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Di Stasio M, Cordopatri C, Nardi C, Busoni S, Noferini L, Colagrande S, Calistri L. Liver Biliary Function Evaluation on a 1.5T Magnetic Resonance Imaging Scan by T1 Reduction Rate Assessment Using Variable-Flip-Angle Sequences. J Comput Assist Tomogr 2024; 48:354-360. [PMID: 38346811 DOI: 10.1097/rct.0000000000001582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVE Magnetic resonance (MR) relaxometry is an absolute and reproducible quantitative method, compared with signal intensity for the evaluation of liver biliary function. This is obtainable by the T1 reduction rate (T1RR), as it carries a smaller systematic error than the pre/post contrast agent T1 measurement. We aimed to develop and test an MR T1 relaxometry tool tailored for the evaluation of liver T1RR after gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid administration on 1.5T MR. METHODS In vitro/vivo (liver) T1RR values with two 3D FLASH variable-flip-angle sequences were calculated by a MATLAB algorithm. In vitro measurements were done by 2 physicists, in consensus. The prospective in vivo study was approved by the local ethical committee and performed on 13 normal/26 cirrhotic livers. A supplemental test in 5 normal/5 cirrhotic livers, out of the studied series, was done to compare the results of our method (without B1 inhomogeneity correction) and those of a standardized commercial tool (with B1 inhomogeneity correction). All in vivo evaluations were performed by 2 radiologists with 7 years of experience in abdominal imaging. Open-source Java-based software ImageJ was used to draw the free-hand regions of interest on liver section and for the measurement of hepatic T1RR values. The T1RR values of each group of patients were compared to assess statistically significant differences. All statistical analyses were performed with IBM-SPSS Statistics. In vivo evaluations, the intrareader and interreader reliability was assessed by intraclass correlation coefficient. RESULTS Our method showed good accuracy in evaluating in vitro T1RR with a maximum percentage error of 9% (constant at various time points) with T1 values in the 200- to 1400-millisecond range. In vivo, a high concordance between the T1RR evaluated with the proposed method and that calculated from the standardized commercial software was verified ( P < 0.05). The median T1RRs were 74.8, 67.9, and 52.1 for the normal liver, Child-Pugh A, and Child-Pugh B cirrhotic groups, respectively. A very good agreement was found, both within intrareader and interreader reliability, with intraclass correlation coefficient values ranging from 0.88 to 0.95 and from 0.85 to 0.90, respectively. CONCLUSIONS The proposed method allowed accurate reliable in vitro/vivo T1RR assessment evaluation of the liver biliary function after gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid administration.
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Affiliation(s)
- Marco Di Stasio
- From the Department of Experimental and Clinical Biomedical Sciences, University of Florence-Azienda Ospedaliero-Universitaria Careggi
| | - Cesare Cordopatri
- From the Department of Experimental and Clinical Biomedical Sciences, University of Florence-Azienda Ospedaliero-Universitaria Careggi
| | - Cosimo Nardi
- From the Department of Experimental and Clinical Biomedical Sciences, University of Florence-Azienda Ospedaliero-Universitaria Careggi
| | - Simone Busoni
- Department of Health Physics, UOC Fisica Sanitaria, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Linhsia Noferini
- Department of Health Physics, UOC Fisica Sanitaria, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Stefano Colagrande
- From the Department of Experimental and Clinical Biomedical Sciences, University of Florence-Azienda Ospedaliero-Universitaria Careggi
| | - Linda Calistri
- From the Department of Experimental and Clinical Biomedical Sciences, University of Florence-Azienda Ospedaliero-Universitaria Careggi
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Grove RL, Vespa F, Aineseder M, Villamil A, Spina JC. Prognostic role of magnetic resonance imaging of the abdomen with intravenous contrast and magnetic resonance cholangiopancreatography in primary sclerosing cholangitis. Radiol Bras 2023; 56:301-307. [PMID: 38504819 PMCID: PMC10948161 DOI: 10.1590/0100-3984.2023.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/27/2023] [Accepted: 10/17/2023] [Indexed: 03/21/2024] Open
Abstract
Objective To evaluate the usefulness of Anali scores, determined by magnetic resonance imaging, for predicting the prognosis of primary sclerosing cholangitis (PSC) and to analyze interobserver variability, as well as to assess the impact of periportal edema and heterogeneous signal intensity on diffusion-weighted imaging of the liver. Materials and Methods This was a retrospective cohort study of 29 patients with PSC and baseline magnetic resonance imaging. Anali scores, without gadolinium (0-5 points) and with gadolinium (0-2 points), were calculated by two radiologists. Clinical end-points included liver transplantation, cirrhotic decompensation, and death. We calculated intraclass correlation coefficients (ICCs) for interobserver agreement on the Anali scores, performed Kaplan-Meier survival analysis comparing event-free survival among the score strata, and calculated the areas under receiver operating characteristic curves to determine sensitivity and specificity. Results Among the patients with a clinical event, the median Anali score was 4 (interquartile range [IQR], 2-5) without gadolinium and 2 (IQR, 1-2) with gadolinium, compared with 1 (IQR, 1.0-2.5) and 1 (IQR, 0.25-1.0), respectively, among those without a clinical event. The ICC was 0.79 (95% confidence interval: 0.57-0.91) for the Anali score with gadolinium and 0.99 (95% confidence interval: 0.98-0.99) for the Anali score without gadolinium. Periportal edema and heterogeneous signal intensity in the liver on diffusion-weighted imaging showed no statistical impact on clinical events (p = 0.65 and p = 0.5, respectively). Conclusion Anali scores correlate with clinical events in PSC, with a high level of interobserver agreement.
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Affiliation(s)
- Roy López Grove
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos
Aires, Argentina
| | - Florência Vespa
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos
Aires, Argentina
| | - Martina Aineseder
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos
Aires, Argentina
| | - Alejandra Villamil
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos
Aires, Argentina
| | - Juan Carlos Spina
- Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos
Aires, Argentina
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Jackson A, Pathak R, deSouza NM, Liu Y, Jacobs BKM, Litiere S, Urbanowicz-Nijaki M, Julie C, Chiti A, Theysohn J, Ayuso JR, Stroobants S, Waterton JC. MRI Apparent Diffusion Coefficient (ADC) as a Biomarker of Tumour Response: Imaging-Pathology Correlation in Patients with Hepatic Metastases from Colorectal Cancer (EORTC 1423). Cancers (Basel) 2023; 15:3580. [PMID: 37509240 PMCID: PMC10377224 DOI: 10.3390/cancers15143580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Background: Tumour apparent diffusion coefficient (ADC) from diffusion-weighted magnetic resonance imaging (MRI) is a putative pharmacodynamic/response biomarker but the relationship between drug-induced effects on the ADC and on the underlying pathology has not been adequately defined. Hypothesis: Changes in ADC during early chemotherapy reflect underlying histological markers of tumour response as measured by tumour regression grade (TRG). Methods: Twenty-six patients were enrolled in the study. Baseline, 14 days, and pre-surgery MRI were performed per study protocol. Surgical resection was performed in 23 of the enrolled patients; imaging-pathological correlation was obtained from 39 lesions from 21 patients. Results: There was no evidence of correlation between TRG and ADC changes at day 14 (study primary endpoint), and no significant correlation with other ADC metrics. In scans acquired one week prior to surgery, there was no significant correlation between ADC metrics and percentage of viable tumour, percentage necrosis, percentage fibrosis, or Ki67 index. Conclusions: Our hypothesis was not supported by the data. The lack of meaningful correlation between change in ADC and TRG is a robust finding which is not explained by variability or small sample size. Change in ADC is not a proxy for TRG in metastatic colorectal cancer.
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Affiliation(s)
- Alan Jackson
- Centre for Imaging Sciences, University of Manchester, Manchester M20 4GJ, UK
| | - Ryan Pathak
- Centre for Imaging Sciences, University of Manchester, Manchester M20 4GJ, UK
| | - Nandita M deSouza
- CRUK Cancer Imaging Centre, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, London SW7 3RP, UK
| | - Yan Liu
- European Organisation for Research and Treatment of Cancer, 1200 Brussels, Belgium
| | - Bart K M Jacobs
- European Organisation for Research and Treatment of Cancer, 1200 Brussels, Belgium
| | - Saskia Litiere
- European Organisation for Research and Treatment of Cancer, 1200 Brussels, Belgium
| | | | - Catherine Julie
- EA 4340 BECCOH, UVSQ, Universite Paris-Saclay, 92104 Boulogne-Billancourt, France
- Department of Pathology, APHP-Hopital Ambroise Pare, 92100 Boulogne-Billancourt, France
| | - Arturo Chiti
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Bio-Medical Sciences, Humanitas University, 20072 Milan, Italy
| | - Jens Theysohn
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Juan R Ayuso
- Radiology Department-CDI, Hospital Clinic Universitari de Barcelona, 08036 Barcelona, Spain
| | - Sigrid Stroobants
- Molecular Imaging and Radiology, University of Antwerp, 2000 Antwerp, Belgium
| | - John C Waterton
- Centre for Imaging Sciences, University of Manchester, Manchester M20 4GJ, UK
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Møller JM, Østergaard M, Thomsen HS, Hangaard S, Sørensen IJ, Madsen OR, Pedersen SJ. Repeatability and reproducibility of MRI apparent diffusion coefficient applied on four different regions of interest for patients with axial spondyloarthritis and healthy volunteers scanned twice within a week. BJR Open 2021; 2:20200004. [PMID: 33409446 PMCID: PMC7768406 DOI: 10.1259/bjro.20200004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 09/24/2020] [Accepted: 10/28/2020] [Indexed: 11/05/2022] Open
Abstract
Objectives: The apparent diffusion coefficient (ADC) may be used as a biomarker for diagnosis and/or monitoring treatment response in patients with axial spondyloarthritis (axSpA), but this requires reliable ADC measurements. This study assessed test–retest repeatability and reproducibility of ADC measurements using four different region of interest (ROI) settings. Methods: In this prospective study, the sacroiliac joints (SIJs) of 25 patients with axSpA and 24 age- and sex-matched healthy volunteers were imaged twice at a mean interval of 6.8 days in a 1.5 T scanner using, multishot echoplanar diffusion-weighted sequences. ADCs at four ROI settings were assessed: 5 mm and 10 mm anatomic band-shaped, 15 mm linear, and 40 mm2 circular. Results: Intraclass correlation coefficient (ICC) assessments showed that the interstudy repeatability was good for median ADC (ADCmed) and 95th-percentile ADC (ADC95) measurements in patients with axSpA (0.77–0.83 and 0.75–0.83, respectively), but poor-to-moderate in healthy subjects (0.27–0.55 and 0.13–0.37, respectively). For all ROI settings, intrareader reproducibility was excellent for ADCmed-measurements (ICC:0.85–0.99) and moderate-to-excellent for ADC95 measurements (ICC:0.68–0.96). The 5 mm ROI had the least estimated bias and highest level of agreement on Bland–Altman plots. The interreader reproducibility was moderate (ICC:0.71). The 15 mm linear ROI produced significantly greater ADCmed and ADC95 measurements than all other ROI settings (p < 0.01–0.02), except for the circular ROI ADC95 measurements. Conclusion: ROI settings influence ADC measurements. Interstudy repeatability of SIJ ADC measurements is independent of ROI settings. However, the 5 mm ROI showed the least bias and random error and seems preferable. Advances in knowledge: ADC measurements are affected by ROI settings, and this should be taken into account when assessing ADC maps.
