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Zhang X, Xu Z, Jin Y, Huang L, Wu W, Gao M. Multi‑parameter quantitative magnetic resonance imaging in the early assessment of radiation‑induced parotid damage in patients with nasopharyngeal carcinoma following intensity‑modulated radiotherapy. Oncol Lett 2024; 27:180. [PMID: 38464343 PMCID: PMC10921267 DOI: 10.3892/ol.2024.14313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/12/2024] [Indexed: 03/12/2024] Open
Abstract
The present study aimed to investigate the value of intravoxel incoherent motion imaging (IVIM) and three-dimensional pulsed continuous arterial spin labeling (ASL) in assessing dynamic changes of the parotid gland in patients with nasopharyngeal carcinoma (NPC) following radiotherapy (RT). A total of 18 patients with NPC who underwent intensity-modulated RT were enrolled in the present study. All patients underwent conventional magnetic resonance imaging, plus IVIM and ASL imaging of the bilateral parotid glands within 2 weeks prior to RT, and 1 week (1W) and 3 months (3M) following RT. Pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (F) and blood flow (BF) were analyzed. D and BF values were significantly increased from pre-RT to 1W post-RT [change rate: Median (IQR), ΔD1W%: 39.28% (38.23%) and ΔBF1W%: 60.84% (54.88%)] and continued to increase from 1W post-RT to 3M post-RT [55.44% (40.56%) and ΔBF%: 120.39% (128.74%)]. In addition, the F value was significantly increased from pre-RT to 1W post-RT, [change rate: Median (IQR), ΔF1W%: 28.13% (44.66%)], and this decreased significantly from 1W post-RT to 3M post-RT. However, no significant differences were observed between pre-RT and 3M post-RT. Results of the present study also demonstrated that the D* value was significantly decreased from pre-RT to 1W post-RT and 3M post-RT [change rate: Median (IQR), ΔD*1w%: -41.86% (51.71%) and ΔD*3M: -29.11% (42.67%)]. No significant difference was observed between the different time intervals post-RT. There was a significant positive correlation between percentage change in ΔBF1W and radiation dose (ρ=0.548, P=0.001). Thus, IVIM-diffusion-weighted imaging and ASL may aid in the detection and prediction of radiation-induced parotid damage in the early stages following RT. They may contribute to further understanding the potential association between damage to the parotid glands and patient-/treatment-related variables, through the assessment of individual microcapillary perfusion and tissue diffusivity.
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Affiliation(s)
- Xianhai Zhang
- Department of Radiology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China
| | - Zhifeng Xu
- Department of Radiology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China
| | - Yabin Jin
- Clinical Research Center, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China
| | - Linwen Huang
- Department of Radiology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China
| | - Wenxiu Wu
- Department of Radiology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China
| | - Mingyong Gao
- Department of Radiology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China
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Chen R, Ye H, Wu Z, Zhou Y, Lin H, Xu Y, He L, Liang C, Liu Z, Wang G. Using the non-distortion IVIM to reduce the need for contrast agents in nasopharyngeal MRI. Magn Reson Imaging 2023; 104:115-120. [PMID: 37844785 DOI: 10.1016/j.mri.2023.10.006] [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: 07/25/2023] [Revised: 09/04/2023] [Accepted: 10/12/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Patients with nasopharyngeal carcinoma (NPC) who undergo longitudinal follow-up contrast-enhanced MRI are at risk of developing gadolinium deposition in their neural tissue, which may potentially harm them. Therefore, for these patients, a non-contrast-enhanced method is potentially beneficial as an alternative approach to predict enhancement in T1-weighted imaging (CE-T1WI). The traditional intravoxel incoherent motion (IVIM) is one of the non-contrast-enhanced methods; however, the severe distortion and signal loss limit its application in patients with NPC. The present study aimed to investigate whether non-distortion IVIM could reduce the need of CE-T1WI in the follow-up of patients with NPC. METHODS The patients with NPC underwent Turbo Spin-echo MVXD diffusion-weighted imaging-based IVIM (non-distortion IVIM) from November 2021 to May 2022. Firstly, thirty patients with NPC were underwent both non-distortion IVIM and traditional IVIM. The distortion rate (DR) of the non-distortion IVIM was compared with the traditional IVIM. Then, twenty-one NPC patients with tumors (areas >50mm2) were included and correlation coefficient analysis was used to assess the relationship between their non-distortion IVIM and CE-T1WI. Linear regression analysis was performed to determine whether non-distortion IVIM predictors could predict CE-T1WI. RESULTS The correlation was observed between the parameter f of the non-distortion IVIM and the enhancement ratio of CE-T1WI (r = 0.543, P = 0.011). Moreover, the linear regression analysis revealed that f was an independent IVIM predictor of CE-T1WI in patients with NPC (P = 0.011). The DR of the non-distortion IVIM was significantly smaller than that of the traditional IVIM (0.12 ± 0.05 vs 0.48 ± 0.16, P < 0.001). CONCLUSIONS In patients with NPC, non-distortion IVIM showed potential clinical benefits to reduce the need for contrast agents, and it can independently predict the enhancement ratio.
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Affiliation(s)
- Rui Chen
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China
| | - Huifen Ye
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China
| | - Zhigang Wu
- MSC Clinical & Technical Solutions, Philips Healthcare, China
| | - Yifen Zhou
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China
| | - Hui Lin
- Department of Radiation Oncology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yongzhou Xu
- MSC Clinical & Technical Solutions, Philips Healthcare, China
| | - Lan He
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China
| | - Changhong Liang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China
| | - Zaiyi Liu
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China.
| | - Guangyi Wang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China.
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Combining Intravoxel Incoherent Motion Diffusion Weighted Imaging and Texture Analysis for a Nomogram to Predict Early Treatment Response to Concurrent Chemoradiotherapy in Cervical Cancer Patients. JOURNAL OF ONCOLOGY 2022; 2021:9345353. [PMID: 34976060 PMCID: PMC8720018 DOI: 10.1155/2021/9345353] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/10/2021] [Indexed: 12/30/2022]
Abstract
This study aimed to predict early treatment response to concurrent chemoradiotherapy (CCRT) by combining intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) with texture analysis (TA) for cervical cancer patients and to develop a nomogram for estimating the risk of residual tumor. Ninty-three cervical cancer patients underwent conventional MRI and IVIM-DWI before CCRT. We conducted TA using T2WI. The patients were allocated to partial response (PR) and complete response (CR) groups on the basis of posttreatment MRI. Multivariate logistic regression analysis on IVIM-DWI parameters and texture features was employed to filter the independent predictors and construct the predictive nomogram. Its discrimination and calibration performances were estimated. Multivariate analysis on the IVIM-DWI parameters showed that D and f were independent predictors (OR = 4.029 and 0.889, resp.; p < 0.05). However, the multivariate analysis on the texture features indicated that GLCM-correlation, GLRLM-LRE, and GLSZM-ZE were independent predictors (OR = 43.789, 9.774, and 23.738, resp.;p < 0.05). The combination of IVIM-DWI parameters and texture features exhibited the highest predictive performance (AUC = 0.975). The nomogram to identify the patients with high-risk residual tumors exhibited an acceptable predictive performance and stability with a C-index of 0.953. Decision curve analysis demonstrated the clinical use of the nomogram. The results demonstrate that D, f, GLCM-correlation, GLRLM-LRE, and GLSZM-ZE were independent predictors for cervical cancer. The nomogram combining IVIM-DWI parameters and texture features makes it possible to identify cervical cancer patients at a high risk of residual tumor after CCRT.
