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Sharma U, Agarwal K, Hari S, Mathur SR, Seenu V, Parshad R, Jagannathan NR. Role of diffusion weighted imaging and magnetic resonance spectroscopy in breast cancer patients with indeterminate dynamic contrast enhanced magnetic resonance imaging findings. Magn Reson Imaging 2019; 61:66-72. [PMID: 31128225 DOI: 10.1016/j.mri.2019.05.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE Dynamic contrast enhanced MRI (DCEMRI), diffusion weighted imaging (DWI) and in vivo proton (1H) magnetic resonance spectroscopy (MRS) provides functional and molecular nature of breast cancer. This study evaluates the potential of the combination of three MR parameters [curve kinetics, apparent diffusion coefficient (ADC) and total choline (tCho) concentration] determined from these techniques in increasing the sensitivity of breast cancer detection. METHODS MR investigations were carried out at 1.5 T on 56 patients with cytologically/histologically confirmed breast carcinoma. Single-voxel MRS was used to determine the tCho concentration. 3D FLASH was used for DCEMRI while single shot EPI based DWI was used for ADC determination. RESULTS On DCEMRI, one patient showed type I curve, while 8 showed type II and 47 showed type III curve thus giving a sensitivity of 83.9% as detection rate of malignancy. tCho concentration was above cut-off value (2.54 mmol/kg) for 50/56 cases giving a sensitivity of 89.3%. Among 9 indeterminate DCEMRI cases, tCho showed malignancy in 6 cases with type II curve. DWI detected malignancy in 54/56 cases that included 9 cases that were false negative on DCEMRI, yielding a sensitivity of 96.4%. A total of 54 cases showed malignancy when any two of the three MR parameters was positive for malignancy yielding a sensitivity of 96.4% while it increased to 100% when any one parameters showed positive result. CONCLUSION DWI showed highest sensitivity of detection compared to DCEMRI and MRS. Multi-parametric approach yielded 96.4% and 100% sensitivity when any two or one of the three parameters was taken as positive for malignancy, respectively. Also the results demonstrated that addition of DWI and MRS play a significant role in establishing the final diagnosis of malignancy, especially in cases where DCEMRI is indeterminate.
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252
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Sun C, Zhou S, Cui Z, Zhang Y, Wang H, Jiang J, Lu F, Ma X. The evaluation on neural status of cervical spinal cord in normal and Hirayama disease using diffusion tensor imaging. Eur Spine J 2019; 28:1872-1878. [PMID: 31111335 DOI: 10.1007/s00586-019-06013-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 03/02/2019] [Accepted: 05/13/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE To explore the changes in diffusion tensor imaging (DTI) parameters in cervical spinal cord in Hirayama disease (HD) patients and healthy volunteers and to compare these parameters between cervical flexion and neutral positions in HD patients. METHODS Seventeen male patients with HD and eleven healthy young males were included to receive DTI scans in cervical flexion and neutral positions. The FA and ADC values of different levels were measured based on the region of interest drawn on the mid-sagittal plane. The dynamic compressed level's parameters were defined as the lowest and the second lowest FA and the highest and the second highest ADC, respectively. The clinical assessment of patients was obtained using their disabilities of the arm, shoulder and hand (DASH) scores. RESULTS For the HD patients, the FA values in the cervical flexion position were lower and the ADC values were much higher than those in the cervical neutral position. Compared with the controls, the ADC values were significantly higher in the lower levels (C5/6-C7/T1) and the FA values obviously lower at C7/T1 in HD patients in cervical neutral position. The FA and ADC values of the dynamic compressed level in HD patients deviated significantly from the average of the lower levels in controls. Both the FA and ADC values of the dynamic compressed level correlated with the DASH scores (FA, R2 = 0.520, P = 0.001; ADC, R2 = 0.421, P = 0.005). CONCLUSIONS DTI parameters can support a hypothesis of dynamic cervical flexion compression and noninvasively reveal the neural status of HD patients. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Chi Sun
- Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Shuyi Zhou
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhongyi Cui
- Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuxuan Zhang
- Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongli Wang
- Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China.
| | - Jianyuan Jiang
- Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China.
| | - Feizhou Lu
- Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China.,The Fifth People' s Hospital of Shanghai, Fudan University, Shanghai, China
| | - Xiaosheng Ma
- Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, China
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Huang TX, Lu N, Lian SS, Li H, Yin SH, Geng ZJ, Xie CM. The primary lesion apparent diffusion coefficient is a prognostic factor for locoregionally advanced nasopharyngeal carcinoma: a retrospective study. BMC Cancer 2019; 19:470. [PMID: 31101029 PMCID: PMC6525458 DOI: 10.1186/s12885-019-5684-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 11/17/2018] [Accepted: 05/08/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND To explore prognostic value of the pre-treatment primary lesion apparent diffusion coefficient (ADC) in locoregionally advanced nasopharyngeal carcinoma (LA-NPC). METHODS A total of 843 patients with newly diagnosed LA-NPC were enrolled from January 2011 to April 2014 and divided into two groups based on ADC values: the low-ADC group and high-ADC group. The 3-year local relapse-free survival (LRFS), distant metastasis free survival (DMFS), disease-free survival (DFS) and overall survival (OS) rates between two groups were compared using Kaplan-Meier curve, and Cox regression analyses were performed to test prognostic value of the pretreatment ADC in LA-NPC. RESULTS The cut-off value of the pretreatment ADC for predicting local relapse was 784.5 × 10- 6 mm2/s (AUC [area under curve] = 0.604; sensitivity = 0.640; specificity = 0.574), thus patients were divided into low-ADC (< 784.5 × 10- 6; n = 473) group and high-ADC (≥784.5 × 10- 6; n = 370) group. The low-ADC group had significantly higher 3-year LRFS rate and DFS rate than the high-ADC group (LRFS: 96.2% vs. 91.4%, P = 0.003; DFS: 81.4% vs. 73.0%, P = 0.0056). Multivariate analysis showed that the pretreatment ADC is an independent prognostic factor for LRFS (HR, 2.04; 95% CI, 1.13-3.66; P = 0.017) and DFS (HR, 1.41; 95% CI, 1.04-1.89; P = 0.024). CONCLUSIONS The pretreatment ADC of the primary lesion is an independent prognostic factor for LRFS and DFS in LA-NPC patients.
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Affiliation(s)
- Tao-Xiang Huang
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China.,Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University (SYSU), No 600, Tianhe Road, Guangzhou, Guangdong, 510630,, People's Republic of China
| | - Nian Lu
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China
| | - Shan-Shan Lian
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China
| | - Hui Li
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China
| | - Shao-Han Yin
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China
| | - Zhi-Jun Geng
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China
| | - Chuan-Miao Xie
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China.
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Payabvash S, Chan A, Jabehdar Maralani P, Malhotra A. Quantitative diffusion magnetic resonance imaging for prediction of human papillomavirus status in head and neck squamous-cell carcinoma: A systematic review and meta-analysis. Neuroradiol J 2019; 32:232-240. [PMID: 31084347 DOI: 10.1177/1971400919849808] [Citation(s) in RCA: 15] [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: 12/13/2022] Open
Abstract
PURPOSE Head and neck squamous-cell carcinoma (HNSCC) related to human papillomavirus (HPV) infection represents a distinct biological and prognostic subtype compared to the HPV-negative form. Prior studies suggest a correlation between the apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI) of primary tumor lesion and HPV status in HNSCC. In this meta-analysis, we compared the average ADC of primary lesion between HPV-positive and HPV-negative HNSCC. METHODS A comprehensive literature search of PubMed and Embase was performed. Studies comparing the average ADC on echo-planar DWI of primary tumor lesions between HPV-positive and HPV-negative HNSCC were included. The standardized mean difference was calculated using fixed- and random-effects models. Tau-squared estimates of total heterogeneity and Higgins inconsistency index (I2 test) were determined. RESULTS A total of five studies, pooling data of 264 patients, were included for meta-analysis. Among these five studies, three had included oral cavity, hypopharyngeal, and/or laryngeal HNSCC in addition to oropharyngeal subsite. Primary lesions were comprised of 185 HPV-negative and 79 HPV-positive HNSCC. The meta-analysis showed lower average ADC values in HPV-positive HNSCC compared to the HPV-negative form, with a standardized mean difference of 0.961 (95% confidence interval 0.644-1.279; p < 0.0001). Since there was no significant heterogeneity in analysis (p = 0.3852), both random- and fixed-effects models resulted in the same estimates of overall effect. CONCLUSIONS HPV-positive HNSCC primary lesions have a lower average ADC compared to the HPV-negative form, highlighting the potential application of quantitative diffusion magnetic resonance imaging as a noninvasive imaging biomarker for prediction of HPV status.
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Affiliation(s)
| | - Aimee Chan
- 2 Department of Medical Imaging, University of Toronto, Canada
| | | | - Ajay Malhotra
- 1 Department of Radiology and Biomedical Imaging, Yale School of Medicine, USA
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Buemi F, Guzzardi G, Del Sette B, Sponghini AP, Matheoud R, Soligo E, Trisoglio A, Carriero A, Stecco A. Apparent diffusion coefficient and tumor volume measurements help stratify progression-free survival of bevacizumab-treated patients with recurrent glioblastoma multiforme. Neuroradiol J 2019; 32:241-249. [PMID: 31066622 DOI: 10.1177/1971400919847184] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 01/15/2023] Open
Abstract
BACKGROUND The aim of this study was to determine whether apparent diffusion coefficient (ADC) bi-component curve-fitting histogram analysis and volume percentage change (VPC) prior to bevacizumab treatment can stratify progression-free survival (PFS) and overall survival (OS) in patients with glioblastoma multiforme (GBM) on first recurrence. METHODS We retrospectively evaluated 17 patients with recurrent GBM who received bevacizumab and fotemustine (n = 13) or only bevacizumab (n = 4) on first recurrence at our institution between December 2009 and July 2015. Both T2/FLAIR abnormalities and enhancing tumor on T1 images were mapped to the ADC images. ADC-L and ADC-M values were obtained trough bi-Gaussian curve fitting histogram analysis. Furthermore, the study population was dichotomized into two subgroups: patients displaying a reduction in enhancing tumor volume of either >55% or <55% between the mean value calculated at baseline and first follow-up. Subsequently, a second dichotomization was performed according to a reduction in the T2 / FLAIR volume >41% or <41% at first check after treatment. OS and PFS were assessed using volume parameters in a Cox regression model adjusted for significant clinical parameters. RESULTS In univariate analysis, contrast-enhanced (CE)-ADC-L was significantly predictive of PFS (p = 0.01) and OS (p = 0.03). When we dichotomized our sample using the 55% cut-off for enhancing tumor volume, CE-VPC was able to predict PFS (p = 0.01) but not OS (p = 0.08). In multivariate analysis, only the CE-ADC-L was predictive of PFS (p = 0.01), albeit not predictive of OS (p = 0.14). CE-ADC-M, T2/FLAIR-ADC-L, T2/FLAIR-ADC, and T2/FLAIR VPC were not significantly predictive of PFS and OS (p > 0.05) in both univariate and multivariate analysis. CONCLUSIONS CE-ADC and CE-VPC can stratify PFS for patients with recurrent glioblastoma prior to bevacizumab treatment.
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Affiliation(s)
| | - Giuseppe Guzzardi
- 2 Radiology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
| | - Bruno Del Sette
- 2 Radiology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
| | - Andrea P Sponghini
- 3 Oncology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
| | - Roberta Matheoud
- 4 Medical Physics Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
| | - Eleonora Soligo
- 2 Radiology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
| | - Alessandra Trisoglio
- 2 Radiology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
| | - Alessandro Carriero
- 2 Radiology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
| | - Alessandro Stecco
- 2 Radiology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
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Schwartz C, Lenski M, Romagna A, Schichor C, Tonn JC, Brueckmann H, Janssen H, Liebig T, Forbrig R, Thon N. Diffusion-weighted magnetic resonance imaging for detection of postoperative intracranial pyogenic abscesses in neurosurgery. Acta Neurochir (Wien) 2019; 161:985-93. [PMID: 30915573 DOI: 10.1007/s00701-019-03875-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 03/08/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging (MRI-DWI) is the modality of choice for detecting intracranial abscesses; however, it is unclear whether prior brain surgery has an influence on its diagnostic value. Thus, we assessed the robustness of MRI-DWI and determination of an ADC cutoff value for detecting intracranial abscesses in patients who underwent brain surgery. METHODS We retrospectively evaluated 19 patients prior to surgery for postoperative supratentorial parenchymal abscesses by means of MRI-DWI. Forty randomly selected patients with routine postoperative MRI-DWI were used for comparative analyses. Clinical and serum biomarkers (C-reactive protein, interleukin-6, white blood cell count) as well as from results of early postoperative imaging findings (computed tomography and/or MRI scan) were recorded. Additionally, ADC values, T1±gadolinium, and T2/fluid-attenuated inversion recovery sequences were investigated. RESULTS After initial surgery, early postoperative control imaging showed evidence of hemorrhage and/or hemostatic agents within the resection cavity in 10/19 patients of the abscess group and in 16/40 patients of the control group. No postoperative ischemia was detected. Neither hemostatic agents nor blood affected the mean ADC values in both the reference group (blood 2.96 ± 0.22 × 10-3 mm2/s vs. no blood 2.95 ± 0.26 × 10-3 mm2/s, p = 0.076) and in the abscess group (blood 0.87 ± 0.07 × 10-3 mm2/s vs. no blood 0.76 ± 0.06 × 10-3 mm2/s, p = 0.128). The mean ADC value within the resection cavity was significantly lower in the abscess group (1.5 T 0.88 ± 0.41 vs. 2.88 ± 0.20 × 10-3 mm2/s, p < .01; 3.0 T 0.75 ± 0.24 vs. 3.02 ± 0.26 × 10-3 mm2/s, p < 0.01). The optimal ADC cut-off for the differentiation of an abscess from normal postoperative findings was found at 1.87 × 10-3 mm2/s (area-under-the-curve 1.0, sensitivity = 100%, specificity = 100%). Moreover, no differences between the abscess patients and the control group were seen with respect to the analyzed serum biomarkers. CONCLUSION MRI-DWI provides a robust tool to discriminate postoperative abscess formation from normal postoperative changes.
