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Quan Q, Peng H, Gong S, Liu J, Lu Y, Chen R, Mu X. The Preeminent Value of the Apparent Diffusion Coefficient in Assessing High-Risk Factors and Prognosis for Stage I Endometrial Carcinoma Patients. Front Oncol 2022; 12:820904. [PMID: 35251987 PMCID: PMC8888536 DOI: 10.3389/fonc.2022.820904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/28/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives To evaluate the role of the apparent diffusion coefficient (ADC) value in the individualized management of stage I endometrial carcinoma (EC). Methods A retrospective analysis was performed on 180 patients with stage I EC who underwent 1.5-T magnetic resonance imaging. The mean ADC (mADC), minimum ADC (minADC), and maximum ADC (maxADC) values of each group were measured and compared. We analyzed the relationship between ADC values and stage I EC prognosis by Kaplan-Meier method and Cox proportional hazards analysis. Results Patients with lower ADC values were more likely to be characterized by higher grades, specific histological subtypes and deeper myometrial invasion. The mADC, minADC and maxADC values (×10-3 mm2/s) were 1.045, 0.809 and 1.339, respectively, in grade 1/2 endometrioid carcinoma with superficial myometrial invasion, which significantly differed from those in grade 3 or nonendometrioid carcinoma or with deep myometrial invasion (0.929, 0.714 and 1.215) (P=<0.001, <0.001 and <0.001). ADC values could be used to predict these clinicopathological factors. Furthermore, the group with higher ADC values showed better disease-free survival and overall survival. Conclusions The present study indicated that ADC values were associated with the high-risk factors for stage I EC and to assess whether fertility-sparing, ovarian preservation or omission of lymphadenectomy represent viable treatment options. Moreover, this information may be applied to predict prognosis. Thus, ADC values could contribute to managing individualized therapeutic schedules to improve quality of life.
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Affiliation(s)
- Quan Quan
- Department of Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hui Peng
- The Department of Obstetrics and Gynecology, Chongqing Wansheng Jingkai District Maternal and Child Health Hospital, Chongqing, China
| | - Sainan Gong
- Department of Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiali Liu
- Department of Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yunfeng Lu
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rongsheng Chen
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoling Mu
- Department of Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Li B, Zhou L, Xu A, Li Q, Xiang H, Huang Y, Peng L, Xiang K, Zhang M, Wang N. Apparent Diffusion Coefficient as a Noninvasive Biomarker for the Early Response in Hepatocellular Carcinoma after Transcatheter Arterial Chemoembolization using Drug-Eluting Beads. Curr Med Imaging 2022; 18:1186-1194. [PMID: 35249499 DOI: 10.2174/1573405618666220304141632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/03/2021] [Accepted: 12/28/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Prognostic evaluation for hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) using drug-eluting beads (DEBs) is essential for guiding the personalized treatment and follow-up strategy. Apparent diffusion coefficient (ADC) has been reported as a biomarker in conventional TACE. OBJECTIVE To evaluate the diagnostic value of ADCbaseline, ADC change, and ADCratio in predicting the early objective response for HCC after DEB-TACE. METHODS This prospective single-center study included 32 consecutive patients undergoing dynamic contrast-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging before and 1 month after DEB-TACE. After DEB-TACE, patients were grouped based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria into responders (complete response [CR], partial response [PR] ) and nonresponders (stable disease [SD], progressive disease [PD]). The Mann-Whitney U test and receiver operating characteristic (ROC) curves were performed to assess the statistical differences in ADCbaseline, ADC change, and ADCratio between responders and nonresponders. RESULTS At post-DEB-TACE follow-up MRI, 62.5% (n = 20, 11 CRs, and 9 PRs) of patients showed objective response, and 37.5% (n = 12, 7 SDs, and 5 PDs) did not respond to chemoembolization. Nonresponders had a significantly higher ADCbaseline value than responders (p < 0.001). The ROC for identifying the response to chemoembolization demonstrated that the threshold ADCbaseline value of 0.920 × 10-3 mm2/s had 100% sensitivity and 70% specificity. The ADC change and ADCratio of responders were higher than that of nonresponders (p < 0.001). CONCLUSION ADCbaseline, ADC change, and ADCratio may be utilized as a noninvasive biomarker for predicting the early response of HCC to DEB-TACE.
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Affiliation(s)
- Basen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Zhou
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Anhui Xu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qin Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huihua Xiang
- Department of Radiology, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Yanrong Huang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Peng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Xiang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mingfeng Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Liu R, Li J, Jiang Y, Wu Z, Ji J, Li A, Wang X, Li R. The utility of diffusion-weighted imaging and ADC values in the characterization of mumps orchitis and seminoma. Acta Radiol 2022; 63:416-423. [PMID: 33557577 DOI: 10.1177/0284185121991980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) can quantitatively reflect the diffusion characteristics of tissues, providing a theoretical basis for qualitative diagnosis and quantitative analysis of a disease. PURPOSE To characterize testicular lesions that present as a hypointense signal on magnetic resonance imaging (MRI) T2-weighted images using DWI. MATERIAL AND METHODS Study participants were divided into three groups. Group A were healthy controls (n = 35), group B included patients with mumps orchitis (n = 20), and group C included patients with seminoma (n = 15). DWI sequences used b-values of 0, 1000, and 2000 s/mm2. Apparent diffusion coefficient (ADC) values between 1000 and 2000 s/mm2 were calculated by MRI postprocessing software. The Kruskal-Wallis test and receiver operating characteristic analysis were performed to evaluate how well ADC values distinguished between mumps orchitis and seminoma. RESULTS Normal testicular tissue showed a hyperintense signal on DWI and hypointensity on the ADC map: mean ADC value was 0.77 (0.69-0.85) ± 0.08 ×10-3 mm2/s. Mumps orchitis and seminoma showed slight hyperintensity on DWI: mean ADC values were 0.85 (0.71-0.99) ± 0.15 ×10-3 mm2/s and 0.43 (0.39-0.47) ± 0.04 × 10-3 mm2/s, respectively. There were statistically significant differences in mean ADC values between normal testicular tissue and seminoma and between mumps orchitis and seminoma. The cutoff ADC value for differentiating seminoma from mumps orchitis was 0.54 × 10-3 mm2/s. The sensitivity, specificity, and Youden Index for diagnosing seminoma were 99%, 31%, and 30%, respectively. CONCLUSION High b-value DWI has potential utility for differentiating mumps orchitis from seminoma in the clinical setting.
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Affiliation(s)
- Renwei Liu
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Jianhua Li
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Yixiang Jiang
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Zhiqing Wu
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Jiayin Ji
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Aibo Li
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Xiaoping Wang
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Ruifeng Li
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
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204
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Haopeng P, Xuefei D, Zengai C, Zhenwei Y, Chien-shan C, Zhiqiang M. High-Resolution Diffusion-Weighted Imaging of C6 Glioma on a 7T BioSpec MRI Scanner: Correlation of Tumor Cellularity and Nuclear-to-Cytoplasmic Ratio with Apparent Diffusion Coefficient. Acad Radiol 2022; 29 Suppl 3:S80-S87. [PMID: 34148856 DOI: 10.1016/j.acra.2021.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/10/2021] [Indexed: 11/01/2022]
Abstract
RATIONALE AND OBJECTIVES To determine the association of the apparent diffusion coefficient (ADC) with quantitative cellularity and the nuclear-to-cytoplasmic ratio in C6 glioma. MATERIALS AND METHODS Animal models bearing C6 gliomas underwent MR scans with T1 rapid acquisition with relaxation enhancement (RARE), T2 RARE, and high-resolution diffusion-weighted imaging sequences. For each model, three consecutive sections were used to draw regions of interest (ROIs) and measure ADC values; the middle section was localized in the plane with the maximal solid tumor area. The minimal, mean, and maximal ADC values were recorded for each ROI. GFAP-immunostained sections coregistered with ADC measurements were used to calculate tumor cellularity and the nuclear-to-cytoplasmic (N/C) ratio. Spearman's correlation was used to assess the relationship between ADC values and quantitative tumor cellularity as well as N/C ratios with a significance level of p < 0.05. RESULTS Thirty-three sections from 11 glioma-bearing rats were analyzed. The median values of the minimal, mean, and maximal ADC were 0.443 × 10-3, 0.744 × 10-3, and 1.140 × 10-3 mm2/s, respectively. The median cellularity and N/C ratio were 2151.234 per 0.025 mm2 and 0.857, respectively. The minimal, mean, and maximal ADCs were all significantly associated with cellularity, with correlation coefficients of -0.712 (p < 0.001), -0.631 (p < 0.001), and -0.460 (p = 0.007), respectively. The minimal and mean ADC had significant negative relationships with the N/C ratio, with correlation coefficients of -0.565 (p = 0.001) and -0.426 (p = 0.013), respectively. CONCLUSION The minimal ADC correlated well with cellularity and N/C ratios in C6 glioma and may be used as a biomarker of these two pathological features.
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205
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Guo C, Zheng K, Ye Q, Lu Z, Xie Z, Li X, Zhao Y. Intravoxel Incoherent Motion Imaging on Sacroiliitis in Patients With Axial Spondyloarthritis: Correlation With Perfusion Characteristics Based on Dynamic Contrast-Enhanced Magnetic Resonance Imaging. Front Med (Lausanne) 2022; 8:798845. [PMID: 35155474 PMCID: PMC8826054 DOI: 10.3389/fmed.2021.798845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To prospectively explore the relationship between intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) parameters of sacroiliitis in patients with axial spondyloarthritis (axSpA). METHODS Patients with initially diagnosed axSpA prospectively underwent on 3.0 T MRI of sacroiliac joint (SIJ). The IVIM parameters (D, f, D *) were calculated using biexponential analysis. K trans, K ep, V e, and V p from DCE-MRI were obtained in SIJ. The uni-variable and multi-variable linear regression analyses were used to evaluate the correlation between the parameters from these two imaging methods after controlling confounders, such as bone marrow edema (BME), age, agenda, scopes, and localization of lesions, and course of the disease. Then, their correlations were measured by calculating the Pearson's correlation coefficient (r). RESULTS The study eventually enrolled 234 patients (178 men, 56 women; mean age, 28.51 ± 9.50 years) with axSpA. With controlling confounders, D was independently related to K trans (regression coefficient [b] = 27.593, p < 0.001), K ep (b = -6.707, p = 0.021), and V e (b = 131.074, p = 0.003), whereas f and D * had no independent correlation with the parameters from DCE MRI. The correlations above were exhibited with Pearson's correlation coefficients (r) (r = 0.662, -0.408, and 0.396, respectively, all p < 0.001). CONCLUSION There were independent correlations between D derived from IVIM DWI and K trans, K ep, and V e derived from DCE-MRI. The factors which affect their correlations mainly included BME, gender, and scopes of lesions.
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Affiliation(s)
- Chang Guo
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Kai Zheng
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Qiang Ye
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Zixiao Lu
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Zhuoyao Xie
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Xin Li
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Yinghua Zhao
- Department of Radiology, Academy of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
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206
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Freihat O, Zoltán T, Pinter T, Kedves A, Sipos D, Repa I, Kovács Á, Zsolt C. Correlation between Tissue Cellularity and Metabolism Represented by Diffusion-Weighted Imaging (DWI) and 18F-FDG PET/MRI in Head and Neck Cancer (HNC). Cancers (Basel) 2022; 14:cancers14030847. [PMID: 35159115 PMCID: PMC8833888 DOI: 10.3390/cancers14030847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 01/02/2023] Open
Abstract
Simple Summary We report on the correlation between the diffusion-weighted imaging (DWI) and the metabolic volume parameters derived from a PET scan, to determine the correlation between these parameters and the tumor cellularity in head and neck primary tumors. Our findings implied that there was no correlation between the information derived from the DWI and the information derived from the FDG metabolic parameters. Thus, both imaging techniques might play a complementary role in HNC diagnosis and assessment. This is significant because the treatment plan of patients with HNC should be well evaluated by using all the available diagnosis techniques, for a better understanding of how the tumor will react. Abstract Background: This study aimed to assess the association of 18F-Fluorodeoxyglucose positron-emission-tomography (18F-FDG/PET) and DWI imaging parameters from a primary tumor and their correlations with clinicopathological factors. Methods: We retrospectively analyzed primary tumors in 71 patients with proven HNC. Primary tumor radiological parameters: DWI and FDG, as well as pathological characteristics were analyzed. Spearman correlation coefficient was used to assess the correlation between DWI and FDG parameters, ANOVA or Kruskal–Wallis, independent sample t-test, Mann–Whitney test, and multiple regression were performed on the clinicopathological features that may affect the 18F- FDG and apparent-diffusion coefficient (ADC) of the tumor. Results: No significant correlations were observed between DWI and any of the 18F-FDG parameters (p > 0.05). SUVmax correlated with N-stages (p = 0.023), TLG and MTV correlated with T-stages (p = 0.006 and p = 0.001), and ADC correlated with tumor grades (p = 0.05). SUVmax was able to differentiate between N+ and N− groups (p = 0.004). Conclusions: Our results revealed a non-significant correlation between the FDG-PET and ADC-MR parameters. FDG-PET-based glucose metabolic and DWI-MR-derived cellularity data may represent different biological aspects of HNC.
