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Skwierawska D, Laun FB, Wenkel E, Kapsner LA, Janka R, Uder M, Ohlmeyer S, Bickelhaupt S. Diffusion-Weighted Imaging for Skin Pathologies of the Breast-A Feasibility Study. Diagnostics (Basel) 2024; 14:934. [PMID: 38732348 PMCID: PMC11083106 DOI: 10.3390/diagnostics14090934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Several breast pathologies can affect the skin, and clinical pathways might differ significantly depending on the underlying diagnosis. This study investigates the feasibility of using diffusion-weighted imaging (DWI) to differentiate skin pathologies in breast MRIs. This retrospective study included 88 female patients who underwent diagnostic breast MRI (1.5 or 3T), including DWI. Skin areas were manually segmented, and the apparent diffusion coefficients (ADCs) were compared between different pathologies: inflammatory breast cancer (IBC; n = 5), benign skin inflammation (BSI; n = 11), Paget's disease (PD; n = 3), and skin-involved breast cancer (SIBC; n = 11). Fifty-eight women had healthy skin (H; n = 58). The SIBC group had a significantly lower mean ADC than the BSI and IBC groups. These differences persisted for the first-order features of the ADC (mean, median, maximum, and minimum) only between the SIBC and BSI groups. The mean ADC did not differ significantly between the BSI and IBC groups. Quantitative DWI assessments demonstrated differences between various skin-affecting pathologies, but did not distinguish clearly between all of them. More extensive studies are needed to assess the utility of quantitative DWI in supplementing the diagnostic assessment of skin pathologies in breast imaging.
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Affiliation(s)
- Dominika Skwierawska
- Institute of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
| | - Frederik B. Laun
- Institute of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
| | - Evelyn Wenkel
- Radiologie München, Burgstraße 7, 80331 München, Germany
- Medical Faculty, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Lorenz A. Kapsner
- Institute of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
- Chair of Medical Informatics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Wetterkreuz 15, 91058 Erlangen-Tennenlohe, Germany
| | - Rolf Janka
- Institute of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
| | - Sabine Ohlmeyer
- Institute of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
| | - Sebastian Bickelhaupt
- Institute of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
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Nissan N, Ochoa-Albiztegui RE, Fruchtman H, Gluskin J, Eskreis-Winkler S, Horvat JV, Kosmidou I, Meng A, Pinker K, Jochelson MS. Breast MRI in patients with implantable loop recorder: initial experience. Eur Radiol 2024; 34:155-164. [PMID: 37555957 PMCID: PMC11181953 DOI: 10.1007/s00330-023-10025-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/10/2023] [Accepted: 06/13/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVES To investigate the feasibility of breast MRI exams and guided biopsies in patients with an implantable loop recorder (ILR) as well as the impact ILRs may have on image interpretation. MATERIALS AND METHODS This retrospective study examined breast MRIs of patients with ILR, from April 2008 to September 2022. Radiological reports and electronic medical records were reviewed for demographic characteristics, safety concerns, and imaging findings. MR images were analyzed and compared statistically for artifact quantification on the various pulse sequences. RESULTS Overall, 40/82,778 (0.049%) MRIs during the study period included ILR. All MRIs were completed without early termination. No patient-related or device-related adverse events occurred. ILRs were most commonly located in the left lower-inner quadrant (64.6%). The main artifact was a signal intensity (SI) void in a dipole formation in the ILR bed with or without areas of peripheral high SI. Artifacts appeared greatest in the cranio-caudal axis (p < 0.001), followed by the anterior-posterior axis (p < 0.001), and then the right-left axis. High peripheral rim-like SI artifacts appeared on the post-contrast and subtracted T1-weighted images, mimicking suspicious enhancement. Artifacts were most prominent on diffusion-weighted (p < 0.001), followed by T2-weighted and T1-weighted images. In eight patients, suspicious findings were found on MRI, resulting in four additional malignant lesions. Of six patients with left breast cancer, the tumor was completely visible in five cases and partially obscured in one. CONCLUSION Breast MRI is feasible and safe among patients with ILR and may provide a significant diagnostic value, albeit with localized, characteristic artifacts. CLINICAL RELEVANCE STATEMENT Indicated breast MRI exams and guided biopsies can be safely performed in patients with implantable loop recorder. Nevertheless, radiologists should be aware of associated limitations including limited assessment of the inner left breast and pseudo-enhancement artifacts. KEY POINTS • Breast MRI in patients with an implantable loop recorder is an infrequent, feasible, and safe procedure. • Despite limited breast visualization of the implantable loop recorder bed and characteristic artifacts, MRI depicted additional lesions in 8/40 (20%) of cases, half of which were malignant. • Breast MRI in patients with an implantable loop recorder should be performed when indicated, taking into consideration typical associated artifacts.
