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Mu RQ, Lv JW, Ma CY, Ma XH, Xing D, Ma HS. Diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging parameters and serum tumor markers in rectal carcinoma prognosis. World J Gastrointest Oncol 2024; 16:1796-1807. [PMID: 38764818 PMCID: PMC11099448 DOI: 10.4251/wjgo.v16.i5.1796] [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: 12/12/2023] [Revised: 01/15/2024] [Accepted: 02/29/2024] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND Rectal carcinoma (RC), one of the most common malignancies globally, presents an increasing incidence and mortality year by year, especially among young people, which seriously affects the prognosis and quality of life of patients. At present, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters and serum carbohydrate antigen 19-9 (CA19-9) and CA125 Levels have been used in clinical practice to evaluate the T stage and differentiation of RC. However, the accuracy of these evaluation modalities still needs further research. This study explores the application and value of these methods in evaluating the T stage and differentiation degree of RC. AIM To analyze the diagnostic performance of DCE-MRI parameters combined with serum tumor markers (TMs) in assessing pathological processes and prognosis of RC patients. METHODS A retrospective analysis was performed on 104 RC patients treated at Yantai Yuhuangding Hospital from May 2018 to January 2022. Patients were categorized into stages T1, T2, T3, and T4, depending on their T stage and differentiation degree. In addition, they were assigned to low (L group) and moderate-high differentiation (M + H group) groups based on their differentiation degree. The levels of DCE-MRI parameters and serum CA19-9 and CA125 in different groups of patients were compared. In addition, the value of DCE-MRI parameters [volume transfer constant (Ktrans), rate constant (Kep), and extravascular extracellular volume fraction (Ve) in assessing the differentiation and T staging of RC patients was discussed. Furthermore, the usefulness of DCE-MRI parameters combined with serum CA19-9 and CA125 Levels in the evaluation of RC differentiation and T staging was analyzed. RESULTS Ktrans, Ve, CA19-9 and CA125 were higher in the high-stage group and L group than in the low-stage group and M + H Group, respectively (P < 0.05). The areas under the curve (AUCs) of the Ktran and Ve parameters were 0.638 and 0.694 in the diagnosis of high and low stages, respectively, and 0.672 and 0.725 in diagnosing moderate-high and low differentiation, respectively. The AUC of DCE-MRI parameters (Ktrans + Ve) in the diagnosis of high and low stages was 0.742, and the AUC in diagnosing moderate-high and low differentiation was 0.769. The AUCs of CA19-9 and CA-125 were 0.773 and 0.802 in the diagnosis of high and low stages, respectively, and 0.834 and 0.796 in diagnosing moderate-high and low differentiation, respectively. Then, we combined DCE-MRI (Ktrans + Ve) parameters with CA19-9 and CA-125 and found that the AUC of DCE-MRI parameters plus serum TMs was 0.836 in the diagnosis of high and low stages and 0.946 in the diagnosis of moderate-high and low differentiation. According to the Delong test, the AUC of DCE-MRI parameters plus serum TMs increased significantly compared with serum TMs alone in the diagnosis of T stage and differentiation degree (P < 0.001). CONCLUSION The levels of the DCE-MRI parameters Ktrans and Ve and the serum TMs CA19-9 and CA125 all increase with increasing T stage and decreasing differentiation degree of RC and can be used as indices to evaluate the differentiation degree of RC in clinical practice. Moreover, the combined evaluation of the above indices has a better effect and more obvious clinical value, providing important guiding importance for clinical condition judgment and treatment selection.
