101
|
Crescenzi R, Donahue PMC, Hartley KG, Desai AA, Scott AO, Braxton V, Mahany H, Lants SK, Donahue MJ. Lymphedema evaluation using noninvasive 3T MR lymphangiography. J Magn Reson Imaging 2017; 46:1349-1360. [PMID: 28245075 DOI: 10.1002/jmri.25670] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 01/30/2017] [Indexed: 01/05/2023] Open
Abstract
PURPOSE To exploit the long 3.0T relaxation times and low flow velocity of lymphatic fluid to develop a noninvasive 3.0T lymphangiography sequence and evaluate its relevance in patients with lymphedema. MATERIALS AND METHODS A 3.0T turbo-spin-echo (TSE) pulse train with long echo time (TEeffective = 600 msec; shot-duration = 13.2 msec) and TSE-factor (TSE-factor = 90) was developed and signal evolution simulated. The method was evaluated in healthy adults (n = 11) and patients with unilateral breast cancer treatment-related lymphedema (BCRL; n = 25), with a subgroup (n = 5) of BCRL participants scanned before and after manual lymphatic drainage (MLD) therapy. Maximal lymphatic vessel cross-sectional area, signal-to-noise-ratio (SNR), and results from a five-point categorical scoring system were recorded. Nonparametric tests were applied to evaluate study parameter differences between controls and patients, as well as between affected and contralateral sides in patients (significance criteria: two-sided P < 0.05). RESULTS Patient volunteers demonstrated larger lymphatic cross-sectional areas in the affected (arm = 12.9 ± 6.3 mm2 ; torso = 17.2 ± 15.6 mm2 ) vs. contralateral (arm = 9.4 ± 3.9 mm2 ; torso = 9.1 ± 4.6 mm2 ) side; this difference was significant both for the arm (P = 0.014) and torso (P = 0.025). Affected (arm: P = 0.010; torso: P = 0.016) but not contralateral (arm: P = 0.42; torso: P = 0.71) vessel areas were significantly elevated compared with control values. Lymphatic cross-sectional areas reduced following MLD on the affected side (pre-MLD: arm = 8.8 ± 1.8 mm2 ; torso = 31.4 ± 26.0 mm2 ; post-MLD: arm = 6.6 ± 1.8 mm2 ; torso = 23.1 ± 24.3 mm2 ). This change was significant in the torso (P = 0.036). The categorical scoring was found to be less specific for detecting lateralizing disease compared to lymphatic-vessel areas. CONCLUSION A 3.0T lymphangiography sequence is proposed, which allows for upper extremity lymph stasis to be detected in ∼10 minutes without exogenous contrast agents. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1349-1360.
Collapse
Affiliation(s)
- Rachelle Crescenzi
- Radiology and Radiological Science, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Paula M C Donahue
- Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.,Dayani Center for Health and Wellness, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Katherine G Hartley
- Radiology and Radiological Science, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Aditi A Desai
- Radiology and Radiological Science, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Allison O Scott
- Radiology and Radiological Science, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Vaughn Braxton
- Radiology and Radiological Science, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Helen Mahany
- Radiology and Radiological Science, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Sarah K Lants
- Radiology and Radiological Science, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Manus J Donahue
- Radiology and Radiological Science, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.,Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.,Psychiatry, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.,Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA
| |
Collapse
|
102
|
Jiang T, Xu JH, Zou Y, Chen R, Peng LR, Zhou ZD, Yang M. Diffusion-weighted imaging (DWI) of hepatocellular carcinomas: a retrospective analysis of the correlation between qualitative and quantitative DWI and tumour grade. Clin Radiol 2017; 72:465-472. [PMID: 28109531 DOI: 10.1016/j.crad.2016.12.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/14/2016] [Accepted: 12/21/2016] [Indexed: 01/11/2023]
Abstract
AIM To evaluate the application of qualitative and quantitative diffusion-weighted imaging (DWI) in predicting the histological grade of hepatocellular carcinoma (HCC). MATERIALS AND METHODS Two hundred and fifty-four patients with pathologically confirmed HCC who underwent hepatic DWI on a 1.5-T platform (b = 0, 600 s/mm2) were evaluated retrospectively. HCCs were divided into well-, moderately, and poorly differentiated groups. The relationships between naked-eye signal intensity (SI), SI values, apparent diffusion coefficient (ADC) values on DWI, and the histopathological differentiation of HCC were analysed. Receiver operating characteristic (ROC) curves were drawn to determine the optimal operating points (OOPs) of the SI and ADC values to predict the tumour grade. RESULTS A weak negative correlation (r=-0.350, p<0.05) was obtained between naked-eye SI and histological grade. There was a significant difference in mean SI values between well- (68.32±31.71) and moderately (102.39±45.55)/poorly (114.55±32.15) differentiated HCC but not between moderately and poorly differentiated HCC. The OOP of the SI value by ROC curve analysis was 66.5 to predict well-differentiated HCC. The mean ADC values of well-, moderately, and poorly differentiated HCC were 1.67±0.13×10-3, 1.31±0.16×10-3, and 1.08±0.11×10-3 mm2/s, respectively, with significant differences between any two combinations of groups. The OOPs of ADC to diagnose well- and poorly differentiated HCC were 1.5×10-3 and 1.24×10-3 mm2/s, respectively. CONCLUSION Qualitative and quantitative SI and ADC values at DWI may be useful to estimate the histological grade of HCC preoperatively and non-invasively.
Collapse
Affiliation(s)
- T Jiang
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China
| | - J H Xu
- Department of Nuclear Medicine, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China.
| | - Y Zou
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China
| | - R Chen
- Guangdong Traditional Medical and Sports Injury Rehabilitation Research Institute, Guangdong No. 2 Provincial People's Hospital, No. 466, Xin GangZhong Road, HaiZhu district, Guangzhou, GuangDong Province, 510317, PR China
| | - L R Peng
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China
| | - Z D Zhou
- Department of Nuclear Medicine, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China
| | - M Yang
- Department of Nuclear Medicine, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 TianHe Road, TianHe district, Guangzhou, GuangDong Province, 510630, PR China
| |
Collapse
|
103
|
Jabehdar Maralani P, Lo SS, Redmond K, Soliman H, Myrehaug S, Husain ZA, Heyn C, Kapadia A, Chan A, Sahgal A. Spinal metastases: multimodality imaging in diagnosis and stereotactic body radiation therapy planning. Future Oncol 2017; 13:77-91. [DOI: 10.2217/fon-2016-0238] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Due to increased effectiveness of cancer treatments and increasing survival rates, metastatic disease has become more frequent compared to the past, with the spine being the most common site of bony metastases. Diagnostic imaging is an integral part of screening, diagnosis and follow-up of spinal metastases. In this article, we review the principles of multimodality imaging for tumor detection with respect to their value for diagnosis and stereotactic body radiation therapy planning for spinal metastases. We will also review the current international consensus agreement for stereotactic body radiation therapy planning, and the role of imaging in achieving the best possible treatment plan.
Collapse
Affiliation(s)
| | - Simon S Lo
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA
| | - Kristin Redmond
- Department of Radiation Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Hany Soliman
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Sten Myrehaug
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Zain A Husain
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - Chinthaka Heyn
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Anish Kapadia
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Aimee Chan
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Arjun Sahgal
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
104
|
Jelinek J, Beaman F. Musculoskeletal and Interventional Radiology in the Management of Sarcoma Patients. Sarcoma 2017. [DOI: 10.1007/978-3-319-43121-5_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
105
|
Talaat Ali M, Fouad Osman M, Homos MD, Mohamed Nabil D. Role of 3-T diffusion-weighted magnetic resonance imaging in differentiation between benign and malignant hepatic lesions. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
106
|
Hasan NMA, Zaki KF, Alam-Eldeen MH, Hamedi HR. Benign versus malignant focal liver lesions: Diagnostic value of qualitative and quantitative diffusion weighted MR imaging. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
107
|
Hering J, Laun FB, Lederer W, Daniel H, Kuder TA, Stieber A, Delorme S, Maier-Hein KH, Schlemmer HP, Bickelhaupt S. Applicability and discriminative value of a semiautomatic three-dimensional spherical volume for the assessment of the apparent diffusion coefficient in suspicious breast lesions—feasibility study. Clin Imaging 2016; 40:1280-1285. [DOI: 10.1016/j.clinimag.2016.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/02/2016] [Accepted: 08/30/2016] [Indexed: 01/01/2023]
|
108
|
Readout-segmented echo-planar imaging improves the image quality of diffusion-weighted MR imaging in rectal cancer: Comparison with single-shot echo-planar diffusion-weighted sequences. Eur J Radiol 2016; 85:1818-1823. [DOI: 10.1016/j.ejrad.2016.08.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 08/07/2016] [Accepted: 08/09/2016] [Indexed: 01/20/2023]
|
109
|
|
110
|
Tomizawa M, Shinozaki F, Uchida Y, Uchiyama K, Fugo K, Sunaoshi T, Ozaki A, Sugiyama E, Baba A, Fukamizu Y, Kagayama S, Hasegawa R, Shirai Y, Oshima Y, Koike N, Toshimitsu Y, Motoyoshi Y, Sugiyama T, Yamamoto S, Kishimoto T, Ishige N. Diffusion-weighted whole-body imaging with background body signal suppression/T2 image fusion and positron emission tomography/computed tomography of upper gastrointestinal cancers. ACTA ACUST UNITED AC 2016; 40:3012-9. [PMID: 26350283 DOI: 10.1007/s00261-015-0545-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE Diffusion-weighted whole-body imaging with background body signal suppression/T2 image fusion (DWIBS/T2) strongly contrasts cancerous tissue against background healthy tissues. Positron emission tomography/computed tomography (PET/CT) applies the uptake of 18-fluorodeoxyglucose in the diagnosis of cancer. Our aim was to compare DWIBS/T2 and PET/CT in patients with upper gastrointestinal cancers. METHODS Patient records, including imaging results from July 2012 to March 2015, were analyzed retrospectively. Four men (age, 72.5 ± 5.3 years) and ten women (age, 71.6 ± 4.0 years) were enrolled in this study. The numbers of patients with esophageal cancer, gastric cancer, gastrointestinal stromal tumor, and duodenal cancer were one, eight, three, and two, respectively. RESULTS Six out of eight patients with gastric cancer had positive results on both DWIBS/T2 and PET/CT. The diameter and depth of invasion of gastric cancer was larger in patients with positive DWIBS/T2 and PET/CT findings than those with negative findings. These results suggested that patients with gastric cancer with larger pixel numbers might tend to show positive results with DWIBS/T2. CONCLUSIONS DWIBS/T2 and PET/CT have similar sensitivity for the diagnosis of upper gastrointestinal cancer. The diameter and depth of invasion affected the detectability of gastric cancer.
