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Mahna A, Boulanger SM, Gatti AA, Alenabi T, Ku A, Hynes LM, Chopp-Hurley JN. Investigating the relationship between quantitative-based ultrasound and MRI estimations of rotator cuff fatty infiltration. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:343-352. [PMID: 38205651 DOI: 10.1002/jcu.23635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/19/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION Fatty infiltration (FI) of the rotator cuff has important clinical implications. Quantitatively estimating FI using ultrasound (US) has considerable benefits for assessing FI in a non-invasive, accessible manner. This research investigated whether FI of the supraspinatus (SS) and infraspinatus (IS), estimated using US was related to intramuscular fat fractions measured from magnetic resonance images (MRI). METHODS Data from 12 healthy young adult participants were used for analysis. US images of the SS and IS were captured using multiple transducer placement techniques from which echogenicity of the muscle region was quantified. Shoulder MRI were captured from which SS and IS were manually segmented and intramuscular fat fractions calculated. Six upper limb strength exertions were performed, resisted by a hand dynamometer. RESULTS IS and SS echogenicity explained a significant amount of variance in MRI fat fractions for certain body positions and transducer techniques. Echogenicity agreement was higher for IS than SS. Significant relationships were identified between strength exertions and both echogenicity and MRI muscle volume, but not MRI fat fraction. CONCLUSIONS This research provides preliminary evidence showing that quantitative-based US methods can be used to estimate MRI calculated fat fractions for the rotator cuff.
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Affiliation(s)
- Alexandra Mahna
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Stephen M Boulanger
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Anthony A Gatti
- Department of Radiology, Stanford University, Stanford, California, USA
- NeuralSeg Ltd., Hamilton, Ontario, Canada
| | - Talia Alenabi
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Austin Ku
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Loriann M Hynes
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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Peng L, Chen B, Yu E, Lin Y, Lin J, Zheng D, Fu Y, Chen Z, Zheng H, Zhan Z, Chen Y. The application value of LAVA-flex sequences in enhanced MRI scans of nasopharyngeal carcinoma: comparison with T1WI-IDEAL. Front Oncol 2024; 14:1320280. [PMID: 38420018 PMCID: PMC10899686 DOI: 10.3389/fonc.2024.1320280] [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: 10/12/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Magnetic resonance imaging (MRI) staging scans are critical for the diagnosis and treatment of patients with nasopharyngeal cancer (NPC). We aimed to evaluate the application value of LAVA-Flex and T1WI-IDEAL sequences in MRI staging scans. Methods Eighty-four newly diagnosed NPC patients underwent both LAVA-Flex and T1WI-IDEAL sequences during MRI examinations. Two radiologists independently scored the acquisitions of image quality, fat suppression quality, artifacts, vascular and nerve display. The obtained scores were compared using the Wilcoxon signed rank test. According to the signal intensity (SI) measurements, the uniformity of fat suppression, contrast between tumor lesions and subcutaneous fat tissue, and signal-to-noise ratio (SNR) were compared by the paired t-test. Results Compared to the T1WI-IDEAL sequence, LAVA-Flex exhibited fewer artifacts (P<0.05), better visualization of nerves and vessels (P<0.05), and performed superior in the fat contrast ratio of the primary lesion and metastatic lymph nodes (0.80 vs. 0.52, 0.81 vs. 0.56, separately, P<0.001). There was no statistically significant difference in overall image quality, tumor signal-to-noise ratio (SNR), muscle SNR, and the detection rate of lesions between the two sequences (P>0.05). T1WI-IDEAL was superior to LAVA-Flex in the evaluation of fat suppression uniformity (P<0.05). Discussion LAVA-Flex sequence provides satisfactory image quality and better visualization of nerves and vessels for NPC with shorter scanning times.
