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Wang K, Wu G. Whole-volume diffusion kurtosis magnetic resonance (MR) imaging histogram analysis of non-small cell lung cancer: correlation with histopathology and degree of tumor differentiation. Clin Radiol 2024; 79:e1072-e1080. [PMID: 38816262 DOI: 10.1016/j.crad.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/24/2024] [Accepted: 04/29/2024] [Indexed: 06/01/2024]
Abstract
AIMS To evaluate the role of diffusion kurtosis imaging (DKI) histogram analysis in the characterization of non-small cell lung cancer (NSCLC) and to correlate DKI parameters with tumor cellularity. MATERIALS AND METHODS Sixty-four patients with pathologically diagnosed NSCLCs were evaluated by DKI on a 3-T scanner. Regions of interest (ROIs) were drawn on the map of b1000 manually. All NSCLCs were histologically graded according to the degree of tumor differentiation. Tumor cellularity was measured by the nuclear-to-cytoplasm (N/C) ratio and the number of tumor cell nuclei (NTCN), the expression of Ki-67 was detected using the streptavidin-peroxidase method. Histogram analysis was performed using voxel-based on raw data from each ROI. RESULTS NSCLCs were classified as grades 1, 2, and 3 according to differentiation degree. Histogram parameters of apparent diffusion coefficient (ADC) and DKI could discriminate between different grades of tumors (p<0.001). Receiver operating characteristic (ROC) curve analysis showed that Kapp 75th exhibited the best performance with an AUC of 0.936 and sensitivity/specificity of 95.74%/80% (p<0.001) in distinguishing grade 1 from grade 2, ADC mean exhibited the best performance with an AUC of 0.923 and sensitivity/specificity of 92.33%/86.67% (p<0.001) in distinguishing grade 2 from 3. N/C ratio and Ki-67 changed significantly with grade (p<0.01). Negative correlations were found between the ADC mean and the N/C ratio, Ki-67, Dapp mean and N/C ratio, whereas Kapp mean and N/C ratio, Ki-67 were positively correlated. CONCLUSIONS DKI histogram analysis could quantitatively characterize NSCLC with different grades by probing non-Gaussian diffusion properties related to changes in the tumor microenvironment or tissue complexities in the tumor.
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Affiliation(s)
- K Wang
- PET-CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan 430000, Hubei, China.
| | - G Wu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430000, Hubei, China
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Schmitzer L, Kaczmarz S, Göttler J, Hoffmann G, Kallmayer M, Eckstein HH, Hedderich DM, Kufer J, Zimmer C, Preibisch C, Hyder F, Sollmann N. Macro- and microvascular contributions to cerebral structural alterations in patients with asymptomatic carotid artery stenosis. J Cereb Blood Flow Metab 2024:271678X241238935. [PMID: 38506325 DOI: 10.1177/0271678x241238935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Atherosclerosis can underly internal carotid artery stenosis (ICAS), a major risk factor for ischemic stroke, as well as small vessel disease (SVD). This study aimed to investigate hemodynamics and structural alterations associated with SVD in ICAS patients. 28 patients with unilateral asymptomatic ICAS and 30 age-matched controls underwent structural (T1-/T2-weighted and diffusion tensor imaging [DTI]) and hemodynamic (pseudo-continuous arterial spin labeling and dynamic susceptibility contrast) magnetic resonance imaging. SVD-related alterations were assessed using free water (FW), FW-corrected DTI, and peak-width of skeletonized mean diffusivity (PSMD). Furthermore, cortical thickness, cerebral blood flow (CBF), and capillary transit time heterogeneity (CTH) were analyzed. Ipsilateral to the stenosis, cortical thickness was significantly decreased in the posterior dorsal cingulate cortex (p = 0.024) and temporal pole (p = 0.028). ICAS patients exhibited elevated PSMD (p = 0.005), FW (p < 0.001), and contralateral alterations in FW-corrected DTI metrics. We found significantly lateralized CBF (p = 0.011) and a tendency for lateralized CTH (p = 0.067) in the white matter (WM) related to ICAS. Elevated PSMD and FW may indicate a link between SVD and WM changes. Contralateral alterations were seen in FW-corrected DTI, whereas hemodynamic and cortical changes were mainly ipsilateral, suggesting SVD might influence global brain changes concurrent with ICAS-related hemodynamic alterations.
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Affiliation(s)
- Lena Schmitzer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiology & Biomedical Imaging, Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Stephan Kaczmarz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiology & Biomedical Imaging, Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Philips GmbH Market DACH, Hamburg, Germany
| | - Jens Göttler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiology & Biomedical Imaging, Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Gabriel Hoffmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Michael Kallmayer
- Department for Vascular and Endovascular Surgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Hans-Henning Eckstein
- Department for Vascular and Endovascular Surgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dennis Martin Hedderich
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan Kufer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiology & Biomedical Imaging, Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christine Preibisch
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Neurology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Fahmeed Hyder
- Department of Radiology & Biomedical Imaging, Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
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Qiu J, Zhu M, Chen CY, Luo Y, Wen J. Diffusion heterogeneity and vascular perfusion in tumor and peritumoral areas for prediction of overall survival in patients with high-grade glioma. Magn Reson Imaging 2023; 104:23-28. [PMID: 37734575 DOI: 10.1016/j.mri.2023.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 08/24/2023] [Accepted: 09/17/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To evaluation of diffusion heterogeneity and vascular perfusion in tumor and peritumoral areas for prognostic prediction in high-grade glioma (HGG, WHO III/IV grade). METHODS Forty patients with HGG underwent diffusion kurtosis imaging (DKI), intravoxel incoherent motion (IVIM), and arterial spin labeling (ASL) MRI before operation. After normalization, the parameters were divided into diffusion heterogeneity parameters (rD, rMD, rMK, rKr, rKa) and vascular perfusion parameters (rD*, rF, rCBF). Univariate and multivariate Cox regression analyses were used to evaluate associations between overall survival (OS) and the above parameters, clinical factors, and IDH1 status. The Mann-Whitney test was used to evaluate differences in the parameters between different IDH1 states. RESULTS In the univariate Cox regression analysis, OS was significantly associated with tumor resection range, IDH1 status, tumor heterogeneity parameters (rD, rMD, rMK, rKr, rKa), and rCBF in tumor area(all p < 0.05). In addition, rD and rCBF measured in the peritumoral region were also predictors of poor OS (both p < 0.01). Multivariate Cox regression analysis indicated that rMK in the tumor area and rCBF in the peritumoral area (hazard ratio = 7.900 and 5.466, respectively, for each 0.1 increase in the normalized value) were independent predictors of OS. CONCLUSION The rMK of tumor area and rCBF of peritumoral area had independent predictive value for OS in patients with HGG. ADVANCES IN KNOWLEDGE This study explored useful imaging biomarkers from the diffusion heterogeneity and vascular perfusion of tumor and peritumoral areas in HGG, which is useful to help clinician to make precise therapeutic plans, and predict the prognostic for glioma patients.
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Affiliation(s)
- Jun Qiu
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230036, China.
| | - Min Zhu
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230036, China
| | - Chuan Yu Chen
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230036, China
| | - Yi Luo
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230036, China
| | - Jie Wen
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230036, China.