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Affiliation(s)
- Ren-Qi Mu
- Department of Radiology, Yantai Mountain Hospital, Yantai 264001, Shandong Province, China
| | - Jun-Wei Lv
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai 264000, Shandong Province, China
| | - Cai-Yun Ma
- Department of Gynaecology, Yantai Yuhuangding Hospital, Yantai 264000, Shandong Province, China
| | - Xiao-Hui Ma
- The First Clinical Medical College, Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
| | - Dong Xing
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai 264000, Shandong Province, China
| | - Hou-Sheng Ma
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai 264000, Shandong Province, China
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Chikui T, Ohga M, Kami Y, Togao O, Kawano S, Kiyoshima T, Yoshiura K. Correlation between diffusion-weighted image-derived parameters and dynamic contrast-enhanced magnetic resonance imaging-derived parameters in the orofacial region. Acta Radiol Open 2024; 13:20584601241244777. [PMID: 38559449 PMCID: PMC10979534 DOI: 10.1177/20584601241244777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
Background Diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are widely used in the orofacial region. Furthermore, quantitative analyses have proven useful. However, a few reports have described the correlation between DWI-derived parameters and DCE-MRI-derived parameters, and the results have been controversial. Purpose To evaluate the correlation among parameters obtained by DWI and DCE-MRI and to compare them between benign and malignant lesions. Material and Methods Fifty orofacial lesions were analysed. The apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) were estimated by DWI. For DCE-MRI, TK model analysis was performed to estimate physiological parameters, for example, the influx forward volume transfer constant into the extracellular-extravascular space (EES) (Ktrans) and fractional volumes of EES and plasma components (ve and vp). Results Both ADC and D showed a moderate positive correlation with ve (ρ = 0.640 and 0.645, respectively). Ktrans showed a marginally weak correlation with f (ρ = 0.296), while vp was not correlated with f or D*; therefore, IVIM perfusion-related parameters and TK model perfusion-related parameters were not straightforward. Both D and ve yielded high diagnostic power between benign lesions and malignant tumours with areas under the curve (AUCs) of 0.830 and 0.782, respectively. Conclusion Both D and ve were reliable parameters that were useful for the differential diagnosis. In addition, the true diffusion coefficient (D) was affected by the fractional volume of EES.
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Affiliation(s)
- Toru Chikui
- Section of Oral and Maxillofacial Radiology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Masahiro Ohga
- Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Yukiko Kami
- Section of Oral and Maxillofacial Radiology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Osamu Togao
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shintaro Kawano
- Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Tamotsu Kiyoshima
- Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kazunori Yoshiura
- Section of Oral and Maxillofacial Radiology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
- Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
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Knuth F, Tohidinezhad F, Winter RM, Bakke KM, Negård A, Holmedal SH, Ree AH, Meltzer S, Traverso A, Redalen KR. Quantitative MRI-based radiomics analysis identifies blood flow feature associated to overall survival for rectal cancer patients. Sci Rep 2024; 14:258. [PMID: 38167665 PMCID: PMC10762039 DOI: 10.1038/s41598-023-50966-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
Radiomics objectively quantifies image information through numerical metrics known as features. In this study, we investigated the stability of magnetic resonance imaging (MRI)-based radiomics features in rectal cancer using both anatomical MRI and quantitative MRI (qMRI), when different methods to define the tumor volume were used. Second, we evaluated the prognostic value of stable features associated to 5-year progression-free survival (PFS) and overall survival (OS). On a 1.5 T MRI scanner, 81 patients underwent diagnostic MRI, an extended diffusion-weighted sequence with calculation of the apparent diffusion coefficient (ADC) and a multiecho dynamic contrast sequence generating both dynamic contrast-enhanced and dynamic susceptibility contrast (DSC) MR, allowing quantification of Ktrans, blood flow (BF) and area under the DSC curve (AUC). Radiomic features were extracted from T2w images and from ADC, Ktrans, BF and AUC maps. Tumor volumes were defined with three methods; machine learning, deep learning and manual delineations. The interclass correlation coefficient (ICC) assessed the stability of features. Internal validation was performed on 1000 bootstrap resamples in terms of discrimination, calibration and decisional benefit. For each combination of image and volume definition, 94 features were extracted. Features from qMRI contained higher prognostic potential than features from anatomical MRI. When stable features (> 90% ICC) were compared with clinical parameters, qMRI features demonstrated the best prognostic potential. A feature extracted from the DSC MRI parameter BF was associated with both PFS (p = 0.004) and OS (p = 0.004). In summary, stable qMRI-based radiomics features was identified, in particular, a feature based on BF from DSC MRI was associated with both PFS and OS.
