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Baxter GC, Graves MJ, Gilbert FJ, Patterson AJ. A Meta-analysis of the Diagnostic Performance of Diffusion MRI for Breast Lesion Characterization. Radiology 2019; 291:632-641. [PMID: 31012817 DOI: 10.1148/radiol.2019182510] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Various techniques are available to assess diffusion properties of breast lesions as a marker of malignancy at MRI. The diagnostic performance of these diffusion markers has not been comprehensively assessed. Purpose To compare by meta-analysis the diagnostic performance of parameters from diffusion-weighted imaging (DWI), diffusion-tensor imaging (DTI), and intravoxel incoherent motion (IVIM) in the differential diagnosis of malignant and benign breast lesions. Materials and Methods PubMed and Embase databases were searched from January to March 2018 for studies in English that assessed the diagnostic performance of DWI, DTI, and IVIM in the breast. Studies were reviewed according to eligibility and exclusion criteria. Publication bias and heterogeneity between studies were assessed. Pooled summary estimates for sensitivity, specificity, and area under the curve were obtained for each parameter by using a bivariate model. A subanalysis investigated the effect of MRI parameters on diagnostic performance by using a Student t test or a one-way analysis of variance. Results From 73 eligible studies, 6791 lesions (3930 malignant and 2861 benign) were included. Publication bias was evident for studies that evaluated apparent diffusion coefficient (ADC). Significant heterogeneity (P < .05) was present for all parameters except the perfusion fraction (f). The pooled sensitivity, specificity, and area under the curve for ADC was 89%, 82%, and 0.92, respectively. The highest performing parameter for DTI was the prime diffusion coefficient (λ1), and pooled sensitivity, specificity, and area under the curve was 93%, 90%, and 0.94, respectively. The highest performing parameter for IVIM was tissue diffusivity (D), and the pooled sensitivity, specificity, and area under the curve was 88%, 79%, and 0.90. Choice of MRI parameters had no significant effect on diagnostic performance. Conclusion Diffusion-weighted imaging, diffusion-tensor imaging, and intravoxel incoherent motion have comparable diagnostic accuracy with high sensitivity and specificity. Intravoxel incoherent motion is comparable to apparent diffusion coefficient. Diffusion-tensor imaging is potentially promising but to date the number of studies is limited. © RSNA, 2019 Online supplemental material is available for this article.
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Affiliation(s)
- Gabrielle C Baxter
- From the Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, England (G.C.B., F.J.G.); and Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England (M.J.G., A.J.P.)
| | - Martin J Graves
- From the Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, England (G.C.B., F.J.G.); and Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England (M.J.G., A.J.P.)
| | - Fiona J Gilbert
- From the Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, England (G.C.B., F.J.G.); and Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England (M.J.G., A.J.P.)
| | - Andrew J Patterson
- From the Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, England (G.C.B., F.J.G.); and Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England (M.J.G., A.J.P.)
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Threshold Isocontouring on High b-Value Diffusion-Weighted Images in Magnetic Resonance Mammography. J Comput Assist Tomogr 2019; 43:434-442. [PMID: 31082949 DOI: 10.1097/rct.0000000000000868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Motivated by the similar appearance of malignant breast lesions in high b-value diffusion-weighted imaging (DWI) and positron emission tomography, the purpose of this work was to evaluate the applicability of a threshold isocontouring approach commonly used in positron emission tomography to analyze DWI data acquired from female human breasts with minimal interobserver variability. METHODS Twenty-three female participants (59.4 ± 10.0 years) with 23 lesions initially classified as suggestive of cancers in x-ray mammography screening were subsequently imaged on a 1.5-T magnetic resonance imaging scanner. Diffusion-weighted imaging was performed prior to biopsy with b values of 0, 100, 750, and 1500 s/mm. Isocontouring with different threshold levels was performed on the highest b-value image to determine the voxels used for subsequent evaluation of diffusion metrics. The coefficient of variation was computed by specifying 4 different regions of interest drawn around the lesion. Additionally, a receiver operating statistical analysis was performed. RESULTS Using a relative threshold level greater than or equal to 0.85 almost completely suppresses the intra-individual and inter-individual variability. Among 4 studied diffusion metrics, the diffusion coefficients from the intravoxel incoherent motion model returned the highest area under curve value of 0.9. The optimal cut-off diffusivity was found to be 0.85 μm/ms with a sensitivity of 87.5% and specificity of 90.9%. CONCLUSION Threshold isocontouring on high b-value maps is a viable approach to reliably evaluate DWI data of suspicious focal lesions in magnetic resonance mammography.
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Vidić I, Jerome NP, Bathen TF, Goa PE, While PT. Accuracy of breast cancer lesion classification using intravoxel incoherent motion diffusion‐weighted imaging is improved by the inclusion of global or local prior knowledge with bayesian methods. J Magn Reson Imaging 2019; 50:1478-1488. [DOI: 10.1002/jmri.26772] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/16/2019] [Indexed: 12/15/2022] Open
Affiliation(s)
- Igor Vidić
- Department of PhysicsNTNU, Norwegian University of Science and Technology Trondheim Norway
| | - Neil P. Jerome
- Department of Circulation and Medical ImagingNTNU, Norwegian University of Science and Technology Trondheim Norway
- Department of Radiology and Nuclear MedicineSt. Olav's University Hospital Trondheim Norway
| | - Tone F. Bathen
- Department of Circulation and Medical ImagingNTNU, Norwegian University of Science and Technology Trondheim Norway
- Department of Radiology and Nuclear MedicineSt. Olav's University Hospital Trondheim Norway
| | - Pål E. Goa
- Department of PhysicsNTNU, Norwegian University of Science and Technology Trondheim Norway
- Department of Radiology and Nuclear MedicineSt. Olav's University Hospital Trondheim Norway
| | - Peter T. While
- Department of Radiology and Nuclear MedicineSt. Olav's University Hospital Trondheim Norway
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Técnicas avanzadas de resonancia magnética en patología tumoral de cabeza y cuello. RADIOLOGIA 2019; 61:191-203. [DOI: 10.1016/j.rx.2018.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/11/2018] [Accepted: 12/20/2018] [Indexed: 11/19/2022]
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Jin YN, Zhang Y, Cheng JL, Zheng DD, Hu Y. Monoexponential, Biexponential, and stretched-exponential models using diffusion-weighted imaging: A quantitative differentiation of breast lesions at 3.0T. J Magn Reson Imaging 2019; 50:1461-1467. [PMID: 30919518 DOI: 10.1002/jmri.26729] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) plays an important role in the differentiation of malignant and benign breast lesions. PURPOSE To investigate the utility of various diffusion parameters obtained from monoexponential, biexponential, and stretched-exponential DWI models in the differential diagnosis of breast lesions. STUDY TYPE Prospective. POPULATION Sixty-one patients (age range: 25-68 years old; mean age: 46 years old) with 31 malignant lesions, 42 benign lesions, and 28 normal breast tissues diagnosed initially by clinical palpation, ultrasonography, or conventional mammography were enrolled in the study from January to September 2016. FIELD STRENGTH 3.0T MR scanner, T1 WI, T2 WI, DWI (conventional and multi-b values), dynamic contrast-enhanced. ASSESSMENT The apparent diffusion coefficient (ADC) was calculated by monoexponential analysis. The diffusion coefficient (ADCslow ), pseudodiffusion coefficient (ADCfast ), and perfusion fraction (f) were calculated using the biexponential model. The distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) were obtained using a stretched-exponential model. All parameters were compared for malignant tumors, benign tumors, and normal breast tissues. A receiver operating characteristic curve was used to compare the ability of these parameters, in order to differentiate benign and malignant breast lesions. STATISTICAL TESTS All statistical analyses were performed using statistical software (SPSS). RESULTS ADC, ADCslow , f, DDC, and α values were significantly lower in malignant tumors when compared with normal breast tissues and benign tumors (P < 0.05). However, ADC and f had higher area under the receiver operating characteristic curve (AUC) values (0.889 and 0.919, respectively). DATA CONCLUSION The parameters derived from the biexponential and stretched-exponential DWI could provide additional information for differentiating between benign and malignant breast tumors when compared with conventional diffusion parameters. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2019;50:1461-1467.
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Affiliation(s)
- Ya-Nan Jin
- Department of Magnetic Resonance Imaging, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Zhang
- Department of Magnetic Resonance Imaging, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing-Liang Cheng
- Department of Magnetic Resonance Imaging, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Ying Hu
- Department of Magnetic Resonance Imaging, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Mazal AT, Ashikyan O, Cheng J, Le LQ, Chhabra A. Diffusion-weighted imaging and diffusion tensor imaging as adjuncts to conventional MRI for the diagnosis and management of peripheral nerve sheath tumors: current perspectives and future directions. Eur Radiol 2018; 29:4123-4132. [PMID: 30535638 DOI: 10.1007/s00330-018-5838-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 09/29/2018] [Accepted: 10/17/2018] [Indexed: 12/21/2022]
Abstract
Peripheral nerve sheath tumors (PNSTs) account for ~ 5% of soft tissue neoplasms and are responsible for a wide spectrum of morbidities ranging from localized neuropathy to fulminant metastatic spread and death. MR imaging represents the gold standard for identification of these neoplasms, however, current anatomic MR imaging markers do not reliably detect or differentiate benign and malignant lesions, and therefore, biopsy or excision is required for definitive diagnosis. Diffusion-weighted MR imaging (DWI) serves as a useful tool in the evaluation and management of PNSTs by providing functional information regarding the degree of diffusion, while diffusion tensor imaging (DTI) aids in determining the directional information of predominant diffusion and has been shown to be particularly useful for pre-operative planning of these tumors by delineating healthy and pathologic fascicles. The article focuses on these important neurogenic lesions, highlighting the current utility of diffusion MR imaging and future directions including computerized radiomic analysis. KEY POINTS: • Anatomic MRI is moderately accurate in differentiating benign from malignant PNST. • Diffusion tensor imaging facilitates pre-operative planning of PNSTs by depicting neuropathy and tractography. • Radiomics will likely augment current observer-based diagnostic criteria for PNSTs.
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Affiliation(s)
- Alexander T Mazal
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, 75022, USA
| | - Oganes Ashikyan
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, 75022, USA
| | - Jonathan Cheng
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Lu Q Le
- Department of Dermatology and Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Avneesh Chhabra
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, 75022, USA.
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Chen Y, Panda A, Pahwa S, Hamilton JI, Dastmalchian S, McGivney DF, Ma D, Batesole J, Seiberlich N, Griswold MA, Plecha D, Gulani V. Three-dimensional MR Fingerprinting for Quantitative Breast Imaging. Radiology 2018; 290:33-40. [PMID: 30375925 DOI: 10.1148/radiol.2018180836] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Purpose To develop a fast three-dimensional method for simultaneous T1 and T2 quantification for breast imaging by using MR fingerprinting. Materials and Methods In this prospective study, variable flip angles and magnetization preparation modules were applied to acquire MR fingerprinting data for each partition of a three-dimensional data set. A fast postprocessing method was implemented by using singular value decomposition. The proposed technique was first validated in phantoms and then applied to 15 healthy female participants (mean age, 24.2 years ± 5.1 [standard deviation]; range, 18-35 years) and 14 female participants with breast cancer (mean age, 55.4 years ± 8.8; range, 39-66 years) between March 2016 and April 2018. The sensitivity of the method to B1 field inhomogeneity was also evaluated by using the Bloch-Siegert method. Results Phantom results showed that accurate and volumetric T1 and T2 quantification was achieved by using the proposed technique. The acquisition time for three-dimensional quantitative maps with a spatial resolution of 1.6 × 1.6 × 3 mm3 was approximately 6 minutes. For healthy participants, averaged T1 and T2 relaxation times for fibroglandular tissues at 3.0 T were 1256 msec ± 171 and 46 msec ± 7, respectively. Compared with normal breast tissues, higher T2 relaxation time (68 msec ± 13) was observed in invasive ductal carcinoma (P < .001), whereas no statistical difference was found in T1 relaxation time (1183 msec ± 256; P = .37). Conclusion A method was developed for breast imaging by using the MR fingerprinting technique, which allows simultaneous and volumetric quantification of T1 and T2 relaxation times for breast tissues. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Yong Chen
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
| | - Ananya Panda
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
| | - Shivani Pahwa
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
| | - Jesse I Hamilton
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
| | - Sara Dastmalchian
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
| | - Debra F McGivney
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
| | - Dan Ma
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
| | - Joshua Batesole
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
| | - Nicole Seiberlich
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
| | - Mark A Griswold
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
| | - Donna Plecha
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
| | - Vikas Gulani
- From the Departments of Radiology (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., N.S., M.A.G., D.P., V.G.) and Biomedical Engineering (J.I.H., N.S., M.A.G., V.G.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106; and Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Y.C., A.P., S.P., S.D., D.F.M., D.M., J.B., M.A.G., D.P., V.G.)
