1
|
Pradeep T, Ravipati A, Melachuri S, Rajaii F, Campbell AA, Hodgson N, Zhang M, Pillai JJ, Nunery WR, Fu R. Utility of diffusion-weighted imaging to differentiate benign and malignant solid orbital tumours. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:455-460. [PMID: 35525263 DOI: 10.1016/j.jcjo.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/24/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We assessed the utility of apparent diffusion coefficients (ADCs) derived from diffusion-weighted imaging to differentiate benign and malignant orbital tumours by oculoplastic surgeons in the clinical setting and sought to validate observed ADC cut-off values. DESIGN AND PARTICIPANTS Retrospective review of patients with benign or malignant biopsy-confirmed orbital tumours. METHODS Blinded graders including 2 oculoplastic surgeons, 1 neuroradiologist, and 1 medical student located and measured orbital tumour ADCs (10-6 mm2/s) using the Region of Interest tool. OUTCOME MEASURES Nonradiologist measurements were compared with each other to assess reliability and with an expert neuroradiologist measurement and final pathology to assess accuracy. RESULTS Twenty-nine orbital tumours met inclusion criteria, consisting of 6 benign tumours and 23 malignant tumours. Mean ADC values for benign orbital tumours were 1430.59 ± 254.81 and 798.68 ± 309.12 mm2/s for malignant tumours. Our calculated optimized ADC cut-off to differentiate benign from malignant orbital tumours was 1120.84 × 10-6 mm2/s (sensitivity 1, specificity 0.9). Inter-rater reliability was excellent (intraclass correlation coefficient = 0.92; 95% CI, 0.86-0.96). Our 3 graders had a combined accuracy of 84.5% (92.3%, 92.3%, and 65.4%). CONCLUSIONS Our ADC cut-off of 1120.84 × 10-6 mm2/s for benign and malignant orbital tumours agrees with previously established values in literature. Without priming with instructions, training, or access to patient characteristics, most tumours were correctly classified using rapid ADC measurements. Surgeons without radiologic expertise can use the ADC tool to quickly risk stratify orbital tumours during clinic visits to guide patient expectations and further work-up.
Collapse
Affiliation(s)
- Tejus Pradeep
- From the Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pa
| | | | - Samyuktha Melachuri
- Department of Ophthalmology, Eye and Ear Institute of the University of Pittsburgh Medical Center, Pittsburgh, Pa.
| | - Fatemeh Rajaii
- Department of Ophthalmic Plastic and Reconstructive Surgery, Wilmer Eye Institute, Baltimore, Md
| | - Ashley A Campbell
- Department of Ophthalmic Plastic and Reconstructive Surgery, Wilmer Eye Institute, Baltimore, Md
| | - Nickisa Hodgson
- Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Matthew Zhang
- Department of Ophthalmology, University of Washington, Seattle, Wash
| | - Jay J Pillai
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Md; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Md
| | - William R Nunery
- Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Ky
| | - Roxana Fu
- Department of Ophthalmology, Eye and Ear Institute of the University of Pittsburgh Medical Center, Pittsburgh, Pa
| |
Collapse
|
2
|
Gupta L, Peterson EL, Williams C, Altman E, Harpole R, Martin DJ, Escott EJ, Timoney PJ, Prendes MA. Diffusion-Weighted Imaging of the Orbit: A Case Series and Systematic Review. Ophthalmic Plast Reconstr Surg 2023; 39:407-418. [PMID: 36757844 DOI: 10.1097/iop.0000000000002325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
PURPOSE To describe the findings of diffusion-weighted imaging (DWI) for a series of orbital lesions and provide a systematic review of relevant literature. METHODS A retrospective review of 20 patients with orbital lesions who underwent MRI with DWI at two academic institutions between 2015 and 2020 was performed. Lesion diagnosis was histopathologically confirmed except a presumed cavernous hemangioma. Echoplanar diffusion-weighted images had been acquired using 2 or 3 b values (b=0 and 1000 or b=0, 500, and 1000) at 1.5T or 3T. Lesions with significant artifacts were excluded. DWI sequences were analyzed by neuro-radiologists blinded to the diagnosis. Mean ADC values of lesions were calculated from a single region of interest. An independent two-tailed t test was used to compare categories of lesions with p < 0.05 considered significant. A systematic review of the literature was performed. RESULTS Our study included 21 lesions. ADC values were significantly lower for malignant lesions (0.628 ± 0.125 × 10 -3 mm 2 /s) than inflammatory lesions (1.167 ± 0.381 × 10 -3 mm 2 /s) ( p < 0.001). ADC values were significantly lower for orbital lymphoma (mean 0.621 ± 0.147 × 10 -3 mm 2 /s) than idiopathic orbital inflammation (mean 1.188 ± 0.269 × 10 -3 mm 2 /s) with no overlap ( p < 0.001). CONCLUSIONS Orbital malignancies demonstrated lower ADC values, while inflammatory processes demonstrated higher ADC values, except IgG4-related disease. DWI and ADC values differentiated idiopathic orbital inflammation from orbital lymphoma. This study highlights the role of DWI in evaluating orbital pathology.