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Affiliation(s)
- Franziska Knuth
- Department of Physics, Norwegian University of Science and Technology, Høgskoleringen 5, 7491, Trondheim, Norway
| | - Fariba Tohidinezhad
- Department of Radiation Oncology (Maastro Clinic), School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - René M Winter
- Department of Physics, Norwegian University of Science and Technology, Høgskoleringen 5, 7491, Trondheim, Norway
| | - Kine Mari Bakke
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne Negård
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Radiology, Akershus University Hospital, Lørenskog, Norway
| | - Stein H Holmedal
- Department of Radiology, Akershus University Hospital, Lørenskog, Norway
| | - Anne Hansen Ree
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sebastian Meltzer
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
| | - Alberto Traverso
- Department of Radiation Oncology (Maastro Clinic), School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kathrine Røe Redalen
- Department of Physics, Norwegian University of Science and Technology, Høgskoleringen 5, 7491, Trondheim, Norway.
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Yin P, Xu J, Sun X, Liu T, Chen L, Hong N. Intravoxel incoherent motion and dynamic contrast-enhanced magnetic resonance imaging for neoadjuvant chemotherapy response evaluation in patients with osteosarcoma. Eur J Radiol 2023; 162:110790. [PMID: 36963332 DOI: 10.1016/j.ejrad.2023.110790] [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: 11/10/2022] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVES This study aims to explore the role of quantitative intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters in characterizing changes in osteosarcoma (OS) patients receiving neoadjuvant chemotherapy (NACT). MATERIAL AND METHODS Twenty-seven patients with histologically proven OS were examined prospectively and divided into good-response group (n = 14) and poor-response group (n = 13). IVIM and DCE-MRI sequences were performed at baseline (pre-NACT) and after three cycles of NACT (post-NACT). Apparent diffusion coefficient (ADC) and IVIM bi-exponential model parameters, including diffusion coefficient (D-Bi), perfusion coefficient (D*-Bi), and perfusion fraction (f-Bi), were evaluated. DCE-MRI parameters, including quantitative parameters (volume transfer constant [Ktrans], elimination rate constant [Kep], and extravascular extracellular space volume ratio [Ve]) and semi-quantitative parameters (initial area under the gadolinium curve [IAUGC] and contrast enhancement rate [CER]), were also measured. RESULTS D-Bi, D*-Bi, and f-Bi post-NACT and ΔD-Bi were statistically different between the good- and poor-response groups (Z1 = - 3.348, Z2 = - 2.572, Z3 = - 2.378, t = 2.235, P < 0.05). ADC, f-Bi, Ktrans, IAUGC, Kep, and CER post-NACT were statistically different from those at pre-NACT (P < 0.05). The receiver operating characteristic curve showed that f-Bi post-NACT had the best performance among all parameters, with area under the curve of 0.769, sensitivity of 1, and specificity of 0.538. The correlation analysis showed that the efficacy of NACT was negatively correlated with D-Bi, D*-Bi post-NACT, and ΔD-Bi (r1 = - 0.530, r2 = - 0.411, r3 = - 0.434, P1 = 0.008, P2 = 0.046, P3 = 0.034) and significantly positively correlated with f-Bi post-NACT (r = 0.482, P = 0.017). CONCLUSIONS The IVIM quantitative parameters D-Bi, D*-Bi, and f-Bi post-NACT and ΔD-Bi could be used as noninvasive imaging biomarkers for early response assessment of NACT in OS.
