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Wudhikulprapan W, Phinyo P, Hadi A, Kanthawang T, Choudur HN. Diagnosing osteomyelitis in diabetic foot by diffusion-weighted imaging and dynamic contrast material-enhanced magnetic resonance imaging: a systematic review and meta-analysis. Clin Radiol 2024; 79:805-817. [PMID: 39168784 DOI: 10.1016/j.crad.2024.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 07/21/2024] [Indexed: 08/23/2024]
Abstract
AIM To evaluate the diagnostic performance of diffusion-weighted imaging (DWI) and dynamic contrast enhanced (DCE), for diagnosing osteomyelitis in the diabetic foot. MATERIALS AND METHODS A thorough search was carried out to identify suitable studies published up to September 2023. The quality of the studies involved was evaluated using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The diagnostic sensitivity and specificity of each imaging modality/method for each specific cut point were summarized. The summary receiver operating characteristic (SROC) curve was calculated using bivariate mixed effects models. RESULTS Five studies investigating 187 patients and 234 bone lesions with 110 diagnosed osteomyelitis were enrolled. Four studies used DWI (172 lesions), three studies used DCE techniques (140 lesions) and two studies presented results of conventional MRI (66 lesions). The sensitivity ranges using conventional MRI, DWI and DCE were 65%-100%, 65%-100% and 64%-100%, respectively. The specificity ranges were 50%-61%, 56%-95%, and 66%-93%, respectively. The SROC curve of DWI and DCE was 0.89 (95% CI, 0.86-0.92) and 0.90 (95% CI, 0.87-0.92), respectively. CONCLUSION Combining DWI and DCE methods, alongside conventional MRI, can improve the reliability and accuracy of diabetic foot osteomyelitis diagnosis. However, the study recognizes result variability due to varying protocols and emphasizes the need for well-designed studies with standardized approaches. To optimize diagnostic performance, the study recommends considering low ADC values, Ktrans or rapid wash-in rate from DCE such as iAUC60, along with using large ROIs that cover the entire lesion while excluding normal bone marrow.
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Affiliation(s)
- W Wudhikulprapan
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Thailand.
| | - P Phinyo
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - A Hadi
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada.
| | - T Kanthawang
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Thailand.
| | - H N Choudur
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada.
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2
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Pehlivan UA, Somay E, Yalcin C, Topkan E. The Prediction of Radiation-Induced Trismus by the Apparent Diffusion Coefficient Values of Masseter Muscles before Chemoradiotherapy in Locally Advanced Nasopharyngeal Carcinomas. Diagnostics (Basel) 2024; 14:2268. [PMID: 39451593 PMCID: PMC11505873 DOI: 10.3390/diagnostics14202268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 10/08/2024] [Accepted: 10/08/2024] [Indexed: 10/26/2024] Open
Abstract
PURPOSE Although the apparent diffusion coefficient (ADC) value from diffusion-weighted imaging can provide insights into various pathological processes, no studies have examined the relationship between the pre-concurrent chemoradiotherapy (CCRT) mean ADC (ADCmean) values of the masseter muscles and radiation-induced trismus (RIT) in locally advanced nasopharyngeal carcinoma (LA-NPC) patients. Therefore, the current research aimed to investigate the significance of pre-CCRT masseter muscle ADCmean values for predicting the RIT rates in LA-NPC patients treated with definitive CCRT. MATERIALS AND METHODS The pre-CCRT ADCmean values of the masseter muscles and the post-CCRT RIT rates were evaluated. A receiver operating characteristic curve analysis was employed to determine the optimal ADCmean cutoff. The primary objective was to examine the relationship between the pre-CCRT masseter muscle ADCmean values and the post-CCRT RIT rates. RESULTS Seventy-seven patients were included. The optimal ADCmean cutoff value was 1381.30 × 10-6 mm2/s, which divided the patients into two groups: an ADCmean < 1381.30 × 10-6 mm2/s (n = 49) versus an ADCmean > 1381.30 × 10-6 mm2/s (n = 28). A masseter muscle ADCmean > 1381.30 × 10-6 mm2/s was found to be associated with significantly higher RIT rates than an ADCmean < 1381.30 × 10-6 mm2/s (71.42% vs. 6.12%; p < 0.001). The multivariate analysis results confirmed a pre-CCRT masseter muscle ADCmean > 1381.30 × 10-6 mm2/s as an independent predictor of RIT. CONCLUSIONS Our study presents the first evidence establishing a connection between elevated masseter muscle ADCmean values and higher RIT rates in LA-NPC patients following CCRT. If confirmed with further research, these findings may help to categorize the risk of RIT in these patients.
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Affiliation(s)
- Umur Anil Pehlivan
- Adana Dr. Turgut Noyan Application and Research Center, Department of Radiology, Faculty of Medicine, Baskent University, Adana 01120, Turkey
| | - Efsun Somay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara 06490, Turkey;
| | - Cigdem Yalcin
- Adana Dr. Turgut Noyan Application and Research Center, Department of Radiology, Faculty of Medicine, Baskent University, Adana 01120, Turkey
| | - Erkan Topkan
- Adana Dr. Turgut Noyan Application and Research Center, Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana 01120, Turkey;
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3
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Yoon JA, Kang C, Park JS, You Y, Min JH, In YN, Jeong W, Ahn HJ, Jeong HS, Kim YH, Lee BK, Kim D. Quantitative analysis of apparent diffusion coefficients to predict neurological prognosis in cardiac arrest survivors: an observational derivation and internal-external validation study. Crit Care 2024; 28:138. [PMID: 38664807 PMCID: PMC11044301 DOI: 10.1186/s13054-024-04909-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND This study aimed to validate apparent diffusion coefficient (ADC) values and thresholds to predict poor neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors by quantitatively analysing the ADC values via brain magnetic resonance imaging (MRI). METHODS This observational study used prospectively collected data from two tertiary academic hospitals. The derivation cohort comprised 70% of the patients randomly selected from one hospital, whereas the internal validation cohort comprised the remaining 30%. The external validation cohort used the data from another hospital, and the MRI data were restricted to scans conducted at 3 T within 72-96 h after an OHCA experience. We analysed the percentage of brain volume below a specific ADC value at 50-step intervals ranging from 200 to 1200 × 10-6 mm2/s, identifying thresholds that differentiate between good and poor outcomes. Poor neurological outcomes were defined as cerebral performance categories 3-5, 6 months after experiencing an OHCA. RESULTS A total of 448 brain MRI scans were evaluated, including a derivation cohort (n = 224) and internal/external validation cohorts (n = 96/128, respectively). The proportion of brain volume with ADC values below 450, 500, 550, 600, and 650 × 10-6 mm2/s demonstrated good to excellent performance in predicting poor neurological outcomes in the derivation group (area under the curve [AUC] 0.89-0.91), and there were no statistically significant differences in performances among the derivation, internal validation, and external validation groups (all P > 0.5). Among these, the proportion of brain volume with an ADC below 600 × 10-6 mm2/s predicted a poor outcome with a 0% false-positive rate (FPR) and 76% (95% confidence interval [CI] 68-83) sensitivity at a threshold of > 13.2% in the derivation cohort. In both the internal and external validation cohorts, when using the same threshold, a specificity of 100% corresponded to sensitivities of 71% (95% CI 58-81) and 78% (95% CI 66-87), respectively. CONCLUSIONS In this validation study, by consistently restricting the MRI types and timing during quantitative analysis of ADC values in brain MRI, we observed high reproducibility and sensitivity at a 0% FPR. Prospective multicentre studies are necessary to validate these findings.
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Affiliation(s)
- Jung A Yoon
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea
| | - Changshin Kang
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jung Soo Park
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea.
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
| | - Yeonho You
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jin Hong Min
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Emergency Medicine, Chungnam National University Sejong Hospital, Daejoen, Republic of Korea
| | - Yong Nam In
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Emergency Medicine, Chungnam National University Sejong Hospital, Daejoen, Republic of Korea
| | - Wonjoon Jeong
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Hong Jun Ahn
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Hye Seon Jeong
- Department of Neurology, Chungnam National University Hospital, Daejoen, Republic of Korea
| | - Yong Hwan Kim
- Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Gyeongsangnam-do, Republic of Korea
| | - Byung Kook Lee
- Department of Emergency Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Dongha Kim
- Department of Statistics, Sungshin Women's University, Seoul, Republic of Korea
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Yoon JA, Kang C, Park JS, You Y, Min JH, In YN, Jeong W, Ahn HJ, Lee IH, Jeong HS, Lee BK, Lee JK. Quantitative analysis of early apparent diffusion coefficient values from MRIs for predicting neurological prognosis in survivors of out-of-hospital cardiac arrest: an observational study. Crit Care 2023; 27:407. [PMID: 37880777 PMCID: PMC10599006 DOI: 10.1186/s13054-023-04696-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/19/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND This study aimed to quantitatively analyse ultra-early brain diffusion-weighted magnetic resonance imaging (DW-MRI) findings to determine the apparent diffusion coefficient (ADC) threshold associated with neurological outcomes in comatose survivors of out-of-hospital cardiac arrest (OHCA). METHODS This retrospective study included adult survivors of comatose OHCA who underwent DW-MRI imaging scans using a 3-T MRI scanner within 6 h of the return of spontaneous circulation (ROSC). We investigated the association between neurological outcomes and ADC values obtained through voxel-based analysis on DW-MRI. Additionally, we constructed multivariable logistic regression models with pupillary light reflex (PLR), serum neuron-specific enolase (NSE), and ADC values as independent variables to predict poor neurological outcomes. The primary outcome was poor neurological outcome 6 months after ROSC, determined by the Cerebral Performance Category 3-5. RESULTS Overall, 131 patients (26% female) were analysed, of whom 74 (57%) showed poor neurological outcomes. The group with a poor neurological outcome had lower mean whole brain ADC values (739.1 vs. 787.1 × 10-6 mm/s) and higher percentages of voxels with ADC below threshold in all ranges (250-1150) (all P < 0.001). The mean whole brain ADC values (area under the receiver operating characteristic curve [AUC] 0.83) and the percentage of voxels with ADC below 600 (AUC 0.81) had the highest sensitivity of 51% (95% confidence interval [CI] 39.4-63.1; cut-off value ≤ 739.2 × 10-6 mm2/s and > 17.2%, respectively) when the false positive rate (FPR) was 0%. In the multivariable model, which also included PLR, NSE, and mean whole brain ADC values, poor neurological outcome was predicted with the highest accuracy (AUC 0.91; 51% sensitivity). This model showed more accurate prediction and sensitivity at an FPR of 0% than did the combination of PLR and NSE (AUC 0.86; 30% sensitivity; P = 0.03). CONCLUSIONS In this cohort study, early voxel-based quantitative ADC analysis after ROSC was associated with poor neurological outcomes 6 months after cardiac arrest. The mean whole brain ADC value demonstrated the highest sensitivity when the FPR was 0%, and including it in the multivariable model improved the prediction of poor neurological outcomes.