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Hsueh S, Chao C, Chen T, Chen Y, Hsueh H, Tsai L, Wu W, Hsieh S. Brain imaging signatures in amyotrophic lateral sclerosis: Correlation with peripheral motor degeneration. Ann Clin Transl Neurol 2023; 10:1456-1466. [PMID: 37340732 PMCID: PMC10424648 DOI: 10.1002/acn3.51835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVE This study aimed to explore the clinical significance of brain imaging signatures in the context of clinical neurological deficits in association with upper and lower motor neuron degeneration in amyotrophic lateral sclerosis (ALS). METHODS We performed brain MRI examinations to quantitatively evaluate (1) gray matter volume and (2) white matter tract fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD). Image-derived indices were correlated with (1) global neurological deficits of MRC muscle strength sum score, revised amyotrophic lateral sclerosis functional rating scale (ALSFRS-R), and forced vital capacity (FVC), and (2) focal scores of University of Pennsylvania Upper motor neuron score (Penn score) and the summation of compound muscle action potential Z scores (CMAP Z sum score). RESULTS There were 39 ALS patients and 32 control subjects matched for age and gender. Compared to controls, ALS patients had a lower gray matter volume in the precentral gyrus of the primary motor cortex, which was correlated with FA of corticofugal tracts. The gray matter volume of the precentral gyrus was correlated with FVC, MRC sum score, and CMAP Z sum score, while the FA of the corticospinal tract was linearly associated with CMAP Z sum score and Penn score on multivariate linear regression model. INTERPRETATION This study indicated that clinical assessment of muscle strength and routine measurements on nerve conduction studies provided surrogate markers of brain structural changes for ALS. Furthermore, these findings suggested parallel involvement of both upper and lower motor neurons in ALS.
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Affiliation(s)
- Sung‐Ju Hsueh
- Department of NeurologyNational Taiwan University Hospital Yunlin BranchDouliu CityYunlin CountyTaiwan
- Department of NeurologyNational Taiwan University HospitalTaipeiTaiwan
| | - Chi‐Chao Chao
- Department of NeurologyNational Taiwan University HospitalTaipeiTaiwan
| | - Ta‐Fu Chen
- Department of NeurologyNational Taiwan University HospitalTaipeiTaiwan
| | - Ya‐Fang Chen
- Department of Medical ImagingNational Taiwan University HospitalTaipeiTaiwan
| | - Hsueh‐Wen Hsueh
- Department of NeurologyNational Taiwan University HospitalTaipeiTaiwan
- Department of Anatomy and Cell BiologyNational Taiwan University College of MedicineTaipeiTaiwan
| | - Li‐Kai Tsai
- Department of NeurologyNational Taiwan University HospitalTaipeiTaiwan
- Department of NeurologyNational Taiwan University Hospital Hsinchu BranchZhubei CityHsinchu CountyTaiwan
| | - Wen‐Chau Wu
- Department of Medical ImagingNational Taiwan University HospitalTaipeiTaiwan
- Graduate Institute of Medical Device and ImagingCollege of MedicineNational Taiwan University HospitalTaipeiTaiwan
| | - Sung‐Tsang Hsieh
- Department of NeurologyNational Taiwan University HospitalTaipeiTaiwan
- Department of Anatomy and Cell BiologyNational Taiwan University College of MedicineTaipeiTaiwan
- Graduate Institute of Clinical MedicineNational Taiwan University College of MedicineTaipeiTaiwan
- Center of Precision MedicineNational Taiwan University College of MedicineTaipeiTaiwan
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Pancreatic Mass Characterization Using IVIM-DKI MRI and Machine Learning-Based Multi-Parametric Texture Analysis. Bioengineering (Basel) 2023; 10:bioengineering10010083. [PMID: 36671655 PMCID: PMC9854749 DOI: 10.3390/bioengineering10010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Non-invasive characterization of pancreatic masses aids in the management of pancreatic lesions. Intravoxel incoherent motion-diffusion kurtosis imaging (IVIM-DKI) and machine learning-based texture analysis was used to differentiate pancreatic masses such as pancreatic ductal adenocarcinoma (PDAC), pancreatic neuroendocrine tumor (pNET), solid pseudopapillary epithelial neoplasm (SPEN), and mass-forming chronic pancreatitis (MFCP). A total of forty-eight biopsy-proven patients with pancreatic masses were recruited and classified into pNET (n = 13), MFCP (n = 6), SPEN (n = 4), and PDAC (n = 25) groups. All patients were scanned for IVIM-DKI sequences acquired with 14 b-values (0 to 2500 s/mm2) on a 1.5T MRI. An IVIM-DKI model with a 3D total variation (TV) penalty function was implemented to estimate the precise IVIM-DKI parametric maps. Texture analysis (TA) of the apparent diffusion coefficient (ADC) and IVIM-DKI parametric map was performed and reduced using the chi-square test. These features were fed to an artificial neural network (ANN) for characterization of pancreatic mass subtypes and validated by 5-fold cross-validation. Receiver operator characteristics (ROC) analyses were used to compute the area under curve (AUC). Perfusion fraction (f) was significantly higher (p < 0.05) in pNET than PDAC. The f showed better diagnostic performance for PDAC vs. MFCP with AUC:0.77. Both pseudo-diffusion coefficient (D*) and f for PDAC vs. pNET showed an AUC of 0.73. ADC and diffusion coefficient (D) showed good diagnostic performance for pNET vs. MFCP with AUC: 0.79 and 0.76, respectively. In the TA of PDAC vs. non-PDAC, f and combined IVIM-DKI parameters showed high accuracy ≥ 84.3% and AUC ≥ 0.84. Mean f and combined IVIM-DKI parameters estimated that the IVIM-DKI model with TV texture features has the potential to be helpful in characterizing pancreatic masses.
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Lee W, Choi G, Lee J, Park H. Registration and quantification network (RQnet) for IVIM-DKI analysis in MRI. Magn Reson Med 2022; 89:250-261. [PMID: 36121205 DOI: 10.1002/mrm.29454] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 11/08/2022]
Abstract
PURPOSE A deep learning method is proposed for aligning diffusion weighted images (DWIs) and estimating intravoxel incoherent motion-diffusion kurtosis imaging parameters simultaneously. METHODS We propose an unsupervised deep learning method that performs 2 tasks: registration and quantification for intravoxel incoherent motion-diffusion kurtosis imaging analysis. A common registration method in diffusion MRI is based on minimizing dissimilarity between various DWIs, which may result in registration errors due to different contrasts in different DWIs. We designed a novel unsupervised deep learning method for both accurate registration and quantification of various diffusion parameters. In order to generate motion-simulated training data and test data, 17 volunteers were scanned without moving their heads, and 4 volunteers moved their heads during the scan in a 3 Tesla MRI. In order to investigate the applicability of the proposed method to other organs, kidney images were also obtained. We compared the registration accuracy of the proposed method, statistical parametric mapping, and a deep learning method with a normalized cross-correlation loss. In the quantification part of the proposed method, a deep learning method that considered the diffusion gradient direction was used. RESULTS Simulations and experimental results showed that the proposed method accurately performed registration and quantification for intravoxel incoherent motion-diffusion kurtosis imaging analysis. The registration accuracy of the proposed method was high for all b values. Furthermore, quantification performance was analyzed through simulations and in vivo experiments, where the proposed method showed the best performance among the compared methods. CONCLUSION The proposed method aligns the DWIs and accurately quantifies the intravoxel incoherent motion-diffusion kurtosis imaging parameters.