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Zhao M, Fu K, Zhang L, Guo W, Wu Q, Bai X, Li Z, Guo Q, Tian J. Intravoxel incoherent motion magnetic resonance imaging for breast cancer: A comparison with benign lesions and evaluation of heterogeneity in different tumor regions with prognostic factors and molecular classification. Oncol Lett 2018. [PMID: 30250578 DOI: 10.3892/ol20189312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023] Open
Abstract
The objective of the present study was to compare the differentiation between breast cancer and benign breast lesions and study regional distribution characteristics in various subtypes of breast cancer using intravoxel incoherent motion (IVIM) parameters. This retrospective study involved 119 patients with breast cancer and 22 patients with benign breast lesions, who underwent 3.0T breast magnetic resonance imaging examinations. The apparent diffusion coefficient (ADC) and IVIM parameters (slow ADC, fast ADC and fraction of fast ADC) were obtained from patients with breast cancer and benign lesions using diffusion-weighted imaging (DWI) with b-values of 0, 50, 100, 150, 200, 400, 500, 1,000 and 1,500 sec/mm2. Compared with patients with benign breast lesions, patients with breast cancer exhibited decreased ADC (P<0.001), slow ADC (P<0.001) and fast ADC (P<0.001) values, and higher fraction of fast ADC (P<0.001) values. Tumors with metastatic axillary lymph nodes demonstrated increased fraction of fast ADC values (P<0.001) and decreased slow ADC values (P<0.001) compared with tumors without metastatic axillary lymph nodes. The Fast ADC values of tumor tissues in estrogen receptor (ER) and progesterone receptor (PR) negative groups were higher than in positive groups (P<0.001), and the slow ADC values of tumor tissues were lower in ER and PR negative groups than positive groups (P<0.001). Luminal B (HER2- negative) tumor (P<0.001) and peritumor (P<0.001) tissues exhibited decreased fraction of fast ADC values, in comparison with other subtypes. Triple-negative breast cancer (TNBC) tumor tissue exhibited increased fast ADC (P<0.001) and fraction of fast ADC values (P<0.001), and decreased slow ADC values (P<0.001), when compared with other subtypes. The TNBC tumor edge tissues had increased fraction of fast ADC values compared with other subtypes (P<0.01) and TNBC tumor tissues (P<0.05). Therefore, the IVIM parameters of tumor, tumor edge and peritumor tissues in various subtypes of breast cancer may be useful for differentiation of breast cancer subtypes and to assess the invasive extent of the tumors.
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Affiliation(s)
- Ming Zhao
- Department of MRI Diagnosis, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Kuang Fu
- Department of MRI Diagnosis, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Lei Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Wenhui Guo
- Department of MRI Diagnosis, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Qiong Wu
- Department of MRI Diagnosis, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Xue Bai
- Department of MRI Diagnosis, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Ziyao Li
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Qiang Guo
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Jiawei Tian
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
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Song SE, Cho KR, Seo BK, Woo OH, Park KH, Son YH, Grimm R. Intravoxel incoherent motion diffusion-weighted MRI of invasive breast cancer: Correlation with prognostic factors and kinetic features acquired with computer-aided diagnosis. J Magn Reson Imaging 2018; 49:118-130. [PMID: 30238533 DOI: 10.1002/jmri.26221] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 05/24/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND As both intravoxel incoherent motion (IVIM) modeling and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) provide perfusion parameters, IVIM-derived perfusion parameters might be expected to correlate with the kinetic features from DCE-MRI. PURPOSE To investigate the association between IVIM parameters and prognostic factors and to evaluate the correlation between IVIM parameters and kinetic features in invasive breast cancer patients using computer-aided diagnosis (CAD). STUDY TYPE Retrospective. POPULATION Eighty-five patients (invasive cancers; mean size, 1.8 cm; range, 0.8-4.8 cm) who underwent diffusion-weighted imaging with 12 b-values (0-1000 s/mm2 ). FIELD STRENGTH/SEQUENCE 3.0T MRI axial, IVIM-DWI epi-sequence, and DCE-MRI. ASSESSMENT Two radiologists measured the apparent diffusion coefficient (ADC), diffusion coefficient, pseudodiffusion coefficient, and perfusion fraction (f) using IVIM modeling. Kinetic features such as peak enhancement and early and delayed enhancement profiles were acquired using CAD. STATISTICAL TESTS The correlation between the IVIM parameters and kinetic features and the association between the IVIM parameters and prognostic factors were investigated using Mann-Whitney test and Spearman correlation test. RESULTS There were no significant associations between IVIM parameters and prognostic factors. When IVIM parameters were correlated with kinetic features by CAD, both the ADC and f values showed correlations with delayed enhancement profiles. The ADC values were lower in tumors with lower persistent components (P = 0.013) and higher washout components (P = 0.045) and showed a positive correlation with persistent proportion (Spearman's rho (r) = 0.222, P = 0.041). The f value was higher in tumors with higher persistent components (P = 0.021) and showed a positive correlation with persistent proportion (r = 0.227, P = 0.029). DATA CONCLUSION This analysis revealed that IVIM-derived ADC and f values showed correlations with kinetic features at the delayed phase as assessed by CAD. These results indicate the potential of IVIM imaging biomarkers to provide information on the biological and kinetic properties of breast cancers without a contrast agent. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:118-130.
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Affiliation(s)
- Sung Eun Song
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kyu Ran Cho
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Bo Kyoung Seo
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Ok Hee Woo
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kyong Hwa Park
- Department of Oncology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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Zhao M, Fu K, Zhang L, Guo W, Wu Q, Bai X, Li Z, Guo Q, Tian J. Intravoxel incoherent motion magnetic resonance imaging for breast cancer: A comparison with benign lesions and evaluation of heterogeneity in different tumor regions with prognostic factors and molecular classification. Oncol Lett 2018; 16:5100-5112. [PMID: 30250578 PMCID: PMC6144878 DOI: 10.3892/ol.2018.9312] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 05/22/2018] [Indexed: 01/04/2023] Open
Abstract
The objective of the present study was to compare the differentiation between breast cancer and benign breast lesions and study regional distribution characteristics in various subtypes of breast cancer using intravoxel incoherent motion (IVIM) parameters. This retrospective study involved 119 patients with breast cancer and 22 patients with benign breast lesions, who underwent 3.0T breast magnetic resonance imaging examinations. The apparent diffusion coefficient (ADC) and IVIM parameters (slow ADC, fast ADC and fraction of fast ADC) were obtained from patients with breast cancer and benign lesions using diffusion-weighted imaging (DWI) with b-values of 0, 50, 100, 150, 200, 400, 500, 1,000 and 1,500 sec/mm2. Compared with patients with benign breast lesions, patients with breast cancer exhibited decreased ADC (P<0.001), slow ADC (P<0.001) and fast ADC (P<0.001) values, and higher fraction of fast ADC (P<0.001) values. Tumors with metastatic axillary lymph nodes demonstrated increased fraction of fast ADC values (P<0.001) and decreased slow ADC values (P<0.001) compared with tumors without metastatic axillary lymph nodes. The Fast ADC values of tumor tissues in estrogen receptor (ER) and progesterone receptor (PR) negative groups were higher than in positive groups (P<0.001), and the slow ADC values of tumor tissues were lower in ER and PR negative groups than positive groups (P<0.001). Luminal B (HER2- negative) tumor (P<0.001) and peritumor (P<0.001) tissues exhibited decreased fraction of fast ADC values, in comparison with other subtypes. Triple-negative breast cancer (TNBC) tumor tissue exhibited increased fast ADC (P<0.001) and fraction of fast ADC values (P<0.001), and decreased slow ADC values (P<0.001), when compared with other subtypes. The TNBC tumor edge tissues had increased fraction of fast ADC values compared with other subtypes (P<0.01) and TNBC tumor tissues (P<0.05). Therefore, the IVIM parameters of tumor, tumor edge and peritumor tissues in various subtypes of breast cancer may be useful for differentiation of breast cancer subtypes and to assess the invasive extent of the tumors.
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Affiliation(s)
- Ming Zhao
- Department of MRI Diagnosis, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Kuang Fu
- Department of MRI Diagnosis, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Lei Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Wenhui Guo
- Department of MRI Diagnosis, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Qiong Wu
- Department of MRI Diagnosis, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Xue Bai
- Department of MRI Diagnosis, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Ziyao Li
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Qiang Guo
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Jiawei Tian
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
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Mao X, Zou X, Yu N, Jiang X, Du J. Quantitative evaluation of intravoxel incoherent motion diffusion-weighted imaging (IVIM) for differential diagnosis and grading prediction of benign and malignant breast lesions. Medicine (Baltimore) 2018; 97:e11109. [PMID: 29952951 PMCID: PMC6039593 DOI: 10.1097/md.0000000000011109] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND That breast carcinoma is the most common malignant lesion in women. This study aimed to differentiate benign from malignant breast lesions and to predict grading of the latter by comparing the diagnostic value of different parameters in intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI). MATERIALS AND METHODS Retrospective analysis was performed utilizing imaging and pathological data from 112 patients with 124 breast lesions that underwent IVIM-DWI examination with 3.0 T MRI. Out of 124, 47 benign and 77 malignant lesions were confirmed by pathological diagnosis. The diagnostic performance of f, D, and D* value to distinguish benign from malignant breast lesions, was evaluated using pathological results as the gold standard. Correlation between D value and Ki-67 index was evaluated to predict grading of malignant breast lesions. RESULTS The D value (0.99 ± 0.21) of patients with malignant lesions was significantly lower than that (1.34 ± 0.18) of patients harboring benign lesions (P = .00). The D* value (7.60 ± 2.10) in malignant lesion group was higher than that (6.83 ± 2.13) of the benign lesion group (P = .113). The f value (8.50 ± 2.13) in malignant lesion group was remarkably higher than that (7.68 ± 1.98) of benign lesion group (P = .035). For differential diagnosis of benign from malignant breast lesions, optimal diagnostic threshold of D value and f value were 1.21 and 7.86, respectively. The areas of D and f values under the ROC curve were 0.883 and 0.601, respectively. The sensitivity, specificity, and accuracy of D value were 83.0%, 86.7%, and 85.5%, respectively. Accordingly, those indexes of f value were 64.9%, 57.4%, and 62.1%, respectively. Furthermore, the Ki-67 staining index of malignant lesions was robustly negatively correlated with D value (r = -0.395, P < .01). CONCLUSION Concrete parameters of IVIM-DWI can help to improve the specificity and accuracy in differential diagnosis of breast benign and malignant lesions. D value is most relevant and valuable in predicting the grading of malignant breast lesions.
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Affiliation(s)
| | | | | | | | - Jing Du
- Cancer Research Institute, Binzhou Medical University Hospital, Binzhou, Shandong, China
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Lu B, Yang X, Xiao X, Chen Y, Yan X, Yu S. Intravoxel Incoherent Motion Diffusion-Weighted Imaging of Primary Rectal Carcinoma: Correlation with Histopathology. Med Sci Monit 2018. [PMID: 29679528 DOI: 10.12659/msm.908574.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Comprehensive and precise assessment of rectal carcinoma is crucial before surgery to plan an individual treatment strategy. New functional techniques, such as intravoxel incoherent motion (IVIM), have emerged and could lead to more detailed information. The aim of this study was to evaluate the difference between the rectal tumor parenchyma and normal wall by IVIM and to explore the correlations of IVIM parameters and histopathology. MATERIAL AND METHODS We prospectively enrolled 128 patients with pathologically proven rectal non-mucinous carcinoma with differentiation degree and 16 patients with mucinous carcinoma. All patients underwent routine MR examination and IVIM sequence. The IVIM maps were automatically generated and 3 ROIs were drawn on the maximal rectal tumor parenchyma and normal rectal wall. The Wilcoxon signed rank test, t test, Mann-Whitney U test, and Spearman's rank correlation test were performed. RESULTS All IVIM parameters demonstrated the difference between rectal tumor parenchyma and normal wall (PD<0.001; PD*=0.014; Pf<0.001). Poorly differentiated carcinoma had a significantly lower f value (Pf=0.049) than well/moderately-differentiated carcinoma. In addition, mucinous carcinoma had a higher D (PD=0.001) and a lower D* value (PD*=0.001) than non-mucinous carcinoma. Correlation analysis between IVIM parameters and histopathology showed that D (|r|=0.538, PD=0.000) and D* (|r|=0.267, PD*=0.001) had statistically significant correlations with histological type and f (|r|=0.175, Pf=0.048) was significantly correlated with differentiation degree. CONCLUSIONS The IVIM parameters of rectal tumor parenchyma and normal wall were significantly different. D appears to be a valid and promising parameter to indicate histological features of rectal carcinoma.