Collapse
Affiliation(s)
- Minoru Tomizawa
- Department of Gastroenterology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan.
| | - Fuminobu Shinozaki
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Yoshitaka Uchida
- Department of Radiology, Diagnostic PET Imaging Center, Sannoh Hospital Medical Center, 166-2 Sannoh-cho Inage-ku, Chiba City, Chiba, 263-0002, Japan
| | - Katsuhiro Uchiyama
- Department of Radiology, Diagnostic PET Imaging Center, Sannoh Hospital Medical Center, 166-2 Sannoh-cho Inage-ku, Chiba City, Chiba, 263-0002, Japan
| | - Kazunori Fugo
- Department of Molecular Pathology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, 260-8670, Japan
| | - Takafumi Sunaoshi
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Aika Ozaki
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Eriko Sugiyama
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Akira Baba
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Yoshiya Fukamizu
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Satoshi Kagayama
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Rumiko Hasegawa
- Department of Surgery, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Yoshinori Shirai
- Department of Surgery, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Yuji Oshima
- Department of Surgery, Seirei Sakura Citizen Hospital, 2-36-2 Ebaradai, Sakura City, Chiba, 285-8765, Japan
| | - Naoto Koike
- Department of Surgery, Seirei Sakura Citizen Hospital, 2-36-2 Ebaradai, Sakura City, Chiba, 285-8765, Japan
| | - Yasuko Toshimitsu
- Department of Surgery, National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba City, Chiba, 260-8606, Japan
| | - Yasufumi Motoyoshi
- Department of Neurology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Takao Sugiyama
- Department of Rheumatology, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Shigenori Yamamoto
- Department of Pediatrics, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| | - Takashi Kishimoto
- Department of Molecular Pathology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, 260-8670, Japan
| | - Naoki Ishige
- Department of Neurosurgery, National Hospital Organization Shimoshizu Hospital, 934-5 Shikawatashi, Yotsukaido City, Chiba, 284-0003, Japan
| |
Collapse
|
111
|
Abstract
PET/computed tomography (PET/CT) is an established hybrid imaging technique for staging and follow-up of gastrointestinal (GI) tract malignancies, especially for colorectal carcinoma. Dedicated hybrid PET/MR imaging scanners are currently available for clinical use. Although they will not replace regular use of PET/CT, they may have utility in selected cases of GI tract malignancies. The superior soft tissue contrast resolution and depiction of anatomy and the functional information obtained from diffusion-weighted imaging (DWI) provided by MR imaging in PET/MR imaging are advantages over CT of PET/CT for T staging and follow-up of rectal carcinoma and for better characterization of liver lesions. Functional information from DWI and use of liver-specific MR imaging contrast agents are an added advantage in follow-up of liver metastases after systemic and locoregional treatment. New radiotracers will improve the utility of PET/MR imaging in staging and follow-up of tumors, which may not be [18F]-2-fluoro-2-deoxy-d-glucose avid, such as hepatocellular carcinoma and neuroendocrine tumors. PET/MR imaging also has application in selected cases of cholangiocarcinoma, gallbladder cancer, and pancreatic carcinoma for initial staging and follow-up assessment.
Collapse
Affiliation(s)
- Raj Mohan Paspulati
- Division of Abdominal Imaging, Department of Radiology, University Hospitals Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
| | - Amit Gupta
- Department of Radiology, University Hospitals Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| |
Collapse
|
112
|
|
113
|
Tomizawa M, Shinozaki F, Fugo K, Sunaoshi T, Kano D, Tanaka S, Ozaki A, Sugiyama E, Shite M, Haga R, Baba A, Fukamizu Y, Fujita T, Kagayama S, Hasegawa R, Togawa A, Shirai Y, Ichiki N, Motoyoshi Y, Sugiyama T, Yamamoto S, Kishimoto T, Ishige N. Diffusion-weighted whole-body imaging with background body signal suppression/T2-weighted image fusion of gastrointestinal cancers. Mol Clin Oncol 2016; 5:44-48. [PMID: 27330763 DOI: 10.3892/mco.2016.897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/27/2016] [Indexed: 01/26/2023] Open
Abstract
Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) yields positive results for cancer against the surrounding tissues. The combination of DWIBS and T2-weighted images (DWIBS/T2) in the diagnosis of gastrointestinal tract cancers was retrospectively analyzed in the present study. Patients were subjected to magnetic resonance imaging after cancer was diagnosed through specimens obtained via biopsy or endoscopic mucosal resection. Sixteen patients were assessed between July, 2012 and June, 2013 and the correlation between detection with DWIBS/T2 and T staging was analyzed. Regarding patients who underwent surgery, the correlation between detection with DWIBS/T2 and the diameter or depth of invasion was analyzed. All cancers that had advanced to >T2 stage were detectable by DWIBS/T2, whereas all cancers staged as <T1 were not (P<0.0001). Tumors that were undetected by DWIBS/T2 had a mean diameter of 1.53±0.25 cm, whereas those detected had a mean diameter of 3.63±1.88 cm; however, the difference was not statistically significant (P=0.1053). Cancers invading beyond the muscularis propria were detectable by DWIBS/T2, while those which had not invaded the mucosa were not (P=0.0476). In conclusion, DWIBS/T2 was able to positively identify gastrointestinal tract cancers at an advanced stage (>T2) or invading beyond the muscularis propria.
Collapse
Affiliation(s)
- Minoru Tomizawa
- Department of Gastroenterology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Fuminobu Shinozaki
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Kazunori Fugo
- Department of Molecular Pathology, Chiba University Graduate School of Medicine, Chiba, Chiba 260-8670, Japan
| | - Takafumi Sunaoshi
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Daisuke Kano
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Satomi Tanaka
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Aika Ozaki
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Eriko Sugiyama
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Misaki Shite
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Ryouta Haga
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Akira Baba
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Yoshiya Fukamizu
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Toshiyuki Fujita
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Satoshi Kagayama
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Rumiko Hasegawa
- Department of Surgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Akira Togawa
- Department of Surgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Yoshinori Shirai
- Department of Surgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Noboru Ichiki
- Department of Surgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Yasufumi Motoyoshi
- Department of Neurology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Takao Sugiyama
- Department of Rheumatology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Shigenori Yamamoto
- Department of Pediatrics, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Takashi Kishimoto
- Department of Molecular Pathology, Chiba University Graduate School of Medicine, Chiba, Chiba 260-8670, Japan
| | - Naoki Ishige
- Department of Neurosurgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| |
Collapse
|
114
|
Whole-body MRI in patients with lymphoma: collateral findings. Radiol Med 2016; 121:793-800. [PMID: 27307001 DOI: 10.1007/s11547-016-0658-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/30/2016] [Indexed: 12/21/2022]
Abstract
PURPOSE To assess the incidence of collateral findings detected on whole-body magnetic resonance (WB-MRI) scans performed on patients with lymphoma. MATERIALS AND METHODS 114 patients (65 male; median age 45.2 years, range 15-86) with histologically confirmed lymphoma (47 Hodgkin, 67 Non-Hodgkin) underwent WB-MRI. The collateral findings were classified into three classes, according to their clinical significance, as follows: not or low significant (class 1), moderately or potentially significant (class 2), and significant (class 3). A Chi-square (χ (2)) test was performed to assess the statistical significance of differences in the incidence of collateral findings based on age (≤50 and >50 years old), gender and histology (Hodgkin and Non-Hodgkin Lymphoma). RESULTS Ninety-one of 114 patients (79.8 %) had one or more incidental findings on WB-MRI. Collateral findings were more frequent in class 1 (43 %); abnormalities found in 35 patients (30.7 %) were considered potentially significant, whereas seven patients (6.1 %) demonstrated significant collateral findings requiring immediate treatment or further diagnostic evaluation. Collateral findings were more frequent in subjects over 50 years old compared to those of 50 years old or younger; differences were statistical significant (χ (2) = 8.42, p < 0.05). There were not statistically significant differences related to gender (χ (2) = 0.17, p > 0.05) and histology (χ (2) = 0.24, p > 0.05). CONCLUSION WB-MRI is an attractive procedure that allows to detect incidental abnormalities of organs not involved by disease offering the opportunity to obtain an early diagnosis of asymptomatic life-threatening diseases.
Collapse
|
115
|
|
116
|
Stecco A, Buemi F, Cassarà A, Matheoud R, Sacchetti GM, Arnulfo A, Brambilla M, Carriero A. Comparison of retrospective PET and MRI-DWI (PET/MRI-DWI) image fusion with PET/CT and MRI-DWI in detection of cervical and endometrial cancer lymph node metastases. LA RADIOLOGIA MEDICA 2016; 121:537-45. [PMID: 27033474 DOI: 10.1007/s11547-016-0626-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 01/26/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of this study was to compare the accuracy of retrospective image fusion of PET/MRI-DWI with that of PET/CT and MRI-DWI alone in detecting metastatic lymph nodes in patients with cervical and endometrial carcinoma. MATERIALS AND METHODS Twenty-seven patients with endometrial (n = 14) and cervical (n = 13) cancer who had undergone preoperative MRI-DWI and PET/CT for staging were retrospectively evaluated. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PET/CT, MRI-DWI, and PET/MRI-DWI image fusion were calculated on a per-patient basis and on a per-node basis. Histopathological and follow-up imaging results were used as the gold standard. RESULTS On a per-patient basis PET/MRI-DWI had the same sensitivity (87.5 %), specificity (84.2 %), diagnostic accuracy (85.1 %), PPV (70 %), and NPV (94.1 %) as PET-CT, but on a per-node basis PET/MRI-DWI showed better sensitivity (89 vs 70.2 %), specificity (91.6 vs 90.5 %), diagnostic accuracy (91.2 vs 87 %), PPV (68.7 vs 60.4 %), and NPV (97.6 vs 93.6 %) than PET-CT. Comparison of the areas under the ROC curves for the detection of metastatic lymph nodes demonstrated a non-significant difference (p = 0.055) between PET/CT and fused PET/MRI-DWI. CONCLUSION PET/MRI-DWI may be a valuable technique for N-staging patients with endometrial and cervical cancer, but more studies are needed to investigate its potential clinical utility.
Collapse
Affiliation(s)
- Alessandro Stecco
- Radiology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Corso Mazzini 18, 28100, Novara, Italy.
| | - Francesco Buemi
- Radiology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Corso Mazzini 18, 28100, Novara, Italy
| | - Alessia Cassarà
- Radiology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Corso Mazzini 18, 28100, Novara, Italy
| | - Roberta Matheoud
- Medical Physics Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
| | - Gian Mauro Sacchetti
- Nuclear Medicine Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
| | - Alberto Arnulfo
- Gynecology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
| | - Marco Brambilla
- Medical Physics Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Novara, Italy
| | - Alessandro Carriero
- Radiology Department, University of Eastern Piedmont, "Maggiore della Carità" Hospital, Corso Mazzini 18, 28100, Novara, Italy
| |
Collapse
|
117
|
Manoharan D, Das CJ, Aggarwal A, Gupta AK. Diffusion weighted imaging in gynecological malignancies - present and future. World J Radiol 2016; 8:288-297. [PMID: 27027614 PMCID: PMC4807338 DOI: 10.4329/wjr.v8.i3.288] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 10/07/2015] [Accepted: 12/04/2015] [Indexed: 02/06/2023] Open
Abstract
The management of gynaecological malignancies has undergone a significant change in recent years with our improved understanding of cancer biogenetics, development of new treatment regimens and enhanced screening. Due to the rapid blooming of newer methods and techniques in gynaecology, surgery and oncology the scope and the role of imaging has also widened. Functional imaging in the form of diffusion weighted imaging (DWI) has been recently found to be very useful in assessing various tumours. Its ability to identify changes in the molecular level has dramatically changed the diagnostic approach of radiologists which was solely based on morphological criteria. It can improve the diagnostic accuracy of conventional magnetic resonance imaging, lend a hand in assessing tumour response to treatment regimens and detect tumour recurrence with better spatial resolution, negative radiation and diagnostic accuracy compared to positron emission tomography scan. The ability to quantify the diffusion has also lead to potential prediction of tumour aggressiveness and grade which directly correlate with the patient prognosis and management. Hence, it has become imperative for a radiologist to understand the concepts of DWI and its present and evolving role. In this article we present a brief description of the basics of DWI followed by its role in evaluation of female gynaecological malignancies.