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Affiliation(s)
- Wonil Lee
- Department of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Giyong Choi
- Department of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Jongyeon Lee
- Department of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - HyunWook Park
- Department of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
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Li B, Xu D, Zhou J, Wang SC, Cai YX, Li H, Xu HB. Monitoring Bevacizumab-Induced Tumor Vascular Normalization by Intravoxel Incoherent Motion Diffusion-Weighted MRI. J Magn Reson Imaging 2021; 56:427-439. [PMID: 34873766 DOI: 10.1002/jmri.28012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Accurate monitoring of tumor blood vessel normalization progression is beneficial to accurate treatment of patients. At present, there is a lack of safe and noninvasive monitoring methods. PURPOSE To serial monitor the vascular normalization time window of tumor antiangiogenesis treatment through intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and histopathological methods. STUDY TYPE Exploratory animal study. POPULATION Sixty rat C6 glioma models were randomly and equally divided into the control groups (N = 30) and bevacizumab treatment groups (N = 30). Twenty-five for magnetic resonance imaging (MRI) and five for electron microscope testing in each group. FIELD STRENGTH/SEQUENCE T1-weighted imaging (T1WI), T2WI with a fast spin echo sequence and IVIM-DWI with a spin-echo echo-planar imaging sequence at 3 T. ASSESSMENT IVIM-DWI quantitative parameters (f, D, D*, and fD*) were obtained on days 0, 2, 4, 6, and 8 after bevacizumab treatment. After MRI, the microvessel density (MVD), pericyte coverage, and hypoxia-inducible factor-1α (HIF-1α) were assessed. Electron microscope observation was performed at each time point. STATISTICAL TESTS One-way analysis of variance and Student's t-tests were used to compare differences within and between groups. Spearman's correlation coefficient (r) assess the correlation between IVIM and pathological parameters. The intragroup correlation coefficient was determined to assess the repeatability of each IVIM parameter. RESULTS The IVIM-DWI perfusion parameters (f and fD*) of the treated group were higher than the control group on days 2 and 4. Compared to the control group, MVD decreased on days 2 and pericyte coverage increased on days 4 in the treatment group. Electron microscopy showed that the tight junctions of the treatment group were prolonged on days 2-4. In the control group, f had the highest correlation with MVD (r = 0.689). In the treated group, f had a good correlation with pericyte coverage (r = 0.557), HIF-1α had a moderately positive correlation with f (r = 0.480) and fD*(r = 0.447). DATA CONCLUSION The vascular normalization time window of bevacizumab treatment of glioma was days 2-4 after antiangiogenesis treatment, which could be monitored noninvasively by IVIM-DWI. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Bo Li
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China.,The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Dan Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jie Zhou
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shou-Chao Wang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yu-Xiang Cai
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Huan Li
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hai-Bo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Li C, Yu L, Jiang Y, Cui Y, Liu Y, Shi K, Hou H, Liu M, Zhang W, Zhang J, Zhang C, Chen M. The Histogram Analysis of Intravoxel Incoherent Motion-Kurtosis Model in the Diagnosis and Grading of Prostate Cancer-A Preliminary Study. Front Oncol 2021; 11:604428. [PMID: 34778020 PMCID: PMC8579734 DOI: 10.3389/fonc.2021.604428] [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] [Received: 09/09/2020] [Accepted: 10/06/2021] [Indexed: 12/09/2022] Open
Abstract
Objectives This study was conducted in order to explore the value of histogram analysis of the intravoxel incoherent motion-kurtosis (IVIM-kurtosis) model in the diagnosis and grading of prostate cancer (PCa), compared with monoexponential model (MEM). Materials and Methods Thirty patients were included in this study. Single-shot echo-planar imaging (SS-EPI) diffusion-weighted images (b-values of 0, 20, 50, 100, 200, 500, 1,000, 1,500, 2,000 s/mm2) were acquired. The pathologies were confirmed by in-bore MR-guided biopsy. The postprocessing and measurements were processed using the software tool Matlab R2015b for the IVIM-kurtosis model and MEM. Regions of interest (ROIs) were drawn manually. Mean values of D, D*, f, K, ADC, and their histogram parameters were acquired. The values of these parameters in PCa and benign prostatic hyperplasia (BPH)/prostatitis were compared. Receiver operating characteristic (ROC) curves were used to investigate the diagnostic efficiency. The Spearman test was used to evaluate the correlation of these parameters and Gleason scores (GS) of PCa. Results For the IVIM-kurtosis model, D (mean, 10th, 25th, 50th, 75th, 90th), D* (90th), and f (10th) were significantly lower in PCa than in BPH/prostatitis, while D (skewness), D* (kurtosis), and K (mean, 75th, 90th) were significantly higher in PCa than in BPH/prostatitis. For MEM, ADC (mean, 10th, 25th, 50th, 75th, 90th) was significantly lower in PCa than in BPH/prostatitis. The area under the ROC curve (AUC) of the IVIM-kurtosis model was higher than MEM, without significant differences (z = 1.761, P = 0.0783). D (mean, 50th, 75th, 90th), D* (mean, 10th, 25th, 50th, 75th), and f (skewness, kurtosis) correlated negatively with GS, while D (kurtosis), D* (skewness, kurtosis), f (mean, 75th, 90th), and K (mean, 75th, 90th) correlated positively with GS. The histogram parameters of ADC did not show correlations with GS. Conclusion The IVIM-kurtosis model has potential value in the differential diagnosis of PCa and BPH/prostatitis. IVIM-kurtosis histogram analysis may provide more information in the grading of PCa than MEM.
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Affiliation(s)
- Chunmei Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Lu Yu
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuwei Jiang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yadong Cui
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Liu
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Huimin Hou
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Ming Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Zhang
- Department of Pathology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jintao Zhang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Chen Zhang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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Wang DJJ, Le Bihan D, Krishnamurthy R, Smith M, Ho ML. Noncontrast Pediatric Brain Perfusion: Arterial Spin Labeling and Intravoxel Incoherent Motion. Magn Reson Imaging Clin N Am 2021; 29:493-513. [PMID: 34717841 DOI: 10.1016/j.mric.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Noncontrast magnetic resonance imaging techniques for measuring brain perfusion include arterial spin labeling (ASL) and intravoxel incoherent motion (IVIM). These techniques provide noninvasive and repeatable assessment of cerebral blood flow or cerebral blood volume without the need for intravenous contrast. This article discusses the technical aspects of ASL and IVIM with a focus on normal physiologic variations, technical parameters, and artifacts. Multiple pediatric clinical applications are presented, including tumors, stroke, vasculopathy, vascular malformations, epilepsy, migraine, trauma, and inflammation.
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Affiliation(s)
- Danny J J Wang
- USC Institute for Neuroimaging and Informatics, SHN, 2025 Zonal Avenue, Health Sciences Campus, Los Angeles, CA 90033, USA
| | - Denis Le Bihan
- NeuroSpin, Centre d'études de Saclay, Bâtiment 145, Gif-sur-Yvette 91191, France
| | - Ram Krishnamurthy
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mark Smith
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA.