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Affiliation(s)
- Baolan Lu
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (mainland)
| | - Xinyue Yang
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (mainland)
| | - Xiaojuan Xiao
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China (mainland)
| | - Yan Chen
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (mainland)
| | - Xu Yan
- MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (mainland)
| | - Shenping Yu
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (mainland)
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Lu B, Yang X, Xiao X, Chen Y, Yan X, Yu S. Intravoxel Incoherent Motion Diffusion-Weighted Imaging of Primary Rectal Carcinoma: Correlation with Histopathology. Med Sci Monit 2018; 24:2429-2436. [PMID: 29679528 PMCID: PMC5930975 DOI: 10.12659/msm.908574] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Comprehensive and precise assessment of rectal carcinoma is crucial before surgery to plan an individual treatment strategy. New functional techniques, such as intravoxel incoherent motion (IVIM), have emerged and could lead to more detailed information. The aim of this study was to evaluate the difference between the rectal tumor parenchyma and normal wall by IVIM and to explore the correlations of IVIM parameters and histopathology. Material/Methods We prospectively enrolled 128 patients with pathologically proven rectal non-mucinous carcinoma with differentiation degree and 16 patients with mucinous carcinoma. All patients underwent routine MR examination and IVIM sequence. The IVIM maps were automatically generated and 3 ROIs were drawn on the maximal rectal tumor parenchyma and normal rectal wall. The Wilcoxon signed rank test, t test, Mann-Whitney U test, and Spearman’s rank correlation test were performed. Results All IVIM parameters demonstrated the difference between rectal tumor parenchyma and normal wall (PD<0.001; PD*=0.014; Pf<0.001). Poorly differentiated carcinoma had a significantly lower f value (Pf=0.049) than well/moderately-differentiated carcinoma. In addition, mucinous carcinoma had a higher D (PD=0.001) and a lower D* value (PD*=0.001) than non-mucinous carcinoma. Correlation analysis between IVIM parameters and histopathology showed that D (|r|=0.538, PD=0.000) and D* (|r|=0.267, PD*=0.001) had statistically significant correlations with histological type and f (|r|=0.175, Pf=0.048) was significantly correlated with differentiation degree. Conclusions The IVIM parameters of rectal tumor parenchyma and normal wall were significantly different. D appears to be a valid and promising parameter to indicate histological features of rectal carcinoma.
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Affiliation(s)
- Baolan Lu
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (mainland)
| | - Xinyue Yang
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (mainland)
| | - Xiaojuan Xiao
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China (mainland)
| | - Yan Chen
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (mainland)
| | - Xu Yan
- MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China (mainland)
| | - Shenping Yu
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (mainland)
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Mozumder M, Beltrachini L, Collier Q, Pozo JM, Frangi AF. Simultaneous magnetic resonance diffusion and pseudo-diffusion tensor imaging. Magn Reson Med 2018; 79:2367-2378. [PMID: 28714249 PMCID: PMC5836966 DOI: 10.1002/mrm.26840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/23/2017] [Accepted: 06/24/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE An emerging topic in diffusion magnetic resonance is imaging blood microcirculation alongside water diffusion using the intravoxel incoherent motion (IVIM) model. Recently, a combined IVIM diffusion tensor imaging (IVIM-DTI) model was proposed, which accounts for both anisotropic pseudo-diffusion due to blood microcirculation and anisotropic diffusion due to tissue microstructures. In this article, we propose a robust IVIM-DTI approach for simultaneous diffusion and pseudo-diffusion tensor imaging. METHODS Conventional IVIM estimation methods can be broadly divided into two-step (diffusion and pseudo-diffusion estimated separately) and one-step (diffusion and pseudo-diffusion estimated simultaneously) methods. Here, both methods were applied on the IVIM-DTI model. An improved one-step method based on damped Gauss-Newton algorithm and a Gaussian prior for the model parameters was also introduced. The sensitivities of these methods to different parameter initializations were tested with realistic in silico simulations and experimental in vivo data. RESULTS The one-step damped Gauss-Newton method with a Gaussian prior was less sensitive to noise and the choice of initial parameters and delivered more accurate estimates of IVIM-DTI parameters compared to the other methods. CONCLUSION One-step estimation using damped Gauss-Newton and a Gaussian prior is a robust method for simultaneous diffusion and pseudo-diffusion tensor imaging using IVIM-DTI model. Magn Reson Med 79:2367-2378, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Meghdoot Mozumder
- Center for Computational Imaging & Simulation Technologies in Biomedicine (CISTIB)Department of Electronic and Electrical Engineering, The University of SheffieldSheffieldUK
| | - Leandro Beltrachini
- Center for Computational Imaging & Simulation Technologies in Biomedicine (CISTIB)Department of Electronic and Electrical Engineering, The University of SheffieldSheffieldUK
| | - Quinten Collier
- iMinds Vision LabDepartment of Physics, University of Antwerp (CDE)AntwerpenBelgium
| | - Jose M. Pozo
- Center for Computational Imaging & Simulation Technologies in Biomedicine (CISTIB)Department of Electronic and Electrical Engineering, The University of SheffieldSheffieldUK
| | - Alejandro F. Frangi
- Center for Computational Imaging & Simulation Technologies in Biomedicine (CISTIB)Department of Electronic and Electrical Engineering, The University of SheffieldSheffieldUK
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Iima M, Kataoka M, Kanao S, Kawai M, Onishi N, Koyasu S, Murata K, Ohashi A, Sakaguchi R, Togashi K. Variability of non-Gaussian diffusion MRI and intravoxel incoherent motion (IVIM) measurements in the breast. PLoS One 2018; 13:e0193444. [PMID: 29494639 PMCID: PMC5832256 DOI: 10.1371/journal.pone.0193444] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 02/12/2018] [Indexed: 01/12/2023] Open
Abstract
We prospectively examined the variability of non-Gaussian diffusion magnetic resonance imaging (MRI) and intravoxel incoherent motion (IVIM) measurements with different numbers of b-values and excitations in normal breast tissue and breast lesions. Thirteen volunteers and fourteen patients with breast lesions (seven malignant, eight benign; one patient had bilateral lesions) were recruited in this prospective study (approved by the Internal Review Board). Diffusion-weighted MRI was performed with 16 b-values (0–2500 s/mm2 with one number of excitations [NEX]) and five b-values (0–2500 s/mm2, 3 NEX), using a 3T breast MRI. Intravoxel incoherent motion (flowing blood volume fraction [fIVIM] and pseudodiffusion coefficient [D*]) and non-Gaussian diffusion (theoretical apparent diffusion coefficient [ADC] at b value of 0 sec/mm2 [ADC0] and kurtosis [K]) parameters were estimated from IVIM and Kurtosis models using 16 b-values, and synthetic apparent diffusion coefficient (sADC) values were obtained from two key b-values. The variabilities between and within subjects and between different diffusion acquisition methods were estimated. There were no statistical differences in ADC0, K, or sADC values between the different b-values or NEX. A good agreement of diffusion parameters was observed between 16 b-values (one NEX), five b-values (one NEX), and five b-values (three NEX) in normal breast tissue or breast lesions. Insufficient agreement was observed for IVIM parameters. There were no statistical differences in the non-Gaussian diffusion MRI estimated values obtained from a different number of b-values or excitations in normal breast tissue or breast lesions. These data suggest that a limited MRI protocol using a few b-values might be relevant in a clinical setting for the estimation of non-Gaussian diffusion MRI parameters in normal breast tissue and breast lesions.
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Affiliation(s)
- Mami Iima
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- The Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan
- * E-mail:
| | - Masako Kataoka
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shotaro Kanao
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Makiko Kawai
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Natsuko Onishi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sho Koyasu
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Akane Ohashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Rena Sakaguchi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Kawashima H, Miyati T, Ohno N, Ohno M, Inokuchi M, Ikeda H, Gabata T. Differentiation between phyllodes tumours and fibroadenomas using intravoxel incoherent motion magnetic resonance imaging: comparison with conventional diffusion-weighted imaging. Br J Radiol 2018; 91:20170687. [PMID: 29231040 DOI: 10.1259/bjr.20170687] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate whether the parameters derived from intravoxel incoherent motion (IVIM) MRI could differentiate phyllodes tumours (PTs) from fibroadenomas (FAs) by comparing the apparent diffusion coefficient (ADC) values. METHODS This retrospective study included 7 FAs, 10 benign PTs (BPTs), 4 borderline PTs, and one malignant PT. Biexponential analyses of IVIM were performed using a 3 T MRI scanner. Quantitative IVIM parameters [pure diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and fraction (f)] were calculated. The ADC was also calculated using monoexponential fitting. RESULTS The D and ADC values showed an increasing tendency in the order of FA, BPT, and borderline or malignant PT (BMPT). No significant difference was found in the D value among the three groups. The ADC value of the BMPT group was significantly higher than that of the FA group (p = 0.048). The D* value showed an increasing tendency in the order of BMPT, BPT, and FA, and the D* value of the BMPT group was significantly lower than that of the FA group (p = 0.048). CONCLUSION The D* derived from IVIM and the ADC were helpful for differentiating between FA and BMPT. Advances in knowledge: IVIM MRI examination showed that the perfusion-related diffusion coefficient is lower in borderline and malignant PTs than in FAs and the opposite is true for the ADC.
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Affiliation(s)
- Hiroko Kawashima
- 1 Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University , Kanazawa , Japan.,2 Department of Breast Oncology, Kanazawa University Hospital , Kanazawa , Japan
| | - Tosiaki Miyati
- 1 Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University , Kanazawa , Japan
| | - Naoki Ohno
- 1 Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University , Kanazawa , Japan
| | - Masako Ohno
- 3 Division of Radiology, Kanazawa University Hospital , Kanazawa , Japan
| | - Masafumi Inokuchi
- 2 Department of Breast Oncology, Kanazawa University Hospital , Kanazawa , Japan
| | - Hiroko Ikeda
- 4 Division of Pathology, Kanazawa University Hospital , Kanazawa , Japan
| | - Toshifumi Gabata
- 5 Department of Radiology, Kanazawa University Hospital , Kanazawa , Japan
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68
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Le Bihan D. What can we see with IVIM MRI? Neuroimage 2017; 187:56-67. [PMID: 29277647 DOI: 10.1016/j.neuroimage.2017.12.062] [Citation(s) in RCA: 246] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/28/2017] [Accepted: 12/19/2017] [Indexed: 12/18/2022] Open
Abstract
Intravoxel Incoherent Motion (IVIM) refers to translational movements which within a given voxel and during the measurement time present a distribution of speeds in orientation and/or amplitude. The IVIM concept has been used to estimate perfusion in tissues as blood flow in randomly oriented capillaries mimics a pseudo-diffusion process. IVIM-based perfusion MRI, which does not require contrast agents, has gained momentum recently, especially in the field oncology. In this introductory review the basic concepts, models, technical requirements and limitations inherent to IVIM-based perfusion MRI are outlined, as well as new, non-perfusion applications of IVIM MRI, such as virtual MR Elastography.
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Affiliation(s)
- Denis Le Bihan
- NeuroSpin, Frédéric Joliot Institute, Bât 145, CEA-Saclay Center, Gif-sur-Yvette, 91191 France.
