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Cao D, Sun Y, Li Y, Su P, Pillai JJ, Qiao Y, Lu H, Van Zijl PC, Knutsson L, Hua J. Concurrent measurement of perfusion parameters related to small blood vessels and cerebrospinal fluid circulation in the human brain using dynamic dual-spin-echo perfusion MRI. NMR IN BIOMEDICINE 2023; 36:e4984. [PMID: 37308297 PMCID: PMC10808973 DOI: 10.1002/nbm.4984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/25/2023] [Accepted: 05/12/2023] [Indexed: 06/14/2023]
Abstract
Accumulating evidence from recent studies has indicated the importance of studying the interaction between the microvascular and lymphatic systems in the brain. To date, most imaging methods can only measure blood or lymphatic vessels separately, such as dynamic susceptibility contrast (DSC) MRI for blood vessels and DSC MRI-in-the-cerebrospinal fluid (CSF) (cDSC MRI) for lymphatic vessels. An approach that can measure both blood and lymphatic vessels in a single scan offers advantages such as a halved scan time and contrast dosage. This study attempts to develop one such approach by optimizing a dual-echo turbo-spin-echo sequence, termed "dynamic dual-spin-echo perfusion (DDSEP) MRI". Bloch simulations were performed to optimize the dual-echo sequence for the measurement of gadolinium (Gd)-induced blood and CSF signal changes using a short and a long echo time, respectively. The proposed method furnishes a T1-dominant contrast in CSF and a T2-dominant contrast in blood. MRI experiments were performed in healthy subjects to evaluate the dual-echo approach by comparing it with existing separate methods. Based on simulations, the short and long echo time were chosen around the time when blood signals show maximum difference between post- and pre-Gd scans, and the time when blood signals are completely suppressed, respectively. The proposed method showed consistent results in human brains as previous studies using separate methods. Signal changes from small blood vessels occurred faster than from lymphatic vessels after intravenous Gd injection. In conclusion, Gd-induced signal changes in blood and CSF can be detected simultaneously in healthy subjects with the proposed sequence. The temporal difference in Gd-induced signal changes from small blood and lymphatic vessels after intravenous Gd injection was confirmed using the proposed approach in the same human subjects. Results from this proof-of-concept study will be used to further optimize DDSEP MRI in subsequent studies.
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Affiliation(s)
- Di Cao
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
| | - Yuanqi Sun
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
| | - Yinghao Li
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
| | - Pan Su
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
| | - Jay J. Pillai
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Division of Neuroradiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, United States
| | - Ye Qiao
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Hanzhang Lu
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
| | - Peter C.M. Van Zijl
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Linda Knutsson
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Jun Hua
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States
- Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
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Sijtsema ND, Petit SF, Verduijn GM, Poot DHJ, Warnert EAH, Hoogeman MS, Hernandez-Tamames JA. Multidelay pseudocontinuous arterial spin labeling to measure blood flow in the head and neck. NMR IN BIOMEDICINE 2023; 36:e4898. [PMID: 36624621 DOI: 10.1002/nbm.4898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 06/15/2023]
Abstract
Perfusion MRI is promising for the assessment, prediction, and monitoring of radiation toxicity in organs at risk in head and neck cancer. Arterial spin labeling (ASL) may be an attractive alternative for conventional perfusion MRI, that does not require the administration of contrast agents. However, currently, little is known about the characteristics and performance of ASL in healthy tissues in the head and neck region. Therefore, the purpose of this study was to optimize and evaluate multidelay pseudocontinuous ASL (pCASL) for the head and neck region and to explore nominal values and measurement repeatability for the blood flow (BF), and the transit time and T1 values needed for BF quantification in healthy tissues. Twenty healthy volunteers underwent a scan session consisting of four repeats of multidelay pCASL (postlabel delays: 1000, 1632, 2479 ms). Regions of interest were defined in the parotid glands, submandibular glands, tonsils, and the cerebellum (as a reference). Nominal values of BF were calculated as the average over four repeats per volunteer. The repeatability coefficient and within-subject coefficient of repeatability (wCV) of BF were calculated. The effect of T1 (map vs. cohort average) and transit time correction on BF was investigated. The mean BF (± SE) was 55.7 ± 3.1 ml/100 g/min for the parotid glands, 41.2 ± 2.8 ml/100 g/min for the submandibular glands, and 32.3 ± 2.2 ml/100 g/min for the tonsils. The best repeatability was found in the parotid glands (wCV = 13.3%-16.1%), followed by the submandibular glands and tonsils (wCV = 20.0%-24.6%). On average, the effect of T1 and transit time correction on BF was limited, although substantial bias occurred in individual acquisitions. In conclusion, we demonstrated the feasibility of BF measurements in the head and neck region using multidelay pCASL and reported on nominal BF values, BF repeatability, the effect of T1, and transit time in various tissues in the head and neck region.
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Affiliation(s)
- Nienke D Sijtsema
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Steven F Petit
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Gerda M Verduijn
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dirk H J Poot
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Esther A H Warnert
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mischa S Hoogeman
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Medical Physics and Informatics, HollandPTC, Delft, The Netherlands
| | - Juan A Hernandez-Tamames
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Khedr D, Razek AAKA, Talaat M. Multi-parametric arterial spin labeling and diffusion-weighted imaging of paranasal sinuses masses. Oral Radiol 2023; 39:321-328. [PMID: 35900660 DOI: 10.1007/s11282-022-00640-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: 03/27/2021] [Accepted: 07/07/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate arterial spin labeling (ASL) and diffusion-weighted imaging (DWI) in discrimination of benign from malignant paranasal sinus (PNS) tumors. MATERIAL AND METHODS A prospective study was done upon 42 cases of PNS masses that underwent magnetic resonance ASL and DWI of the head. Tumor blood flow (TBF) and apparent diffusion coefficient (ADC) of the masses were calculated by two observers. The pathological diagnosis was malignant (n = 28) and benign (n = 14) cases. RESULTS For both observers, the malignant PNS masses had significantly higher TBF (P < 0.001, 0.001) and lower ADC (P < 0.001, 0.001) than in benign masses. The ROC curve analysis of TBF, The threshed TBF was (121.45, 122.68 mL/100 g/min) used for differentiation between benign and malignant PNS masses, revealed sensitivity (92.9%, 89.3%), specificity (85.7%, 85.7%), accuracy (90.5%, 88.1%) and the AUC was 0.87 and 0.86 by both observers. the ROC curve analysis of ADC, The threshold ADC (1.215, 1.205 X10-3mm2/s) was used for differentiation between benign and malignant PNS masses, revealed sensitivity (96.4%, 89.3%), specificity (78.6%, 78.6%), accuracy of (90.5%, 85.7%) and the AUC was 0.93 and 0.92 by both observers. Combined analysis of TBF and ADC used for differentiation between benign and malignant PNS masses had revealed sensitivity (96.4%, 89.3%), specificity (92.9%, 85.7%) accuracy of (95.2%, 88.1%) and AUC. (0.995, 0.985) for both observers. CONCLUSION Combined using of TBF and ADC have a role in differentiation malignant from benign PNS masses.
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Affiliation(s)
- Doaa Khedr
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Elgomheryia street, Mansoura, 35511, Egypt.
| | | | - Mona Talaat
- Department of Diagnostic Radiology, Kafr Elsheak Faculty of Medicine, Kafrelsheikh, Egypt
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Liao L, Liu T, Wei B. Prediction of short-term treatment outcome of nasopharyngeal carcinoma based on voxel incoherent motion imaging and arterial spin labeling quantitative parameters. Eur J Radiol Open 2022; 10:100466. [PMID: 36590328 PMCID: PMC9794885 DOI: 10.1016/j.ejro.2022.100466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose To evaluate the early response of chemoradiotherapy (CRT) in nasopharyngeal carcinoma (NPC) based on intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and three-dimensional pseudo-continuous arterial spin labeling (3D pCASL). Materials and methods Forty patients diagnosed with NPC were recruited and divided into complete remission (CR) and partial remission (PR) group after CRT. All patients underwent IVIM and ASL and the related parameters was obtained. These parameters include pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), average blood flow ( BFavg), minimum blood flow (BFmin), and maximum blood flow (BFmax). Student's t test was used to compare the difference in ASL and IVIM derived parameters between CR and PR. The Areas under curve (AUC) of the receiver operating characteristic (ROC) was used to analyze the diagnostic performance of each parameter of ASL and IVIM to the treatment outcome. Results the D value of IVIM in CR group was lower than that of the PR group ( P = 0.014),. Among the parameters of ASL, the BFavg and BFmax of the CR group were higher than those of the PR group(p = 0.004,0.013), but the BFmin had no statistical significance in the two groups(P = 0.54). AUC of D, BFavg, and BFmax is about 0.731, 0.753, and 0.724, respectively, all of their combined AUC diagnosis was 0.812. Conclusion The early response of NPC after CRT can predict by IVIM's diffusion parameters and ASL-related blood flow parameters.