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Uwano I, Kobayashi M, Setta K, Ogasawara K, Yamashita F, Mori F, Matsuda T, Sasaki M. Assessment of Impaired Cerebrovascular Reactivity in Chronic Cerebral Ischemia using Intravoxel Incoherent Motion Magnetic Resonance Imaging. J Stroke Cerebrovasc Dis 2021; 30:106107. [PMID: 34562793 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106107] [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: 02/25/2021] [Revised: 08/10/2021] [Accepted: 09/04/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The severity of chronic cerebral ischemia can be assessed using cerebrovascular reactivity (CVR) to acetazolamide (ACZ) challenge, which is measured by single-photon emission computed tomography (SPECT); however, this is an invasive method. We investigated whether intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) can assess impaired CVR in preoperative patients with chronic cerebral ischemia and compared it to SPECT-CVR. METHODS Forty-seven patients with unilateral cervical carotid artery stenosis underwent diffusion-weighted MRI with 11 b-values in the range of 0-800 s/mm2 and cerebral perfusion SPECT with the ACZ challenge. The perfusion fraction (f) and diffusion coefficient (D) of the IVIM parameters were calculated using a bi-exponential model. The f and D values and these ratios of the ipsilateral middle cerebral artery territory against the contralateral side were compared with the CVR values of the affected side calculated from the SPECT data. RESULTS The IVIM-f and D values in the affected side were significantly higher than those in the unaffected side (median: 7.74% vs. 7.45%, p = 0.027; 0.816 vs. 0.801 10-3mm2/s, p < 0.001; respectively). However, there were no significant correlations between the f or D values and SPECT-CVR values in the affected side. In contrast, the f ratio showed a moderate negative correlation with the SPECT-CVR values (r = -0.40, p = 0.006) and detected impaired CVR (< 18.4%) with a sensitivity/specificity of 0.71/0.90. CONCLUSION The IVIM perfusion parameter, f, can noninvasively assess impaired CVR with high sensitivity and specificity in patients with unilateral cervical carotid artery stenosis.
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Affiliation(s)
- Ikuko Uwano
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 1-1-1 Idai-dori, Yahaba, Iwate 028-3694, Japan.
| | - Masakazu Kobayashi
- Department of Neurosurgery, Iwate Medical University, Yahaba, Iwate, Japan
| | - Kengo Setta
- Department of Neurosurgery, Iwate Medical University, Yahaba, Iwate, Japan
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, Yahaba, Iwate, Japan
| | - Fumio Yamashita
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 1-1-1 Idai-dori, Yahaba, Iwate 028-3694, Japan
| | - Futoshi Mori
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 1-1-1 Idai-dori, Yahaba, Iwate 028-3694, Japan
| | - Tsuyoshi Matsuda
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 1-1-1 Idai-dori, Yahaba, Iwate 028-3694, Japan
| | - Makoto Sasaki
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 1-1-1 Idai-dori, Yahaba, Iwate 028-3694, Japan
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Predict Treatment Response by Magnetic Resonance Diffusion Weighted Imaging: A Preliminary Study on 46 Meningiomas Treated with Proton-Therapy. Diagnostics (Basel) 2021; 11:diagnostics11091684. [PMID: 34574025 PMCID: PMC8469991 DOI: 10.3390/diagnostics11091684] [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: 08/19/2021] [Revised: 09/10/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: a considerable subgroup of meningiomas (MN) exhibit indolent and insidious growth. Strategies to detect earlier treatment responses based on tumour biology rather than on size can be useful. We aimed to characterize therapy-induced changes in the apparent diffusion coefficient (ADC) of MN treated with proton-therapy (PT), determining whether the pre- and early post-treatment ADC values may predict tumour response. Methods: Forty-four subjects with MN treated with PT were retrospectively enrolled. All patients underwent conventional magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) at baseline and each 3 months for a follow-up period up to 36 months after the beginning of PT. Mean relative ADC (rADCm) values of 46 MN were measured at each exam. The volume variation percentage (VV) for each MN was calculated. The Wilcoxon test was used to assess the differences in rADCm values between pre-treatment and post-treatment exams. Patients were grouped in terms of VV (threshold −20%). A p < 0.05 was considered statistically significant for all the tests. Results: A significant progressive increase of rADCm values was detected at each time point when compared to baseline rADCm (p < 0.05). Subjects that showed higher pre-treatment rADCm values had no significant volume changes or showed volume increase, while subjects that showed a VV < −20% had significantly lower pre-treatment rADCm values. Higher and earlier rADCm increases (3 months) are related to greater volume reduction. Conclusion: In MN treated with PT, pre-treatment rADCm values and longitudinal rADCm changes may predict treatment response.
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Liu N, Yang X, Lei L, Pan K, Liu Q, Huang X. Intravoxel Incoherent Motion Model in Differentiating the Pathological Grades of Esophageal Carcinoma: Comparison of Mono-Exponential and Bi-Exponential Fit Model. Front Oncol 2021; 11:625891. [PMID: 33912449 PMCID: PMC8071935 DOI: 10.3389/fonc.2021.625891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/15/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To compare the diagnostic efficiency of the mono-exponential model and bi-exponential model deriving from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in differentiating the pathological grade of esophageal squamous cell carcinoma (ESCC). METHODS Fifty-four patients with ESCC were divided into three groups of poorly-differentiated (PD), moderately-differentiated (MD), and well-differentiated (WD), and underwent the IVIM-DWI scan. Mono-exponential (Dmono, D*mono, and fmono) and bi-exponential fit parameters (Dbi, D*bi, and fbi) were calculated using the IVIM data for the tumors. Mean parameter values of three groups were compared using a one-way ANOVA followed by post hoc tests. The receiver operating characteristic curve was drawn for differentiating pathological grade of ESCC. Correlations between pathological grades and IVIM parameters were analyzed. RESULTS There were significant differences in fmono and fbi among the PD, MD and WD ESCC groups (all p<0.05). The fmono were 0.32 ± 0.07, 0.23 ± 0.08, and 0.16 ± 0.05, respectively, and the fbi were 0.35 ± 0.08, 0.26 ± 0.10, and 0.18 ± 0.07, respectively. There was a significant difference in the Dmono between the WD and the PD group (1.48 ± 0.51* 10-3 mm2/s versus 1.05 ± 0.44*10-3 mm2/s, p<0.05), but there was no significant difference between the WD and MD groups, MD and PD groups (all p>0.05). The D*mono, Dbi, and D*bi showed no significant difference among the three groups (all p>0.05). The area under the curve (AUC) of Dmono, fmono and fbi in differentiating WD from PD ESCC were 0.764, 0.961 and 0.932, and the sensitivity and specificity were 92.9% and 60%, 92.9% and 90%, 85.7% and 100%, respectively. The AUC of fmono and fbi in differentiating MD from PD ESCC were 0.839 and 0.757, and the sensitivity and specificity were 78.6% and 80%, 85.7% and 70%, respectively. The AUC of fmono and fbi in differentiating MD from WD ESCC were 0.746 and 0.740, and the sensitivity and specificity were 65% and 85%, 80% and 60%, respectively. The pathologically differentiated grade was correlated with all IVIM parameters (all p<0.05). CONCLUSIONS The mono-exponential IVIM model is superior to the bi-exponential IVIM model in differentiating pathological grades of ESCC, which may be a promising imaging method to predict pathological grades of ESCC.
