51
|
Ma S, Zhu M, Xia X, Guo L, Genin GM, Sacks MS, Gao M, Mutic S, Hu Y, Hu CH, Feng Y. A preliminary study of the local biomechanical environment of liver tumors in vivo. Med Phys 2019; 46:1728-1739. [PMID: 30730058 DOI: 10.1002/mp.13434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Biomechanical properties can be used as biomarkers to diagnose tumors, monitor tumor development, and evaluate treatment efficacy. The purpose of this preliminary study is to characterize the biomechanical environment of two typical liver tumors, hemangiomas (HEMs) and hepatocellular carcinomas (HCCs), and to investigate the potential of using strain metrics as biomarkers for tumor diagnosis, based on a limited clinical dataset. METHODS Magnetic resonance (MR) tagging was used to quantify the motion and deformation of the two types of liver tumors. Displacements of the tumors arising from a heartbeat were measured over one cardiac cycle. Local biomechanical conditions of the tumors were characterized by estimating two principal strains (ε1 and ε2 ) and an octahedral shear strain (εsoct ) of the tumor and its peripheral region. Biomechanical conditions of the tumors were compared with those of the arbitrarily selected regions from healthy volunteers. RESULTS We observed that the HCCs had significantly smaller strain values compared to their peripheral tissues. However, the HEMs did not have significantly different strains from those of the peripheral tissues, and were similar to healthy liver regions. The sensitivity of using ε1 , ε2 , and εsoct to diagnose HCC were all 1, while the sensitivity of using ε1 , ε2 , and εsoct to diagnose HEM were 0.67, 0.17, and 0.67, respectively. CONCLUSIONS Lagrangian strain metrics provide insight into the biomechanical conditions of certain liver tumors in the human body and may provide another perspective for tumor characterization and diagnosis.
Collapse
Affiliation(s)
- Shengyuan Ma
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200030, China.,State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Soochow University, Suzhou, 215123, China.,Center for Molecular Imaging and Nuclear Medicine, School of Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, Jiangsu, 215123, China
| | - Mo Zhu
- Department of Radiology, The first affiliated hospital of Soochow University, Suzhou, Jiangsu, 215021, China
| | - Xiaolong Xia
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Soochow University, Suzhou, 215123, China.,Center for Molecular Imaging and Nuclear Medicine, School of Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, Jiangsu, 215123, China
| | - Liang Guo
- Department of Radiology, The first affiliated hospital of Soochow University, Suzhou, Jiangsu, 215021, China
| | - Guy M Genin
- NSF Science and Technology Center for Engineering Mechanobiology, Department of Mechanical Engineering and Materials Science, Washington University, St. Louis, MO, 63130, USA
| | - Michael S Sacks
- Center of Cardiovascular Simulation, The University of Texas at Austin, Austin, TX, 70745, USA
| | - Mingyuan Gao
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Soochow University, Suzhou, 215123, China.,Center for Molecular Imaging and Nuclear Medicine, School of Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, Jiangsu, 215123, China
| | - Sasa Mutic
- Department of Radiation Oncology, Washington University, St. Louis, MO, 63110, USA
| | - Yanle Hu
- Department of Radiation Oncology, Mayo Clinic in Arizona, Phoenix, AZ, 85054, USA
| | - Chun-Hong Hu
- Department of Radiology, The first affiliated hospital of Soochow University, Suzhou, Jiangsu, 215021, China
| | - Yuan Feng
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200030, China.,State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Soochow University, Suzhou, 215123, China.,Center for Molecular Imaging and Nuclear Medicine, School of Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, Jiangsu, 215123, China
| |
Collapse
|
52
|
Garteiser P, Doblas S, Van Beers BE. Magnetic resonance elastography of liver and spleen: Methods and applications. NMR IN BIOMEDICINE 2018; 31:e3891. [PMID: 29369503 DOI: 10.1002/nbm.3891] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/16/2017] [Accepted: 12/04/2017] [Indexed: 05/06/2023]
Abstract
The viscoelastic properties of the liver and spleen can be assessed with magnetic resonance elastography (MRE). Several actuators, MRI acquisition sequences and reconstruction algorithms have been proposed for this purpose. Reproducible results are obtained, especially when the examination is performed in standard conditions with the patient fasting. Accurate staging of liver fibrosis can be obtained by measuring liver stiffness or elasticity with MRE. Moreover, emerging evidence shows that assessing the tissue viscous parameters with MRE is useful for characterizing liver inflammation, non-alcoholic steatohepatitis, hepatic congestion, portal hypertension, and hepatic tumors. Further advances such as multifrequency acquisitions and compression-sensitive MRE may provide novel quantitative markers of hepatic and splenic mechanical properties that may improve the diagnosis of hepatic and splenic diseases.
Collapse
Affiliation(s)
- Philippe Garteiser
- Laboratory of Imaging Biomarkers, Center of Research on Inflammation, UMR 1149 INSERM-University Paris Diderot, Paris, France
| | - Sabrina Doblas
- Laboratory of Imaging Biomarkers, Center of Research on Inflammation, UMR 1149 INSERM-University Paris Diderot, Paris, France
| | - Bernard E Van Beers
- Laboratory of Imaging Biomarkers, Center of Research on Inflammation, UMR 1149 INSERM-University Paris Diderot, Paris, France
- Department of Radiology, Beaujon University Hospital Paris Nord, Clichy, France
| |
Collapse
|
53
|
|
54
|
Fovargue D, Nordsletten D, Sinkus R. Stiffness reconstruction methods for MR elastography. NMR IN BIOMEDICINE 2018; 31:e3935. [PMID: 29774974 PMCID: PMC6175248 DOI: 10.1002/nbm.3935] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 03/27/2018] [Accepted: 03/27/2018] [Indexed: 05/19/2023]
Abstract
Assessment of tissue stiffness is desirable for clinicians and researchers, as it is well established that pathophysiological mechanisms often alter the structural properties of tissue. Magnetic resonance elastography (MRE) provides an avenue for measuring tissue stiffness and has a long history of clinical application, including staging liver fibrosis and stratifying breast cancer malignancy. A vital component of MRE consists of the reconstruction algorithms used to derive stiffness from wave-motion images by solving inverse problems. A large range of reconstruction methods have been presented in the literature, with differing computational expense, required user input, underlying physical assumptions, and techniques for numerical evaluation. These differences, in turn, have led to varying accuracy, robustness, and ease of use. While most reconstruction techniques have been validated against in silico or in vitro phantoms, performance with real data is often more challenging, stressing the robustness and assumptions of these algorithms. This article reviews many current MRE reconstruction methods and discusses the aforementioned differences. The material assumptions underlying the methods are developed and various approaches for noise reduction, regularization, and numerical discretization are discussed. Reconstruction methods are categorized by inversion type, underlying assumptions, and their use in human and animal studies. Future directions, such as alternative material assumptions, are also discussed.
Collapse
Affiliation(s)
- Daniel Fovargue
- Imaging Sciences & Biomedical EngineeringKing's College LondonLondonUK
| | - David Nordsletten
- Imaging Sciences & Biomedical EngineeringKing's College LondonLondonUK
| | - Ralph Sinkus
- Imaging Sciences & Biomedical EngineeringKing's College LondonLondonUK
- Inserm U1148, LVTSUniversity Paris Diderot, University Paris 13Paris75018France
| |
Collapse
|
55
|
Venkatesh SK, Wells ML, Miller FH, Jhaveri KS, Silva AC, Taouli B, Ehman RL. Magnetic resonance elastography: beyond liver fibrosis-a case-based pictorial review. Abdom Radiol (NY) 2018; 43:1590-1611. [PMID: 29143076 PMCID: PMC6731769 DOI: 10.1007/s00261-017-1383-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Magnetic resonance elastography (MRE) has been introduced for clinical evaluation of liver fibrosis for nearly a decade. MRE has proven to be a robust and accurate technique for diagnosis and staging of liver fibrosis. As clinical experience with MRE grows, the possible role in evaluation of other diffuse and focal disorders of liver is emerging. Stiffness maps provide an opportunity to evaluate mechanical properties within a large volume of liver tissue. This enables appreciation of spatial heterogeneity of stiffness. Stiffness maps may reveal characteristic and differentiating features of chronic liver diseases and focal liver lesions and therefore provide useful information for clinical management. The objective of this pictorial review is to recapture the essentials of MRE technique and illustrate with examples, the utility of stiffness maps in other chronic liver disorders and focal liver lesions.
Collapse
Affiliation(s)
- Sudhakar K Venkatesh
- Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, 200, First Street SW, Rochester, MN, 55905, USA.
| | - Michael L Wells
- Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, 200, First Street SW, Rochester, MN, 55905, USA
| | - Frank H Miller
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Kartik S Jhaveri
- Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Alvin C Silva
- Department of Radiology, Mayo Clinic, Scottsdale, AZ, USA
| | - Bachir Taouli
- NYU Medical College, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Richard L Ehman
- Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, 200, First Street SW, Rochester, MN, 55905, USA
| |
Collapse
|
56
|
Dregely I, Prezzi D, Kelly‐Morland C, Roccia E, Neji R, Goh V. Imaging biomarkers in oncology: Basics and application to MRI. J Magn Reson Imaging 2018; 48:13-26. [PMID: 29969192 PMCID: PMC6587121 DOI: 10.1002/jmri.26058] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/26/2018] [Indexed: 12/12/2022] Open
Abstract
Cancer remains a global killer alongside cardiovascular disease. A better understanding of cancer biology has transformed its management with an increasing emphasis on a personalized approach, so-called "precision cancer medicine." Imaging has a key role to play in the management of cancer patients. Imaging biomarkers that objectively inform on tumor biology, the tumor environment, and tumor changes in response to an intervention complement genomic and molecular diagnostics. In this review we describe the key principles for imaging biomarker development and discuss the current status with respect to magnetic resonance imaging (MRI). LEVEL OF EVIDENCE 5 TECHNICAL EFFICACY: Stage 5 J. Magn. Reson. Imaging 2018;48:13-26.
Collapse
Affiliation(s)
- Isabel Dregely
- Biomedical Engineering, School of Biomedical Engineering & Imaging SciencesKing's Health Partners, St Thomas' HospitalLondon, UK
| | - Davide Prezzi
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences King's College London, King's Health Partners, St Thomas' Hospital, LondonUK
- RadiologyGuy's & St Thomas' NHS Foundation TrustLondonUK
| | - Christian Kelly‐Morland
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences King's College London, King's Health Partners, St Thomas' Hospital, LondonUK
- RadiologyGuy's & St Thomas' NHS Foundation TrustLondonUK
| | - Elisa Roccia
- Biomedical Engineering, School of Biomedical Engineering & Imaging SciencesKing's Health Partners, St Thomas' HospitalLondon, UK
| | - Radhouene Neji
- Biomedical Engineering, School of Biomedical Engineering & Imaging SciencesKing's Health Partners, St Thomas' HospitalLondon, UK
- MR Research CollaborationsSiemens HealthcareFrimleyUK
| | - Vicky Goh
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences King's College London, King's Health Partners, St Thomas' Hospital, LondonUK
- RadiologyGuy's & St Thomas' NHS Foundation TrustLondonUK
| |
Collapse
|
57
|
Mohammadi H, Sahai E. Mechanisms and impact of altered tumour mechanics. Nat Cell Biol 2018; 20:766-774. [PMID: 29950570 DOI: 10.1038/s41556-018-0131-2] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/24/2018] [Accepted: 05/24/2018] [Indexed: 02/06/2023]
Abstract
The physical characteristics of tumours are intricately linked to the tumour phenotype and difficulties during treatment. Many factors contribute to the increased stiffness of tumours; from increased matrix deposition, matrix remodelling by forces from cancer cells and stromal fibroblasts, matrix crosslinking, increased cellularity, and the build-up of both solid and interstitial pressure. Increased stiffness then feeds back to increase tumour invasiveness and reduce therapy efficacy. Increased understanding of this interplay is offering new therapeutic avenues.
