{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:34:58Z","timestamp":1793370898808,"version":"4.5.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine preliminary quantitative ADC thresholds for functional response and to evaluate whether integrating DWI metrics with RECIST 1.1 provides complementary information for early systemic therapy response assessment in bone metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single-center study included lung cancer patients with pelvic bone metastases who underwent 3 MRIs between November 2015 and November 2023: baseline, early time point (&amp;lt;4\u2009months, TP1), and late (6-15\u2009months, TP2) time points. ROC analysis based on lesion size change at TP2 determined ADC thresholds defining DWI response. A DWI response was defined as ADC &amp;gt; 1300\u2009\u00b5m2\/s or \u0394ADC &amp;gt; 0.14. An integrated response scheme (DWI-RECIST) combined this DWI-based response with RECIST assessment. Early responses at TP1 were compared between RECIST and DWI-RECIST using RECIST at TP2 as reference standard. Interobserver agreement was assessed using intraclass correlation coefficient, and diagnostic performance was evaluated using net reclassification improvement and AUCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy-eight lesions from 27 patients were included. Compared with RECIST, DWI-RECIST yielded net classification gains of 7.4% (reader 1) and 11.1% (reader 2). DWI-RECIST showed higher AUCs than RECIST (reader 1: 0.6964 vs. 0.6184, P\u2009=\u2009.472; reader 2: 0.6415 vs. 0.6184, P\u2009=\u2009.781). Interobserver agreement for ADC was good (ICC 0.83-0.86).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Integrating ADC-derived DWI metrics with RECIST 1.1 may provide complementary information for early assessment of pelvic bone metastases from lung cancer, particularly in lesions categorized as stable disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>This pilot study proposes quantitative ADC thresholds and introduces a framework integrating these with RECIST 1.1 to support more objective response assessment in lung cancer pelvic bone metastases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqag249","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:37:46Z","timestamp":1792481866000},"source":"Crossref","is-referenced-by-count":0,"title":["Integrating diffusion-weighted imaging parameters with RECIST 1.1 for early assessment of systemic therapy response in lung cancer pelvic bone metastases"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7063-1514","authenticated-orcid":false,"given":"Hyemin","family":"Park","sequence":"first","affiliation":[{"name":"Department of Radiology, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea , Seoul,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2951-7869","authenticated-orcid":false,"given":"Seungeun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea , Seoul,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0109-0998","authenticated-orcid":false,"given":"So-Yeon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea , Seoul,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1684-2996","authenticated-orcid":false,"given":"Sungwon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea , Seoul,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6909-0919","authenticated-orcid":false,"given":"Joon-Yong","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea , Seoul,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"2026103010065074800_tqag249-B1","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1002\/1097-0142(19810101)47:1&lt;207::AID-CNCR2820470134&gt;3.0.CO","article-title":"Reporting results of cancer treatment","volume":"47","author":"Miller","year":"1981","journal-title":"Cancer"},{"key":"2026103010065074800_tqag249-B2","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur J Cancer"},{"key":"2026103010065074800_tqag249-B3","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1007\/s11864-022-00994-w","article-title":"Targeted therapy in early stage non-small cell lung cancer","volume":"23","author":"Liu","year":"2022","journal-title":"Curr Treat Options Oncol"},{"key":"2026103010065074800_tqag249-B4","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1186\/s12916-022-02287-3","article-title":"Targeted therapies for cancer","volume":"20","author":"Zhou","year":"2022","journal-title":"BMC Med"},{"key":"2026103010065074800_tqag249-B5","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1186\/s12935-023-02990-y","article-title":"Recent advances in non-small cell lung cancer targeted therapy; an update