Collapse
Affiliation(s)
- Lalita Gupta
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Eric L Peterson
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Cody Williams
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Emily Altman
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Ryan Harpole
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Douglas J Martin
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio
| | - Edward J Escott
- Department of Radiology, Division of Neuroradiology, University of Kentucky Medical Center, Lexington, Kentucky
| | - Peter J Timoney
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Mark A Prendes
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio
| |
Collapse
|
3
|
Cameron CA, Tong JY, Juniat V, Patel S, Selva D. Diagnostic Utility of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient for Common Orbital Lesions: A Review. Ophthalmic Plast Reconstr Surg 2022; 38:515-521. [PMID: 34798654 DOI: 10.1097/iop.0000000000002092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To review and summarize the existing literature surrounding the clinical use of diffusion-weighted imaging and apparent diffusion coefficient (ADC) as diagnostic tools in differentiating common orbital lesions. METHODS A systematic literature review on the use of ADC and diffusion-weighted imaging sequences for orbital imaging was performed. Only original research articles that reported ADC values for benign or malignant lesions were included. RESULTS Malignant orbital tumors have an overall lower mean ADC value than benign masses. Orbital lymphoma is characterized by consistently lower ADC values compared with other malignant orbital masses; a threshold value less than 0.775 × 10 -3 mm 2 /s has been proposed to distinguish orbital lymphoma from other neoplastic and non-neoplastic orbital masses. To differentiate orbital inflammatory disease from lymphoma, an ADC threshold greater than 0.92 × 10 -3 mm 2 /s has been proposed. CONCLUSIONS Orbital masses encompass a host of benign and malignant etiologies and can present a diagnostic challenge on both clinical and radiological assessment. Recent advanced MRI techniques such as diffusion-weighted imaging and ADC can improve the diagnostic specificity for orbital disease, particularly in differentiating benign from malignant lesions and lymphoma from orbital inflammatory disease.
Collapse
Affiliation(s)
- Cassie A Cameron
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide and the South Australian Institute of Ophthalmology, Adelaide
| | | | - Valerie Juniat
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide and the South Australian Institute of Ophthalmology, Adelaide
| | - Sandy Patel
- Department of Medical Imaging, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Dinesh Selva
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide and the South Australian Institute of Ophthalmology, Adelaide
| |
Collapse
|
4
|
Harada N, Kondo K, Terazono S, Uchino K, Fuchinoue Y, Sugo N. The diagnostic value of 123I-IMP SPECT in ocular adnexal lymphoma. Int Ophthalmol 2022; 42:1205-1212. [PMID: 34725770 DOI: 10.1007/s10792-021-02105-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 10/21/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND N-isopropyl- (123I) p-iodoamphetamine (123I-IMP) is specifically accumulated in primary central nervous system lymphoma (PCNSL) during single-photon emission tomography (SPECT) and contributes to its diagnostic imaging. However, whether 123I-IMP is accumulated in ocular adnexal lymphoma (OAL), one of the malignant intraorbital tumors, remains unclear. This study aimed to evaluate the diagnostic value of 123I-IMP SPECT in OAL. METHODS Between August 2005 and June 2020, 26 patients with intraorbital tumors underwent neurosurgery at the tertiary care center. Of these, 15 patients who underwent 123I-IMPSPECT before surgery were retrospectively examined. The region of interest was set in the cerebellum ipsilateral to the intraorbital tumor on 123I-IMP SPECT, and the tumor-to-cerebellum ratio (T/C ratio) was calculated using the following formula: T/C ratio = [accumulation of tumor (count/pixel)]/[accumulation of ipsilateral normal cerebellar hemisphere (count/pixel)]. RESULTS Six patients were included in the OAL group, who were pathologically diagnosed with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), diffuse large B-cell lymphoma (DLBCL), and plasmacytoma. The T/C ratio in the OAL group was statistically higher than that in the non-OAL group (p < 0.01). The optimal cutoff values for both groups were between 0.76 and < 0.93. The sensitivity and specificity were 1.00, respectively. CONCLUSIONS 123I-IMP SPECT is useful as one of the examinations in the differential diagnoses of OAL, because it showed a significantly higher accumulation in OAL group than in non-OAL group.
Collapse
Affiliation(s)
- Naoyuki Harada
- Department of Neurosurgery (Omori), Faculty of Medicine, School of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Kosuke Kondo
- Department of Neurosurgery (Omori), Faculty of Medicine, School of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Sayaka Terazono
- Department of Neurosurgery (Omori), Faculty of Medicine, School of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Kei Uchino
- Department of Neurosurgery (Omori), Faculty of Medicine, School of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Yutaka Fuchinoue
- Department of Neurosurgery (Omori), Faculty of Medicine, School of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Nobuo Sugo
- Department of Neurosurgery (Omori), Faculty of Medicine, School of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
| |
Collapse
|
5
|
Oda T, Kikuchi K, Togao O, Baba S, Mizoguchi M, Tanabe M, Ito M, Yamamoto H, Ishigami K, Hiwatashi A. Alveolar soft part sarcoma of the orbit: A case report. Radiol Case Rep 2021; 16:3766-3771. [PMID: 34630814 PMCID: PMC8493516 DOI: 10.1016/j.radcr.2021.09.005] [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: 08/24/2021] [Revised: 08/30/2021] [Accepted: 09/04/2021] [Indexed: 11/22/2022] Open
Abstract
Alveolar soft part sarcoma is a rare soft tissue neoplasm that accounts for approximately 1% of all sarcomas and is usually identified in the extremities in adults. The occurrence of alveolar soft part sarcoma in the orbit is extremely rare, estimated at approximately 5% – 15% among all cases of alveolar soft part sarcoma . Here, we present a case of 29-year-old woman with orbital alveolar soft part sarcoma. We describe the magnetic resonance and F-18 2-fluoro-2-deoxy-D-glucose-position emission tomography/computed tomography findings of this case. This young woman had a spindle-shaped mass. A higher signal compared to the extraocular muscle on T1-weighted images, numerous flow voids on T2-weighted images, and intense enhancement could be key findings of this disease.