Collapse
|
58
|
Prezzi D, Neji R, Kelly-Morland C, Verma H, OʼBrien T, Challacombe B, Fernando A, Chandra A, Sinkus R, Goh V. Characterization of Small Renal Tumors With Magnetic Resonance Elastography: A Feasibility Study. Invest Radiol 2018; 53:344-351. [PMID: 29462024 DOI: 10.1097/rli.0000000000000449] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of this study was to explore the feasibility of magnetic resonance elastography (MRE) for characterizing indeterminate small renal tumors (SRTs) as part of a multiparametric magnetic resonance (MR) imaging protocol. MATERIALS AND METHODS After institutional review board approval and informed consent were obtained, 21 prospective adults (15 men; median age, 55 years; age range, 25-72 years) with SRT were enrolled. Tumors (2-5 cm Ø) were imaged using 3-directional, gradient echo MRE. Viscoelastic parametric maps (shear wave velocity [c] and attenuation [α]) were analyzed by 2 independent radiologists. Interobserver agreement (Bland-Altman statistics and intraclass correlation coefficients) was assessed. Anatomical T2-weighted, dynamic contrast-enhanced (DCE) and diffusion sequences completed the acquisition protocol. Imaging parameters were compared between groups (Mann-Whitney U test). RESULTS Quality of MRE was good in 18 cases (mean nonlinearity <50%), including 1 papillary renal cell carcinoma and 1 metanephric adenoma. A cohort of 5 oncocytomas and 11 clear-cell renal cell carcinomas (ccRCCs) was analyzed for statistical differences. The MRE viscoelastic parameters were the strongest imaging discriminators: oncocytomas displayed significantly lower shear velocity c (median, 0.77 m/s; interquartile range [IQR], 0.76-0.79) (P = 0.007) and higher shear attenuation α (median, 0.087 mm; IQR, 0.082-0.087) (P = 0.008) than ccRCC (medians, 0.92 m/s and 0.066 mm; IQR, 0.84-0.97 and 0.054-0.074, respectively). T2 signal intensity ratio (tumor/renal cortex) was lower in oncocytomas (P = 0.02). The DCE and diffusion MR parameters overlapped substantially (P ≥ 0.1). Oncocytomas displayed a consistent MRE viscoelastic profile, corresponding to data point clustering in a bidimensional scatter plot. Values for MRE intraclass correlation coefficient were 0.982 for c and 0.984 for α, indicating excellent interobserver agreement. CONCLUSIONS Magnetic resonance elastography is feasible for SRT characterization; MRE viscoelastic parameters were stronger discriminators between oncocytoma and ccRCC than anatomical, DCE and diffusion MR imaging parameters.
Collapse
|
59
|
Wong GLH. Non-invasive assessments for liver fibrosis: The crystal ball we long for. J Gastroenterol Hepatol 2018; 33:1009-1015. [PMID: 29380413 DOI: 10.1111/jgh.14103] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/26/2017] [Accepted: 01/20/2018] [Indexed: 12/14/2022]
Abstract
Non-invasive assessment of liver fibrosis has been one of the most rapidly advancing fields in hepatology in the last decade. Progressive liver fibrosis results in cirrhosis, hepatocellular carcinoma (HCC), and various liver-related complications in essentially all chronic liver diseases. Assessment of liver fibrosis allows clinicians to determine the prognosis, need of treatment, disease progression, and response to treatment in patients with chronic liver disease. Liver biopsy has been the gold standard in last few decades and most adopted diagnostic tool in clinical trials. Nonetheless, it is impractical to apply the test in a large number of patients or to do it serially. Hence, various non-invasive assessments have been developed and adopted in some international management guidelines. Liver stiffness measurement (LSM) with transient elastography is one of the most widely validated non-invasive assessments for liver fibrosis. It is an accurate and reproducible method to predict advanced fibrosis in chronic hepatitis B. Using transient elastography, it is possible to perform repeated liver fibrosis assessments on a large number of asymptomatic patients. The key challenge of his tool is the confounding effect of alanine aminotransferase (ALT) level, such that decrease in LSM may only reflect ALT normalization, hence not accurate enough to indicate regression of liver fibrosis. This may be partially handled by combining LSM with a serum-based formula, which is independent of ALT such as the Forns index and enhanced liver fibrosis test. An LSM-based HCC risk score is useful to prioritize patients for HCC surveillance.
Collapse
Affiliation(s)
- Grace Lai-Hung Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Sha Tin, Hong Kong.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Sha Tin, Hong Kong.,State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| |
Collapse
|
60
|
Kennedy P, Wagner M, Castéra L, Hong CW, Johnson CL, Sirlin CB, Taouli B. Quantitative Elastography Methods in Liver Disease: Current Evidence and Future Directions. Radiology 2018; 286:738-763. [PMID: 29461949 DOI: 10.1148/radiol.2018170601] [Citation(s) in RCA: 186] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Chronic liver diseases often result in the development of liver fibrosis and ultimately, cirrhosis. Treatment strategies and prognosis differ greatly depending on the severity of liver fibrosis, thus liver fibrosis staging is clinically relevant. Traditionally, liver biopsy has been the method of choice for fibrosis evaluation. Because of liver biopsy limitations, noninvasive methods have become a key research interest in the field. Elastography enables the noninvasive measurement of tissue mechanical properties through observation of shear-wave propagation in the tissue of interest. Increasing fibrosis stage is associated with increased liver stiffness, providing a discriminatory feature that can be exploited by elastographic methods. Ultrasonographic (US) and magnetic resonance (MR) imaging elastographic methods are commercially available, each with their respective strengths and limitations. Here, the authors review the technical basis, acquisition techniques, and results and limitations of US- and MR-based elastography techniques. Diagnostic performance in the most common etiologies of chronic liver disease will be presented. Reliability, reproducibility, failure rate, and emerging advances will be discussed. © RSNA, 2018 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Paul Kennedy
- From the Translational and Molecular Imaging Institute (P.K., B.T.) and Department of Radiology (B.T.), Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY 10029; Department of Radiology, Sorbonne Universités, UPMC, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France (M.W.); Department of Hepatology, University Paris-VII, Hôpital Beaujon, Clichy, France (L.C.); Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (C.W.H., C.B.S.); Department of Biomedical Engineering, University of Delaware, Newark, Del (C.L.J.)
| | - Mathilde Wagner
- From the Translational and Molecular Imaging Institute (P.K., B.T.) and Department of Radiology (B.T.), Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY 10029; Department of Radiology, Sorbonne Universités, UPMC, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France (M.W.); Department of Hepatology, University Paris-VII, Hôpital Beaujon, Clichy, France (L.C.); Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (C.W.H., C.B.S.); Department of Biomedical Engineering, University of Delaware, Newark, Del (C.L.J.)
| | - Laurent Castéra
- From the Translational and Molecular Imaging Institute (P.K., B.T.) and Department of Radiology (B.T.), Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY 10029; Department of Radiology, Sorbonne Universités, UPMC, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France (M.W.); Department of Hepatology, University Paris-VII, Hôpital Beaujon, Clichy, France (L.C.); Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (C.W.H., C.B.S.); Department of Biomedical Engineering, University of Delaware, Newark, Del (C.L.J.)
| | - Cheng William Hong
- From the Translational and Molecular Imaging Institute (P.K., B.T.) and Department of Radiology (B.T.), Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY 10029; Department of Radiology, Sorbonne Universités, UPMC, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France (M.W.); Department of Hepatology, University Paris-VII, Hôpital Beaujon, Clichy, France (L.C.); Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (C.W.H., C.B.S.); Department of Biomedical Engineering, University of Delaware, Newark, Del (C.L.J.)
| | - Curtis L Johnson
- From the Translational and Molecular Imaging Institute (P.K., B.T.) and Department of Radiology (B.T.), Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY 10029; Department of Radiology, Sorbonne Universités, UPMC, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France (M.W.); Department of Hepatology, University Paris-VII, Hôpital Beaujon, Clichy, France (L.C.); Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (C.W.H., C.B.S.); Department of Biomedical Engineering, University of Delaware, Newark, Del (C.L.J.)
| | - Claude B Sirlin
- From the Translational and Molecular Imaging Institute (P.K., B.T.) and Department of Radiology (B.T.), Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY 10029; Department of Radiology, Sorbonne Universités, UPMC, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France (M.W.); Department of Hepatology, University Paris-VII, Hôpital Beaujon, Clichy, France (L.C.); Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (C.W.H., C.B.S.); Department of Biomedical Engineering, University of Delaware, Newark, Del (C.L.J.)
| | - Bachir Taouli
- From the Translational and Molecular Imaging Institute (P.K., B.T.) and Department of Radiology (B.T.), Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY 10029; Department of Radiology, Sorbonne Universités, UPMC, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France (M.W.); Department of Hepatology, University Paris-VII, Hôpital Beaujon, Clichy, France (L.C.); Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (C.W.H., C.B.S.); Department of Biomedical Engineering, University of Delaware, Newark, Del (C.L.J.)
| |
Collapse
|
61
|
Fovargue D, Kozerke S, Sinkus R, Nordsletten D. Robust MR elastography stiffness quantification using a localized divergence free finite element reconstruction. Med Image Anal 2018; 44:126-142. [DOI: 10.1016/j.media.2017.12.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 10/10/2017] [Accepted: 12/04/2017] [Indexed: 01/24/2023]
|
62
|
Bernard S, Cloutier G. Forward and inverse viscoelastic wave scattering by irregular inclusions for shear wave elastography. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2017; 142:2346. [PMID: 29092551 DOI: 10.1121/1.5007729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Inversion methods in shear wave elastography use simplifying assumptions to recover the mechanical properties of soft tissues. Consequently, these methods suffer from artifacts when applied to media containing strong stiffness contrasts, and do not provide a map of the viscosity. In this work, the shear wave field recorded inside and around an inclusion was used to estimate the viscoelastic properties of the inclusion and surrounding medium, based on an inverse problem approach assuming local homogeneity of both media. An efficient semi-analytical method was developed to model the scattering of an elastic wave by an irregular inclusion, based on a decomposition of the field by Bessel functions and on a decomposition of the boundaries as Fourier series. This model was validated against finite element modeling. Shear waves were experimentally induced by acoustic radiation force in soft tissue phantoms containing stiff and soft inclusions, and the displacement field was imaged at a high frame rate using plane wave imaging. A nonlinear least-squares algorithm compared the model to the experimental data and adjusted the geometrical and mechanical parameters. The estimated shear storage and loss moduli were in good agreement with reference measurements, as well as the estimated inclusion shape. This approach provides an accurate estimation of geometry and viscoelastic properties for a single inclusion in a homogeneous background in the context of radiation force elastography.
Collapse
Affiliation(s)
- Simon Bernard
- Laboratory of Biorheology and Medical Ultrasonics, University of Montréal Hospital Research Center (CRCHUM), 900 St-Denis, Suite R11.720, Montréal, Québec H2X 0A9, Canada
| | - Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, University of Montréal Hospital Research Center (CRCHUM), 900 St-Denis, Suite R11.720, Montréal, Québec H2X 0A9, Canada
| |
Collapse
|
63
|
Nabavizadeh A, Kinnick RR, Bayat M, Amador C, Urban MW, Alizad A, Fatemi M. Automated Compression Device for Viscoelasticity Imaging. IEEE Trans Biomed Eng 2017; 64:1535-1546. [PMID: 28113299 PMCID: PMC5485831 DOI: 10.1109/tbme.2016.2612541] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Noninvasive measurement of tissue viscoelastic properties is gaining more attention for screening and diagnostic purposes. Recently, measuring dynamic response of tissue under a constant force has been studied for estimation of tissue viscoelastic properties in terms of retardation times. The essential part of such a test is an instrument that is capable of creating a controlled axial force and is suitable for clinical applications. Such a device should be lightweight, portable, and easy to use for patient studies to capture tissue dynamics under external stress. In this paper, we present the design of an automated compression device for studying the creep response of materials with tissue-like behaviors. The device can be used to apply a ramp-and-hold force excitation for a predetermined duration of time and it houses an ultrasound probe for monitoring the creep response of the underlying tissue. To validate the performance of the device, several creep tests were performed on tissue-mimicking phantoms, and the results were compared against those from a commercial mechanical testing instrument. Using a second-order Kelvin-Voigt model and surface measurement of the forces and displacements, retardation times T1 and T2 were estimated from each test. These tests showed strong agreement between our automated compression device and the commercial mechanical testing system, with an average relative error of 2.9% and 12.4%, for T1 and T2, respectively. Also, we present the application of compression device to measure local retardation times for four different phantoms with different size and stiffness.
Collapse
|
64
|
Gordic S, Ayache JB, Kennedy P, Besa C, Wagner M, Bane O, Ehman RL, Kim E, Taouli B. Value of tumor stiffness measured with MR elastography for assessment of response of hepatocellular carcinoma to locoregional therapy. Abdom Radiol (NY) 2017; 42:1685-1694. [PMID: 28154910 PMCID: PMC5590631 DOI: 10.1007/s00261-017-1066-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE The aim of the study was to correlate tumor stiffness (TS) measured with MR elastography (MRE) with degree of tumor enhancement and necrosis on contrast-enhanced T1-weighted imaging (CE-T1WI) in hepatocellular carcinomas (HCC) treated with Yttrium-90 radioembolization (RE) or transarterial chemoembolization plus radiofrequency ablation (TACE/RFA). MATERIAL AND METHODS This retrospective study was IRB-approved and the requirement for informed consent was waived. 52 patients (M/F 38/14, mean age 67 years) with HCC who underwent RE (n = 22) or TACE/RFA (n = 30) and 11 controls (M/F 6/5, mean age 64 years) with newly diagnosed untreated HCC were included. The MRI protocol included a 2D MRE sequence. TS and LS (liver stiffness) were measured on stiffness maps. Degree of tumor necrosis was assessed on subtraction images by two observers, and tumor enhancement ratios (ER) were calculated on CE-T1WI by one observer. RESULTS 63 HCCs (mean size 3.2 ± 1.6 cm) were evaluated. TS was significantly lower in treated vs. untreated tumors (3.9 ± 1.8 vs. 6.9 ± 3.4 kPa, p = 0.006) and also compared to LS (5.3 ± 2.2 kPa, p = 0.002). There were significant correlations between TS and each of enhancement ratios (r = 0.514, p = 0.0001), and percentage of necrosis (r = -0.540, p = 0.0001). The observed correlations were stronger in patients treated with RE (TS vs. ER, r = 0.636, TS vs. necrosis, r = -0.711, both p = 0.0001). Percentage of necrosis and T1-signal in native T1WI were significant independent predictors of TS (p = 0.0001 and 0.001, respectively). CONCLUSION TS measured with MRE shows a significant correlation with tumor enhancement and necrosis, especially in HCCs treated with RE.
