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Kitami M, Saito M, Aoki H. Diffusion-weighted Imaging as a "Gatekeeper" Sequence in the Evaluation of Clinically Diagnosed "Infantile Hemangioma". Radiographics 2024; 44:e240041. [PMID: 38547033 DOI: 10.1148/rg.240041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Affiliation(s)
- Masahiro Kitami
- Department of Diagnostic Radiology, Miyagi Children's Hospital, 4-3-17 Ochiai, Aoba-ku, Sendai 989-3126, Japan
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mioko Saito
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hidekazu Aoki
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Neumane S, Lesage A, Dangouloff-Ros V, Levy R, Roux CJ, Robert MP, Bremond-Gignac D, Boddaert N. Arterial Spin-Labeling in the Assessment of Pediatric Nontraumatic Orbital Lesions. AJNR Am J Neuroradiol 2023; 44:1219-1223. [PMID: 37652581 PMCID: PMC10549944 DOI: 10.3174/ajnr.a7977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/02/2023] [Indexed: 09/02/2023]
Abstract
Benign and malignant pediatric orbital lesions can sometimes have overlapping features on conventional MR imaging sequences. MR imaging of 27 children was retrospectively reviewed to describe the signal of some common pediatric extraocular orbital lesions on arterial spin-labeling and to evaluate whether this sequence helps to discriminate malignant from benign masses, with or without ADC value measurements. Qualitative and quantitative assessments of arterial spin-labeling CBF and ADC were performed. All lesions were classified into 3 arterial spin-labeling perfusion patterns: homogeneous hypoperfusion (pattern 1, n = 15; benign lesions), heterogeneous hyperperfusion (pattern 2, n = 9; cellulitis, histiocytosis, malignant tumors), and homogeneous intense hyperperfusion (pattern 3, n = 3; infantile hemangiomas). Arterial spin-labeling can be a valuable tool to improve the diagnostic confidence of some orbital lesions, including infantile hemangioma. An algorithm is proposed.
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Affiliation(s)
- S Neumane
- From the Department of Pediatric Radiology (S.N., A.L., V.D.-R., R.L., C.-J.R., N.B.), Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- NeuroSpin, UNIACT (S.N.), Commissariat à l'Énergie Atomique et aux Énergies Alternatives (CEA), Université Paris-Saclay, Gif-sur-Yvette, France
| | - A Lesage
- From the Department of Pediatric Radiology (S.N., A.L., V.D.-R., R.L., C.-J.R., N.B.), Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Department of Pediatric Radiology (A.L.), Centre Hospitalier Universitaire Saint-Justine, Montréal, Quebec, Canada
| | - V Dangouloff-Ros
- From the Department of Pediatric Radiology (S.N., A.L., V.D.-R., R.L., C.-J.R., N.B.), Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Institut Imagine (V.D.-R., R.L., C.-J.R., N.B.), Institut National de la Santé et de la Recherche Médicale (INSERM) U1163 and U1299, Université Paris Cité, Paris, France
| | - R Levy
- From the Department of Pediatric Radiology (S.N., A.L., V.D.-R., R.L., C.-J.R., N.B.), Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Institut Imagine (V.D.-R., R.L., C.-J.R., N.B.), Institut National de la Santé et de la Recherche Médicale (INSERM) U1163 and U1299, Université Paris Cité, Paris, France
| | - C-J Roux
- From the Department of Pediatric Radiology (S.N., A.L., V.D.-R., R.L., C.-J.R., N.B.), Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Institut Imagine (V.D.-R., R.L., C.-J.R., N.B.), Institut National de la Santé et de la Recherche Médicale (INSERM) U1163 and U1299, Université Paris Cité, Paris, France
| | - M P Robert
- Department of Ophthalmology (M.P.R., D.B.-G.), Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Centre Borelli UMR 9010 (M.P.R.), Université Paris Cité, Université Paris-Saclay, ENS Paris-Saclay, CNRS, SSA, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France
| | - D Bremond-Gignac
- Department of Ophthalmology (M.P.R., D.B.-G.), Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Team 17 (D.B.-G.), Institut National de la Santé et de la Recherche Médicale, UMRS1138, Université Paris Cité, Paris, France
| | - N Boddaert
- From the Department of Pediatric Radiology (S.N., A.L., V.D.-R., R.L., C.-J.R., N.B.), Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Institut Imagine (V.D.-R., R.L., C.-J.R., N.B.), Institut National de la Santé et de la Recherche Médicale (INSERM) U1163 and U1299, Université Paris Cité, Paris, France
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Gupta L, Peterson EL, Williams C, Altman E, Harpole R, Martin DJ, Escott EJ, Timoney PJ, Prendes MA. Diffusion-Weighted Imaging of the Orbit: A Case Series and Systematic Review. Ophthalmic Plast Reconstr Surg 2023; 39:407-418. [PMID: 36757844 DOI: 10.1097/iop.0000000000002325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
PURPOSE To describe the findings of diffusion-weighted imaging (DWI) for a series of orbital lesions and provide a systematic review of relevant literature. METHODS A retrospective review of 20 patients with orbital lesions who underwent MRI with DWI at two academic institutions between 2015 and 2020 was performed. Lesion diagnosis was histopathologically confirmed except a presumed cavernous hemangioma. Echoplanar diffusion-weighted images had been acquired using 2 or 3 b values (b=0 and 1000 or b=0, 500, and 1000) at 1.5T or 3T. Lesions with significant artifacts were excluded. DWI sequences were analyzed by neuro-radiologists blinded to the diagnosis. Mean ADC values of lesions were calculated from a single region of interest. An independent two-tailed t test was used to compare categories of lesions with p < 0.05 considered significant. A systematic review of the literature was performed. RESULTS Our study included 21 lesions. ADC values were significantly lower for malignant lesions (0.628 ± 0.125 × 10 -3 mm 2 /s) than inflammatory lesions (1.167 ± 0.381 × 10 -3 mm 2 /s) ( p < 0.001). ADC values were significantly lower for orbital lymphoma (mean 0.621 ± 0.147 × 10 -3 mm 2 /s) than idiopathic orbital inflammation (mean 1.188 ± 0.269 × 10 -3 mm 2 /s) with no overlap ( p < 0.001). CONCLUSIONS Orbital malignancies demonstrated lower ADC values, while inflammatory processes demonstrated higher ADC values, except IgG4-related disease. DWI and ADC values differentiated idiopathic orbital inflammation from orbital lymphoma. This study highlights the role of DWI in evaluating orbital pathology.