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Affiliation(s)
- Ping Yin
- Department of Radiology, Peking University People's Hospital, 11 Xizhimen Nandajie, Xicheng District, Beijing 100044, PR China
| | - Jie Xu
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing 100044, PR China
| | - Xin Sun
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing 100044, PR China
| | - Tao Liu
- Department of Radiology, Peking University People's Hospital, 11 Xizhimen Nandajie, Xicheng District, Beijing 100044, PR China
| | - Lei Chen
- Department of Radiology, Peking University People's Hospital, 11 Xizhimen Nandajie, Xicheng District, Beijing 100044, PR China
| | - Nan Hong
- Department of Radiology, Peking University People's Hospital, 11 Xizhimen Nandajie, Xicheng District, Beijing 100044, PR China.
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Single- and multiparameter magnetic resonance imaging for diagnosing and severity grading of chronic pancreatitis. Abdom Radiol (NY) 2023; 48:630-641. [PMID: 36477631 DOI: 10.1007/s00261-022-03760-6] [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: 11/02/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The study aimed to determine the performance of advanced magnetic resonance imaging (MRI), including a multiparametric MRI-index, for diagnosing and severity grading of chronic pancreatitis (CP) at various functional stages with focus on detection of CP with preserved pancreatic function. METHODS Fifty-four CP patients and 35 healthy controls underwent MRI including assessment of pancreatic volume, main pancreatic duct (MPD) diameter, T1 relaxation time, magnetic resonance elastography (MRE) derived stiffness, and intravoxel incoherent motion (IVIM) diffusion-weighted imaging. Patients were categorized into three subgroups: Preserved pancreatic function (n = 14), partial pancreatic insufficiency (exocrine insufficiency or diabetes, n = 25), and complete pancreatic insufficiency (exocrine insufficiency and diabetes, n = 15). A multiparametric MRI-index was based on ordinal logistic regression analysis. Diagnostic performances of MRI parameters for diagnosing CP at different functional stages were determined using receiver operating characteristic (ROC) analysis. RESULTS All MRI parameters differed across CP subgroups and healthy controls (all P < 0.001), except for IVIM. T1 relaxation time (ROC area under the curve (ROC-AUC) 0.82), MRE (ROC-AUC 0.88), and MRI-index (ROC-AUC 0.86) showed the highest performance for detecting patients with preserved pancreatic function (early CP) vs. healthy controls. For detecting preserved pancreatic function vs. partial insufficiency, pancreatic volume, MRI-index, and T1 relaxation time performed best (all ROC-AUC > 0.75), with the MRI-index tending to outperform MRE (ROC-AUC 0.77 vs. 0.63; P = 0.10). CONCLUSION Quantitative assessments of T1 relaxation time and MRE-derived stiffness seem promising for diagnosing CP at different functional stages and may together with multiparametric MRI-index be used for early identification, staging and monitoring of CP.
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Bakke KM, Meltzer S, Grøvik E, Negård A, Holmedal SH, Mikalsen LTG, Færden AE, Lyckander LG, Julbø FMI, Bjørnerud A, Gjesdal KI, Ree AH, Redalen KR. Imaging the tumour microenvironment in rectal cancer: Decline in tumour blood flow during radiotherapy predicts good outcome. Phys Imaging Radiat Oncol 2023; 25:100417. [PMID: 36718357 PMCID: PMC9883255 DOI: 10.1016/j.phro.2023.100417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
Background and purpose Measuring rectal tumour response to radiation is pivotal to restaging patients and for possibly stratification to a watch-and-wait strategy. Recognizing the importance of the tumour microenvironment, we investigated a less explored quantitative imaging marker assessing tumour blood flow (BF) for its potential to predict overall survival (OS). Materials and methods 24 rectal cancer patients given curative-intent neoadjuvant radiotherapy underwent a multi-echo dynamic magnetic resonance imaging (MRI) sequence with gadolinium contrast for quantification of tumour BF before either 25x2 Gy (n = 18) with concomitant chemotherapy or 5x5 Gy (n = 6). CD34 staining of excised tumour tissue was performed and baseline blood samples were analysed for lactate dehydrogenase (LDH) and angiopoietin-2 (ANGPT-2). Tumour volumes were measured before and after treatment. After subsequent surgery, ypTN scoring assessed tumour response. Cox regression for 5-year OS analysis and t-test for group comparisons were performed. Results The change in tumour BF (ΔBF) during neoadjuvant radiotherapy was a significant marker of OS, whereas tumour stage and volume were not related to OS. All patients with >20 % decline in BF were long-term survivors. Separating cases in two groups based on ΔBF revealed that patients with increase or a low decrease had higher baseline LDH (p = 0.032) and ANGPT-2 (p = 0.028) levels. Conclusion MRI-assessed tumour ΔBF during neoadjuvant treatment is a significant predictor of OS in rectal cancer patients, making ΔBF a potential quantitative imaging biomarker for treatment stratification. Blood LDH and ANGPT-2 indicate that non-responding tumours may have a hypoxic microenvironment resistant to radiotherapy.
