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Ba ZC, Zhang HX, Liu AY, Zhou XX, Liu L, Wang XY, Nanding A, Sang XQ, Kuai ZX. Combination of DCE-MRI and NME-DWI via Deep Neural Network for Predicting Breast Cancer Molecular Subtypes. Clin Breast Cancer 2024; 24:e417-e427. [PMID: 38555225 DOI: 10.1016/j.clbc.2024.03.006] [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: 12/06/2023] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND To explore whether the combination of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and nonmono-exponential (NME) model-based diffusion-weighted imaging (DWI) via deep neural network (DNN) can improve the prediction of breast cancer molecular subtypes compared to either imaging technique used alone. PATIENTS AND METHODS This prospective study examined 480 breast cancers in 475 patients undergoing DCE-MRI and NME-DWI at 3.0 T. Breast cancers were classified as follows: human epidermal growth factor receptor 2 enriched (HER2-enriched), luminal A, luminal B (HER2-), luminal B (HER2+), and triple-negative subtypes. A total of 20% cases were withheld as an independent test dataset, and the remaining cases were used to train DNN with an 80% to 20% training-validation split and 5-fold cross-validation. The diagnostic accuracies of DNN in 5-way subtype classification between the DCE-MRI, NME-DWI, and their combined multiparametric-MRI datasets were compared using analysis of variance with least significant difference posthoc test. Areas under the receiver-operating characteristic curves were calculated to assess the performances of DNN in binary subtype classification between the 3 datasets. RESULTS The 5-way classification accuracies of DNN on both DCE-MRI (0.71) and NME-DWI (0.64) were significantly lower (P < .05) than on multiparametric-MRI (0.76), while on DCE-MRI was significantly higher (P < .05) than on NME-DWI. The comparative results of binary classification between the 3 datasets were consistent with the 5-way classification. CONCLUSION The combination of DCE-MRI and NME-DWI via DNN achieved a significant improvement in breast cancer molecular subtype prediction compared to either imaging technique used alone. Additionally, DCE-MRI outperformed NME-DWI in differentiating subtypes.
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Affiliation(s)
- Zhi-Chang Ba
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Hong-Xia Zhang
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Ao-Yu Liu
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xin-Xiang Zhou
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Lu Liu
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xin-Yi Wang
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Abiyasi Nanding
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xi-Qiao Sang
- Division of Respiratory Disease, Fourth Affiliated Hospital of Harbin Medical University, Yiyuan street No.37, Nangang District, Harbin, China.
| | - Zi-Xiang Kuai
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China.
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He L, Qin Y, Hu Q, Liu Z, Zhang Y, Ai T. Quantitative characterization of breast lesions and normal fibroglandular tissue using compartmentalized diffusion-weighted model: comparison of intravoxel incoherent motion and restriction spectrum imaging. Breast Cancer Res 2024; 26:71. [PMID: 38658999 PMCID: PMC11044413 DOI: 10.1186/s13058-024-01828-3] [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: 12/18/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND To compare the compartmentalized diffusion-weighted models, intravoxel incoherent motion (IVIM) and restriction spectrum imaging (RSI), in characterizing breast lesions and normal fibroglandular tissue. METHODS This prospective study enrolled 152 patients with 157 histopathologically verified breast lesions (41 benign and 116 malignant). All patients underwent a full-protocol preoperative breast MRI, including a multi-b-value DWI sequence. The diffusion parameters derived from the mono-exponential model (ADC), IVIM model (Dt, Dp, f), and RSI model (C1, C2, C3, C1C2, F1, F2, F3, F1F2) were quantitatively measured and then compared among malignant lesions, benign lesions and normal fibroglandular tissues using Kruskal-Wallis test. The Mann-Whitney U-test was used for the pairwise comparisons. Diagnostic models were built by logistic regression analysis. The ROC analysis was performed using five-fold cross-validation and the mean AUC values were calculated and compared to evaluate the discriminative ability of each parameter or model. RESULTS Almost all quantitative diffusion parameters showed significant differences in distinguishing malignant breast lesions from both benign lesions (other than C2) and normal fibroglandular tissue (all parameters) (all P < 0.0167). In terms of the comparisons of benign lesions and normal fibroglandular tissues, the parameters derived from IVIM (Dp, f) and RSI (C1, C2, C1C2, F1, F2, F3) showed significant differences (all P < 0.005). When using individual parameters, RSI-derived parameters-F1, C1C2, and C2 values yielded the highest AUCs for the comparisons of malignant vs. benign, malignant vs. normal tissue and benign vs. normal tissue (AUCs = 0.871, 0.982, and 0.863, respectively). Furthermore, the combined diagnostic model (IVIM + RSI) exhibited the highest diagnostic efficacy for the pairwise discriminations (AUCs = 0.893, 0.991, and 0.928, respectively). CONCLUSIONS Quantitative parameters derived from the three-compartment RSI model have great promise as imaging indicators for the differential diagnosis of breast lesions compared with the bi-exponential IVIM model. Additionally, the combined model of IVIM and RSI achieves superior diagnostic performance in characterizing breast lesions.
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Affiliation(s)
- Litong He
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, NO. 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030, China
| | - Yanjin Qin
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58th the Second Zhongshan Road, Guangzhou, 510080, China
| | - Qilan Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, NO. 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030, China
| | - Zhiqiang Liu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, NO. 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030, China
| | - Yunfei Zhang
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Tao Ai
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, NO. 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030, China.