Collapse
Affiliation(s)
- Takeshi Oda
- Departments of Clinical Radiology, Graduate School of Medical Sciences Kyushu University, Fukuoka, Japan
| | - Kazufumi Kikuchi
- Departments of Clinical Radiology, Graduate School of Medical Sciences Kyushu University, Fukuoka, Japan
| | - Osamu Togao
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shingo Baba
- Departments of Clinical Radiology, Graduate School of Medical Sciences Kyushu University, Fukuoka, Japan
| | - Masahiro Mizoguchi
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mika Tanabe
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mamoru Ito
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kousei Ishigami
- Departments of Clinical Radiology, Graduate School of Medical Sciences Kyushu University, Fukuoka, Japan
| | - Akio Hiwatashi
- Departments of Clinical Radiology, Graduate School of Medical Sciences Kyushu University, Fukuoka, Japan
| |
Collapse
|
6
|
Values of Apparent Diffusion Coefficient and Lesion-to-Spinal Cord Signal Intensity in Diagnosing Solitary Pulmonary Lesions: Turbo Spin-Echo versus Echo-Planar Imaging Diffusion-Weighted Imaging. BIOMED RESEARCH INTERNATIONAL 2021; 2021:3345953. [PMID: 34435042 PMCID: PMC8382531 DOI: 10.1155/2021/3345953] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/30/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022]
Abstract
Objective This study is aimed at comparing the image quality and diagnostic performance of mean apparent diffusion coefficient (ADC) and lesion-to-spinal cord signal intensity ratio (LSR) derived from turbo spin-echo diffusion-weighted imaging (TSE-DWI) and echo-planar imaging- (EPI-) DWI in patients with a solitary pulmonary lesion (SPL). Methods 33 patients with SPL underwent chest imaging using EPI-DWI and TSE-DWI with b = 600 s/mm2 in free breathing. A comparison of the distortion ratio (DR), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) was drawn between the two techniques using a Wilcoxon signed-rank test. The interprotocol reproducibility between quantitative parameters of EPI-DWI and TSE-DWI was evaluated using a Bland-Altman plot. ADCs and LSRs derived from EPI-DWI and TSE-DWI were calculated and compared between malignant and benign groups using the Mann-Whitney test. Results TSE-DWI had similar SNR and CNR compared with EPI-DWI. DR was significantly lower on TSE-DWI than EPI-DWI. ADC and LSR showed slightly higher values with TSE-DWI, while the Bland-Altman analysis showed unacceptable limits of agreement between the two sequences. ADC and LSR of both DWI techniques differed significantly between lung cancer and benign lesions (P < 0.05). The LSR(EPI-DWI) showed the highest area under the curve (AUC = 0.818), followed by ADC(EPI-DWI) (AUC = 0.789), ADC(TSE-DWI) (AUC = 0.781), and LSR(TSE-DWI) (AUC = 0.748), respectively. Among these parameters, the difference in diagnostic accuracy was not statistically significant. Conclusions TSE-DWI provides significantly improved image quality in patients with SPL as compared with EPI-DWI. However, there was no difference in diagnostic efficacy between these two techniques, according to ADC and LSR.
Collapse
|
7
|
Shor N, Sené T, Zuber K, Zmuda M, Bergès O, Savatovsky J, Lecler A. Discriminating between IgG4-related orbital disease and other causes of orbital inflammation with intra voxel incoherent motion (IVIM) MR imaging at 3T. Diagn Interv Imaging 2021; 102:727-734. [PMID: 34326025 DOI: 10.1016/j.diii.2021.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/20/2021] [Accepted: 06/27/2021] [Indexed: 01/01/2023]
Abstract
PURPOSE The purpose of this prospective study was to determine the capabilities of intravoxel incoherent motion (IVIM) MRI at 3 Tesla in discriminating between IgG4-related orbital disease (IgG4-ROD) and other causes of orbital inflammation. MATERIALS AND METHODS Main selection criteria for the patients enrolled in this prospective study were age over 18 years and histopathologicaly proven orbital inflammatory lesion. MRI examinations were performed prior to surgery and treatment in all patients with suspected orbital inflammation. Two neuroradiologists, blinded to clinical data, independently analyzed structural MRI examinations and IVIM sequences obtained with 15 b values ranging from 0 to 2000 s/mm². Apparent diffusion coefficient (ADC), "true" diffusion coefficient (D), perfusion fraction (f) and pseudodiffusion coefficient (D*) values were calculated from all orbital lesions. Diagnostic capabilities of IVIM parameters were assessed using receiver operating-characteristic (ROC) curves and area under the curve (AUC). Sensitivity, specificity, and accuracy of IVIM parameters were calculated for the best threshold values and reported with their corresponding 95% confidence intervals (CI). RESULTS Thirty-five patients (21 women and 14 men; mean age, 49.2 ± 13.75 [SD] years; age range: 23-77 years) with 48 orbital lesions were enrolled in the study. Fifteen patients (15/35; 43%) had IgG4-ROD and 20 (20/35; 57%) had other causes of orbital inflammation. Median D value was significantly greater in patients with IgG4-ROD (1 × 10-3 mm2/s; interquartile range [IQR]: 0.9 × 10-3; 1.2 × 10-3) as compared to patients with non IgG4-ROD (0.80 × 10-3 mm2/s; IQR: 0.7 × 10-3; 1 × 10-3) (P = 0.04). There was no significant difference for ADC, f or D*. Area under the curve were of 0.54, 0.73, 0.63 and 0.56 for ADC, D, f and D*, respectively. Optimal threshold derived from ROC curves for D was 0.87 × 10-3 mm2/s, yielding 92% sensitivity (95% CI: 62-100%) and 71% specificity (95% CI: 44-90%) for the diagnosis of IgG4-ROD. No differences in standard morphological MRI criteria were found between IgG4-ROD and non IgG4-ROD. CONCLUSION Our study shows that IVIM MRI is a useful imaging technique to distinguish IgG4-ROD from other causes of orbital inflammation.