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Affiliation(s)
- Kine Mari Bakke
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway,Corresponding author at: Skremmaveien 40, 1425 Ski, Norway.
| | - Sebastian Meltzer
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
| | - Endre Grøvik
- Møre and Romsdal Hospital Trust, Ålesund,Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Negård
- Department of Radiology, Akershus University Hospital, Lørenskog, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Lars Tore Gyland Mikalsen
- Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway,Department of Life Sciences and Health, Oslo Metropolitan University, Oslo, Norway
| | - Arne Engebret Færden
- Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway
| | | | - Frida Marie Ihle Julbø
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway,Institute for Cancer Genetics and Informatics, Oslo University Hospital, Norway
| | - Atle Bjørnerud
- Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway,Department of Physics, University of Oslo, Oslo, Norway
| | - Kjell-Inge Gjesdal
- Department of Radiology, Akershus University Hospital, Lørenskog, Norway,Sunnmøre MR-klinikk, Ålesund, Norway
| | - Anne Hansen Ree
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kathrine Røe Redalen
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
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Knuth F, Adde IA, Huynh BN, Groendahl AR, Winter RM, Negård A, Holmedal SH, Meltzer S, Ree AH, Flatmark K, Dueland S, Hole KH, Seierstad T, Redalen KR, Futsaether CM. MRI-based automatic segmentation of rectal cancer using 2D U-Net on two independent cohorts. Acta Oncol 2022; 61:255-263. [PMID: 34918621 DOI: 10.1080/0284186x.2021.2013530] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Tumor delineation is time- and labor-intensive and prone to inter- and intraobserver variations. Magnetic resonance imaging (MRI) provides good soft tissue contrast, and functional MRI captures tissue properties that may be valuable for tumor delineation. We explored MRI-based automatic segmentation of rectal cancer using a deep learning (DL) approach. We first investigated potential improvements when including both anatomical T2-weighted (T2w) MRI and diffusion-weighted MR images (DWI). Secondly, we investigated generalizability by including a second, independent cohort. MATERIAL AND METHODS Two cohorts of rectal cancer patients (C1 and C2) from different hospitals with 109 and 83 patients, respectively, were subject to 1.5 T MRI at baseline. T2w images were acquired for both cohorts and DWI (b-value of 500 s/mm2) for patients in C1. Tumors were manually delineated by three radiologists (two in C1, one in C2). A 2D U-Net was trained on T2w and T2w + DWI. Optimal parameters for image pre-processing and training were identified on C1 using five-fold cross-validation and patient Dice similarity coefficient (DSCp) as performance measure. The optimized models were evaluated on a C1 hold-out test set and the generalizability was investigated using C2. RESULTS For cohort C1, the T2w model resulted in a median DSCp of 0.77 on the test set. Inclusion of DWI did not further improve the performance (DSCp 0.76). The T2w-based model trained on C1 and applied to C2 achieved a DSCp of 0.59. CONCLUSION T2w MR-based DL models demonstrated high performance for automatic tumor segmentation, at the same level as published data on interobserver variation. DWI did not improve results further. Using DL models on unseen cohorts requires caution, and one cannot expect the same performance.