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Li H, Li A, Zhu H, Hu Y, Li J, Xia L, Hu D, Kamel IR, Li Z. Whole-Tumor Quantitative Apparent Diffusion Coefficient Histogram and Texture Analysis to Differentiation of Minimal Fat Angiomyolipoma from Clear Cell Renal Cell Carcinoma. Acad Radiol 2019; 26:632-9. [PMID: 30087067 DOI: 10.1016/j.acra.2018.06.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/12/2018] [Accepted: 06/15/2018] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the diagnostic value of whole-tumor quantitative apparent diffusion coefficient (ADC) histogram and texture analysis for differentiation of minimal fat angiomyolipoma (MFAML) from clear cell renal cell carcinoma (ccRCC). MATERIALS AND METHODS We retrospectively reviewed 27 patients with MFAML and 113 patients with ccRCC pathologically proven. All patients performed magnetic resonance imaging (MRI) including diffusion-weighted imaging (b = 0, 800s/mm2). Whole-tumor regions of interest were drawn on all slices of diffusion-weighted imaging to obtain histogram and texture parameters, including the mean ADC, median ADC, 10th, 25th, 75th, 90th percentiles ADC, standard deviation, skewness, kurtosis, and entropy. The Student's t test was used to compare the parameters between MFAML and ccRCC. Receiver operating characteristic curves analysis was used to compare the diagnostic value of each significant parameter. RESULTS MFAML had significantly lower mean ADC, median ADC, 10th, 25th, 75th, 90th percentiles ADC than ccRCC (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, respectively). Skewness of MFAML was significantly higher than that of ccRCC (p = 0.016). However, standard deviation, kurtosis, and entropy were not significantly different (p = 0.409, p = 0.085, p = 0.206, respectively). The 90th percentile ADC generated the highest AUC (AUC, 0.854; Sensitivity, 78.8%; Specificity, 81.5%) for differentiating MFAML from ccRCC. CONCLUSION Whole-tumor ADC histogram and texture analysis could be considered a useful and noninvasive method to help differentiate MFAML of ccRCC with higher accuracy.
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Traverso A, Kazmierski M, Shi Z, Kalendralis P, Welch M, Nissen HD, Jaffray D, Dekker A, Wee L. Stability of radiomic features of apparent diffusion coefficient (ADC) maps for locally advanced rectal cancer in response to image pre-processing. Phys Med 2019; 61:44-51. [PMID: 31151578 DOI: 10.1016/j.ejmp.2019.04.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 12/03/2018] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 12/14/2022] Open
Abstract
Quantitative imaging features (radiomics) extracted from apparent diffusion coefficient (ADC) maps of rectal cancer patients can provide additional information to support treatment decision. Most available radiomic computational packages allow extraction of hundreds to thousands of features. However, two major factors can influence the reproducibility of radiomic features: interobserver variability, and imaging filtering applied prior to features extraction. In this exploratory study we seek to determine to what extent various commonly-used features are reproducible with regards to the mentioned factors using ADC maps from two different clinics (56 patients). Features derived from intensity distribution histograms are less sensitive to manual tumour delineation differences, noise in ADC images, pixel size resampling and intensity discretization. Shape features appear to be strongly affected by delineation quality. On the whole, textural features appear to be poorly or moderately reproducible with respect to the image pre-processing perturbations we reproduced.
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Affiliation(s)
- Alberto Traverso
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, The Netherlands; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada.
| | - Michal Kazmierski
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, The Netherlands
| | - Zhenwei Shi
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, The Netherlands
| | - Petros Kalendralis
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, The Netherlands
| | - Mattea Welch
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
| | | | - David Jaffray
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Andre Dekker
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, The Netherlands
| | - Leonard Wee
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, The Netherlands
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Ho JC, Fang P, Cardenas CE, Mohamed ASR, Fuller CD, Allen PK, Bhosale PR, Frumovitz MM, Jhingran A, Klopp AH. Volumetric assessment of apparent diffusion coefficient predicts outcome following chemoradiation for cervical cancer. Radiother Oncol 2019; 135:58-64. [PMID: 31015171 DOI: 10.1016/j.radonc.2019.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 10/31/2018] [Revised: 02/11/2019] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the utility of volumetric diffusion weighted imaging (DWI) compared to other clinical factors for predicting recurrence and survival in cervical cancer patients treated with definitive chemoradiation. METHODS AND MATERIALS We retrospectively studied cervical cancer patients treated with definitive chemoradiation between 2009-2013 at a single institution with a baseline MRI with DWI and 18F-FDG positron emission tomography/computed tomography (FDG-PET) scan. To identify clinical and imaging metrics correlated with survival and recurrence endpoints, variable importance values were calculated from random forest models. To provide clinically relevant threshold values, recursive partitioning analysis dichotomized patients into potential risk groups based on selected metrics. Cox's proportional hazard models assessed the effect of clinical and imaging factors on survival endpoints. RESULTS Ninety-three patients were included in the analysis (median age 50 years). At a median follow-up of 35.6 months, 32 patients (34%) had disease recurrence. In the best multivariate model including clinical and imaging parameters, 90th percentile ADC < 1.917 was the only significantly associated factor with worse progression free survival (PFS). Overall survival, PFS, and distant metastasis free survival (DMFS) were significantly different between patient groups divided on 90th percentile ADC with threshold of 1.917 × 10-3 mm2/s and MRI volume with threshold of 18.9 cc (P = 0.037, P = 0.0002, P = 0.001). High MRI volume and low ADC were associated with worse clinical outcomes. CONCLUSIONS Volumetric 90th percentile ADC value of the primary tumor on pretreatment MRI was a significant predictor of PFS and DMFS in cervical cancer patients, independent of established clinical factors and SUV on FDG-PET.
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Affiliation(s)
- Jennifer C Ho
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Penny Fang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Carlos E Cardenas
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Abdallah S R Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Pamela K Allen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Priya R Bhosale
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Michael M Frumovitz
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Anuja Jhingran
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Ann H Klopp
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
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Shen Y, Lv F, Xiao Z, Bi Q. Utility of the relative apparent diffusion coefficient for preoperative assessment of low risk endometrial carcinoma. Clin Imaging 2019; 56:28-32. [PMID: 30851496 DOI: 10.1016/j.clinimag.2019.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/03/2019] [Revised: 02/11/2019] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Lymphadenectomy is not recommended for low risk stage I endometrial carcinoma (EC) patients. This study was to investigate the predictive value of apparent diffusion coefficient (ADC) values in predicting patients with low risk EC, and to identify an optimum ADC measurement for preoperative assessment. MATERIALS AND METHODS Eighty-one patients with stage I EC who underwent diffusion-weighted imaging (DWI) at 1.5T were included and divided into low group and intermediate-high risk group based on the ESMO-ESGO-ESTRO classification. Clinical indexes, conventional MRI parameters, minimum ADC values (minADC), mean ADC values (meanADC) and relative ADC values (rADC) were compared between those two groups. rADC was calculated using the equation ADC (cancer)/ADC (reference) with the obturator internus muscle as reference. The optimal ADC measurement and cut-off ADC value for low risk EC were calculated using the receiver operating characteristic (ROC) curve. RESULTS The low risk group had significantly higher meanADC, minADC, and rADC values than did the intermediate-high risk group (1.095 vs. 0.902 × 10-3 mm2/s, 0.755 vs. 0.657 × 10-3 mm2/s, 0.754 vs. 0.603, respectively). In assessments of low risk EC patients, the area under the curve (AUC) values for meanADC, minADC, and rADC were 0.840 (95%CI, 0.749,0.931), 0.681 (95% CI: 0.561,0.800), and 0.876(95% CI: 0.798,0.954), respectively. The optimal cut-off rADC value for prediction was 0.669, the maximum Youden index, sensitivity, specificity, and accuracy values were 0.683, 81.8%, 86.5%, and 84.0%, respectively. CONCLUSIONS rADC is superior to minADC and meanADC for predicting patients with low risk EC, and could potentially aid to the surgical management of these patients in avoiding unnecessary lymphadenectomy.
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Affiliation(s)
- Yiqing Shen
- Department of Radiology, the First Affiliated Hospital of Chongqing, Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China
| | - Fajin Lv
- Department of Radiology, the First Affiliated Hospital of Chongqing, Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China.
| | - Zhibo Xiao
- Department of Radiology, the First Affiliated Hospital of Chongqing, Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China
| | - Qiu Bi
- Department of Radiology, the First Affiliated Hospital of Chongqing, Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China
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Maetani Y, Nakamori M, Imamura E, Ishii Y, Aihara H, Suyama Y, Wakabayashi S, Maruyama H. Utility of Minimum Apparent Diffusion Coefficient Ratios in Alberta Stroke Program Early CT Score Regions for Deciding on Stroke Therapy. J Stroke Cerebrovasc Dis 2019; 28:1371-1380. [PMID: 30803784 DOI: 10.1016/j.jstrokecerebrovasdis.2019.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/12/2019] [Revised: 01/28/2019] [Accepted: 02/05/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND AND PURPOSE Therapeutic indications for recombinant tissue plasminogen activator therapy and endovascular therapy need to be assessed for patients with hyperacute ischemic stroke. We investigated the relationship between the minimum apparent diffusion coefficient ratios in each Alberta Stroke Program Early CT Score region and reversible lesion in patients with hyperacute ischemic stroke receiving recombinant tissue plasminogen activator therapy and/or treated with endovascular therapy. MATERIALS AND METHODS We retrospectively evaluated 29 patients with first ischemic stroke due to stenosis/occlusion of the internal carotid artery or horizontal portion of the middle cerebral artery that was successfully recanalized by recombinant tissue plasminogen activator therapy and/or treated with endovascular therapy. We measured the minimum apparent diffusion coefficient value in each Alberta Stroke Program Early CT Score region (11 regions) and calculated the ratio. RESULTS There was a significant difference in minimum apparent diffusion coefficient ratios between regions that included and did not include infarction (P < .0001), which were distinguishable with a cutoff value of .808 (area under the curve = .80, P < .001). A statistical difference in the proportion of infarction with the cutoff value was observed between patients treated with endovascular therapy and receiving recombinant tissue plasminogen activator therapy alone (9.9% versus 24.6%, P = .0041) and between patients with affected middle cerebral and internal carotid arteries (7.0% versus 24.2%, P = .0002). The lowest apparent diffusion coefficient ratio was associated with the time to recombinant tissue plasminogen activator injection. CONCLUSIONS Minimum apparent diffusion coefficient ratios in Alberta Stroke Program Early CT Score regions are useful in predicting therapeutic effect.
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Affiliation(s)
- Yuta Maetani
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan; Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Masahiro Nakamori
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan.
| | - Eiji Imamura
- Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Yosuke Ishii
- Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Hiroshi Aihara
- Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | - Yoshio Suyama
- Department of Neurosurgery, Suiseikai Kajikawa Hospital, Hiroshima, Japan
| | | | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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262
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Zhang AD, Wang YF, Shi GF, Han C, Zhang J, Wang L, Liu H, Li Y. [Predictive value of diffusion-weighted magnetic resonance imaging in patients with esophageal carcinoma treated with radiotherapy: an animal trial]. Zhonghua Zhong Liu Za Zhi 2019; 41:102-106. [PMID: 30862138 DOI: 10.3760/cma.j.issn.0253-3766.2019.02.005] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the value of diffusion-weighted magnetic resonance imaging (MR-DWI) technique in predicting the efficacy of radiotherapy in patients with esophageal cancer, using experimental animal models. Methods: BALB/c nude mice were subcutaneously injected with Eca-109 cell lines and then tumor formed. The experimental group (16 cases) received a single dose of 15 Gy (6 MV X-rays) delivered by a medical linear accelerator, while the control group (24 cases) did not receive any treatment. The two groups were scanned every other day, started one day before the radiotherapy. The scanning sequences included T1-weight imaging, T2-weight imaging, and DWI. The observation time was 1 month. According to the changes of the tumor volume and apparent diffusion coefficient (ADC) value of the two groups, 7 key time points were selected to observe the difference of cell density and tissue necrosis ratio between the two groups (6 cases in each group). Results: From day 7 after radiotherapy, the experimental group had statistically smaller volume of transplanted tumors than the control group, namely (1.729±0.906) cm(3) vs (2.671±0.915) cm(3)(P<0.05). From day 3 after radiotherapy, the experimental group had statistically higher ADC values [(1.017±0.255)×10(-6) vs (0.833±0.142)×10(-6) mm(2)/s, P<0.05], lower cell density of transplanted tumor (25.56±1.40 vs 33.48±4.18%, P<0.05), and less proportion of tissue necrosis [(32.19±1.21) % vs (29.16±2.16)%, P<0.05], respectively. The ADC value was negatively correlated with cell density (r=-0.703, P<0.001) and positively correlated with tissue necrosis ratio (r=0.658, P=0.003). Conclusions: Single dose of large fraction radiotherapy could inhibit the growth of xenograft. ADC values may change at the early stage prior to morphological changes of tumor. The change of cell density and necrosis ratio of transplanted tumor are in line with the change of ADC value. MR-DWI has the value of early prediction of esophageal cancer radiotherapy efficacy.
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Affiliation(s)
- A D Zhang
- Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y F Wang
- Department of CT and MRI, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - G F Shi
- Department of CT and MRI, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - C Han
- Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - J Zhang
- Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - L Wang
- Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - H Liu
- Department of CT and MRI, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Li
- Department of CT and MRI, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
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263
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Sureka B, Rai B, Varshney V, Nag VL, Garg MK, Garg PK, Yadav T, Khera PS, Goel A. Quantitative diffusion-weighted magnetic resonance imaging for prediction of early infection in pancreatic collections: Results of a pilot study. Saudi J Gastroenterol 2019; 26:20-25. [PMID: 31997778 PMCID: PMC7045770 DOI: 10.4103/sjg.sjg_411_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND/AIMS The development of infection in pancreatitis increases the mortality rate up to 32%. Therefore, it is important to identify patients who are at high risk of developing infection, at an early stage. The objectives of the study were (a) to analyze the quantitative parameters of diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) in infected as well as sterile pancreatic collections (b) to establish "cut-off" values for ADC that can identify infected pancreatic collections. MATERIALS AND METHODS Prospective observational study of pancreatitis cases who underwent DW-MRI from August 2018 to July 2019 were enrolled in the study. The collections were analyzed for diffusion restriction. The average of the three ADC values from the wall and center of collection was noted. RESULTS Infected collections were seen in 7 and sterile collections observed in 11 cases. The optimal cut-off ADC value to differentiate sterile and infected collection in our study was 1.651 × 10-3 mm2/s (sensitivity of 81.8%; specificity of 100.0%). ROC curve for mean ADC from the wall showed a significant diagnostic accuracy with AUC: 0.91; 95% CI: 0.77-1.0 (P = 0.004). CONCLUSION DW-MRI is a reliable noninvasive technique to differentiate sterile and infected pancreatic collections. ADC values from the periphery of the collection can predict infected pancreatic collections at an early stage. DW-MRI should not be considered as a substitute for aspiration cytology in patients with septic symptoms and absent diffusion restriction on MRI.