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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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Zhang L, Zhou XX, Liu L, Liu AY, Zhao WJ, Zhang HX, Zhu YM, Kuai ZX. Comparison of Dynamic Contrast-Enhanced MRI and Non-Mono-Exponential Model-Based Diffusion-Weighted Imaging for the Prediction of Prognostic Biomarkers and Molecular Subtypes of Breast Cancer Based on Radiomics. J Magn Reson Imaging 2023; 58:1590-1602. [PMID: 36661350 DOI: 10.1002/jmri.28611] [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: 11/29/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Dynamic contrast-enhanced (DCE) MRI and non-mono-exponential model-based diffusion-weighted imaging (NME-DWI) that does not require contrast agent can both characterize breast cancer. However, which technique is superior remains unclear. PURPOSE To compare the performances of DCE-MRI, NME-DWI and their combination as multiparametric MRI (MP-MRI) in the prediction of breast cancer prognostic biomarkers and molecular subtypes based on radiomics. STUDY TYPE Prospective. POPULATION A total of 477 female patients with 483 breast cancers (5-fold cross-validation: training/validation, 80%/20%). FIELD STRENGTH/SEQUENCE A 3.0 T/DCE-MRI (6 dynamic frames) and NME-DWI (13 b values). ASSESSMENT After data preprocessing, high-throughput features were extracted from each tumor volume of interest, and optimal features were selected using recursive feature elimination method. To identify ER+ vs. ER-, PR+ vs. PR-, HER2+ vs. HER2-, Ki-67+ vs. Ki-67-, luminal A/B vs. nonluminal A/B, and triple negative (TN) vs. non-TN, the following models were implemented: random forest, adaptive boosting, support vector machine, linear discriminant analysis, and logistic regression. STATISTICAL TESTS Student's t, chi-square, and Fisher's exact tests were applied on clinical characteristics to confirm whether significant differences exist between different statuses (±) of prognostic biomarkers or molecular subtypes. The model performances were compared between the DCE-MRI, NME-DWI, and MP-MRI datasets using the area under the receiver-operating characteristic curve (AUC) and the DeLong test. P < 0.05 was considered significant. RESULTS With few exceptions, no significant differences (P = 0.062-0.984) were observed in the AUCs of models for six classification tasks between the DCE-MRI (AUC = 0.62-0.87) and NME-DWI (AUC = 0.62-0.91) datasets, while the model performances on the two imaging datasets were significantly poorer than on the MP-MRI dataset (AUC = 0.68-0.93). Additionally, the random forest and adaptive boosting models (AUC = 0.62-0.93) outperformed other three models (AUC = 0.62-0.90). DATA CONCLUSION NME-DWI was comparable with DCE-MRI in predictive performance and could be used as an alternative technique. Besides, MP-MRI demonstrated significantly higher AUCs than either DCE-MRI or NME-DWI. EVIDENCE LEVEL 2. TECHNICAL EFFICACY Stage 2.
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Affiliation(s)
- Lan Zhang
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xin-Xiang Zhou
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Lu Liu
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Ao-Yu Liu
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Wen-Juan Zhao
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Hong-Xia Zhang
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yue-Min Zhu
- CREATIS, CNRS UMR 5220-INSERM U1206-University Lyon 1-INSA Lyon-University Jean Monnet Saint-Etienne, Lyon, France
| | - Zi-Xiang Kuai
- Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China
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Qin Y, Tang C, Hu Q, Yi J, Yin T, Ai T. Assessment of Prognostic Factors and Molecular Subtypes of Breast Cancer With a Continuous-Time Random-Walk MR Diffusion Model: Using Whole Tumor Histogram Analysis. J Magn Reson Imaging 2023; 58:93-105. [PMID: 36251468 DOI: 10.1002/jmri.28474] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The continuous-time random-walk (CTRW) diffusion model to evaluate breast cancer prognosis is rarely reported. PURPOSE To investigate the correlations between apparent diffusion coefficient (ADC) and CTRW-specific parameters with prognostic factors and molecular subtypes of breast cancer. STUDY TYPE Retrospective. POPULATION One hundred fifty-seven women (median age, 50 years; range, 26-81 years) with histopathology-confirmed breast cancer. FIELD STRENGTH/SEQUENCE Simultaneous multi-slice readout-segmented echo-planar imaging at 3.0T. ASSESSMENT The histogram metrics of ADC, anomalous diffusion coefficient (D), temporal diffusion heterogeneity (α), and spatial diffusion heterogeneity (β) were calculated for whole-tumor volume. Associations between histogram metrics and prognostic factors (estrogen receptor [ER], progesterone receptor [PR], human epidermal growth factor receptor 2 [HER2], and Ki-67 proliferation index), axillary lymph node metastasis (ALNM), and tumor grade were assessed. The performance of histogram metrics, both alone and in combination, for differentiating molecular subtypes (HER2-positive, Luminal or triple negative) was also assessed. STATISTICAL TESTS Comparisons were made using Mann-Whitney test between different prognostic factor statuses and molecular subtypes. Receiver operating characteristic curve analysis was used to assess the performance of mean and median histogram metrics in differentiating the molecular subtypes. A P value <0.05 was considered statistically significant. RESULTS The histogram metrics of ADC, D, and α differed significantly between ER-positive and ER-negative status, and between PR-positive and PR-negative status. The histogram metrics of ADC, D, α, and β were also significantly different between the HER2-positive and HER2-negative subgroups, and between ALNM-positive and ALNM-negative subgroups. The histogram metrics of α and β significantly differed between high and low Ki-67 proliferation subgroups, and between histological grade subgroups. The combination of αmean and βmean achieved the highest performance (AUC = 0.702) to discriminate the Luminal and HER2-positive subtypes. DATA CONCLUSION Whole-tumor histogram analysis of the CTRW model has potential to provide additional information on the prognosis and intrinsic subtyping classification of breast cancer. EVIDENCE LEVEL 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Yanjin Qin
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Caili Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qilan Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingru Yi
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Yin
- MR Collaborations, Siemens Healthineers Ltd., Chengdu, China
| | - Tao Ai
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Yao FF, Zhang Y. A review of quantitative diffusion-weighted MR imaging for breast cancer: Towards noninvasive biomarker. Clin Imaging 2023; 98:36-58. [PMID: 36996598 DOI: 10.1016/j.clinimag.2023.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/03/2023] [Accepted: 03/21/2023] [Indexed: 04/01/2023]
Abstract
Quantitative diffusion-weighted imaging (DWI) is an important adjunct to conventional breast MRI and shows promise as a noninvasive biomarker of breast cancer in multiple clinical scenarios, from the discrimination of benign and malignant lesions, prediction, and evaluation of treatment response to a prognostic assessment of breast cancer. Various quantitative parameters are derived from different DWI models based on special prior knowledge and assumptions, have different meanings, and are easy to confuse. In this review, we describe the quantitative parameters derived from conventional and advanced DWI models commonly used in breast cancer and summarize the promising clinical applications of these quantitative parameters. Although promising, it is still challenging for these quantitative parameters to become clinically useful noninvasive biomarkers in breast cancer, as multiple factors may result in variations in quantitative parameter measurements. Finally, we briefly describe some considerations regarding the factors that cause variations.