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Zhou QQ, Zhang W, Yu YS, Li HY, Wei L, Li XS, He ZZ, Zhang H. Comparative Study between ZOOMit and Conventional Intravoxel Incoherent Motion MRI for Assessing Parotid Gland Abnormalities in Patients with Early- or Mid-Stage Sjögren’s Syndrome. Korean J Radiol 2022; 23:455-465. [PMID: 35289149 PMCID: PMC8961020 DOI: 10.3348/kjr.2021.0695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/11/2021] [Accepted: 12/27/2021] [Indexed: 11/25/2022] Open
Abstract
Objective To compare the reproducibility and performance of quantitative metrics between ZOOMit and conventional intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in the diagnosis of early- and mid-stage Sjögren’s syndrome (SS). Materials and Methods Twenty-two patients (mean age ± standard deviation, 52.0 ± 10.8 years; male:female, 2:20) with early- or mid-stage SS and 20 healthy controls (46.9 ± 14.6 years; male:female, 7:13) were prospectively enrolled in our study. ZOOMit IVIM and conventional IVIM MRI were performed simultaneously in all individuals using a 3T scanner. Quantitative IVIM parameters - including tissue diffusivity (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) - inter- and intra-observer reproducibility in measuring these parameters, and their ability to distinguish patients with SS from healthy individuals were assessed and compared between ZOOMit IVIM and conventional IVIM methods, appropriately. MR gland nodular grade (MRG) was also examined. Results Inter- and intra-observer reproducibility was better with ZOOMit imaging than with conventional IVIM imaging (ZOOMit vs. conventional, intraclass correlation coefficient of 0.897–0.941 vs. 0.667–0.782 for inter-observer reproducibility and 0.891–0.968 vs. 0.814–0.853 for intra-observer reproducibility). Significant differences in ZOOMit f, ZOOMit D*, conventional D*, and MRG between patients with SS and healthy individuals (all p < 0.05) were observed. ZOOMit D* outperformed conventional D* in diagnosing early- and mid-stage SS (area under receiver operating curve, 0.867 and 0.658, respectively; p = 0.002). The combination of ZOOMit D*, MRG, and ZOOMit f as a new diagnostic index for SS, increased diagnostic area under the curve to 0.961, which was higher than that of any single parameter (all p < 0.01). Conclusion Considering its better reproducibility and performance, ZOOMit IVIM may be preferred over conventional IVIM MRI, and may subsequently improve the ability to diagnose early- and mid-stage SS.
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Affiliation(s)
- Qing-Qing Zhou
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Zhang
- Department of Immunology and Rheumatology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Yu-Sheng Yu
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Hong-Yan Li
- Department of Immunology and Rheumatology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Liang Wei
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Xue-Song Li
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Zhen-Zhen He
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
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Ohno M, Ohno N, Miyati T, Kawashima H, Kozaka K, Matsuura Y, Gabata T, Kobayashi S. Triexponential Diffusion Analysis of Diffusion-weighted Imaging for Breast Ductal Carcinoma in Situ and Invasive Ductal Carcinoma. Magn Reson Med Sci 2021; 20:396-403. [PMID: 33563872 PMCID: PMC8922350 DOI: 10.2463/mrms.mp.2020-0103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose To obtain detailed information in breast ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) using triexponential diffusion analysis. Methods Diffusion-weighted images (DWI) of the breast were obtained using single-shot diffusion echo-planar imaging with 15 b-values. Mean signal intensities at each b-value were measured in the DCIS and IDC lesions and fitted with the triexponential function based on a two-step approach: slow-restricted diffusion coefficient (Ds) was initially determined using a monoexponential function with b-values > 800 s/mm2. The diffusion coefficient of free water at 37°C was assigned to the fast-free diffusion coefficient (Df). Finally, the perfusion-related diffusion coefficient (Dp) was derived using all the b-values. Furthermore, biexponential analysis was performed to obtain the perfusion-related diffusion coefficient (D*) and the perfusion-independent diffusion coefficient (D). Monoexponential analysis was performed to obtain the apparent diffusion coefficient (ADC). The sensitivity and specificity of the aforementioned diffusion coefficients for distinguishing between DCIS and IDC were evaluated using the pathological results. Results The Ds, D, and ADC of DCIS were significantly higher than those of IDC (P < 0.01 for all). There was no significant correlation between Dp and Ds, but there was a weak correlation between D* and D. The combination of Dp and Ds showed higher sensitivity and specificity (85.9% and 71.4%, respectively), compared to the combination of D* and D (81.5% and 33.3%, respectively). Conclusion Triexponential analysis can provide detailed diffusion information for breast tumors that can be used to differentiate between DCIS and IDC.
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Affiliation(s)
- Masako Ohno
- Department of Radiological Technology, Kanazawa University Hospital
| | - Naoki Ohno
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | - Tosiaki Miyati
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | - Hiroko Kawashima
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University.,Department of Radiology, Kanazawa University Hospital
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University Hospital
| | | | | | - Satoshi Kobayashi
- Department of Radiological Technology, Kanazawa University Hospital.,Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University.,Department of Radiology, Kanazawa University Hospital
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Li Y, Li X, Yu X, Lin M, Ouyang H, Xie L, Shang Y. Investigating the value of arterial spin labeling and intravoxel incoherent motion imaging on diagnosing nasopharyngeal carcinoma in T1 stage. Cancer Imaging 2020; 20:62. [PMID: 32859273 PMCID: PMC7456064 DOI: 10.1186/s40644-020-00339-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/17/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND To investigate the diagnostic value of arterial spin labeling (ASL) and intravoxel incoherent motion (IVIM) imaging in distinguishing nasopharyngeal carcinoma (NPC) in T1 stage from healthy controls (HC). METHODS Forty-five newly diagnosed NPC patients in the T1 stage and thirty-one healthy volunteers who underwent MR examinations for both 3D pseudo-continuous ASL (pCASL) and IVIM were enrolled in this study. The Mann-Whitney test was used to compare the mean values of blood flow (BF) derived from pCASL and IVIM derived parameters, including apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f) between NPC tumor and benign nasopharyngeal mucosa of HC. Receiver Operating Characteristic (ROC) was performed to determine diagnostic cutoff and efficiency. The correlation coefficients among parameters were investigated using Spearman's test. RESULTS The NPC in the T1 stage showed higher mean BF, lower ADC, D, and f compared to benign nasopharyngeal mucosa (P < 0.001) with the area under curve of ROC of 0.742-0.996 (highest by BF). BF cutoff was set at > 36 mL/100 g/min; the corresponding sensitivity, specificity, and accuracy in differentiating NPC stage T1 from benign nasopharyngeal mucosa were 95.56% (43/45), 100% (31/31) and 97.37% (74/76), respectively. BF demonstrated moderate negative correlation with D* on HC (ρ [Spearman correlation coefficients] = - 0.426, P = 0.017). CONCLUSIONS ASL and IVIM could reflect the difference in perfusion and diffusion between tumor and benign nasopharyngeal mucosa, indicating a potential for accessing early diagnosis of NPC. Notably, BF, with a specificity of 100%, demonstrated better performance compared to IVIM in distinguishing malignant lesions from healthy tissue.