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Key Words
- 3DpCASL, three-dimensional quasi-continuous arterial spin labeling
- ADC, apparent diffusion coefficient
- AUC, area under the curve
- Arterial spin labeling
- BFavg, average of blood flow
- BFmax, maximum blood flow
- BFmin, minimum blood flow
- CR, complete remission
- CRT, chemoradiotherapy
- Chemoradiotherapy
- D*, pseudo-diffusion coefficient
- D, pure diffusion coefficient
- DCE-MRI, dynamic contrast-enhanced magnetic resonance imaging
- IVIM-DWI, intravoxel incoherent motion diffusion-weighted imaging
- Intravoxel incoherent motion diffusion-weighted imaging
- NPC, nasopharyngeal carcinoma
- Nasopharyngeal carcinoma
- PR, partial remission
- f, perfusion fraction
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Affiliation(s)
- Liping Liao
- Department of Radiology, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Clinical Medical Research Center of Imaging Medicine, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Key Clinical Specialties, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Medical University Cancer Hospital Superiority Cultivation Discipline, 71 Hedi Road, Nanning, Guangxi, People's Republic of China
| | - Teng Liu
- Department of Radiology, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Clinical Medical Research Center of Imaging Medicine, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Key Clinical Specialties, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Medical University Cancer Hospital Superiority Cultivation Discipline, 71 Hedi Road, Nanning, Guangxi, People's Republic of China
| | - Bo Wei
- Department of Radiology, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Clinical Medical Research Center of Imaging Medicine, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Key Clinical Specialties, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Medical University Cancer Hospital Superiority Cultivation Discipline, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Corresponding author at: Department of Radiology, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning, Guangxi, People's Republic of China.
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5
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Romeo V, Stanzione A, Ugga L, Cuocolo R, Cocozza S, Quarantelli M, Chawla S, Farina D, Golay X, Parker G, Shukla-Dave A, Thoeny H, Vidiri A, Brunetti A, Surlan-Popovic K, Bisdas S. Clinical indications and acquisition protocol for the use of dynamic contrast-enhanced MRI in head and neck cancer squamous cell carcinoma: recommendations from an expert panel. Insights Imaging 2022; 13:198. [PMID: 36528678 PMCID: PMC9759606 DOI: 10.1186/s13244-022-01317-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The clinical role of perfusion-weighted MRI (PWI) in head and neck squamous cell carcinoma (HNSCC) remains to be defined. The aim of this study was to provide evidence-based recommendations for the use of PWI sequence in HNSCC with regard to clinical indications and acquisition parameters. METHODS Public databases were searched, and selected papers evaluated applying the Oxford criteria 2011. A questionnaire was prepared including statements on clinical indications of PWI as well as its acquisition technique and submitted to selected panelists who worked in anonymity using a modified Delphi approach. Each panelist was asked to rate each statement using a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree). Statements with scores equal or inferior to 5 assigned by at least two panelists were revised and re-submitted for the subsequent Delphi round to reach a final consensus. RESULTS Two Delphi rounds were conducted. The final questionnaire consisted of 6 statements on clinical indications of PWI and 9 statements on the acquisition technique of PWI. Four of 19 (21%) statements obtained scores equal or inferior to 5 by two panelists, all dealing with clinical indications. The Delphi process was considered concluded as reasons entered by panelists for lower scores were mainly related to the lack of robust evidence, so that no further modifications were suggested. CONCLUSIONS Evidence-based recommendations on the use of PWI have been provided by an independent panel of experts worldwide, encouraging a standardized use of PWI across university and research centers to produce more robust evidence.
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Affiliation(s)
- Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Renato Cuocolo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.,Interdepartmental Research Center on Management and Innovation in Healthcare - CIRMIS, University of Naples Federico II, Naples, Italy
| | - Sirio Cocozza
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Mario Quarantelli
- Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
| | - Sanjeev Chawla
- Department of Radiology, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA
| | - Davide Farina
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Xavier Golay
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK.,Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Trust, London, UK
| | - Geoff Parker
- Department of Computer Science, Centre for Medical Image Computing, Queen Square Institute of Neurology, University College London, London, UK
| | - Amita Shukla-Dave
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Departments of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Harriet Thoeny
- Department of Radiology, Cantonal Hospital Fribourg, University of Fribourg, Fribourg, Switzerland
| | - Antonello Vidiri
- Department of Radiology and Diagnostic Imaging, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | | | - Sotirios Bisdas
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK. .,Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Trust, London, UK.
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Lin CH, Hsieh TJ, Chou YC, Chen CKH. Feasibility of Arterial Spin Labeling Magnetic Resonance Imaging for Musculoskeletal Tumors with Optimized Post-Labeling Delay. Diagnostics (Basel) 2022; 12:diagnostics12102450. [PMID: 36292139 PMCID: PMC9600497 DOI: 10.3390/diagnostics12102450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/08/2022] [Accepted: 10/08/2022] [Indexed: 11/16/2022] Open
Abstract
Arterial spin labeling (ASL) magnetic resonance imaging (MRI) is used to perform perfusion imaging without administration of contrast media. However, the reliability of ASL for musculoskeletal tumors and the influence of post-labeling delay (PLD) have not been fully clarified. This study aimed to evaluate the performance of ASL with different PLDs in the imaging of musculoskeletal tumors. Forty-five patients were enrolled and were divided into a malignant group, a hypervascular benign group, a hypovascular benign group and a control group. The tissue blood flow (TBF) of the lesions and normal muscles was measured and the lesion-to-muscle TBF ratio and differences were calculated. The results showed that both the TBF of lesions and muscles increased as the PLD increased, and the TBF of muscles correlated significantly and positively with the TBF of lesions (all p < 0.05). The TBF and lesion-to-muscle TBF differences of the malignant lesions were significantly higher than those of the hypovascular benign lesions and the control group in all PLD groups (all p < 0.0125) and only those of the hypervascular benign lesions in the longest PLD (3025 ms) group (p = 0.0120, 0.0116). In conclusion, ASL detects high TBF in malignant tumors and hypervascular benign lesions, and a longer PLD is recommended for ASL to differentiate musculoskeletal tumors.
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Affiliation(s)
- Chien-Hung Lin
- Department of Medical Imaging, Chi Mei Medical Center, Yongkang, Tainan 71004, Taiwan
| | - Tsyh-Jyi Hsieh
- Department of Medical Imaging, Chi Mei Medical Center, Yongkang, Tainan 71004, Taiwan
- Department of Radiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: ; Tel.: +886-6-2812811 (ext. 53130)
| | - Yi-Chen Chou
- Department of Medical Imaging, Chi Mei Medical Center, Yongkang, Tainan 71004, Taiwan
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Pseudocontinuous Arterial Spin Labeling: Clinical Applications and Usefulness in Head and Neck Entities. Cancers (Basel) 2022; 14:cancers14163872. [PMID: 36010866 PMCID: PMC9405982 DOI: 10.3390/cancers14163872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Conventional imaging methods, such as ultrasonography, computed tomography, and magnetic resonance imaging may be inadequate to accurately diagnose lesions of the head and neck because they vary widely. Recently, the arterial spin labeling technique, especially pseudocontinuous arterial spin labeling (pCASL) with the three-dimensional (3D) readout method, has been dramatically developed to improve diagnostic performance for lesion differentiation, which can show prominent blood flow characteristics. Here, we demonstrate the clinical usefulness of 3D pCASL for diagnosing various entities, including inflammatory lesions, hypervascular lesions, and neoplasms in the head and neck, for evaluating squamous cell carcinoma (SCC) treatment responses, and for predicting SCC prognosis. Abstract As functional magnetic resonance imaging, arterial spin labeling (ASL) techniques have been developed to provide quantitative tissue blood flow measurements, which can improve the performance of lesion diagnosis. ASL does not require contrast agents, thus, it can be applied to a variety of patients regardless of renal impairments and contrast agent allergic reactions. The clinical implementation of head and neck lesions is limited, although, in recent years, ASL has been increasingly utilized in brain lesions. Here, we review the development of the ASL techniques, including pseudocontinuous ASL (pCASL). We compare readout methods between three-dimensional (3D) turbo spin-echo and 2D echo planar pCASL for the clinical applications of pCASL to head and neck lesions. We demonstrate the clinical usefulness of 3D pCASL for diagnosing various entities, including inflammatory lesions, hypervascular lesions, and neoplasms; for evaluating squamous cell carcinoma (SCC) treatment responses, and for predicting SCC prognosis.
