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Yang X, Niu W, Wu K, Li X, Hou H, Tan Y, Wang X, Yang G, Wang L, Zhang H. Diffusion kurtosis imaging-based habitat analysis identifies high-risk molecular subtypes and heterogeneity matching in diffuse gliomas. Ann Clin Transl Neurol 2024; 11:2073-2087. [PMID: 38887966 PMCID: PMC11330218 DOI: 10.1002/acn3.52128] [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: 03/06/2024] [Revised: 05/14/2024] [Accepted: 06/02/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE High-risk types of diffuse gliomas in adults include isocitrate dehydrogenase (IDH) wild-type glioblastomas and grade 4 astrocytomas. Achieving noninvasive prediction of high-risk molecular subtypes of gliomas is important for personalized and precise diagnosis and treatment. METHODS We retrospectively collected data from 116 patients diagnosed with adult diffuse gliomas. Multiple high-risk molecular markers were tested, and various habitat models and whole-tumor models were constructed based on preoperative routine and diffusion kurtosis imaging (DKI) sequences to predict high-risk molecular subtypes of gliomas. Feature selection and model construction utilized Least absolute shrinkage and selection operator (LASSO) and support vector machine (SVM). Finally, the Wilcoxon rank-sum test was employed to explore the correlation between habitat quantitative features (intra-tumor heterogeneity score,ITH score) and heterogeneity, as well as high-risk molecular subtypes. RESULTS The results showed that the habitat analysis model based on DKI performed remarkably well (with AUC values reaching 0.977 and 0.902 in the training and test sets, respectively). The model's performance was further enhanced when combined with clinical variables. (The AUC values were 0.994 and 0.920, respectively.) Additionally, we found a close correlation between ITH score and heterogeneity, with statistically significant differences observed between high-risk and non-high-risk molecular subtypes. INTERPRETATION The habitat model based on DKI is an ideal means for preoperatively predicting high-risk molecular subtypes of gliomas, holding significant value for noninvasively alerting malignant gliomas and those with malignant transformation potential.
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Affiliation(s)
- Xiangli Yang
- Department of RadiologyFirst Hospital of Shanxi Medical UniversityTaiyuan030001China
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi HospitalTaiyuan030032China
- College of Medical Imaging, Shanxi Medical UniversityTaiyuan030001China
| | - Wenju Niu
- College of Medical Imaging, Shanxi Medical UniversityTaiyuan030001China
| | - Kai Wu
- Department of Information ManagementFirst Hospital of Shanxi Medical UniversityTaiyuan030001China
| | - Xiang Li
- College of Medical Imaging, Shanxi Medical UniversityTaiyuan030001China
| | - Heng Hou
- Department of RadiologyFirst Hospital of Shanxi Medical UniversityTaiyuan030001China
| | - Yan Tan
- Department of RadiologyFirst Hospital of Shanxi Medical UniversityTaiyuan030001China
| | - Xiaochun Wang
- Department of RadiologyFirst Hospital of Shanxi Medical UniversityTaiyuan030001China
| | - Guoqiang Yang
- Department of RadiologyFirst Hospital of Shanxi Medical UniversityTaiyuan030001China
- College of Medical Imaging, Shanxi Medical UniversityTaiyuan030001China
- Shanxi Key Laboratory of Intelligent Imaging and NanomedicineFirst Hospital of Shanxi Medical UniversityTaiyuan030001China
| | - Lei Wang
- Beijing Tiantan HospitalCapital Medical UniversityBeijing100050China
| | - Hui Zhang
- Department of RadiologyFirst Hospital of Shanxi Medical UniversityTaiyuan030001China
- College of Medical Imaging, Shanxi Medical UniversityTaiyuan030001China
- Shanxi Key Laboratory of Intelligent Imaging and NanomedicineFirst Hospital of Shanxi Medical UniversityTaiyuan030001China
- Intelligent Imaging Big Data and Functional Nano‐imaging Engineering Research Center of Shanxi ProvinceFirst Hospital of Shanxi Medical UniversityTaiyuan030001China
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Song Q, Dong W, Tian S, Xie L, Chen L, Wei Q, Liu A. Diffusion kurtosis imaging with multiple quantitative parameters for predicting microsatellite instability status of endometrial carcinoma. Abdom Radiol (NY) 2023; 48:3746-3756. [PMID: 37740047 DOI: 10.1007/s00261-023-04041-6] [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: 05/05/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/24/2023]
Abstract