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Affiliation(s)
- Lalita Gupta
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Eric L Peterson
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Cody Williams
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Emily Altman
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Ryan Harpole
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Douglas J Martin
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio
| | - Edward J Escott
- Department of Radiology, Division of Neuroradiology, University of Kentucky Medical Center, Lexington, Kentucky
| | - Peter J Timoney
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Mark A Prendes
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio
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Cameron CA, Tong JY, Juniat V, Patel S, Selva D. Diagnostic Utility of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient for Common Orbital Lesions: A Review. Ophthalmic Plast Reconstr Surg 2022; 38:515-521. [PMID: 34798654 DOI: 10.1097/iop.0000000000002092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To review and summarize the existing literature surrounding the clinical use of diffusion-weighted imaging and apparent diffusion coefficient (ADC) as diagnostic tools in differentiating common orbital lesions. METHODS A systematic literature review on the use of ADC and diffusion-weighted imaging sequences for orbital imaging was performed. Only original research articles that reported ADC values for benign or malignant lesions were included. RESULTS Malignant orbital tumors have an overall lower mean ADC value than benign masses. Orbital lymphoma is characterized by consistently lower ADC values compared with other malignant orbital masses; a threshold value less than 0.775 × 10 -3 mm 2 /s has been proposed to distinguish orbital lymphoma from other neoplastic and non-neoplastic orbital masses. To differentiate orbital inflammatory disease from lymphoma, an ADC threshold greater than 0.92 × 10 -3 mm 2 /s has been proposed. CONCLUSIONS Orbital masses encompass a host of benign and malignant etiologies and can present a diagnostic challenge on both clinical and radiological assessment. Recent advanced MRI techniques such as diffusion-weighted imaging and ADC can improve the diagnostic specificity for orbital disease, particularly in differentiating benign from malignant lesions and lymphoma from orbital inflammatory disease.
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Affiliation(s)
- Cassie A Cameron
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide and the South Australian Institute of Ophthalmology, Adelaide
| | | | - Valerie Juniat
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide and the South Australian Institute of Ophthalmology, Adelaide
| | - Sandy Patel
- Department of Medical Imaging, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Dinesh Selva
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide and the South Australian Institute of Ophthalmology, Adelaide
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To Explore MR Imaging Radiomics for the Differentiation of Orbital Lymphoma and IgG4-Related Ophthalmic Disease. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6668510. [PMID: 33628805 PMCID: PMC7884128 DOI: 10.1155/2021/6668510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/29/2020] [Accepted: 01/23/2021] [Indexed: 12/28/2022]
Abstract
Among orbital lymphoproliferative disorders, about 55% of diagnosed cancerous tumors are orbital lymphomas, and nearly 50% of benign cases are immunoglobulin G4-related ophthalmic disease (IgG4-ROD). However, due to nonspecific characteristics, the differentiation of the two diseases is challenging. In this study, conventional magnetic resonance imaging-based radiomics approaches were explored for clinical recognition of orbital lymphomas and IgG4-ROD. We investigated the value of radiomics features of axial T1- (T1WI-) and T2-weighted (T2WI), contrast-enhanced T1WI in axial (CE-T1WI) and coronal (CE-T1WI-cor) planes, and 78 patients (orbital lymphoma, 36; IgG4-ROD, 42) were retrospectively reviewed. The mass lesions were manually annotated and represented with 99 features. The performance of elastic net-based radiomics models using single or multiple modalities with or without feature selection was compared. The demographic features showed orbital lymphoma patients were significantly older than IgG4-ROD patients (p < 0.01), and most of the patients were male (72% in the orbital lymphoma group vs. 23% in the IgG4-ROD group; p = 0.03). The MR imaging findings revealed orbital lymphomas were mostly unilateral (81%, p = 0.02) and wrapped eyeballs or optic nerves frequently (78%, p = 0.02). In addition, orbital lymphomas showed isointense in T1WI (100%, p < 0.01), and IgG4-ROD was isointense (60%, p < 0.01) or hyperintense (40%, p < 0.01) in T1WI with well-defined shape (64%, p < 0.01). The experimental comparison indicated that using CE-T1WI radiomics features achieved superior results, and the features in combination with CE-T1WI-cor features and the feature preselection method could further improve the classification performance. In conclusion, this study comparatively analyzed orbital lymphoma and IgG4-ROD from demographic features, MR imaging findings, and radiomics features. It might deepen our understanding and benefit disease management.
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