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Affiliation(s)
- Li Peng
- Department of Radiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China
| | - Bijuan Chen
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China
| | - Erhan Yu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Yifei Lin
- Department of Radiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China
| | - Jiahao Lin
- Department of Radiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China
| | - Dechun Zheng
- Department of Radiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China
| | - Yu Fu
- School of Basic Medical Sciences of Fujian Medical University, Fuzhou, Fujian, China
| | - Zhipeng Chen
- School of Basic Medical Sciences of Fujian Medical University, Fuzhou, Fujian, China
| | - Hanchen Zheng
- Department of Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China
| | - Zhouwei Zhan
- Department of Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China
| | - Yunbin Chen
- Department of Radiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China
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Zhang W, Ge Y, Liu Y, Yuan Y, Geng J, Zhou F, Huang P, Shi J, Ma K, Cheng Z, Blake GM, Yang M, Wu X, Cheng X, Wang L. Associations of Quantitative and Qualitative Muscle Parameters With Second Hip Fracture Risk in Older Women: A Prospective Cohort Study. JBMR Plus 2023; 7:e10834. [PMID: 38130767 PMCID: PMC10731097 DOI: 10.1002/jbm4.10834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/03/2023] [Indexed: 12/23/2023] Open
Abstract
Older women with a first hip fracture exhibit heightened susceptibility and incidence of second fracture and potentially severe consequences. This prospective study was to compare the predictive power of qualitative and quantitative muscle parameters for a second hip fracture in older women with a first hip fracture. A total of 206 subjects were recruited from the longitudinal Chinese Second Hip Fracture Evaluation study. Hip computed tomography (CT) scans were obtained immediately after the first fracture. Muscle fat infiltration was assessed according to the Goutallier classification qualitatively. Quantitative parameters included cross-sectional area and density of gluteus maximus (G.MaxM) and gluteus medius and minimus (G.Med/MinM) muscles. CT X-ray absorptiometry was used to measure the areal bone mineral density (aBMD) of the contralateral femur. Cox proportional hazards models were used to compute hazard ratios (HR) of second hip fracture risk. The mean age of subjects was 74.9 (±9.5) years at baseline. After 4.5 years, 35 had a second hip fracture, 153 without a second hip fracture, and 18 died. Except for the combined G.MinM Goutallier grade 3 and 4 groups before adjustment for covariates (HR = 5.83; 95% confidence interval [CI] 1.49-22.83), there were no significant HRs for qualitative classification to predict a second hip fracture. Among quantitative metrics, after adjustment for covariates, G.Med/MinM density was significant in the original (HR = 1.44; CI 1.02-2.04) and competing risk analyses (HR = 1.46; CI 1.02-2.07). After additional adjustment for femoral neck (FN) aBMD, G.Med/MinM density remained borderline significant for predicting a second hip fracture in competing risk analysis (HR = 1.43; CI 0.99-2.06; p = 0.057). Our study revealed that Goutallier classification was less effective than quantitative muscle metrics for predicting hip second fracture in this elderly female cohort. After adjustment for FN aBMD, G.Med/MinM density is a borderline independent predictor of second hip fracture risk. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Wenshuang Zhang
- Department of Radiology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
- Department of RadiologyPeking University Fourth School of Clinical MedicineBeijingChina
| | - Yufeng Ge
- Department of Orthopaedics and Traumatology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
| | - Yandong Liu
- Department of Radiology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
| | - Yi Yuan
- Department of Radiology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
- Department of RadiologyPeking University Fourth School of Clinical MedicineBeijingChina
| | - Jian Geng
- Department of Radiology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
| | - Fengyun Zhou
- Department of Radiology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
| | - Pengju Huang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding HospitalCapital Medical UniversityBeijingChina
| | - Jia Shi
- National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
| | - Kangkang Ma
- Department of Radiology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
- Department of RadiologyPeking University Fourth School of Clinical MedicineBeijingChina
| | - Zitong Cheng
- Department of Radiology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
- Department of RadiologyPeking University Fourth School of Clinical MedicineBeijingChina
| | - Glen M. Blake
- School of Biomedical Engineering & Imaging Sciences, King's College LondonSt Thomas' HospitalLondonUK
| | - Minghui Yang
- Department of Orthopaedics and Traumatology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
| | - Xinbao Wu
- Department of Orthopaedics and Traumatology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
- Department of RadiologyPeking University Fourth School of Clinical MedicineBeijingChina
| | - Ling Wang
- Department of Radiology, Beijing Jishuitan HospitalCapital Medical UniversityBeijingChina
- Sarcopenia Research Center, Beijing Research Institute of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, National Center for OrthopaedicsFourth Clinical Medical College of Peking UniversityBeijingChina
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Hoshikawa K, Yuri T, Oishi R, Uno T, Nagai J, Giambini H, Mura N. Muscle belly ratio is the most suitable estimate of the activity of the torn supraspinatus muscle. JSES Int 2023; 7:2373-2378. [PMID: 37969501 PMCID: PMC10638582 DOI: 10.1016/j.jseint.2023.07.004] [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] [Indexed: 11/17/2023] Open
