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Sample C, Wu J, Clark H. Image denoising and model-independent parameterization for IVIM MRI. Phys Med Biol 2024; 69:105001. [PMID: 38604177 DOI: 10.1088/1361-6560/ad3db8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/11/2024] [Indexed: 04/13/2024]
Abstract
Objective. To improve intravoxel incoherent motion imaging (IVIM) magnetic resonance Imaging quality using a new image denoising technique and model-independent parameterization of the signal versusb-value curve.Approach. IVIM images were acquired for 13 head-and-neck patients prior to radiotherapy. Post-radiotherapy scans were also acquired for five of these patients. Images were denoised prior to parameter fitting using neural blind deconvolution, a method of solving the ill-posed mathematical problem of blind deconvolution using neural networks. The signal decay curve was then quantified in terms of several area under the curve (AUC) parameters. Improvements in image quality were assessed using blind image quality metrics, total variation (TV), and the correlations between parameter changes in parotid glands with radiotherapy dose levels. The validity of blur kernel predictions was assessed by the testing the method's ability to recover artificial 'pseudokernels'. AUC parameters were compared with monoexponential, biexponential, and triexponential model parameters in terms of their correlations with dose, contrast-to-noise (CNR) around parotid glands, and relative importance via principal component analysis.Main results. Image denoising improved blind image quality metrics, smoothed the signal versusb-value curve, and strengthened correlations between IVIM parameters and dose levels. Image TV was reduced and parameter CNRs generally increased following denoising.AUCparameters were more correlated with dose and had higher relative importance than exponential model parameters.Significance. IVIM parameters have high variability in the literature and perfusion-related parameters are difficult to interpret. Describing the signal versusb-value curve with model-independent parameters like theAUCand preprocessing images with denoising techniques could potentially benefit IVIM image parameterization in terms of reproducibility and functional utility.
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Affiliation(s)
- Caleb Sample
- Department of Physics and Astronomy, Faculty of Science, University of British Columbia, Vancouver, BC, CA, Canada
- Department of Medical Physics, BC Cancer, Surrey, BC, CA, Canada
| | - Jonn Wu
- Department of Radiation Oncology, BC Cancer, Vancouver, BC, CA, Canada
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, CA, Canada
| | - Haley Clark
- Department of Physics and Astronomy, Faculty of Science, University of British Columbia, Vancouver, BC, CA, Canada
- Department of Medical Physics, BC Cancer, Surrey, BC, CA, Canada
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, CA, Canada
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Kopřivová T, Keřkovský M, Jůza T, Vybíhal V, Rohan T, Kozubek M, Dostál M. Possibilities of Using Multi-b-value Diffusion Magnetic Resonance Imaging for Classification of Brain Lesions. Acad Radiol 2024; 31:261-272. [PMID: 37932166 DOI: 10.1016/j.acra.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 11/08/2023]
Abstract
In contrast to conventional diffusion magnetic resonance imaging (MRI), multi-b-value diffusion MRI methods are able to separate the signal from free water, pseudo-diffusion, and non-Gaussian components of water molecule diffusion. These approaches can then be utilised in so-called intravoxel incoherent motion imaging and diffusion kurtosis imaging. Various parameters provided by these methods can describe additional characteristics of the tissue microstructure and potentially help in the diagnosis and classification of various pathological processes. In this review, we present the basic principles and methods of analysing multi-b-value diffusion imaging data and specifically focus on the known possibilities for its use in the diagnosis of brain lesions. We also suggest possible directions for further research.
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Affiliation(s)
- Tereza Kopřivová
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic (T.K., M.K., T.J., T.R., M.D.)
| | - Miloš Keřkovský
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic (T.K., M.K., T.J., T.R., M.D.).
| | - Tomáš Jůza
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic (T.K., M.K., T.J., T.R., M.D.); Department of Biophysics, Faculty of Medicine, Masaryk University, Brno, Czech Republic (T.J., M.D.)
| | - Václav Vybíhal
- Department of Neurosurgery, Faculty of Medicine, Masaryk University Brno and University Hospital Brno, 625 00, Brno, Czech Republic (V.V.)
| | - Tomáš Rohan
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic (T.K., M.K., T.J., T.R., M.D.)
| | - Michal Kozubek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Šumavská, Brno, Czech Republic (M.K.)
| | - Marek Dostál
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic (T.K., M.K., T.J., T.R., M.D.); Department of Biophysics, Faculty of Medicine, Masaryk University, Brno, Czech Republic (T.J., M.D.)
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Martín-Noguerol T, Díaz-Angulo C, Vilanova C, Barceló A, Barceló J, Luna A, Vilanova JC. How to do and evaluate DWI and DCE-MRI sequences for diabetic foot assessment. Skeletal Radiol 2023:10.1007/s00256-023-04518-x. [PMID: 38001301 DOI: 10.1007/s00256-023-04518-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
MRI evaluation of the diabetic foot is still a challenge not only from an interpretative but also from a technical point of view. The incorporation of advanced sequences such as diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) MRI into standard protocols for diabetic foot assessment could aid radiologists in differentiating between neuropathic osteoarthropathy (Charcot's foot) and osteomyelitis. This distinction is crucial as both conditions can coexist in diabetic patients, and they require markedly different clinical management and have distinct prognoses. Over the past decade, several studies have explored the effectiveness of DWI and dynamic contrast-enhanced MRI (DCE-MRI) in distinguishing between septic and reactive bone marrow, as well as soft tissue involvement in diabetic patients, yielding promising results. DWI, without the need for exogenous contrast, can provide insights into the cellularity of bone marrow and soft tissues. DCE-MRI allows for a more precise evaluation of soft tissue and bone marrow perfusion compared to conventional post-gadolinium imaging. The data obtained from these sequences will complement the traditional MRI approach in assessing the diabetic foot. The objective of this review is to familiarize readers with the fundamental concepts of DWI and DCE-MRI, including technical adjustments and practical tips for image interpretation in diabetic foot cases.
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Affiliation(s)
| | | | - Cristina Vilanova
- Department of Orthopaedic Surgery, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - Ariadna Barceló
- Department of Radiology, Complejo Asistencial Universitario de Palencia (CAUPA), Palencia, Spain
| | - Joaquim Barceló
- Department of Radiology, Clinical Girona, Institute of Diagnostic Imaging (IDI) Girona, University of Girona, Girona, Spain
| | - Antonio Luna
- MRI unit, Radiology Department, HT medica, Carmelo Torres 2, 23007, Jaén, Spain
| | - Joan C Vilanova
- Department of Radiology, Clinical Girona, Institute of Diagnostic Imaging (IDI) Girona, University of Girona, Girona, Spain
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Sheng Y, Dang X, Zhang H, Rui W, Wang J, Cheng H, Qiu T, Zhang Y, Ding Y, Yao Z, Pang H, Ren Y. Correlations between intravoxel incoherent motion-derived fast diffusion and perfusion fraction parameters and VEGF- and MIB-1-positive rates in brain gliomas: an intraoperative MR-navigated, biopsy-based histopathologic study. Eur Radiol 2023; 33:5236-5246. [PMID: 36941492 DOI: 10.1007/s00330-023-09506-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 12/23/2022] [Accepted: 01/30/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES To explore the correlations between histopathologic findings and intravoxel incoherent motion (IVIM)-derived perfusion and diffusion parameters in brain gliomas. METHODS Thirty-two biopsy samples from twenty-one patients with newly diagnosed gliomas from a previous prospective cohort study were retrospectively analyzed. All patients underwent diffusion-weighted MRI with 22 b values (0-5000 s/mm2), followed by intraoperative MR-guided biopsy surgery and surgical resection. All 32 biopsy samples underwent immunohistochemical staining followed by quantitative analysis of cell density (cellularity), percent of MIB-1 (Ki67)-positive expression (pMIB-1), number of CD34-stained vessels (CD34-MVD), and percent of VEGF-positive expressing cells (pVEGF) using a multispectral phenotyping microscope. Based on the co-registered localized biopsy, correlation analysis was performed between the IVIM-derived biexponential model-based parameters (Dfast1500 and Dfast5000, Dslow1500 and Dslow5000, PF1500 and PF5000) and the above four pathological biomarkers and glioma grades. RESULTS Significant positive correlations were revealed between Dfast5000 and pVEGF (rho (r) = 0.466, p = 0.007), and Dfast1500 and pVEGF (r = 0.371, p = 0.037). A significant negative correlation was revealed between PF5000 with pMIB-1 (r = - 0.456, p = 0.01). Moderate to good positive correlations were shown between Dfast5000 and glioma grades (r = 0.509, p = 0.003) and Dfast1500 and glioma grades (r = 0.476, p = 0.006). CONCLUSIONS IVIM-DWI-derived Dfast and PF correlate, respectively, with intratumor pVEGF and pMIB-1. When using the wide-high b value scheme, IVIM-derived Dfast and PF tend to demonstrate better efficacy in evaluating malignancy-related characteristics such as angiogenesis and cellular proliferation in gliomas. KEY POINTS • Intravoxel incoherent motion-diffusion-weighted imaging (IVIM-DWI)-derived fast diffusion (Dfast) and perfusion fraction (PF) can quantitatively reflect intratumor pVEGF and pMIB-1. • IVIM-DWI-derived Dfast and PF tend to demonstrate better efficacy in evaluating glioma malignancy when an optimized scheme is used. • IVIM-DWI-derived Dfast5000 and PF5000 are promising non-invasive parameters correlating with pVEGF and pMIB-1 in gliomas.
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Affiliation(s)
- Yaru Sheng
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xuefei Dang
- Department of Oncology, Minhang Branch of Fudan University Shanghai Cancer Center, Shanghai, 200240, China
| | - Hua Zhang
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, 266000, China
| | - Wenting Rui
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Jing Wang
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Haixia Cheng
- Neuropathology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Tianming Qiu
- Neurosurgery Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yong Zhang
- MR Research, GE Healthcare, 1 Huatuo Road, Shanghai, 201203, China
| | - Yueyue Ding
- Department of Echocardiology, Children's Hospital, Suzhou University, Suzhou, 215000, China
| | - Zhenwei Yao
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Haopeng Pang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, #197 Rui Jin Er Road, Shanghai, 200025, China.
- Department of Integrative Oncology, Minimally Invasive Therapy Center, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Radiology Department of Huashan Hospital, Fudan University, Mid 12 Wulumuqi Road, Shanghai, 200040, China.
| | - Yan Ren
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China.
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Guo D, Jiang B. Noninvasively evaluating the grade and IDH mutation status of gliomas by using mono-exponential, bi-exponential diffusion-weighted imaging and three-dimensional pseudo-continuous arterial spin labeling. Eur J Radiol 2023; 160:110721. [PMID: 36738600 DOI: 10.1016/j.ejrad.2023.110721] [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: 10/13/2022] [Revised: 01/14/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To noninvasively assess the diagnostic performance of diffusion-weighted imaging (DWI), bi-exponential intravoxel incoherent motion imaging (IVIM) and three-dimensional pseudo-continuous arterial spin labeling (3D pCASL) in differentiating lower-grade gliomas (LGGs) from high-grade gliomas (HGGs), and predicting the isocitrate dehydrogenase (IDH) mutation status. MATERIALS AND METHODS Ninety-five patients with pathologically confirmed grade 2-4 gliomas with preoperative DWI, IVIM and 3D pCASL were enrolled in this study. The Student's t test and Mann-Whitney U test were used to evaluate differences in parameters of DWI, IVIM and 3D pCASL between LGG and HGG as well as between mutant and wild-type IDH in grade 2 and 3 diffusion astrocytoma; receiver operator characteristic (ROC) analysis was used to assess the diagnostic performance. RESULTS The value of ADCmean, ADCmin, Dmean and Dmin in HGGs were lower than in LGGs, while the value of CBFmean and CBFmax in HGGs were higher than in LGGs. In ROC analysis, the AUC values of Dmean, Dmin and CBFmax were 0.827, 0.878 and 0.839, respectively. The combination of CBFmax and Dmin displayed the highest diagnostic performance to distinguish LGGs from HGGs, with AUC 0.906, sensitivity 82.4 %, and specificity 86.4 %. In grades 2 and 3 diffusion astrocytoma patients, ADCmin, Dmean, Dmin, CBFmean and CBFmax showed significant differences between IDHmut and IDHwt group (p < 0.05, 0.001, 0.001, 0.01 and 0.001, respectively) and the AUC values were 0. 709, 0.849, 0.919, 0.755 and 0.873, respectively. Similarly, the combination of CBFmax and Dmin demonstrated the highest AUC value (0.938) in prediction IDH mutation status, with sensitivity 92.9 %, and specificity 95.5 %. CONCLUSION The combination of IVIM and 3D pCASL can be used in prediction histologic grade and IDH mutation status of glioma noninvasively.