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Affiliation(s)
- Nian Liu
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiongxiong Yang
- Department of Radiology, Nanchong Hospital of Traditional Chinese Medicine, Nanchong, China
| | - Lixing Lei
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ke Pan
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Qianqian Liu
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiaohua Huang
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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13
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Zhu J, Luo X, Gao J, Li S, Li C, Chen M. Application of diffusion kurtosis tensor MR imaging in characterization of renal cell carcinomas with different pathological types and grades. Cancer Imaging 2021; 21:30. [PMID: 33726862 PMCID: PMC7962255 DOI: 10.1186/s40644-021-00394-7] [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] [Received: 08/03/2020] [Accepted: 02/19/2021] [Indexed: 12/13/2022] Open
Abstract
Background To probe the feasibility and reproducibility of diffusion kurtosis tensor imaging (DKTI) in renal cell carcinoma (RCC) and to apply DKTI in distinguishing the subtypes of RCC and the grades of clear cell RCC (CCRCC). Methods Thirty-eight patients with pathologically confirmed RCCs [CCRCC for 30 tumors, papillary RCC (PRCC) for 5 tumors and chromophobic RCC (CRCC) for 3 tumors] were involved in the study. Diffusion kurtosis tensor MR imaging were performed with 3 b-values (0, 500, 1000s/mm2) and 30 diffusion directions. The mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr) values and mean diffusity (MD) for RCC and contralateral normal parenchyma were acquired. The inter-observer agreements of all DKTI metrics of contralateral renal cortex and medulla were evaluated using Bland-Altman plots. Statistical comparisons with DKTI metrics of 3 RCC subtypes and between low-grade (Furman grade I ~ II, 22 cases) and high-grade (Furman grade III ~ IV, 8 cases) CCRCC were performed with ANOVA test and Student t test separately. Receiver operating characteristic (ROC) curve analyses were used to compare the diagnostic efficacy of DKTI metrics for predicting nuclear grades of CCRCC. Correlations between DKTI metrics and nuclear grades were also evaluated with Spearman correlation analysis. Results Inter-observer measurements for each metric showed great reproducibility with excellent ICCs ranging from 0.81 to 0.87. There were significant differences between the DKTI metrics of RCCs and contralateral renal parenchyma, also among the subtypes of RCC. MK and Ka values of CRCC were significantly higher than those of CCRCC and PRCC. Statistical difference of the MK, Ka, Kr and MD values were also obtained between CCRCC with high- and low-grades. MK values were more effective for distinguishing between low- and high- grade CCRCC (area under the ROC curve: 0.949). A threshold value of 0.851 permitted distinction with high sensitivity (90.9%) and specificity (87.5%). Conclusion Our preliminary results suggest a possible role of DKTI in differentiating CRCC from CCRCC and PRCC. MK, the principle DKTI metric might be a surrogate biomarker to predict nuclear grades of CCRCC. Trial registration ChiCTC, ChiCTR-DOD-17010833, Registered 10 March, 2017, retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=17559.
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Affiliation(s)
- Jie Zhu
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Xiaojie Luo
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Jiayin Gao
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Saying Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Chunmei Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China.
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Lee W, Kim B, Park H. Quantification of intravoxel incoherent motion with optimized b-values using deep neural network. Magn Reson Med 2021; 86:230-244. [PMID: 33594783 DOI: 10.1002/mrm.28708] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE To develop a framework for quantifying intravoxel incoherent motion (IVIM) parameters, where a neural network for quantification and b-values for diffusion-weighted imaging are simultaneously optimized. METHOD A deep neural network (DNN) method is proposed for accurate quantification of IVIM parameters from multiple diffusion-weighted images. In addition, optimal b-values are selected to acquire the multiple diffusion-weighted images. The proposed framework consists of an MRI signal generation part and an IVIM parameter quantification part. Monte-Carlo (MC) simulations were performed to evaluate the accuracy of the IVIM parameter quantification and the efficacy of b-value optimization. In order to analyze the effect of noise on the optimized b-values, simulations were performed with five different noise levels. For in vivo data, diffusion images were acquired with the b-values from four b-values selection methods for five healthy volunteers at 3T MRI system. RESULTS Experiment results showed that both the optimization of b-values and the training of DNN were simultaneously performed to quantify IVIM parameters. We found that the accuracies of the perfusion coefficient (Dp ) and perfusion fraction (f) were more sensitive to b-values than the diffusion coefficient (D) was. Furthermore, when the noise level changed, the optimized b-values also changed. Therefore, noise level has to be considered when optimizing b-values for IVIM quantification. CONCLUSION The proposed scheme can simultaneously optimize b-values and train DNN to minimize quantification errors of IVIM parameters. The trained DNN can quantify IVIM parameters from the diffusion-weighted images obtained with the optimized b-values.
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Affiliation(s)
- Wonil Lee
- Department of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Byungjai Kim
- Department of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - HyunWook Park
- Department of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
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15
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Hu H, Jiang H, Wang S, Jiang H, Zhao S, Pan W. 3.0 T MRI IVIM-DWI for predicting the efficacy of neoadjuvant chemoradiation for locally advanced rectal cancer. Abdom Radiol (NY) 2021; 46:134-143. [PMID: 32462386 PMCID: PMC7864832 DOI: 10.1007/s00261-020-02594-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose The purpose of this study was to determine the diagnostic performance of intravoxel incoherent motion (IVIM) on assessing response to neoadjuvant chemoradiation (nCRT) in patients with Locally Advanced Rectal Cancer (LARC). Methods 50 patients with rectal cancer who underwent magnetic resonance (MR) imaging before and after nCRT, the values of pre-nCRT and post-nCRT IVIM-DWI parameters apparent diffusion coefficient (ADC), diffusion coefficient (D), false diffusion coefficient (D*), and perfusion fraction (f), together with the percentage changes (∆% parametric value) induced by nCRT were calculated. According to the patient's response to nCRT, the patients were divided into pathological complete response (pCR) and non-pCR groups, Good Response (GR) group and Poor Response (PR) group, and the above values were compared between different groups. Univariate and multiple logistic regression analysis were done to investigate the relation between different parameters and patient nCRT. Draw ROC curve according to sensitivity and specificity, and compare its diagnostic efficacy. Results There were no significant differences in the baseline data of 50 patients. After nCRT, the ADC and D values for LARC increased significantly (all p < 0.05). The pCR group (n = 9) had higher preD*, pref, postD*, ∆%ADC and ∆%D values than the non-pCR group (n = 41) (all p < 0.05). The GR group (n = 17) exhibited higher post D, ∆%ADC and ∆%D values than the PR group (n = 33) (all p < 0.05). From the results of Logistic regression analysis found that ∆%ADC and ∆%D were significantly correlated with patients' response to nCRT. Based on ROC analysis, ∆%D had a higher area under the curve value than ∆%ADC (p = 0.009) in discriminating the pCR from non-pCR groups. Conclusions IVIM-DWI technology may be helpful in identifying the pCR and GR patients to nCRT for LARC.
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Affiliation(s)
- Hongbo Hu
- Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Huijie Jiang
- Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
| | - Song Wang
- Department of Radiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, No. 725, South Wanping Road, Shanghai, 200032, China
| | - Hao Jiang
- Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Sheng Zhao
- Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Wenbin Pan
- Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
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16
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Conficoni A, Feraco P, Mazzatenta D, Zoli M, Asioli S, Zenesini C, Fabbri VP, Cellerini M, Bacci A. Biomarkers of pituitary macroadenomas aggressive behaviour: a conventional MRI and DWI 3T study. Br J Radiol 2020; 93:20200321. [PMID: 32628097 DOI: 10.1259/bjr.20200321] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Pituitary macroadenomas (PAs) are usually defined as benign intracranial tumors. However, they may present local aggressive course. High Ki67 labelling index (LI) values have been related to an aggressive tumor behavior. A recent clinicopathological classification of PA based on local invasiveness and proliferation indexes, divided them in groups with different prognosis. We evaluated the utility of conventional MRI (cMRI) and diffusion-weighted imaging (DWI), in predicting the Ki67- LI according the clinicopathological classification. METHODS 17 patients (12 M and 5 F) who underwent surgical removal of a PA were studied. cMRI features, quantification of T1W and T2W signal intensity, degree of contrast uptake (enhancement ratio, ER) and apparent diffusion coefficient (ADC) values were evaluated by using a 3 T scan. Statistics included Mann-Whitney test, Spearman's test, and receiver operating characteristic analysis. A value of p ≤ 0.05 was considered significant for all the tests. RESULTS Negative correlations were observed between Ki-67 LI, ADCm (ρ = - 0.67, p value = 0.005) and ER values (ρ = -0.62; p = 0.008). ER values were significantly lower in the proliferative PA group (p = 0.028; p = 0.017). ADCm showed sensitivity and specificity of 90 and 85% respectively into predict Ki67-LI value. A value of ADCm ≤0, 711 x 10-6 mm2 emerged as a cut-off of a value of Ki67-LI ≥ 3%. CONCLUSION Adding quantitative measures of ADC values to cMRI could be used routinely as a non-invasive marker of specific predictive biomarker of the proliferative activity of PA. ADVANCES IN KNOWLEDGE Routinely use of DWI on diagnostic work-up of pituitary adenomas may help in establish the likely biological aggressive lesions.
