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Khedr D, Razek AAKA, Talaat M. Multi-parametric arterial spin labeling and diffusion-weighted imaging of paranasal sinuses masses. Oral Radiol 2023; 39:321-328. [PMID: 35900660 DOI: 10.1007/s11282-022-00640-z] [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: 03/27/2021] [Accepted: 07/07/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate arterial spin labeling (ASL) and diffusion-weighted imaging (DWI) in discrimination of benign from malignant paranasal sinus (PNS) tumors. MATERIAL AND METHODS A prospective study was done upon 42 cases of PNS masses that underwent magnetic resonance ASL and DWI of the head. Tumor blood flow (TBF) and apparent diffusion coefficient (ADC) of the masses were calculated by two observers. The pathological diagnosis was malignant (n = 28) and benign (n = 14) cases. RESULTS For both observers, the malignant PNS masses had significantly higher TBF (P < 0.001, 0.001) and lower ADC (P < 0.001, 0.001) than in benign masses. The ROC curve analysis of TBF, The threshed TBF was (121.45, 122.68 mL/100 g/min) used for differentiation between benign and malignant PNS masses, revealed sensitivity (92.9%, 89.3%), specificity (85.7%, 85.7%), accuracy (90.5%, 88.1%) and the AUC was 0.87 and 0.86 by both observers. the ROC curve analysis of ADC, The threshold ADC (1.215, 1.205 X10-3mm2/s) was used for differentiation between benign and malignant PNS masses, revealed sensitivity (96.4%, 89.3%), specificity (78.6%, 78.6%), accuracy of (90.5%, 85.7%) and the AUC was 0.93 and 0.92 by both observers. Combined analysis of TBF and ADC used for differentiation between benign and malignant PNS masses had revealed sensitivity (96.4%, 89.3%), specificity (92.9%, 85.7%) accuracy of (95.2%, 88.1%) and AUC. (0.995, 0.985) for both observers. CONCLUSION Combined using of TBF and ADC have a role in differentiation malignant from benign PNS masses.
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Affiliation(s)
- Doaa Khedr
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Elgomheryia street, Mansoura, 35511, Egypt.
| | | | - Mona Talaat
- Department of Diagnostic Radiology, Kafr Elsheak Faculty of Medicine, Kafrelsheikh, Egypt
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Histogram analysis of synthetic magnetic resonance imaging: Correlations with histopathological factors in head and neck squamous cell carcinoma. Eur J Radiol 2023; 160:110715. [PMID: 36753947 DOI: 10.1016/j.ejrad.2023.110715] [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: 12/31/2022] [Accepted: 01/24/2023] [Indexed: 01/30/2023]
Abstract
PURPOSE To analyse the association between histogram parameters derived from synthetic MRI (SyMRI) and different histopathological factors in head and neck squamous cell carcinoma (HNSCC). METHOD Sixty-one patients with histologically proven primary HNSCC were prospectively enrolled. The correlations between histogram parameters of SyMRI (T1, T2 and proton density (PD) maps) and histopathological factors were analysed using Spearman analysis. The Mann-Whitney U test or Student's t test was utilized to differentiate histological grades and human papillomavirus (HPV) status. The ROC curves and leave-one-out cross-validation (LOOCV) were used to evaluate the differentiation performance. Bootstrapping was applied to avoid overfitting. RESULTS Several histogram parameters were associated with histological grade: T1 map (r = 0.291) and PD map (r = 0.294 - 0.382/-0.343), and PD_75th Percentile showed the highest differentiation performance (AUC: 0.721 (ROC) and 0.719 (LOOCV)). Moderately negative correlations were found between p16 status and the histogram parameters: T1 map (r = -0.587 - -0.390), T2 map (r = -0.649 - -0.357) and PD map (r = -0.537 - -0.338). In differentiating HPV infection, Entropy was the most discriminative parameter in each map and T2_Entropy showed the highest diagnostic performance (AUC: 0.851 [ROC] and 0.851 [LOOCV]). Additionally, several histogram parameters were correlated with Ki-67 (r = -0.379/-0.397), epidermal growth factor receptor (EGFR) (r = 0.318/0.322) status and p53 (r = 0.452 - 0.665/-0.607) status. CONCLUSIONS Histogram parameters derived from SyMRI may serve as a potential biomarker for discriminating relevant histopathological features, including histological differentiation grade, HPV infection, Ki-67, EGFR and p53 statuses.
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Liao L, Liu T, Wei B. Prediction of short-term treatment outcome of nasopharyngeal carcinoma based on voxel incoherent motion imaging and arterial spin labeling quantitative parameters. Eur J Radiol Open 2022; 10:100466. [PMID: 36590328 PMCID: PMC9794885 DOI: 10.1016/j.ejro.2022.100466] [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: 06/13/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose To evaluate the early response of chemoradiotherapy (CRT) in nasopharyngeal carcinoma (NPC) based on intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and three-dimensional pseudo-continuous arterial spin labeling (3D pCASL). Materials and methods Forty patients diagnosed with NPC were recruited and divided into complete remission (CR) and partial remission (PR) group after CRT. All patients underwent IVIM and ASL and the related parameters was obtained. These parameters include pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), average blood flow ( BFavg), minimum blood flow (BFmin), and maximum blood flow (BFmax). Student's t test was used to compare the difference in ASL and IVIM derived parameters between CR and PR. The Areas under curve (AUC) of the receiver operating characteristic (ROC) was used to analyze the diagnostic performance of each parameter of ASL and IVIM to the treatment outcome. Results the D value of IVIM in CR group was lower than that of the PR group ( P = 0.014),. Among the parameters of ASL, the BFavg and BFmax of the CR group were higher than those of the PR group(p = 0.004,0.013), but the BFmin had no statistical significance in the two groups(P = 0.54). AUC of D, BFavg, and BFmax is about 0.731, 0.753, and 0.724, respectively, all of their combined AUC diagnosis was 0.812. Conclusion The early response of NPC after CRT can predict by IVIM's diffusion parameters and ASL-related blood flow parameters.