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Affiliation(s)
- Binit Sureka
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India,Address for correspondence: Dr. Binit Sureka, Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur - 342 005, Rajasthan, India. E-mail:
| | - Balwant Rai
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Vaibhav Varshney
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Vijaya L. Nag
- Department of Microbiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Mahendra K. Garg
- Department of General Medicine, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Pawan K. Garg
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Taruna Yadav
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Pushpinder S. Khera
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Akhil Goel
- Department of Community Medicine, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
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264
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Giordano M, Samii A, Samii M, Nabavi A. Magnetic Resonance Imaging- Apparent Diffusion Coefficient Assessment of Vestibular Schwannomas: Systematic Approach, Methodology, and Pitfalls. World Neurosurg 2019; 125:e820-e823. [PMID: 30738940 DOI: 10.1016/j.wneu.2019.01.176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Received: 12/10/2018] [Revised: 01/17/2019] [Accepted: 01/19/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To investigate the validity of various approaches to extract quantitative measurements of diffusion imaging (i.e., apparent diffusion coefficient [ADC]) to investigate tumors of the central nervous system. In current studies, the region of interest (ROI) for the quantitative measurements are placed arbitrarily according to morphology. Our aim is to investigate how placement patterns influence the ADC estimation in intracranial tumors. METHODS Twenty consecutive patients affected by vestibular schwannoma were studied using diffusion imaging. ADC values were obtained using different ROI placement methods: segmentation ADC values of the entire volume (vADC), random ADC values were obtained in 10 different ROI points, and a single ROI in the ADC of the internal auditory canal portion of the tumor. RESULTS ADC of the internal auditory canal portion of the tumor and vADC differed significantly (P < 0.01). vADC was different between cystic and microcystic schwannomas (P = 0.009) and between cystic and solid schwannomas (P = 0.006). CONCLUSIONS The positioning of ROI in these measurements is pivotal. Although "whole tumor volume" measurements represent the largest amount of information, multiple seed points can be used as well. However, there must be multiple seeds and their placement must be reported. ADC can be used as a versatile tool for tumor assessment but must be used judiciously and structured to yield comparable results.
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Affiliation(s)
- Mario Giordano
- Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany.
| | - Amir Samii
- Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany; Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Madjid Samii
- Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany
| | - Arya Nabavi
- Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany
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265
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Rowland MJ, Ezra M, Winkler A, Garry P, Lamb C, Kelly M, Okell TW, Westbrook J, Wise RG, Douaud G, Pattinson KT. Calcium channel blockade with nimodipine reverses MRI evidence of cerebral oedema following acute hypoxia. J Cereb Blood Flow Metab 2019; 39:285-301. [PMID: 28857714 PMCID: PMC6360646 DOI: 10.1177/0271678x17726624] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Indexed: 11/19/2022]
Abstract
Acute cerebral hypoxia causes rapid calcium shifts leading to neuronal damage and death. Calcium channel antagonists improve outcomes in some clinical conditions, but mechanisms remain unclear. In 18 healthy participants we: (i) quantified with multiparametric MRI the effect of hypoxia on the thalamus, a region particularly sensitive to hypoxia, and on the whole brain in general; (ii) investigated how calcium channel antagonism with the drug nimodipine affects the brain response to hypoxia. Hypoxia resulted in a significant decrease in apparent diffusion coefficient (ADC), a measure particularly sensitive to cell swelling, in a widespread network of regions across the brain, and the thalamus in particular. In hypoxia, nimodipine significantly increased ADC in the same brain regions, normalizing ADC towards normoxia baseline. There was positive correlation between blood nimodipine levels and ADC change. In the thalamus, there was a significant decrease in the amplitude of low frequency fluctuations (ALFF) in resting state functional MRI and an apparent increase of grey matter volume in hypoxia, with the ALFF partially normalized towards normoxia baseline with nimodipine. This study provides further evidence that the brain response to acute hypoxia is mediated by calcium, and importantly that manipulation of intracellular calcium flux following hypoxia may reduce cerebral cytotoxic oedema.
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Affiliation(s)
- Matthew J Rowland
- 1 Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,2 FMRIB, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,3 Neurosciences Intensive Care Unit, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Martyn Ezra
- 1 Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,2 FMRIB, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,3 Neurosciences Intensive Care Unit, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Anderson Winkler
- 2 FMRIB, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Payashi Garry
- 1 Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,3 Neurosciences Intensive Care Unit, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Catherine Lamb
- 3 Neurosciences Intensive Care Unit, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Michael Kelly
- 4 Preclinical Imaging Facility, Core Biotechnology Services, University of Leicester, Leicester, UK
| | - Thomas W Okell
- 2 FMRIB, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Jon Westbrook
- 1 Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,3 Neurosciences Intensive Care Unit, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Richard G Wise
- 5 Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, UK
| | - Gwenaëlle Douaud
- 2 FMRIB, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Kyle Ts Pattinson
- 1 Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,2 FMRIB, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,3 Neurosciences Intensive Care Unit, Oxford University Hospitals NHS Trust, Oxford, UK
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266
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Peschmann AL, Beer M, Ammann B, Dreyhaupt J, Kneer K, Beer AJ, Beltinger C, Steinbach D, Cario H, Neubauer H. Quantitative DWI predicts event-free survival in children with neuroblastic tumours: preliminary findings from a retrospective cohort study. Eur Radiol Exp 2019; 3:6. [PMID: 30701332 PMCID: PMC6353978 DOI: 10.1186/s41747-019-0087-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 08/31/2018] [Accepted: 01/04/2019] [Indexed: 01/18/2023] Open
Abstract
Background Quantitative diffusion-weighted imaging (DWI) probes into tissue microstructure in solid tumours. In this retrospective ethically approved study, we investigated DWI as a potential non-invasive predictor of tumour dignity and prognosis in paediatric patients with neuroblastic tumours. Methods Nineteen consecutive patients with neuroblastoma (NB, n = 15), ganglioneuroblastoma (GNB, n = 1) and ganglioneuroma (GN, n = 3) underwent 3-T magnetic resonance imaging at first diagnosis and after 3-month follow-up, following a protocol including DWI (b = 50 and 800 s/mm2) in addition to standard sequences. All DWI scans were analysed for tumour volume assessment and apparent diffusion coefficient (ADC) calculation. Correlation with tumour pathology and risk factors (bone-marrow metastases, MYCN-amplification and 1p-deletion), therapeutic regime (observation versus chemotherapy) and clinical follow-up was evaluated. Results At baseline, mean ADC in NB was lower than in GNB/GN (0.76 vs. 1.47 × 10−3 mm2/s, p = 0.003). An ADC cutoff ≤ 1.05 identified malignant disease with 100.0% sensitivity (95% confidence interval [CI] 29.2–100.0%) and 93.8% specificity (95% CI 69.8–99.8%). Initial ADC was < 0.80 in all NB patients with eventual tumour relapse. During follow-up, tumour ADC values increased in the observation group (NB/GN) without relapse (p = 0.043). In eventually relapsing tumours, ADC values at follow-up tended to decrease further despite reduction in tumour volume. Conclusions ADC values at first presentation differed significantly between malignant and benign neuroblastic tumours. Low baseline ADC was predictive of tumour progression and relapse in NB patients. With therapy, increasing ADC values appeared to predict relapse-free survival, while a decreasing ADC during therapy was an indicator of poor prognosis.
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Affiliation(s)
- Anna-Lydia Peschmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Schweitzer-Allee 23, 89081, Ulm, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Schweitzer-Allee 23, 89081, Ulm, Germany
| | - Bettina Ammann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Schweitzer-Allee 23, 89081, Ulm, Germany
| | - Jens Dreyhaupt
- Department of Biometrics, University Hospital Ulm, 89081, Ulm, Germany
| | - Katharina Kneer
- Department of Nuclear Medicine, University Hospital Ulm, 89081, Ulm, Germany
| | - Ambros J Beer
- Department of Nuclear Medicine, University Hospital Ulm, 89081, Ulm, Germany
| | - Christian Beltinger
- Department of Paediatrics and Adolescent Medicine, University Hospital Ulm, 89081, Ulm, Germany
| | - Daniel Steinbach
- Department of Paediatrics and Adolescent Medicine, University Hospital Ulm, 89081, Ulm, Germany
| | - Holger Cario
- Department of Paediatrics and Adolescent Medicine, University Hospital Ulm, 89081, Ulm, Germany
| | - Henning Neubauer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Schweitzer-Allee 23, 89081, Ulm, Germany.
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267
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Surov A, Meyer HJ, Wienke A. Correlations between Apparent Diffusion Coefficient and Gleason Score in Prostate Cancer: A Systematic Review. Eur Urol Oncol 2019; 3:489-497. [PMID: 31412009 DOI: 10.1016/j.euo.2018.12.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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] [Received: 08/03/2018] [Revised: 11/29/2018] [Accepted: 12/07/2018] [Indexed: 01/29/2023]
Abstract
BACKGROUND Reported data regarding the associations between apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) and Gleason score in prostate cancer (PC) are inconsistent. OBJECTIVE The aim of the present systematic review was to analyze relationships between ADC and Gleason score in PC. DESIGN, SETTING, AND PARTICIPANTS MEDLINE library, SCOPUS, and EMBASE databases were screened for relationships between ADC and Gleason score in PC up to April 2018. Overall, 39 studies with 2457 patients were identified. Data on the following parameters were extracted from the literature: number of patients, cancer localization, and correlation coefficients between ADC and Gleason score. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Associations between ADC and Gleason score were analyzed by the Spearman's correlation coefficient. RESULTS AND LIMITATIONS In overall sample, the pooled correlation coefficient between ADC and Gleason score was -0.45 (95% confidence interval [CI]=[-0.50; -0.40]). In PC in the transitional zone, the pooled correlation coefficient was -0.22 (95% CI=[-0.47; 0.03]). In PC in the peripheral zone, the pooled correlation coefficient was -0.48 (95% CI=[-0.54; -0.42]). CONCLUSIONS In PC located in the peripheral zone, ADC correlated moderately with Gleason score. In PC located in the transitional zone, ADC correlated weakly with Gleason score. PATIENT SUMMARY We reviewed studies using apparent diffusion coefficient for the prediction of Gleason score in prostate cancer patients.
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Affiliation(s)
- Alexey Surov
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany.
| | - Hans Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
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268
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He W, Xiao X, Li X, Guo Y, Guo L, Liu X, Xu Y, Zhou J, Wu Y. Whole-tumor histogram analysis of apparent diffusion coefficient in differentiating intracranial solitary fibrous tumor/hemangiopericytoma from angiomatous meningioma. Eur J Radiol 2019; 112:186-191. [PMID: 30777209 DOI: 10.1016/j.ejrad.2019.01.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 10/28/2018] [Revised: 01/16/2019] [Accepted: 01/21/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE To assess the role of histogram analysis of apparent diffusion coefficient (ADC) maps based on whole-tumor in differentiating intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC) from angiomatous meningioma (AM). MATERIALS AND METHODS Pathologically confirmed intracranial SFT/HPC (n = 15) and AM (n = 20) were retrospectively collected and their clinical and conventional MRI features were analyzed. Diffusion-weighted (DW) images (b = 0 and 1000 s/mm2) were processed with the mono-exponential model. Regions of interest covering the whole tumor were drawn on all slices of the ADC maps to obtain histogram parameters, including mean ADC (ADCmean), median ADC (ADCmedian), maximum ADC (ADCmax), minimum ADC (ADCmin), skewness and kurtosis, as well as the 5th, 10th, 25th, 75th, 90th and 95th percentile ADC (ADC5, ADC10, ADC25, ADC75, ADC90 and ADC95). Differences of histogram parameters between SFT/HPC and AM were compared using Mann-Whitney U test. Receiver operating characteristic (ROC) curve was used to determine the diagnostic performance. RESULTS The ADCmin (P = 0.001) and ADC5 (P = 0.045) were significantly lower in SFT/HPCs than in AMs, while no significant difference was found in sex, age, conventional MRI features or any other histogram parameters between the two entities (P = 0.051-1.000). ADCmin showed the best diagnostic performance (area under curve [AUC], 0.86; sensitivity, 81.3%; specificity, 83.3%) in differentiating SFT/HPC from AM with optimal cutoff value being 569.00 × 10-6 mm2/s, followed by ADC5 (AUC, 0.72; sensitivity, 68.8%; specificity, 75%) with optimal cutoff value being 781.97 × 10-6 mm2/s. CONCLUSION SFT/HPC and AM share similar conventional MR appearances. Whole-tumor histogram analysis of ADC maps may be a useful tool for differential diagnosis, with ADCmin and ADC5 being potential parameters.
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Affiliation(s)
- Wenle He
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Xiang Xiao
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Xiaodan Li
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yihao Guo
- Faculty of Biomedical Engineering, Guangdong Provincial Key Laborary of Medical Image Processing, Southern Medical University, Guangzhou 510515, China
| | - Liuji Guo
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Xiaomin Liu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yikai Xu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Jun Zhou
- Department of Pathology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yuankui Wu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
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269
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Abstract
Apparent diffusion coefficient (ADC), derived from diffusion-weighted magnetic resonance images (DW-MRI), measures the motion of water molecules in vivo and can be used to quantify tumor response so as to determine the best therapy approach. In this paper, our goal was to determine whether the DW-MRI can be used for qualitative and quantitative liver cancer analysis, where an automated method will be proposed for improving the accuracy of liver segmentation in DW-MRI to increase the ability of diagnosis of disease. We firstly analyzed the research status of liver cancer diagnosis, especially on the issues of liver image segmentation technology in MRI. Then, the imaging mechanism and image features of the DW-MRI were analyzed, and the initial DW-MRI slice was segmented by graph-cut algorithm. Finally, our obtained result from the liver DW-MRI image is quantitatively and qualitatively analyzed. Experimental results show that DW-MRI has a great advantage in the diagnosis, the DWI images of benign lesion group was lower than that of malignant lesion, thus DW-MRI is segmented by graph-cut algorithm can provide important additional information regarding differential diagnosis of specific liver cancer to some extend.
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Affiliation(s)
| | - Yue Yang
- Tongde hospital of Zhejiang province, Zhejiang, 310012, Hangzhou, China.