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Affiliation(s)
- Fei-Fei Yao
- Department of MRI in the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
| | - Yan Zhang
- Department of MRI in the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
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Shahbazi-Gahrouei D, Aminolroayaei F, Nematollahi H, Ghaderian M, Gahrouei SS. Advanced Magnetic Resonance Imaging Modalities for Breast Cancer Diagnosis: An Overview of Recent Findings and Perspectives. Diagnostics (Basel) 2022; 12:2741. [PMID: 36359584 PMCID: PMC9689118 DOI: 10.3390/diagnostics12112741] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/26/2022] [Accepted: 11/07/2022] [Indexed: 08/28/2023] Open
Abstract
Breast cancer is the most prevalent cancer among women and the leading cause of death. Diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are advanced magnetic resonance imaging (MRI) procedures that are widely used in the diagnostic and treatment evaluation of breast cancer. This review article describes the characteristics of new MRI methods and reviews recent findings on breast cancer diagnosis. This review study was performed on the literature sourced from scientific citation websites such as Google Scholar, PubMed, and Web of Science until July 2021. All relevant works published on the mentioned scientific citation websites were investigated. Because of the propensity of malignancies to limit diffusion, DWI can improve MRI diagnostic specificity. Diffusion tensor imaging gives additional information about diffusion directionality and anisotropy over traditional DWI. Recent findings showed that DWI and DTI and their characteristics may facilitate earlier and more accurate diagnosis, followed by better treatment. Overall, with the development of instruments and novel MRI modalities, it may be possible to diagnose breast cancer more effectively in the early stages.
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Affiliation(s)
- Daryoush Shahbazi-Gahrouei
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Fahimeh Aminolroayaei
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Hamide Nematollahi
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Mohammad Ghaderian
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Sogand Shahbazi Gahrouei
- Department of Management, School of Humanities, Najafabad Branch, Islamic Azad University, Najafabad 8514143131, Iran
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Qin Y, Tang C, Hu Q, Zhang Y, Yi J, Dai Y, Ai T. Quantitative Assessment of Restriction Spectrum MR Imaging for the Diagnosis of Breast Cancer and Association With Prognostic Factors. J Magn Reson Imaging 2022; 57:1832-1841. [PMID: 36205354 DOI: 10.1002/jmri.28468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 09/23/2022] [Accepted: 09/23/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Restriction spectrum imaging (RSI) is an advanced quantitative diffusion-weighted magnetic resonance imaging (DWI) technique to assess breast cancer. PURPOSE To investigate the ability of RSI to differentiate the benign and malignant breast lesions and the association with prognostic factors of breast cancer. STUDY TYPE Retrospective. POPULATION Seventy women (mean age, 49.6 ± 12.3 years) with 56 malignant and 19 benign breast lesions. FIELD STRENGTH/SEQUENCE 3-T; RSI-based DWI sequence with echo-planar imaging technique. ASSESSMENT The apparent diffusion coefficient (ADC) and RSI parameters (restricted diffusion f1 , hindered diffusion f2 , free diffusion f3 , and signal fractions f1 f2 ) were calculated by two readers for the whole lesion volume and compared between the benign and malignant groups and the subgroups with different statuses of prognostic factors in breast cancer. STATISTICAL TESTS Mann-Whitney U test or Student's t-test was applied to compare the quantitative parameters between the different groups. Intraclass correlation coefficient (ICC) was used to assess readers' reproducibility. Binary logistic regression was used to combine parameters. Area under the curve (AUC) of receiver operating characteristic curve analysis was used to evaluate the diagnostic performance of parameters to distinguish benign from malignant breast lesions. A P-value <0.05 was considered statistically significant. RESULTS Malignant breast lesions showed significantly lower ADC and f3 values, and significantly higher f1 and f1 f2 values than the benign lesions, with AUC of 0.951, 0.877, 0.868, and 0.860, respectively. When RSI-derived parameters and ADC were combined, the diagnostic performance was superior to either single parameter (AUC = 0.973). The f3 value was significantly differed between estrogen receptor (ER)-positive and ER-negative tumors. The ADC, f1 , f3 , and f1 f2 values were significantly different progesterone receptor (PR)-positive and PR-negative status. DATA CONCLUSION The RSI-derived parameters (f1 , f3 , and f1 f2 ) may facilitate the differential diagnosis between benign and malignant breast lesions. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Yanjin Qin
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Caili Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qilan Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunfei Zhang
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Jingru Yi
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongming Dai
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Tao Ai
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Almutlaq ZM, Wilson DJ, Bacon SE, Sharma N, Stephens S, Dondo T, Buckley DL. Evaluation of Monoexponential, Stretched-Exponential and Intravoxel Incoherent Motion MRI Diffusion Models in Early Response Monitoring to Neoadjuvant Chemotherapy in Patients With Breast Cancer-A Preliminary Study. J Magn Reson Imaging 2022; 56:1079-1088. [PMID: 35156741 PMCID: PMC9543625 DOI: 10.1002/jmri.28113] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND There has been a growing interest in exploring the applications of stretched-exponential (SEM) and intravoxel incoherent motion (IVIM) models of diffusion-weighted imaging (DWI) in breast imaging, with the focus on differentiation of breast lesions. However, the use of SEM and IVIM models to predict early response to neoadjuvant chemotherapy (NACT) has received less attention. PURPOSE To investigate the value of monoexponential, SEM, and IVIM models to predict early response to NACT in patients with primary breast cancer. STUDY TYPE Prospective. POPULATION Thirty-seven patients with primary breast cancer (aged 46 ± 11 years) due to undergo NACT. FIELD STRENGTH/SEQUENCES A 1.5-T MR scanner, T1 -weighted three-dimensional spoiled gradient-echo, two-dimensional single-shot spin-echo echo-planar imaging sequence (DWI) at six b-values (0-800 s mm-2 ). ASSESSMENT Tumor volume, apparent diffusion coefficient, tissue diffusion (Dt ), pseudo-diffusion coefficient (Dp ), perfusion fraction (f), distributed diffusion coefficient, and alpha (α) were extracted, following volumetric sampling of the tumors, at three time-points: pretreatment, post one and three cycles of NACT. STATISTICAL TESTS Mann-Whitney test, receiver operating characteristic (ROC) curve. Statistical significance level was P < 0.05. RESULTS Following NACT, 17 patients were determined to be pathological responders and 20 nonresponders. Tumor volume was significantly larger in nonresponders at each MRI time-point and demonstrated reasonable performance in predicting response (area under the ROC curve [AUC] = 0.83-0.87). No significant differences between groups were found in the diffusion coefficients at each time-point (P = 0.09-1). The parameters α (SEM), f, and f × Dp (IVIM) were able to differentiate between response groups after one cycle of NACT (AUC = 0.73, 0.72, and 0.74, respectively). CONCLUSION Diffusion coefficients derived from the monoexponential, SEM, and IVIM models did not predict pathological response. However, the IVIM-derived parameters f and f × Dp and the SEM-derived parameter α were able to predict response to NACT in breast cancer patients following one cycle of NACT. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Zyad M. Almutlaq