PURPOSE To explore the value of Diffusion kurtosis imaging (DKI) with multiple quantitative parameters in predicting microsatellite instability (MSI) status in endometrial carcinoma (EC). METHODS Data of 38 patients with EC were retrospectively analyzed, including 12 MSI and 26 microsatellite stability (MSS). All patients underwent preoperative 1.5T MR examination. The quantitative values of the DKI sequence in the tumor parenchyma of the two groups, including mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), fractional anisotropy (FA), fractional anisotropy of kurtosis (FAk), mean diffusivity (MD), axial diffusivity (Da), and radial diffusivity (Dr) were measured by two observers, respectively. RESULTS The MK, Ka, Kr, FA, FAk, MD, Da, and Dr values of the MSI group were 1.074 ± 0.162, 1.253 ± 0.229, 0.886 ± 0.205, 0.207 ± 0.041, 0.397 ± 0.129, 0.890 ± 0.158 μm2/ms, 1.083 ± 0.218 μm2/ms, and 0.793 ± 0.133 μm2/ms, and 0.956 (0.889,1.002), 1.048 ± 0.211, 0.831 ± 0.099, 0.188 ± 0.061, 0.334 (0.241,0.410), 1.043 ± 0.217 μm2/ms, 1.235 ± 0.229 μm2/ms, and 0.946 ± 0.215 μm2/ms in the MSS group. The MK and Ka values of the MSI group were higher than those of the MSS group (P<0.05), while the MD and Dr values were lower than those of the MSS group (P<0.05). The AUC of MK, Ka, MD, and Dr values in predicting MSI status of EC was 0.763, 0.729, 0.731, 0.748, respectively. The sensitivity was 58.3%, 50.0%, 65.4%, 61.5%, and the specificity was 96.2%, 92.3%, 75.0%, 83.3%, respectively. CONCLUSION DKI can provide multiple quantitative parameters for predicting the MSI status of EC, and assist gynecologist to optimize the treatment plan for the patients.
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Affiliation(s)
- Qingling Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, 116011, China
| | - Wan Dong
- Department of Radiology, Wuhan Children's Hospital, Tongji Medical College of Huazhong University of Science & Technology, Jiang'an District Wuhan Hong Kong Road No.100, Wuhan, 430019, China
| | - Shifeng Tian
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, 116011, China
| | - Lizhi Xie
- GE Healthcare, MR Research, Beijing, 100024, China
| | - Lihua Chen
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, 116011, China
| | - Qiang Wei
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, 116011, China
| | - Ailian Liu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, 116011, China.
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Pang H, Dang X, Ren Y, Yao Z, Shen Y, Feng X, Wang Z. DKI can distinguish high-grade gliomas from IDH1-mutant low-grade gliomas and correlate with their different nuclear-to-cytoplasm ratio: a localized biopsy-based study. Eur Radiol 2023:10.1007/s00330-023-10325-8. [PMID: 37962597 DOI: 10.1007/s00330-023-10325-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 08/01/2023] [Accepted: 08/18/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVES To explore whether differences in diffusional kurtosis imaging (DKI) between therapy-naïve high-grade gliomas (HGGs) and low-grade gliomas (LGGs) are related to the cellularity and/or the nuclear-to-cytoplasmic (N/C) ratio. METHODS We analyzed 44 and 40 diffuse glioma samples that were pathologically confirmed as HGGs and IDH1-mutant LGGs, respectively. The DKI parameters included kurtosis metrics (mean kurtosis [MK], axial kurtosis [K//], and radial kurtosis [K⊥]), and the diffusional metrics (fractional anisotropy [FA], mean diffusion [MD], axial diffusion [λ//], and radial diffusion [λ⊥]). The cellularity and the N/C ratio were compared within LGGs and HGGs using the Mann-Whitney U test (significant level, p < 0.007 [0.05/7]); Bonferroni correction). Spearman's correlation analysis was used to calculate the correlation coefficients among DKI metrics, cellularity, and the N/C ratio at a significant level of p = 0.05. RESULTS Excluding FA, all DKI metrics showed significant differences between HGGs and LGGs (all p ≤ 0.001). The N/C ratio of HGGs was significantly higher than that of LGGs; however, differences in cellularity were not significant between the two glioma groups (p = 0.525). Similarly, excluding FA, all DKI metrics were significantly correlated with the N/C ratio in LGGs, with correlation coefficients of - 0.365 (MD), - 0.313 (λ//), - 0.376 (λ⊥), 0.859 (MK), 0.772 (K//), and 0.842 (K//). There was a non-significant correlation between any DKI parameters and the cellularity in LGGs. Additionally, the cellularity and N/C ratios in HGGs did not correlate with any DKI metrics. CONCLUSIONS DKI differentiate LGGs from HGGs associated with their different N/C ratios. CLINICAL RELEVANCE STATEMENT This study shows that DKI differentiates LGGs from HGGs may correlated with their different N/C ratios, this could provide a possible histopathological mechanism about why DKI can DKI differentiate LGGs from HGGs. KEY POINTS • Excluding FA, all DKI metrics showed a significant difference between high-grade gliomas and IDH1-mutant low-grade gliomas. • The nuclear-to-cytoplasm ratios in high-grade gliomas were significantly more extensive than that in IDH1-mutant low-grade gliomas, but not the cellularity. • Significant associations were seen between DKI measures and the N/C ratio; a non-significant correlation was noted between any DKI metric and cellularity in glioma specimens.