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Affiliation(s)
- Noam Nissan
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | | | - Hila Fruchtman
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Jill Gluskin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Sarah Eskreis-Winkler
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Joao V Horvat
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ioanna Kosmidou
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Alicia Meng
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Katja Pinker
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Maxine S Jochelson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
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Moran CJ, Middione MJ, Mazzoli V, McKay-Nault JA, Guidon A, Waheed U, Rosen EL, Poplack SP, Rosenberg J, Ennis DB, Hargreaves BA, Daniel BL. Multishot Diffusion-Weighted MRI of the Breasts in the Supine vs. Prone Position. J Magn Reson Imaging 2023; 58:951-962. [PMID: 36583628 PMCID: PMC10310889 DOI: 10.1002/jmri.28582] [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: 12/30/2021] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) may allow for breast cancer screening MRI without a contrast injection. Multishot methods improve prone DWI of the breasts but face different challenges in the supine position. PURPOSE To establish a multishot DWI (msDWI) protocol for supine breast MRI and to evaluate the performance of supine vs. prone msDWI. STUDY TYPE Prospective. POPULATION Protocol optimization: 10 healthy women (ages 22-56), supine vs. prone: 24 healthy women (ages 22-62) and five women (ages 29-61) with breast tumors. FIELD STRENGTH/SEQUENCE 3-T, protocol optimization msDWI: free-breathing (FB) 2-shots, FB 4-shots, respiratory-triggered (RT) 2-shots, RT 4-shots, supine vs. prone: RT 4-shot msDWI, T2-weighted fast-spin echo. ASSESSMENT Protocol optimization and supine vs. prone: three observers performed an image quality assessment of sharpness, aliasing, distortion (vs. T2), perceived SNR, and overall image quality (scale of 1-5). Apparent diffusion coefficients (ADCs) in fibroglandular tissue (FGT) and breast tumors were measured. STATISTICAL TESTS Effect of study variables on dichotomized ratings (4/5 vs. 1/2/3) and FGT ADCs were assessed with mixed-effects logistic regression. Interobserver agreement utilized Gwet's agreement coefficient (AC). Lesion ADCs were assessed by Bland-Altman analysis and concordance correlation (ρc ). P value <0.05 was considered statistically significant. RESULTS Protocol optimization: 4-shots significantly improved sharpness and distortion; RT significantly improved sharpness, aliasing, perceived SNR, and overall image quality. FGT ADCs were not significantly different between shots (P = 0.812), FB vs. RT (P = 0.591), or side (P = 0.574). Supine vs. prone: supine images were rated significantly higher for sharpness, aliasing, and overall image quality. FGT ADCs were significantly higher supine; lesion ADCs were highly correlated (ρc = 0.92). DATA CONCLUSION Based on image quality, supine msDWI outperformed prone msDWI. Lesion ADCs were highly correlated between the two positions, while FGT ADCs were higher in the supine position. EVIDENCE LEVEL 2. TECHNICAL EFFICACY Stage 1.