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Affiliation(s)
- Yujie Li
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No17, Panjiayuannanli, Chaoyang District, Beijing, P.R. China, 100021
| | - Xiaolu Li
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No17, Panjiayuannanli, Chaoyang District, Beijing, P.R. China, 100021
| | - Xiaoduo Yu
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No17, Panjiayuannanli, Chaoyang District, Beijing, P.R. China, 100021
| | - Meng Lin
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No17, Panjiayuannanli, Chaoyang District, Beijing, P.R. China, 100021.
| | - Han Ouyang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No17, Panjiayuannanli, Chaoyang District, Beijing, P.R. China, 100021
| | - Lizhi Xie
- MR Research China, GE Healthcare, Beijing, Beijing, P.R. China, 100176
| | - Yuqing Shang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, CT06510, USA
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Yu JY, Zhang D, Huang XL, Ma J, Yang C, Li XJ, Xiong H, Zhou B, Liao RK, Tang ZY. Quantitative Analysis of DCE-MRI and RESOLVE-DWI for Differentiating Nasopharyngeal Carcinoma from Nasopharyngeal Lymphoid Hyperplasia. J Med Syst 2020; 44:75. [PMID: 32103352 DOI: 10.1007/s10916-020-01549-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/18/2020] [Indexed: 02/08/2023]
Abstract
To explore the ability of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) analysis and readout segmentation of long variable echo-trains diffusion weighted imaging (RESOLVE-DWI) to distinguish nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPLH). Twenty-five patients with NPC and 30 patients with NPLH were evaluated. Three quantitative DCE-MRI parameters (Ktrans, Kep and Ve) and the apparent diffusion coeffcient (ADC) of lesions were calculated. The two independent samples t test or Mann-Whitney U test was used to compare the parameters between NPC and NPLH group. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic ability for distinguishing NPC from NPLH. A P value less than 0.05 was considered statistically significant. The difference in Ktrans value between the NPC group and the NPLH group was statistically significant, and the value of the NPC group was larger than that of the NPLH group. There was no statistical difference in Kep and Ve between the two groups. The ADC value of NPC group was smaller than that of NPLH group, and the difference was statistically significant. ROC curve analysis showed that both Ktrans and ADC were effective in diagnosing NPC and the area under the curve (AUC) was 0.773 and 0.704, respectively. In addition, the combination of Ktrans and ADC demonstrated the obviously improved AUC of 0.884. DCE-MRI and RESOLVE-DWI are effective in differentiating NPC from NPLH, especially the combination of the two models.
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Affiliation(s)
- J Y Yu
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - D Zhang
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - X L Huang
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - J Ma
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - C Yang
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - X J Li
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - H Xiong
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - B Zhou
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - R K Liao
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - Z Y Tang
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China. .,Molecular and Functional Imaging Laboratory, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, 400014, China.
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Cheng Y, Bai L, Shang J, Tang Y, Ling X, Guo B, Gong J, Wang L, Xu H. Preliminary clinical results for PET/MR compared with PET/CT in patients with nasopharyngeal carcinoma. Oncol Rep 2019; 43:177-187. [PMID: 31746412 PMCID: PMC6908933 DOI: 10.3892/or.2019.7392] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 09/09/2019] [Indexed: 12/23/2022] Open
Abstract
The present study aimed to assess the performance of positron emission tomography-magnetic resonance imaging (PET/MR) for the visualization and characterization of lesions. In addition, the present study investigated whether the apparent diffusion coefficient (ADC) and intravoxel incoherent motion parameters exhibited any significant correlation with standardized uptake values (SUV) in patients with nasopharyngeal carcinoma (NPC). A total of 35 patients with NPC underwent whole body PET-computed tomography (CT) and head and neck MR imaging (MRI) scans using the PET/CT-MRI system. Image quality, lesion conspicuity and the diagnostic confidence of PET/CT, T1 weighted (T1w) PET/MR and T2w PET/MR imaging were assessed. The true diffusion coefficient (D), the pseudo-diffusion coefficient or diffusion within the microcirculation (D*), and the perfusion fraction or the contribution of water moving in the capillaries (f), and ADC, were calculated. The correlation between the ADC, D*, D and f values and the SUV were analyzed using Pearson's correlation analysis. Similar image quality was obtained using PET/CT, T1w PET/MR and T2w PET/MR imaging. However, the T1w PET/MR and T2w PET/MR imaging were more effective than PET/CT in analyzing the lesion conspicuity of the primary tumors and lymph nodes. In addition, T2w PET/MR imaging was more efficient than T1w PET/MR imaging in analyzing primary tumors and lymph nodes. Pearson's correlation analysis showed no significant correlation between the SUV and ADC, and D*, D and f values in NPC. The present results suggested that the application of PET/MR is feasible and could serve as a reliable alternative to PET/CT, while SUV and ADC, D*, D and f values were identified as independent biomarkers in NPC.
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Affiliation(s)
- Yong Cheng
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Le Bai
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Jingjie Shang
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Yongjin Tang
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Xueying Ling
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Bin Guo
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Jian Gong
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Lu Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Hao Xu
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
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Wu G, Xie R, Liu X, Hou B, Li Y, Li X. Intravoxel incoherent motion diffusion MR and diffusion kurtosis imaging for discriminating atypical bone metastasis from benign bone lesion. Br J Radiol 2019; 92:20190119. [PMID: 31204855 PMCID: PMC6724638 DOI: 10.1259/bjr.20190119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objectives: To investigate the feasibility of intravoxel incoherent motion (IVIM) diffusion MR and diffusion kurtosis imaging (DKI) in discriminating atypical bone metastasis from benign bone lesion in patients with tumors. Methods: Patients with bone lesions in lower extremity suspected of metastases were enrolled in this prospective study. IVIM diffusion MR and DKI were performed before biopsy. Apparent diffusion coefficient (ADC), true diffusion (D), perfusion fraction (f) and perfusion-related pseudodiffusion (D*) were generated with IVIM, while mean kurtosis (MK) and mean diffusion (MD) generated with DKI. Two radiologists blinded to pathology results separately measured these parameters for each lesion through drawing region of interest. Intraclass correlation coefficient was used to determine the inter-reader viability in measurement. The patients with pathology-confirmed metastasis or benign lesion were analyzed. The Mann–Whitney test was used to compare IVIM and DKI parameters between metastasis group and benign lesion group. Receiver operating characteristic curves were constructed to evaluate the ability of discrimination. Results: Bone lesions from 28 patients (metastasis, n = 15; benign lesion, n = 13; mean age = 55 years; age range, 34~77) were analyzed with IVIM and DKI. Intraclass correlation coefficient was greater than 0.8 for all parameters. ADC, D and MD were significantly lower in metastases versus benign lesions (p<0.05). MK and f value were significantly higher in metastases versus benign lesions (p<0.05). D* was not significantly different between the two groups (p>0.05). Areas under curve for ADC, D, f, MK and MD were 0.935, 0.939, 0.891, 0.840 and 0.844 respectively. Conclusions: IVIM and DKI derived parameters distinguish between atypical bone metastasis and benign bone lesion in selected patients with tumors. Advances in knowledge: Bone metastasis and benign bone lesion differ in water molecular diffusion. Intravoxel incoherent motion derived true diffusion distinguishes between atypical bone metastasis and benign lesion.
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Affiliation(s)
- Gang Wu
- 1 Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Ruyi Xie
- 1 Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xuanlin Liu
- 1 Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Bowen Hou
- 1 Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yitong Li
- 1 Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiaoming Li
- 1 Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Yang X, Xiao X, Lu B, Chen Y, Wen Z, Yu S. Perfusion-sensitive parameters of intravoxel incoherent motion MRI in rectal cancer: evaluation of reproducibility and correlation with dynamic contrast-enhanced MRI. Acta Radiol 2019; 60:569-577. [PMID: 30114928 DOI: 10.1177/0284185118791201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Intravoxel incoherent motion magnetic resonance imaging (IVIM-MRI) acquires tumor perfusion information without injection of contrast medium, which is promising in tumor assessment. However, its consistency with dynamic contrast-enhanced MRI (DCE-MRI), a more widely used method for tumor perfusion evaluation, is not revealed in rectal cancer. PURPOSE In this study, we aimed to investigate the correlation of perfusion-sensitive parameters derived from IVIM-MRI with DCE-MRI and measurement reproducibility of IVIM-MRI parameters in rectal cancer. MATERIAL AND METHODS Forty-seven rectal cancer patients underwent IVIM-MRI with 16 b-values and DCE-MRI. The perfusion fraction ( f), pseudo-diffusion coefficient ( D*), and f· D* were measured by two radiologists independently and correlated with the transfer constant ( Ktrans), reflux constant ( kep), and extravascular extracellular fractional volume ( ve) obtained from DCE-MRI. RESULTS Pearson's correlation analyses of IVIM-MRI and DCE-MRI parameters showed fair to moderate correlation between f and Ktrans ( r = 0.461, P = 0.001), followed by f and kep ( r = 0.430, P = 0.003), f·D*, and Ktrans ( r = 0.425, P = 0.003), f·D*, and kep ( r = 0.384, P = 0.008). There was no significant correlation between ve and f, ve and D*, ve and f· D*, D* and Ktrans, and D* and kep. The reproducibility of IVIM-MRI measurements was moderate. For parameter f, intraclass correlation coefficient (ICC) = 0.71 (0.53-0.82), coefficient of variation (CV) = 13.05 ± 0.02%, limit of agreement (LoA) = -0.05-0.04; for parameter D*, ICC = 0.55 (0.32-0.72), CV = 20.28 ± 3.23%, LoA = -9.6-8.4. CONCLUSION Perfusion-sensitive parameters derived from IVIM-MRI correlated fairly to moderately with DCE-MRI in rectal cancer patients and showed moderate measurement reproducibility. IVIM-MRI supplements routine high-resolution MRI without contrast enhancement to provide information of tumor microcirculation.