Collapse
|
118
|
Tomizawa M, Shinozaki F, Fugo K, Sunaoshi T, Sugiyama E, Kano D, Shite M, Haga R, Fukamizu Y, Kagayama S, Hasegawa R, Shirai Y, Motoyoshi Y, Sugiyama T, Yamamoto S, Kishimoto T, Ishige N. Negative signals for adenomyomatosis of the gallbladder upon diffusion-weighted whole body imaging with background body signal suppression/T2-weighted image fusion analysis. Exp Ther Med 2016; 11:1777-1780. [PMID: 27168802 DOI: 10.3892/etm.2016.3126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 01/14/2016] [Indexed: 01/09/2023] Open
Abstract
Differentiation between adenomyomatosis (ADM) and cancer of the gallbladder is necessary during diagnosis. Diffusion-weighted whole body imaging with background body signal suppression (DWIBS) images are able to indicate cancer and inflammation. The fusion of a DWIBS with a T2 weighted image (DWIBS/T2) facilitates both functional and anatomical investigations. In the present study, patient records and images from patients with surgically confirmed ADM from April 2012 to October 2014 were analyzed retrospectively. The enrolled patients, including 6 men (64.2±13.1 years) and 4 women (57.3±12.4 years) were subjected to DWIBS/T2 during routine clinical practice. The diagnosis of ADM was based on magnetic resonance cholangiopancreatography, transabdominal ultrasonography, and endoscopic ultrasonography; ADM was diagnosed definitively when cystic lesions were observed, indicating the Rokitansky-Aschoff sinus. A single patient was indicated to be positive by DWIBS/T2 imaging. The Rokitansky-Aschoff sinus revealed a relatively high signal intensity; however, it was not as strong as that of the spleen. The signal intensity was also high on an apparent diffusion coefficient map, suggesting T2 shine-through. The thickened wall displayed low signal intensity. The aforementioned results indicate that ADM may be negative upon DWIBS/T2 imaging; one false positive case was determined to be ADM, accompanied by chronic cholecystitis. The majority of patients with ADM displayed negative findings upon DWIBS/T2 imaging, and chronic cholecystitis may cause false positives.
Collapse
Affiliation(s)
- Minoru Tomizawa
- Department of Gastroenterology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Fuminobu Shinozaki
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Kazunori Fugo
- Department of Molecular Pathology, Chiba University Graduate School of Medicine, Chuo, Chiba 260-8670, Japan
| | - Takafumi Sunaoshi
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Eriko Sugiyama
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Daisuke Kano
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Misaki Shite
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Ryouta Haga
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Yoshiya Fukamizu
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Satoshi Kagayama
- Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Rumiko Hasegawa
- Department of Surgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Yoshinori Shirai
- Department of Surgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Yasufumi Motoyoshi
- Department of Neurology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Takao Sugiyama
- Department of Rheumatology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Shigenori Yamamoto
- Department of Pediatrics, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| | - Takashi Kishimoto
- Department of Molecular Pathology, Chiba University Graduate School of Medicine, Chuo, Chiba 260-8670, Japan
| | - Naoki Ishige
- Department of Neurosurgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284-0003, Japan
| |
Collapse
|
119
|
Aliotta E, Wu HH, Ennis DB. Convex optimized diffusion encoding (CODE) gradient waveforms for minimum echo time and bulk motion-compensated diffusion-weighted MRI. Magn Reson Med 2016; 77:717-729. [PMID: 26900872 DOI: 10.1002/mrm.26166] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 01/21/2016] [Accepted: 01/24/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate convex optimized diffusion encoding (CODE) gradient waveforms for minimum echo time and bulk motion-compensated diffusion-weighted imaging (DWI). METHODS Diffusion-encoding gradient waveforms were designed for a range of b-values and spatial resolutions with and without motion compensation using the CODE framework. CODE, first moment (M1 ) nulled CODE-M1 , and first and second moment (M2 ) nulled CODE-M1 M2 were used to acquire neuro, liver, and cardiac ADC maps in healthy subjects (n=10) that were compared respectively to monopolar (MONO), BIPOLAR (M1 = 0), and motion-compensated (MOCO, M1 + M2 = 0) diffusion encoding. RESULTS CODE significantly improved the SNR of neuro ADC maps compared with MONO (19.5 ± 2.5 versus 14.5 ± 1.9). CODE-M1 liver ADCs were significantly lower (1.3 ± 0.1 versus 1.8 ± 0.3 × 10-3 mm2 /s, ie, less motion corrupted) and more spatially uniform (6% versus 55% ROI difference) than MONO and had higher SNR than BIPOLAR (SNR = 14.9 ± 5.3 versus 8.0 ± 3.1). CODE-M1 M2 cardiac ADCs were significantly lower than MONO (1.9 ± 0.6 versus 3.8 ± 0.3 x10-3 mm2 /s) throughout the cardiac cycle and had higher SNR than MOCO at systole (9.1 ± 3.9 versus 7.0 ± 2.6) while reporting similar ADCs (1.5 ± 0.2 versus 1.4 ± 0.6 × 10-3 mm2 /s). CONCLUSIONS CODE significantly improved SNR for ADC mapping in the brain, liver and heart, and significantly improved DWI bulk motion robustness in the liver and heart. Magn Reson Med 77:717-729, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
Collapse
Affiliation(s)
- Eric Aliotta
- Department of Radiological Sciences, University of California, Los Angeles, California, USA.,Biomedical Physics Interdepartmental Program, University of California, Los Angeles, California, USA
| | - Holden H Wu
- Department of Radiological Sciences, University of California, Los Angeles, California, USA.,Biomedical Physics Interdepartmental Program, University of California, Los Angeles, California, USA
| | - Daniel B Ennis
- Department of Radiological Sciences, University of California, Los Angeles, California, USA.,Biomedical Physics Interdepartmental Program, University of California, Los Angeles, California, USA
| |
Collapse
|
120
|
Ni P, Lin Y, Zhong Q, Chen Z, Sandrasegaran K, Lin C. Technical advancements and protocol optimization of diffusion-weighted imaging (DWI) in liver. Abdom Radiol (NY) 2016; 41:189-202. [PMID: 26830624 DOI: 10.1007/s00261-015-0602-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
An area of rapid advancement in abdominal MRI is diffusion-weighted imaging (DWI). By measuring diffusion properties of water molecules, DWI is capable of non-invasively probing tissue properties and physiology at cellular and macromolecular level. The integration of DWI as part of abdominal MRI exam allows better lesion characterization and therefore more accurate initial diagnosis and treatment monitoring. One of the most technical challenging, but also most useful abdominal DWI applications is in liver and therefore requires special attention and careful optimization. In this article, the latest technical developments of DWI and its liver applications are reviewed with the explanations of the technical principles, recommendations of the imaging parameters, and examples of clinical applications. More advanced DWI techniques, including Intra-Voxel Incoherent Motion (IVIM) diffusion imaging, anomalous diffusion imaging, and Diffusion Kurtosis Imaging (DKI) are discussed.
Collapse
Affiliation(s)
- Ping Ni
- Department of Medical Imaging, Fuzhou General Hospital, Fuzhou, Fujian, China
| | - Yuning Lin
- Department of Medical Imaging, Fuzhou General Hospital, Fuzhou, Fujian, China
| | - Qun Zhong
- Department of Medical Imaging, Fuzhou General Hospital, Fuzhou, Fujian, China
| | - Ziqian Chen
- Department of Medical Imaging, Fuzhou General Hospital, Fuzhou, Fujian, China
| | - Kumar Sandrasegaran
- Department of Radiology and Imaging Science, Indiana University School of Medicine, 950 West Walnut St. R2 E124, Indianapolis, IN, 46202, USA
| | - Chen Lin
- Department of Radiology and Imaging Science, Indiana University School of Medicine, 950 West Walnut St. R2 E124, Indianapolis, IN, 46202, USA.
| |
Collapse
|
121
|
Balbo-Mussetto A, Cirillo S, Bruna R, Gueli A, Saviolo C, Petracchini M, Fornari A, Lario CV, Gottardi D, De Crescenzo A, Tarella C. Whole-body MRI with diffusion-weighted imaging: a valuable alternative to contrast-enhanced CT for initial staging of aggressive lymphoma. Clin Radiol 2015; 71:271-9. [PMID: 26749081 DOI: 10.1016/j.crad.2015.11.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 10/13/2015] [Accepted: 11/24/2015] [Indexed: 12/11/2022]
Abstract
AIM To compare the accuracy of whole-body magnetic resonance imaging (Wb-MRI) with diffusion-weighted imaging (DWI) to that of contrast-enhanced computed tomography (CE-CT) and 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron-emission tomography co-registered with low dose-CT (PET-CT) in defining lymphoma disease stage. MATERIALS AND METHODS From February 2010 to May 2014, 41 lymphoma patients underwent Wb-MRI-DWI, CE-CT, and (18)F-FDG PET-CT. Histological subtypes included aggressive B-cell (n=11), follicular (n=13), mantle cell (n=3), and Hodgkin's (n=14) lymphoma. To compare the procedures, the reference standard (RS) assessment was defined by combining the results from (18)F-FDG PET-CT, CE-CT, and bone marrow (BM) histology, modifications after therapy, and histological re-assessments of uncertain lesions. RESULTS Among 1025 nodal sites, 217 had disease involvement according to the RS. CE-CT yielded 23 false-negative and 11 false-positive errors. Wb-MRI-DWI failed to recognise 17 localisations and had six false-positive errors; (18)F-FDG PET-CT had no errors. Among 458 extranodal sites, 37 were positive according to the RS. (18)F-FDG PET-CT yielded four false-negative and two false-positive results. CE-CT yielded 17 false-negative errors. Wb-MRI-DWI yielded a single false-negative error. Wb-MRI-DWI was the most reliable imaging technique for BM evaluation. Considering each procedure alone, the final stage would have been missed in four cases using (18)F-FDG PET-CT, 12 cases using CE-CT, and none using Wb-MRI-DWI. CONCLUSION The present data support Wb-MRI-DWI as a sensitive and specific imaging technique for lymphoma evaluation, supporting its use in place of CE-CT for staging.