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Affiliation(s)
| | | | | | - Stine Hangaard
- Department of Radiology, Herlev-Gentofte Hospital, Herlev, Denmark
| | | | | | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
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Michoux NF, Ceranka JW, Vandemeulebroucke J, Peeters F, Lu P, Absil J, Triqueneaux P, Liu Y, Collette L, Willekens I, Brussaard C, Debeir O, Hahn S, Raeymaekers H, de Mey J, Metens T, Lecouvet FE. Repeatability and reproducibility of ADC measurements: a prospective multicenter whole-body-MRI study. Eur Radiol 2021; 31:4514-4527. [PMID: 33409773 DOI: 10.1007/s00330-020-07522-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/31/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Multicenter oncology trials increasingly include MRI examinations with apparent diffusion coefficient (ADC) quantification for lesion characterization and follow-up. However, the repeatability and reproducibility (R&R) limits above which a true change in ADC can be considered relevant are poorly defined. This study assessed these limits in a standardized whole-body (WB)-MRI protocol. METHODS A prospective, multicenter study was performed at three centers equipped with the same 3.0-T scanners to test a WB-MRI protocol including diffusion-weighted imaging (DWI). Eight healthy volunteers per center were enrolled to undergo test and retest examinations in the same center and a third examination in another center. ADC variability was assessed in multiple organs by two readers using two-way mixed ANOVA, Bland-Altman plots, coefficient of variation (CoV), and the upper limit of the 95% CI on repeatability (RC) and reproducibility (RDC) coefficients. RESULTS CoV of ADC was not influenced by other factors (center, reader) than the organ. Based on the upper limit of the 95% CI on RC and RDC (from both readers), a change in ADC in an individual patient must be superior to 12% (cerebrum white matter), 16% (paraspinal muscle), 22% (renal cortex), 26% (central and peripheral zones of the prostate), 29% (renal medulla), 35% (liver), 45% (spleen), 50% (posterior iliac crest), 66% (L5 vertebra), 68% (femur), and 94% (acetabulum) to be significant. CONCLUSIONS This study proposes R&R limits above which ADC changes can be considered as a reliable quantitative endpoint to assess disease or treatment-related changes in the tissue microstructure in the setting of multicenter WB-MRI trials. KEY POINTS • The present study showed the range of R&R of ADC in WB-MRI that may be achieved in a multicenter framework when a standardized protocol is deployed. • R&R was not influenced by the site of acquisition of DW images. • Clinically significant changes in ADC measured in a multicenter WB-MRI protocol performed with the same type of MRI scanner must be superior to 12% (cerebrum white matter), 16% (paraspinal muscle), 22% (renal cortex), 26% (central zone and peripheral zone of prostate), 29% (renal medulla), 35% (liver), 45% (spleen), 50% (posterior iliac crest), 66% (L5 vertebra), 68% (femur), and 94% (acetabulum) to be detected with a 95% confidence level.
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Affiliation(s)
- Nicolas F Michoux
- Institut de Recherche Expérimentale & Clinique (IREC) - Radiology Department, Université Catholique de Louvain (UCLouvain) - Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B-1200, Brussels, Belgium.
| | - Jakub W Ceranka
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Jef Vandemeulebroucke
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Frank Peeters
- Institut de Recherche Expérimentale & Clinique (IREC) - Radiology Department, Université Catholique de Louvain (UCLouvain) - Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B-1200, Brussels, Belgium
| | - Pierre Lu
- Institut de Recherche Expérimentale & Clinique (IREC) - Radiology Department, Université Catholique de Louvain (UCLouvain) - Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B-1200, Brussels, Belgium
| | - Julie Absil
- Radiology Department, Université libre de Bruxelles, Hôpital Erasme, Brussels, Belgium
| | - Perrine Triqueneaux
- Institut de Recherche Expérimentale & Clinique (IREC) - Radiology Department, Université Catholique de Louvain (UCLouvain) - Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B-1200, Brussels, Belgium
| | - Yan Liu
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Laurence Collette
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | | | | | - Olivier Debeir
- LISA (Laboratories of Image Synthesis and Analysis), Ecole Polytechnique de Bruxelles, Université libre de Bruxelles, Brussels, Belgium
| | - Stephan Hahn
- LISA (Laboratories of Image Synthesis and Analysis), Ecole Polytechnique de Bruxelles, Université libre de Bruxelles, Brussels, Belgium
| | | | | | - Thierry Metens
- Radiology Department, Université libre de Bruxelles, Hôpital Erasme, Brussels, Belgium
| | - Frédéric E Lecouvet
- Institut de Recherche Expérimentale & Clinique (IREC) - Radiology Department, Université Catholique de Louvain (UCLouvain) - Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B-1200, Brussels, Belgium
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Association between liver diffusion-weighted imaging apparent diffusion coefficient values and other measures of liver disease in pediatric autoimmune liver disease patients. Abdom Radiol (NY) 2021; 46:197-204. [PMID: 32462385 DOI: 10.1007/s00261-020-02595-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Multiple quantitative magnetic resonance imaging (MRI) methods have been described to noninvasively detect and characterize liver fibrosis, including diffusion-weighted imaging (DWI). PURPOSE To evaluate associations between liver MRI DWI apparent diffusion coefficient (ADC) values and clinical factors and other quantitative liver MRI metrics in pediatric patients with autoimmune liver disease (AILD). MATERIALS AND METHODS Fifty-seven research liver MRI examinations performed from January 2017 to August 2018 for pediatric AILD registry participants were evaluated. Liver DWI ADC values, liver and spleen stiffness (kPa), and iron-corrected T1 (cT1; Perspectum Diagnostics) were measured at four anatomic levels. Participant age, sex, and laboratory data (alanine aminotransferase [ALT], total bilirubin, alkaline phosphatase, gamma-glutamyl transferase [GGT]) were recorded. Spearman's rank-order correlation (rho) and multiple linear regression were used to evaluate the associations between liver ADC values and predictor variables. RESULTS Mean (SD) participant age was 14.8 (4.0) years, 45.6% (26/57) were girls. Mean liver DWI ADC value was 1.34 (0.14 × 10-3) mm2/s. Liver ADC values showed weak to moderate correlations with liver stiffness (r = - 0.42, p = 0.001), spleen stiffness (r = - 0.34; p = 0.015), whole-liver mean cT1 (r = - 0.39; p = 0.007), ALT (r = - 0.50; p = 0.0001), and GGT (r = - 0.48; p = 0.0004). Multiple linear regression showed liver stiffness (p = 0.0009) and sex (p = 0.023) to be independent predictors of liver ADC values. CONCLUSION Liver DWI ADC values are significantly associated with liver and spleen stiffnesses, liver cT1, ALT, GGT, and participant sex, with liver stiffness and sex remaining significant at multivariable regression. Liver ADC ultimately may play a role in multi-parametric prediction of chronic liver disease/fibrosis severity.
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Ye C, Xu D, Qin Y, Wang L, Wang R, Li W, Kuai Z, Zhu Y. Accurate intravoxel incoherent motion parameter estimation using Bayesian fitting and reduced number of low b-values. Med Phys 2020; 47:4372-4385. [PMID: 32403175 DOI: 10.1002/mp.14233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/02/2020] [Accepted: 04/15/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Intravoxel incoherent motion (IVIM) magnetic resonance imaging is a potential noninvasive technique for the diagnosis of brain tumors. However, perfusion-related parameter mapping is a persistent problem. The purpose of this paper is to investigate the IVIM parameter mapping of brain tumors using Bayesian fitting and low b-values. METHODS Bayesian shrinkage prior (BSP) fitting method and different low b-value distributions were used to estimate IVIM parameters (diffusion D, pseudo-diffusion D*, and perfusion fraction F). The results were compared to those obtained by least squares (LSQ) on both simulated and in vivo brain data. Relative error (RE) and reproducibility were used to evaluate the results. The differences of IVIM parameters between brain tumor and normal regions were compared and used to assess the performance of Bayesian fitting in the IVIM application of brain tumor. RESULTS In tumor regions, the value of D* tended to be decreased when the number of low b-values was insufficient, especially with LSQ. BSP required less low b-values than LSQ for the correct estimation of perfusion parameters of brain tumors. The IVIM parameter maps of brain tumors yielded by BSP had smaller variability, lower RE, and higher reproducibility with respect to those obtained by LSQ. Obvious differences were observed between tumor and normal regions in parameters D (P < 0.05) and F (P < 0.001), especially F. BSP generated fewer outliers than LSQ, and distinguished better tumors from normal regions in parameter F. CONCLUSIONS Intravoxel incoherent motion parameters clearly allow brain tumors to be differentiated from normal regions. Bayesian fitting yields robust IVIM parameter mapping with fewer outliers and requires less low b-values than LSQ for the parameter estimation.
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Affiliation(s)
- Chen Ye
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Daoyun Xu
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Yongbin Qin
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Lihui Wang
- Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, School of Computer Science and Technology, Guizhou University, Guiyang, China
| | - Rongpin Wang
- Department of Radiology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Wuchao Li
- Department of Radiology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Zixiang Kuai
- Harbin Medical University Cancer Hospital, Harbin, China
| | - Yuemin Zhu
- Univ Lyon, INSA Lyon, CNRS, INSERM, CREATIS UMR 5220, U1206, Lyon, F-69621, France
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Peña-Nogales Ó, Hernando D, Aja-Fernández S, de Luis-Garcia R. Determination of optimized set of b-values for Apparent Diffusion Coefficient mapping in liver Diffusion-Weighted MRI. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2020; 310:106634. [PMID: 31710951 DOI: 10.1016/j.jmr.2019.106634] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/21/2019] [Accepted: 10/25/2019] [Indexed: 06/10/2023]
Abstract
In this manuscript we derive the Cramér-Rao Lower Bound (CRLB) of the monoexponential diffusion-weighted signal model under a realistic noise assumption, and propose a formulation to obtain optimized sets of b-values that maximize the noise performance of the Apparent Diffusion Coefficient (ADC) maps given a target ADC and a signal-to-noise ratio. Therefore, for various sets of parameters (S0 and ADC), signal-to-noise ratios (SNR) and noise distribution, we computed optimized sets of b-values using CRLB-based analysis in two different ways: (i) through a greedy algorithm where b-values from a pool of candidates were added iteratively to the set, and (ii) through a two b-value search algorithm were all two b-value combinations of the pool of candidates were tested. Further, optimized sets of b-values were computed from synthetic data, phantoms, and in-vivo liver diffusion-weighted imaging (DWI) experiments to validate the CRLB-based analysis. The optimized sets of b-values obtained through the proposed CRLB-based analysis showed good agreement with the optimized sets obtained experimentally from synthetic, phantoms, and in-vivo liver data. The variance of the ADC maps decreased when employing the optimized set of b-values compared to various sets of b-values proposed in the literature for in-vivo liver DWI, although differences of notable magnitude between noise models and optimization strategies were not found. In addition, the higher b-values decreased for lower SNR under the Rician noise distribution. Optimization of the set b-values is critical to maximize the noise performance (i.e., maximize the precision and minimize the variance) of the estimated ADC maps in diffusion-weighted MRI. Hence, the proposed approach may help to optimize and standardize liver diffusion-weighted MRI acquisitions by computing optimized set of b-values for a given set of parameters.