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Affiliation(s)
- Jung A Yoon
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea
| | - Changshin Kang
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jung Soo Park
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea.
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
| | - Yeonho You
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jin Hong Min
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Emergency Medicine, Sejong Chungnam National University Hospital, Daejoen, Republic of Korea
| | - Yong Nam In
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
- Department of Emergency Medicine, Sejong Chungnam National University Hospital, Daejoen, Republic of Korea
| | - Wonjoon Jeong
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Hong Joon Ahn
- Department of Emergency Medicine, Chungnam National University Hospital, Daejoen, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - In Ho Lee
- Department of Radiology, College of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Hye Seon Jeong
- Department of Neurology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Byung Kook Lee
- Department of Emergency Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jae Kwang Lee
- Department of Emergency Medicine, College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea
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Kunimatsu N, Kunimatsu A, Miura K, Mori I, Kiryu S. Differentiation between pleomorphic adenoma and schwannoma in the parapharyngeal space: histogram analysis of apparent diffusion coefficient. Dentomaxillofac Radiol 2023; 52:20230140. [PMID: 37665011 PMCID: PMC10552127 DOI: 10.1259/dmfr.20230140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVES To elucidate the differences between pleomorphic adenomas and schwannomas occurring in the parapharyngeal space by histogram analyses of apparent diffusion coefficient (ADC) values measured with diffusion-weighted MRI. METHODS This retrospective study included 29 patients with pleomorphic adenoma and 22 patients with schwannoma arising in the parapharyngeal space or extending into the parapharyngeal space from the parotid region. Using pre-operative MR images, ADC values of tumor lesions showing the maximum diameter were measured. The regions of interest for ADC measurement were placed by contouring the tumor margin, and the histogram metrics of ADC values were compared between pleomorphic adenomas and schwannomas regarding the mean, skewness, and kurtosis by Wilcoxon's rank sum test. Subsequent to the primary analysis which included all lesions, we performed two subgroup analyses regarding b-values and magnetic field strength used for MRI. RESULTS The mean ADC values did not show significant differences between pleomorphic adenomas and schwannomas for the primary and subgroup analyses. Schwannomas showed higher skewness (p = 0.0001) and lower kurtosis (p = 0.003) of ADC histograms compared with pleomorphic adenomas in the primary analysis. Skewness was significantly higher in schwannomas in all the subgroup analyses. Kurtosis was consistently lower in schwannomas but did not reach statistical significance in one subgroup analysis. CONCLUSIONS Skewness and kurtosis showed significant differences between pleomorphic adenomas and schwannomas occupying the parapharyngeal space, but the mean ADC values did not. Our results suggest that the skewness and kurtosis of ADC histograms may be useful in differentiating these two parapharyngeal tumors.
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Affiliation(s)
| | - Akira Kunimatsu
- Department of Radiology, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - Koki Miura
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | | | - Shigeru Kiryu
- Department of Radiology, International University of Health and Welfare Narita Hospital, Chiba, Japan
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Kruk KA, Dietrich TJ, Wildermuth S, Leschka S, Toepfer A, Waelti S, Kim CHO, Güsewell S, Fischer T. Diffusion-Weighted Imaging Distinguishes Between Osteomyelitis, Bone Marrow Edema, and Healthy Bone on Forefoot Magnetic Resonance Imaging. J Magn Reson Imaging 2022; 56:1571-1579. [PMID: 35106870 DOI: 10.1002/jmri.28091] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diagnosis of osteomyelitis by imaging can be challenging. The feasibility of diffusion-weighted imaging (DWI) as ancillary sequence was evaluated in this study. PURPOSE To evaluate DWI for differentiation between osteomyelitis, bone marrow edema, and healthy bone on forefoot magnetic resonance imaging (MRI). STUDY TYPE Prospective. SUBJECTS A total of 60 consecutive patients undergoing forefoot MRI divided into three study groups (20 subjects each): osteomyelitis, bone marrow edema, and healthy bone. FIELD STRENGTH/SEQUENCE A 1.5T and 3T MRI scanners; readout-segmented multishot echo planar DWI. ASSESSMENT Two independent radiologists measured apparent diffusion coefficient (ADC) values within abnormal or healthy bone. STATISTICAL TESTS ADC values were compared between groups (pairwise t-test with Bonferroni-Holm correction for multiple testing). Intraclass correlation coefficient (ICC) was calculated to assess inter-reader agreement. Threshold ADC values were determined as the cutoffs that maximized the sum of sensitivity and specificity. Receiver operating characteristic (ROC) analysis was performed with statistical threshold of P < 0.05. RESULTS Inter-reader agreement was 0.92 in the healthy bone group and 0.78 in both the edema and osteomyelitis groups. Average ADC values were significantly different between groups: 1432 ± 222 × 10-6 mm2 /sec (osteomyelitis), 1071 ± 196 × 10-6 mm2 /sec (bone marrow edema), and 277 ± 89 × 10-6 mm2 /sec (healthy bone). A threshold ADC value of 534 × 10-6 mm2 /sec distinguishes between healthy and abnormal bone with specificity and sensitivity of 100% each. For distinction between osteomyelitis and bone marrow edema, two cutoff values were determined: a 95%-specificity cutoff indicating osteomyelitis (>1320 × 10-6 mm2 /sec) and a 95%-sensitivity cutoff indicating bone marrow edema (<1155 × 10-6 mm2 /sec). Diagnostic accuracy of 95% was achieved for 73% (29/40) of the subjects. DATA CONCLUSION DWI with ADC maps distinguishes between healthy and abnormal bone on forefoot MRI. Calculated cutoff values allow confirmation or exclusion of osteomyelitis in a high proportion of subjects. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Konrad A Kruk
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
| | - Tobias J Dietrich
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
| | - Simon Wildermuth
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
| | - Sebastian Leschka
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
| | - Andreas Toepfer
- Department of Orthopaedics and Traumatology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Stephan Waelti
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
| | - Chan-Hi Olaf Kim
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland
| | - Sabine Güsewell
- Clinical Trials Unit, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Tim Fischer
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, CH-9007, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, CH-8091, Switzerland
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7
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Segev M, Djurabayev B, Katorza E, Yaniv G, Hoffmann C, Shrot S. 3.0 Tesla normative diffusivity in 3rd trimester fetal brain. Neuroradiology 2021; 64:1249-1254. [PMID: 34820712 DOI: 10.1007/s00234-021-02863-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Apparent diffusion coefficient (ADC) values in the developing fetus provide valuable information on the diagnosis and prognosis of prenatal brain pathologies. Normative ADC data has been previously established in 1.5 T MR scanners but lacking in 3.0 T scanners. Our objective was to measure ADC values in various brain areas in a cohort of normal singleton fetuses scanned in a 3.0 T MR scanner. METHODS DWI (diffusion-weighted imaging) was performed in 47 singleton fetuses with normal or questionably abnormal results on sonography followed by normal structural MR imaging. ADC values were measured in cerebral lobes (frontal, parietal, temporal lobes), basal ganglia, and pons. Regression analysis was used to examine gestational age-related changes in regional ADC. RESULTS Median gestational age was 30.1 weeks (range, 26-34 weeks). There was a significant effect of region on ADC values, whereby ADC values were highest in cerebral lobes (parietal > frontal > temporal lobes), compared with basal ganglia. The lowest values were found in the pons. On regression analysis, there was a decrease in ADC values in basal ganglia and pons with increasing gestational age. ADC values in frontal, parietal, and temporal lobes were stable in our cohort. CONCLUSION Regional brain ADC values in 3.0 T scanners are comparable with previously reported values in 1.5 T scanners, with similar changes over gestational age. Using 3.0 T scanners is increasing worldwide. For fetal imaging, establishing normal ADC values is critical as DWI enables a sensitive and quantitative technique to evaluate normal and abnormal brain development.
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Affiliation(s)
- Maria Segev
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel. .,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Bella Djurabayev
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel
| | - Eldad Katorza
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Antenatal Diagnostic Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Gal Yaniv
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Chen Hoffmann
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shai Shrot
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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8
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Schick F, Pieper CC, Kupczyk P, Almansour H, Keller G, Springer F, Mürtz P, Endler C, Sprinkart AM, Kaufmann S, Herrmann J, Attenberger UI. 1.5 vs 3 Tesla Magnetic Resonance Imaging: A Review of Favorite Clinical Applications for Both Field Strengths-Part 1. Invest Radiol 2021; 56:680-691. [PMID: 34324464 DOI: 10.1097/rli.0000000000000812] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACT Whole-body magnetic resonance imaging (MRI) systems with a field strength of 3 T have been offered by all leading manufacturers for approximately 2 decades and are increasingly used in clinical diagnostics despite higher costs. Technologically, MRI systems operating at 3 T have reached a high standard in recent years, as well as the 1.5-T devices that have been in use for a longer time. For modern MRI systems with 3 T, more complexity is required, especially for the magnet and the radiofrequency (RF) system (with multichannel transmission). Many clinical applications benefit greatly from the higher field strength due to the higher signal yield (eg, imaging of the brain or extremities), but there are also applications where the disadvantages of 3 T might outweigh the advantages (eg, lung imaging or examinations in the presence of implants). This review describes some technical features of modern 1.5-T and 3-T whole-body MRI systems, and reports on the experience of using both types of devices in different clinical settings, with all sections written by specialist radiologists in the respective fields.This first part of the review includes an overview of the general physicotechnical aspects of both field strengths and elaborates the special conditions of diffusion imaging. Many relevant aspects in the application areas of musculoskeletal imaging, abdominal imaging, and prostate diagnostics are discussed.