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Affiliation(s)
- Alberto Conficoni
- Department of Radiology, Neuroradiology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro, 44124 Ferrara, Italy.,Department of Neuroradiology, Ospedale Bellaria, IRCCS Institute of Neurological Sciences of Bologna, Via Altura, 3; 40100 Bolgona, Italy
| | - Paola Feraco
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via S. Giacomo 14, 40138 Bologna, Italy.,Department of Neuroradiology, Ospedale S. Chiara, Azienda Provinciale per i Servizi Sanitari, Largo medaglie d'oro 9, 38122 , Trento, Italy
| | - Diego Mazzatenta
- Department of Biomedical and Neuromotor Sciences (DIBINEM) of Neurological Sciences of Bologna, Pituitary Unit, Center for the Diagnosis and Treatment of Hypothalamic and Pituitary Diseases, Bologna, Italy
| | - Matteo Zoli
- Department of Biomedical and Neuromotor Sciences (DIBINEM) of Neurological Sciences of Bologna, Pituitary Unit, Center for the Diagnosis and Treatment of Hypothalamic and Pituitary Diseases, Bologna, Italy
| | - Sofia Asioli
- Section of Anatomic Pathology 'M. Malpighi', Bellaria Hospital, Bologna, Italy, Via Altura9; 40100 Bolgona, Italy
| | - Corrado Zenesini
- Epidemiology and Statistics Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Viscardo Paolo Fabbri
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via S. Giacomo 14, 40138 Bologna, Italy.,Section of Anatomic Pathology 'M. Malpighi', Bellaria Hospital, Bologna, Italy, Via Altura9; 40100 Bolgona, Italy
| | - Martino Cellerini
- Department of Neuroradiology, Ospedale Bellaria, IRCCS Institute of Neurological Sciences of Bologna, Via Altura, 3; 40100 Bolgona, Italy
| | - Antonella Bacci
- Department of Neuroradiology, Ospedale Bellaria, IRCCS Institute of Neurological Sciences of Bologna, Via Altura, 3; 40100 Bolgona, Italy
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17
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Ianuş A, Santiago I, Galzerano A, Montesinos P, Loução N, Sanchez-Gonzalez J, Alexander DC, Matos C, Shemesh N. Higher-order diffusion MRI characterization of mesorectal lymph nodes in rectal cancer. Magn Reson Med 2019; 84:348-364. [PMID: 31850546 DOI: 10.1002/mrm.28102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/05/2019] [Accepted: 11/07/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE Mesorectal lymph node staging plays an important role in treatment decision making. Here, we explore the benefit of higher-order diffusion MRI models accounting for non-Gaussian diffusion effects to classify mesorectal lymph nodes both 1) ex vivo at ultrahigh field correlated with histology and 2) in vivo in a clinical scanner upon patient staging. METHODS The preclinical investigation included 54 mesorectal lymph nodes, which were scanned at 16.4 T with an extensive diffusion MRI acquisition. Eight diffusion models were compared in terms of goodness of fit, lymph node classification ability, and histology correlation. In the clinical part of this study, 10 rectal cancer patients were scanned with diffusion MRI at 1.5 T, and 72 lymph nodes were analyzed with Apparent Diffusion Coefficient (ADC), Intravoxel Incoherent Motion (IVIM), Kurtosis, and IVIM-Kurtosis. RESULTS Compartment models including restricted and anisotropic diffusion improved the preclinical data fit, as well as the lymph node classification, compared to standard ADC. The comparison with histology revealed only moderate correlations, and the highest values were observed between diffusion anisotropy metrics and cell area fraction. In the clinical study, the diffusivity from IVIM-Kurtosis was the only metric showing significant differences between benign (0.80 ± 0.30 μm2 /ms) and malignant (1.02 ± 0.41 μm2 /ms, P = .03) nodes. IVIM-Kurtosis also yielded the largest area under the receiver operating characteristic curve (0.73) and significantly improved the node differentiation when added to the standard visual analysis by experts based on T2 -weighted imaging. CONCLUSION Higher-order diffusion MRI models perform better than standard ADC and may be of added value for mesorectal lymph node classification in rectal cancer patients.
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Affiliation(s)
- Andrada Ianuş
- Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Ines Santiago
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Nova Medical School, Lisbon, Portugal
| | - Antonio Galzerano
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | | | | | | | - Daniel C Alexander
- Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Celso Matos
- Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Noam Shemesh
- Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal
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Wang X, Chen XZ, Shi L, Dai JP. Glioma grading and IDH1 mutational status: assessment by intravoxel incoherent motion MRI. Clin Radiol 2019; 74:651.e7-651.e14. [DOI: 10.1016/j.crad.2019.03.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/22/2019] [Indexed: 01/07/2023]
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Multiple mathematical models of diffusion-weighted magnetic resonance imaging combined with prognostic factors for assessing the response to neoadjuvant chemotherapy and radiation therapy in locally advanced rectal cancer. Eur J Radiol 2018; 110:249-255. [PMID: 30599868 DOI: 10.1016/j.ejrad.2018.12.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/25/2018] [Accepted: 12/04/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE To investigate whether the apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM), and stretched exponential model (SEM) based on histogram analyses derived from the whole-tumor volume combined with prognostic factors can be used to assess the response to chemotherapy and radiation therapy (CRT) in locally advanced rectal cancer (LARC). MATERIALS AND METHODS This study included 60 patients with LARC who underwent diffusion-weighted imaging with 9b values (0-1000s/mm2) before CRT. Histograms derived from the whole-tumor volume were used to obtain the ADC, IVIM (Dslow, Dfast, and f), and SEM parameters (distributed diffusion coefficient (DDC) and α). The histogram metrics and prognostic factors before CRT were compared between pathological complete response (pCR) and non-pCR patients. The receiver operating characteristic (ROC) and the area under the ROC curve (AUC) were generated to analyze the histogram metrics and prognostic factors. RESULTS A significant difference was only found in the tumor volume between the pCR and non-pCR groups (p = 0.033, AUC = 0.740). The ADC mean, DDC median, and most of the histogram metrics were significantly lower in the pCR group than the non-pCR group (p = 0.000-0.025), and AUC was highest for the ADC mean (0.890). Only the Dslow median differed significantly between the two groups (p = 0.023, AUC = 0.721). However, the Dfast, f, and α histogram metrics did not differ significantly between the pCR and non-pCR groups. The AUC for the ADC mean combined with the tumor volume was 0.908, with a sensitivity of 100% and specificity of 81%. The inter-observer agreements were good or excellent for the ADC and SEM histogram parameters but generally fair for IVIM. CONCLUSION The whole-tumor ADC mean combined with the tumor volume was highly accurate for predicting pCR. The IVIM models were inferior to ADC and SEM at predicting pCR.