- Biomedical ImagingUniversity of LeedsLeedsUK
- Radiological Sciences Department, College of Applied Medical SciencesKing Saud bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia
| | - Daniel J. Wilson
- Department of Medical Physics & EngineeringLeeds Teaching Hospitals NHS TrustLeedsUK
| | - Sarah E. Bacon
- Department of Medical Physics & EngineeringLeeds Teaching Hospitals NHS TrustLeedsUK
| | - Nisha Sharma
- Department of RadiologyLeeds Teaching Hospitals NHS TrustLeedsUK
| | | | - Tatendashe Dondo
- Clinical and Population Sciences Department, Leeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
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AĞLAMIŞ S, BAYKARA M. Meme manyetik rezonans görüntülemede malign ve benign lezyonların ayrımında histogram analizi: ön çalışma. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1090183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: The present study assesses whether malignant and benign lesions can be distinguished through histogram analysis of non-fat-suppressed T1-weighted and fat-suppressed T2-weighted breast magnetic resonance images (MRIs).
Materials and Methods: MRIs of 20 malignant and 20 benign breast lesions were reviewed retrospectively by histogram analysis performed using Osirix V.4.9 software. The regions of interest (ROIs) were drawn manually to include almost the entire lesion, and values from these ROIs were used to calculate gray-level intensity mean, standard deviation, entropy, uniformity, skewness, kurtosis, and percentile values.
Results: In non-fat-suppressed T1-weighted images, the minimum, 1st, 3rd, 5th, 10th and 25th percentile values were significantly lower in the malignant lesions than in the benign lesions. The minimum value had sensitivity of 70% and specificity of 63.2%. On the fat-suppressed T2-weighted images, skewness was significantly higher while uniformity was significantly lower in malignant lesions than benign lesions. Skewness had 68.4% sensitivity and 60% specificity, and uniformity had 65% sensitivity and 68.4% specificity.
Conclusion: The results of this study demonstrated that histogram analysis of non-fat-suppressed T1-weighted and fat-suppressed T2-weighted images can be used to differentiate malignant and benign lesions in breast MRI.
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11
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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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12
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Mendez AM, Fang LK, Meriwether CH, Batasin SJ, Loubrie S, Rodríguez-Soto AE, Rakow-Penner RA. Diffusion Breast MRI: Current Standard and Emerging Techniques. Front Oncol 2022; 12:844790. [PMID: 35880168 PMCID: PMC9307963 DOI: 10.3389/fonc.2022.844790] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
The role of diffusion weighted imaging (DWI) as a biomarker has been the subject of active investigation in the field of breast radiology. By quantifying the random motion of water within a voxel of tissue, DWI provides indirect metrics that reveal cellularity and architectural features. Studies show that data obtained from DWI may provide information related to the characterization, prognosis, and treatment response of breast cancer. The incorporation of DWI in breast imaging demonstrates its potential to serve as a non-invasive tool to help guide diagnosis and treatment. In this review, current technical literature of diffusion-weighted breast imaging will be discussed, in addition to clinical applications, advanced techniques, and emerging use in the field of radiomics.
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Affiliation(s)
- Ashley M. Mendez
- Department of Radiology, University of California San Diego, La Jolla, CA, United States
| | - Lauren K. Fang
- Department of Radiology, University of California San Diego, La Jolla, CA, United States
| | - Claire H. Meriwether
- Department of Radiology, University of California San Diego, La Jolla, CA, United States
| | - Summer J. Batasin
- Department of Radiology, University of California San Diego, La Jolla, CA, United States
| | - Stéphane Loubrie
- Department of Radiology, University of California San Diego, La Jolla, CA, United States
| | - Ana E. Rodríguez-Soto
- Department of Radiology, University of California San Diego, La Jolla, CA, United States
| | - Rebecca A. Rakow-Penner
- Department of Radiology, University of California San Diego, La Jolla, CA, United States,Department of Bioengineering, University of California San Diego, La Jolla, CA, United States,*Correspondence: Rebecca A. Rakow-Penner,
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13
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Bone Marrow Fat Distribution in Patients With β-Thalassemia: A Study Using Chemical Shift-Based Water-Fat MRI. Acad Radiol 2022; 29:e39-e48. [PMID: 33992535 DOI: 10.1016/j.acra.2021.03.028] [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: 01/07/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 11/01/2022]
Abstract
RATIONALE AND OBJECTIVES Molecular studies have shown the changes in bone marrow fat in relation to altered hematopoiesis. This study aims to investigate the changes in the bone marrow fat in patients affected by β-thalassemia by using chemical shift-encoded (CSE)-MRI. MATERIALS AND METHODS Twenty-three subjects, comprising of six healthy (17-31 years old) and 17 β-thalassemia subjects (19-39 years old), were scanned using a multiecho fast low angle shot sequence (0.94 × 0.94 × 3.00 mm3) and a stimulated echo acquisition mode sequence using 3T MRI. Bone marrow proton density fat fraction (PDFF) was quantified in the left femur of each subject. Regression and Bland-Altman analysis were used to analyze agreement between CSE-MRI and 1H-MRS. PDFF distribution was analyzed using Hartigan's dip test and the computed Wasserstein distances. Jonckheere-Terpstra trend analysis was performed to evaluate the effect of disease severity on PDFF distribution. RESULTS An excellent agreement was found between PDFF measured using CSE-MRI with 1H-MRS (R2 = 0.91; bias =-1.41%). Healthy subjects showed left-skewed or bimodal PDFF distribution while β-thalassemia subjects showed bimodal, normal or right-skewed distribution. Jonckheere-Terpstra test shows that PDFF distribution was increasingly different from the norm as disease severity increased (TJT = 166.0, z = 3.806, p < 0.05). Increase in variability of PDFF distribution within each subject group was also seen with increasing disease severity (TJT = 169.0, z = 3.971, p < 0.05). CONCLUSION CSE-MRI is a promising tool to demonstrate spatial changes and variability in marrow fat distribution, resulting from ineffective erythropoiesis.
