Fig. 7
A 63-year-old woman with metastatic breast cancer treated with an anti-HER2 agent and hormonotherapy. a Whole body diffusion-weighted inverted gray-scale maximun intensity projection (MIP) of b = 900 s/mm2 images superimposing the ADC values associated with each voxel in color scale before (left) and after one cycle of therapy (right). Red colored voxels represent untreated disease or those with no-detectable response. The yellow voxels lie between the 95th centile value of the pre-treatment histogram and 1500 μm2/s. Thus, yellow voxels represent regions “likely” to be responding. Green colored voxels have ADC values ≥ 1500 μm2/s representing voxels that are “highly likely” to be responding with tumor cell kill. In this case, response assessment demonstrated a discrete change in ADC values (predominantly yellow voxels). b The detailed ADC analysis of histogram metrics evidenced an increased tumor volume with moderate changes in several histogram metrics (mean ADC, kurtosis, etc.) suggesting an apoptotic effect of targeted therapies (compare to Fig. 6)