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Affiliation(s)
- Franziska Knuth
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingvild Askim Adde
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bao Ngoc Huynh
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
| | | | - René Mario Winter
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Negård
- Department of Radiology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Sebastian Meltzer
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
| | - Anne Hansen Ree
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
| | - Kjersti Flatmark
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway
| | - Svein Dueland
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Knut Håkon Hole
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Therese Seierstad
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Kathrine Røe Redalen
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
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Li J, Lin L, Gao X, Li S, Cheng J. Amide Proton Transfer Weighted and Intravoxel Incoherent Motion Imaging in Evaluation of Prognostic Factors for Rectal Adenocarcinoma. Front Oncol 2022; 11:783544. [PMID: 35047400 PMCID: PMC8761907 DOI: 10.3389/fonc.2021.783544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives To analyze the value of amide proton transfer (APT) weighted and intravoxel incoherent motion (IVIM) imaging in evaluation of prognostic factors for rectal adenocarcinoma, compared with diffusion weighted imaging (DWI). Materials and Methods Preoperative pelvic MRI data of 110 patients with surgical pathologically confirmed diagnosis of rectal adenocarcinoma were retrospectively evaluated. All patients underwent high-resolution T2-weighted imaging (T2WI), APT, IVIM, and DWI. Parameters including APT signal intensity (APT SI), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADC) were measured in different histopathologic types, grades, stages, and structure invasion statuses. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy, and the corresponding area under the curves (AUCs) were calculated. Results APT SI, D and ADC values of rectal mucinous adenocarcinoma (MC) were significantly higher than those of rectal common adenocarcinoma (AC) ([3.192 ± 0.661%] vs. [2.333 ± 0.471%], [1.153 ± 0.238×10-3 mm2/s] vs. [0.792 ± 0.173×10-3 mm2/s], and [1.535 ± 0.203×10-3 mm2/s] vs. [0.986 ± 0.124×10-3 mm2/s], respectively; all P<0.001). In AC group, the APT SI and D values showed significant differences between low- and high-grade tumors ([2.226 ± 0.347%] vs. [2.668 ± 0.638%], and [0.842 ± 0.148×10-3 mm2/s] vs. [0.777 ± 0.178×10-3 mm2/s], respectively, both P<0.05). The D value had significant difference between positive and negative extramural vascular invasion (EMVI) tumors ([0.771 ± 0.175×10-3 mm2/s] vs. [0.858 ± 0.151×10-3 mm2/s], P<0.05). No significant difference of APT SI, D, D*, f or ADC was observed in different T stages, N stages, perineural and lymphovascular invasions (all P>0.05). The ROC curves showed that the AUCs of APT SI, D and ADC values for distinguishing MC from AC were 0.921, 0.893 and 0.995, respectively. The AUCs of APT SI and D values in distinguishing low- from high-grade AC were 0.737 and 0.663, respectively. The AUC of the D value for evaluating EMVI involvement was 0.646. Conclusion APT and IVIM were helpful to assess the prognostic factors related to rectal adenocarcinoma, including histopathological type, tumor grade and the EMVI status.