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Kawashima H, Miyati T, Ohno N, Ohno M, Inokuchi M, Ikeda H, Gabata T. Differentiation Between Luminal-A and Luminal-B Breast Cancer Using Intravoxel Incoherent Motion and Dynamic Contrast-Enhanced Magnetic Resonance Imaging. Acad Radiol 2017; 24:1575-1581. [PMID: 28778511 DOI: 10.1016/j.acra.2017.06.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 06/17/2017] [Accepted: 06/19/2017] [Indexed: 01/15/2023]
Abstract
RATIONALE AND OBJECTIVES The study aimed to investigate whether intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) can differentiate luminal-B from luminal-A breast cancer MATERIALS AND METHODS: Biexponential analyses of IVIM and DCE MRI were performed using a 3.0-T MRI scanner, involving 134 patients with 137 pathologically confirmed luminal-type invasive breast cancers. Luminal-type breast cancer was categorized as luminal-B breast cancer (LBBC, Ki-67 ≧ 14%) or luminal-A breast cancer (LABC, Ki-67 < 14%). Quantitative parameters from IVIM (pure diffusion coefficient [D], perfusion-related diffusion coefficient [D*], and fraction [f]) and DCE MRI (initial percentage of enhancement and signal enhancement ratio [SER]) were calculated. The apparent diffusion coefficient (ADC) was also calculated using monoexponential fitting. We correlated these data with the Ki-67 status. RESULTS The D and ADC values of LBBC were significantly lower than those of LABC (P = 0.028, P = 0.037). The SER of LBBC was significantly higher than that of LABC (P = 0.004). A univariate analysis showed that a significantly lower D (<0.847 x 10-3 mm2/s), lower ADC (<0.960 × 10-3 mm2/s), and higher SER (>1.071) values were associated with LBBC (all P values <0.01), compared to LABC. In a multivariate analysis, a higher SER (>1.071; odds ratio: 3.0099, 95% confidence interval: 1.4246-6.3593; P = 0.003) value and a lower D (<0.847 × 10-3 mm2/s; odds ratio: 2.6878, 95% confidence interval: 1.0445-6.9162; P = 0.040) value were significantly associated with LBBC, compared to LABC. CONCLUSION The SER derived from DCE MRI and the D derived from IVIM are associated independently with the Ki-67 status in patients with luminal-type breast cancer.
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Affiliation(s)
- Hiroko Kawashima
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa 920-0942, Japan; Department of Breast Oncology, Kanazawa University Hospital, Kanazawa, Japan.
| | - Tosiaki Miyati
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa 920-0942, Japan
| | - Naoki Ohno
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa 920-0942, Japan
| | - Masako Ohno
- Radiology Division, Kanazawa University Hospital, Kanazawa, Japan
| | - Masafumi Inokuchi
- Department of Breast Oncology, Kanazawa University Hospital, Kanazawa, Japan
| | - Hiroko Ikeda
- Division of Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Hospital, Kanazawa, Japan
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While PT, Teruel JR, Vidić I, Bathen TF, Goa PE. Relative enhanced diffusivity: noise sensitivity, protocol optimization, and the relation to intravoxel incoherent motion. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 31:425-438. [PMID: 29110241 DOI: 10.1007/s10334-017-0660-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 10/17/2017] [Accepted: 10/19/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To explore the relationship between relative enhanced diffusivity (RED) and intravoxel incoherent motion (IVIM), as well as the impact of noise and the choice of intermediate diffusion weighting (b value) on the RED parameter. MATERIALS AND METHODS A mathematical derivation was performed to cast RED in terms of the IVIM parameters. Noise analysis and b value optimization was conducted by using Monte Carlo calculations to generate diffusion-weighted imaging data appropriate to breast and liver tissue at three different signal-to-noise ratios. RESULTS RED was shown to be approximately linearly proportional to the IVIM parameter f, inversely proportional to D and to follow an inverse exponential decay with respect to D*. The choice of intermediate b value was shown to be important in minimizing the impact of noise on RED and in maximizing its discriminatory power. RED was shown to be essentially a reparameterization of the IVIM estimates for f and D obtained with three b values. CONCLUSION RED imaging in the breast and liver should be performed with intermediate b values of 100 and 50 s/mm2, respectively. Future clinical studies involving RED should also estimate the IVIM parameters f and D using three b values for comparison.
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Affiliation(s)
- Peter T While
- Department of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim, Norway.
| | - Jose R Teruel
- Department of Radiation Oncology, New York University Langone Health, New York, NY, USA.,Department of Radiology, University of California, San Diego, CA, USA.,Department of Circulation and Medical Imaging, Norwegian University of Science and Technology-NTNU, Trondheim, Norway
| | - Igor Vidić
- Department of Physics, Norwegian University of Science and Technology-NTNU, Trondheim, Norway
| | - Tone F Bathen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology-NTNU, Trondheim, Norway
| | - Pål Erik Goa
- Department of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim, Norway.,Department of Physics, Norwegian University of Science and Technology-NTNU, Trondheim, Norway
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Iima M, Kataoka M, Kanao S, Onishi N, Kawai M, Ohashi A, Sakaguchi R, Toi M, Togashi K. Intravoxel Incoherent Motion and Quantitative Non-Gaussian Diffusion MR Imaging: Evaluation of the Diagnostic and Prognostic Value of Several Markers of Malignant and Benign Breast Lesions. Radiology 2017; 287:432-441. [PMID: 29095673 DOI: 10.1148/radiol.2017162853] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose To investigate the performance of integrated approaches that combined intravoxel incoherent motion (IVIM) and non-Gaussian diffusion parameters compared with the Breast Imaging and Reporting Data System (BI-RADS) to establish multiparameter thresholds scores or probabilities by using Bayesian analysis to distinguish malignant from benign breast lesions and their correlation with molecular prognostic factors. Materials and Methods Between May 2013 and March 2015, 411 patients were prospectively enrolled and 199 patients (allocated to training [n = 99] and validation [n = 100] sets) were included in this study. IVIM parameters (flowing blood volume fraction [fIVIM] and pseudodiffusion coefficient [D*]) and non-Gaussian diffusion parameters (theoretical apparent diffusion coefficient [ADC] at b value of 0 sec/mm2 [ADC0] and kurtosis [K]) by using IVIM and kurtosis models were estimated from diffusion-weighted image series (16 b values up to 2500 sec/mm2), as well as a synthetic ADC (sADC) calculated by using b values of 200 and 1500 (sADC200-1500) and a standard ADC calculated by using b values of 0 and 800 sec/mm2 (ADC0-800). The performance of two diagnostic approaches (combined parameter thresholds and Bayesian analysis) combining IVIM and diffusion parameters was evaluated and compared with BI-RADS performance. The Mann-Whitney U test and a nonparametric multiple comparison test were used to compare their performance to determine benignity or malignancy and as molecular prognostic biomarkers and subtypes of breast cancer. Results Significant differences were found between malignant and benign breast lesions for IVIM and non-Gaussian diffusion parameters (ADC0, K, fIVIM, fIVIM · D*, sADC200-1500, and ADC0-800; P < .05). Sensitivity and specificity for the validation set by radiologists A and B were as follows: sensitivity, 94.7% and 89.5%, and specificity, 75.0% and 79.2% for sADC200-1500, respectively; sensitivity, 94.7% and 96.1%, and specificity, 75.0% and 66.7%, for the combined thresholds approach, respectively; sensitivity, 92.1% and 92.1%, and specificity, 83.3% and 66.7%, for Bayesian analysis, respectively; and sensitivity and specificity, 100% and 79.2%, for BI-RADS, respectively. The significant difference in values of sADC200-1500 in progesterone receptor status (P = .002) was noted. sADC200-1500 was significantly different between histologic subtypes (P = .006). Conclusion Approaches that combined various IVIM and non-Gaussian diffusion MR imaging parameters may provide BI-RADS-equivalent scores almost comparable to BI-RADS categories without the use of contrast agents. Non-Gaussian diffusion parameters also differed by biologic prognostic factors. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Mami Iima
- From the Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan (M.I., M. Kataoka, S.K., N.O., M. Kawai, A.O., R.S., K.T.); Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan (M.I.); and Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan (M.T.)
| | - Masako Kataoka
- From the Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan (M.I., M. Kataoka, S.K., N.O., M. Kawai, A.O., R.S., K.T.); Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan (M.I.); and Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan (M.T.)
| | - Shotaro Kanao
- From the Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan (M.I., M. Kataoka, S.K., N.O., M. Kawai, A.O., R.S., K.T.); Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan (M.I.); and Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan (M.T.)
| | - Natsuko Onishi
- From the Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan (M.I., M. Kataoka, S.K., N.O., M. Kawai, A.O., R.S., K.T.); Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan (M.I.); and Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan (M.T.)
| | - Makiko Kawai
- From the Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan (M.I., M. Kataoka, S.K., N.O., M. Kawai, A.O., R.S., K.T.); Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan (M.I.); and Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan (M.T.)
| | - Akane Ohashi
- From the Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan (M.I., M. Kataoka, S.K., N.O., M. Kawai, A.O., R.S., K.T.); Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan (M.I.); and Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan (M.T.)
| | - Rena Sakaguchi
- From the Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan (M.I., M. Kataoka, S.K., N.O., M. Kawai, A.O., R.S., K.T.); Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan (M.I.); and Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan (M.T.)
| | - Masakazu Toi
- From the Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan (M.I., M. Kataoka, S.K., N.O., M. Kawai, A.O., R.S., K.T.); Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan (M.I.); and Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan (M.T.)
| | - Kaori Togashi
- From the Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan (M.I., M. Kataoka, S.K., N.O., M. Kawai, A.O., R.S., K.T.); Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan (M.I.); and Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan (M.T.)
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Meeus EM, Novak J, Dehghani H, Peet AC. Rapid measurement of intravoxel incoherent motion (IVIM) derived perfusion fraction for clinical magnetic resonance imaging. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 31:269-283. [PMID: 29075909 PMCID: PMC5871652 DOI: 10.1007/s10334-017-0656-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 09/26/2017] [Accepted: 09/27/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to investigate the reliability of intravoxel incoherent motion (IVIM) model derived parameters D and f and their dependence on b value distributions with a rapid three b value acquisition protocol. MATERIALS AND METHODS Diffusion models for brain, kidney, and liver were assessed for bias, error, and reproducibility for the estimated IVIM parameters using b values 0 and 1000, and a b value between 200 and 900, at signal-to-noise ratios (SNR) 40, 55, and 80. Relative errors were used to estimate optimal b value distributions for each tissue scenario. Sixteen volunteers underwent brain DW-MRI, for which bias and coefficient of variation were determined in the grey matter. RESULTS Bias had a large influence in the estimation of D and f for the low-perfused brain model, particularly at lower b values, with the same trends being confirmed by in vivo imaging. Significant differences were demonstrated in vivo for estimation of D (P = 0.029) and f (P < 0.001) with [300,1000] and [500,1000] distributions. The effect of bias was considerably lower for the high-perfused models. The optimal b value distributions were estimated to be brain500,1000, kidney300,1000, and liver200,1000. CONCLUSION IVIM parameters can be estimated using a rapid DW-MRI protocol, where the optimal b value distribution depends on tissue characteristics and compromise between bias and variability.
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Affiliation(s)
- Emma M Meeus
- Physical Sciences of Imaging in Biomedical Sciences (PSIBS) Doctoral Training Centre, University of Birmingham, Birmingham, B15 2TT, UK.,Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK.,Department of Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Jan Novak
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK.,Department of Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Hamid Dehghani
- Physical Sciences of Imaging in Biomedical Sciences (PSIBS) Doctoral Training Centre, University of Birmingham, Birmingham, B15 2TT, UK.,School of Computer Science, University of Birmingham, Birmingham, B15 2TT, UK
| | - Andrew C Peet
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK. .,Department of Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
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73
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Vidić I, Egnell L, Jerome NP, Teruel JR, Sjøbakk TE, Østlie A, Fjøsne HE, Bathen TF, Goa PE. Support vector machine for breast cancer classification using diffusion-weighted MRI histogram features: Preliminary study. J Magn Reson Imaging 2017; 47:1205-1216. [PMID: 29044896 DOI: 10.1002/jmri.25873] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/23/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Diffusion-weighted MRI (DWI) is currently one of the fastest developing MRI-based techniques in oncology. Histogram properties from model fitting of DWI are useful features for differentiation of lesions, and classification can potentially be improved by machine learning. PURPOSE To evaluate classification of malignant and benign tumors and breast cancer subtypes using support vector machine (SVM). STUDY TYPE Prospective. SUBJECTS Fifty-one patients with benign (n = 23) and malignant (n = 28) breast tumors (26 ER+, whereof six were HER2+). FIELD STRENGTH/SEQUENCE Patients were imaged with DW-MRI (3T) using twice refocused spin-echo echo-planar imaging with echo time / repetition time (TR/TE) = 9000/86 msec, 90 × 90 matrix size, 2 × 2 mm in-plane resolution, 2.5 mm slice thickness, and 13 b-values. ASSESSMENT Apparent diffusion coefficient (ADC), relative enhanced diffusivity (RED), and the intravoxel incoherent motion (IVIM) parameters diffusivity (D), pseudo-diffusivity (D*), and perfusion fraction (f) were calculated. The histogram properties (median, mean, standard deviation, skewness, kurtosis) were used as features in SVM (10-fold cross-validation) for differentiation of lesions and subtyping. STATISTICAL TESTS Accuracies of the SVM classifications were calculated to find the combination of features with highest prediction accuracy. Mann-Whitney tests were performed for univariate comparisons. RESULTS For benign versus malignant tumors, univariate analysis found 11 histogram properties to be significant differentiators. Using SVM, the highest accuracy (0.96) was achieved from a single feature (mean of RED), or from three feature combinations of IVIM or ADC. Combining features from all models gave perfect classification. No single feature predicted HER2 status of ER + tumors (univariate or SVM), although high accuracy (0.90) was achieved with SVM combining several features. Importantly, these features had to include higher-order statistics (kurtosis and skewness), indicating the importance to account for heterogeneity. DATA CONCLUSION Our findings suggest that SVM, using features from a combination of diffusion models, improves prediction accuracy for differentiation of benign versus malignant breast tumors, and may further assist in subtyping of breast cancer. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1205-1216.