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270
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Tokunaga A, Imagawa A, Nishio H, Hayata S, Shimomura I, Abiru N, Awata T, Ikegami H, Uchigata Y, Oikawa Y, Osawa H, Kajio H, Kawasaki E, Kawabata Y, Kozawa J, Shimada A, Takahashi K, Tanaka S, Chujo D, Fukui T, Miura J, Yasuda K, Yasuda H, Kobayashi T, Hanafusa T; consultation of Japan Diabetes Society Committee on Fulminant Type 1 Diabetes Mellitus Research. Diffusion-weighted magnetic resonance imaging in the pancreas of fulminant type 1 diabetes. Diabetol Int 2018; 9:257-65. [PMID: 30603375 DOI: 10.1007/s13340-018-0355-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 04/04/2018] [Indexed: 12/16/2022]
Abstract
Abrupt disease onset and severe metabolic disorders are main characteristics of fulminant type 1 diabetes. Diffusion-weighted magnetic resonance imaging (DWI) is an imaging technique that reflects restricted diffusion in organs and can detect mononuclear cell infiltration into the pancreas at the onset of the disease. Fourteen patients with fulminant type 1 diabetes who underwent abdominal magnetic resonance imaging were recruited for the measurement of apparent diffusion coefficient (ADC) values of the pancreas that were compared with those of 21 non-diabetic controls. The ADC values of all parts of the pancreas were significantly lower in fulminant type 1 diabetes than in controls (head, 1.424 ± 0.382 × 10-3 vs. 1.675 ± 0.227 × 10-3 mm2/s; body, 1.399 ± 0.317 × 10-3 vs. 1.667 ± 0.170 × 10-3 mm2/s; tail, 1.336 ± 0.247 × 10-3 vs. 1.561 ± 0.191 × 10-3 mm2/s; mean, 1.386 ± 0.309 × 10-3 vs. 1.634 ± 0.175 × 10-3 mm2/s) (p < 0.01). The best cut-off value indicated that the sensitivity was 86% and the specificity was 71% when using DWI, which was also efficient in two atypical patients with fulminant type 1 diabetes without elevated levels of exocrine pancreatic enzymes or with high HbA1c levels due to the preexistence of type 2 diabetes. The ADC values were significantly correlated to plasma glucose levels and arterial pH, and tended to increase with the lapse of time. DWI may be an additional tool for making an efficient diagnosis of fulminant type 1 diabetes.
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271
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Al-Sharydah AM, Al-Arfaj HK, Saleh Al-Muhaish H, Al-Suhaibani SS, Al-Aftan MS, Almedallah DK, Al-Abdulwahhab AH, Al-Hedaithy AA, Al-Jubran SA. Can apparent diffusion coefficient values help distinguish between different types of pediatric brain tumors? Eur J Radiol Open 2019; 6:49-55. [PMID: 30627595 PMCID: PMC6321863 DOI: 10.1016/j.ejro.2018.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/09/2018] [Accepted: 12/17/2018] [Indexed: 11/29/2022] Open
Abstract
Rationale and objectives Classifying brain tumors is challenging, but recently developed imaging techniques offer the opportunity for neuroradiologists and neurosurgeons to diagnose, differentiate, and manage different types of brain tumors. Such advances will be reflected in improvements in patients’ life expectancy and quality of life. Among the newest techniques, the apparent diffusion coefficient (ADC), which tracks the rate of microscopic water diffusion within tissues, has become a focus of investigation. Recently, ADC has been used as a preoperative diffusion-weighted magnetic resonance imaging (MRI) parameter that facilitates tumor diagnosis and grading. Here, we aimed to determine the ADC cutoff values for pediatric brain tumors (PBTs) categorized according to the World Health Organization (WHO) classification of brain tumors. Materials and methods We retrospectively reviewed 80 cases, and assessed them based on their MRI-derived ADC. These results were compared with those of WHO classification-based histopathology. Results Whole-lesion ADC values ranged 0.225–1.240 × 10−3 mm2/s for ependymal tumors, 0.107–1.571 × 10−3 mm2/s for embryonal tumors, 0.1065–2.37801 × 10−3 mm2/s for diffuse astrocytic and oligodendroglial tumors, 0.5220–0.7840 × 10−3 mm2/s for other astrocytic tumors, and 0.1530–0.8160 × 10−3 mm2/s for meningiomas. These findings revealed the usefulness of ADC in the differential diagnosis of PBT, as it was able to discriminate between five types of PBTs. Conclusion The application of an ADC diagnostic criterion would reduce the need for spectroscopic analysis. However, further research is needed to implement ADC in the differential diagnosis of PBT.
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Affiliation(s)
- Abdulaziz Mohammad Al-Sharydah
- Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Al-Khobar City, Eastern Province, Saudi Arabia
| | - Hussain Khalid Al-Arfaj
- Medical Imaging Department, King Fahad Specialist Hospital, Dammam City, Eastern Province, Saudi Arabia
| | - Husam Saleh Al-Muhaish
- Medical Imaging Department, King Fahad Specialist Hospital, Dammam City, Eastern Province, Saudi Arabia
| | - Sari Saleh Al-Suhaibani
- Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Al-Khobar City, Eastern Province, Saudi Arabia
| | - Mohammad Saad Al-Aftan
- Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Al-Khobar City, Eastern Province, Saudi Arabia
| | - Dana Khaled Almedallah
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam City, Eastern Province, Saudi Arabia
| | - Abdulrhman Hamad Al-Abdulwahhab
- Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Al-Khobar City, Eastern Province, Saudi Arabia
| | | | - Saeed Ahmad Al-Jubran
- Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Al-Khobar City, Eastern Province, Saudi Arabia
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272
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Alessandrino F, Taghipour M, Hassanzadeh E, Ziaei A, Vangel M, Fedorov A, Tempany CM, Fennessy FM. Predictive role of PI-RADSv2 and ADC parameters in differentiating Gleason pattern 3 + 4 and 4 + 3 prostate cancer. Abdom Radiol (NY) 2019; 44:279-285. [PMID: 30066169 PMCID: PMC6349548 DOI: 10.1007/s00261-018-1718-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 12/29/2022]
Abstract
PURPOSE To compare the predictive roles of qualitative (PI-RADSv2) and quantitative assessment (ADC metrics), in differentiating Gleason pattern (GP) 3 + 4 from the more aggressive GP 4 + 3 prostate cancer (PCa) using radical prostatectomy (RP) specimen as the reference standard. METHODS We retrospectively identified treatment-naïve peripheral (PZ) and transitional zone (TZ) Gleason Score 7 PCa patients who underwent multiparametric 3T prostate MRI (DWI with b value of 0,1400 and where unavailable, 0,500) and subsequent RP from 2011 to 2015. For each lesion identified on MRI, a PI-RADSv2 score was assigned by a radiologist blinded to pathology data. A PI-RADSv2 score ≤ 3 was defined as "low risk," a PI-RADSv2 score ≥ 4 as "high risk" for clinically significant PCa. Mean tumor ADC (ADCT), ADC of adjacent normal tissue (ADCN), and ADCratio (ADCT/ADCN) were calculated. Stepwise regression analysis using tumor location, ADCT and ADCratio, b value, low vs. high PI-RADSv2 score was performed to differentiate GP 3 + 4 from 4 + 3. RESULTS 119 out of 645 cases initially identified met eligibility requirements. 76 lesions were GP 3 + 4, 43 were 4 + 3. ADCratio was significantly different between the two GP groups (p = 0.001). PI-RADSv2 score ("low" vs. "high") was not significantly different between the two GP groups (p = 0.17). Regression analysis selected ADCT (p = 0.03) and ADCratio (p = 0.0007) as best predictors to differentiate GP 4 + 3 from 3 + 4. Estimated sensitivity, specificity, and accuracy of the predictive model in differentiating GP 4 + 3 from 3 + 4 were 37, 82, and 66%, respectively. CONCLUSIONS ADC metrics could differentiate GP 3 + 4 from 4 + 3 PCa with high specificity and moderate accuracy while PI-RADSv2, did not differentiate between these patterns.
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Affiliation(s)
- Francesco Alessandrino
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA.
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
| | - Mehdi Taghipour
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA
| | - Elmira Hassanzadeh
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA
- Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA
| | - Alireza Ziaei
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA
| | - Mark Vangel
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA
| | - Andriy Fedorov
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA
| | - Clare M Tempany
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA
| | - Fiona M Fennessy
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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273
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Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging (DW-MRI) has evolved as a major diagnostic and prognostic tool in cervical cancer. The aim of our study was to compare the change in mean apparent diffusion coefficient (ADC) value before and after concurrent chemoradiation therapy (CCRT) in carcinoma cervix thereby establishing its role as a cancer biomarker. MATERIALS AND METHODS A hospital-based prospective study was conducted in 35 patients diagnosed with cervical cancer. All 35 patients underwent pelvic MRI before and after 6 months of CCRT. The study was done over a period of 12 months. Conventional axial and sagittal T2 imaging was followed by DW-MRI. In the axial DW/ADC images at "b-value" of 800 s/mm2, a circular region of interest was drawn covering more than 60% of the tumor volume to calculate the ADC values. Statistical Package for the Social Sciences (version 21.0) was used for statistical evaluation. Chi-square test, independent samples t-test, and analysis of variance were used to analyze the data. The results are depicted as frequencies (number), proportion (percentages), and mean ± standard deviation. RESULTS Pre-CCRT mean ADC value was 0.814 × 10-3 mm2/s. Post-CCRT mean ADC value was 1.294 × 10-3 mm2/s. Mean ADC value of patients having lymph node involvement and parametrial extension was significantly lower when compared with those without lymph node involvement and parametrial extension (P = 0.001). Nonresponders with residual lesion had lower ADC values than responders with no residual lesion. An interesting and unique observation was that pre-CCRT mean ADC value of responders was higher than nonresponders. CONCLUSION An increase in mean ADC value of 0.480 × 10-3 mm2/s after CCRT was found to be statistically significant (P < 0.001) thereby proving its role as an imaging biomarker in cancer cervix.
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Affiliation(s)
- Sunita Dashottar
- Department of Radiology and Imaging, Command Hospital (Central Command), Lucknow, Uttar Pradesh, India
| | - T Preeth Pany
- Department of Radiology and Imaging, Command Hospital (Central Command), Lucknow, Uttar Pradesh, India
| | - Nishant Lohia
- Department of Radiation Oncology, Command Hospital (Central Command), Lucknow, Uttar Pradesh, India
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Abstract
BACKGROUND Understanding the association between MR parameters and age related deterioration in human intervertebral disks forms an important step in the development of clinical diagnostic protocols for disk disease. METHODS Ten unfixed thoracic and lumbar cadaver disk joints, age 37-81 years were imaged at 9.4 T using T2 relaxation (CPMG) and ADC (DWI spin echo) MR protocols. For each MR parameter, spatial maps were computed from the axial images, with the AF and NP segmented based on the T2 maps. Linear regression tested for the correlation between mean and variance (COV) of T2 and ADC with age in the disk, nucleus and annulus, and the effect of thoracic vs. lumbar spine on these correlations. FINDINGS In the disk, age negatively correlated with mean ADC (P < 0.001) and positively with COV of ADC (P < 0.001) and T2 (P < 0.05). Age was negatively correlated with mean T2 (P < 0.01), mean ADC (P < 0.001) and positively with COV of ADC (P < 0.001) and T2 (P < 0.05) in the NP and positively correlated with mean T2 (P < 0.05), COV of ADC (P < 0.01) and T2 (P < 0.05) and negatively with mean ADC (P < 0.05) in the AF. Compared to thoracic disks, lumbar disks showed higher mean ADC (P < 0.05), lower mean T2 (P < 0.001) and higher COV of ADC (P < 0.01) and T2 (P < 0.05). INTERPRETATION Compared to T2, MR diffusion was a more sensitive measure of age mediated changes in disk tissues. Strong differences in the association of MR parameters with age between the lumbar and thoracic suggest that mechanical environment effects tissue specific MR parameters' association with age.
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Affiliation(s)
- Ron Alkalay
- Center for Advanced Orthopaedic Studies, Department of Orthopedics, Beth Israel Deaconess Medical Center and Harvard medical School, Boston, MA, United States.
| | - Hackney David
- Department of Radiology, Beth Israel Deaconess Medical Center and Harvard medical School, Boston, MA, United States of America
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275
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Lee SL, Lee J, Craig T, Berlin A, Chung P, Ménard C, Foltz WD. Changes in apparent diffusion coefficient radiomics features during dose-painted radiotherapy and high dose rate brachytherapy for prostate cancer. Phys Imaging Radiat Oncol 2018; 9:1-6. [PMID: 33458419 PMCID: PMC7807683 DOI: 10.1016/j.phro.2018.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 11/16/2018] [Accepted: 11/19/2018] [Indexed: 01/22/2023]
Abstract
Background and purpose Dose escalation has improved cancer outcomes for patients with localized prostate cancer. Targeting subprostatic tumor regions for dose intensification may further improve outcomes. Apparent Diffusion Coefficient (ADC) maps may enable early radiation response assessment and dose adaptation. This study was a proof-of-principle investigation of early changes in ADC radiomics features for patients undergoing radiotherapy with dose escalation to the gross tumor volume (GTV). Materials and methods Fifty-nine patients were enrolled on a prospective tumor dose-escalation trial. Multi-parametric MRI was performed at baseline and week six, corresponding to the time of peak ADC change. GTV and prostate contours were deformably registered between baseline and week six T2-weighted images, and applied to ADC maps, to account for diminished image contrast post-EBRT and possible differences in prostate gland volume, shape, and orientation. A total of 101 radiomics features were tested for significant change post-EBRT using two-tailed Student's t-test. All ADC features of the prostate and GTV volumes were correlated using Pearson's coefficient (p < 0.00008, based on Bonferroni correction). Results ADC feature extraction was insensitive to b = 0 s/mm2 exclusion, and to gradient non-linearity bias. GTV presented predominant changes in first-order features, particularly 10Percentile, and prostate volumes presented predominant changes in second-order features. Changes in both first and second-order features of GTV and prostate ROIs were strongly correlated. Conclusions Our data confirmed significant changes in numerous GTV and prostate features assessed from ADC and T2-weighted images during radiotherapy; all of which may be potential biomarkers of early radiation response.
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Affiliation(s)
- Sangjune Laurence Lee
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Jenny Lee
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Tim Craig
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Alejandro Berlin
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Peter Chung
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Cynthia Ménard
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada.,Centre de Recherche du Centre Hospitalier de l Université de Montréal (CRCHUM), Montréal, Canada
| | - Warren D Foltz
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
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276
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Baranska D, Matera K, Podgorski M, Gorska-Chrzastek M, Krajewska K, Trelinska J, Grzelak P. Feasibility of diffusion-weighted imaging with DWIBS in staging Hodgkin lymphoma in pediatric patients: comparison with PET/CT. MAGMA 2018; 32:381-390. [PMID: 30498885 PMCID: PMC6525117 DOI: 10.1007/s10334-018-0726-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 11/20/2018] [Accepted: 11/22/2018] [Indexed: 12/17/2022]
Abstract
Objective The aim of the study was to evaluate feasibility of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) method in diagnosing Hodgkin lymphoma in pediatric patients and to compare it with 18F-FDG PET/CT as a gold standard. Materials and methods Eleven patients (median age 14) with newly diagnosed Hodgkin lymphoma were examined with 18F-FDG PET/CT and MRI including whole-body DWIBS sequence (b = 0, 800 s/mm2), before the oncologic treatment. About 26 locations of lymphatic tissues were evaluated visually and quantitatively using ADCmean (DWIBS) and SUVmax (18F-FDG PET/CT), respectively. Results All affected lymph node regions (n = 134) diagnosed in 18F-FDG PET/CT were found with DWIBS, presenting decreased diffusion. Significant correlation was found between ADC and SUV values (R2 = − 0.37; p = 0.0001). Nevertheless, additional 33 regions were recognized only by DWIBS. They were significantly smaller than regions diagnosed by both methods. Discussion Agreement between DWIBS and 18F-FDG PET/CT for detection and staging of malignant lymphoma is high. DWIBS can be used for the evaluation of pediatric Hodgkin lymphoma.