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Affiliation(s)
- Haopeng Pang
- Department of Integrative Oncology, Fudan University Shanghai Cancer Center, #270 DongAn Road, Shanghai, 200032, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, #270 DongAn Road, Shanghai, 200032, People's Republic of China.
| | - Xuefei Dang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Minhang District, #106 Ruili Road, Shanghai, 200240, People's Republic of China
| | - Yan Ren
- Department of Radiology, Huashan Hospital, Fudan University, #12 Mid Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Zhenwei Yao
- Department of Radiology, Huashan Hospital, Fudan University, #12 Mid Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Yehua Shen
- Department of Integrative Oncology, Fudan University Shanghai Cancer Center, #270 DongAn Road, Shanghai, 200032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, #270 DongAn Road, Shanghai, 200032, People's Republic of China
| | - Xiaoyuan Feng
- Department of Radiology, Huashan Hospital, Fudan University, #12 Mid Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Zhongmin Wang
- Department of Radiology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, #149 South Chongqing Road, Shanghai, 200020, People's Republic of China
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Sheng Y, Dang X, Zhang H, Rui W, Wang J, Cheng H, Qiu T, Zhang Y, Ding Y, Yao Z, Pang H, Ren Y. Correlations between intravoxel incoherent motion-derived fast diffusion and perfusion fraction parameters and VEGF- and MIB-1-positive rates in brain gliomas: an intraoperative MR-navigated, biopsy-based histopathologic study. Eur Radiol 2023; 33:5236-5246. [PMID: 36941492 DOI: 10.1007/s00330-023-09506-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 12/23/2022] [Accepted: 01/30/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES To explore the correlations between histopathologic findings and intravoxel incoherent motion (IVIM)-derived perfusion and diffusion parameters in brain gliomas. METHODS Thirty-two biopsy samples from twenty-one patients with newly diagnosed gliomas from a previous prospective cohort study were retrospectively analyzed. All patients underwent diffusion-weighted MRI with 22 b values (0-5000 s/mm2), followed by intraoperative MR-guided biopsy surgery and surgical resection. All 32 biopsy samples underwent immunohistochemical staining followed by quantitative analysis of cell density (cellularity), percent of MIB-1 (Ki67)-positive expression (pMIB-1), number of CD34-stained vessels (CD34-MVD), and percent of VEGF-positive expressing cells (pVEGF) using a multispectral phenotyping microscope. Based on the co-registered localized biopsy, correlation analysis was performed between the IVIM-derived biexponential model-based parameters (Dfast1500 and Dfast5000, Dslow1500 and Dslow5000, PF1500 and PF5000) and the above four pathological biomarkers and glioma grades. RESULTS Significant positive correlations were revealed between Dfast5000 and pVEGF (rho (r) = 0.466, p = 0.007), and Dfast1500 and pVEGF (r = 0.371, p = 0.037). A significant negative correlation was revealed between PF5000 with pMIB-1 (r = - 0.456, p = 0.01). Moderate to good positive correlations were shown between Dfast5000 and glioma grades (r = 0.509, p = 0.003) and Dfast1500 and glioma grades (r = 0.476, p = 0.006). CONCLUSIONS IVIM-DWI-derived Dfast and PF correlate, respectively, with intratumor pVEGF and pMIB-1. When using the wide-high b value scheme, IVIM-derived Dfast and PF tend to demonstrate better efficacy in evaluating malignancy-related characteristics such as angiogenesis and cellular proliferation in gliomas. KEY POINTS • Intravoxel incoherent motion-diffusion-weighted imaging (IVIM-DWI)-derived fast diffusion (Dfast) and perfusion fraction (PF) can quantitatively reflect intratumor pVEGF and pMIB-1. • IVIM-DWI-derived Dfast and PF tend to demonstrate better efficacy in evaluating glioma malignancy when an optimized scheme is used. • IVIM-DWI-derived Dfast5000 and PF5000 are promising non-invasive parameters correlating with pVEGF and pMIB-1 in gliomas.