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Affiliation(s)
- Igor Vidić
- Department of Physics, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Liv Egnell
- Department of Physics, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Neil P Jerome
- Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Jose R Teruel
- Department of Radiology, University of California San Diego, La Jolla, California, USA.,Department of Radiation Oncology, NYU Langone Medical Center, New York, New York, USA
| | - Torill E Sjøbakk
- Department of Circulation and Medical Imaging, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Agnes Østlie
- Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Hans E Fjøsne
- Department of Cancer Research and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Department of Surgery, St. Olavs University Hospital, Trondheim, Norway
| | - Tone F Bathen
- Department of Circulation and Medical Imaging, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Pål Erik Goa
- Department of Physics, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
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74
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Kayal EB, Kandasamy D, Khare K, Alampally JT, Bakhshi S, Sharma R, Mehndiratta A. Quantitative Analysis of Intravoxel Incoherent Motion (IVIM) Diffusion MRI using Total Variation and Huber Penalty Function. Med Phys 2017; 44:5849-5858. [DOI: 10.1002/mp.12520] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/04/2017] [Accepted: 08/08/2017] [Indexed: 11/07/2022] Open
Affiliation(s)
- Esha Baidya Kayal
- Centre for Biomedical Engineering; Indian Institute of Technology Delhi; New Delhi India
| | | | - Kedar Khare
- Department of Physics; Indian Institute of Technology Delhi; New Delhi India
| | | | - Sameer Bakhshi
- Dr. B.R. Ambedkar Institute-Rotary Cancer Hospital (IRCH); All India Institute of Medical Sciences; New Delhi India
| | - Raju Sharma
- Department of Radio Diagnosis; All India Institute of Medical Sciences; New Delhi India
| | - Amit Mehndiratta
- Centre for Biomedical Engineering; Indian Institute of Technology Delhi; New Delhi India
- Department of Biomedical Engineering; All India Institute of Medical Sciences; New Delhi India
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75
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Zhang XY, Li XT, Sun J, Sun YS. Initial experience of correlating diffusion spectral parameters with histopathologic indexes in murine colorectal tumor homografts. Onco Targets Ther 2017; 10:4213-4223. [PMID: 28894378 PMCID: PMC5584890 DOI: 10.2147/ott.s127283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the correlation between continuously distributed diffusion-weighted image (DWI)-derived parameters and histopathologic indexes. Methods Fifty-four mice bearing HCT-116 colorectal tumors were included for analysis; 12 mice were used for continuous observation, and the other 42 mice were used for break-point observation. All mice were randomly divided into radiotherapy and non-radiotherapy groups. Optical imaging and MRI were performed at different time points according to radiotherapy regimen (baseline, 24 h, 48 h, 72 h, 7 d, 14 d, and 28 d). Continuous observation data were analyzed to show the difference of dynamic changing trends of optical and MR-DWI–derived parameters between radiotherapy and non-radiotherapy groups (photon numbers, D_max, full width half maximum [FWHM], and apparent diffusion coefficient [ADC] value). Break-point observation data were used to analyze the correlation between histopathologic indices and DWI-derived parameters. Results There was a significant difference in the changing trends of photon numbers, D_max, FWHM, and ADC value between radiotherapy and non-radiotherapy groups, especially at early time points. There was moderate negative correlation between Ki67 and percentage changes of D_max, FWHM, and ADC values (the correlation coefficients were 0.632, 0.449, and 0.586, P<0.001, P=0.008, and P<0.001, respectively). There was moderate negative correlation between survivin and percentage changes of D_max and ADC values (correlation coefficients were 0.496 and 0.473, P=0.004 and P=0.006, respectively). Conclusion The continuously distributed DWI-derived parameters could reflect histological behavior to some extent and, thus, are potential markers for early noninvasive monitoring of tumor cell apoptosis and proliferation.
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Affiliation(s)
- Xiao-Yan Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Xiao-Ting Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Jia Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Ying-Shi Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
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76
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Cho GY, Gennaro L, Sutton EJ, Zabor EC, Zhang Z, Giri D, Moy L, Sodickson DK, Morris EA, Sigmund EE, Thakur SB. Intravoxel incoherent motion (IVIM) histogram biomarkers for prediction of neoadjuvant treatment response in breast cancer patients. Eur J Radiol Open 2017; 4:101-107. [PMID: 28856177 PMCID: PMC5565789 DOI: 10.1016/j.ejro.2017.07.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 07/16/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To examine the prognostic capabilities of intravoxel incoherent motion (IVIM) metrics and their ability to predict response to neoadjuvant treatment (NAT). Additionally, to observe changes in IVIM metrics between pre- and post-treatment MRI. METHODS This IRB-approved, HIPAA-compliant retrospective study observed 31 breast cancer patients (32 lesions). Patients underwent standard bilateral breast MRI along with diffusion-weighted imaging before and after NAT. Six patients underwent an additional IVIM-MRI scan 12-14 weeks after initial scan and 2 cycles of treatment. In addition to apparent diffusion coefficients (ADC) from monoexponential decay, IVIM mean values (tissue diffusivity Dt, perfusion fraction fp, and pseudodiffusivity Dp) and histogram metrics were derived using a biexponential model. An additional filter identified voxels of highly vascular tumor tissue (VTT), excluding necrotic or normal tissue. Clinical data include histology of biopsy and clinical response to treatment through RECIST assessment. Comparisons of treatment response were made using Wilcoxon rank-sum tests. RESULTS Average, kurtosis, and skewness of pseudodiffusion Dp significantly differentiated RECIST responders from nonresponders. ADC and Dt values generally increased (∼70%) and VTT% values generally decreased (∼20%) post-treatment. CONCLUSION Dp metrics showed prognostic capabilities; slow and heterogeneous pseudodiffusion offer poor prognosis. Baseline ADC/Dt parameters were not significant predictors of response. This work suggests that IVIM mean values and heterogeneity metrics may have prognostic value in the setting of breast cancer NAT.
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Affiliation(s)
- Gene Y Cho
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York School of Medicine, New York, NY, 10016, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), New York University Langone Medical Center, New York, NY, 10016, USA
| | - Lucas Gennaro
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Elizabeth J Sutton
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Emily C Zabor
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA
| | - Zhigang Zhang
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA
| | - Dilip Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Linda Moy
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York School of Medicine, New York, NY, 10016, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), New York University Langone Medical Center, New York, NY, 10016, USA
| | - Daniel K Sodickson
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York School of Medicine, New York, NY, 10016, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), New York University Langone Medical Center, New York, NY, 10016, USA
| | - Elizabeth A Morris
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Eric E Sigmund
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York School of Medicine, New York, NY, 10016, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), New York University Langone Medical Center, New York, NY, 10016, USA
| | - Sunitha B Thakur
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
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77
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Wang F, Wu LM, Hua XL, Zhao ZZ, Chen XX, Xu JR. Intravoxel incoherent motion diffusion-weighted imaging in assessing bladder cancer invasiveness and cell proliferation. J Magn Reson Imaging 2017; 47:1054-1060. [PMID: 28815808 DOI: 10.1002/jmri.25839] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 07/29/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Nonmuscle-invasive bladder cancer (NMIBC, Stage T1 or lower) is treated with transurethral resection (TUR), while muscle-invasive bladder cancer (MIBC, Stage T2 or more) requires neoadjuvant chemotherapy before radical cystectomy. Hence, preoperative differentiation is vital. PURPOSE To investigate whether intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) can differentiate NMIBC from MIBC and to assess whether there were correlations between IVIM parameters and the Ki-67 labeling index (LI). STUDY TYPE Retrospective. SUBJECTS Thirty-six patients diagnosed with bladder cancer confirmed by histopathological findings. FIELD STRENGTH/SEQUENCE 3.0T magnetic resonance imaging (MRI) DWI with eight b-values ranging from 0 to 1000 s/mm2 . ASSESSMENT Molecular diffusion coefficient (D), perfusion-related diffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADC) were calculated by biexponential and monoexponential models fits, respectively. STATISTICAL TESTS Comparisons were made between the MIBC and NMIBC group, and differences were analyzed by comparing the areas under the receiver-operating characteristic curves (AUCs). The correlations between these parameters and Ki-67 LI were assessed by Spearman's rank correlation analysis. RESULTS The ADC and D value were significantly lower in patients with MIBC compared to those with NMIBC (P < 0.01). No significant (P > 0.05) differences were observed in D* and f. The AUC of D value (0.894) was significantly (P < 0.05) larger than the ADC value (0.786), with sensitivities and specificities of 95% and 87.5% (D) and 80% and 68.7% (ADC), respectively. In addition, the D and ADC values were significantly correlated with Ki-67 LI (r = -0.785, r = -0.643, respectively; both P < 0.01). DATA CONCLUSION The D value obtained from IVIM exhibited better performance than conventional DWI for distinguishing NMIBC from MIBC and may serve as a potential imaging biomarker for bladder cancer invasion. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1054-1060.
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Affiliation(s)
- Fang Wang
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Lian-Ming Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Xiao-Lan Hua
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Zi-Zhou Zhao
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Xiao-Xi Chen
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Jian-Rong Xu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
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78
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Bedair R, Priest AN, Patterson AJ, McLean MA, Graves MJ, Manavaki R, Gill AB, Abeyakoon O, Griffiths JR, Gilbert FJ. Assessment of early treatment response to neoadjuvant chemotherapy in breast cancer using non-mono-exponential diffusion models: a feasibility study comparing the baseline and mid-treatment MRI examinations. Eur Radiol 2017; 27:2726-2736. [PMID: 27798751 PMCID: PMC5486805 DOI: 10.1007/s00330-016-4630-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 09/29/2016] [Accepted: 10/03/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To assess the feasibility of the mono-exponential, bi-exponential and stretched-exponential models in evaluating response of breast tumours to neoadjuvant chemotherapy (NACT) at 3 T. METHODS Thirty-six female patients (median age 53, range 32-75 years) with invasive breast cancer undergoing NACT were enrolled for diffusion-weighted MRI (DW-MRI) prior to the start of treatment. For assessment of early response, changes in parameters were evaluated on mid-treatment MRI in 22 patients. DW-MRI was performed using eight b values (0, 30, 60, 90, 120, 300, 600, 900 s/mm2). Apparent diffusion coefficient (ADC), tissue diffusion coefficient (D t), vascular fraction (ƒ), distributed diffusion coefficient (DDC) and alpha (α) parameters were derived. Then t tests compared the baseline and changes in parameters between response groups. Repeatability was assessed at inter- and intraobserver levels. RESULTS All patients underwent baseline MRI whereas 22 lesions were available at mid-treatment. At pretreatment, mean diffusion coefficients demonstrated significant differences between groups (p < 0.05). At mid-treatment, percentage increase in ADC and DDC showed significant differences between responders (49 % and 43 %) and non-responders (21 % and 32 %) (p = 0.03, p = 0.04). Overall, stretched-exponential parameters showed excellent repeatability. CONCLUSION DW-MRI is sensitive to baseline and early treatment changes in breast cancer using non-mono-exponential models, and the stretched-exponential model can potentially monitor such changes. KEY POINTS • Baseline diffusion coefficients demonstrated significant differences between complete pathological responders and non-responders. • Increase in ADC and DDC at mid-treatment can discriminate responders and non-responders. • The ƒ fraction at mid-treatment decreased in responders whereas increased in non-responders. • The mono- and stretched-exponential models showed excellent inter- and intrarater repeatability. • Treatment effects can potentially be assessed by non-mono-exponential diffusion models.