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Affiliation(s)
- Fritz Schick
- From the Section of Experimental Radiology, Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen
| | | | - Patrick Kupczyk
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Haidara Almansour
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Gabriel Keller
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Fabian Springer
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Petra Mürtz
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Christoph Endler
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Alois M Sprinkart
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Sascha Kaufmann
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Judith Herrmann
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Ulrike I Attenberger
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
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Rathebe PC. Health and safety control measures and MR quality control results in the MRI units of two public hospitals within the Mangaung metropolitan. SN APPLIED SCIENCES 2021. [DOI: 10.1007/s42452-021-04707-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AbstractThis study aimed to identify risks and hazards in the magnetic resonance imaging (MRI) units, and assess the quality compliance of the scanners within two public hospitals in Mangaung. This is a follow-up study from a previously published study that measured static magnetic fields and radiofrequency magnetic fields in the MRI units included here. An observational checklist was used to identify risks and hazards which were later fed into a baseline risk assessment to classify and review existing control measures in the MRI units of hospitals A and B. The availability of MRI Health and Safety measures were benchmarked against the latest American College of Radiology (ACR) MRI safety requirements. The probability of risk occurrence and severity of hazards were assigned a score ranging from improbable (1) to very likely (5) and minimal (1) to irreversible effect (5). The weekly quality control test results obtained from both units were measured against the ACR quality control acceptable criteria. Similar risks were observed in both MRI units but the multiplication of probability and consequence in all risk categories resulted in a moderate risk-rating score of 12.3 for hospital A and 13.1 for hospital B. Lack of demarcation of four MRI safety zones, ferromagnetic detectors, 5-gauss line, and access control in both units scored above 15 and were classified as high risk. The defective air-cooling systems influenced the temperature of the scanner room, which affected the apparent diffusion coefficient (ADC) measurements performed from 1.5 T Siemens. On a 3.0 T Philips, a low contrast object detectability had 29 spokes for ACR T2, while the percent integral uniformity for image intensity uniformity was 78.2 %. High and moderate risks observed in both units could be reduced by the implementation of an effective health and safety programme. The ambient temperature within the scanner room should be maintained at 21 °C to attain well-performing ADC measurements and RF subsystems should be visually inspected and maintained regularly to obtain optimal image quality.
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Malagi AV, Netaji A, Kumar V, Baidya Kayal E, Khare K, Das CJ, Calamante F, Mehndiratta A. IVIM-DKI for differentiation between prostate cancer and benign prostatic hyperplasia: comparison of 1.5 T vs. 3 T MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 35:609-620. [PMID: 34052899 DOI: 10.1007/s10334-021-00932-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To implement an advanced spatial penalty-based reconstruction to constrain the intravoxel incoherent motion (IVIM)-diffusion kurtosis imaging (DKI) model and investigate whether it provides a suitable alternative at 1.5 T to the traditional IVIM-DKI model at 3 T for clinical characterization of prostate cancer (PCa) and benign prostatic hyperplasia (BPH). MATERIALS AND METHODS Thirty-two patients with biopsy-proven PCa were recruited for MRI examination (n = 16 scanned at 1.5 T, n = 16 scanned at 3 T). Diffusion-weighted imaging (DWI) with 13 b values (b = 0 to 2000 s/mm2 up to 3 averages, 1.5 T: TR = 5.774 s, TE = 81 ms and 3 T: TR = 4.899 s, TE = 100 ms), T2-weighted, and T1-weighted imaging were used on the 1.5 T and 3 T MRI scanner, respectively. The IVIM-DKI signal was modeled using the traditional IVIM-DKI model and a novel model in which the total variation (TV) penalty function was combined with the traditional model to optimize non-physiological variations. Paired and unpaired t-tests were used to compare intra-scanner and scanner group differences in IVIM-DKI parameters obtained using the novel and the traditional models. Analysis of variance with post hoc test and receiver operating characteristic (ROC) curve analysis were used to assess the ability of parameters obtained using the novel model (at 1.5 T) and the traditional model (at 3 T) to characterize prostate lesions. RESULTS IVIM-DKI modeled using novel model with TV spatial penalty function at 1.5 T, produced parameter maps with 50-78% lower coefficient of variation (CV) than traditional model at 3 T. Novel model estimated higher D with lower D*, f and k values at both field strengths compared to traditional model. For scanner differences, the novel model at 1.5 T estimated lower D* and f values as compared to traditional model at 3 T. At 1.5 T, D and f values were significantly lower with k values significantly higher in tumor than BPH and healthy tissue. D (AUC: 0.98), f (AUC: 0.82), and k (AUC: 0.91) parameters estimated using novel model showed high diagnostic performance in cancer lesion detection at 1.5 T. DISCUSSION In comparison with the IVIM-DKI model at 3 T, IVIM-DKI signal modeled with the TV penalty function at 1.5 T showed lower estimation errors. The proposed novel model can be utilized for improved detection of prostate lesions.
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Affiliation(s)
- Archana Vadiraj Malagi
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India
| | - Arjunlokesh Netaji
- Department of Radio-Diagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Virendra Kumar
- Department of Nuclear Magnetic Resonance, All India Institute of Medical Sciences, New Delhi, India
| | - Esha Baidya Kayal
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India
| | - Kedar Khare
- Department of Physics, Indian Institute of Technology Delhi, New Delhi, India
| | - Chandan Jyoti Das
- Department of Radio-Diagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Fernando Calamante
- Sydney Imaging and School of Biomedical Engineering, University of Sydney, Sydney, Australia
| | - Amit Mehndiratta
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India.
- Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, India.
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11
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Yoshida T, Urikura A, Hosokawa Y, Shirata K, Nakaya Y, Endo M. Apparent diffusion coefficient measurement using thin-slice diffusion-weighted magnetic resonance imaging: assessment of measurement errors and repeatability. Radiol Phys Technol 2021; 14:203-209. [PMID: 33725272 DOI: 10.1007/s12194-021-00616-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/04/2021] [Accepted: 03/12/2021] [Indexed: 12/24/2022]
Abstract
We investigated the measurement error and repeatability of the apparent diffusion coefficient (ADC) obtained using thin-slice imaging. Diffusion-weighted images of an ice-water phantom were acquired using 1.5-T and 3.0-T scanners with 1-, 3-, and 5-mm thickness. ADC maps were generated at b = 0 and 1000 mm2/s using five consecutive scans. Measurement errors were assessed with accuracy and precision. Repeatability was assessed using the within-subject coefficient of variation. The ADC accuracy of both scanners agreed with the ADC of water at 0 °C. At 1-mm, precisions were 2.9% and 8.4% for the 3.0-T and 1.5-T scanners, respectively. The repeatabilities of 1-mm thickness were 1.3% and 3.4% in the 3.0-T and 1.5-T scanners, respectively. The 3.0-T scanner showed acceptable measurement errors and moderate repeatability compared with Quantitative Imaging Biomarkers Alliance recommendation. A 3.0-T scanner can be used for reliable ADC measurement, even with a 1-mm thickness at a reasonable scan time.
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Affiliation(s)
- Tsukasa Yoshida
- Department of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Sunto, Shizuoka, 411-8777, Japan.
- Department of Radiation Science, Hirosaki University Graduate School of Health Sciences, 66-1 Hon-cho, Hirosaki, 036-8564, Japan.
| | - Atsushi Urikura
- Department of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Sunto, Shizuoka, 411-8777, Japan
| | - Yoichiro Hosokawa
- Department of Radiological Life Sciences, Division of Medical Life Sciences, Hirosaki University, 66-1 Hon-cho, Hirosaki, 036-8564, Japan
| | - Kensei Shirata
- Department of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Sunto, Shizuoka, 411-8777, Japan
| | - Yoshihiro Nakaya
- Department of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Sunto, Shizuoka, 411-8777, Japan
| | - Masahiro Endo
- Department of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Sunto, Shizuoka, 411-8777, Japan
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12
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Habre C, Dabadie A, Loundou AD, Banos JB, Desvignes C, Pico H, Aschero A, Colavolpe N, Seiler C, Bouvier C, Peltier E, Gentet JC, Baunin C, Auquier P, Petit P. Diffusion-weighted imaging in differentiating mid-course responders to chemotherapy for long-bone osteosarcoma compared to the histologic response: an update. Pediatr Radiol 2021; 51:1714-1723. [PMID: 33877417 PMCID: PMC8363524 DOI: 10.1007/s00247-021-05037-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/28/2020] [Accepted: 02/28/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) has been described to correlate with tumoural necrosis in response to preoperative chemotherapy for osteosarcoma. OBJECTIVE To assess the accuracy of DWI in evaluating the response to neoadjuvant chemotherapy at the mid-course treatment of long-bone osteosarcoma and in predicting survival. MATERIALS AND METHODS We conducted a prospective single-centre study over a continuous period of 11 years. Consecutive patients younger than 20 years treated with a neoadjuvant regimen for peripheral conventional osteosarcoma were eligible for inclusion. Magnetic resonance imaging (MRI) with DWI was performed at diagnosis, and mid- and end-course chemotherapy with mean apparent diffusion coefficients (ADC) calculated at each time point. A percentage less than or equal to 10% of the viable residual tissue at the histological analysis of the surgical specimen was defined as a good responder to chemotherapy. Survival comparisons were calculated using the Kaplan-Meier method. Uni- and multivariate analyses with ADC change were performed by Cox modelling. This is an expansion and update of our previous work. RESULTS Twenty-six patients between the ages of 4.8 and 19.6 years were included, of whom 14 were good responders. At mid-course chemotherapy, good responders had significantly higher mean ADC values (P=0.046) and a higher increase in ADC (P=0.015) than poor responders. The ADC change from diagnosis to mid-course MRI did not appear to be a prognosticator of survival and did not impact survival rates of both groups. CONCLUSION DWI at mid-course preoperative chemotherapy for osteosarcoma should be considered to evaluate the degree of histological necrosis and to predict survival. The anticipation of a response to neoadjuvant treatment by DWI may have potential implications on preoperative management.