Collapse
Affiliation(s)
- Sonja Gordic
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Jad Bou Ayache
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul Kennedy
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA
| | - Cecilia Besa
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA
| | - Mathilde Wagner
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA
| | - Octavia Bane
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA
| | | | - Edward Kim
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bachir Taouli
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA.
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
65
|
Palacio-Torralba J, Good DW, McNeill SA, Reuben RL, Chen Y. Histology-based homogenization analysis of soft tissue: application to prostate cancer. J R Soc Interface 2017; 14:rsif.2017.0088. [PMID: 28404869 PMCID: PMC5414912 DOI: 10.1098/rsif.2017.0088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 03/16/2017] [Indexed: 12/21/2022] Open
Abstract
It is well known that the changes in tissue microstructure associated with certain pathophysiological conditions can influence its mechanical properties. Quantitatively relating the tissue microstructure to the macroscopic mechanical properties could lead to significant improvements in clinical diagnosis, especially when the mechanical properties of the tissue are used as diagnostic indices such as in digital rectal examination and elastography. In this study, a novel method of imposing periodic boundary conditions in non-periodic finite-element meshes is presented. This method is used to develop quantitative relationships between tissue microstructure and its apparent mechanical properties for benign and malignant tissue at various length scales. Finally, the inter-patient variation in the tissue properties is also investigated. Results show significant changes in the statistical distribution of the mechanical properties at different length scales. More importantly the loss of the normal differentiation of glandular structure of cancerous tissue has been demonstrated to lead to changes in mechanical properties and anisotropy. The proposed methodology is not limited to a particular tissue or material and the example used could help better understand how changes in the tissue microstructure caused by pathological conditions influence the mechanical properties, ultimately leading to more sensitive and accurate diagnostic technologies.
Collapse
Affiliation(s)
- Javier Palacio-Torralba
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK
| | - Daniel W Good
- Edinburgh Urological Cancer Group, Division of Pathology Laboratories, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK.,Department of Urology, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - S Alan McNeill
- Edinburgh Urological Cancer Group, Division of Pathology Laboratories, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK.,Department of Urology, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - Robert L Reuben
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK
| | - Yuhang Chen
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK
| |
Collapse
|
66
|
Alibert C, Goud B, Manneville JB. Are cancer cells really softer than normal cells? Biol Cell 2017; 109:167-189. [DOI: 10.1111/boc.201600078] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/23/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Charlotte Alibert
- Institut Curie; PSL Research University, CNRS; UMR 144 Paris France
- Sorbonne Universités, UPMC University Paris 06, CNRS; UMR 144 Paris France
| | - Bruno Goud
- Institut Curie; PSL Research University, CNRS; UMR 144 Paris France
- Sorbonne Universités, UPMC University Paris 06, CNRS; UMR 144 Paris France
| | - Jean-Baptiste Manneville
- Institut Curie; PSL Research University, CNRS; UMR 144 Paris France
- Sorbonne Universités, UPMC University Paris 06, CNRS; UMR 144 Paris France
| |
Collapse
|
67
|
Bernard S, Kazemirad S, Cloutier G. A Frequency-Shift Method to Measure Shear-Wave Attenuation in Soft Tissues. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2017; 64:514-524. [PMID: 27913343 DOI: 10.1109/tuffc.2016.2634329] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
In vivo quantification of shear-wave attenuation in soft tissues may help to better understand human tissue rheology and lead to new diagnostic strategies. Attenuation is difficult to measure in acoustic radiation force elastography because the shear-wave amplitude decreases due to a combination of diffraction and viscous attenuation. Diffraction correction requires assuming a cylindrical wavefront and an isotropic propagation medium, which may not be the case in some applications. In this paper, the frequency-shift method, used in ultrasound imaging and seismology, was adapted for shear-wave attenuation measurement in elastography. This method is not sensitive to diffraction effects. For a linear frequency dependence of the attenuation, a closed-form relation was obtained between the decrease in the peak frequency of the gamma-distributed wave amplitude spectrum and the attenuation coefficient of the propagation medium. The proposed method was tested against a plane-wave reference method in homogeneous agar-gelatin phantoms with 0%, 10%, and 20% oil concentrations, and hence different attenuations of 0.117, 0.202, and 0.292 [Formula: see text]/Hz, respectively. Applicability to biological tissues was demonstrated with two ex vivo porcine liver samples (0.79 and 1.35 [Formula: see text]/Hz) and an in vivo human muscle, measured along (0.43 [Formula: see text]/Hz) and across (1.77 [Formula: see text]/Hz) the tissue fibers. In all cases, the data supported the assumptions of a gamma-distributed spectrum for the source and linear frequency attenuation for the tissue. This method provides tissue attenuation, which is relevant diagnostic information to model viscosity, in addition to shear-wave velocity used to assess elasticity. Data processing is simple and could be performed automatically in real time for clinical applications.
Collapse
|
68
|
Shannon S, Jia D, Entersz I, Beelen P, Yu M, Carcione C, Carcione J, Mahtabfar A, Vaca C, Weaver M, Shreiber D, Zahn JD, Liu L, Lin H, Foty RA. Inhibition of glioblastoma dispersal by the MEK inhibitor PD0325901. BMC Cancer 2017; 17:121. [PMID: 28187762 PMCID: PMC5303286 DOI: 10.1186/s12885-017-3107-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 02/02/2017] [Indexed: 01/20/2023] Open
Abstract
Background Dispersal of glioblastoma (GBM) cells leads to recurrence and poor prognosis. Accordingly, molecular pathways involved in dispersal are potential therapeutic targets. The mitogen activated protein kinase/extracellular signal regulated kinase (MAPK/ERK) pathway is commonly dysregulated in GBM, and targeting this pathway with MEK inhibitors has proven effective in controlling tumor growth. Since this pathway also regulates ECM remodeling and actin organization − processes crucial to cell adhesion, substrate attachment, and cell motility – the aim of this study was to determine whether inhibiting this pathway could also impede dispersal. Methods A variety of methods were used to quantify the effects of the MEK inhibitor, PD0325901, on potential regulators of dispersal. Cohesion, stiffness and viscosity were quantified using a method based on ellipsoid relaxation after removal of a deforming external force. Attachment strength, cell motility, spheroid dispersal velocity, and 3D growth rate were quantified using previously described methods. Results We show that PD0325901 significantly increases aggregate cohesion, stiffness, and viscosity but only when tumor cells have access to high concentrations of fibronectin. Treatment also results in reorganization of actin from cortical into stress fibers, in both 2D and 3D culture. Moreover, drug treatment localized pFAK at sites of cell-substratum adhesion. Collectively, these changes resulted in increased strength of substrate attachment and decreased motility, a decrease in aggregate dispersal velocity, and in a marked decrease in growth rate of both 2D and 3D cultures. Conclusions Inhibition of the MAPK/ERK pathway by PD0325901 may be an effective therapy for reducing dispersal and growth of GBM cells. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3107-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Stephen Shannon
- Department of Surgery-Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - Dongxuan Jia
- Department of Surgery-Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - Ildiko Entersz
- Department of Surgery-Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - Paul Beelen
- Department of Surgery-Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - Miao Yu
- Rutgers-Department of Mechanical and Aerospace Engineering, 98 Brett Rd, Piscataway Township, NJ, 08854, USA
| | - Christian Carcione
- Department of Surgery-Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - Jonathan Carcione
- Department of Surgery-Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - Aria Mahtabfar
- Department of Surgery-Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - Connan Vaca
- Department of Surgery-Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - Michael Weaver
- Department of Surgery-Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, New Brunswick, NJ, 08901, USA
| | - David Shreiber
- Rutgers-Department of Biomedical Engineering, 599 Taylor Road, Piscataway, NJ, 08854, USA
| | - Jeffrey D Zahn
- Rutgers-Department of Biomedical Engineering, 599 Taylor Road, Piscataway, NJ, 08854, USA
| | - Liping Liu
- Rutgers-Department of Mechanical and Aerospace Engineering, 98 Brett Rd, Piscataway Township, NJ, 08854, USA.,Rutgers-Department of Mathematics, 110 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Hao Lin
- Rutgers-Department of Mechanical and Aerospace Engineering, 98 Brett Rd, Piscataway Township, NJ, 08854, USA
| | - Ramsey A Foty
- Department of Surgery-Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, New Brunswick, NJ, 08901, USA.
| |
Collapse
|
69
|
Yin M, Glaser KJ, Manduca A, Mounajjed T, Malhi H, Simonetto DA, Wang R, Yang L, Mao SA, Glorioso JM, Elgilani FM, Ward CJ, Harris PC, Nyberg SL, Shah VH, Ehman RL. Distinguishing between Hepatic Inflammation and Fibrosis with MR Elastography. Radiology 2017; 284:694-705. [PMID: 28128707 DOI: 10.1148/radiol.2017160622] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Purpose To investigate the utility of magnetic resonance (MR) elastography-derived mechanical properties in the discrimination of hepatic inflammation and fibrosis in the early stages of chronic liver diseases. Materials and Methods All studies were approved by the institutional animal care and use committee. A total of 187 animals were studied, including 182 mice and five pigs. These animals represented five different liver diseases with a varying combination and extent of hepatic inflammation, fibrosis, congestion, and portal hypertension. Multifrequency three-dimensional MR elastography was performed, and shear stiffness, storage modulus, shear loss modulus, and damping ratio were calculated for all animals. Necroinflammation, fibrosis, and portal pressure were either histologically scored or biochemically and physically quantified in all animals. Two-sided Welch t tests were used to evaluate mean differences between disease and control groups. Spearman correlation analyses were used to evaluate the relationships between mechanical parameters and quantitative fibrosis extent (hydroxyproline concentration) and portal pressure. Results Liver stiffness and storage modulus increased with progressively developed fibrosis and portal hypertension (mean stiffness at 80 Hz and 48-week feeding, 0.51 kPa ± 0.12 in the steatohepatitis group vs 0.29 kPa ± 0.01 in the control group; P = .02). Damping ratio and shear loss modulus can be used to distinguish inflammation from fibrosis at early stages of disease, even before the development of histologically detectable necroinflammation and fibrosis (mean damping ratio at 80 Hz and 20-week feeding, 0.044 ± 0.012 in the steatohepatitis group vs 0.014 ± 0.008 in the control group; P < .001). Damping ratio and liver stiffness vary differently with respect to cause of portal hypertension (ie, congestion- or cirrhosis-induced hypertension). These differentiation abilities have frequency-dependent variations. Conclusion Liver stiffness and damping ratio measurements can extend hepatic MR elastography to potentially enable assessment of necroinflammatory, congestive, and fibrotic processes of chronic liver diseases. © RSNA, 2017 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Meng Yin
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Kevin J Glaser
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Armando Manduca
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Taofic Mounajjed
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Harmeet Malhi
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Douglas A Simonetto
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Ruisi Wang
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Liu Yang
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Shennen A Mao
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Jaime M Glorioso
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Faysal M Elgilani
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Christopher J Ward
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Peter C Harris
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Scott L Nyberg
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Vijay H Shah
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Richard L Ehman
- From the Departments of Radiology (M.Y., K.J.G., A.M., R.L.E.) and Physiology and Biomedical Engineering (A.M.) and the Divisions of Anatomic Pathology (T.M.), Gastroenterology and Hepatology (H.M., D.A.S., R.W., L.Y., V.H.S.), Transplantation Surgery (S.A.M., J.M.G., F.M.E., S.L.N.), and Nephrology and Hypertension (C.J.W., P.C.H.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| |
Collapse
|
70
|
Nelissen JL, de Graaf L, Traa WA, Schreurs TJL, Moerman KM, Nederveen AJ, Sinkus R, Oomens CWJ, Nicolay K, Strijkers GJ. A MRI-Compatible Combined Mechanical Loading and MR Elastography Setup to Study Deformation-Induced Skeletal Muscle Damage in Rats. PLoS One 2017; 12:e0169864. [PMID: 28076414 PMCID: PMC5226723 DOI: 10.1371/journal.pone.0169864] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 12/23/2016] [Indexed: 02/01/2023] Open
Abstract
Deformation of skeletal muscle in the proximity of bony structures may lead to deep tissue injury category of pressure ulcers. Changes in mechanical properties have been proposed as a risk factor in the development of deep tissue injury and may be useful as a diagnostic tool for early detection. MRE allows for the estimation of mechanical properties of soft tissue through analysis of shear wave data. The shear waves originate from vibrations induced by an external actuator placed on the tissue surface. In this study a combined Magnetic Resonance (MR) compatible indentation and MR Elastography (MRE) setup is presented to study mechanical properties associated with deep tissue injury in rats. The proposed setup allows for MRE investigations combined with damage-inducing large strain indentation of the Tibialis Anterior muscle in the rat hind leg inside a small animal MR scanner. An alginate cast allowed proper fixation of the animal leg with anatomical perfect fit, provided boundary condition information for FEA and provided good susceptibility matching. MR Elastography data could be recorded for the Tibialis Anterior muscle prior to, during, and after indentation. A decaying shear wave with an average amplitude of approximately 2 μm propagated in the whole muscle. MRE elastograms representing local tissue shear storage modulus Gd showed significant increased mean values due to damage-inducing indentation (from 4.2 ± 0.1 kPa before to 5.1 ± 0.6 kPa after, p<0.05). The proposed setup enables controlled deformation under MRI-guidance, monitoring of the wound development by MRI, and quantification of tissue mechanical properties by MRE. We expect that improved knowledge of changes in soft tissue mechanical properties due to deep tissue injury, will provide new insights in the etiology of deep tissue injuries, skeletal muscle damage and other related muscle pathologies.