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Lobo R, Turk S, Bapuraj JR, Srinivasan A. Advanced CT and MR Imaging of the Posttreatment Head and Neck. Neuroimaging Clin N Am 2021; 32:133-144. [PMID: 34809834 DOI: 10.1016/j.nic.2021.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Advances in MR and computed tomography (CT) techniques have resulted in greater fidelity in the assessment of treatment response and residual tumor on one hand and the assessment of recurrent head and neck malignancies on the other hand. The advances in MR techniques primarily are related to diffusion and perfusion imaging which rely on the intrinsic architecture of the tissues and organ systems. The techniques exploit the density of the cellular architecture; and the vascularity of benign and malignant lesions which in turn affect the changes in the passage of contrast through the vascular bed. Dual-energy CT and CT perfusion are the major advances in CT techniques that have found significant applications in the assessment of treatment response and tumor recurrence.
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Affiliation(s)
- Remy Lobo
- Neuroradiology Division, Radiology, Michigan Medicine, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Sevcan Turk
- Neuroradiology Division, Radiology, Michigan Medicine, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA
| | - J Rajiv Bapuraj
- Neuroradiology Division, Radiology, Michigan Medicine, 1500 E Medical Center Drive, B2A209, Ann Arbor, MI 48109, USA
| | - Ashok Srinivasan
- Neuroradiology Division, Radiology, Michigan Medicine, 1500 E Medical Center Drive, B2A209, Ann Arbor, MI 48109, USA.
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9
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Fujima N, Shimizu Y, Yoshida D, Kano S, Mizumachi T, Homma A, Yasuda K, Onimaru R, Sakai O, Kudo K, Shirato H. Multiparametric Analysis of Tumor Morphological and Functional MR Parameters Potentially Predicts Local Failure in Pharynx Squamous Cell Carcinoma Patients. THE JOURNAL OF MEDICAL INVESTIGATION 2021; 68:354-361. [PMID: 34759158 DOI: 10.2152/jmi.68.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Purpose : To predict local control / failure by a multiparametric approach using magnetic resonance (MR)-derived tumor morphological and functional parameters in pharynx squamous cell carcinoma (SCC) patients. Materials and Methods : Twenty-eight patients with oropharyngeal and hypopharyngeal SCCs were included in this study. Quantitative morphological parameters and intratumoral characteristics on T2-weighted images, tumor blood flow from pseudo-continuous arterial spin labeling, and tumor diffusion parameters of three diffusion models from multi-b-value diffusion-weighted imaging as well as patients' characteristics were analyzed. The patients were divided into local control / failure groups. Univariate and multiparametric analysis were performed for the patient group division. Results : The value of morphological parameter of 'sphericity' and intratumoral characteristic of 'homogeneity' was revealed respectively significant for the prediction of the local control status in univariate analysis. Higher diagnostic performance was obtained with the sensitivity of 0.8, specificity of 0.75, positive predictive value of 0.89, negative predictive value of 0.6 and accuracy of 0.79 by multiparametric diagnostic model compared to results in the univariate analysis. Conclusion : A multiparametric analysis with MR-derived quantitative parameters may be useful to predict local control in pharynx SCC patients. J. Med. Invest. 68 : 354-361, August, 2021.
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Affiliation(s)
- Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.,The Global Station for Quantum Medical Science and Engineering, Global Institution for collaborative research and education, Sapporo, Japan
| | - Yukie Shimizu
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Daisuke Yoshida
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takatsugu Mizumachi
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Koichi Yasuda
- The Global Station for Quantum Medical Science and Engineering, Global Institution for collaborative research and education, Sapporo, Japan.,Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Rikiya Onimaru
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Osamu Sakai
- Departments of Radiology, Otolaryngology-Head and Neck Surgery, and Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Kohsuke Kudo
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.,The Global Station for Quantum Medical Science and Engineering, Global Institution for collaborative research and education, Sapporo, Japan
| | - Hiroki Shirato
- The Global Station for Quantum Medical Science and Engineering, Global Institution for collaborative research and education, Sapporo, Japan.,Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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10
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Wang DJJ, Le Bihan D, Krishnamurthy R, Smith M, Ho ML. Noncontrast Pediatric Brain Perfusion: Arterial Spin Labeling and Intravoxel Incoherent Motion. Magn Reson Imaging Clin N Am 2021; 29:493-513. [PMID: 34717841 DOI: 10.1016/j.mric.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Noncontrast magnetic resonance imaging techniques for measuring brain perfusion include arterial spin labeling (ASL) and intravoxel incoherent motion (IVIM). These techniques provide noninvasive and repeatable assessment of cerebral blood flow or cerebral blood volume without the need for intravenous contrast. This article discusses the technical aspects of ASL and IVIM with a focus on normal physiologic variations, technical parameters, and artifacts. Multiple pediatric clinical applications are presented, including tumors, stroke, vasculopathy, vascular malformations, epilepsy, migraine, trauma, and inflammation.
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Affiliation(s)
- Danny J J Wang
- USC Institute for Neuroimaging and Informatics, SHN, 2025 Zonal Avenue, Health Sciences Campus, Los Angeles, CA 90033, USA
| | - Denis Le Bihan
- NeuroSpin, Centre d'études de Saclay, Bâtiment 145, Gif-sur-Yvette 91191, France
| | - Ram Krishnamurthy
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mark Smith
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA.
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11
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Martín-Noguerol T, Kirsch CFE, Montesinos P, Luna A. Arterial spin labeling for head and neck lesion assessment: technical adjustments and clinical applications. Neuroradiology 2021; 63:1969-1983. [PMID: 34427708 DOI: 10.1007/s00234-021-02772-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/12/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Despite, currently, "state-of-the-art" magnetic resonance imaging (MRI) protocols for head and neck (H&N) lesion assessment incorporate perfusion sequences, these acquisitions require the intravenous injection of exogenous gadolinium-based contrast agents (GBCAs), which may have potential risks. Alternative techniques such as arterial spin labeling (ASL) can provide quantitative microvascular information similar to conventional perfusion sequences for H&N lesions evaluation, as a potential alternative without GBCA administration. METHODS We review the existing literature and analyze the latest evidence regarding ASL in H&N area highlighting the technical adjustments needed for a proper ASL acquisition in this challenging region for lesion characterization, treatment monitoring, and tumor recurrence detection. RESULTS ASL techniques, widely used for central nervous system lesions evaluation, can be also applied to the H&N region. Technical adjustments, especially regarding post-labeling delay, are mandatory to obtain robust and reproducible results. Several studies have demonstrated the feasibility of ASL in the H&N area including the orbits, skull base, paranasal sinuses, upper airway, salivary glands, and thyroid. CONCLUSION ASL is a feasible technique for the assessment of H&N lesions without the need of GBCAs. This manuscript reviews ASL's physical basis, emphasizing the technical adjustments necessary for proper ASL acquisition in this unique and challenging anatomical region, and the main applications in evaluating H&N lesions.
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Affiliation(s)
| | - Claudia F E Kirsch
- Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine At Northwell, North Shore University Hospital, 300 Community Drive, Manhasset, NY, 11030, USA
| | - Paula Montesinos
- Philips Iberia, Calle de María de Portugal, 1, 28050, Madrid, Spain
| | - Antonio Luna
- MRI Unit, Radiology Department, HT Medica, Carmelo Torres 2, 23007, Jaén, Spain
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12
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Wu W, Jiang G, Xu Z, Wang R, Pan A, Gao M, Yu T, Huang L, Quan Q, Li J. Three-dimensional pulsed continuous arterial spin labeling and intravoxel incoherent motion imaging of nasopharyngeal carcinoma: correlations with Ki-67 proliferation status. Quant Imaging Med Surg 2021; 11:1394-1405. [PMID: 33816177 DOI: 10.21037/qims-20-349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Recurrence and distant metastasis are still the main problems affecting the long-term prognosis of nasopharyngeal carcinoma (NPC) patients, and may be related to the Ki-67 proliferation status. We therefore explored the potential correlation between Ki-67 proliferation status in NPC with the parameters derived from two imaging techniques: three-dimensional pulsed continuous arterial spin labeling (3D pCASL) and intravoxel incoherent motion (IVIM). Methods Thirty-six patients with pathologically confirmed NPC were included, and the Ki-67 labeling index (LI) was measured by immunohistochemistry. All patients underwent plain and contrast-enhanced magnetic resonance imaging (MRI), IVIM, and 3D pCASL examination. The mean, maximum, and minimum of blood flow (BF), minimum of apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) parameters were all measured, and Spearman's correlation analysis was performed to evaluate the relationships between these parameters and the Ki-67 LI. According to the Ki-67 values, the patients were divided into two groups: high (>50%) and low (≤50%). The rank-sum test (Mann-Whitney U test) was then used to compare the differences in quantitative parameters between the high and low Ki-67 groups. Results Ki-67 LI was positively correlated with BFmean and BFmax (r=0.415 and 0.425). D*mean and D*min did have positive correlation with Ki-67, but this was not significant (P=0.082 and 0.072). BFmax was significantly different between the high and low Ki-67 groups (P=0.028). Conclusions 3D pCASL and IVIM are noninvasive functional MR perfusion imaging techniques that can evaluate perfusion information and perfusion parameters. Our study suggests that 3D pCASL is more effective than IVIM for assessing the proliferation status of NPC, which is beneficial for evaluating the prognosis of patients. Furthermore, BFmax is the best biomarker for distinguishing high from low Ki-67 levels.