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Affiliation(s)
- Omar Freihat
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
- Correspondence: (O.F.); (Á.K.); Tel.: +36-52-411-600 (Á.K.)
| | - Tóth Zoltán
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- MEDICOPUS Healthcare Provider and Public Nonprofit Ltd., Somogy County Moritz Kaposi Teaching Hospital, 7400 Kaposvár, Hungary
| | - Tamas Pinter
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
| | - András Kedves
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
- Institute of Information Technology and Electrical Technology, Faculty of Engineering and Information Technology, University of Pécs, 7621 Pécs, Hungary
| | - Dávid Sipos
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
| | - Imre Repa
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
| | - Árpád Kovács
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Department of Oncoradiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Correspondence: (O.F.); (Á.K.); Tel.: +36-52-411-600 (Á.K.)
| | - Cselik Zsolt
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Csolnoky Ferenc County Hospital, 8200 Veszprém, Hungary
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207
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Zhang Y, Yang C, Liang L, Shi Z, Zhu S, Chen C, Dai Y, Zeng M. Preliminary Experience of 5.0 T Higher Field Abdominal Diffusion-Weighted MRI: Agreement of Apparent Diffusion Coefficient With 3.0 T Imaging. J Magn Reson Imaging 2022; 56:1009-1017. [PMID: 35119776 DOI: 10.1002/jmri.28097] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recently, a prototype 5.0 T whole-body MRI scanner was developed. A 5.0 T diffusion-weighted imaging (DWI) may help overcome the issues that limit 3.0 T DWI. PURPOSE To evaluate the feasibility of 5.0 T high-field DWI in the upper abdomen and assess the agreement of the apparent diffusion coefficient (ADC) with that from 3.0 T abdominal DWI. STUDY TYPE Prospective proof of concept. POPULATION Nine volunteers (mean ± SD age: 37.3 ± 7.0 years, 8 M), eight healthy and one with liver and kidney cysts. FIELD STRENGTH/SEQUENCE 3.0 T and 5.0 T; respiratory-triggered spin-echo echo-planar-imaging (SE-EPI)-based DWI sequence. ASSESSMENT Subjective image quality scores. The ADC values in abdominal organs (liver, pancreas, spleen, and kidney) were measured by two observers for evaluating the interobserver and interfield agreement. STATISTICAL TESTS Wilcoxon-rank sum test, Bland-Altman analysis, intraclass correlation coefficients (ICCs), and coefficients of variation (CVs). RESULTS The 5.0 T DWI displayed an increase in subjective image quality score compared to 3.0 T DWI without the significant difference (3.0 T DWI: 3.50 ± 0.47, 5.0 T DWI: 3.72 ± 0.42, P = 0.157). Both the interfield and interobserver agreements of ADC values were substantial to excellent (ICCs = 0.640-0.902). For all four upper abdominal organs, there were no significant differences between the ADC values measured by two observers and between the ADC values of 3.0 T and 5.0 T DWI (P = 0.134-1.000). The CVs of ADC measurements from 3.0 T and 5.0 T DWI were all less than 15.0% (6.7%-14.2%). DATA CONCLUSION The substantial to excellent agreements between the ADC values measured with 3.0 T and 5.0 T DWI for liver, pancreas, spleen, and kidney suggested that 5.0 T DWI can be applied for abdominal imaging. The ADC values from 5.0 T abdominal DWI hold the potential to serve as the quantitative markers for clinical investigations. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Yunfei Zhang
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China.,Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Chun Yang
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China.,Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Liang Liang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhang Shi
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shuo Zhu
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Caizhong Chen
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yongming Dai
- Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Mengsu Zeng
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China.,Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
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208
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Yin H, Jiang Y, Xu Z, Huang W, Chen T, Lin G. Apparent Diffusion Coefficient-Based Convolutional Neural Network Model Can Be Better Than Sole Diffusion-Weighted Magnetic Resonance Imaging to Improve the Differentiation of Invasive Breast Cancer From Breast Ductal Carcinoma In Situ. Front Oncol 2022; 11:805911. [PMID: 35096609 PMCID: PMC8795910 DOI: 10.3389/fonc.2021.805911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/24/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND PURPOSE Breast ductal carcinoma in situ (DCIS) has no metastatic potential, and has better clinical outcomes compared with invasive breast cancer (IBC). Convolutional neural networks (CNNs) can adaptively extract features and may achieve higher efficiency in apparent diffusion coefficient (ADC)-based tumor invasion assessment. This study aimed to determine the feasibility of constructing an ADC-based CNN model to discriminate DCIS from IBC. METHODS The study retrospectively enrolled 700 patients with primary breast cancer between March 2006 and June 2019 from our hospital, and randomly selected 560 patients as the training and validation sets (ratio of 3 to 1), and 140 patients as the internal test set. An independent external test set of 102 patients during July 2019 and May 2021 from a different scanner of our hospital was selected as the primary cohort using the same criteria. In each set, the status of tumor invasion was confirmed by pathologic examination. The CNN model was constructed to discriminate DCIS from IBC using the training and validation sets. The CNN model was evaluated using the internal and external tests, and compared with the discriminating performance using the mean ADC. The area under the curve (AUC), sensitivity, specificity, and accuracy were calculated to evaluate the performance of the previous model. RESULTS The AUCs of the ADC-based CNN model using the internal and external test sets were larger than those of the mean ADC (AUC: 0.977 vs. 0.866, P = 0.001; and 0.926 vs. 0.845, P = 0.096, respectively). Regarding the internal test set and external test set, the ADC-based CNN model yielded sensitivities of 0.893 and 0.873, specificities of 0.929 and 0.894, and accuracies of 0.907 and 0.902, respectively. Regarding the two test sets, the mean ADC showed sensitivities of 0.845 and 0.818, specificities of 0.821 and 0.829, and accuracies of 0.836 and 0.824, respectively. Using the ADC-based CNN model, the prediction only takes approximately one second for a single lesion. CONCLUSION The ADC-based CNN model can improve the differentiation of IBC from DCIS with higher accuracy and less time.
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Affiliation(s)
- Haolin Yin
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Yu Jiang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Zihan Xu
- Lung Cancer Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Wenjun Huang
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Tianwu Chen
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Guangwu Lin
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
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209
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Zhang J, Zhao XM, Chen Y. [Application of Diffusion Weighted Imaging in Pathological Grading/Typing and Clinical Staging of 95 Cases of Cervical Adenocarcinoma]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2022; 44:60-64. [PMID: 35300766 DOI: 10.3881/j.issn.1000-503x.14452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective To investigate the correlations of diffusion weighted imaging (DWI) with pathological grading,typing and clinical staging of cervical adenocarcinoma. Methods The data of 95 patients with cervical adenocarcinoma from May 2011 to February 2018 in Cancer Hospital Chinese Academy of Medical Sciences were collected for retrospective analysis.Before treatment,conventional MRI and DWI (b=0,800 s/mm2) were performed,and the apparent diffusion coefficient (ADC) value of cervical adenocarcinoma was measured.The ADC values were compared among different pathological grades,types,and clinical stages. Results The mean ADC value was (1.00±0.25)×10-3 mm2/s in the poorly differentiation group,(1.09±0.25)×10-3 mm2/s in the moderately differentiation group,and (1.22±0.20)×10-3 mm2/s in the well differentiation group,which showed significant difference between the poorly and well differentiation groups (P=0.002).The mean ADC values were (1.04±0.24) ×10-3 mm2/s and (1.21±0.26)×10-3 mm2/s in the endocervical adenocarcinoma (usual type) group and mucinous carcinoma group,respectively,which showed significant difference (P=0.005). Conclusions The worse differentiation of cervical adenocarcinoma corresponded to the lower ADC value.The ADC value of mucinous carcinoma was higher than that of endocervical adenocarcinoma (usual type).
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Affiliation(s)
- Jie Zhang
- Department of Radiology,National Cancer Center,National Clinical Research Center for Cancer, Cancer Hospital,CAMS and PUMC,Beijing 100021,China
| | - Xin-Ming Zhao
- Department of Radiology,National Cancer Center,National Clinical Research Center for Cancer, Cancer Hospital,CAMS and PUMC,Beijing 100021,China
| | - Yan Chen
- Department of Radiology,National Cancer Center,National Clinical Research Center for Cancer, Cancer Hospital,CAMS and PUMC,Beijing 100021,China
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210
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Rosenkranz MA, Dean DC, Bendlin BB, Jarjour NN, Esnault S, Zetterberg H, Heslegrave A, Evans MD, Davidson RJ, Busse WW. Neuroimaging and biomarker evidence of neurodegeneration in asthma. J Allergy Clin Immunol 2022; 149:589-598.e6. [PMID: 34536414 PMCID: PMC8821112 DOI: 10.1016/j.jaci.2021.09.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/19/2021] [Accepted: 09/07/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Epidemiologic studies have shown that Alzheimer's disease (AD) and related dementias (ADRD) are seen more frequently with asthma, especially with greater asthma severity or exacerbation frequency. OBJECTIVE To examine the changes in brain structure that may underlie this phenomenon, we examined diffusion-weighted magnetic resonance imaging (dMRI) and blood-based biomarkers of AD (phosphorylated tau 181, p-Tau181), neurodegeneration (neurofilament light chain, NfL), and glial activation (glial fibrillary acidic protein, GFAP). METHODS dMRI data were obtained in 111 individuals with asthma, ranging in disease severity from mild to severe, and 135 healthy controls. Regression analyses were used to test the relationships between asthma severity and neuroimaging measures, as well as AD pathology, neurodegeneration, and glial activation, indexed by plasma p-Tau181, NfL, and GFAP, respectively. Additional relationships were tested with cognitive function. RESULTS Asthma participants had widespread and large-magnitude differences in several dMRI metrics, which were indicative of neuroinflammation and neurodegeneration, and which were robustly associated with GFAP and, to a lesser extent, NfL. The AD biomarker p-Tau181 was only minimally associated with neuroimaging outcomes. Further, asthma severity was associated with deleterious changes in neuroimaging outcomes, which in turn were associated with slower processing speed, a test of cognitive performance. CONCLUSIONS Asthma, particularly when severe, is associated with characteristics of neuroinflammation and neurodegeneration, and may be a potential risk factor for neural injury and cognitive dysfunction. There is a need to determine how asthma may affect brain health and whether treatment directed toward characteristics of asthma associated with these risks can mitigate these effects.
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Affiliation(s)
- Melissa A Rosenkranz
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisc; Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisc.
| | - Douglas C Dean
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisc; Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisc; Waisman Center, University of Wisconsin-Madison, Madison, Wisc
| | - Barbara B Bendlin
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisc; Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, Madison, Wisc
| | - Nizar N Jarjour
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisc
| | - Stephane Esnault
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisc
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom; UK Dementia Research Institute at UCL, London, United Kingdom
| | | | - Michael D Evans
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minn
| | - Richard J Davidson
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisc; Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisc; Department of Psychology, University of Wisconsin-Madison, Madison, Wisc
| | - William W Busse
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisc
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211
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Meng X, Hu H, Wang Y, Feng C, Hu D, Liu Z, Kamel IR, Li Z. Accuracy and Challenges in the Vesical Imaging-Reporting and Data System for Staging Bladder Cancer. J Magn Reson Imaging 2022; 56:391-398. [PMID: 35049074 DOI: 10.1002/jmri.28064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The Vesical Imaging-Reporting and Data System (VI-RADS) scoring system has been widely used to stage bladder cancer (BCa) since 2018. PURPOSE To describe the characteristics of cases with discordant T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) scores in patients with BCa and further verify the accuracy of the VI-RADS scoring system and the necessity of dynamic contrast-enhanced (DCE) sequence. STUDY TYPE Retrospective. SUBJECTS A total of 106 patients (include 16.5% female) with bladder cancer. SEQUENCE T2WI (fast spin echo), DWI (echo planer imaging), and DCE (gradient echo). ASSESSMENT Some cases are difficult to score according to the system, mainly when the T2WI (category 4) and DWI (category 2) sequence scores are discordant, termed the discordant group below. The complementary group will be termed concordant group. Each MRI sequence was reviewed respectively according to the 5-point VI-RADS scoring system by three observers. The diagnostic ability of sequences for evaluating muscle invasion by BCa was calculated using histopathology as the reference standards. STATISTICAL TESTS Receiver operating characteristic (ROC) curve, DeLong test, intraclass correlation coefficient. A P value of 0.05 or less was considered statistically significant. RESULTS Fourteen cases (13.2%) had discordant VI-RADS scoring system. In the discordant group, the area under the ROC curve (AUC) of DCE was 0.875, while the T2WI and DWI showed limited diagnostic performance (AUCs = 0.50). In the concordant group, there was no significant difference in diagnostic efficacy between the overall VI-RADS (AUC: 0.950) and the combination of T2WI and DWI (AUC: 0.946) (P = 0.56). Among all patients, the AUC of overall VIRADS was 0.939 with a 3 or greater cutoff value. DATA CONCLUSION The DCE was crucial in the discordant group for evaluating muscle-invasiveness, while DCE may not be necessary for the concordant group. The VI-RADS scoring system performed with overall good diagnostic performance in evaluating muscle-invasiveness in BCa patients. EVIDENCE LEVEL 4 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Xiaoyan Meng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Henglong Hu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanchun Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Cui Feng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Daoyu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zheng Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ihab R Kamel
- Russell H. Morgan Department of Radiology and Radiological Science, the Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Shi B, Xue K, Yin Y, Xu Q, Shi B, Wu D, Ye J. Grading of clear cell renal cell carcinoma using diffusion MRI with a fractional order calculus model. Acta Radiol 2022; 64:421-430. [PMID: 35040361 DOI: 10.1177/02841851211072482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The fractional order calculus (FROC) model has been developed to describe restrained motion of water molecules as well as microstructural heterogeneity, providing a novel tool for non-invasive tumor grading. PURPOSE To evaluate the role of the FROC model in characterizing clear cell renal cell carcinoma (ccRCC) grades. MATERIAL AND METHODS A total of 59 patients diagnosed with ccRCC were included in this prospective study. The diffusion metrics derived from the mono-exponential model (apparent diffusion coefficient [ADC]), intra-voxel incoherent motion [IVIM] model [D, D*, f], and FROC model [Dfroc, β, μ]) were calculated and compared between low- and high-grade ccRCCs. Binary logistic regression analysis was performed to establish the diagnostic models. Receiver operating characteristic (ROC) analysis and DeLong test were performed to evaluate and compare the diagnostic performance of metrics in grading ccRCC. RESULTS All the metrics except D* and f exhibited statistical differences between low- and high-grade ccRCCs. ROC analysis showed individual FROC parameters, μ, Dfroc, and β, outperformed ADC and IVIM parameters in grading ccRCC. For single parameter, μ demonstrated the highest AUC value, sensitivity, and diagnostic accuracy in discriminating the two ccRCC groups while β exhibited the optimal specificity. Importantly, the combination of Dfroc, μ, and β could further improve the diagnostic performance. CONCLUSION The FROC parameters were superior to ADC and IVIM parameters in grading ccRCC, indicating the great potential of the FROC model in distinguishing low- and high-grade ccRCCs.
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Affiliation(s)
- Bowen Shi
- Department of Medical Imaging, Clinic Medical School, Yangzhou University, Northern Jiangsu Province Hospital, Yangzhou, PR China
| | - Ke Xue
- Central Research Institute, United Imaging Healthcare, Shanghai, PR China
| | - Yili Yin
- Department of Medical Imaging, Clinic Medical School, Yangzhou University, Northern Jiangsu Province Hospital, Yangzhou, PR China
| | - Qing Xu
- Department of Medical Imaging, Clinic Medical School, Yangzhou University, Northern Jiangsu Province Hospital, Yangzhou, PR China
| | - Binbin Shi
- Department of Medical Imaging, Clinic Medical School, Yangzhou University, Northern Jiangsu Province Hospital, Yangzhou, PR China
| | - Dongmei Wu
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronics Science, East China Normal University, Shanghai, PR China
| | - Jing Ye
- Department of Medical Imaging, Clinic Medical School, Yangzhou University, Northern Jiangsu Province Hospital, Yangzhou, PR China
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213
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Chung HY, Chan SCW, Lee KH, Tsang HHL, Ng LL, Lau CS. Both ASDAS and ADC are associated with spinal mobility in active axial spondyloarthritis: A comparison between early and later disease. Int J Rheum Dis 2022; 25:317-326. [PMID: 35019230 DOI: 10.1111/1756-185x.14278] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/21/2021] [Accepted: 12/20/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Using diffusion-weighted imaging (DWI)-derived apparent diffusion coefficient (ADC), we aimed to determine the relationship between intensity of spinal inflammation and mobility in patients with axial spondyloarthritis (SpA) in early and later stages of active disease. The Ankylosing Spondylitis Disease Activity Score (ASDAS) was also used for a more comprehensive evaluation. METHODS Participants with axial SpA and back pain were recruited from 10 rheumatology centers. Clinical, biochemical and radiological parameters were collected. Short tau inversion recovery (STIR) sequence magnetic resonance imaging (MRI) and DWI of the spine and sacroiliac (SI) joints were performed. ADC maps were generated. Participants were examined for Bath Ankylosing Spondylitis Metrology Index (BASMI). Linear regression models were used to determine associations between BASMI and various clinical, radiological, and MRI parameters in participants with active inflammation on spinal ADC maps. RESULTS One-hundred and twenty-seven participants were included in the analyses. Multivariate linear regression showed that mean ADC spine (ß = .16; P = .03), ASDAS-C-reactive protein (CRP) (ß = .29, P < .001), and ASDAS-erythrocyte sedimentation rate (ESR) (ß = .25, P < .01) were associated with BASMI. In participants with duration of back pain ≤3 years, mean spine ADC (ß = .37; P = .03), ASDAS-CRP (ß = .44; P = .01), and ASDAS-ESR (ß = .42; P = .01) were associated with BASMI after adjustment for confounding factors. In participants with duration of back pain >3 years, only ASDAS-CRP (ß = .25; P < .01) and ASDAS-ESR (ß = .20; P = .20) were associated with BASMI. CONCLUSION Intensity of inflammation and clinical disease activity were independently associated with impairment of spinal mobility. The associations were stronger in early (≤3 years) than later disease.