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Key Words
- 3DpCASL, three-dimensional quasi-continuous arterial spin labeling
- ADC, apparent diffusion coefficient
- AUC, area under the curve
- Arterial spin labeling
- BFavg, average of blood flow
- BFmax, maximum blood flow
- BFmin, minimum blood flow
- CR, complete remission
- CRT, chemoradiotherapy
- Chemoradiotherapy
- D*, pseudo-diffusion coefficient
- D, pure diffusion coefficient
- DCE-MRI, dynamic contrast-enhanced magnetic resonance imaging
- IVIM-DWI, intravoxel incoherent motion diffusion-weighted imaging
- Intravoxel incoherent motion diffusion-weighted imaging
- NPC, nasopharyngeal carcinoma
- Nasopharyngeal carcinoma
- PR, partial remission
- f, perfusion fraction
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Affiliation(s)
- Liping Liao
- Department of Radiology, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Clinical Medical Research Center of Imaging Medicine, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Key Clinical Specialties, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Medical University Cancer Hospital Superiority Cultivation Discipline, 71 Hedi Road, Nanning, Guangxi, People's Republic of China
| | - Teng Liu
- Department of Radiology, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Clinical Medical Research Center of Imaging Medicine, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Key Clinical Specialties, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Medical University Cancer Hospital Superiority Cultivation Discipline, 71 Hedi Road, Nanning, Guangxi, People's Republic of China
| | - Bo Wei
- Department of Radiology, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Clinical Medical Research Center of Imaging Medicine, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Key Clinical Specialties, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Department of Radiology, Guangxi Medical University Cancer Hospital Superiority Cultivation Discipline, 71 Hedi Road, Nanning, Guangxi, People's Republic of China,Corresponding author at: Department of Radiology, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning, Guangxi, People's Republic of China.
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4
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Romeo V, Stanzione A, Ugga L, Cuocolo R, Cocozza S, Quarantelli M, Chawla S, Farina D, Golay X, Parker G, Shukla-Dave A, Thoeny H, Vidiri A, Brunetti A, Surlan-Popovic K, Bisdas S. Clinical indications and acquisition protocol for the use of dynamic contrast-enhanced MRI in head and neck cancer squamous cell carcinoma: recommendations from an expert panel. Insights Imaging 2022; 13:198. [PMID: 36528678 PMCID: PMC9759606 DOI: 10.1186/s13244-022-01317-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The clinical role of perfusion-weighted MRI (PWI) in head and neck squamous cell carcinoma (HNSCC) remains to be defined. The aim of this study was to provide evidence-based recommendations for the use of PWI sequence in HNSCC with regard to clinical indications and acquisition parameters. METHODS Public databases were searched, and selected papers evaluated applying the Oxford criteria 2011. A questionnaire was prepared including statements on clinical indications of PWI as well as its acquisition technique and submitted to selected panelists who worked in anonymity using a modified Delphi approach. Each panelist was asked to rate each statement using a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree). Statements with scores equal or inferior to 5 assigned by at least two panelists were revised and re-submitted for the subsequent Delphi round to reach a final consensus. RESULTS Two Delphi rounds were conducted. The final questionnaire consisted of 6 statements on clinical indications of PWI and 9 statements on the acquisition technique of PWI. Four of 19 (21%) statements obtained scores equal or inferior to 5 by two panelists, all dealing with clinical indications. The Delphi process was considered concluded as reasons entered by panelists for lower scores were mainly related to the lack of robust evidence, so that no further modifications were suggested. CONCLUSIONS Evidence-based recommendations on the use of PWI have been provided by an independent panel of experts worldwide, encouraging a standardized use of PWI across university and research centers to produce more robust evidence.
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Affiliation(s)
- Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Renato Cuocolo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.,Interdepartmental Research Center on Management and Innovation in Healthcare - CIRMIS, University of Naples Federico II, Naples, Italy
| | - Sirio Cocozza
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Mario Quarantelli
- Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
| | - Sanjeev Chawla
- Department of Radiology, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA
| | - Davide Farina
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Xavier Golay
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK.,Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Trust, London, UK
| | - Geoff Parker
- Department of Computer Science, Centre for Medical Image Computing, Queen Square Institute of Neurology, University College London, London, UK
| | - Amita Shukla-Dave
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Departments of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Harriet Thoeny
- Department of Radiology, Cantonal Hospital Fribourg, University of Fribourg, Fribourg, Switzerland
| | - Antonello Vidiri
- Department of Radiology and Diagnostic Imaging, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | | | - Sotirios Bisdas
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK. .,Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Trust, London, UK.
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Abdel Razek AAK, Baky KA, Helmy E. Diffusion Tensor Imaging in Characterization of Mediastinal Lymphadenopathy. Acad Radiol 2022; 29 Suppl 2:S165-S172. [PMID: 34736860 DOI: 10.1016/j.acra.2021.06.016] [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: 05/19/2021] [Revised: 06/20/2021] [Accepted: 06/28/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the efficacy of diffusion-weighted MRI (DWI) and diffusion tensor imaging (DTI) in the characterization of mediastinal lymphadenopathy and the differentiation between malignant and benign lymph nodes (LNs). METHODS a retrospective evaluation of 58 patients with mediastinal lymphadenopathy that underwent DWI and DTI with calculation of apparent diffusion coefficient (ADC), fractional anisotropy (FA), and mean diffusivity (MD) values of LNs. Final diagnosis was made by the histopathology and proved metastatic (n = 21), lymphomatous (n = 14), granulomatous (n = 11) and reactive (n = 12) LNs. RESULTS Malignant mediastinal LNs had remarkably lower ADC and MD; (p = 0.001) and higher FA; (p = 0.001) than in benign LNs. The threshold of ADC, MD, and FA at (1.48, 1.32 × 10-3 mm2/s), (1.31, 1.33 × 10-3 mm2/s), (0.62, 0.52) to differentiate malignant from benign LNs has AUC of (0.89, 0.94), (0.96, 0.95), (0.72, 0.82), accuracy of (87%, 86%), (89%, 86%), (70%, 72%) by both observers respectively. The threshold of ADC, MD, and FA at (1.47, 1.32 × 10-3 mm2/s), (1.31, 1.3 × 10-3 mm2/s), (0.62, 0.67) used to differentiate metastatic from reactive LNs revealed AUC of (0.90, 0.94), (0.96, 0.96), (0.73, 0.77), accuracy of (87%, 81%), (87%, 81%), (72%, 66%) by both observers respectively. The mean ADC and MD values of metastatic LNs were statistically significant (p = 0.001) and (p = 0.002, 0.02) respectively when compared with that of lymphoma. The threshold of ADC, and MD (0.94, 0.97 × 10-3 mm2/s) and (0.87, 0.91 × 10-3 mm2/s) used to differentiates metastatic from lymphomatous nodes revealed AUC of (0.90, 0.91), (0.81, 0.74), an accuracy of (85%, 91%), (71%, 71%), by both observers respectively. The inter-class correlation between two observers for all nodes for ADC, MD and FA was r= 0.931, 0.956 and 0.885 respectively. CONCLUSION Using ADC, MD, and FA can help in the characterization of mediastinal lymphadenopathy noninvasively.