Collapse
Affiliation(s)
- A Balbo-Mussetto
- Radiology Division, Mauriziano-Umberto I Hospital, Torino, Italy.
| | - S Cirillo
- Radiology Division, Mauriziano-Umberto I Hospital, Torino, Italy
| | - R Bruna
- Hematology and Cell Therapy Division, Mauriziano-Umberto I Hospital & University, Torino, Italy
| | - A Gueli
- Hematology and Cell Therapy Division, Mauriziano-Umberto I Hospital & University, Torino, Italy
| | - C Saviolo
- Radiology Division, Mauriziano-Umberto I Hospital, Torino, Italy
| | - M Petracchini
- Radiology Division, Mauriziano-Umberto I Hospital, Torino, Italy
| | - A Fornari
- Radiology Division, Mauriziano-Umberto I Hospital, Torino, Italy
| | - C V Lario
- Radiology Division, Mauriziano-Umberto I Hospital, Torino, Italy
| | - D Gottardi
- Hematology and Cell Therapy Division, Mauriziano-Umberto I Hospital & University, Torino, Italy
| | - A De Crescenzo
- Hematology and Cell Therapy Division, Mauriziano-Umberto I Hospital & University, Torino, Italy
| | - C Tarella
- Hematology and Cell Therapy Division, Mauriziano-Umberto I Hospital & University, Torino, Italy
| |
Collapse
|
122
|
Bhojwani N, Szpakowski P, Partovi S, Maurer MH, Grosse U, von Tengg-Kobligk H, Zipp-Partovi L, Fergus N, Kosmas C, Nikolaou K, Robbin MR. Diffusion-weighted imaging in musculoskeletal radiology-clinical applications and future directions. Quant Imaging Med Surg 2015; 5:740-53. [PMID: 26682143 DOI: 10.3978/j.issn.2223-4292.2015.07.07] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Diffusion-weighted imaging (DWI) is an established diagnostic tool with regards to the central nervous system (CNS) and research into its application in the musculoskeletal system has been growing. It has been shown that DWI has utility in differentiating vertebral compression fractures from malignant ones, assessing partial and complete tears of the anterior cruciate ligament (ACL), monitoring tumor response to therapy, and characterization of soft-tissue and bone tumors. DWI is however less useful in differentiating malignant vs. infectious processes. As of yet, no definitive qualitative or quantitative properties have been established due to reasons ranging from variability in acquisition protocols to overlapping imaging characteristics. Even with these limitations, DWI can still provide clinically useful information, increasing diagnostic accuracy and improving patient management when magnetic resonance imaging (MRI) findings are inconclusive. The purpose of this article is to summarize recent research into DWI applications in the musculoskeletal system.
Collapse
Affiliation(s)
- Nicholas Bhojwani
- 1 Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, Freiburgstrasse, Bern 3010, Switzerland ; 4 Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany ; 5 Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Peter Szpakowski
- 1 Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, Freiburgstrasse, Bern 3010, Switzerland ; 4 Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany ; 5 Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Sasan Partovi
- 1 Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, Freiburgstrasse, Bern 3010, Switzerland ; 4 Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany ; 5 Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Martin H Maurer
- 1 Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, Freiburgstrasse, Bern 3010, Switzerland ; 4 Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany ; 5 Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Ulrich Grosse
- 1 Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, Freiburgstrasse, Bern 3010, Switzerland ; 4 Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany ; 5 Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Hendrik von Tengg-Kobligk
- 1 Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, Freiburgstrasse, Bern 3010, Switzerland ; 4 Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany ; 5 Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Lisa Zipp-Partovi
- 1 Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, Freiburgstrasse, Bern 3010, Switzerland ; 4 Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany ; 5 Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Nathan Fergus
- 1 Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, Freiburgstrasse, Bern 3010, Switzerland ; 4 Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany ; 5 Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Christos Kosmas
- 1 Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, Freiburgstrasse, Bern 3010, Switzerland ; 4 Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany ; 5 Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Konstantin Nikolaou
- 1 Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, Freiburgstrasse, Bern 3010, Switzerland ; 4 Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany ; 5 Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Mark R Robbin
- 1 Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; 2 Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA ; 3 Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, Freiburgstrasse, Bern 3010, Switzerland ; 4 Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany ; 5 Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| |
Collapse
|
123
|
Kwee RM, Kwee TC. Modern imaging techniques for preoperative detection of distant metastases in gastric cancer. World J Gastroenterol 2015; 21:10502-10509. [PMID: 26457011 PMCID: PMC4588073 DOI: 10.3748/wjg.v21.i37.10502] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 04/20/2015] [Accepted: 08/25/2015] [Indexed: 02/06/2023] Open
Abstract
A substantial portion of patients with newly diagnosed gastric cancer has distant metastases (M1 disease). These patients have a very poor prognosis and it is generally accepted that they should be treated with noncurative intent. Because it dramatically changes prognosis and treatment plans, it is very important to diagnose distant metastases. In this article, the definition, pathways, incidence and sites of distant metastases in gastric cancer are described. Subsequently, the current performance of imaging in detecting distant metastases in newly diagnosed gastric cancer is outlined and future prospects are discussed.
Collapse
|
124
|
Park JY, Suh TS, Lee JW, Ahn KJ, Park HJ, Choe BY, Hong S. Dosimetric Effects of Magnetic Resonance Imaging-assisted Radiotherapy Planning: Dose Optimization for Target Volumes at High Risk and Analytic Radiobiological Dose Evaluation. J Korean Med Sci 2015; 30:1522-30. [PMID: 26425053 PMCID: PMC4575945 DOI: 10.3346/jkms.2015.30.10.1522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 07/07/2015] [Indexed: 01/26/2023] Open
Abstract
Based on the assumption that apparent diffusion coefficients (ADCs) define high-risk clinical target volume (aCTVHR) in high-grade glioma in a cellularity-dependent manner, the dosimetric effects of aCTVHR-targeted dose optimization were evaluated in two intensity-modulated radiation therapy (IMRT) plans. Diffusion-weighted magnetic resonance (MR) images and ADC maps were analyzed qualitatively and quantitatively to determine aCTVHR in a high-grade glioma with high cellularity. After confirming tumor malignancy using the average and minimum ADCs and ADC ratios, the aCTVHR with double- or triple-restricted water diffusion was defined on computed tomography images through image registration. Doses to the aCTVHR and CTV defined on T1-weighted MR images were optimized using a simultaneous integrated boost technique. The dosimetric benefits for CTVs and organs at risk (OARs) were compared using dose volume histograms and various biophysical indices in an ADC map-based IMRT (IMRTADC) plan and a conventional IMRT (IMRTconv) plan. The IMRTADC plan improved dose conformity up to 15 times, compared to the IMRTconv plan. It reduced the equivalent uniform doses in the visual system and brain stem by more than 10% and 16%, respectively. The ADC-based target differentiation and dose optimization may facilitate conformal dose distribution to the aCTVHR and OAR sparing in an IMRT plan.
Collapse
Affiliation(s)
- Ji-Yeon Park
- Department of Radiation Oncology, University of Florida, FL, USA
| | - Tae Suk Suh
- Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong-Woo Lee
- Department of Radiation Oncology, Konkuk University Medical Center, Seoul, Korea
| | - Kook-Jin Ahn
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae-Jin Park
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Bo-Young Choe
- Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Semie Hong
- Department of Radiation Oncology, Konkuk University Medical Center, Seoul, Korea
| |
Collapse
|
125
|
Bonaffini PA, Ippolito D, Casiraghi A, Besostri V, Franzesi CT, Sironi S. Apparent diffusion coefficient maps integrated in whole-body MRI examination for the evaluation of tumor response to chemotherapy in patients with multiple myeloma. Acad Radiol 2015; 22:1163-71. [PMID: 26182979 DOI: 10.1016/j.acra.2015.05.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 05/26/2015] [Accepted: 05/27/2015] [Indexed: 02/08/2023]
Abstract
RATIONALE AND OBJECTIVES To determine the diagnostic value of apparent diffusion coefficient (ADC) maps in the assessment of response to chemotherapy in patients with multiple myeloma (MM). MATERIALS AND METHODS Fourteen patients (seven women) with MM underwent whole-body magnetic resonance imaging (WB-MRI) study on a 1.5T scanner, before and after chemotherapy. DWI with background body signal suppression (DWIBS) sequences (b values: 0, 500, and 1000 mm(2)/sec) were qualitatively analyzed, along with T1 turbo spine echo and short tau inversion recovery T2-weighted images, to evaluate bone lesions. On ADC maps, regions of interest were manually drawn along contours of lesions. The ADC values percentage variation (ΔADC) before (MR1) and after (MR2) chemotherapy were calculated and compared between responders (11 of 14) and nonresponders (3 of 14). The percentage of plasma cells by the means of the bone marrow aspirate was evaluated as parameter for response to chemotherapy. RESULTS Twenty-four lesions, hyperintense on DWIBS as compared to normal bone marrow, were evaluated. In responder group, the mean ADC values were 0.63 ± 0.24 × 10(-3) mm(2)/s on MR1 and 1.04 ± 0.46 × 10(-3) mm(2)/s on MR2; partial or complete signal intensity decrease during follow-up on DWIBS was found along with a reduction of plasma cells infiltration in the bone marrow. The mean ADC values for nonresponders were 0.61 ± 0.05 × 10(-3) mm(2)/s on MR1 and 0.69 ± 0.09 × 10(-3) mm(2)/s on MR2. The mean variation of ΔADC in responders (Δ = 66%) was significantly different (P < .05) than in nonresponders (Δ = 15%). CONCLUSIONS WB-MRI with DWIBS sequences, by evaluating posttreatment changes of ADC values, might represent a complementary diagnostic tool in the assessment of response to chemotherapy in MM patients.
Collapse
Affiliation(s)
- Pietro Andrea Bonaffini
- School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy; Department of Diagnostic Radiology, H. San Gerardo, Monza, Italy; Department of Health Sciences, Tecnomed Foundation, University of Milano-Bicocca, Monza, Italy.
| | - Davide Ippolito
- School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy; Department of Diagnostic Radiology, H. San Gerardo, Monza, Italy
| | - Alessandra Casiraghi
- School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy; Department of Diagnostic Radiology, H. San Gerardo, Monza, Italy
| | - Valeria Besostri
- School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy; Department of Diagnostic Radiology, H. San Gerardo, Monza, Italy
| | - Cammillo Talei Franzesi
- School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy; Department of Diagnostic Radiology, H. San Gerardo, Monza, Italy
| | - Sandro Sironi
- School of Medicine, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy; Department of Diagnostic Radiology, H. San Gerardo, Monza, Italy
| |
Collapse
|
126
|
Mahmood F, Johannesen HH, Geertsen P, Opheim GF, Hansen RH. The effect of region of interest strategies on apparent diffusion coefficient assessment in patients treated with palliative radiation therapy to brain metastases. Acta Oncol 2015; 54:1529-34. [PMID: 26236963 DOI: 10.3109/0284186x.2015.1061211] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Although diffusion-weighted magnetic resonance imaging (DW-MRI) is widely used in radiation therapy (RT) response studies, no standard of delineating the region of interest (ROI) exists. In this retrospective study, we evaluate the effect of four ROI strategies on the apparent diffusion coefficients (ADC) in patients receiving palliative RT to brain metastases. MATERIAL AND METHODS Twenty-two metastases from nine patients, treated with whole-brain irradiation (30 Gy in 10 fractions) were analyzed. Patients were scanned with a 1T MR system to acquire DW- (eight b-values), T2*W-, T2W- and T1W scans, before start of RT (pre-RT) and at the 9th/10th fraction (end-RT). The following ROI strategies were applied. ROIb800 and ROIb0: Entire tumor volume visible on DW(b = 800 s/mm(2)) and DW(b = 0 s/mm(2)) images, respectively. ROIb800vi: Viable tumor volume based on DW(b = 800 s/mm(2)). ROIb800rep: ROIb800 from pre-RT scan replicated to end-RT scan. Delineations were aided by co-registered T1W, T2W and T2*W images. ADC was estimated with two mono-exponential fits and one bi-exponential fit. RESULTS Differences in absolute ADC values were non-significant across ROI strategy independent of fitting method, while significantly different between fitting methods. Evaluation of individual metastases showed that ROI strategies disagreed on the relative ADC change (from pre-RT to end-RT) in 13 of the 22 metastases when all fitting methods were added up. CONCLUSION The ROI strategies have an effect on the relative ADC change, which may be important for the assessment of individual patient's response to RT and the interpretation of the current literature.