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Affiliation(s)
- Dobromila Baranska
- Department of Diagnostic Imaging, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, 93-338, Lodz, Poland
| | - Katarzyna Matera
- Department of Diagnostic Imaging, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, 93-338, Lodz, Poland.
| | - Michal Podgorski
- Department of Diagnostic Imaging, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, 93-338, Lodz, Poland
| | | | - Karolina Krajewska
- Department of Pediatrics, Oncology, Hematology and Diabetology Medical, University of Lodz, Pankiewicza 16, 91-738, Lodz, Poland
| | - Joanna Trelinska
- Department of Pediatrics, Oncology, Hematology and Diabetology Medical, University of Lodz, Pankiewicza 16, 91-738, Lodz, Poland
| | - Piotr Grzelak
- Department of Diagnostic Imaging, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, 93-338, Lodz, Poland
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277
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Chen L, Shen F, Li Z, Lu H, Chen Y, Wang Z, Lu J. Diffusion-weighted imaging of rectal cancer on repeatability and cancer characterization: an effect of b-value distribution study. Cancer Imaging 2018; 18:43. [PMID: 30442202 PMCID: PMC6238345 DOI: 10.1186/s40644-018-0177-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 06/11/2018] [Accepted: 11/05/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND To explore the effect of b-value distributions on the repeatability and diagnostic performance of the ADC value in rectal cancer patients using multiple b-values and mono-exponential model diffusion-weighted imaging (DWI). METHODS Thirty-two preoperative rectal cancer patients, without receiving neoadjuvant therapy, were scanned on a 3 Tesla magnetic resonance imaging scanner using DWI with 10 b-values ranging from 0 to 2000 s/mm2. The apparent diffusion coefficient (ADC) value was calculated using a mono-exponential model and 31 b-value combinations consisting of 2 to 10 b-values were explored. Regions of interest with the maximum cross-sectional tumour size were outlined on the ADC map by two independent observers. Intraclass correlation coefficients (ICC), coefficient of variation (CV), and Bland-Altman plots between the two observers were calculated and evaluated to determine repeatability. Areas under receiver operating characteristic curves (AUCs) were evaluated for rectal cancer characterization. Correlations between the mean ADC values and T stage were assessed using the Spearman correlation coefficient (ρ). α (= ICC + AUC + |ρ|- CV - |bias|) was defined and used to assess the optimal b-value distribution. RESULTS Postoperative pathology tests revealed 4 patients with T1, 10 patients with T2, and 18 patients with T3 stages. There were no significant difference in age and sex between the two groups (T1-2 vs. T3). Excellent reproducibility was observed for ADC values between two observers with ICC and CV values ranging from 0.920 to 0.998, and 1.475 to 5.568%, respectively. The mean percent difference and ρ between the paired measurements was ranged from - 2.7 to 1.2% and from - 0.759 to - 0.407, respectively. The b-value combinations with the top three α values were b(0, 1000 s/mm2), b(500, 1500, 2000 s/mm2) and b(100, 1000, 1500 s/mm2) for α = 2.581, 2.571 and 2.569, respectively. CONCLUSIONS The number of b-values and their distributions influenced the repeatability of the ADC values and their diagnostic performance. The optimal b-value combination was 0 and 1000 s/mm2 for DWI examination of rectal cancer patients.
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Affiliation(s)
- Luguang Chen
- Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No.168 Changhai Road, Shanghai, 200433, China
| | - Fu Shen
- Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No.168 Changhai Road, Shanghai, 200433, China
| | - Zhihui Li
- Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No.168 Changhai Road, Shanghai, 200433, China
| | - Haidi Lu
- Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No.168 Changhai Road, Shanghai, 200433, China
| | - Yukun Chen
- Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No.168 Changhai Road, Shanghai, 200433, China
| | - Zhen Wang
- Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No.168 Changhai Road, Shanghai, 200433, China
| | - Jianping Lu
- Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No.168 Changhai Road, Shanghai, 200433, China.
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278
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Rohilla S, Garg HK, Singh I, Yadav RK, Dhaulakhandi DB. rCBV- and ADC-based Grading of Meningiomas With Glimpse Into Emerging Molecular Diagnostics. Basic Clin Neurosci 2018; 9:417-428. [PMID: 30719256 PMCID: PMC6359681 DOI: 10.32598/bcn.9.6.417] [Citation(s) in RCA: 3] [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: 01/23/2017] [Revised: 02/25/2017] [Accepted: 05/05/2017] [Indexed: 11/20/2022] Open
Abstract
Introduction This study was conducted to grade meningiomas based on relative Cerebral Blood Volume (rCBV) and Apparent Diffusion Coefficient (ADC) to help surgeons plan the approach and extent of operation as well as decide on the need of any adjuvant radio/chemo therapy. The current and evolving genomic, proteomic, and spectroscopic technologies are also discussed which can supplement the current radiologic methods and procedures in grading meningiomas. Methods A total of 35 patients with meningioma prospectively underwent basic MR sequences (T1W, T2W, T2W/FLAIR) in axial, sagittal and coronal planes followed by Diffusion Weighted (DW) imaging having b value of 1000 (minimum ADC values used for analysis). Then, gadobenate dimeglumine/meglumine gadoterate was administered (0.1 mmol/kg at a rate of 4 mL/s) followed by saline flush (20 mL at a rate of 4 mL/s). Next, T2*W/FFE dynamic images were acquired; dynamics showing maximum fall in intensity was used for creating rCBV and relative Cerebral Blood Flow (rCBF) maps and calculating rCBV. Results Both maximum rCBV and minimum ADC within the tumor were not significant for differentiating benign from malignant meningiomas. A cut-off maximum rCBV of 2.5 mL/100 g in peritumoral edema was 75% sensitive, 84.6% specific, and 83.3% accurate in differentiating benign from malignant meningiomas. Conclusion Benign and malignant meningiomas can be differentiated based on maximum rCBV in peritumoral edema but ADC values within the tumor are insignificant in differentiating benign and malignant tumors. rCBV values within tumor, however, may be helpful in subtyping meningiomas, especially transitional and meningothelial meningiomas.
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Affiliation(s)
- Seema Rohilla
- Department of Radiodiagnosis & Imaging, Post Graduate Institute of Medical Sciences, Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Harender K Garg
- Department of Radiodiagnosis & Imaging, Post Graduate Institute of Medical Sciences, Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Ishwar Singh
- Department of Neurosurgery, Post Graduate Institute of Medical Sciences, Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Rohtas K Yadav
- Department of Radiodiagnosis & Imaging, Post Graduate Institute of Medical Sciences, Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Dhara B Dhaulakhandi
- Department of Biotechnology & Molecular Medicine, Post Graduate Institute of Medical Sciences, Regional Cancer Centre, Sharma University of Health Sciences, Rohtak, Haryana, India
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279
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Merhemic Z, Imsirovic B, Bilalovic N, Stojanov D, Boban J, Thurnher MM. Apparent diffusion coefficient reproducibility in brain tumors measured on 1.5 and 3 T clinical scanners: A pilot study. Eur J Radiol 2018; 108:249-53. [PMID: 30396664 DOI: 10.1016/j.ejrad.2018.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/04/2018] [Accepted: 10/11/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Gradient and coil systems, pulse sequence design, and imaging parameters, as well as different scanners, can influence apparent diffusion coefficient (ADC) values. The aim of this study was to evaluate the effect of two different field strengths on the reproducibility of mean absolute ADC measurements in various primary and secondary brain tumors. METHODS Fifty patients with histologically proven brain tumors were prospectively examined on two MR scanners from the same vendor, with different field strengths-1.5T and 3T-on the same day. Absolute ADC values were compared using the Wilcoxon matched-pairs signed-rank test. Inter-scanner agreement between two different fields in the same tumor was examined using correlation coefficients, and the discrepancy between the highest and the lowest mean absolute ADC values between scanners was tested using a one-way analysis of variance. Statistical significance was set at p < 0.05. RESULTS There was no statistically significant difference between mean absolute ADC values obtained on 1.5T and 3T scanners for all patients and all brain tumor types. The intratumoral difference in ADC values, averaged from two scanners in the same tumor type, ranged from 1.58 to 4.5% for 1.5T, and from 1.18 to 4.37% for 3T.Inter-scanner agreement was high, and the kappa coefficient ranged from 0.88 to 0.99, with no significant difference between obtained values on different field strengths. CONCLUSION Based on the results obtained in our study, there is no significant difference between mean absolute ADC values measured in various primary and secondary brain tumors at different field strengths (1.5 and 3.0T MR systems), in the same patient, and in the same tumor, measured on the same day.
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Magin RL, Karaman MM, Hall MG, Zhu W, Zhou XJ. Capturing complexity of the diffusion-weighted MR signal decay. Magn Reson Imaging 2018; 56:110-118. [PMID: 30314665 DOI: 10.1016/j.mri.2018.09.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 07/19/2018] [Revised: 09/26/2018] [Accepted: 09/28/2018] [Indexed: 12/12/2022]
Abstract
Diffusion-weighted MRI (dMRI) is a key component of clinical radiology. When analyzing diffusion-weighted images, radiologists often seek to infer microscopic tissue structure through measurements of the diffusion coefficient, D0 (mm2/s). This multi-scale problem is framed by the creation of diffusion models of signal decay based on physical laws, histological structure, and biophysical constraints. The purpose of this paper is to simplify the model building process by focusing on the observed decay in the effective diffusion coefficient as a function of diffusion weighting (b-value), D(b), that is often observed in complex biological tissues. We call this approach the varying diffusion curvature (VDC) model. Since this is a heuristic model, the exact functional form of this decay is not important, so here we examine a simple exponential function, D(b) = D0exp(-bD1), where D0 and D1 capture aspects of hindered and restricted diffusion, respectively. As an example of the potential of the VDC model, we applied it to dMRI data collected from normal and diseased human brain tissue using Stejskal-Tanner diffusion gradient pulses. In order to illustrate the connection between D0 and D1 and the sub-voxel structure we also analyzed dMRI data from families of Sephadex beads selected with increasing tortuosity. Finally, we applied the VDC model to dMRI simulations of nested muscle fiber phantoms whose permeability, atrophy, and fiber size distribution could be changed. These results demonstrate that the VDC model is sensitive to sub-voxel tissue structure and composition (porosity, tortuosity, and permeability), hence can capture tissue complexity in a manner that could be easily applied in clinical dMRI.
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Affiliation(s)
- Richard L Magin
- Richard and Loan Hill Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA.
| | - M Muge Karaman
- Center for Magnetic Resonance Research, University of Illinois College of Medicine, Chicago, IL 60602, USA
| | - Matt G Hall
- Institute of Child Health, University College London, London WC1N 1EH, United Kingdom
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaohong Joe Zhou
- Center for Magnetic Resonance Research and Department of Radiology, University of Illinois College of Medicine, Chicago, IL 60602, USA
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281
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Sanefuji M, Ichimiya Y, Kaku N, Sasazuki M, Yonemoto K, Torio M, Mizuguchi S, Motomura Y, Muraoka M, Lee S, Baba H, Ohkubo K, Sonoda Y, Ishizaki Y, Sakai Y, Ohga S. Vascular pathomechanism in acute encephalopathy with biphasic seizures and late reduced diffusion. J Neurol Sci 2018; 395:141-146. [PMID: 30317181 DOI: 10.1016/j.jns.2018.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 05/25/2018] [Revised: 09/30/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a childhood-onset encephalopathy, but the precise pathophysiology remains unclear. We encountered a child with Moyamoya syndrome and AESD. He exhibited left-predominant stenosis of the middle cerebral artery (MCA), and later developed broad lesions in the left hemisphere, raising the possibility that insufficient blood supply relates to formation of the lesions. To test the hypothesis, we investigated the relationship between MCA volume and lesion extent in seven AESD children without preexisting diseases. The MCA volume and lesion extent were quantified with time of flight images for construction of magnetic resonance angiography and apparent diffusion coefficient maps, respectively. Lateralization indices ([right - left]/[right + left]) of the MCA volume and lesion extent were calculated. We found that the lateralization indices were negatively correlated (r = -0.786, p = .036), that is, when the MCA volume was smaller in one side than the other side, the lesions were likely to develop more extensively in the ipsilateral side than the contralateral side. This indicates the association of insufficient blood supply with the lesions. The present study provides the first observation to suggest the involvement of vascular mechanism in AESD and has potential implications for novel therapeutic approach.
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Affiliation(s)
- Masafumi Sanefuji
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yuko Ichimiya
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Noriyuki Kaku
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Momoko Sasazuki
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kosuke Yonemoto
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Michiko Torio
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Soichi Mizuguchi
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Yoshitomo Motomura
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Mamoru Muraoka
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Sooyoung Lee
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Intensive Care, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Haruhisa Baba
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Pediatrics, National Fukuoka-Higashi Medical Center, Fukuoka, Japan
| | - Kazuhiro Ohkubo
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuri Sonoda
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshito Ishizaki
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasunari Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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282
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Vandecasteele K, Tummers P, Van Bockstal M, De Visschere P, Vercauteren T, De Gersem W, Denys H, Naert E, Makar A, De Neve W. EXclusion of non-Involved uterus from the Target Volume (EXIT-trial): an individualized treatment for locally advanced cervical cancer using modern radiotherapy and imaging techniques. BMC Cancer 2018; 18:898. [PMID: 30223802 PMCID: PMC6142314 DOI: 10.1186/s12885-018-4800-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 06/12/2018] [Accepted: 09/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background Definitive chemoradiotherapy is standard of care in locally advanced cervical cancer (LACC). Both toxicity and local relapse remain major concerns in this treatment. We hypothesize that a magnetic resonance imaging (MRI) based redefining of the radiotherapeutic target volume will lead to a reduction of acute and late toxicity. In our center, chemoradiotherapy followed by hysterectomy was implemented successfully in the past. This enables us to assess the safety of reducing the target volume but also to explore the biological effects of chemoradiation on the resected hysterectomy specimen. Methods The EXIT-trial is a phase II, single arm study aimed at LACC patients. This study evaluates whether a MRI-based exclusion of the non-tumor-bearing parts of the uterus out of the target volume results in absence of tumor in the non-high doses irradiated part of the uterus in the hysterectomy specimen. Secondary endpoints include a dosimetric comparison of dose on normal tissue when comparing study treatment plans compared to treatment of the whole uterus at high doses; acute and chronic toxicity, overall survival, local relapse- and progression-free survival. In the translational part of the study, we will evaluate the hypothesis that the baseline apparent diffusion coefficient (ADC) values of diffusion weighted MRI and its evolution 2 weeks after start of CRT, for the whole tumor as well as for intra-tumoral regions, is prognostic for residual tumor on the hysterectomy specimen. Discussion Although MRI is already used to guide target delineation in brachytherapy, the EXIT-trial is the first to use this information to guide target delineation in external beam radiotherapy. Early therapy resistance prediction using DW-MRI opens a window for early treatment adaptation or further dose-escalation on tumors/intratumoral regions at risk for treatment failure. Trial registration Belgian Registration: B670201526181 (prospectively registered, 26/11/2015); ClinicalTrials.gov Identifier: NCT03542942 (retrospectively registered, 17/5/2018).