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Affiliation(s)
| | - Khaled Abdel Baky
- Department of Diagnostic Radiology. Port Said University. Faculty of medicine. Port Said. Egypt
| | - Eman Helmy
- Department of Diagnostic Radiology. Mansoura University. faculty of medicine. Mansoura, Egypt
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Abdel Razek AAK, Elsebaie NA, Gamaleldin OA, AbdelKhalek A, Mukherji SK. Role of MR Imaging in Head and Neck Squamous Cell Carcinoma. Magn Reson Imaging Clin N Am 2021; 30:1-18. [PMID: 34802573 DOI: 10.1016/j.mric.2021.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Routine and advanced MR imaging sequences are used for locoregional spread, nodal, and distant staging of head and neck squamous cell carcinoma, aids treatment planning, predicts treatment response, differentiates recurrence for postradiation changes, and monitors patients after chemoradiotherapy.
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Affiliation(s)
| | - Nermeen A Elsebaie
- Department of Radiology, Alexandria Faculty of Medicine, Champollion Street, El-Khartoum Square, El Azareeta Medical Campus, Alexandria 21131, Egypt
| | - Omneya A Gamaleldin
- Department of Radiology, Alexandria Faculty of Medicine, Champollion Street, El-Khartoum Square, El Azareeta Medical Campus, Alexandria 21131, Egypt
| | - Amro AbdelKhalek
- Internship at Mansoura University Hospital, Mansoura Faculty of Medicine, 60 Elgomheryia Street, Mansoura 35512, Egypt
| | - Suresh K Mukherji
- Marian University, Head and Neck Radiology, ProScan Imaging, Carmel, IN, USA.
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7
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Posttreatment Magnetic Resonance Imaging Surveillance of Head and Neck Cancers. Magn Reson Imaging Clin N Am 2021; 30:109-120. [PMID: 34802574 DOI: 10.1016/j.mric.2021.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Treatment strategies and recommended surveillance imaging differ for head and neck cancers depending on subsite and neoplasm type, and pose confusion for referring physicians and interpreting radiologists. The superior soft tissue resolution offered by magnetic resonance imaging is most useful in the surveillance of cancers with high propensities for intraorbital, intracranial, or perineural disease spread, which most commonly include those arising from the sinonasal cavities, nasopharynx, orbits, salivary glands, and the skin. This article discusses recommended surveillance protocoling and reviews treatment approaches, common posttreatment changes, and pearls for identifying disease recurrence in a subsite-based approach.
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Abstract
Artificial intelligence (AI) algorithms, particularly deep learning, have developed to the point that they can be applied in image recognition tasks. The use of AI in medical imaging can guide radiologists to more accurate image interpretation and diagnosis in radiology. The software will provide data that we cannot extract from the images. The rapid development in computational capabilities supports the wide applications of AI in a range of cancers. Among those are its widespread applications in head and neck cancer.
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Wang DJJ, Le Bihan D, Krishnamurthy R, Smith M, Ho ML. Noncontrast Pediatric Brain Perfusion: Arterial Spin Labeling and Intravoxel Incoherent Motion. Magn Reson Imaging Clin N Am 2021; 29:493-513. [PMID: 34717841 DOI: 10.1016/j.mric.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Noncontrast magnetic resonance imaging techniques for measuring brain perfusion include arterial spin labeling (ASL) and intravoxel incoherent motion (IVIM). These techniques provide noninvasive and repeatable assessment of cerebral blood flow or cerebral blood volume without the need for intravenous contrast. This article discusses the technical aspects of ASL and IVIM with a focus on normal physiologic variations, technical parameters, and artifacts. Multiple pediatric clinical applications are presented, including tumors, stroke, vasculopathy, vascular malformations, epilepsy, migraine, trauma, and inflammation.
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Affiliation(s)
- Danny J J Wang
- USC Institute for Neuroimaging and Informatics, SHN, 2025 Zonal Avenue, Health Sciences Campus, Los Angeles, CA 90033, USA
| | - Denis Le Bihan
- NeuroSpin, Centre d'études de Saclay, Bâtiment 145, Gif-sur-Yvette 91191, France
| | - Ram Krishnamurthy
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mark Smith
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA.
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Martín-Noguerol T, Kirsch CFE, Montesinos P, Luna A. Arterial spin labeling for head and neck lesion assessment: technical adjustments and clinical applications. Neuroradiology 2021; 63:1969-1983. [PMID: 34427708 DOI: 10.1007/s00234-021-02772-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/12/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Despite, currently, "state-of-the-art" magnetic resonance imaging (MRI) protocols for head and neck (H&N) lesion assessment incorporate perfusion sequences, these acquisitions require the intravenous injection of exogenous gadolinium-based contrast agents (GBCAs), which may have potential risks. Alternative techniques such as arterial spin labeling (ASL) can provide quantitative microvascular information similar to conventional perfusion sequences for H&N lesions evaluation, as a potential alternative without GBCA administration. METHODS We review the existing literature and analyze the latest evidence regarding ASL in H&N area highlighting the technical adjustments needed for a proper ASL acquisition in this challenging region for lesion characterization, treatment monitoring, and tumor recurrence detection. RESULTS ASL techniques, widely used for central nervous system lesions evaluation, can be also applied to the H&N region. Technical adjustments, especially regarding post-labeling delay, are mandatory to obtain robust and reproducible results. Several studies have demonstrated the feasibility of ASL in the H&N area including the orbits, skull base, paranasal sinuses, upper airway, salivary glands, and thyroid. CONCLUSION ASL is a feasible technique for the assessment of H&N lesions without the need of GBCAs. This manuscript reviews ASL's physical basis, emphasizing the technical adjustments necessary for proper ASL acquisition in this unique and challenging anatomical region, and the main applications in evaluating H&N lesions.