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Affiliation(s)
- Reem Bedair
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Andrew N Priest
- Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Andrew J Patterson
- Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Mary A McLean
- Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, CB2 0RE, UK
| | - Martin J Graves
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
- Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Roido Manavaki
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Andrew B Gill
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Oshaani Abeyakoon
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - John R Griffiths
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, CB2 0RE, UK
| | - Fiona J Gilbert
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
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79
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Intravoxel Incoherent Motion Diffusion for Identification of Breast Malignant and Benign Tumors Using Chemometrics. BIOMED RESEARCH INTERNATIONAL 2017. [PMID: 28630864 PMCID: PMC5467388 DOI: 10.1155/2017/3845409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the paper is to identify the breast malignant and benign lesions using the features of apparent diffusion coefficient (ADC), perfusion fraction f, pseudodiffusion coefficient D⁎, and true diffusion coefficient D from intravoxel incoherent motion (IVIM). There are 69 malignant cases (including 9 early malignant cases) and 35 benign breast cases who underwent diffusion-weighted MRI at 3.0 T with 8 b-values (0~1000 s/mm2). ADC and IVIM parameters were determined in lesions. The early malignant cases are used as advanced malignant and benign tumors, respectively, so as to assess the effectiveness on the result. A predictive model was constructed using Support Vector Machine Binary Classification (SVMBC, also known Support Vector Machine Discriminant Analysis (SVMDA)) and Partial Least Squares Discriminant Analysis (PLSDA) and compared the difference between them both. The D value and ADC provide accurate identification of malignant lesions with b = 300, if early malignant tumor was considered as advanced malignant (cancer). The classification accuracy is 93.5% for cross-validation using SVMBC with ADC and tissue diffusivity only. The sensitivity and specificity are 100% and 87.0%, respectively, r2cv = 0.8163, and root mean square error of cross-validation (RMSECV) is 0.043. ADC and IVIM provide quantitative measurement of tissue diffusivity for cellularity and are helpful with the method of SVMBC, getting comprehensive and complementary information for differentiation between benign and malignant breast lesions.
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80
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Marzi S, Piludu F, Forina C, Sanguineti G, Covello R, Spriano G, Vidiri A. Correlation study between intravoxel incoherent motion MRI and dynamic contrast-enhanced MRI in head and neck squamous cell carcinoma: Evaluation in primary tumors and metastatic nodes. Magn Reson Imaging 2017; 37:1-8. [DOI: 10.1016/j.mri.2016.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/07/2016] [Accepted: 10/05/2016] [Indexed: 12/12/2022]
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81
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A comparative simulation study of bayesian fitting approaches to intravoxel incoherent motion modeling in diffusion-weighted MRI. Magn Reson Med 2017; 78:2373-2387. [DOI: 10.1002/mrm.26598] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 12/08/2016] [Accepted: 12/13/2016] [Indexed: 01/27/2023]
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82
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Chen W, Zhang J, Long D, Wang Z, Zhu JM. Optimization of intra-voxel incoherent motion measurement in diffusion-weighted imaging of breast cancer. J Appl Clin Med Phys 2017; 18:191-199. [PMID: 28349630 PMCID: PMC5689860 DOI: 10.1002/acm2.12065] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/04/2017] [Accepted: 02/10/2017] [Indexed: 01/17/2023] Open
Abstract
Purpose The purpose of this study was to optimize intra‐voxel incoherent motion (IVIM) measurement in diffusion‐weighted imaging (DWI) of breast cancer by separating perfusion and diffusion effects through the determination of an optimal threshold b‐value, thus benign and cancerous breast tissues can be accurately differentiated using IVIM‐derived diffusion and perfusion parameters. Materials and Methods Twenty‐eight patients, with biopsy‐confirmed breast cancers, were studied with a 3T MRI scanner, using T1‐weighted dynamic contrast‐enhanced MRI images, and diffusion‐weighted images with nine b‐values, ranging from 0 to 1000 s/mm². IVIM‐derived parameter maps for tissue diffusion coefficients D, perfusion fraction f, and pseudo‐diffusion coefficients D* were computed using the segmented fitting method with optimized threshold b‐value, and the sum of squared residuals (SSR) were calculated for IVIM‐derived parameters in different breast lesions. Results The IVIM analysis method developed in this work can separate perfusion and diffusion effects with the optimal threshold b‐value of 300 s/mm², and the results of diffusion and perfusion parameters from IVIM analysis can be used to differentiate pathological changes in breast tissues. It was found that the averages and standard deviations of the diffusion and perfusion parameters, D, f, D*, are the following, for malignant, benign and normal breast tissues respectively: D (0.813 ± 0.225 × 10−3 mm2/s, 1.437 ± 0.538 × 10−3 mm2/s, 1.838 ± 0.213 × 10−3 mm2/s), f (10.73 ± 3.44%, 7.86 ± 3.70%, 8.92 ± 3.72%), D* (15.23 ± 12.17×10−3 mm²/s, 12.02 ± 3.19 × 10−3 mm2/s, 12.03 ± 7.21 × 10−3 mm2/s). Conclusion IVIM‐derived diffusion and perfusion parameter maps depend highly on the choice of threshold b‐value. Using the methodology developed in this work, and with the optimized threshold b‐value, the diffusion and perfusion parameters of breast tissues can be accurately assessed, making IVIM MRI a technique of choice for differential diagnosis of breast cancer.
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Affiliation(s)
- Wenjing Chen
- Institute for Biomedical Engineering, China Jiliang University, Hangzhou, Zhejiang, China
| | - Juan Zhang
- Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
| | - Dan Long
- Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
| | - Zhenchang Wang
- Department of Radiology and Center for Medical Imaging Research, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jian-Ming Zhu
- Institute for Biomedical Engineering, China Jiliang University, Hangzhou, Zhejiang, China.,Department of Radiology and Center for Medical Imaging Research, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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83
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Bailey C, Siow B, Panagiotaki E, Hipwell JH, Mertzanidou T, Owen J, Gazinska P, Pinder SE, Alexander DC, Hawkes DJ. Microstructural models for diffusion MRI in breast cancer and surrounding stroma: an ex vivo study. NMR IN BIOMEDICINE 2017; 30:e3679. [PMID: 28000292 PMCID: PMC5244665 DOI: 10.1002/nbm.3679] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 11/06/2016] [Accepted: 11/07/2016] [Indexed: 05/17/2023]
Abstract
The diffusion signal in breast tissue has primarily been modelled using apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM) and diffusion tensor (DT) models, which may be too simplistic to describe the underlying tissue microstructure. Formalin-fixed breast cancer samples were scanned using a wide range of gradient strengths, durations, separations and orientations. A variety of one- and two-compartment models were tested to determine which best described the data. Models with restricted diffusion components and anisotropy were selected in most cancerous regions and there were no regions in which conventional ADC or DT models were selected. Maps of ADC generally related to cellularity on histology, but maps of parameters from more complex models suggest that both overall cell volume fraction and individual cell size can contribute to the diffusion signal, affecting the specificity of ADC to the tissue microstructure. The areas of coherence in diffusion anisotropy images were small, approximately 1 mm, but the orientation corresponded to stromal orientation patterns on histology.
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Affiliation(s)
- Colleen Bailey
- University College LondonCentre for Medical Image ComputingLondonUK
| | - Bernard Siow
- University College LondonCentre for Advanced Biomedical ImagingLondonUK
| | | | - John H. Hipwell
- University College LondonCentre for Medical Image ComputingLondonUK
| | | | - Julie Owen
- King's College LondonGuy's Hospital, Breast ResearchPathologyLondonUK
| | - Patrycja Gazinska
- King's College LondonGuy's Hospital, Breast ResearchPathologyLondonUK
| | - Sarah E. Pinder
- King's College LondonGuy's Hospital, Breast ResearchPathologyLondonUK
| | | | - David J. Hawkes
- University College LondonCentre for Medical Image ComputingLondonUK
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84
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Ma D, Lu F, Zou X, Zhang H, Li Y, Zhang L, Chen L, Qin D, Wang B. Intravoxel incoherent motion diffusion-weighted imaging as an adjunct to dynamic contrast-enhanced MRI to improve accuracy of the differential diagnosis of benign and malignant breast lesions. Magn Reson Imaging 2017; 36:175-179. [DOI: 10.1016/j.mri.2016.10.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/29/2016] [Accepted: 10/05/2016] [Indexed: 12/19/2022]
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85
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Suo S, Cheng F, Cao M, Kang J, Wang M, Hua J, Hua X, Li L, Lu Q, Liu J, Xu J. Multiparametric diffusion-weighted imaging in breast lesions: Association with pathologic diagnosis and prognostic factors. J Magn Reson Imaging 2017; 46:740-750. [PMID: 28139036 DOI: 10.1002/jmri.25612] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 12/09/2016] [Indexed: 12/16/2022] Open
Affiliation(s)
- Shiteng Suo
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Fang Cheng
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Mengqiu Cao
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Jiwen Kang
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Mingyao Wang
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Jia Hua
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Xiaolan Hua
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Lan Li
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Qing Lu
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Jialin Liu
- School of Biomedical Engineering; Shanghai Jiao Tong University; Shanghai PR China
| | - Jianrong Xu
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
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86
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Accelerating the Diffusion-Weighted Imaging Biomarker in the clinical practice: comparative study. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.procs.2017.05.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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87
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Comparison of non-Gaussian and Gaussian diffusion models of diffusion weighted imaging of rectal cancer at 3.0 T MRI. Sci Rep 2016; 6:38782. [PMID: 27934928 PMCID: PMC5146921 DOI: 10.1038/srep38782] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 11/14/2016] [Indexed: 02/07/2023] Open
Abstract
Water molecular diffusion in vivo tissue is much more complicated. We aimed to compare non-Gaussian diffusion models of diffusion-weighted imaging (DWI) including intra-voxel incoherent motion (IVIM), stretched-exponential model (SEM) and Gaussian diffusion model at 3.0 T MRI in patients with rectal cancer, and to determine the optimal model for investigating the water diffusion properties and characterization of rectal carcinoma. Fifty-nine consecutive patients with pathologically confirmed rectal adenocarcinoma underwent DWI with 16 b-values at a 3.0 T MRI system. DWI signals were fitted to the mono-exponential and non-Gaussian diffusion models (IVIM-mono, IVIM-bi and SEM) on primary tumor and adjacent normal rectal tissue. Parameters of standard apparent diffusion coefficient (ADC), slow- and fast-ADC, fraction of fast ADC (f), α value and distributed diffusion coefficient (DDC) were generated and compared between the tumor and normal tissues. The SEM exhibited the best fitting results of actual DWI signal in rectal cancer and the normal rectal wall (R2 = 0.998, 0.999 respectively). The DDC achieved relatively high area under the curve (AUC = 0.980) in differentiating tumor from normal rectal wall. Non-Gaussian diffusion models could assess tissue properties more accurately than the ADC derived Gaussian diffusion model. SEM may be used as a potential optimal model for characterization of rectal cancer.