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Affiliation(s)
- Óscar Peña-Nogales
- Laboratorio de Procesado de Imagen, Universidad de Valladolid, Valladolid, Spain. http://www.lpi.tel.uva.es
| | - Diego Hernando
- Departments of Radiology, Medical Physics, and Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States
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Khoshpouri P, Habibabadi RR, Hazhirkarzar B, Ameli S, Ghadimi M, Ghasabeh MA, Menias CO, Kim A, Li Z, Kamel IR. Imaging Features of Primary Sclerosing Cholangitis: From Diagnosis to Liver Transplant Follow-up. Radiographics 2019; 39:1938-1964. [DOI: 10.1148/rg.2019180213] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Pegah Khoshpouri
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, MRI Room 143, Baltimore, MD 21287 (P.K., R.R.H., B.H., S.A., M.G., M.A.G., A.K., Z.L., I.R.K.); and Department of Radiology, Mayo Clinic Phoenix, Scottsdale, Ariz (C.O.M.)
| | - Roya Rezvani Habibabadi
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, MRI Room 143, Baltimore, MD 21287 (P.K., R.R.H., B.H., S.A., M.G., M.A.G., A.K., Z.L., I.R.K.); and Department of Radiology, Mayo Clinic Phoenix, Scottsdale, Ariz (C.O.M.)
| | - Bita Hazhirkarzar
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, MRI Room 143, Baltimore, MD 21287 (P.K., R.R.H., B.H., S.A., M.G., M.A.G., A.K., Z.L., I.R.K.); and Department of Radiology, Mayo Clinic Phoenix, Scottsdale, Ariz (C.O.M.)
| | - Sanaz Ameli
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, MRI Room 143, Baltimore, MD 21287 (P.K., R.R.H., B.H., S.A., M.G., M.A.G., A.K., Z.L., I.R.K.); and Department of Radiology, Mayo Clinic Phoenix, Scottsdale, Ariz (C.O.M.)
| | - Maryam Ghadimi
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, MRI Room 143, Baltimore, MD 21287 (P.K., R.R.H., B.H., S.A., M.G., M.A.G., A.K., Z.L., I.R.K.); and Department of Radiology, Mayo Clinic Phoenix, Scottsdale, Ariz (C.O.M.)
| | - Mounes Aliyari Ghasabeh
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, MRI Room 143, Baltimore, MD 21287 (P.K., R.R.H., B.H., S.A., M.G., M.A.G., A.K., Z.L., I.R.K.); and Department of Radiology, Mayo Clinic Phoenix, Scottsdale, Ariz (C.O.M.)
| | - Christine O. Menias
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, MRI Room 143, Baltimore, MD 21287 (P.K., R.R.H., B.H., S.A., M.G., M.A.G., A.K., Z.L., I.R.K.); and Department of Radiology, Mayo Clinic Phoenix, Scottsdale, Ariz (C.O.M.)
| | - Amy Kim
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, MRI Room 143, Baltimore, MD 21287 (P.K., R.R.H., B.H., S.A., M.G., M.A.G., A.K., Z.L., I.R.K.); and Department of Radiology, Mayo Clinic Phoenix, Scottsdale, Ariz (C.O.M.)
| | - Zhiping Li
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, MRI Room 143, Baltimore, MD 21287 (P.K., R.R.H., B.H., S.A., M.G., M.A.G., A.K., Z.L., I.R.K.); and Department of Radiology, Mayo Clinic Phoenix, Scottsdale, Ariz (C.O.M.)
| | - Ihab R. Kamel
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, MRI Room 143, Baltimore, MD 21287 (P.K., R.R.H., B.H., S.A., M.G., M.A.G., A.K., Z.L., I.R.K.); and Department of Radiology, Mayo Clinic Phoenix, Scottsdale, Ariz (C.O.M.)
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Diffusion kurtosis imaging in the characterisation of rectal cancer: utilizing the most repeatable region-of-interest strategy for diffusion parameters on a 3T scanner. Eur Radiol 2018; 28:5211-5220. [DOI: 10.1007/s00330-018-5495-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 04/09/2018] [Accepted: 04/17/2018] [Indexed: 01/26/2023]
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11
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Koc Z, Erbay G, Karadeli E. Internal comparison standard for abdominal diffusion-weighted imaging. Acta Radiol 2017; 58:1029-1036. [PMID: 27956463 DOI: 10.1177/0284185116681040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Standards for abdominal diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) measurements, and analysis are required for reproducibility. Purpose To identify optimal internal comparison standards for DWI to normalize the measured ADC for increased accuracy of differentiating malignant and benign abdominal lesions. Material and Methods We retrospectively studied 97 lesions (89 patients; age, 57 ± 13 years) with histopathologically confirmed abdominal disease. Seven normal body parts/contents (normal parenchyma, spleen, kidney, gallbladder bile, paraspinal muscle, spinal cord, and cerebrospinal fluid [CSF]) were assessed as internal references for possible use as comparison standards. Three observers performed ADC measurements. Statistical analyses included interclass correlation coefficients (ICCs), Mann-Whitney and Kruskal-Wallis tests, and coefficient of variation (CV). ROC analyses were performed to assess diagnostic accuracy of lesion ADC and normalized ADC for differentiating lesions. Pathology results were the reference standard. Results Mean and normalized ADCs were significantly lower for malignant lesions than for benign lesions ( P < 0.001). ICC was excellent for all internal references. Gallbladder had the lowest CV. Receiver operating characteristic (ROC) analyses showed that normalized ADCs obtained using normal parenchyma were better than lesion ADCs for differentiating malignant and benign abdominal lesions (area under the curve [AUC], 0.808 and 0.756, respectively). The normalized ADCs obtained using CSF shows higher accuracy than lesion ADCs (0.80 and 0.76, respectively) for differentiating between malignant and benign abdominal lesions. Conclusion The normal parenchyma from a lesion-detected organ can be used as an internal comparison standard for DWI. CSF can be used as a generalizable in plane reference standard.
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Affiliation(s)
- Zafer Koc
- Faculty of Medicine, Department of Radiology, Baskent University, Ankara, Turkey
| | - Gurcan Erbay
- Faculty of Medicine, Department of Radiology, Baskent University, Ankara, Turkey
| | - Elif Karadeli
- Faculty of Medicine, Department of Radiology, Baskent University, Ankara, Turkey
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Albayrak E, Sahin S. Evaluation of upper abdominal organs with DWI in patients with familial Mediterranean fever. Abdom Radiol (NY) 2017; 42:1393-1399. [PMID: 27909774 DOI: 10.1007/s00261-016-1005-3] [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] [Indexed: 01/02/2023]
Abstract
PURPOSE To investigate the diagnostic efficiency of diffusion-weighted magnetic resonance imaging (DWI) for the evaluation of functional changes that can occur in upper abdominal organs in patients with familial Mediterranean fever (FMF). METHODS The study included 50 controls, 45 patients with FMF, and 14 patients with FMF who had accompanying proteinuria. Measurement of apparent diffusion coefficient (ADC) was performed using DWI sections obtained from liver, spleen, kidney, and pancreas parenchyma with 1.5T MRI using b = 500 and b = 1000 s/mm2 values both in patients and control groups. Mean ADC values were compared between patient and control groups. RESULTS Renal ADC values were lower in the patient groups compared to the control group. Additionally, renal ADC values showed further decrease in the patient group in the presence of accompanying proteinuria, when compared to the FMF group without proteinuria (p < 0.001). Based on the ROC analysis, calculated cutoff values for the determination of FMF and FMF accompanied by proteinuria were 2.26 × 10-3 and 2.04 × 10-3 mm2/s, respectively. Liver, spleen, and pancreas ADC values did not show remarkable change between patient and control groups. CONCLUSION Present findings indicate that the presence of FMF and its clinical progression expressed by proteinuria can be differentially determined with renal DWI.
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Intrasession and Intersession Repeatability of Diffusion Tensor Imaging in Healthy Human Liver. J Comput Assist Tomogr 2017; 41:578-585. [DOI: 10.1097/rct.0000000000000572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Xu XQ, Hu H, Su GY, Liu H, Shi HB, Wu FY. Diffusion Weighted Imaging for Differentiating Benign from Malignant Orbital Tumors: Diagnostic Performance of the Apparent Diffusion Coefficient Based on Region of Interest Selection Method. Korean J Radiol 2016; 17:650-6. [PMID: 27587953 PMCID: PMC5007391 DOI: 10.3348/kjr.2016.17.5.650] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 06/10/2016] [Indexed: 12/30/2022] Open
Abstract
Objective To evaluate the differences in the apparent diffusion coefficient (ADC) measurements based on three different region of interest (ROI) selection methods, and compare their diagnostic performance in differentiating benign from malignant orbital tumors. Materials and Methods Diffusion-weighted imaging data of sixty-four patients with orbital tumors (33 benign and 31 malignant) were retrospectively analyzed. Two readers independently measured the ADC values using three different ROIs selection methods including whole-tumor (WT), single-slice (SS), and reader-defined small sample (RDSS). The differences of ADC values (ADC-ROIWT, ADC-ROISS, and ADC-ROIRDSS) between benign and malignant group were compared using unpaired t test. Receiver operating characteristic curve was used to determine and compare their diagnostic ability. The ADC measurement time was compared using ANOVA analysis and the measurement reproducibility was assessed using Bland-Altman method and intra-class correlation coefficient (ICC). Results Malignant group showed significantly lower ADC-ROIWT, ADC-ROISS, and ADC-ROIRDSS than benign group (all p < 0.05). The areas under the curve showed no significant difference when using ADC-ROIWT, ADC-ROISS, and ADC-ROIRDSS as differentiating index, respectively (all p > 0.05). The ROISS and ROIRDSS required comparable measurement time (p > 0.05), while significantly shorter than ROIWT (p < 0.05). The ROISS showed the best reproducibility (mean difference ± limits of agreement between two readers were 0.022 [-0.080–0.123] × 10-3 mm2/s; ICC, 0.997) among three ROI methods. Conclusion Apparent diffusion coefficient values based on the three different ROI selection methods can help to differentiate benign from malignant orbital tumors. The results of measurement time, reproducibility and diagnostic ability suggest that the ROISS method are potentially useful for clinical practice.
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Affiliation(s)
- Xiao-Quan Xu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Hao Hu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Guo-Yi Su
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Hu Liu
- Department of Ophthalmology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Hai-Bin Shi
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Fei-Yun Wu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
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Scan time minimization in hepatic diffusion-weighted imaging: evaluation of the simultaneous multislice acceleration technique with different acceleration factors and gradient preparation schemes. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 29:739-49. [DOI: 10.1007/s10334-016-0553-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/15/2016] [Accepted: 03/16/2016] [Indexed: 01/21/2023]
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16
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Colagrande S, Castellani A, Nardi C, Lorini C, Calistri L, Filippone A. The role of diffusion-weighted imaging in the detection of hepatic metastases from colorectal cancer: A comparison with unenhanced and Gd-EOB-DTPA enhanced MRI. Eur J Radiol 2016; 85:1027-34. [PMID: 27130067 DOI: 10.1016/j.ejrad.2016.02.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 12/14/2015] [Accepted: 02/08/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To compare the role of DWI vs. gadoxetic-acid-disodium enhanced MRI in the detection of colorectal hepatic metastases. METHODS Fifty-four patients with 115 hepatic metastases were included in this retrospective study, approved by the Ethical Board. All patients underwent intraoperative-ultrasound and surgical resection within two weeks after MRI. Images were grouped in 4 sets, which were analyzed by two radiologists in different sessions: unenhanced T1-T2w (set A), set A plus DWI (set B), set A plus gadoxetic-acid-disodium (set C), set A plus DWI plus gadoxetic-acid-disodium (set D). For each set, metastases presence/size/site was reported. Interobserver agreement and statistical significance were assessed by Cohen's kappa and Mc-Nemar's test, respectively. RESULTS Readers' agreement was always very good (k>0.80). Mean sensitivity values were 84.3/92.1/95.6/97.3% for set A/B/C/D, respectively. Mean specificity, positive predicted, negative predicted, and accuracy values strongly and progressively increased in the various set too: from 62.5% (set A) to 85.0% as for specificity, from 92.8% to 97.3% as for positive predicted value, from 41.0% to 85.1% as for negative predicted value, and from 81.1% to 95.5% as for accuracy. For each reader from set A to D, the number of false negatives progressively decreases. CONCLUSIONS For both readers, DWI improved all statistical parameters in the unenhanced examinations, as for nodules either smaller or greater than 1cm, while in the EOB-enhanced examinations DWI prevalently increased specificity/negative predictive value.
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Affiliation(s)
- Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy.
| | - Alessandro Castellani
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy.
| | - Cosimo Nardi
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy.
| | - Chiara Lorini
- Department of Health Science, University of Florence, viale GB Morgagni 48, Florence 50134, Italy.
| | - Linda Calistri
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy.
| | - Antonella Filippone
- Departement of Neurosciences and Imaging, Section of Radiological Imaging, "G. d'Annunzio" University-Ospedale SS. Annunziata, Via dei Vestini, Chieti 66013, Italy.