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Affiliation(s)
| | - Claudia F E Kirsch
- Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine At Northwell, North Shore University Hospital, 300 Community Drive, Manhasset, NY, 11030, USA
| | - Paula Montesinos
- Philips Iberia, Calle de María de Portugal, 1, 28050, Madrid, Spain
| | - Antonio Luna
- MRI Unit, Radiology Department, HT Medica, Carmelo Torres 2, 23007, Jaén, Spain
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Cao X, Song J, Xu J, Gong G, Yang X, Su Y, Wang L, Bai X, Hu M, Yin Y. Tumor Blood Flow Is a Predictor of Radiotherapy Response in Patients With Nasopharyngeal Carcinoma. Front Oncol 2021; 11:567954. [PMID: 34422622 PMCID: PMC8377414 DOI: 10.3389/fonc.2021.567954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 06/10/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of this study was to evaluate tumor blood flow (TBF) as a predictor of radiotherapy response for nasopharyngeal carcinoma (NPC). Materials and Method A total of 134 patients were divided into two groups, the complete response (CR) group and the partial response (PR) group based on RECIST 1.1 recommendations. The statistical difference was evaluated for pre- and mid- or post-treatment TBF and changes of TBF for tumors and metastatic lymph nodes between CR and PR, respectively. The receiver operation characteristic (ROC) curve was utilized to evaluate the accuracy of TBF in predicting the response of radiation therapy. The association between TBF and SUVmax was also investigated. Results The reduction of TBF in CR was significantly lower than that in PR for primary tumors (P <0.001) and metastatic lymph nodes (P <0.001). The multivariate logistic regression analysis indicated that the reduction of TBF is an independent predictor of the response of radiation therapy for primary tumors (P <0.001) and metastatic lymph nodes (P <0.001). The accuracy of TBF reduction in predicting the response of radiation therapy was 0.817 in primary tumors and 0.924 in metastatic lymph nodes, respectively. No significant correlation was observed between the TBF values and SUVmax of primary tumors (r = -0.008, P = 0.954) and metastasis lymph nodes (r = -0.061, P = 0.652). Conclusion This study suggests that the reduction of TBF is a promising parameter for evaluating the response of radiation therapy.
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Affiliation(s)
- Xiujuan Cao
- Department of Radiation Oncology, Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Jian Song
- Medical Imageology, Shandong Medical College, Jinan, China
| | - Juan Xu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Guanzhong Gong
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Xinhua Yang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Ya Su
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Lizhen Wang
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Xiaodong Bai
- Department of Plastic Surgery, Southern University of Science and Technology Hospital, Shenzhen, China
| | - Man Hu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Yong Yin
- Department of Radiation Oncology, Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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Ahn Y, Choi YJ, Sung YS, Pfeuffer J, Suh CH, Chung SR, Baek JH, Lee JH. Histogram analysis of arterial spin labeling perfusion data to determine the human papillomavirus status of oropharyngeal squamous cell carcinomas. Neuroradiology 2021; 63:1345-1352. [PMID: 34185105 DOI: 10.1007/s00234-021-02751-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the correlation between histogram parameters derived from pseudo-continuous arterial spin labeling (PCASL) and human papillomavirus (HPV) status in patients with oropharyngeal squamous cell carcinoma (OPSCC). METHODS This study included a total of 58 patients (HPV-positive: n = 45; -negative: n = 13) from a prospective cohort of consecutive patients aged ≥ 18 years, who were newly diagnosed with oropharyngeal squamous cell carcinoma. All patients were required to have undergone pre-treatment MRI with PCASL to measure regional perfusion. The region of interest was drawn by two radiologists, encompassing the entire tumor volume on all corresponding slices. Differences in the histogram parameters derived from tumor blood flow (TBF) in ASL were assessed for HPV-positive and -negative patients. Receiver operating characteristic curve analysis was performed to determine the best differentiating parameters, and a leave-one-out cross-validation was used. RESULTS Patients with HPV-positive OPSCC showed a significantly lower overall standard deviation and 95th percentile value of tumor blood flow (P < .007). The standard deviation of TBF was the single best predictive parameter. Leave-one-out cross-validation tests revealed that the area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity were 0.745, 75.9%, 75.6%, and 76.9%, respectively. CONCLUSION PCASL revealed differences in perfusion parameters according to HPV status in patients with OPSCC, reflecting their distinct histopathology.
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Affiliation(s)
- Yura Ahn
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
| | - Yu Sub Sung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Josef Pfeuffer
- Siemens Healthcare, MR Application Development, Erlangen, Germany
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Sae Rom Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
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Razek AAKA, El-Diasty T, Elhendy A, Fahmy D, El-Adalany MA. Prostate Imaging Reporting and Data System (PI-RADS): What the radiologists need to know? Clin Imaging 2021; 79:183-200. [PMID: 34098371 DOI: 10.1016/j.clinimag.2021.05.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 01/14/2023]
Abstract
We aim to review the new modifications in MR imaging technique, image interpretation, lexicon, and scoring system of the last version of Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) in a simple and practical way. This last version of PI-RADS v2.1 describes the new technical modifications in the protocol of Multiparametric MRI (MpMRI) including T2, diffusion-weighted imaging (DWI), and dynamic contrast enhancement (DCE) parameters. It includes also; new guidelines in the image interpretation specifications in new locations (lesions located in the central zone and anterior fibromuscular stroma), clarification of T2 scoring of lesions of the transition zone, the distinction between DWI score 2 and 3 lesions in the transition zone and peripheral zone, as well as between positive and negative enhancement in DCE. Biparametric MRI (BpMRI) along with simplified PI-RADS is gaining more acceptances in the assessment of clinically significant prostatic cancer.
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Affiliation(s)
| | - Tarek El-Diasty
- Department of Diagnostic Radiology, Mansoura Urology and Nephrology Center, Mansoura, Egypt
| | - Ahmed Elhendy
- Department of Diagnostic Radiology, Mansoura Urology and Nephrology Center, Mansoura, Egypt
| | - Dalia Fahmy
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
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Wu W, Jiang G, Xu Z, Wang R, Pan A, Gao M, Yu T, Huang L, Quan Q, Li J. Three-dimensional pulsed continuous arterial spin labeling and intravoxel incoherent motion imaging of nasopharyngeal carcinoma: correlations with Ki-67 proliferation status. Quant Imaging Med Surg 2021; 11:1394-1405. [PMID: 33816177 DOI: 10.21037/qims-20-349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Recurrence and distant metastasis are still the main problems affecting the long-term prognosis of nasopharyngeal carcinoma (NPC) patients, and may be related to the Ki-67 proliferation status. We therefore explored the potential correlation between Ki-67 proliferation status in NPC with the parameters derived from two imaging techniques: three-dimensional pulsed continuous arterial spin labeling (3D pCASL) and intravoxel incoherent motion (IVIM). Methods Thirty-six patients with pathologically confirmed NPC were included, and the Ki-67 labeling index (LI) was measured by immunohistochemistry. All patients underwent plain and contrast-enhanced magnetic resonance imaging (MRI), IVIM, and 3D pCASL examination. The mean, maximum, and minimum of blood flow (BF), minimum of apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) parameters were all measured, and Spearman's correlation analysis was performed to evaluate the relationships between these parameters and the Ki-67 LI. According to the Ki-67 values, the patients were divided into two groups: high (>50%) and low (≤50%). The rank-sum test (Mann-Whitney U test) was then used to compare the differences in quantitative parameters between the high and low Ki-67 groups. Results Ki-67 LI was positively correlated with BFmean and BFmax (r=0.415 and 0.425). D*mean and D*min did have positive correlation with Ki-67, but this was not significant (P=0.082 and 0.072). BFmax was significantly different between the high and low Ki-67 groups (P=0.028). Conclusions 3D pCASL and IVIM are noninvasive functional MR perfusion imaging techniques that can evaluate perfusion information and perfusion parameters. Our study suggests that 3D pCASL is more effective than IVIM for assessing the proliferation status of NPC, which is beneficial for evaluating the prognosis of patients. Furthermore, BFmax is the best biomarker for distinguishing high from low Ki-67 levels.