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Affiliation(s)
- Da Guo
- Department of Radiology, The Sixth People's Hospital of Nanchong, Sichuan Province, People's Republic of China
| | - Binghu Jiang
- Department of Radiology, Nanchong Central Hospital, Sichuan Province, People's Republic of China.
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Series of Intravoxel Incoherent Motion and T2* Magnetic Resonance Imaging Mapping in Detection of Liver Perfusion Changes and Regeneration Among Partial Hepatectomy in Sprague-Dawley Rats. Acad Radiol 2022; 29:1810-1818. [PMID: 35871060 DOI: 10.1016/j.acra.2022.04.018] [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: 11/27/2021] [Revised: 03/13/2022] [Accepted: 04/19/2022] [Indexed: 01/26/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate liver perfusion changes and their effect on liver regeneration (LR) after partial hepatectomy (PH) using intravoxel incoherent motion (IVIM) and T2* mapping in a rat model. METHODS One hundred and two rats underwent 30%, 50%, or 70% PH. Within each group (n = 34), rats in MR imaging subgroup (n = 10) underwent liver IVIM and T2* mapping before and within 2 h, 1, 2, 3, 5, 7, 14, and 21 days post-PH to measure D*, perfusion fraction (PF), and T2* values. Three rats from histologic subgroup (n = 24) sacrificed at each time point for hepatocyte Ki-67 indices and diameters measurement. RESULTS Liver D* and PF values decreased immediately post-PH, then returned to original level as LR progressed in all groups. PF values in 70% PH group were significantly lower than in the other two groups (p < .05). D* and PF values correlated significantly with hepatocyte Ki-67 indices (r = -0.588 to -0.915; p < .05) and hepatocyte diameter (r = -0.555 to -0.792; p < .05). Liver T2* values decreased immediately within 2 h post-PH, then increased to a high level and followed with returning to original level gradually. The duration of the high T2* levels was consistent with Ki-67 indices. CONCLUSIONS Liver perfusion decreased immediately followed with increasing gradually after PH. IVIM and T2* mapping are promising methods for monitoring changes of liver perfusion. IVIM-derived D* value is the best indicator in reflecting the process of LR noninvasively.
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Liu YF, Zou ZY, Cai LM, Lin JH, Zhou MX, Huang NX, Zhan C, Chen HJ. Characterizing Sensorimotor-Related Area Abnormalities in Amyotrophic Lateral Sclerosis: An Intravoxel Incoherent Motion Magnetic Resonance Imaging Study. Acad Radiol 2022; 29 Suppl 3:S141-S146. [PMID: 34481706 DOI: 10.1016/j.acra.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/08/2021] [Accepted: 07/18/2021] [Indexed: 12/12/2022]
Abstract
RATIONALE AND OBJECTIVES To investigate the microperfusion and water molecule diffusion alterations in sensorimotor-related areas in amyotrophic lateral sclerosis (ALS) using intravoxel incoherent motion (IVIM) magnetic resonance imaging. MATERIALS AND METHODS IVIM data were obtained from 43 ALS patients and 31 controls. This study employed the revised ALS Functional Rating Scale (ALSFRS-R) in evaluating disease severity. IVIM-derived metrics were calculated, including diffusion coefficient (D), pseudo-diffusion coefficient, and perfusion fraction. Conventional apparent diffusion coefficient was also computed. Atlas-based analysis was conducted to detect between-group difference in these metrics in sensorimotor-related gray/white matter areas. Spearman correlation analysis was employed to establish correlation between various metrics and ALSFRS-R. RESULTS ALS patients had perfusion fraction (× 10-3) reduction in the left presupplementary motor area (60.72 ± 16.15 vs. 71.15 ± 12.98, p = 0.016), right presupplementary motor area (61.35 ± 17.02 vs. 72.18 ± 14.22, p = 0.016), left supplementary motor area (55.73 ± 12.29 vs. 64.12 ± 9.17, p = 0.015), and right supplementary motor area (56.53 ± 11.93 vs. 63.67 ± 10.03, p = 0.020). Patients showed D (× 10-6 mm2/s) increase in a white matter tract projecting to the right ventral premotor cortex (714.20 ± 39.75 vs. 691.01 ± 24.53, p = 0.034). A negative correlation between D of right ventral premotor cortex tract and ALSFRS-R score was observed (r = -0.316, p = 0.039). CONCLUSION These findings suggest aberrant microperfusion and water molecule diffusion in the sensorimotor-related areas in ALS patients, which are associated with motor impairment in ALS.
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Affiliation(s)
- Yuan-Fen Liu
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Zhang-Yu Zou
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Li-Min Cai
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Jia-Hui Lin
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Min-Xiong Zhou
- College of Medical Imaging, Shang Hai University of Medicine & Health Sciences, Shanghai, China
| | - Nao-Xin Huang
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Chuanyin Zhan
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Hua-Jun Chen
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou 350001, China.
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Wang DJJ, Le Bihan D, Krishnamurthy R, Smith M, Ho ML. Noncontrast Pediatric Brain Perfusion: Arterial Spin Labeling and Intravoxel Incoherent Motion. Magn Reson Imaging Clin N Am 2021; 29:493-513. [PMID: 34717841 DOI: 10.1016/j.mric.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Noncontrast magnetic resonance imaging techniques for measuring brain perfusion include arterial spin labeling (ASL) and intravoxel incoherent motion (IVIM). These techniques provide noninvasive and repeatable assessment of cerebral blood flow or cerebral blood volume without the need for intravenous contrast. This article discusses the technical aspects of ASL and IVIM with a focus on normal physiologic variations, technical parameters, and artifacts. Multiple pediatric clinical applications are presented, including tumors, stroke, vasculopathy, vascular malformations, epilepsy, migraine, trauma, and inflammation.
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Affiliation(s)
- Danny J J Wang
- USC Institute for Neuroimaging and Informatics, SHN, 2025 Zonal Avenue, Health Sciences Campus, Los Angeles, CA 90033, USA
| | - Denis Le Bihan
- NeuroSpin, Centre d'études de Saclay, Bâtiment 145, Gif-sur-Yvette 91191, France
| | - Ram Krishnamurthy
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mark Smith
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA.
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Martín-Noguerol T, Mohan S, Santos-Armentia E, Cabrera-Zubizarreta A, Luna A. Advanced MRI assessment of non-enhancing peritumoral signal abnormality in brain lesions. Eur J Radiol 2021; 143:109900. [PMID: 34412007 DOI: 10.1016/j.ejrad.2021.109900] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/24/2021] [Accepted: 08/03/2021] [Indexed: 12/30/2022]
Abstract
Evaluation of Central Nervous System (CNS) focal lesions has been classically made focusing on the assessment solid or enhancing component. However, the assessment of solitary peripherally enhancing lesions where the differential diagnosis includes High-Grade Gliomas (HGG) and metastasis, is usually challenging. Several studies have tried to address the characteristics of peritumoral non-enhancing areas, for better characterization of these lesions. Peritumoral hyperintense T2/FLAIR signal abnormality predominantly contains infiltrating tumor cells in HGG whereas CNS metastasis induce pure vasogenic edema. In addition, the accurate determination of the real extension of HGG is critical for treatment selection and outcome. Conventional MRI sequences are limited in distinguishing infiltrating neoplasm from vasogenic edema. Advanced MRI sequences like Diffusion Weighted Imaging (DWI), Diffusion Tensor Imaging (DTI), Perfusion Weighted Imaging (PWI) and MR spectroscopy (MRS) have all been utilized for this aim with acceptable results. Other advanced MRI approaches, less explored for this task such as Arterial Spin Labelling (ASL), Diffusion Kurtosis Imaging (DKI), T2 relaxometry or Amide Proton Transfer (APT) are also showning promising results in this scenario. In this article, we will discuss the physiopathological basis of peritumoral T2/FLAIR signal abnormality and review potential applications of advanced MRI sequences for its evaluation.
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Affiliation(s)
| | - Suyash Mohan
- Division of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
| | | | | | - Antonio Luna
- MRI Unit, Radiology Department, HT Medica, Jaén, Spain.
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Tao YY, Zhou Y, Wang R, Gong XQ, Zheng J, Yang C, Yang L, Zhang XM. Progress of intravoxel incoherent motion diffusion-weighted imaging in liver diseases. World J Clin Cases 2020; 8:3164-3176. [PMID: 32874971 PMCID: PMC7441263 DOI: 10.12998/wjcc.v8.i15.3164] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/11/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
Traditional magnetic resonance (MR) diffusion-weighted imaging (DWI) uses a single exponential model to obtain the apparent diffusion coefficient to quantitatively reflect the diffusion motion of water molecules in living tissues, but it is affected by blood perfusion. Intravoxel incoherent motion (IVIM)-DWI utilizes a double-exponential model to obtain information on pure water molecule diffusion and microcirculatory perfusion-related diffusion, which compensates for the insufficiency of traditional DWI. In recent years, research on the application of IVIM-DWI in the diagnosis and treatment of hepatic diseases has gradually increased and has achieved considerable progress. This study mainly reviews the basic principles of IVIM-DWI and related research progress in the diagnosis and treatment of hepatic diseases.
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Affiliation(s)
- Yun-Yun Tao
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Yi Zhou
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Ran Wang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xue-Qin Gong
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Jing Zheng
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Cui Yang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Lin Yang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xiao-Ming Zhang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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Simplified perfusion fraction from diffusion-weighted imaging in preoperative prediction of IDH1 mutation in WHO grade II-III gliomas: comparison with dynamic contrast-enhanced and intravoxel incoherent motion MRI. Radiol Oncol 2020; 54:301-310. [PMID: 32559177 PMCID: PMC7409598 DOI: 10.2478/raon-2020-0037] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/13/2020] [Indexed: 11/20/2022] Open
Abstract
Background Effect of isocitr ate dehydrogenase 1 (IDH1) mutation in neovascularization might be linked with tissue perfusion in gliomas. At present, the need of injection of contrast agent and the increasing scanning time limit the application of perfusion techniques. We used a simplified intravoxel incoherent motion (IVIM)-derived perfusion fraction (SPF) calculated from diffusion-weighted imaging (DWI) using only three b-values to quantitatively assess IDH1-linked tissue perfusion changes in WHO grade II-III gliomas (LGGs). Additionally, by comparing accuracy with dynamic contrast-enhanced (DCE) and full IVIM MRI, we tried to find the optimal imaging markers to predict IDH1 mutation status. Patients and methods Thirty patients were prospectively examined using DCE and multi-b-value DWI. All parameters were compared between the IDH1 mutant and wild-type LGGs using the Mann-Whitney U test, including the DCE MRI-derived Ktrans, ve and vp, the conventional apparen t diffusion coefficient (ADC0,1000), IVIM-de rived perfusion fraction (f), diffusion coefficient (D) and pseudo-diffusion coefficient (D*), SPF. We evaluated the diagnostic performance by receive r operating characteristic (ROC) analysis. Results Significant differences were detected between WHO grade II-III gliomas for all perfusion and diffusion parameters (P < 0.05). When compared to IDH1 mutant LGGs, IDH1 wild-type LGGs exhibited significantly higher perfusion metrics (P < 0.05) and lower diffusion metrics (P < 0.05). Among all parameters, SPF showed a higher diagnostic performance (area under the curve 0.861), with 94.4% sensitivity and 75% specificity. Conclusions DWI, DCE and IVIM MRI may noninvasively help discriminate IDH1 mutation statuses in LGGs. Specifically, simplified DWI-derived SPF showed a superior diagnostic performance.
