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Pietersen PI, Lynggård Bo Madsen J, Asmussen J, Lund L, Nielsen TK, Pedersen M, Engvad B, Graumann O. Multiparametric magnetic resonance imaging for characterizing renal tumors: A validation study of the algorithm presented by Cornelis et al. J Clin Imaging Sci 2023; 13:7. [PMID: 36908585 PMCID: PMC9992978 DOI: 10.25259/jcis_124_2022] [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: 10/15/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
Objectives In the last decade, the incidence of renal cell carcinoma (RCC) has been rising, with the greatest increase observed for solid tumors. Magnetic resonance imaging (MRI) protocols and algorithms have recently been available for classifying RCC subtypes and benign subtypes. The objective of this study was to prospectively validate the MRI algorithm presented by Cornelis et al. for RCC classification. Material and Methods Over a 7-month period, 38 patients with 44 renal tumors were prospectively included in the study and received an MRI examination in addition to the conventional investigation program. The MRI sequences were: T2-weighted, dual chemical shift MRI, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced T1-weighted in wash-in and wash-out phases. The images were evaluated according to the algorithm by two experienced, blinded radiologists, and the histopathological diagnosis served as the gold standard. Results Of 44 tumors in 38 patients, only 8 tumors (18.2%) received the same MRI diagnosis according to the algorithm as the histopathological diagnosis. MRI diagnosed 16 angiomyolipoma, 14 clear cell RCC (ccRCC), 12 chromophobe RCC (chRCC), and two papillary RCC (pRCC), while histopathological examination diagnosed 24 ccRCC, four pRCC, one chRCC, and one mixed tumor of both pRCC and chRCC. Malignant tumors were statistically significantly larger than the benign (3.16 ± 1.34 cm vs. 2.00 ± 1.04 cm, P = 0.006). Conclusion This prospective study could not reproduce Cornelis et al.'s results and does not support differentiating renal masses using multiparametric MRI without percutaneous biopsy in the future. The MRI algorithm showed few promising results to categorize renal tumors, indicating histopathology for clinical decisions and follow-up regimes of renal masses are still required.
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Affiliation(s)
| | - Janni Lynggård Bo Madsen
- Research and Innovation Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jon Asmussen
- Department of Radiology, Odense University Hospital, Odense, Denmark
| | - Lars Lund
- Department of Urology, Odense University Hospital, Odense, Denmark
| | | | - Michael Pedersen
- Department of Clinical Medicine - Comparative Medicine Lab, Aarhus University Hospital, Aarhus, Denmark
| | - Birte Engvad
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Ole Graumann
- Department of Radiology, Odense University Hospital, Odense, Denmark
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Zhou X, Fan X, Mustafi D, Pineda F, Markiewicz E, Zamora M, Sheth D, Olopade OI, Oto A, Karczmar GS. Comparison of DCE-MRI of murine model cancers with a low dose and high dose of contrast agent. Phys Med 2021; 81:31-39. [PMID: 33373779 DOI: 10.1016/j.ejmp.2020.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/27/2020] [Accepted: 11/19/2020] [Indexed: 02/08/2023] Open
Abstract
There are increasing concerns regarding intracellular accumulation of gadolinium (Gd) after multiple dynamic contrast enhanced (DCE) MRI scans. We investigated whether a low dose (LD) of Gd-based contrast agent is as effective as a high dose (HD) for quantitative analysis of DCE-MRI data, and evaluated the use of a split dose protocol to obtain new diagnostic parameters. Female C3H mice (n = 6) were injected with mammary carcinoma cells in the hind leg. MRI experiments were performed on 9.4 T scanner. DCE-MRI data were acquired with 1.5 s temporal resolution before and after a LD (0.04 mmol/kg), then again after 30 min followed by a HD (0.2 mmol/kg) bolus injection of Omniscan. The standard Tofts model was used to extract physiological parameters (Ktrans and ve) with the arterial input function derived from muscle reference tissue. In addition, an empirical mathematical model was used to characterize maximum contrast agent uptake (A), contrast agent uptake rate (α) and washout rate (β and γ). There were moderate to strong correlations (r = 0.69-0.97, p < 0001) for parameters Ktrans, ve, A, α and β from LD versus HD data. On average, tumor parameters obtained from LD data were significantly larger (p < 0.05) than those from HD data. The parameter ratios, Ktrans, ve, A and α calculated from the LD data divided by the HD data, were all significantly larger than 1.0 (p < 0.003) for tumor. T2* changes following contrast agent injection affected parameters calculated from HD data, but this was not the case for LD data. The results suggest that quantitative analysis of LD data may be at least as effective for cancer characterization as quantitative analysis of HD data. In addition, the combination of parameters from two different doses may provide useful diagnostic information.
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Affiliation(s)
- Xueyan Zhou
- School of Technology, Harbin University, Harbin, China; Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Xiaobing Fan
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Devkumar Mustafi
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Federico Pineda
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Erica Markiewicz
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Marta Zamora
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Deepa Sheth
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | | | - Aytekin Oto
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Gregory S Karczmar
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States.