Collapse
Affiliation(s)
- Jules L. Nelissen
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands
- * E-mail:
| | - Larry de Graaf
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Willeke A. Traa
- Soft Tissue Biomechanics and Engineering, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Tom J. L. Schreurs
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands
| | - Kevin M. Moerman
- Center for Extreme Bionics, Media lab, MIT, Cambridge, MA, United States of America
| | - Aart J. Nederveen
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Ralph Sinkus
- Image Sciences & Biomedical Engineering, King’s College London, London, United Kingdom
| | - Cees W. J. Oomens
- Soft Tissue Biomechanics and Engineering, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Klaas Nicolay
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Gustav J. Strijkers
- Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
71
|
K-space data processing for magnetic resonance elastography (MRE). MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 30:203-213. [DOI: 10.1007/s10334-016-0594-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/30/2016] [Accepted: 10/06/2016] [Indexed: 11/26/2022]
|
72
|
Leitão HS, Doblas S, Garteiser P, d'Assignies G, Paradis V, Mouri F, Geraldes CFGC, Ronot M, Van Beers BE. Hepatic Fibrosis, Inflammation, and Steatosis: Influence on the MR Viscoelastic and Diffusion Parameters in Patients with Chronic Liver Disease. Radiology 2016; 283:98-107. [PMID: 27788034 DOI: 10.1148/radiol.2016151570] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose To determine the relationship of liver fibrosis, inflammation, and steatosis with the magnetic resonance (MR) viscoelastic and diffusion parameters in patients with chronic liver disease and to compare the diagnostic accuracy of the imaging parameters in staging liver fibrosis. Materials and Methods Consecutive patients with chronic liver disease scheduled for liver biopsy were prospectively recruited from November 2010 to October 2012 for this institutional review board-approved study after they provided written informed consent. Sixty-eight patients underwent three-dimensional MR elastography and intravoxel incoherent motion diffusion-weighted MR imaging with a 1.5-T MR system. Fibrosis, inflammation, and steatosis were assessed with the METAVIR and steatosis, activity, and fibrosis (or SAF) scoring systems. Spearman correlation and multiple regression analyses were performed to determine the relationship between liver fibrosis, inflammation, steatosis, and alanine aminotransferase (ALT) levels and viscoelastic and diffusion parameters. The accuracy of three-dimensional MR elastography and diffusion-weighted MR imaging in the determination of fibrosis stage was assessed with Obuchowski measures. Results At multiple regression analysis, fibrosis was the only variable associated with viscoelastic parameters (β = 0.6, P < .001, R2 = 0.33 for shear modulus; β = 0.6, P < .001, R2 = 0.32 for elasticity). Fibrosis had a weaker independent association with the apparent diffusion coefficient (β = -0.3, P = .02, R2 = 0.33) than did steatosis (β = -0.5, P < .001, R2 = 0.33). Steatosis was the only factor independently associated with the pure diffusion coefficient (β = -0.4, P = .002, R2 = 0.22). Inflammation and ALT level were not associated with the viscoelastic or diffusion parameters. The diagnostic accuracy of fibrosis staging was significantly higher when measuring the shear modulus rather than the apparent diffusion coefficient (Obuchowski measures, 0.82 ± 0.04 vs 0.30 ± 0.06; P < .001). Conclusion Fibrosis is independently associated with the MR viscoelastic parameters and is less associated with the diffusion parameters than is steatosis. These results and those of diagnostic accuracy suggest that MR elastography should be preferred over diffusion-weighted MR imaging in the staging of liver fibrosis. © RSNA, 2016.
Collapse
Affiliation(s)
- Helena S Leitão
- From the Laboratory of Imaging Biomarkers, Center of Research on Inflammation, Department of Radiology, UMR1149, INSERM-University Paris Diderot, Sorbonne Paris Cité, Beaujon Hospital, AP-HP, 100 Boulevard du Général Leclerc, 92118 Clichy, France
| | - Sabrina Doblas
- From the Laboratory of Imaging Biomarkers, Center of Research on Inflammation, Department of Radiology, UMR1149, INSERM-University Paris Diderot, Sorbonne Paris Cité, Beaujon Hospital, AP-HP, 100 Boulevard du Général Leclerc, 92118 Clichy, France
| | - Philippe Garteiser
- From the Laboratory of Imaging Biomarkers, Center of Research on Inflammation, Department of Radiology, UMR1149, INSERM-University Paris Diderot, Sorbonne Paris Cité, Beaujon Hospital, AP-HP, 100 Boulevard du Général Leclerc, 92118 Clichy, France
| | - Gaspard d'Assignies
- From the Laboratory of Imaging Biomarkers, Center of Research on Inflammation, Department of Radiology, UMR1149, INSERM-University Paris Diderot, Sorbonne Paris Cité, Beaujon Hospital, AP-HP, 100 Boulevard du Général Leclerc, 92118 Clichy, France
| | - Valérie Paradis
- From the Laboratory of Imaging Biomarkers, Center of Research on Inflammation, Department of Radiology, UMR1149, INSERM-University Paris Diderot, Sorbonne Paris Cité, Beaujon Hospital, AP-HP, 100 Boulevard du Général Leclerc, 92118 Clichy, France
| | - Feryel Mouri
- From the Laboratory of Imaging Biomarkers, Center of Research on Inflammation, Department of Radiology, UMR1149, INSERM-University Paris Diderot, Sorbonne Paris Cité, Beaujon Hospital, AP-HP, 100 Boulevard du Général Leclerc, 92118 Clichy, France
| | - Carlos F G C Geraldes
- From the Laboratory of Imaging Biomarkers, Center of Research on Inflammation, Department of Radiology, UMR1149, INSERM-University Paris Diderot, Sorbonne Paris Cité, Beaujon Hospital, AP-HP, 100 Boulevard du Général Leclerc, 92118 Clichy, France
| | - Maxime Ronot
- From the Laboratory of Imaging Biomarkers, Center of Research on Inflammation, Department of Radiology, UMR1149, INSERM-University Paris Diderot, Sorbonne Paris Cité, Beaujon Hospital, AP-HP, 100 Boulevard du Général Leclerc, 92118 Clichy, France
| | - Bernard E Van Beers
- From the Laboratory of Imaging Biomarkers, Center of Research on Inflammation, Department of Radiology, UMR1149, INSERM-University Paris Diderot, Sorbonne Paris Cité, Beaujon Hospital, AP-HP, 100 Boulevard du Général Leclerc, 92118 Clichy, France
| |
Collapse
|
73
|
Etchell E, Jugé L, Hatt A, Sinkus R, Bilston LE. Liver Stiffness Values Are Lower in Pediatric Subjects than in Adults and Increase with Age: A Multifrequency MR Elastography Study. Radiology 2016; 283:222-230. [PMID: 27755913 DOI: 10.1148/radiol.2016160252] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Purpose To determine if healthy hepatic mechanical properties differ between pediatric and adult subjects at magnetic resonance (MR) elastography. Materials and Methods Liver shear moduli in 24 healthy pediatric participants (13 children aged 5-14 years [seven boys, six girls] and 11 adolescents aged 15-18 years [six boys, five girls]) and 10 healthy adults (aged 22-36 years [five men, five women]) were obtained with 3-T MR elastography at 28, 56, and 84 Hz. Relationships between shear moduli and age were assessed with Spearman correlations. Differences between age groups were determined with one-way analysis of variance and Tukey multiple comparisons tests. Results Liver stiffness values (means ± standard deviations) were significantly lower in children and adolescents than in adults at 56 Hz (children, 2.2 kPa ± 0.3; adolescents, 2.2 kPa ± 0.2; adults, 2.6 kPa ± 0.3; analysis of variance, P = .009) and 84 Hz (children, 5.6 kPa ± 0.8; adolescents, 6.5 kPa ± 1.2; adults, 7.8 kPa ± 1.2; analysis of variance, P = .0003) but not at 28 Hz (children, 1.2 kPa ± 0.2; adolescents, 1.3 kPa ± 0.3; adults, 1.2 kPa ± 0.2; analysis of variance, P = .40). At 56 and 84 Hz, liver stiffness increased with age (Spearman correlation, r = 0.38 [P = .03] and r = 0.54 [P = .001], respectively). Stiffness varied less with frequency in children and adolescents than in adults (analysis of variance, P = .0009). No significant differences were found in shear moduli at 28, 56, or 84 Hz or frequency dependence between children and adolescents (P = .38, P = .99, P = .14, and P = .30, respectively, according to Tukey tests). Conclusion Liver stiffness values are lower and vary less with frequency in children and adolescents than in adults. Stiffness increases with age during normal development and approaches adult values during adolescence. Comparing pediatric liver stiffness to adult baseline values to detect pediatric liver mechanical abnormalities may not allow detection of mild disease and may lead to underestimation of severity. © RSNA, 2016 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Emily Etchell
- From Neuroscience Research Australia, Margarete Ainsworth Building, Barker St, Randwick, NSW 2031, Australia (E.E., L.J., A.H., L.E.B.); and Department of Biomedical Engineering, King's College London, London, England (R.S.)
| | - Lauriane Jugé
- From Neuroscience Research Australia, Margarete Ainsworth Building, Barker St, Randwick, NSW 2031, Australia (E.E., L.J., A.H., L.E.B.); and Department of Biomedical Engineering, King's College London, London, England (R.S.)
| | - Alice Hatt
- From Neuroscience Research Australia, Margarete Ainsworth Building, Barker St, Randwick, NSW 2031, Australia (E.E., L.J., A.H., L.E.B.); and Department of Biomedical Engineering, King's College London, London, England (R.S.)
| | - Ralph Sinkus
- From Neuroscience Research Australia, Margarete Ainsworth Building, Barker St, Randwick, NSW 2031, Australia (E.E., L.J., A.H., L.E.B.); and Department of Biomedical Engineering, King's College London, London, England (R.S.)
| | - Lynne E Bilston
- From Neuroscience Research Australia, Margarete Ainsworth Building, Barker St, Randwick, NSW 2031, Australia (E.E., L.J., A.H., L.E.B.); and Department of Biomedical Engineering, King's College London, London, England (R.S.)
| |
Collapse
|
74
|
Ivey JW, Bonakdar M, Kanitkar A, Davalos RV, Verbridge SS. Improving cancer therapies by targeting the physical and chemical hallmarks of the tumor microenvironment. Cancer Lett 2016; 380:330-9. [PMID: 26724680 PMCID: PMC4919249 DOI: 10.1016/j.canlet.2015.12.019] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 12/09/2015] [Accepted: 12/10/2015] [Indexed: 12/18/2022]
Abstract
Tumors are highly heterogeneous at the patient, tissue, cellular, and molecular levels. This multi-scale heterogeneity poses significant challenges for effective therapies, which ideally must not only distinguish between tumorous and healthy tissue, but also fully address the wide variety of tumorous sub-clones. Commonly used therapies either leverage a biological phenotype of cancer cells (e.g. high rate of proliferation) or indiscriminately kill all the cells present in a targeted volume. Tumor microenvironment (TME) targeting represents a promising therapeutic direction, because a number of TME hallmarks are conserved across different tumor types, despite the underlying genetic heterogeneity. Historically, TME targeting has largely focused on the cells that support tumor growth (e.g. vascular endothelial cells). However, by viewing the intrinsic physical and chemical alterations in the TME as additional therapeutic opportunities rather than barriers, a new class of TME-inspired treatments has great promise to complement or replace existing therapeutic strategies. In this review we summarize the physical and chemical hallmarks of the TME, and discuss how these tumor characteristics either currently are, or may ultimately be targeted to improve cancer therapies.