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Affiliation(s)
- Wenxiu Wu
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Zhifeng Xu
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Ruoning Wang
- Minimally Invasive Center, Tumor hospital, Sun Yat-Sen University, Guangzhou, China
| | - Aizhen Pan
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Mingyong Gao
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Tian Yu
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Linwen Huang
- Department of Radiology, The First People's Hospital of Foshan, Foshan, China
| | - Qiang Quan
- Nasopharyngeal Radiotherapy Department 2, The First People's Hospital of Foshan, Foshan, China
| | - Jin Li
- Pathology Department, The First People's Hospital of Foshan, Foshan, China
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Ren J, Qi M, Yuan Y, Tao X. Radiomics of apparent diffusion coefficient maps to predict histologic grade in squamous cell carcinoma of the oral tongue and floor of mouth: a preliminary study. Acta Radiol 2021; 62:453-461. [PMID: 32536260 DOI: 10.1177/0284185120931683] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Histologic grade assessment plays an important part in the clinical decision making and prognostic evaluation of squamous cell carcinoma (SCC) of the oral tongue and floor of mouth (FOM). PURPOSE To assess the value of apparent diffusion coefficient (ADC)-based radiomics in discriminating between low- and high-grade SCC of the oral tongue and FOM. MATERIAL AND METHODS We included data from 88 patients (training cohort: n = 59; testing cohort: n = 29) who underwent diffusion-weighted imaging with a 3.0-T magnetic resonance imaging scanner before treatment. A total of 526 radiomics features were extracted from ADC maps to construct a radiomics signature with least absolute shrinkage and selection operator logistic regression. Receiver operating characteristic curves and areas under the curve (AUCs) were used to evaluate the performance of radiomic signature. RESULTS Five features were selected to construct the radiomics signature for predicting histologic grade. The ADC-based radiomics signature performed well for discriminating between low- and high-grade tumors, with AUCs of 0.83 in both cohorts. Based on the cut-off value of the training cohort, the radiomics signature achieved accuracies of 0.78 and 0.79, sensitivities of 0.65 and 0.71, and specificities of 0.85 and 0.82 in the training and testing cohorts, respectively. CONCLUSION ADC-based radiomics can be a useful and promising non-invasive method for predicting histologic grade of SCC of the oral tongue and FOM.
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Affiliation(s)
- Jiliang Ren
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Meng Qi
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, PR China
| | - Ying Yuan
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
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Xiao B, Wang P, Zhao Y, Liu Y, Ye Z. Using arterial spin labeling blood flow and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma from lymphoid hyperplasia. Medicine (Baltimore) 2021; 100:e24955. [PMID: 33663135 PMCID: PMC7909173 DOI: 10.1097/md.0000000000024955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 02/04/2021] [Indexed: 01/05/2023] Open
Abstract
To investigate the feasibility of arterial spin labeling (ASL) blood flow (BF) and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPLH).Sixty-three stage T1 NPC patients and benign NPLH patients underwent ASL on a 3.0-T magnetic resonance imaging system. BF histogram parameters were derived automatically, including the mean, median, maximum, minimum, kurtosis, skewness, and variance. Absolute values were obtained for skewness and kurtosis (absolute value of skewness [AVS] and absolute value of kurtosis [AVK], respectively). The Mann-Whitney U test, receiver operating characteristic curve, and multiple logistic regression models were used for statistical analysis.The mean, maximum, and variance of ASL BF values were significantly higher in early-stage NPC than in NPLH (all P < 0.0001), while the median and AVK values of early-stage NPC were also significantly higher than those of NPLH (all P < 0.001). No significant difference was found between the minimum and AVS values in early-stage NPC compared with NPLH (P = 0.125 and P = 0.084, respectively). The area under the curve (AUC) of the maximum was significantly higher than those of the mean and median (P < 0.05). The AUC of variance was significantly higher than those of the other parameters (all P < 0.05). Multivariate analysis showed that variance was the only independent predictor of outcome (P < 0.05).ASL BF and its histogram analysis could distinguish early-stage NPC from NPLH, and the variance value was a unique independent predictor.
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Affiliation(s)
| | - Peiguo Wang
- Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
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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.
