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Kaur G, Manchanda S, Sharma R, Vyas S, Kandasamy D, Hari S, Bhatla N, Mathur SR. Comparison of conventional diffusion-weighted imaging, diffusion kurtosis imaging and intravoxel incoherent motion in characterization of sonographically indeterminate adnexal masses. Abdom Radiol (NY) 2024; 49:1512-1521. [PMID: 38607571 DOI: 10.1007/s00261-024-04292-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE To evaluate the role of conventional diffusion weighted imaging, diffusion kurtosis imaging (DKI), and intravoxel incoherent motion (IVIM) in distinguishing benign from malignant adnexal masses. METHODS 38 patients with 45 adnexal masses were enrolled in this prospective study and assessed with multiparametric MRI, including the IVIM-DKI sequence, on a 3 T MRI system. The mean apparent diffusion coefficient (ADC) from conventional DWI, the apparent diffusion coefficient derived from DKI (Dapp), the apparent kurtosis coefficient (Kapp), true diffusion coefficient (Dt), perfusion fraction (f) and pseudo-diffusion coefficient (Dp) were measured. RESULTS The mean ADC, Dapp, and Dt were significantly higher in benign adnexal masses than in malignant adnexal masses (p < 0.001). f and Dp were also significantly higher in benign adnexal masses, with p values of 0.026 and 0.002, respectively. Kapp was higher in malignant masses (p < 0.001). Among mean ADC, Dapp, and Dt, mean ADC had the highest area under the curve (AUC) of 0.885. However, no statistically significant differences were observed between the ROCs of various diffusion parameters. CONCLUSION The mean ADC, Dapp, and Kapp are useful parameters in discriminating between benign and malignant adnexal masses. Dt derived from IVIM also helps in distinguishing benign and malignant adnexal masses; however, no incremental role of IVIM and DKI over ADC could be identified in our study.
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Affiliation(s)
- Gurkawal Kaur
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Smita Manchanda
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Raju Sharma
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Surabhi Vyas
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Devasenathipathy Kandasamy
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Smriti Hari
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Neerja Bhatla
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep R Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Zhu HB, Zhao B, Li XT, Zhang XY, Yao Q, Sun YS. Value of multiple models of diffusion-weighted imaging to predict hepatic lymph node metastases in colorectal liver metastases patients. World J Gastroenterol 2024; 30:308-317. [PMID: 38313236 PMCID: PMC10835543 DOI: 10.3748/wjg.v30.i4.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/15/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND About 10%-31% of colorectal liver metastases (CRLM) patients would concomitantly show hepatic lymph node metastases (LNM), which was considered as sign of poor biological behavior and a relative contraindication for liver resection. Up to now, there's still lack of reliable preoperative methods to assess the status of hepatic lymph nodes in patients with CRLM, except for pathology examination of lymph node after resection. AIM To compare the ability of mono-exponential, bi-exponential, and stretched-exponential diffusion-weighted imaging (DWI) models in distinguishing between benign and malignant hepatic lymph nodes in patients with CRLM who received neoadjuvant chemotherapy prior to surgery. METHODS In this retrospective study, 97 CRLM patients with pathologically confirmed hepatic lymph node status underwent magnetic resonance imaging, including DWI with ten b values before and after chemotherapy. Various parameters, such as the apparent diffusion coefficient from the mono-exponential model, and the true diffusion coefficient, the pseudo-diffusion coefficient, and the perfusion fraction derived from the intravoxel incoherent motion model, along with distributed diffusion coefficient (DDC) and α from the stretched-exponential model (SEM), were measured. The parameters before and after chemotherapy were compared between positive and negative hepatic lymph node groups. A nomogram was constructed to predict the hepatic lymph node status. The reliability and agreement of the measurements were assessed using the coefficient of variation and intraclass correlation coefficient. RESULTS Multivariate analysis revealed that the pre-treatment DDC value and the short diameter of the largest lymph node after treatment were independent predictors of metastatic hepatic lymph nodes. A nomogram combining these two factors demonstrated excellent performance in distinguishing between benign and malignant lymph nodes in CRLM patients, with an area under the curve of 0.873. Furthermore, parameters from SEM showed substantial repeatability. CONCLUSION The developed nomogram, incorporating the pre-treatment DDC and the short axis of the largest lymph node, can be used to predict the presence of hepatic LNM in CRLM patients undergoing chemotherapy before surgery. This nomogram was proven to be more valuable, exhibiting superior diagnostic performance compared to quantitative parameters derived from multiple b values of DWI. The nomogram can serve as a preoperative assessment tool for determining the status of hepatic lymph nodes and aiding in the decision-making process for surgical treatment in CRLM patients.
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Affiliation(s)
- Hai-Bin Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Bo Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Xiao-Ting Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Xiao-Yan Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Qian Yao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Ying-Shi Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
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Deep learning for the ovarian lesion localization and discrimination between borderline and malignant ovarian tumors based on routine MR imaging. Sci Rep 2023; 13:2770. [PMID: 36797331 PMCID: PMC9935539 DOI: 10.1038/s41598-023-29814-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 02/10/2023] [Indexed: 02/18/2023] Open
Abstract
To establish a deep learning (DL) model in differentiating borderline ovarian tumor (BOT) from epithelial ovarian cancer (EOC) on conventional MR imaging. We retrospectively enrolled 201 patients of 102 pathologically proven BOTs and 99 EOCs at OB/GYN hospital Fudan University, between January 2015 and December 2017. All imaging data were reviewed on picture archiving and communication systems (PACS) server. Both T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) MR images were used for lesion area determination. We trained a U-net++ model with deep supervision to segment the lesion area on MR images. Then, the segmented regions were fed into a classification model based on DL network to categorize ovarian masses automatically. For ovarian lesion segmentation, the mean dice similarity coefficient (DSC) of the trained U-net++ model in the testing dataset achieved 0.73 [Formula: see text] 0.25, 0.76 [Formula: see text] 0.18, and 0.60 [Formula: see text] 0.24 in the sagittal T2WI, coronal T2WI, and axial T1WI images, respectively. The DL model by combined T2WI computerized network could differentiate BOT from EOC with a significantly higher AUC of 0.87, an accuracy of 83.7%, a sensitivity of 75.0% and a specificity of 87.5%. In comparison, the AUC yielded by radiologist was only 0.75, with an accuracy of 75.5%, a sensitivity of 96.0% and specificity of 54.2% (P < 0.001).The trained DL network model derived from routine MR imaging could help to distinguish BOT from EOC with a high accuracy, which was superior to radiologists' assessment.
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Hong Y, Song G, Jia Y, Wu R, He R, Li A. Predicting tumor deposits in patients with rectal cancer: Using the models of multiple mathematical parameters derived from diffusion-weighted imaging. Eur J Radiol 2022; 157:110573. [DOI: 10.1016/j.ejrad.2022.110573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/09/2022] [Accepted: 10/23/2022] [Indexed: 11/08/2022]
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Zhang J, Xing X, Wang Q, Chen Y, Yuan H, Lang N. Preliminary study of monoexponential, biexponential, and stretched-exponential models of diffusion-weighted MRI and diffusion kurtosis imaging on differential diagnosis of spinal metastases and chordoma. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:3130-3138. [PMID: 35648206 DOI: 10.1007/s00586-022-07269-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/03/2022] [Accepted: 05/15/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Quantitative comparison of diffusion parameters from various models of diffusion-weighted (DWI) and diffusion kurtosis (DKI) imaging for distinguishing spinal metastases and chordomas. METHODS DWI and DKI examinations were performed in 31 and 13 cases of spinal metastases and chordomas, respectively. DWI derived apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), water molecular distributed diffusion coefficient (DDC), and intravoxel water diffusion heterogeneity (α). DKI derived mean diffusivity (MD) and mean kurtosis (MK). Independent sample t-testing compared statistical differences among parameters. Sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve were determined. Pearson correlation analysis evaluated the parameters' correlations. RESULTS ADC, D, f, DDC, α, and MD were significantly lower in spinal metastases than chordomas (all P < 0.05). MK was significantly higher in spinal metastases than chordomas (P < 0.05). D had the highest area under the ROC curve (AUC) of 0.886, greater than MD (AUC = 0.706) or DDC (AUC = 0.742) in differentiating the two tumors (both P < 0.05). Combining D with f and α statistically significantly increased the AUC for diagnosis (to 0.995) relative to D alone (P < 0.05). There was a certain correlation among DDC, ADC, and D (all P < 0.05). CONCLUSIONS Monoexponential, biexponential, and stretched-exponential models of DWI and DKI can potentially differentiate spinal metastases and chordomas. D combined with f and α performed best.
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Affiliation(s)
- Jiahui Zhang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Xiaoying Xing
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Qizheng Wang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Yongye Chen
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Ning Lang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.
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Zhu X, Wang J, Wang YC, Zhu ZF, Tang J, Wen XW, Fang Y, Han J. Quantitative differentiation of malignant and benign thyroid nodules with multi-parameter diffusion-weighted imaging. World J Clin Cases 2022; 10:8587-8598. [PMID: 36157818 PMCID: PMC9453341 DOI: 10.12998/wjcc.v10.i24.8587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/25/2022] [Accepted: 07/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The value of conventional magnetic resonance imaging in the differential diagnosis of thyroid nodules is limited; however, the value of multi-parameter diffusion-weighted imaging (DWI) in the quantitative evaluation of thyroid nodules has not been well determined.