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Affiliation(s)
- Juan Li
- Department of Magnetic Resonance Imaging (MRI), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liangjie Lin
- Advanced Technical Support, Philips Healthcare, Beijing, China
| | - Xuemei Gao
- Department of Magnetic Resonance Imaging (MRI), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shenglei Li
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging (MRI), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Low-Rank Matrix Denoising Algorithm-Based MRI Image Feature for Therapeutic Effect Evaluation of NCRT on Rectal Cancer. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:3080640. [PMID: 34880974 PMCID: PMC8648445 DOI: 10.1155/2021/3080640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to explore the therapeutic effects of neoadjuvant chemoradiotherapy (NCRT) on rectal cancer patients using the MRI based on low-rank matrix denoising algorithm, which was then compared with the postoperative pathological examination to evaluate its application value in tumor staging after NCRT treatment. 15 patients with rectal cancer who met the requirements of radiotherapy and chemotherapy after conventional MRI were selected as the research subjects. The conventional MRI images before and after NCRT treatment were divided in two groups. One group was not processed and set as the conventional group; the other group was processed with low-rank matrix denoising algorithm and set as the optimized group. The two groups of images were observed for the changes in the ADC value and length and thickness of the tumor before and after NCRT treatment. The two groups were compared with the pathological examination for the complete remission of pathology (pCR) after the NCRT treatment and the tumor stage results. The results showed that Root Mean Square Error (RMSE) and Peak Signal to Noise Ratio (PSNR) (18.9121 and 74.9911 dB) after introducing the low-rank matrix denoising algorithm were significantly better than those before (20.1234 and 70.1234 dB) (P < 0.05); there were notable differences in the tumor index data within the two groups before and after NCRT treatment (P < 0.05), indicating that the NCRT treatment was effective. The pathological examination results of pCR data of the two groups were not much different (P > 0.05); the examination results between the two groups were different, but no notable difference was noted (P < 0.05); in the optimized group, there was no notable difference between the MRI results and the pathological examination results (P < 0.05), while in the conventional group, there were notable differences in the MRI results and pathological examination results (P < 0.05). In conclusion, MRI images based on low-rank matrix denoising algorithm are clearer, which can improve the diagnosis rate of patients and better display the changes of the microenvironment after NCRT treatment. It also indicates that NCRT treatment has significant clinical effects in the treatment of rectal cancer patients, which is worth promoting.
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Luo H, He L, Cheng W, Gao S. The diagnostic value of intravoxel incoherent motion imaging in differentiating high-grade from low-grade gliomas: a systematic review and meta-analysis. Br J Radiol 2021; 94:20201321. [PMID: 33876653 DOI: 10.1259/bjr.20201321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This meta-analysis was carried out for assessing the accuracy of intravoxel incoherent motion (IVIM) parameters true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) in differentiating low-grade gliomas (LGGs) from high-grade gliomas (HGGs). METHODS Literatures concerning IVIM in the grading of brain gliomas published prior to October 20, 2020, searched in the Embase, PubMed, and Cochrane library. Use the quality assessment of diagnostic accuracy studies 2 (QUADAS 2) to evaluate the quality of studies. We estimated the pooled sensitivity, specificity, and the area under the summary ROC (SROC) curve to identification the accuracy of IVIM parameters D, D*, and f evaluation in grading gliomas. RESULTS Totally, 6 articles including 252 brain gliomas conform to the inclusion criteria. The pooled sensitivity of parameters D, D*, and f derived from IVIM were 0.85 (95%Cl, 0.76-0.91), 0.78 (95%Cl, 0.71-0.85), and 0.89 (95%Cl, 0.76-0.96), respectively. The pooled specificity were 0.78 (95%Cl, 0.60-0.90), 0.68 (95%Cl, 0.56-0.79), and 0.88 (95%Cl, 0.76-0.94), respectively. Meanwhile, the AUC of SROC curve were 0.89 (95%Cl, 0.86-0.92) , 0.81 (95%Cl, 0.77-0.84), and 0.94 (95%Cl, 0.92-0.96), respectively. CONCLUSION This meta-analysis suggested that IVIM parameters D, D*, and f have moderate or high diagnosis value accuracy in differentiating HGGs from LGGs, and the parameter f has greater sensitivity and specificity. Standardized methodology is warranted to guide the use of this method for clinical decision-making. However, more clinical studies are needed to prove our view. ADVANCES IN KNOWLEDGE IVIM parameter f showed greater sensitivity and specificity, as well as excellent performance than parameter D* and D.