review","volume":"23","author":"Araghi","year":"2023","journal-title":"Cancer Cell Int"},{"key":"2026103010065074800_tqag249-B6","doi-asserted-by":"publisher","first-page":"4716","DOI":"10.1158\/1078-0432.CCR-17-0454","article-title":"Monitoring daily dynamics of early tumor response to targeted therapy by detecting circulating tumor DNA in urine","volume":"23","author":"Husain","year":"2017","journal-title":"Clin Cancer Res"},{"key":"2026103010065074800_tqag249-B7","doi-asserted-by":"publisher","first-page":"1387345","DOI":"10.3389\/fonc.2024.1387345","article-title":"Understanding the treatment response and resistance to targeted therapies in non-small cell lung cancer: clinical insights and perspectives","volume":"14","author":"Zhang","year":"2024","journal-title":"Front Oncol"},{"key":"2026103010065074800_tqag249-B8","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s10020-025-01075-y","article-title":"Targeted therapy and immunotherapy for gastric cancer: rational strategies, novel advancements, challenges, and future perspectives","volume":"31","author":"Luo","year":"2025","journal-title":"Mol Med"},{"key":"2026103010065074800_tqag249-B9","doi-asserted-by":"publisher","first-page":"e0140009","DOI":"10.1371\/journal.pone.0140009","article-title":"Diffusion-weighted MRI in the assessment of early treatment response in patients with squamous-cell carcinoma of the head and neck: comparison with morphological and PET\/CT findings","volume":"10","author":"Martins","year":"2015","journal-title":"PLoS One"},{"key":"2026103010065074800_tqag249-B10","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.jvir.2019.08.027","article-title":"Diffusion-weighted MR imaging of primary and secondary lung cancer: predictive value for response to transpulmonary chemoembolization and transarterial chemoperfusion","volume":"31","author":"Vogl","year":"2020","journal-title":"J Vasc Interv Radiol"},{"key":"2026103010065074800_tqag249-B11","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1186\/s12967-021-02886-3","article-title":"Diffusion-weighted MRI for predicting pathologic response to neoadjuvant chemotherapy in breast cancer: evaluation with mono-, bi-, and stretched-exponential models","volume":"19","author":"Suo","year":"2021","journal-title":"J Transl Med"},{"key":"2026103010065074800_tqag249-B12","doi-asserted-by":"publisher","first-page":"110810","DOI":"10.1016\/j.ejrad.2023.110810","article-title":"Diffusion-weighted MRI for predicting and assessing treatment response of liver metastases from CRC - a systematic review and meta-analysis","volume":"163","author":"Sobeh","year":"2023","journal-title":"Eur J Radiol"},{"key":"2026103010065074800_tqag249-B13","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s40644-025-00854-4","article-title":"Change in diffusion weighted imaging after induction chemotherapy outperforms RECIST guideline for long-term outcome prediction in advanced nasopharyngeal carcinoma","volume":"25","author":"Ai","year":"2025","journal-title":"Cancer Imaging"},{"key":"2026103010065074800_tqag249-B14","doi-asserted-by":"publisher","first-page":"135841","DOI":"10.1155\/2014\/135841","article-title":"Prediction of early response to chemotherapy in lung cancer by using diffusion-weighted MR imaging","volume":"2014","author":"Yu","year":"2014","journal-title":"ScientificWorldJournal"},{"key":"2026103010065074800_tqag249-B15","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1002\/jbmr.3444","article-title":"Functional and hybrid imaging of bone metastases","volume":"33","author":"Cook","year":"2018","journal-title":"J Bone Miner Res"},{"key":"2026103010065074800_tqag249-B16","doi-asserted-by":"publisher","first-page":"1986","DOI":"10.1007\/s00330-013-2792-3","article-title":"MRI for response assessment in metastatic bone disease","volume":"23","author":"Lecouvet","year":"2013","journal-title":"Eur Radiol"},{"key":"2026103010065074800_tqag249-B17","doi-asserted-by":"publisher","first-page":"3757","DOI":"10.3390\/cancers15153757","article-title":"Diffusion-weighted MRI for treatment response assessment in osteoblastic metastases\u2014a repeatability study","volume":"15","author":"Eveslage","year":"2023","journal-title":"Cancers (Basel)"},{"key":"2026103010065074800_tqag249-B18","doi-asserted-by":"publisher","first-page":"2495","DOI":"10.1007\/s00330-009-1443-1","article-title":"Imaging response to systemic therapy for bone metastases","volume":"19","author":"B\u00e4uerle","year":"2009","journal-title":"Eur Radiol"},{"key":"2026103010065074800_tqag249-B19","doi-asserted-by":"publisher","first-page":"80","DOI":"10.7150\/jca.1.80","article-title":"Cancer response criteria and bone metastases: RECIST 1.1, MDA and