Collapse
Affiliation(s)
- Faisal Mahmood
- a Radiotherapy Research Unit (RRU), Department of Oncology , University of Copenhagen, Herlev and Gentofte Hospital , Herlev , Denmark
| | - Helle H Johannesen
- b Department of Radiology , University of Copenhagen, Herlev and Gentofte Hospital , Herlev , Denmark
| | - Poul Geertsen
- a Radiotherapy Research Unit (RRU), Department of Oncology , University of Copenhagen, Herlev and Gentofte Hospital , Herlev , Denmark
| | - Giske F Opheim
- a Radiotherapy Research Unit (RRU), Department of Oncology , University of Copenhagen, Herlev and Gentofte Hospital , Herlev , Denmark
| | - Rasmus H Hansen
- b Department of Radiology , University of Copenhagen, Herlev and Gentofte Hospital , Herlev , Denmark
| |
Collapse
|
127
|
Lavdas I, Rockall AG, Castelli F, Sandhu RS, Papadaki A, Honeyfield L, Waldman AD, Aboagye EO. Apparent Diffusion Coefficient of Normal Abdominal Organs and Bone Marrow From Whole-Body DWI at 1.5 T: The Effect of Sex and Age. AJR Am J Roentgenol 2015; 205:242-50. [PMID: 26204271 DOI: 10.2214/ajr.14.13964] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2024]
Abstract
OBJECTIVE The objectives of this study were to define the range of apparent diffusion coefficients (ADCs) from whole-body DWI in normal abdominal organs and bone marrow, to identify ADC differences between sexes and changes occurring with age, and to evaluate the effect of the fat fraction (FF) on the ADC of normal liver parenchyma and bone marrow. MATERIALS AND METHODS Fifty-one healthy volunteers (mean age = 38 years; age range = 23-68 years) underwent whole-body DWI using single-shot echo-planar imaging (b = 0, 150, 400, 750, and 1000 s/mm(2)). A two-point Dixon technique was used to evaluate the FF. Perfusion-sensitive ADCs, which we refer to as "ADCALL," and perfusion-insensitive ADCs, which we refer to as "ADCHIGH," of the liver and renal parenchyma, spleen, pancreatic tail, and red and yellow bone marrow were calculated. The relationships between ADC and sex, age, and FF were examined. RESULTS ADCALL and ADCHIGH were significantly higher in female volunteers for the pancreatic tail (p = 0.046 and 0.008, respectively), red bone marrow (p = 0.029 and 0.001), and yellow bone marrow (p < 0.001 for both) but with considerable overlap. There were significant negative correlations between ADCALL and ADCHIGH and age in the liver parenchyma (p = 0.008 and 0.01, respectively) and in the yellow bone marrow (p = 0.013 and 0.039) for all subjects. ADCALL and ADCHIGH were also negatively correlated with FF in the liver parenchyma (p = 0.006 and 0.008, respectively) and in yellow bone marrow (p < 0.001 and p = 0.001) in all subjects. CONCLUSION The ADCs of normal liver parenchyma and bone marrow change significantly with age. The ADCs of bone marrow in women are significantly higher than those of men and correlate strongly with FF. These effects may have an impact on image interpretation when using whole-body DWI to assess disease burden and treatment response.
Collapse
Affiliation(s)
- Ioannis Lavdas
- 1 Department of Surgery and Cancer, Comprehensive Cancer Imaging Centre, Imperial College, Hammersmith Campus, DuCane Rd, London W12 0NN, UK
| | - Andrea G Rockall
- 2 Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | | | - Ranbir S Sandhu
- 2 Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | - Annie Papadaki
- 4 Radiological Sciences Unit, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Lesley Honeyfield
- 2 Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | - Adam D Waldman
- 2 Imaging Department, Imperial College Healthcare NHS Trust, London, UK
- 5 Department of Medicine, Division of Brain Sciences, Imperial College, London, UK
| | - Eric O Aboagye
- 1 Department of Surgery and Cancer, Comprehensive Cancer Imaging Centre, Imperial College, Hammersmith Campus, DuCane Rd, London W12 0NN, UK
| |
Collapse
|
128
|
Abstract
OBJECTIVE Pediatric patients with inflammatory bowel disease (IBD) commonly need repetitive imaging to assess disease activity and complications. Recently, MR enterography has become a first-line radiologic study in children with IBD because of improved image quality, excellent soft-tissue contrast resolution, and lack of ionizing radiation. The purpose of this article is to describe the use of diffusion-weighted imaging (DWI) in MR enterography and the evaluation of pediatric IBD. CONCLUSION Several contemporary publications have shown that DWI can be useful for assessing both pediatric and adult patients with IBD as an important adjunct pulse sequence. Specifically, DWI can be used to identify abnormal bowel segments, assess disease inflammatory activity, and detect and characterize a variety of extraintestinal IBD-related manifestations and complications.
Collapse
|
129
|
Whole-body diffusion-weighted MRI and (18)F-FDG PET/CT can discriminate between different lymphoma subtypes. Clin Radiol 2015. [PMID: 26208992 DOI: 10.1016/j.crad.2015.06.087] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIM To determine whether combined 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron-emission tomography (PET)/computed tomography (CT) and diffusion-weighted imaging (DWI) can be used for characterisation of different lymphoma subtypes, i.e., indolent versus aggressive lymphoma, and also to assess the prognostic value of different quantitative parameters of whole-body (WB) DWI and (18)F-FDG PET/CT. MATERIALS AND METHODS Pre-therapeutic WB magnetic resonance imaging (MRI) including DWI and (18)F-FDG PET/CT were performed in lymphoma patients. Different quantitative DWI and (18)F-FDG PET/CT parameters were evaluated for characterisation of different lymphoma subtypes. These parameters were also correlated, both separately and in combination, against overall survival (OS) and progression-free survival (PFS). A lesion-by-lesion analysis was performed for correlation analysis between maximum standardised uptake value (SUVmax), mean standardised uptake value (SUVmean) and mean apparent diffusion coefficient (ADC). RESULTS Fifty patients were included in the study and divided into three groups: Hodgkin's lymphoma (HL), n=12; aggressive non-Hodgkin's lymphoma (NHL), n=29 (including 20 patients with diffuse large B-cell lymphoma, DLBCL); and indolent NHL, n=9. Indolent NHL showed significantly lower mean ADC values than the other two lymphoma groups (p=0.013). Aggressive NHL had a higher SUVmax than HL. The OS analysis of all patients showed a relationship (p=0.006) between increased mean ADC and longer OS. A model with both SUVmean and mean ADC, strengthened the possibility to predict PFS; however, a separate analysis of the DLBCL patients showed that none of the quantitative parameters could predict OS or PFS. CONCLUSION ADC can discriminate between indolent and aggressive NHL. This finding can be useful in assessing possible transformation from indolent to aggressive NHL. ADC, ADC/SUV, and SUV cannot predict OS/PFS independent of lymphoma subtype.
Collapse
|
130
|
Whole-body diffusion kurtosis imaging: initial experience on non-Gaussian diffusion in various organs. Invest Radiol 2015; 49:773-8. [PMID: 24979203 DOI: 10.1097/rli.0000000000000082] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Diffusion kurtosis imaging (DKI) is based on a non-Gaussian diffusion model that should inherently better account for restricted water diffusion within the complex microstructure of most tissues than the conventional diffusion-weighted imaging (DWI), which presumes Gaussian distributed water molecule displacement probability. The aim of this investigation was to test the technical feasibility of in vivo whole-body DKI, probe for organ-specific differences, and compare whole-body DKI and DWI results. MATERIALS AND METHODS Eight healthy subjects underwent whole-body DWI on a clinical 3.0 T magnetic resonance imaging system. Echo-planar images in the axial orientation were acquired at b-values of 0, 150, 300, 500, and 800 mm²/s. Parametrical whole-body maps of the diffusion coefficient (D), the kurtosis (K), and the traditional apparent diffusion coefficient (ADC) were generated. Goodness of fit was compared between DKI and DWI fits using the sums of squared residuals. Data groups were tested for significant differences of the mean by paired Student t tests. RESULTS Good-quality parametrical whole-body maps of D, K, and ADC could be computed. Compared with ADC values, D values were significantly higher in the cerebral gray matter (by 30%) and white matter (27%), renal cortex (23%) and medulla (21%), spleen (101%), as well as erector spinae muscle (34%) (each P value <0.001). No significant differences between D and ADC were found in the cerebrospinal fluid (P = 0.08) and in the liver (P = 0.13). Curves of DKI fitted the measurement points significantly better than DWI curves did in most organs. CONCLUSIONS Whole-body DKI is technically feasible and may reflect tissue microstructure more meaningfully than whole-body DWI.
Collapse
|
131
|
|
132
|
Chilla GS, Tan CH, Xu C, Poh CL. Diffusion weighted magnetic resonance imaging and its recent trend-a survey. Quant Imaging Med Surg 2015; 5:407-22. [PMID: 26029644 DOI: 10.3978/j.issn.2223-4292.2015.03.01] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 01/15/2015] [Indexed: 12/14/2022]
Abstract
Since its inception in 1985, diffusion weighted magnetic resonance imaging has been evolving and is becoming instrumental in diagnosis and investigation of tissue functions in various organs including brain, cartilage, and liver. Even though brain related pathology and/or investigation remains as the main application, diffusion weighted magnetic resonance imaging (DWI) is becoming a standard in oncology and in several other applications. This review article provides a brief introduction of diffusion weighted magnetic resonance imaging, challenges involved and recent advancements.