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Affiliation(s)
- Wenxiu Wu
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Zhifeng Xu
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Ruoning Wang
- Minimally Invasive Center, Tumor hospital, Sun Yat-Sen University, Guangzhou, China
| | - Aizhen Pan
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Mingyong Gao
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Tian Yu
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Linwen Huang
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Qiang Quan
- Nasopharyngeal Radiotherapy Department 2, The First People's Hospital of Foshan, Foshan, China
| | - Jin Li
- Pathology Department, The First People's Hospital of Foshan, Foshan, China
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13
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Xiao B, Wang P, Zhao Y, Liu Y, Ye Z. Using arterial spin labeling blood flow and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma from lymphoid hyperplasia. Medicine (Baltimore) 2021; 100:e24955. [PMID: 33663135 PMCID: PMC7909173 DOI: 10.1097/md.0000000000024955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 02/04/2021] [Indexed: 01/05/2023] Open
Abstract
To investigate the feasibility of arterial spin labeling (ASL) blood flow (BF) and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPLH).Sixty-three stage T1 NPC patients and benign NPLH patients underwent ASL on a 3.0-T magnetic resonance imaging system. BF histogram parameters were derived automatically, including the mean, median, maximum, minimum, kurtosis, skewness, and variance. Absolute values were obtained for skewness and kurtosis (absolute value of skewness [AVS] and absolute value of kurtosis [AVK], respectively). The Mann-Whitney U test, receiver operating characteristic curve, and multiple logistic regression models were used for statistical analysis.The mean, maximum, and variance of ASL BF values were significantly higher in early-stage NPC than in NPLH (all P < 0.0001), while the median and AVK values of early-stage NPC were also significantly higher than those of NPLH (all P < 0.001). No significant difference was found between the minimum and AVS values in early-stage NPC compared with NPLH (P = 0.125 and P = 0.084, respectively). The area under the curve (AUC) of the maximum was significantly higher than those of the mean and median (P < 0.05). The AUC of variance was significantly higher than those of the other parameters (all P < 0.05). Multivariate analysis showed that variance was the only independent predictor of outcome (P < 0.05).ASL BF and its histogram analysis could distinguish early-stage NPC from NPLH, and the variance value was a unique independent predictor.
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Affiliation(s)
| | - Peiguo Wang
- Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
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14
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Differentiating malignant from benign salivary gland lesions: a multiparametric non-contrast MR imaging approach. Sci Rep 2021; 11:2780. [PMID: 33531644 PMCID: PMC7854671 DOI: 10.1038/s41598-021-82455-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/19/2021] [Indexed: 02/08/2023] Open
Abstract
The purpose of this study is to determine whether multiparametric non-contrast MR imaging including diffusion-weighted imaging (DWI), arterial spin labeling (ASL), and amide proton transfer (APT) weighted imaging can help differentiate malignant from benign salivary gland lesions. The study population consisted of 42 patients, with 31 benign and 11 malignant salivary gland lesions. All patients were evaluated using DWI, three-dimensional pseudo-continuous ASL, and APT-weighted imaging on 3 T MR imaging before treatment. Apparent diffusion coefficient (ADC), tumor blood flow (TBF), and APT-related signal intensity (APTSI) values within the lesion were compared between the malignant and benign lesions by Mann–Whitney U test. For each parameter, optimal cutoff values were chosen using a threshold criterion that maximized the Youden index for predicting malignant lesions. The performance of ADC, TBF, APTSI, individually and combined, was evaluated in terms of diagnostic ability for malignant lesions. Diagnostic performance was compared by McNemar test. APTSI was significantly higher in malignant lesions (2.18 ± 0.89%) than in benign lesions (1.57 ± 1.09%, p = 0.047). There was no significant difference in ADC or TBF between benign and malignant lesions (p = 0.155 and 0.498, respectively). The accuracy of ADC, TBF, and APTSI for diagnosing malignant lesions was 47.6%, 50.0%, and 66.7%, respectively; whereas the accuracy of the three parameters combined was 85.7%, which was significantly higher than that of each parameter alone (p = 0.001, 0.001, and 0.008, respectively). Therefore, the combination of ADC, TBF, and APTSI can help differentiate malignant from benign salivary gland lesions.
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15
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Gökçe E. Editorial for "Can arterial spin labeling perfusion imaging be used to differentiate nasopharyngeal carcinoma from nasopharyngeal lymphoma?". J Magn Reson Imaging 2020; 53:1149-1150. [PMID: 33340177 DOI: 10.1002/jmri.27482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Erkan Gökçe
- Department of Radiology, Medical School, Tokat Gaziosmanpaşa University, Tokat, Turkey
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16
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Eissa L, Abdel Razek AAK, Helmy E. Arterial spin labeling and diffusion-weighted MR imaging: Utility in differentiating idiopathic orbital inflammatory pseudotumor from orbital lymphoma. Clin Imaging 2020; 71:63-68. [PMID: 33171369 DOI: 10.1016/j.clinimag.2020.10.057] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 09/26/2020] [Accepted: 10/26/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess arterial spin-labeling (ASL) and diffusion-weighted imaging (DWI) and in combination for differentiating between idiopathic orbital inflammatory pseudotumor (IOIP) and orbital lymphoma. MATERIAL AND METHODS A retrospective study was done on 37 untreated patients with orbital masses, suspected to be IOIP or orbital lymphoma that underwent ASL and DWI of the orbit. Quantitative measurement of tumor blood flow (TBF) and apparent diffusion coefficient (ADC) of the orbital lesion was done. RESULTS There was a significant difference (P = 0.001) in TBF between patients with IOIP (n = 21) (38.1 ± 6.2, 40.3 ± 7.1 ml/100 g/min) and orbital lymphoma (n = 16) (55.5 ± 7.1, 56.8 ± 7.9 ml/100 g/min) for both observers respectively. Thresholds of TBF used for differentiating IOIP from orbital lymphoma were 48, 46 ml/100 g/min revealed area under the curve (AUC) of (0.958 and 0.921), and accuracy of (86% and 83%) for both observers respectively. There was a significant difference (P = 0.001) in ADC between patients with IOIP (1.04 ± 0.19, 1.12 ± 0.23 × 10-3 mm2/s) and orbital lymphoma (0.69 ± 0.10, 0.72 ± 0.11 × 10-3 mm2/s) for both observers respectively. Thresholds of ADC used for differentiating IOIP from orbital lymphoma were 0.84 and 0.86 × 10-3 mm2/s with AUC of (0.933 and 0.920), and accuracy of 89% and 90% for both observers respectively. The combined TBF and ADC used for differentiating IOIP from orbital lymphoma had AUC of (0.973 and 0.970) and accuracy of (91% and 89%) for both observers respectively. CONCLUSION TBF and ADC alone and in combination are useful for differentiating IOIP from orbital lymphoma.
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Affiliation(s)
- Lamya Eissa
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Ahmed Abdel Khalek Abdel Razek
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.