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Affiliation(s)
- Céline Habre
- Division of Pediatric Radiology, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, 264 Rue Sainte Pierre, 13385, Marseille Cedex 05, France. .,Division of Pediatric Onco-Hematology, Hôpitaux Universitaires de Genève, Genève, Suisse.
| | - Alexia Dabadie
- grid.414336.70000 0001 0407 1584Division of Pediatric Radiology, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, 264 Rue Sainte Pierre, 13385 Marseille Cedex 05, France
| | - Anderson D. Loundou
- grid.5399.60000 0001 2176 4817Division of Statistics and Methodology for Clinical Research, Assistance publique - Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
| | - Jean-Bruno Banos
- grid.414336.70000 0001 0407 1584Division of Pediatric Radiology, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, 264 Rue Sainte Pierre, 13385 Marseille Cedex 05, France
| | - Catherine Desvignes
- grid.414336.70000 0001 0407 1584Division of Pediatric Radiology, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, 264 Rue Sainte Pierre, 13385 Marseille Cedex 05, France
| | - Harmony Pico
- grid.414336.70000 0001 0407 1584Division of Pediatric Radiology, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, 264 Rue Sainte Pierre, 13385 Marseille Cedex 05, France
| | - Audrey Aschero
- grid.414336.70000 0001 0407 1584Division of Pediatric Radiology, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, 264 Rue Sainte Pierre, 13385 Marseille Cedex 05, France
| | - Nathalie Colavolpe
- grid.414336.70000 0001 0407 1584Division of Pediatric Radiology, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, 264 Rue Sainte Pierre, 13385 Marseille Cedex 05, France
| | - Charlotte Seiler
- grid.414336.70000 0001 0407 1584Division of Pediatric Radiology, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, 264 Rue Sainte Pierre, 13385 Marseille Cedex 05, France
| | - Corinne Bouvier
- grid.414336.70000 0001 0407 1584Anatomopathology Laboratory, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, Marseille, France
| | - Emilie Peltier
- grid.414336.70000 0001 0407 1584Division of Pediatric Radiology and Prenatal Imaging, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, Marseille, France
| | - Jean-Claude Gentet
- grid.414336.70000 0001 0407 1584Division of Pediatric Orthopedic Surgery, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, Marseille, France
| | - Christiane Baunin
- grid.414336.70000 0001 0407 1584Division of Pediatric Radiology, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, 264 Rue Sainte Pierre, 13385 Marseille Cedex 05, France
| | - Pascal Auquier
- grid.5399.60000 0001 2176 4817Division of Statistics and Methodology for Clinical Research, Assistance publique - Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
| | - Philippe Petit
- grid.414336.70000 0001 0407 1584Division of Pediatric Radiology, Hôpital Timone Enfants, Assistance publique - Hôpitaux de Marseille, 264 Rue Sainte Pierre, 13385 Marseille Cedex 05, France ,grid.5399.60000 0001 2176 4817Division of Statistics and Methodology for Clinical Research, Assistance publique - Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
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Quantitative characterization of extraocular orbital lesions in children using diffusion-weighted imaging. Pediatr Radiol 2021; 51:119-127. [PMID: 32901319 DOI: 10.1007/s00247-020-04807-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/16/2020] [Accepted: 08/10/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) has been shown to be helpful in providing information about cellular density and also predicting the histological features of aggressive tumors. Several studies have evaluated this technique for orbital tumors. However, very few articles have focused exclusively on evaluating pediatric orbital masses and, within those, only a small number of patients were included in the study. OBJECTIVE This study aimed to evaluate the use of DWI and apparent diffusion coefficient (ADC) values to differentiate between benign and malignant extraocular orbital lesions in children. MATERIALS AND METHODS This retrospective study included 73 patients under the age of 18 seen in our hospital between October 2016 and February 2019. The extraocular orbital lesions were evaluated clinically and radiologically using DWI. The diagnosis was confirmed by either histological examination (after biopsy or surgery) or based on clinical and radiologic evaluation. RESULTS The malignant lesions were found to have increased diffusion restriction in comparison to the benign lesions. The ADC values of the malignant lesions were significantly lower (P<0.0001). The use of a cutoff value of 0.99×10-3 mm2/s allowed for the differentiation of the benign lesions and malignant lesions with a sensitivity of 75% and a specificity of 100% while the cutoff point of 1.26×10-3 mm2/s had a sensitivity of 100% and a specificity of 73%. CONCLUSION Measurement of ADC in extraocular orbital lesions in children may help differentiate malignant lesions from benign lesions.
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A prospective comparative dosimetric study between diffusion weighted MRI (DWI) & T2-weighted MRI (T2W) for target delineation and planning in cervical cancer brachytherapy. Rep Pract Oncol Radiother 2020; 25:1011-1016. [PMID: 33299382 DOI: 10.1016/j.rpor.2020.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/21/2020] [Accepted: 08/17/2020] [Indexed: 11/21/2022] Open
Abstract
Aim To evaluate the difference between GTVBT (Gross Tumor Volume at Brachytherapy) and HR CTV (High Risk Clinical Tumor Volume) delineated with DWI and T2W MRI. To evaluate doses to organs at risk and targets from plans generated using T2W and DWI. Background Functional imaging with DWI can improve cervical tumor distinction as it is more sensitive than T2W MRI even in detecting parametrial invasion. This study does a dosimetric comparison between a T2W and DWI based plan. Methods Fifty carcinoma cervix patients were subjected to MRI based brachytherapy. T2W and a diffusion weighted sequence were acquired. Target delineation and brachytherapy planning was done on both T2W and DWI. Standard DVH parameters were recorded and the treatment was given using the plan generated from T2W images. Results GTVBT and HRCTV contours on DWI were different when compared with T2W. Mean GTVBT volume on T2W and DWI was 5.25 and 5.23, respectively (p value 0.8). Mean HRCTV on T2W and DWI was 28.3 and 27 cc, respectively (p value 0.003). Planning on the above volumes resulted in a superior coverage in terms of HRCTV D90 and D100 for DWI based plan, HRCTV D90 - 735.1 and 741 cGy for T2W and DWI, respectively (p value 0.006), HRCTV D100 - 441.05 and 444.5 for T2W and DWI plans, respectively (p value = 0.006). Doses to the OAR were not significantly increased. Conclusion GEC ESTRO based contouring guidelines cover all the functionally abnormal areas on DWI. DWI should only be used as a supplement to T2W for contouring target volumes.
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Longo D, Bottino F, Lucignani G, Scarciolla L, Pasquini L, Rossi Espagnet MC, Polito C, Figà-Talamanca L, Calbi G, Savarese I, Giliberti P, Napolitano A. DTI parameters in neonates with hypoxic-ischemic encephalopathy after total body hypothermia. J Matern Fetal Neonatal Med 2020; 35:4035-4042. [PMID: 33203279 DOI: 10.1080/14767058.2020.1846180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging provides means for discriminating different patterns of Hypoxic-ischemic encephalopathy (HIE) and may distinguish most severe cases from less severe but is unable to predict long-term outcome. Diffusion tensor imaging (DTI) offers information for a more complete characterization of HIE. The purpose of this study is to compare the modifications of DTI parameters in newborns one week and six months following total-body cooling to healthy controls. METHODS Forty-seven cooled newborns were studied with MRI, 20 underwent follow-up at 6 months. 12 healthy newborns and nine children at 6 months were enrolled as control groups (HC). Inferior Longitudinal Fasciculus (ILF), Corpus Callosum Fasciculus (CCF), Corticospinal Tract (CST), Optical Tract (OT), Optic Radiation (OR) were generated in all subjects. DTI parameters were evaluated in basal ganglia (BG), thalamus (TH) and tracks. Statistical analysis was performed with MANOVA. RESULTS In newborns HIE versus HC, there were significantly lower fractional anisotropy (FA) on OR and CST and higher axial diffusivity (AD), apparent diffusion coefficient (ADC) and radial diffusivity (RD) values on CST, BG and TH in HIE-N. At 6 months there were no significant grouping effects. The analysis showed a significant increase of FA, decrease of ADC, AD, RD after 6 months for HIE and HC. CONCLUSIONS We observed modifications of parameter values in HIE newborns vs HC; however normalization of values at 6 months suggests that changes of parameters cannot be considered early biomarkers for evaluation of therapeutic hypothermia in newborns with moderate HIE and normal conventional MRI.
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Affiliation(s)
- D Longo
- Imaging Department, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - F Bottino
- Medical Physics Department, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - G Lucignani
- Imaging Department, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - L Scarciolla
- Imaging Department, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - L Pasquini
- NESMOS, Neuroradiology Department, Sapienza University, Rome, Italy
| | - M C Rossi Espagnet
- Imaging Department, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.,NESMOS, Neuroradiology Department, Sapienza University, Rome, Italy
| | - C Polito
- Medical Physics Department, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - L Figà-Talamanca
- Imaging Department, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - G Calbi
- Anesthesiology Unit, DEA-ARCO, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - I Savarese
- Neonatal Intensive Care Unit, Department of Medical and Surgical Neonatology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - P Giliberti
- Neonatal Intensive Care Unit, Department of Medical and Surgical Neonatology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - A Napolitano
- Medical Physics Department, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
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Yun JS, Lee MH, Lee SM, Lee JS, Kim HJ, Lee SJ, Chung HW, Lee SH, Shin MJ. Peripheral nerve sheath tumor: differentiation of malignant from benign tumors with conventional and diffusion-weighted MRI. Eur Radiol 2020; 31:1548-1557. [PMID: 32894357 DOI: 10.1007/s00330-020-07234-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 07/15/2020] [Accepted: 08/27/2020] [Indexed: 01/30/2023]
Abstract
OBJECTIVES To evaluate potential of conventional MRI and diffusion-weighted imaging (DWI) for differentiating malignant from benign peripheral nerve sheath tumors (PNSTs). METHODS Eighty-seven cases of malignant or benign PNSTs in the trunk or extremities that underwent conventional MRI with contrast enhancement, DWI, and pathologic confirmation between Sep. 2014 and Dec. 2017 were identified. Of these, 55 tumors of uncertain nature on MRI were included. Tumor size, signal, and morphology were reviewed on conventional MRI, and apparent diffusion coefficient (ADC) values of solid enhancing portions were measured from DWI. Patient demographics, MRI features, and ADC values were compared between benign and malignant tumors, and robust imaging findings for malignant peripheral nerve sheath tumors (MPNSTs) were identified using multivariable models. RESULTS A total of 55 uncertain tumors consisted of 18 malignant and 37 benign PNSTs. On MRI, tumor size, margin, perilesional edema, and presence of split fat, fascicular, and target signs were significantly different between groups (p < 0.05), as were mean and minimum ADC values (p = 0.002, p < 0.0001). Most inter-reader agreement was moderate to excellent (κ value, 0.45-1.0). The mean ADC value and absence of a split fat sign were identified as being associated with MPNSTs (odds ratios = 13.19 and 25.67 for reader 1; 49.05 and 117.91 for reader 2, respectively). The C-indices obtained by combining these two findings were 0.90 and 0.95, respectively. CONCLUSIONS Benign and malignant PNSTs showed different features on MRI and DWI. A combination of mean ADC value and absence of split fat was excellent for discriminating malignant from benign PNSTs. KEY POINTS • It is important to distinguish between malignant peripheral nerve sheath tumors (MPNSTs) and benign peripheral nerve sheath tumors (BPNSTs) to ensure an appropriate treatment plan. • On conventional MRI and diffusion-weighted imaging (DWI), MPNSTs and BPNSTs showed significant differences in tumor size, margin, presence of perilesional edema, and absence of split fat, fascicular, and target signs. • Absence of a split fat sign and mean apparent diffusion coefficient (ADC) values were robust imaging findings distinguishing MPNSTs from BPNSTs, with a C-index of > 0.9.