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Affiliation(s)
- Katrien Vandecasteele
- Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Philippe Tummers
- Gynaecologic Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Mieke Van Bockstal
- Pathology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.,Pathology, Erasmus Medical Center, s-Gravendijkwal 230, 3015, Rotterdam, The Netherlands
| | - Pieter De Visschere
- Radiology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Tom Vercauteren
- Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Werner De Gersem
- Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Hannelore Denys
- Medical Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Eline Naert
- Medical Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Amin Makar
- Gynaecologic Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Wilfried De Neve
- Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
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283
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Abstract
PURPOSE This study aimed to investigate whether ADC similarity can predict microvascular invasion (MVI) in patients with bifocal hepatocellular carcinoma (HCC). MATERIALS AND METHODS Between January 2015 and September 2015, 51 patients with two HCC lesions were included. All patients underwent conventional magnetic resonance imaging including diffusion-weighted imaging (DWI) before the HCC lesions were surgically resected; the tumor specimens were examined histopathologically. Similarity between two HCC lesions regarding DWI signal intensity (SI) and ADC value was calculated as the difference between the two lesions: Value Similarity = [1-(|valuelarge lesion-valuesmall lesion|)/(valuelarge lesion + valuesmall lesion)] × 100%. Univariate and multivariate logistic regression analyses were performed to assess the presence of MVI. RESULTS Risk factors significantly related to MVI of bifocal HCC in univariate analysis were cirrhosis (P = 0.010), histological grade (P = 0.040), DWI SI similarity (P = 0.027) and ADC similarity (P = 0.003). In multivariate analysis, cirrhosis (odds ratio 0.068, P = 0.022) and ADC similarity (odds ratio 1.204, P = 0.008) were independent risk factors for MVI of bifocal HCC. CONCLUSION In patients with two HCC lesions, highly similar ADC values for the two HCC lesions may be a preoperative predictor of MVI.
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Affiliation(s)
- Chun Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Heqing Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Yibo Tang
- Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Shengxiang Rao
- Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Ruofan Sheng
- Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Yuan Ji
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
- Shanghai Institute of Medical Imaging, Shanghai, China.
- Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China.
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284
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Kim SY, Kim EK, Moon HJ, Yoon JH, Koo JS, Kim SG, Kim MJ. Association among T2 signal intensity, necrosis, ADC and Ki-67 in estrogen receptor-positive and HER2-negative invasive ductal carcinoma. Magn Reson Imaging 2018; 54:176-82. [PMID: 30172938 DOI: 10.1016/j.mri.2018.08.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 08/13/2018] [Accepted: 08/27/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE To determine whether T2 signal intensity, necrosis, and ADC values are associated with Ki-67 in patients with Estrogen Receptor (ER)-positive and Human epidermal growth factor receptor type 2 (HER2)-negative invasive ductal carcinoma (IDC). MATERIALS AND METHODS Between March 2012 and February 2013, one hundred eighty seven women with ER-positive and HER2-negative IDC who underwent breast MRI and subsequent surgery were included. Intratumoral signal intensity was evaluated based on a combination of T2-weighted (low or equal, high, or very high) and contrast-enhanced MR images (enhancement or not). Necrosis was defined as very high T2 and no enhancement. Using the analysis of variance and pairwise t-test, a model based on intratumoral signal intensity was developed to assess Ki-67 of the surgical specimen. Inter-observer agreement for the developed model was analyzed. Conventional mean and minimum apparent diffusion coefficient (ADC) measurements were performed and correlated with Ki-67. RESULTS As the grade of the developed model increased (Grade I: low or equal T2, Grade II: high T2, or necrosis < 50%, Grade III: necrosis ≥ 50%), mean Ki-67 significantly increased (Grade I to III: 12.5%, 17.6%, 45.0%, respectively; P < 0.001). Good inter-observer agreement was found for the model (κ = 0.846, P < 0.001). ADC did not show significant correlations with Ki-67 (Pearson's correlation coefficient, 0.140 [P = 0.057] for mean ADC; -0.079 [P = 0.284] for minimum ADC). CONCLUSION Intratumoral signal intensity but not ADC was associated with Ki-67 in patients with ER-positive and HER2-negative IDC.
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285
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Tang L, Li J, Li ZY, Li XT, Gong JF, Ji JF, Sun YS, Shen L. MRI in predicting the response of gastrointestinal stromal tumor to targeted therapy: a patient-based multi-parameter study. BMC Cancer 2018; 18:811. [PMID: 30103713 PMCID: PMC6088415 DOI: 10.1186/s12885-018-4606-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 09/30/2016] [Accepted: 06/18/2018] [Indexed: 01/28/2023] Open
Abstract
Background To investigate the performance of quantitative indicators of MRI in early prediction of the response of gastrointestinal stromal tumor (GIST) to targeted therapy in a patient-based study. Methods MRI examinations were performed on 62 patients with GIST using 1.5 T scanners before and at two and 12 weeks after treatment with targeted agents. The longest diameter (LD) and contrast-to-noise ratio (CNR) of the tumors were measured by T2-weighted imaging (T2WI), and the apparent diffusion coefficient (ADC) was determined using diffusion-weighted imaging (DWI). The pre-therapy and early percentage changes (%Δ) of the three parameters were compared with regard to their abilities to differentiate responder and non- responder patients, using ROC curves. Results There were 42 patients in responder and 20 in non-responder group. After two weeks of therapy, the percentage changes in the ADC and LD were significantly different between the two groups (ADC: responder 30% vs. non- responder 1%, Z = − 4.819, P < 0.001; LD: responder − 7% vs. non- responder − 2%, Z = − 3.238, P = 0.001), but not in T2WI-CNR (responder − 3% vs. non-responder 9%, Z = − 0.663, P = 0.508). The AUCs on ROC for %ΔLD, %ΔT2WI-CNR and %ΔADC after two weeks of therapy were 0.756, 0.552 and 0.881, respectively, for response differentiation. When %ΔADC ≥15% was used to predict responder, the PPV was 93.3%. Conclusions The percentage change of the ADC after two weeks of therapy outperformed T2WI-CNR and longest diameter in predicting the early response of GIST to targeted therapy.
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Affiliation(s)
- Lei Tang
- Department of Radiology, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), No. 52Fu Cheng Road, HaiDian District, Beijing, 100142, China
| | - Jian Li
- Department of Gastroenterology, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), No.52 Fu Cheng Road, HaiDian District, Beijing, 100142, China
| | - Zi-Yu Li
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), No.52Fu Cheng Road, HaiDian District, Beijing, 100142, China
| | - Xiao-Ting Li
- Department of Radiology, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), No. 52Fu Cheng Road, HaiDian District, Beijing, 100142, China
| | - Ji-Fang Gong
- Department of Gastroenterology, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), No.52 Fu Cheng Road, HaiDian District, Beijing, 100142, China
| | - Jia-Fu Ji
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), No.52Fu Cheng Road, HaiDian District, Beijing, 100142, China
| | - Ying-Shi Sun
- Department of Radiology, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), No. 52Fu Cheng Road, HaiDian District, Beijing, 100142, China.
| | - Lin Shen
- Department of Gastroenterology, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), No.52 Fu Cheng Road, HaiDian District, Beijing, 100142, China.
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286
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Ueno YR, Tamada T, Takahashi S, Tanaka U, Sofue K, Kanda T, Nogami M, Ohno Y, Hinata N, Fujisawa M, Murakami T. Computed Diffusion-Weighted Imaging in Prostate Cancer: Basics, Advantages, Cautions, and Future Prospects. Korean J Radiol 2018; 19:832-837. [PMID: 30174471 PMCID: PMC6082756 DOI: 10.3348/kjr.2018.19.5.832] [Citation(s) in RCA: 15] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/20/2018] [Indexed: 12/28/2022] Open
Abstract
Computed diffusion-weighted MRI is a recently proposed post-processing technique that produces b-value images from diffusion-weighted imaging (DWI), acquired using at least two different b-values. This article presents an argument for computed DWI for prostate cancer by viewing four aspects of DWI: fundamentals, image quality and diagnostic performance, computing procedures, and future uses.
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Affiliation(s)
- Yoshiko R Ueno
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Tsutomu Tamada
- Department of Radiology, Kawasaki Medical School, Kurashiki 701-0192, Japan
| | - Satoru Takahashi
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Utaru Tanaka
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Keitaro Sofue
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Tomonori Kanda
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Munenobu Nogami
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yoshiharu Ohno
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.,Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Nobuyuki Hinata
- Department of Urology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Masato Fujisawa
- Department of Urology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
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287
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Long 龙淼淼 M, Wang 王蕾 L, Mou 牟玲 L, Zhang 张可 K, Liu 刘丽华 L, Li 李艳艳 Y, Liu 刘晓斌 X, Yu 于文娟 W, Gao 高光峰 G, Chen 陈新娟 X, Shen 沈文 W, Shrestha A. Z-Score transformation of ADC values: A way to universal cut off between malignant and benign lymph nodes. Eur J Radiol 2018; 106:122-127. [PMID: 30150033 DOI: 10.1016/j.ejrad.2018.07.022] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 07/08/2018] [Accepted: 07/25/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE To determine the possibility of a universal cut off value between benign and malignant lymph nodes in patients with tumour by Z-Score transformation method. MATERIALS AND METHODS Diffusion weighted imaging, ADC measurements of malignant and benign lymph nodes of 6 studies (4 body parts), conducted for 5 times, in two institutions with variable technical details were analyzed in their original value as well as the standardized Z-Score value. The standardized Z-Score value was obtained by subtracting the population mean of the control group from an individual raw score and then dividing the difference by the population standard deviation of the control group. General cut off values were obtained by both Mega-analysis by receiver operator characteristic curve analysis, when data from the 6 studies were combined and Meta-analysis with weighting coefficients and cut off values of the six individual studies. Sensitivity, specificity and accuracy with cut offs from individual studies, meta-analysis and mega-analysis were calculated. Kappa test was performed to assess the consistency of diagnostic test accuracy, between optimized cut offs of individual studies and the proposed universal cut offs obtained from meta-analysis and mega-analysis. RESULTS The ADC values of benign and malignant lymph nodes are significantly different, but with large overlap across the studies. The overlap can be minimized by Z-Score transformation. The result of ROC analysis of the collective Z-Score transformed ADC values of 6 studies was superior to that of the collective original ADC values (sensitivity: 87.4% versus 67.2%, specificity: 90.5% versus 87.9%, accuracy: 89.6% versus 81.4%). The universal Z-Score cut off from Meta-analysis is also better than the original ADC cut off (sensitivity: 82.8% versus 76.3%, specificity 92.6% versus 62.9%, accuracy 89.6% versus 67.1%). Applied to the individual studies, the universal transformed Z-Score cut offs produced superior consistency with the individual optimal cut offs (individual and meta Z-Score: 0.7228-0.9793; individual and mega Z-Score: 0.7111-0.9169) compared with the universal original ADC cut offs (individual and meta ADC: 0.3030-1.0000; individual and mega ADC 0.3268-0.9618). CONCLUSION Z-Score transformation could minimize inter-study variations due to heterogeneity of MR systems and sequence parameters, and provide a more consistent universal cut off value between benign and malignant nodes across studies.
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Affiliation(s)
- Miaomiao Long 龙淼淼
- Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China.
| | - Lei Wang 王蕾
- School of Chinese Medicine, Tianjin University of TCM, Tianjin 300193, China
| | - Ling Mou 牟玲
- Department of Radiology, People's Hospital of Rizhao City, Rizhao, 276827, China
| | - Ke Zhang 张可
- Department of Radiology, People's Hospital of Rizhao City, Rizhao, 276827, China
| | - Lihua Liu 刘丽华
- Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China
| | - Yanyan Li 李艳艳
- Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China
| | - Xiaobin Liu 刘晓斌
- Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China
| | - Wenjuan Yu 于文娟
- Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China
| | - Guangfeng Gao 高光峰
- Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China
| | - Xinjuan Chen 陈新娟
- Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China; Academic Affairs Office, Weifang Medical University, City Weifang, 261053, China
| | - Wen Shen 沈文
- Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China
| | - Apurwa Shrestha
- Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China
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288
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Tang C, Lin MB, Xu JL, Zhang LH, Zuo XM, Zhang ZS, Liu MX, Xu JM. Are ADC values of readout-segmented echo-planar diffusion-weighted imaging (RESOLVE) correlated with pathological prognostic factors in rectal adenocarcinoma? World J Surg Oncol 2018; 16:138. [PMID: 30001205 PMCID: PMC6043992 DOI: 10.1186/s12957-018-1445-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 02/06/2018] [Accepted: 07/05/2018] [Indexed: 02/06/2023] Open
Abstract
Background Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values as imaging biomarkers of rectal cancer are currently a hot research spot. The use of ADC values for preoperative judgment of pathological features in rectal cancer has been generally accepted. The image quality evaluation of conventional diffusion is severe deformation, and the measurement of ADC values can easily lead to bias. Readout-segmented echo-planar diffusion-weighted imaging (RESOLVE) provides high signal-to-noise ratio images and significantly reduces distortions caused by magnetosensitive effects. The purpose of this study was to explore the correlations between ADC values of RESOLVE and pathological prognostic factors in rectal adenocarcinoma. Methods We collected pathological data of 89 patients with pathologically confirmed rectal adenocarcinoma who directly underwent surgical resection without receiving adjuvant therapy. The patients were grouped according to the pathologic type, gross classification, degree of differentiation, TN stage, and immunohistochemical expression of epidermal growth factor receptor (EGFR). Results RESOLVE ADC values of rectal cancer were measured at b = 800, and correlations between the RESOLVE ADC values obtained in different groups were analysed. We found that RESOLVE ADC values in the ulcer-type group were significantly higher than those in the eminence-type group. Conclusion RESOLVE ADC values in different pathologic types of rectal cancer were significantly different. RESOLVE ADC values in the EGFR-positive group were significantly lower than those in the EGFR-negative group. There was no significant difference in RESOLVE ADC values between different degrees of pathologic differentiation, TN stages, and positive or negative lymph nodes. The quantitative description of RESOLVE ADC values could be used to assess the biological behaviour of rectal adenocarcinoma.
