coefficient): Overall water movement.
D (pure diffusion coefficient): Water movement independent of blood flow.
D (pseudo-diffusion coefficient): Water movement related to microcirculation.
f (perfusion fraction): The proportion of water movement related to microcirculation.

The results showed that certain IVIM-DWI parameters, especially D and f before treatment, and changes in ADC and D after treatment, were significantly correlated with the tumor regression grade (TRG). Specifically, the percentage change in D (A%D) emerged as a highly accurate predictor of pCR, outperforming traditional DWI-based ADC measurements. This means IVIM-DWI could help doctors identify patients who are most likely to achieve pCR with nCRT.

The Future of Cancer Treatment: Personalized and Precise

IVIM-DWI holds great promise for transforming how doctors treat rectal cancer and potentially other cancers as well. By providing a more detailed picture of what's happening at the cellular and microvascular level, this technique can help tailor treatments to each individual patient, increasing the likelihood of success and minimizing unnecessary side effects.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1038/s41598-017-09227-9, Alternate LINK

Title: Intravoxel Incoherent Motion Diffusion-Weighted Imaging For Discriminating The Pathological Response To Neoadjuvant Chemoradiotherapy In Locally Advanced Rectal Cancer

Subject: Multidisciplinary

Journal: Scientific Reports

Publisher: Springer Science and Business Media LLC

Authors: Wen Lu, Hou Jing, Zhou Ju-Mei, Nie Shao-Lin, Cao Fang, Yu Xiao-Ping, Lu Qiang, Zeng Biao, Zhu Su-Yu, Hu Ying

Published: 2017-08-17

Everything You Need To Know

What is Intravoxel Incoherent Motion Diffusion-Weighted Imaging (IVIM-DWI), and how does it work?

Intravoxel Incoherent Motion Diffusion-Weighted Imaging or IVIM-DWI is an advanced imaging technique. It builds upon standard Diffusion-Weighted Imaging (DWI) by separating water molecule movement in tissues into pure diffusion and microcirculation components. By measuring parameters like ADC, D, D*, and f, IVIM-DWI provides insights into cellular structure and blood supply, which is useful for predicting treatment response in cancers like locally advanced rectal cancer (LARC).

What key parameters are measured using IVIM-DWI in the study, and what do these parameters indicate?

The study measured several key parameters using IVIM-DWI, including ADC (apparent diffusion coefficient), which represents overall water movement, D (pure diffusion coefficient) which looks at water movement independent of blood flow, D* (pseudo-diffusion coefficient) which measures water movement related to microcirculation, and f (perfusion fraction) which quantifies the proportion of water movement related to microcirculation. Changes in these parameters before and after neoadjuvant chemoradiotherapy (nCRT) are then correlated with the pathological response observed after surgery to determine the effectiveness of IVIM-DWI.

Which IVIM-DWI parameter showed the most promise in predicting treatment success, and why is this significant?

The parameter 'A%D,' representing the percentage change in D (pure diffusion coefficient), has emerged as a highly accurate predictor of pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT). This is significant because it means that IVIM-DWI can potentially identify patients most likely to achieve pCR, outperforming traditional DWI-based ADC measurements and facilitating more informed treatment decisions.

How does IVIM-DWI improve upon traditional methods and other imaging techniques for assessing treatment response in rectal cancer?

Traditional methods like MRI volumetric evaluation and T-downstaging primarily focus on changes in tumor size and structure, which can lag behind the changes happening at the cellular level. While more advanced techniques like standard diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) have been developed, they still have limitations such as inconsistent results and the need for contrast agents. IVIM-DWI improves on these methods by providing a more detailed picture of water movement at the microvascular level.

What are the potential benefits of using IVIM-DWI in cancer treatment, and how could it impact patient care and outcomes?

The potential benefits of IVIM-DWI include the ability to predict treatment response more accurately in patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemoradiotherapy (nCRT). This can lead to personalized treatment strategies, potentially sparing patients from ineffective treatments and unnecessary side effects, while also identifying those who might benefit most from surgery. The ultimate aim is to increase the likelihood of successful outcomes and improve the overall quality of life for cancer patients. The applicability of IVIM-DWI to other cancers is also a promising area for future research.