| | - Eman Helmy
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
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17
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Wang H, Sun J, Li J, Li H, Wang Y, Wang Z. Ocular Blood Flow Measurements in Diabetic Retinopathy Using 3D Pseudocontinuous Arterial Spin Labeling. J Magn Reson Imaging 2020; 53:791-798. [PMID: 33140547 DOI: 10.1002/jmri.27398] [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: 08/03/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Distinguishing between the two broad categories of diabetic retinopathy (DR), nonproliferative DR (NPDR) and proliferative DR (PDR), is significant, as the therapeutic strategies for each are completely different. PURPOSE To characterize the ocular blood flow (OBF) of DR patients and evaluate the potential utility of OBF values in categorizing DR. STUDY TYPE Prospective. SUBJECTS A total of 41 DR patients (82 eyes) were recruited in our study. Group 1 comprised 48 eyes with NPDR, and Group 2 comprised 34 eyes with PDR. FIELD STRENGTH/SEQUENCE 3D pseudocontinuous arterial spin labeling (3D-pcASL) with two postlabeling delays (PLDs) was acquired at 3.0T MR. ASSESSMENT OBF values were independently obtained by two doctors from the OBF map. STATISTICAL TESTS OBF values and clinical characteristics were compared between the groups using two-sample t-tests and chi-square tests. Receiver operating characteristic (ROC) curves were obtained, and the area under the curve (AUC) was calculated. The consistency of OBF values reported by the two doctors was evaluated using the intraclass correlation coefficient (ICC). RESULTS OBF values at PLDs of 1.5 seconds and 2.5 seconds were significantly lower in Group 2 than in Group 1 (P < 0.05 for both PLDs). The OBF values of Group 2 showed a greater increase than those of Group 1 from PLD 1.5 to 2.5 seconds. The AUC of OBF at the 1.5 seconds PLD was 0.90, with a cutoff of 7.73 mL/min/100 g, and the AUC of the OBF at the 2.5 seconds PLD was 0.75, with a cutoff of 8.44 mL/min/100 g. The ICC between the two observers was 0.844 for the OBF at 1.5 seconds PLD and 0.872 for the OBF at 2.5 seconds PLD. DATA CONCLUSION PDR can be differentiated from NPDR by the value of OBF as measured by 3D-pcASL. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Huihui Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jiao Sun
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hongyang Li
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yanling Wang
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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18
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Multi-parametric arterial spin labeling and diffusion-weighted imaging in differentiation of metastatic from reactive lymph nodes in head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 2020; 278:2529-2535. [DOI: 10.1007/s00405-020-06390-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 09/20/2020] [Indexed: 12/19/2022]
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19
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Ma G, Xu XQ, Zhu LN, Jiang JS, Su GY, Hu H, Bu SS, Wu FY. Intravoxel Incoherent Motion Magnetic Resonance Imaging for Assessing Parotid Gland Tumors: Correlation and Comparison with Arterial Spin Labeling Imaging. Korean J Radiol 2020; 22:243-252. [PMID: 32932565 PMCID: PMC7817638 DOI: 10.3348/kjr.2020.0290] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 04/14/2020] [Accepted: 06/06/2020] [Indexed: 12/26/2022] Open
Abstract
Objective To compare and correlate the findings of intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging and arterial spin labeling (ASL) imaging in characterizing parotid gland tumors. Materials and Methods We retrospectively reviewed 56 patients with parotid gland tumors evaluated by MR imaging. The true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and fraction of perfusion (f) values of IVIM imaging and tumor-to-parotid gland signal intensity ratio (SIR) on ASL imaging were calculated. Spearman rank correlation coefficient, chi-squared, Mann-Whitney U, and Kruskal-Wallis tests with the post-hoc Dunn-Bonferroni method and receiver operating characteristic curve assessments were used for statistical analysis. Results Malignant parotid gland tumors showed significantly lower D than benign tumors (p = 0.019). Within subgroup analyses, pleomorphic adenomas (PAs) showed significantly higher D than malignant tumors (MTs) and Warthin's tumors (WTs) (p < 0.001). The D* of WTs was significantly higher than that of PAs (p = 0.031). The f and SIR on ASL imaging of WTs were significantly higher than those of MTs and PAs (p < 0.05). Significantly positive correlation was found between SIR on ASL imaging and f (r = 0.446, p = 0.001). In comparison with f, SIR on ASL imaging showed a higher area under curve (0.853 vs. 0.891) in discriminating MTs from WTs, although the difference was not significant (p = 0.720). Conclusion IVIM and ASL imaging could help differentiate parotid gland tumors. SIR on ASL imaging showed a significantly positive correlation with f. ASL imaging might hold potential to improve the ability to discriminate MTs from WTs.
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Affiliation(s)
- Gao Ma
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Liu Ning Zhu
- Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jia Suo Jiang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guo Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shou Shan Bu
- Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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20
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Cao D, Kang N, Pillai JJ, Miao X, Paez A, Xu X, Xu J, Li X, Qin Q, Van Zijl PCM, Barker P, Hua J. Fast whole brain MR imaging of dynamic susceptibility contrast changes in the cerebrospinal fluid (cDSC MRI). Magn Reson Med 2020; 84:3256-3270. [PMID: 32621291 DOI: 10.1002/mrm.28389] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 01/28/2023]
Abstract
PURPOSE The circulation of cerebrospinal fluid (CSF) is closely associated with many aspects of brain physiology. When gadolinium(Gd)-based contrast is administered intravenously, pre- and post-contrast MR signal changes can often be observed in the CSF at certain locations within the intra-cranial space, mainly due to the lack of a blood-brain barrier in the dural blood vessels. This study aims to develop and systemically optimize MRI sequences that can detect dynamic signal changes in the CSF after Gd administration with a sub-millimeter spatial resolution, a temporal resolution of <10 s, and whole brain coverage. METHODS Bloch simulations were performed to determine optimal imaging parameters for maximum CSF contrast before and after Gd injection. Simulations were validated with phantom scans. An optimized turbo-spin-echo (TSE) sequence was performed on healthy volunteers on 3T and 7T. RESULTS Simulation results agreed well with phantom scans. In human scans, dynamic signal changes after Gd injection in the CSF were detected at several locations where cerebral lymphatic vessels were identified in previous studies. The concentration of Gd in CSF in these regions was estimated to be approximately 0.2 mmol/L. CONCLUSION Dynamic signal changes induced by the distribution of Gd in the CSF can be detected in healthy human subjects with an optimized TSE sequence. The proposed methodology does not rely on any particular theory on CSF circulation. We expect it to be useful for studies on CSF circulation and cerebral lymphatic vessels in the brain.
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Affiliation(s)
- Di Cao
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ningdong Kang
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jay J Pillai
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Xinyuan Miao
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Adrian Paez
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Xiang Xu
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jiadi Xu
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Xu Li
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Qin Qin
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Peter C M Van Zijl
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Peter Barker
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jun Hua
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Neurosection, Division of MRI Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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21
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Combination of diffusion-weighted imaging and arterial spin labeling at 3.0 T for the clinical staging of nasopharyngeal carcinoma. Clin Imaging 2020; 66:127-132. [PMID: 32480267 DOI: 10.1016/j.clinimag.2020.05.007] [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: 09/13/2019] [Revised: 04/27/2020] [Accepted: 05/13/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE To probe the utility of diffusion-weighted imaging (DWI) and 3D arterial spin labeling (ASL) in assessing the clinical stage of nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS This prospective study included sixty-five newly diagnosed NPC patients who underwent DWI and 3D ASL scans on a 3.0-T magnetic resonance imaging (MRI) system. The apparent diffusion coefficient (ADC) and the tumor blood flow (TBF) of NPC were measured. Tumors were classified as low or high T, N and American Joint Committee on Cancer (AJCC) stages. Student's t-test was used to evaluate the differences between tumors with low and high clinical stages. Pearson correlation analyses were performed to determine the correlation between MRI parameters and clinical stages. Receiver operating characteristic (ROC) curves were then used to evaluate diagnostic capability. RESULTS High T stage (T3/4) NPC showed significantly lower ADCmin (P = 0.000) and higher TBFmax (P = 0.003) and TBFmean (P = 0.008) values than low T stage (T1/2) NPC. High N stage (N2/3) NPC showed significantly lower ADCmin values (P = 0.023) than low N stage (N0/1) NPC. High AJCC stage (III/IV) NPC showed significantly lower ADCmin (P = 0.000) and higher TBFmax (P = 0.005) and TBFmean (P = 0.011) values than low AJCC stage (I/II) NPC. ADCmin values showed moderate negative correlations with T stage (r = -0.512, P = 0.000), N stage (r = -0.281, P = 0.023), and AJCC stage (r = -0.494, P = 0.000). TBFmax values showed moderate positive correlations with T stage (r = 0.369, P = 0.003) and AJCC stage (r = 0.346, P = 0.005). Compared with ADCmin and TBFmax alone, the combination of ADCmin and TBFmax improved the accuracy from 72.3% and 75.4% to 78.5%, respectively, for T staging, as well as from 72.3% and 69.2% to 83.1% for AJCC staging. CONCLUSIONS ADCmin and TBFmax values in patients with NPC could help evaluate clinical stages. ADCmin and TBFmax values combined could clearly improve the accuracy in the assessment of AJCC stage.
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Gökçe E. Multiparametric Magnetic Resonance Imaging for the Diagnosis and Differential Diagnosis of Parotid Gland Tumors. J Magn Reson Imaging 2020; 52:11-32. [PMID: 32065489 DOI: 10.1002/jmri.27061] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 01/02/2020] [Accepted: 01/03/2020] [Indexed: 12/18/2022] Open
Abstract
The majority of salivary gland tumors occur in the parotid glands. Characterization (ie, benign or malignant, and histological type), location (deep or superficial), and invasion into the neighboring tissues of parotid tumors determine preoperative treatment planning. MRI gives more information than other imaging methods about the internal structure, localization, and relationship with other tissues of parotid tumors. Functional MRI methods (diffusion-weighted imaging, dynamic contrast-enhanced MRI, perfusion-weighted MRI, MR spectroscopy, etc.) have been increasingly used recently to increase the power of radiologists to characterize the tumors. Although they increase the workload of radiologists, the combined use of functional MRI methods improves accuracy in the differentiation of the tumors. There are a wide range of studies in the literature dealing with the combined use of different functional imaging methods in combination with conventional sequences. The aim of the present review is to evaluate conventional and functional/advanced MR methods, as well as multiparametric MRI applications combining them in the diagnosis of parotid gland tumors. Evidence Level: 5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2020;52:11-32.