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Affiliation(s)
- Cui Tang
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China
| | - Mou-Bin Lin
- Department of General Surgery, Tongji University Affiliated Yangpu Hospital, Shanghai, 200090, China
| | - Jin-Lei Xu
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China
| | - Lan-Hua Zhang
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China
| | - Xiao-Ming Zuo
- Department of Pathology, Tongji University Affiliated Yangpu Hospital, Shanghai, 200090, China
| | | | | | - Jin-Ming Xu
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China.
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289
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Furuya S, Iwasaki M, Yokohama T, Ohura D, Okuaki T. Highly Accurate Analysis of the Cervical Neural Tract of the Elderly Using ZOOM DTI. Neurospine 2018; 15:169-174. [PMID: 29991247 PMCID: PMC6104736 DOI: 10.14245/ns.1836116.058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 04/19/2018] [Accepted: 05/15/2018] [Indexed: 11/30/2022] Open
Abstract
Background/Aims To investigate the fractional anisotropy (FA) values of the cervical spinal cord in elderly individuals using zonally magnified oblique multislice (ZOOM) diffusion tensor imaging (DTI).
Methods Fourteen healthy elderly volunteers (group E) and 10 young volunteers (group Y) were enrolled. We assessed the FA, apparent diffusion coefficient (ADC), and λ1–λ3 values using 3-T magnetic resonance imaging. The region of interest was contoured entirely inside the spinal cord, with no gray/white matter distinction, in order to avoid including the cerebrospinal fluid.
Results As lower cervical levels were approached, the FA values gradually decreased, while the ADC values increased. The mean FA values at each cervical level were as follows in groups E and Y: 0.71 and 0.70 at the C2/3 level, 0.66 and 0.66 at the C3/4 level, 0.63 and 0.62 at the C4/5 level, 0.57 and 0.57 at the C5/6 level, and 0.58 and 0.57 at the C6/7 level, respectively. The mean ADC values in groups E and Y were 1.06 and 0.99 at the C2/3 level, 1.05 and 1.06 at the C3/4 level, 1.14 and 1.06 at the C4/5 level, 1.18 and 1.21 at the C5/6 level, and 1.39 and 1.46 at the C6/7 level, respectively. There were no significant differences between the elderly and young participants.
Conclusion In both asymptomatic elderly and young individuals, the FA values gradually decreased and the ADC values increased moving towards lower cervical levels. Age did not affect the FA values, even though mild cord compression was evident due to spondylotic changes. ZOOM DTI has the potential to provide more information than conventional DTI.
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Affiliation(s)
- Sho Furuya
- Department of Neurosurgery, Otaru General Hospital, Otaru, Japan
| | - Motoyuki Iwasaki
- Department of Neurosurgery, Otaru General Hospital, Otaru, Japan
| | - Takumi Yokohama
- Department of Radiology, Otaru General Hospital, Otaru, Japan
| | - Daisuke Ohura
- Department of Radiology, Otaru General Hospital, Otaru, Japan
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290
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Yazdani M, Rumboldt Z, Tabesh A, Giglio P, Schiarelli C, Morgan PS, Spampinato MV. Perilesional apparent diffusion coefficient in the preoperative evaluation of glioma grade. Clin Imaging 2018; 52:88-94. [PMID: 30032069 DOI: 10.1016/j.clinimag.2018.07.005] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 06/15/2018] [Accepted: 07/04/2018] [Indexed: 01/22/2023]
Abstract
Preoperative identification of high-grade gliomas is critical to optimize treatment strategy and to predict prognosis. To determine whether perilesional apparent diffusion coefficient (ADC) values differ between high- and low-grade tumors, we assessed water diffusivity within normal-appearing brain parenchyma (NABP) surrounding gliomas in twenty-one treatment-naïve patients. This showed significantly lower mean and 25th percentile (Q1) ADC values in high- grade compared to low-grade gliomas respectively in the range of 10-25 and 10-30 mm away from combined tumor and surrounding T2 signal. Thus, perilesional ADC measurement may reflect the extent of tumor infiltration beyond the abnormality seen on conventional MRI.
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Affiliation(s)
- Milad Yazdani
- Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, USA.
| | - Zoran Rumboldt
- Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, USA
| | - Ali Tabesh
- Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, USA
| | - Pierre Giglio
- Department of Neurology, Ohio State University, Wexner Medical College, Columbus, OH, USA
| | - Chiara Schiarelli
- Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, USA
| | - Paul S Morgan
- Medical Physics & Clinical Engineering, QMC Campus, University of Nottingham, Nottingham, UK
| | - Maria V Spampinato
- Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, USA
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291
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Tschischka A, Schleich C, Boos J, Eichner M, Schaper J, Aissa J, Antoch G, Klee D. Age-related apparent diffusion coefficients of lumbar vertebrae in healthy children at 1.5 T. Pediatr Radiol 2018; 48:1008-1012. [PMID: 29651606 DOI: 10.1007/s00247-018-4119-7] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 02/12/2018] [Accepted: 03/14/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient (ADC) calculation is important for detecting bone marrow pathologies. OBJECTIVE To investigate age-related differences of lumbar vertebral body ADC to establish normal values for healthy children. MATERIALS AND METHODS Forty-nine healthy children without any history of oncological or hematological diseases (10.2±4.7 years, range: 0-20 years) were included in this retrospective study. All magnetic resonance imaging (MRI) examinations were performed at 1.5 T and with similar scan parameters. The diffusion-weighted sequences were performed with b values of 50, 400 and 800 s/mm2. ADC values were measured by placing regions of interest at three different levels within each lumbar vertebral body (L1 to L5). ADC values were analyzed for different age groups (0-2 years, 3-6 years, 7-11 years, 12-14 years, 15-20 years), for each vertebral and intravertebral level. RESULTS The mean ADC of the whole study group was 0.60±0.09 × 10-3 mm2/s. Children between the ages of 12 and 14 years had significantly higher ADC compared to the other age groups (P≤0.0003). ADC values were significantly higher in the 1st lumbar vertebral body compared to the other levels of the lumbar spine (P<0.005) with the exception of L5, and in the upper third of the vertebral bodies compared to the middle or lower thirds (P≤0.003). CONCLUSION The age-, vertebral- and intravertebral level-dependent differences in ADC suggest a varying composition and cellularity in different age groups and in different locations.
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Affiliation(s)
- Alexander Tschischka
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225, Dusseldorf, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225, Dusseldorf, Germany
| | - Johannes Boos
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225, Dusseldorf, Germany
| | - Markus Eichner
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225, Dusseldorf, Germany
| | - Jörg Schaper
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225, Dusseldorf, Germany
| | - Joel Aissa
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225, Dusseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225, Dusseldorf, Germany
| | - Dirk Klee
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225, Dusseldorf, Germany.
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292
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Xu X, Palmer SL, Lin X, Li W, Chen K, Yan F, Li X. Diffusion-weighted imaging and pathology of chronic kidney disease: initial study. Abdom Radiol (NY) 2018; 43:1749-1755. [PMID: 29110054 DOI: 10.1007/s00261-017-1362-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE To investigate the value of diffusion-weighted imaging (DWI) for assessing histopathologic changes observed in chronic kidney disease (CKD). METHODS Fifty-two patients with CKD underwent DWI before renal biopsy. The renal apparent diffusion coefficient (ADC) values and histopathologic changes were analyzed. The pathologic changes were scored using a semi-quantitative method (no lesion as 0, mild lesion as 1, moderate lesion as 2, and severe lesion as 3). The relationships between renal histopathologic scores, types, classification, and right renal ADCs were analyzed using ANOVA and Pearson's or Spearman's correlation tests. RESULTS Negative correlations were found between the right renal ADCs and scores of tubulointerstitial lesions (r = - 0.354, P = 0.012), the severity of tubular atrophy (r = - 0.439, P = 0.002), and the severity of interstitial fibrosis (r = - 0.272, P = 0.049). There were no correlations between the ADCs and scores of glomeruli and peritubular vessel lesions (P > 0.05). There were significant differences among groups based on pathology types (P = 0.009). There was no significant relationship between renal ADCs and the pathologic classification (P > 0.05). CONCLUSIONS DWI may be helpful to detect tubulointerstitial injury, including tubular atrophy and interstitial fibrosis. DWI may have the potential to serve as an effective auxiliary method to help nephrologists to evaluate patients with CKD.
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293
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Wang GJ, Wang Y, Ye Y, Chen F, Lu YT, Li SL. [Characteristics of high resolution diffusion weighted imaging apparent diffusion coefficient histogram and its correlations with cancer stages in patients with nasopharyngeal carcinoma]. Zhonghua Yi Xue Za Zhi 2017; 97:3244-9. [PMID: 29141363 DOI: 10.3760/cma.j.issn.0376-2491.2017.41.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the features of apparent diffusion coefficient (ADC) histogram parameters based on entire tumor volume data in high resolution diffusion weighted imaging of nasopharyngeal carcinoma (NPC) and to evaluate its correlations with cancer stages. Methods: This retrospective study included 154 cases of NPC patients[102 males and 52 females, mean age (48±11) years]who had received readout segmentation of long variable echo trains of MRI scan before radiation therapy. The area of tumor was delineated on each section of axial ADC maps to generate ADC histogram by using Image J. ADC histogram of entire tumor along with the histogram parameters-the tumor voxels, ADC(mean), ADC(25%), ADC(50%), ADC(75%), skewness and kurtosis were obtained by merging all sections with SPSS 22.0 software. Intra-observer repeatability was assessed by using intra-class correlation coefficients (ICC). The patients were subdivided into two groups according to cancer volume: small cancer group (<305 voxels, about 2 cm(3)) and large cancer group (≥2 cm(3)). The correlation between ADC histogram parameters and cancer stages was evaluated with Spearman test. Results: The ICC of measuring ADC histogram parameters of tumor voxels, ADC(mean), ADC(25%), ADC(50%), ADC(75%), skewness, kurtosis was 0.938, 0.861, 0.885, 0.838, 0.836, 0.358 and 0.456, respectively. The tumor voxels was positively correlated with T staging (r=0.368, P<0.05). There were significant differences in tumor voxels among patients with different T stages (K=22.306, P<0.05). There were significant differences in the ADC(mean), ADC(25%), ADC(50%) among patients with different T stages in the small cancer group(K=8.409, 8.187, 8.699, all P<0.05), and the up-mentioned three indices were positively correlated with T staging (r=0.221, 0.209, 0.235, all P<0.05). Skewness and kurtosis differed significantly between the groups with different cancer volume(t=-2.987, Z=-3.770, both P<0.05). Conclusion: The tumor volume, tissue uniformity of NPC are important factors affecting ADC and cancer stages, parameters of ADC histogram (ADC(mean), ADC(25%), ADC(50%)) increases with T staging in NPC smaller than 2 cm(3).
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294
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Jackson AR, Eismont A, Yu L, Li N, Gu W, Eismont F, Brown MD. Diffusion of antibiotics in intervertebral disc. J Biomech 2018; 76:259-262. [PMID: 29941209 DOI: 10.1016/j.jbiomech.2018.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 02/28/2018] [Revised: 05/22/2018] [Accepted: 06/09/2018] [Indexed: 10/14/2022]
Abstract
Delivering charged antibiotics to the intervertebral disc is challenging because of the avascular, negatively charged extracellular matrix (ECM) of the tissue. The purpose of this study was to measure the apparent diffusion coefficient of two clinically relevant, charged antibiotics, vancomycin (positively charged) and oxacillin (negatively charged) in IVD. A one-dimensional steady state diffusion experiment was employed to measure the apparent diffusion coefficient of the two antibiotics in bovine coccygeal annulus fibrosus (AF) tissue. The averaged apparent diffusion coefficient for vancomycin under 20% compressive strain was 7.94 ± 2.00 × 10-12 m2/s (n = 10), while that of oxacillin was 2.26 ± 0.68 × 10-10 m2/s (n = 10). A student's t-test showed that the diffusivity of vancomycin was significantly lower than that of oxacillin. This finding may be attributed to two factors: solute size and possible binding effects. Vancomycin is approximately 3 times larger in molecular weight than oxacillin, meaning that steric hindrance likely plays a role in the slower transport. Reversible binding between positive vancomycin and the negative ECM could also slow down the rate of diffusion. Therefore, more investigation is necessary to determine the specific relationship between net charge on antibiotic and diffusion coefficients in IVD. This study provides essential quantitative information regarding the transport rates of antibiotics in the IVD, which is critical in using computational modeling to design effective strategies to treat disc infection.
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Affiliation(s)
- Alicia R Jackson
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Adam Eismont
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Lu Yu
- Department of Mechanical and Aerospace Engineering, University of Miami, Coral Gables, FL, USA
| | - Na Li
- Department of Mechanical and Aerospace Engineering, University of Miami, Coral Gables, FL, USA
| | - Weiyong Gu
- Department of Mechanical and Aerospace Engineering, University of Miami, Coral Gables, FL, USA.
| | - Frank Eismont
- Department of Orthopaedics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Mark D Brown
- Department of Orthopaedics, Miller School of Medicine, University of Miami, Miami, FL, USA
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295
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Shen L, Zhou G, Tang F, Lin Y, Zhou J, Lv P, Wang Y, Zong G, Zhao J. MR diffusion kurtosis imaging for cancer diagnosis: A meta-analysis of the diagnostic accuracy of quantitative kurtosis value and diffusion coefficient. Clin Imaging 2018; 52:44-56. [PMID: 29908349 DOI: 10.1016/j.clinimag.2018.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/04/2018] [Accepted: 06/06/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE To perform a meta-analysis for assessing the accuracy of diffusion kurtosis imaging (DKI)-derived quantitative parameters (kurtosis values, K; and corrected diffusion coefficients non-Gaussian bias, D) in separating malignant cancers from benign lesions. METHODS Relevant studies were searched in PubMed and Cochrane Library databases and were analyzed by Meta-DiSc software. RESULTS Fourteen eligible studies involving 1847 lesions in 1107 patients (895 were benign and 952 were malignant) were included. Pooled analysis showed the sensitivity, specificity, positive likelihood ratio (LR), and negative LR were respectively 0.83 (95% CI, 0.79-0.85), 0.83 (95% CI, 0.80-0.86), 4.61 (95% CI, 2.98-7.14), and 0.22 (95% CI, 0.18-0.28) for K, with the overall area under curve (AUC) of 0.89. The sensitivity, specificity, positive LR, and negative LR were 0.85 (95% CI, 0.80-0.88), 0.85 (95% CI, 0.79-0.89), 6.39 (95% CI, 3.14-12.99), and 0.18 (95% CI, 0.14-0.23) for D, with the overall AUC of 0.92. The sensitivity, specificity, positive LR, and negative LR for apparent diffusion coefficient (ADC) derived from standard diffusion-weighted imaging (DWI) were 0.82 (95% CI, 0.79-0.84), 0.85 (95% CI, 0.82-0.88), 4.75 (95% CI, 3.38-6.68), and 0.24 (95% CI, 0.19-0.29), with the overall AUC of 0.89. The superiority of D to K and ADC was also confirmed by the subgroup analysis of prostate cancer. CONCLUSION Our findings suggest that DKI should be added to the routine imaging protocol for screening cancer, with the highest diagnostic accuracy of diffusion coefficients.