PERCIST","volume":"1","author":"Costelloe","year":"2010","journal-title":"J Cancer"},{"key":"2026103010065074800_tqag249-B20","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1093\/annonc\/mdu558","article-title":"Assessing response to treatment of bone metastases from breast cancer: what should be the standard of care?","volume":"26","author":"Woolf","year":"2015","journal-title":"Ann Oncol"},{"key":"2026103010065074800_tqag249-B21","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1148\/radiol.2016160646","article-title":"Diffusion-weighted imaging as a treatment response biomarker for evaluating bone metastases in prostate cancer: a pilot study","volume":"283","author":"Perez-Lopez","year":"2017","journal-title":"Radiology"},{"key":"2026103010065074800_tqag249-B22","doi-asserted-by":"publisher","first-page":"1290","DOI":"10.1007\/s12094-022-02784-0","article-title":"Review of imaging techniques for evaluating morphological and functional responses to the treatment of bone metastases in prostate and breast cancer","volume":"24","author":"Orcajo-Rincon","year":"2022","journal-title":"Clin Transl Oncol"},{"key":"2026103010065074800_tqag249-B23","doi-asserted-by":"publisher","first-page":"2727","DOI":"10.3390\/cancers15102727","article-title":"Salvage radical prostatectomy after primary focal ablative therapy: a systematic review and meta-analysis","volume":"15","author":"Blank","year":"2023","journal-title":"Cancers (Basel)"},{"key":"2026103010065074800_tqag249-B24","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A guideline of selecting and reporting intraclass correlation coefficients for reliability research","volume":"15","author":"Koo","year":"2016","journal-title":"J Chiropr Med"},{"key":"2026103010065074800_tqag249-B25","doi-asserted-by":"publisher","first-page":"2029","DOI":"10.1093\/jnci\/92.24.2029","article-title":"Diffusion magnetic resonance imaging: an early surrogate marker of therapeutic efficacy in brain tumors","volume":"92","author":"Chenevert","year":"2000","journal-title":"J Natl Cancer Inst"},{"key":"2026103010065074800_tqag249-B26","doi-asserted-by":"publisher","first-page":"3524","DOI":"10.1158\/0008-5472.Can-06-4236","article-title":"An imaging biomarker of early treatment response in prostate cancer that has metastasized to the bone","volume":"67","author":"Lee","year":"2007","journal-title":"Cancer Res"},{"key":"2026103010065074800_tqag249-B27","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/j.mri.2005.11.005","article-title":"Diffusion changes precede size reduction in neoadjuvant treatment of breast cancer","volume":"24","author":"Pickles","year":"2006","journal-title":"Magn Reson Imaging"},{"key":"2026103010065074800_tqag249-B28","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1002\/jmri.23959","article-title":"Imaging the early response to chemotherapy in advanced lung cancer with diffusion-weighted magnetic resonance imaging compared to fluorine-18 fluorodeoxyglucose positron emission tomography and computed tomography","volume":"38","author":"Tsuchida","year":"2013","journal-title":"J Magn Reson Imaging"},{"key":"2026103010065074800_tqag249-B29","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1023\/A:1022995403081","article-title":"The skeleton as a unique environment for breast cancer cells","volume":"20","author":"Mastro","year":"2003","journal-title":"Clin Exp Metastasis"},{"key":"2026103010065074800_tqag249-B30","doi-asserted-by":"publisher","first-page":"2942","DOI":"10.1200\/jco.2004.08.181","article-title":"Bone imaging in metastatic breast cancer","volume":"22","author":"Hamaoka","year":"2004","journal-title":"J Clin Oncol"},{"key":"2026103010065074800_tqag249-B31","doi-asserted-by":"publisher","first-page":"10459","DOI":"10.1038\/s41598-021-90065-1","article-title":"Diffusion-weighted and dynamic contrast-enhanced magnetic resonance imaging after radiation therapy for bone metastases in patients with hepatocellular carcinoma","volume":"11","author":"Lee","year":"2021","journal-title":"Sci Rep"}],"container-title":["British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/advance-article-pdf\/doi\/10.1093\/bjr\/tqag249\/72124885\/tqag249.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/advance-article-pdf\/doi\/10.1093\/bjr\/tqag249\/72124885\/tqag249.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:06:58Z","timestamp":1793369218000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/advance-article\/doi\/10.1093\/bjr\/tqag249\/8943944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":31,"URL":"https:\/\/doi.org\/10.1093\/bjr\/tqag249","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]},"article-number":"tqag249"}}