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Affiliation(s)
- Xinyue Yang
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - Xiaojuan Xiao
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Baolan Lu
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - Yan Chen
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - Ziqiang Wen
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - Shenping Yu
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
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Ai QY, King AD, Chan JSM, Chen W, Chan KCA, Woo JKS, Zee BCY, Chan ATC, Poon DMC, Ma BBY, Hui EP, Ahuja AT, Vlantis AC, Yuan J. Distinguishing early-stage nasopharyngeal carcinoma from benign hyperplasia using intravoxel incoherent motion diffusion-weighted MRI. Eur Radiol 2019; 29:5627-5634. [DOI: 10.1007/s00330-019-06133-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/14/2019] [Accepted: 03/06/2019] [Indexed: 11/29/2022]
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12
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Xu XQ, Hu H, Su GY, Liu H, Wu FY, Shi HB. Differentiation between orbital malignant and benign tumors using intravoxel incoherent motion diffusion-weighted imaging: Correlation with dynamic contrast-enhanced magnetic resonance imaging. Medicine (Baltimore) 2019; 98:e14897. [PMID: 30896639 PMCID: PMC6709032 DOI: 10.1097/md.0000000000014897] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To evaluate the performance of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for differentiating orbital malignant from benign tumors, and to assess the correlation between IVIM-DWI parameters and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters.Twenty-seven patients (17 benign and 10 malignant) with orbital tumors underwent 3.0T MRI examination for pre-treatment evaluation, including IVIM-DWI and DCE-MRI. IVIM-DWI parameters (tissue diffusivity, D; pseudo-diffusion coefficient, D; and perfusion fraction, f) were quantified using bi-exponential fitting model. DCE-MRI parameters (K, the volume transfer constant between the plasma and the extracellular extravascular space [EES]; Ve, the volume fraction of the EES, and Kep, the rate constant from EES to blood plasma) were quantified using modified Tofts model. Independent-sample t test, receiver operating characteristic curve analyses and Spearman correlation test were used for statistical analyses.Malignant orbital tumors showed lower D (P <.001) and higher D (P = .002) than benign tumors. Setting a D value of 0.966 × 10 mm/s as the cut-off value, a diagnostic performance (AUC, 0.888; sensitivity, 100%; specificity, 82.35%) could be obtained for diagnosing malignant tumors. While setting a D value of 42.371 × 10 mm/s as cut-off value, a diagnostic performance could be achieved (AUC, 0.847; sensitivity, 90.00%; specificity, 70.59%). Poor or moderated correlations were found between IVIM-DWI and DCE-MRI parameters (D and Kep, r = 0.427, P = .027; D and Ve, r = 0.626, P <.001).IVIM-DWI is potentially useful for differentiating orbital malignant from benign tumors. Poor or moderate correlations exist between IVIM-DWI and DCE-MRI parameters. IVIM-DWI may be a useful adjunctive perfusion technique for the differential diagnosis of orbital tumors.
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Affiliation(s)
| | | | | | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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13
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Investigating the correlation of arterial spin labeling and dynamic contrast enhanced perfusion in primary tumor of nasopharyngeal carcinoma. Eur J Radiol 2018; 108:222-229. [DOI: 10.1016/j.ejrad.2018.09.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 09/26/2018] [Accepted: 09/30/2018] [Indexed: 12/11/2022]
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14
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Zhong Y, Xiao Z, Tang Z, Qiang J, Wang R. Intravoxel incoherent motion MRI for differentiating sinonasal small round cell malignant tumours (SRCMTs) from Non-SRCMTs: comparison and correlation with dynamic contrast-enhanced MRI. Clin Radiol 2018; 73:966-974. [PMID: 30086857 DOI: 10.1016/j.crad.2018.07.097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 07/05/2018] [Indexed: 12/13/2022]
Abstract
AIM To investigate the value of intravoxel incoherent motion (IVIM) in the differentiation of sinonasal small round cell malignant tumours (SRCMTs) from non-SRCMTs and to compare and correlate these results with those of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI). MATERIALS AND METHODS Ninety patients with histologically confirmed sinonasal malignant tumours (53 SRCMTs and 37 non-SRCMTs) who underwent conventional MRI, IVIM, and DCE-MRI before treatment were enrolled. The IVIM and DCE-MRI parameters were measured. Statistical analyses were performed using Student's t-tests, receiver operating characteristic (ROC) curve analyses, and Spearman's correlation coefficients. RESULTS A lower pure diffusion coefficient (D) value and a higher pseudo-diffusion coefficient (D*) value were found in the sinonasal SRCMTs than in the non-SRCMTs (p<0.001 and p=0.011, respectively). Moreover, the mean extravascular extracellular space volume ratio (Ve) of the SRCMTs was significantly lower than that of the non-SRCMTs (p=0.020). ROC curve analysis showed that the diagnostic performance of D outperformed those of the other perfusion and diffusion parameters. A cut-off D value of 0.56 ×10-3 mm2/s yielded a sensitivity of 80.4%, a specificity of 75%, and an accuracy of 78.2%, with an AUC of 0.825. Significant but poor-to-fair correlations were found between the parameters from IVIM and DCE-MRI. CONCLUSIONS The D and D* values of IVIM and the Ve value of DCE-MRI are helpful in distinguishing sinonasal SRCMTs from non-SRCMTs, with the D values having the best diagnostic efficiency.
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Affiliation(s)
- Y Zhong
- Department of Radiology, Jinshan Hospital of Fudan University, Shanghai Medical College, Shanghai 201508, China; Department of Radiology, Eye and ENT Hospital of Fudan University, Shanghai Medical College, Shanghai 200031, China; Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200011, China
| | - Z Xiao
- Department of Radiology, Eye and ENT Hospital of Fudan University, Shanghai Medical College, Shanghai 200031, China
| | - Z Tang
- Department of Radiology, Eye and ENT Hospital of Fudan University, Shanghai Medical College, Shanghai 200031, China.
| | - J Qiang
- Department of Radiology, Jinshan Hospital of Fudan University, Shanghai Medical College, Shanghai 201508, China.