Collapse
Affiliation(s)
- Geetha Soujanya Chilla
- 1 School of Chemical & Biomedical Engineering, Nanyang Technological University, Singapore 637459, Singapore ; 2 Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Cher Heng Tan
- 1 School of Chemical & Biomedical Engineering, Nanyang Technological University, Singapore 637459, Singapore ; 2 Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Chenjie Xu
- 1 School of Chemical & Biomedical Engineering, Nanyang Technological University, Singapore 637459, Singapore ; 2 Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Chueh Loo Poh
- 1 School of Chemical & Biomedical Engineering, Nanyang Technological University, Singapore 637459, Singapore ; 2 Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore
| |
Collapse
|
133
|
Squillaci E, Bolacchi F, Altobelli S, Franceschini L, Bergamini A, Cantonetti M, Simonetti G. Pre-treatment staging of multiple myeloma patients: comparison of whole-body diffusion weighted imaging with whole-body T1-weighted contrast-enhanced imaging. Acta Radiol 2015; 56:733-8. [PMID: 24973257 DOI: 10.1177/0284185114538792] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 05/14/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Multiple myeloma (MM) is a hematologic malignancy characterized by the clonal proliferation of plasma cells. Accurate staging is of pivotal importance in the management of MM. Advanced imaging techniques, such as magnetic resonance imaging (MRI), are increasingly used for the initial diagnosis and staging of MM. PURPOSE To compare whole-body (WB) MR diffusion-weighted imaging with background body signal suppression (DWIBS) with (WB) MR fat-suppressed T1-weighted contrast-enhanced imaging (T1-CE) in the pre-treatment staging evaluation of multiple myeloma (MM) patients. MATERIAL AND METHODS Thirty-six patients with MM were included in the study. T1-CE and DWIBS were performed using a 3 T scanner. The Durie-Salmon plus staging system was used. Kappa statistics was used to assess agreement. RESULTS For all MM stages good to very good agreement was found for both T1-CE and DWIBS. The unweighted kappa statistic indicated a moderate, good and very good agreement between T1-CE and DWIBS for stages I, II, and III, respectively. In particular, in 67% of patients the MM staging according to T1-CE was not different from DWIBS. In the remaining 33% of patients, the MM stage obtained with T1-CE was lower than that provided by DWIBS. CONCLUSION DWIBS and T1-CE were concordant in the majority of patients. In a minority of cases DWIBS evidenced areas of water restriction that did not correspond to contrast enhancement areas. Studies monitoring therapeutic response in relation to tumour burden and aggressiveness should be performed to assess the clinical relevance of DWIBS findings.
Collapse
Affiliation(s)
- Ettore Squillaci
- University Hospital Policlinico Tor Vergata, Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome “Tor Vergata”, Rome, Italy
| | - Francesca Bolacchi
- University Hospital Policlinico Tor Vergata, Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome “Tor Vergata”, Rome, Italy
| | - Simone Altobelli
- University Hospital Policlinico Tor Vergata, Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome “Tor Vergata”, Rome, Italy
| | - Luca Franceschini
- Department of Internal Medicine, Hematology/Oncology Unit, Tor Vergata University, Rome, Italy
| | - Alberto Bergamini
- Department of Internal Medicine, Hematology/Oncology Unit, Tor Vergata University, Rome, Italy
- Department of Public Health and Cellular Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Maria Cantonetti
- Department of Internal Medicine, Hematology/Oncology Unit, Tor Vergata University, Rome, Italy
| | - Giovanni Simonetti
- University Hospital Policlinico Tor Vergata, Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome “Tor Vergata”, Rome, Italy
| |
Collapse
|
134
|
wbMRI to detect bone metastases: critical review on diagnostic accuracy and comparison to other imaging modalities. Clin Transl Imaging 2015. [DOI: 10.1007/s40336-015-0120-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
135
|
Toledano-Massiah S, Luciani A, Itti E, Zerbib P, Vignaud A, Belhadj K, Baranes L, Haioun C, Lin C, Rahmouni A. Whole-Body Diffusion-weighted Imaging in Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma. Radiographics 2015; 35:747-64. [PMID: 25815803 DOI: 10.1148/rg.2015140145] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Whole-body imaging, in particular molecular imaging with fluorine 18 ((18)F)-fluorodeoxyglucose (FDG) positron emission tomography (PET), is essential to management of lymphoma. The assessment of disease extent provided by use of whole-body imaging is mandatory for planning appropriate treatment and determining patient prognosis. Assessment of treatment response allows clinicians to tailor the treatment strategy during therapy if necessary and to document complete remission at the end of treatment. Because of rapid technical developments, such as echo-planar sequences, parallel imaging, multichannel phased-array surface coils, respiratory gating, and moving examination tables, whole-body diffusion-weighted (DW) magnetic resonance (MR) imaging that reflects cell density is now feasible in routine clinical practice. Whole-body DW MR imaging allows anatomic assessment as well as functional and quantitative evaluation of tumor sites by calculation of the apparent diffusion coefficient (ADC). Because of their high cellularity and high nucleus-to-cytoplasm ratio, lymphomatous lesions have low ADC values and appear hypointense on ADC maps. As a result, whole-body DW MR imaging with ADC mapping has become a promising tool for lymphoma staging and treatment response assessment. The authors review their 4 years of experience with 1.5-T and 3-T whole-body DW MR imaging used with (18)F-FDG PET/computed tomography at baseline, interim, and end of treatment in patients with Hodgkin lymphoma and diffuse large B-cell lymphoma and discuss the spectrum of imaging findings and potential pitfalls, limitations, and challenges associated with whole-body DW MR imaging in these patients.
Collapse
Affiliation(s)
- Sarah Toledano-Massiah
- From the Department of Medical Imaging (S.T.M., A.L., P.Z., L.B., A.R.), Department of Nuclear Medicine (E.I., L.B.), and Lymphoproliferative Unit (K.B., C.H.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, 94010 Creteil, France; Faculty of Medicine, Université Paris Est Creteil, Creteil, France (A.L., E.I., L.B., C.H., A.R.); Neurospin, CEA, Saclay, France (A.V.); and Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Gueishan, Taiwan (C.L.)
| | | | | | | | | | | | | | | | | | | |
Collapse
|
136
|
Diffusion-weighted MRI for the assessment of liver fibrosis: principles and applications. BIOMED RESEARCH INTERNATIONAL 2015; 2015:874201. [PMID: 25866819 PMCID: PMC4383436 DOI: 10.1155/2015/874201] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 12/14/2014] [Accepted: 01/01/2015] [Indexed: 12/19/2022]
Abstract
The importance of an early identification of hepatic fibrosis has been emphasized, in order to start therapy and obtain fibrosis regression. Biopsy is the gold-standard method for the assessment of liver fibrosis in chronic liver diseases, but it is limited by complications, interobserver variability, and sampling errors. Several noninvasive methods have been recently introduced into clinical routine, in order to detect liver fibrosis early. One of the most diffuse approaches is represented by diffusion-weighted liver MRI. In this review, the main technical principles are briefly reported in order to explain the rationale for clinical applications. In addition, roles of apparent diffusion coefficient, intravoxel incoherent motion, and relative apparent diffusion coefficient are also reported, showing their advantages and limits.
Collapse
|
137
|
Donahue MJ, Donahue PCM, Rane S, Thompson CR, Strother MK, Scott AO, Smith SA. Assessment of lymphatic impairment and interstitial protein accumulation in patients with breast cancer treatment-related lymphedema using CEST MRI. Magn Reson Med 2015; 75:345-55. [PMID: 25752499 DOI: 10.1002/mrm.25649] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/12/2015] [Accepted: 01/15/2015] [Indexed: 12/19/2022]
Abstract
PURPOSE Lymphatic impairment is known to reduce quality of life in some of the most crippling diseases of the 21st century, including obesity, lymphedema, and cancer. However, the lymphatics are not nearly as well-understood as other bodily systems, largely owing to a lack of sensitive imaging technologies that can be applied using standard clinical equipment. Here, proton exchange-weighted MRI is translated to the lymphatics in patients with breast cancer treatment-related lymphedema (BCRL). METHODS Healthy volunteers (N = 8) and BCRL patients (N = 7) were scanned at 3 Tesla using customized structural MRI and amide proton transfer (APT) chemical exchange saturation transfer (CEST) MRI in sequence with the hypothesis that APT effects would be elevated in lymphedematous tissue. APT contrast, lymphedema stage, symptomatology, and histology information were evaluated. RESULTS No significant difference between proton-weighted APT contrast in the right and left arms of healthy controls was observed. An increase in APT contrast in the affected arms of patients was found (P = 0.025; Cohen's d = 2.4), and variability among patients was consistent with documented damage to lymphatics as quantified by lymphedema stage. CONCLUSION APT CEST MRI may have relevance for evaluating lymphatic impairment in patients with BCRL, and may extend to other pathologies where lymphatic compromise is evident.
Collapse
Affiliation(s)
- Manus J Donahue
- Department of Radiology, Vanderbilt School of Medicine, Nashville, Tennessee.,Department of Psychiatry, Vanderbilt School of Medicine, Nashville, Tennessee.,Department of Neurology, Vanderbilt School of Medicine, Nashville, Tennessee.,Department of Physics and Astronomy, Vanderbilt School of Medicine, Nashville, Tennessee
| | - Paula C M Donahue
- Physical Medicine and Rehabilitation, Vanderbilt School of Medicine, Nashville, Tennessee.,Dayani Center for Health and Wellness, Nashville, Tennessee
| | - Swati Rane
- Department of Radiology, Vanderbilt School of Medicine, Nashville, Tennessee
| | - Christopher R Thompson
- Vanderbilt University Institute of Imaging Science, Vanderbilt School of Medicine, Nashville, Tennessee
| | - Megan K Strother
- Department of Radiology, Vanderbilt School of Medicine, Nashville, Tennessee
| | - Allison O Scott
- Department of Radiology, Vanderbilt School of Medicine, Nashville, Tennessee
| | - Seth A Smith
- Department of Radiology, Vanderbilt School of Medicine, Nashville, Tennessee
| |
Collapse
|
138
|
Regacini R, Puchnick A, Shigueoka DC, Iared W, Lederman HM. Whole-body diffusion-weighted magnetic resonance imaging versus FDG-PET/CT for initial lymphoma staging: systematic review on diagnostic test accuracy studies. SAO PAULO MED J 2015; 133:141-50. [PMID: 25789779 PMCID: PMC10496634 DOI: 10.1590/1516-3180.2014.8312810] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 01/31/2014] [Accepted: 10/28/2014] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Positron emission tomography with [18]F-fluoro-2-deoxyglucose (FDG-PET/CT) has been advocated as the method of choice for lymphoma staging, since it enables whole-body analysis with high sensitivity for detection of affected areas and because it combines capacities for anatomical and functional assessment. With technological advances, magnetic resonance imaging (MRI) has emerged as an alternative to FDG-PET/CT. This systematic review with meta-analysis aimed to compare whole-body diffusion-weighted MRI (WB-MRI) with FDG-PET/CT for lymphoma staging. DESIGN AND SETTING Systematic review on diagnostic test accuracy studies conducted at a public university. METHODS The Medline, Scopus, Embase and Lilacs databases were searched for studies published up to September 2013 that compared WB-MRI and FDG-PET/CT for lymphoma staging. The reference lists of included studies were checked for any relevant additional citations. RESULTS Six studies that evaluated the initial lymphoma staging in 116 patients were included. WB-MRI and FDG-PET/CT agreed in 90.5% of the cases (κ = 0.871; P < 0.0001). In most of the studies, when there was disagreement between the methods, WB-MRI overstaged in relation to FDG-PET/CT. The sensitivity of WB-MRI and FDG-PET/CT, in comparison with the clinical-radiological standard, ranged from 59 to 100% and from 63 to 100% respectively. CONCLUSION WB-MRI is a highly sensitive method for initial lymphoma staging. It has excellent agreement with FDG-PET/CT and is a great alternative for managing lymphoma patients, without using ionizing radiation or an intravenous contrast agent.