AIM To determine the utility of multi-parametric DWI including mono-exponential, bi-exponential, stretched exponential, and kurtosis models for the differentiation of thyroid lesions.
METHODS Seventy-nine patients (62 with benign and 17 with malignant nodules) underwent multi-b value diffusion-weighted imaging of the thyroid. Multiple DWI parameters were obtained for statistical analysis.
RESULTS Good agreement was found for diffusion parameters of thyroid nodules. Malignant lesions displayed lower diffusion parameters including apparent diffusion coefficient (ADC), the true diffusion coefficient (D), the perfusion fraction (f), the distributed diffusion coefficient (DDC), the intravoxel water diffusion heterogeneity (α) and kurtosis model-derived ADC (Dapp), and higher apparent diffusional kurtosis (Kapp) than benign entities (all P < 0.01), except for the pseudodiffusion coefficient (D*) (P > 0.05). The area under the ROC curve (AUC) of the ADC(0 and 1000) was not significantly different from that of the ADC(0 and 2000), ADC(0 to 2000), ADC(0 to 1000), D, DDC, Dapp and Kapp (all P > 0.05), but was significantly higher than the AUC of D*, f and α (all P < 0.05) for differentiating benign from malignant lesions.
CONCLUSION Multiple DWI parameters including ADC, D, f, DDC, α, Dapp and Kapp could discriminate benign and malignant thyroid nodules. The metrics including D, DDC, Dapp and Kapp provide additional information with similar diagnostic performance of ADC, combination of these metrics may contribute to differentiate benign and malignant thyroid nodules. The ADC calculated with higher b values may not lead to improved diagnostic performance.
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Affiliation(s)
- Xiang Zhu
- Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Jia Wang
- Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Yan-Chun Wang
- Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Ze-Feng Zhu
- Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Jian Tang
- Department of Head and Neck Surgery, the First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Xiao-Wei Wen
- Department of Pathology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Ying Fang
- Department of Pathology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Jun Han
- Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
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Yang H, Ge X, Zheng X, Li X, Li J, Liu M, Zhu J, Qin J. Predicting Grade of Esophageal Squamous Carcinoma: Can Stretched Exponential Model-Based DWI Perform Better Than Bi-Exponential and Mono-Exponential Model? Front Oncol 2022; 12:904625. [PMID: 35912203 PMCID: PMC9329622 DOI: 10.3389/fonc.2022.904625] [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: 04/20/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background To evaluate and compare the potential performance of various diffusion parameters obtained from mono-exponential model (MEM)-, bi-exponential model (BEM)-, and stretched exponential model (SEM)-based diffusion-weighted imaging (DWI) in grading of esophageal squamous carcinoma (ESC). Methods Eighty-two patients with pathologically confirmed ESC without treatment underwent multi-b-value DWI scan with 13 b values (0~12,00 s/mm2). The apparent diffusion coefficient (ADC) deriving from the MEM; the pure molecular diffusion (ADCslow), pseudo-diffusion coefficient (ADCfast), perfusion, and fraction (f) deriving from the BEM; and the distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) deriving from the SEM were calculated and compared between poorly differentiated and well/moderately differentiated ESC, respectively. The prediction parameters and diagnostic efficiency were compared by drawing receiver operating characteristic (ROC) curves. Results The ADC, ADCslow, ADCfast, and DDC in poorly ESC were significantly lower than those in well/moderately differentiated ones. By using only one parameter, ADCslow, DDC had the moderate diagnostic efficiency and the areas under the curve (AUC) were 0.758 and 0.813 in differentiating ESC. The DDC had the maximum AUC with sensitivity (88.00%) and specificity (68.42%). Combining ADC with ADCfast, ADCslow, and DDC and combining ADCslow with ADCfast can provide a higher diagnostic accuracy with AUC ranging from 0.756, 0.771, 0.816, and 0.793, respectively. Conclusion Various parameters derived from different DWI models including MEM, BEM, and SEM were potentially helpful in grading ESC. DDC obtained from SEM was the most promising diffusion parameter for predicting the grade of ESC.
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Affiliation(s)
- Hui Yang
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai’an, China
| | - Xubo Ge
- Department of Radiology, The Fourth People’s Hospital of Taian, Tai’an, China
| | - Xiuzhu Zheng
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai’an, China
| | - Xiaoqian Li
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai’an, China
| | - Jiang Li
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai’an, China
| | - Min Liu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai’an, China
| | - Jianzhong Zhu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai’an, China
| | - Jian Qin
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai’an, China
- *Correspondence: Jian Qin,
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Li C, Wang H, Chen Y, Zhu C, Gao Y, Wang X, Dong J, Wu X. Nomograms of Combining MRI Multisequences Radiomics and Clinical Factors for Differentiating High-Grade From Low-Grade Serous Ovarian Carcinoma. Front Oncol 2022; 12:816982. [PMID: 35747838 PMCID: PMC9211758 DOI: 10.3389/fonc.2022.816982] [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: 11/17/2021] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To compare the performance of clinical factors, FS-T2WI, DWI, T1WI+C based radiomics and a combined clinic-radiomics model in predicting the type of serous ovarian carcinomas (SOCs). Methods In this retrospective analysis, 138 SOC patients were confirmed by histology. Significant clinical factors (P < 0.05, and with the area under the curve (AUC) > 0.7) was retained to establish a clinical model. The radiomics model included FS-T2WI, DWI, and T1WI+C, and also, a multisequence model was established. A total of 1,316 radiomics features of each sequence were extracted; the univariate and multivariate logistic regressions, cross-validations were performed to reduce valueless features and then radiomics signatures were developed. Nomogram models using clinical factors, combined with radiomics features, were developed in the training cohort. The predictive performance was validated by receiver operating characteristic curve (ROC) analysis and decision curve analysis (DCA). A stratified analysis was conducted to compare the differences between the combined radiomics model and the clinical model in identifying low- and high-grade SOC. Results The AUC of the clinical model and multisequence radiomics model in the training and validation cohorts was 0.90 and 0.89, 0.91 and 0.86, respectively. By incorporating clinical factors and multi-radiomics signature, the AUC of the radiomic-clinical nomogram in the training and validation cohorts was 0.98 and 0.95. The model comparison results show that the AUC of the combined model is higher than that of the uncombined models (P= 0.05, 0.002). Conclusion The nomogram models of clinical factors combined with MRI multisequence radiomics signatures can help identifying low- and high-grade SOCs and a provide a more comprehensive, effective method to evaluate preoperative risk stratification for SOCs.
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Affiliation(s)
- Cuiping Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Radiology, The First Affiliated Hospital of the University of Science and Technology of China, Anhui Provincial Cancer Hospital, Hefei, China
| | - Hongfei Wang
- Department of Radiotherapy, The First Affiliated Hospital, University of Science and Technology of China, Anhui Provincial Cancer Hospital, Hefei, China
| | - Yulan Chen
- Department of Radiology, The First Affiliated Hospital of the University of Science and Technology of China, Anhui Provincial Cancer Hospital, Hefei, China
| | - Chao Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yankun Gao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xia Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jiangning Dong
- Department of Radiology, The First Affiliated Hospital of the University of Science and Technology of China, Anhui Provincial Cancer Hospital, Hefei, China
- *Correspondence: Jiangning Dong, ; Xingwang Wu,
| | - Xingwang Wu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Jiangning Dong, ; Xingwang Wu,
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Guo Y, Chen J, Zhang Y, Guo Y, Jiang M, Dai Y, Yao X. Differentiating Cytokeratin 19 expression of hepatocellular carcinoma by using multi-b-value diffusion-weighted MR imaging with mono-exponential, stretched exponential, intravoxel incoherent motion, diffusion kurtosis imaging and fractional order calculus models. Eur J Radiol 2022; 150:110237. [DOI: 10.1016/j.ejrad.2022.110237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 02/02/2022] [Accepted: 03/03/2022] [Indexed: 12/25/2022]
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Zeng P, Ma L, Liu J, Song Z, Liu J, Yuan H. The diagnostic value of intravoxel incoherent motion diffusion-weighted imaging for distinguishing nonhypervascular pancreatic neuroendocrine tumors from pancreatic ductal adenocarcinomas. Eur J Radiol 2022; 150:110261. [PMID: 35316674 DOI: 10.1016/j.ejrad.2022.110261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/19/2022] [Accepted: 03/14/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE To primarily evaluate the diagnostic performance of the monoexponential and intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI) models for differentiating between nonhypervascular pancreatic neuroendocrine tumors (PNETs) and pancreatic ductal adenocarcinomas (PDACs). METHODS 63 patients with PNETs (35 nonhypervascular PNETs and 28 hypervascular PNETs) and 164 patients with PDACs were retrospectively enrolled in the study and underwent multiple b-value DWI. Intraobserver and interobserver reliabilities of DWI parameters were assessed by using the intraclass correlation coefficient (ICC). The parameters of apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) of nonhypervascular PNETs were compared with PDACs and hypervascular PNETs using the independent sample t test or the Mann-Whitney U test. The diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis. RESULTS All DWI parameters values showed good to excellent intra- and interobserver agreements (ICC = 0.743-0.873). Nonhypervascular PNETs had significantly lower ADC and D, but significantly higher f than PDACs (P = 0.005, P < 0.001 and P < 0.001, respectively). ADC, D and f of nonhypervascular PNETs were lower than hypervascular PNETs (P = 0.001, <0.001 and 0.093, respectively). D* of nonhypervascular PNETs showed no statistically significant differences with PDACs and hypervascular PNETs (P = 0.809 and 0.420). D showed a higher area under the curve (AUC), followed by ADC and f (AUC = 0.885, 0.665 and 0.740, respectively) in differentiating nonhypervascular PNETs from PDACs. CONCLUSION Monoexponential and IVIM diffusion models are valuable to differentiate nonhypervascular PNETs from PDACs. D showed better performance than f and ADC.