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296
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Korostyshevskaya AM, Savelov AA, Papusha LI, Druy AE, Yarnykh VL. Congenital medulloblastoma: Fetal and postnatal longitudinal observation with quantitative MRI. Clin Imaging 2018; 52:172-176. [PMID: 30096555 DOI: 10.1016/j.clinimag.2018.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 02/21/2018] [Revised: 05/21/2018] [Accepted: 06/04/2018] [Indexed: 10/14/2022]
Abstract
Congenital medulloblastoma is extremely rare. MRI appearance of this tumor in the fetal brain has not been described. A case of congenital medulloblastoma initially observed by antenatal MRI with postnatal follow-up and treatment is presented. A pregnant female underwent fetal MRI on the 31st gestational week for routine indications. Midline cerebellar lesion of ≤2 cm in size with minor T2 hypointensity and T1 hyperintensity was identified. Additionally, quantitative MRI including apparent diffusion coefficient (ADC) and fast macromolecular proton fraction (MPF) mapping was performed. The lesion showed a marked ADC decrease and MPF increase. MPF maps depicted the lesion most conspicuously. After term delivery, a male neonate presented with symptoms of increased intracranial pressure. Postnatal MRI identified obstructive hydrocephalus caused by a large posterior fossa mass. The child was treated by cerebrospinal fluid shunt placement. Follow-up quantitative MRI on the fifth month revealed tumor growth and vivid changes of its tissue contrast associated with brain maturation. The tumor appeared nearly isointense on T1- and T2-weighted images and slightly hypointense on the ADC map. MPF contrast showed the most remarkable change from hyper- to hypointensity due to brain myelination with stable MPF in the tumor. Subsequently, the child underwent partial tumor resection, and currently continues treatment with chemotherapy. The pathological diagnosis was desmoplastic/nodular medulloblastoma. The described case illustrates evolution of the tumor contrast in the course of fetal and postnatal brain development and highlights the added diagnostic value of MPF mapping in fetal and neonatal neuroimaging.
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Affiliation(s)
- Alexandra M Korostyshevskaya
- Institute "International Tomography Center" of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation.
| | - Andrey A Savelov
- Institute "International Tomography Center" of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Liudmila I Papusha
- Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
| | - Alexander E Druy
- Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
| | - Vasily L Yarnykh
- Department of Radiology, University of Washington, Seattle, WA, USA; Research Institute of Biology and Biophysics, National Research Tomsk State University, Tomsk, Russian Federation
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297
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Moon JY, Kim SH, Choi SY, Hwang JA, Lee JE, Lee J. Differentiating malignant from benign hyperintense nodules on unenhanced T1-weighted images in patients with chronic liver disease: using gadoxetic acid-enhanced and diffusion-weighted MR imaging. Jpn J Radiol 2018; 36:489-499. [PMID: 29876721 DOI: 10.1007/s11604-018-0748-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 02/08/2018] [Accepted: 05/28/2018] [Indexed: 01/04/2023]
Abstract
PURPOSE To evaluate value of gadoxetic acid-enhanced and diffusion-weighted (DW) MRI for distinguishing malignant from benign hyperintense nodules on unenhanced T1-weighted images (T1WIs) in patients with chronic liver disease. MATERIALS AND METHODS Forty-two patients with 37 malignant and 41 benign hyperintense nodules on unenhanced T1WIs who underwent gadoxetic acid-enhanced and DW MRI, followed by histopathological examination, were included. Qualitative and quantitative analyses were conducted. Significant findings on univariate and multivariate analyses were identified and their diagnostic performances were analyzed for predicting hyperintense hepatocellular carcinomas (HCCs). RESULTS In univariate analysis, hyperintensity on T2WI, arterial enhancement, washout, hypointensity on hepatobiliary phase, and diffusion restriction were more frequently observed (P < 0.05) in hyperintense HCCs. Tumor-to-liver SI ratio on hepatobiliary phase and minimum apparent diffusion coefficient (ADCmin) were significantly lower in hyperintense HCCs (P < 0.05). In multivariate analysis, hyperintensity on T2WI (OR, 13.58; P = 0.02), arterial enhancement (OR, 8.21; P = 0.002), and ADCmin ≤ 0.83 × 10-3 mm2/s (OR, 6.88; P = 0.008) were independently significant factors for predicting hyperintense HCCs. When two of three criteria were combined, 75.7% (28/37) of hyperintense HCCs were identified with a specificity of 92.7%, and when all three criteria were satisfied, the specificity was 97.6%. CONCLUSION Gadoxetic acid-enhanced and DW MRI may be helpful for differentiating malignant from benign hyperintense nodules on unenhanced T1WI.
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Affiliation(s)
- Ji Yoon Moon
- Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 150 Seongan-ro Gangdong-Gu, Seoul, 134-701, South Korea
| | - Seong Hyun Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul, 135-710, South Korea.
| | - Seo-Youn Choi
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Kyunggi-do, South Korea
| | - Jeong Ah Hwang
- Department of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan, Chungcheongnam-do, South Korea
| | - Ji Eun Lee
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Kyunggi-do, South Korea
| | - Jisun Lee
- Department of Radiology, Chungbuk National University Hospital, 776, 1 Sunhwan-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do, South Korea
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298
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Domachevsky L, Goldberg N, Bernstine H, Nidam M, Groshar D. Quantitative characterisation of clinically significant intra-prostatic cancer by prostate-specific membrane antigen (PSMA) expression and cell density on PSMA-11. Eur Radiol 2018; 28:5275-5283. [PMID: 29846803 DOI: 10.1007/s00330-018-5484-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 12/28/2017] [Revised: 03/26/2018] [Accepted: 04/12/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To quantitatively characterize clinically significant intra-prostatic cancer (IPC) by prostate-specific membrane antigen (PSMA) expression and cell density on PSMA-11 positron emission tomography/magnetic resonance (PET/MR). METHODS Retrospective study approved by the institutional review board with informed written consent obtained. Patients with a solitary, biopsy-proven prostate cancer, Gleason score (GS) ≥7, presenting for initial evaluation by PET/computerised tomography (PET/CT), underwent early prostate PET/MR immediately after PSMA-11 tracer injection. PET/MR [MRI-based attenuation correction (MRAC)] and PET/CT [CT-based AC (CTAC)] maximal standardised uptake value (SUVmax) and minimal and mean apparent diffusion coefficient (ADCmin, ADCmean; respectively) in normal prostatic tissue (NPT) were compared to IPC area. The relationship between SUVmax, ADCmin and ADCmean measurements was obtained. RESULTS Twenty-two patients (mean age 69.5±5.0 years) were included in the analysis. Forty-four prostate areas were evaluated (22 IPC and 22 NPT). Median MRAC SUVmax of NPT was significantly lower than median MRAC SUVmax of IPC (p < 0.0001). Median ADCmin and ADCmean of NPT was significantly higher than median ADCmin and ADCmean of IPC (p < 0.0001). A very good correlation was found between MRAC SUVmax with CTAC SUVmax (rho = -0.843, p < 0.0001). A good inverse relationship was found between MRAC SUVmax and CTAC SUVmax with ADCmin (rho = -0.717, p < 0.0001 and -0.740, p < 0.0001; respectively; Z = 0.22, p = 0.82, NS) and with MRAC SUVmax and ADCmean (rho = -0.737, p < 0.0001). CONCLUSIONS PET/MR SUVmax, ADCmin and ADCmean are distinct biomarkers able to differentiate between IPC and NPT in naïve prostate cancer patients with GS ≥ 7. KEY POINTS • PSMA PET/MR metrics differentiate between normal and tumoural prostatic tissue. • A multi-parametric approach combining molecular and anatomical information might direct prostate biopsy. • PSMA PET/MR metrics are warranted for radiomics analysis.
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Affiliation(s)
- Liran Domachevsky
- Department of Nuclear Medicine, Assuta Medical Centers, 20 Habarzel St, 6971028, Tel-Aviv, Israel.
| | - Natalia Goldberg
- Department of Nuclear Medicine, Assuta Medical Centers, 20 Habarzel St, 6971028, Tel-Aviv, Israel
| | - Hanna Bernstine
- Department of Nuclear Medicine, Assuta Medical Centers, 20 Habarzel St, 6971028, Tel-Aviv, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Meital Nidam
- Department of Nuclear Medicine, Assuta Medical Centers, 20 Habarzel St, 6971028, Tel-Aviv, Israel
| | - David Groshar
- Department of Nuclear Medicine, Assuta Medical Centers, 20 Habarzel St, 6971028, Tel-Aviv, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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299
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Welzel T, Meyerhof E, Uhl M, Huang K, von Deimling A, Herfarth K, Debus J. Diagnostic accuracy of DW MR imaging in the differentiation of chordomas and chondrosarcomas of the skull base: A 3.0-T MRI study of 105 cases. Eur J Radiol 2018; 105:119-24. [PMID: 30017267 DOI: 10.1016/j.ejrad.2018.05.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE To determine the diagnostic accuracy of DW MR imaging with apparent diffusion coefficient (ADC) mapping for the distinction of skull base chordoma from skull base chondrosarcoma. PATIENTS AND METHODS From October 2009 to April 2014, 105 consecutive patients (chordomas (n = 70), and chondrosarcomas (n = 35) who were planned to receive proton or heavy-ion beam therapy underwent DW MR imaging on a 3.0 T. MR images were assessed by means of consensus of three experienced radiologists who were blinded to pathologic and clinical information. ADC values (mean, minimum, maximum, and normalized) of the solid tumor component were evaluated. Group means and cut-off points were established to separate skull base chordoma from skull base chondrosarcoma, and statistical significances were calculated by Student's t or Mann-Whitney-U tests, and receiver operating characteristic (ROC) curve analyses. The prospective study was approved by the institutional ethics committee. RESULTS For solid tumor component, there were higher mean, minimum, maximum, and normalized ADC values in chondrosarcomas compared with those in chordomas (all p < 0.001). ROC analysis revealed areas under the curve for mean, minimum, maximum, and normalized ADC values between 0.79 and 0.93. The mean ADC value of the solid tumor components had the best AUC, with a cut-off point of 1585 × 10(-6) mm (2)/s and sensitivity and specificity of 94.3% and 98.6%, respectively. CONCLUSION Skull base Chondrosarcomas generally have higher mean, minimum, maximum, and normalized ADC values than skull base chordomas, with the mean ADC value of the solid tumor component offering the highest accuracy for characterization.
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Obara-Michlewska M, Ding F, Popek M, Verkhratsky A, Nedergaard M, Zielinska M, Albrecht J. Interstitial ion homeostasis and acid-base balance are maintained in oedematous brain of mice with acute toxic liver failure. Neurochem Int 2018; 118:286-291. [PMID: 29772253 DOI: 10.1016/j.neuint.2018.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 01/16/2018] [Revised: 05/11/2018] [Accepted: 05/13/2018] [Indexed: 01/25/2023]
Abstract
Acute toxic liver failure (ATLF) rapidly leads to brain oedema and neurological decline. We evaluated the ability of ATLF-affected brain to control the ionic composition and acid-base balance of the interstitial fluid. ATLF was induced in 10-12 weeks old male C57Bl mice by single intraperitoneal (i.p.) injection of 100 μg/g azoxymethane (AOM). Analyses were carried out in cerebral cortex of precomatous mice 20-24 h after AOM administration. Brain fluid status was evaluated by measuring apparent diffusion coefficient [ADC] using NMR spectroscopy, Evans Blue extravasation, and accumulation of an intracisternally-injected fluorescent tracer. Extracellular pH ([pH]e) and ([K+]e) were measured in situ with ion-sensitive microelectrodes. Cerebral cortical microdialysates were subjected to photometric analysis of extracellular potassium ([K+]e), sodium ([Na+]e) and luminometric assay of extracellular lactate ([Lac]e). Potassium transport in cerebral cortical slices was measured ex vivo as 86Rb uptake. Cerebral cortex of AOM-treated mice presented decreased ADC supporting the view that ATLF-induced brain oedema is primarily cytotoxic in nature. In addition, increased Evans blue extravasation indicated blood brain barrier leakage, and increased fluorescent tracer accumulation suggested impaired interstitial fluid passage. However, [K+]e, [Na+]e, [Lac]e, [pH]e and potassium transport in brain of AOM-treated mice was not different from control mice. We conclude that in spite of cytotoxic oedema and deregulated interstitial fluid passage, brain of mice with ATLF retains the ability to maintain interstitial ion homeostasis and acid-base balance. Tentatively, uncompromised brain ion homeostasis and acid-base balance may contribute to the relatively frequent brain function recovery and spontaneous survival rate in human patients with ATLF.
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Affiliation(s)
- Marta Obara-Michlewska
- Department of Neurotoxicology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 5 Pawińskiego St, 02-106 Warsaw, Poland.
| | - Fengfei Ding
- Center for Translational Neuromedicine, University of Rochester, NY, USA
| | - Mariusz Popek
- Department of Neurotoxicology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 5 Pawińskiego St, 02-106 Warsaw, Poland
| | - Alexei Verkhratsky
- Faculty of Life Sciences, University of Manchester, UK; Achucarro Center for Neuroscience, IKERBASQUE, Basque Foundation for Science, 48011 Bilbao, Spain
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, University of Rochester, NY, USA
| | - Magdalena Zielinska
- Department of Neurotoxicology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 5 Pawińskiego St, 02-106 Warsaw, Poland
| | - Jan Albrecht
- Department of Neurotoxicology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 5 Pawińskiego St, 02-106 Warsaw, Poland.
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