Abstract
Background A torn rotator cuff muscle deteriorates over time leading with an increase in muscle atrophy and fatty infiltration. There are several clinical assessments for evaluating the atrophy of the torn supraspinatus muscle. However, it is unclear which approach can more accurately estimate the activity of the torn supraspinatus muscle. The purpose of this study was to determine which magnetic resonance imaging-based muscle atrophy imaging assessment currently implemented in the clinical setting accurately estimates the activity of the torn supraspinatus muscle. Methods Forty patients who were diagnosed with a rotator cuff tear and were candidates for repairs were selected for this study. Cross-sectional area, occupation ratio, and tangent sign were analyzed on T1-weighted oblique sagittal plane magnetic resonance images in which the scapular spine leads to the Y-section. Muscle belly ratio of the supraspinatus muscle was analyzed by calculating the ratio of the width of the muscle belly to the distance from the greater tubercle to the proximal end of the muscle on T1-weighted coronal plane magnetic resonance imaging images. Fatty infiltration was evaluated using the Goutallier classification system. Tear size was obtained intraoperatively by measuring the width and length of the tear and classified based on the Cofield's classification. To assess activity of the torn supraspinatus muscle, participants were first instructed to sit on a chair with the affected arm resting on a table and the shoulder abducted to 60° in the scapular plane with neutral rotation. Elasticity of the supraspinatus muscle belly was then obtained at rest and during isometric contraction using with real-time tissue elastography. Muscle activity, a surrogate for contractility, was defined as the difference between the elasticities measured at rest and during isometric contraction. A stepwise multiple regression analysis was used to investigate independent factors, such as sex, tear width, cross-sectional area, occupation ratio, tangent sign, and muscle belly ratio, related to muscle activity. Results Stepwise multiple regression analysis (R2 = 0.522, P < .001) revealed that supraspinatus muscle activity was significantly correlated with muscle belly ratio (β = 0.306, P = .044) and Goutallier stage (β = -0.490, P = .002). Conclusion Estimations of muscle belly ratio are most suitable for assessing the activity of a torn supraspinatus muscle compared to other clinical measurements.
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Affiliation(s)
- Kyosuke Hoshikawa
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
- Department of Biomedical Engineering and Chemical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
- Department of Orthopedic Surgery, Yoshioka Hospital, Yamagata, Japan
| | - Takuma Yuri
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Ryuta Oishi
- Department of Orthopedic Surgery, Yoshioka Hospital, Yamagata, Japan
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tomohiro Uno
- Department of Orthopedic Surgery, Yoshioka Hospital, Yamagata, Japan
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Jun Nagai
- Department of Orthopedic Surgery, Yoshioka Hospital, Yamagata, Japan
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Hugo Giambini
- Department of Biomedical Engineering and Chemical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Nariyuki Mura
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
- Department of Orthopedic Surgery, Yoshioka Hospital, Yamagata, Japan
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Trevino Iii JH, Yuri T, Hatta T, Kiyoshige Y, Jacobs PM, Giambini H. Three-dimensional quantitative measurements of atrophy and fat infiltration in sub-regions of the supraspinatus muscle show heterogeneous distributions: a cadaveric study. Arch Orthop Trauma Surg 2022; 142:1395-1403. [PMID: 33484308 DOI: 10.1007/s00402-021-03765-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/01/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Rotator cuff tears are common in the older population. Atrophy and fat infiltration develop un-evenly in torn supraspinatus (SSP) muscles leading to pre- and post-surgical complications. The purpose of the current study was twofold: first, to implement a volumetric and quantitative magnetic resonance imaging (MRI) approach to quantify the degree of muscle atrophy and fat infiltration within the SSP muscle and its four sub-regions (AS, PS, AD, and PD); second to compare 3-D MRI outcomes to the standard 2-D assessment and investigate their relationship with tear size. MATERIALS AND METHODS Fifteen cadaveric shoulders were obtained and MRI performed. Quantitative 3-D outcomes included SSP muscle volume, fossa volume, fat-free muscle volume, and fat fraction for the whole SSP muscle and its four sub-regions. 2-D and qualitative measurements included tear size, 2-D fat infiltration using the Goutallier classification, tangent sign, and occupation ratio. RESULTS Linear regression outcomes with tear size were not significant for both cross-sectional area (r = - 0.494, p = 0.061) and occupation ratio (r = - 0.011, p = 0.969). Tear size negatively correlated with fat-free muscle volume for both AS and PS sub-regions (AS: r = - 0.78, p < 0.001; PS: r = - 0.68, p = 0.005, respectively) while showing no significant correlation with fat fraction outcomes. AD and PD sub-regions positively correlated with tear size and fat fraction outcomes (AD: r = 0.70, p = 0.017; PD: r = 0.52, p = 0.045, respectively), while no significant correlation was observed between tear size and fat-free muscle volumes. CONCLUSION Quantitative 3-D volumetric assessment of muscle degeneration resulted in better outcomes compared to the standard 2-D evaluation. The superficial supraspinatus muscle sub-regions primarily presented muscle atrophy, while the deep sub-regions were mainly affected by fat infiltration. 3-D assessments could be used pre-surgically to determine the best course of treatment and to estimate the muscles' regenerative capacity and function.