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12
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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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13
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Perfusion and diffusion in meningioma tumors: a preliminary multiparametric analysis with Dynamic Susceptibility Contrast and IntraVoxel Incoherent Motion MRI. Magn Reson Imaging 2020; 67:69-78. [DOI: 10.1016/j.mri.2019.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 11/15/2019] [Accepted: 12/05/2019] [Indexed: 12/19/2022]
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14
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Hu YC, Yan LF, Han Y, Duan SJ, Sun Q, Li GF, Wang W, Wei XC, Zheng DD, Cui GB. Can the low and high b-value distribution influence the pseudodiffusion parameter derived from IVIM DWI in normal brain? BMC Med Imaging 2020; 20:14. [PMID: 32041549 PMCID: PMC7011602 DOI: 10.1186/s12880-020-0419-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/30/2020] [Indexed: 12/28/2022] Open
Abstract
Background Our study aims to reveal whether the low b-values distribution, high b-values upper limit, and the number of excitation (NEX) influence the accuracy of the intravoxel incoherent motion (IVIM) parameter derived from multi-b-value diffusion-weighted imaging (DWI) in the brain. Methods This prospective study was approved by the local Ethics Committee and informed consent was obtained from each participant. The five consecutive multi-b DWI with different b-value protocols (0–3500 s/mm2) were performed in 22 male healthy volunteers on a 3.0-T MRI system. The IVIM parameters from normal white matter (WM) and gray matter (GM) including slow diffusion coefficient (D), fast perfusion coefficient (D*) and perfusion fraction (f) were compared for differences among defined groups with different IVIM protocols by one-way ANOVA. Results The D* and f value of WM or GM in groups with less low b-values distribution (less than or equal to 5 b-values) were significantly lower than ones in any other group with more low b-values distribution (all P < 0.05), but no significant differences among groups with more low b-values distribution (P > 0.05). In addition, no significant differences in the D, D* and f value of WM or GM were found between group with one and more NEX of low b-values distribution (all P > 0.05). IVIM parameters in normal WM and GM strongly depended on the choice of the high b-value upper limit. Conclusions Metrics of IVIM parameters can be affected by low and high b value distribution. Eight low b-values distribution with high b-value upper limit of 800–1000 s/mm2 may be the relatively proper set when performing brain IVIM studies.
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Affiliation(s)
- Yu-Chuan Hu
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Lin-Feng Yan
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Yu Han
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Shi-Jun Duan
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Qian Sun
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Gang-Feng Li
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Wen Wang
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China
| | - Xiao-Cheng Wei
- MR Research China, GE Healthcare China, Beijing, 100176, China
| | - Dan-Dan Zheng
- MR Research China, GE Healthcare China, Beijing, 100176, China
| | - Guang-Bin Cui
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, Shaanxi, People's Republic of China.
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15
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He M, Song Y, Li H, Lu J, Li Y, Duan S, Qiang J. Histogram Analysis Comparison of Monoexponential, Advanced Diffusion‐Weighted Imaging, and Dynamic Contrast‐Enhanced MRI for Differentiating Borderline From Malignant Epithelial Ovarian Tumors. J Magn Reson Imaging 2020; 52:257-268. [PMID: 31922327 DOI: 10.1002/jmri.27037] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/08/2019] [Accepted: 12/11/2019] [Indexed: 12/14/2022] Open
Affiliation(s)
- Mengge He
- Department of RadiologyJinshan Hospital, Fudan University Shanghai China
- The Shanghai Institution of Medical ImagingFudan University Shanghai China
| | - Yang Song
- Shanghai Key Laboratory of Magnetic ResonanceEast China Normal University Shanghai China
| | - Haiming Li
- Department of RadiologyFudan University Shanghai Cancer Center Shanghai China
- Department of OncologyShanghai Medical College, Fudan University Shanghai China
| | - Jing Lu
- Department of RadiologyJinshan Hospital, Fudan University Shanghai China
| | - Yongai Li
- Department of RadiologyJinshan Hospital, Fudan University Shanghai China
| | | | - Jinwei Qiang
- Department of RadiologyJinshan Hospital, Fudan University Shanghai China
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16
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Xiao Z, Tang Z, Zheng C, Luo J, Zhao K, Zhang Z. Diffusion Kurtosis Imaging and Intravoxel Incoherent Motion in Differentiating Nasal Malignancies. Laryngoscope 2019; 130:E727-E735. [PMID: 31747056 DOI: 10.1002/lary.28424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/22/2019] [Accepted: 10/26/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the usefulness of diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) in the differentiation of sinonasal malignant tumors (SNMTs) with different histological types. STUDY DESIGN Retrospective observational and diagnostic study. METHODS Sixty-five patients with SNMTs who underwent DKI and IVIM were enrolled in this retrospective study, including 27 squamous cell carcinomas (SCCs), 13 olfactory neuroblastomas (ONBs), 14 malignant melanomas (MMs) and 11 lymphomas. The kurtosis (K) and diffusion coefficient (Dk) from DKI and the pure diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and the product of D* and f (f∙D*) from IVIM were measured. Kruskal-Wallis and Dunn multiple comparison tests with Bonferroni correction, receiver operating characteristic curve, and logistic regression analyses were used for statistical analysis. RESULTS Lymphomas demonstrated the highest K values but lowest Dk, D, D*, f, and f∙D* values among these four malignant tumors. ONBs exhibited high K values and MMs had highest D*, f, and f∙D* values. The cutoff value of ≤0.887 × 10-3 mm2 /sec for f∙D* provided a sensitivity, specificity, and an accuracy of 100%, 98.1%, and 98.5%, respectively, for differentiating lymphomas from the other three entities. The combination of f∙D* and D values showed a sensitivity of 92.9% and a specificity of 92.5% for the discrimination of MMs from ONBs and SCCs. The K value was useful for differentiating ONBs from SCCs, with a threshold value of 0.942 (sensitivity, 84.6%; specificity, 63.0%). CONCLUSIONS The combined use of DKI and IVIM is helpful for differentiating among four histological types of SNMTs. LEVEL OF EVIDENCE 3 Laryngoscope, 2019.
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Affiliation(s)
- Zebin Xiao
- Department of Radiology, Eye and Ear, Nose, and Throat Hospital of Shanghai Medical School, Fudan University, Shanghai, China
| | - Zuohua Tang
- Department of Radiology, Eye and Ear, Nose, and Throat Hospital of Shanghai Medical School, Fudan University, Shanghai, China
| | - Chunquan Zheng
- Department of Otolaryngology, Eye and Ear, Nose, and Throat Hospital of Shanghai Medical School, Fudan University, Shanghai, China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Keqing Zhao
- Department of Otolaryngology, Eye and Ear, Nose, and Throat Hospital of Shanghai Medical School, Fudan University, Shanghai, China
| | - Zhongshuai Zhang
- Department of Diagnostic Imaging, Siemens Healthcare Ltd., Shanghai, China
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17
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Bakke KM, Grøvik E, Meltzer S, Negård A, Holmedal SH, Mikalsen LTG, Lyckander LG, Ree AH, Gjesdal KI, Redalen KR, Bjørnerud A. Comparison of Intravoxel incoherent motion imaging and multiecho dynamic contrast-based MRI in rectal cancer. J Magn Reson Imaging 2019; 50:1114-1124. [PMID: 30945379 PMCID: PMC6767772 DOI: 10.1002/jmri.26740] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 03/21/2019] [Accepted: 03/21/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Dynamic contrast-based MRI and intravoxel incoherent motion imaging (IVIM) MRI are both methods showing promise as diagnostic and prognostic tools in rectal cancer. Both methods aim at measuring perfusion-related parameters, but the relationship between them is unclear. PURPOSE To investigate the relationship between perfusion- and permeability-related parameters obtained by IVIM-MRI, T1 -weighted dynamic contrast-enhanced (DCE)-MRI and T2 *-weighted dynamic susceptibility contrast (DSC)-MRI. STUDY TYPE Prospective. SUBJECTS In all, 94 patients with histologically confirmed rectal cancer. FIELD STRENGTH/SEQUENCE Subjects underwent pretreatment 1.5T clinical procedure MRI, and in addition a study-specific diffusion-weighted sequence (b = 0, 25, 50, 100, 500, 1000, 1300 s/mm2 ) and a multiecho dynamic contrast-based echo-planer imaging sequence. ASSESSMENT Median tumor values were obtained from IVIM (perfusion fraction [f], pseudodiffusion [D*], diffusion [D]), from the extended Tofts model applied to DCE data (Ktrans , kep , vp , ve ) and from model free deconvolution of DSC (blood flow [BF] and area under curve). A subgroup of the excised tumors underwent immunohistochemistry with quantification of microvessel density and vessel size. STATISTICAL TEST Spearman's rank correlation test. RESULTS D* was correlated with BF (rs = 0.47, P < 0.001), and f was negatively correlated with kep (rs = -0.31, P = 0.002). BF was correlated with Ktrans (rs = 0.29, P = 0.004), but this correlation varied extensively when separating tumors into groups of low (rs = 0.62, P < 0.001) and high (rs = -0.06, P = 0.68) BF. Ktrans was negatively correlated with vessel size (rs = -0.82, P = 0.004) in the subgroup of tumors with high BF. DATA CONCLUSION We found an association between D* from IVIM and BF estimated from DSC-MRI. The relationship between IVIM and DCE-MRI was less clear. Comparing parameters from DSC-MRI and DCE-MRI highlights the importance of the underlying biology for the interpretation of these parameters. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:1114-1124.
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Affiliation(s)
- Kine Mari Bakke
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Department of Physics, University of Oslo, Oslo, Norway
| | - Endre Grøvik
- Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.,Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway
| | - Sebastian Meltzer
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
| | - Anne Negård
- Department of Radiology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Lars Tore G Mikalsen
- Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Anne H Ree
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kjell-Inge Gjesdal
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Sunnmøre MR-klinikk, Ålesund, Norway
| | - Kathrine R Redalen
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Atle Bjørnerud
- Department of Physics, University of Oslo, Oslo, Norway.,Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
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18
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Pan JH, Zhu S, Huang J, Liang J, Zhang D, Zhao X, Ding H, Qin L, Shi C, Luo L, Pan Y. Monitoring the Process of Endostar-Induced Tumor Vascular Normalization by Non-contrast Intravoxel Incoherent Motion Diffusion-Weighted MRI. Front Oncol 2018; 8:524. [PMID: 30483478 PMCID: PMC6243029 DOI: 10.3389/fonc.2018.00524] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/25/2018] [Indexed: 01/26/2023] Open
Abstract
Tumor vascular normalization has been proposed as a new concept in anti-tumor angiogenesis, and the normalization window is considered as an opportunity to increase the effect of chemoradiotherapy. However, there is still a lack of a non-invasive method for monitoring the process of tumor vascular normalization. Intravoxel incoherent motion diffusion-weighted magnetic resonance imaging (IVIM DW-MRI) is an emerging approach which can effectively assess microperfusion in tumors, without the need for exogenous contrast agents. However, its role in monitoring tumor vascular normalization still needs further study. In this study, we established a tumor vascular normalization model of CT26 colon-carcinoma-bearing mice by means of Endostar treatment. We then employed IVIM DW-MRI and immunofluorescence to detect the process of tumor vascular normalization at different times after treatment. We found that the D* values of the Endostar group were significantly higher than those of the control group on days 4, 6, 8, and 10 after treatment, and the f values of the Endostar group were significantly higher than those of the control group on days 6 and 8. Furthermore, we confirmed through analysis of histologic parameters that Endostar treatment induced the CT26 tumor vascular normalization window starting from day 4 after treatment, and this window lasted for 6 days. Moreover, we found that D* and f values were well correlated with pericyte coverage (r = 0.469 and 0.504, respectively; P < 0.001, both) and relative perfusion (r = 0.424 and 0.457, respectively; P < 0.001, both). Taken together, our findings suggest that IVIM DW-MRI has the potential to serve as a non-invasive approach for monitoring Endostar-induced tumor vascular normalization.