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Affiliation(s)
- Ho Yin Chung
- Division of Rheumatology and Clinical Immunology, The University of Hong Kong, Hong Kong, China
| | - Shirley Chiu Wai Chan
- Division of Rheumatology and Clinical Immunology, The University of Hong Kong, Hong Kong, China
| | - Kam Ho Lee
- Department of Radiology, Queen Mary Hospital, Hong Kong, China
| | - Helen Hoi Lun Tsang
- Division of Rheumatology and Clinical Immunology, The University of Hong Kong, Hong Kong, China
| | - Ling Ling Ng
- Division of Rheumatology and Clinical Immunology, The University of Hong Kong, Hong Kong, China
| | - Chak Sing Lau
- Division of Rheumatology and Clinical Immunology, The University of Hong Kong, Hong Kong, China
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214
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Elsheikh SSM, Chimusa ER, Mulder NJ, Crimi A. Relating Global and Local Connectome Changes to Dementia and Targeted Gene Expression in Alzheimer's Disease. Front Hum Neurosci 2022; 15:761424. [PMID: 35002653 PMCID: PMC8734427 DOI: 10.3389/fnhum.2021.761424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/25/2021] [Indexed: 01/01/2023] Open
Abstract
Networks are present in many aspects of our lives, and networks in neuroscience have recently gained much attention leading to novel representations of brain connectivity. The integration of neuroimaging characteristics and genetics data allows a better understanding of the effects of the gene expression on brain structural and functional connections. The current work uses whole-brain tractography in a longitudinal setting, and by measuring the brain structural connectivity changes studies the neurodegeneration of Alzheimer's disease. This is accomplished by examining the effect of targeted genetic risk factors on the most common local and global brain connectivity measures. Furthermore, we examined the extent to which Clinical Dementia Rating relates to brain connections longitudinally, as well as to gene expression. For instance, here we show that the expression of PLAU gene increases the change over time in betweenness centrality related to the fusiform gyrus. We also show that the betweenness centrality metric impact dementia-related changes in distinct brain regions. Our findings provide insights into the complex longitudinal interplay between genetics and brain characteristics and highlight the role of Alzheimer's genetic risk factors in the estimation of regional brain connectivity alterations.
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Affiliation(s)
- Samar S M Elsheikh
- Pharmacogenetic Research Clinic, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Computational Biology Division, Department of Integrative Biomedical Sciences, Faculty of Health Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Emile R Chimusa
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Nicola J Mulder
- Computational Biology Division, Department of Integrative Biomedical Sciences, Faculty of Health Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Alessandro Crimi
- Computer Vision Group, Sano Centre for Computational Medicine, Kraków, Poland.,Institute for Neuropathology, University Hospital of Zurich, Zurich, Switzerland.,Department of Mathematics, African Institute for Mathematical Sciences, Cape Coast, Ghana
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215
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Kurokawa R, Umemura Y, Capizzano A, Kurokawa M, Baba A, Holmes A, Kim J, Ota Y, Srinivasan A, Moritani T. Dynamic susceptibility contrast and diffusion-weighted MRI in posterior fossa pilocytic astrocytoma and medulloblastoma. J Neuroimaging 2022; 32:511-520. [PMID: 34997668 DOI: 10.1111/jon.12962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND PURPOSE The utility of perfusion MRI in distinguishing between pilocytic astrocytoma (PA) and medulloblastoma (MB) is unclear. This study aimed to evaluate the diagnostic and prognostic performance of dynamic susceptibility contrast (DSC)-MRI parameters and apparent diffusion coefficient (ADC) values between PA and MB. METHODS Between January 2012 and August 2021, 49 (median, 7 years [range, 1-28 years]; 28 females) and 35 (median, 8 years [1-24 years]; 12 females) patients with pathologically confirmed PA and MB, respectively, were included. The normalized relative cerebral blood volume and flow (nrCBV and nrCBF) and mean and minimal normalized ADC (nADCmean and nADCmin) values were calculated using volume-of-interest analyses. Diagnostic performance and Pearson's correlation with progression-free survival were also evaluated. RESULTS The MB group showed a significantly higher nrCBV and nrCBF (nrCBV: 1.69 [0.93-4.23] vs. 0.95 [range, 0.37-2.28], p = .0032; nrCBF: 1.62 [0.93-3.16] vs. 1.07 [0.46-2.26], p = .0084) and significantly lower nADCmean and nADCmin (nADCmean: 0.97 [0.70-1.68] vs. 2.21 [1.44-2.80], p < .001; nADCmin: 0.50 [0.19-0.89] vs. 1.42 [0.89-2.20], p < .001) than the PA group. All parameters exhibited good diagnostic ability (accuracy >0.80) with nADCmin achieving the highest score (accuracy = 1). A moderate correlation was found between nADCmean and progression-free survival for MB (r = 0.44, p = .0084). CONCLUSIONS DSC-MRI parameters and ADC values were useful for distinguishing between PA and MB. A lower ADC indicated an unfavorable MB prognosis, but the DSC-MRI parameters did not correlate with progression-free survival in either group.
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Affiliation(s)
- Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yoshie Umemura
- Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Aristides Capizzano
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Adam Holmes
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - John Kim
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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216
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Lee KY, Khil EK, Jo SW, Jang MU, Choi JA, Lee MS. Acute to Subacute Spinal Cord Infarction Mimicking Acute Multiple Sclerosis: Usefulness of Diffusion-Weighted MRI for Diagnosis. Curr Med Imaging 2022; 18:893-897. [PMID: 34979892 DOI: 10.2174/1573405618666220103105910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/18/2021] [Accepted: 10/28/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Spinal cord infarction (SCI) is difficult to diagnose because of its rarity, unknown etiology, and unestablished diagnostic criteria. Additionally, the timeline of SCI has not been studied in detail, as few studies using diffusion-weighted image (DWI) sequences of the spine of a small target population have been previously conducted. CASE STUDY A 56-year-old male with underlying arrhythmia suddenly developed visual field defects on the right side, pain in the left upper extremity, and a tingling sensation in the left hand. Brain Magnetic resonance imaging (MRI) revealed acute to subacute stages of multifocal brain infarction. On additional cervical spinal MRI, it showed atypical MRI findings of SCI, considered late acute to early subacute phase, which were similar to those seen in the acute phase of multiple sclerosis (MS). Additional DWI revealed restricted diffusion. From these findings, it could be inferred that the patient's SCI occurred at the same time as the multifocal brain infarctions caused by atrial fibrillation. CONCLUSION A DWI sequence of spine MRI could be helpful in the diagnosis of acute to subacute phase SCI and in differentiating with acute MS.
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Affiliation(s)
- Kyoung Yeon Lee
- Department of Radiology, Hallym University Dongtan Sacred Hospital, Hwaseong-si, Gyeonggi-Do, Korea
| | - Eun Kyung Khil
- Department of Radiology, Hallym University Dongtan Sacred Hospital, Hwaseong-si, Gyeonggi-Do, Korea
| | - Sang Won Jo
- Department of Radiology, Hallym University Dongtan Sacred Hospital, Hwaseong-si, Gyeonggi-Do, Korea
| | - Min Uk Jang
- Department of Neurology, Hallym University Dongtan Sacred Hospital, Hwaseong-si, Gyeonggi-Do, Korea
| | - Jung-Ah Choi
- Department of Radiology, Hallym University Dongtan Sacred Hospital, Hwaseong-si, Gyeonggi-Do, Korea
| | - Min-Sang Lee
- Department of Medicine, Soonchunhyang University Hospital Cheonan, Cheonan-si, Chungcheongnam-do, Korea
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217
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Wu W, Gong T, Niu J, Li W, Li J, Song X, Cui S, Bian W, Wang J. Study of bone marrow microstructure in healthy young adults using intravoxel incoherent motion diffusion-weighted MRI. Front Endocrinol (Lausanne) 2022; 13:958151. [PMID: 36440214 PMCID: PMC9691993 DOI: 10.3389/fendo.2022.958151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
Bone marrow is one of the most important organs in the human body. The evaluation of bone marrow microstructure and gender-related cellular and capillary networks in healthy young adults can help to better understand the process of bone metabolism. Intravoxel incoherent motion (IVIM) provides both diffusion and perfusion quantifications without requiring intravenous contrast agent injection. In this prospective study, 60 healthy young age-matched volunteers (30 men and 30 women) underwent MRI scans at 1.5 T using multi-b-value diffusion-weighted imaging on sagittal planes covering the lumbar bone marrow. The apparent diffusion coefficient (ADC), true ADC (D), pseudo-ADC (D*), and perfusion fraction (f) were calculated from the diffusion-weighted images using the mono- and bi-exponential models. Lumbar cancellous bone (L2-L4) was selected as the region of interest. An independent t-test was used to detect significant differences in ADC values and IVIM parameters between men and women. The differences in IVIM parameters among the L2, L3, and L4 groups were compared with analysis of variance. The D and f values in women were significantly higher than that in men (p = 0.001, 0.026). However, D* was significantly lower in women than that in men (p = 0.001). Furthermore, there was no significant gender difference for the conventional ADC value (p = 0.186). Moreover, there were no significant differences in the D, f, and D* values among the L2, L3, and L4 vertebras of women or men. IVIM parameters can show differences in bone marrow between young women and men. As a non-invasive method, it can assess bone marrow microstructure, such as cellularity and perfusion.
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Affiliation(s)
- Wenqi Wu
- Departments of Radiology, The Second Hospital, Shanxi Medical University, Taiyuan, China
| | - Tong Gong
- Departments of Radiology, People’s Hospital, Sichuan, China
| | - Jinliang Niu
- Departments of Radiology, The Second Hospital, Shanxi Medical University, Taiyuan, China
- *Correspondence: Jinliang Niu,
| | - Wenjin Li
- Department of stomatology, The Second Hospital, Shanxi Medical University, Taiyuan, China
| | - Jianting Li
- Departments of Radiology, The Second Hospital, Shanxi Medical University, Taiyuan, China
| | - Xiaoli Song
- Departments of Radiology, The Second Hospital, Shanxi Medical University, Taiyuan, China
| | - Sha Cui
- Departments of Radiology, The Second Hospital, Shanxi Medical University, Taiyuan, China
| | - Wenjin Bian
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, China
| | - Jun Wang
- Departments of Radiology, The Second Hospital, Shanxi Medical University, Taiyuan, China
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Zhang J, Ta N, Fu M, Tian FH, Wang J, Zhang T, Wang B. Use of DWI-FLAIR Mismatch to Estimate the Onset Time in Wake-Up Strokes. Neuropsychiatr Dis Treat 2022; 18:355-361. [PMID: 35228801 PMCID: PMC8881675 DOI: 10.2147/ndt.s351943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/06/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE To compare the MRI characteristics of patients with wake-up ischemic stroke (WUS) and with ischemic stroke with known onset time (clear-onset-time stroke, COS) to clarify the role of diffusion-weighted imaging-fluid-attenuated inversion recovery (DWI-FLAIR) mismatch in estimating the onset time of WUS patients. PATIENTS AND METHODS Two hundred patients with acute ischemic stroke were selected for complete brain MRI within six hours of symptom onset, including DWI and FLAIR sequences. The patients were divided into WUS (n = 78) and COS (n = 122) groups, based on whether the time of onset was known. The general conditions and imaging characteristics were collected to compare the DWI-FLAIR mismatch features between the two groups at different time intervals. RESULTS There was no significant difference in the DWI-FLAIR mismatch on MRI within 2 hour after the first found abnormality between the two groups (50.0% vs 71.8%, p = 0.180). With increasing time, the DWI-FLAIR mismatch decreased substantially in the WUS group, while a higher DWI-FLAIR mismatch presence persisted in the COS group within a four-hour interval from the onset of symptoms to the MRI. The DWI-FLAIR mismatch was significantly lower in the WUS group than in the COS group from symptom identification to MRI at 2-3 h, 3-4 h, and 4-5 h intervals (15% vs 60%, 10.5% vs 48%, 6.7% vs 45.4%; p < 0.01). CONCLUSION Our results suggest that the presence of DWI-FLAIR mismatch within 2 h of the first found abnormality was not significantly different between WUS and COS. Therefore, Patients with WUS within 2 hours after the first detected abnormality may be suitable for intravenous thrombolysis.
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Affiliation(s)
- Jinfeng Zhang
- Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, People's Republic of China.,Cerebrovascular Disease Research Institute of Inner Mongolia Autonomous Region, Baotou, Inner Mongolia, People's Republic of China
| | - Na Ta
- Practical Teaching Skills Center, Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, People's Republic of China
| | - Meng Fu
- Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, People's Republic of China.,Cerebrovascular Disease Research Institute of Inner Mongolia Autonomous Region, Baotou, Inner Mongolia, People's Republic of China
| | - Fan Hua Tian
- Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, People's Republic of China.,Cerebrovascular Disease Research Institute of Inner Mongolia Autonomous Region, Baotou, Inner Mongolia, People's Republic of China
| | - Jie Wang
- Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, People's Republic of China.,Cerebrovascular Disease Research Institute of Inner Mongolia Autonomous Region, Baotou, Inner Mongolia, People's Republic of China
| | - Tianyou Zhang
- Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, People's Republic of China.,Cerebrovascular Disease Research Institute of Inner Mongolia Autonomous Region, Baotou, Inner Mongolia, People's Republic of China
| | - Baojun Wang
- Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, People's Republic of China.,Cerebrovascular Disease Research Institute of Inner Mongolia Autonomous Region, Baotou, Inner Mongolia, People's Republic of China
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Parlak Ş, Gümeler E, Bulut E. Pediatric head and neck rhabdomyosarcoma; the role of MRI in differentiation from other common pediatric malignant head and neck tumors. Turk J Pediatr 2022; 64:519-530. [PMID: 35899565 DOI: 10.24953/turkjped.2021.4600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The tumor localization/extent and imaging characteristics of rhabdomyosarcomas (RMSs) especially parameningeal type, could overlap with the common tumors of the head and neck (H&N) such as lymphoma and nasopharyngeal carcinoma (NPC). Our goal was to investigate magnetic resonance imaging (MRI) features that could favor the diagnosis of RMS over lymphoma and NPC in H&N region. METHODS Pretreatment MRI of 42 pediatric patients (mean: 9.7±5.1 years, min-max: 2-18 years) with a recent diagnosis of RMS (n=12), lymphoma (n=14) and NPC (n=16) were retrospectively studied. Tumor localization, extension and spread were evaluated. Signal and enhancement characteristics of the tumors and the presence of necrosis were noted. ADC values were measured by using both the small sample and single slice methods. For comparison of three groups, the Kruskal Wallis test and Pairwise comparisons were used. The intra-class correlation coefficient (ICC) was calculated for the assessment of inter-observer agreement. RESULTS Nasopharynx ±parapharyngeal space involvement was detected in 58.3% of RMSs. Rhabdomyosarcoma was more heterogeneous in T2 images compared to lymphoma (p=0.014). Rhabdomyosarcoma showed significantly higher frequency of heterogeneous enhancement (p < 0.001) and necrosis (p < 0.001) among these tumors. The mean ADC values of lymphoma were significantly lower than the values of RMS (p < 0.001) and NPC (p < 0.01) for both observers. The mean ADC values were higher in RMSs than NPCs (p > 0.05). Intra-class correlation in ADC measurements was higher for the single slice method (ICC=0.997) than the small sample method (ICC=0.989). CONCLUSIONS Rhabdomyosarcoma tends to have higher ADC values than lymphoma and has a higher frequency of heterogeneous enhancement and necrotic parts than both lymphoma and nasopharyngeal carcinoma. These features could help radiologists to differentiate RMS from the above-mentioned mimickers.