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Jafar MM, Parsai A, Miquel ME. Diffusion-weighted magnetic resonance imaging in cancer: Reported apparent diffusion coefficients, in-vitro and in-vivo reproducibility. World J Radiol 2016; 8:21-49. [PMID: 26834942 PMCID: PMC4731347 DOI: 10.4329/wjr.v8.i1.21] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/10/2015] [Accepted: 12/07/2015] [Indexed: 02/06/2023] Open
Abstract
There is considerable disparity in the published apparent diffusion coefficient (ADC) values across different anatomies. Institutions are increasingly assessing repeatability and reproducibility of the derived ADC to determine its variation, which could potentially be used as an indicator in determining tumour aggressiveness or assessing tumour response. In this manuscript, a review of selected articles published to date in healthy extra-cranial body diffusion-weighted magnetic resonance imaging is presented, detailing reported ADC values and discussing their variation across different studies. In total 115 studies were selected including 28 for liver parenchyma, 15 for kidney (renal parenchyma), 14 for spleen, 13 for pancreatic body, 6 for gallbladder, 13 for prostate, 13 for uterus (endometrium, myometrium, cervix) and 13 for fibroglandular breast tissue. Median ADC values in selected studies were found to be 1.28 × 10(-3) mm(2)/s in liver, 1.94 × 10(-3) mm(2)/s in kidney, 1.60 × 10(-3) mm(2)/s in pancreatic body, 0.85 × 10(-3) mm(2)/s in spleen, 2.73 × 10(-3) mm(2)/s in gallbladder, 1.64 × 10(-3) mm(2)/s and 1.31 × 10(-3) mm(2)/s in prostate peripheral zone and central gland respectively (combined median value of 1.54×10(-3) mm(2)/s), 1.44 × 10(-3) mm(2)/s in endometrium, 1.53 × 10(-3) mm(2)/s in myometrium, 1.71 × 10(-3) mm(2)/s in cervix and 1.92 × 10(-3) mm(2)/s in breast. In addition, six phantom studies and thirteen in vivo studies were summarized to compare repeatability and reproducibility of the measured ADC. All selected phantom studies demonstrated lower intra-scanner and inter-scanner variation compared to in vivo studies. Based on the findings of this manuscript, it is recommended that protocols need to be optimised for the body part studied and that system-induced variability must be established using a standardized phantom in any clinical study. Reproducibility of the measured ADC must also be assessed in a volunteer population, as variations are far more significant in vivo compared with phantom studies.
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18
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Kuai ZX, Liu WY, Zhang YL, Zhu YM. Generalization of intravoxel incoherent motion model by introducing the notion of continuous pseudodiffusion variable. Magn Reson Med 2015; 76:1594-1603. [DOI: 10.1002/mrm.26064] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/29/2015] [Accepted: 10/29/2015] [Indexed: 12/24/2022]
Affiliation(s)
- Zi-Xiang Kuai
- International Associated Laboratory (LIA)-CNRS Medical Engineering and Theory in Image and Signal Laboratory (Metislab), Harbin Institute of Technology (HIT); Harbin China
- CREATIS, CNRS (UMR 5220); INSERM (U1044); INSA Lyon; Universite de Lyon; Villeurbanne France
| | - Wan-Yu Liu
- International Associated Laboratory (LIA)-CNRS Medical Engineering and Theory in Image and Signal Laboratory (Metislab), Harbin Institute of Technology (HIT); Harbin China
| | - Yan-Li Zhang
- International Associated Laboratory (LIA)-CNRS Medical Engineering and Theory in Image and Signal Laboratory (Metislab), Harbin Institute of Technology (HIT); Harbin China
| | - Yue-Min Zhu
- International Associated Laboratory (LIA)-CNRS Medical Engineering and Theory in Image and Signal Laboratory (Metislab), Harbin Institute of Technology (HIT); Harbin China
- CREATIS, CNRS (UMR 5220); INSERM (U1044); INSA Lyon; Universite de Lyon; Villeurbanne France
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19
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Metens T, Absil J, Denolin V, Bali MA, Matos C. Liver apparent diffusion coefficient repeatability with individually predetermined optimal cardiac timing and artifact elimination by signal filtering. J Magn Reson Imaging 2015; 43:1100-10. [DOI: 10.1002/jmri.25089] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/26/2015] [Indexed: 12/11/2022] Open
Affiliation(s)
- Thierry Metens
- MRI Clinics; Department of Radiology; Hopital Erasme; Universite Libre de Bruxelles; Bruxelles Belgium
| | - Julie Absil
- MRI Clinics; Department of Radiology; Hopital Erasme; Universite Libre de Bruxelles; Bruxelles Belgium
| | | | - Maria Antonietta Bali
- MRI Clinics; Department of Radiology; Hopital Erasme; Universite Libre de Bruxelles; Bruxelles Belgium
| | - Celso Matos
- MRI Clinics; Department of Radiology; Hopital Erasme; Universite Libre de Bruxelles; Bruxelles Belgium
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20
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Malyarenko DI, Ross BD, Chenevert TL. Analysis and correction of gradient nonlinearity bias in apparent diffusion coefficient measurements. Magn Reson Med 2015; 71:1312-23. [PMID: 23794533 DOI: 10.1002/mrm.24773] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE Gradient nonlinearity of MRI systems leads to spatially dependent b-values and consequently high non-uniformity errors (10-20%) in apparent diffusion coefficient (ADC) measurements over clinically relevant field-of-views. This work seeks practical correction procedure that effectively reduces observed ADC bias for media of arbitrary anisotropy in the fewest measurements. METHODS All-inclusive bias analysis considers spatial and time-domain cross-terms for diffusion and imaging gradients. The proposed correction is based on rotation of the gradient nonlinearity tensor into the diffusion gradient frame where spatial bias of b-matrix can be approximated by its Euclidean norm. Correction efficiency of the proposed procedure is numerically evaluated for a range of model diffusion tensor anisotropies and orientations. RESULTS Spatial dependence of nonlinearity correction terms accounts for the bulk (75-95%) of ADC bias for FA = 0.3-0.9. Residual ADC non-uniformity errors are amplified for anisotropic diffusion. This approximation obviates need for full diffusion tensor measurement and diagonalization to derive a corrected ADC. Practical scenarios are outlined for implementation of the correction on clinical MRI systems. CONCLUSIONS The proposed simplified correction algorithm appears sufficient to control ADC non-uniformity errors in clinical studies using three orthogonal diffusion measurements. The most efficient reduction of ADC bias for anisotropic medium is achieved with non-lab-based diffusion gradients.
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Wolff D, van Melle JP, Dijkstra H, Bartelds B, Willems TP, Hillege H, van den Berg AP, Ebels T, Sijens PE, Berger RMF. The Fontan circulation and the liver: A magnetic resonance diffusion-weighted imaging study. Int J Cardiol 2015; 202:595-600. [PMID: 26447669 DOI: 10.1016/j.ijcard.2015.09.088] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 08/10/2015] [Accepted: 09/24/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with a Fontan circulation tend to develop liver fibrosis, liver cirrhosis and even hepatocellular carcinoma. The aim of this study is to use the magnetic resonance technique diffusing-weighted imaging (DWI) for detecting liver fibrosis/cirrhosis in Fontan patients and to establish whether DWI results are associated with functional aspects of the Fontan circulation. METHODS In a cross-sectional study, 59 Fontan patients were evaluated by liver DWI. The association between apparent diffusion coefficients (ADC) and patient characteristics, laboratory measurements and functional aspects of the Fontan circulation (NYHA class, maximum oxygen uptake during exercise and cardiac index) was assessed. RESULTS Liver ADC values were low (0.82×10(-3)±0.11×10(-3) mm2/s) compared with literature values for healthy volunteers and correlated negatively with calculated liver fibrosis/cirrhosis scores (Fib-4 score, p=0.019; AST/ALT ratio, p=0.009) and gamma-glutamyl transferase (p=0.001). Furthermore, ADC values correlated negatively with follow-up duration (p<0.001) and positively with cardiac index (p=0.019). No correlation between ADC values and exercise tests was found. In multivariable analysis, the ADC values were independently correlated with follow-up duration after Fontan completion. CONCLUSIONS The results of the current study suggest that progressive liver damage due to chronic congestion and potential hypoperfusion is reflected in the liver ADC values in Fontan patients. This study highlights that liver damage in the context of the Fontan circulation might be far more common than previously thought, and that the implementation of liver assessment in the routine follow-up of Fontan patients is recommendable.
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Affiliation(s)
- Djoeke Wolff
- Center for Congenital Heart Diseases, Department of Pediatric Cardiology/Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, The Netherlands.
| | - Joost P van Melle
- Center for Congenital Heart Diseases, Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Hildebrand Dijkstra
- Department of Radiology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Beatrijs Bartelds
- Center for Congenital Heart Diseases, Department of Pediatric Cardiology/Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Tineke P Willems
- Department of Radiology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Hans Hillege
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Aad P van den Berg
- Department of Gastroenterology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Tjark Ebels
- Center for Congenital Heart Diseases, Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Paul E Sijens
- Department of Radiology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Rolf M F Berger
- Center for Congenital Heart Diseases, Department of Pediatric Cardiology/Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, The Netherlands
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Giannotti E, Waugh S, Priba L, Davis Z, Crowe E, Vinnicombe S. Assessment and quantification of sources of variability in breast apparent diffusion coefficient (ADC) measurements at diffusion weighted imaging. Eur J Radiol 2015; 84:1729-36. [DOI: 10.1016/j.ejrad.2015.05.032] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/21/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022]
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Assessment of Liver Perfusion by IntraVoxel Incoherent Motion (IVIM) Magnetic Resonance-Diffusion-Weighted Imaging: Correlation With Phase-Contrast Portal Venous Flow Measurements. J Comput Assist Tomogr 2015; 39:365-72. [PMID: 25700227 DOI: 10.1097/rct.0000000000000220] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To prospectively verify, in vivo, Le Bihan's model of signal decay in magnetic resonance/diffusion-weighted imaging (intravoxel incoherent motion) in healthy liver parenchyma. METHODS Informed consent and institutional board approval were obtained. To measure both underfasting and postprandial conditions, apparent, slow, and fast diffusion (D*) coefficients and perfusion fraction of liver parenchyma, 40 healthy volunteers (19 women and 21 men) underwent a 3.0-T magnetic resonance imaging examination, including portal venous flow measurements by a 2-dimensional phase-contrast sequence, and multi-b diffusion-weighted imaging acquired before and 30 minutes after a 600-Kcal meal. Parameters were measured by fitting procedure with regions of interest drawn on the right liver lobe. Paired-sample t test was performed to search for any statistically significant difference between preprandial and postprandial values of each parameter and of portal flow. Pearson correlation coefficients were calculated to evaluate the relationship between portal flow increase and diffusion-weighted imaging parameter changes in postprandial conditions. Interobserver agreement for measurement of the intravoxel incoherent motion parameters was determined, both for preprandial and postprandial values. RESULTS Mean increase in postprandial portal flow was 98% (P < 0.0009). The t test did not show any statistically significant difference between the preprandial and postprandial values for apparent, slow diffusion coefficients and perfusion fraction (P ≥ 0.05), whereas a statistically significant postprandial increase (P < 0.01) of D* was detected. Correlation with portal venous flow increase at Pearson test was statistically significant for D* (P = 0.04) and nonsignificant for the other parameters. All the parameters showed wide variability, with a higher percent coefficient of variation for D*. Interobserver agreement was always greater than 0.70. CONCLUSIONS This study verifies Le Bihan's theory, confirming that in the liver, D* is influenced by perfusional changes related to portal venous flow.