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Affiliation(s)
- Jing-Hua Pan
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shengbin Zhu
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jinlian Huang
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jianye Liang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Dong Zhang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xiaoxu Zhao
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hui Ding
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Li Qin
- Department of Histology and Embryology, Medical School of Jinan University, Guangzhou, China
| | - Changzheng Shi
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Liangping Luo
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yunlong Pan
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
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19
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Paschoal AM, Leoni RF, Dos Santos AC, Paiva FF. Intravoxel incoherent motion MRI in neurological and cerebrovascular diseases. Neuroimage Clin 2018; 20:705-714. [PMID: 30221622 PMCID: PMC6141267 DOI: 10.1016/j.nicl.2018.08.030] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 08/27/2018] [Accepted: 08/30/2018] [Indexed: 12/20/2022]
Abstract
Intravoxel Incoherent Motion (IVIM) is a recently rediscovered noninvasive magnetic resonance imaging (MRI) method based on diffusion-weighted imaging. It enables the separation of the intravoxel signal into diffusion due to Brownian motion and perfusion-related contributions and provides important information on microperfusion in the tissue and therefore it is a promising tool for applications in neurological and neurovascular diseases. This review focuses on the basic principles and outputs of IVIM and details it major applications in the brain, such as stroke, tumor, and cerebral small vessel disease. A bi-exponential model that considers two different compartments, namely capillaries, and medium-sized vessels, has been frequently used for the description of the IVIM signal and may be important in those clinical applications cited before. Moreover, the combination of IVIM and arterial spin labeling MRI enables the estimation of water permeability across the blood-brain barrier (BBB), suggesting a potential imaging biomarker for disrupted-BBB diseases.
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Affiliation(s)
- André M Paschoal
- Inbrain Lab, Department de Física, FFCLRP, Universidade de São Paulo, São Carlos, SP, Brazil
| | - Renata F Leoni
- Inbrain Lab, Department de Física, FFCLRP, Universidade de São Paulo, São Carlos, SP, Brazil
| | - Antonio C Dos Santos
- Departamento de Clínica Médica, FMRP, Universidade de São Paulo, São Carlos, SP, Brazil
| | - Fernando F Paiva
- Instituto de Física de São Carlos, Universidade de São Paulo, São Carlos, SP, Brazil.
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20
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Xiao Y, Chen Y, Chen Y, He Z, Yao Y, Pan J. Longitudinal Assessment of Intravoxel Incoherent Motion Diffusion Weighted Imaging in Evaluating the Radio-sensitivity of Nasopharyngeal Carcinoma Treated with Intensity-Modulated Radiation Therapy. Cancer Res Treat 2018; 51:345-356. [PMID: 29764118 PMCID: PMC6334000 DOI: 10.4143/crt.2018.089] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/09/2018] [Indexed: 12/15/2022] Open
Abstract
Purpose Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI)was evaluated regarding its ability to preliminarily predict the short-term treatment response of nasopharyngeal carcinoma (NPC) following intensity-modulated radiation therapy. Materials and Methods IVIM-DWI with 14 b-factors (0-1,000 sec/mm2) was performed with a 3T MR system on 47 consecutive NPCs before, during (end of the 5th, 10th, 15th, 20th, and 25th fractions), and after fractional radiotherapy. IVIM parametrics (D, f, and D*) were calculated and compared to the baseline and xth fraction. Patients were categorized into responders and non-responders after radiotherapy. IVIM parametrics were also compared between subgroups. Results After fractional radiations, the D (except D5 and D at the end of the 5th fraction) after radiations were larger than the baseline D0 (p < 0.05), and the post-radiation D* (except D*5 and D*10) were smaller than D*0 (p < 0.05). f0 was smaller than f5 and f10 (p < 0.001) but larger than fend (p < 0.05). Furthermore, greater D5, D10, D15, and f10 coupled with smaller f0, D*20, and D*25 were observed in responders than non-responders (all p < 0.01). Responders also presented larger ΔD10, Δf10, ΔD*20, and δD*20 than non-responders (p < 0.05). Receiver operating characteristic curve analysis indicated that the D5, D*20, and f10 could better differentiate responders from non-responders. Conclusion IVIM-DWI could efficiently assess tumor treatment response to fractional radiotherapy and predict the radio-sensitivity for NPCs.
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Affiliation(s)
- Youping Xiao
- Department of Radiology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Ying Chen
- Department of Radiology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Yunbin Chen
- Department of Radiology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Zhuangzhen He
- Department of Radiology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Yiqi Yao
- Department of Radiology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Jianji Pan
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
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21
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Thulborn KR. Quantitative sodium MR imaging: A review of its evolving role in medicine. Neuroimage 2018; 168:250-268. [PMID: 27890804 PMCID: PMC5443706 DOI: 10.1016/j.neuroimage.2016.11.056] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/23/2016] [Accepted: 11/22/2016] [Indexed: 12/26/2022] Open
Abstract
Sodium magnetic resonance (MR) imaging in humans has promised metabolic information that can improve medical management in important diseases. This technology has yet to find a role in clinical practice, lagging proton MR imaging by decades. This review covers the literature that demonstrates that this delay is explained by initial challenges of low sensitivity at low magnetic fields and the limited performance of gradients and electronics available in the 1980s. These constraints were removed by the introduction of 3T and now ultrahigh (≥7T) magnetic field scanners with superior gradients and electronics for proton MR imaging. New projection pulse sequence designs have greatly improved sodium acquisition efficiency. The increased field strength has provided the expected increased sensitivity to achieve resolutions acceptable for metabolic interpretation even in small target tissues. Consistency of quantification of the sodium MR image to provide metabolic parametric maps has been demonstrated by several different pulse sequences and calibration procedures. The vital roles of sodium ion in membrane transport and the extracellular matrix will be reviewed to indicate the broad opportunities that now exist for clinical sodium MR imaging. The final challenge is for the technology to be supplied on clinical ≥3T scanners.
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Affiliation(s)
- Keith R Thulborn
- Center for Magnetic Resonance Research, University of Illinois at Chicago, 1801 West Taylor Street, Chicago, IL 60612, United States.
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22
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Intravoxel Incoherent Motion Diffusion-Weighted Imaging Versus Dynamic Contrast-Enhanced Magnetic Resonance Imaging: Comparison of the Diagnostic Performance of Perfusion-Related Parameters in Breast. J Comput Assist Tomogr 2018; 42:6-11. [PMID: 28786902 DOI: 10.1097/rct.0000000000000661] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the diagnostic performance of the perfusion-related parameters of intravoxel incoherent motion (IVIM) imaging for breast lesions, compared with dynamic contrast-enhanced magnetic resonance imaging (DCE MRI). METHODS Fifty-nine patients with both IVIM imaging and subsequent DCE MRI were enrolled. Perfusion-related parameters of IVIM imaging (perfusion fraction, f; pseudo-diffusion coefficient, D*), as well as model-based and model-free parameters of DCE MRI, were measured. Receiver operating characteristic curve analysis and correlations between the IVIM and DCE MRI parameters were performed. RESULTS Thirty-one malignant and 35 benign lesions were pathologically proved. The area under the receiver operating characteristic curves (AUC) of D* plus f (AUCf+D*) was 0.834. The combined AUC of all model-based DCE MRI parameters (AUCmodel-based) was 0.904. The combined AUC of all model-free DCE MRI parameters (AUCmodel-free) was 0.876. AUCf+D* had no significant difference with either AUCmodel-based or AUCmodel-free. No significant correlation was found between f or D* and DCE-derived parameters. CONCLUSIONS Intravoxel incoherent motion imaging has the same value in differentiating malignant and benign breast lesions, compared with DCE MRI, in terms of perfusion-related parameters.
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23
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Cao M, Suo S, Han X, Jin K, Sun Y, Wang Y, Ding W, Qu J, Zhang X, Zhou Y. Application of a Simplified Method for Estimating Perfusion Derived from Diffusion-Weighted MR Imaging in Glioma Grading. Front Aging Neurosci 2018; 9:432. [PMID: 29358915 PMCID: PMC5766639 DOI: 10.3389/fnagi.2017.00432] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 12/15/2017] [Indexed: 01/21/2023] Open
Abstract
Purpose: To evaluate the feasibility of a simplified method based on diffusion-weighted imaging (DWI) acquired with three b-values to measure tissue perfusion linked to microcirculation, to validate it against from perfusion-related parameters derived from intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging, and to investigate its utility to differentiate low- from high-grade gliomas. Materials and Methods: The prospective study was approved by the local institutional review board and written informed consent was obtained from all patients. From May 2016 and May 2017, 50 patients confirmed with glioma were assessed with multi-b-value DWI and DCE MR imaging at 3.0 T. Besides conventional apparent diffusion coefficient (ADC0,1000) map, perfusion-related parametric maps for IVIM-derived perfusion fraction (f) and pseudodiffusion coefficient (D*), DCE MR imaging-derived pharmacokinetic metrics, including Ktrans, ve and vp, as well as a metric named simplified perfusion fraction (SPF), were generated. Correlation between perfusion-related parameters was analyzed by using the Spearman rank correlation. All imaging parameters were compared between the low-grade (n = 19) and high-grade (n = 31) groups by using the Mann-Whitney U test. The diagnostic performance for tumor grading was evaluated with receiver operating characteristic (ROC) analysis. Results: SPF showed strong correlation with IVIM-derived f and D* (ρ = 0.732 and 0.716, respectively; both P < 0.001). Compared with f, SPF was more correlated with DCE MR imaging-derived Ktrans (ρ = 0.607; P < 0.001) and vp (ρ = 0.397; P = 0.004). Among all parameters, SPF achieved the highest accuracy for differentiating low- from high-grade gliomas, with an area under the ROC curve value of 0.942, which was significantly higher than that of ADC0,1000 (P = 0.004). By using SPF as a discriminative index, the diagnostic sensitivity and specificity were 87.1% and 94.7%, respectively, at the optimal cut-off value of 19.26%. Conclusion: The simplified method to measure tissue perfusion based on DWI by using three b-values may be helpful to differentiate low- from high-grade gliomas. SPF may serve as a valuable alternative to measure tumor perfusion in gliomas in a noninvasive, convenient and efficient way.
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Affiliation(s)
- Mengqiu Cao
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shiteng Suo
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xu Han
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ke Jin
- Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yawen Sun
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yao Wang
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weina Ding
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | | | - Xiaohua Zhang
- Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Zhou
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Le Bihan D. What can we see with IVIM MRI? Neuroimage 2017; 187:56-67. [PMID: 29277647 DOI: 10.1016/j.neuroimage.2017.12.062] [Citation(s) in RCA: 246] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/28/2017] [Accepted: 12/19/2017] [Indexed: 12/18/2022] Open
Abstract
Intravoxel Incoherent Motion (IVIM) refers to translational movements which within a given voxel and during the measurement time present a distribution of speeds in orientation and/or amplitude. The IVIM concept has been used to estimate perfusion in tissues as blood flow in randomly oriented capillaries mimics a pseudo-diffusion process. IVIM-based perfusion MRI, which does not require contrast agents, has gained momentum recently, especially in the field oncology. In this introductory review the basic concepts, models, technical requirements and limitations inherent to IVIM-based perfusion MRI are outlined, as well as new, non-perfusion applications of IVIM MRI, such as virtual MR Elastography.
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Affiliation(s)
- Denis Le Bihan
- NeuroSpin, Frédéric Joliot Institute, Bât 145, CEA-Saclay Center, Gif-sur-Yvette, 91191 France.