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88
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Teruel JR, Goa PE, Sjøbakk TE, Østlie A, Fjøsne HE, Bathen TF. A Simplified Approach to Measure the Effect of the Microvasculature in Diffusion-weighted MR Imaging Applied to Breast Tumors: Preliminary Results. Radiology 2016; 281:373-381. [DOI: 10.1148/radiol.2016151630] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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89
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Lee YJ, Kim SH, Kang BJ, Kang YJ, Yoo H, Yoo J, Lee J, Son YH, Grimm R. Intravoxel incoherent motion (IVIM)‐derived parameters in diffusion‐weighted MRI: Associations with prognostic factors in invasive ductal carcinoma. J Magn Reson Imaging 2016; 45:1394-1406. [DOI: 10.1002/jmri.25514] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 10/05/2016] [Indexed: 12/26/2022] Open
Affiliation(s)
- Youn Joo Lee
- Department of RadiologyDaejeon St. Mary's HospitalSeoul Republic of Korea
| | - Sung Hun Kim
- Seoul St. Mary's HospitalSeoul Republic of Korea
| | | | - Young Jee Kang
- College of MedicineThe Catholic University of KoreaSeoul Republic of Korea
| | - Heesoo Yoo
- College of MedicineThe Catholic University of KoreaSeoul Republic of Korea
| | - Jaewan Yoo
- College of MedicineThe Catholic University of KoreaSeoul Republic of Korea
| | - Jaeun Lee
- College of MedicineThe Catholic University of KoreaSeoul Republic of Korea
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90
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Ostenson J, Pujara AC, Mikheev A, Moy L, Kim SG, Melsaether AN, Jhaveri K, Adams S, Faul D, Glielmi C, Geppert C, Feiweier T, Jackson K, Cho GY, Boada FE, Sigmund EE. Voxelwise analysis of simultaneously acquired and spatially correlated 18 F-fluorodeoxyglucose (FDG)-PET and intravoxel incoherent motion metrics in breast cancer. Magn Reson Med 2016; 78:1147-1156. [PMID: 27779790 DOI: 10.1002/mrm.26505] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/15/2016] [Accepted: 09/19/2016] [Indexed: 12/21/2022]
Abstract
PURPOSE Diffusion-weighted imaging (DWI) and 18 F-fluorodeoxyglucose-positron emission tomography (18 F-FDG-PET) independently correlate with malignancy in breast cancer, but the relationship between their structural and metabolic metrics is not completely understood. This study spatially correlates diffusion, perfusion, and glucose avidity in breast cancer with simultaneous PET/MR imaging and compares correlations with clinical prognostics. METHODS In this Health Insurance Portability and Accountability Act-compliant prospective study, with written informed consent and approval of the institutional review board and using simultaneously acquired FDG-PET and DWI, tissue diffusion (Dt ), and perfusion fraction (fp ) from intravoxel incoherent motion (IVIM) analysis were registered to FDG-PET within 14 locally advanced breast cancers. Lesions were analyzed using 2D histograms and correlation coefficients between Dt , fp , and standardized uptake value (SUV). Correlations were compared with prognostics from biopsy, metastatic burden from whole-body PET, and treatment history. RESULTS SUV||Dt correlation coefficient significantly distinguished treated (0.11 ± 0.24) from nontreated (-0.33 ± 0.26) patients (P = 0.005). SUV||fp correlations were on average negative for the whole cohort (-0.17 ± 0.13). CONCLUSION Simultaneously acquired and registered FDG-PET/DWI allowed quantifiable descriptions of breast cancer microenvironments that may provide a framework for monitoring and predicting response to treatment. Magn Reson Med 78:1147-1156, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Jason Ostenson
- Department of Radiology, New York University School of Medicine, New York, New York, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Medical Center, New York, New York, USA.,Vanderbilt University Institute of Imaging Science, Nashville, Tennessee, USA
| | - Akshat C Pujara
- Department of Radiology, New York University School of Medicine, New York, New York, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Medical Center, New York, New York, USA
| | - Artem Mikheev
- Department of Radiology, New York University School of Medicine, New York, New York, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Medical Center, New York, New York, USA
| | - Linda Moy
- Department of Radiology, New York University School of Medicine, New York, New York, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Medical Center, New York, New York, USA
| | - Sungheon G Kim
- Department of Radiology, New York University School of Medicine, New York, New York, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Medical Center, New York, New York, USA
| | - Amy N Melsaether
- Department of Radiology, New York University School of Medicine, New York, New York, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Medical Center, New York, New York, USA
| | - Komal Jhaveri
- Perlmutter Cancer Center, NYU Langone Medical Center, New York, New York, USA.,Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Sylvia Adams
- Perlmutter Cancer Center, NYU Langone Medical Center, New York, New York, USA
| | - David Faul
- Siemens Healthcare, New York, New York, USA
| | | | - Christian Geppert
- Siemens Healthcare, New York, New York, USA.,Siemens Healthcare, Erlangen, Germany
| | | | - Kimberly Jackson
- Department of Radiology, New York University School of Medicine, New York, New York, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Medical Center, New York, New York, USA
| | - Gene Y Cho
- Department of Radiology, New York University School of Medicine, New York, New York, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Medical Center, New York, New York, USA
| | - Fernando E Boada
- Department of Radiology, New York University School of Medicine, New York, New York, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Medical Center, New York, New York, USA
| | - Eric E Sigmund
- Department of Radiology, New York University School of Medicine, New York, New York, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Medical Center, New York, New York, USA
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91
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Partridge SC, Nissan N, Rahbar H, Kitsch AE, Sigmund EE. Diffusion-weighted breast MRI: Clinical applications and emerging techniques. J Magn Reson Imaging 2016; 45:337-355. [PMID: 27690173 DOI: 10.1002/jmri.25479] [Citation(s) in RCA: 215] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 08/29/2016] [Indexed: 12/28/2022] Open
Abstract
Diffusion-weighted MRI (DWI) holds potential to improve the detection and biological characterization of breast cancer. DWI is increasingly being incorporated into breast MRI protocols to address some of the shortcomings of routine clinical breast MRI. Potential benefits include improved differentiation of benign and malignant breast lesions, assessment and prediction of therapeutic efficacy, and noncontrast detection of breast cancer. The breast presents a unique imaging environment with significant physiologic and inter-subject variations, as well as specific challenges to achieving reliable high quality diffusion-weighted MR images. Technical innovations are helping to overcome many of the image quality issues that have limited widespread use of DWI for breast imaging. Advanced modeling approaches to further characterize tissue perfusion, complexity, and glandular organization may expand knowledge and yield improved diagnostic tools. LEVEL OF EVIDENCE 5 J. Magn. Reson. Imaging 2016 J. Magn. Reson. Imaging 2017;45:337-355.
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Affiliation(s)
- Savannah C Partridge
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA.,Breast Imaging, Seattle Cancer Care Alliance, Seattle, Washington, USA
| | - Noam Nissan
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Habib Rahbar
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA.,Breast Imaging, Seattle Cancer Care Alliance, Seattle, Washington, USA
| | - Averi E Kitsch
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA.,Breast Imaging, Seattle Cancer Care Alliance, Seattle, Washington, USA
| | - Eric E Sigmund
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
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92
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Choi IY, Lee SS, Sung YS, Cheong H, Lee H, Byun JH, Kim SY, Lee SJ, Shin YM, Lee MG. Intravoxel incoherent motion diffusion-weighted imaging for characterizing focal hepatic lesions: Correlation with lesion enhancement. J Magn Reson Imaging 2016; 45:1589-1598. [PMID: 27664970 DOI: 10.1002/jmri.25492] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 09/10/2016] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To evaluate the value of intravoxel incoherent motion (IVIM) parameters for characterizing focal hepatic lesions, and to assess the correlation between IVIM parameters and arterial nodule enhancement. MATERIALS AND METHODS We retrospectively evaluated 161 lesions (91 hepatocellular carcinomas [HCCs], 27 intrahepatic cholangiocarcinomas [IHCCs], 20 hemangiomas, 9 combined hepatocellular-cholangiocarcinomas, 9 metastases, and 5 other tumors) in 161 patients (105 men and 56 women; mean age, 56.4 years). Diffusion-weighted imaging was performed using nine b-values (0-900 s/mm2 ) at 1.5T. Apparent diffusion coefficient (ADC), molecular diffusion coefficient (Dslow ), perfusion fraction (f), and perfusion-related diffusion coefficient (Dfast ) were compared among the hepatic lesions using analysis of variance (ANOVA). Receiver-operating-characteristic analysis was performed to assess diagnostic performance. The enhancement fraction (EF) and the relative enhancement (RE) of the hepatic lesions on arterial phase gadoxetic acid-enhanced images were correlated with the IVIM parameters using Spearman's test. RESULTS For the differentiation of hemangiomas from malignant tumors, Dslow showed the largest area under the curve (0.933) among all parameters. Although ADC did not show any difference among malignant lesions (P ≥ 0.28), HCCs showed a significantly lower Dslow than IHCC (P < 0.001) and a higher f than did IHCC (P < 0.001) and metastasis (P = 0.027); f had a significant positive correlation with EF (r = 0.420, P < 0.001) and RE (r = 0.264, P = 0.001). CONCLUSION IVIM parameters are more helpful in characterizing malignant hepatic lesions than ADC; f may reflect the extent and degree of hepatic nodule enhancement in the arterial phase, and may allow for differentiation of HCC from IHCC and metastasis. LEVEL OF EVIDENCE 3 J. MAGN. RESON. IMAGING 2017;45:1589-1598.
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Affiliation(s)
- In Young Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung Soo Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Yu Sub Sung
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hyunhee Cheong
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hoyoung Lee
- University of Ulsan, College of Medicine, Seoul, Korea
| | - Jae Ho Byun
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - So Yeon Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - So Jung Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Yong Moon Shin
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
| | - Moon-Gyu Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
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93
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Abstract
Breast MR imaging has increased in popularity over the past 2 decades due to evidence of its high sensitivity for cancer detection. Current clinical MR imaging approaches rely on the use of a dynamic contrast-enhanced acquisition that facilitates morphologic and semiquantitative kinetic assessments of breast lesions. The use of more functional and quantitative parameters holds promise to broaden the utility of MR imaging and improve its specificity. Because of wide variations in approaches for measuring these parameters and the considerable technical challenges, robust multicenter data supporting their routine use are not yet available, limiting current applications of many of these tools to research purposes.
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Affiliation(s)
- Habib Rahbar
- Breast Imaging Section, Department of Radiology, Seattle Cancer Care Alliance, University of Washington, 825 Eastlake Avenue East, PO Box 19023, Seattle, WA 98109-1023, USA
| | - Savannah C Partridge
- Breast Imaging Section, Department of Radiology, Seattle Cancer Care Alliance, University of Washington, 825 Eastlake Avenue East, PO Box 19023, Seattle, WA 98109-1023, USA.
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94
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Taouli B, Beer AJ, Chenevert T, Collins D, Lehman C, Matos C, Padhani AR, Rosenkrantz AB, Shukla-Dave A, Sigmund E, Tanenbaum L, Thoeny H, Thomassin-Naggara I, Barbieri S, Corcuera-Solano I, Orton M, Partridge SC, Koh DM. Diffusion-weighted imaging outside the brain: Consensus statement from an ISMRM-sponsored workshop. J Magn Reson Imaging 2016; 44:521-40. [PMID: 26892827 PMCID: PMC4983499 DOI: 10.1002/jmri.25196] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/28/2016] [Accepted: 01/30/2016] [Indexed: 12/11/2022] Open
Abstract
The significant advances in magnetic resonance imaging (MRI) hardware and software, sequence design, and postprocessing methods have made diffusion-weighted imaging (DWI) an important part of body MRI protocols and have fueled extensive research on quantitative diffusion outside the brain, particularly in the oncologic setting. In this review, we summarize the most up-to-date information on DWI acquisition and clinical applications outside the brain, as discussed in an ISMRM-sponsored symposium held in April 2015. We first introduce recent advances in acquisition, processing, and quality control; then review scientific evidence in major organ systems; and finally describe future directions. J. Magn. Reson. Imaging 2016;44:521-540.
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Affiliation(s)
- Bachir Taouli
- Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ambros J. Beer
- Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany
| | - Thomas Chenevert
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - David Collins
- CR UK Cancer Imaging Centre, Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
| | - Constance Lehman
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Celso Matos
- Department of Radiology, Champalimaud Clinical Centre, Lisbon, Portugal
| | | | | | - Amita Shukla-Dave
- Departments of Medical Physics and Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Eric Sigmund
- Irene and Bernard Schwartz Center for Biomedical Imaging (CBI) and Center for Advanced Imaging and Innovation (CAIR), Department of Radiology, NYU Langone Medical Center, New York, New York, USA
| | - Lawrence Tanenbaum
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Harriet Thoeny
- Department of Diagnostic Radiology, Inselspital Bern, Bern, Switzerland
| | | | | | - Idoia Corcuera-Solano
- Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Matthew Orton
- CR UK Cancer Imaging Centre, Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
| | | | - Dow-Mu Koh
- Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
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95
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Wang Q, Guo Y, Zhang J, Wang Z, Huang M, Zhang Y. Contribution of IVIM to Conventional Dynamic Contrast-Enhanced and Diffusion-Weighted MRI in Differentiating Benign from Malignant Breast Masses. Breast Care (Basel) 2016; 11:254-258. [PMID: 27721712 DOI: 10.1159/000447765] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The aim of this study was to determine whether the indicators obtained from intravoxel incoherent motion (IVIM) imaging can improve the characterization of benign and malignant breast masses compared with conventional dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted magnetic resonance imaging (DW-MRI). PATIENTS AND METHODS This study included 23 benign and 31 malignant breast masses of 48 patients. Main indicators were initial enhancement ratio (IER), time-signal intensity curve (TIC), apparent diffusion coefficient (ADC), tissue diffusivity (D), pseudodiffusivity (D*), and perfusion fraction (f). The discriminative abilities of the different models were compared by means of receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) analysis. RESULTS D had the highest AUC (0.980), sensitivity (93.55%), specificity (100%), and diagnostic accuracy (96.36%). Both D and TIC could provide the independent predicted features for malignant breast masses. The combination of D and TIC had an AUC of up to 0.990. CONCLUSION D of IVIM can effectively complement existing conventional DCE-MRI and DW-MRI in differentiating malignant from benign breast masses. IVIM combined with DCE-MRI is a robust means of evaluating breast masses.