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Affiliation(s)
| | | | - Valentina Mazzoli
- Department of Radiology, Stanford University, Stanford, California, USA
| | | | - Arnaud Guidon
- Global MR Application and Workflow, GE Healthcare, Boston, Massachusetts, USA
| | - Uzma Waheed
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Eric L. Rosen
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Steven P. Poplack
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Jarrett Rosenberg
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Daniel B. Ennis
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Brian A. Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Bruce L. Daniel
- Department of Radiology, Stanford University, Stanford, California, USA
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Franklin SL, Schuurmans M, Otikovs M, Borman PTS, van Osch MJP, Bos C. Arterial spin labeling using spatio-temporal encoding readout for robust perfusion imaging in inhomogenous magnetic fields. Magn Reson Med 2023; 89:1092-1101. [PMID: 36420871 PMCID: PMC10099794 DOI: 10.1002/mrm.29506] [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: 11/30/2021] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the feasibility of spatio-temporal encoding (SPEN) readout for pseudo-continuous ASL (pCASL) in brain, and its robustness to susceptibility artifacts as introduced by aneurysm clips. METHODS A 2D self-refocused T2 *-compensated hybrid SPEN scheme, with super-resolution reconstruction was implemented on a 1.5T Philips system. Q (=BWchirp *Tchirp ) was varied and, the aneurysm clip-induced artifact was evaluated in phantom (label-images) as well as in vivo (perfusion-weighted signal (PWS)-maps and temporal SNR (tSNR)). In vivo results were compared to gradient-echo EPI (GE-EPI) and spin-echo EPI (SE-EPI). The dependence of tSNR on TR was evaluated separately for SPEN and SE-EPI. SPEN with Q ˜ 75 encodes with the same off-resonance robustness as EPI. RESULTS The clip-induced artifact with SPEN decreased with increase in Q, and was smaller compared to SE-EPI and GE-EPI in vivo. tSNR decreased with Q and the tSNR of GE-EPI and SE-EPI corresponded to SPEN with a Q-value of approximately ˜85 and ˜108, respectively. In addition, SPEN perfusion images showed a higher tSNR (p < 0.05) for TR = 4000 ms compared to TR = 2100 ms, while SE-EPI did not. tSNR remained relatively stable when the time between SPEN-excitation and start of the next labeling-module was more than ˜1000 ms. CONCLUSION Feasibility of combining SPEN with pCASL imaging was demonstrated, enabling cerebral perfusion measurements with a higher robustness to field inhomogeneity (Q > 75) compared to SE-EPI and GE-EPI. However, the SPEN chirp-pulse saturates incoming blood, thereby reducing pCASL labeling efficiency of the next acquisition for short TRs. Future developments are needed to enable 3D scanning.
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Affiliation(s)
- Suzanne L Franklin
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.,C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Megan Schuurmans
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martins Otikovs
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel
| | - Pim T S Borman
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Matthias J P van Osch
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Clemens Bos
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
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Solomon E, Lemberskiy G, Baete S, Hu K, Malyarenko D, Swanson S, Shukla-Dave A, Russek SE, Zan E, Kim SG. Time-dependent diffusivity and kurtosis in phantoms and patients with head and neck cancer. Magn Reson Med 2023; 89:522-535. [PMID: 36219464 PMCID: PMC9712275 DOI: 10.1002/mrm.29457] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE To assess the reliability of measuring diffusivity, diffusional kurtosis, and cellular-interstitial water exchange time with long diffusion times (100-800 ms) using stimulated-echo DWI. METHODS Time-dependent diffusion MRI was tested on two well-established diffusion phantoms and in 5 patients with head and neck cancer. Measurements were conducted using an in-house diffusion-weighted STEAM-EPI pulse sequence with multiple diffusion times at a fixed TE on three scanners. We