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25
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Federau C. Intravoxel incoherent motion MRI as a means to measure in vivo perfusion: A review of the evidence. NMR IN BIOMEDICINE 2017; 30. [PMID: 28885745 DOI: 10.1002/nbm.3780] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/19/2017] [Accepted: 07/07/2017] [Indexed: 05/07/2023]
Abstract
The idea that in vivo intravoxel incoherent motion magnetic resonance signal is influenced by blood motion in the microvasculature is exciting, because it suggests that local and quantitative perfusion information can be obtained in a simple and elegant way from a few diffusion-weighted images, without contrast injection. When the method was proposed in the late 1980s some doubts appeared as to its feasibility, and, probably because the signal to noise and image quality at the time was not sufficient, no obvious experimental evidence could be produced to alleviate them. Helped by the tremendous improvements seen in the last three decades in MR hardware, pulse design, and post-processing capabilities, an increasing number of encouraging reports on the value of intravoxel incoherent motion perfusion imaging have emerged. The aim of this article is to review the current published evidence on the feasibility of in vivo perfusion imaging with intravoxel incoherent motion MRI.
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Affiliation(s)
- Christian Federau
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology, University Hospital Basel, Petersgraben, Basle, Switzerland
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26
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Xu XQ, Wu CJ, Lu SS, Gao QQ, Zu QQ, Liu XL, Shi HB, Liu S. Correlation between Intravoxel Incoherent Motion Magnetic Resonance Imaging Derived Metrics and Serum Soluble CD40 Ligand Level in an Embolic Canine Stroke Model. Korean J Radiol 2017; 18:835-843. [PMID: 28860901 PMCID: PMC5552467 DOI: 10.3348/kjr.2017.18.5.835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 01/22/2017] [Indexed: 12/18/2022] Open
Abstract
Objective To determine the relationship between intravoxel incoherent motion (IVIM) imaging derived quantitative metrics and serum soluble CD40 ligand (sCD40L) level in an embolic canine stroke model. Materials and Methods A middle cerebral artery occlusion model was established in 24 beagle dogs. Experimental dogs were divided into low- and high-sCD40L group according to serum sCD40L level at 4.5 hours after establishing the model. IVIM imaging was scanned at 4.5 hours after model establishment using 10 b values ranging from 0 to 900 s/mm2. Quantitative metrics diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) of ischemic lesions were calculated. Quantitative metrics of ischemic lesions were normalized by contralateral hemisphere using the following formula: normalized D = Dstroke / Dcontralateral. Differences in IVIM metrics between the low- and high-sCD40L groups were compared using t test. Pearson's correlation analyses were performed to determine the relationship between IVIM metrics and serum sCD40L level. Results The high-sCD40L group showed significantly lower f and normalized f values than the low-sCD40L group (f, p < 0.001; normalized f, p < 0.001). There was no significant difference in D*, normalized D*, D, or normalized D value between the two groups (All p > 0.05). Both f and normalized f values were negatively correlated with serum sCD40L level (f, r = −0.789, p < 0.001; normalized f, r = −0.823, p < 0.001). However, serum sCD40L level had no significant correlation with D*, normalized D*, D, or normalized D (All p > 0.05). Conclusion The f value derived from IVIM imaging was negatively correlated with serum sCD40L level. f value might serve as a potential imaging biomarker to assess the formation of microvascular thrombosis in hyperacute period of ischemic stroke.
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Affiliation(s)
- Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Chen-Jiang Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Shan-Shan Lu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Qian-Qian Gao
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Qing-Quan Zu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xing-Long Liu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hai-Bin Shi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Sheng Liu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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27
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Differentiating radiation necrosis from tumor progression in brain metastases treated with stereotactic radiotherapy: utility of intravoxel incoherent motion perfusion MRI and correlation with histopathology. J Neurooncol 2017; 134:433-441. [PMID: 28674974 DOI: 10.1007/s11060-017-2545-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 06/27/2017] [Indexed: 12/22/2022]
Abstract
Radiation necrosis is a serious potential adverse event of stereotactic radiosurgery that cannot be reliably differentiated from recurrent tumor using conventional imaging techniques. Intravoxel incoherent motion (IVIM) is a magnetic resonance imaging (MRI) based method that uses a diffusion-weighted sequence to estimate quantitative perfusion and diffusion parameters. This study evaluated the IVIM-derived apparent diffusion coefficient (ADC) and perfusion fraction (f), and compared the results to the gold standard histopathological-defined outcomes of radiation necrosis or recurrent tumor. Nine patients with ten lesions were included in this study; all lesions exhibited radiographic progression after stereotactic radiosurgery for brain metastases that subsequently underwent surgical resection due to uncertainty regarding the presence of radiation necrosis versus recurrent tumor. Pre-surgical IVIM was performed to obtain f and ADC values and the results were compared to histopathology. Five lesions exhibited pathological radiation necrosis and five had predominantly recurrent tumor. The IVIM perfusion fraction reliably differentiated tumor recurrence from radiation necrosis (fmean = 10.1 ± 0.7 vs. 8.3 ± 1.2, p = 0.02; cutoff value of 9.0 yielding a sensitivity/specificity of 100%/80%) while the ADC did not distinguish between the two (ADCmean = 1.1 ± 0.2 vs. 1.2 ± 0.4, p = 0.6). IVIM shows promise in differentiating recurrent tumor from radiation necrosis for brain metastases treated with radiosurgery, but needs to be validated in a larger cohort.
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28
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Martín Noguerol T, Martínez Barbero J. Advanced diffusion MRI and biomarkers in the central nervous system: A new approach. RADIOLOGIA 2017. [DOI: 10.1016/j.rxeng.2017.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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29
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Temporal evolution of perfusion parameters in brain metastases treated with stereotactic radiosurgery: comparison of intravoxel incoherent motion and dynamic contrast enhanced MRI. J Neurooncol 2017; 135:119-127. [PMID: 28669014 DOI: 10.1007/s11060-017-2556-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 06/27/2017] [Indexed: 12/20/2022]
Abstract
Intravoxel incoherent motion (IVIM) is a magnetic resonance imaging (MRI) technique that is seeing increasing use in neuro-oncology and offers an alternative to contrast-enhanced perfusion techniques for evaluation of tumor blood volume after stereotactic radiosurgery (SRS). To date, IVIM has not been validated against contrast enhanced techniques for brain metastases after SRS. In the present study, we measure blood volume for 20 brain metastases (15 patients) at baseline, 1 week and 1 month after SRS using IVIM and dynamic contrast enhanced (DCE)-MRI. Correlation between blood volume measurements made with IVIM and DCE-MRI show poor correlation at baseline, 1 week, and 1 month post SRS (r = 0.33, 0.14 and 0.30 respectively). At 1 week after treatment, no significant change in tumor blood volume was found using IVIM or DCE-MRI (p = 0.81 and 0.41 respectively). At 1 month, DCE-MRI showed a significant decrease in blood volume (p = 0.0002). IVIM, on the other hand, demonstrated the opposite effect and showed a significant increase in blood volume at 1 month (p = 0.03). The results of this study indicate that blood volume measured with IVIM and DCE-MRI are not equivalent. While this may relate to differences in the type of perfusion information each technique is providing, it could also reflect a limitation of tumor blood volume measurements made with IVIM after SRS. IVIM measurements of tumor blood volume in the month after SRS should therefore be interpreted with caution.
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30
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Pavilla A, Gambarota G, Arrigo A, Mejdoubi M, Duvauferrier R, Saint-Jalmes H. Diffusional kurtosis imaging (DKI) incorporation into an intravoxel incoherent motion (IVIM) MR model to measure cerebral hypoperfusion induced by hyperventilation challenge in healthy subjects. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 30:545-554. [PMID: 28608327 DOI: 10.1007/s10334-017-0629-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 05/18/2017] [Accepted: 05/23/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The objectives were to investigate the diffusional kurtosis imaging (DKI) incorporation into the intravoxel incoherent motion (IVIM) model for measurements of cerebral hypoperfusion in healthy subjects. MATERIALS AND METHODS Eight healthy subjects underwent a hyperventilation challenge with a 4-min diffusion weighted imaging protocol, using 8 b values chosen with the Cramer-Rao Lower Bound optimization approach. Four regions of interest in gray matter (GM) were analyzed with the DKI-IVIM model and the bi-exponential IVIM model, for normoventilation and hyperventilation conditions. RESULTS A significant reduction in the perfusion fraction (f) and in the product fD* of the perfusion fraction with the pseudodiffusion coefficient (D*) was found with the DKI-IVIM model, during the hyperventilation challenge. In the cerebellum GM, the percentage changes were f: -43.7 ± 40.1, p = 0.011 and fD*: -50.6 ± 32.1, p = 0.011; in thalamus GM, f: -47.7 ± 34.7, p = 0.012 and fD*: -47.2 ± 48.7, p = 0.040. In comparison, using the bi-exponential IVIM model, only a significant decrease in the parameter fD* was observed for the same regions of interest. In frontal-GM and posterior-GM, the reduction in f and fD* did not reach statistical significance, either with DKI-IVIM or the bi-exponential IVIM model. CONCLUSION When compared to the bi-exponential IVIM model, the DKI-IVIM model displays a higher sensitivity to detect changes in perfusion induced by the hyperventilation condition.
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Affiliation(s)
- Aude Pavilla
- INSERM, UMR 1099, 35000, Rennes, France. .,Université de Rennes 1, LTSI, 35000, Rennes, France. .,Department of Neuroradiology, Pierre-Zobda-Quitman Hospital, University Hospital of Martinique, Fort-de- France, Martinique, France.
| | - Giulio Gambarota
- INSERM, UMR 1099, 35000, Rennes, France.,Université de Rennes 1, LTSI, 35000, Rennes, France
| | - Alessandro Arrigo
- Department of Neuroradiology, Pierre-Zobda-Quitman Hospital, University Hospital of Martinique, Fort-de- France, Martinique, France
| | - Mehdi Mejdoubi
- Department of Neuroradiology, Pierre-Zobda-Quitman Hospital, University Hospital of Martinique, Fort-de- France, Martinique, France
| | - Régis Duvauferrier
- Department of Neuroradiology, Pierre-Zobda-Quitman Hospital, University Hospital of Martinique, Fort-de- France, Martinique, France
| | - Hervé Saint-Jalmes
- INSERM, UMR 1099, 35000, Rennes, France.,Université de Rennes 1, LTSI, 35000, Rennes, France.,CRLCC, Centre Eugène Marquis, 35000, Rennes, France
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Martín Noguerol T, Martínez Barbero JP. Advanced diffusion MRI and biomarkers in the central nervous system: a new approach. RADIOLOGIA 2017; 59:273-285. [PMID: 28552216 DOI: 10.1016/j.rx.2017.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 03/13/2017] [Accepted: 04/16/2017] [Indexed: 01/08/2023]
Abstract
The introduction of diffusion-weighted sequences has revolutionized the detection and characterization of central nervous system (CNS) disease. Nevertheless, the assessment of diffusion studies of the CNS is often limited to qualitative estimation. Moreover, the pathophysiological complexity of the different entities that affect the CNS cannot always be correctly explained through classical models. The development of new models for the analysis of diffusion sequences provides numerous parameters that enable a quantitative approach to both diagnosis and prognosis as well as to monitoring the response to treatment; these parameters can be considered potential biomarkers of health and disease. In this update, we review the physical bases underlying diffusion studies and diffusion tensor imaging, advanced models for their analysis (intravoxel coherent motion and kurtosis), and the biological significance of the parameters derived.