Collapse
Affiliation(s)
- Jill W Ivey
- Department of Biomedical Engineering and Mechanics, Virginia Tech-Wake Forest University, Blacksburg, VA 24061, USA
| | - Mohammad Bonakdar
- Department of Mechanical Engineering, Virginia Tech, Blacksburg, VA 24061, USA
| | - Akanksha Kanitkar
- Department of Biomedical Engineering and Mechanics, Virginia Tech-Wake Forest University, Blacksburg, VA 24061, USA
| | - Rafael V Davalos
- Department of Biomedical Engineering and Mechanics, Virginia Tech-Wake Forest University, Blacksburg, VA 24061, USA; Department of Mechanical Engineering, Virginia Tech, Blacksburg, VA 24061, USA
| | - Scott S Verbridge
- Department of Biomedical Engineering and Mechanics, Virginia Tech-Wake Forest University, Blacksburg, VA 24061, USA.
| |
Collapse
|
75
|
Abramson RG, Arlinghaus LR, Dula AN, Quarles CC, Stokes AM, Weis JA, Whisenant JG, Chekmenev EY, Zhukov I, Williams JM, Yankeelov TE. MR Imaging Biomarkers in Oncology Clinical Trials. Magn Reson Imaging Clin N Am 2016; 24:11-29. [PMID: 26613873 DOI: 10.1016/j.mric.2015.08.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The authors discuss eight areas of quantitative MR imaging that are currently used (RECIST, DCE-MR imaging, DSC-MR imaging, diffusion MR imaging) in clinical trials or emerging (CEST, elastography, hyperpolarized MR imaging, multiparameter MR imaging) as promising techniques in diagnosing cancer and assessing or predicting response of cancer to therapy. Illustrative applications of the techniques in the clinical setting are summarized before describing the current limitations of the methods.
Collapse
Affiliation(s)
- Richard G Abramson
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA
| | - Lori R Arlinghaus
- Department of Radiology and Radiological Sciences, Vanderbilt University, 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA
| | - Adrienne N Dula
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA
| | - C Chad Quarles
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA; Department of Biomedical Engineering, Institute of Imaging Science, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA; Department of Cancer Biology, Institute of Imaging Science, Vanderbilt University, 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA
| | - Ashley M Stokes
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA
| | - Jared A Weis
- Department of Biomedical Engineering, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA
| | - Jennifer G Whisenant
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA
| | - Eduard Y Chekmenev
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA; Department of Biomedical Engineering, Institute of Imaging Science, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA; Department of Biochemistry, Institute of Imaging Science, Vanderbilt University, 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA
| | - Igor Zhukov
- National Research Nuclear University MEPhI, Kashirskoye highway, 31, Moscow 115409, Russia
| | - Jason M Williams
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University, 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA
| | - Thomas E Yankeelov
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA; Department of Biomedical Engineering, Institute of Imaging Science, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA; Department of Cancer Biology, Institute of Imaging Science, Vanderbilt University, 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA; Department of Physics, Institute of Imaging Science, Vanderbilt University, VUIIS 1161 21st Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, USA.
| |
Collapse
|
76
|
Kazemirad S, Bernard S, Hybois S, Tang A, Cloutier G. Ultrasound Shear Wave Viscoelastography: Model-Independent Quantification of the Complex Shear Modulus. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2016; 63:1399-1408. [PMID: 27362951 DOI: 10.1109/tuffc.2016.2583785] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Ultrasound shear wave elastography methods are commonly used for estimation of mechanical properties of soft biological tissues in diagnostic medicine. A limitation of most currently used elastography methods is that they yield only the shear storage modulus ( G' ) but not the loss modulus ( G'' ). Therefore, no information on viscosity or loss tangent (tan δ) is provided. In this paper, an ultrasound shear wave viscoelastography method is developed for model-independent quantification of frequency-dependent viscoelastic complex shear modulus of macroscopically homogeneous tissues. Three in vitro tissue-mimicking phantoms and two ex vivo porcine liver samples were evaluated. Shear waves were remotely induced within the samples using several acoustic radiation force pushes to generate a semicylindrical wave field similar to those generated by most clinically used elastography systems. The complex shear modulus was estimated over a broad frequency range (up to 1000 Hz) through the analytical solution of the developed inverse wave propagation problem using the measured shear wave speed and amplitude decay versus propagation distance. The shear storage and loss moduli obtained for the in vitro phantoms were compared with those from a planar shear wave method and the average differences over the whole frequency range studied were smaller than 7% and 15%, respectively. The reliability of the proposed method highlights its potential for viscoelastic tissue characterization, which may improve noninvasive diagnosis.
Collapse
|
77
|
Corbin N, Vappou J, Breton E, Boehler Q, Barbé L, Renaud P, Mathelin M. Interventional MR elastography for MRI‐guided percutaneous procedures. Magn Reson Med 2016; 75:1110-8. [DOI: 10.1002/mrm.25694] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/18/2015] [Accepted: 02/23/2015] [Indexed: 12/22/2022]
Affiliation(s)
- Nadège Corbin
- ICubeUniversity of Strasbourg, CNRS, IHU Strasbourg France
| | | | - Elodie Breton
- ICubeUniversity of Strasbourg, CNRS, IHU Strasbourg France
| | | | - Laurent Barbé
- ICubeUniversity of Strasbourg, CNRS, IHU Strasbourg France
| | - Pierre Renaud
- ICubeUniversity of Strasbourg, CNRS, IHU Strasbourg France
| | | |
Collapse
|
78
|
Tzschätzsch H, Guo J, Dittmann F, Hirsch S, Barnhill E, Jöhrens K, Braun J, Sack I. Tomoelastography by multifrequency wave number recovery from time-harmonic propagating shear waves. Med Image Anal 2016; 30:1-10. [PMID: 26845371 DOI: 10.1016/j.media.2016.01.001] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 12/23/2015] [Accepted: 01/04/2016] [Indexed: 01/02/2023]
Abstract
Palpation is one of the most sensitive, effective diagnostic practices, motivating the quantitative and spatially resolved determination of soft tissue elasticity parameters by medical ultrasound or MRI. However, this so-called elastography often suffers from limited anatomical resolution due to noise and insufficient elastic deformation, currently precluding its use as a tomographic modality on its own. We here introduce an efficient way of processing wave images acquired by multifrequency magnetic resonance elastography (MMRE), which relies on wave number reconstruction at different harmonic frequencies followed by their amplitude-weighted averaging prior to inversion. This results in compound maps of wave speed, which reveal variations in tissue elasticity in a tomographic fashion, i.e. an unmasked, slice-wise display of anatomical details at pixel-wise resolution. The method is demonstrated using MMRE data from the literature including abdominal and pelvic organs such as the liver, spleen, uterus body and uterus cervix. Even in small regions with low wave amplitudes, such as nucleus pulposus and spinal cord, elastic parameters consistent with literature values were obtained. Overall, the proposed method provides a simple and noise-robust strategy of in-plane wave analysis of MMRE data, with a pixel-wise resolution producing superior detail to MRE direct inversion methods.
Collapse
Affiliation(s)
- Heiko Tzschätzsch
- Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jing Guo
- Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Florian Dittmann
- Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Sebastian Hirsch
- Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Eric Barnhill
- Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Korinna Jöhrens
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Germany
| | - Jürgen Braun
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
| |
Collapse
|
79
|
Hennedige T, Venkatesh SK. Advances in computed tomography and magnetic resonance imaging of hepatocellular carcinoma. World J Gastroenterol 2016; 22:205-220. [PMID: 26755871 PMCID: PMC4698486 DOI: 10.3748/wjg.v22.i1.205] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 12/01/2015] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Imaging is important for establishing a diagnosis of HCC and early diagnosis is imperative as several potentially curative treatments are available when HCC is small. Hepatocarcinogenesis occurs in a stepwise manner on a background of chronic liver disease or cirrhosis wherein multiple genes are altered resulting in a range of cirrhosis-associated nodules. This progression is related to increased cellularity, neovascularity and size of the nodule. An understanding of the stepwise progression may aid in early diagnosis. Dynamic and multiphase contrast-enhanced computed tomography and magnetic resonance imaging still form the cornerstone in the diagnosis of HCC. An overview of the current diagnostic standards of HCC in accordance to the more common practicing guidelines and their differences will be reviewed. Ancillary features contribute to diagnostic confidence and has been incorporated into the more recent Liver Imaging Reporting and Data System. The use of hepatocyte-specific contrast agents is increasing and gradually changing the standard of diagnosis of HCC; the most significant benefit being the lack of uptake in the hepatocyte phase in the earlier stages of HCC progression. An outline of supplementary techniques in the imaging of HCC will also be reviewed.
Collapse
|
80
|
Palacio‐Torralba J, Jiménez Aguilar E, Good DW, Hammer S, McNeill SA, Stewart GD, Reuben RL, Chen Y. Patient specific modeling of palpation-based prostate cancer diagnosis: effects of pelvic cavity anatomy and intrabladder pressure. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2016; 32:e02734. [PMID: 26190813 PMCID: PMC4975704 DOI: 10.1002/cnm.2734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 04/20/2015] [Accepted: 06/08/2015] [Indexed: 06/04/2023]
Abstract
Computational modeling has become a successful tool for scientific advances including understanding the behavior of biological and biomedical systems as well as improving clinical practice. In most cases, only general models are used without taking into account patient-specific features. However, patient specificity has proven to be crucial in guiding clinical practice because of disastrous consequences that can arise should the model be inaccurate. This paper proposes a framework for the computational modeling applied to the example of the male pelvic cavity for the purpose of prostate cancer diagnostics using palpation. The effects of patient specific structural features on palpation response are studied in three selected patients with very different pathophysiological conditions whose pelvic cavities are reconstructed from MRI scans. In particular, the role of intrabladder pressure in the outcome of digital rectal examination is investigated with the objective of providing guidelines to practitioners to enhance the effectiveness of diagnosis. Furthermore, the presence of the pelvic bone in the model is assessed to determine the pathophysiological conditions in which it has to be modeled. The conclusions and suggestions of this work have potential use not only in clinical practice and also for biomechanical modeling where structural patient-specificity needs to be considered. © 2015 The Authors. International Journal for Numerical Methods in Biomedical Engineering published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- Javier Palacio‐Torralba
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical SciencesHeriot‐Watt UniversityEdinburghEH14 4ASUK
| | | | - Daniel W. Good
- Edinburgh Urological Cancer Group, Division of Pathology Laboratories, Institute of Genetics and Molecular MedicineUniversity of Edinburgh, Western General HospitalCrewe Road SouthEdinburghEH4 2XUUK
| | - Steven Hammer
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical SciencesHeriot‐Watt UniversityEdinburghEH14 4ASUK
| | - S. Alan McNeill
- Edinburgh Urological Cancer Group, Division of Pathology Laboratories, Institute of Genetics and Molecular MedicineUniversity of Edinburgh, Western General HospitalCrewe Road SouthEdinburghEH4 2XUUK
- Department of Urology, NHS LothianWestern General HospitalCrewe Road SouthEdinburghEH4 2XUUK
| | - Grant D. Stewart
- Edinburgh Urological Cancer Group, Division of Pathology Laboratories, Institute of Genetics and Molecular MedicineUniversity of Edinburgh, Western General HospitalCrewe Road SouthEdinburghEH4 2XUUK
- Department of Urology, NHS LothianWestern General HospitalCrewe Road SouthEdinburghEH4 2XUUK
| | - Robert L. Reuben
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical SciencesHeriot‐Watt UniversityEdinburghEH14 4ASUK
| | - Yuhang Chen
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical SciencesHeriot‐Watt UniversityEdinburghEH14 4ASUK
| |
Collapse
|
81
|
Abstract
Many diseases cause substantial changes in the mechanical properties of tissue, and this provides motivation for developing methods to noninvasively assess the stiffness of tissue using imaging technology. Magnetic resonance elastography (MRE) has emerged as a versatile MRI-based technique, based on direct visualization of propagating shear waves in the tissues. The most established clinical application of MRE in the abdomen is in chronic liver disease. MRE is currently regarded as the most accurate noninvasive technique for detection and staging of liver fibrosis. Increasing experience and ongoing research is leading to exploration of applications in other abdominal organs. In this review article, the current use of MRE in liver disease and the potential future applications of this technology in other parts of the abdomen are surveyed.
Collapse
|
82
|
Jugé L, Petiet A, Lambert SA, Nicole P, Chatelin S, Vilgrain V, Van Beers BE, Bilston LE, Sinkus R. Microvasculature alters the dispersion properties of shear waves--a multi-frequency MR elastography study. NMR IN BIOMEDICINE 2015; 28:1763-1771. [PMID: 26768491 DOI: 10.1002/nbm.3438] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 09/25/2015] [Accepted: 10/01/2015] [Indexed: 06/05/2023]
Abstract
Magnetic Resonance Elastography (MRE) uses macroscopic shear wave propagation to quantify mechanical properties of soft tissues. Micro-obstacles are capable of affecting the macroscopic dispersion properties of shear waves. Since disease or therapy can change the mechanical integrity and organization of vascular structures, MRE should be able to sense these changes if blood vessels represent a source for wave scattering. To verify this, MRE was performed to quantify alteration of the shear wave speed cs due to the presence of vascular outgrowths using an aortic ring model. Eighteen fragments of rat aorta included in a Matrigel matrix (n=6 without outgrowths, n=6 with a radial outgrowth extent of ~600 µm and n=6 with ~850 µm) were imaged using a 7 Tesla MR scanner (Bruker, PharmaScan). High resolution anatomical images were acquired in addition to multi-frequency MRE (ν = 100, 115, 125, 135 and 150 Hz). Average cs was measured within a ring of ~900 µm thickness encompassing the aorta and were normalized to cs0 of the corresponding Matrigel. The frequency dependence was fit to the power law model cs ~ν(y). After scanning, optical microscopy was performed to visualize outgrowths. Results demonstrated that in presence of vascular outgrowths (1) normalized cs significantly increased for the three highest frequencies (Kruskal-Wallis test, P = 0.0002 at 125 Hz and P = 0.002 at 135 Hz and P = 0.003 at 150 Hz) but not for the two lowest (Kruskal-Wallis test, P = 0.63 at 100 Hz and P = 0.87 at 115 Hz), and (2) normalized cs followed a power law behavior not seen in absence of vascular outgrowths (ANOVA test, P < 0.0001). These results showed that vascular outgrowths acted as micro-obstacles altering the dispersion relationships of propagating shear waves and that MRE could provide valuable information about microvascular changes.