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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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15
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Sun K, Jiao Z, Zhu H, Chai W, Yan X, Fu C, Cheng JZ, Yan F, Shen D. Radiomics-based machine learning analysis and characterization of breast lesions with multiparametric diffusion-weighted MR. J Transl Med 2021; 19:443. [PMID: 34689804 PMCID: PMC8543912 DOI: 10.1186/s12967-021-03117-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 10/13/2021] [Indexed: 12/29/2022] Open
Abstract
Background This study aimed to evaluate the utility of radiomics-based machine learning analysis with multiparametric DWI and to compare the diagnostic performance of radiomics features and mean diffusion metrics in the characterization of breast lesions. Methods This retrospective study included 542 lesions from February 2018 to November 2018. One hundred radiomics features were computed from mono-exponential (ME), biexponential (BE), stretched exponential (SE), and diffusion-kurtosis imaging (DKI). Radiomics-based analysis was performed by comparing four classifiers, including random forest (RF), principal component analysis (PCA), L1 regularization (L1R), and support vector machine (SVM). These four classifiers were trained on a training set with 271 patients via ten-fold cross-validation and tested on an independent testing set with 271 patients. The diagnostic performance of the mean diffusion metrics of ME (mADCall b, mADC0–1000), BE (mD, mD*, mf), SE (mDDC, mα), and DKI (mK, mD) were also calculated for comparison. The area under the receiver operating characteristic curve (AUC) was used to compare the diagnostic performance. Results RF attained higher AUCs than L1R, PCA and SVM. The AUCs of radiomics features for the differential diagnosis of breast lesions ranged from 0.80 (BE_D*) to 0.85 (BE_D). The AUCs of the mean diffusion metrics ranged from 0.54 (BE_mf) to 0.79 (ME_mADC0–1000). There were significant differences in the AUCs between the mean values of all diffusion metrics and radiomics features of AUCs (all P < 0.001) for the differentiation of benign and malignant breast lesions. Of the radiomics features computed, the most important sequence was BE_D (AUC: 0.85), and the most important feature was FO-10 percentile (Feature Importance: 0.04). Conclusions The radiomics-based analysis of multiparametric DWI by RF enables better differentiation of benign and malignant breast lesions than the mean diffusion metrics. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-03117-5.
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Affiliation(s)
- Kun Sun
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhicheng Jiao
- Department of Diagnostic Imaging, Alpert Medical School of Brown University, Providence, USA
| | - Hong Zhu
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Weimin Chai
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xu Yan
- Scientific Marketing, Siemens Shanghai Magnetic Resonance Ltd., Shanghai, China
| | - Caixia Fu
- MR Application Development, Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Jie-Zhi Cheng
- Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd., Shanghai, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Dinggang Shen
- Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd., Shanghai, China. .,School of BME, Shanghai Tech University, Shanghai, China.
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Reiter DA, Adelnia F, Cameron D, Spencer RG, Ferrucci L. Parsimonious modeling of skeletal muscle perfusion: Connecting the stretched exponential and fractional Fickian diffusion. Magn Reson Med 2021; 86:1045-1057. [PMID: 33724547 DOI: 10.1002/mrm.28766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE To develop an anomalous (non-Gaussian) diffusion model for characterizing skeletal muscle perfusion using multi-b-value DWI. THEORY AND METHODS Fick's first law was extended for describing tissue perfusion as anomalous superdiffusion, which is non-Gaussian diffusion exhibiting greater particle spread than that of the Gaussian case. This was accomplished using a space-fractional derivative that gives rise to a power-law relationship between mean squared displacement and time, and produces a stretched exponential signal decay as a function of b-value. Numerical simulations were used to estimate parameter errors under in vivo conditions, and examine the effect of limited SNR and residual fat signal. Stretched exponential DWI parameters, α and D , were measured in thigh muscles of 4 healthy volunteers at rest and following in-magnet exercise. These parameters were related to a stable distribution of jump-length probabilities and used to estimate microvascular volume fractions. RESULTS Numerical simulations showed low dispersion in parameter estimates within 1.5% and 1%, and bias errors within 3% and 10%, for α and D , respectively. Superdiffusion was observed in resting muscle, and to a greater degree following exercise. Resting microvascular volume fraction was between 0.0067 and 0.0139 and increased between 2.2-fold and 4.7-fold following exercise. CONCLUSIONS This model captures superdiffusive molecular motions consistent with perfusion, using a parsimonious representation of the DWI signal, providing approximations of microvascular volume fraction comparable with histological estimates. This signal model demonstrates low parameter-estimation errors, and therefore holds potential for a wide range of applications in skeletal muscle and elsewhere in the body.