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Affiliation(s)
- T Martín Noguerol
- Sección de Neurorradiología. Clínica las Nieves. SERCOSA. Grupo HealthTime, Jaén, España.
| | - J P Martínez Barbero
- Sección de Neurorradiología. Clínica las Nieves. SERCOSA. Grupo HealthTime, Jaén, España
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32
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Dang YX, Shi KN, Wang XM. Early Changes in Glutamate Metabolism and Perfusion in Basal Ganglia following Hypoxia-Ischemia in Neonatal Piglets: A Multi-Sequence 3.0T MR Study. Front Physiol 2017; 8:237. [PMID: 28487658 PMCID: PMC5404207 DOI: 10.3389/fphys.2017.00237] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 04/05/2017] [Indexed: 12/20/2022] Open
Abstract
The excitotoxicity of glutamate metabolism as well as hemodynamic disorders of the brain are both risk factors for neonatal hypoxic–ischemic brain damage (HIBD). In the present study, changes in glutamate metabolism in the basal ganglia were detected by proton magnetic resonance spectroscopy (1H-MRS) at 0–6, 8–12, 24–30, and 48–60 h after the induction of hypoxia-ischemia (HI) in newborn piglets. Meanwhile, correlation analysis was performed by combining the microcirculatory perfusion informations acquired by intravoxel incoherent motion (IVIM) scan to explore their possible interaction mechanism. The results suggested that Glu level in the basal ganglia underwent a “two-phase” change after HI; perfusion fraction f, an IVIM-derived perfusion parameter, was clearly decreased in the early stage after HI, then demonstrated a transient and slight recovery process, and thereafter continued to decrease. The changes in f and Glu level were in a significant negative correlation (r = −0.643, P = 0.001). Our study results revealed that Glu level is closely associated with the microcirculatory perfusion changes in the acute stage of HIBD.
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Affiliation(s)
- Yu-Xue Dang
- Department of Radiology, Shengjing Hospital of China Medical UniversityShenyang, China
| | - Kai-Ning Shi
- Department of Imaging Systems Clinical Science, Philips HealthcareBeijing, China
| | - Xiao-Ming Wang
- Department of Radiology, Shengjing Hospital of China Medical UniversityShenyang, China
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33
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Marzi S, Piludu F, Forina C, Sanguineti G, Covello R, Spriano G, Vidiri A. Correlation study between intravoxel incoherent motion MRI and dynamic contrast-enhanced MRI in head and neck squamous cell carcinoma: Evaluation in primary tumors and metastatic nodes. Magn Reson Imaging 2017; 37:1-8. [DOI: 10.1016/j.mri.2016.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/07/2016] [Accepted: 10/05/2016] [Indexed: 12/12/2022]
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34
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Keil VC, Mädler B, Gielen GH, Pintea B, Hiththetiya K, Gaspranova AR, Gieseke J, Simon M, Schild HH, Hadizadeh DR. Intravoxel incoherent motion MRI in the brain: Impact of the fitting model on perfusion fraction and lesion differentiability. J Magn Reson Imaging 2017; 46:1187-1199. [PMID: 28152250 DOI: 10.1002/jmri.25615] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 12/13/2016] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To investigate the effect of the choice of the curve-fitting model on the perfusion fraction (fIVIM ) with regard to tissue type characterization, correlation with microvascular anatomy, and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters. Several curve-fitting models coexist in intravoxel incoherent motion (IVIM) MRI to derive the (fIVIM ). MATERIALS AND METHODS In all, 29 patients with brain lesions (12 gliomas, 11 meningiomas, three metastases, two gliotic scars, one multiple sclerosis) underwent IVIM-MRI (32 b-values, 0 to 2000 s/mm2 ) at 3T. fIVIM was determined by classic monoexponential, biexponential, and a novel nonnegative least squares (NNLS) fitting in 352 regions of interest (lesion-containing and normal-appearing tissue) and tested their correlation with DCE-MRI kinetic parameters and microvascular anatomy derived from 57 region of interest (ROI)-based biopsies and their capacities to differentiate histologically different lesions. RESULTS fIVIM differed significantly between all three models and all tissue types (monoexponential confidence interval in percent [CI 3.4-3.8]; biexponential [CI 11.21-12.45]; NNLS [CI 2.06-2.60]; all P < 0.001). For all models an increase in fIVIM was associated with a shift to larger vessels and higher vessel area / tissue area ratio (regression coefficient 0.07-0.52; P = 0.04-0.001). Correlation with kinetic parameters derived from DCE-MRI was usually not significant. Only biexponential fitting allowed differentiation of both gliosis from edema and high- from low-grade glioma (both P < 0.001). CONCLUSION The curve-fitting model has an important impact on fIVIM and its capacity to differentiate tissues. fIVIM may possibly be used to assess microvascular anatomy and is weakly correlated with DCE-MRI kinetic parameters. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1187-1199.
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Affiliation(s)
- Vera C Keil
- University Hospital Bonn/Germany, Department of Radiology, Bonn, Germany
| | | | - Gerrit H Gielen
- University Hospital Bonn/Germany, Department of Neuropathology, Center for Pathology, Bonn, Germany
| | - Bogdan Pintea
- BG Krankenhaus Bergmannsheil, Bochum/Germany, Bochum, Germany
| | | | - Alisa R Gaspranova
- University Hospital Bonn/Germany, Department of Radiology, Bonn, Germany
| | | | - Matthias Simon
- Ev. Krankenhaus Bielefeld/Germany, Department of Neurosurgery, Bielefeld, Germany.,University Hospital Bonn/Germany, Department of Neurosurgery and Stereotaxy, Bonn, Germany
| | - Hans H Schild
- University Hospital Bonn/Germany, Department of Radiology, Bonn, Germany
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Distribution of intravoxel incoherent motion MRI-related parameters in the brain: evidence of interhemispheric asymmetry. Clin Radiol 2017; 72:94.e1-94.e6. [DOI: 10.1016/j.crad.2016.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/08/2016] [Accepted: 09/07/2016] [Indexed: 12/14/2022]
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36
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Comparison of non-Gaussian and Gaussian diffusion models of diffusion weighted imaging of rectal cancer at 3.0 T MRI. Sci Rep 2016; 6:38782. [PMID: 27934928 PMCID: PMC5146921 DOI: 10.1038/srep38782] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 11/14/2016] [Indexed: 02/07/2023] Open
Abstract
Water molecular diffusion in vivo tissue is much more complicated. We aimed to compare non-Gaussian diffusion models of diffusion-weighted imaging (DWI) including intra-voxel incoherent motion (IVIM), stretched-exponential model (SEM) and Gaussian diffusion model at 3.0 T MRI in patients with rectal cancer, and to determine the optimal model for investigating the water diffusion properties and characterization of rectal carcinoma. Fifty-nine consecutive patients with pathologically confirmed rectal adenocarcinoma underwent DWI with 16 b-values at a 3.0 T MRI system. DWI signals were fitted to the mono-exponential and non-Gaussian diffusion models (IVIM-mono, IVIM-bi and SEM) on primary tumor and adjacent normal rectal tissue. Parameters of standard apparent diffusion coefficient (ADC), slow- and fast-ADC, fraction of fast ADC (f), α value and distributed diffusion coefficient (DDC) were generated and compared between the tumor and normal tissues. The SEM exhibited the best fitting results of actual DWI signal in rectal cancer and the normal rectal wall (R2 = 0.998, 0.999 respectively). The DDC achieved relatively high area under the curve (AUC = 0.980) in differentiating tumor from normal rectal wall. Non-Gaussian diffusion models could assess tissue properties more accurately than the ADC derived Gaussian diffusion model. SEM may be used as a potential optimal model for characterization of rectal cancer.
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Contribution of mono-exponential, bi-exponential and stretched exponential model-based diffusion-weighted MR imaging in the diagnosis and differentiation of uterine cervical carcinoma. Eur Radiol 2016; 27:2400-2410. [DOI: 10.1007/s00330-016-4596-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 08/24/2016] [Accepted: 09/01/2016] [Indexed: 10/20/2022]
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38
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Conklin J, Heyn C, Roux M, Cerny M, Wintermark M, Federau C. A Simplified Model for Intravoxel Incoherent Motion Perfusion Imaging of the Brain. AJNR Am J Neuroradiol 2016; 37:2251-2257. [PMID: 27561834 DOI: 10.3174/ajnr.a4929] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 07/16/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Despite a recent resurgence, intravoxel incoherent motion MRI faces practical challenges, including limited SNR and demanding acquisition and postprocessing requirements. A simplified approach using linear fitting of a subset of higher b-values has seen success in other organ systems. We sought to validate this method for evaluation of brain pathology by comparing perfusion measurements using simplified linear fitting to conventional biexponential fitting. MATERIALS AND METHODS Forty-nine patients with gliomas and 17 with acute strokes underwent 3T MRI, including DWI with 16 b-values (range, 0-900 s/mm2). Conventional intravoxel incoherent motion was performed using nonlinear fitting of the standard biexponential equation. Simplified intravoxel incoherent motion was performed using linear fitting of the log-normalized signal curves for subsets of b-values >200 s/mm2. Comparisons between ROIs (tumors, strokes, contralateral brain) and between models (biexponential and simplified linear) were performed by using 2-way ANOVA. The root mean square error and coefficient of determination (R2) were computed for the simplified model, with biexponential fitting as the reference standard. RESULTS Perfusion maps using simplified linear fitting were qualitatively similar to conventional biexponential fitting. The perfusion fraction was elevated in high-grade (n = 33) compared to low-grade (n = 16) gliomas and was reduced in strokes compared to the contralateral brain (P < .001 for both main effects). Decreasing the number of b-values used for linear fitting resulted in reduced accuracy (higher root mean square error and lower R2) compared with full biexponential fitting. CONCLUSIONS Intravoxel incoherent motion perfusion imaging of common brain pathology can be performed by using simplified linear fitting, with preservation of clinically relevant perfusion information.
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Affiliation(s)
- J Conklin
- From the Department of Medical Imaging (J.C., C.H.), Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
| | - C Heyn
- From the Department of Medical Imaging (J.C., C.H.), Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
| | - M Roux
- Department of Diagnostic and Interventional Radiology (M.R., M.C., C.F.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - M Cerny
- Department of Diagnostic and Interventional Radiology (M.R., M.C., C.F.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - M Wintermark
- Department of Radiology (M.W.), University of Virginia, Charlottesville, Virginia.,Department of Radiology (M.W., C.F.), Stanford University, Stanford, California
| | - C Federau
- Department of Diagnostic and Interventional Radiology (M.R., M.C., C.F.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland .,Department of Radiology (M.W., C.F.), Stanford University, Stanford, California
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Xu XQ, Choi YJ, Sung YS, Yoon RG, Jang SW, Park JE, Heo YJ, Baek JH, Lee JH. Intravoxel Incoherent Motion MR Imaging in the Head and Neck: Correlation with Dynamic Contrast-Enhanced MR Imaging and Diffusion-Weighted Imaging. Korean J Radiol 2016; 17:641-9. [PMID: 27587952 PMCID: PMC5007390 DOI: 10.3348/kjr.2016.17.5.641] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 05/17/2016] [Indexed: 12/25/2022] Open
Abstract
Objective To investigate the correlation between perfusion- and diffusion-related parameters from intravoxel incoherent motion (IVIM) and those from dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion-weighted imaging in tumors and normal muscles of the head and neck. Materials and Methods We retrospectively enrolled 20 consecutive patients with head and neck tumors with MR imaging performed using a 3T MR scanner. Tissue diffusivity (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were derived from bi-exponential fitting of IVIM data obtained with 14 different b-values in three orthogonal directions. We investigated the correlation between D, f, and D* and model-free parameters from the DCE-MRI (wash-in, Tmax, Emax, initial AUC60, whole AUC) and the apparent diffusion coefficient (ADC) value in the tumor and normal masseter muscle using a whole volume-of-interest approach. Pearson's correlation test was used for statistical analysis. Results No correlation was found between f or D* and any of the parameters from the DCE-MRI in all patients or in patients with squamous cell carcinoma (p > 0.05). The ADC was significantly correlated with D values in the tumors (p < 0.001, r = 0.980) and muscles (p = 0.013, r = 0.542), despite its significantly higher value than D. The difference between ADC and D showed significant correlation with f values in the tumors (p = 0.017, r = 0.528) and muscles (p = 0.003, r = 0.630), but no correlation with D* (p > 0.05, respectively). Conclusion Intravoxel incoherent motion shows no significant correlation with model-free perfusion parameters derived from the DCE-MRI but is feasible for the analysis of diffusivity in both tumors and normal muscles of the head and neck.