used the weighted linear least-squares fit method to estimate time-dependent diffusivity,D ( t ) $$ D(t) $$ , and diffusional kurtosis,K ( t ) $$ K(t) $$ . Additionally, the Kärger model was used to estimate cellular-interstitial water exchange time (τ ex $$ {\tau}_{ex} $$ ) fromK ( t ) $$ K(t) $$ . RESULTS Diffusivity measured by time-dependent STEAM-EPI measurements and commercial SE-EPI showed comparable results with R2 above 0.98 and overall 5.4 ± 3.0% deviation across diffusion times. Diffusional kurtosis phantom data showed expected patterns: constantD $$ D $$ andK $$ K $$ = 0 for negative controls and slow varyingD $$ D $$ andK $$ K $$ for samples made of nanoscopic vesicles. Time-dependent diffusion MRI in patients with head and neck cancer found that the Kärger model could be considered valid in 72% ± 23% of the voxels in the metastatic lymph nodes. The median cellular-interstitial water exchange time estimated for lesions was between 58.5 ms and 70.6 ms. CONCLUSIONS Based on two well-established diffusion phantoms, we found that time-dependent diffusion MRI measurements can provide stable diffusion and kurtosis values over a wide range of diffusion times and across multiple MRI systems. Moreover, estimation of cellular-interstitial water exchange time can be achieved using the Kärger model for the metastatic lymph nodes in patients with head and neck cancer.
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Affiliation(s)
- Eddy Solomon
- Department of Radiology, MRI Research Institute, Weill Cornell Medical College, New York, NY, United States
| | - Gregory Lemberskiy
- Department of Radiology, MRI Research Institute, Weill Cornell Medical College, New York, NY, United States
| | - Steven Baete
- Department of Radiology, MRI Research Institute, Weill Cornell Medical College, New York, NY, United States
| | - Kenneth Hu
- Department of Radiation Oncology, New York University, New York, NY, United States
| | - Dariya Malyarenko
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Scott Swanson
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Amita Shukla-Dave
- Departments of Medical Physics and Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Stephen E Russek
- National Institute of Standards and Technology, Boulder, CO, United States
| | - Elcin Zan
- Department of Radiology, MRI Research Institute, Weill Cornell Medical College, New York, NY, United States
| | - Sungheon Gene Kim
- Department of Radiology, MRI Research Institute, Weill Cornell Medical College, New York, NY, United States
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Cho P, Park CS, Park GE, Kim SH, Kim HS, Oh SJ. Diagnostic Usefulness of Diffusion-Weighted MRI for Axillary Lymph Node Evaluation in Patients with Breast Cancer. Diagnostics (Basel) 2023; 13:diagnostics13030513. [PMID: 36766617 PMCID: PMC9914452 DOI: 10.3390/diagnostics13030513] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/20/2023] [Accepted: 01/21/2023] [Indexed: 02/01/2023] Open
Abstract
This study aimed to determine whether apparent diffusion coefficient (ADC) and morphological features on diffusion-weighted MRI (DW-MRI) can discriminate metastatic axillary lymph nodes (ALNs) from benign in patients with breast cancer. Two radiologists measured ADC, long and short diameters, long-to-short diameter ratio, and cortical thickness and assessed eccentric cortical thickening, loss of fatty hilum, irregular margin, asymmetry in shape or number, and rim sign of ALNs on DW-MRI and categorized them into benign or suspicious ALNs. Pathologic reports were used as a reference standard. Statistical analysis was performed using the Mann-Whitney U test and chi-square test. Overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of DW-MRI were calculated. The ADC of metastatic ALNs was 0.905 × 10-3 mm2/s, and that of benign ALNs was 0.991 × 10-3 mm2/s (p = 0.243). All morphologic features showed significant difference between the two groups. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the final categorization on DW-MRI were 77.1%, 93.3%, 79.4%, 92.5%, and 86.2%, respectively. Our results suggest that morphologic evaluation of ALNs on DWI can discriminate metastatic ALNs from benign. The ADC value of metastatic ALNs was lower than that of benign nodes, but the difference was not statistically significant.
