Equivalent cross-relaxation rate imaging for sentinel lymph node biopsy in breast carcinoma

Correlation between equivalent cross-relaxation rate and cellular density in soft tissue tumors

OBJECTIVE

Equivalent cross-relaxation rate (ECR) imaging (ECRI), which allows quantitation of macromolecular tissue components, is a potentially useful nuclear magnetic resonance (NMR) technique for histopathological diagnosis. The purpose of this study was to compare ECR values among various histological types and assess the correlation between ECR and tumor cellular image in soft tissue tumors.

MATERIALS AND METHODS

We performed ECRI to evaluate cellular images of soft tissue tumors and tumorous lesions. Thirty-three patients who underwent evaluation with MRI and ECRI at the first visit were enrolled. Resection or biopsy was performed to obtain a histopathological diagnosis, followed by cell density measurement. ECR values of the histological subgroups were compared, and the correlation between ECR and cell density was analyzed to assess whether ECR can be used as an indicator of histological cell density.

RESULTS

ECR values for benign tumors varied widely and were not significantly different from those for malignant tumors. However, the mean ECR value was significantly higher for high-grade malignant tumors than for low-grade tumors (p < 0.01). Moreover, a positive correlation was found between ECR and cell density (r s = 0.72; p < 0.01).

CONCLUSIONS

ECR reflects the cell density and malignancy grade of a soft tissue tumor. ECRI could provide cellular imaging and useful clinical information to aid the pre-operative diagnosis of soft tissue tumors.

Evaluation of parotid gland function using equivalent cross-relaxation rate imaging applied magnetization transfer effect

Safe imaging modalities are needed for evaluating parotid gland function. The aim of this study was to validate the utility of a magnetic resonance imaging (MRI) tool, equivalent cross-relaxation rate imaging (ECRI), as a measurement of parotid gland function after chemoradiotherapy. Subjects comprised 18 patients with head-neck cancer who underwent ECRI and salivary gland scintigraphy. First, we calculated ECR values (signal intensity on ECRI), maximum uptake rate (MUR) and washout rate (WOR) from salivary gland scintigraphy data at the parotid glands. Second, we investigated correlations between ECR values and each parameter of MUR (uptake function) and WOR (secretory function) obtained by salivary gland scintigraphy at the parotid gland. Next, we investigated each dose-response for ECR, MUR and WOR at the parotid gland. A correlation was detected between ECR values and MUR in both the pre- (r = -0.55, p < 0.01) and post-treatment (r = -0.50, p < 0.05) groups. A significant post-treatment correlation was detected between the percentage change in ECR values at 3-5 months after chemoradiotherapy and median dose to the parotid gland (Pearson correlation, r = -0.62, p < 0.05). However, no correlations were detected between median dose to the parotid gland and either MUR or WOR. ECRI is a new imaging tool for evaluating the uptake function of the parotid gland after chemoradiotherapy.

Cellular Imaging Using Equivalent Cross-Relaxation Rate Technique in Rabbit VX-2 Tumor Model

Purpose:

Equivalent cross-relaxation rate (ECR) imaging (ECRI) is a measurement technique that can be used to quantitatively evaluate changes in structural organization and cellular density by MRI. The aim of this study was to evaluate the correlation between the ECR value and cellular density in the rabbit VX2 tumor model.

Materials and methods:

Five rabbits implanted with 10 VX2 tumors in the femur muscles were included in this study. We adopted the off-resonance technique with a single saturation transfer pulse frequency of 7 ppm downfield from water resonance. The ECR value was defined as the percentage of signal loss between the unsaturated and saturated images. ECR images were constructed based on the percentage of the ECR value. Pathological specimens were divided into 34 areas and classified into two groups: the viable group and the necrotic group. ECR values were measured and compared between groups. The correlation between the ECR value and cellular density was then determined.

Results:

The mean ECR value was significantly higher in the viable group than in the necrotic group (61.2% vs. 35.8%). The area under the curve that calculated by receiver operating characteristic curve was 0.991 at 7 ppm. The regression graph showed a linear relationship between the ECR value and cellular density; the correlation coefficient (r) was 0.858.

Conclusion:

There is a strong association between the ECR value and cellular density in VX2 tumors and so ECRI could be a potentially useful technique for accurately depicting viable and necrotic areas.