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Affiliation(s)
- Piaoe Zeng
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, Beijing, China
| | - Lu Ma
- Department of Radiology, Tsinghua University Hospital, 30 Shuangqing Road, Beijing 100084, Beijing, China
| | - Jianfang Liu
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, Beijing, China
| | - Zixiu Song
- Department of Pathology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, Beijing, China
| | - Jianyu Liu
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, Beijing, China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, Beijing, China.
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Gagliardi T, Adejolu M, deSouza NM. Diffusion-Weighted Magnetic Resonance Imaging in Ovarian Cancer: Exploiting Strengths and Understanding Limitations. J Clin Med 2022; 11:1524. [PMID: 35329850 PMCID: PMC8949455 DOI: 10.3390/jcm11061524] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/05/2022] [Accepted: 03/08/2022] [Indexed: 02/06/2023] Open
Abstract
Detection, characterization, staging, and response assessment are key steps in the imaging pathway of ovarian cancer. The most common type, high grade serous ovarian cancer, often presents late, so that accurate disease staging and response assessment are required through imaging in order to improve patient management. Currently, computerized tomography (CT) is the most common method for these tasks, but due to its poor soft-tissue contrast, it is unable to quantify early response within lesions before shrinkage is observed by size criteria. Therefore, quantifiable techniques, such as diffusion-weighted magnetic resonance imaging (DW-MRI), which generates high contrast between tumor and healthy tissue, are increasingly being explored. This article discusses the basis of diffusion-weighted contrast and the technical issues that must be addressed in order to achieve optimal implementation and robust quantifiable diffusion-weighted metrics in the abdomen and pelvis. The role of DW-MRI in characterizing adnexal masses in order to distinguish benign from malignant disease, and to differentiate borderline from frankly invasive malignancy is discussed, emphasizing the importance of morphological imaging over diffusion-weighted metrics in this regard. Its key role in disease staging and predicting resectability in comparison to CT is addressed, including its valuable use as a biomarker for following response within individual lesions, where early changes in the apparent diffusion coefficient in peritoneal metastases may be detected. Finally, the task of implementing DW-MRI into clinical trials in order to validate this biomarker for clinical use are discussed, along with the trials that include it within their protocols.
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Affiliation(s)
- Tanja Gagliardi
- Department of Imaging, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (T.G.); (M.A.)
| | - Margaret Adejolu
- Department of Imaging, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (T.G.); (M.A.)
| | - Nandita M. deSouza
- Department of Imaging, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (T.G.); (M.A.)
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SW7 3RP, UK
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Liu X, Wang T, Zhang G, Hua K, Jiang H, Duan S, Jin J, Zhang H. Two-dimensional and three-dimensional T2 weighted imaging-based radiomic signatures for the preoperative discrimination of ovarian borderline tumors and malignant tumors. J Ovarian Res 2022; 15:22. [PMID: 35115022 PMCID: PMC8815217 DOI: 10.1186/s13048-022-00943-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 12/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ovarian cancer is the most women malignancy in the whole world. It is difficult to differentiate ovarian cancers from ovarian borderline tumors because of some similar imaging findings.Radiomics study may help clinicians to make a proper diagnosis before invasive surgery. PURPOSE To evaluate the ability of T2-weighted imaging (T2WI)-based radiomics to discriminate ovarian borderline tumors (BOTs) from malignancies based on two-dimensional (2D) and three-dimensional (3D) lesion segmentation methods. METHODS A total of 95 patients with pathologically proven ovarian BOTs and 101 patients with malignancies were retrospectively included in this study. We evaluated the diagnostic performance of the signatures derived from T2WI-based radiomics in their ability to differentiate between BOTs and malignancies and compared the performance differences in the 2D and 3D segmentation models. The least absolute shrinkage and selection operator method (Lasso) was used for radiomics feature selection and machine learning processing. RESULTS The radiomics score between BOTs and malignancies in four types of selected T2WI-based radiomics models differed significantly at the statistical level (p < 0.0001). For the classification between BOTs and malignant masses, the 2D and 3D coronal T2WI-based radiomics models yielded accuracy values of 0.79 and 0.83 in the testing group, respectively; the 2D and 3D sagittal fat-suppressed (fs) T2WI-based radiomics models yielded an accuracy of 0.78 and 0.99, respectively. CONCLUSIONS Our results suggest that T2WI-based radiomic features were highly correlated with ovarian tumor subtype classification. 3D-sagittal MRI radiomics features may help clinicians differentiate ovarian BOTs from malignancies with high ACC.
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Affiliation(s)
- Xuefen Liu
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R. China
| | - Tianping Wang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R. China
| | - Guofu Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R. China
| | - Keqin Hua
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R. China
| | - Hua Jiang
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R. China
| | | | - Jun Jin
- Department of Pathology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R. China
| | - He Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R. China.
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Improved Performance of Compartments in Detecting the Activity of Axial Spondyloarthritis Based on IVIM DWI with Optimized Threshold
b
Value. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2276102. [PMID: 35047629 PMCID: PMC8763495 DOI: 10.1155/2022/2276102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/12/2021] [Accepted: 12/18/2021] [Indexed: 11/25/2022]
Abstract
Purpose To explore the diagnostic performance of the optimized threshold b values on IVIM to detect the activity in axial spondyloarthritis (axSpA) patients. Method 40 axSpA patients in the active group, 144 axSpA patients in the inactive group, and 20 healthy volunteers were used to evaluate the tissue diffusion coefficient (Dslow), perfusion fraction (f), and pseudodiffusion coefficient (Dfast) with b thresholds of 10, 20, and 30 s/mm2. The Kruskal-Wallis test and one way ANOVA test was used to compare the different activity among the three groups in axSpA patients, and receiver operating characteristic (ROC) curve analysis was applied to evaluate the performance for Dslow, f, and Dfast to detect the activity in axSpA patients, respectively. Results Dslow demonstrated a statistical difference between two groups (P < 0.05) with all threshold b values. With the threshold b value of 30 s/mm2, f could discriminate the active from control groups (P < 0.05). Dslow had similar performance between the active and the inactive groups with threshold b values of 10, 20, and 30 s/mm2 (AUC: 0.877, 0.882, and 0.881, respectively, all P < 0.017). Using the optimized threshold b value of 30 s/mm2, f showed the best performance to separate the active from the inactive and the control groups with AUC of 0.613 and 0.738 (both P < 0.017) among all threshold b values. Conclusion Dslow and f exhibited increased diagnostic performance using the optimized threshold b value of 30 s/mm2 compared with 10 and 20 s/mm2, whereas Dfast did not.
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Song H, Bak S, Kim I, Woo JY, Cho EJ, Choi YJ, Rha SE, Oh SA, Youn SY, Lee SJ. An Application of Machine Learning That Uses the Magnetic Resonance Imaging Metric, Mean Apparent Diffusion Coefficient, to Differentiate between the Histological Types of Ovarian Cancer. J Clin Med 2021; 11:jcm11010229. [PMID: 35011970 PMCID: PMC8745699 DOI: 10.3390/jcm11010229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/21/2021] [Accepted: 12/29/2021] [Indexed: 12/13/2022] Open
Abstract
This retrospective single-center study included patients diagnosed with epithelial ovarian cancer (EOC) using preoperative pelvic magnetic resonance imaging (MRI). The apparent diffusion coefficient (ADC) of the axial MRI maps that included the largest solid portion of the ovarian mass was analysed. The mean ADC values (ADCmean) were derived from the regions of interest (ROIs) of each largest solid portion. Logistic regression and three types of machine learning (ML) applications were used to analyse the ADCs and clinical factors. Of the 200 patients, 103 had high-grade serous ovarian cancer (HGSOC), and 97 had non-HGSOC (endometrioid carcinoma, clear cell carcinoma, mucinous carcinoma, and low-grade serous ovarian cancer). The median ADCmean of patients with HGSOC was significantly lower than that of patients without HGSOCs. Low ADCmean and CA 19-9 levels were independent predictors for HGSOC over non-HGSOC. Compared to stage I disease, stage III disease was associated with HGSOC. Gradient boosting machine and extreme gradient boosting machine showed the highest accuracy in distinguishing between the histological findings of HGSOC versus non-HGSOC and between the five histological types of EOC. In conclusion, ADCmean, disease stage at diagnosis, and CA 19-9 level were significant factors for differentiating between EOC histological types.