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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
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Wang H, Sun J, Li J, Li H, Wang Y, Wang Z. Ocular Blood Flow Measurements in Diabetic Retinopathy Using 3D Pseudocontinuous Arterial Spin Labeling. J Magn Reson Imaging 2020; 53:791-798. [PMID: 33140547 DOI: 10.1002/jmri.27398] [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: 08/03/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Distinguishing between the two broad categories of diabetic retinopathy (DR), nonproliferative DR (NPDR) and proliferative DR (PDR), is significant, as the therapeutic strategies for each are completely different. PURPOSE To characterize the ocular blood flow (OBF) of DR patients and evaluate the potential utility of OBF values in categorizing DR. STUDY TYPE Prospective. SUBJECTS A total of 41 DR patients (82 eyes) were recruited in our study. Group 1 comprised 48 eyes with NPDR, and Group 2 comprised 34 eyes with PDR. FIELD STRENGTH/SEQUENCE 3D pseudocontinuous arterial spin labeling (3D-pcASL) with two postlabeling delays (PLDs) was acquired at 3.0T MR. ASSESSMENT OBF values were independently obtained by two doctors from the OBF map. STATISTICAL TESTS OBF values and clinical characteristics were compared between the groups using two-sample t-tests and chi-square tests. Receiver operating characteristic (ROC) curves were obtained, and the area under the curve (AUC) was calculated. The consistency of OBF values reported by the two doctors was evaluated using the intraclass correlation coefficient (ICC). RESULTS OBF values at PLDs of 1.5 seconds and 2.5 seconds were significantly lower in Group 2 than in Group 1 (P < 0.05 for both PLDs). The OBF values of Group 2 showed a greater increase than those of Group 1 from PLD 1.5 to 2.5 seconds. The AUC of OBF at the 1.5 seconds PLD was 0.90, with a cutoff of 7.73 mL/min/100 g, and the AUC of the OBF at the 2.5 seconds PLD was 0.75, with a cutoff of 8.44 mL/min/100 g. The ICC between the two observers was 0.844 for the OBF at 1.5 seconds PLD and 0.872 for the OBF at 2.5 seconds PLD. DATA CONCLUSION PDR can be differentiated from NPDR by the value of OBF as measured by 3D-pcASL. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Huihui Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jiao Sun
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hongyang Li
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yanling Wang
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Peripheral Nerve Sheath Tumors of Head and Neck: Imaging-Based Review of World Health Organization Classification. J Comput Assist Tomogr 2020; 44:928-940. [DOI: 10.1097/rct.0000000000001109] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Paterson C, Hargreaves S, Rumley CN. Functional Imaging to Predict Treatment Response in Head and Neck Cancer: How Close are We to Biologically Adaptive Radiotherapy? Clin Oncol (R Coll Radiol) 2020; 32:861-873. [PMID: 33127234 DOI: 10.1016/j.clon.2020.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/28/2020] [Accepted: 10/05/2020] [Indexed: 02/07/2023]
Abstract
It is increasingly recognised that head and neck cancer represents a spectrum of disease with a differential response to standard treatments. Although prognostic factors are well established, they do not reliably predict response. The ability to predict response early during radiotherapy would allow adaptation of treatment: intensifying treatment for those not responding adequately or de-intensifying remaining therapy for those likely to achieve a complete response. Functional imaging offers such an opportunity. Changes in parameters obtained with functional magnetic resonance imaging or positron emission tomography-computed tomography during treatment have been found to be predictive of disease control in head and neck cancer. Although many questions remain unanswered regarding the optimal implementation of these techniques, current, maturing and future studies may provide the much-needed homogeneous cohorts with larger sample sizes and external validation of parameters. With a stepwise and collaborative approach, we may be able to develop imaging biomarkers that allow us to deliver personalised, biologically adaptive radiotherapy for head and neck cancer.
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Affiliation(s)
- C Paterson
- Beatson West of Scotland Cancer Centre, Glasgow, UK.
| | | | - C N Rumley
- Department of Radiation Oncology, Townsville University Hospital, Douglas, Australia; South Western Clinical School, University of New South Wales, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia
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Multi-parametric arterial spin labeling and diffusion-weighted imaging in differentiation of metastatic from reactive lymph nodes in head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 2020; 278:2529-2535. [DOI: 10.1007/s00405-020-06390-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 09/20/2020] [Indexed: 12/19/2022]
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Combination of diffusion-weighted imaging and arterial spin labeling at 3.0 T for the clinical staging of nasopharyngeal carcinoma. Clin Imaging 2020; 66:127-132. [PMID: 32480267 DOI: 10.1016/j.clinimag.2020.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 04/27/2020] [Accepted: 05/13/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE To probe the utility of diffusion-weighted imaging (DWI) and 3D arterial spin labeling (ASL) in assessing the clinical stage of nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS This prospective study included sixty-five newly diagnosed NPC patients who underwent DWI and 3D ASL scans on a 3.0-T magnetic resonance imaging (MRI) system. The apparent diffusion coefficient (ADC) and the tumor blood flow (TBF) of NPC were measured. Tumors were classified as low or high T, N and American Joint Committee on Cancer (AJCC) stages. Student's t-test was used to evaluate the differences between tumors with low and high clinical stages. Pearson correlation analyses were performed to determine the correlation between MRI parameters and clinical stages. Receiver operating characteristic (ROC) curves were then used to evaluate diagnostic capability. RESULTS High T stage (T3/4) NPC showed significantly lower ADCmin (P = 0.000) and higher TBFmax (P = 0.003) and TBFmean (P = 0.008) values than low T stage (T1/2) NPC. High N stage (N2/3) NPC showed significantly lower ADCmin values (P = 0.023) than low N stage (N0/1) NPC. High AJCC stage (III/IV) NPC showed significantly lower ADCmin (P = 0.000) and higher TBFmax (P = 0.005) and TBFmean (P = 0.011) values than low AJCC stage (I/II) NPC. ADCmin values showed moderate negative correlations with T stage (r = -0.512, P = 0.000), N stage (r = -0.281, P = 0.023), and AJCC stage (r = -0.494, P = 0.000). TBFmax values showed moderate positive correlations with T stage (r = 0.369, P = 0.003) and AJCC stage (r = 0.346, P = 0.005). Compared with ADCmin and TBFmax alone, the combination of ADCmin and TBFmax improved the accuracy from 72.3% and 75.4% to 78.5%, respectively, for T staging, as well as from 72.3% and 69.2% to 83.1% for AJCC staging. CONCLUSIONS ADCmin and TBFmax values in patients with NPC could help evaluate clinical stages. ADCmin and TBFmax values combined could clearly improve the accuracy in the assessment of AJCC stage.
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Neck Imaging Reporting and Data System: What Does Radiologist Want to Know? J Comput Assist Tomogr 2020; 44:527-532. [DOI: 10.1097/rct.0000000000001032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vidiri A, Panfili M, Boellis A, Cristalli G, Gangemi E, Pellini R, Marzi S, Covello R. The role of MRI-derived depth of invasion in staging oral tongue squamous cell carcinoma: inter-reader and radiological-pathological agreement. Acta Radiol 2020; 61:344-352. [PMID: 31319692 DOI: 10.1177/0284185119862946] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background The 8th edition of tumor, node, metastasis (TNM) classification incorporates depth of invasion evaluation in the staging of oral cavity squamous cell carcinoma, since it is a predictor of nodal metastasis and an independent prognostic factor. Although the histopathological definition of depth of invasion is clear, an accurate method for its radiological assessment has not yet been validated. Purpose To investigate the role of MRI-derived depth of invasion evaluation in staging oral tongue squamous cell carcinoma and to assess the inter-reader agreement and the radiological–pathological correlation. Material and Methods We retrospectively reviewed 43 patients with oral tongue squamous cell carcinoma who underwent preoperative MRI. The MRI-derived depth of invasion was measured by two radiologists, each with a different degree of experience in head and neck imaging. The pathological depth of invasion was recorded from histopathological reports. The inter-reader and the radiological–histopathological correlations for the depth of invasion were evaluated with Bland–Altman plots, the intraclass correlation coefficients (ICC), and the paired samples test; agreements for T staging were assessed using the Kappa coefficient. Results Inter-reader reliability was excellent for the MRI-derived depth of invasion (ICC = 0.91), very good between MRI-derived depth of invasion and pathological depth of invasion (ICC = 0.89 for the experienced reader, 0.86 for the inexperienced reader). Both readers reached a good agreement regarding T staging (kappa value = 0.70). Furthermore, the agreement between radiological and pathological T staging was good (kappa value = 0.74 for the experienced reader, 0.60 for the inexperienced reader). Conclusion MRI-derived depth of invasion should be measured in the pretreatment assessment of oral tongue squamous cell carcinoma as it has an excellent inter-reader reliability and nearly excellent radiological–pathological correlation.