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Affiliation(s)
- Yaru Sheng
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xuefei Dang
- Department of Oncology, Minhang Branch of Fudan University Shanghai Cancer Center, Shanghai, 200240, China
| | - Hua Zhang
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, 266000, China
| | - Wenting Rui
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Jing Wang
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Haixia Cheng
- Neuropathology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Tianming Qiu
- Neurosurgery Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yong Zhang
- MR Research, GE Healthcare, 1 Huatuo Road, Shanghai, 201203, China
| | - Yueyue Ding
- Department of Echocardiology, Children's Hospital, Suzhou University, Suzhou, 215000, China
| | - Zhenwei Yao
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Haopeng Pang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, #197 Rui Jin Er Road, Shanghai, 200025, China.
- Department of Integrative Oncology, Minimally Invasive Therapy Center, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Radiology Department of Huashan Hospital, Fudan University, Mid 12 Wulumuqi Road, Shanghai, 200040, China.
| | - Yan Ren
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, 200040, China.
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Scola E, Del Vecchio G, Busto G, Bianchi A, Desideri I, Gadda D, Mancini S, Carlesi E, Moretti M, Desideri I, Muscas G, Della Puppa A, Fainardi E. Conventional and Advanced Magnetic Resonance Imaging Assessment of Non-Enhancing Peritumoral Area in Brain Tumor. Cancers (Basel) 2023; 15:cancers15112992. [PMID: 37296953 DOI: 10.3390/cancers15112992] [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: 05/04/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
The non-enhancing peritumoral area (NEPA) is defined as the hyperintense region in T2-weighted and fluid-attenuated inversion recovery (FLAIR) images surrounding a brain tumor. The NEPA corresponds to different pathological processes, including vasogenic edema and infiltrative edema. The analysis of the NEPA with conventional and advanced magnetic resonance imaging (MRI) was proposed in the differential diagnosis of solid brain tumors, showing higher accuracy than MRI evaluation of the enhancing part of the tumor. In particular, MRI assessment of the NEPA was demonstrated to be a promising tool for distinguishing high-grade gliomas from primary lymphoma and brain metastases. Additionally, the MRI characteristics of the NEPA were found to correlate with prognosis and treatment response. The purpose of this narrative review was to describe MRI features of the NEPA obtained with conventional and advanced MRI techniques to better understand their potential in identifying the different characteristics of high-grade gliomas, primary lymphoma and brain metastases and in predicting clinical outcome and response to surgery and chemo-irradiation. Diffusion and perfusion techniques, such as diffusion tensor imaging (DTI), diffusional kurtosis imaging (DKI), dynamic susceptibility contrast-enhanced (DSC) perfusion imaging, dynamic contrast-enhanced (DCE) perfusion imaging, arterial spin labeling (ASL), spectroscopy and amide proton transfer (APT), were the advanced MRI procedures we reviewed.
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Affiliation(s)
- Elisa Scola
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Guido Del Vecchio
- Radiodiagnostic Unit N. 2, Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy
| | - Giorgio Busto
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Andrea Bianchi
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Ilaria Desideri
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Davide Gadda
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Sara Mancini
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Edoardo Carlesi
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Marco Moretti
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Isacco Desideri
- Radiation Oncology, Oncology Department, Careggi University Hospital, University of Florence, 50121 Florence, Italy
| | - Giovanni Muscas
- Neurosurgery Unit, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi University Hospital, University of Florence, 50121 Florence, Italy
| | - Alessandro Della Puppa
- Neurosurgery Unit, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi University Hospital, University of Florence, 50121 Florence, Italy
| | - Enrico Fainardi
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
- Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50121 Florence, Italy
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Wang J, Zhang H, Dang X, Rui W, Cheng H, Wang J, Zhang Y, Qiu T, Yao Z, Liu H, Pang H, Ren Y. Multi-b-value diffusion stretched-exponential model parameters correlate with MIB-1 and CD34 expression in Glioma patients, an intraoperative MR-navigated, biopsy-based histopathologic study. Front Oncol 2023; 13:1104610. [PMID: 37182187 PMCID: PMC10171458 DOI: 10.3389/fonc.2023.1104610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/13/2023] [Indexed: 05/16/2023] Open
Abstract
Background To understand the pathological correlations of multi-b-value diffusion-weighted imaging (MDWI) stretched-exponential model (SEM) parameters of α and diffusion distribution index (DDC) in patients with glioma. SEM parameters, as promising biomarkers, played an important role in histologically grading gliomas. Methods Biopsy specimens were grouped as high-grade glioma (HGG) or low-grade glioma (LGG). MDWI-SEM parametric mapping of DDC1500, α1500 fitted by 15 b-values (0-1,500 sec/mm2)and DDC5000 and α5000 fitted by 22 b-values (0-5,000 sec/mm2) were matched with pathological samples (stained by MIB-1 and CD34) by coregistered localized biopsies, and all SEM parameters were correlated with these pathological indices pMIB-1(percentage of MIB-1 expression positive rate) and CD34-MVD (CD34 expression positive microvascular density for each specimen). The two-tailed Spearman's correlation was calculated for pathological indexes and SEM parameters, as well as WHO grades and SEM parameters. Results MDWI-derived α1500 negatively correlated with CD34-MVD in both LGG (6 specimens) and HGG (26 specimens) (r=-0.437, P =0.012). MDWI-derived DDC1500 and DDC5000 negatively correlated with MIB-1 expression in all glioma patients (P<0.05). WHO grades negatively correlated with α1500(r=-0.485; P=0.005) and α5000(r=-0.395; P=0.025). Conclusions SEM-derived DDC and α are significant in histologically grading gliomas, DDC may indicate the proliferative ability, and CD34 stained microvascular perfusion may be an important determinant of water diffusion inhomogeneity α in glioma.