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Ma C, Liu L, Li J, Wang L, Chen LG, Zhang Y, Chen SY, Lu JP. Apparent diffusion coefficient (ADC) measurements in pancreatic adenocarcinoma: A preliminary study of the effect of region of interest on ADC values and interobserver variability. J Magn Reson Imaging 2015; 43:407-13. [PMID: 26182908 DOI: 10.1002/jmri.25007] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 06/30/2015] [Accepted: 06/30/2015] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To assess the influence of region of interest (ROI) on tumor apparent diffusion coefficient (ADC) measurements and interobserver variability in pancreatic ductal adenocarcinoma (PDAC). MATERIALS AND METHODS Twenty-two patients recruited with pathology-proven PDAC underwent diffusion-weighted imaging (DWI, 3.0T) prior to the surgical resection. Two independent readers measured tumor ADCs according to three ROI methods: whole-volume, single-slice, and small solid sample of tumor. Minimum and mean ADCs were obtained. The interobserver variability for each of the three methods was analyzed using interclass correlation coefficient (ICC) and Bland-Altman analysis. The minimum and mean ADCs among the ROI methods were compared using nonparametric tests. RESULTS The single-slice ROI method showed the best reproducibility in the minimum ADC measurements (mean difference ± limits of agreement between two readers were 0.025 ± 0.25 × 10(-3) mm2 /s; ICC, 0.92) among the three ROI methods. For the solid tumor sample ROI, both minimum ADC and mean ADC measurements reproducibility were the worst, with limits of agreement up to ±0.50 × 10(-3) mm2 /s and ±0.32 × 10(-3) mm2 /s, respectively (ICCs, 0.41/0.58). Both the minimum and mean ADCs demonstrated significant differences among the three ROI methods (both P < 0.001). The post-hoc analyses results showed no significant difference with regard to the mean ADCs between whole-volume and single-slice ROI methods (P = 0.14). CONCLUSION The ROI method had a considerable influence on both the minimum and mean ADC values and the interobserver variability in PDAC. The worst interobserver variability was observed for both the minimum and mean ADCs derived from small solid-sample ROI.
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Affiliation(s)
- Chao Ma
- Department of Radiology, Changhai Hospital of Shanghai, Second Military Medical University, Shanghai, China
| | - Li Liu
- Department of Radiology, Changhai Hospital of Shanghai, Second Military Medical University, Shanghai, China
| | - Jing Li
- Department of Radiology, Changhai Hospital of Shanghai, Second Military Medical University, Shanghai, China
| | - Li Wang
- Department of Radiology, Changhai Hospital of Shanghai, Second Military Medical University, Shanghai, China
| | - Lu-Guang Chen
- Department of Radiology, Changhai Hospital of Shanghai, Second Military Medical University, Shanghai, China
| | - Yong Zhang
- GE Healthcare, MR Group, Shanghai, China
| | - Shi-Yue Chen
- Department of Radiology, Changhai Hospital of Shanghai, Second Military Medical University, Shanghai, China
| | - Jian-Ping Lu
- Department of Radiology, Changhai Hospital of Shanghai, Second Military Medical University, Shanghai, China
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Montanholi YR, Lim M, Macdonald A, Smith BA, Goldhawk C, Schwartzkopf-Genswein K, Miller SP. Technological, environmental and biological factors: referent variance values for infrared imaging of the bovine. J Anim Sci Biotechnol 2015. [PMID: 26217486 PMCID: PMC4515930 DOI: 10.1186/s40104-015-0027-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Despite its variety of potential applications, the wide implementation of infrared technology in cattle production faces technical, environmental and biological challenges similar to other indicators of metabolic state. Nine trials, divided into three classes (technological, environmental and biological factors) were conducted to illustrate the influence of these factors on body surface temperature assessed through infrared imaging. Results Evaluation of technological factors indicated the following: measurements of body temperatures were strongly repeatable when taken within 10 s; appropriateness of differing infrared camera technologies was influenced by distance to the target; and results were consistent when analysis of thermographs was compared between judges. Evaluation of environmental factors illustrated that wind and debris caused decreases in body surface temperatures without affecting metabolic rate; additionally, body surface temperature increased due to sunlight but returned to baseline values within minutes of shade exposure. Examination/investigation/exploration of animal factors demonstrated that exercise caused an increase in body surface temperature and metabolic rate. Administration of sedative and anti-sedative caused changes on body surface temperature and metabolic rate, and during late pregnancy a foetal thermal imprint was visible through abdominal infrared imaging. Conclusion The above factors should be considered in order to standardize operational procedures for taking thermographs, thereby optimizing the use of such technology in cattle operations.
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Affiliation(s)
- Yuri R Montanholi
- Department of Animal and Poultry Science, University of Guelph, Guelph, ON N1G 2W1 Canada ; Department of Plant and Animal Sciences, Dalhousie University, Truro, NS B2N 5E3 Canada
| | - Melissa Lim
- Department of Animal and Poultry Science, University of Guelph, Guelph, ON N1G 2W1 Canada
| | - Alaina Macdonald
- Department of Animal and Poultry Science, University of Guelph, Guelph, ON N1G 2W1 Canada
| | - Brock A Smith
- Department of Animal and Poultry Science, University of Guelph, Guelph, ON N1G 2W1 Canada ; Monsanto, Headingley, MB R3T 6E3 Canada
| | - Christy Goldhawk
- Agriculture and Agri-Food Canada, Lethbridge, AB T1J 4B1 Canada ; Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4Z6 Canada
| | | | - Stephen P Miller
- Department of Animal and Poultry Science, University of Guelph, Guelph, ON N1G 2W1 Canada ; Invermay Agricultural Centre, AgResearch Limited, Mosgiel, 9053 New Zealand
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Belli G, Busoni S, Ciccarone A, Coniglio A, Esposito M, Giannelli M, Mazzoni LN, Nocetti L, Sghedoni R, Tarducci R, Zatelli G, Anoja RA, Belmonte G, Bertolino N, Betti M, Biagini C, Ciarmatori A, Cretti F, Fabbri E, Fedeli L, Filice S, Fulcheri CPL, Gasperi C, Mangili PA, Mazzocchi S, Meliadò G, Morzenti S, Noferini L, Oberhofer N, Orsingher L, Paruccini N, Princigalli G, Quattrocchi M, Rinaldi A, Scelfo D, Freixas GV, Tenori L, Zucca I, Luchinat C, Gori C, Gobbi G. Quality assurance multicenter comparison of different MR scanners for quantitative diffusion-weighted imaging. J Magn Reson Imaging 2015; 43:213-9. [PMID: 26013043 DOI: 10.1002/jmri.24956] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 05/11/2015] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To propose a magnetic resonance imaging (MRI) quality assurance procedure that can be used for multicenter comparison of different MR scanners for quantitative diffusion-weighted imaging (DWI). MATERIALS AND METHODS Twenty-six centers (35 MR scanners with field strengths: 1T, 1.5T, and 3T) were enrolled in the study. Two different DWI acquisition series (b-value ranges 0-1000 and 0-3000 s/mm(2) , respectively) were performed for each MR scanner. All DWI acquisitions were performed by using a cylindrical doped water phantom. Mean apparent diffusion coefficient (ADC) values as well as ADC values along each of the three main orthogonal directions of the diffusion gradients (x, y, and z) were calculated. Short-term repeatability of ADC measurement was evaluated for 26 MR scanners. RESULTS A good agreement was found between the nominal and measured mean ADC over all the centers. More than 80% of mean ADC measurements were within 5% from the nominal value, and the highest deviation and overall standard deviation were 9.3% and 3.5%, respectively. Short-term repeatability of ADC measurement was found <2.5% for all MR scanners. CONCLUSION A specific and widely accepted protocol for quality controls in DWI is still lacking. The DWI quality assurance protocol proposed in this study can be applied in order to assess the reliability of DWI-derived indices before tackling single- as well as multicenter studies.
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Affiliation(s)
| | | | | | - Angela Coniglio
- Medical Physics Department, Fondazione Fatebenefratelli per la Ricerca e la Formazione sanitaria e sociale, San Giovanni Calibita Hospital, Rome, Italy
| | | | | | | | - Luca Nocetti
- Medical Phisics Department, AOU Policlinico Modena, Italy
| | - Roberto Sghedoni
- Medical Physics Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | | | | | | | | | - Nicola Bertolino
- UO Direzione Sanitaria, IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Margherita Betti
- Health Physics Unit, Centro Oncologico Fiorentino, Sesto Fiorentino, Italy
| | - Cristiano Biagini
- Radiodiagnostic Unit, Centro Oncologico Fiorentino, Sesto Fiorentino, Italy
| | | | | | - Emma Fabbri
- Health Physics Unit, Ospedale Sant'Orsola-Malpighi, Bologna, Italy
| | - Luca Fedeli
- Health Physics Unit, AOU Careggi, Florence, Italy
| | | | | | | | | | | | | | | | | | - Nadia Oberhofer
- Health Physics Unit, Azienda Sanitaria dell'Alto Adige-Ospedale Bolzano, Italy
| | - Laura Orsingher
- Medical Physics Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | | | | | | | - Adele Rinaldi
- Medical Physics Department, Fondazione Fatebenefratelli per la Ricerca e la Formazione sanitaria e sociale, San Giovanni Calibita Hospital, Rome, Italy
| | - Danilo Scelfo
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy
| | | | - Leonardo Tenori
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy; FiorGen Foundation, Sesto Fiorentino, Italy
| | - Ileana Zucca
- UO Direzione Scientifica, IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Claudio Luchinat
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy; FiorGen Foundation, Sesto Fiorentino, Italy
| | - Cesare Gori
- Health Physics Unit, AOU Careggi, Florence, Italy
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Colagrande S, Regini F, Taliani GG, Nardi C, Inghilesi AL. Advanced hepatocellular carcinoma and sorafenib: Diagnosis, indications, clinical and radiological follow-up. World J Hepatol 2015; 7:1041-1053. [PMID: 26052393 PMCID: PMC4450181 DOI: 10.4254/wjh.v7.i8.1041] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 12/27/2014] [Accepted: 02/02/2015] [Indexed: 02/06/2023] Open
Abstract
Advanced stage hepatocellular carcinoma (HCC) is a category of disease defined by radiological, clinical and hepatic function parameters, comprehending a wide range of patients with different general conditions. The main therapeutic option is represented by sorafenib treatment, a multi-kinase inhibitor with anti-proliferative and anti-angiogenic effect. Trans-arterial Radio Embolization also represents a promising new approach to intermediate/advanced HCC. Post-marketing clinical studies showed that only a portion of patients actually benefits from sorafenib treatment, and an even smaller percentage of patients treated shows partial/complete response on follow-up examinations, up against relevant costs and an incidence of drug related adverse effects. Although the treatment with sorafenib has shown a significant increase in mean overall survival in different studies, only a part of patients actually shows real benefits, while the incidence of drug related significant adverse effects and the economic costs are relatively high. Moreover, only a small percentage of patients also shows a response in terms of lesion dimensions reduction. Being able to properly differentiate patients who are responding to the therapy from non-responders as early as possible is then still difficult and could be a pivotal challenge for the future; in fact it could spare several patients a therapy often difficult to bear, directing them to other second line treatments (many of which are at the moment still under investigation). For this reason, some supplemental criteria to be added to the standard modified Response Evaluation Criteria in Solid Tumors evaluation are being searched for. In particular, finding some parameters (cellular density, perfusion grade and enhancement rate) able to predict the sensitivity of the lesions to anti-angiogenic agents could help in stratifying patients in terms of treatment responsiveness before the beginning of the therapy itself, or in the first weeks of sorafenib treatment. This would bring a strongly desirable help in clinical managements of these patients.
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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.