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Affiliation(s)
- Jose H Trevino Iii
- Department of Biomedical Engineering and Chemical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA
| | - Takuma Yuri
- Department of Biomedical Engineering and Chemical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA.,Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Taku Hatta
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Yoshiro Kiyoshige
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Philip M Jacobs
- Department of Orthopedics, The University of Texas Health Science Center, San Antonio, TX, USA
| | - Hugo Giambini
- Department of Biomedical Engineering and Chemical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA. .,Department of Orthopedics, The University of Texas Health Science Center, San Antonio, TX, USA.
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Liu B, Xu J, Jin Y, Su W, Zhang X, Qiao Y, Yu W, Cheng L, Zhao J, Li Y. Advantages of 3-dimensional Measurements for Supraspinatus Intramuscular Fatty Evaluation in Patients With Medium to Massive Rotator Cuff Tears: Comparison With a Single Sagittal Slice. Am J Sports Med 2022; 50:699-707. [PMID: 35044262 DOI: 10.1177/03635465211068854] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Fatty infiltration of the rotator cuff muscles is highly related to poor outcomes after rotator cuff tears. Fat fraction (FF) based on traditional 2-dimensional measurements (2D-FF) from a single sagittal Y-view slice cannot determine intramuscular FF in the rotator cuff muscles; the newly developed 3-dimensional method (3D-FF) is supposed to precede 2D measurements for intramuscular FF evaluation in accuracy and reliability. PURPOSE (1) To measure 3D-FF and (2) to compare 3D-FF and 2D-FF in terms of quantitative values and intra- and interobserver agreement. STUDY DESIGN Cohort study (diagnosis); Level of evidence, 2. METHODS Six-point Dixon magnetic resonance imaging was performed in patients with full-thickness supraspinatus tears. 2D-FF was calculated on a single sagittal Y-view. Semiautomatic segmentation software (ITK-SNAP) was used to reconstruct 3D volumes of the supraspinatus muscle and fat. 3D-FF was obtained by dividing the fat volume by the total volume of the supraspinatus muscle. A paired t test was used to compare the individual differences between 2D-FF and 3D-FF results. Linear regression and Bland-Altman analyses were performed to determine the agreement between 2D-FF and 3D-FF. Intraclass correlation coefficients (ICCs) were calculated to determine intra- and interobserver agreement. RESULTS The 3D muscular and fatty models presented an inhomogeneous distribution of intramuscular fat in the supraspinatus, indicating the superiority of 3D-FF over 2D-FF in capturing all muscle morphologic information. 2D-FF was significantly higher than 3D-FF in the supraspinatus with large (19.5% ± 5.9% vs 16.2% ± 3.7%; P = .002) and massive (34.8% ± 13.3% vs 26.2% ± 9.4%; P < .001) rotator cuff tears. 2D-FF overestimated the FF compared with 3D-FF by >50% in 14.7% of all patients and by >15% in 67.6% of patients with large or massive RCTs. The discrepancy between 2D-FF and 3D-FF increased with increasing mean FF. The intra- and interobserver agreement of 3D-FF (ICCs, 0.89-0.99 and 0.89-0.95) was superior to that of 2D-FF (ICCs, 0.71-0.95 and 0.64-0.79). CONCLUSION 3D-FF indicated an inhomogeneous distribution of intramuscular fat by capturing all muscle and fat morphologic information. In patients with large and massive rotator cuff tears, 2D-FF of the supraspinatus was significantly higher than 3D-FF. 3D-FF was more reliable than 2D-FF for estimating fatty infiltration in the supraspinatus, with better intra- and interobserver agreement.