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Affiliation(s)
- Xiao Quan Xu
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.; Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Yu Sub Sung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Ra Gyoung Yoon
- Department of Radiology, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon 22711, Korea
| | - Seung Won Jang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Young Jin Heo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.; Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
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40
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De Luca A, Bertoldo A, Froeling M. Effects of perfusion on DTI and DKI estimates in the skeletal muscle. Magn Reson Med 2016; 78:233-246. [PMID: 27538923 DOI: 10.1002/mrm.26373] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/28/2016] [Accepted: 07/18/2016] [Indexed: 12/20/2022]
Abstract
PURPOSE In this study, we evaluated the effects of perfusion of the skeletal muscle on diffusion tensor imaging (DTI) and diffusional kurtosis imaging (DKI) parameters and their reproducibility. METHODS Diffusion tensor imaging and DKI models, with and without intravoxel incoherent motion (IVIM) correction, were applied to simulated data at different physiological conditions and signal-to-noise ratio levels. Next, the same models were applied to data of the right calf of five healthy volunteers, acquired twice at 3 telsa. For six muscles, we evaluated the correlation of the perfusion signal fraction, with parameters derived from DTI and DKI, and performed repeatability analysis with and without IVIM correction. Additionally, the IVIM correction was compared to a multishell acquisition approach that minimizes perfusion effects on DTI estimates. RESULTS Simulations and acquired data showed that DTI and DKI estimates were biased proportionally to the perfusion signal fraction, and that IVIM correction was needed for accurate estimation of the DTI and DKI parameters. However, taking perfusion into account did not improve repeatability. CONCLUSION Blood perfusion has an effect on DTI and DKI estimations, but it can be minimized with IVIM correction or multishell acquisition strategies. Magn Reson Med 78:233-246, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Alberto De Luca
- Department of Information Engineering, University of Padova, Padova, Italy.,Department of Radiology, University Medical Center, Utrecht, The Netherlands.,Neuroimaging Lab, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, LC, Italy
| | | | - Martijn Froeling
- Department of Radiology, University Medical Center, Utrecht, The Netherlands
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Intravoxel Incoherent Motion Metrics as Potential Biomarkers for Survival in Glioblastoma. PLoS One 2016; 11:e0158887. [PMID: 27387822 PMCID: PMC4936699 DOI: 10.1371/journal.pone.0158887] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 06/23/2016] [Indexed: 01/03/2023] Open
Abstract
Objective Intravoxel incoherent motion (IVIM) is an MRI technique with potential applications in measuring brain tumor perfusion, but its clinical impact remains to be determined. We assessed the usefulness of IVIM-metrics in predicting survival in newly diagnosed glioblastoma. Methods Fifteen patients with glioblastoma underwent MRI including spin-echo echo-planar DWI using 13 b-values ranging from 0 to 1000 s/mm2. Parametric maps for diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were generated for contrast-enhancing regions (CER) and non-enhancing regions (NCER). Regions of interest were manually drawn in regions of maximum f and on the corresponding dynamic susceptibility contrast images. Prognostic factors were evaluated by Kaplan-Meier survival and Cox proportional hazards analyses. Results We found that fCER and D*CER correlated with rCBFCER. The best cutoffs for 6-month survival were fCER>9.86% and D*CER>21.712 x10−3mm2/s (100% sensitivity, 71.4% specificity, 100% and 80% positive predictive values, and 80% and 100% negative predictive values; AUC:0.893 and 0.857, respectively). Treatment yielded the highest hazard ratio (5.484; 95% CI: 1.162–25.88; AUC: 0.723; P = 0.031); fCER combined with treatment predicted survival with 100% accuracy. Conclusions The IVIM-metrics fCER and D*CER are promising biomarkers of 6-month survival in newly diagnosed glioblastoma.
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Stieb S, Boss A, Wurnig MC, Özbay PS, Weiss T, Guckenberger M, Riesterer O, Rossi C. Non-parametric intravoxel incoherent motion analysis in patients with intracranial lesions: Test-retest reliability and correlation with arterial spin labeling. NEUROIMAGE-CLINICAL 2016; 11:780-788. [PMID: 27354956 PMCID: PMC4910187 DOI: 10.1016/j.nicl.2016.05.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 05/30/2016] [Accepted: 05/31/2016] [Indexed: 12/26/2022]
Abstract
Intravoxel incoherent motion (IVIM) analysis of diffusion imaging data provides biomarkers of true passive water diffusion and perfusion properties. A new IVIM algorithm with variable adjustment of the b-value threshold separating diffusion and perfusion effects was applied for cerebral tissue characterization in healthy volunteers, computation of test-retest reliability, correlation with arterial spin labeling, and assessment of applicability in a small cohort of patients with malignant intracranial masses. The main results of this study are threefold: (i) accounting for regional differences in the separation of the perfusion and the diffusion components improves the reliability of the model parameters; (ii) if differences in the b-value threshold are not accounted for, a significant tissue-dependent systematic bias of the IVIM parameters occurs; (iii) accounting for voxel-wise differences in the b-value threshold improves the correlation with CBF measurements in healthy volunteers and patients. The proposed algorithm provides a robust characterization of regional micro-vascularization and cellularity without a priori assumptions on tissue diffusion properties. The glioblastoma multiforme with its inherently high variability of tumor vascularization and tumor cell density may benefit from a non-invasive clinical characterization of diffusion and perfusion properties. The novel IVIM algorithm accounts for regional differences in the separation of the perfusion and the diffusion components. The algorithm improves the reliability of IVIM parameters. The algorithm improves the correlation with CBF in healthy volunteers and patients.
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Affiliation(s)
- Sonja Stieb
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| | - Andreas Boss
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Switzerland
| | - Moritz C Wurnig
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Switzerland
| | - Pinar S Özbay
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Switzerland; Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland
| | - Tobias Weiss
- Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland
| | - Matthias Guckenberger
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Switzerland
| | - Oliver Riesterer
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Switzerland
| | - Cristina Rossi
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Switzerland.
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43
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Suo S, Cao M, Zhu W, Li L, Li J, Shen F, Zu J, Zhou Z, Zhuang Z, Qu J, Chen Z, Xu J. Stroke assessment with intravoxel incoherent motion diffusion-weighted MRI. NMR IN BIOMEDICINE 2016; 29:320-328. [PMID: 26748572 DOI: 10.1002/nbm.3467] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 11/19/2015] [Accepted: 11/23/2015] [Indexed: 06/05/2023]
Abstract
Intravoxel incoherent motion (IVIM) diffusion-weighted MRI can simultaneously measure diffusion and perfusion characteristics in a non-invasive way. This study aimed to determine the potential utility of IVIM in characterizing brain diffusion and perfusion properties for clinical stroke. The multi-b-value diffusion-weighted images of 101 patients diagnosed with acute/subacute ischemic stroke were retrospectively evaluated. The diffusion coefficient D, representing the water apparent diffusivity, was obtained by fitting the diffusion data with increasing high b-values to a simple mono-exponential model. The IVIM-derived perfusion parameters, pseudodiffusion coefficient D*, vascular volume fraction f and blood flow-related parameter fD*, were calculated with the bi-exponential model. Additionally, the apparent diffusion coefficient (ADC) was fitted according to the mono-exponential model using all b-values. The diffusion parameters for the ischemic lesion and normal contralateral region were measured in each patient. Statistical analysis was performed using the paired Student t-test and Pearson correlation test. Diffusion data in both the ischemic lesion and normal contralateral region followed the IVIM bi-exponential behavior, and the IVIM model showed better goodness of fit than the mono-exponential model with lower Akaike information criterion values. The paired Student t-test revealed significant differences for all diffusion parameters (all P < 0.001) except D* (P = 0.218) between ischemic and normal areas. For all patients in both ischemic and normal regions, ADC was significantly positively correlated with D (both r = 1, both P < 0.001) and f (r = 0.541, P < 0.001; r = 0.262, P = 0.008); significant correlation was also found between ADC and fD* in the ischemic region (r = 0.254, P = 0.010). For all pixels within the region of interest from a representative subject in both ischemic and normal regions, ADC was significantly positively correlated with D (both r = 1, both P < 0.001), f (r = 0.823, P < 0.001; r = 0.652, P < 0.001) and fD* (r = 0.294, P < 0.001; r = 0.340, P < 0.001). These findings may have clinical implications for the use of IVIM imaging in the assessment and management of acute/subacute stroke patients. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shiteng Suo
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mengqiu Cao
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wanqiu Zhu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Li
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Li
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Fei Shen
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jinyan Zu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zien Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiguo Zhuang
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | | | - Zengai Chen
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jianrong Xu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Hectors SJ, Wagner M, Besa C, Bane O, Dyvorne HA, Fiel MI, Zhu H, Donovan M, Taouli B. Intravoxel incoherent motion diffusion-weighted imaging of hepatocellular carcinoma: Is there a correlation with flow and perfusion metrics obtained with dynamic contrast-enhanced MRI? J Magn Reson Imaging 2016; 44:856-64. [PMID: 26919327 DOI: 10.1002/jmri.25194] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 01/28/2016] [Accepted: 01/30/2016] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To assess the correlation between intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) metrics in hepatocellular carcinoma (HCC) and liver parenchyma. MATERIALS AND METHODS Twenty-five patients with HCC (M/F 23/2, mean age 58 years) underwent abdominal MRI at 1.5 or 3.0T, including IVIM-DWI (with 16 b-values) and DCE-MRI (3D FLASH sequence, mean temporal resolution of 2.3 sec). IVIM-DWI parameters (pseudodiffusion coefficient, D*, diffusion coefficient, D, and perfusion fraction, PF) were quantified in HCC lesions and liver parenchyma using a Bayesian fitting algorithm. DCE-MRI parameters (arterial flow, Fa , portal flow, Fp , total flow, Ft , mean transit time, MTT, distribution volume, DV, and arterial fraction, ART) were quantified using a dual-input single-compartment model. Correlations between IVIM-DWI and DCE-MRI parameters were assessed using a Spearman correlation test. RESULTS Thirty-three HCC lesions (average size 5.0 ± 3.6 cm) were analyzed. D, D*, and PF were all significantly lower in HCC vs. liver (P < 0.05). Significantly higher Fa and ART and lower Fp were observed in HCC vs. liver (P < 0.001). Significant moderate to strong negative correlations were observed between ART and D* (r = -0.443, P = 0.028), ART and PF (r = -0.536, P = 0.006), ART and PFxD* (r = -0.655, P < 0.001), Fa and PF (r = 0.455, P = 0.023), and Fa and PFxD* (r = -0.475, P = 0.018) in liver parenchyma. There was no significant correlation between IVIM-DWI and DCE-MRI metrics in HCC lesions. CONCLUSION IVIM-DWI and DCE-MRI provide nonredundant information in HCC, while they correlate in liver parenchyma. These findings may be secondary to predominant portal inflow in the liver and tortuous vasculature and tissue heterogeneity in tumors. J. MAGN. RESON. IMAGING 2016;44:856-864.