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Cercueil JP, Petit JM, Nougaret S, Soyer P, Fohlen A, Pierredon-Foulongne MA, Schembri V, Delhom E, Schmidt S, Denys A, Aho S, Guiu B. Intravoxel incoherent motion diffusion-weighted imaging in the liver: comparison of mono-, bi- and tri-exponential modelling at 3.0-T. Eur Radiol 2014; 25:1541-50. [PMID: 25527431 DOI: 10.1007/s00330-014-3554-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 10/31/2014] [Accepted: 12/03/2014] [Indexed: 12/18/2022]
Abstract
PURPOSE To determine whether a mono-, bi- or tri-exponential model best fits the intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) signal of normal livers. MATERIALS AND METHODS The pilot and validation studies were conducted in 38 and 36 patients with normal livers, respectively. The DWI sequence was performed using single-shot echoplanar imaging with 11 (pilot study) and 16 (validation study) b values. In each study, data from all patients were used to model the IVIM signal of normal liver. Diffusion coefficients (Di ± standard deviations) and their fractions (fi ± standard deviations) were determined from each model. The models were compared using the extra sum-of-squares test and information criteria. RESULTS The tri-exponential model provided a better fit than both the bi- and mono-exponential models. The tri-exponential IVIM model determined three diffusion compartments: a slow (D1 = 1.35 ± 0.03 × 10(-3) mm(2)/s; f1 = 72.7 ± 0.9 %), a fast (D2 = 26.50 ± 2.49 × 10(-3) mm(2)/s; f2 = 13.7 ± 0.6 %) and a very fast (D3 = 404.00 ± 43.7 × 10(-3) mm(2)/s; f3 = 13.5 ± 0.8 %) diffusion compartment [results from the validation study]. The very fast compartment contributed to the IVIM signal only for b values ≤15 s/mm(2) CONCLUSION: The tri-exponential model provided the best fit for IVIM signal decay in the liver over the 0-800 s/mm(2) range. In IVIM analysis of normal liver, a third very fast (pseudo)diffusion component might be relevant. KEY POINTS • For normal liver, tri-exponential IVIM model might be superior to bi-exponential • A very fast compartment (D = 404.00 ± 43.7 × 10 (-3) mm (2) /s; f = 13.5 ± 0.8 %) is determined from the tri-exponential model • The compartment contributes to the IVIM signal only for b ≤ 15 s/mm(2).
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Girometti R, Maieron M, Lissandrello G, Bazzocchi M, Zuiani C. Test-retest reliability of diffusion tensor imaging of the liver at 3.0 T. Radiol Med 2014; 120:489-97. [PMID: 25421264 DOI: 10.1007/s11547-014-0479-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 07/17/2014] [Indexed: 12/12/2022]
Abstract
PURPOSE This study was done to evaluate test-retest reliability of liver diffusion tensor imaging (LDTI). MATERIALS AND METHODS Ten healthy volunteers (median age 23 years) underwent two LDTI scans on a 3.0 T magnet during two imaging sessions separated by 2 weeks (session-1/-2, respectively). Fifteen gradient directions and b values of 0-1,000 s/mm(2) were used. Two radiologists in consensus assessed liver apparent diffusion coefficient (ADC) and fraction of anisotropy (FA) values on ADC and FA maps at four reference levels, namely: right upper level (RUL), right lower level (RLL), left upper level (LUL) and left lower level (LLL). We then assessed (a) whether ADC and FA values overlapped when measured on different levels within the same imaging session or between different imaging sessions; (b) the degree of variability on an intra-session and inter-session basis, respectively, using the coefficient of variation (CV). RESULTS In sessions 1 and 2, the ADC/FA values were significantly larger in the left liver lobe (LUL/LLL) compared to right liver lobe (RUL/RLL) (p < 0.05/6). Intra-session CVs were 9.51 % (session 1) and 9.73 % (session 2) for ADC, and 12.93 % (session 1) and 11.82 % (session 2) for FA, respectively. When comparing RUL, RLL, LUL and LLL on an inter-session basis, CVs were 6.52, 8.20, 6.52 and 11.06 % for ADC, and 15.42, 15.80, 15.42 and 6.80 % for FA, respectively. CONCLUSION LDTI provides consistent and repeatable measurements. However, since larger left lobe ADC/FA values can be attributed to artefacts, right lobe values should be considered the most reliable measurements of water diffusivity within the liver.
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Affiliation(s)
- Rossano Girometti
- Department of Medical and Biological Sciences, Institute of Diagnostic Radiology, University of Udine, Via Colugna n. 50, 33100, Udine, Italy,
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Magnetic resonance imaging of the liver: apparent diffusion coefficients from multiexponential analysis of b values greater than 50 s/mm2 do not respond to caloric intake despite increased portal-venous blood flow. Invest Radiol 2014; 49:138-46. [PMID: 24169068 DOI: 10.1097/rli.0000000000000005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE The purpose of this study was to measure potential changes of the apparent diffusion coefficient (ADC) in diffusion-weighted imaging of the liver before and after caloric challenge in correlation to the induced changes in portal vein flow. MATERIALS AND METHODS The study was approved by the local ethics committee. Each of 10 healthy volunteers underwent 4 measurements in a 1.5-T whole-body magnetic resonance scanner on 2 different days: a first scan after fasting for at least 8 hours and a second scan 30 minutes after intake of a standardized caloric either a protein- or carbohydrate-rich meal. Diffusion-weighted spin-echo echo-planar magnetic resonance images were acquired at b values of 0, 50, 150, 250, 500, 750, and 1000 s/mm. In addition, portal vein flow was quantified with 2-dimensional phase-contrast imaging (velocity encoding parallel to flow direction, 60 cm/s). Mean ADC values for regions of interest in 3 different slices were measured from b50 to b250 and from b500 to b1000 images. RESULTS Carbohydrate- and protein-rich food intake both resulted in a substantial increase in the portal vein flow (fasting state, 638.6 ± 202.3 mL/min; after protein intake, 1322 ± 266.8; after carbohydrate intake, 1767 ± 421.6). The signal decay with increasingly strong diffusion weighting (b values from 0 to 1000 s/mm2) exhibited a triexponential characteristic, implying fast, intermediate, and slow-moving water-molecule proton-spin ensembles in the liver parenchyma. Mean ADC for high b values (b500-b1000) after fasting was 0.93 ± 0.09 × 10 mm/s; that after protein intake, 0.93 ± 0.11 × 10; and that after carbohydrate intake, 0.93 ± 0.08 × 10. For intermediate b values (b50-b250), the signal-decay constants were 1.27 ± 0.14 × 10 mm/s, 1.28 ± 0.15 × 10, and 1.31 ± 0.09 × 10, respectively. There was no statistically significant difference between fasting and caloric challenge. CONCLUSIONS The postprandial increase in portal vein flow is not accompanied by a change of liver parenchymal ADC values. In clinical diffusion imaging, patients may be scanned without prescan food-intake preparations. To minimize interference of perfusion effects, liver-tissue molecular water diffusion should be quantified using high b values (≥500 s/mm) only.
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Rosenkrantz AB, Geppert C, Kiritsy M, Feiweier T, Mossa DJ, Chandarana H. Diffusion-weighted imaging of the liver: comparison of image quality between monopolar and bipolar acquisition schemes at 3T. ACTA ACUST UNITED AC 2014; 40:289-98. [DOI: 10.1007/s00261-014-0215-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Abstract
In this article, functional magnetic resonance (MR) imaging techniques in the abdomen are discussed. Diffusion-weighted imaging (DWI) increases the confidence in detecting and characterizing focal hepatic lesions. The potential uses of DWI in kidneys, adrenal glands, bowel, and pancreas are outlined. Studies have shown potential use of quantitative dynamic contrast-enhanced MR imaging parameters, such as K(trans), in predicting outcomes in cancer therapy. MR elastography is considered to be a useful tool in staging liver fibrosis. A major issue with all functional MR imaging techniques is the lack of standardization of the protocol.
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Affiliation(s)
- Kumar Sandrasegaran
- Department of Radiology, Indiana University School of Medicine, 550 N University Blvd, UH 0279, Indianapolis, IN 46202, USA.
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Mungai F, Morone M, Villanacci A, Bondioni MP, Mazzoni LN, Grazioli L, Colagrande S. Diffusion weighted MR and apparent diffusion coefficient measurement in classification and characterization of noncystic focal liver lesions: does a clinical role exist? Medicine (Baltimore) 2014; 93:e40. [PMID: 25058143 PMCID: PMC4602426 DOI: 10.1097/md.0000000000000040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The objective of this study was to assess the clinical role of apparent diffusion coefficient (ADC) analysis in noncystic focal liver lesion (FLL) classification/characterization.Six hundred liver magnetic resonances with multi-b (b = 50, 400, 800 s/mm) diffusion-weighted imaging (DwI) were retrospectively reviewed. Mean ADC was measured in 388 lesions (195 benign and 193 malignant) excluding internal necrotic areas. Cystic benign lesions were excluded from analysis. Sensitivity and specificity in distinguishing benign from malignant lesions were calculated. Analysis of variance was performed to detect differences among subgroups of solid lesions.Mean ADC of malignant lesions was 0.980 × 10 mm/s, significantly (P < 0.05) lower than mean ADC of benign lesions (1.433 × 10 mm/s). Applying an ADC cutoff of 1.066 × 10 mm/s, specificity and sensitivity for malignancy were respectively 86.6% and 73.6%. Of all lesions, >1/3 (39.5%) presented values lower than 1 × 10 mm/s, with 90.0% chance of malignancy. Above 1.5 × 10 mm/s (about 20% of all lesions) chance of malignancy was 9.5%.DwI cannot assist in noncystic FLL characterization, but can help in FLL classification in about half the cases.
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Affiliation(s)
- Francesco Mungai
- Department of Radiology (MM, MPB, LG), Institute of Hygiene, Epidemiology and Public Health, University of Brescia, Spedali Civili di Brescia, Piazzale Spedali Civili 1, Brescia, Department of Radiology (AV), Ospedale S. Cuore di Gesù, Viale Principe di Napoli, 14/A, Benevento, and Department of Experimental and Clinical Biomedical Sciences (FM, SC), Radiodiagnostic Unit no. 2 and Department of Physics (LNM), University of Florence, Azienda Ospedaliero, Universitaria Careggi, Largo Brambilla 3, Florence, Italy
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The effect of respiratory and cardiac motion in liver diffusion tensor imaging (DTI). J Comput Assist Tomogr 2014; 38:352-9. [PMID: 24681854 DOI: 10.1097/rct.0000000000000064] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the effect of respiratory and cardiac motion on diffusion tensor imaging (DTI) metrics in healthy human liver. METHODS Fifteen healthy subjects, participating in either part of this study, were scanned using a 1.5-T magnetic resonance imaging (MRI) device. Coronal liver DTI (6 diffusion-encoding directions; b, 300 mm/s) during breath holding was compared to free breathing. Cardiac motion effects were evaluated by comparing breath-held DTI scans acquired during both diastole and systole. RESULTS Free breathing resulted in a significantly increased mean diffusivity (P < 0.05), λ1 (P < 0.01), λ2 (P < 0.05), and λ3 (P < 0.01) compared to breath holding. During systole significant increases in fractional anisotropy (P < 0.05), mean diffusivity (P < 0.05), and λ1 (P < 0.05), compared to systole, were found in the left lobe. The right lobe, which is less affected by cardiac motion, showed no significant change in DTI metrics over the cardiac cycle. CONCLUSIONS Respiratory and cardiac motion tends to increase liver DTI metrics.