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Isotropically weighted intravoxel incoherent motion brain imaging at 7T. Magn Reson Imaging 2018; 57:124-132. [PMID: 30472300 DOI: 10.1016/j.mri.2018.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/30/2018] [Accepted: 11/17/2018] [Indexed: 12/13/2022]
Abstract
Perfusion magnetic resonance imaging (MRI) is a promising non-invasive technique providing insights regarding the brain's microvascular architecture in vivo. The scalar perfusion metrics can be used for quantitative diagnostics of various brain abnormalities, in particular, in the stroke cases and tumours. However, conventional MRI-based perfusion approaches such as dynamic contrast-enhanced perfusion imaging or arterial spin labelling have a few weaknesses, for instance, contrast agent deposition, low signal-to-noise ratio, limited temporal and spatial resolution, and specific absorption rate constraints. As an alternative, the intravoxel incoherent motion (IVIM) approach exploits an extension of diffusion MRI in order to estimate perfusion parameters in the human brain. Application of IVIM imaging at ultra-high field MRI might employ the advantage of a higher signal-to-noise ratio, and thereby the use of higher spatial and temporal resolutions. In the present work, we demonstrate an application of recently developed isotropic diffusion weighted sequences to the evaluation of IVIM parameters at an ultra-high 7T field. The used sequence exhibits high immunity to image degrading factors and allows one to acquire the data in a fast and efficient way. Utilising the bi-exponential fitting model of the signal attenuation, we performed an extensive analysis of the IVIM scalar metrics obtained by a isotropic diffusion weighted sequence in vivo and compared results with a conventional pulsed gradient sequence at 7T. In order to evaluate a possible metric bias originating from blood flows, we additionally used a truncated b-value protocol (b-values from 100 to 200 s/mm2 with the step 20 s/mm2) accompanied to the full range (b-values from 0 to 200 s/mm2). The IVIM scalar metrics have been assessed and analysed together with a large and middle vessel density atlas of the human brain. We found that the diffusion coefficients and perfusion fractions of the voxels consisting of large and middle vessels have higher values in contrast to other tissues. Additionally, we did not find a strong dependence of the IVIM metrics on the density values of the vessel atlas. Perspectives and limitations of the developed isotropic diffusion weighted perfusion are presented and discussed.
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Xiong Y, Sui Y, Zhang S, Zhou XJ, Yang S, Fan Y, Zhang Q, Zhu W. Brain microstructural alterations in type 2 diabetes: diffusion kurtosis imaging provides added value to diffusion tensor imaging. Eur Radiol 2018; 29:1997-2008. [DOI: 10.1007/s00330-018-5746-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/03/2018] [Accepted: 09/10/2018] [Indexed: 12/25/2022]
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Nørhøj Jespersen S. White matter biomarkers from diffusion MRI. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2018; 291:127-140. [PMID: 29705041 DOI: 10.1016/j.jmr.2018.03.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/14/2018] [Accepted: 03/02/2018] [Indexed: 06/08/2023]
Abstract
As part of an issue celebrating 2 decades of Joseph Ackerman editing the Journal of Magnetic Resonance, this paper reviews recent progress in one of the many areas in which Ackerman and his lab has made significant contributions: NMR measurement of diffusion in biological media, specifically in brain tissue. NMR diffusion signals display exquisite sensitivity to tissue microstructure, and have the potential to offer quantitative and specific information on the cellular scale orders of magnitude below nominal image resolution when combined with biophysical modeling. Here, I offer a personal perspective on some recent advances in diffusion imaging, from diffusion kurtosis imaging to microstructural modeling, and the connection between the two. A new result on the estimation accuracy of axial and radial kurtosis with axially symmetric DKI is presented. I moreover touch upon recently suggested generalized diffusion sequences, promising to offer independent microstructural information. We discuss the need and some methods for validation, and end with an outlook on some promising future directions.
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Affiliation(s)
- Sune Nørhøj Jespersen
- Center of Functionally Integrative Neuroscience (CFIN) and MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark.
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Togao O, Hiwatashi A, Yamashita K, Kikuchi K, Momosaka D, Yoshimoto K, Kuga D, Mizoguchi M, Suzuki SO, Iwaki T, Van Cauteren M, Iihara K, Honda H. Measurement of the perfusion fraction in brain tumors with intravoxel incoherent motion MR imaging: validation with histopathological vascular density in meningiomas. Br J Radiol 2018; 91:20170912. [PMID: 29412000 DOI: 10.1259/bjr.20170912] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To evaluate the quantification performance of the perfusion fraction (f) measured with intravoxel incoherent motion (IVIM) MR imaging in a comparison with the histological vascular density in meningiomas. METHODS 29 consecutive patients with meningioma (59.0 ± 16.8 years old, 8 males and 21 females) who underwent a subsequent surgical resection were examined with both IVIM imaging and a histopathological analysis. IVIM imaging was conducted using a single-shot SE-EPI sequence with 13 b-factors (0, 10, 20, 30, 50, 80, 100, 200, 300, 400, 600, 800, 1000 s mm-2) at 3T. The perfusion fraction (f) was calculated by fitting the IVIM bi-exponential model. The 90-percentile f-value in the tumor region-of-interest (ROI) was defined as the maximum f-value (f-max). Histopathological vascular density (%Vessel) was measured on CD31-immunostainted histopathological specimens. The correlation and agreement between the f-values and %Vessel was assessed. RESULTS The f-max (15.5 ± 5.5%) showed excellent agreement [intraclass correlation coefficient (ICC) = 0.754] and a significant correlation (r = 0.69, p < 0.0001) with the %Vessel (12.9 ± 9.4%) of the tumors. The Bland-Altman plot analysis showed excellent agreement between the f-max and %Vessel (bias, -2.6%; 95% limits of agreement, from -16.0 to 10.8%). The f-max was not significantly different among the histological subtypes of meningioma. CONCLUSION An excellent agreement and a significant correlation were observed between the f-values and %Vessel. The f-value can be used as a noninvasive quantitative imaging measure to directly assess the vascular volume fraction in brain tumors. Advances in knowledge: The f-value measured by IVIM imaging showed a significant correlation and an excellent agreement with the histological vascular density in the meningiomas. The f-value can be used as a noninvasive and quantitative imaging measure to directly assess the volume fraction of capillaries in brain tumors.