Comparative 1H NMR studies of saturation transfer in copolymer gels and mouse lenses

Saturation transfer in cross-linked copolymer gels and excised intact and perforating trauma-induced cataract mouse lenses (4- or 8-week-old) were studied using intermolecular cross-relaxation rates (1/T(IS)(H(2)O); 1/T(IS)), monitored with f(2)-irradiation at -8.79, -4.00, and 7.13 ppm (gammaH(2)/2pi approximately 69 Hz). [1] The 1/T(IS)(7.13 ppm) vs dry weight [W (%)] profiles for hydrophilic copolymer gels were far steeper than those for hydrophobic copolymer gels, indicating the participation of an amount of bound water and a number of copolymer hydroxyl groups in the saturation transfer process. In contrast, the 1/T(IS)(-8.79 ppm) vs W (%) profiles exhibited little difference between the hydrophilic and hydrophobic copolymer gels, indicating the major participation of molecular rigidity, i.e. W (%) in the saturation transfer process. [2] The 1/T(IS)(7.13 ppm) values for cataractous mouse lenses were larger than those for intact lenses, indicating the formation of large, immobile lens protein associates or aggregates containing a sufficient amount of bound water for the saturation transfer. [3] The 1/T(IS)(7.13 ppm) vs W (%) profiles for the hydrophilic copolymer gels exhibited similar characteristics to the intact and cataractous mouse lenses with regard to the saturation transfer process.

Cellular density evaluation for malignant lymphoma using equivalent cross-relaxation rate imaging - initial experience

Objective

Equivalent cross-relaxation rate (ECR) imaging is an MRI technique used to evaluate quantitatively a change in the protein-water interaction. We aimed to evaluate retrospectively the usefulness of ECR imaging for the histologic classification of malignant lymphoma (ML).

Materials and Methods

Institutional Review Board approval was obtained and all patients provided informed consent. The study subjects included 15 patients with untreated ML who were histologically diagnosed with follicular lymphoma (FL; n = 8) or diffuse large B-cell lymphoma (DLBCL; n = 7). All patients underwent ECR imaging and the offset frequency was set at 7 ppm.

Results

The median ECR values were 71% (range; 60.7 to 75.5) in FL and 54% (50.8 to 59.4) in DLBCL (p = 0.001). The median cellular density was 1.5 ± 0.17 × 10⁶ / mm² in FL and 1.0 ± 0.70 × 10⁶ / mm² in DLBCL (p = 0.001). The correlation coefficient between the ECR values and cellular density in ML was 0.88 (p = 0.001). In FL and DLBCL, assuming ECR value cut-off points of 60%, both sensitivity and specificity were 100%.

Conclusion

A strong correlation between ECR and cellular density in ML is demonstrated and the ECR may be a useful technique to differentiate between FL and DLBCL.

Equivalent cross-relaxation rate imaging of axillary lymph nodes in breast cancer

PURPOSE

To determine whether equivalent cross-relaxation rate (ECR) imaging (ECRI) is a feasible method for optimization of axillary lymph node dissection (ALND) and thereby improve quality-of-life (QOL).

MATERIALS AND METHODS

A total of 50 breast cancer patients underwent ECRI, with off-resonance saturation pulse at frequency offset of 5 ppm. ECR threshold values were determined to evaluate metastases to lymph nodes in the ALND group before examining the relationship between ECR value and cellular density. Metastases to lymph nodes of the sentinel lymph node biopsy (SLNB) group were evaluated based on the results of the ALND group.

RESULTS

In the ALND group, regions without metastases showed a higher cellular density and ECR value than those with metastases. The relationship of ECR value to cellular density formed two clusters according to the presence or absence of metastasis; cellular density was related to ECR value for both clusters. In the SLNB group, supposing a threshold ECR value of 80%, sensitivity and specificity were 88.2% and 100%, respectively.

CONCLUSION

ECRI is a potentially useful method for cellular density imaging of axillary lymph nodes. ECRI provides active information that enables ALND to be avoided, thus improving QOL.

Modeling pulsed magnetization transfer

Modeling the effects of clinical magnetization transfer (MT) scans, which generate contrast using short, shaped radiofrequency (RF) pulses (pulsed MT), is complex and time-consuming. As a result, several studies have proposed approximate methods for a simplified analysis of the experimental data. However, potential differences in the MT parameters estimated by each method may complicate the comparison of reported results. In this study we evaluated three approximate methods currently used in quantitative MT (qMT) studies. In the first part of the investigation, an MT modeling technique that makes minimal approximations, other than the use of a two-pool tissue representation, was developed and validated. Subsequently, this technique served as a standard against which to evaluate the other, more approximate models. Each model was used to fit experimental data from samples of wild-type (WT) and shiverer mouse spinal cord, as well as simulated data generated by our minimal approximation modeling technique. The results of this study demonstrate that the approximations used in pulsed MT modeling are quite robust. In particular, it was shown that the semisolid pool fraction, M(0)(B), which is known to correlate strongly with myelin content, and the transverse relaxation time of macromolecular protons, T(2)(B), could be evaluated with reasonable accuracy regardless of the model used.