Collapse
Affiliation(s)
- Lauriane Jugé
- Neuroscience Research Australia, Randwick, Sidney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Kensington, Sidney, NSW, Australia
| | - Anne Petiet
- Fédération de Recherche en Imagerie multimodalité (FRIM), U1148 INSERM, UFR de Médecine, University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Simon A Lambert
- BHF Centre of Excellence, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Pascal Nicole
- Laboratory from inflammation to cancer in digestive diseases, UMR1149 INSERM, University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Simon Chatelin
- Laboratory of Imaging Biomarkers, UMR1149 INSERM, University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Valerie Vilgrain
- Laboratory of Imaging Biomarkers, UMR1149 INSERM, University Paris Diderot, Sorbonne Paris Cité, Paris, France
- Department of Radiology, Beaujon University Hospital Paris Nord, Clichy, France
| | - Bernard E Van Beers
- Laboratory of Imaging Biomarkers, UMR1149 INSERM, University Paris Diderot, Sorbonne Paris Cité, Paris, France
- Department of Radiology, Beaujon University Hospital Paris Nord, Clichy, France
| | - Lynne E Bilston
- Neuroscience Research Australia, Randwick, Sidney, NSW, Australia
- Prince of Wales Clinical School, University of New South Wales, Kensington, Sydney, NSW, Australia
| | - Ralph Sinkus
- BHF Centre of Excellence, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| |
Collapse
|
83
|
Pepin KM, Ehman RL, McGee KP. Magnetic resonance elastography (MRE) in cancer: Technique, analysis, and applications. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2015; 90-91:32-48. [PMID: 26592944 PMCID: PMC4660259 DOI: 10.1016/j.pnmrs.2015.06.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 06/15/2015] [Accepted: 06/16/2015] [Indexed: 05/07/2023]
Abstract
Tissue mechanical properties are significantly altered with the development of cancer. Magnetic resonance elastography (MRE) is a noninvasive technique capable of quantifying tissue mechanical properties in vivo. This review describes the basic principles of MRE and introduces some of the many promising MRE methods that have been developed for the detection and characterization of cancer, evaluation of response to therapy, and investigation of the underlying mechanical mechanisms associated with malignancy.
Collapse
|
84
|
Fowkes LA, Koh DM, Collins DJ, Jerome NP, MacVicar D, Chua SC, Pearson ADJ. Childhood extracranial neoplasms: the role of imaging in drug development and clinical trials. Pediatr Radiol 2015; 45:1600-15. [PMID: 26045035 DOI: 10.1007/s00247-015-3342-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/16/2015] [Accepted: 03/16/2015] [Indexed: 12/25/2022]
Abstract
Cancer is the leading cause of death in children older than 1 year of age and new drugs are necessary to improve outcomes. Imaging is crucial to the drug development process and assessment of therapeutic response. In adults, tumours are often assessed with CT using size criteria. Unfortunately, techniques established in adults are not necessarily applicable in children due to differing pathophysiology, ability to cooperate and increased susceptibility to ionising radiation. MRI, in particular quantitative MRI, has to date not been fully utilised in children with extracranial neoplasms. The specific challenges of imaging in children, the potential for functional imaging techniques to inform upon and their inclusion in clinical trials are discussed.
Collapse
Affiliation(s)
- Lucy A Fowkes
- Department of Radiology, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK.
| | - Dow-Mu Koh
- Department of Radiology, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK
| | - David J Collins
- Cancer Research UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, Surrey, UK
| | - Neil P Jerome
- Cancer Research UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, Surrey, UK
| | - David MacVicar
- Department of Radiology, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK
| | - Sue C Chua
- Nuclear Medicine & PET Department, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK
| | - Andrew D J Pearson
- Paediatric Drug Development Unit, Children and Young People's Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK
| |
Collapse
|
85
|
Itoh Y, Takehara Y, Kawase T, Terashima K, Ohkawa Y, Hirose Y, Koda A, Hyodo N, Ushio T, Hirai Y, Yoshizawa N, Yamashita S, Nasu H, Ohishi N, Sakahara H. Feasibility of magnetic resonance elastography for the pancreas at 3T. J Magn Reson Imaging 2015; 43:384-90. [DOI: 10.1002/jmri.24995] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/18/2015] [Indexed: 01/27/2023] Open
Affiliation(s)
- Yohei Itoh
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University, School of Medicine; Hamamatsu Japan
| | - Yasuo Takehara
- Department of Radiology; Hamamatsu University Hospital; Hamamatsu Japan
| | - Toshihiro Kawase
- Department of Radiological Technology; Chutoen General Medical Center; Kakegawa Japan
| | | | - Yoshihisa Ohkawa
- Department of Diagnostic Radiology; Chutoen General Medical Center; Kakegawa Japan
| | - Yuko Hirose
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University, School of Medicine; Hamamatsu Japan
| | - Ai Koda
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University, School of Medicine; Hamamatsu Japan
| | - Naoko Hyodo
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University, School of Medicine; Hamamatsu Japan
| | - Takasuke Ushio
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University, School of Medicine; Hamamatsu Japan
| | - Yuki Hirai
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University, School of Medicine; Hamamatsu Japan
| | - Nobuko Yoshizawa
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University, School of Medicine; Hamamatsu Japan
| | - Shuhei Yamashita
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University, School of Medicine; Hamamatsu Japan
| | - Hatsuko Nasu
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University, School of Medicine; Hamamatsu Japan
| | - Naoki Ohishi
- Department of Radiology; Hamamatsu University Hospital; Hamamatsu Japan
| | - Harumi Sakahara
- Department of Diagnostic Radiology & Nuclear Medicine; Hamamatsu University, School of Medicine; Hamamatsu Japan
| |
Collapse
|
86
|
Weis JA, Flint KM, Sanchez V, Yankeelov TE, Miga MI. Assessing the accuracy and reproducibility of modality independent elastography in a murine model of breast cancer. J Med Imaging (Bellingham) 2015; 2:036001. [PMID: 26158120 DOI: 10.1117/1.jmi.2.3.036001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 06/02/2015] [Indexed: 01/21/2023] Open
Abstract
Cancer progression has been linked to mechanics. Therefore, there has been recent interest in developing noninvasive imaging tools for cancer assessment that are sensitive to changes in tissue mechanical properties. We have developed one such method, modality independent elastography (MIE), that estimates the relative elastic properties of tissue by fitting anatomical image volumes acquired before and after the application of compression to biomechanical models. The aim of this study was to assess the accuracy and reproducibility of the method using phantoms and a murine breast cancer model. Magnetic resonance imaging data were acquired, and the MIE method was used to estimate relative volumetric stiffness. Accuracy was assessed using phantom data by comparing to gold-standard mechanical testing of elasticity ratios. Validation error was [Formula: see text]. Reproducibility analysis was performed on animal data, and within-subject coefficients of variation ranged from 2 to 13% at the bulk level and 32% at the voxel level. To our knowledge, this is the first study to assess the reproducibility of an elasticity imaging metric in a preclinical cancer model. Our results suggest that the MIE method can reproducibly generate accurate estimates of the relative mechanical stiffness and provide guidance on the degree of change needed in order to declare biological changes rather than experimental error in future therapeutic studies.
Collapse
Affiliation(s)
- Jared A Weis
- Vanderbilt University , Department of Biomedical Engineering, PMB 351631, 2301 Vanderbilt Place, Nashville, Tennessee 37235-1631, United States ; Vanderbilt University , Institute of Imaging Science, 1161 21st Avenue South, AA-1105 MCN, Nashville, Tennessee 37232-2310, United States ; Vanderbilt University , Radiology and Radiological Sciences, 1161 21st Avenue South, MCN CCC-1118, Nashville, Tennessee 37232-2675, United States
| | - Katelyn M Flint
- Vanderbilt University , Department of Biomedical Engineering, PMB 351631, 2301 Vanderbilt Place, Nashville, Tennessee 37235-1631, United States
| | - Violeta Sanchez
- Vanderbilt University , Vanderbilt-Ingram Cancer Center, 2220 Pierce Avenue, 691 PRB, Nashville, Tennessee 37232-6838, United States
| | - Thomas E Yankeelov
- Vanderbilt University , Department of Biomedical Engineering, PMB 351631, 2301 Vanderbilt Place, Nashville, Tennessee 37235-1631, United States ; Vanderbilt University , Institute of Imaging Science, 1161 21st Avenue South, AA-1105 MCN, Nashville, Tennessee 37232-2310, United States ; Vanderbilt University , Radiology and Radiological Sciences, 1161 21st Avenue South, MCN CCC-1118, Nashville, Tennessee 37232-2675, United States ; Vanderbilt University , Vanderbilt-Ingram Cancer Center, 2220 Pierce Avenue, 691 PRB, Nashville, Tennessee 37232-6838, United States ; Vanderbilt University , Physics and Astronomy, PMB 401807, 2301 Vanderbilt Place, Nashville, Tennessee 37240-1807, United States ; Vanderbilt University , Cancer Biology, 2220 Pierce Avenue, 771 PRB, Nashville, Tennessee 37232-6840, United States
| | - Michael I Miga
- Vanderbilt University , Department of Biomedical Engineering, PMB 351631, 2301 Vanderbilt Place, Nashville, Tennessee 37235-1631, United States ; Vanderbilt University , Institute of Imaging Science, 1161 21st Avenue South, AA-1105 MCN, Nashville, Tennessee 37232-2310, United States ; Vanderbilt University , Radiology and Radiological Sciences, 1161 21st Avenue South, MCN CCC-1118, Nashville, Tennessee 37232-2675, United States ; Vanderbilt University , Vanderbilt-Ingram Cancer Center, 2220 Pierce Avenue, 691 PRB, Nashville, Tennessee 37232-6838, United States ; Vanderbilt University , Neurosurgery, T-4224 MCN Nashville, Tennessee 37232-2380, United States
| |
Collapse
|
87
|
Hennedige TP, Hallinan JTPD, Leung FP, Teo LLS, Iyer S, Wang G, Chang S, Madhavan KK, Wee A, Venkatesh SK. Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions. Eur Radiol 2015; 26:398-406. [PMID: 26032879 DOI: 10.1007/s00330-015-3835-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 04/23/2015] [Accepted: 05/07/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Comparison of magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI) for differentiating malignant and benign focal liver lesions (FLLs). METHODS Seventy-nine subjects with 124 FLLs (44 benign and 80 malignant) underwent both MRE and DWI. MRE was performed with a modified gradient-echo sequence and DWI with a free breathing technique (b = 0.500). Apparent diffusion coefficient (ADC) maps and stiffness maps were generated. FLL mean stiffness and ADC values were obtained by placing regions of interest over the FLLs on stiffness and ADC maps. The accuracy of MRE and DWI for differentiation of benign and malignant FLL was compared using receiver operating curve (ROC) analysis. RESULTS There was a significant negative correlation between stiffness and ADC (r = -0.54, p < 0.0001) of FLLs. Malignant FLLs had significantly higher mean stiffness (7.9kPa vs. 3.1kPa, p < 0.001) and lower mean ADC (129 vs. 200 × 10(-3)mm(2)/s, p < 0.001) than benign FLLs. The sensitivity/specificity/positive predictive value/negative predictive value for differentiating malignant from benign FLLs with MRE (cut-off, >4.54kPa) and DWI (cut-off, <151 × 10(-3)mm(2)/s) were 96.3/95.5/97.5/93.3% (p < 0.001) and 85/81.8/88.3/75% (p < 0.001), respectively. ROC analysis showed significantly higher accuracy for MRE than DWI (0.986 vs. 0.82, p = 0.0016). CONCLUSION MRE is significantly more accurate than DWI for differentiating benign and malignant FLLs. KEY POINTS • MRE is superior to DWI for differentiating benign and malignant focal liver lesions. • Benign lesions with large fibrous components may have higher stiffness with MRE. • Cholangiocarcinomas tend to have higher stiffness than hepatocellular carcinomas. • Hepatocellular adenomas tend to have lower stiffness than focal nodular hyperplasia. • MRE is superior to conventional MRI in differentiating benign and malignant liver lesions.