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Affiliation(s)
- Antonello Vidiri
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Marco Panfili
- Department of Radiological Science, Radiotherapy and Hematology, Institute of Radiology, Fondazione Policlinico A. Gemelli IRCCS – Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Boellis
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giovanni Cristalli
- Department of Otolaryngology & Head and Neck Surgery, Regina Elena National Cancer Institute, Rome, Italy
| | - Emma Gangemi
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Raul Pellini
- Department of Otolaryngology & Head and Neck Surgery, Regina Elena National Cancer Institute, Rome, Italy
| | - Simona Marzi
- Medical Physics Laboratory, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Renato Covello
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Multi-parametric arterial spin labelling and diffusion-weighted magnetic resonance imaging in differentiation of grade II and grade III gliomas. Pol J Radiol 2020; 85:e110-e117. [PMID: 32467745 PMCID: PMC7247019 DOI: 10.5114/pjr.2020.93397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/20/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose To assess arterial spin labelling (ASL) perfusion and diffusion MR imaging (DWI) in the differentiation of grade II from grade III gliomas. Material and methods A prospective cohort study was done on 36 patients (20 male and 16 female) with diffuse gliomas, who underwent ASL and DWI. Diffuse gliomas were classified into grade II and grade III. Calculation of tumoural blood flow (TBF) and apparent diffusion coefficient (ADC) of the tumoral and peritumoural regions was made. The ROC curve was drawn to differentiate grade II from grade III gliomas. Results There was a significant difference in TBF of tumoural and peritumoural regions of grade II and III gliomas (p = 0.02 and p =0.001, respectively). Selection of 26.1 and 14.8 ml/100 g/min as the cut-off for TBF of tumoural and peritumoural regions differentiated between both groups with area under curve (AUC) of 0.69 and 0.957, and accuracy of 77.8% and 88.9%, respectively. There was small but significant difference in the ADC of tumoural and peritumoural regions between grade II and III gliomas (p = 0.02 for both). The selection of 1.06 and 1.36 × 10-3 mm2/s as the cut-off of ADC of tumoural and peritumoural regions was made, to differentiate grade II from III with AUC of 0.701 and 0.748, and accuracy of 80.6% and 80.6%, respectively. Combined TBF and ADC of tumoural regions revealed an AUC of 0.808 and accuracy of 72.7%. Combined TBF and ADC for peritumoural regions revealed an AUC of 0.96 and accuracy of 94.4%. Conclusion TBF and ADC of tumoural and peritumoural regions are accurate non-invasive methods of differentiation of grade II from grade III gliomas.
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Razek AAKA. Multi-parametric MR imaging using pseudo-continuous arterial-spin labeling and diffusion-weighted MR imaging in differentiating subtypes of parotid tumors. Magn Reson Imaging 2019; 63:55-59. [DOI: 10.1016/j.mri.2019.08.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/05/2019] [Accepted: 08/15/2019] [Indexed: 12/26/2022]
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Wu W, Ye J, Wang Q, Luo J, Xu S. CT-Based Radiomics Signature for the Preoperative Discrimination Between Head and Neck Squamous Cell Carcinoma Grades. Front Oncol 2019; 9:821. [PMID: 31544063 PMCID: PMC6729100 DOI: 10.3389/fonc.2019.00821] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/09/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Radiomics has been widely used to non-invasively mine quantitative information from medical images and could potentially predict tumor phenotypes. Pathologic grade is considered a predictive prognostic factor for head and neck squamous cell carcinoma (HNSCC) patients. A preoperative histological assessment can be important in the clinical management of patients. We applied radiomics analysis to devise non-invasive biomarkers and accurately differentiate between well-differentiated (WD) and moderately differentiated (MD) and poorly differentiated (PD) HNSCC. Methods: This study involved 206 consecutive HNSCC patients (training cohort: n = 137; testing cohort: n = 69). In total, we extracted 670 radiomics features from contrast-enhanced computed tomography (CT) images. Radiomics signatures were constructed with a kernel principal component analysis (KPCA), random forest classifier and a variance-threshold (VT) selection. The associations between the radiomics signatures and HNSCC histological grades were investigated. A clinical model and combined model were also constructed. Areas under the receiver operating characteristic curves (AUCs) were applied to evaluate the performances of the three models. Results: In total, 670 features were selected by the KPCA and random forest methods from the CT images. The radiomics signatures had a good performance in discriminating between the two cohorts of HNSCC grades, with an AUC of 0.96 and an accuracy of 0.92. The specificity, accuracy, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of the abovementioned method with a VT selection for determining HNSCC grades were 0.83, 0.92, 0.96, 0.94, and 0.91, respectively; without VT, the corresponding results were 0.70, 0.83, 0.88, 0.80, and 0.84. The differences in accuracy, sensitivity and NPV were significant between these approaches (p < 0.05). The AUCs with VT and without VT were 0.96 and 0.89, respectively (p < 0.05). Compared to the combined model and the radiomics signatures, The clinical model had a worse performance, and the differences were significant (p < 0.05). The combined model had the best performance, but the difference between the combined model and the radiomics signature weren't significant (p > 0.05). Conclusions: The CT-based radiomics signature could discriminate between WD and MD and PD HNSCC and might serve as a biomarker for preoperative grading.