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Affiliation(s)
- Heekyoung Song
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea; (H.S.); (S.B.); (I.K.); (J.Y.W.); (E.J.C.); (Y.J.C.)
| | - Seongeun Bak
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea; (H.S.); (S.B.); (I.K.); (J.Y.W.); (E.J.C.); (Y.J.C.)
| | - Imhyeon Kim
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea; (H.S.); (S.B.); (I.K.); (J.Y.W.); (E.J.C.); (Y.J.C.)
| | - Jae Yeon Woo
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea; (H.S.); (S.B.); (I.K.); (J.Y.W.); (E.J.C.); (Y.J.C.)
| | - Eui Jin Cho
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea; (H.S.); (S.B.); (I.K.); (J.Y.W.); (E.J.C.); (Y.J.C.)
| | - Youn Jin Choi
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea; (H.S.); (S.B.); (I.K.); (J.Y.W.); (E.J.C.); (Y.J.C.)
| | - Sung Eun Rha
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea;
| | - Shin Ah Oh
- NAVER Clova, 246, Hwangsaeul-ro, Bundang-gu, Seongnam-si 13595, Korea;
| | - Seo Yeon Youn
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea;
- Correspondence: (S.Y.Y.); (S.J.L.)
| | - Sung Jong Lee
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea; (H.S.); (S.B.); (I.K.); (J.Y.W.); (E.J.C.); (Y.J.C.)
- Correspondence: (S.Y.Y.); (S.J.L.)
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Li H, Wang L, Zhang J, Duan Q, Xu Y, Xue Y. Evaluation of microvascular invasion of hepatocellular carcinoma using whole-lesion histogram analysis with the stretched-exponential diffusion model. Br J Radiol 2021; 95:20210631. [PMID: 34928172 DOI: 10.1259/bjr.20210631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the potential role of histogram analysis of stretched exponential model (SEM) through whole-tumor volume for preoperative prediction of microvascular invasion (MVI) in single hepatocellular carcinoma (HCC). METHODS This study included 43 patients with pathologically proven HCCs by surgery who underwent multiple b-values diffusion-weighted imaging (DWI) and contrast-enhanced MRI.The histogram metrics of distributed diffusion coefficient (DDC) and heterogeneity index (α) from SEM were compared between HCCs with and without MVI, by using the independent t-test. Morphologic features of conventional MRI and clinical data were evaluated with chi-squared or Fisher's exact tests. Receiver operating characteristic (ROC) and multivariable logistic regression analyses were performed to evaluate the diagnostic performance of different parameters for predicting MVI. RESULTS The tumor size and non-smooth tumor margin were significantly associated with MVI (all p < 0.05). The mean, fifth, 25th, 50th percentiles of DDC, and the fifth percentile of ADC between HCCs with and without MVI were statistically significant differences (all p < 0.05). The histogram parameters of α showed no statistically significant differences (all p > 0.05). At multivariate analysis,the fifth percentile of DDC was independent risk factor for MVI of HCC(p = 0.006). CONCLUSIONS Histogram parameters DDC and ADC, but not the α value, are useful predictors of MVI. The fifth percentile of DDC was the most useful value to predict MVI of HCC. ADVANCES IN KNOWLEDGE There is limited literature addressing the role of SEM for evaluating MVI of HCC. Our findings suggest that histogram analysis of SEM based on whole-tumor volume can be useful for MVI prediction.
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Affiliation(s)
- Hongxiang Li
- Department of Radiology, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, Fujian, PR China
| | - LiLi Wang
- Department of Radiology, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, Fujian, PR China
| | - Jing Zhang
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Qing Duan
- Department of Radiology, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, Fujian, PR China
| | - Yikai Xu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Yunjing Xue
- Department of Radiology, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, Fujian, PR China
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Cai W, Min X, Chen D, Fan C, Feng Z, Li B, Zhang P, You H, Xie J, Liu J, Wang L. Noninvasive Differentiation of Obstructive Azoospermia and Nonobstructive Azoospermia Using Multimodel Diffusion Weighted Imaging. Acad Radiol 2021; 28:1375-1382. [PMID: 32622745 DOI: 10.1016/j.acra.2020.05.039] [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: 03/26/2020] [Revised: 05/13/2020] [Accepted: 05/30/2020] [Indexed: 10/23/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate the diagnostic performance of parameters derived from multimodel diffusion weighted imaging (monoexponential, stretched-exponential diffusion weighted imaging and diffusion kurtosis imaging [DKI]) from noninvasive magnetic resonance imaging in distinguishing obstructive azoospermia (OA) from nonobstructive azoospermia (NOA). MATERIALS AND METHODS Forty-six patients with azoospermia were prospectively enrolled and classified into two groups (21 OA patients and 25 NOA patients). The multimodel parameters of diffusion-weighted imaging (DWI; apparent diffusion coefficient [ADC], distributed diffusion coefficient [DDC], diffusion heterogeneity [α], diffusion kurtosis diffusivity [Dapp], and diffusion kurtosis coefficient [Kapp]) were derived. The diagnostic performance of these parameters for the differentiation of OA and NOA patients were evaluated using receiver operating characteristic analysis. The area under the curve (AUC) was calculated to evaluate the diagnostic accuracy of each parameter. RESULTS All the parameters (ADC, α, DDC, Dapp, and Kapp) values were significantly different between OA and NOA (P < 0.001 for all). For the differentiation of OA from NOA, Kapp showed the highest AUC value (0.965), followed by DDC (0.946), Dapp (0.933), ADC (0.922), and α (0.887). Kapp had a significantly higher AUC than the conventional ADC (P < 0.05). CONCLUSION Parameters derived from multimodels of DWI have the potential for the noninvasive differentiation of OA and NOA. The Kapp value derived from the DKI model might serve as a useful imaging marker for the differentiation of azoospermia.
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Seo M, Choi MHDORESMHCOMTCUOKSROKCSICESMHCOMTCUOKSROK, Lee YJ, Jung SE, Rha SE. Evaluating the added benefit of CT texture analysis on conventional CT analysis to differentiate benign ovarian cysts. Diagn Interv Radiol 2021; 27:460-468. [PMID: 34313229 DOI: 10.5152/dir.2021.20225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to evaluate the benefit of adding CT texture analysis on conventional CT features of benign adnexal cystic lesions, especially in identifying mucinous cystadenoma. METHODS This retrospective study included patients who underwent surgical removal of benign ovarian cysts (44 mucinous cystadenomas, 32 serous cystadenomas, 16 follicular/simple cysts and 43 endometriotic cysts) at our institution between January 2015 and November 2017. The CT images were independently reviewed by an abdominal radiologist (reviewer 1) and a resident (reviewer 2). Both reviewers recorded the conventional characteristics and performed texture analysis. Based on reviewer 1's results, two decision trees for differential diagnosis were developed. Reviewer 2's results were then applied to the decision trees. The diagnostic performances of each reviewer with and without the decision trees were compared. RESULTS Several conventional features and texture analysis parameters showed significant differences between mucinous cystadenomas and other benign adnexal cysts. The first decision tree selected septum number and thickness as significant features, whereas the second decision tree selected septum number and the mean values at spatial scaling factor (SSF) 0. Reviewer 1's performance did not change significantly with or without the use of the decision trees. Reviewer 2's interpretations were significantly less sensitive than reviewer 1's interpretations (p = 0.001). However, when aided by the first and second decision trees, Reviewer 2's interpretations were significantly more sensitive than reviewer 1's interpretations (86.4%, p < 0.001; 72.7%, p = 0.001). CONCLUSION This study suggests the benefit of CT texture analysis on conventional images to differentiate mucinous cystadenoma from other benign adnexal cysts, particularly for less experienced radiologists.
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Affiliation(s)
- Minkook Seo
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Moon Hyung Department Of Radiology Eunpyeong St Mary's Hospital College Of Medicine The Catholic University Of Korea Seoul Republic Of Korea Catholic Smart Imaging Center Eunpyeong St Mary's Hospital College Of Medicine The Catholic University Of Korea Seoul Republic Of Korea Choi
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea;Catholic Smart Imaging Center, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Young Joon Lee
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Eun Jung
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea;Catholic Smart Imaging Center, Eunpyeong St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Eun Rha
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
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Current update on malignant epithelial ovarian tumors. Abdom Radiol (NY) 2021; 46:2264-2280. [PMID: 34089360 DOI: 10.1007/s00261-021-03081-0] [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] [Received: 01/23/2021] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 01/16/2023]
Abstract
Epithelial ovarian cancer (EOC) represents the most frequently occurring gynecological malignancy, accounting for more than 70% of ovarian cancer deaths. Preoperative imaging plays an important role in assessing the extent of disease and guides the next step in surgical decision-making and operative planning. In this article, we will review the multimodality imaging features of various subtypes of EOC. We will also discuss the role of imaging in the staging, management, and surveillance of EOC.