| | - R Wang
- Department of Radiology, Eye and ENT Hospital of Fudan University, Shanghai Medical College, Shanghai 200031, China
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15
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Park S, Yoon JK, Chung NS, Kim SH, Hwang J, Lee HY, Kwack KS. Correlations between intravoxel incoherent motion diffusion-weighted MR imaging parameters and 18F-FDG PET/CT metabolic parameters in patients with vertebral bone metastases: initial experience. Br J Radiol 2018; 91:20170889. [PMID: 29509489 DOI: 10.1259/bjr.20170889] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To investigate the relationship between intravoxel incoherent motion (IVIM) diffusion-weighted MRI (DW MRI) parameters and 18F-fluodeoxyglucose (FDG) (PET/CT) metabolic parameters in patients with vertebral bone metastases. METHODS 19 patients with vertebral bone metastases were retrospectively included in this institutional review board-approved study. All patients underwent IVIM DW-MRI and 18F-FDG PET/CT before treatment. The IVIM parameters [molecular diffusion coefficient (D), perfusion fraction (f), and perfusion-related D (D*)] and apparent diffusion coefficient were acquired using 11 b-values (0, 10, 15, 20, 25, 50, 80, 120, 200, 300, and 800 s mm-2). Maximum and mean standardized uptake values (SUVmax and SUVmean, respectively), metabolic tumor volume, and total lesion glycolysis derived from 18F-FDG PET/CT were calculated using thresholds of 3.0 SUV. The associations among parameters were evaluated by Spearman's correlation analysis. RESULTS A total of 19 patients and 41 regions of interest were included in this study. The IVIM parameter f was positively correlated with the metabolic parameters SUVmean and SUVmax [ρ = 0.499 (p < 0.01) and ρ = 0.413 (p < 0.01), respectively]. There was a weak positive correlation between D* and SUVmean (ρ = 0.321, p = 0.041). CONCLUSION IVIM perfusion-related parameters, especially f, were correlated with 18F-FDG PET/CT metabolic parameters in patients with vertebral bone metastases. IVIM DW-MRI, used to evaluate metabolic activity, appears to have diagnostic potential for bone metastasis and may also have utility in monitoring the post-treatment response. Advances in knowledge: The use of IVIM for vertebral bone metastasis is demonstrated. f may be more suitable to reflect the metabolic activity and may facilitate another diagnostic potential for monitoring the posttreatment response.
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Affiliation(s)
- Sunghoon Park
- 1 Department of Radiology, Ajou University School of Medicine , Suwon , South Korea.,2 Musculoskeletal Imaging Laboratory, Ajou University Medical Center , Suwon , South Korea
| | - Joon-Kee Yoon
- 3 Department of Nuclear Medicine and Molecular Imaging , Suwon , South Korea
| | - Nam-Su Chung
- 4 Department of Orthopaedic Surgery, Ajou University School of Medicine , Suwon , South Korea
| | - Sang Hyun Kim
- 5 Department of Neurosurgery, Ajou University School of Medicine , Suwon , South Korea
| | - Jinwoo Hwang
- 6 Department of Clinical Science, Philips Healthcare , Seoul , South Korea
| | - Hyun Young Lee
- 7 Regional Clinical Trial Center, Ajou University Medical Center , Suwon , South Korea.,8 Department of Biostatistics, Yonsei University College of Medicine , Seoul , South Korea
| | - Kyu-Sung Kwack
- 1 Department of Radiology, Ajou University School of Medicine , Suwon , South Korea.,2 Musculoskeletal Imaging Laboratory, Ajou University Medical Center , Suwon , South Korea
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Non-invasive prediction of the tumor growth rate using advanced diffusion models in head and neck squamous cell carcinoma patients. Oncotarget 2018; 8:33631-33643. [PMID: 28430583 PMCID: PMC5464896 DOI: 10.18632/oncotarget.16851] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/28/2017] [Indexed: 12/19/2022] Open
Abstract
We assessed parameters of advanced diffusion weighted imaging (DWI) models for the prediction of the tumor growth rate in 55 head and neck squamous cell carcinoma (HNSCC) patients. The DWI acquisition used single-shot spin-echo echo-planar imaging with 12 b-values (0−2000). We calculated 14 DWI parameters using mono-exponential, bi-exponential, tri-exponential, stretched exponential and diffusion kurtosis imaging models. We directly measured the tumor growth rate from two sets of different-date imaging data. We divided the patients into a discovery group (n = 40) and validation group (n = 15) based on their MR acquisition dates. In the discovery group, we performed univariate and multivariate regression analyses to establish the multiple regression equation for the prediction of the tumor growth rate using diffusion parameters. The equation obtained with the discovery group was applied to the validation group for the confirmation of the equation's accuracy. After the univariate and multivariate regression analyses in the discovery-group patients, the estimated tumor growth rate equation was established by using the significant parameters of intermediate diffusion coefficient D2 and slow diffusion coefficient D3 obtained by the tri-exponential model. The discovery group's correlation coefficient between the estimated and directly measured tumor growth rates was 0.74. In the validation group, the correlation coefficient (r = 0.66) and intra-class correlation coefficient (0.65) between the estimated and directly measured tumor growth rates were respectively good. In conclusion, advanced DWI model parameters can be a predictor for determining HNSCC patients’ tumor growth rate.
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Xiao Z, Tang Z, Qiang J, Wang S, Qian W, Zhong Y, Wang R, Wang J, Wu L, Tang W, Zhang Z. Intravoxel Incoherent Motion MR Imaging in the Differentiation of Benign and Malignant Sinonasal Lesions: Comparison with Conventional Diffusion-Weighted MR Imaging. AJNR Am J Neuroradiol 2018; 39:538-546. [PMID: 29371251 DOI: 10.3174/ajnr.a5532] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/14/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Intravoxel incoherent motion is a promising method for the differentiation of sinonasal lesions. This study aimed to evaluate the value of intravoxel incoherent motion in the differentiation of benign and malignant sinonasal lesions and to compare the diagnostic performance of intravoxel incoherent motion with that of conventional DWI. MATERIALS AND METHODS One hundred thirty-one patients with histologically proved solid sinonasal lesions (56 benign and 75 malignant) who underwent conventional DWI and intravoxel incoherent motion were recruited in this study. The diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values derived from intravoxel incoherent motion and ADC values derived from conventional DWI were measured and compared between the 2 groups using the Student t test. Receiver operating characteristic curve analysis, logistic regression analysis, and 10-fold cross-validation were performed to evaluate the diagnostic performance of single-parametric and multiparametric models. RESULTS The mean ADC and D values were significantly lower in malignant sinonasal lesions than in benign sinonasal lesions (both P < .001). The mean f value was higher in malignant lesions than in benign lesions (P = .003). Multiparametric models can significantly improve the cross-validated areas under the curve for the differentiation of sinonasal lesions compared with single-parametric models (all corrected P < .05 except the D value). The model of D+f provided a better diagnostic performance than the ADC value (corrected P < .001). CONCLUSIONS Intravoxel incoherent motion appears to be a more effective MR imaging technique than conventional DWI in the differentiation of benign and malignant sinonasal lesions.
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Affiliation(s)
- Z Xiao
- From the Departments of Radiology (Z.X., Z.T., W.Q., R.W.)
| | - Z Tang
- From the Departments of Radiology (Z.X., Z.T., W.Q., R.W.)
| | - J Qiang
- Department of Radiology (J.Q., Y.Z.), Jinshan Hospital of Shanghai Medical School, Fudan University, Shanghai, P. R. China
| | | | - W Qian
- From the Departments of Radiology (Z.X., Z.T., W.Q., R.W.)
| | - Y Zhong
- Department of Radiology (J.Q., Y.Z.), Jinshan Hospital of Shanghai Medical School, Fudan University, Shanghai, P. R. China
| | - R Wang
- From the Departments of Radiology (Z.X., Z.T., W.Q., R.W.)
| | | | - L Wu
- Otolaryngology (L.W.), Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, P. R. China
| | - W Tang
- Siemens Healthcare Ltd (W.T., Z.Z.), Shanghai, P. R. China
| | - Z Zhang
- Siemens Healthcare Ltd (W.T., Z.Z.), Shanghai, P. R. China
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Assessment of Correlation between Intravoxel Incoherent Motion Diffusion Weighted MR Imaging and Dynamic Contrast-Enhanced MR Imaging of Sacroiliitis with Ankylosing Spondylitis. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8135863. [PMID: 29445743 PMCID: PMC5763214 DOI: 10.1155/2017/8135863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/07/2017] [Accepted: 12/03/2017] [Indexed: 12/18/2022]
Abstract
The relationships between IVIM and DCE-MRI parameters in AS are not clear. We explore the correlation between intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI) and dynamic contrast-enhanced (DCE) parameters obtained on MR images in patients with ankylosing spondylitis (AS). Forty-four patients with AS were prospectively examined using a 1.5-T MR system. IVIM DWI was performed with 11 b values (range, 0–800 s/mm2) for all patients. The correlation coefficients between IVIM and DCE-MRI parameters were analyzed using Spearman's method. Our results showed that intra- and interobserver reproducibility were excellent to relatively good (ICC = 0.804–0.981; narrow width of 95% limits of agreement). Moderate positive correlations were observed between pure molecular diffusion (Ds) and maximum enhancement (ME) and relative enhancement (RE) (r = 0.700, P < 0.001; r = 0.607, P < 0.001, resp.). Perfusion-related diffusion (Df) showed negative moderate correlation with ME (r = −0.608, P < 0.001). However, no correlation was observed between perfusion fraction (f) and any parameters of ME, RE, TTP, and BE (r = −0.093–0.213; P > 0.165). In conclusion, the IVIM parameters, especially f, might play a critical role in detecting the progression of AS, because it can provide more perfusion information compared with DCE-MRI; besides the IVIM MRI is a noninvasive method.