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Affiliation(s)
- Beibei Liu
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Junjie Xu
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yuchen Jin
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Human Oncology and Pathogenesis, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Wei Su
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xiuyuan Zhang
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yi Qiao
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Weibin Yu
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lude Cheng
- Siemens Medical Systems Co, Ltd, Shanghai, China
| | - Jinzhong Zhao
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yuehua Li
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Takumi O, Hirofumi T, Hiroshi A, Hiroki Y, Toshihiro M, Masatomo M, Takuma H, Tsukasa K. Presence of adipose tissue along the posteromedial tibial border. J Exp Orthop 2021; 8:92. [PMID: 34668094 PMCID: PMC8526639 DOI: 10.1186/s40634-021-00408-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/23/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose The flexor digitorum longus and posterior tibial tendon as well as the perforating veins are located along the distal posteromedial tibial border. Adipose tissue may surround these structures and possibly play a role in reducing mechanical stress. This study aimed to examine the adipose tissue along the posteromedial tibial border via magnetic resonance imaging (MRI), ultrasound, and gross anatomical examination. Methods The lower legs of 11 healthy individuals were examined every 3 cm from the medial malleolus using MRI and ultrasound. The fat fraction was calculated using fat fraction images. In addition, the gross anatomy of the flexor digitorum longus origin and adipose tissue along the posteromedial tibial border was examined in seven fresh cadavers. The fat fraction was compared at different heights along the posteromedial tibial border and in Kager’s fat pads; we also compared the height of the flexor digitorum longus origin and adipose tissue. Results In vivo, the adipose tissue was identified along the entire posteromedial tibial border using MRI and ultrasound. There was no significant difference in fat fraction between Kager’s fat pads and the adipose tissue along the posteromedial tibial border, except at the 6 cm mark. All seven cadavers presented adipose tissue along the posteromedial tibial border, significantly more distal than the flexor digitorum longus origin. Conclusion The adipose tissue was identified along the posteromedial tibial border via MRI, ultrasound, and gross anatomical examination; thus, this tissue may play a role in reducing friction and compressive stress in tendons.
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Affiliation(s)
- Okunuki Takumi
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan.
| | - Tanaka Hirofumi
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan.,Hyakutake Orthopedic & Sports Clinic, Saga, Japan
| | - Akuzawa Hiroshi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Yabiku Hiroki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan.,Department of Orthopedic Surgery, University of Ryukyus, Okinawa, Japan
| | | | - Matsumoto Masatomo
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan.,Kuwana City Medical Center, Kuwana, Mie, Japan
| | | | - Kumai Tsukasa
- Faculty of Sport Sciences, Waseda University, Saitama, Japan.
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Chen R, Bai Y, Liu T, Zhang G, Han Y, Chen L, Gao H, Wei W, Wang M. Evaluation of Glypican-3 Expression in Hepatocellular Carcinoma by Using IDEAL IQ Magnetic Resonance Imaging. Acad Radiol 2021; 28:e227-e234. [PMID: 32540197 DOI: 10.1016/j.acra.2020.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 12/11/2022]
Abstract
RATIONALE AND OBJECTIVES To investigate the value of iterative decomposition of water and fat with echo asymmetry and least squares estimation (IDEAL IQ) and gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for evaluating Glypican-3 (GPC3) expression in hepatocellular carcinoma (HCC). MATERIALS AND METHODS Seventy-six patients with histopathologic diagnosis of HCC were retrospectively included in this study. In all patients IDEAL IQ and Gd-EOB-DTPA-enhanced MRI were performed preoperatively using a 3 T MRI system. For an identical slice through the liver of each patient a region of interest was drawn on the tumor in the hepatobiliary phase image and copied to the R2* map and fat fraction map produced by IDEAL IQ. A Mann-Whitney U test was used to compare the region of interest values of R2*, fat fraction and uptake of Gd-EOB-DTPA values between patients with positive and negative GPC3 expression HCC. Receiver operating characteristic analysis was used to determine the diagnostic performances of each of the MRI parameters in evaluating GPC3 expression and histological grade in HCC. RESULTS R2* value was significantly higher in cases of positive than negative GPC3 expression HCCs (p < 0.001), whereas there were no significant differences in fat fraction and uptake of Gd-EOB-DTPA between the 2 groups (both p > 0.05). R2* value had higher areas under receiver operating characteristic (0.881), sensitivity (85.96%), and specificity (84.21%) compared to the fat fraction and uptake of Gd-EOB-DTPA. CONCLUSION R2* value yielded from IDEAL IQ could reliably predict GPC3 expression in HCC prior to surgery.
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Affiliation(s)
- Rushi Chen
- Academy of Medical Sciences & the People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Bai
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Taiyuan Liu
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Ge Zhang
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Yanhong Han
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Lijuan Chen
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Haiyan Gao
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Wei Wei
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, 450003, China.