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Affiliation(s)
- Junlong Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hua Zhang
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Xuefei Dang
- Department of Oncology, Minhang Branch of Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Wenting Rui
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Haixia Cheng
- Department of Neuropathology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jing Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yong Zhang
- Department of Magnetic Resonance Research, General Electric Healthcare, Shanghai, China
| | - Tianming Qiu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenwei Yao
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hanqiu Liu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Hanqiu Liu, ; Haopeng Pang, ; Yan Ren,
| | - Haopeng Pang
- Minimally Invasive Therapy Center, Shanghai Cancer Center, Fudan University, Shanghai, China
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Hanqiu Liu, ; Haopeng Pang, ; Yan Ren,
| | - Yan Ren
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Hanqiu Liu, ; Haopeng Pang, ; Yan Ren,
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Haopeng P, Xuefei D, Zengai C, Zhenwei Y, Chien-shan C, Zhiqiang M. High-Resolution Diffusion-Weighted Imaging of C6 Glioma on a 7T BioSpec MRI Scanner: Correlation of Tumor Cellularity and Nuclear-to-Cytoplasmic Ratio with Apparent Diffusion Coefficient. Acad Radiol 2022; 29 Suppl 3:S80-S87. [PMID: 34148856 DOI: 10.1016/j.acra.2021.02.009] [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: 01/25/2021] [Accepted: 02/10/2021] [Indexed: 11/01/2022]
Abstract
RATIONALE AND OBJECTIVES To determine the association of the apparent diffusion coefficient (ADC) with quantitative cellularity and the nuclear-to-cytoplasmic ratio in C6 glioma. MATERIALS AND METHODS Animal models bearing C6 gliomas underwent MR scans with T1 rapid acquisition with relaxation enhancement (RARE), T2 RARE, and high-resolution diffusion-weighted imaging sequences. For each model, three consecutive sections were used to draw regions of interest (ROIs) and measure ADC values; the middle section was localized in the plane with the maximal solid tumor area. The minimal, mean, and maximal ADC values were recorded for each ROI. GFAP-immunostained sections coregistered with ADC measurements were used to calculate tumor cellularity and the nuclear-to-cytoplasmic (N/C) ratio. Spearman's correlation was used to assess the relationship between ADC values and quantitative tumor cellularity as well as N/C ratios with a significance level of p < 0.05. RESULTS Thirty-three sections from 11 glioma-bearing rats were analyzed. The median values of the minimal, mean, and maximal ADC were 0.443 × 10-3, 0.744 × 10-3, and 1.140 × 10-3 mm2/s, respectively. The median cellularity and N/C ratio were 2151.234 per 0.025 mm2 and 0.857, respectively. The minimal, mean, and maximal ADCs were all significantly associated with cellularity, with correlation coefficients of -0.712 (p < 0.001), -0.631 (p < 0.001), and -0.460 (p = 0.007), respectively. The minimal and mean ADC had significant negative relationships with the N/C ratio, with correlation coefficients of -0.565 (p = 0.001) and -0.426 (p = 0.013), respectively. CONCLUSION The minimal ADC correlated well with cellularity and N/C ratios in C6 glioma and may be used as a biomarker of these two pathological features.