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Affiliation(s)
- Pyeonghwa Cho
- Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea School of Medicine, Seoul 21431, Republic of Korea
| | - Chang Suk Park
- Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea School of Medicine, Seoul 21431, Republic of Korea
- Correspondence: ; Tel.: +82-32-280-7305; Fax: +82-32-280-5192
| | - Ga Eun Park
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea School of Medicine, Seoul 06591, Republic of Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea School of Medicine, Seoul 06591, Republic of Korea
| | - Hyeon Sook Kim
- Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea School of Medicine, Seoul 21431, Republic of Korea
| | - Se-Jeong Oh
- Department of General Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea School of Medicine, Seoul 21431, Republic of Korea
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Springer CS, Baker EM, Li X, Moloney B, Pike MM, Wilson GJ, Anderson VC, Sammi MK, Garzotto MG, Kopp RP, Coakley FV, Rooney WD, Maki JH. Metabolic activity diffusion imaging (MADI): II. Noninvasive, high-resolution human brain mapping of sodium pump flux and cell metrics. NMR IN BIOMEDICINE 2023; 36:e4782. [PMID: 35654761 DOI: 10.1002/nbm.4782] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 06/15/2023]
Abstract
We introduce a new 1 H2 O magnetic resonance approach: metabolic activity diffusion imaging (MADI). Numerical diffusion-weighted imaging decay simulations characterized by the mean cellular water efflux (unidirectional) rate constant (kio ), mean cell volume (V), and cell number density (ρ) are produced from Monte Carlo random walks in virtual stochastically sized/shaped cell ensembles. Because of active steady-state trans-membrane water cycling (AWC), kio reflects the cytolemmal Na+ , K+ ATPase (NKA) homeostatic cellular metabolic rate (c MRNKA ). A digital 3D "library" contains thousands of simulated single diffusion-encoded (SDE) decays. Library entries match well with disparate, animal, and human experimental SDE decays. The V and ρ values are consistent with estimates from pertinent in vitro cytometric and ex vivo histopathological literature: in vivo V and ρ values were previously unavailable. The library allows noniterative pixel-by-pixel experimental SDE decay library matchings that can be used to advantage. They yield proof-of-concept MADI parametric mappings of the awake, resting human brain. These reflect the tissue morphology seen in conventional MRI. While V is larger in gray matter (GM) than in white matter (WM), the reverse is true for ρ. Many brain structures have kio values too large for current, invasive methods. For example, the median WM kio is 22s-1 ; likely reflecting mostly exchange within myelin. The kio •V product map displays brain tissue c MRNKA variation. The GM activity correlates, quantitatively and qualitatively, with the analogous resting-state brain 18 FDG-PET tissue glucose consumption rate (t MRglucose ) map; but noninvasively, with higher spatial resolution, and no pharmacokinetic requirement. The cortex, thalamus, putamen, and caudate exhibit elevated metabolic activity. MADI accuracy and precision are assessed. The results are contextualized with literature overall homeostatic brain glucose consumption and ATP production/consumption measures. The MADI/PET results suggest different GM and WM metabolic pathways. Preliminary human prostate results are also presented.