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Malagi AV, Netaji A, Kumar V, Baidya Kayal E, Khare K, Das CJ, Calamante F, Mehndiratta A. IVIM-DKI for differentiation between prostate cancer and benign prostatic hyperplasia: comparison of 1.5 T vs. 3 T MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 35:609-620. [PMID: 34052899 DOI: 10.1007/s10334-021-00932-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To implement an advanced spatial penalty-based reconstruction to constrain the intravoxel incoherent motion (IVIM)-diffusion kurtosis imaging (DKI) model and investigate whether it provides a suitable alternative at 1.5 T to the traditional IVIM-DKI model at 3 T for clinical characterization of prostate cancer (PCa) and benign prostatic hyperplasia (BPH). MATERIALS AND METHODS Thirty-two patients with biopsy-proven PCa were recruited for MRI examination (n = 16 scanned at 1.5 T, n = 16 scanned at 3 T). Diffusion-weighted imaging (DWI) with 13 b values (b = 0 to 2000 s/mm2 up to 3 averages, 1.5 T: TR = 5.774 s, TE = 81 ms and 3 T: TR = 4.899 s, TE = 100 ms), T2-weighted, and T1-weighted imaging were used on the 1.5 T and 3 T MRI scanner, respectively. The IVIM-DKI signal was modeled using the traditional IVIM-DKI model and a novel model in which the total variation (TV) penalty function was combined with the traditional model to optimize non-physiological variations. Paired and unpaired t-tests were used to compare intra-scanner and scanner group differences in IVIM-DKI parameters obtained using the novel and the traditional models. Analysis of variance with post hoc test and receiver operating characteristic (ROC) curve analysis were used to assess the ability of parameters obtained using the novel model (at 1.5 T) and the traditional model (at 3 T) to characterize prostate lesions. RESULTS IVIM-DKI modeled using novel model with TV spatial penalty function at 1.5 T, produced parameter maps with 50-78% lower coefficient of variation (CV) than traditional model at 3 T. Novel model estimated higher D with lower D*, f and k values at both field strengths compared to traditional model. For scanner differences, the novel model at 1.5 T estimated lower D* and f values as compared to traditional model at 3 T. At 1.5 T, D and f values were significantly lower with k values significantly higher in tumor than BPH and healthy tissue. D (AUC: 0.98), f (AUC: 0.82), and k (AUC: 0.91) parameters estimated using novel model showed high diagnostic performance in cancer lesion detection at 1.5 T. DISCUSSION In comparison with the IVIM-DKI model at 3 T, IVIM-DKI signal modeled with the TV penalty function at 1.5 T showed lower estimation errors. The proposed novel model can be utilized for improved detection of prostate lesions.
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Affiliation(s)
- Archana Vadiraj Malagi
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India
| | - Arjunlokesh Netaji
- Department of Radio-Diagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Virendra Kumar
- Department of Nuclear Magnetic Resonance, All India Institute of Medical Sciences, New Delhi, India
| | - Esha Baidya Kayal
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India
| | - Kedar Khare
- Department of Physics, Indian Institute of Technology Delhi, New Delhi, India
| | - Chandan Jyoti Das
- Department of Radio-Diagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Fernando Calamante
- Sydney Imaging and School of Biomedical Engineering, University of Sydney, Sydney, Australia
| | - Amit Mehndiratta
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India.
- Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, India.
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Prediction of Platinum-based Chemotherapy Response in Advanced High-grade Serous Ovarian Cancer: ADC Histogram Analysis of Primary Tumors. Acad Radiol 2021; 28:e77-e85. [PMID: 32061467 DOI: 10.1016/j.acra.2020.01.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/11/2020] [Accepted: 01/13/2020] [Indexed: 02/06/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate the feasibility of apparent diffusion coefficient (ADC) histogram analysis of primary advanced high-grade serous ovarian cancer (HGSOC) to predict patient response to platinum-based chemotherapy. MATERIALS AND METHODS A total of 70 patients with 102 advanced stage HGSOCs (International Federation of Gynecology and Obstetrics (FIGO) stages III-IV) who received standard treatment of primary debulking surgery followed by the first line of platinum-based chemotherapy were retrospectively enrolled. Patients were grouped as platinum-resistant and platinum-sensitive according to whether relapse occurred within 6 months. Clinical characteristics, including age, pretherapy CA125 level, International Federation of Gynecology and Obstetrics stage, residual tumor, and histogram parameters derived from whole tumor and solid component such as ADCmean; 10th, 20th, 25th, 30th, 40th, 50th, 60th, 70th, 75th, 80th, 90th percentiles; skewness and kurtosis, were compared between platinum-resistant and platinum-sensitive groups. RESULTS No significantly different clinical characteristics were observed between platinum-sensitive and platinum-resistant patients. There were no significant differences in any whole-tumor histogram-derived parameters between the two groups. Significantly higher ADCmean and percentiles and significantly lower skewness and kurtosis from the solid-component histogram parameters were observed in the platinum-sensitive group when compared with the platinum-resistant group. ADCmean, skewness and kurtosis showed moderate prediction performances, with areas under the curve of 0.667, 0.733 and 0.616, respectively. Skewness was an independent risk factor for platinum resistance. CONCLUSION Pretreatment ADC histogram analysis of primary tumors has the potential to allow prediction of response to platinum-based chemotherapy in patients with advanced HGSOC.
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MR image-based radiomics to differentiate type Ι and type ΙΙ epithelial ovarian cancers. Eur Radiol 2020; 31:403-410. [PMID: 32743768 DOI: 10.1007/s00330-020-07091-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/20/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Epithelial ovarian cancers (EOC) can be divided into type I and type II according to etiology and prognosis. Accurate subtype differentiation can substantially impact patient management. In this study, we aimed to construct an MR image-based radiomics model to differentiate between type I and type II EOC. METHODS In this multicenter retrospective study, a total of 294 EOC patients from January 2010 to February 2019 were enrolled. Quantitative MR imaging features were extracted from the following axial sequences: T2WI FS, DWI, ADC, and CE-T1WI. A combined model was constructed based on the combination of these four MR sequences. The diagnostic performance was evaluated by ROC-AUC. In addition, an occlusion test was carried out to identify the most critical region for EOC differentiation. RESULTS The combined radiomics model exhibited superior diagnostic capability over all four single-parametric radiomics models, both in internal and external validation cohorts (AUC of 0.806 and 0.847, respectively). The occlusion test revealed that the most critical region for differential diagnosis was the border zone between the solid and cystic components, or the less compact areas of solid component on direct visual inspection. CONCLUSIONS MR image-based radiomics modeling can differentiate between type I and type II EOC and identify the most critical region for differential diagnosis. KEY POINTS • Combined radiomics models exhibited superior diagnostic capability over all four single-parametric radiomics models, both in internal and external validation cohorts (AUC of 0.834 and 0.847, respectively). • The occlusion test revealed that the most crucial region for differentiating type Ι and type ΙΙ EOC was the border zone between the solid and cystic components, or the less compact areas of solid component on direct visual inspection on T2WI FS. • The light-combined model (constructed by T2WI FS, DWI, and ADC sequences) can be used for patients who are not suitable for contrast agent use.
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Qian L, Ren J, Liu A, Gao Y, Hao F, Zhao L, Wu H, Niu G. MR imaging of epithelial ovarian cancer: a combined model to predict histologic subtypes. Eur Radiol 2020; 30:5815-5825. [PMID: 32535738 DOI: 10.1007/s00330-020-06993-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 04/15/2020] [Accepted: 05/28/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To compare the performance of clinical features, conventional MR image features, ADC value, T2WI, DWI, DCE-MRI radiomics, and a combined multiple features model in predicting the type of epithelial ovarian cancer (EOC). METHODS In this retrospective analysis, 61 EOC patients were confirmed by histology. Significant features (p < 0.05) by multivariate logistic regression were retained to establish a clinical model, conventional MRI morphological model, ADC model, and traditional model. The radiomics model included FS-T2WI, DWI, and DCE-MRI, and also, a multisequence model was established. A total of 1070 radiomics features of each sequence were extracted; then, univariate analysis and LASSO were used to select important features. Traditional models were combined with a combined radiomics model to establish a mixed model. The predictive performance was validated by receiver operating characteristic curve (ROC) analysis, calibration curve, and decision curve analysis (DCA). A stratified analysis was conducted to compare the differences between the combined radiomics model and the traditional model in identifying early- and late-stage EOC. RESULTS Traditional models showed the highest performance (AUC = 0.96). The performance of the mixed model (AUC = 0.97) was not significantly different from that of the traditional model. The calibration curve showed that the traditional model had the highest reliability. Stratified analysis showed the potential of the combined radiomics model in the early distinction of the two tumor types. CONCLUSION The traditional model is an effective tool to distinguish EOC type I/II. Combined radiomics models have the potential to better distinguish EOC types in early FIGO stage disease. KEY POINTS • The combined radiomics model resulted in a better predictive model than that from a single sequence model. • The traditional model showed higher classification accuracy than the combined radiomics model. • Combined radiomics models have the potential to better distinguish EOC types in early FIGO stage disease.
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Affiliation(s)
- LuoDan Qian
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China
| | - JiaLiang Ren
- GE Healthcare (Shanghai) Co., Ltd., Shanghai, 210000, China
| | - AiShi Liu
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China
| | - Yang Gao
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China
| | - FenE Hao
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China
| | - Lei Zhao
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China
| | - Hui Wu
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China.
| | - GuangMing Niu
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China.