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Guo J, Dong C, Wu Z, Sun W, Li X, Zhou R, Xu W. Diffusion kurtosis imaging assessment of the response to radiotherapy in a VX2 bone tumor model: an animal study. Acta Radiol 2022; 63:182-191. [PMID: 33535770 DOI: 10.1177/0284185121989519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Neoadjuvant radiotherapy plays a vital role in the treatment of malignant bone tumors, and non-invasive imaging methods are needed to evaluate the response to treatment. PURPOSE To assess the value of diffusion kurtosis imaging (DKI) for monitoring early response to radiotherapy in malignant bone tumors. MATERIAL AND METHODS Treatment response was evaluated in a rabbit VX2 bone tumor model (n = 35) using magnetic resonance imaging (MRI), DKI, and histopathologic examinations. Subjects were divided into three groups: pre-treatment, post-treatment, and control groups. The post-treatment group was subclassified into good response and poor response groups according to the results of histopathologic examination. Apparent diffusion coefficient (ADC) and DKI parameters (mean diffusion coefficient [MD] and mean kurtosis [MK]) were recorded. The relationship between ADC, DKI parameters, and histopathologic changes after radiotherapy was determined using Pearson's correlation coefficient. The diagnostic performance of these parameters was assessed using receiver operating characteristic analysis. RESULTS MD in the good response group was higher after treatment than before treatment (P < 0.001) and higher than that in the poor response group (P = 0.009). MD was highly correlated with tumor cell density and apoptosis rate (r = -0.771, P < 0.001 and r = 0.625, P < 0.001, respectively). MD was superior to other parameters for determining the curative effect of radiotherapy, with a sensitivity of 75.0%, specificity of 100.0%, and area under the curve of 0.917 (P < 0.001). CONCLUSION The correlations between MD, tumor cell density, and apoptosis suggest that MD could be useful for assessing the early response to radiotherapy in rabbit VX2 malignant bone tumors.
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Affiliation(s)
- Jia Guo
- Department of Radiology; The Affiliated Hospital of Qingdao University Qingdao, Shandong, PR China
| | - Cheng Dong
- Department of Radiology; The Affiliated Hospital of Qingdao University Qingdao, Shandong, PR China
| | - Zengjie Wu
- Department of Radiology; The Affiliated Hospital of Qingdao University Qingdao, Shandong, PR China
| | - Weikai Sun
- Department of Radiology; The Affiliated Hospital of Qingdao University Qingdao, Shandong, PR China
| | - Xiaoli Li
- Department of Radiology; The Affiliated Hospital of Qingdao University Qingdao, Shandong, PR China
| | - Ruizhi Zhou
- Department of Radiology; The Affiliated Hospital of Qingdao University Qingdao, Shandong, PR China
| | - Wenjian Xu
- Department of Radiology; The Affiliated Hospital of Qingdao University Qingdao, Shandong, PR China
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Xie Y, Li S, Shen N, Gan T, Zhang S, Liu WV, Zhu W. Assessment of Isocitrate Dehydrogenase 1 Genotype and Cell Proliferation in Gliomas Using Multiple Diffusion Magnetic Resonance Imaging. Front Neurosci 2021; 15:783361. [PMID: 34880724 PMCID: PMC8645648 DOI: 10.3389/fnins.2021.783361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 10/20/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To compare the efficacy of parameters from multiple diffusion magnetic resonance imaging (dMRI) for prediction of isocitrate dehydrogenase 1 (IDH1) genotype and assessment of cell proliferation in gliomas. Methods: Ninety-one patients with glioma underwent diffusion weighted imaging (DWI), multi-b-value DWI, and diffusion kurtosis imaging (DKI)/neurite orientation dispersion and density imaging (NODDI) on 3.0T MRI. Each parameter was compared between IDH1-mutant and IDH1 wild-type groups by Mann-Whitney U test in lower-grade gliomas (LrGGs) and glioblastomas (GBMs), respectively. Further, performance of each parameter was compared for glioma grading under the same IDH1 genotype. Spearman correlation coefficient between Ki-67 labeling index (LI) and each parameter was calculated. Results: The diagnostic performance was better achieved with apparent diffusion coefficient (ADC), slow ADC (D), fast ADC (D∗), perfusion fraction (f), distributed diffusion coefficient (DDC), heterogeneity index (α), mean diffusivity (MD), mean kurtosis (MK), and intracellular volume fraction (ICVF) for distinguishing IDH1 genotypes in LrGGs, with statistically insignificant AUC values from 0.750 to 0.817. In GBMs, no difference between the two groups was found. For IDH1-mutant group, all parameters, except for fractional anisotropy (FA) and D∗, significantly discriminated LrGGs from GBMs (P < 0.05). However, for IDH1 wild-type group, only ADC statistically discriminated the two (P = 0.048). In addition, MK has maximal correlation coefficient (r = 0.567, P < 0.001) with Ki-67 LI. Conclusion: dMRI-derived parameters are promising biomarkers for predicting IDH1 genotype in LrGGs, and MK has shown great potential in assessing glioma cell proliferation.