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Lee Y, Kim H. Assessment of diffusion tensor MR imaging (DTI) in liver fibrosis with minimal confounding effect of hepatic steatosis. Magn Reson Med 2014; 73:1602-8. [PMID: 24733754 DOI: 10.1002/mrm.25253] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 03/10/2014] [Accepted: 03/25/2014] [Indexed: 02/06/2023]
Abstract
PURPOSE Given the potential confounding effect of fat on apparent diffusion coefficient (ADC) in the liver, we have assessed diffusion tensor imaging in liver fibrosis with minimal effect of fat on ADC and fractional anisotropy (FA). METHODS Thirty-six mice were used, among which 20 mice were CCl4 treated for fibrosis induction. Diffusion tensor imaging was performed at 9.4T using a spin-echo diffusion tensor imaging sequence with six gradient directions. Hepatic fat fraction obtained by MR spectroscopy was used as hepatic fat content. Fibrosis scores were obtained from histopathology. RESULTS The hepatic fat fractions of the two animal groups were below 5.5% and not different (5.3 ± 1.5 vs. 4.6 ± 1.1%; P = 0.115). Fibrosis scores were higher in CCl4 -treated mice (0.0 ± 0.0 vs. 2.1 ± 0.7; P < 0.001). Nonetheless, there was no difference in ADC between the two groups (0.711 ± 0.068 × 10(-3) vs. 0.718 ± 0.095 × 10(-3) mm(2) s(-1) ; P = 0.911). The treated group had a lower FA than control (0.552 ± 0.050 vs. 0.586 ± 0.013; P = 0.023). ADC was not correlated with hepatic fat fraction and fibrosis. FA was correlated with hepatic fat fraction (r = 0.418, P = 0.011) and fibrosis (r = -0.411, P = 0.012). CONCLUSION FA may be more sensitive to mild-to-moderate liver fibrosis than ADC. In addition to ADC, FA may also be sensitive to hepatic fat content, and therefore need careful interpretation in liver fibrosis with concomitant fatty liver.
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Affiliation(s)
- Yunjung Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
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Li G, Xu P, Pan X, Qin H, Chen Y. The effect of age on apparent diffusion coefficient values in normal spleen: A preliminary study. Clin Radiol 2014; 69:e165-7. [DOI: 10.1016/j.crad.2013.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/21/2013] [Accepted: 11/26/2013] [Indexed: 01/19/2023]
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Mungai F, Pasquinelli F, Mazzoni LN, Virgili G, Ragozzino A, Quaia E, Morana G, Giovagnoni A, Grazioli L, Colagrande S. Diffusion-weighted magnetic resonance imaging in the prediction and assessment of chemotherapy outcome in liver metastases. Radiol Med 2014; 119:625-33. [PMID: 24408046 DOI: 10.1007/s11547-013-0379-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 06/25/2013] [Indexed: 12/16/2022]
Abstract
PURPOSE This study assessed the capability of magnetic resonance (MR) diffusion-weighted imaging (DwI) with measurement of apparent diffusion coefficient (ADC) in both predicting and evaluating the response to chemotherapy (CHT) of liver metastases by itself and along with preliminary dimensional assessment. METHODS AND MATERIALS Patients affected by liver metastases from cancers of the digestive tract and breast were prospectively enrolled and underwent computed tomography and MR-DwI before CHT (time 0) and 20-25 days after the beginning of the second cycle (time 3). Moreover, MR-DwI was performed 10-15 (time 1) and 20-25 days (time 2) after the beginning of the first cycle. Maximum diameter and mean ADC value (×10(-3) mm(2)/s) of metastases were evaluated. Lesions were classified as progressive disease (PD), stable disease (SD) or partial response (PR) according to dimensional changes between time 0 and time 3, following RECIST 1.1 indications. Clinically, PD lesions were defined as nonresponding (NR), and SD and PR lesions as responding (R). Analysis of variance and ROC analyses were performed (significance at p < 0.05). RESULTS Eighty-six metastases (33 patients) were classified as follows: 15 PD, 39 SD and 32 PR without significant differences in mean ADC values among the groups before CHT and at all corresponding times. The mean ADC values of SD and PR groups at times 1 (respectively 1.66 ± 0.36 and 1.59 ± 0.23), 2 (1.72 ± 0.42 and 1.68 ± 0.37) and 3 (1.86 ± 0.44 and 1.73 ± 0.39) were significantly higher than the corresponding values at time 0 (1.50 ± 0.30 and 1.39 ± 0.33). An accurate cutoff value of ADC increase or diameter decrease for the early identification of R or NR lesions was not found. CONCLUSION The pretreatment ADC value of a liver metastasis does not seem useful in predicting the CHT outcome. A trend towards early ADC increase, alone or occurring with dimensional decrease, may be a good indicator of a responding lesion.
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Affiliation(s)
- Francesco Mungai
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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Kakite S, Dyvorne H, Besa C, Cooper N, Facciuto M, Donnerhack C, Taouli B. Hepatocellular carcinoma: short-term reproducibility of apparent diffusion coefficient and intravoxel incoherent motion parameters at 3.0T. J Magn Reson Imaging 2014; 41:149-56. [PMID: 24415565 DOI: 10.1002/jmri.24538] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 11/05/2013] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate short-term test-retest and interobserver reproducibility of IVIM (intravoxel incoherent motion) diffusion parameters and ADC (apparent diffusion coefficient) of hepatocellular carcinoma (HCC) and liver parenchyma at 3.0T. MATERIALS AND METHODS In this prospective Institutional Review Board (IRB)-approved study, 11 patients were scanned twice using a free-breathing single-shot echo-planar-imaging, diffusion-weighted imaging (DWI) sequence using 4 b values (b = 0, 50, 500, 1000 s/mm(2)) and IVIM DWI using 16 b values (0-800 s/mm(2)) at 3.0T. IVIM parameters (D: true diffusion coefficient, D*: pseudodiffusion coefficient, PF: perfusion fraction) and ADC (using 4 b and 16 b) were calculated. Short-term test-retest and interobserver reproducibility of IVIM parameters and ADC were assessed by measuring correlation coefficient, coefficient of variation (CV), and Bland-Altman limits of agreements (BA-LA). RESULTS Fifteen HCCs were assessed in 10 patients. Reproducibility of IVIM metrics in HCC was poor for D* and PF (mean CV 60.6% and 37.3%, BA-LA: -161.6% to 135.3% and -66.2% to 101.0%, for D* and PF, respectively), good for D and ADC (CV 19.7% and <16%, BA-LA -57.4% to 36.3% and -38.2 to 34.1%, for D and ADC, respectively). Interobserver reproducibility was on the same order of test-retest reproducibility except for PF in HCC. Reproducibility of diffusion parameters was better in liver parenchyma compared to HCC. CONCLUSION Poor reproducibility of D*/PF and good reproducibility for D/ADC were observed in HCC and liver parenchyma. These findings may have implications for trials using DWI in HCC.
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Affiliation(s)
- Suguru Kakite
- Department of Radiology/Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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40
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Mazzoni LN, Lucarini S, Chiti S, Busoni S, Gori C, Menchi I. Diffusion-weighted signal models in healthy and cancerous peripheral prostate tissues: Comparison of outcomes obtained at different b-values. J Magn Reson Imaging 2013; 39:512-8. [DOI: 10.1002/jmri.24184] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 04/01/2013] [Indexed: 01/31/2023] Open
Affiliation(s)
- Lorenzo N. Mazzoni
- Health Physics Unit; Azienda Ospedaliero-Universitaria Careggi; Florence Italy
| | - Silvia Lucarini
- Medical Imaging Department; Azienda Ospedaliero-Universitaria Careggi; Florence Italy
| | - Stefano Chiti
- Medical Imaging Department; Azienda Ospedaliero-Universitaria Careggi; Florence Italy
| | - Simone Busoni
- Health Physics Unit; Azienda Ospedaliero-Universitaria Careggi; Florence Italy
| | - Cesare Gori
- Health Physics Unit; Azienda Ospedaliero-Universitaria Careggi; Florence Italy
| | - Ilario Menchi
- Medical Imaging Department; Azienda Ospedaliero-Universitaria Careggi; Florence Italy
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41
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Lee YJ, Lee JM, Lee JE, Lee KB, Lee ES, Yoon JH, Yu MH, Baek JH, Shin CI, Han JK, Choi BI. MR elastography for noninvasive assessment of hepatic fibrosis: Reproducibility of the examination and reproducibility and repeatability of the liver stiffness value measurement. J Magn Reson Imaging 2013; 39:326-31. [DOI: 10.1002/jmri.24147] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 03/01/2013] [Indexed: 12/14/2022] Open
Affiliation(s)
- Ye ji Lee
- Department of Radiology; Seoul National University Hospital; Seoul Korea
| | - Jeong Min Lee
- Department of Radiology; Seoul National University Hospital; Seoul Korea
| | - Jeong Eun Lee
- Department of Radiology; Chungnam National University Hospital; Daejeon Korea
| | - Kyung Bun Lee
- Department of Pathology; Seoul National University Hospital; Seoul Korea
| | - Eun Sun Lee
- Department of Radiology; Seoul National University Hospital; Seoul Korea
| | - Jeong-Hee Yoon
- Department of Radiology; Seoul National University Hospital; Seoul Korea
| | - Mi Hye Yu
- Department of Radiology; Seoul National University Hospital; Seoul Korea
| | - Jee Hyun Baek
- Department of Radiology; Seoul National University Hospital; Seoul Korea
| | - Cheong Il Shin
- Department of Radiology; Seoul National University Hospital; Seoul Korea
| | - Joon Koo Han
- Department of Radiology; Seoul National University Hospital; Seoul Korea
- Institute of Radiation Medicine; Seoul National University Hospital; Seoul Korea
| | - Byung Ihn Choi
- Department of Radiology; Seoul National University Hospital; Seoul Korea
- Institute of Radiation Medicine; Seoul National University Hospital; Seoul Korea
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Abstract
Diffusion-weighted magnetic resonance imaging (DW-MRI) is now widely used as a standard imaging sequence for evaluation of the liver. The technique is easy to implement across different MRI platforms, and results in enhanced disease detection and characterization. With careful implementation, the quantitative apparent diffusion coefficient derived shows good measurement reproducibility, which can be applied for tissue characterization, the assessment of tumour response and disease prognostication. There is now a body of evidence that highlights the relative strengths and limitations of the technique for the assessment of liver diseases. The potential for more sophisticated analysis of DW-MRI data is currently being widely investigated.
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Affiliation(s)
- N Bharwani
- Department of Radiology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
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43
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Quantitative liver ADC measurements using diffusion-weighted MRI at 3 Tesla: evaluation of reproducibility and perfusion dependence using different techniques for respiratory compensation. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2013; 26:431-42. [PMID: 23483359 DOI: 10.1007/s10334-013-0375-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Revised: 02/22/2013] [Accepted: 02/23/2013] [Indexed: 12/13/2022]
Abstract
OBJECT Diffusion weighted imaging (DWI) of the liver suffers from low signal to noise making 3 Tesla (3 T) an attractive option, but 3 T data is scarce. It was the aim to study the influence of different b values and respiratory compensation methods (RCM) on the apparent diffusion coefficient (ADC) level and on ADC reproducibility at 3 T. MATERIALS AND METHODS Ten healthy volunteers and 12 patients with malignant liver lesions underwent repeated (2-22 days) breathhold, free-breathing and respiratory triggered DWI at 3 T using b values between 0 and 1,000 s/mm(2). RESULTS The ADCs changed up to 150% in healthy livers and up to 48% in malignant lesions depending on b value combinations. Best ADC reproducibility in healthy livers were obtained with respiratory triggering (95% limits of agreement: ±0.12) and free-breathing (±0.14). In malignant lesions equivalent reproducibility was obtained with less RCM dependence. The use of a lower maximum b value (b = 500) decreased reproducibility (±0.14 to ±0.32) in both normal liver and malignant lesions. CONCLUSION Large differences in absolute ADC values and reproducibility caused by varying combinations of clinically realistic b values were demonstrated. Different RCMs caused smaller differences. Lowering maximum b value to 500 increased limits of agreement up to a factor of two. Serial ADC changes larger than approximately 15% can be detected confidently on an individual basis in both malignant lesions and normal liver parenchyma at 3 T using appropriate b values and respiratory compensation.