Collapse
Affiliation(s)
- Tiffany P Hennedige
- Department of Diagnostic Imaging, National University Hospital, National University Health System, Singapore, Singapore
| | | | - Fiona P Leung
- Department of Diagnostic Imaging, National University Hospital, National University Health System, Singapore, Singapore.,South West Radiology, Liverpool, NSW, Australia
| | - Lynette Li San Teo
- Department of Diagnostic Imaging, National University Hospital, National University Health System, Singapore, Singapore
| | - Sridhar Iyer
- Department of Surgery, National University Health System, Singapore, Singapore
| | - Gang Wang
- Department of Diagnostic Imaging, National University Hospital, National University Health System, Singapore, Singapore.,University of Calgary, Alberta, Canada
| | - Stephen Chang
- Department of Surgery, National University Health System, Singapore, Singapore
| | | | - Aileen Wee
- Department of Pathology, National University Hospital, National University Health System, Singapore, Singapore
| | - Sudhakar K Venkatesh
- Department of Radiology, Mayo Clinic, 200, First Street SW, Rochester, MN, 55905, USA.
| |
Collapse
|
88
|
Jamin Y, Boult JK, Li J, Popov S, Garteiser P, Ulloa JL, Cummings C, Box G, Eccles SA, Jones C, Waterton JC, Bamber JC, Sinkus R, Robinson SP. Exploring the biomechanical properties of brain malignancies and their pathologic determinants in vivo with magnetic resonance elastography. Cancer Res 2015; 75:1216-1224. [PMID: 25672978 PMCID: PMC4384983 DOI: 10.1158/0008-5472.can-14-1997] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 01/15/2015] [Indexed: 12/29/2022]
Abstract
Malignant tumors are typically associated with altered rigidity relative to normal host tissue. Magnetic resonance elastography (MRE) enables the noninvasive quantitation of the mechanical properties of deep-seated tissue following application of an external vibrational mechanical stress to that tissue. In this preclinical study, we used MRE to quantify (kPa) the elasticity modulus Gd and viscosity modulus Gl of three intracranially implanted glioma and breast metastatic tumor models. In all these brain tumors, we found a notable softness characterized by lower elasticity and viscosity than normal brain parenchyma, enabling their detection on Gd and Gl parametric maps. The most circumscribed tumor (U-87 MG glioma) was the stiffest, whereas the most infiltrative tumor (MDA-MB-231 metastatic breast carcinoma) was the softest. Tumor cell density and microvessel density correlated significantly and positively with elasticity and viscosity, whereas there was no association with the extent of collagen deposition or myelin fiber entrapment. In conclusion, although malignant tumors tend to exhibit increased rigidity, intracranial tumors presented as remarkably softer than normal brain parenchyma. Our findings reinforce the case for MRE use in diagnosing and staging brain malignancies, based on the association of different tumor phenotypes with different mechanical properties.
Collapse
Affiliation(s)
- Yann Jamin
- Division of Radiotherapy & Imaging, The Institute of Cancer Research and Royal Marsden NHS Trust, London, United Kingdom
| | - Jessica K.R. Boult
- Division of Radiotherapy & Imaging, The Institute of Cancer Research and Royal Marsden NHS Trust, London, United Kingdom
| | - Jin Li
- Division of Radiotherapy & Imaging, The Institute of Cancer Research and Royal Marsden NHS Trust, London, United Kingdom
| | - Sergey Popov
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Philippe Garteiser
- INSERM U1149, CRI, Centre de Recherche sur l’Inflammation, Paris, France
| | | | - Craig Cummings
- Division of Radiotherapy & Imaging, The Institute of Cancer Research and Royal Marsden NHS Trust, London, United Kingdom
| | - Gary Box
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Suzanne A. Eccles
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Chris Jones
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - John C. Waterton
- Personalised Healthcare and Biomarkers, AstraZeneca, Alderley Park, Macclesfield, Cheshire, United Kingdom
| | - Jeffrey C. Bamber
- Division of Radiotherapy & Imaging, The Institute of Cancer Research and Royal Marsden NHS Trust, London, United Kingdom
| | - Ralph Sinkus
- BHF Centre of Excellence, Division of Imaging Sciences and Biomedical Engineering, King’s College London, King’s Health Partners, St. Thomas’ Hospital, London, United Kingdom
| | - Simon P. Robinson
- Division of Radiotherapy & Imaging, The Institute of Cancer Research and Royal Marsden NHS Trust, London, United Kingdom
| |
Collapse
|
89
|
Abstract
Newly developed or advanced methods of ultrasonography and MR imaging provide combined anatomical and quantitative functional information about diffuse and focal liver diseases. Ultrasound elastography has a central role for staging liver fibrosis and an increasing role in grading portal hypertension; dynamic contrast-enhanced ultrasonography may improve tumor characterization. In clinical practice, MR imaging examinations currently include diffusion-weighted and dynamic MR imaging, enhanced with extracellular or hepatobiliary contrast agents. Moreover, quantitative parameters obtained with diffusion-weighted MR imaging, dynamic contrast-enhanced MR imaging and MR elastography have the potential to characterize further diffuse and focal liver diseases, by adding information about tissue cellularity, perfusion, hepatocyte transport function and visco-elasticity. The multiparametric capability of ultrasonography and more markedly of MR imaging gives the opportunity for high diagnostic performance by combining imaging biomarkers. However, image acquisition and post-processing methods should be further standardized and validated in multicenter trials.
Collapse
|
90
|
Ipek-Ugay S, Drießle T, Ledwig M, Guo J, Hirsch S, Sack I, Braun J. Tabletop magnetic resonance elastography for the measurement of viscoelastic parameters of small tissue samples. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2015; 251:13-18. [PMID: 25554945 DOI: 10.1016/j.jmr.2014.11.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 11/18/2014] [Accepted: 11/19/2014] [Indexed: 06/04/2023]
Abstract
We demonstrate the feasibility of low-cost tabletop MR elastography (MRE) for quantifying the complex shear modulus G(∗) of small soft biological tissue samples as provided by pathologists. The MRE system was developed based on a tabletop MRI scanner equipped with a 0.5 T permanent magnet and a tissue sample holder mounted to a loudspeaker. A spin echo sequence was enhanced with motion-encoding gradients of 250 mT/m amplitude synchronized to acoustic vibration frequencies. Shear wave images suitable for elastography were acquired between vibration frequencies of 0.5 and 1 kHz in agarose, ultrasound gel, porcine liver, porcine skeletal muscle, and bovine heart with a spatial resolution of 234 μm pixel edge length. The measured frequency dependence of G(∗) agreed well with previous work based on high-field MR systems. The ratio between loss and storage moduli was highest in liver and ultrasound gel, followed by muscle tissue and agarose gel while ultrasound gel and liver showed similarly low storage moduli compared to the other samples. The shear wave to noise ratio is an important imaging criteria for MRE and was about 4.2 times lower for the preliminary setup of the 0.5 T tabletop system compared to a 7 T animal scanner. In the future, the new tabletop MRE system may serve as a low cost device for preclinical research on the correlation of viscoelastic parameters with histopathology of biological samples.
Collapse
Affiliation(s)
- Selcan Ipek-Ugay
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Jing Guo
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sebastian Hirsch
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen Braun
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| |
Collapse
|
91
|
Nightingale KR, Rouze NC, Rosenzweig SJ, Wang MH, Abdelmalek MF, Guy CD, Palmeri ML. Derivation and analysis of viscoelastic properties in human liver: impact of frequency on fibrosis and steatosis staging. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2015; 62:165-75. [PMID: 25585400 PMCID: PMC4405169 DOI: 10.1109/tuffc.2014.006653] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Commercially-available shear wave imaging systems measure group shear wave speed (SWS) and often report stiffness parameters applying purely elastic material models. Soft tissues, however, are viscoelastic, and higher-order material models are necessary to characterize the dispersion associated with broadband shear waves. In this paper, we describe a robust, model-based algorithm and use a linear dispersion model to perform shear wave dispersion analysis in traditionally difficult-to-image subjects. In a cohort of 135 non-alcoholic fatty liver disease patients, we compare the performance of group SWS with dispersion analysis-derived phase velocity c(200 Hz) and dispersion slope dc/df parameters to stage hepatic fibrosis and steatosis. Area under the ROC curve (AUROC) analysis demonstrates correlation between all parameters [group SWS, c(200 Hz), and, to a lesser extent dc/df ] and fibrosis stage, whereas no correlation was observed between steatosis stage and any of the material parameters. Interestingly, optimal AUROC threshold SWS values separating advanced liver fibrosis (≥F3) from mild-to-moderate fibrosis (≤F2) were shown to be frequency-dependent, and to increase from 1.8 to 3.3 m/s over the 0 to 400 Hz shear wave frequency range.
Collapse
|
92
|
Palacio-Torralba J, Hammer S, Good DW, Alan McNeill S, Stewart GD, Reuben RL, Chen Y. Quantitative diagnostics of soft tissue through viscoelastic characterization using time-based instrumented palpation. J Mech Behav Biomed Mater 2014; 41:149-60. [PMID: 25460411 DOI: 10.1016/j.jmbbm.2014.09.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/18/2014] [Accepted: 09/23/2014] [Indexed: 10/24/2022]
Abstract
Although palpation has been successfully employed for centuries to assess soft tissue quality, it is a subjective test, and is therefore qualitative and depends on the experience of the practitioner. To reproduce what the medical practitioner feels needs more than a simple quasi-static stiffness measurement. This paper assesses the capacity of dynamic mechanical palpation to measure the changes in viscoelastic properties that soft tissue can exhibit under certain pathological conditions. A diagnostic framework is proposed to measure elastic and viscous behaviors simultaneously using a reduced set of viscoelastic parameters, giving a reliable index for quantitative assessment of tissue quality. The approach is illustrated on prostate models reconstructed from prostate MRI scans. The examples show that the change in viscoelastic time constant between healthy and cancerous tissue is a key index for quantitative diagnostics using point probing. The method is not limited to any particular tissue or material and is therefore useful for tissue where defining a unique time constant is not trivial. The proposed framework of quantitative assessment could become a useful tool in clinical diagnostics for soft tissue.
Collapse
Affiliation(s)
- Javier Palacio-Torralba
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK
| | - Steven Hammer
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK
| | - Daniel W Good
- Edinburgh Urological Cancer Group, Division of Pathology Laboratories, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - S Alan McNeill
- Edinburgh Urological Cancer Group, Division of Pathology Laboratories, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK; Department of Urology, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - Grant D Stewart
- Edinburgh Urological Cancer Group, Division of Pathology Laboratories, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK; Department of Urology, NHS Lothian, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
| | - Robert L Reuben
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK
| | - Yuhang Chen
- Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK.
| |
Collapse
|
93
|
Streitberger KJ, Reiss-Zimmermann M, Freimann FB, Bayerl S, Guo J, Arlt F, Wuerfel J, Braun J, Hoffmann KT, Sack I. High-resolution mechanical imaging of glioblastoma by multifrequency magnetic resonance elastography. PLoS One 2014; 9:e110588. [PMID: 25338072 PMCID: PMC4206430 DOI: 10.1371/journal.pone.0110588] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 09/17/2014] [Indexed: 12/14/2022] Open
Abstract
Objective To generate high-resolution maps of the viscoelastic properties of human brain parenchyma for presurgical quantitative assessment in glioblastoma (GB). Methods Twenty-two GB patients underwent routine presurgical work-up supplemented by additional multifrequency magnetic resonance elastography. Two three-dimensional viscoelastic parameter maps, magnitude |G*|, and phase angle φ of the complex shear modulus were reconstructed by inversion of full wave field data in 2-mm isotropic resolution at seven harmonic drive frequencies ranging from 30 to 60 Hz. Results Mechanical brain maps confirmed that GB are composed of stiff and soft compartments, resulting in high intratumor heterogeneity. GB could be easily differentiated from healthy reference tissue by their reduced viscous behavior quantified by φ (0.37±0.08 vs. 0.58±0.07). |G*|, which in solids more relates to the material's stiffness, was significantly reduced in GB with a mean value of 1.32±0.26 kPa compared to 1.54±0.27 kPa in healthy tissue (P = 0.001). However, some GB (5 of 22) showed increased stiffness. Conclusion GB are generally less viscous and softer than healthy brain parenchyma. Unrelated to the morphology-based contrast of standard magnetic resonance imaging, elastography provides an entirely new neuroradiological marker and contrast related to the biomechanical properties of tumors.
Collapse
Affiliation(s)
| | | | | | - Simon Bayerl
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jing Guo
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Felix Arlt
- Department of Neurosurgery, Universitätsmedizin Leipzig, Leipzig, Germany
| | - Jens Wuerfel
- Institute of Neuroradiology, Universitätsmedizin Göttingen, Göttingen, Germany
- NeuroCure, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen Braun
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Ingolf Sack
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- * E-mail:
| |
Collapse
|
94
|
Characterization of fortuitously discovered focal liver lesions: additional information provided by shearwave elastography. Eur Radiol 2014; 25:346-58. [PMID: 25231131 DOI: 10.1007/s00330-014-3370-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 06/24/2014] [Accepted: 07/21/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To prospectively assess the stiffness of incidentally discovered focal liver lesions (FLL) with no history of chronic liver disease or extrahepatic cancer using shearwave elastography (SWE). METHODS Between June 2011 and May 2012, all FLL fortuitously discovered on ultrasound examination were prospectively included. For each lesion, stiffness was measured (kPa). Characterization of the lesion relied on magnetic resonance imaging (MRI) and/or contrast-enhanced ultrasound, or biopsy. Tumour stiffness was analysed using ANOVA and non-parametric Mann-Whitney tests. RESULTS 105 lesions were successfully evaluated in 73 patients (61 women, 84%) with a mean age of 44.8 (range: 20‒75). The mean stiffness was 33.3 ± 12.7 kPa for the 60 focal nodular hyperplasia (FNH), 19.7 ± 9.8 k Pa for the 17 hepatocellular adenomas (HCA), 17.1 ± 7 kPa for the 20 haemangiomas, 11.3 ± 4.3 kPa for the five focal fatty sparing, 34.1 ± 7.3 kPa for the two cholangiocarcinomas, and 19.6 kPa for one hepatocellular carcinoma (p < 0.0001). There was no difference between the benign and the malignant groups (p = 0.64). FNHs were significantly stiffer than HCAs (p < 0.0001). Telangiectatic/inflammatory HCAs were significantly stiffer than the steatotic HCAs (p = 0.014). The area under the ROC curve (AUROC) for differentiating FNH from other lesions was 0.86 ± 0.04. CONCLUSION SWE may provide additional information for the characterization of FFL, and may help in differentiating FNH from HCAs, and in subtyping HCAs. KEY POINTS • SWE might be helpful for the characterization of solid focal liver lesions • SWE cannot differentiate benign from malignant liver lesions • FNHs are significantly stiffer than other benign lesions • Telangiectatic/inflammatory HCA are significantly stiffer than steatotic ones.