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Affiliation(s)
- Wenli Wu
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Junyong Ye
- Key Laboratory of Optoelectronic Technology and Systems of the Ministry of Education, Chongqing University, Chongqing, China
| | - Qi Wang
- Department of Information, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jin Luo
- Key Laboratory of Optoelectronic Technology and Systems of the Ministry of Education, Chongqing University, Chongqing, China
| | - Shengsheng Xu
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
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Abdel Razek AK, Elkhamary S, Nada N. Correlation of apparent diffusion coefficient with histopathological parameters of salivary gland cancer. Int J Oral Maxillofac Surg 2019; 48:995-1000. [DOI: 10.1016/j.ijom.2019.03.897] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/31/2019] [Accepted: 03/18/2019] [Indexed: 12/18/2022]
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Application of a 3D pseudocontinuous arterial spin-labeled perfusion MRI scan combined with a postlabeling delay value in the diagnosis of neonatal hypoxic-ischemic encephalopathy. PLoS One 2019; 14:e0219284. [PMID: 31283776 PMCID: PMC6613698 DOI: 10.1371/journal.pone.0219284] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 06/20/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Currently, there are many studies on the application of the 3D pseudocontinuous arterial spin-labeled (3D-pcASL) perfusion MRI technique for adult brain examinations, but few studies exist on the application of the technique for child brain examinations. PURPOSE To explore the application of a 3D-pcASL perfusion MRI scan combined with postlabeling delay (PLD) for assessing neonatal hypoxic-ischemic encephalopathy (HIE). MATERIALS AND METHODS Two-hundred neonates diagnosed with neonatal HIE were equally divided into five groups (40/group): 0- to <24-hour-old HIE group, 1- to <3-day-old HIE group, 3- to <7-day-old HIE group, 7- to <15-day-old HIE group and 15- to 28-day-old HIE group; 200 healthy neonates were equivalently divided. All 10 groups received a conventional and a 3D-pcASL perfusion MRI scan. For groups <3 days old, PLD values for the 3D-pcASL cerebral perfusion MRI scan were preset at 1025 ms; in all other groups, PLD values were preset at 1525 ms. CBF values for the 3D-pcASL cerebral perfusion MRI were compared between the HIE and corresponding control groups to determine the distinguishing characteristics of CBF values in HIE neonates. RESULTS On the 3D-pcASL cerebral perfusion MRI scan, in the 1- to <3-day-old groups, HIE neonate CBF values were higher than those of controls in all brain regions (excluding the frontal lobe); in the 0- to <24-hour-old and 3- to <7-day-old groups, HIE neonate CBF values were lower than those of corresponding controls in all brain regions; in the 7- to <15-day-old and 15- to 28-day-old groups, there were no significant differences in the CBF values between groups in any brain regions. CONCLUSIONS The 3D-pcASL perfusion MRI scan combined with a PLD can assist in the early diagnosis of neonatal HIE, as this method more comprehensively reflects the HIE pathological process.
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Differentiating Glioblastomas from Solitary Brain Metastases Using Arterial Spin Labeling Perfusion− and Diffusion Tensor Imaging−Derived Metrics. World Neurosurg 2019; 127:e593-e598. [DOI: 10.1016/j.wneu.2019.03.213] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 12/20/2022]
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Razek A, Samir S. Differentiation malignant from benign pericardial effusion with diffusion-weighted MRI. Clin Radiol 2019; 74:325.e19-325.e24. [DOI: 10.1016/j.crad.2019.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 01/08/2019] [Indexed: 12/12/2022]
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Application of Postlabeling Delay Time in 3-Dimensional Pseudocontinuous Arterial Spin-Labeled Perfusion Imaging in Normal Children. J Comput Assist Tomogr 2019; 43:697-707. [DOI: 10.1097/rct.0000000000000911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Abdel Razek AAK. Diffusion tensor imaging in differentiation of residual head and neck squamous cell carcinoma from post-radiation changes. Magn Reson Imaging 2018; 54:84-89. [DOI: 10.1016/j.mri.2018.08.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 08/19/2018] [Accepted: 08/20/2018] [Indexed: 01/13/2023]
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Abdel Razek AAK, El-Serougy L, Abdelsalam M, Gaballa G, Talaat M. Differentiation of Primary Central Nervous System Lymphoma From Glioblastoma: Quantitative Analysis Using Arterial Spin Labeling and Diffusion Tensor Imaging. World Neurosurg 2018; 123:e303-e309. [PMID: 30502475 DOI: 10.1016/j.wneu.2018.11.155] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/16/2018] [Accepted: 11/18/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Differentiation of primary central nervous system lymphoma (PCNSL) from glioblastoma using arterial spin labeling perfusion and diffusion tensor imaging (DTI). METHODS We performed a prospective study of 31 patients with a provisional diagnosis of PCNSL and glioblastoma who underwent conventional magnetic resonance imaging, DTI, and arterial spin labeling of the brain. The tumor blood flow (TBF), mean diffusivity (MD) plus fractional anisotropy (FA) of the mass were measured. The final diagnosis was confirmed by pathological examination. RESULTS The TBF of PCNSL (26.41 ± 4.03 mL/100 g/minute) was significantly lower than that of glioblastoma (51.08 ± 3.9 mL/100 g/minute; P = 0.001). The TBF cutoff (35.73 mL/100 g/minute) used for differentiation showed area under the curve (AUC) of 0.93, accuracy of 95.2%, sensitivity of 91.7%, and specificity of 100%. The MD of PCNSL (0.87 ± 0.2X 10-3 mm2/second) was significantly lower than that of glioblastoma (0.87 ± 0.2 × 10-3 mm2/second; P = 0.01). The MD cutoff (0.935 × 10-3 mm2/second) used for differentiation showed an AUC of 0.73 and accuracy of 66.7% and a sensitivity of 75% and specificity of 55.6%. The FA of PCNSL (0.253 ± 0.05) was significantly greater than that of glioblastoma (0.135 ± 0.06; P = 0.001). The FA cutoff (0.185) used for differentiation revealed an AUC of 0.944 and accuracy of 85.7% and a sensitivity of 83.3% and specificity of 88.9%. The combined TBF, MD, and FA cutoffs revealed an AUC of 0.96 and accuracy of 95.5% and a sensitivity of 83.3% and specificity of 100%. CONCLUSION The noninvasive imaging parameters using TBF and DTI might help in differentiating PCNSL from glioblastoma.
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Affiliation(s)
| | - Lamiaa El-Serougy
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | | | - Gada Gaballa
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Mona Talaat
- Department of Diagnostic Radiology, Kafr Elsheak Faculty of Medicine, Kafr Elsheak, Egypt
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Diffusion tensor imaging of the optic disc in idiopathic intracranial hypertension. Neuroradiology 2018; 60:1159-1166. [DOI: 10.1007/s00234-018-2078-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 08/07/2018] [Indexed: 12/11/2022]
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