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Affiliation(s)
- Yan Xie
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shihui Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nanxi Shen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tongjia Gan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shun Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weiyin Vivian Liu
- Magnetic Resonance Research, General Electric Healthcare, Beijing, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Song Q, Guo Y, Yao X, Rao S, Qian C, Ye D, Zeng M. Comparative study of evaluating the microcirculatory function status of primary small HCC between the CE (DCE-MRI) and Non-CE (IVIM-DWI) MR Perfusion Imaging. Abdom Radiol (NY) 2021; 46:2575-2583. [PMID: 33483778 DOI: 10.1007/s00261-020-02945-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/20/2020] [Accepted: 12/31/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE To compare the difference of evaluating the microcirculatory function status of primary small HCC between DCE-MRI with two-compartmental pharmacokinetic model and IVIM-DWI. METHODS 27 patients (22 men, 5 women; mean age, 49 years; range 36-65 years) with primary single sHCC who underwent IVIM-DWI and DCE-MRI before the operation were included in this retrospective study. The MR perfusion parameters are Ktrans, Ve, Kep, D, D* and f. Pathological results include pathological grade (low grade ≤ II, high grade > II) and MVD. The perfusion parameters and pathological results of sHCC were analyzed and compared in their relevance, sensitivity and specificity. Statistical methods included Spearman and ROC curve analysis. RESULTS The perfusion parameters (Ktrans, Kep, D*, f) were significantly positive correlated (r = 0.892, 0.808, 0.589 and 0.543, P = 0.000, 0.000, 0.001 and 0.003 with MVD of sHCC. The parameter Ve and D values were negatively correlated (r = - 0.454 and - 0.399, P = 0.017 and 0.039, respectively) with the pathological grade. Regarding the evaluation MVD of sHCC, the evaluation of the sensitivity and specificity performance was present in descending order: Ktrans > Kep > PF > D*. In the evaluation pathological grade of sHCC, the sensitivity and specificity were better by parameters D than Ve. CONCLUSION DCE-MRI is better than IVIM-DWI for evaluation microcirculation functional status of sHCC. But for evaluating the pathological grade, IVIM-DWI is better than DCE-MRI. Combination of the two imaging techniques may provide more comprehensive evaluation in microcirculation functional status of the sHCC.
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Affiliation(s)
- Qiong Song
- Department of Radiology, Zhongshan Hospital of Fudan University, Fudan University, Shanghai Institute of Medical Imaging, No 130, Dongan Rd, Xuhui District, Shanghai, 200032, People's Republic of China
- Radiology Department, Xuzhou Mining Group General Hospital, Xuzhou, 221000, Jiangsu, People's Republic of China
- Shanghai Aitrox Technology Corporation Limited, Shanghai, 200032, People's Republic of China
| | - Yixian Guo
- Department of Radiology, Zhongshan Hospital of Fudan University, Fudan University, Shanghai Institute of Medical Imaging, No 130, Dongan Rd, Xuhui District, Shanghai, 200032, People's Republic of China
| | - Xiuzhong Yao
- Department of Radiology, Zhongshan Hospital of Fudan University, Fudan University, Shanghai Institute of Medical Imaging, No 130, Dongan Rd, Xuhui District, Shanghai, 200032, People's Republic of China
| | - Shengxiang Rao
- Department of Radiology, Zhongshan Hospital of Fudan University, Fudan University, Shanghai Institute of Medical Imaging, No 130, Dongan Rd, Xuhui District, Shanghai, 200032, People's Republic of China
| | - Chengyao Qian
- Shanghai Aitrox Technology Corporation Limited, Shanghai, 200032, People's Republic of China
| | - Dexian Ye
- Shanghai Aitrox Technology Corporation Limited, Shanghai, 200032, People's Republic of China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital of Fudan University, Fudan University, Shanghai Institute of Medical Imaging, No 130, Dongan Rd, Xuhui District, Shanghai, 200032, People's Republic of China.
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11
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Wang P, Shi YH, Li JY, Zhang CZ. Differentiating Glioblastoma from Primary Central Nervous System Lymphoma: The Value of Shaping and Nonenhancing Peritumoral Hyperintense Gyral Lesion on FLAIR Imaging. World Neurosurg 2021; 149:e696-e704. [PMID: 33548537 DOI: 10.1016/j.wneu.2021.01.114] [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: 12/15/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND This study describes a distinct magnetic resonance imaging (MRI) feature, placing emphasis on fluid-attenuation inversion recovery (FLAIR) and contrast-enhanced T1-weighted (T1C) images for the preoperative differentiation of glioblastoma (GBM) from primary central nervous system lymphoma (PCNSL). METHODS The preoperative MRI findings of 116 pathologically confirmed glioblastoma (n = 72) and PCNSL (n = 44) were retrospectively reviewed. Two neuroimaging specialists analyzed the MRIs, and image analysis was focused on the presence or absence of a shaping and nonenhancing peritumoral hyperintense gyral lesion on FLAIR imaging (SNEPGF, i.e., hyperintense lesion in a shaping and nonenhancing peritumoral gyral area on FLAIR imaging). The gyral area adjacent to and within 3 cm of the enhanced tumor was defined as the peritumoral gyrus region. The FLAIR hyperintensity lesion were termed as the signal intensity ratio ≥30% compared with contralateral normal gray matter. Then, the differential diagnostic efficacy of SNEFPG sign for GBM and PCNSL was analyzed. RESULTS The SNEPGF sign was found in 33 GBM cases (33 of 72, 45.8%), and the FLAIR signal intensity and apparent diffusion coefficient value of these area were lower than the peritumoral edema area (P < 0.0001). In 44 PCNSL cases, no SNEPGF sign was found. A slightly higher FLAIR signal intensity was seen in 9 PCNSLs, but uniform and marked enhancement was seen in these areas. The sensitivity, specificity, positive predictive value, and negative predictive value of the differential diagnosis of GBM and PCNSL with SNEPGF sign were 45.8%, 100%, 100%, and 53.0%, respectively. CONCLUSIONS The SNEPGF sign is effective in identifying GBM from PCNSL, especially with high specificity.