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Affiliation(s)
- Şafak Parlak
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ekim Gümeler
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Elif Bulut
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Yu H, Wang Z, Sun Y, Bo W, Duan K, Song C, Hu Y, Zhou J, Mu Z, Wu N. Prognosis of ischemic stroke predicted by machine learning based on multi-modal MRI radiomics. Front Psychiatry 2022; 13:1105496. [PMID: 36699499 PMCID: PMC9868394 DOI: 10.3389/fpsyt.2022.1105496] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/12/2022] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Increased risk of stroke is highly associated with psychiatric disorders. We aimed to conduct the machine learning model based on multi-modal magnetic resonance imaging (MRI) radiomics predicting the prognosis of ischemic stroke. METHODS This study retrospectively analyzed 148 patients with acute ischemic stroke due to anterior circulation artery occlusion. Based on the modified Rankin Scale (mRS) score, patients were divided into good (mRS ≤ 2) and poor (mRS > 2) outcome groups. Segmentation of the infarct region was performed by manually outlining a mask of the lesion on diffusion-weighted images (DWI) using MRIcron software. The apparent diffusion coefficient (ADC), fluid decay inversion recoverage (FLAIR), susceptibility weighted imaging (SWI) and T1-weighted (T1w) images were aligned to the DWI images and the radiomic features within the lesion area were extracted for each image modality. The calculations were done using pyradiomics software and a total of 4,744 stroke-related imaging features were automatically calculated. Next, feature selection based on recursive feature elimination was used for each modality and three radiomic features were extracted from each modality plus one feature from the lesion mask, for a total of 16 radiomic features. At last, five machine learning (ML) models were trained and tested to predict stroke prognosis, calculate the received operating characteristic (ROC) curves and other parameters, evaluate the performance of the models and validate their predictive efficacy by five-fold cross-validation. RESULTS Sixteen radiomic features were selected to construct the ML models for prognostic classification. By five-fold cross-validation, light gradient boosting machine (LightGBM) model-based muti-modal MRI radiomic features performed best in binary prognostic classification with accuracy of 0.831, sensitivity of 0.739, specificity of 0.902, F1-score of 0.788 and an area under the curve (AUC) of 0.902. CONCLUSION The ML models based on muti-modal MRI radiomics are of high value for predicting clinical outcomes in acute stroke patients.
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Affiliation(s)
- Huan Yu
- Department of Radiology, Liangxiang Hospital, Beijing, China
| | - Zhenwei Wang
- Department of Radiology, Liangxiang Hospital, Beijing, China
| | - Yiqing Sun
- Department of Radiology, Liangxiang Hospital, Beijing, China
| | - Wenwei Bo
- Department of Radiology, Liangxiang Hospital, Beijing, China
| | - Kai Duan
- Department of Radiology, Liangxiang Hospital, Beijing, China
| | - Chunhua Song
- Department of Radiology, Liangxiang Hospital, Beijing, China
| | - Yi Hu
- Department of Radiology, Liangxiang Hospital, Beijing, China
| | - Jie Zhou
- Department of Radiology, Liangxiang Hospital, Beijing, China
| | - Zizhang Mu
- Department of Neurology, Liangxiang Hospital, Beijing, China
| | - Ning Wu
- Department of Medical Imaging, Yanjing Medical College, Capital Medical University, Beijing, China
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Bange M, Gonzalez-Escamilla G, Lang NSC, Ding H, Radetz A, Herz DM, Schöllhorn WI, Muthuraman M, Groppa S. Gait Abnormalities in Parkinson's Disease Are Associated with Extracellular Free-Water Characteristics in the Substantia Nigra. J Parkinsons Dis 2022; 12:1575-1590. [PMID: 35570500 DOI: 10.3233/jpd-223225] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Gait impairments are common in Parkinson's disease (PD). The pathological mechanisms are complex and not thoroughly elucidated, thus quantitative and objective parameters that closely relate to gait characteristics are critically needed to improve the diagnostic assessments and monitor disease progression. The substantia nigra is a relay structure within basal ganglia brainstem loops that is centrally involved in gait modulation. OBJECTIVE We tested the hypothesis that quantitative gait biomechanics are related to the microstructural integrity of the substantia nigra and PD-relevant gait abnormalities are independent from bradykinesia-linked speed reductions. METHODS Thirty-eight PD patients and 33 age-matched control participants walked on a treadmill at fixed speeds. Gait parameters were fed into a principal component analysis to delineate relevant features. We applied the neurite orientation dispersion and density imaging (NODDI) model on diffusion-weighted MR-images to calculate the free-water content as an advanced marker of microstructural integrity of the substantia nigra and tested its associations with gait parameters. RESULTS Patients showed increased duration of stance phase, load response, pre-swing, and double support time, as well as reduced duration of single support and swing time. Gait rhythmic alterations associated positively with the free-water content in the right substantia nigra in PD, indicating that patients with more severe neurodegeneration extend the duration of stance phase, load response, and pre-swing. CONCLUSION The results provide evidence that gait alterations are not merely a byproduct of bradykinesia-related reduced walking speed. The data-supported association between free-water and the rhythmic component highlights the potential of substantia nigra microstructure imaging as a measure of gait-dysfunction and disease-progression.
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Affiliation(s)
- Manuel Bange
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Gabriel Gonzalez-Escamilla
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Nadine Sandra Claudia Lang
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Hao Ding
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Angela Radetz
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Damian Marc Herz
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- MRC Brain Network Dynamics Unit at the University of Oxford, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - Muthuraman Muthuraman
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Lee J, Yoon YC, Lee JH, Kim HS. Which Parameter Influences Local Disease-Free Survival after Radiation Therapy Due to Osteolytic Metastasis? A Retrospective Study with Pre- and Post-Radiation Therapy MRI including Diffusion-Weighted Images. J Clin Med 2021; 11:jcm11010106. [PMID: 35011847 PMCID: PMC8745622 DOI: 10.3390/jcm11010106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/10/2021] [Accepted: 12/22/2021] [Indexed: 12/23/2022] Open
Abstract
Although radiation therapy (RT) plays an important role in the palliation of localized bone metastases, there is no consensus on a reliable method for evaluating treatment response. Therefore, we retrospectively evaluated the potential of magnetic resonance imaging (MRI) using apparent diffusion coefficient (ADC) maps and conventional images in whole-tumor volumetric analysis of texture features for assessing treatment response after RT. For this purpose, 28 patients who received RT for osteolytic bone metastasis and underwent both pre- and post-RT MRI were enrolled. Volumetric ADC histograms and conventional parameters were compared. Cox regression analyses were used to determine whether the change ratio in these parameters was associated with local disease progression-free survival (LDPFS). The ADCmaximum, ADCmean, ADCmedian, ADCSD, maximum diameter, and volume of the target lesions after RT significantly increased. Change ratios of ADCmean < 1.41, tumor diameter ≥ 1.17, and tumor volume ≥ 1.55 were significant predictors of poor LDPFS. Whole-tumor volumetric ADC analysis might be utilized for monitoring patient response to RT and potentially useful in predicting clinical outcomes.
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Arora V, Khatana J, Singh K. Does diffusion-weighted magnetic resonance imaging help in the detection of renal parenchymal disease and staging/prognostication in chronic kidney disease? Pol J Radiol 2021; 86:e614-9. [PMID: 34925650 DOI: 10.5114/pjr.2021.111360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/26/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose Diffusion-weighted imaging (DWI) in renal diseases is an upcoming modality, and its utility as an additional marker is yet to be proven. This study was intended to find the relationship between apparent diffusion coefficient (ADC) values with renal function tests and stages of chronic kidney disease (CKD) to assess renal dysfunction, and to label a cut-off for normal renal function and dysfunction. Material and methods A prospective diagnostic study was conducted on 120 patients: 60 with deranged renal function tests (RFT) and 60 with normal RFT. DWI using a 1.5-Tesla MRI (at b-values of 0 and 500 s/mm2) was done. A region of interest of size 1-2 cm2 was placed on renal parenchyma in the region of medulla, one each, over the superior, mid, and lower regions of each kidney separately. ADC values were recorded for renal parenchyma and compared. Results In patients with renal dysfunction ADC values were significantly lower than in patients with normal function (1.75 ± 0.25 vs. 2.28 ± 0.21 of right kidney and 1.79 ± 0.17 vs. 2.29 ± 0.21 of left kidney [×10−3 mm2/s]; p = 0.001). ADC values of different stages of CKD showed a decreasing trend with increasing stage. Conclusions ADC values taken at all poles to get focal involvement of the kidney can be used to measure each kidney separately, and values can be individually correlated with the elevated renal parameters. The cut-off value of the mean ADC for individual kidneys was > 2.28 (×10−3 mm2/s) in normal renal function and < 2.00 (×10−3 mm2/s) in renal dysfunction.
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Yang S, Zhao L, Pei L, Cao S, Gao Y, Fang H, Liu K, Sun S, Wu J, Song B, Xu Y. Nonfocal Symptoms in Patients with Transient Ischemic Attack and Association with Stroke Risk. Curr Neurovasc Res 2021; 18:474-478. [PMID: 34923945 DOI: 10.2174/1567202619666211217124919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Patients with transient ischemic attack(TIA)occasionally showed nonfocal symptoms, such as decreased consciousness, amnesia and non-rotatory dizziness. This study intended to evaluate the effect of nonfocal symptoms on the prognosis of patients with TIA. METHODS Data from the prospective hospital-based TIA database of the First Affiliated Hospital of Zhengzhou University were analyzed. The predictive outcome was stroke occurrence at 1 year. Cumulative risks of stroke in patients with and without nonfocal symptoms were estimated with Kaplan-Meier models. RESULTS We studied 1384 patients with TIA (842 men; mean age, 56±13 years), including 450 (32.5%) with nonfocal symptoms. In the first year after TIA, stroke occurred in 168(12.1%) patients. There was no difference in the risk of stroke between patients with both focal and nonfocal symptoms and patients with focal symptoms alone (11.8% vs 12.4%, log-rank; P=0.691). CONCLUSIONS The occurrence of nonfocal symptoms did not increase the risk of stroke at one-year follow-up compared to the occurrence of focal symptoms alone.
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Affiliation(s)
- Shuxiang Yang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Lu Zhao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Lulu Pei
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Shuang Cao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yuan Gao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Hui Fang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Kai Liu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Shilei Sun
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Jun Wu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Bo Song
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yuming Xu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
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Goyal A, Gulati M, Sharma R, Gamanagatti S, Seith Bhalla A, Seth A. Multimodality imaging evaluation of pseudotumors in chronic renal dysfunction: exposing the masquerade! Acta Radiol 2021; 64:387-394. [PMID: 34913396 DOI: 10.1177/02841851211061441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Focal renal lesions in the background of chronic kidney disease (CKD) present a diagnostic challenge. Contrast administration is usually avoided in such a setting, undermining the usefulness of computed tomography and magnetic resonance imaging. Focal regenerating nodules may occur in the background of CKD and closely mimic renal neoplasms. The aim of the present article was to highlight the salient manifestations of such CKD pseudotumors on different imaging modalities and also to depict the differentiating features from malignancy. Radiologists must be aware of the imaging appearance of this uncommonly talked about entity so as to avoid inadvertent surgery or cause undue anxiety to the patient.
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Affiliation(s)
- Ankur Goyal
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Malvika Gulati
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Raju Sharma
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Shivanand Gamanagatti
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashu Seith Bhalla
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Amlesh Seth
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
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226
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Huang Z, Li X, Wang Z, Meng N, Fu F, Han H, Li D, Bai Y, Wei W, Fang T, Feng P, Yuan J, Yang Y, Wang M. Application of Simultaneous 18 F-FDG PET With Monoexponential, Biexponential, and Stretched Exponential Model-Based Diffusion-Weighted MR Imaging in Assessing the Proliferation Status of Lung Adenocarcinoma. J Magn Reson Imaging 2021; 56:63-74. [PMID: 34888990 DOI: 10.1002/jmri.28010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ki-67 proliferation index (PI) is important for providing information on tumor behavior, treatment response, and prognosis. Integrated positron emission tomography/magnetic resonance (PET/MR) may have the potential to assess Ki-67 PI in patients with lung adenocarcinoma. PURPOSE To explore the value of simultaneous 18 F-fluorodeoxyglucose (18 F-FDG) PET/MR-derived parameters in assessing the proliferation status of lung adenocarcinoma and to determine the best combination of parameters. STUDY TYPE Prospective. POPULATION Seventy-eight patients with lung adenocarcinoma and with Ki-67 PI. FIELD STRENGTH/SEQUENCE 3.0 T, simultaneous PET/MRI including diffusion-weighted imaging (DWI) and 18 F-FDG PET. ASSESSMENT DWI-derived parameters, namely, apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), diffusion heterogeneity index (α), and distributed diffusion coefficient (DDC); and PET-derived parameters, namely, maximum standardized uptake value (SUVmax ), metabolic tumor volume (MTV), and total lesion glycolytic volume (TLG), were calculated and compared between the high (>25%) and low (≤25%) Ki-67 PI groups. The correlations between PET-derived parameters and DWI-derived parameters were analyzed. STATISTICAL TESTS Student's t-test, Mann-Whitney U test, chi-square test, and receiver operating characteristic (ROC) curves. A P-value <0.05 was considered statistically significant. RESULTS The SUVmax , MTV, TLG, ADC, D, and DDC values were significantly different between the high (N = 35) and low Ki-67 PI groups (N = 43). D, SUVmax , and MTV independently predicted the Ki-67 PI status. The combination of D, SUVmax , and MTV had the largest area under the ROC curve (AUC = 0.900), which was significantly larger than the AUC alone of DDC (AUC = 0.725), SUVmax (AUC = 0.815), MTV (AUC = 0.774), or TLG (AUC = 0.783). The perfusion fraction did not correlate with SUVmax , MTV, or TLG (r = -0.03, -0.11, and -0.04, respectively; P = 0.786, 0.348, and 0.733). DATA CONCLUSION The combination of D, SUVmax , and MTV may predict Ki-67 PI status. No correlation was observed between perfusion parameters and metabolic parameters. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhun Huang
- Department of Medical Imaging, Henan University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China.,Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China
| | - Xiaochen Li
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Zhixue Wang
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Nan Meng
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Fangfang Fu
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Hui Han
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Dujuan Li
- Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Yan Bai
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Wei Wei
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Ting Fang
- Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Pengyang Feng
- Department of Medical Imaging, Henan University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China.,Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China
| | - Jianmin Yuan
- Central Research Institute, UIH Group, Shanghai, China
| | - Yang Yang
- Beijing United Imaging Research Institute of Intelligent Imaging, Beijing, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China.,Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China.,Department of Medical imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
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Cheng X, Li J, Lan Y, Liu J, Chen S, Lu G. Cerebrovascular Disease in the Setting of Posterior Reversible Encephalopathy Syndrome. Front Neurol 2021; 12:765333. [PMID: 34867751 PMCID: PMC8635685 DOI: 10.3389/fneur.2021.765333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/25/2021] [Indexed: 12/03/2022] Open
Abstract
Overlap between the pathogenesis of posterior reversible encephalopathy syndrome and that of cerebrovascular disease can confound their clinical and radiological presentations, posing a diagnostic challenge. This article presents a literature review and discussion of the clinical manifestations, pathological mechanisms, and imaging manifestations of subarachnoid hemorrhage and vasculitis leading to posterior reversible encephalopathy syndrome, coexistence of posterior reversible encephalopathy syndrome with reversible cerebral vasoconstriction syndrome, and hemorrhage and infarction secondary to posterior reversible encephalopathy syndrome. The findings show that posterior reversible encephalopathy syndrome shares some overlapping pathophysiological mechanisms with cerebrovascular disease. Importantly, neuroimaging plays an important role in identifying this entity in a timely manner and differentiating it from other diseases.