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Affiliation(s)
- Jae Sung Yun
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, South Korea
- Department of Radiology, Ajou University School of Medicine, Suwon, South Korea
| | - Min Hee Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - Seung Min Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, South Korea
- Department of Radiology, Leaders Hospital, Seoul, South Korea
| | - Jong Seok Lee
- Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Hwa Jung Kim
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, South Korea
- Department of Clinical Epidemiology and Biostatics, Asan Medical Center, Seoul, South Korea
| | - Sun Joo Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Hye Won Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sang Hoon Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Myung Jin Shin
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, South Korea
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Sumikawa T, Yabuuchi H, Sumikawa C, Nakashima Y, Miura G. Influence of blade width and magnetic field strength on the ADC on PROPELLER DWI in head and neck. Neuroradiol J 2019; 33:39-47. [PMID: 31407966 DOI: 10.1177/1971400919870178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the influence of blade width and magnetic field strength on apparent diffusion coefficient values of periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) diffusion-weighted imaging in the head and neck at 1.5 and 3.0 T magnetic resonance imaging. METHODS Fifteen healthy volunteers (eight men and seven women; mean age 36.4 ± 10.1 years) underwent PROPELLER diffusion-weighted imaging using four blade widths at 3.0 T and three blade widths at 1.5 T. For the multigroup comparison of apparent diffusion coefficient values, we performed analysis of variance and Tukey-Kramer tests. The apparent diffusion coefficient values in each organ were compared among the different blade widths and magnetic field strengths by a t test. Inter and intra-observer agreements regarding apparent diffusion coefficient value measurements were evaluated using the intraclass correlation coefficient. RESULTS No significant differences were observed in apparent diffusion coefficient values of the cerebellum in each blade width at both field strengths. The apparent diffusion coefficient values of the right parotid glands were significantly lower for blade width 32 than for blade width 16 at 3.0 T (1.16 × 10-3 mm2/s vs. 1.01 × 10-3 mm2/s; P < 0.05). The apparent diffusion coefficient values of bilateral parotid glands were significantly higher at 1.5 T than at 3.0 T. Intraclass correlation coefficients were almost perfect to substantial in the cerebellum, whereas they showed moderate agreement in the parotid glands. CONCLUSION The largest blade width 32 at 3.0 T and high magnetic field strength lowered the apparent diffusion coefficient values of parotid glands of PROPELLER diffusion-weighted imaging. The apparent diffusion coefficient values in the parotid glands of PROPELLER diffusion-weighted imaging may be affected for blade width and magnetic field strength.
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Affiliation(s)
- Tetsuo Sumikawa
- Department of Radiology, Yamaguchi Prefectural Grand Medical Center, Japan.,Department of Health Sciences, Kyushu University, Japan
| | | | - Chiharu Sumikawa
- Department of Radiology, Yamaguchi Prefectural Grand Medical Center, Japan
| | | | - Gouji Miura
- Department of Health Sciences, Kyushu University, Japan
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White Matter Microstructure in Illiterate and Low-Literate Elderly Brazilians: Preliminary Findings. Cogn Behav Neurol 2019; 31:193-200. [PMID: 30562228 DOI: 10.1097/wnn.0000000000000173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate differences in white matter microstructure between illiterate and low-literate elderly Brazilians. BACKGROUND High literacy levels are believed to partially counteract the negative effects of neurodegenerative diseases. Investigating the impact of low literacy versus illiteracy on brain structure can contribute knowledge about cognitive reserve in elderly populations with low educational attainment. Fractional anisotropy is a measure derived from diffusion tensor imaging sequences that positively correlate with the integrity of the brain's white matter microstructure. METHODS Older adults who participated in an epidemiological study to investigate brain aging in Brazil and had magnetic resonance scans with the diffusion tensor imaging acquisition were selected (n=31). Participants were divided into two groups: (a) low-literate (n=21), with 3.4 (1.4) years of education, 79.8 (3.8) years of age, 17 cognitively healthy and four with cognitive impairment-no dementia; and (b) illiterate (n=10) with no formal schooling, 80.7 (4.1) years of age, six cognitively healthy and four with cognitive impairment-no dementia. We contrasted the two groups' white matter microstructure measures using whole-brain and region of interest approaches. RESULTS The low-literate participants had significantly higher fractional anisotropy values in the right superior longitudinal fasciculus than did the illiterate ones. CONCLUSIONS Although our results are preliminary because of the sample size, they suggest that low literacy, versus illiteracy, is associated with higher fractional anisotropy values, which are indirect measurements of white matter microstructure. This finding provides insight into a possible mechanism by which literacy, even at low levels, may contribute to cognitive reserve.
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Corrias G, Raeside MC, Agostini A, Huicochea-Castellanos S, Aramburu-Nunez D, Paudyal R, Shukla-Dave A, Smelianskaia O, Capanu M, Zheng J, Fung M, Kelsen DP, Mangino DA, Robson ME, Goldfrank DJ, Carter J, Allen PJ, Conti B, Monti S, Do RKG, Mannelli L. Pilot study of rapid MR pancreas screening for patients with BRCA mutation. Eur Radiol 2019; 29:3976-3985. [PMID: 30689033 DOI: 10.1007/s00330-018-5975-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/16/2018] [Accepted: 12/14/2018] [Indexed: 01/03/2023]
Abstract
PURPOSE To develop and optimize a rapid magnetic resonance imaging (MRI) screening protocol for pancreatic cancer to be performed in conjunction with breast MRI screening in breast cancer susceptibility gene (BRCA)-positive individuals. METHODS An IRB-approved prospective study was conducted. The rapid screening pancreatic MR protocol was designed to be less than 10 min to be performed after a standard breast MRI protocol. Protocol consisted of coronal NT T2 SSFSE, axial NT T2 SSFSE and axial NT rFOV FOCUS DWI, and axial T1. Images were acquired with the patient in the same prone position of breast MRI using the built-in body coil. Image quality was qualitatively assessed by two radiologists with 12 and 13 years of MRI experience, respectively. The imaging protocol was modified until an endpoint of five consecutive patients with high-quality diagnostic images were achieved. Signal-to-noise ratio and contrast-to-noise ratio were assessed. RESULTS The rapid pancreas MR protocol was successfully completed in all patients. Diagnostic image quality was achieved for all patients. Excellent image quality was achieved for low b values; however, image quality at higher b values was more variable. In one patient, a pancreatic neuroendocrine tumor was found and the patient was treated surgically. In four patients, small pancreatic cystic lesions were detected. In one subject, a hepatic mass was identified and confirmed as adenoma by liver MRI. CONCLUSION Rapid MR protocol for pancreatic cancer screening is feasible and has the potential to play a role in screening BRCA patients undergoing breast MRI. KEY POINT • Develop and optimize a rapid magnetic resonance imaging (MRI) screening protocol for pancreatic cancer to be performed in conjunction with breast MRI screening in BRCA mutation positive individuals.
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Affiliation(s)
- Giuseppe Corrias
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | - Mitchell C Raeside
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Andrea Agostini
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- Department of Radiology, Università Politecnica delle Marche, Ancona, Italy
| | | | - David Aramburu-Nunez
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ramesh Paudyal
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Amita Shukla-Dave
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Olga Smelianskaia
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Marinela Capanu
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Junting Zheng
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maggie Fung
- GE Healthcare, Global MR Applications and Workflow, New York, NY, USA
| | - David P Kelsen
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Debra A Mangino
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mark E Robson
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Deborah J Goldfrank
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jean Carter
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter J Allen
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bettina Conti
- Policlinico Umberto I, Department of Radiology, Sapienza University of Rome, Rome, Italy
| | | | - Richard K G Do
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Lorenzo Mannelli
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
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Apparent diffusion coefficient reproducibility in brain tumors measured on 1.5 and 3 T clinical scanners: A pilot study. Eur J Radiol 2018; 108:249-253. [PMID: 30396664 DOI: 10.1016/j.ejrad.2018.10.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/04/2018] [Accepted: 10/11/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Gradient and coil systems, pulse sequence design, and imaging parameters, as well as different scanners, can influence apparent diffusion coefficient (ADC) values. The aim of this study was to evaluate the effect of two different field strengths on the reproducibility of mean absolute ADC measurements in various primary and secondary brain tumors. METHODS Fifty patients with histologically proven brain tumors were prospectively examined on two MR scanners from the same vendor, with different field strengths-1.5T and 3T-on the same day. Absolute ADC values were compared using the Wilcoxon matched-pairs signed-rank test. Inter-scanner agreement between two different fields in the same tumor was examined using correlation coefficients, and the discrepancy between the highest and the lowest mean absolute ADC values between scanners was tested using a one-way analysis of variance. Statistical significance was set at p < 0.05. RESULTS There was no statistically significant difference between mean absolute ADC values obtained on 1.5T and 3T scanners for all patients and all brain tumor types. The intratumoral difference in ADC values, averaged from two scanners in the same tumor type, ranged from 1.58 to 4.5% for 1.5T, and from 1.18 to 4.37% for 3T.Inter-scanner agreement was high, and the kappa coefficient ranged from 0.88 to 0.99, with no significant difference between obtained values on different field strengths. CONCLUSION Based on the results obtained in our study, there is no significant difference between mean absolute ADC values measured in various primary and secondary brain tumors at different field strengths (1.5 and 3.0T MR systems), in the same patient, and in the same tumor, measured on the same day.