Collapse
Affiliation(s)
- Rodrigo Regacini
- MD, MSc. Radiologist, Discipline of Pediatric Radiology, Department of Diagnostic Imaging, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
| | - Andrea Puchnick
- BSc. Professor and Coordinator of Educational and Research Support, Department of Diagnostic Imaging, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
| | - David Carlos Shigueoka
- MD, PhD. Adjunct Professor, Department of Diagnostic Imaging, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
| | - Wagner Iared
- MD, PhD. Assistant Research Radiologist, Department of Diagnostic Imaging, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil
| | - Henrique Manoel Lederman
- MD, PhD. Full Professor and Head of the Discipline of Pediatric Radiology, Department of Diagnostic Imaging, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
| |
Collapse
|
139
|
Takayama Y, Nishie A, Asayama Y, Ishigami K, Kakihara D, Ushijima Y, Fujita N, Yoshiura T, Takemura A, Obara M, Takahara T, Honda H. Optimization and Clinical Feasibility of Free-breathing Diffusion-weighted Imaging of the Liver: Comparison with Respiratory-Triggered Diffusion-weighted Imaging. Magn Reson Med Sci 2015; 14:123-32. [PMID: 25740235 DOI: 10.2463/mrms.2014-0032] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
PURPOSE We compared the image quality of free-breathing diffusion-weighted imaging (FB-DWI) to that of respiratory-triggered DWI (RT-DWI) after proper optimization. MATERIALS AND METHODS Three healthy subjects were scanned to optimize magnetic resonance (MR) parameters of FB-DWI to improve image quality, including spatial resolution, image noise, and chemical shift artifacts. After this optimization, we scanned 32 patients with liver disease to assess the clinical feasibility of the optimized FB-DWI. Of the 32 patients, 14 had a total of 28 hepatocellular carcinomas (HCCs), four had a total of 15 metastatic liver tumors, and the other 14 had no tumor. Qualitatively, we compared the image quality scores of FB-DWI with those of RT-DWI with the Wilcoxon signed-rank test. Quantitatively, we compared the signal-to-noise ratios (SNRs) of the liver parenchyma, lesion-to-nonlesion contrast-to-noise ratios (CNRs) and apparent diffusion coefficient (ADC) values of the liver parenchyma and liver tumor by the paired t-test. RESULTS The average scores of image quality for sharpness of liver contour, image noise, and chemical shift artifacts were significantly higher for FB-DWI than RT-DWI (P < 0.05). SNRs, CNRs, and ADC values of the liver parenchyma and tumors did not differ significantly between the 2 DWI methods. CONCLUSION Compared with RT-DWI, the optimized FB-DWI provided better spatial resolution, fewer artifacts, and comparable SNRs, lesion-to-nonlesion CNRs, and ADC values.
Collapse
Affiliation(s)
- Yukihisa Takayama
- Department of Radiology Informatics and Network, Graduate School of Medical Sciences, Kyushu University
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
140
|
Guo H, Ma X, Zhang Z, Zhang B, Yuan C, Huang F. POCS-enhanced inherent correction of motion-induced phase errors (POCS-ICE) for high-resolution multishot diffusion MRI. Magn Reson Med 2015; 75:169-80. [PMID: 25648591 DOI: 10.1002/mrm.25594] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 11/04/2014] [Accepted: 12/07/2014] [Indexed: 11/07/2022]
Abstract
PURPOSE For multishot diffusion weighted imaging (DWI), one of the challenges is to remove phase variations induced by physiological motion among different shots. In this study, a new method is proposed to iteratively solve the phase errors and DWI images simultaneously, for navigator-free acquisitions. THEORY AND METHODS Instead of solving phase errors and the image sequentially in the two-step parallel imaging, the proposed method, named POCS-enhanced Inherent Correction of motion-induced phase Errors (POCS-ICE), treats both the phase and DWI image as unknowns and solves them simultaneously. Multishot DWI with constant density spiral trajectory served as a specific example. Simulation and in vivo experiments were performed to evaluate the proposed method. RESULTS POCS-ICE shows improved image quality in terms of higher SNR and fewer artifacts than the compared method, SENSE+CG. The improvement becomes more conspicuous as the number of shots increases. The convergence behavior of POCS-ICE was also shown to be more stable. CONCLUSION POCS-ICE can inherently and reliably correct motion-induced phase errors in navigator-free multishot DWI, and it is easier to determine the stopping criterion without manual interventions. The improved spatial resolution and image resolvability are beneficial to study of brain microstructures and physiological features for neuroscience.
Collapse
Affiliation(s)
- Hua Guo
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Xiaodong Ma
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Zhe Zhang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Bida Zhang
- Healthcare Department, Philips Research China, Shanghai, China
| | - Chun Yuan
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China.,Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Feng Huang
- Philips Healthcare (Suzhou) Co., Ltd., Suzhou, China
| |
Collapse
|
141
|
Whole-body intravoxel incoherent motion imaging. Eur Radiol 2015; 25:2049-58. [PMID: 25576232 DOI: 10.1007/s00330-014-3577-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 12/07/2014] [Accepted: 12/18/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To investigate the technical feasibility of whole-body intravoxel incoherent motion (IVIM) imaging. MATERIALS AND METHODS Whole-body MR images of eight healthy volunteers were acquired at 3T using a spin-echo echo-planar imaging sequence with eight b-values. Coronal parametrical whole-body maps of diffusion (D), pseudodiffusion (D*), and the perfusion fraction (Fp) were calculated. Image quality was rated qualitatively by two independent radiologists, and inter-reader reliability was tested with intra-class correlation coefficients (ICCs). Region of interest (ROI) analysis was performed in the brain, liver, kidney, and erector spinae muscle. RESULTS Depiction of anatomic structures was rated as good on D maps and good to fair on D* and Fp maps. Exemplary mean D (10(-3) mm(2)/s), D* (10(-3) mm(2)/s) and Fp (%) values (± standard deviation) of the renal cortex were as follows: 1.7 ± 0.2; 15.6 ± 6.5; 20.9 ± 4.4. Inter-observer agreement was "substantial" to "almost perfect" (ICC = 0.80 - 0.92). The coefficient of variation of D* was significantly lower with the proposed algorithm compared to the conventional algorithm (p < 0.001), indicating higher stability. CONCLUSION The proposed IVIM protocol allows computation of parametrical maps with good to fair image quality. Potential future clinical applications may include characterization of widespread disease such as metastatic tumours or inflammatory myopathies. KEY POINTS • IVIM imaging allows estimation of tissue perfusion based on diffusion-weighted MRI. • In this study, a clinically suitable whole-body IVIM algorithm is presented. • Coronal parametrical whole-body maps showed good depiction of anatomic details. • Potential future applications include detection of widespread metastatic or inflammatory disease.
Collapse
|
142
|
Papalavrentios L, Sinakos E, Chourmouzi D, Hytiroglou P, Drevelegas K, Constantinides M, Drevelegas A, Talwalkar J, Akriviadis E. Value of 3 Tesla diffusion-weighted magnetic resonance imaging for assessing liver fibrosis. Ann Gastroenterol 2015; 28:118-123. [PMID: 25608776 PMCID: PMC4289984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 07/20/2014] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Limited data are available regarding the role of magnetic resonance imaging (MRI), particularly the new generation 3 Tesla technology, and especially diffusion-weighted imaging (DWI) in predicting liver fibrosis. The aim of our pilot study was to assess the clinical performance of the apparent diffusion coefficient (ADC) of liver parenchyma for the assessment of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). METHODS 18 patients with biopsy-proven NAFLD underwent DWI with 3 Tesla MRI. DWI was performed with single-shot echo-planar technique at b values of 0-500 and 0-1000 s/mm2. ADC was measured in four locations in the liver and the mean ADC value was used for analysis. Staging of fibrosis was performed according to the METAVIR system. RESULTS The median age of patients was 52 years (range 23-73). The distribution of patients in different fibrosis stages was: 0 (n=1), 1 (n=7), 2 (n=1), 3 (n=5), 4 (n=4). Fibrosis stage was poorly associated with ADC at b value of 0-500 s/mm2 (r= -0.30, P=0.27). However it was significantly associated with ADC at b value of 0-1000 s/mm2 (r= -0.57, P=0.01). For this b value (0-1000 s/mm2) the area under receiver-operating characteristic curve was 0.93 for fibrosis stage ≥3 and the optimal ADC cut-off value was 1.16 ×10-3 mm2/s. CONCLUSION 3 Tesla DWI can possibly predict the presence of advanced fibrosis in patients with NAFLD.