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Affiliation(s)
- XiaoQing Cheng
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - JianRui Li
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Ying Lan
- Special Medical Service, Lushan Rehabilitation and Recuperation Center of People's Liberation Army (PLA), Jiujiang, China
| | - Jia Liu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Sui Chen
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - GuangMing Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
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Li B, Xu D, Zhou J, Wang SC, Cai YX, Li H, Xu HB. Monitoring Bevacizumab-Induced Tumor Vascular Normalization by Intravoxel Incoherent Motion Diffusion-Weighted MRI. J Magn Reson Imaging 2021; 56:427-439. [PMID: 34873766 DOI: 10.1002/jmri.28012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Accurate monitoring of tumor blood vessel normalization progression is beneficial to accurate treatment of patients. At present, there is a lack of safe and noninvasive monitoring methods. PURPOSE To serial monitor the vascular normalization time window of tumor antiangiogenesis treatment through intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and histopathological methods. STUDY TYPE Exploratory animal study. POPULATION Sixty rat C6 glioma models were randomly and equally divided into the control groups (N = 30) and bevacizumab treatment groups (N = 30). Twenty-five for magnetic resonance imaging (MRI) and five for electron microscope testing in each group. FIELD STRENGTH/SEQUENCE T1-weighted imaging (T1WI), T2WI with a fast spin echo sequence and IVIM-DWI with a spin-echo echo-planar imaging sequence at 3 T. ASSESSMENT IVIM-DWI quantitative parameters (f, D, D*, and fD*) were obtained on days 0, 2, 4, 6, and 8 after bevacizumab treatment. After MRI, the microvessel density (MVD), pericyte coverage, and hypoxia-inducible factor-1α (HIF-1α) were assessed. Electron microscope observation was performed at each time point. STATISTICAL TESTS One-way analysis of variance and Student's t-tests were used to compare differences within and between groups. Spearman's correlation coefficient (r) assess the correlation between IVIM and pathological parameters. The intragroup correlation coefficient was determined to assess the repeatability of each IVIM parameter. RESULTS The IVIM-DWI perfusion parameters (f and fD*) of the treated group were higher than the control group on days 2 and 4. Compared to the control group, MVD decreased on days 2 and pericyte coverage increased on days 4 in the treatment group. Electron microscopy showed that the tight junctions of the treatment group were prolonged on days 2-4. In the control group, f had the highest correlation with MVD (r = 0.689). In the treated group, f had a good correlation with pericyte coverage (r = 0.557), HIF-1α had a moderately positive correlation with f (r = 0.480) and fD*(r = 0.447). DATA CONCLUSION The vascular normalization time window of bevacizumab treatment of glioma was days 2-4 after antiangiogenesis treatment, which could be monitored noninvasively by IVIM-DWI. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Bo Li
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China.,The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Dan Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jie Zhou
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shou-Chao Wang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yu-Xiang Cai
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Huan Li
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hai-Bo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Peng S, Guo Y, Zhang X, Tao J, Liu J, Zhu W, Chen L, Yang F. High-Resolution DWI with Simultaneous Multi-Slice Readout-Segmented Echo Planar Imaging for the Evaluation of Malignant and Benign Breast Lesions. Diagnostics (Basel) 2021; 11:2273. [PMID: 34943509 DOI: 10.3390/diagnostics11122273] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/19/2022] Open
Abstract
To investigate the feasibility and effectiveness of high-resolution readout-segmented echo planar imaging (rs-EPI), diffusion-weighted imaging (DWI) is used simultaneously with multi-slice (SMS) imaging (SMS rs-EPI) for the differentiation of breast malignant and benign lesions in comparison to conventional rs-EPI on a 3T MR scanner. A total of 102 patients with 113 breast lesions underwent bilateral breast MRI using a prototype SMS rs-EPI sequence and a conventional rs-EPI sequence. Subjective image quality was assessed using a 5-point Likert scale (1 = poor, 5 = excellent). Signal-to-noise ratio (SNR), lesion contrast-to-noise ratio (CNR) and apparent diffusion coefficients (ADC) value of the lesion were measured for comparison. Receiver operating characteristic curve analysis was performed to evaluate the diagnosis performance of ADC, and the corresponding area under curve (AUC) was calculated. The image quality scores in anatomic distortion, lesion conspicuity, sharpness of anatomical details and overall image quality of SMS rs-EPI were significantly higher than those of conventional rs-EPI. CNR was enhanced in the high-resolution SMS rs-EPI acquisition (6.48 ± 1.71 vs. 4.23 ± 1.49; p < 0.001). The mean ADC value was comparable in SMS rs-EPI and conventional rs-EPI (benign 1.45 × 10−3 vs. 1.43 × 10−3 mm2/s, p = 0.702; malignant 0.91 × 10−3 vs. 0.89 × 10−3 mm2/s, p = 0.076). The AUC was 0.957 in SMS rs-EPI and 0.983 in conventional rs-EPI. SMS rs-EPI technique allows for higher spatial resolution and slight reduction of scan time in comparison to conventional rs-EPI, which has potential for better differentiation between malignant and benign lesions of the breast.
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Abstract
The shortly upcoming 5th edition of the World Health Organization Classification of Tumors of the Central Nervous System is bringing extensive changes in the terminology of diffuse high-grade gliomas (DHGGs). Previously "glioblastoma," as a descriptive entity, could have been applied to classify some tumors from the family of pediatric or adult DHGGs. However, now the term "glioblastoma" has been divested and is no longer applied to tumors in the family of pediatric types of DHGGs. As an entity, glioblastoma remains, however, in the family of adult types of diffuse gliomas under the insignia of "glioblastoma, IDH-wildtype." Of note, glioblastomas still can be detected in children when glioblastoma, IDH-wildtype is found in this population, despite being much more common in adults. Despite the separation from the family of pediatric types of DHGGs, what was previously labeled as "pediatric glioblastomas" still remains with novel labels and as new entities. As a result of advances in molecular biology, most of the previously called "pediatric glioblastomas" are now classified in one of the four family members of pediatric types of DHGGs. In this review, the term glioblastoma is still apocryphally employed mainly due to its historical relevance and the paucity of recent literature dealing with the recently described new entities. Therefore, "glioblastoma" is used here as an umbrella term in the attempt to encompass multiple entities such as astrocytoma, IDH-mutant (grade 4); glioblastoma, IDH-wildtype; diffuse hemispheric glioma, H3 G34-mutant; diffuse pediatric-type high-grade glioma, H3-wildtype and IDH-wildtype; and high grade infant-type hemispheric glioma. Glioblastomas are highly aggressive neoplasms. They may arise anywhere in the developing central nervous system, including the spinal cord. Signs and symptoms are non-specific, typically of short duration, and usually derived from increased intracranial pressure or seizure. Localized symptoms may also occur. The standard of care of "pediatric glioblastomas" is not well-established, typically composed of surgery with maximal safe tumor resection. Subsequent chemoradiation is recommended if the patient is older than 3 years. If younger than 3 years, surgery is followed by chemotherapy. In general, "pediatric glioblastomas" also have a poor prognosis despite surgery and adjuvant therapy. Magnetic resonance imaging (MRI) is the imaging modality of choice for the evaluation of glioblastomas. In addition to the typical conventional MRI features, i.e., highly heterogeneous invasive masses with indistinct borders, mass effect on surrounding structures, and a variable degree of enhancement, the lesions may show restricted diffusion in the solid components, hemorrhage, and increased perfusion, reflecting increased vascularity and angiogenesis. In addition, magnetic resonance spectroscopy has proven helpful in pre- and postsurgical evaluation. Lastly, we will refer to new MRI techniques, which have already been applied in evaluating adult glioblastomas, with promising results, yet not widely utilized in children.
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Affiliation(s)
- Fabrício Guimarães Gonçalves
- Division of Neuroradiology, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Angela N Viaene
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Arastoo Vossough
- Division of Neuroradiology, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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231
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Shibasaki J, Niwa T, Piedvache A, Tomiyasu M, Morisaki N, Fujii Y, Toyoshima K, Aida N. Comparison of Predictive Values of Magnetic Resonance Biomarkers Based on Scan Timing in Neonatal Encephalopathy Following Therapeutic Hypothermia. J Pediatr 2021; 239:101-109.e4. [PMID: 34391766 DOI: 10.1016/j.jpeds.2021.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/28/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the optimal quantitative magnetic resonance (MR) biomarker in neonatal encephalopathy following therapeutic hypothermia based on scan timing. STUDY DESIGN This retrospective study included 98 neonates (35-41 weeks of gestation) with neonatal encephalopathy, who underwent therapeutic hypothermia; diffusion-weighted imaging and proton MR spectroscopy were performed at 24-96 hours (n = 56) and 7-14 days (n = 92) after birth, respectively, to estimate apparent diffusion coefficient (ADC) values, N-acetylaspartate and N-acetylaspartylglutamate (tNAA), lactate, and choline concentrations, and lactate/tNAA, tNAA/choline ratios in the deep gray matter. Adverse outcomes included death or neurodevelopmental impairment at 18-22 months of age. We used receiver operating characteristic curves to examine the prognostic accuracy of each MR biomarker. RESULTS Deep gray matter tNAA concentrations showed the best prognostic value, with an area under the curve (AUC) of 0.97 and 1.00 at 24-96 hours and 7-14 days after birth, respectively. At 24-96 hours of age, ADC values, lactate concentrations, and lactate/tNAA ratios showed prognostic value with AUCs of 0.90, 0.95, and 0.97, respectively. At 7-14 days of age, the AUCs of ADC values, lactate, and lactate/tNAA ratios were 0.61, 0.67, and 0.80, respectively; these were lower than those at 24-96 hours of age. CONCLUSIONS During the first 2 weeks of life, the deep gray matter tNAA concentration was the most accurate quantitative MR biomarker. Although ADC values, lactate levels, and lactate/tNAA ratios also showed high prognostic value during 24-96 hours of life, only tNAA retained high prognostic value in the second week of life.
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Affiliation(s)
- Jun Shibasaki
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tetsu Niwa
- Department of Radiology, Tokai University School of Medicine, Isehara, Japan; Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Japan.
| | - Aurélie Piedvache
- Division of Lifecourse Epidemiology, Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Moyoko Tomiyasu
- Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Japan; Department of Molecular Imaging and Theranostics, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Naho Morisaki
- Division of Lifecourse Epidemiology, Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Yuta Fujii
- Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Katsuaki Toyoshima
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Noriko Aida
- Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Japan
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Taoka T, Kawai H, Nakane T, Abe T, Nakamichi R, Ito R, Sasaki Y, Nishida A, Naganawa S. Evaluating the Effect of Arterial Pulsation on Cerebrospinal Fluid Motion in the Sylvian Fissure of Patients with Middle Cerebral Artery Occlusion Using Low b-value Diffusion-weighted Imaging. Magn Reson Med Sci 2021; 20:371-377. [PMID: 33408311 PMCID: PMC8922347 DOI: 10.2463/mrms.mp.2020-0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Decrease in signal of the cerebrospinal fluid (CSF) on low b-value diffusion weighted image (DWI) due to non-uniform flow can provide additional information regarding CSF motion. The purpose of the current study was to evaluate whether arterial pulsations constitute the driving force of CSF motion. METHODS We evaluated the CSF signals within the Sylvian fissure on low b-value DWI in 19 patients with unilateral middle cerebral artery (MCA) occlusion. DWI with b-value of 500 s/mm2 was evaluated for a decrease in CSF signal within the Sylvian fissure including the Sylvian vallecula and lower, middle, and higher Sylvian fissures and graded as follows: the same as contralateral side; smaller signal decrease than that on contralateral side; and no signal decrease. MR angiography (MRA) findings of MCA were graded as follows: the same as contralateral, lower signal than contralateral signal, and no signal. In 15 patients, regional cerebral blood flow (rCBF) was evaluated using single-photon emission computed tomography (SPECT) studies and graded as >90%, 90%-70%, and <70% rCBF compared to contralateral. The correlations between the gradings were evaluated using G likelihood-ratio test. RESULTS There was no statistically significant correlation between the MRA and low b-value DWI gradings of CSF in all areas. There were statistically significant correlations between the decreases in CBF on SPECT and CSF signals in the middle Sylvian fissure. CONCLUSION The driving force of CSF pulsation in the Sylvian sinus may be related to the pulsations of the cerebral hemisphere rather than direct arterial pulsations.