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The use of whole body diffusion-weighted post-mortem magnetic resonance imaging in timing of perinatal deaths. Int J Legal Med 2018; 132:1735-1741. [PMID: 30056622 PMCID: PMC6208717 DOI: 10.1007/s00414-018-1906-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 07/19/2018] [Indexed: 12/05/2022]
Abstract
Objectives Diffusion-weighted MRI provides information regarding body water movement following death, which may be an imaging marker of post-mortem interval (time since death; PMI) or maceration (degree of tissue degradation during intra-uterine retention) in perinatal deaths. Our aim was to evaluate the relationship between maceration, PMI and body organ apparent diffusion coefficient (ADC) values in a cohort of subjects across a wide gestational range. Materials Whole body post-mortem MRI with diffusion-weighted imaging (DWI) sequences were performed at 1.5 T, with b values of 0, 500 and 1000 mm2/s. Mean ADC values were calculated from regions of interest (ROIs) placed in the lungs, myocardium, spleen, renal cortex, liver and psoas muscle by two independent readers. Multivariable regression analysis was performed against PMI, gestational age, post-mortem weight, maceration score and gender. Results Eighty perinatal deaths were imaged with mean gestational age of 32 weeks (18–41 weeks), of which 49 (61.3%) were male. The mean PMI was 8 days (1–18 days). Maceration scores were statistically significant predictive factors for ADC values in all included body organs except the lungs, but PMI was not a predictor for ADC values in any body organ. In the absence of maceration (n = 14), PMI was not statistically associated with ADC values in any of the body areas. The ratio of agreement in the majority of body areas was close to 1 (range between 0.95 and 1.10). Conclusion Maceration, not PMI, is significantly associated with ADC values in perinatal deaths. Further research is needed to understand organ-specific changes in the post-mortem period.
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Resende EDPF, Tovar-Moll FF, Ferreira FM, Bramati I, de Souza LC, Carmona KC, Guimarães HC, Carvalho VA, Barbosa MT, Caramelli P. Integrity of white matter structure is related to episodic memory performance in the low-educated elderly. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 75:778-784. [PMID: 29236820 DOI: 10.1590/0004-282x20170158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/11/2017] [Indexed: 11/22/2022]
Abstract
The low-educated elderly are a vulnerable population in whom studying the role of white matter integrity on memory may provide insights for understanding how memory declines with aging and disease. METHODS Thirty-one participants (22 women), 23 cognitively healthy and eight with cognitive impairment-no dementia, aged 80.4 ± 3.8 years, with 2.2 ± 1.9 years of education, underwent an MRI scan with diffusion tensor imaging (DTI) acquisition. We verified if there were correlations between the performance on the Brief Cognitive Screening Battery (BCSB) and the Rey Auditory Verbal Learning Test (RAVLT) with DTI parameters. RESULTS The BCSB delayed recall task correlated with frontotemporoparietal connection bundles, with the hippocampal part of the cingulum bilaterally and with the right superior longitudinal fasciculus. The RAVLT learning and delayed recall scores also correlated with the hippocampal part of the cingulum bilaterally. CONCLUSIONS Although preliminary, our study suggests that the integrity of white matter frontotemporoparietal fasciculi seems to play a role in episodic memory performance in the low-educated elderly. This finding opens opportunities to study potential targets for memory decline prevention in vulnerable populations.
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Affiliation(s)
- Elisa de Paula França Resende
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | | | | | - Ivanei Bramati
- IDOR - Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro RJ, Brasil
| | - Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | - Karoline Carvalho Carmona
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | - Henrique Cerqueira Guimarães
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | - Viviane Amaral Carvalho
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Faculdade de Medicina da Belo Horizonte, Departamento de Clínica Médica, Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Belo Horizonte MG, Brasil
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Jakab A, Tuura R, Kellenberger C, Scheer I. In utero diffusion tensor imaging of the fetal brain: A reproducibility study. NEUROIMAGE-CLINICAL 2017; 15:601-612. [PMID: 28652972 PMCID: PMC5477067 DOI: 10.1016/j.nicl.2017.06.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/25/2017] [Accepted: 06/08/2017] [Indexed: 02/06/2023]
Abstract
Our purpose was to evaluate the within-subject reproducibility of in utero diffusion tensor imaging (DTI) metrics and the visibility of major white matter structures. Images for 30 fetuses (20-33. postmenstrual weeks, normal neurodevelopment: 6 cases, cerebral pathology: 24 cases) were acquired on 1.5 T or 3.0 T MRI. DTI with 15 diffusion-weighting directions was repeated three times for each case, TR/TE: 2200/63 ms, voxel size: 1 ∗ 1 mm, slice thickness: 3-5 mm, b-factor: 700 s/mm2. Reproducibility was evaluated from structure detectability, variability of DTI measures using the coefficient of variation (CV), image correlation and structural similarity across repeated scans for six selected structures. The effect of age, scanner type, presence of pathology was determined using Wilcoxon rank sum test. White matter structures were detectable in the following percentage of fetuses in at least two of the three repeated scans: corpus callosum genu 76%, splenium 64%, internal capsule, posterior limb 60%, brainstem fibers 40% and temporooccipital association pathways 60%. The mean CV of DTI metrics ranged between 3% and 14.6% and we measured higher reproducibility in fetuses with normal brain development. Head motion was negatively correlated with reproducibility, this effect was partially ameliorated by motion-correction algorithm using image registration. Structures on 3.0 T had higher variability both with- and without motion correction. Fetal DTI is reproducible for projection and commissural bundles during mid-gestation, however, in 16-30% of the cases, data were corrupted by artifacts, resulting in impaired detection of white matter structures. To achieve robust results for the quantitative analysis of diffusivity and anisotropy values, fetal-specific image processing is recommended and repeated DTI is needed to ensure the detectability of fiber pathways.
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Key Words
- AD, axial diffusivity
- CCA, corpus callosum agenesis
- CV, coefficient of variation
- Connectome
- DTI, diffusion tensor imaging
- Diffusion tensor imaging
- FA, fractional anisotropy
- Fetal brain connectivity
- Fetal diffusion MRI
- GW, gestational week
- MD, mean diffusivity
- Prenatal development
- RD, radial diffusivity
- ROI, region of interest
- SSIM, structural similarity index
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Affiliation(s)
- András Jakab
- Center for MR-Research, University Children's Hospital, Zürich, Switzerland; Computational Imaging Research Lab (CIR), Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
| | - Ruth Tuura
- Center for MR-Research, University Children's Hospital, Zürich, Switzerland
| | | | - Ianina Scheer
- Department of Diagnostic Imaging, University Children's Hospital, Zürich, Switzerland
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Souza EMD, Costa ET, Castellano G. Phantoms for diffusion-weighted imaging and diffusion tensor imaging quality control: a review and new perspectives. ACTA ACUST UNITED AC 2017. [DOI: 10.1590/2446-4740.07816] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Gabriela Castellano
- University of Campinas, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, Brazil
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Crombe A, Alberti N, Hiba B, Uettwiller M, Dousset V, Tourdias T. Cervical Spinal Cord DTI Is Improved by Reduced FOV with Specific Balance between the Number of Diffusion Gradient Directions and Averages. AJNR Am J Neuroradiol 2016; 37:2163-2170. [PMID: 27365330 DOI: 10.3174/ajnr.a4850] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/25/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Reduced-FOV DTI is promising for exploring the cervical spinal cord, but the optimal set of parameters needs to be clarified. We hypothesized that the number of excitations should be favored over the number of diffusion gradient directions regarding the strong orientation of the cord in a single rostrocaudal axis. MATERIALS AND METHODS Fifteen healthy individuals underwent cervical spinal cord MR imaging at 3T, including an anatomic 3D-Multi-Echo Recombined Gradient Echo, high-resolution full-FOV DTI with a NEX of 3 and 20 diffusion gradient directions and 5 sets of reduced-FOV DTIs differently balanced in terms of NEX/number of diffusion gradient directions: (NEX/number of diffusion gradient directions = 3/20, 5/16, 7/12, 9/9, and 12/6). Each DTI sequence lasted 4 minutes 30 seconds, an acceptable duration, to cover C1-C4 in the axial plane. Fractional anisotropy maps and tractograms were reconstructed. Qualitatively, 2 radiologists rated the DTI sets blinded to the sequence. Quantitatively, we compared distortions, SNR, variance of fractional anisotropy values, and numbers of detected fibers. RESULTS Qualitatively, reduced-FOV DTI sequences with a NEX of ≥5 were significantly better rated than the full-FOV DTI and the reduced-FOV DTI with low NEX (N = 3) and a high number of diffusion gradient directions (D = 20). Quantitatively, the best trade-off was reached by the reduced-FOV DTI with a NEX of 9 and 9 diffusion gradient directions, which provided significantly fewer artifacts, higher SNR on trace at b = 750 s/mm2 and an increased number of fibers tracked while maintaining similar fractional anisotropy values and dispersion. CONCLUSIONS Optimized reduced-FOV DTI improves spinal cord imaging. The best compromise was obtained with a NEX of 9 and 9 diffusion gradient directions, which emphasizes the need for increasing the NEX at the expense of the number of diffusion gradient directions for spinal cord DTI contrary to brain DTI.