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Zhang Q, Ouyang H, Ye F, Chen S, Xie L, Zhao X, Yu X. Multiple mathematical models of diffusion-weighted imaging for endometrial cancer characterization: Correlation with prognosis-related risk factors. Eur J Radiol 2020; 130:109102. [PMID: 32673928 DOI: 10.1016/j.ejrad.2020.109102] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To investigate mono-exponential, bi-exponential, and stretched-exponential models of diffusion-weighted imaging (DWI) for evaluation of prognosis-related risk factors of endometrial cancer (EC). METHOD Sixty-one consecutive patients with EC who preoperatively underwent pelvic MRI with multiple b value DWI between September 2016 and May 2018 were enrolled. The apparent-diffusion-coefficient (ADC), bi-exponential model parameters (D, D* and f) and stretched-exponential model parameters (DDC and α) were measured and compared to analyze the following prognosis-related risk factors confirmed by pathology: histological grade, depth of myometrial invasion, cervical stromal infiltration (CSI) and lymphovascular invasion (LVSI). A stepwise multilvariate logistic regression and the receiver operating characteristic (ROC) curves were performed for further statistical analysis. RESULTS Lower ADC, D, f, and DDC were observed in tumor with high grade compared with a low-grade group, and the largest area under curve (AUC) was obtained when combining f and DDC values. ADC, D, f, DDC, and α were significantly different in patients with deep myometrial invasion (DMI) compared to those without DMI; the combination of f, DDC and α showed the highest AUC. Significantly different ADC and f were found between patients' presence and absence CSI; the f values showed the highest diagnostic performance with an AUC of 0.825. Regarding the LVSI, ADC, D*, f, and DDC were significantly lower in tumors with LVSI compared to those without LVSI; the combination of f and DDC showed the largest AUC. CONCLUSION Multiple mathematical DWI models are a useful approach for the prediction of prognosis-related risk factors in EC.
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Affiliation(s)
- Qi Zhang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, China Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Han Ouyang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, China Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Feng Ye
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, China Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Shuang Chen
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, China Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Lizhi Xie
- GE Healthcare, MR Research China, Beijing, China
| | - Xinming Zhao
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, China Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Xiaoduo Yu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, China Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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24
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Wang F, Wang Y, Zhou Y, Liu C, Liang D, Xie L, Yao Z, Liu J. Apparent Diffusion Coefficient Histogram Analysis for Assessing Tumor Staging and Detection of Lymph Node Metastasis in Epithelial Ovarian Cancer: Correlation with p53 and Ki-67 Expression. Mol Imaging Biol 2020; 21:731-739. [PMID: 30456593 DOI: 10.1007/s11307-018-1295-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate the potential of apparent diffusion coefficient (ADC) histogram parameters in epithelial ovarian cancer (EOC) for distinguishing different tumor stages and determining lymph node status and correlations between ADC values and p53 and Ki-67 expression. PROCEDURES Forty-nine EOC patients underwent preoperative magnetic resonance imaging. Staging and lymph node status were determined postoperatively. ADC values were measured using histogram analysis and compared between groups. Relationships between ADCs and Ki-67 and p53 expression were explored. RESULTS DC parameters differed significantly between stage I vs II, I vs III, and I vs IV. The parameters were significantly lower in the lymph node-positive group than in the lymph node-negative group, were significantly negatively correlated with Ki-67 labeling index, and were all significantly lower in the mutation-type p53 group than in the wild-type p53 group. CONCLUSIONS ADC histogram analysis can help discriminate stage I from advanced-stage EOC and predict lymph node metastasis. ADC parameters were correlated with Ki-67 labeling index; the parameters may help indicate p53 expression.
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Affiliation(s)
- Feng Wang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing, 100191, China
| | - Yuxiang Wang
- Department of Pathology, School of Basic Medical Science, Peking University Third Hospital, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yan Zhou
- Department of Radiology, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing, 100191, China
| | - Congrong Liu
- Department of Pathology, School of Basic Medical Science, Peking University Third Hospital, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Dong Liang
- Siemens Ltd., China, 7 Wangjing Zhonghuan Nanlu, Chaoyang District, Beijing, 100102, China
| | - Lizhi Xie
- GE Healthcare China, 1 Yongchang North Road, Beijing, 100176, China
| | - Zhihang Yao
- Department of Radiology, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing, 100191, China
| | - Jianyu Liu
- Department of Radiology, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing, 100191, China.
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He M, Song Y, Li H, Lu J, Li Y, Duan S, Qiang J. Histogram Analysis Comparison of Monoexponential, Advanced Diffusion‐Weighted Imaging, and Dynamic Contrast‐Enhanced MRI for Differentiating Borderline From Malignant Epithelial Ovarian Tumors. J Magn Reson Imaging 2020; 52:257-268. [PMID: 31922327 DOI: 10.1002/jmri.27037] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/08/2019] [Accepted: 12/11/2019] [Indexed: 12/14/2022] Open
Affiliation(s)
- Mengge He
- Department of RadiologyJinshan Hospital, Fudan University Shanghai China
- The Shanghai Institution of Medical ImagingFudan University Shanghai China
| | - Yang Song
- Shanghai Key Laboratory of Magnetic ResonanceEast China Normal University Shanghai China
| | - Haiming Li
- Department of RadiologyFudan University Shanghai Cancer Center Shanghai China
- Department of OncologyShanghai Medical College, Fudan University Shanghai China
| | - Jing Lu
- Department of RadiologyJinshan Hospital, Fudan University Shanghai China
| | - Yongai Li
- Department of RadiologyJinshan Hospital, Fudan University Shanghai China
| | | | - Jinwei Qiang
- Department of RadiologyJinshan Hospital, Fudan University Shanghai China
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26
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Whole solid tumour volume histogram analysis of the apparent diffusion coefficient for differentiating high-grade from low-grade serous ovarian carcinoma: correlation with Ki-67 proliferation status. Clin Radiol 2019; 74:918-925. [DOI: 10.1016/j.crad.2019.07.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 07/24/2019] [Indexed: 12/21/2022]
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Lu JY, Yu H, Zou XL, Li Z, Hu XM, Shen YQ, Hu DY. Apparent diffusion coefficient-based histogram analysis differentiates histological subtypes of periampullary adenocarcinoma. World J Gastroenterol 2019; 25:6116-6128. [PMID: 31686767 PMCID: PMC6824280 DOI: 10.3748/wjg.v25.i40.6116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/17/2019] [Accepted: 09/28/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND For periampullary adenocarcinoma, the histological subtype is a better prognostic predictor than the site of tumor origin. Intestinal-type periampullary adenocarcinoma (IPAC) is reported to have a better prognosis than the pan-creatobiliary-type periampullary adenocarcinoma (PPAC). However, the classification of histological subtypes is difficult to determine before surgery. Apparent diffusion coefficient (ADC) histogram analysis is a noninvasive, non-enhanced method with high reproducibility that could help differentiate the two subtypes.
AIM To investigate whether volumetric ADC histogram analysis is helpful for distinguishing IPAC from PPAC.
METHODS Between January 2015 and October 2018, 476 consecutive patients who were suspected of having a periampullary tumor and underwent magnetic resonance imaging (MRI) were reviewed in this retrospective study. Only patients who underwent MRI at 3.0 T with different diffusion-weighted images (b-values = 800 and 1000 s/mm2) and who were confirmed with a periampullary adenocarcinoma were further analyzed. Then, the mean, 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of ADC values and ADCmin, ADCmax, kurtosis, skewness, and entropy were obtained from the volumetric histogram analysis. Comparisons were made by an independent Student's t-test or Mann-Whitney U test. Multiple-class receiver operating characteristic curve analysis was performed to determine and compare the diagnostic value of each significant parameter.
RESULTS In total, 40 patients with histopathologically confirmed IPAC (n = 17) or PPAC (n = 23) were enrolled. The mean, 5th, 25th, 50th, 75th, 90th, and 95th percentiles and ADCmax derived from ADC1000 were significantly lower in the PPAC group than in the IPAC group (P < 0.05). However, values derived from ADC800 showed no significant difference between the two groups. The 75th percentile of ADC1000 values achieved the highest area under the curve (AUC) for differentiating IPAC from PPAC (AUC = 0.781; sensitivity, 91%; specificity, 59%; cut-off value, 1.50 × 10-3 mm2/s).
CONCLUSION Volumetric ADC histogram analysis at a b-value of 1000 s/mm2 might be helpful for differentiating the histological subtypes of periampullary adenocarcinoma before surgery.
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Affiliation(s)
- Jing-Yu Lu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Hao Yu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Xian-Lun Zou
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Xue-Mei Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Ya-Qi Shen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Dao-Yu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
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Kurata Y, Nishio M, Kido A, Fujimoto K, Yakami M, Isoda H, Togashi K. Automatic segmentation of the uterus on MRI using a convolutional neural network. Comput Biol Med 2019; 114:103438. [PMID: 31521902 DOI: 10.1016/j.compbiomed.2019.103438] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/20/2019] [Accepted: 09/04/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND This study was performed to evaluate the clinical feasibility of a U-net for fully automatic uterine segmentation on MRI by using images of major uterine disorders. METHODS This study included 122 female patients (14 with uterine endometrial cancer, 15 with uterine cervical cancer, and 55 with uterine leiomyoma). U-net architecture optimized for our research was used for automatic segmentation. Three-fold cross-validation was performed for validation. The results of manual segmentation of the uterus by a radiologist on T2-weighted sagittal images were used as the gold standard. Dice similarity coefficient (DSC) and mean absolute distance (MAD) were used for quantitative evaluation of the automatic segmentation. Visual evaluation using a 4-point scale was performed by two radiologists. DSC, MAD, and the score of the visual evaluation were compared between uteruses with and without uterine disorders. RESULTS The mean DSC of our model for all patients was 0.82. The mean DSCs for patients with and without uterine disorders were 0.84 and 0.78, respectively (p = 0.19). The mean MADs for patients with and without uterine disorders were 18.5 and 21.4 [pixels], respectively (p = 0.39). The scores of the visual evaluation were not significantly different between uteruses with and without uterine disorders. CONCLUSIONS Fully automatic uterine segmentation with our modified U-net was clinically feasible. The performance of the segmentation of our model was not influenced by the presence of uterine disorders.