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Xian Z, Orien JO, Box GN, Zynger DL. Clinicopathologic analysis of renal cell carcinoma containing Intratumoral fat with and without osseous metaplasia. Diagn Pathol 2020; 15:21. [PMID: 32143646 PMCID: PMC7059685 DOI: 10.1186/s13000-020-00941-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 02/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is minimal information regarding the prevalence of intratumoral adipose in renal cell carcinoma (RCC), and no study has assessed the impact of intratumoral adipose on the preoperative imaging diagnosis. The aim of this study was to investigate the prevalence and histopathologic characteristics of entrapped adipose with or without osseous metaplasia in RCC nephrectomy specimens and to determine if this finding impacted the preoperative imaging interpretation. METHODS 704 RCC specimens were prospectively evaluated for entrapped adipose and osseous metaplasia (423 partial nephrectomies, 281 total nephrectomies; 327 pT1a, 377 ≥ pT1b; 510 clear cell, 119 papillary, 30 chromophobe, 22 clear cell papillary, 23 other). Imaging reports were obtained, and the presence of intratumoral fat or calcification and the radiologic diagnostic impression were recorded. RESULTS 3% (n = 21) contained microscopically identified intratumoral adipose, with a similar frequency in the main histologic subtypes (p = 0.76). Mean metaplastic deposit size was 0.4 cm, mean deposit to capsule distance 0.2 cm, and 29% involved the tumor capsule. Histologically identified adipose was infrequently noted via imaging (13%), and only 1 case with histologically identified metaplasia had a radiologic diagnostic differential of angiomyolipoma (1/704, 0.1%). CONCLUSION While intratumoral adipose and/or osseous metaplasia can be observed within RCC, it is extremely rare for the radiologic diagnostic impression to have been confounded by histologically identified entrapped adipose. Awareness that metaplastic deposits are usually near the tumor capsule and may be minute could help prevent errors in diagnosis or staging.
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Affiliation(s)
- Zhaoying Xian
- Department of Pathology, The Ohio State University Medical Center, 410 W 10th Ave., 401 Doan Hall, Columbus, OH, 43210, USA
| | - Jason O Orien
- Department of Urology, The Ohio State University Medical Center, 410 W 10th Ave., 401 Doan Hall, Columbus, OH, 43210, USA
| | - Geoffrey N Box
- Department of Urology, The Ohio State University Medical Center, 410 W 10th Ave., 401 Doan Hall, Columbus, OH, 43210, USA
| | - Debra L Zynger
- Department of Pathology, The Ohio State University Medical Center, 410 W 10th Ave., 401 Doan Hall, Columbus, OH, 43210, USA.
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Crisi G, Filice S, Erb G, Bozzetti F. Effectiveness of a high relaxivity contrast agent administered at half dose in dynamic susceptibility contrast MRI of brain gliomas. J Magn Reson Imaging 2016; 45:500-506. [PMID: 27373976 DOI: 10.1002/jmri.25370] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 06/17/2016] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To determine whether half of the approved dose of gadobenate dimeglumine (MultiHance) is as effective as a full dose of gadoterate meglumine (Dotarem) for qualitative and quantitative cerebral blood volume (CBV) perfusion evaluation at 3T in patients with brain gliomas. MATERIALS AND METHODS We enrolled 65 adult patients in an interindividual comparative study. Patients were randomized to one of two study arms: 33 patients received 0.1 mmol/kg body weight (bw) of gadoterate, 32 patients received 0.05 mmol/kg bw of gadobenate. The patients underwent identical examinations at 3T. Arterial input function (AIF), tissue function (TF), and the maximum tumor CBV (CBV_T) were obtained from each patient. The quality of the CBV maps were independently reviewed by two neuroradiologists blinded to the administered contrast agent. RESULTS The administration of a half dose of gadobenate led to a roughly 40% reduction in signal drop compared to that achieved with a full dose of gadoterate (P values for AIF and TF maximum and integral were <0.01); quantitative and qualitative assessment of CBV maps revealed no difference between contrast agents (P values for CBV_T of high- and low-grade gliomas, image quality evaluation were 0.87, 0.48, >0.65, respectively) CONCLUSION: The CBV maps obtained with a half dose gadobenate (0.05 mmol/kg bw) are of comparable diagnostic quality as the corresponding images acquired with a full dose of gadoterate (0.1 mmol/kg bw). LEVEL OF EVIDENCE 2 J. Magn. Reson. Imaging 2017;45:500-506.