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Affiliation(s)
- A Crombe
- From the Centre Hospitalier Universitaire de Bordeaux (A.C., V.D., T.T.), Service de NeuroImagerie Diagnostique de Thérapeutique, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale U1215 (A.C., V.D., T.T.), Physiopathologie de la Plasticité Neuronale, Bordeaux, France
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
| | - N Alberti
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
- Centre de Résonance Magnétique des Systèmes Biologiques (N.A., B.H.), Centre National de la Recherche Scientifique Unité Mixte de Recherche 5536, Bordeaux, France
| | - B Hiba
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
- Centre de Résonance Magnétique des Systèmes Biologiques (N.A., B.H.), Centre National de la Recherche Scientifique Unité Mixte de Recherche 5536, Bordeaux, France
- Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (B.H.), Centre National de la Recherche Scientifique Unité Mixte de Recherche 5287, Bordeaux, France
| | - M Uettwiller
- GE Healthcare (M.U.), Vélizy-Villacoublay, France
| | - V Dousset
- From the Centre Hospitalier Universitaire de Bordeaux (A.C., V.D., T.T.), Service de NeuroImagerie Diagnostique de Thérapeutique, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale U1215 (A.C., V.D., T.T.), Physiopathologie de la Plasticité Neuronale, Bordeaux, France
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
| | - T Tourdias
- From the Centre Hospitalier Universitaire de Bordeaux (A.C., V.D., T.T.), Service de NeuroImagerie Diagnostique de Thérapeutique, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale U1215 (A.C., V.D., T.T.), Physiopathologie de la Plasticité Neuronale, Bordeaux, France
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
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Ihalainen T, Kuusela L, Soikkeli M, Lantto E, Ovissi A, Sipilä O. A body-sized phantom for evaluation of diffusion-weighted MRI data using conventional, readout-segmented, and zoomed echo-planar sequences. Acta Radiol 2016; 57:947-54. [PMID: 26543056 DOI: 10.1177/0284185115613652] [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] [Received: 03/20/2015] [Accepted: 09/25/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Abdominal diffusion-weighted imaging (DWI) has been rapidly increasing during the last few years. For the evaluation of new DWI techniques, the development of suitable phantoms and quality assurance methods is important. PURPOSE To construct a body-diameter phantom for abdominal DWI and study the impact of different acquisition options on image quality. MATERIAL AND METHODS A phantom with a diameter of 31 cm and a volume of 26 L was constructed, containing four samples representing a clinically relevant range of apparent diffusion coefficient (ADC) values. Measurements were carried out on 1.5T and 3.0T MRI systems using conventional echo-planar imaging (EPI), readout-segmented EPI, and zoomed EPI (3.0T) sequences. The effects of parallel imaging, coil intensity normalization, and patient-specific B1 shim (3.0T) were also examined. ADC values and signal-to-noise ratios of the samples were measured, and the level of artifacts was visually evaluated. RESULTS The agreement of ADC values between different acquisition options was generally good, but higher values (by 0.07 × 10(-3) mm(2)/s on the average) with readout-segmented EPI as well as ADC variations of approximately 0.1 × 10(-3) mm(2)/s in slice direction were observed. The image artifacts were reduced by using patient-specific B1 shim, readout-segmented EPI, or zoomed EPI. CONCLUSION The body-sized phantom demonstrated well the expected image artifacts in DWI with large field of view. The use of patient-specific B1 shim, readout-segmented EPI, or zoomed EPI improved image quality of DWI in this study.
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Affiliation(s)
- Toni Ihalainen
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Linda Kuusela
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Maiju Soikkeli
- Department of Chemistry, University of Helsinki, Helsinki, Finland
| | - Eila Lantto
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ali Ovissi
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Outi Sipilä
- HUS Medical Imaging Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Yoshida T, Urikura A, Shirata K, Nakaya Y, Terashima S, Hosokawa Y. Image quality assessment of single-shot turbo spin echo diffusion-weighted imaging with parallel imaging technique: a phantom study. Br J Radiol 2016; 89:20160512. [PMID: 27452269 DOI: 10.1259/bjr.20160512] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the image quality and apparent diffusion coefficient (ADC) values of single-shot turbo spin echo (TSE) diffusion-weighted (DW) images obtained using a parallel imaging (PI) technique. METHODS All measurements were performed on a 3.0-T whole-body MRI system and 32-channel phased-array coil. Signal-to-noise ratio (SNR) and ADC values were measured with a DW imaging (DWI) phantom comprising granulated sugar and agar. The SNRs were calculated using a subtraction method and compared among TSE-DW images at acceleration factors (AFs) of 1-4. Image blur was visually assessed on TSE-DW images of a pin phantom at AFs of 1-4. The ADC values were calculated using DW images with b = 0 and 1000 s mm(-2). The ADC values of TSE-DW images and echo-planar imaging EPI-DW images were compared. RESULTS The SNRs decreased as AFs increased, despite selecting the shortest echo time. A lower AF caused increased image blur in the phase-encoding direction. The ADC values of TSE-DWI tended to be lower than those of EPI-DWI, and AFs of 3 and 4 yielded variable ADC values on TSE-DW images. CONCLUSION TSE-DWI with an AF of 3 or 4 yielded reduced SNRs; in addition, the image noise and artefacts associated with PI technique may have affected ADC measurements, despite improving image blur in the phase-encoding direction. ADVANCES IN KNOWLEDGE Optimizing the imaging parameters of TSE-DWI is useful for providing good image quality and accurate ADC measurements.
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Affiliation(s)
- Tsukasa Yoshida
- 1 Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan.,2 Department of Radiation Science, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Atsushi Urikura
- 1 Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kensei Shirata
- 1 Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoshihiro Nakaya
- 1 Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shingo Terashima
- 3 Department of Radiological Life Sciences, Division of Medical Life Sciences, Hirosaki University, Hirosaki, Japan
| | - Yoichiro Hosokawa
- 3 Department of Radiological Life Sciences, Division of Medical Life Sciences, Hirosaki University, Hirosaki, Japan
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Jerome NP, Papoutsaki MV, Orton MR, Parkes HG, Winfield JM, Boss MA, Leach MO, deSouza NM, Collins DJ. Development of a temperature-controlled phantom for magnetic resonance quality assurance of diffusion, dynamic, and relaxometry measurements. Med Phys 2016; 43:2998-3007. [PMID: 27277048 DOI: 10.1118/1.4948997] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 04/20/2016] [Accepted: 04/28/2016] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Diffusion-weighted (DW) and dynamic contrast-enhanced magnetic resonance imaging (MRI) are increasingly applied for the assessment of functional tissue biomarkers for diagnosis, lesion characterization, or for monitoring of treatment response. However, these techniques are vulnerable to the influence of various factors, so there is a necessity for a standardized MR quality assurance procedure utilizing a phantom to facilitate the reliable estimation of repeatability of these quantitative biomarkers arising from technical factors (e.g., B1 variation) affecting acquisition on scanners of different vendors and field strengths. The purpose of this study is to present a novel phantom designed for use in quality assurance for multicenter trials, and the associated repeatability measurements of functional and quantitative imaging protocols across different MR vendors and field strengths. METHODS A cylindrical acrylic phantom was manufactured containing 7 vials of polyvinylpyrrolidone (PVP) solutions of different concentrations, ranging from 0% (distilled water) to 25% w/w, to create a range of different MR contrast parameters. Temperature control was achieved by equilibration with ice-water. Repeated MR imaging measurements of the phantom were performed on four clinical scanners (two at 1.5 T, two at 3.0 T; two vendors) using the same scanning protocol to assess the long-term and short-term repeatability. The scanning protocol consisted of DW measurements, inversion recovery (IR) T1 measurements, multiecho T2 measurement, and dynamic T1-weighted sequence allowing multiple variable flip angle (VFA) estimation of T1 values over time. For each measurement, the corresponding calculated parameter maps were produced. On each calculated map, regions of interest (ROIs) were drawn within each vial and the median value of these voxels was assessed. For the dynamic data, the autocorrelation function and their variance were calculated; for the assessment of the repeatability, the coefficients of variation (CoV) were calculated. RESULTS For both field strengths across the available vendors, the apparent diffusion coefficient (ADC) at 0 °C ranged from (1.12 ± 0.01) × 10(-3) mm(2)/s for pure water to (0.48 ± 0.02) × 10(-3) mm(2)/s for the 25% w/w PVP concentration, presenting a minor variability between the vendors and the field strengths. T2 and IR-T1 relaxation time results demonstrated variability between the field strengths and the vendors across the different acquisitions. Moreover, the T1 values derived from the VFA method exhibited a large variation compared with the IR-T1 values across all the scanners for all repeated measurements, although the calculation of the standard deviation of the VFA-T1 estimate across each ROI and the autocorrelation showed a stability of the signal for three scanners, with autocorrelation of the signal over the dynamic series revealing a periodic variation in one scanner. Finally, the ADC, the T2, and the IR-T1 values exhibited an excellent repeatability across the scanners, whereas for the dynamic data, the CoVs were higher. CONCLUSIONS The combination of a novel PVP phantom, with multiple compartments to give a physiologically relevant range of ADC and T1 values, together with ice-water as a temperature-controlled medium, allows reliable quality assurance measurements that can be used to measure agreement between MRI scanners, critical in multicenter functional and quantitative imaging studies.