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Affiliation(s)
- David A Reiter
- Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia, USA.,Department of Orthopedics, Emory University, Atlanta, Georgia, USA
| | - Fatemeh Adelnia
- Vanderbilt University Institute of Imaging Sciences, Vanderbilt University, Medical center, Nashville, Tennessee, USA
| | - Donnie Cameron
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom.,C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden Medical Center, Leiden, the Netherlands
| | - Richard G Spencer
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
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17
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Multi-parametric MRI lesion heterogeneity biomarkers for breast cancer diagnosis. Phys Med 2020; 80:101-110. [PMID: 33137621 DOI: 10.1016/j.ejmp.2020.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/07/2020] [Accepted: 10/10/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To identify intra-lesion imaging heterogeneity biomarkers in multi-parametric Magnetic Resonance Imaging (mpMRI) for breast lesion diagnosis. METHODS Dynamic Contrast Enhanced (DCE) and Diffusion Weighted Imaging (DWI) of 73 female patients, with 85 histologically verified breast lesions were acquired. Non-rigid multi-resolution registration was utilized to spatially align sequences. Four (4) DCE (2nd post-contrast frame, Initial-Enhancement, Post-Initial-Enhancement and Signal-Enhancement-Ratio) and one (1) DWI (Apparent-Diffusion-Coefficient) representations were analyzed, considering a representative lesion slice. 11 1st-order-statistics and 16 texture features (Gray-Level-Co-occurrence-Matrix (GLCM) and Gray-Level-Run-Length-Matrix (GLRLM) based) were derived from lesion segments, provided by Fuzzy C-Means segmentation, across the 5 representations, resulting in 135 features. Least-Absolute-Shrinkage and Selection-Operator (LASSO) regression was utilized to select optimal feature subsets, subsequently fed into 3 classification schemes: Logistic-Regression (LR), Random-Forest (RF), Support-Vector-Machine-Sequential-Minimal-Optimization (SVM-SMO), assessed with Receiver-Operating-Characteristic (ROC) analysis. RESULTS LASSO regression resulted in 7, 6 and 7 features subsets from DCE, DWI and mpMRI, respectively. Best classification performance was obtained by the RF multi-parametric scheme (Area-Under-ROC-Curve, (AUC) ± Standard-Error (SE), AUC ± SE = 0.984 ± 0.025), as compared to DCE (AUC ± SE = 0.961 ± 0.030) and DWI (AUC ± SE = 0.938 ± 0.032) and statistically significantly higher as compared to DWI. The selected mpMRI feature subset highlights the significance of entropy (1st-order-statistics and 2nd-order-statistics (GLCM)) and percentile features extracted from 2nd post-contrast frame, PIE, SER maps and ADC map. CONCLUSION Capturing breast intra-lesion heterogeneity, across mpMRI lesion segments with 1st-order-statistics and texture features (GLCM and GLRLM based), offers a valuable diagnostic tool for breast cancer.
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Xu F, Liang YY, Guo Y, Liang ZP, Wu M, Chen S, Zeng XW. Diagnostic performance of whole-lesion apparent diffusion coefficient histogram analysis metrics for differentiating benign and malignant breast lesions: a systematic review and diagnostic meta-analysis. Acta Radiol 2020; 61:1165-1175. [PMID: 31924104 DOI: 10.1177/0284185119896520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Although whole-lesion apparent diffusion coefficient (ADC) histogram has been increasingly used for breast lesions, it has not been routinely used in clinical practice as an emergent promising imaging tool. PURPOSE To evaluate the performance of whole-lesion ADC histogram analysis metrics for differentiating benign and malignant breast lesions. MATERIAL AND METHODS A systematic PubMed/EMBASE/Cochrane electronic database search was performed for original diagnostic studies from 1 January 1970 to 2 January 2019. Summary estimates of diagnostic accuracy were generated and meta-regression was performed to explore sources of heterogeneity according to study and magnetic resonance imaging characteristics. RESULTS Five original articles involving 493 patients were included in the meta-analysis. The pooled sensitivity and specificity of whole-lesion ADC histogram analysis were 0.85 (95% confidence interval [CI] = 0.81-0.89) and 0.79 (95% CI = 0.72-0.84) for distinguishing benign and malignant breast lesions, respectively. The area under the curve (AUC) was 0.9178. No publication bias was detected (P = 0.51). In subgroup analysis, the summary sensitivity and specificity of 50th percentile ADC value were 0.81 (95% CI = 0.71-0.88) and 0.86 (95% CI = 0.74-0.94), respectively. Meta-regression analysis indicated no covariates were sources of heterogeneity (P > 0.05). CONCLUSION Whole-lesion ADC histogram analysis demonstrated good diagnostic performance for differentiating between benign and malignant breast lesions, with 50th percentile ADC value showing higher diagnostic accuracy than other histogram parameters. Given the limited number of studies included in the analysis, the findings from our meta-analysis will need further confirmation in future research.
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Affiliation(s)
- Fan Xu
- Department of Radiology, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou, Guangdong Province, PR China
| | - Ying-ying Liang
- Department of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong Province, PR China
| | - Yuan Guo
- Department of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong Province, PR China
| | - Zhi-ping Liang
- Department of Radiology, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou, Guangdong Province, PR China
| | - Mei Wu
- Department of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong Province, PR China
| | - Song Chen
- Department of Radiology, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou, Guangdong Province, PR China
| | - Xu-wen Zeng
- Department of Radiology, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou, Guangdong Province, PR China
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Zhang G, Ma W, Dong H, Shu J, Hou W, Guo Y, Wang M, Wei X, Ren J, Zhang J. Based on Histogram Analysis: ADC aqp Derived from Ultra-high b-Value DWI could be a Non-invasive Specific Biomarker for Rectal Cancer Prognosis. Sci Rep 2020; 10:10158. [PMID: 32576929 PMCID: PMC7311405 DOI: 10.1038/s41598-020-67263-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/04/2020] [Indexed: 12/30/2022] Open
Abstract
Aquaporins (AQP) are not only water channel protein, but also potential prognostic indicator and therapeutic target for rectal cancer. Some previous studies have demonstrated the AQP expression could be estimated by ADCaqp value derived from ultra-high b-value diffusion-weighted imaging (DWI). We aim to determine whether ADCaqp could be a new and specific biomarker for indicating the AQP expression and prognostic factors of rectal cancer. 76 untreated patients with rectal cancer confirmed by colonoscopy biopsy were enrolled. ADCaqp value was generated from ultra-high b-value DWI with five b-values (1700–3500 s/mm2). AQP (AQP1, 3 and 5)staining intensity was estimated by both of software (QuPath) and manual manner. The relationships between histogram features of ADCaqp and AQP staining intensity were analyzed. The correlations between histogram features of ADCaqp and differentiation degrees (good, moderate, poor), T stage (T1–2 vs T3–4), and lymph node status (N+ vs N−) were also evaluated respectively. The mean, 75th percentile and 97.5th percentile of ADCaqp were correlated with AQP1 staining intensity (r = 0.237, 0.323 and 0.362, respectively, all P < 0.05) . No correlation was found between the histogram features of ADCaqp and AQP3 or AQP5 staining intensity. The mean, 50th percentile, 75th percentile and 97.5th percentile of ADCaqp value exhibited significant differences between differentiation status (all P < 0.05). Histogram features of ADCaqp value showed no significant differences in two subgroups of T stage and lymph node status (all P > 0.05). Histogram analysis showed that the ADCaqp value derived from ultra-high b-value DWI of rectal cancer could reflect AQP1’s expression and rectal cancer’s malignancy degree. ADCaqp might be a new imaging biomarker for evaluating rectal cancer.