Collapse
|
95
|
Liver masses: a clinical, radiologic, and pathologic perspective. Clin Gastroenterol Hepatol 2014; 12:1414-29. [PMID: 24055987 PMCID: PMC3959647 DOI: 10.1016/j.cgh.2013.09.017] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 08/26/2013] [Accepted: 09/06/2013] [Indexed: 02/07/2023]
Abstract
Liver masses present a relatively common clinical dilemma, particularly with the increasing use of various imaging modalities in the diagnosis of abdominal and other symptoms. The accurate and reliable determination of the nature of the liver mass is critical, not only to reassure individuals with benign lesions but also, and perhaps more importantly, to ensure that malignant lesions are diagnosed correctly. This avoids the devastating consequences of missed diagnosis and the delayed treatment of malignancy or the unnecessary treatment of benign lesions. With appropriate interpretation of the clinical history and physical examination, and the judicious use of laboratory and imaging studies, the majority of liver masses can be characterized noninvasively. Accurate characterization of liver masses by cross-sectional imaging is particularly dependent on an understanding of the unique phasic vascular perfusion of the liver and the characteristic behaviors of different lesions during multiphasic contrast imaging. When noninvasive characterization is indeterminate, a liver biopsy may be necessary for definitive diagnosis. Standard histologic examination usually is complemented by immunohistochemical analysis of protein biomarkers. Accurate diagnosis allows the appropriate selection of optimal management, which is frequently reassurance or intermittent follow-up evaluations for benign masses. For malignant lesions or those at risk of malignant transformation, management depends on the tumor staging, the functional status of the uninvolved liver, and technical surgical considerations. Unresectable metastatic masses require oncologic consultation and therapy. The efficient characterization and management of liver masses therefore requires a multidisciplinary collaboration between the gastroenterologist/hepatologist, radiologist, pathologist, hepatobiliary or transplant surgeon, and medical oncologist.
Collapse
|
96
|
Abstract
Magnetic resonance elastography (MRE) assesses tissue stiffness in vivo by imaging propagating shear waves through the tissues and processing the wave information. MRE is a robust technology with excellent technical success; is applicable in almost all patients and body habitus; and has excellent reproducibility, repeatability, and interobserver agreement for assessing liver stiffness. It is currently the most accurate noninvasive technique for detection and staging of liver fibrosis and has the potential to replace liver biopsy. This article describes the principles and technique of MRE, current clinical applications, and emerging clinical indications.
Collapse
Affiliation(s)
- Sudhakar Kundapur Venkatesh
- Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Richard L Ehman
- Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| |
Collapse
|
97
|
Abstract
In this article, functional magnetic resonance (MR) imaging techniques in the abdomen are discussed. Diffusion-weighted imaging (DWI) increases the confidence in detecting and characterizing focal hepatic lesions. The potential uses of DWI in kidneys, adrenal glands, bowel, and pancreas are outlined. Studies have shown potential use of quantitative dynamic contrast-enhanced MR imaging parameters, such as K(trans), in predicting outcomes in cancer therapy. MR elastography is considered to be a useful tool in staging liver fibrosis. A major issue with all functional MR imaging techniques is the lack of standardization of the protocol.
Collapse
Affiliation(s)
- Kumar Sandrasegaran
- Department of Radiology, Indiana University School of Medicine, 550 N University Blvd, UH 0279, Indianapolis, IN 46202, USA.
| |
Collapse
|
98
|
Reiss-Zimmermann M, Streitberger KJ, Sack I, Braun J, Arlt F, Fritzsch D, Hoffmann KT. High Resolution Imaging of Viscoelastic Properties of Intracranial Tumours by Multi-Frequency Magnetic Resonance Elastography. Clin Neuroradiol 2014; 25:371-8. [PMID: 24916129 DOI: 10.1007/s00062-014-0311-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 04/29/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE In recent years Magnetic Resonance Elastography (MRE) emerged into a clinically applicable imaging technique. It has been shown that MRE is capable of measuring global changes of the viscoelastic properties of cerebral tissue. The purpose of our study was to evaluate a spatially resolved three-dimensional multi-frequent MRE (3DMMRE) for assessment of the viscoelastic properties of intracranial tumours. METHODS A total of 27 patients (63 ± 13 years) were included. All examinations were performed on a 3.0 T scanner, using a modified phase-contrast echo planar imaging sequence. We used 7 vibration frequencies in the low acoustic range with a temporal resolution of 8 dynamics per wave cycle. Post-processing included multi-frequency dual elasto-visco (MDEV) inversion to generate high-resolution maps of the magnitude |G*| and the phase angle φ of the complex valued shear modulus. RESULTS The tumour entities included in this study were: glioblastoma (n = 11), anaplastic astrocytoma (n = 3), meningioma (n = 7), cerebral metastasis (n = 5) and intracerebral abscess formation (n = 1). Primary brain tumours and cerebral metastases were not distinguishable in terms of |G*| and φ. Glioblastoma presented the largest range of |G*| values and a trend was delineable that glioblastoma were slightly softer than WHO grade III tumours. In terms of φ, meningiomas were clearly distinguishable from all other entities. CONCLUSIONS In this pilot study, while analysing the viscoelastic constants of various intracranial tumour entities with an improved spatial resolution, it was possible to characterize intracranial tumours by their mechanical properties. We were able to clearly delineate meningiomas from intraaxial tumours, while for the latter group an overlap remains in viscoelastic terms.
Collapse
Affiliation(s)
- M Reiss-Zimmermann
- Department of Neuroradiology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
| | - K-J Streitberger
- Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - I Sack
- Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - J Braun
- Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - F Arlt
- Department of Neurosurgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - D Fritzsch
- Department of Neuroradiology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - K-T Hoffmann
- Department of Neuroradiology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| |
Collapse
|
99
|
Chen Y, Yan Y, Li X, Li H, Tan H, Li H, Zhu Y, Niemeyer P, Yaega M, Yu B. Application of ultrasound on monitoring the evolution of the collagen fiber reinforced nHAC/CS composites in vivo. BIOMED RESEARCH INTERNATIONAL 2014; 2014:418302. [PMID: 24822206 PMCID: PMC4009107 DOI: 10.1155/2014/418302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 03/04/2014] [Indexed: 11/17/2022]
Abstract
To date, fiber reinforce scaffolds have been largely applied to repair hard and soft tissues. Meanwhile, monitoring the scaffolds for long periods in vivo is recognized as a crucial issue before its wide use. As a consequence, there is a growing need for noninvasive and convenient methods to analyze the implantation remolding process in situ and in real time. In this paper, diagnostic medical ultrasound was used to monitor the in vivo bone formation and degradation process of the novel mineralized collagen fiber reinforced composite which is synthesized by chitosan (CS), nanohydroxyapatite (nHA), and collagen fiber (Col). To observe the impact of cells on bone remodeling process, the scaffolds were planted into the back of the SD rats with and without rat bone mesenchymal stem cells (rBMSCs). Systematic data of scaffolds in vivo was extracted from ultrasound images. Significant consistency between the data from the ultrasound and DXA could be observed (P < 0.05). This indicated that ultrasound may serve as a feasible alternative for noninvasive monitoring the evolution of scaffolds in situ during cell growth.
Collapse
Affiliation(s)
- Yan Chen
- Department of Ultrasonic Diagnosis, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China
| | - Yuting Yan
- The Second Clinical Medical College of Southern Medical University, Guangzhou 510282, China
| | - Xiaoming Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - He Li
- The Second Clinical Medical College of Southern Medical University, Guangzhou 510282, China
| | - Huiting Tan
- The Second Clinical Medical College of Southern Medical University, Guangzhou 510282, China
| | - Huajun Li
- The Second Clinical Medical College of Southern Medical University, Guangzhou 510282, China
| | - Yanwen Zhu
- The Second Clinical Medical College of Southern Medical University, Guangzhou 510282, China
| | - Philipp Niemeyer
- Department of Orthopaedic surgery and Traumatology, Freiburg University Hospital, Freiburg, Germany
| | - Matin Yaega
- Department of Orthopaedic surgery and Traumatology, Freiburg University Hospital, Freiburg, Germany
| | - Bo Yu
- Department of Orthopedics, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China
| |
Collapse
|
100
|
Ronot M, Lambert SA, Wagner M, Garteiser P, Doblas S, Albuquerque M, Paradis V, Vilgrain V, Sinkus R, Van Beers BE. Viscoelastic parameters for quantifying liver fibrosis: three-dimensional multifrequency MR elastography study on thin liver rat slices. PLoS One 2014; 9:e94679. [PMID: 24722733 PMCID: PMC3983230 DOI: 10.1371/journal.pone.0094679] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 03/19/2014] [Indexed: 01/22/2023] Open
Abstract
Objective To assess in a high-resolution model of thin liver rat slices which viscoelastic parameter at three-dimensional multifrequency MR elastography has the best diagnostic performance for quantifying liver fibrosis. Materials and Methods The study was approved by the ethics committee for animal care of our institution. Eight normal rats and 42 rats with carbon tetrachloride induced liver fibrosis were used in the study. The rats were sacrificed, their livers were resected and three-dimensional MR elastography of 5±2 mm liver slices was performed at 7T with mechanical frequencies of 500, 600 and 700 Hz. The complex shear, storage and loss moduli, and the coefficient of the frequency power law were calculated. At histopathology, fibrosis and inflammation were assessed with METAVIR score, fibrosis was further quantified with morphometry. The diagnostic value of the viscoelastic parameters for assessing fibrosis severity was evaluated with simple and multiple linear regressions, receiver operating characteristic analysis and Obuchowski measures. Results At simple regression, the shear, storage and loss moduli were associated with the severity of fibrosis. At multiple regression, the storage modulus at 600 Hz was the only parameter associated with fibrosis severity (r = 0.86, p<0.0001). This parameter had an Obuchowski measure of 0.89+/−0.03. This measure was significantly larger than that of the loss modulus (0.78+/−0.04, p = 0.028), but not than that of the complex shear modulus (0.88+/−0.03, p = 0.84). Conclusion Our high resolution, three-dimensional multifrequency MR elastography study of thin liver slices shows that the storage modulus is the viscoelastic parameter that has the best association with the severity of liver fibrosis. However, its diagnostic performance does not differ significantly from that of the complex shear modulus.
Collapse
Affiliation(s)
- Maxime Ronot
- Department of Radiology, Beaujon University Hospitals Paris Nord Val de Seine, Clichy, France
- University Paris Diderot, Sorbonne Paris Cité, France
- IPMA, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France
- * E-mail:
| | - Simon A. Lambert
- University Paris Diderot, Sorbonne Paris Cité, France
- IPMA, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France
| | - Mathilde Wagner
- Department of Radiology, Beaujon University Hospitals Paris Nord Val de Seine, Clichy, France
- University Paris Diderot, Sorbonne Paris Cité, France
- IPMA, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France
| | - Philippe Garteiser
- University Paris Diderot, Sorbonne Paris Cité, France
- IPMA, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France
| | - Sabrina Doblas
- University Paris Diderot, Sorbonne Paris Cité, France
- IPMA, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France
| | - Miguel Albuquerque
- IPMA, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France
- Department of Pathology, Beaujon University Hospitals Paris Nord Val de Seine, Clichy, France
| | - Valérie Paradis
- University Paris Diderot, Sorbonne Paris Cité, France
- IPMA, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France
- Department of Pathology, Beaujon University Hospitals Paris Nord Val de Seine, Clichy, France
| | - Valérie Vilgrain
- Department of Radiology, Beaujon University Hospitals Paris Nord Val de Seine, Clichy, France
- University Paris Diderot, Sorbonne Paris Cité, France
- IPMA, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France
| | - Ralph Sinkus
- University Paris Diderot, Sorbonne Paris Cité, France
- IPMA, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France
| | - Bernard E. Van Beers
- Department of Radiology, Beaujon University Hospitals Paris Nord Val de Seine, Clichy, France
- University Paris Diderot, Sorbonne Paris Cité, France
- IPMA, INSERM U773, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France
| |
Collapse
|