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Lee DH, Lee JM, Han JK, Choi BI. MR elastography of healthy liver parenchyma: Normal value and reliability of the liver stiffness value measurement. J Magn Reson Imaging 2012; 38:1215-23. [PMID: 23281116 DOI: 10.1002/jmri.23958] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Accepted: 10/16/2012] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To investigate the normal liver stiffness value using MR elastography (MRE) and to compare the repeatability and reproducibility of three measurement methods. MATERIALS AND METHODS Forty-nine subjects who underwent liver MR imaging including elastography using a 1.5 Tesla scanner, who had normal laboratory test results, and who underwent liver donation, were included in this study. Two, independent readers measured the liver stiffness value of the hepatic parenchyma using three methods, including evaluating various liver parenchyma portions using different-sized, regions-of-interest (ROIs): 2cm-ROI-per-slice in the right lobe (2cm-per-slice); 1cm-ROI-per-segment (1cm-S); and 70%-of-the-surface area (70% S). The mean liver stiffness values were compared between gender using the t-test and among the age groups using one-way analysis of variance. The reproducibility and repeatability of the three liver stiffness value measurement methods were determined using intraclass correlation coefficients (ICCs) and the 95% Bland-Altman limits of agreement. RESULTS The liver stiffness values in living liver donors ranged from 1.54 to 2.87 kPa. The mean stiffness value was 2.05 kilopascal using the 2cm-per-slice method, 2.01 kilopascal with the 1cm-S method and 2.12 kilopascal using the 70% S method. There was no significant difference in the liver stiffness value according to the gender or age factors. For reproducibility, the ICCs were 0.416 with the 2cm-per-slice method, 0.800 using the 1cm-S method, and 0.845 with the 70% S method. In terms of repeatability, the ICCs were 0.238 using the 2cm-per-slice method, 0.914 with the 1cm-S method, and 0.852 using the 70% S method. The ICCs determined using the 2cm-per-slice method were significantly lower than those of the 1cm-S or 70% S method for assessing both reproducibility and repeatability. The 95% limit of agreement was 54.0% with the 2cm-per-slice method, 24.0% using the 1cm-S method, and 18.8% with the 70% S method, in terms of reproducibility. To assess the repeatability, the 95% limit of agreement was 63.3% using the 2cm-per-slice method, 20.6% with the 1cm-S method, and 17.4% using the 70% S method. CONCLUSION The mean liver stiffness values in living donors ranged from 2.05 to 2.12 kilopascals and did not differ significantly for either gender or age. The 1cm-S and 70% S methods were significantly more reliable compared with the 2cm-per-slice method.
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Affiliation(s)
- Dong Ho Lee
- Department of Radiology, Suncheon OH Hospital, Suncheon City, Korea
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Colagrande S, Mazzoni LN, Mazzoni E, Pradella S. Effects of gadoxetic acid on quantitative diffusion-weighted imaging of the liver. J Magn Reson Imaging 2012; 38:365-70. [PMID: 23239165 DOI: 10.1002/jmri.23978] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 11/05/2012] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To prospectively evaluate the effect of gadoxetic acid (Gd-EOB-DTPA; Primovist, Bayer-Schering, Berlin, Germany) on quantitative diffusion-weighted imaging (DWI) using the Le Bihan IntraVoxel Incoherent Motion model and considering separately the following parameters: slow diffusion coefficient (D), fast diffusion coefficient (D*), perfusion fraction (PF), and apparent diffusion coefficient (ADC). MATERIALS AND METHODS Twenty-four consecutive patients were submitted to the same magnetic resonance (MR)-DWI acquisition before and after gadoxetic acid administration. Patients were divided into four groups according to the time at which the DW sequence was repeated, then 5, 10, 15, 20 minutes after contrast agent administration. A total of 48 manually drawn regions of interest (ROIs) of about 1200 pixels were placed in the middle right liver lobe. The mean and standard deviation (SD) were calculated in each group/patient for every DWI-related parameter. Analysis of variance was performed (threshold P = 0.05). Bonferroni and Games-Howell post-hoc tests were applied if significant differences were found among groups; otherwise, data were averaged together. RESULTS D, D*, PF, and ADC did not show any significant difference before and after contrast agent administration, at any time. CONCLUSION It is possible to perform DW acquisitions after gadoxetic acid administration without any significant variation of the values of DW-related parameters under consideration in this study.
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Affiliation(s)
- Stefano Colagrande
- Department of Clinical Physiopathology, Section of Radiodiagnostics, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
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Suh YJ, Kim MJ, Choi JY, Park MS, Kim KW. Preoperative prediction of the microvascular invasion of hepatocellular carcinoma with diffusion-weighted imaging. Liver Transpl 2012; 18:1171-8. [PMID: 22767394 DOI: 10.1002/lt.23502] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aim of this study was to investigate whether diffusion-weighted imaging (DWI) could be useful in predicting the microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Sixty-seven surgically proven HCCs from 65 patients (54 men and 11 women with an age range of 35-75 years and a mean age of 56.0 years) were retrospectively analyzed. The signal intensities (SIs) of the lesions on preoperative diffusion-weighted (DW) images were visually categorized as isointense or hyperintense in comparison with the adjacent liver. We also quantitatively measured SIs and apparent diffusion coefficients (ADCs) by drawing regions of interest in HCCs and livers on DW images with b values of 50, 400, and 800 second/mm(2) and on ADC map images. Logistic regression analyses were performed so that we could identify independent predictors of MVI among laboratory and DWI findings. A univariate analysis showed that a histological grade of 3, a larger tumor size, a higher SI ratio on DW images, and a lower ADC value were significantly associated with MVI. A multiple logistic regression analysis showed that a histological grade of 3 and the ADC value were independent predictors of MVI. With a cutoff of 1.11 × 10(-3) mm(2)/second, the ADC value provided a sensitivity of 93.5% and a specificity of 72.2% for the prediction of MVI with an odds ratio of 24.5 (95% confidence interval = 4.14-144.8, P < 0.001). In conclusion, lower ADC values (1.11 × 10(-3) mm(2)/second or less) can be a useful predictor of MVI during the preoperative evaluation of HCC.
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Affiliation(s)
- Young Joo Suh
- Department of Radiology, Research Institute of Radiological Science, Yonsei University Severance Hospital, Seoul, Republic of Korea
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Malyarenko D, Galbán CJ, Londy FJ, Meyer CR, Johnson TD, Rehemtulla A, Ross BD, Chenevert TL. Multi-system repeatability and reproducibility of apparent diffusion coefficient measurement using an ice-water phantom. J Magn Reson Imaging 2012; 37:1238-46. [PMID: 23023785 DOI: 10.1002/jmri.23825] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 08/16/2012] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To determine quantitative quality control procedures to evaluate technical variability in multi-center measurements of the diffusion coefficient of water as a prerequisite to use of the biomarker apparent diffusion coefficient (ADC) in multi-center clinical trials. MATERIALS AND METHODS A uniform data acquisition protocol was developed and shared with 18 participating test sites along with a temperature-controlled diffusion phantom delivered to each site. Usable diffusion weighted imaging data of ice water at five b-values were collected on 35 clinical MRI systems from three vendors at two field strengths (1.5 and 3 Tesla [T]) and analyzed at a central processing site. RESULTS Standard deviation of bore-center ADCs measured across 35 scanners was <2%; error range: -2% to +5% from literature value. Day-to-day repeatability of the measurements was within 4.5%. Intra-exam repeatability at the phantom center was within 1%. Excluding one outlier, inter-site reproducibility of ADC at magnet isocenter was within 3%, although variability increased for off-center measurements. Significant (>10%) vendor-specific and system-specific spatial nonuniformity ADC bias was detected for the off-center measurement that was consistent with gradient nonlinearity. CONCLUSION Standardization of DWI protocol has improved reproducibility of ADC measurements and allowed identifying spatial ADC nonuniformity as a source of error in multi-site clinical studies.
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Affiliation(s)
- Dariya Malyarenko
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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48
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Sufana Iancu A, Colin P, Puech P, Villers A, Ouzzane A, Fantoni JC, Leroy X, Lemaitre L. Significance of ADC value for detection and characterization of urothelial carcinoma of upper urinary tract using diffusion-weighted MRI. World J Urol 2012; 31:13-9. [DOI: 10.1007/s00345-012-0945-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 09/07/2012] [Indexed: 10/27/2022] Open
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Eatesam M, Noworolski SM, Tien PC, Nystrom M, Dodge JL, Merriman RB, Qayyum A. Liver diffusivity in healthy volunteers and patients with chronic liver disease: comparison of breathhold and free-breathing techniques. J Magn Reson Imaging 2011; 35:103-9. [PMID: 22034200 DOI: 10.1002/jmri.22748] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 07/18/2011] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To compare liver ADC obtained with breathhold and free-breathing diffusion weighted imaging (DWI) in healthy volunteers and patients with liver disease. MATERIALS AND METHODS Twenty-eight subjects, 12 healthy volunteers and 16 patients (9 NAFLD, 7 chronic active HCV), underwent breathhold (BH) and free-breathing (FB) DWI MRI at 1.5 Tesla. Pearson's correlation coefficient was used to determine correlation while paired t-tests assessed differences between BH and FB ADC. Estimated bias was calculated using the Bland-Altman method. RESULTS Liver ADC (×10(-3) mm(2) /s) was lower on BH for all groups (mean difference 0.36 ± 0.20; P < 0.01). ADC was higher in healthy volunteers (BH 1.80 ± 0.18; FB 2.24 ± 0.20) compared with NAFLD patients (BH 1.43 ± 0.27; FB 1.78 ± 0.28) (P < 0.001) and HCV patients (BH 1.63 ± 0.191; FB 1.88 ± 0.12). Overall correlation between BH and FB ADC was (r = 0.75), greatest in NAFLD (r = 0.90) compared with the correlation in HCV (r = 0.24) and healthy subjects (r = 0.34). Bland-Altman plots did not show agreement in mean absolute difference and estimated bias between subjects. CONCLUSION Correlation between BH and FB liver ADC is moderate indicating that BH and FB should not be used interchangeably. Additionally, the lower ADC values in BH versus FB should be accounted for when comparing different liver DWI studies.
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Affiliation(s)
- Mamak Eatesam
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California 94143-0628, USA
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Pasquinelli F, Belli G, Mazzoni LN, Regini F, Nardi C, Grazioli L, Zignego AL, Zignego AL, Colagrande S. MR-diffusion imaging in assessing chronic liver diseases: does a clinical role exist? Radiol Med 2011; 117:242-53. [PMID: 22020423 DOI: 10.1007/s11547-011-0730-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 03/23/2011] [Indexed: 12/13/2022]
Abstract
PURPOSE This study was done to evaluate whether and which of the magnetic resonance diffusion-weighted imaging (MR-DWI) parameters - apparent diffusion coefficient (ADC), diffusion (D) or perfusion fraction (f) - correlates with the degree of chronic liver disease progression. MATERIALS AND METHODS Twenty-eight patients were evaluated with abdominal MR-DWI from March to November 2010: seven healthy volunteers, seven patients with chronic liver disease F0-F2 (METAVIR score), seven F3-F4 Child-Pugh A, and seven F4 Child-Pugh BC, classified as groups 1-4, respectively. DWI acquisitions were performed during breath-holding (b = 0-150 s/mm(2) and 1,000) and free breathing (multi-b = 0-200-400-600-800-1,000 s/mm(2)). Using a double-blind control procedure, two observers estimated ADC, D, and f by applying a region of interest (ROI) in 4/12 sections in the middle-lower portion of the right hepatic lobe. Statistical analysis was done with analysis of variance (ANOVA). RESULTS A reduction in the mean value of f, ADC(150) and, to a lesser extent, ADC(1,000) is shown to progress from healthy volunteers (group 1) to cirrhosis patients (group 4), with wide overlap among groups. There were no statistically significant changes of D. CONCLUSIONS Our results indicate that stratifying patients with chronic liver disease for clinical purposes cannot be done with DWI. However, there is a tendency among groups for reduced perfusion-related parameters as chronic liver disease progresses.
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Affiliation(s)
- F Pasquinelli
- Department of Clinical Physiopathology, Section of Radiodiagnostics, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134, Florence, Italy
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