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Affiliation(s)
- Charles S Springer
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Brenden-Colson Center for Pancreatic Care, Oregon Health & Science University, Portland, Oregon, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA
- Department of Chemical Physiology and Biochemistry, Oregon Health & Science University, Portland, Oregon, USA
| | - Eric M Baker
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Xin Li
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Brenden-Colson Center for Pancreatic Care, Oregon Health & Science University, Portland, Oregon, USA
| | - Brendan Moloney
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Martin M Pike
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA
| | - Gregory J Wilson
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Valerie C Anderson
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Manoj K Sammi
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Mark G Garzotto
- Department of Urology, Portland VA Center, Portland, Oregon, USA
- Department of Urology, Oregon Health & Science University, Portland, Oregon, USA
| | - Ryan P Kopp
- Department of Urology, Portland VA Center, Portland, Oregon, USA
- Department of Urology, Oregon Health & Science University, Portland, Oregon, USA
| | - Fergus V Coakley
- Department of Radiology, Oregon Health & Science University, Portland, Oregon, USA
| | - William D Rooney
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA
| | - Jeffrey H Maki
- Department of Radiology, Anschutz Medical Center, University of Colorado, Aurora, Colorado, USA
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Nissan N, Bauer E, Moss Massasa EE, Sklair-Levy M. Breast MRI during pregnancy and lactation: clinical challenges and technical advances. Insights Imaging 2022; 13:71. [PMID: 35397082 PMCID: PMC8994812 DOI: 10.1186/s13244-022-01214-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/21/2022] [Indexed: 12/12/2022] Open
Abstract
The breast experiences substantial changes in morphology and function during pregnancy and lactation which affects its imaging properties and may reduce the visibility of a concurrent pathological process. The high incidence of benign gestational-related entities may further add complexity to the clinical and radiological evaluation of the breast during the period. Consequently, pregnancy-associated breast cancer (PABC) is often a delayed diagnosis and carries a poor prognosis. This state-of-the-art pictorial review illustrates how despite currently being underutilized, technical advances and new clinical evidence support the use of unenhanced breast MRI during pregnancy and both unenhanced and dynamic-contrast enhanced (DCE) during lactation, to serve as effective supplementary modalities in the diagnostic work-up of PABC.
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Affiliation(s)
- Noam Nissan
- Radiology Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.
- Sackler Medicine School, Tel Aviv University, Tel Aviv, Israel.
| | - Ethan Bauer
- Sackler Medicine School, New-York Program, Tel Aviv University, Tel Aviv, Israel
| | - Efi Efraim Moss Massasa
- Joint Medicine School Program of Sheba Medical Center, St. George's, University of London and the University of Nicosia, Sheba Medical Center, Tel Hashomer, Israel
| | - Miri Sklair-Levy
- Radiology Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel
- Sackler Medicine School, Tel Aviv University, Tel Aviv, Israel
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9
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Single-shell to multi-shell dMRI transformation using spatial and volumetric multilevel hierarchical reconstruction framework. Magn Reson Imaging 2022; 87:133-156. [PMID: 35017034 DOI: 10.1016/j.mri.2021.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 12/21/2021] [Accepted: 12/27/2021] [Indexed: 12/12/2022]
Abstract
Single or Multi-shell high angular resolution diffusion imaging (HARDI) has become an important dMRI acquisition technique for studying brain white matter fibers. Existing single-shell HARDI makes it challenging to estimate the intravoxel structure up to the desired resolution. However, multi-shell acquisition (with multiple b-values) can provide higher resolution for the intravoxel structure, which further helps in getting accurate fiber tracts; But, this comes at the cost of larger acquisition time and larger setup. Hence, we propose a novel deep learning architecture for the reconstruction of diffusion MRI volumes for different b-values (degree of diffusion weighting) using acquisitions at a fixed b-value (termed as single-shell) acquisition. This reconstruction has been performed in the spherical harmonics space to better manage varying gradient directions. In this work, we have demonstrated such a reconstruction for b = 3000 s/mm2 and b = 2000 s/mm2 from b = 1000 s/mm2. The proposed Multilevel Hierarchical Spherical Harmonics Coefficients Reconstruction (MHSH) framework takes advantage of contextual information within each slice as well as across the slices by involving Slice Level ReconNet (SLRNet) network and a Volumetric ROI Level ReconNet (VPLRNet) network, respectively. Three-loss functions have been used to optimize network learning, i.e., L1, Adversarial, and Total Variation Loss. Finally, the network is trained and validated on the publicly available HCP data-set with standard qualitative and quantitative performance measures and achieves promising results.