Collapse
Affiliation(s)
- Natalia Shor
- Department of Neuroradiology, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France; Department of Neuroradiology, Pitié-Salpêtriére Hospital, Assistance Publique-Hopitaux de Paris, 75013 Paris, France.
| | - Thomas Sené
- Department of Internal Medicine, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
| | - Kevin Zuber
- Department of Clinical Research, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
| | - Mathieu Zmuda
- Department of Orbitopalpebral Surgery, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
| | - Olivier Bergès
- Department of Neuroradiology, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
| | - Julien Savatovsky
- Department of Neuroradiology, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
| | - Augustin Lecler
- Department of Neuroradiology, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
| |
Collapse
|
8
|
Ogawa M, Urano M, Takaishi T, Kan H, Arai N, Takahashi H, Hara M, Saito M, Shibamoto Y. T-staging of rectal cancer: Utility of single-shot turbo spin-echo diffusion-weighted imaging with T2-weighted images and fusion images. PLoS One 2021; 16:e0249433. [PMID: 33882087 PMCID: PMC8059798 DOI: 10.1371/journal.pone.0249433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/17/2021] [Indexed: 01/06/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the usefulness of turbo spin-echo (TSE) DWI with fusion images in the T-staging compared with T2-weighted imaging (T2WI) alone and conventional echo-planner imaging (EPI) DWI. METHODS In this prospective study, 4-mm-thick axial EPI-DWI, TSE-DWI, and T2WI were performed with the same slice locations for 20 patients with rectal cancer. Fusion images of DWI and T2WI were created for both EPI-DWI and TSE-DWI. Ten readers independently diagnosed the T-stages and scored the degree of confidence referring to T2WI alone and then to DWI, T2WI, and fusion images (DWI+T2WI) for each EPI-DWI and TSE-DWI. Visual score assessments of image quality were performed for each DWI. RESULTS Inter-observer agreement of T-staging for 10 readers was slight on T2WI alone but fair on EPI-DWI+T2WI and excellent on TSE-DWI+T2WI images. No readers gave higher confidence scores for T2WI compared to EPI/TSE-DWI+T2WI and for EPI-DWI+T2WI compared to TSE-DWI+T2WI. In seven pathologically-proven cases, poor, poor to slight, and fair to perfect agreements with the pathological T-stage were observed with T2WI alone, EPI-DWI+T2WI, and TSE-DWI+T2WI, respectively. All readers gave higher scores regarding image distortion and lower scores regarding image noise for TSE-DWI compared to EPI-DWI. For DWI utility, higher scores were assigned for TSE-DWI compared to EPI-DWI in 7 readers and there were no significant differences in the other 3 readers. CONCLUSION TSE-DWI images might be more appropriate for image fusion with T2WI and rectal cancer T-staging compared with EPI-DWI and T2WI alone.
Collapse
Affiliation(s)
- Masaki Ogawa
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Misugi Urano
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Taku Takaishi
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hirohito Kan
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Arai
- Department of Radiological Technology, Suzuka University of Medical Science, Suzuka, Japan
| | - Hiroki Takahashi
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masayasu Hara
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Miki Saito
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| |
Collapse
|
9
|
Gumeler E, Parlak S, Yazici G, Karabulut E, Kiratli H, Oguz KK. Single shot echo planar imaging (ssEPI) vs single shot turbo spin echo (ssTSE) DWI of the orbit in patients with ocular melanoma. Br J Radiol 2020; 94:20200825. [PMID: 33264035 DOI: 10.1259/bjr.20200825] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Diffusion weighted imaging (DWI) has become important for orbital imaging. However, the echoplanar imaging (EPI) DWI has inherent obstacles due to susceptibility to magnetic field inhomogeneities. We conducted a comparative study assessing the image quality of orbits in a patient cohort with uveal melanoma (UM). We hypothesized that single shot turbo spin echo (ssTSE) DWI would have better image quality in terms of less distortion and artifacts and yield better tissue evaluation compared to ssEPI-DWI. METHODS ssEPI-DWI and ssTSE-DWI of orbits were obtained from 50 patients with uveal melanoma who were prospectively enrolled in the study. Distortion ratio (DR), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), diffusion signal properties, and apparent diffusion coefficient (ADC) values were collected and compared between ssEPI-DWI and ssTSE-DWI. Two reviewers evaluated and compared the geometric distortion, susceptibility and ghosting artifacts, resolution, demarcation of ocular mass, and overall quality. RESULTS A higher DR was found in ssEPI-DWI compared to ssTSE-DWI (p < 0.001). SNR and CNR were lower for the temporal lobe cortex (p ≤ 0.004), but higher for melanoma in ssEPI-DWI than ssTSE-DWI (p ≤ 0.037). Geometric distortion and artifacts were more common in ssEPI-DWI (p < 0.001). Resolution (p ≤ 0.013) and overall quality (p < 0.001) were better in ssTSE-DWI. Ocular masses were demarcated better on ssEPI-DWI (p ≤ 0.002). Significant negative correlations between T1 and T2 signal intensities (r = -0.369, p ≤ 0.008) and positive correlations between T2 and both DWI signal intensities (r = 0.686 and p < 0.001 for ssEPI-DWI, r = 0.747 and p < 0.001 for ssTSE-DWI) were revealed. CONCLUSION With less geometric distortion and susceptibility artifacts, better resolution, and overall quality, ssTSE-DWI can serve as an alternative to ssEPI-DWI for orbital DWI. ADVANCES IN KNOWLEDGE ssTSE-DWI can be a better alternative of diffusion imaging of orbits with less susceptibility artifact and geometric distortion compared to ssEPI-DWI.