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Affiliation(s)
- Guangwen Zhang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, P.R. China
| | - Wanling Ma
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, P.R. China
| | - Hui Dong
- Research Equipment Management Center, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, P.R. China
| | - Jun Shu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, P.R. China
| | - Weihuan Hou
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, P.R. China
| | - Yong Guo
- Department of Gastrointestinal Pathology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, P.R. China
| | - Mian Wang
- Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, P.R. China
| | - Xiaocheng Wei
- MR Research China, GE Healthcare Greater China, Beijing, P.R. China
| | - Jialiang Ren
- MR Research China, GE Healthcare Greater China, Beijing, P.R. China
| | - Jinsong Zhang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, P.R. China.
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Differentiation of high-grade from low-grade diffuse gliomas using diffusion-weighted imaging: a comparative study of mono-, bi-, and stretched-exponential diffusion models. Neuroradiology 2020; 62:815-823. [PMID: 32424712 PMCID: PMC7311374 DOI: 10.1007/s00234-020-02456-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 05/05/2020] [Indexed: 12/13/2022]
Abstract
Purpose Diffusion-weighted imaging (DWI) plays an important role in the preoperative assessment of gliomas; however, the diagnostic performance of histogram-derived parameters from mono-, bi-, and stretched-exponential DWI models in the grading of gliomas has not been fully investigated. Therefore, we compared these models’ ability to differentiate between high-grade and low-grade gliomas. Methods This retrospective study included 22 patients with diffuse gliomas (age, 23–74 years; 12 males; 11 high-grade and 11 low-grade gliomas) who underwent preoperative 3 T-magnetic resonance imaging from October 2014 to August 2019. The apparent diffusion coefficient was calculated from the mono-exponential model. Using 13 b-values, the true-diffusion coefficient, pseudo-diffusion coefficient, and perfusion fraction were obtained from the bi-exponential model, and the distributed-diffusion coefficient and heterogeneity index were obtained from the stretched-exponential model. Region-of-interests were drawn on each imaging parameter map for subsequent histogram analyses. Results The skewness of the apparent diffusion, true-diffusion, and distributed-diffusion coefficients was significantly higher in high-grade than in low-grade gliomas (0.67 ± 0.67 vs. − 0.18 ± 0.63, 0.68 ± 0.74 vs. − 0.08 ± 0.66, 0.63 ± 0.72 vs. − 0.15 ± 0.73; P = 0.0066, 0.0192, and 0.0128, respectively). The 10th percentile of the heterogeneity index was significantly lower (0.77 ± 0.08 vs. 0.88 ± 0.04; P = 0.0004), and the 90th percentile of the perfusion fraction was significantly higher (12.64 ± 3.44 vs. 7.14 ± 1.70%: P < 0.0001), in high-grade than in low-grade gliomas. The combination of the 10th percentile of the true-diffusion coefficient and 90th percentile of the perfusion fraction showed the best area under the receiver operating characteristic curve (0.96). Conclusion The bi-exponential model exhibited the best diagnostic performance for differentiating high-grade from low-grade gliomas. Electronic supplementary material The online version of this article (10.1007/s00234-020-02456-2) contains supplementary material, which is available to authorized users.
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Noda Y, Goshima S, Fujimoto K, Akamine Y, Kajita K, Kawai N, Matsuo M. Comparison of the Diagnostic Value of Mono-exponential, Bi-exponential, and Stretched Exponential Signal Models in Diffusion-weighted MR Imaging for Differentiating Benign and Malignant Hepatic Lesions. Magn Reson Med Sci 2020; 20:69-75. [PMID: 32161202 PMCID: PMC7952197 DOI: 10.2463/mrms.mp.2019-0151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To compare the diagnostic value of mono-exponential, bi-exponential, and stretched exponential diffusion-weighted imaging (DWI) for differentiating benign and malignant hepatic lesions. METHODS This prospective study was approved by our Institutional Review Board and the patients provided written informed consent. Magnetic resonance imaging was acquired for 56 patients with suspected liver disease. This identified 90 focal liver lesions with a maximum diameter >10 mm, of which 47 were benign and 43 were malignant. Using home-built software, two radiologists measured the DWI parameters of hepatic lesions for three models: the apparent diffusion coefficient (ADC) from a mono-exponential model; the true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) from a bi-exponential model; and the distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) from a stretched exponential model. The parameters were compared between benign and malignant hepatic lesions. RESULTS ADC, D, D*, f, and DDC values were significantly lower for malignant hepatic lesions than for benign lesions (P < 0.0001-0.03). Although logistic regression analysis demonstrated that DDC was the only statistically significant parameter for differentiating benign and malignant lesions (P = 0.039), however, the areas under the receiver operating characteristic curve for differentiating benign and malignant lesions were comparable between ADC (0.98) and DDC (0.98) values. CONCLUSION DDC values obtained from the stretched exponential model could be also used as a quantitative imaging biomarker for differentiating benign and malignant hepatic lesions, however, the diagnostic performance was comparable with ADC values.