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Affiliation(s)
- Yasuhisa Kurata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan; Department of Diagnostic Radiology, Kobe City Medical Center General Hospital, 2-1-1, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Mizuho Nishio
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan; Preemptive Medicine and Lifestyle-Related Disease Research Center, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan.
| | - Aki Kido
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
| | - Koji Fujimoto
- Human Brain Research Center Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
| | - Masahiro Yakami
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan; Preemptive Medicine and Lifestyle-Related Disease Research Center, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan; Preemptive Medicine and Lifestyle-Related Disease Research Center, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
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Sun S, Bonaffini PA, Nougaret S, Fournier L, Dohan A, Chong J, Smith J, Addley H, Reinhold C. How to differentiate uterine leiomyosarcoma from leiomyoma with imaging. Diagn Interv Imaging 2019; 100:619-634. [PMID: 31427216 DOI: 10.1016/j.diii.2019.07.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/14/2019] [Accepted: 07/15/2019] [Indexed: 12/16/2022]
Abstract
Uterine leiomyomas, the most frequent benign myomatous tumors of the uterus, often cannot be distinguished from malignant uterine leiomyosarcomas using clinical criteria. Furthermore, imaging differentiation between both entities is frequently challenging due to their potential overlapping features. Because a suspected leiomyoma is often managed conservatively or with minimally invasive treatments, the misdiagnosis of leiomyosarcoma for a benign leiomyoma could potentially result in significant treatment delays, therefore increasing morbidity and mortality. In this review, we provide an overview of the differences between leiomyoma and leiomyosarcoma, mainly focusing on imaging characteristics, but also briefly touching upon their demographic, histopathological and clinical differences. The main indications and limitations of available cross-sectional imaging techniques are discussed, including ultrasound, computed tomography, magnetic resonance imaging (MRI) and positron emission tomography/computed tomography. A particular emphasis is placed on the review of specific MRI features that may allow distinction between leiomyomas and leiomyosarcomas according to the most recent evidence in the literature. The potential contribution of texture analysis is also discussed. In order to help guide-imaging diagnosis, we provide an MRI-based diagnostic algorithm which takes into account morphological and functional features, both individually and in combination, in an attempt to optimize radiologic differentiation of leiomyomas from leiomyosarcomas.
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Affiliation(s)
- S Sun
- Department of Radiology, McGill University Health Centre, 1001 Decarie boulevard, H4A 3J1 Montreal, QC, Canada.
| | - P A Bonaffini
- Department of Radiology, McGill University Health Centre, 1001 Decarie boulevard, H4A 3J1 Montreal, QC, Canada
| | - S Nougaret
- Inserm, U1194, Department of Radiology, Montpellier Cancer Institute, University of Montpellier, 34295 Montpellier, France
| | - L Fournier
- Université de Paris, Descartes-Paris 5, 75006 Paris, France; Department of Radiology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
| | - A Dohan
- Université de Paris, Descartes-Paris 5, 75006 Paris, France; Department of Radiology A, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France
| | - J Chong
- Department of Radiology, McGill University Health Centre, 1001 Decarie boulevard, H4A 3J1 Montreal, QC, Canada
| | - J Smith
- Department of Radiology, Cambridge University Hospitals, NHS Foundation Trust, CB2 0QQ Cambridge, United Kingdom
| | - H Addley
- Department of Radiology, Cambridge University Hospitals, NHS Foundation Trust, CB2 0QQ Cambridge, United Kingdom
| | - C Reinhold
- Department of Radiology, McGill University Health Centre, 1001 Decarie boulevard, H4A 3J1 Montreal, QC, Canada
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Zhang G, Yao W, Sun T, Liu X, Zhang P, Jin J, Bai Y, Hua K, Zhang H. Magnetic resonance imaging in categorization of ovarian epithelial cancer and survival analysis with focus on apparent diffusion coefficient value: correlation with Ki-67 expression and serum cancer antigen-125 level. J Ovarian Res 2019; 12:59. [PMID: 31242916 PMCID: PMC6595619 DOI: 10.1186/s13048-019-0534-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 06/21/2019] [Indexed: 01/25/2023] Open
Abstract
Background To determine whether magnetic resonance (MR) imaging features combined with apparent diffusion coefficient (ADC) values could be used as a tool for categorizing ovarian epithelial cancer (OEC) and predicting survival, as well as correlating with laboratory tests (serum cancer antigen 125, serum CA-125) and tumor proliferative index (Ki-67 expression). Methods and materials MRI examination was undertaken before invasive procedures. MRI features were interpreted and recorded on the picture archive communication system (PACS). ADC measurements were manually performed on post-process workstation. Clinical characteristics were individually retrieved and recorded through the hospital information system (HIS). Cox hazard model was used to estimate the effects of both clinical and MRI features on overall survival. Results Both clinical and MRI features differed significantly between Type I and Type II cancer groups (p < 0.05). The mean ADC value was inversely correlated with Ki-67 expression in Type I cancer (ρ = − 0.14, p < 0.05). A higher mean ADC value was more likely to suggest Type I ovarian cancer (Odds Ratio (OR) = 16.80, p < 0.01). Old age and an advanced International Federation of Gynecology and Obstetrics (FIGO) stage were significantly related to Type II ovarian cancer (OR = 0.22/0.02, p < 0.05). An advanced FIGO stage, solid components, and old age were significantly associated with poor survival (Hazard Ratio (HR) = 23.54/3.69/2.46, p < 0.05). Clear cell cancer type had a poorer survival than any other pathological subtypes of ovarian cancer (HR = 13.6, p < 0.01). Conclusions MR imaging features combined with ADC value are helpful in categorizing OEC. ADC values can reflect tumor proliferative ability. A solid mass may predict poor prognosis for OEC patients. Electronic supplementary material The online version of this article (10.1186/s13048-019-0534-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Guofu Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Weigen Yao
- Department of Radiology, Yuyao People's Hospital, Ningbo, Zhejiang province, People's Republic of China
| | - Taotao Sun
- Department of Radiology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xuefen Liu
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Peng Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jun Jin
- Department of Pathology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yu Bai
- Center for Child and Family Policy, Duke University, Durham, USA
| | - Keqin Hua
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - He Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China.
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31
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Magnetic resonance imaging radiomics in categorizing ovarian masses and predicting clinical outcome: a preliminary study. Eur Radiol 2019; 29:3358-3371. [DOI: 10.1007/s00330-019-06124-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/09/2019] [Accepted: 02/22/2019] [Indexed: 12/13/2022]
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Differentiating Transition Zone Cancers From Benign Prostatic Hyperplasia by Histogram Analysis of Apparent Diffusion Coefficient Maps With Standard and Ultrahigh b-value Diffusion-weighted MR Imaging. J Comput Assist Tomogr 2019; 43:235-241. [PMID: 30475249 DOI: 10.1097/rct.0000000000000829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To compare the diagnostic performance of standard and ultrahigh b-value Diffusion-weighted Imaging (DWI) using volumetric histogram analysis in differentiating transition zone (TZ) cancer from benign prostatic hyperplasia (BPH). METHODS 57 TZ cancer and 61 BPH patients received standard (1000 s/mm) and ultrahigh b-value (2000 s/mm) DWI. The diagnostic ability of ADC histogram parameters derived from two DWI for differentiating TZ cancer from BPH was determined by receiver operating characteristic curve. RESULTS Median, minimum, the 10th, 25th percentile ADC in both ADC1000 and ADC2000 and skewness in ADC2000 had significant differences between TZ cancer and BPH (for all, P < 0.05).The 10th percentile ADC showed highest area under the ROC curve (AUC) in both ADC1000 and ADC2000.The 10th percentile ADC of ADC2000 showed significantly higher AUC than did ADC1000 (P = 0.0385). CONCLUSIONS The 10th percentile ADC obtained from ultrahigh b-value DWI performed better for differentiating TZ cancer from BPH.
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Tang L, Zhou XJ. Diffusion MRI of cancer: From low to high b-values. J Magn Reson Imaging 2018; 49:23-40. [PMID: 30311988 DOI: 10.1002/jmri.26293] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 12/14/2022] Open
Abstract
Following its success in early detection of cerebral ischemia, diffusion-weighted imaging (DWI) has been increasingly used in cancer diagnosis and treatment evaluation. These applications are propelled by the rapid development of novel diffusion models to extract biologically valuable information from diffusion-weighted MR signals, and significant advances in MR hardware that has enabled image acquisition with high b-values. This article reviews recent technical developments and clinical applications in cancer imaging using DWI, with a special emphasis on high b-value diffusion models. The article is organized in four sections. First, we provide an overview of diffusion models that are relevant to cancer imaging. The model parameters are discussed in relation to three tissue properties-cellularity, vascularity, and microstructures. An emphasis is placed on characterization of microstructural heterogeneity, given its novelty and close relevance to cancer. Second, we illustrate diffusion MR clinical applications in each of the following three categories: 1) cancer detection and diagnosis; 2) cancer grading, staging, and classification; and 3) cancer treatment response prediction and evaluation. Third, we discuss several practical issues, including selection of image acquisition parameters, reproducibility and reliability, motion management, image distortion, etc., that are commonly encountered when applying DWI to cancer in clinical settings. Lastly, we highlight a few ongoing challenges and provide some possible future directions, particularly in the area of establishing standards via well-organized multicenter clinical trials to accelerate clinical translation of advanced DWI techniques to improving cancer care on a large scale. Level of Evidence: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:23-40.