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Affiliation(s)
- Toshiaki Taoka
- Department of Innovative Biomedical Visualization (iBMV), Nagoya University Graduate School of Medicine.,Department of Radiology, Nagoya University Graduate School of Medicine
| | - Hisashi Kawai
- Department of Radiology, Nagoya University Graduate School of Medicine
| | - Toshiki Nakane
- Department of Radiology, Nagoya University Graduate School of Medicine
| | - Takashi Abe
- Department of Radiology, Nagoya University Graduate School of Medicine
| | - Rei Nakamichi
- Department of Radiology, Nagoya University Graduate School of Medicine
| | - Rintaro Ito
- Department of Innovative Biomedical Visualization (iBMV), Nagoya University Graduate School of Medicine.,Department of Radiology, Nagoya University Graduate School of Medicine
| | - Yutaro Sasaki
- Department of Radiology, Nagoya University Graduate School of Medicine
| | - Ayumi Nishida
- Department of Radiology, Nagoya University Graduate School of Medicine
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine
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Langbein BJ, Szczepankiewicz F, Westin CF, Bay C, Maier SE, Kibel AS, Tempany CM, Fenness FM. A Pilot Study of Multidimensional Diffusion MRI for Assessment of Tissue Heterogeneity in Prostate Cancer. Invest Radiol 2021; 56:845-853. [PMID: 34049334 PMCID: PMC8626531 DOI: 10.1097/rli.0000000000000796] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objectives of this exploratory study were to investigate the feasibility of multidimensional diffusion magnetic resonance imaging (MddMRI) in assessing diffusion heterogeneity at both a macroscopic and microscopic level in prostate cancer (PCa). MATERIALS AND METHODS Informed consent was obtained from 46 subjects who underwent 3.0-T prostate multiparametric MRI, complemented with a prototype spin echo-based MddMRI sequence in this institutional review board-approved study. Prostate cancer tumors and comparative normal tissue from each patient were contoured on both apparent diffusion coefficient and MddMRI-derived mean diffusivity (MD) maps (from which microscopic diffusion heterogeneity [MKi] and microscopic diffusion anisotropy were derived) using 3D Slicer. The discriminative ability of MddMRI-derived parameters to differentiate PCa from normal tissue was determined using the Friedman test. To determine if tumor diffusion heterogeneity is similar on macroscopic and microscopic scales, the linear association between SD of MD and mean MKi was estimated using robust regression (bisquare weighting). Hypothesis testing was 2 tailed; P values less than 0.05 were considered statistically significant. RESULTS All MddMRI-derived parameters could distinguish tumor from normal tissue in the fixed-effects analysis (P < 0.0001). Tumor MKi was higher (P < 0.05) compared with normal tissue (median, 0.40; interquartile range, 0.29-0.52 vs 0.20-0.18; 0.25), as was tumor microscopic diffusion anisotropy (0.55; 0.36-0.81 vs 0.20-0.15; 0.28). The MKi could not be predicted (no significant association) by SD of MD. There was a significant correlation between tumor volume and SD of MD (R2 = 0.50, slope = 0.008 μm2/ms per millimeter, P < 0.001) but not between tumor volume and MKi. CONCLUSIONS This explorative study demonstrates that MddMRI provides novel information on MKi and microscopic anisotropy, which differ from measures at the macroscopic level. MddMRI has the potential to characterize tumor tissue heterogeneity at different spatial scales.
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Affiliation(s)
- Björn J. Langbein
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA
- University Clinic Magdeburg, Otto von Guericke University, Magdeburg, Germany
- Harvard Medical School, Boston, MA
| | - Filip Szczepankiewicz
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Carl-Fredrik Westin
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Camden Bay
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Stephan E. Maier
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Adam S. Kibel
- Harvard Medical School, Boston, MA
- Department of Urology, Brigham and Women’s Hospital, Boston, MA
| | - Clare M. Tempany
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Fiona M. Fenness
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
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234
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Yang X, Lin Y, Xing Z, She D, Su Y, Cao D. Predicting 1p/19q codeletion status using diffusion-, susceptibility-, perfusion-weighted, and conventional MRI in IDH-mutant lower-grade gliomas. Acta Radiol 2021; 62:1657-1665. [PMID: 33222488 DOI: 10.1177/0284185120973624] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Isocitrate dehydrogenase (IDH)-mutant lower-grade gliomas (LGGs) are further classified into two classes: with and without 1p/19q codeletion. IDH-mutant and 1p/19q codeleted LGGs have better prognosis compared with IDH-mutant and 1p/19q non-codeleted LGGs. PURPOSE To evaluate conventional magnetic resonance imaging (cMRI), diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) for predicting 1p/19q codeletion status of IDH-mutant LGGs. MATERIAL AND METHODS We retrospectively reviewed cMRI, DWI, SWI, and DSC-PWI in 142 cases of IDH mutant LGGs with known 1p/19q codeletion status. Features of cMRI, relative ADC (rADC), intratumoral susceptibility signals (ITSSs), and the value of relative cerebral blood volume (rCBV) were compared between IDH-mutant LGGs with and without 1p/19q codeletion. Receiver operating characteristic curve and logistic regression were used to determine diagnostic performances. RESULTS IDH-mutant and 1p/19q non-codeleted LGGs tended to present with the T2/FLAIR mismatch sign and distinct borders (P < 0.001 and P = 0.038, respectively). Parameters of rADC, ITSSs, and rCBVmax were significantly different between the 1p/19q codeleted and 1p/19q non-codeleted groups (P < 0.001, P = 0.017, and P < 0.001, respectively). A combination of cMRI, SWI, DWI, and DSC-PWI for predicting 1p/19q codeletion status in IDH-mutant LGGs resulted in a sensitivity, specificity, positive predictive value, negative predictive value, and an AUC of 80.36%, 78.57%, 83.30%, 75.00%, and 0.88, respectively. CONCLUSION 1p/19q codeletion status of IDH-mutant LGGs can be stratified using cMRI and advanced MRI techniques, including DWI, SWI, and DSC-PWI. A combination of cMRI, rADC, ITSSs, and rCBVmax may improve the diagnostic performance for predicting 1p/19q codeletion status.
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Affiliation(s)
- Xiefeng Yang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| | - Yu Lin
- Department of Radiology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, PR China
| | - Zhen Xing
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| | - Dejun She
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| | - Yan Su
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
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235
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Ohno M, Ohno N, Miyati T, Kawashima H, Kozaka K, Matsuura Y, Gabata T, Kobayashi S. Triexponential Diffusion Analysis of Diffusion-weighted Imaging for Breast Ductal Carcinoma in Situ and Invasive Ductal Carcinoma. Magn Reson Med Sci 2021; 20:396-403. [PMID: 33563872 PMCID: PMC8922350 DOI: 10.2463/mrms.mp.2020-0103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose To obtain detailed information in breast ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) using triexponential diffusion analysis. Methods Diffusion-weighted images (DWI) of the breast were obtained using single-shot diffusion echo-planar imaging with 15 b-values. Mean signal intensities at each b-value were measured in the DCIS and IDC lesions and fitted with the triexponential function based on a two-step approach: slow-restricted diffusion coefficient (Ds) was initially determined using a monoexponential function with b-values > 800 s/mm2. The diffusion coefficient of free water at 37°C was assigned to the fast-free diffusion coefficient (Df). Finally, the perfusion-related diffusion coefficient (Dp) was derived using all the b-values. Furthermore, biexponential analysis was performed to obtain the perfusion-related diffusion coefficient (D*) and the perfusion-independent diffusion coefficient (D). Monoexponential analysis was performed to obtain the apparent diffusion coefficient (ADC). The sensitivity and specificity of the aforementioned diffusion coefficients for distinguishing between DCIS and IDC were evaluated using the pathological results. Results The Ds, D, and ADC of DCIS were significantly higher than those of IDC (P < 0.01 for all). There was no significant correlation between Dp and Ds, but there was a weak correlation between D* and D. The combination of Dp and Ds showed higher sensitivity and specificity (85.9% and 71.4%, respectively), compared to the combination of D* and D (81.5% and 33.3%, respectively). Conclusion Triexponential analysis can provide detailed diffusion information for breast tumors that can be used to differentiate between DCIS and IDC.
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Affiliation(s)
- Masako Ohno
- Department of Radiological Technology, Kanazawa University Hospital
| | - Naoki Ohno
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | - Tosiaki Miyati
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | - Hiroko Kawashima
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University.,Department of Radiology, Kanazawa University Hospital
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University Hospital
| | | | | | - Satoshi Kobayashi
- Department of Radiological Technology, Kanazawa University Hospital.,Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University.,Department of Radiology, Kanazawa University Hospital
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236
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Barbara M, Covelli E, Monini S, Bandiera G, Filippi C, Margani V, Volpini L, Salerno G, Romano A, Bozzao A. Early non-EPI DW-MRI after cholesteatoma surgery. Ear Nose Throat J 2021:1455613211042946. [PMID: 34846196 DOI: 10.1177/01455613211042946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Middle ear cholesteatoma may lead to the erosion of the bony structures of the temporal bone, possibly causing intra- and extracranial complications. Surgical treatment is mandatory, and due to possible residual/recurrent disease, the use of reliable diagnostic methods is essential. Our study aimed to evaluate the reliability of non-EPI DW-MRI for the follow-up of cholesteatoma after surgery. METHODS In a study group including 53 consecutive patients who underwent surgery for cholesteatoma at a tertiary university hospital, an imaging protocol was applied, including non-echo planar diffusion-weighted imaging magnetic resonance (MR) at 1 month after surgery and then at 6 and 12 months after surgery. Based on the combination of preoperative assessment and intraoperative findings, the study group was divided into 3 subgroups: petrous bone (PB) cholesteatoma, complicated cholesteatoma and uncomplicated cholesteatoma. PB cholesteatoma patients were treated by a subtotal petrosectomy, whereas complicated and uncomplicated cholesteatoma patients were treated either by a canal wall up procedure or a retrograde (inside-out) canal wall down technique with bone obliteration technique (BOT). RESULTS The results show that patients who had positive findings on non-EPI DW-MRI scans 1 month after surgery consequently underwent revision surgery during which residual cholesteatoma was noted. All the patients who displayed negative findings on non-EPI DWI-MRI scan at 1 month after surgery did not show the presence of a lesion at the 6- and 12-month evaluations. The 6 patients who displayed residual cholesteatoma at the 1-month follow-up presented dehiscence/exposure of the facial nerve canal at the primary surgery, mostly at the level of the labyrinthine segment. CONCLUSION Non-EPI DW-MRI is a useful and reliable tool for follow-up cholesteatoma surgery, and when applied early, as was done in the protocol proposed in the present study, this tool may be used to detect the presence of residual cholesteatoma in some patients, prompting the planning of early revision surgery.
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Affiliation(s)
- Maurizio Barbara
- NESMOS Department, ENT Clinic, 9311Sapienza University, Rome, Italy
| | - Edoardo Covelli
- NESMOS Department, ENT Clinic, 9311Sapienza University, Rome, Italy
| | - Simonetta Monini
- NESMOS Department, ENT Clinic, 9311Sapienza University, Rome, Italy
| | - Giorgio Bandiera
- NESMOS Department, ENT Clinic, 9311Sapienza University, Rome, Italy
| | - Chiara Filippi
- NESMOS Department, ENT Clinic, 9311Sapienza University, Rome, Italy
| | - Valerio Margani
- NESMOS Department, ENT Clinic, 9311Sapienza University, Rome, Italy
| | - Luigi Volpini
- NESMOS Department, ENT Clinic, 9311Sapienza University, Rome, Italy
| | - Gerardo Salerno
- NESMOS Department, Laboratory Unit, Sant'Andrea University Hospital, Rome, Italy
| | - Andrea Romano
- NESMOS Department, Neuroradiology Unit, 9311Sapienza University, Rome, Italy
| | - Alessandro Bozzao
- NESMOS Department, Neuroradiology Unit, 9311Sapienza University, Rome, Italy
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Gadjimuradov F, Benkert T, Nickel MD, Maier A. Robust partial Fourier reconstruction for diffusion-weighted imaging using a recurrent convolutional neural network. Magn Reson Med 2021; 87:2018-2033. [PMID: 34841550 DOI: 10.1002/mrm.29100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/21/2021] [Accepted: 11/07/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To develop an algorithm for robust partial Fourier (PF) reconstruction applicable to diffusion-weighted (DW) images with non-smooth phase variations. METHODS Based on an unrolled proximal splitting algorithm, a neural network architecture is derived, which alternates between data consistency operations and regularization implemented by recurrent convolutions. In order to exploit correlations, multiple repetitions of the same slice are jointly reconstructed under consideration of permutation-equivariance. The algorithm is trained on DW liver data of 60 volunteers and evaluated on retrospectively and prospectively subsampled data of different anatomies and resolutions. RESULTS The proposed method is able to significantly outperform conventional PF techniques on retrospectively subsampled data in terms of quantitative measures as well as perceptual image quality. In this context, joint reconstruction of repetitions as well as the particular type of recurrent network unrolling are found to be beneficial with respect to reconstruction quality. On prospectively PF-sampled data, the proposed method enables DW imaging with higher signal without sacrificing image resolution or introducing additional artifacts. Alternatively, it can be used to counter the TE increase in acquisitions with higher resolution. Furthermore, generalizability can be shown to prospective brain data exhibiting anatomies and contrasts not present in the training set. CONCLUSION This work demonstrates that robust PF reconstruction of DW data is feasible even at strong PF factors in anatomies prone to phase variations. Since the proposed method does not rely on smoothness priors of the phase but uses learned recurrent convolutions instead, artifacts of conventional PF methods can be avoided.
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Affiliation(s)
- Fasil Gadjimuradov
- Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Magnetic Resonance Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Thomas Benkert
- Magnetic Resonance Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Marcel Dominik Nickel
- Magnetic Resonance Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Andreas Maier
- Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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238
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Dhamija E, Gulati M, Manchanda S, Singhal S, Sharma D, Kumar S, Bhatla N. Imaging in Carcinoma Cervix and Revised 2018 FIGO Staging System: Implications in Radiology Reporting. Indian J Radiol Imaging 2021; 31:623-634. [PMID: 34790308 PMCID: PMC8590564 DOI: 10.1055/s-0041-1735502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
The International Federation of Gynecology and Obstetrics (FIGO) staging system of carcinoma cervix saw a radical change in 2018 with the inclusion of cross-sectional imaging tools for the assessment of disease extent and staging. One of the major revisions is the inclusion of lymph node status, detected either on imaging or pathological evaluation, in the staging system. The changes were based on long-term patient follow-up and survival rates reported in literature. Thus, it becomes imperative for a radiologist to be well versed with the recent staging system, its limitations, and implications on the patient management.