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Affiliation(s)
- Erkan Gökçe
- Department of Radiology, Medical School, Tokat Gaziosmanpaşa University, Tokat, Turkey
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Razek AAKA. Multi-parametric MR imaging using pseudo-continuous arterial-spin labeling and diffusion-weighted MR imaging in differentiating subtypes of parotid tumors. Magn Reson Imaging 2019; 63:55-59. [DOI: 10.1016/j.mri.2019.08.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/05/2019] [Accepted: 08/15/2019] [Indexed: 12/26/2022]
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Fujima N, Shimizu Y, Yoshida D, Kano S, Mizumachi T, Homma A, Yasuda K, Onimaru R, Sakai O, Kudo K, Shirato H. Machine-Learning-Based Prediction of Treatment Outcomes Using MR Imaging-Derived Quantitative Tumor Information in Patients with Sinonasal Squamous Cell Carcinomas: A Preliminary Study. Cancers (Basel) 2019; 11:cancers11060800. [PMID: 31185611 PMCID: PMC6627127 DOI: 10.3390/cancers11060800] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/02/2019] [Accepted: 06/06/2019] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study was to determine the predictive power for treatment outcome of a machine-learning algorithm combining magnetic resonance imaging (MRI)-derived data in patients with sinonasal squamous cell carcinomas (SCCs). Thirty-six primary lesions in 36 patients were evaluated. Quantitative morphological parameters and intratumoral characteristics from T2-weighted images, tumor perfusion parameters from arterial spin labeling (ASL) and tumor diffusion parameters of five diffusion models from multi-b-value diffusion-weighted imaging (DWI) were obtained. Machine learning by a non-linear support vector machine (SVM) was used to construct the best diagnostic algorithm for the prediction of local control and failure. The diagnostic accuracy was evaluated using a 9-fold cross-validation scheme, dividing patients into training and validation sets. Classification criteria for the division of local control and failure in nine training sets could be constructed with a mean sensitivity of 0.98, specificity of 0.91, positive predictive value (PPV) of 0.94, negative predictive value (NPV) of 0.97, and accuracy of 0.96. The nine validation data sets showed a mean sensitivity of 1.0, specificity of 0.82, PPV of 0.86, NPV of 1.0, and accuracy of 0.92. In conclusion, a machine-learning algorithm using various MR imaging-derived data can be helpful for the prediction of treatment outcomes in patients with sinonasal SCCs.
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Affiliation(s)
- Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan.
| | - Yukie Shimizu
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan.
| | - Daisuke Yoshida
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan.
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Hokkaido, Japan.
| | - Takatsugu Mizumachi
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Hokkaido, Japan.
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Hokkaido, Japan.
| | - Koichi Yasuda
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Hokkaido, Japan.
| | - Rikiya Onimaru
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Hokkaido, Japan.
| | - Osamu Sakai
- Departments of Radiology, Otolaryngology-Head and Neck Surgery, and Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA.
| | - Kohsuke Kudo
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan.
| | - Hiroki Shirato
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Hokkaido, Japan.
- The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Sapporo 060-0808, Hokkaido, Japan.
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Arterial spin labelling and diffusion-weighted magnetic resonance imaging in differentiation of recurrent head and neck cancer from post-radiation changes. The Journal of Laryngology & Otology 2018; 132:923-928. [DOI: 10.1017/s0022215118001743] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AbstractObjectiveTo assess arterial spin labelling and diffusion-weighted imaging in the differentiation of recurrent head and neck cancer from post-radiation changes.MethodsA retrospective study was conducted of 47 patients with head and neck cancer, treated with radiotherapy, who underwent magnetic resonance arterial spin labelling and diffusion-weighted magnetic resonance imaging. Tumour blood flow and apparent diffusion co-efficient of the lesion were calculated.ResultsThere was significant difference (p= 0.001) in tumour blood flow between patients with recurrent head and neck cancer (n= 31) (47.37 ± 16.3 ml/100 g/minute) and those with post-radiation changes (n= 16) (18.80 ± 2.9 ml/100 g/minute). The thresholds of tumour blood flow and apparent diffusion co-efficient used for differentiating recurrence from post-radiation changes were more than 24.0 ml/100 g/minute and 1.21 × 10−3mm2/second or less, with area under the curve values of 0.94 and 0.90, and accuracy rates of 88.2 per cent and 88.2 per cent, respectively. The combined tumour blood flow and apparent diffusion co-efficient values used for differentiating recurrence from post-radiation changes had an area under the curve of 0.96 and an accuracy of 90.2 per cent.ConclusionCombined tumour blood flow and apparent diffusion co-efficient can differentiate recurrence from post-radiation changes.
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Investigating the correlation of arterial spin labeling and dynamic contrast enhanced perfusion in primary tumor of nasopharyngeal carcinoma. Eur J Radiol 2018; 108:222-229. [DOI: 10.1016/j.ejrad.2018.09.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 09/26/2018] [Accepted: 09/30/2018] [Indexed: 12/11/2022]
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Arterial spin labeling perfusion-weighted MR imaging: correlation of tumor blood flow with pathological degree of tumor differentiation, clinical stage and nodal metastasis of head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 2018; 275:1301-1307. [DOI: 10.1007/s00405-018-4950-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 03/22/2018] [Indexed: 01/09/2023]
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Kabadi SJ, Fatterpekar GM, Anzai Y, Mogen J, Hagiwara M, Patel SH. Dynamic Contrast-Enhanced MR Imaging in Head and Neck Cancer. Magn Reson Imaging Clin N Am 2018; 26:135-149. [DOI: 10.1016/j.mric.2017.08.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Nooij RP, Hof JJ, van Laar PJ, van der Hoorn A. Functional MRI for Treatment Evaluation in Patients with Head and Neck Squamous Cell Carcinoma: A Review of the Literature from a Radiologist Perspective. CURRENT RADIOLOGY REPORTS 2018; 6:2. [PMID: 29416951 PMCID: PMC5778171 DOI: 10.1007/s40134-018-0262-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW To show the role of functional MRI in patients treated for head and neck squamous cell carcinoma. RECENT FINDINGS MRI is commonly used for treatment evaluation in patients with head and neck tumors. However, anatomical MRI has its limits in differentiating between post-treatment effects and tumor recurrence. Recent studies showed promising results of functional MRI for response evaluation. SUMMARY This review analyzes possibilities and limitations of functional MRI sequences separately to obtain insight in the post-therapy setting. Diffusion, perfusion and spectroscopy show promise, especially when utilized complimentary to each other. These functional MRI sequences aid in the early detection which might improve survival by increasing effectiveness of salvage therapy. Future multicenter longitudinal prospective studies are needed to provide standardized guidelines for the use of functional MRI in daily clinical practice.
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Affiliation(s)
- Roland P. Nooij
- Department of Radiology, Medical Spectrum Twente, Enschede, The Netherlands
| | - Jan J. Hof
- Department of Radiology, Medical Spectrum Twente, Enschede, The Netherlands
| | - Peter Jan van Laar
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P. O. Box 30.001, 9700 RB Groningen, The Netherlands
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anouk van der Hoorn
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P. O. Box 30.001, 9700 RB Groningen, The Netherlands
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Geerts B, Leclercq D, Tezenas du Montcel S, Law-ye B, Gerber S, Bernardeschi D, Galanaud D, Dormont D, Pyatigorskaya N. Characterization of Skull Base Lesions Using Pseudo-Continuous Arterial Spin Labeling. Clin Neuroradiol 2017; 29:75-86. [DOI: 10.1007/s00062-017-0623-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/19/2017] [Indexed: 10/18/2022]
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31
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State of the art MRI in head and neck cancer. Clin Radiol 2017; 73:45-59. [PMID: 28655406 DOI: 10.1016/j.crad.2017.05.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 05/26/2017] [Indexed: 12/17/2022]
Abstract
Head and neck cancer affects more than 11,000 new patients per year in the UK1 and imaging has an important role in the diagnosis, treatment planning, and assessment, and post-treatment surveillance of these patients. The anatomical detail produced by magnetic resonance imaging (MRI) is ideally suited to staging and follow-up of primary tumours and cervical nodal metastases in the head and neck; however, anatomical images have limitations in cancer imaging and so increasingly functional-based MRI techniques, which provide molecular, metabolic, and physiological information, are being incorporated into MRI protocols. This article reviews the state of the art of these functional MRI techniques with emphasis on those that are most relevant to the current management of patients with head and neck cancer.