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Affiliation(s)
- Hechuan Luo
- Department of Radiology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Ling He
- Department of Radiology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Weiqin Cheng
- Department of Radiology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Sijie Gao
- Department of Radiology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
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Bakke KM, Meltzer S, Grøvik E, Negård A, Holmedal SH, Gjesdal KI, Bjørnerud A, Ree AH, Redalen KR. Sex Differences and Tumor Blood Flow from Dynamic Susceptibility Contrast MRI Are Associated with Treatment Response after Chemoradiation and Long-term Survival in Rectal Cancer. Radiology 2020; 297:352-360. [PMID: 32870132 DOI: 10.1148/radiol.2020200287] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background MRI is the standard tool for rectal cancer staging. However, more precise diagnostic tests that can assess biologic tumor features decisive for treatment outcome are necessary. Tumor perfusion and hypoxia are two important features; however, no reference methods that measure these exist in clinical use. Purpose To assess the potential predictive and prognostic value of MRI-assessed rectal cancer perfusion, as a surrogate measure of hypoxia, for local treatment response and survival. Materials and Methods In this prospective observational cohort study, 94 study participants were enrolled from October 2013 to December 2017 (ClinicalTrials.gov: NCT01816607). Participants had histologically confirmed rectal cancer and underwent routine diagnostic MRI, an extended diffusion-weighted sequence, and a multiecho dynamic contrast agent-based sequence. Predictive and prognostic values of dynamic contrast-enhanced, dynamic susceptibility contrast (DSC), and intravoxel incoherent motion MRI were investigated with response to neoadjuvant treatment, progression-free survival, and overall survival as end points. Secondary objectives investigated potential sex differences in MRI parameters and relationship with lymph node stage. Statistical methods used were Cox regression, Student t test, and Mann-Whitney U test. Results A total of 94 study participants (mean age, 64 years ± 11 [standard deviation]; 61 men) were evaluated. Baseline tumor blood flow from DSC MRI was lower in patients who had poor local tumor response to neoadjuvant treatment (96 mL/min/100 g ± 33 for ypT2-4, 120 mL/min/100 g ± 21 for ypT0-1; P = .01), shorter progression-free survival (hazard ratio = 0.97; 95% confidence interval: 0.96, 0.98; P < .001), and shorter overall survival (hazard ratio = 0.98; 95% confidence interval: 0.98, 0.99; P < .001). Women had higher blood flow (125 mL/min/100 g ± 27) than men (74 mL/min/100 g ± 26, P < .001) at stage 4. Volume transfer constant and plasma volume from dynamic contrast-enhanced MRI as well as ΔR2* peak and area under the curve for 30 and 60 seconds from DSC MRI were associated with local malignant lymph nodes (pN status). Median area under the curve for 30 seconds was 0.09 arbitrary units (au) ± 0.03 for pN1-2 and 0.19 au ± 0.12 for pN0 (P = .001). Conclusion Low tumor blood flow from dynamic susceptibility contrast MRI was associated with poor treatment response in study participants with rectal cancer. © RSNA, 2020 Online supplemental material is available for this article.
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Affiliation(s)
- Kine M Bakke
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Sebastian Meltzer
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Endre Grøvik
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Anne Negård
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Stein H Holmedal
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Kjell-Inge Gjesdal
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Atle Bjørnerud
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Anne H Ree
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Kathrine R Redalen
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
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Iima M. Perfusion-driven Intravoxel Incoherent Motion (IVIM) MRI in Oncology: Applications, Challenges, and Future Trends. Magn Reson Med Sci 2020; 20:125-138. [PMID: 32536681 PMCID: PMC8203481 DOI: 10.2463/mrms.rev.2019-0124] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Recent developments in MR hardware and software have allowed a surge of interest in intravoxel incoherent motion (IVIM) MRI in oncology. Beyond diffusion-weighted imaging (and the standard apparent diffusion coefficient mapping most commonly used clinically), IVIM provides information on tissue microcirculation without the need for contrast agents. In oncology, perfusion-driven IVIM MRI has already shown its potential for the differential diagnosis of malignant and benign tumors, as well as for detecting prognostic biomarkers and treatment monitoring. Current developments in IVIM data processing, and its use as a method of scanning patients who cannot receive contrast agents, are expected to increase further utilization. This paper reviews the current applications, challenges, and future trends of perfusion-driven IVIM in oncology.
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Affiliation(s)
- Mami Iima
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine.,Department of Clinical Innovative Medicine, Institute for Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital
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