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Affiliation(s)
- Stefanie J Hectors
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mathilde Wagner
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Cecilia Besa
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Octavia Bane
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hadrien A Dyvorne
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - M Isabel Fiel
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hongfa Zhu
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael Donovan
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bachir Taouli
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. .,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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Shen N, Zhao L, Jiang J, Jiang R, Su C, Zhang S, Tang X, Zhu W. Intravoxel incoherent motion diffusion-weighted imaging analysis of diffusion and microperfusion in grading gliomas and comparison with arterial spin labeling for evaluation of tumor perfusion. J Magn Reson Imaging 2016; 44:620-32. [PMID: 26880230 DOI: 10.1002/jmri.25191] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 01/25/2016] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To determine the utility of intravoxel incoherent motion (IVIM) imaging in grading gliomas and compare IVIM perfusion metrics with arterial spin labeling (ASL)-derived cerebral blood flow (CBF). MATERIALS AND METHODS Fifty-two patients with pathologically confirmed gliomas underwent IVIM and ASL imaging at 3.0T. IVIM perfusion-related diffusivity (D*), perfusion fraction (f), product of f and D*(f×D*), true diffusivity (D), and apparent diffusion coefficient (ADC) were obtained to distinguish glioma grades. The CBF derived from pseudocontinuous ASL within the solid tumor was compared and correlated with IVIM perfusion metrics for grading of gliomas. Values were also normalized to the contralateral normal-appearing white matter. Receiver-operating characteristic was performed to determine diagnostic efficiency. The reliability was estimated with intraclass coefficient, coefficient of variance, and Bland-Altman plots. RESULTS IVIM perfusion metrics and CBF were significantly higher in the high-grade than the low-grade gliomas (P < 0.001), ADC and D were significantly lower in the high-grade than the low-grade gliomas (P < 0.001). f×D* differed significantly between grades II through IV (P < 0.05 for all). The other metrics showed significant difference between grade II and grade III (P < 0.05 for all). Area under the curve (AUC) was largest for f×D* in distinguishing high-grade from low-grade gliomas (AUC = 0.979, P < 0.001) and between grade II and grade III (AUC = 0.957, P < 0.001). f×D* improved diagnostic performance of CBF in grading gliomas and showed strong correlation with CBF (r = 0.696, P < 0.001). CONCLUSION IVIM-derived metrics are promising biomarkers in preoperative grading gliomas. IVIM imaging may be an additive method to ASL and ADC for evaluating tumor perfusion and diffusion. J. Magn. Reson. Imaging 2016;44:620-632.
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Affiliation(s)
- Nanxi Shen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lingyun Zhao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingjing Jiang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rifeng Jiang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Changliang Su
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shun Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiangyu Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Marzi S, Stefanetti L, Sperati F, Anelli V. Relationship between diffusion parameters derived from intravoxel incoherent motion MRI and perfusion measured by dynamic contrast-enhanced MRI of soft tissue tumors. NMR IN BIOMEDICINE 2016; 29:6-14. [PMID: 26602061 DOI: 10.1002/nbm.3446] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 10/21/2015] [Accepted: 10/21/2015] [Indexed: 06/05/2023]
Abstract
Our aim was to evaluate the link between diffusion parameters measured by intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and the perfusion metrics obtained with dynamic contrast-enhanced (DCE) MRI in soft tissue tumors (STTs). Twenty-eight patients affected by histopathologically confirmed STT were included in a prospective study. All patients underwent both DCE MRI and IVIM DWI. The perfusion fraction f, diffusion coefficient D and perfusion-related diffusion coefficient D* were estimated using a bi-exponential function to fit the DWI data. DCE MRI was acquired with a temporal resolution of 3-5 s. Maps of the initial area under the gadolinium concentration curve (IAUGC), time to peak (TTP) and maximum slope of increase (MSI) were derived using commercial software. The relationships between the DCE MRI and IVIM DWI measurements were assessed by Spearman's test. To exclude false positive results under multiple testing, the false discovery rate (FDR) procedure was applied. The Mann-Whitney test was used to evaluate the differences between all variables in patients with non-myxoid and myxoid STT. No significant relationship was found between IVIM parameters and any DCE MRI parameters. Higher f and D*f values were found in non-myxoid tumors compared with myxoid tumors (p = 0.004 and p = 0.003, respectively). MSI was significantly higher in non-myxoid tumors than in myxoid tumors (p = 0.029). From the visual assessments of single clinical cases, both f and D*f maps were in satisfactory agreement with DCE maps in the extreme cases of an avascular mass and a highly vascularized mass, whereas, for tumors with slight vascularity or with a highly heterogeneous perfusion pattern, this association was not straightforward. Although IVIM DWI was demonstrated to be feasible in STT, our data did not support evident relationships between perfusion-related IVIM parameters and perfusion measured by DCE MRI.
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Affiliation(s)
- Simona Marzi
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Rome, Italy
| | - Linda Stefanetti
- Department of Radiology, S. Andrea Hospital, Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Rome, Italy
| | - Francesca Sperati
- Biostatistics-Scientific Direction, Regina Elena National Cancer Institute, Rome, Italy
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Department, Regina Elena National Cancer Institute, Rome, Italy
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Yan R, Haopeng P, Xiaoyuan F, Jinsong W, Jiawen Z, Chengjun Y, Tianming Q, Ji X, Mao S, Yueyue D, Yong Z, Jianfeng L, Zhenwei Y. Non-Gaussian diffusion MR imaging of glioma: comparisons of multiple diffusion parameters and correlation with histologic grade and MIB-1 (Ki-67 labeling) index. Neuroradiology 2015; 58:121-32. [PMID: 26494463 DOI: 10.1007/s00234-015-1606-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 10/02/2015] [Indexed: 12/12/2022]
Abstract
INTRODUCTION This study was conducted to compare the association of Gaussian and non-Gaussian magnetic resonance imaging (MRI)-derived parameters with histologic grade and MIB-1 (Ki-67 labeling) index (MI) in brain glioma. METHODS Sixty-five patients with pathologically confirmed glioma, who underwent diffusion-weighted MRI with 2 b values (0, 1000 s/mm(2)) and 22 b values (≤5000 s/mm(2)), respectively, were divided into three groups of grade II (n = 35), grade III (n = 8), and grade IV (n = 22). Comparisons by two groups were made for apparent diffusion coefficient (ADC), slow diffusion coefficient (Dslow), distributed diffusion coefficient (DDC), and heterogeneity index α. Analyses of receiver operating characteristic (ROC) curve were performed to maximize the area under the curve (AUC) for differentiating grade III + IV (high-grade glioma, HGG) from grade II (low-grade glioma, LGG) and grade IV (glioblastoma multiforme, GBM) from grade II + III (other grade glioma, OGG). Correlations with MI were analyzed for the MRI parameters. RESULTS On tumor regions, the values of ADC, Dslow, DDC, and α were significantly higher in grade II [(1.37 ± 0.29, 0.70 ± 0.11, 1.39 ± 0.34) (×10(-3) mm(2)/s) and 0.88 ± 0.05, respectively] than in grade III [(0.99 ± 0.13, 0.55 ± 0.07, 1.04 ± 0.20) (×10(-3) mm(2)/s) and 0.80 ± 0.03, respectively] and grade IV [(1.03 ± 0.14, 0.50 ± 0.05, 1.02 ± 0.16) (×10(-3) mm(2)/s) and 0.76 ± 0.04, respectively] (all P < 0.001). The parameter α showed the highest AUCs of 0.950 and 0.922 in discriminating HGG from LGG and GBM from OGG, respectively. Significant correlations with histologic grade and MI were observed for the MRI parameters. CONCLUSION The non-Gaussian MRI-derived parameters α and Dslow are superior to ADC in glioma grading, which are comparable with ADC as reliable biomarkers in noninvasively predicting the proliferation level of glioma malignancy.
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Affiliation(s)
- Ren Yan
- Department of Radiology, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China
| | - Pang Haopeng
- Department of Radiology, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China
| | - Feng Xiaoyuan
- Department of Radiology, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China.
| | - Wu Jinsong
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Zhang Jiawen
- Department of Radiology, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China
| | - Yao Chengjun
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Qiu Tianming
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Xiong Ji
- Department of Neuropathology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Sheng Mao
- Department of Imaging, Suzhou Children's Hospital, Suzhou, Jiangsu, PR China
| | - Ding Yueyue
- Department of Imaging, Suzhou Children's Hospital, Suzhou, Jiangsu, PR China
| | - Zhang Yong
- MR Research, GE Healthcare, Shanghai, PR China
| | - Luo Jianfeng
- Department of Biostatistics, Public Health School, Fudan University, Shanghai, PR China
| | - Yao Zhenwei
- Department of Radiology, Huashan Hospital, Fudan University, Mid Wulumuqi Road, Shanghai, 200040, PR China
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Guo Z, Zhang Q, Li X, Jing Z. Intravoxel Incoherent Motion Diffusion Weighted MR Imaging for Monitoring the Instantly Therapeutic Efficacy of Radiofrequency Ablation in Rabbit VX2 Tumors without Evident Links between Conventional Perfusion Weighted Images. PLoS One 2015; 10:e0127964. [PMID: 26020785 PMCID: PMC4447409 DOI: 10.1371/journal.pone.0127964] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 04/21/2015] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To investigate the intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) as a potential valuable marker to monitor the therapy responses of VX2 to radiofrequency ablation (RF Ablation). METHODS The institutional animal care and use committee approved this study. In 10 VX2 tumor-bearing rabbits, IVIM-DWI examinations were performed with a 3.0T imaging unit by using 16 b values from 0 to 800 sec/mm2. The true diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) of tumors were compared between before and instantly after RF Ablation treatment. The differences of D, D* and f and conventional perfusion parameters (from perfusion CT and dynamic enhanced magnetic resonance imaging, DCE-MRI) in the coagulation necrosis area, residual unablated area, untreated area, and normal control had been calculated by compared t-test. The correlation between f or D* with perfusion weighted CT including blood flow, BF (milliliter per 100 mL/min), blood volume, BV (milliliter per 100 mL/min), and capillary permeability-surface area, PMB (as a fraction) or from DCE-MRI: transfer constant (Ktrans), extra-vascular extra-cellular volume fraction (Ve) and reflux constant (Kep) values had been analyzed by region-of-interest (ROI) methods to calculate Pearson's correlation coefficients. RESULTS In the ablated necrosis areas, f and D* significantly decreased and D significantly increased, compared with residual unblazed areas or untreated control groups and normal control groups (P < 0.001). The IVIM-DWI derived f parameters showed significant increases in the residual unablated tumor area. There was no significant correlations between f or D* and conventional perfusion parameters. CONCLUSIONS The IVIM-DW derived f, D and D* parameters have the potential to indicate therapy response immediately after RF Ablation treatment, while no significant correlations with classical tumor perfusion metrics were derived from DCE-MRI and perfusion-CT measurements.
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Affiliation(s)
- Ziyi Guo
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Department of Radiology, Haikou People’s Hospital, Xiangya Medical School, Central South University, Haikou, 570208, Hainan, P.R. China
| | - Qiang Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Xiaoguang Li
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- * E-mail: (ZGY); (XGL)
| | - Zhengyu Jing
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- * E-mail: (ZGY); (XGL)
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49
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Lee EYP, Hui ESK, Chan KKL, Tse KY, Kwong WK, Chang TY, Chan Q, Khong PL. Relationship between intravoxel incoherent motion diffusion-weighted MRI and dynamic contrast-enhanced MRI in tissue perfusion of cervical cancers. J Magn Reson Imaging 2014; 42:454-9. [PMID: 25413245 DOI: 10.1002/jmri.24808] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 11/04/2014] [Accepted: 11/04/2014] [Indexed: 11/09/2022] Open
Affiliation(s)
- Elaine Yuen Phin Lee
- Department of Diagnostic Radiology; Queen Mary Hospital; The University of Hong Kong; Hong Kong China
| | - Edward Sai Kam Hui
- Department of Diagnostic Radiology; Queen Mary Hospital; The University of Hong Kong; Hong Kong China
| | - Karen Kar Loen Chan
- Department of Obstetrics and Gynaecology; Queen Mary Hospital; The University of Hong Kong; Hong Kong China
| | - Ka Yu Tse
- Department of Obstetrics and Gynaecology; Queen Mary Hospital; The University of Hong Kong; Hong Kong China
| | - Wai Kay Kwong
- Department of Clinical Oncology; Queen Mary Hospital; Hong Kong China
| | - Tien Yee Chang
- Department of Clinical Oncology; Pamela Youde Nethersole Eastern Hospital; Hong Kong China
| | | | - Pek-Lan Khong
- Department of Diagnostic Radiology; Queen Mary Hospital; The University of Hong Kong; Hong Kong China
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