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Affiliation(s)
| | - Satoshi Goshima
- Department of Diagnostic Radiology & Nuclear Medicine, Hamamatsu University
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Li T, Hong Y, Kong D, Li K. Histogram analysis of diffusion kurtosis imaging based on whole-volume images of breast lesions. J Magn Reson Imaging 2019; 51:627-634. [PMID: 31385429 DOI: 10.1002/jmri.26884] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/27/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Breast diffusion kurtosis imaging (DKI) is a novel MRI technique to assess breast cancer but the effectivity still remains to be improved. PURPOSE To investigate the performance of whole-volume histogram parameters derived from a DKI model for differentiating benign and malignant breast lesions. STUDY TYPE Retrospective. POPULATION In all, 120 patients with breast lesions (62 malignant, 58 benign). SEQUENCE DKI sequence with seven b-values (0, 500, 1000, 1500, 2000, 2500, and 3000 s/mm2 ) and DWI sequence with two b-values (0 and 1000 s/mm2 ) on 3.0T MRI. ASSESSMENT Histogram parameters of the DKI model (K and D) and the DWI model (ADC), including the minimum, maximum, mean, percentile values (25th, 50th, 75th, and 95th), standard deviation, kurtosis and skewness, were calculated by two radiologists for the whole lesion volume. STATISTICAL TESTS Student's t-test was used to compare malignant and benign lesions. The diagnostic performances were evaluated by receiver operating characteristic (ROC) analysis. RESULTS Kmax , Dmin , and ADCmin had the highest area under the curve (AUC) (0.875, 0.830, and 0.847, respectively), sensitivity (85.5%, 74.2%, and 77.4%, respectively), and accuracy (85.0%, 79.2%, and 81.7%, respectively) in their individual histogram parameter groups, and Kmax was found to outperform Dmin and ADCmin . ADC histogram parameters (from ADCmin to ADCsd ) were significantly lower than D histogram parameters in all groups. DATA CONCLUSION Kmax , Dmin , and ADCmin were found to be better metrics than the corresponding average values for differentiating benign from malignant tumors. Histogram parameters derived from the DKI model provided more information and had better diagnostic performance than ADC parameters derived from the DWI model. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:627-634.
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Affiliation(s)
- Ting Li
- The Department of Radiology, First People's Hospital of Changzhou, Jiangsu, P.R. China
| | - Yuan Hong
- School of Mathematical Sciences, Zhejiang University, Hangzhou, P.R. China
| | - Dexing Kong
- School of Mathematical Sciences, Zhejiang University, Hangzhou, P.R. China
| | - Kangan Li
- Department of Radiology, Shanghai General Hospital, Shanghai, P.R. China
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Histogram analysis of diffusion kurtosis imaging in the differentiation of malignant from benign breast lesions. Eur J Radiol 2019; 117:156-163. [DOI: 10.1016/j.ejrad.2019.06.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 05/08/2019] [Accepted: 06/11/2019] [Indexed: 01/20/2023]
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You C, Li J, Zhi W, Chen Y, Yang W, Gu Y, Peng W. The volumetric-tumour histogram-based analysis of intravoxel incoherent motion and non-Gaussian diffusion MRI: association with prognostic factors in HER2-positive breast cancer. J Transl Med 2019; 17:182. [PMID: 31262334 PMCID: PMC6604303 DOI: 10.1186/s12967-019-1911-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 05/08/2019] [Indexed: 12/27/2022] Open
Abstract
Background To evaluate the imaging biomarkers of human epidermal growth factor receptor 2 (HER2) positive breast cancer in comparison to other molecular subtypes and to determine the feasibility of identifying hormone receptor (HR) status and lymph node metastasis status using volumetric-tumour histogram-based analysis through intravoxel incoherent motion (IVIM) and non-Gaussian diffusion. Methods This study included 145 breast cancer patients with 148 lesions between January and November in 2018. Among the 148 lesions, 74 were confirmed to be HER2-positive. The volumetric-tumour histogram-based features were extracted from the combined IVIM and non-Gaussian diffusion model. IVIM and non-Gaussian diffusion parameters obtained from images of the subjects with different molecular prognostic biomarker statuses were compared by Student’s t test or the Mann–Whitney U test. The area under the curve (AUC), sensitivity, and specificity at the best cut-off point were reported. The Spearman correlation coefficient was calculated to analyse the correlations of clinical tumor nodule metastasis (TNM) stage and Ki67 with the IVIM and non-Gaussian diffusion parameters. Results The entropy of mean kurtosis (MK) was significantly higher in the HER2-positive group than in the HER2-negative group (p = 0.015), with an AUC of 0.629 (95% CI 0.546, 0.707), a sensitivity of 62.6%, and a specificity of 66.2%. For HR status, the MD 5th percentile was higher in the HR-positive group of HER2-positive breast cancer (p = 0.041), with an AUC of 0.643 (95% CI 0.523, 0.751), while for lymph node status, the entropy of mean diffusivity (MK) was lower in the lymph node positive group (p = 0.040), with an AUC of 0.587 (95% CI 0.504, 0.668). The clinical TNM stage and Ki67 index were correlated with several histogram parameters. Conclusion Volumetric-lesion histogram analysis of IVIM and the non-Gaussian diffusion model can be used to provide prognostic information about HER2-positive breast cancers and potentially contribute to individualized anti-HER2 targeted therapy plans . Electronic supplementary material The online version of this article (10.1186/s12967-019-1911-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chao You
- Department of Radiology, Fudan University Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, No. 270, Dongan Road, Shanghai, 200032, People's Republic of China
| | - Jianwei Li
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Wenxiang Zhi
- Department of Ultrasound, Fudan University Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yanqiong Chen
- Department of Radiology, Fudan University Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, No. 270, Dongan Road, Shanghai, 200032, People's Republic of China
| | - Wentao Yang
- Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University Shanghai, Shanghai, People's Republic of China
| | - Yajia Gu
- Department of Radiology, Fudan University Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, No. 270, Dongan Road, Shanghai, 200032, People's Republic of China.
| | - Weijun Peng
- Department of Radiology, Fudan University Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, No. 270, Dongan Road, Shanghai, 200032, People's Republic of China.
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