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Affiliation(s)
- Lei Tang
- Department of Radiology, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research, Beijing, China
| | - Xiaohong Joe Zhou
- Center for MR Research and Departments of Radiology, Neurosurgery, and Bioengineering, University of Illinois at Chicago, Chicago, Illinois, USA
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Mono-exponential and bi-exponential model-based diffusion-weighted MR imaging and IDEAL-IQ sequence for quantitative evaluation of sacroiliitis in patients with ankylosing spondylitis. Clin Rheumatol 2018; 37:3069-3076. [DOI: 10.1007/s10067-018-4321-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/13/2018] [Accepted: 10/01/2018] [Indexed: 01/02/2023]
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35
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Li H, Zhang J, Zheng Z, Guo Y, Chen M, Xie C, Zhang Z, Mei Y, Feng Y, Xu Y. Preoperative histogram analysis of intravoxel incoherent motion (IVIM) for predicting microvascular invasion in patients with single hepatocellular carcinoma. Eur J Radiol 2018; 105:65-71. [PMID: 30017300 DOI: 10.1016/j.ejrad.2018.05.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 05/30/2018] [Accepted: 05/31/2018] [Indexed: 02/09/2023]
Abstract
PURPOSE To evaluate the value of intravoxel incoherent motion (IVIM) histogram analysis based on whole tumor volume in predicting microvascular invasion (MVI) of single hepatocellular carcinoma (HCC). MATERIALS AND METHODS The study enrolled 41 patients with pathologically proven HCCs who underwent IVIM diffusion-weighted imaging with nine b values and contrast-enhanced magnetic resonance imaging (MRI). Histogram parameters including mean; skewness; kurtosis; and percentiles (5th, 10th, 25th, 50th, 75th, 90th, 95th) were derived from apparent diffusion coefficient (ADC), perfusion fraction (f), true diffusion coefficient (D), and pseudo diffusion coefficient (D*). Quantitative histogram parameters and clinical data were compared between HCCs with and without MVI. For significant parameters, receiver operating characteristic (ROC) curves were further plotted to compare the diagnosis performance for identifying MVI. RESULTS The mean, 5th, 10th, 25th, 50th, and 75th percentiles of D, and the 5th, 10th, and 25th percentiles of ADC between HCCs with and without MVI were statistically significant (all P<0.05). The histogram parameters of D* and f showed no statistically significant differences between HCCs with and without MVI (all P>0.05). The areas under the ROC curves (AUCs) were 0.707-0.874 for D and 0.668-0.720 for ADC. The largest AUC of D (5th percentile) showed significantly higher accuracy than that of ADC or tumor size (P = 0.009-0.046). With a cut-off of 0.403 × 10-3 mm²/s, the 5th percentile of D value provided a sensitivity of 81% and a specificity of 85% in the prediction of MVI. CONCLUSIONS Histogram analysis of IVIM based on whole tumor volume can be useful for predicting MVI. The 5th percentile of D was most useful value to predict MVI of HCC.
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Affiliation(s)
- Hongxiang Li
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | - Jing Zhang
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | - Zeyu Zheng
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | - Yihao Guo
- School of Biomedical Engineering, Southern Medical University, Guangzhou, PR China.
| | - Maodong Chen
- School of Biomedical Engineering, Southern Medical University, Guangzhou, PR China.
| | - Caiqin Xie
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | | | - Yingjie Mei
- Philips Intergrated Solution Center, Guangzhou, PR China.
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou, PR China.
| | - Yikai Xu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
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Llueca A, Serra A, Herraiz JL, Rivadulla I, Gomez-Quiles L, Gilabert-Estelles J, Escrig J. Peritoneal carcinomatosis index as a predictor of diaphragmatic involvement in stage III and IV ovarian cancer. Onco Targets Ther 2018; 11:2771-2777. [PMID: 29844678 PMCID: PMC5961326 DOI: 10.2147/ott.s147559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To analyze the surgical outcomes and diaphragmatic involvement in stage III and IV ovarian cancer. Patients and methods All patients with stage III–IV ovarian cancer between January 2013 and January 2016 were included. The outcomes of interest reviewed were as follows: surgical (complications, mortality), peritoneal carcinomatosis index (PCI), rate of complete resection, and disease-free interval and survival. Results Fifty-seven patients were included, 38 (67%) with diaphragmatic involvement; in 10 cases (18%), diaphragmatic resection was required. Optimal cytoreduction (OCR) was obtained in 49 cases (86%). The PCI was >10 in 31 cases (54%). Respiratory complications occurred in 10 cases (18%) and mortality in 3 (5%). Disease-free survival rate in 3 years was 53%, being 87% in cases without diaphragmatic involvement. The overall survival rate in 3 years is 46%, 83% in the cases without diaphragmatic involvement and 27% in cases with affectation (p<0.05). In cases of OCR, 3 year survival rate was 65%. In the multivariate analysis for the overall survival of cases with OCR, the only independent prognostic factor found was the operative PCI. A strong correlation was found between the total PCI and the diaphragmatic PCI (p<0.001). With a PCI >10, virtually all cases will present diaphragmatic involvement (p<0.05). Conclusion The tumor burden is different in stages III and IV of advanced ovarian cancer and the PCI is an effective method to quantify it. The PCI constitutes an independent prognostic factor for the advanced stages of ovarian cancer. A PCI >10 constitutes a useful prognostic factor of the affectation and forces the surgeon to thoroughly review both diaphragms.
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Affiliation(s)
- Antoni Llueca
- Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellón, Castellón, Spain.,Department of Obstetrics and Gynecology, University General Hospital of Castellón, Castellón, Spain.,Department of Medicine, Universitat Jaume I, Castellón, Spain
| | - Anna Serra
- Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellón, Castellón, Spain.,Department of Obstetrics and Gynecology, University General Hospital of Castellón, Castellón, Spain.,Department of Medicine, Universitat Jaume I, Castellón, Spain
| | - José Luis Herraiz
- Department of Obstetrics and Gynecology, University General Hospital of Castellón, Castellón, Spain
| | - Isabel Rivadulla
- Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellón, Castellón, Spain.,Department of General Surgery, University General Hospital of Castellón, Castellón, Spain
| | - Luis Gomez-Quiles
- Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellón, Castellón, Spain.,Department of General Surgery, University General Hospital of Castellón, Castellón, Spain
| | - Juan Gilabert-Estelles
- Department of Obstetrics and Gynecology, University General Hospital of Valencia, Valencia, Spain.,Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain
| | - Javier Escrig
- Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellón, Castellón, Spain.,Department of Medicine, Universitat Jaume I, Castellón, Spain.,Department of General Surgery, University General Hospital of Castellón, Castellón, Spain
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Explorative Investigation of Whole-Lesion Histogram MRI Metrics for Differentiating Uterine Leiomyomas and Leiomyosarcomas. AJR Am J Roentgenol 2018; 210:1172-1177. [DOI: 10.2214/ajr.17.18605] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Min X, Feng Z, Wang L, Cai J, Li B, Ke Z, Zhang P, You H, Yan X. Multi-model Analysis of Diffusion-weighted Imaging of Normal Testes at 3.0 T: Preliminary Findings. Acad Radiol 2018; 25:445-452. [PMID: 29331362 DOI: 10.1016/j.acra.2017.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/01/2017] [Accepted: 11/05/2017] [Indexed: 01/08/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to establish diffusion quantitative parameters (apparent diffusion coefficient [ADC], DDC, α, Dapp, and Kapp) in normal testes at 3.0 T. MATERIALS AND METHODS Sixty-four healthy volunteers in two age groups (A: 10-39 years; B: ≥ 40 years) underwent diffusion-weighted imaging scanning at 3.0 T. ADC1000, ADC2000, ADC3000, DDC, α, Dapp, and Kapp were calculated using the mono-exponential, stretched-exponential, and kurtosis models. The correlations between parameters and the age were analyzed. The parameters were compared between the age groups and between the right and the left testes. RESULTS The average ADC1000, ADC2000, ADC3000, DDC, α, Dapp, and Kapp values did not significantly differ between the right and the left testes (P > .05 for all). The following significant correlations were found: positive correlations between age and testicular ADC1000, ADC2000, ADC3000, DDC, and Dapp (r = 0.516, 0.518, 0.518, 0.521, and 0.516, respectively; P < .01 for all) and negative correlations between age and testicular α and Kapp (r = -0.363, -0.427, respectively; P < .01 for both). Compared to group B, in group A, ADC1000, ADC2000, ADC3000, DDC, and Dapp were significantly lower (P < .05 for all), but α and Kapp were significantly higher (P < .05 for both). CONCLUSIONS Our study demonstrated the applicability of the testicular mono-exponential, stretched-exponential, and kurtosis models. Our results can help establish a baseline for the normal testicular parameters in these diffusion models. The contralateral normal testis can serve as a suitable reference for evaluating the abnormalities of the other side. The effect of age on these parameters requires further attention.
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