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Affiliation(s)
- Girolamo Crisi
- Department of Neuroradiology, University Hospital of Parma, Parma, Italy
| | - Silvano Filice
- Department of Medical Physics, University Hospital of Parma, Parma, Italy
| | - Gunter Erb
- Bracco Group, Medical and Regulatory Affairs, Konstanz, Germany
| | - Francesca Bozzetti
- Department of Neuroradiology, University Hospital of Parma, Parma, Italy
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Vaneckova M, Herman M, Smith MP, Mechl M, Maravilla KR, Weichet J, Spampinato MV, Žižka J, Wippold FJ, Baima JJ, Babbel R, Bültmann E, Huang RY, Buhk JH, Bonafé A, Colosimo C, Lui S, Kirchin MA, Shen N, Pirovano G, Spinazzi A. The Benefits of High Relaxivity for Brain Tumor Imaging: Results of a Multicenter Intraindividual Crossover Comparison of Gadobenate Dimeglumine with Gadoterate Meglumine (The BENEFIT Study). AJNR Am J Neuroradiol 2015; 36:1589-98. [PMID: 26185325 DOI: 10.3174/ajnr.a4468] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 06/08/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE Gadobenate dimeglumine (MultiHance) has higher r1 relaxivity than gadoterate meglumine (Dotarem) which may permit the use of lower doses for MR imaging applications. Our aim was to compare 0.1- and 0.05-mmol/kg body weight gadobenate with 0.1-mmol/kg body weight gadoterate for MR imaging assessment of brain tumors. MATERIALS AND METHODS We performed crossover, intraindividual comparison of 0.1-mmol/kg gadobenate with 0.1-mmol/kg gadoterate (Arm 1) and 0.05-mmol/kg gadobenate with 0.1-mmol/kg gadoterate (Arm 2). Adult patients with suspected or known brain tumors were randomized to Arm 1 (70 patients) or Arm 2 (107 patients) and underwent 2 identical examinations at 1.5 T. The agents were injected in randomized-sequence order, and the 2 examinations were separated by 2-14 days. MR imaging scanners, imaging sequences (T1-weighted spin-echo and T1-weighted high-resolution gradient-echo), and acquisition timing were identical for the 2 examinations. Three blinded readers evaluated images for diagnostic information (degree of definition of lesion extent, lesion border delineation, visualization of lesion internal morphology, contrast enhancement) and quantitatively for percentage lesion enhancement and lesion-to-background ratio. Safety assessments were performed. RESULTS In Arm 1, a highly significant superiority (P < .002) of 0.1-mmol/kg gadobenate was demonstrated by all readers for all end points. In Arm 2, no significant differences (P > .1) were observed for any reader and any end point, with the exception of percentage enhancement for reader 2 (P < .05) in favor of 0.05-mmol/kg gadobenate. Study agent-related adverse events were reported by 2/169 (1.2%) patients after gadobenate and by 5/175 (2.9%) patients after gadoterate. CONCLUSIONS Significantly superior morphologic information and contrast enhancement are demonstrated on brain MR imaging with 0.1-mmol/kg gadobenate compared with 0.1-mmol/kg gadoterate. No meaningful differences were recorded between 0.05-mmol/kg gadobenate and 0.1-mmol/kg gadoterate.
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Affiliation(s)
- M Vaneckova
- From the Charles University in Prague (M.V.), First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - M Herman
- University Hospital Olomouc (M.H.), Olomouc, Czech Republic
| | - M P Smith
- Beth Israel Deaconess Medical Center (M.P.S.), Boston, Massachusetts
| | - M Mechl
- Faculty of Medicine (M.M.), University Hospital Brno, Masaryk University, Brno, Czech Republic
| | - K R Maravilla
- MR Research Laboratory (K.R.M.), University of Washington, Seattle, Washington
| | - J Weichet
- Na Homolce Hospital (J.W.), Prague, Czech Republic
| | - M V Spampinato
- Department of Radiology and Radiological Science (M.V.S.), Medical University of South Carolina, Charleston, South Carolina
| | - J Žižka
- University Faculty of Medicine in Hradec Králové (J.Ž.), University Hospital Hradec Králové and Charles University in Prague, Prague, Czech Republic
| | - F J Wippold
- Mallinckrodt Institute of Radiology (F.J.W.), Washington University School of Medicine, St. Louis, Missouri
| | - J J Baima
- Clinical Radiologists, S.C. (J.J.B.), Springfield, Illinois
| | - R Babbel
- Good Samaritan Regional Medical Center (R.B.), Corvallis, Oregon
| | - E Bültmann
- Institute of Diagnostic and Interventional Neuroradiology (E.B.), Hannover, Germany
| | - R Y Huang
- Harvard Medical School (R.Y.H.), Brigham and Women's Hospital, Boston, Massachusetts
| | - J-H Buhk
- University Medical Center Hamburg Eppendorf (J.-H.B.), Hamburg, Germany
| | - A Bonafé
- Hopital Gui de Chauliac (A.B.), Montpellier, France
| | - C Colosimo
- Policlinico "Agostino Gemelli" (C.C.), Rome, Italy
| | - S Lui
- West China Hospital of Sichuan University (S.L.), Chengdu, Sichuan, China
| | - M A Kirchin
- Global Medical & Regulatory Affairs (M.A.K.), Bracco Imaging S.p.A., Milan, Italy
| | - N Shen
- Global Medical & Regulatory Affairs (N.S., G.P., A.S.), Bracco Diagnostics, Monroe, New Jersey
| | - G Pirovano
- Global Medical & Regulatory Affairs (N.S., G.P., A.S.), Bracco Diagnostics, Monroe, New Jersey
| | - A Spinazzi
- Global Medical & Regulatory Affairs (N.S., G.P., A.S.), Bracco Diagnostics, Monroe, New Jersey
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