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Fujima N, Sakashita T, Homma A, Hirata K, Shiga T, Kudo K, Shirato H. Glucose Metabolism and Its Complicated Relationship with Tumor Growth and Perfusion in Head and Neck Squamous Cell Carcinoma. PLoS One 2016; 11:e0166236. [PMID: 27824931 PMCID: PMC5100940 DOI: 10.1371/journal.pone.0166236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 10/25/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To determine the relationship between tumor glucose metabolism and tumor blood flow (TBF) in head and neck squamous cell carcinoma (HNSCC). METHODS We retrospectively analyzed 57 HNSCC patients. Tumor glucose metabolism was assessed by maximum and mean standardized uptake values (SUVmax and SUVmean) obtained by 18F-fluorodeoxyglucose positron-emission tomography. TBF values were obtained by arterial spin labeling with 3-tesla MRI. The correlations between both SUVs and TBF were assessed in the total series and among patients divided by T-stage (T1-T3 and T4 groups) and tumor location (pharynx/oral cavity and sinonasal cavity groups). Pearson's correlation coefficients were calculated for significant correlations. RESULTS Significant correlations were detected: a negative correlation in the advanced T-stage group (TBF and SUV max: r, -0.61, SUVmean: r, -0.62), a positive correlation in the non-advanced T-stage pharynx/oral cavity group (TBF and SUVmax: r, 0.70, SUVmean: r, 0.73), a negative correlation in the advanced T-stage pharynx/oral cavity group (TBF and SUVmax: r, -0.62, SUVmean: r, -0.65), and a negative correlation in the advanced T-stage sinonasal cavity group (TBF and SUVmax: r, -0.61, SUVmean: r, -0.65). CONCLUSION Significant correlations between glucose uptake and TBF in HNSCC were revealed by the division of T-stage and tumor location.
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Affiliation(s)
- Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Tomohiro Sakashita
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kenji Hirata
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tohru Shiga
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kohsuke Kudo
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Hiroki Shirato
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- The Global Station for Quantum Medical Science and Engineering, Global Institution for collaborative research and education, Sapporo, Japan
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Wu Y, Agarwal S, Jones CK, Webb AG, van Zijl PCM, Hua J, Pillai JJ. Measurement of arteriolar blood volume in brain tumors using MRI without exogenous contrast agent administration at 7T. J Magn Reson Imaging 2016; 44:1244-1255. [PMID: 27028493 PMCID: PMC5045323 DOI: 10.1002/jmri.25248] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/04/2016] [Indexed: 11/11/2022] Open
Abstract
PURPOSE Arteriolar cerebral-blood-volume (CBVa) is an important perfusion parameter that can be measured using inflow-based vascular-space-occupancy (iVASO) MRI without exogenous contrast agent administration. The purpose of this study is to assess the potential diagnostic value of CBVa in brain tumor patients by comparing it with total-CBV (including arterial, capillary and venous vessels) measured by dynamic-susceptibility-contrast (DSC) MRI. MATERIALS AND METHODS Twelve brain tumor patients were scanned using iVASO (on 7T as part of a research project) and DSC (on 3T as part of routine clinical protocols) MRI. Region-of-interest analysis was performed to compare the resulting perfusion measures between tumoral and contralateral regions, and to evaluate their associations with tumor grades. RESULTS CBVa measured by iVASO MRI significantly correlated with WHO grade (ρ = 0.37, P = 0.04). Total-CBV measured by DSC MRI showed a trend of correlation with WHO grade (ρ = 0.28, P = 0.5). The signal-to-noise ratio was comparable (P > 0.1) between the two methods, while the contrast-to-noise ratio between tumoral and contralateral regions was higher in iVASO-CBVa than DSC-CBV in WHO II/III patients (P < 0.05) but comparable in WHO IV patients (P > 0.1). A trend of positive correlation between DSC-CBV and iVASO-CBVa was observed (R2 = 0.28, P = 0.07). CONCLUSION In this initial patient study, CBVa demonstrated a stronger correlation with WHO grade than total-CBV. Further investigation with a larger cohort is warranted to validate whether CBVa can be a better classifier than total-CBV for the stratification of brain tumors, and whether iVASO MRI can be a useful alternative method for the assessment of tumor perfusion, especially when exogenous contrast agent administration is difficult in certain patient populations. J. Magn. Reson. Imaging 2016;44:1244-1255.
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Affiliation(s)
- Yuankui Wu
- Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Shruti Agarwal
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Craig K Jones
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Andrew G Webb
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden, University Medical Center, Leiden, The Netherlands
| | - Peter C M van Zijl
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Jun Hua
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.
| | - Jay J Pillai
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Jansen JFA, Parra C, Lu Y, Shukla-Dave A. Evaluation of Head and Neck Tumors with Functional MR Imaging. Magn Reson Imaging Clin N Am 2016; 24:123-133. [PMID: 26613878 DOI: 10.1016/j.mric.2015.08.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Head and neck cancer is one of the most common cancers worldwide. MR imaging-based diffusion and perfusion techniques enable the noninvasive assessment of tumor biology and physiology, which supplement information obtained from standard structural scans. Diffusion and perfusion MR imaging techniques provide novel biomarkers that can aid monitoring in pretreatment, during treatment, and posttreatment stages to improve patient selection for therapeutic strategies; provide evidence for change of therapy regime; and evaluate treatment response. This review discusses pertinent aspects of the role of diffusion and perfusion MR imaging and computational analysis methods in studying head and neck cancer.
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Affiliation(s)
- Jacobus F A Jansen
- Department of Radiology, Maastricht University Medical Center, PO Box 5800, Maastricht 6202 AZ, The Netherlands.
| | - Carlos Parra
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Yonggang Lu
- Department of Radiation Oncology, University of Washington, 4921 Parkview Pl, St Louis, MO 63110, USA
| | - Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
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Yuan J, Lo G, King AD. Functional magnetic resonance imaging techniques and their development for radiation therapy planning and monitoring in the head and neck cancers. Quant Imaging Med Surg 2016; 6:430-448. [PMID: 27709079 PMCID: PMC5009093 DOI: 10.21037/qims.2016.06.11] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 05/27/2016] [Indexed: 01/05/2023]
Abstract
Radiation therapy (RT), in particular intensity-modulated radiation therapy (IMRT), is becoming a more important nonsurgical treatment strategy in head and neck cancer (HNC). The further development of IMRT imposes more critical requirements on clinical imaging, and these requirements cannot be fully fulfilled by the existing radiotherapeutic imaging workhorse of X-ray based imaging methods. Magnetic resonance imaging (MRI) has increasingly gained more interests from radiation oncology community and holds great potential for RT applications, mainly due to its non-ionizing radiation nature and superior soft tissue image contrast. Beyond anatomical imaging, MRI provides a variety of functional imaging techniques to investigate the functionality and metabolism of living tissue. The major purpose of this paper is to give a concise and timely review of some advanced functional MRI techniques that may potentially benefit conformal, tailored and adaptive RT in the HNC. The basic principle of each functional MRI technique is briefly introduced and their use in RT of HNC is described. Limitation and future development of these functional MRI techniques for HNC radiotherapeutic applications are discussed. More rigorous studies are warranted to translate the hypotheses into credible evidences in order to establish the role of functional MRI in the clinical practice of head and neck radiation oncology.
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Affiliation(s)
- Jing Yuan
- Department of Medical Physics and Research, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China
| | - Gladys Lo
- Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China
| | - Ann D. King
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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Sakashita T, Kamishima T, Kobayashi Y, Sugimori H, Tang M, Sutherland K, Noguchi A, Kono M, Atsumi T. Accurate quantitative assessment of synovitis in rheumatoid arthritis using pixel-by-pixel, time-intensity curve shape analysis. Br J Radiol 2016; 89:20151000. [PMID: 26942294 DOI: 10.1259/bjr.20151000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To improve on the reproducibility and sensitivity of the assessment of patients with rheumatoid arthritis (RA), two semi-automated measurement methods of the area of enhancing pannus (AEP), based on thresholding (AEP_THRES) and pixel-by-pixel time-intensity curve analysis (AEP_TIC), were evaluated as an alternative for the gold-standard manual contouring method (AEP_MANUAL). METHODS 8 patients (7 females and 1 male) with RA of the wrist or finger joints participated in the study. A three-dimensional contrast-enhanced dynamic sequence was used at 3 T. After identifying the most relevant time-intensity curve (TIC) shape in terms of synovitis by comparing with the synovitis score using the RA-MRI scoring system, three different approaches for measuring the AEP were performed. Spearman's test of rank correlation was used to compare AEPs via two semi-automated methods (AEP_THRES and AEP_TIC) against manual segmentation (AEP_MANUAL) in the entire hand region as well as the wrist and the finger regions. RESULTS The TIC shape of "washout after fast initial enhancement" had excellent correlation with synovitis score (r = 0.809). The correlation coefficient between AEP_TIC and AEP_MANUAL was evaluated to be better than that of AEP_THRES and AEP_MANUAL in the wrist region (AEP_THRES: r = 0.716, AEP_TIC: r = 0.815), whereas these were of comparable accuracy for the entire hand and the finger regions. CONCLUSION This study suggests that TIC analysis may be an alternative to manual contouring for pannus quantification and provides important clinical information of the extent of the disease in patients with RA. ADVANCES IN KNOWLEDGE TIC shape analysis can be applied for new quantitative assessment for RA synovitis in the wrist.