Collapse
Affiliation(s)
- Ekim Gumeler
- Department of Radiology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Safak Parlak
- Department of Radiology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Gozde Yazici
- Department of Radiation Oncology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Hayyam Kiratli
- Department of Ophtalmology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Kader K Oguz
- Department of Radiology, Hacettepe University, School of Medicine, Ankara, Turkey
| |
Collapse
|
10
|
Eissa L, Abdel Razek AAK, Helmy E. Arterial spin labeling and diffusion-weighted MR imaging: Utility in differentiating idiopathic orbital inflammatory pseudotumor from orbital lymphoma. Clin Imaging 2020; 71:63-68. [PMID: 33171369 DOI: 10.1016/j.clinimag.2020.10.057] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 09/26/2020] [Accepted: 10/26/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess arterial spin-labeling (ASL) and diffusion-weighted imaging (DWI) and in combination for differentiating between idiopathic orbital inflammatory pseudotumor (IOIP) and orbital lymphoma. MATERIAL AND METHODS A retrospective study was done on 37 untreated patients with orbital masses, suspected to be IOIP or orbital lymphoma that underwent ASL and DWI of the orbit. Quantitative measurement of tumor blood flow (TBF) and apparent diffusion coefficient (ADC) of the orbital lesion was done. RESULTS There was a significant difference (P = 0.001) in TBF between patients with IOIP (n = 21) (38.1 ± 6.2, 40.3 ± 7.1 ml/100 g/min) and orbital lymphoma (n = 16) (55.5 ± 7.1, 56.8 ± 7.9 ml/100 g/min) for both observers respectively. Thresholds of TBF used for differentiating IOIP from orbital lymphoma were 48, 46 ml/100 g/min revealed area under the curve (AUC) of (0.958 and 0.921), and accuracy of (86% and 83%) for both observers respectively. There was a significant difference (P = 0.001) in ADC between patients with IOIP (1.04 ± 0.19, 1.12 ± 0.23 × 10-3 mm2/s) and orbital lymphoma (0.69 ± 0.10, 0.72 ± 0.11 × 10-3 mm2/s) for both observers respectively. Thresholds of ADC used for differentiating IOIP from orbital lymphoma were 0.84 and 0.86 × 10-3 mm2/s with AUC of (0.933 and 0.920), and accuracy of 89% and 90% for both observers respectively. The combined TBF and ADC used for differentiating IOIP from orbital lymphoma had AUC of (0.973 and 0.970) and accuracy of (91% and 89%) for both observers respectively. CONCLUSION TBF and ADC alone and in combination are useful for differentiating IOIP from orbital lymphoma.
Collapse
Affiliation(s)
- Lamya Eissa
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Ahmed Abdel Khalek Abdel Razek
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.
| | - Eman Helmy
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| |
Collapse
|
11
|
Jiang H, Wang S, Li Z, Xie L, Wei W, Ma J, Xian J. Improving diagnostic performance of differentiating ocular adnexal lymphoma and idiopathic orbital inflammation using intravoxel incoherent motion diffusion-weighted MRI. Eur J Radiol 2020; 130:109191. [PMID: 32745898 DOI: 10.1016/j.ejrad.2020.109191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/24/2020] [Accepted: 07/16/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate the utility of intravoxel incoherent motion diffusion-weighted MRI (IVIM-DWI) derived diffusion and perfusion parameters in differentiating ocular adnexal lymphoma (OAL) from idiopathic orbital inflammation (IOI), and to assess whether IVIM-DWI provides improved diagnostic performance for the distinction. METHOD Twenty-one patients with OAL and 24 patients with IOI underwent IVIM-DWI. Apparent diffusion coefficient (ADC) and IVIM-DWI parameters including true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were measured in lesions by two independent radiologists. The MRI parameter differences between OAL and IOI were tested using two-sample t-test. The receiver operating characteristic (ROC) analysis curves were used to determine the diagnostic performance of significant parameters for differentiation between OAL and IOI. RESULTS The ADC, D, and f were lower in OAL than those in IOI (ADC = 0.78 ± 0.12 vs. 0.99 ± 0.16 × 10-3 mm2/s, P < 0.001; D = 0.34 ± 0.15 vs. 0.76 ± 0.25 × 10-3 mm2/s, P < 0.001; f = 0.31 ± 0.06 vs. 0.41 ± 0.08 × 100 %, P < 0.001). There was no significant difference in D* between OAL and IOI (P = 0.235). The optimal cut-off values of ADC, D, and f in differentiating OAL from IOI were 0.83 × 10-3 mm2/s, 0.56 × 10-3 mm2/s, and 0.36 × 100 %, respectively. No significant differences were found in areas under the curve (AUCs) among ADC, D and f (all P > 0.05). The combination of D and f provided significantly higher AUC than ADC (AUC = 0.984 vs. 0.838, Z = 2.128, P = 0.033), and had higher sensitivity of 95.24 %, specificity of 95.83 %, and accuracy of 95.56 %. CONCLUSIONS IVIM-DWI is valuable in differentiating OAL from IOI, and D combined f can improve the performance of differential diagnosis.
Collapse
Affiliation(s)
- Hong Jiang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China
| | - Shijun Wang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China
| | - Zheng Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China
| | | | - Wenbin Wei
- Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China; Beijing Key Lab. of Intraocular Tumor Diagnosis and Treatment, Beijing 100730, China; Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Jianmin Ma
- Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China; Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China.
| |
Collapse
|
12
|
Hou Y, Xie X, Chen J, Lv P, Jiang S, He X, Yang L, Zhao F. Bag-of-features-based radiomics for differentiation of ocular adnexal lymphoma and idiopathic orbital inflammation from contrast-enhanced MRI. Eur Radiol 2020; 31:24-33. [PMID: 32789530 DOI: 10.1007/s00330-020-07110-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/04/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of bag-of-features (BOF)-based radiomics for differentiating ocular adnexal lymphoma (OAL) and idiopathic orbital inflammation (IOI) from contrast-enhanced MRI (CE-MRI). METHODS Fifty-six patients with pathologically confirmed IOI (28 patients) and OAL (28 patients) were randomly divided into training (n = 42) and testing (n = 14) groups. One hundred sixty texture features extracted from the CE-MR image were encoded into the BOF representation with fewer features. The support vector machine (SVM) with a linear kernel was used as the classifier. Data augmented was performed by cropping orbital lesions in different directions to alleviate the over-fitting problem. Student's t test and the Holm-Bonferroni method were employed to compare the performance of different analysis methods. The chi-square test was used to compare the analysis with MRI and human radiological diagnosis. RESULTS In the independent testing group, the differentiation by the BOF features with augmentation achieved an area under the curve (AUC) of 0.803 (95% CI: 0.725-0.880), which was significantly higher than that of the BOF features without augmentation and that of the texture features (p < 0.05). In addition, the same radiomic analysis with pre-contrast MRI obtained an AUC of 0.618 (95% CI: 0.560-0.677), which was significantly lower than that with CE-MRI. The diagnostic performance of the analysis with CE-MRI was significantly better than the radiology resident (p < 0.05) but had no significant difference with the experienced radiologist, even though there was less consistency between the radiomic analysis and the human visual diagnosis. CONCLUSIONS The BOF-based radiomics may be helpful for the differentiation between OAL and IOI. KEY POINTS • It is challenging to differentiate OAL from IOI due to the similar clinical and image features. • Radiomics has great potential for the noninvasive diagnosis of orbital diseases. • The BOF representation from patch to image may help the differentiation of OAL and IOI.