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Zhang N, Kang J, Wang H, Liu A, Miao Y, Ma X, Song Q, Zhang L, Wang J, Shen Z, Xu X. Differentiation of fibroadenomas versus malignant breast tumors utilizing three-dimensional amide proton transfer weighted magnetic resonance imaging. Clin Imaging 2021; 81:15-23. [PMID: 34597999 DOI: 10.1016/j.clinimag.2021.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To explore the value of amide proton transfer-weighted (APTw) magnetic resonance imaging (MRI) for differential diagnosis of fibroadenomas and malignant breast tumors. MATERIALS AND METHODS This prospective study enrolled 56 patients with suspected breast tumors and performed APTw imaging. Based on the histopathology results, patients were divided into group 1 with malignant breast tumors (n = 41) and group 2 with fibroadenomas (n = 15). The measured image parameters (APTw value, ADC value, type of Time of Intensity Curve, maximum tumor diameter in image) and the maximal diameter of the tumors measured from surgical resection were compared between the two groups, and the diagnostic performance based on these parameters was quantified with ROC curve. Spearman's correlation coefficient was used to analyze the association between APTw or ADC values and ER, PR, HER2, and Ki-67 expressions. RESULTS The intraclass correlation coefficients (ICC = 0.87 and 0.91) indicated a good inter-observer agreement of the measured APTw values. APTw values of malignant lesions were significantly higher than those of fibroadenomas (3.21 ± 1.04% vs 1.50 ± 0.54%, p < 0.001). Area under the curve (AUC) obtained from APTw imaging, DWI, DCE, APTw imaging+DWI, APTw imaging+DWI, and APTw imaging+DWI + DCE was 0.959, 0.897, 0.976, 0.997, and 1 respectively. The APTw value showed a negative correlation with ER expression (r = -0.357). CONCLUSION APTw imaging yielded similar diagnosis performance in discriminating fibroadenomas and malignant breast tumors when compared to the DCE and better than DWI imaging, and provided supplement information on tumor cell activity to DWI images. The APTw value showed correlations with some prognostic factors for breast cancer.
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Affiliation(s)
- Nan Zhang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Jianyun Kang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Huali Wang
- Department of Pathology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Ailian Liu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Yanwei Miao
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Xiaolu Ma
- Department of Clinical Laboratory, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Qingwei Song
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China.
| | - Lina Zhang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China.
| | - Jiazheng Wang
- MSC Clinical & Technical Solutions, Philips Healthcare, 16 Tianze Road, Beijing, PR China.
| | - Zhiwei Shen
- MSC Clinical & Technical Solutions, Philips Healthcare, 16 Tianze Road, Beijing, PR China.
| | - Xiaofang Xu
- MSC Clinical & Technical Solutions, Philips Healthcare, 16 Tianze Road, Beijing, PR China.