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Rajlawot K, Jiang T, Zhou J, Lin C, Kuang S, Chen J, Zhang Y, Yang H, Deng Y, He B, Hernando D, Reeder SB, Wang J. Accuracies of Chemical Shift In/Opposed Phase and Chemical Shift Encoded Magnetic Resonance Imaging to Detect Intratumoral Fat in Hepatocellular Carcinoma. J Magn Reson Imaging 2021; 53:1791-1802. [PMID: 33580551 DOI: 10.1002/jmri.27539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Magnetic Resonance Imaging (MRI) being a noninvasive modality may help in preoperative evaluation of intratumoral fat in hepatocellular carcinoma (HCC) using chemical shift encoded (CSE) MRI and in-/opposed-phase (IOP) imaging sequences. PURPOSE To compare the diagnostic accuracy of chemical shift encoded fat fraction at three different flip angles (FAs) using quantitative chemical shift encoded MRI (CSE-MRI) with in-/opposed phase (IOP) imaging to evaluate intratumoral fat in HCC. STUDY TYPE Retrospective. POPULATION Eighty-six patients with 87 pathology proven HCCs. FIELD STRENGTH/SEQUENCE IOP (LAVA-Flex) and CSE-MRI (IDEAL IQ) a three-dimensional spoiled gradient-echo pulse sequences acquired at 3 T. ASSESSMENT Regions of interest (ROIs) were manually drawn by two observers in the tumors to measure mean fat fractions. Surgical specimens were reassessed for intratumoral fat content. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were assessed for CSE-MRI sequence at FA 3°, 8°, and 9°. STATISTICAL TESTS Intraclass correlation coefficient (ICC) was expressed in terms of inter- and intra-observer agreements. Receiver operating characteristic curve analysis was performed for the diagnostic performance followed by combined metric of both. SNR/CNR were analyzed by Kruskal-Wallis test. RESULTS Excellent inter- and intra-observer agreements (ICC >0.95, P < 0.001) were observed for both IOP and CSE-MRI. IOP (86.4%) showed higher sensitivity than CSE-MRI at FA 3° (72.5%), FA 8° (76.4%) and FA 9° (76.3%). In contrast, the specificity for CSE-MRI at FA 3° (86%), FA 8° (87%), and FA 9° (87%) were greater than IOP (72%). A combined metric of IOP and CSE-MRI derived fat fractions at FA 8° gave highest AUC of 87% and accuracy of 86%. SNR and CNR for CSE-MRI were significantly higher at FA 8° and FA 9° than FA 3° (P < 0.05). DATA CONCLUSION IOP and quantitative CSE-MRI are both feasible methods to detect intratumoral fat in HCC with higher accuracy and SNR for CSE-MRI at FA 8° and 9°. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Kritisha Rajlawot
- Department of Radiology, Third Affiliated Hospital of Sun Yat sen University (SYSU), Guangzhou, China
| | - Ting Jiang
- Department of Radiology, Third Affiliated Hospital of Sun Yat sen University (SYSU), Guangzhou, China
| | - Jing Zhou
- Department of Pathology, Third Affiliated Hospital of Sun Yat sen University (SYSU), Guangzhou, China
| | - ChuRong Lin
- Department of Radiology, Third Affiliated Hospital of Sun Yat sen University (SYSU), Guangzhou, China
| | - Sichi Kuang
- Department of Radiology, Third Affiliated Hospital of Sun Yat sen University (SYSU), Guangzhou, China
| | - Jingbiao Chen
- Department of Radiology, Third Affiliated Hospital of Sun Yat sen University (SYSU), Guangzhou, China
| | - Yao Zhang
- Department of Radiology, Third Affiliated Hospital of Sun Yat sen University (SYSU), Guangzhou, China
| | - Hao Yang
- Department of Radiology, Third Affiliated Hospital of Sun Yat sen University (SYSU), Guangzhou, China
| | - Ying Deng
- Department of Radiology, Third Affiliated Hospital of Sun Yat sen University (SYSU), Guangzhou, China
| | - Bingjun He
- Department of Radiology, Third Affiliated Hospital of Sun Yat sen University (SYSU), Guangzhou, China
| | - Diego Hernando
- Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Scott B Reeder
- Departments of Radiology and Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Jin Wang
- Department of Radiology, Third Affiliated Hospital of Sun Yat sen University (SYSU), Guangzhou, China
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