Collapse
Affiliation(s)
- Yuqing Hou
- School of Information Science and Technology, Northwest University, Xi'an, 710069, Shaanxi, China.,Xi'an Key Lab of Radiomics and Intelligent Perception, Northwest University, Xi'an, 710069, Shaanxi, China
| | - Xiaoyang Xie
- School of Information Science and Technology, Northwest University, Xi'an, 710069, Shaanxi, China.,Xi'an Key Lab of Radiomics and Intelligent Perception, Northwest University, Xi'an, 710069, Shaanxi, China
| | - Jixin Chen
- School of Information Science and Technology, Northwest University, Xi'an, 710069, Shaanxi, China.,Xi'an Key Lab of Radiomics and Intelligent Perception, Northwest University, Xi'an, 710069, Shaanxi, China
| | - Peng Lv
- Department of Radiology, Xi'an Fourth Hospital, Xi'an, 710004, Shaanxi, China
| | - Shijie Jiang
- Department of Radiology, Xi'an Fourth Hospital, Xi'an, 710004, Shaanxi, China
| | - Xiaowei He
- School of Information Science and Technology, Northwest University, Xi'an, 710069, Shaanxi, China.,Xi'an Key Lab of Radiomics and Intelligent Perception, Northwest University, Xi'an, 710069, Shaanxi, China
| | - Lijuan Yang
- Department of Radiology, Xi'an Fourth Hospital, Xi'an, 710004, Shaanxi, China.
| | - Fengjun Zhao
- School of Information Science and Technology, Northwest University, Xi'an, 710069, Shaanxi, China. .,Xi'an Key Lab of Radiomics and Intelligent Perception, Northwest University, Xi'an, 710069, Shaanxi, China.
| |
Collapse
|
13
|
Intravoxel incoherent motion (IVIM) 3 T MRI for orbital lesion characterization. Eur Radiol 2020; 31:14-23. [PMID: 32740820 DOI: 10.1007/s00330-020-07103-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/28/2020] [Accepted: 07/22/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To determine the diagnostic accuracy of MRI intravoxel incoherent motion (IVIM) when characterizing orbital lesions, which is challenging due to a wide range of locations and histologic types. METHODS This IRB-approved prospective single-center study enrolled participants presenting with an orbital lesion undergoing a 3-T MRI prior to surgery from December 2015 to July 2019. An IVIM sequence with 15 b values ranging from 0 to 2000 s/mm2 was performed. Two neuroradiologists, blinded to clinical data, individually analyzed morphological MRIs. They drew one region of interest inside each orbital lesion, providing apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion fraction (f), and pseudodiffusion coefficient (D*) values. T test, Mann-Whitney U test, and receiver operating characteristic curve analyses were performed to discriminate between orbital lesions and to determine the diagnostic accuracy of the IVIM parameters. RESULTS One hundred fifty-six participants (84 women and 72 men, mean age 54.4 ± 17.5 years) with 167 orbital lesions (98/167 [59%] benign lesions including 54 orbital inflammations and 69/167 [41%] malignant lesions including 32 lymphomas) were included in the study. ADC and D were significantly lower in malignant than in benign lesions: 0.8 × 10-3 mm2/s [0.45] versus 1.04 × 10-3 mm2/s [0.33], p < 0.001, and 0.75 × 10-3 mm2/s [0.40] versus 0.98 × 10-3 mm2/s [0.42], p < 0.001, respectively. D* was significantly higher in malignant lesions than in benign ones: 12.8 × 10-3 mm2/s [20.17] versus 7.52 × 10-3 mm2/s [7.57], p = 0.005. Area under curve was of 0.73, 0.74, 0.72, and 0.81 for ADC, D, D*, and a combination of D, f, and D*, respectively. CONCLUSIONS Our study showed that IVIM might help better characterize orbital lesions. KEY POINTS • Intravoxel incoherent motion (IVIM) helps clinicians to assess patients with orbital lesions. • Intravoxel incoherent motion (IVIM) helps clinicians to characterize orbital lymphoma versus orbital inflammation. • Management of patients becomes more appropriate.
Collapse
|
14
|
Lee MJ, Planck SR, Choi D, Harrington CA, Wilson DJ, Dailey RA, Ng JD, Steele EA, Hamilton BE, Khwarg SI, Rosenbaum JT. Non-specific orbital inflammation: Current understanding and unmet needs. Prog Retin Eye Res 2020; 81:100885. [PMID: 32717379 DOI: 10.1016/j.preteyeres.2020.100885] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/11/2020] [Accepted: 07/14/2020] [Indexed: 12/17/2022]
Abstract
Non-specific orbital inflammation (NSOI) is a noninfectious inflammatory condition of the orbit. Although it is generally considered the most common diagnosis derived from an orbital biopsy, it is a diagnosis of exclusion, meaning that the diagnosis requires exclusion of a systemic process or another identifiable etiology of orbital inflammation. The clinical diagnosis of NSOI is ill-defined, but it is typically characterized by acute orbital signs and symptoms, including pain, proptosis, periorbital edema, chemosis, diplopia, and less commonly visual disturbance. NSOI poses a diagnostic and therapeutic challenge: The clinical presentations and histological findings are heterogeneous, and there are no specific diagnostic criteria or treatment guidelines. The etiology and pathogenesis of NSOI are poorly understood. Here we recapitulate our current clinical understanding of NSOI, with an emphasis on the most recent findings on clinical characteristics, imaging findings, and treatment outcomes. Furthermore, gene expression profiling of NSOI and its implications are presented and discussed.