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Affiliation(s)
- Osamu Togao
- 1 Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Akio Hiwatashi
- 1 Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Koji Yamashita
- 1 Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Kazufumi Kikuchi
- 1 Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Daichi Momosaka
- 1 Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Koji Yoshimoto
- 2 Departments of Neurosurgery, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Daisuke Kuga
- 2 Departments of Neurosurgery, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Masahiro Mizoguchi
- 2 Departments of Neurosurgery, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Satoshi O Suzuki
- 3 Departments of Neuropathology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Toru Iwaki
- 3 Departments of Neuropathology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | | | - Koji Iihara
- 2 Departments of Neurosurgery, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - Hiroshi Honda
- 1 Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
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Li X, Wang P, Li D, Zhu H, Meng L, Song Y, Xie L, Zhu J, Yu T. Intravoxel incoherent motion MR imaging of early cervical carcinoma: correlation between imaging parameters and tumor-stroma ratio. Eur Radiol 2017; 28:1875-1883. [DOI: 10.1007/s00330-017-5183-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/01/2017] [Accepted: 11/07/2017] [Indexed: 12/11/2022]
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Bertleff M, Domsch S, Weingärtner S, Zapp J, O'Brien K, Barth M, Schad LR. Diffusion parameter mapping with the combined intravoxel incoherent motion and kurtosis model using artificial neural networks at 3 T. NMR IN BIOMEDICINE 2017; 30:e3833. [PMID: 28960549 DOI: 10.1002/nbm.3833] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 08/17/2017] [Accepted: 08/17/2017] [Indexed: 06/07/2023]
Abstract
Artificial neural networks (ANNs) were used for voxel-wise parameter estimation with the combined intravoxel incoherent motion (IVIM) and kurtosis model facilitating robust diffusion parameter mapping in the human brain. The proposed ANN approach was compared with conventional least-squares regression (LSR) and state-of-the-art multi-step fitting (LSR-MS) in Monte-Carlo simulations and in vivo in terms of estimation accuracy and precision, number of outliers and sensitivity in the distinction between grey (GM) and white (WM) matter. Both the proposed ANN approach and LSR-MS yielded visually increased parameter map quality. Estimations of all parameters (perfusion fraction f, diffusion coefficient D, pseudo-diffusion coefficient D*, kurtosis K) were in good agreement with the literature using ANN, whereas LSR-MS resulted in D* overestimation and LSR yielded increased values for f and D*, as well as decreased values for K. Using ANN, outliers were reduced for the parameters f (ANN, 1%; LSR-MS, 19%; LSR, 8%), D* (ANN, 21%; LSR-MS, 25%; LSR, 23%) and K (ANN, 0%; LSR-MS, 0%; LSR, 15%). Moreover, ANN enabled significant distinction between GM and WM based on all parameters, whereas LSR facilitated this distinction only based on D and LSR-MS on f, D and K. Overall, the proposed ANN approach was found to be superior to conventional LSR, posing a powerful alternative to the state-of-the-art method LSR-MS with several advantages in the estimation of IVIM-kurtosis parameters, which might facilitate increased applicability of enhanced diffusion models at clinical scan times.
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Affiliation(s)
- Marco Bertleff
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sebastian Domsch
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sebastian Weingärtner
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, USA
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Jascha Zapp
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Kieran O'Brien
- Center for Advanced Imaging, University of Queensland, St Lucia, QLD, Australia
| | - Markus Barth
- Center for Advanced Imaging, University of Queensland, St Lucia, QLD, Australia
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Pavilla A, Gambarota G, Arrigo A, Mejdoubi M, Duvauferrier R, Saint-Jalmes H. Diffusional kurtosis imaging (DKI) incorporation into an intravoxel incoherent motion (IVIM) MR model to measure cerebral hypoperfusion induced by hyperventilation challenge in healthy subjects. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 30:545-554. [PMID: 28608327 DOI: 10.1007/s10334-017-0629-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 05/18/2017] [Accepted: 05/23/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The objectives were to investigate the diffusional kurtosis imaging (DKI) incorporation into the intravoxel incoherent motion (IVIM) model for measurements of cerebral hypoperfusion in healthy subjects. MATERIALS AND METHODS Eight healthy subjects underwent a hyperventilation challenge with a 4-min diffusion weighted imaging protocol, using 8 b values chosen with the Cramer-Rao Lower Bound optimization approach. Four regions of interest in gray matter (GM) were analyzed with the DKI-IVIM model and the bi-exponential IVIM model, for normoventilation and hyperventilation conditions. RESULTS A significant reduction in the perfusion fraction (f) and in the product fD* of the perfusion fraction with the pseudodiffusion coefficient (D*) was found with the DKI-IVIM model, during the hyperventilation challenge. In the cerebellum GM, the percentage changes were f: -43.7 ± 40.1, p = 0.011 and fD*: -50.6 ± 32.1, p = 0.011; in thalamus GM, f: -47.7 ± 34.7, p = 0.012 and fD*: -47.2 ± 48.7, p = 0.040. In comparison, using the bi-exponential IVIM model, only a significant decrease in the parameter fD* was observed for the same regions of interest. In frontal-GM and posterior-GM, the reduction in f and fD* did not reach statistical significance, either with DKI-IVIM or the bi-exponential IVIM model. CONCLUSION When compared to the bi-exponential IVIM model, the DKI-IVIM model displays a higher sensitivity to detect changes in perfusion induced by the hyperventilation condition.
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Affiliation(s)
- Aude Pavilla
- INSERM, UMR 1099, 35000, Rennes, France. .,Université de Rennes 1, LTSI, 35000, Rennes, France. .,Department of Neuroradiology, Pierre-Zobda-Quitman Hospital, University Hospital of Martinique, Fort-de- France, Martinique, France.
| | - Giulio Gambarota
- INSERM, UMR 1099, 35000, Rennes, France.,Université de Rennes 1, LTSI, 35000, Rennes, France
| | - Alessandro Arrigo
- Department of Neuroradiology, Pierre-Zobda-Quitman Hospital, University Hospital of Martinique, Fort-de- France, Martinique, France
| | - Mehdi Mejdoubi
- Department of Neuroradiology, Pierre-Zobda-Quitman Hospital, University Hospital of Martinique, Fort-de- France, Martinique, France
| | - Régis Duvauferrier
- Department of Neuroradiology, Pierre-Zobda-Quitman Hospital, University Hospital of Martinique, Fort-de- France, Martinique, France
| | - Hervé Saint-Jalmes
- INSERM, UMR 1099, 35000, Rennes, France.,Université de Rennes 1, LTSI, 35000, Rennes, France.,CRLCC, Centre Eugène Marquis, 35000, Rennes, France
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Fujima N, Sakashita T, Homma A, Yoshida D, Kudo K, Shirato H. Utility of a Hybrid IVIM-DKI Model to Predict the Development of Distant Metastasis in Head and Neck Squamous Cell Carcinoma Patients. Magn Reson Med Sci 2017; 17:21-27. [PMID: 28515412 PMCID: PMC5760229 DOI: 10.2463/mrms.mp.2016-0136] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: To evaluate the diagnostic power of hybrid intravoxel incoherent motion (IVIM)-diffusion kurtosis imaging (DKI) model parameters in pretreatment for the prediction of future distant metastasis in head and neck squamous cell carcinoma (HNSCC) patients. Materials and Methods: We retrospectively evaluated 49 HNSCC patients who underwent curative chemoradiation therapy. Diffusion-weighted image (DWI) acquired by single-shot spin-echo echo-planar imaging with 12 b-values (0–2000) was performed in all patients before any treatment. We calculated the IVIM-DKI parameters and the conventional apparent diffusion coefficient (ADC) in the ROI placed on the primary lesion. The presence of future distant metastasis was determined by histological findings or clinical follow-up. Results: A univariate analysis revealed significant differences between the patients with distant metastasis and those without in slow diffusion coefficient (D) and kurtosis value (K). Highest diagnostic accuracy was obtained by the D value. In addition, a multivariate analysis revealed that the D value was an independent predictor of future distant metastasis. Conclusion: The D and K values obtained by this hybrid IVIM-DKI model can be one of the diagnostic tools for the prediction of future distant metastasis in HNSCC patients.
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Affiliation(s)
- Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital
| | - Tomohiro Sakashita
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine
| | - Daisuke Yoshida
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital
| | - Kohsuke Kudo
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital
| | - Hiroki Shirato
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine.,The Global Station for Quantum Medical Science and Engineering, Global Institution for collaborative research and education
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