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Intravoxel incoherent motion MR imaging in nasopharyngeal carcinoma: comparison and correlation with dynamic contrast enhanced MR imaging. Oncotarget 2017; 8:68472-68482. [PMID: 28978131 PMCID: PMC5620271 DOI: 10.18632/oncotarget.19575] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 06/27/2017] [Indexed: 12/21/2022] Open
Abstract
Objectives To compare accuracy and assess agreement between intravoxel incoherent motion (IVIM) magnetic resonance (MR) perfusion-related parameters and quantitative dynamic contrast-enhanced (DCE) MR parameters in nasopharyngeal carcinoma (NPC). Results D, f, D*, Ktrans, Kep and Vp were significantly lower in the high stage group while Ve was significantly higher in the high stage group. Optimal cut-off values were: D=0.749 × 10−3 mm2/s; f=0.145; D*=100.401 × 10−3 mm2/s; Ktrans=0.571/min; Kep=0.8196/min; Ve=0.6556 %; Vp=0.0757 %. D* (p=0.001), Ktrans (p<0.001), Ve (p=0.014) were all reliable independent predictors for AJCC staging. IVIM-MR perfusion-related (f, D*) and DCE-MR (Ktrans, Kep, Ve, Vp) parameters were significantly correlated (p<0.001). Materials and Methods 75 patients with newly diagnosed NPC were prospectively recruited. Diffusion-weighted MR and DCE-MR imaging were performed with respective IVIM (D, f, D*) and DCE (Ktrans, Kep, Ve, Vp) MR parameters calculated. Patients were stratified into low and high tumor stage groups according to American Joint Committee on Cancer (AJCC) staging for determination of the predictive powers of IVIM-MR and DCE-MR parameters using t–test, ROC curve analyses and multiple logistic regression analysis. Correlation between IVIM-MR perfusion-related and DCE-MR parameters was assessed using Spearman's rank correlation. Conclusion IVIM-MR perfusion-related and quantitative DCE-MR parameters were significantly correlated in the assessment of NPC and were both reliable independent predictors in the prediction of AJCC staging. IVIM-MR perfusion imaging can be a potential useful non-invasive perfusion imaging tool for clinical use in the assessment of NPC.
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Lu P, Sha Y, Wan H, Wang F, Tian G. Role of coronal high-resolution diffusion-weighted imaging in acute optic neuritis: a comparison with axial orientation. Neuroradiology 2017. [PMID: 28647756 DOI: 10.1007/s00234-017-1853-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE Through a comparison with the axial orientation, we aimed to evaluate the role of coronal high-resolution diffusion-weighted imaging (DWI) in acute optic neuritis based on diagnostic accuracy and the reproducibility of apparent diffusion coefficient (ADC) measurements. METHODS Orbital DWI, using readout-segmented, parallel imaging, and 2D navigator-based reacquisition (RESOLVE-DWI), was performed on 49 patients with acute vision loss. The coronal (thickness = 3 mm) and axial (thickness = 2 mm) diffusion images were evaluated by two neuroradiologists retrospectively. The sensitivity, specificity, and accuracy were calculated through diagnostic test; the inter- and intra-observer reliabilities were assessed with a weighted Cohen's kappa test. In addition, the agreement of ADC measurement among observers was evaluated by the intra-class correlation coefficient (ICC), coefficient of variation (CV), and Bland-Altman plots. Comparison of ADC values was also performed by unpaired t test. RESULTS Among the 49 patients, 47 clinically positive optic nerves and 51 clinically negative optic nerves were found. The sensitivity, specificity, and accuracy were 85.1/87.2%, 90.2/94.12%, and 87.8/90.8%, respectively, for coronal RESOLVE-DWI and 83.0/85.1%, 66.7/76.5%, and 75.5/79.6%, respectively, for axial RESOLVE-DWI. The inter-observer kappa values were 0.710 and 0.806 for axial and coronal RESOLVE-DWI, respectively, and the intra-observer kappa values were 0.822 and 0.909, respectively (each P < 0.0001). Regarding the reproducibility of ADC measurements on axial and coronal RESOLVE-DWI, the ICCs among observers were 0.846 and 0.941, respectively, and the CV values were 7.046 and 4.810%, respectively. Bland-Altman plots revealed smaller inter-observer variability on coronal RESOLVE-DWI. ADC values were significantly lower in positive group (each P < 0.0001). CONCLUSION Higher specificity and better reproducibility of ADC measurements were found for coronal RESOLVE-DWI, which demonstrated the feasibility of the use of coronal RESOLVE-DWI to examine acute optic neuritis patients.
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Affiliation(s)
- Ping Lu
- Shanghai Institution of Medical Imaging, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Yan Sha
- Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
| | - Hailin Wan
- Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Feng Wang
- Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Guohong Tian
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
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State of the art MRI in head and neck cancer. Clin Radiol 2017; 73:45-59. [PMID: 28655406 DOI: 10.1016/j.crad.2017.05.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 05/26/2017] [Indexed: 12/17/2022]
Abstract
Head and neck cancer affects more than 11,000 new patients per year in the UK1 and imaging has an important role in the diagnosis, treatment planning, and assessment, and post-treatment surveillance of these patients. The anatomical detail produced by magnetic resonance imaging (MRI) is ideally suited to staging and follow-up of primary tumours and cervical nodal metastases in the head and neck; however, anatomical images have limitations in cancer imaging and so increasingly functional-based MRI techniques, which provide molecular, metabolic, and physiological information, are being incorporated into MRI protocols. This article reviews the state of the art of these functional MRI techniques with emphasis on those that are most relevant to the current management of patients with head and neck cancer.
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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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Zhou N, Chu C, Dou X, Li M, Liu S, Zhu L, Liu B, Guo T, Chen W, He J, Yan J, Zhou Z, Yang X, Liu T. Early evaluation of irradiated parotid glands with intravoxel incoherent motion MR imaging: correlation with dynamic contrast-enhanced MR imaging. BMC Cancer 2016; 16:865. [PMID: 27821130 PMCID: PMC5100256 DOI: 10.1186/s12885-016-2900-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/30/2016] [Indexed: 12/13/2022] Open
Abstract
Background Radiation-induced parotid damage is one of the most common complications in patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy (RT). Intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging has been reported for evaluating irradiated parotid damage. However, the changes of IVIM perfusion-related parameters in irradiated parotid glands have not been confirmed by conventional perfusion measurements obtained from dynamic contrast-enhanced (DCE) MR imaging. The purposes of this study were to monitor radiation-induced parotid damage using IVIM and DCE MR imaging and to investigate the correlations between changes of these MR parameters. Methods Eighteen NPC patients underwent bilateral parotid T1-weighted, IVIM and DCE MR imaging pre-RT (2 weeks before RT) and post-RT (4 weeks after RT). Parotid volume; IVIM MR parameters, including apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f); and DCE MR parameters, including maximum relative enhancement (MRE), time to peak (TTP), Wash in Rate, and the degree of xerostomia were recorded. Correlations of parotid MR parameters with mean radiation dose, atrophy rate and xerostomia degree, as well as the relationships between IVIM and DCE MR parameters, were investigated. Results From pre-RT to post-RT, all of the IVIM and DCE MR parameters increased significantly (p < 0.001 for ADC, D, f, MRE, Wash in Rate; p = 0.024 for D*; p = 0.037 for TTP). Change rates of ADC, f and MRE were negatively correlated with atrophy rate significantly (all p < 0.05). Significant correlations were observed between the change rates of D* and MRE (r = 0.371, p = 0.026) and between the change rates of D* and TTP (r = 0.396, p = 0.017). The intra- and interobserver reproducibility of IVIM and DCE MR parameters was good to excellent (intraclass correlation coefficient, 0.633–0.983). Conclusions Early radiation-induced changes of parotid glands could be evaluated by IVIM and DCE MR imaging. Certain IVIM and DCE MR parameters were correlated significantly.