Collapse
Affiliation(s)
- Min Joung Lee
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang, Gyeonggi-do, 14068, Republic of Korea; Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Blvd, Portland, OR, 97239, USA
| | - Stephen R Planck
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Blvd, Portland, OR, 97239, USA
| | - Dongseok Choi
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Blvd, Portland, OR, 97239, USA; OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SWSam Jackson Park Road, Portland, OR, 97239, USA; Department of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA; Graduate School of Dentistry, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Christina A Harrington
- Integrated Genomics Laboratory, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - David J Wilson
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Blvd, Portland, OR, 97239, USA
| | - Roger A Dailey
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Blvd, Portland, OR, 97239, USA
| | - John D Ng
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Blvd, Portland, OR, 97239, USA
| | - Eric A Steele
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Blvd, Portland, OR, 97239, USA
| | - Bronwyn E Hamilton
- Department of Radiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Sang In Khwarg
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - James T Rosenbaum
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Blvd, Portland, OR, 97239, USA; Department of Radiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA; Devers Eye Institute, Legacy Health Systems, 1040 NW 22nd Avenue, Portland, OR, 97210, USA.
| |
Collapse
|
15
|
Abstract
Head and neck MR imaging is technically challenging because of magnetic field inhomogeneity, respiratory and swallowing motion, and necessity of high-resolution imaging to trace key anatomic structures. These challenges have been answered by advances in MR imaging technology, including isovolumetric three-dimensional imaging, robust fat-water separation techniques, and novel deep learning-based reconstruction algorithms. New applications of MR imaging have been advanced and functional imaging has been improved. Improvements in acquisition and reconstruction technique facilitate novel applications of morphologic and functional imaging. This results in opportunities to improve diagnosis, staging, and treatment selection through application of advanced MR imaging techniques.
Collapse
|
16
|
Intravoxel Incoherent Motion Diffusion-Weighted Imaging of Lung Cancer: Comparison Between Turbo Spin-Echo and Echo-Planar Imaging. J Comput Assist Tomogr 2020; 44:334-340. [PMID: 32217894 DOI: 10.1097/rct.0000000000001004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of the study was to compare intravoxel incoherent motion diffusion-weighted imaging (DWI) for evaluating lung cancer using single-shot turbo spin-echo (TSE) and single-shot echo-planar imaging (EPI) in a 3T MR system. METHODS Both single-shot TSE-DWI and single-shot EPI-DWI were scanned twice respectively for 15 patients with lung cancer. Distortion ratio, signal-to-noise ratio, and contrast-to-noise ratio were compared between the 2 techniques. The Bland-Altman analysis was performed to analyze reproducibility between the parameters of TSE-DWI and EPI-DWI. Short-term test-retest repeatability, as well as interobserver agreement, was evaluated using the coefficient of variation (CV) and the intraclass correlation coefficient (ICC). RESULT Turbo spin-echo DWI has lower signal-to-noise ratio and similar contrast-to-noise ratio compared with EPI-DWI. Distortion ratio of TSE-DWI was significantly smaller than that of EPI-DWI. The apparent diffusion coefficient (ADC) and true diffusivity (D) of TSE-DWI showed higher values than those of EPI-DWI. The Bland-Altman analysis showed unacceptable limits of agreement between these 2 sequences. Test-retest repeatability was good for ADC and D of EPI-DWI (CV, 14.11%-16.60% and 17.08%-19.53%) and excellent for ADC and D of TSE-DWI (CV, 4.8%-6.19% and 6.05%-8.71%), but relatively poor for perfusion fraction (f) and pseudo-diffusion coefficient (D*) (CV, 25.95%-27.70% and 56.92%-71.84% for EPI, 23.67%-28.67% and 60.85%-70.17% for TSE). For interobserver agreement, both techniques were good to excellent in ADC and D (The lower limit of 95% confidence interval for ICC was almost all greater than 0.75), whereas D* and f had higher interobserver variabilities with D* of TSE-DWI showing poorest reproducibility (ICC, -0.27 to 0.12). CONCLUSIONS Lung DWI or IVIM using TSE could provide distortion-free images and improve the test-retest robustness of ADC and D as compared with EPI-DWI; however, it might exert a negative effect on perfusion parameter D*.
Collapse
|
17
|
Laban KG, Kalmann R, Bekker CPJ, Hiddingh S, van der Veen RLP, Eenhorst CAE, Genders SW, Mourits MP, Verhagen FH, Leijten EFA, Haitjema S, de Groot MCH, Radstake TRDJ, de Boer JH, Kuiper JJW. A pan-inflammatory microRNA-cluster is associated with orbital non-Hodgkin lymphoma and idiopathic orbital inflammation. Eur J Immunol 2020; 50:86-96. [PMID: 31713839 PMCID: PMC6973116 DOI: 10.1002/eji.201948343] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 09/20/2019] [Accepted: 11/08/2019] [Indexed: 12/16/2022]
Abstract
Non-Hodgkin orbital lymphoma (NHOL) and idiopathic orbital inflammation (IOI) are common orbital conditions with largely unknown pathophysiology that can be difficult to diagnose. In this study we aim to identify serum miRNAs associated with NHOL and IOI. We performed OpenArray® miRNA profiling in 33 patients and controls. Differentially expressed miRNAs were technically validated across technology platforms and replicated in an additional cohort of 32 patients and controls. We identified and independently validated a serum miRNA profile of NHOL that was remarkably similar to IOI and characterized by an increased expression of a cluster of eight miRNAs. Pathway enrichment analysis indicated that the miRNA-cluster is associated with immune-mediated pathways, which we supported by demonstrating the elevated expression of this cluster in serum of patients with other inflammatory conditions. The cluster contained miR-148a, a key driver of B-cell tolerance, and miR-365 that correlated with serum IgG and IgM concentrations. In addition, miR-29a and miR-223 were associated with blood lymphocyte and neutrophil populations, respectively. NHOL and IOI are characterized by an abnormal serum miRNA-cluster associated with immune pathway activation and linked to B cell and neutrophil dysfunction.