Collapse
Affiliation(s)
- Lavrentios Papalavrentios
- 4th Internal Medicine Unit, University of Thessaloniki (Lavrentios Papalavrentios, Emmanouil Sinakos, Evangelos Akriviadis), Greece,
Correspondence to: Lavrentios Papalavrentios, M.D., Samanidi 36, Panorama, Thessaloniki, Greece, Tel.: +30 2310 342046, Fax: +30 2310 471056, e-mail:
| | - Emmanouil Sinakos
- 4th Internal Medicine Unit, University of Thessaloniki (Lavrentios Papalavrentios, Emmanouil Sinakos, Evangelos Akriviadis), Greece
| | - Danai Chourmouzi
- Department of Radiology, Interbalkan Medical Center, Thessaloniki (Danai Chourmouzi, Konstantinos Drevelegas, Manos Constantinides, Antonios Drevelegas), Greece
| | - Prodromos Hytiroglou
- Department of Pathology, University of Thessaloniki (Prodromos Hytiroglou), Greece
| | - Konstantinos Drevelegas
- Department of Radiology, Interbalkan Medical Center, Thessaloniki (Danai Chourmouzi, Konstantinos Drevelegas, Manos Constantinides, Antonios Drevelegas), Greece
| | - Manos Constantinides
- Department of Radiology, Interbalkan Medical Center, Thessaloniki (Danai Chourmouzi, Konstantinos Drevelegas, Manos Constantinides, Antonios Drevelegas), Greece
| | - Antonios Drevelegas
- Department of Radiology, Interbalkan Medical Center, Thessaloniki (Danai Chourmouzi, Konstantinos Drevelegas, Manos Constantinides, Antonios Drevelegas), Greece
| | - Jayant Talwalkar
- Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, MN, USA (Jayant Talwalkar)
| | - Evangelos Akriviadis
- 4th Internal Medicine Unit, University of Thessaloniki (Lavrentios Papalavrentios, Emmanouil Sinakos, Evangelos Akriviadis), Greece
| |
Collapse
|
143
|
Moschetta M, Telegrafo M, Rella L, Stabile Ianora AA, Angelelli G. Effect of gadolinium injection on diffusion-weighted imaging with background body signal suppression (DWIBS) imaging of breast lesions. Magn Reson Imaging 2014; 32:1242-6. [DOI: 10.1016/j.mri.2014.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 05/29/2014] [Accepted: 07/25/2014] [Indexed: 02/07/2023]
|
144
|
Wang XF, Wu YH, Wang MS, Wang YS. CEA, AFP, CA125, CA153 and CA199 in malignant pleural effusions predict the cause. Asian Pac J Cancer Prev 2014; 15:363-8. [PMID: 24528057 DOI: 10.7314/apjcp.2014.15.1.363] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Determination of the cause of malignant pleural effusions is important for treatment and management, especially in cases of unknown primaries. There are limited biomarkers available for prediction of the cause of malignant pleural effusion in clinical practice. Hence, we evaluated pleural levels of five tumor biomarkers (CEA, AFP, CA125, CA153 and CA199) in predicting the cause of malignant pleural effusion in a retrospective study. Kruskal-Wallis or Mann-Whitney U tests were carried out to compare levels of tumor markers in pleural effusion among different forms of neoplasia - lung squamous cell carcinoma, adenocarcinoma, or small cell carcinoma, mesothelioma, breast cancer, lymphoma/leukemia and miscellaneous. Receiver operator characteristic analysis was performed to evaluate sensitivity and specificity of biomarkers. The Kruskal-Wallis test showed significant differences in levels of pleural effusion CEA (P<0.01), AFP (P<0.01), CA153 (P<0.01) and CA199 (P<0.01), but not CA125 (P>0.05), among the seven groups. Receiver operator characteristic analysis showed that, compared with other four tumor markers, CA153 was the best biomarker in diagnosing malignant pleural effusions of lung adenocarcinoma (area under curve (AUC): 0.838 (95%confidence interval: 0.787, 0.888); cut-off value: 10.2U/ ml; sensitivity: 73.2% (64.4-80.8)%, specificity: 85.2% (77.8-90.8)%), lung squamous cell carcinoma (AUC: 0.716 (0.652, 0.780); cut-off value: 14.2U/ml; sensitivity: 57.6% (50.7-64.3)%, specificity: 91.2% (76.3-98.0)%), and small-cell lung cancer (AUC: 0.812 (0.740, 0.884); cut-off value: 9.7U/ml; sensitivity: 61.5% (55.0-67.8)%, specificity: 94.1% (71.2-99.0)%); CEA was the best biomarker in diagnosing MPEs of mesothelioma (AUC: 0.726 (0.593, 0.858); cut-off value: 1.43ng/ml; sensitivity: 83.7% (78.3-88.2)%, specificity: 61.1% (35.8-82.6)%) and lymphoma/leukemia (AUC: 0.923 (0.872, 0.974); cut-off value: 1.71ng/ml; sensitivity: 82.8% (77.4-87.3)%, specificity: 92.3% (63.9-98.7)%). Thus CA153 and CEA appear to be good biomarkers in diagnosing different causes of malignant pleural effusion. Our findings implied that the two tumor markers may improve the diagnosis and treatment for effusions of unknown primaries.
Collapse
Affiliation(s)
- Xin-Feng Wang
- Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China E-mail : ,
| | | | | | | |
Collapse
|
145
|
Insights into quantitative diffusion-weighted MRI for musculoskeletal tumor imaging. AJR Am J Roentgenol 2014; 203:560-72. [PMID: 25148158 DOI: 10.2214/ajr.13.12165] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The purposes of this article are to discuss the technical considerations for performing quantitative diffusion-weighted MRI (DWI) with apparent diffusion coefficient (ADC) mapping, examine the role of DWI in whole-body MRI, and review how DWI with ADC mapping can serve as an adjunct to information gleaned from conventional MRI in the radiologic evaluation of musculoskeletal lesions. CONCLUSION The primary role of whole-body DWI is in tumor detection; localized DWI is helpful in differentiating malignant bone and soft-tissue lesions. After treatment, an increase in tumor ADC values correlates with response to cytotoxic therapy. The use of DWI in the evaluation of musculoskeletal lesions requires knowledge of potential diagnostic pitfalls that stem from technical challenges and confounding biochemical factors that influence ADC maps but are unrelated to lesion cellularity.
Collapse
|
146
|
Park JJ, Kim CK, Park SY, Park BK. Parametrial invasion in cervical cancer: fused T2-weighted imaging and high-b-value diffusion-weighted imaging with background body signal suppression at 3 T. Radiology 2014; 274:734-41. [PMID: 25299787 DOI: 10.1148/radiol.14140920] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE To retrospectively investigate the value of fused T2-weighted and high-b-value diffusion-weighted imaging with background body signal suppression (DWIBS) at 3 T to evaluate parametrial invasion in cervical cancer. MATERIALS AND METHODS In this institutional review board-approved study, 152 consecutive patients with biopsy-proven cervical cancer who underwent radical hysterectomies also underwent pretreatment magnetic resonance imaging (T2-weighted imaging and DWIBS) at 3 T. Two radiologists independently evaluated the presence of parametrial invasion at T2-weighted imaging, fused T2-weighted imaging and high-b-value DWIBS (ie, fused T2-weighted DWIBS), and combined T2-weighted imaging and fused T2-weighted DWIBS, and the results were compared with histopathologic findings. RESULTS Parametrial invasion was identified by pathologic analysis in 37 of 152 patients (24.3%). For association with parametrial invasion, the specificity and accuracy of fused T2-weighted DWIBS (97.4% and 90.1%, respectively, for reader 1; 95.7% and 89.5%, respectively, for reader 2) and combined T2-weighted imaging and fused T2-weighted DWIBS (99.1% and 93.4%, respectively, for reader 1; 96.5% and 92.8%, respectively, for reader 2) were significantly better than those of T2-weighted imaging alone (88.7% and 85.5%, respectively, for reader 1; 85.2% and 83.6%, respectively, for reader 2) (all P < .05). The respective sensitivity of T2-weighted imaging, fused T2-weighted DWIBS, and combined T2-weighted imaging and fused T2-weighted DWIBS was 75.7%, 67.6%, and 75.7% for reader 1 and 78.4%, 70.3%, and 81.1% for reader 2, and did not show significant differences (P value, ≤.375 to >.999). The respective area under the curve for association with parametrial invasion of T2-weighted imaging, fused T2-weighted DWIBS, and combined T2-weighted imaging and fused T2-weighted DWIBS was 0.912, 0.951, and 0.976 for reader 1 and 0.890, 0.932, and 0.968 for reader 2 (P < .05). Interreader agreements were excellent (κ = 0.89, 0.9, and 0.86 for T2-weighted imaging, fused T2-weighted DWIBS, and combined T2-weighted imaging and fused T2-weighted DWIBS, respectively). CONCLUSION Fusion of high-b-value DWIBS with T2-weighted imaging can improve the diagnostic performance in association with parametrial invasion in cervical cancer compared with T2-weighted imaging alone.
Collapse
Affiliation(s)
- Jung Jae Park
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea
| | | | | | | |
Collapse
|
147
|
Tsuji K, Kishi S, Tsuchida T, Yamauchi T, Ikegaya S, Urasaki Y, Fujiwara Y, Ueda T, Okazawa H, Kimura H. Evaluation of staging and early response to chemotherapy with whole-body diffusion-weighted MRI in malignant lymphoma patients: A comparison with FDG-PET/CT. J Magn Reson Imaging 2014; 41:1601-7. [DOI: 10.1002/jmri.24714] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 07/13/2014] [Accepted: 07/15/2014] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kazunobu Tsuji
- Department of Radiology; University of Fukui Hospital; Fukui Japan
| | - Shinji Kishi
- Department of Hematology; University of Fukui Hospital; Fukui Japan
| | - Tatsuro Tsuchida
- Department of Radiology; University of Fukui Hospital; Fukui Japan
| | | | - Satoshi Ikegaya
- Department of Hematology; University of Fukui Hospital; Fukui Japan
| | | | | | - Takanori Ueda
- Department of Hematology; University of Fukui Hospital; Fukui Japan
| | - Hidehiko Okazawa
- Biomedical Imaging Research Center; University of Fukui; Fukui Japan
| | - Hirohiko Kimura
- Department of Radiology; University of Fukui Hospital; Fukui Japan
| |
Collapse
|
148
|
MR evaluation of breast lesions obtained by diffusion-weighted imaging with background body signal suppression (DWIBS) and correlations with histological findings. Magn Reson Imaging 2014; 32:605-9. [DOI: 10.1016/j.mri.2014.03.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 02/12/2014] [Accepted: 03/07/2014] [Indexed: 01/22/2023]
|
149
|
Usefulness of free-breathing readout-segmented echo-planar imaging (RESOLVE) for detection of malignant liver tumors: comparison with single-shot echo-planar imaging (SS-EPI). Eur J Radiol 2014; 83:1728-33. [PMID: 25043495 DOI: 10.1016/j.ejrad.2014.06.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 06/10/2014] [Accepted: 06/14/2014] [Indexed: 01/08/2023]
Abstract
PURPOSE We aimed to clarify the usefulness of free-breathing readout-segmented echo-planar imaging (RESOLVE), which is multi-shot echo-planar imaging based on a 2D-navigator-based reacquisition technique, for detecting malignant liver tumor. MATERIALS AND METHODS In 77 patients with malignant liver tumors, free-breathing RESOLVE and respiratory-triggered single-shot echo-planar imaging (SS-EPI) at 3-T MR unit were performed. We set a scan time up to approximately 5 min (300s) before examination, measured actual scan time and assessed (1) susceptibility and (2) motion artifacts in the right and left liver lobes (3, no artifact; 1, marked), and (3) detectability of malignant liver tumors (3, good; 1, poor) using a 3-point scale. RESULTS The median actual scan time of RESOLVE/SS-EPI was 365/423s. The median scores of each factor in RESOLVE/SS-EPI were as following in this order: (1) 3/2 (right lobe); 3/3 (left lobe), (2) 2/3 (right lobe); 1/2 (left lobe), and (3) 3/3, respectively. Significant differences were noted between RESOLVE and SS-EPI in all evaluated factors (P<0.05) except for susceptibility of left lobe and detectability of the lesions. CONCLUSION Despite the effect of motion artifacts, RESOLVE provides a comparable detectability of the lesion and the advantage of reducing scanning time compared with SS-EPI.
Collapse
|
150
|
Advanced techniques in pediatric abdominopelvic oncologic magnetic resonance imaging. Magn Reson Imaging Clin N Am 2014; 21:829-41. [PMID: 24183528 DOI: 10.1016/j.mric.2013.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Advances in the treatment of pediatric abdominopelvic malignancies have increased survival drastically. Imaging is critical in initial tumor characterization/staging, assessment of treatment response, and surveillance following therapy. Magnetic resonance imaging (MRI) is playing an increasing role in the care of these patients due to its lack of ionizing radiation, superior contrast resolution and the ability to characterize tumors based on tissue characteristics (e.g., T1 and T2 relaxation times). Modern MR techniques also allow for assessment of tumors based on functional characteristics. This article is focused on emerging MRI technologies and potential applications in the imaging of pediatric abdominopelvic malignancies.
Collapse
|