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Affiliation(s)
- Ekta Dhamija
- Department of Radiodiagnosis, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Malvika Gulati
- Department of Radiodiagnosis, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Smita Manchanda
- Department of Radiodiagnosis, Dr B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Singhal
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Dayanand Sharma
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Sunesh Kumar
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Neerja Bhatla
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
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239
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Turtzo LC, Luby M, Jikaria N, Griffin AD, Greenman D, Bokkers RPH, Parikh G, Peterkin N, Whiting M, Latour LL. Cytotoxic Edema Associated with Hemorrhage Predicts Poor Outcome after Traumatic Brain Injury. J Neurotrauma 2021; 38:3107-3118. [PMID: 34541886 DOI: 10.1089/neu.2021.0037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Magnetic resonance imaging (MRI) is used rarely in the acute evaluation of traumatic brain injury (TBI) but may identify findings of clinical importance not detected by computed tomography (CT). We aimed to characterize the association of cytotoxic edema and hemorrhage, including traumatic microbleeds, on MRI obtained within hours of acute head trauma and investigated the relationship to clinical outcomes. Patients prospectively enrolled in the Traumatic Head Injury Neuroimaging Classification study (NCT01132937) with evidence of diffusion-related findings or hemorrhage on neuroimaging were included. Blinded interpretation of MRI for diffusion-weighted lesions and hemorrhage was conducted, with subsequent quantification of apparent diffusion coefficient (ADC) values. Of 161 who met criteria, 82 patients had conspicuous hyperintense lesions on diffusion-weighted imaging (DWI) with corresponding regions of hypointense ADC in proximity to hemorrhage. Median time from injury to MRI was 21 (10-30) h. Median ADC values per patient grouped by time from injury to MRI were lowest within 24 h after injury. The ADC values associated with hemorrhagic lesions are lowest early after injury, with an increase in diffusion during the subacute period, suggesting transformation from cytotoxic to vasogenic edema during the subacute post-injury period. Of 118 patients with outcome data, 60 had Glasgow Outcome Scale Extended scores ≤6 at 30/90 days post-injury. Cytotoxic edema on MRI (odds ratio [OR] 2.91 [1.32-6.37], p = 0.008) and TBI severity (OR 2.51 [1.32-4.74], p = 0.005) were independent predictors of outcome. These findings suggest that in patients with TBI who had findings of hemorrhage on CT, patients with DWI/ADC lesions on MRI are more likely to do worse.
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Affiliation(s)
- L Christine Turtzo
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Marie Luby
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Neekita Jikaria
- Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA
| | | | - Danielle Greenman
- Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA
| | - Reinoud P H Bokkers
- Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gunjan Parikh
- R Adams Shock Trauma Center and University of Maryland School of Medicine, Baltimore, Maryland, USA.,Division of Neurocritical Care and Emergency Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Nicole Peterkin
- Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA
| | - Mark Whiting
- Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA
| | - Lawrence L Latour
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.,Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA
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240
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Tangyoosuk T, Lertbutsayanukul C, Jittapiromsak N. Utility of diffusion-weighted magnetic resonance imaging in predicting the treatment response of nasopharyngeal carcinoma. Neuroradiol J 2021; 35:477-485. [PMID: 34730049 PMCID: PMC9437492 DOI: 10.1177/19714009211055191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Predicting the treatment response in patients with nasopharyngeal carcinoma (NPC) is challenging. This study evaluated the utility of diffusion-weighted imaging (DWI) in predicting the treatment response in patients with NPC. METHODS We prospectively enrolled 33 patients with newly diagnosed NPC who underwent magnetic resonance imaging with the propeller DWI and apparent diffusion coefficient (ADC) map before and at 5 weeks after chemoradiation. The following ADC values of the primary tumor were calculated: pre-treatment ADC (pre-ADC), pre-treatment ADC ratio (pre-ADC ratio), ADC change (▵ADC), ADC change ratio (▵ADC ratio), and percentage of ADC change (▵%ADC). The correlations between these parameters and treatment outcomes were explored, and the patients were classified as good responders (complete response) and poor responders (stable disease, partial response, or progressive disease) based on the Response Evaluation Criteria in Solid Tumors, version 1.1. RESULTS The ▵ADC, ▵ADC ratio, and ▵%ADC were significantly lower in the poor-responder group (n = 12) than in the good-responder group (n = 21; p = 0.001, p = 0.002, and p = 0.004, respectively). There was no significant difference between groups in the pre-ADC and pre-ADC ratios (p = 0.602 and p = 0.685, respectively). The optimal ▵ADC, ▵ADC ratio, and ▵%ADC cutoff values for predicting poor response were >0.65 mm2/sec, 0.28, and 60%, respectively (sensitivity: 83.3%, 75%, and 83.3%; specificity: 71.4%, 85.7%, and 71.4%, respectively). CONCLUSION The ▵ADC, ▵ADC ratio, and ▵%ADC obtained during the pre-treatment and mid-treatment periods could be potential biomarkers for predicting treatment response in patients with NPC.
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Affiliation(s)
- Thidaporn Tangyoosuk
- Department of Radiology, Faculty of Medicine, Division of Diagnostic Radiology, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Chawalit Lertbutsayanukul
- Department of Radiology, Faculty of Medicine, Division of Radiation Oncology, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Nutchawan Jittapiromsak
- Department of Radiology, Faculty of Medicine, Division of Diagnostic Radiology, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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241
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Ohno N, Yoshida K, Ueda Y, Makino Y, Miyati T, Gabata T, Kobayashi S. Diffusion-weighted Imaging of the Abdomen during a Single Breath-hold Using Simultaneous-multislice Echo-planar Imaging. Magn Reson Med Sci 2021; 22:253-262. [PMID: 34732598 PMCID: PMC10086397 DOI: 10.2463/mrms.mp.2021-0087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This multi-scanner study aimed to investigate the validity of single breath-hold (BH) diffusion-weighted imaging (DWI) using simultaneous-multislice (SMS) echo-planar imaging in multiple abdominal organs to enable faster acquisition and reliable quantification of apparent diffusion coefficient (ADC). METHODS SNR, geometric distortion (GD), and ADC in a phantom; the ADC in the liver, renal cortex, paraspinal muscle, spleen, and pancreas; and the signal intensity ratio of the portal vein-to-muscle (SIRPV-M) in healthy volunteers were compared between BH- and respiratory-triggered (RT) DWI with b-values of 0 and 800 s/mm2 in two different MRI scanners. RESULTS The phantom study showed that the SNR of BH-DWI was significantly lower than that of the RT-DWI (P < 0.05 for both scanners), whereas the GD and ADC of BH-DWI did not differ significantly from those of the RT-DWI (P = 0.09-0.60). In the volunteer study, the scan times were 23 seconds for BH-DWI and 184±33 seconds for RT-DWI, respectively. The ADC of the liver in BH-DWI was significantly lower than that in RT-DWI (P < 0.05 for both scanners), whereas there were no significant differences in the ADCs of the renal cortex, paraspinal muscle, spleen, or pancreas between BH-DWI and RT-DWI (P = 0.07-0.86). The SIRPV-M in BH-DWI was significantly smaller than in RT-DWI (P < 0.05 for both scanners). CONCLUSION The proposed method enables the acquisition of abdominal diffusion-weighted images in a single BH.
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Affiliation(s)
- Naoki Ohno
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | | | - Yu Ueda
- MR Clinical Science, Philips Japan, Ltd
| | - Yuki Makino
- Department of Radiological Technology, Kanazawa University Hospital
| | - Tosiaki Miyati
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | | | - Satoshi Kobayashi
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University.,Department of Radiology, Kanazawa University Hospital.,Department of Radiological Technology, Kanazawa University Hospital
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242
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Kim SE, Parker DL, Roberts JA, Treiman GS, Alexander M, Baradaran H, de Havenon A, McNally JS. Differentiation of symptomatic and asymptomatic carotid intraplaque hemorrhage using 3D high-resolution diffusion-weighted stack of stars imaging. NMR Biomed 2021; 34:e4582. [PMID: 34296793 DOI: 10.1002/nbm.4582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Ischemic events related to carotid disease are far more strongly associated with plaque instability than stenosis. 3D high-resolution diffusion-weighted (DW) imaging can provide quantitative diffusion measurements on carotid atherosclerosis and may improve detection of vulnerable intraplaque hemorrhage (IPH). The 3D DW-stack of stars (SOS) sequence was implemented with 3D SOS acquisition combined with DW preparation. After simulation of signals created from 3D DW-SOS, phantom studies were performed. Three healthy subjects and 20 patients with carotid disease were recruited. Apparent diffusion coefficient (ADC) values were statistically analyzed on three subgroups by using a two-group comparison Wilcoxon-Mann-Whitney U test with p values less than 0.05: symptomatic versus asymptomatic; IPH-positive versus IPH-negative; and IPH-positive symptomatic versus asymptomatic plaques to determine the relationship with plaque vulnerability. ADC values calculated by 3D DW-SOS provided values similar to those calculated from other techniques. Mean ADC of symptomatic plaque was significantly lower than asymptomatic plaque (0.68 ± 0.18 vs. 0.98 ± 0.16 x 10-3 mm2 /s, p < 0.001). ADC was also significantly lower in IPH-positive versus IPH-negative plaque (0.68 ± 0.13 vs. 1.04 ± 0.11 x 10-3 mm2 /s, p < 0.001). Additionally, ADC was significantly lower in symptomatic versus asymptomatic IPH-positive plaque (0.57 ± 0.09 vs. 0.75 ± 0.11 x 10-3 mm2 /s, p < 0.001). Our results provide strong evidence that ADC measurements from 3D DW-SOS correlate with the symptomatic status of extracranial internal carotid artery plaque. Further, ADC improved discrimination of symptomatic plaque in IPH. These data suggest that diffusion characteristics may improve detection of destabilized plaque leading to elevated stroke risk.
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Affiliation(s)
- Seong-Eun Kim
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Dennis L Parker
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - John A Roberts
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Gerald S Treiman
- Department of Veterans Affairs, VASLCHCS, Salt Lake City, Utah, USA
| | - Matthew Alexander
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Hediyeh Baradaran
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Adam de Havenon
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - J Scott McNally
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
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243
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Kristensen TD, Glenthøj LB, Ambrosen K, Syeda W, Raghava JM, Krakauer K, Wenneberg C, Fagerlund B, Pantelis C, Glenthøj BY, Nordentoft M, Ebdrup BH. Global fractional anisotropy predicts transition to psychosis after 12 months in individuals at ultra-high risk for psychosis. Acta Psychiatr Scand 2021; 144:448-463. [PMID: 34333760 DOI: 10.1111/acps.13355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Psychosis spectrum disorders are associated with cerebral changes, but the prognostic value and clinical utility of these findings are unclear. Here, we applied a multivariate statistical model to examine the predictive accuracy of global white matter fractional anisotropy (FA) for transition to psychosis in individuals at ultra-high risk for psychosis (UHR). METHODS 110 UHR individuals underwent 3 Tesla diffusion-weighted imaging and clinical assessments at baseline, and after 6 and 12 months. Using logistic regression, we examined the reliability of global FA at baseline as a predictor for psychosis transition after 12 months. We tested the predictive accuracy, sensitivity and specificity of global FA in a multivariate prediction model accounting for potential confounders to FA (head motion in scanner, age, gender, antipsychotic medication, parental socioeconomic status and activity level). In secondary analyses, we tested FA as a predictor of clinical symptoms and functional level using multivariate linear regression. RESULTS Ten UHR individuals had transitioned to psychosis after 12 months (9%). The model reliably predicted transition at 12 months (χ2 = 17.595, p = 0.040), accounted for 15-33% of the variance in transition outcome with a sensitivity of 0.70, a specificity of 0.88 and AUC of 0.87. Global FA predicted level of UHR symptoms (R2 = 0.055, F = 6.084, p = 0.016) and functional level (R2 = 0.040, F = 4.57, p = 0.036) at 6 months, but not at 12 months. CONCLUSION Global FA provided prognostic information on clinical outcome and symptom course of UHR individuals. Our findings suggest that the application of prediction models including neuroimaging data can inform clinical management on risk for psychosis transition.
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Affiliation(s)
- Tina D Kristensen
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Louise B Glenthøj
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Karen Ambrosen
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Warda Syeda
- Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, Melbourne, Vic., Australia
| | - Jayachandra M Raghava
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Glostrup, Denmark
| | - Kristine Krakauer
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Christina Wenneberg
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | - Birgitte Fagerlund
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christos Pantelis
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne, Melbourne, Vic., Australia
| | - Birte Y Glenthøj
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn H Ebdrup
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark.,Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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244
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Zhou X, Su Y, Huang W, Lin X, Xing Z, Cao D. Differentiation between supratentorial pilocytic astrocytoma and extraventricular ependymoma using multiparametric MRI. Acta Radiol 2021; 63:1661-1668. [PMID: 34709088 DOI: 10.1177/02841851211054195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The differentiation of supratentorial pilocytic astrocytomas (STPAs) and supratentorial extraventricular ependymomas (STEEs) is clinically pivotal because of distinct therapeutic management and prognosis, which is sometimes challenging to both neuroradiologists and pathologists. PURPOSE To explore and compare the conventional and advanced magnetic resonance imaging (MRI) features between STPA and STEE. MATERIAL AND METHODS A total of 23 patients with STPAs and 23 patients with STEEs were reviewed in this study. All patients performed conventional MRI, susceptibility-weighted imaging (SWI), and diffusion-weighted imaging (DWI), and 34 patients (17 with STPAs and 17 with STEEs) examined dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) in addition. Clinical data, conventional MRI features, minimum relative apparent diffusion coefficient ratio (rADCmin), and maximum relative cerebral blood volume ratio (rCBVmax) were compared between the two groups and subgroups. The optimal cutoff values of rADCmin and rCBVmax with sensitivity and specificity were calculated. RESULTS STPA manifested similar to STEE as a solid-cystic mass but more frequently presented with a marked enhancing deep nodule (P = 0.02), no peritumoral edema (P = 0.036), higher rADCmin value (2.0 ± 0.5 vs. 0.9 ± 0.2; P < 0.001), and lower rCBVmax value (2.1 ± 0.4 vs. 14.4 ± 5.5; P < 0.001). The cutoff value of >1.39 for rADCmin and ≤ 2.81 for rCBVmax produced a high sensitivity of 95.65% and 100.0%, respectively, and all produced a specificity of 100.0% in differentiating STPAs from STEEs. CONCLUSION Multiparametric MRI techniques including conventional MRI, DWI, and DSC-PWI contribute to the differential diagnosis of STPA and STEE.
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Affiliation(s)
- Xiaofang Zhou
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China
| | - Yan Su
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China
| | - Wanrong Huang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China
| | - Xiaojun Lin
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China
| | - Zhen Xing
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China
- Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, PR China
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, PR China
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245
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Cluceru J, Interian Y, Phillips JJ, Molinaro AM, Luks TL, Alcaide-Leon P, Olson MP, Nair D, LaFontaine M, Shai A, Chunduru P, Pedoia V, Villanueva-Meyer JE, Chang SM, Lupo JM. Improving the noninvasive classification of glioma genetic subtype with deep learning and diffusion-weighted imaging. Neuro Oncol 2021; 24:639-652. [PMID: 34653254 DOI: 10.1093/neuonc/noab238] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Diagnostic classification of diffuse gliomas now requires an assessment of molecular features, often including IDH-mutation and 1p19q-codeletion status. Because genetic testing requires an invasive process, an alternative noninvasive approach is attractive, particularly if resection is not recommended. The goal of this study was to evaluate the effects of training strategy and incorporation of biologically relevant images on predicting genetic subtypes with deep learning. METHODS Our dataset consisted of 384 patients with newly-diagnosed gliomas who underwent preoperative MR imaging with standard anatomical and diffusion-weighted imaging, and 147 patients from an external cohort with anatomical imaging. Using tissue samples acquired during surgery, each glioma was classified into IDH-wildtype (IDHwt), IDH-mutant/1p19q-noncodeleted (IDHmut-intact), and IDH-mutant/1p19q-codeleted (IDHmut-codel) subgroups. After optimizing training parameters, top performing convolutional neural network (CNN) classifiers were trained, validated, and tested using combinations of anatomical and diffusion MRI with either a 3-class or tiered structure. Generalization to an external cohort was assessed using anatomical imaging models. RESULTS The best model used a 3-class CNN containing diffusion-weighted imaging as an input, achieving 85.7% (95% CI:[77.1,100]) overall test accuracy and correctly classifying 95.2%, 88.9%, 60.0% of the IDHwt, IDHmut-intact, and IDHmut-codel tumors. In general, 3-class models outperformed tiered approaches by 13.5-17.5%, and models that included diffusion-weighted imaging were 5-8.8% more accurate than those that used only anatomical imaging. CONCLUSION Training a classifier to predict both IDH-mutation and 1p19q-codeletion status outperformed a tiered structure that first predicted IDH-mutation, then1p19q-codeletion. Including ADC, a surrogate marker of cellularity, more accurately captured differences between subgroups.