Collapse
Affiliation(s)
- Kamil G. Laban
- Ophthalmo‐Immunology UnitUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Department of OphthalmologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Laboratory of Translational ImmunologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Rachel Kalmann
- Ophthalmo‐Immunology UnitUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Department of OphthalmologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Cornelis P. J. Bekker
- Laboratory of Translational ImmunologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Department of Rheumatology & Clinical ImmunologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Sanne Hiddingh
- Ophthalmo‐Immunology UnitUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Department of OphthalmologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Laboratory of Translational ImmunologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Rob L. P. van der Veen
- Department of OphthalmologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Christine A. E. Eenhorst
- Department of OphthalmologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Stijn W. Genders
- Department of OphthalmologyLeiden University Medical CenterLeidenThe Netherlands
| | - Maarten P. Mourits
- Department of OphthalmologyAcademic Medical CenterAmsterdamThe Netherlands
| | - Fleurieke H. Verhagen
- Ophthalmo‐Immunology UnitUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Department of OphthalmologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Laboratory of Translational ImmunologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Emmerik F. A. Leijten
- Laboratory of Translational ImmunologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Department of Rheumatology & Clinical ImmunologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Saskia Haitjema
- Laboratory of Clinical Chemistry and HaematologyUniversity Medical Center UtrechtUtrecht UniversityUtrechtNetherlands
| | - Mark C. H. de Groot
- Laboratory of Clinical Chemistry and HaematologyUniversity Medical Center UtrechtUtrecht UniversityUtrechtNetherlands
| | - Timothy R. D. J. Radstake
- Ophthalmo‐Immunology UnitUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Laboratory of Translational ImmunologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Department of Rheumatology & Clinical ImmunologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Joke H. de Boer
- Ophthalmo‐Immunology UnitUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Department of OphthalmologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| | - Jonas J. W. Kuiper
- Ophthalmo‐Immunology UnitUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Department of OphthalmologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
- Laboratory of Translational ImmunologyUniversity Medical Center UtrechtUniversity UtrechtUtrechtThe Netherlands
| |
Collapse
|
18
|
Ogawa M, Nakagawa M, Arai N, Kan H, Ohba S, Shibata S, Maki H, Shibamoto Y. Evaluation of Thin-slice Coronal Single-shot Turbo Spin-echo Diffusion-weighted Imaging of the Hand: A Comparison with Conventional Echo-planar Diffusion-weighted Imaging. Magn Reson Med Sci 2019; 19:382-388. [PMID: 31645537 PMCID: PMC7809136 DOI: 10.2463/mrms.tn-2019-0115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We prospectively evaluated thin-slice coronal turbo spin-echo (TSE) diffusion-weighted imaging (DWI) covering a larger area with the recently-developed techniques on a 3T MRI scanner, compared with echo-planar imaging (EPI)-DWI in patients undergoing routine hand MRI. Visual score assessment and apparent diffusion coefficient (ADC) measurement were performed for patients with suspected hand tumors. TSE-DWI was superior to EPI-DWI, with less image distortion. The visual score and ADC comparison assessments proved that the image noise of TSE-DWI was acceptable.
Collapse
Affiliation(s)
- Masaki Ogawa
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences
| | - Motoo Nakagawa
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences
| | - Nobuyuki Arai
- Department of Radiology, Nagoya City University Hospital
| | - Hirohito Kan
- Department of Radiology, Nagoya City University Hospital
| | - Shota Ohba
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences
| | - Shunsuke Shibata
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences
| | - Hiroyuki Maki
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences
| |
Collapse
|
19
|
Laban KG, Kalmann R, Leguit RJ, de Keizer B. Zirconium-89-labelled rituximab PET-CT in orbital inflammatory disease. EJNMMI Res 2019; 9:69. [PMID: 31363937 PMCID: PMC6667535 DOI: 10.1186/s13550-019-0530-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 07/12/2019] [Indexed: 01/21/2023] Open
Abstract
Background Orbital inflammatory diseases are a heterogenic group of conditions that often entail a difficult diagnostic process and many patients are treatment resistant. Inflammatory diseases can be visualized by Zirconium-89-labelled rituximab PET-CT (89Zr-rituximab PET/CT). In this study, we describe our experience and possible potential of the 89Zr-rituximab PET/CT for diagnostic and therapeutic management of refractory orbital inflammation. Results Retrospectively, 89Zr-rituximab uptake was assessed and related to clinical data. The main outcome measures were the characteristics of the scan and the clinical relation of uptake with the diagnostic process and treatment effectivity. Twelve patients with thyroid eye disease (TED) and suspected idiopathic orbital inflammation (IOI) were scanned. Six patients had a strong 89Zr-rituximab uptake and showed a focal distribution within the lesion. Four patients (one TED, three IOI) responded well to rituximab treatment after a positive scan. 89Zr-rituximab PET/CT was essential to the diagnosis of optic nerve meningioma in one patient. Conclusion 89Zr-rituximab PET/CT has the potential to be a powerful tool for the detection of B cell-mediated disease within the orbit and ocular adnexa. This technique can be a valuable addition for diagnosing diseases around the eye and can potentially predict rituximab treatment response in patients with refractory inflammation.
Collapse
Affiliation(s)
- Kamil G Laban
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Room E 03.136, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands. .,Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Rachel Kalmann
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Room E 03.136, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands
| | - Roos J Leguit
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Bart de Keizer
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
20
|
Hiwatashi A, Togao O, Yamashita K, Kikuchi K, Momosaka D, Honda H. Diffusion-weighted magnetic resonance imaging of extraocular muscles in patients with Grave's ophthalmopathy using turbo field echo with diffusion-sensitized driven-equilibrium preparation. Diagn Interv Imaging 2018; 99:457-463. [DOI: 10.1016/j.diii.2018.02.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/24/2018] [Accepted: 02/26/2018] [Indexed: 12/26/2022]
|