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Affiliation(s)
- Nan Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Chen Chu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Xin Dou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Ming Li
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Song Liu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Lijing Zhu
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, 210008, China
| | - Baorui Liu
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, 210008, China
| | - Tingting Guo
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210008, China
| | - Weibo Chen
- Philips Healthcare, Shanghai, 200233, China
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Jing Yan
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, 210008, China.
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
| | - Tian Liu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
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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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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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The Role of Intravoxel Incoherent Motion MRI in Predicting Early Treatment Response to Chemoradiation for Metastatic Lymph Nodes in Nasopharyngeal Carcinoma. Adv Ther 2016; 33:1158-68. [PMID: 27294489 DOI: 10.1007/s12325-016-0352-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Pilot studies have suggested potential clinical applications for intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in head and neck cancers. This study aimed to characterize metastatic lymph nodes using IVIM MRI, and to evaluate the role of IVIM MRI in the prediction of the early treatment response of lymph node metastasis from nasopharyngeal carcinoma (NPC). METHODS A total of 122 patients with metastatic lymph nodes from NPC underwent two MRI examinations, pre-treatment and post-treatment (at 4 weeks and at ≥2 years from the end of chemoradiotherapy). Treatment response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1. Differences in the initial IVIM parameters [pure molecular diffusion (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f)] between nodes with a partial response (PR) and a complete response (CR) were analyzed in 102 patients after the exclusion of 20. RESULTS The initial D*, D, and apparent diffusion coefficient (ADC) did not reveal a significant difference between nodes showing a PR or a CR. The mean initial f value was significantly higher in patients with a PR relative to patients with a CR (p = 0.003), and its sensitivity and specificity in predicting treatment response to chemoradiotherapy were 86.7% and 100%, respectively. CONCLUSIONS The present study indicated that the initial f value may be more accurate than the initial D*, D, and ADC in the early prediction of treatment response to chemoradiotherapy for metastatic lymph nodes in patients with NPC.
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Fujima N, Yoshida D, Sakashita T, Homma A, Tsukahara A, Shimizu Y, Tha KK, Kudo K, Shirato H. Prediction of the treatment outcome using intravoxel incoherent motion and diffusional kurtosis imaging in nasal or sinonasal squamous cell carcinoma patients. Eur Radiol 2016; 27:956-965. [DOI: 10.1007/s00330-016-4440-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 03/10/2016] [Accepted: 05/23/2016] [Indexed: 12/11/2022]
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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: 42] [Impact Index Per Article: 5.3] [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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Intravoxel incoherent motion MR imaging for breast lesions: comparison and correlation with pharmacokinetic evaluation from dynamic contrast-enhanced MR imaging. Eur Radiol 2016; 26:3888-3898. [PMID: 26863896 DOI: 10.1007/s00330-016-4241-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 12/28/2015] [Accepted: 01/22/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To compare diagnostic performance for breast lesions by quantitative parameters derived from intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and to explore whether correlations exist between these parameters. METHODS IVIM and DCE MRI were performed on a 1.5-T MRI scanner in patients with suspicious breast lesions. Thirty-six breast cancers and 23 benign lesions were included in the study. Quantitative parameters from IVIM (D, f and D*) and DCE MRI (Ktrans, Kep, Ve and Vp) were calculated and compared between malignant and benign lesions. Spearman correlation test was used to evaluate correlations between them. RESULTS D, f, D* from IVIM and Ktrans, Kep, Vp from DCE MRI were statistically different between breast cancers and benign lesions (p < 0.05, respectively) and D demonstrated the largest area under the receiver-operating characteristic curve (AUC = 0.917) and had the highest specificity (83 %). The f value was moderately statistically correlated with Vp (r = 0.692) and had a poor correlation with Ktrans (r = 0.456). CONCLUSIONS IVIM MRI is useful in the differentiation of breast lesions. Significant correlations were found between perfusion-related parameters from IVIM and DCE MRI. IVIM may be a useful adjunctive tool to standard MRI in diagnosing breast cancer. KEY POINTS • IVIM provided diffusion as well as perfusion information • IVIM could help differential diagnosis of breast lesions • Correlations were found between perfusion-related parameters from IVIM and DCE MRI.
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Head and neck reconstructive surgery: what the radiologist needs to know. Eur Radiol 2016; 26:3345-52. [DOI: 10.1007/s00330-015-4184-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 12/17/2015] [Accepted: 12/18/2015] [Indexed: 10/22/2022]
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Su GY, Xu XQ, Wang YY, Hu H, Shen J, Hong XN, Shi HB, Wu FY. Feasibility study of using intravoxel incoherent motion mri to detect parotid gland abnormalities in early-stage Sjögren syndrome patients. J Magn Reson Imaging 2015; 43:1455-61. [PMID: 26583877 DOI: 10.1002/jmri.25096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/02/2015] [Indexed: 12/20/2022] Open
Affiliation(s)
- Guo-Yi Su
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Xiao-Quan Xu
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Yan-Yan Wang
- Department of Rheumatology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Hao Hu
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Jie Shen
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Xun-Ning Hong
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Hai-Bin Shi
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Fei-Yun Wu
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing China
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Cui Y, Zhang C, Li X, Liu H, Yin B, Xu T, Zhang Y, Wang D. Intravoxel Incoherent Motion Diffusion-weighted Magnetic Resonance Imaging for Monitoring the Early Response to ZD6474 from Nasopharyngeal Carcinoma in Nude Mouse. Sci Rep 2015; 5:16389. [PMID: 26574153 PMCID: PMC4648100 DOI: 10.1038/srep16389] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 10/14/2015] [Indexed: 01/02/2023] Open
Abstract
Early therapeutic effects of anti-angiogenic agent ZD6474 upon nasopharyngeal carcinoma (NPC) in nude mouse were monitored by using intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI). Mice bearing NPC underwent IVIM DWI at baseline and after 1, 3, and 7 days of treatment with ZD6474 or vehicle (n = 12 per group). Parameters of apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion fraction (f), and blood pseudodiffusion coefficient (D*) at different time points were compared between the two groups or within the treated group. In the treated group, the perfusion-related parameters f and D* of the tumors decreased significantly on day 1 while the diffusion-related parameters ADC and D were significantly higher beginning on day 3 compared with the control group. The decreases in f on day 1 and D* on day 3 were moderately correlated with the smaller tumor size change on day 7. Moderate correlations were established between MVD and f and D* as well as between increased TUNEL or decreased Ki-67 index and ADC and D. This study supports that IVIM DWI is sensitive to detect the ZD6474-induced changes in NPC in nude mouse and the f parameter could predict early response to anti-angiogenic treatment.