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Affiliation(s)
- Ping Wang
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai, Shandong, PR China
| | - Ying-Hong Shi
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai, Shandong, PR China
| | - Jian-Ye Li
- Department of Radiology, Gutian Hospital, Gutian, Fujian, PR China
| | - Cheng-Zhou Zhang
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai, Shandong, PR China.
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Yang Z, Rong Y, Cao Z, Wu Y, Zhao X, Xie Q, Luo M, Liu Y. Microstructural and Cerebral Blood Flow Abnormalities in Subjective Cognitive Decline Plus: Diffusional Kurtosis Imaging and Three-Dimensional Arterial Spin Labeling Study. Front Aging Neurosci 2021; 13:625843. [PMID: 33597860 PMCID: PMC7882515 DOI: 10.3389/fnagi.2021.625843] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
Objective: To explore microstructural and cerebral blood flow (CBF) abnormalities in individuals with subjective cognitive decline plus (SCD plus) using diffusional kurtosis imaging (DKI) and three-dimensional (3D) arterial spin labeling (ASL). Methods: Twenty-seven patients with SCD plus, 31 patients with amnestic mild cognitive impairment (aMCI), and 33 elderly controls (ECs) were recruited and underwent DKI and 3D ASL using a GE 3.0-T MRI. Mean kurtosis (MK), fractional anisotropy (FA), mean diffusivity (MD), and CBF values were acquired from 24 regions of interest (ROIs) in the brain, including the bilateral hippocampal (Hip) subregions (head, body, and tail), posterior cingulate cortex (PCC), precuneus, dorsal thalamus subregions (anterior nucleus, ventrolateral nucleus, and medial nucleus), lenticular nucleus, caput nuclei caudati, white matter (WM) of the frontal lobe, and WM of the occipital lobe. Pearson's correlation analysis was performed to assess the relationships among the DKI-derived parameters, CBF values, and key neuropsychological tests for SCD plus. Results: Compared with ECs, participants with SCD plus showed a significant decline in MK and CBF values, mainly in the Hip head and PCC, and participants with aMCI exhibited more significant abnormalities in the MK and CBF values than individuals with ECs and SCD plus in multiple regions. Combined MK values showed better discrimination between patients with SCD plus and ECs than that obtained using CBF levels, with areas under the receiver operating characteristic (ROC) curve (AUC) of 0.874 and 0.837, respectively. Similarly, the AUC in discriminating SCD plus from aMCI patients obtained using combined MK values was 0.823, which was also higher than the combined AUC of 0.779 obtained using CBF values. Moreover, MK levels in the left Hip (h) and left PCC positively correlated with the auditory verbal learning test-delayed recall (AVLT-DR) score in participants with SCD plus. By contrast, only the CBF value in the left Hip head positively correlated with the AVLT-DR score. Conclusions: Our results provide new evidence of microstructural and CBF changes in patients with SCD plus. MK may be used as an early potential neuroimaging biomarker and may be a more sensitive DKI parameter than CBF at the very early stage of Alzheimer's disease (AD).
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Affiliation(s)
- Zhongxian Yang
- Medical Imaging Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China.,Medical Imaging Center, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Yu Rong
- Medical Imaging Center, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China.,Department of Neurology, The People's Hospital of Gaozhou City, Maoming, China
| | - Zhen Cao
- Medical Imaging Center, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Yi Wu
- Department of Neurology, Shantou Central Hospital and Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, China
| | - Xinzhu Zhao
- Medical Imaging Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Qiuxia Xie
- Medical Imaging Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Min Luo
- Medical Imaging Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Yubao Liu
- Medical Imaging Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China
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