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Affiliation(s)
- Taro Sakashita
- 1 Graduate School of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Tamotsu Kamishima
- 2 Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yuto Kobayashi
- 3 Department of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hiroyuki Sugimori
- 4 Department of Radiology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.,5 Department of Clinical Support for Medical Practice, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Minghui Tang
- 1 Graduate School of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kenneth Sutherland
- 6 Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Atsushi Noguchi
- 7 Internal Medicine 2, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.,8 Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Michihito Kono
- 7 Internal Medicine 2, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.,8 Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tatsuya Atsumi
- 7 Internal Medicine 2, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.,8 Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Fujima N, Yoshida D, Sakashita T, Homma A, Tsukahara A, Tha KK, Kudo K, Shirato H. Usefulness of Pseudocontinuous Arterial Spin-Labeling for the Assessment of Patients with Head and Neck Squamous Cell Carcinoma by Measuring Tumor Blood Flow in the Pretreatment and Early Treatment Period. AJNR Am J Neuroradiol 2016; 37:342-8. [PMID: 26427828 DOI: 10.3174/ajnr.a4513] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 07/06/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE For the assessment of the treatment response in non-surgical treatment, tumor blood flow provides the functional information of the tumor which is different from the morphological information such as tumor volume. The purpose of this study was to evaluate the diagnostic value of tumor blood flow values obtained by pseudocontinuous arterial spin-labeling in patients with head and neck squamous cell carcinoma. MATERIALS AND METHODS Forty-one patients with head and neck squamous cell carcinoma were evaluated by using pseudocontinuous arterial spin-labeling. Quantitative tumor blood flow was calculated at the pretreatment and the early treatment periods in all the patients, and the percentage change of tumor blood flow between the two was calculated. At the early treatment period, based on their tumor volume reduction rate, we divided the patients into stable disease and partial response groups for a subgroup analysis. The local control or failure was confirmed either by histopathology or by radiologic evaluation within the follow-up. RESULTS Pretreatment tumor blood flow in patients in the failure group was significantly lower than that in patients in the local control group. In the subgroup analysis of patients with stable disease, the percentage change of tumor blood flow was significantly larger (due to the tumor blood flow increase from pretreatment value) in the local control group than in the failure group. In addition, in patients with a partial response, the percentage change of tumor blood flow was significantly smaller (due to the tumor blood flow decrease from the pretreatment value) in the local control group than in the failure group. The accuracy for determination of the local control group or the failure group in pretreatment tumor blood flow was 0.83 and that in the combination use of the percentage change of tumor blood flow and tumor volume in the early treatment period was 0.93. CONCLUSIONS Tumor blood flow obtained by pseudocontinuous arterial spin-labeling can be useful for the determination of local control. The combined use of the percentage change of tumor blood flow and tumor volume had particularly high diagnostic accuracy.
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Affiliation(s)
- N Fujima
- From the Department of Diagnostic and Interventional Radiology (N.F., D.Y., A.T., K.K.), Hokkaido University Hospital, Sapporo, Japan
| | - D Yoshida
- From the Department of Diagnostic and Interventional Radiology (N.F., D.Y., A.T., K.K.), Hokkaido University Hospital, Sapporo, Japan
| | - T Sakashita
- Departments of Otolaryngology-Head and Neck Surgery (T.S., A.H.)
| | - A Homma
- Departments of Otolaryngology-Head and Neck Surgery (T.S., A.H.)
| | - A Tsukahara
- From the Department of Diagnostic and Interventional Radiology (N.F., D.Y., A.T., K.K.), Hokkaido University Hospital, Sapporo, Japan
| | - K K Tha
- Radiation Medicine (K.K.T., H.S.), Hokkaido University Graduate School of Medicine, Sapporo, Japan Global Station for Quantum Medical Science and Engineering (K.K.T., H.S.), Global Institution for Collaborative Research and Education, Sapporo, Japan
| | - K Kudo
- From the Department of Diagnostic and Interventional Radiology (N.F., D.Y., A.T., K.K.), Hokkaido University Hospital, Sapporo, Japan
| | - H Shirato
- Radiation Medicine (K.K.T., H.S.), Hokkaido University Graduate School of Medicine, Sapporo, Japan Global Station for Quantum Medical Science and Engineering (K.K.T., H.S.), Global Institution for Collaborative Research and Education, Sapporo, Japan
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Khashbat, MD D, Abe, MD T, Ganbold, MD M, Iwamoto, MD S, Uyama, MD N, Irahara, MD S, Otomi, MD, PhD Y, Harada, MD, PhD M, Kageji, MD, PhD T, Nagahiro, MD, PhD S. Correlation of 3D Arterial Spin Labeling and Multi-Parametric Dynamic Susceptibility Contrast Perfusion MRI in Brain Tumors. THE JOURNAL OF MEDICAL INVESTIGATION 2016; 63:175-81. [DOI: 10.2152/jmi.63.175] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Delgerdalai Khashbat, MD
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Takashi Abe, MD
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Mungunbagana Ganbold, MD
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Seiji Iwamoto, MD
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Naoto Uyama, MD
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Saho Irahara, MD
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Youichi Otomi, MD, PhD
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Masafumi Harada, MD, PhD
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | | | - Shinji Nagahiro, MD, PhD
- Department of Neurosurgery, Institute of Biomedical Sciences, Tokushima University Graduate School
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Fujima N, Nakamaru Y, Sakashita T, Homma A, Tsukahara A, Kudo K, Shirato H. Differentiation of squamous cell carcinoma and inverted papilloma using non-invasive MR perfusion imaging. Dentomaxillofac Radiol 2015; 44:20150074. [PMID: 26054571 PMCID: PMC5083900 DOI: 10.1259/dmfr.20150074] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/28/2015] [Accepted: 06/08/2015] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To investigate the diagnostic value of tumour blood flow (TBF) obtained with pseudocontinuous arterial spin labelling for the differentiation of squamous cell carcinoma (SCC) and inverted papilloma (IP) in the nasal or sinonasal cavity. METHODS We retrospectively analysed the cases of 33 patients with SCC and 8 patients with IP in the nasal or sinonasal cavity. Pseudocontinuous arterial spin labelling scanning was performed for all patients using a 3.0-T MR unit. Quantitative TBF values were measured by two neuroradiologists by respectively delineating the whole-tumour regions of interest, and the mean of them was determined as TBF value in each patient. Additionally, the presence of imaging findings of convoluted cerebriform pattern (CCP) on MR T2 weighted images was determined in all patients. As a subgroup analysis, patients with IP were divided into aggressive and non-aggressive IPs depending on their progression range. First, an intraclass correlation coefficient (ICC) of TBF values between two neuroradiologists was determined. Next, a statistical comparison of the TBF value by a Mann-Whitney U test between the patients with SCC and IP was performed. Additionally, the comparison by an ANOVA with a post hoc test of Tukey's method among the SCC, non-aggressive IP and aggressive IP groups was also performed. If significance was observed, the diagnostic accuracy to differentiate SCCs from IPs was calculated. Diagnostic accuracy by CCP findings alone and by the combination of CCP findings and TBF were also assessed. RESULTS The ICC of TBF values between two neuroradiologists was 0.82. The mean TBF values in the patients with SCC, all patients with IP, those with aggressive IP and those with non-aggressive IP were 141.2 ± 33.1, 77.8 ± 31.5, 109.4 ± 16.7 and 58.8 ± 19.9 ml 100 g⁻¹ min⁻¹, respectively. A significant difference was observed between SCC and IP (p < 0.001), SCC and non-aggressive IP (p < 0.01) and non-aggressive IP and aggressive IP (p < 0.01). The diagnostic accuracy values obtained with receiver operating characteristic curve analysis for the differentiation of SCC from IP and for SCC from non-aggressive IP were 0.90 and 0.92, respectively. The diagnostic accuracy was elevated (0.95 from 0.88) by adding the TBF value to CCP findings. CONCLUSIONS The pseudocontinuous arterial spin labelling technique can be a useful non-invasive diagnostic tool to differentiate SCC from IP in nasal or sinonasal cavity.
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Affiliation(s)
- N Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Y Nakamaru
- Department of Otolaryngology–Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - T Sakashita
- Department of Otolaryngology–Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - A Homma
- Department of Otolaryngology–Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - A Tsukahara
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - K Kudo
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - H Shirato
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- The Global Station for Quantum Medical Science and Engineering, Global Institution for collaborative research and education, Sapporo, Japan
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