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Affiliation(s)
- Neil P Jerome
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, 123 Old Brompton Road, London SM2 5NG, United Kingdom
| | - Marianthi-Vasiliki Papoutsaki
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, 123 Old Brompton Road, London SM2 5NG, United Kingdom
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, 123 Old Brompton Road, London SM2 5NG, United Kingdom and Members of the Quantitative Imaging in Cancer: Connecting Cellular Processes with Therapy (QuiC-ConCePT) Consortium
| | - Matthew R Orton
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, 123 Old Brompton Road, London SM2 5NG, United Kingdom
| | - Harold G Parkes
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, 123 Old Brompton Road, London SM2 5NG, United Kingdom
| | - Jessica M Winfield
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, 123 Old Brompton Road, London SM2 5NG, United Kingdom
| | - Michael A Boss
- National Institute of Standards and Technology, 325 Broadway, Boulder, Colorado 80305
| | - Martin O Leach
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, 123 Old Brompton Road, London SM2 5NG, United Kingdom
| | - Nandita M deSouza
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, 123 Old Brompton Road, London SM2 5NG, United Kingdom and Members of the Quantitative Imaging in Cancer: Connecting Cellular Processes with Therapy (QuiC-ConCePT) Consortium
| | - David J Collins
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden Hospital, 123 Old Brompton Road, London SM2 5NG, United Kingdom
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Foti PV, Ognibene N, Spadola S, Caltabiano R, Farina R, Palmucci S, Milone P, Ettorre GC. Non-neoplastic diseases of the fallopian tube: MR imaging with emphasis on diffusion-weighted imaging. Insights Imaging 2016; 7:311-27. [PMID: 26992404 PMCID: PMC4877350 DOI: 10.1007/s13244-016-0484-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/26/2016] [Accepted: 03/03/2016] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE We illustrate the magnetic resonance imaging (MRI) features of non-neoplastic tubaric conditions. BACKGROUND A variety of pathologic non-neoplastic conditions may affect the fallopian tubes. Knowledge of their imaging appearance is important for correct diagnosis. With recent advances in MRI, along with conventional MR sequences, diffusion-weighted imaging (DWI) sequences are available and may improve lesion characterization by discriminating the nature of the content of the dilated tube. Tubal fluid with low signal intensity on T1-weighted images, high signal intensity on T2-weighted images and no restricted diffusion on DWI is indicative of hydrosalpinx. Content with high signal intensity on T1-weighted images and restricted diffusion on DWI is suggestive of hematosalpinx associated with endometriosis or tubal pregnancy. A dilated tube with variable or heterogeneous signal intensity content on conventional MR sequences and restricted diffusion on DWI may suggest a pyosalpinx or tubo-ovarian abscess. We describe morphological characteristics, MR signal intensity features, enhancement behaviour and possible differential diagnosis of each lesion. CONCLUSION MRI is the method of choice to study adnexal pelvic masses. Qualitative and quantitative functional imaging with DWI can be of help in characterization of tubaric diseases, provided that findings are interpreted in conjunction with those obtained with conventional MRI sequences. TEACHING POINTS • Nondilated fallopian tubes are not usually seen on MR images. • MRI is the method of choice to characterize and localize utero-adnexal masses. • MRI allows characterization of lesions through evaluation of the fluid content's signal intensity. • DWI in conjunction with conventional MRI sequences may improve tissue characterization. • Pelvic inflammatory disease is the most common tubal pathology.
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Affiliation(s)
- Pietro Valerio Foti
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy.
| | - Noemi Ognibene
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Saveria Spadola
- Department G.F. Ingrassia - Institute of Pathology, University of Catania, Catania, Italy
| | - Rosario Caltabiano
- Department G.F. Ingrassia - Institute of Pathology, University of Catania, Catania, Italy
| | - Renato Farina
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Stefano Palmucci
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Pietro Milone
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Giovanni Carlo Ettorre
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
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Foti PV, Attinà G, Spadola S, Caltabiano R, Farina R, Palmucci S, Zarbo G, Zarbo R, D'Arrigo M, Milone P, Ettorre GC. MR imaging of ovarian masses: classification and differential diagnosis. Insights Imaging 2016; 7:21-41. [PMID: 26671276 PMCID: PMC4729709 DOI: 10.1007/s13244-015-0455-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/18/2015] [Accepted: 11/27/2015] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE We propose a Magnetic Resonance Imaging (MRI) guided approach to differential diagnosis of ovarian tumours based on morphological appearance. BACKGROUND Characterization of ovarian lesions is of great importance in order to plan adequate therapeutic procedures, and may influence patient's management. Optimal assessment of adnexal masses requires a multidisciplinary approach, based on physical examination, laboratory tests and imaging techniques. Primary ovarian tumours can be classified into three main categories according to tumour origin: epithelial, germ cell and sex cord-stromal tumours. Ovarian neoplasms may be benign, borderline or malignant. Using an imaging-guided approach based on morphological appearance, we classified adnexal masses into four main groups: unilocular cyst, multilocular cyst, cystic and solid, predominantly solid. We describe MR signal intensity features and enhancement behaviour of ovarian lesions using pathologically proven examples from our institution. CONCLUSION MRI is an essential problem-solving tool to determine the site of origin of a pelvic mass, to characterize an adnexal mass, and to detect local invasion. The main advantages of MRI are the high contrast resolution and lack of ionizing radiation exposure. Although different pathological conditions may show similar radiologic manifestations, radiologists should be aware of MRI features of ovarian lesions that may orientate differential diagnosis. TEACHING POINTS • Diagnostic imaging plays a crucial role in detection, characterization and staging of adnexal masses. • Characterization of an ovarian lesion may influence patient's management. • Different pathological conditions may have similar radiologic manifestations. • Non-neoplastic lesions should always be taken into consideration.
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Affiliation(s)
- Pietro Valerio Foti
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy.
| | - Giancarlo Attinà
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Saveria Spadola
- Department G.F. Ingrassia - Institute of Pathology, University of Catania, Catania, Italy
| | - Rosario Caltabiano
- Department G.F. Ingrassia - Institute of Pathology, University of Catania, Catania, Italy
| | - Renato Farina
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Stefano Palmucci
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Giuseppe Zarbo
- Department of General Surgery and Medical-Surgical Specialties - Institute of Obstetrics and Ginecology, University of Catania, Catania, Italy
| | - Rosario Zarbo
- Department of General Surgery and Medical-Surgical Specialties - Institute of Obstetrics and Ginecology, University of Catania, Catania, Italy
| | - Maria D'Arrigo
- Pathology Unit, University Hospital "Policlinico-Vittorio Emanuele", Catania, Italy
| | - Pietro Milone
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Giovanni Carlo Ettorre
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, 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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Doblas S, Almeida GS, Blé FX, Garteiser P, Hoff BA, McIntyre DJ, Wachsmuth L, Chenevert TL, Faber C, Griffiths JR, Jacobs AH, Morris DM, O’Connor JP, Robinson SP, Van Beers BE, Waterton JC. Apparent diffusion coefficient is highly reproducible on preclinical imaging systems: Evidence from a seven-center multivendor study. J Magn Reson Imaging 2015; 42:1759-64. [PMID: 26012876 PMCID: PMC5968828 DOI: 10.1002/jmri.24955] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/08/2015] [Accepted: 05/11/2015] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To evaluate between-site agreement of apparent diffusion coefficient (ADC) measurements in preclinical magnetic resonance imaging (MRI) systems. MATERIALS AND METHODS A miniaturized thermally stable ice-water phantom was devised. ADC (mean and interquartile range) was measured over several days, on 4.7T, 7T, and 9.4T Bruker, Agilent, and Magnex small-animal MRI systems using a common protocol across seven sites. Day-to-day repeatability was expressed as percent variation of mean ADC between acquisitions. Cross-site reproducibility was expressed as 1.96 × standard deviation of percent deviation of ADC values. RESULTS ADC measurements were equivalent across all seven sites with a cross-site ADC reproducibility of 6.3%. Mean day-to-day repeatability of ADC measurements was 2.3%, and no site was identified as presenting different measurements than others (analysis of variance [ANOVA] P = 0.02, post-hoc test n.s.). Between-slice ADC variability was negligible and similar between sites (P = 0.15). Mean within-region-of-interest ADC variability was 5.5%, with one site presenting a significantly greater variation than the others (P = 0.0013). CONCLUSION Absolute ADC values in preclinical studies are comparable between sites and equipment, provided standardized protocols are employed.
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Affiliation(s)
- Sabrina Doblas
- Laboratory of imaging biomarkers, UMR 1149 – CRI, Inserm, Paris Diderot University, Paris, France
| | - Gilberto S. Almeida
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | | | - Philippe Garteiser
- Laboratory of imaging biomarkers, UMR 1149 – CRI, Inserm, Paris Diderot University, Paris, France
| | - Benjamin A. Hoff
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Lydia Wachsmuth
- Department of Clinical Radiology, Münster University Hospital, Westfälische Wilhelms-Universität, Münster, Germany
| | | | - Cornelius Faber
- Department of Clinical Radiology, Münster University Hospital, Westfälische Wilhelms-Universität, Münster, Germany
| | | | - Andreas H. Jacobs
- European Institute for Molecular Imaging, Westfälische Wilhelms-Universität, Münster, Germany
| | - David M. Morris
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | | | - Simon P. Robinson
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - Bernard E. Van Beers
- Laboratory of imaging biomarkers, UMR 1149 – CRI, Inserm, Paris Diderot University, Paris, France
| | - John C. Waterton
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
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Foti PV, Farina R, Coronella M, Palmucci S, Montana A, Sigona A, Reibaldi M, Longo A, Russo A, Avitabile T, Caltabiano R, Puzzo L, Ragusa M, Mariotti C, Milone P, Ettorre GC. Diffusion-weighted magnetic resonance imaging for predicting and detecting the response of ocular melanoma to proton beam therapy: initial results. Radiol Med 2015; 120:526-35. [PMID: 25578783 DOI: 10.1007/s11547-014-0488-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 09/15/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this study was to investigate the utility of diffusion-weighted magnetic resonance (MR) imaging for prediction and early detection of response to proton beam therapy in ocular melanoma. MATERIALS AND METHODS Ten ocular melanoma patients treated with proton beam therapy were enrolled in the study. All patients underwent conventional MR imaging and diffusion-weighted imaging (DWI) before the start of therapy, and after 1, 3 and 6 months of therapy. Tumour volumes and apparent diffusion coefficient (ADC) values of ocular lesions were measured at each examination. Tumour volumes and mean ADC measurements of the four examination series were compared; correlation of ADC values and tumour regression was investigated. RESULTS Mean ADC value of ocular melanomas significantly increased as early as 3 months after therapy; tumour volume significantly decreased as early as 6 months after therapy. The ADC values of ocular melanomas before therapy significantly correlated with tumour regression. CONCLUSIONS DWI may provide an early surrogate biomarker for prediction and early detection of tumour response to eye-preserving therapies in ocular melanoma.
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Affiliation(s)
- Pietro Valerio Foti
- Dipartimento Specialità Medico-Chirurgiche, Sezione di Scienze Radiologiche, Università di Catania, Via Santa Sofia 78, 95123, Catania, Italy,
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