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Affiliation(s)
- Qingjun Wang
- Department of Radiology, Chinese Navy General Hospital of PLA, Beijing, China
| | - Yong Guo
- Department of Radiology, Chinese Navy General Hospital of PLA, Beijing, China
| | - Jing Zhang
- Department of Radiology, Chinese Navy General Hospital of PLA, Beijing, China
| | - Zijun Wang
- Department of Radiology, Chinese Navy General Hospital of PLA, Beijing, China
| | - Minhua Huang
- Department of Radiology, Chinese Navy General Hospital of PLA, Beijing, China
| | - Yun Zhang
- Department of Radiology, Chinese Navy General Hospital of PLA, Beijing, China
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96
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Yuan J, Wong OL, Lo GG, Chan HHL, Wong TT, Cheung PSY. Statistical assessment of bi-exponential diffusion weighted imaging signal characteristics induced by intravoxel incoherent motion in malignant breast tumors. Quant Imaging Med Surg 2016; 6:418-429. [PMID: 27709078 DOI: 10.21037/qims.2016.08.05] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The purpose of this study is to statistically assess whether bi-exponential intravoxel incoherent motion (IVIM) model better characterizes diffusion weighted imaging (DWI) signal of malignant breast tumor than mono-exponential Gaussian diffusion model. METHODS 3 T DWI data of 29 malignant breast tumors were retrospectively included. Linear least-square mono-exponential fitting and segmented least-square bi-exponential fitting were used for apparent diffusion coefficient (ADC) and IVIM parameter quantification, respectively. F-test and Akaike Information Criterion (AIC) were used to statistically assess the preference of mono-exponential and bi-exponential model using region-of-interests (ROI)-averaged and voxel-wise analysis. RESULTS For ROI-averaged analysis, 15 tumors were significantly better fitted by bi-exponential function and 14 tumors exhibited mono-exponential behavior. The calculated ADC, D (true diffusion coefficient) and f (pseudo-diffusion fraction) showed no significant differences between mono-exponential and bi-exponential preferable tumors. Voxel-wise analysis revealed that 27 tumors contained more voxels exhibiting mono-exponential DWI decay while only 2 tumors presented more bi-exponential decay voxels. ADC was consistently and significantly larger than D for both ROI-averaged and voxel-wise analysis. CONCLUSIONS Although the presence of IVIM effect in malignant breast tumors could be suggested, statistical assessment shows that bi-exponential fitting does not necessarily better represent the DWI signal decay in breast cancer under clinically typical acquisition protocol and signal-to-noise ratio (SNR). Our study indicates the importance to statistically examine the breast cancer DWI signal characteristics in practice.
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Affiliation(s)
- Jing Yuan
- Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Oi Lei Wong
- Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Gladys G Lo
- Department of Diagnostic and Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Helen H L Chan
- Department of Diagnostic and Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Ting Ting Wong
- Breast Care Centre, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China
| | - Polly S Y Cheung
- Breast Care Centre, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China
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97
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Teruel JR, Cho GY, Moccaldi Rt M, Goa PE, Bathen TF, Feiweier T, Kim SG, Moy L, Sigmund EE. Stimulated echo diffusion tensor imaging (STEAM-DTI) with varying diffusion times as a probe of breast tissue. J Magn Reson Imaging 2016; 45:84-93. [PMID: 27441890 DOI: 10.1002/jmri.25376] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/21/2016] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To explore the application of diffusion tensor imaging (DTI) for breast tissue and breast pathologies using a stimulated-echo acquisition mode (STEAM) with variable diffusion times. MATERIALS AND METHODS In this Health Insurance Portability and Accountability Act-compliant study, approved by the local institutional review board, eight patients and six healthy volunteers underwent an MRI examination at 3 Tesla including STEAM-DTI with several diffusion times ranging from 68.5 to 902.5 ms. A DTI model was fitted to the data for each diffusion time, and parametric maps of mean diffusivity, fractional anisotropy, axial diffusivity, and radial diffusivity were computed for healthy fibroglandular tissue (FGT) and lesions. The median value of radial diffusivity for FGT was fitted to a linear decay to obtain an estimation of the surface-to-volume ratio, from which the radial diameter was calculated. RESULTS For healthy FGT, radial diffusivity presented a linear decay with the square root of the diffusion time resulting in a range of estimated radial diameters from 202 to 496 µm, while axial diffusivity presented a nearly time-independent diffusion. Residual fat signal was reduced at longer diffusion times due to the shorter T1 of fat. Residual fat signal to the overall signal in the healthy volunteers' FGT was found to range from 2.39% to 2.55% (shortest mixing time), and from 0.40% to 0.51% (longest mixing time) for the b500 images. CONCLUSION The use of variable diffusion times may provide an in vivo noninvasive tool to probe diffusion lengths in breast tissue and breast pathology, and might aid by improving fat suppression at longer diffusion times. LEVEL OF EVIDENCE 2 J. Magn. Reson. Imaging 2017;45:84-93.
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Affiliation(s)
- Jose R Teruel
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Radiology, University of California San Diego (UCSD), La Jolla, California, USA
| | - Gene Y Cho
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, New York, USA.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Melanie Moccaldi Rt
- Cancer Institute, New York University School of Medicine, New York, New York, USA
| | - Pål E Goa
- Department of Physics, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tone F Bathen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | | - Sungheon G Kim
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, New York, USA.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Linda Moy
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, New York, USA.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Eric E Sigmund
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, New York, USA.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
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98
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Jiang R, Ma Z, Dong H, Sun S, Zeng X, Li X. Diffusion tensor imaging of breast lesions: evaluation of apparent diffusion coefficient and fractional anisotropy and tissue cellularity. Br J Radiol 2016; 89:20160076. [PMID: 27302492 DOI: 10.1259/bjr.20160076] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) measured by diffusion tensor imaging (DTI), tissue cellularity and their relationship in breast malignant/benign lesions. METHODS 88 patients with 88 breast lesions who underwent DTI and dynamic contrast-enhanced MR scanning between November 2013 and December 2014 were retrospectively analyzed. The diagnosis was confirmed pathologically. ADC and FA values as well as histopathological cellularity of different pathological types of lesions were analyzed and compared statistically. The Pearson's correlation between cellularity and ADC and FA was calculated. RESULTS There were 59 cases of breast cancer and 29 cases of benign lesions included in the study. ADC values of breast cancers were statistically lower than that of benign lesions (p < 0.001). FA and cellularity were higher in cancers than in benign lesions with statistical significance (p < 0.05 and p < 0.001, respectively). The mean FA values in the patients with invasive ductal carcinoma (IDC) were higher than that in the patients with ductal carcinoma in situ (DCIS) without statistical difference (p > 0.05). The ADC and the cellularity in the IDC of grade III were statistically lower (p < 0.05) and higher (p < 0.05) than that in the DCIS and IDC of grade I-II, respectively. ADC was negatively correlated to cellularity (r = -0.8319, p < 0.001) and FA was positively correlated to cellularity (r = 0.4231, p < 0.001). CONCLUSION ADC and FA values were statistically different between benign and malignant breast lesions and were significantly correlated to tissue cellularity. ADC and FA may help to discriminate malignant from benign breast lesions and to predict cellularity. ADC is helpful in the prediction of the grade of breast cancer. ADVANCES IN KNOWLEDGE ADC and FA values were statistically different between benign and malignant breast lesions and were significantly correlated to tissue cellularity.
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Affiliation(s)
- Ruisheng Jiang
- 1 Department of Computer Tomography and Magnetic Resonance Imaging, Weifang Medical College Affiliated Yidu Central Hospital, Weifang, China
| | - Zhijun Ma
- 1 Department of Computer Tomography and Magnetic Resonance Imaging, Weifang Medical College Affiliated Yidu Central Hospital, Weifang, China
| | - Haixia Dong
- 1 Department of Computer Tomography and Magnetic Resonance Imaging, Weifang Medical College Affiliated Yidu Central Hospital, Weifang, China
| | - Shihang Sun
- 1 Department of Computer Tomography and Magnetic Resonance Imaging, Weifang Medical College Affiliated Yidu Central Hospital, Weifang, China
| | - Xiangmin Zeng
- 1 Department of Computer Tomography and Magnetic Resonance Imaging, Weifang Medical College Affiliated Yidu Central Hospital, Weifang, China
| | - Xiao Li
- 2 Medical Imaging Center, Linyi People's Hospital, Linyi, China
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99
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Kim B, Lee SS, Sung YS, Cheong H, Byun JH, Kim HJ, Kim JH. Intravoxel incoherent motion diffusion-weighted imaging of the pancreas: Characterization of benign and malignant pancreatic pathologies. J Magn Reson Imaging 2016; 45:260-269. [PMID: 27273754 DOI: 10.1002/jmri.25334] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 05/23/2016] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To evaluate the diagnostic value of apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) parameters in differentiating patients with either a normal pancreas (NP), pancreatic ductal adenocarcinoma (PDAC), neuroendocrine tumor (NET), solid pseudopapillary tumor (SPT), acute pancreatitis (AcP), vs. autoimmune pancreatitis (AIP). MATERIALS AND METHODS In all, 84 pathologically confirmed pancreatic tumors (60 PDACs, 15 NETs, 9 SPTs), 20 pancreatitis (13 AcPs, 7 AIPs), and 30 NP subjects underwent IVIM diffusion-weighted imaging using 10 b-values (0-900 sec/mm2 ) at 1.5T. The ADC, pure molecular diffusion coefficient (Dslow ), perfusion fraction (f), and perfusion-related diffusion coefficient (Dfast ) were calculated and compared using a Kruskal-Wallis test and post-hoc Dunn procedure. Receiver operating characteristic (ROC) analysis was performed to assess diagnostic performance. RESULTS The f and Dfast of the PDAC were significantly lower than that of the NP (f = 0.10 vs. 0.24; Dfast = 42.21 vs. 71.74 × 10-3 mm2 /sec; P < 0.05). In ROC analysis, f showed the best diagnostic performance (area-under-the-curve, 0.919) among all parameters in differentiating PDAC from NP (P ≤ 0.001). The f values of AcP (0.11) and AIP (0.13) and the Dfast values of SPT (20.48 × 10-3 mm2 /sec) and AcP (24.49 × 10-3 mm2 /sec) were significantly lower compared with NP (f = 0.24; Dfast = 71.74 × 10-3 mm2 /sec; P < 0.05). For NET, the f (0.21) was significantly higher than that of PDAC (0.10, P < 0.01). CONCLUSION Perfusion-related parameters f and Dfast are more helpful in characterizing pancreatic diseases than ADC or Dslow . The PDCA, SPT, AcP, and AIP were characterized by reduced f and Dfast values compared with normal pancreas. The f value might help in differentiating between PDAC and NET. LEVEL OF EVIDENCE 3 J. Magn. Reson. Imaging 2017;45:260-269.
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Affiliation(s)
- Bohyun Kim
- Department of Radiology, Ajou University Hospital, Suwon, South Korea
| | - Seung Soo Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yu Sub Sung
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyunhee Cheong
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae Ho Byun
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyoung Jung Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Hee Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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100
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Mao J, Shen J, Yang Q, Yu T, Duan X, Zhong J, Phuyal P, Liang B. Intravoxel incoherent motion MRI in differentiation between recurrent carcinoma and postchemoradiation fibrosis of the skull base in patients with nasopharyngeal carcinoma. J Magn Reson Imaging 2016; 44:1556-1564. [PMID: 27227674 DOI: 10.1002/jmri.25302] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/25/2016] [Indexed: 12/27/2022] Open
Affiliation(s)
- Jiaji Mao
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Jun Shen
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Qihua Yang
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Taihui Yu
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Xiaohui Duan
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Jinglian Zhong
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Prakash Phuyal
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Biling Liang
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
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