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Affiliation(s)
- Julia Cluceru
- Department of Radiology & Biomedical Imaging, University of California San Francisco
| | | | - Joanna J Phillips
- Department of Neurological Surgery, University of California San Francisco.,Department of Pathology, University of California San Francisco
| | - Annette M Molinaro
- Department of Neurological Surgery, University of California San Francisco
| | - Tracy L Luks
- Department of Radiology & Biomedical Imaging, University of California San Francisco
| | - Paula Alcaide-Leon
- Department of Radiology & Biomedical Imaging, University of California San Francisco.,Department of Medical Imaging, University of Toronto
| | - Marram P Olson
- Department of Radiology & Biomedical Imaging, University of California San Francisco
| | - Devika Nair
- Department of Radiology & Biomedical Imaging, University of California San Francisco
| | - Marisa LaFontaine
- Department of Radiology & Biomedical Imaging, University of California San Francisco
| | - Anny Shai
- Department of Neurological Surgery, University of California San Francisco
| | - Pranathi Chunduru
- Department of Neurological Surgery, University of California San Francisco
| | - Valentina Pedoia
- Department of Radiology & Biomedical Imaging, University of California San Francisco
| | | | - Susan M Chang
- Department of Neurological Surgery, University of California San Francisco
| | - Janine M Lupo
- Department of Radiology & Biomedical Imaging, University of California San Francisco
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246
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Lee YJ, Kim SH, Kang BJ, Son YH, Grimm R. Associations between angiogenic factors and intravoxel incoherent motion-derived parameters in diffusion-weighted magnetic resonance imaging of breast cancer. Medicine (Baltimore) 2021; 100:e27495. [PMID: 34731130 PMCID: PMC8519258 DOI: 10.1097/md.0000000000027495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/23/2021] [Indexed: 01/05/2023] Open
Abstract
Intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) can be used to estimate perfusion-related parameters, but these parameters may differ, based on the curve-fitting algorithm used for IVIM. Microvessel density (MVD) and vascular endothelial growth factor (VEGF) status are used as angiogenic factors in breast cancer. We aimed to investigate the relationship between MVD, VEGF, and intravoxel incoherent motion (IVIM)-derived parameters, obtained by 4 curve-fitting algorithms, in patients with invasive breast cancers.This retrospective study investigated IVIM-derived parameters, D (ie, tissue diffusivity), D∗ (ie, pseudodiffusivity), and f (ie, perfusion fraction), of 55 breast cancers, using 10 b values (range, 0-800 s/mm2) and 4 curve-fitting algorithms: algorithm 1, linear fitting of D and f first, followed by D∗; algorithm 2, linear fitting of D and f and nonlinear fitting of D∗; algorithm 3, linear fitting of D and f, linear fitting of D∗, and ignoring D contribution for low b values; and algorithm 4, full nonlinear fitting of D, f, and D∗. We evaluated whole-tumor histograms of D, f, and D∗ for their association with MVD and VEGF.D∗10, D∗25, D∗50, D∗mean, D∗75, D∗90, f10, and f25, derived using algorithm 3, were associated with VEGF expression (P = .043, P = 0.012, P = .019, P = .024, P = .044, P = .041, P = .010, and P = .005, respectively). However, no correlation existed between MVD and IVIM-derived parameters.Perfusion-related IVIM parameters obtained by curve-fitting algorithm 3 may reflect VEGF expression.
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Affiliation(s)
- Youn Joo Lee
- Department of Radiology, Daejeon St. Mary's Hospital, Daejeon
| | - Sung Hun Kim
- Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea
| | - Bong Joo Kang
- Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea
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247
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Ramírez-Toraño F, Abbas K, Bruña R, Marcos de Pedro S, Gómez-Ruiz N, Barabash A, Pereda E, Marcos A, López-Higes R, Maestu F, Goñi J. A Structural Connectivity Disruption One Decade before the Typical Age for Dementia: A Study in Healthy Subjects with Family History of Alzheimer's Disease. Cereb Cortex Commun 2021; 2:tgab051. [PMID: 34647029 PMCID: PMC8501268 DOI: 10.1093/texcom/tgab051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/23/2022] Open
Abstract
The concept of the brain has shifted to a complex system where different subnetworks support the human cognitive functions. Neurodegenerative diseases would affect the interactions among these subnetworks and, the evolution of impairment and the subnetworks involved would be unique for each neurodegenerative disease. In this study, we seek for structural connectivity traits associated with the family history of Alzheimer’s disease, that is, early signs of subnetworks impairment due to Alzheimer’s disease. The sample in this study consisted of 123 first-degree Alzheimer’s disease relatives and 61 nonrelatives. For each subject, structural connectomes were obtained using classical diffusion tensor imaging measures and different resolutions of cortical parcellation. For the whole sample, independent structural-connectome-traits were obtained under the framework of connICA. Finally, we tested the association of the structural-connectome-traits with different factors of relevance for Alzheimer’s disease by means of a multiple linear regression. The analysis revealed a structural-connectome-trait obtained from fractional anisotropy associated with the family history of Alzheimer’s disease. The structural-connectome-trait presents a reduced fractional anisotropy pattern in first-degree relatives in the tracts connecting posterior areas and temporal areas. The family history of Alzheimer’s disease structural-connectome-trait presents a posterior–posterior and posterior–temporal pattern, supplying new evidences to the cascading network failure model.
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Affiliation(s)
- F Ramírez-Toraño
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid 28223, Comunidad de Madrid, Spain
| | - Kausar Abbas
- Purdue Institute for Integrative Neuroscience, Purdue University, West-Lafayette, IN 46202, USA
| | - Ricardo Bruña
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid 28223, Comunidad de Madrid, Spain
| | - Silvia Marcos de Pedro
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid 28223, Comunidad de Madrid, Spain
| | - Natividad Gómez-Ruiz
- Sección Neurorradiología, Servicio de Diagnóstico por Imagen, Hospital Clínico San Carlos, Madrid 28040, Comunidad de Madrid, Spain
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clinico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid 28040, Comunidad de Madrid, Spain
| | - Ernesto Pereda
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid 28223, Comunidad de Madrid, Spain
| | - Alberto Marcos
- Neurology Department, Hospital Clinico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid 28040, Comunidad de Madrid, Spain
| | - Ramón López-Higes
- Department of Experimental Psychology, Universidad Complutense de Madrid, Madrid 28223, Comunidad de Madrid, Spain
| | - Fernando Maestu
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid 28223, Comunidad de Madrid, Spain
| | - Joaquín Goñi
- Purdue Institute for Integrative Neuroscience, Purdue University, West-Lafayette, IN 46202, USA
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248
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Ogura A, Kawabata K, Watanabe H, Choy SW, Bagarinao E, Kato T, Imai K, Masuda M, Ohdake R, Hara K, Nakamura R, Atsuta N, Nakamura T, Katsuno M, Sobue G. Fiber-specific white matter analysis reflects upper motor neuron impairment in amyotrophic lateral sclerosis. Eur J Neurol 2021; 29:432-440. [PMID: 34632672 DOI: 10.1111/ene.15136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE To clarify the relationship between fiber-specific white matter changes in amyotrophic lateral sclerosis (ALS) and clinical signs of upper motor neuron (UMN) involvement, we performed a fixel-based analysis (FBA), a novel framework for diffusion-weighted imaging analysis. METHODS We enrolled 96 participants, including 48 nonfamilial ALS patients and 48 age- and sex-matched healthy controls (HCs), in this study and conducted whole-brain FBA and voxel-based morphometry analysis. We compared the fiber density (FD), fiber morphology (fiber cross-section [FC]), and a combined index of FD and FC (FDC) between the ALS and HC groups. We performed a tract-of-interest analysis to extract FD values across the significant regions in the whole-brain analysis. Then, we evaluated the associations between FD values and clinical variables. RESULTS The bilateral corticospinal tracts (CSTs) and the corpus callosum (CC) showed reduced FD and FDC in ALS patients compared with HCs (p < 0.05, familywise error-corrected), and the comparison of FCs revealed no region that was significantly different from another. Voxel-based morphometry showed cortical volume reduction in the regions, including the primary motor area. Clinical scores showed correlations with FD values in the CSTs (UMN score: rho = -0.530, p < 0.001; central motor conduction time [CMCT] in the upper limb: rho = -0.474, p = 0.008; disease duration: rho = -0.383, p = 0.007; ALS Functional Rating Scale-Revised: rho = 0.340, p = 0.018). In addition, patients whose CMCT was not calculated due to unevoked waves also showed FD reduction in the CSTs. CONCLUSIONS Our findings suggest that FD values in the CST estimated via FBA can be potentially used in evaluating UMN impairments.
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Affiliation(s)
- Aya Ogura
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuya Kawabata
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hirohisa Watanabe
- Brain and Mind Research Center, Nagoya University, Nagoya, Japan.,Department of Neurology, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Shao Wei Choy
- Center for Intelligent Signal and Imaging Research, Universiti Teknologi PETRONAS, Seri Iskandar, Malaysia
| | - Epifanio Bagarinao
- Brain and Mind Research Center, Nagoya University, Nagoya, Japan.,Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshiyasu Kato
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazunori Imai
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michihito Masuda
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Reiko Ohdake
- Brain and Mind Research Center, Nagoya University, Nagoya, Japan
| | - Kazuhiro Hara
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryoichi Nakamura
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoki Atsuta
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomohiko Nakamura
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Gen Sobue
- Brain and Mind Research Center, Nagoya University, Nagoya, Japan.,Research Division of Dementia and Neurodegenerative Disease, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Aichi Medical University, Nagakute, Japan
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249
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Michels L, Stämpfli P, Aldusary N, Piccirelli M, Freund P, Weber KP, Fierz FC, Kollias S, Traber G. Widespread White Matter Alterations in Patients With Visual Snow Syndrome. Front Neurol 2021; 12:723805. [PMID: 34621237 PMCID: PMC8490630 DOI: 10.3389/fneur.2021.723805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Visual snow is considered a disorder of central visual processing resulting in a perturbed perception of constant binocular flickering or pixilation of the whole visual field. The underlying neurophysiological and structural alterations remain elusive. Methods: In this study, we included patients (final n = 14, five dropouts; five females, mean age: 32 years) with visual snow syndrome (VSS) and age- and sex-matched controls (final n = 20, 6 dropouts, 13 females, mean age: 28.2 years). We applied diffusion tensor imaging to examine possible white matter (WM) alterations in patients with VSS. Results: The patient group demonstrated higher (p-corrected < 0.05, adjusted for age and sex) fractional anisotropy (FA) and lower mean diffusivity (MD) and radial diffusivity (RD) compared to controls. These changes were seen in the prefrontal WM (including the inferior fronto-occipital fascicle), temporal and occipital WM, superior and middle longitudinal fascicle, and sagittal stratum. When additionally corrected for migraine or tinnitus-dominant comorbidities in VSS-similar group differences were seen for FA and RD, but less pronounced. Conclusions: Our results indicate that patients with VSS present WM alterations in parts of the visual cortex and outside the visual cortex. As parts of the inferior fronto-occipital fascicle and sagittal stratum are associated with visual processing and visual conceptualisation, our results suggest that the WM alterations in these regions may indicate atypical visual processing in patients with VSS. Yet, the frequent presence of migraine and other comorbidities such as tinnitus in VSS makes it difficult to attribute WM disruptions solely to VSS.
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Affiliation(s)
- Lars Michels
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Njoud Aldusary
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | | | - Konrad P Weber
- Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Fabienne C Fierz
- Department of Ophthalmology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Spyros Kollias
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Ghislaine Traber
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland.,Department of Ophthalmology, University of Basel, Basel, Switzerland
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250
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Møller JM, Andreasen CM, Buus TW, Pedersen SJ, Østergaard M, Thomsen HS, Jurik AG. Diffusion-weighted MR imaging in chronic non-bacterial osteitis: Proof-of-concept of the apparent diffusion coefficient as an outcome measure. Acta Radiol Open 2021; 10:20584601211044478. [PMID: 34616565 PMCID: PMC8489758 DOI: 10.1177/20584601211044478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 08/19/2021] [Indexed: 11/16/2022] Open
Abstract
Background The apparent diffusion coefficient (ADC), as determined by whole-body diffusion-weighted MRI, may be useful as an outcome measure for monitoring response to treatment in chronic non-bacterial osteitis. Purpose To test and demonstrate the feasibility of ADC-measurement methods for use as outcome measure in chronic non-bacterial osteitis. Materials and Methods Using data from a randomized pilot study, feasibility of change-score ADC between baseline and second MRI (ΔADC12) and third MRI (ΔADC13) as outcome measure was assessed in three settings: “whole-lesion,” “single-slice per lesion,” and “index-lesion per patient”. Bone marrow edema lesions were depicted on short tau inversion recovery sequence at baseline and copied to ADC maps at the three time-points. Correlations between the three settings were measured as were analysis of variances. Discriminant validity was assessed as inter- and intra-observer reproducibility and smallest detectable change. Results 12 subjects were enrolled, and MRI was performed at baseline and weeks 12 and 36. Pearson correlation was high (r > 0.86; p ≤ 0.01) for ΔADC between single-slice—whole-lesion and whole-lesion—index-lesion and tended to be significant for single-slice—index-lesion settings (p = 0.06). For ΔADC12 and ΔADC13, Bland–Altman plots showed small differences (0.02, 0.03) and narrow 95% limits-of-agreement (−0.13–0.09, −0.07–0.05 μm2/s) between whole-lesion and single-slice ROI settings. Inter-observer reproducibility measured by intra-class correlation coefficient was poor-to-fair (range: 0.09–0.31), whereas intra-observer reproducibility was good-to-excellent (range: 0.67–0.90). Smallest detectable changes were between 0.21–0.28 μm2/s. Conclusion ADC change-score as outcome measure was feasible, and the single-slice per lesion ROI setting performed almost equally to whole-lesion setting resulting in reduced assessment time.
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Affiliation(s)
- Jakob M Møller
- Department of Radiology, Herlev-Gentofte Hospital, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Caroline M Andreasen
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Medicine, Rheumatology, Vejle Hospital, Vejle, Denmark
| | - Thomas W Buus
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - Mikkel Østergaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - Henrik S Thomsen
- Department of Radiology, Herlev-Gentofte Hospital, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne G Jurik
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
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