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Affiliation(s)
- Yanfen Cui
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Caiyuan Zhang
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Xiaoming Li
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Huanhuan Liu
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Bing Yin
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Tianyong Xu
- MR Advanced Application and Research Center, GE Healthcare China, Shanghai 201203, China
| | - Yong Zhang
- MR Advanced Application and Research Center, GE Healthcare China, Shanghai 201203, China
| | - Dengbin Wang
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
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Xiao-ping Y, Jing H, Fei-ping L, Yin H, Qiang L, Lanlan W, Wei W. Intravoxel incoherent motion MRI for predicting early response to induction chemotherapy and chemoradiotherapy in patients with nasopharyngeal carcinoma. J Magn Reson Imaging 2015; 43:1179-90. [PMID: 26540374 DOI: 10.1002/jmri.25075] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 09/29/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND To investigate the value of intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (DW-MRI) in predicting the early response to induction chemotherapy (IC) and chemoradiotherapy (CRT) in nasopharyngeal carcinoma (NPC). METHODS Fifty NPC patients who received IC and CRT underwent an IVIM DW-MRI on a 1.5-Tesla MRI scanner. The pretreatment and posttreatment (20 days after IC initiation) IVIM-based parameters (ADC, D, D*, and f), and their percentage changes (△%), were compared between the effective (complete response or partial response) and ineffective (stable disease) groups based on RECIST 1.1, and between the residual and nonresidual groups. RESULTS None of the perfusion-related parameter' values showed significant differences between the effective and ineffective groups (p values for pref, postf, △%f, preD*, postD*, and △%D* were 0.364, 0.129, 0.792, 0.804, 0.167, and 0.428, respectively), or between the residual and nonresidual groups (P values for pref, postf, △%f, preD*, postD*, and △%D* were 0.328, 0.776, 0.546, 0.558, 0.214, and 0.414, respectively). The ineffective group exhibited higher preADC, higher preD and lower △%D values than the effective group (all P < 0.001). The nonresidual group had lower preD, lower preADC and higher △%D values (all P < 0.05) than the residual group. △%D had the highest area under curve (0.859) in predicting the response to IC, whereas preD had the highest area under curve (0.841) in predicting tumor residue after CRT. CONCLUSION Diffusion-related IVIM-based parameters might be more helpful than perfusion-related parameters in predicting the early effects of IC and CRT for NPC.
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Affiliation(s)
- Yu Xiao-ping
- Department of Radiology, the third Xiangya Hospital, Central South University, Changsha, Hunan, China.,Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hou Jing
- Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Li Fei-ping
- Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hu Yin
- Department of Radiotherapy, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Lu Qiang
- Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Wang Lanlan
- Department of Diagnostic Radiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Wang Wei
- Department of Radiology, the third Xiangya Hospital, Central South University, Changsha, Hunan, China
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Xu XQ, Su GY, Liu J, Hu H, Hong XN, Shi HB, Wu FY. Intravoxel incoherent motion MR imaging measurements of the bilateral parotid glands at 3.0-T MR: effect of age, gender and laterality in healthy adults. Br J Radiol 2015; 88:20150646. [PMID: 26449128 PMCID: PMC4984946 DOI: 10.1259/bjr.20150646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/22/2015] [Accepted: 10/07/2015] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate the effect of age, gender and laterality on the intravoxel incoherent motion (IVIM) MR imaging measurements of parotid glands in healthy participants at 3.0-T MRI. METHODS A total of 108 healthy participants were prospectively recruited. IVIM MRI scan was performed using a 3.0-T MR scanner, and corresponding parameters (perfusion fraction, f; pseudodiffusion coefficient, D*; tissue diffusivity, D) were derived from biexponential fitting of IVIM data. Pearson correlation analysis was performed to determine the association between the IVIM MRI parameters and age. The parameter difference between male and female participants or between left and right parotid glands was compared using unpaired or paired t test, respectively. RESULTS Excellent interreader and intrareader agreements on the measurements of IVIM MRI parameters were achieved. Both D and f values correlated inversely with the age in both left and right parotid glands (p < 0.05) while D* value did not (p > 0.05). Male participants had higher IVIM MRI parameters than the female participants in both left and right glands (p < 0.05). No significant differences were found in the IVIM MRI parameters between left and right glands in both male and female participants (p > 0.05). CONCLUSION The IVIM MRI parameters are age and gender dependent, but not laterality dependent. Age- and gender-related effect should be taken into consideration in future IVIM MRI studies for parotid glands. ADVANCES IN KNOWLEDGE (1) Both D and f values correlated inversely with the age in healthy parotid glands, while D* value did not. (2) The parotid glands of males showed higher IVIM MRI parameters than that of females. (3) There were no significant differences on the IVIM MRI parameters between the left and right glands. (4) Age- and gender-related effect should be taken into consideration in future IVIM MRI studies for parotid glands.
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Affiliation(s)
- Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guo-Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jun Liu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xun-Ning Hong
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hai-Bin Shi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Zhang HM, Wu YH, Gan Q, Lyu X, Zhu XL, Kuang M, Liu RB, Huang ZX, Yuan F, Liu XJ, Song B. Diagnostic Utility of Diffusion-weighted Magnetic Resonance Imaging in Differentiating Small Solid Renal Tumors (≤ 4 cm) at 3.0T Magnetic Resonance Imaging. Chin Med J (Engl) 2015; 128:1444-9. [PMID: 26021498 PMCID: PMC4733766 DOI: 10.4103/0366-6999.157648] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The aim of this study was to assess the performance of apparent diffusion coefficient (ADC) measurement obtained with diffusion-weighted magnetic resonance imaging (DW-MRI) to distinguish renal cell carcinomas (RCCs) from small benign solid renal tumors (≤ 4 cm). METHODS In this cross-sectional study, 49 consecutive patients with histopathologically confirmed small solid renal tumors, and seven healthy volunteers were imaged using nonenhanced MRI and DW-MRI. The ADC map was calculated using the b values of 0, 50, 400, and 600 s/mm 2 and values compared via the Kruskal-Wallis and Mann-Whitney tests. The utility of ADC for differentiating RCCs and benign lesions was assessed using a receiver operating characteristic curve. Multiple nonenhanced MRI features were analyzed by Logistic regression. RESULTS The tumors consisted of 33 cases of clear-cell RCCs (ccRCCs) and 16 cases of benign tumors, including 14 cases of minimal fat angiomyolipomas and 2 cases of oncocytomas. The ADCs showed significant differences among benign tumors ([0.90 ± 0.52] × 10-3 mm 2 /s), ccRCCs ([1.53 ± 0.31] × 10-3 mm 2 /s) and the normal renal parenchyma ([2.22 ± 0.12] × 10-3 mm 2 /s) (P < 0.001). Moreover, there was statistically significant difference between high and low-grade ccRCCs (P = 0.004). Using a cut-off ADC of 1.36 × 10-3 mm 2 /s, DW-MRI resulted in an area under the curve (AUC), sensitivity, and specificity equal to 0.839, 75.8%, and 87.5%, respectively. Nonenhanced MRI alone and the combination of imaging methods led to an AUC, sensitivity and specificity equal to 0.919, 93.9%, and 81.2%, 0.998, 97%, and 100%, respectively. The Logistic regression showed that the location of the center of the tumor (inside the contour of the kidney) and appearance of stiff blood vessel were significantly helpful for diagnosing ccRCCs. CONCLUSIONS DW-MRI has potential in distinguishing ccRCCs from benign lesions in human small solid renal tumors (≤ 4 cm), and in increasing the accuracy for diagnosing ccRCCs when combined with nonenhanced MRI.
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Affiliation(s)
- Han-Mei Zhang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ying-Hua Wu
- Department of Radiology, The Second Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610041, China
| | - Qi Gan
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiao Lyu
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiang-Lan Zhu
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Min Kuang
- Department of Radiology, The Second Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610041, China
| | - Rong-Bo Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Zi-Xing Huang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Fang Yuan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xi-Jiao Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Address for correspondence: Dr. Bin Song, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China E-Mail:
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