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Kupče Ē, Frydman L, Webb AG, Yong JRJ, Claridge TDW. Parallel nuclear magnetic resonance spectroscopy. ACTA ACUST UNITED AC 2021. [DOI: 10.1038/s43586-021-00024-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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12
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Otikovs M, Nissan N, Furman-Haran E, Anaby D, Allweis TM, Agassi R, Sklair-Levy M, Frydman L. Diffusivity in breast malignancies analyzed for b > 1000 s/mm 2 at 1 mm in-plane resolutions: Insight from Gaussian and non-Gaussian behaviors. J Magn Reson Imaging 2020; 53:1913-1925. [PMID: 33368734 DOI: 10.1002/jmri.27489] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 12/20/2022] Open
Abstract
Diffusion-weighted imaging (DWI) can improve breast cancer characterizations, but often suffers from low image quality -particularly at informative b > 1000 s/mm2 values. The aim of this study was to evaluate multishot approaches characterizing Gaussian and non-Gaussian diffusivities in breast cancer. This was a prospective study, in which 15 subjects, including 13 patients with biopsy-confirmed breast cancers, were enrolled. DWI was acquired at 3 T using echo planar imaging (EPI) with and without zoomed excitations, readout-segmented EPI (RESOLVE), and spatiotemporal encoding (SPEN); dynamic contrast-enhanced (DCE) data were collected using three-dimensional gradient-echo T1 weighting; anatomies were evaluated with T2 -weighted two-dimensional turbo spin-echo. Congruence between malignancies delineated by DCE was assessed against high-resolution DWI scans with b-values in the 0-1800 s/mm2 range, as well as against apparent diffusion coefficient (ADC) and kurtosis maps. Data were evaluated by independent magnetic resonance scientists with 3-20 years of experience, and radiologists with 6 and 20 years of experience in breast MRI. Malignancies were assessed from ADC and kurtosis maps, using paired t tests after confirming that these values had a Gaussian distribution. Agreements between DWI and DCE datasets were also evaluated using Sorensen-Dice similarity coefficients. Cancerous and normal tissues were clearly separable by ADCs: by SPEN their average values were (1.03 ± 0.17) × 10-3 and (1.69 ± 0.19) × 10-3 mm2 /s (p < 0.0001); by RESOLVE these values were (1.16 ± 0.16) × 10-3 and (1.52 ± 0.14) × 10-3 (p = 0.00026). Kurtosis also distinguished lesions (K = 0.64 ± 0.15) from normal tissues (K = 0.45 ± 0.05), but only when measured by SPEN (p = 0.0008). The best statistical agreement with DCE-highlighted regions arose for SPEN-based DWIs recorded with b = 1800 s/mm2 (Sorensen-Dice coefficient = 0.67); DWI data recorded with b = 850 and 1200 s/mm2 , led to lower coefficients. Both ADC and kurtosis maps highlighted the breast malignancies, with ADCs providing a more significant separation. The most promising alternative for contrast-free delineations of the cancerous lesions arose from b = 1800 s/mm2 DWI. LEVEL OF EVIDENCE: 2. TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Martins Otikovs
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel
| | - Noam Nissan
- Department of Radiology, Sheba-Medical-Center, Ramat-Gan, Israel
| | - Edna Furman-Haran
- Life Sciences Core Facilities, Weizmann Institute of Science, Rehovot, Israel.,Azrieli National Center for Brain Imaging, Weizmann Institute of Science, Rehovot, Israel
| | - Debbie Anaby
- Department of Radiology, Sheba-Medical-Center, Ramat-Gan, Israel
| | - Tanir M Allweis
- Department of Surgery, Kaplan Medical Center, Rehovot, Israel
| | - Ravit Agassi
- Department of Surgery, Ben Gurion University Hospital, Beer Sheba, Israel
| | - Miri Sklair-Levy
- Department of Radiology, Sheba-Medical-Center, Ramat-Gan, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Lucio Frydman
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel.,Azrieli National Center for Brain Imaging, Weizmann Institute of Science, Rehovot, Israel
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Nogueira L, Nunes RG. Editorial for "Radiomics Based on Multimodal MRI for the Differential Diagnosis of Benign and Malignant Breast Lesions". J Magn Reson Imaging 2020; 52:608-609. [PMID: 32333824 DOI: 10.1002/jmri.27168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 03/28/2020] [Accepted: 03/30/2020] [Indexed: 01/28/2023] Open
Abstract
LEVEL OF EVIDENCE 5 TECHNICAL EFFICACY STAGE: 2 J. Magn. Reson. Imaging 2020;52:608-609.
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Affiliation(s)
- Luísa Nogueira
- Department of Radiology, School of Health of Porto/Polytechnic Institute of Porto (ESS/IPP), Porto, Portugal.,EPIUnit - Instituto de Saúde Pública da Universidade do Porto (ISPUP), Porto, Portugal
| | - Rita Gouveia Nunes
- Institute for Systems and Robotics (LARSYS), University of Lisbon, Lisbon, Portugal.,Department of Bioengineering, Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal
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