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Xu Z, Huang L, Yang Y, Cai Z, Chen M, Lu R, Ouyang Y, Hong Z, Huang W, Xu Z. Discriminating atypical parotid carcinoma and pleomorphic adenoma utilizing extracellular volume fraction and arterial enhancement fraction derived from contrast-enhanced CT imaging: A multicenter study. Cancer Med 2024; 13:e7407. [PMID: 38899534 PMCID: PMC11187748 DOI: 10.1002/cam4.7407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVES To investigate the added value of extracellular volume fraction (ECV) and arterial enhancement fraction (AEF) derived from enhanced CT to conventional image and clinical features for differentiating between pleomorphic adenoma (PA) and atypical parotid adenocarcinoma (PCA) pre-operation. METHODS From January 2010 to October 2023, a total of 187 cases of parotid tumors were recruited, and divided into training cohort (102 PAs and 51 PCAs) and testing cohort (24 PAs and 10 atypical PCAs). Clinical and CT image features of tumor were assessed. Both enhanced CT-derived ECV and AEF were calculated. Univariate analysis identified variables with statistically significant differences between the two subgroups in the training cohort. Multivariate logistic regression analysis with the forward variable selection method was used to build four models (clinical model, clinical model+ECV, clinical model+AEF, and combined model). Diagnostic performances were evaluated using receiver operating characteristic (ROC) curve analyses. Delong's test compared model differences, and calibration curve and decision curve analysis (DCA) assessed calibration and clinical application. RESULTS Age and boundary were chosen to build clinical model, and to construct its ROC curve. Amalgamating the clinical model, ECV, and AEF to establish a combined model demonstrated superior diagnostic effectiveness compared to the clinical model in both the training and test cohorts (AUC = 0.888, 0.867). There was a significant statistical difference between the combined model and the clinical model in the training cohort (p = 0.0145). CONCLUSIONS ECV and AEF are helpful in differentiating PA and atypical PCA, and integrating clinical and CT image features can further improve the diagnostic performance.
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Affiliation(s)
- Zhen‐Yu Xu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Lin‐Wen Huang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Yun‐Jun Yang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Zhi‐Ping Cai
- Department of RadiologyShunde Hospital, Southern Medical University (The First People's Hospital of Shunde)FoshanChina
| | - Mei‐Lin Chen
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Rui‐Liang Lu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Yong‐Xi Ouyang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Zhen‐Kai Hong
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Wei‐Jun Huang
- Department of UltrasoundThe First People's Hospital of FoshanFoshanChina
| | - Zhi‐Feng Xu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
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Takumi K, Nagano H, Oose A, Gohara M, Kamimura K, Nakajo M, Harada-Takeda A, Ueda K, Tabata K, Yoshiura T. Extracellular volume fraction derived from equilibrium contrast-enhanced CT as a diagnostic parameter in anterior mediastinal tumors. Eur J Radiol 2023; 165:110891. [PMID: 37245341 DOI: 10.1016/j.ejrad.2023.110891] [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: 04/10/2023] [Revised: 05/08/2023] [Accepted: 05/22/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE To assess the usefulness of extracellular volume (ECV) fraction derived from equilibrium contrast-enhanced CT (CECT) for diagnosing anterior mediastinal tumors. METHOD This study included 161 histologically confirmed anterior mediastinal tumors (55 low-risk thymomas, 57 high-risk thymomas, 32 thymic carcinomas, and 17 malignant lymphomas) that were assessed by pretreatment CECT. ECV fraction was calculated using measurements obtained within the lesion and the aorta on unenhanced and equilibrium phase CECT. ECV fraction was compared among anterior mediastinal tumors using one-way ANOVA or t-test. Receiver-operating characteristic (ROC) curve analysis was performed to evaluate the ability of ECV fraction to differentiate thymic carcinomas/lymphomas from thymomas. RESULTS ECV fraction differed significantly among the anterior mediastinal tumors (p < 0.001). ECV fraction of thymic carcinomas was significantly higher than those of low-risk thymomas, high-risk thymomas, and lymphomas (p < 0.001, p < 0.001, and p = 0.006, respectively). ECV fraction of lymphomas was significantly higher than that of low-risk thymomas (p < 0.001). ECV fraction was significantly higher in thymic carcinomas/lymphomas than in thymomas (40.1 % vs. 27.7 %, p < 0.001). The optimal cutoff value to differentiate thymic carcinomas/lymphomas from thymomas was 38.5 % (AUC, 0.805; 95 %CI, 0.736-0.863). CONCLUSIONS ECV fraction derived from equilibrium CECT is helpful in diagnosing anterior mediastinal tumors. High ECV fraction is indicative of thymic carcinomas/lymphomas, particularly thymic carcinomas.
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Affiliation(s)
- Koji Takumi
- Departments of Radiology Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan.
| | - Hiroaki Nagano
- Departments of Radiology Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan
| | - Arata Oose
- Departments of Radiology Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan
| | - Misaki Gohara
- Departments of Radiology Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan
| | - Kiyohisa Kamimura
- Departments of Radiology Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan
| | - Masatoyo Nakajo
- Departments of Radiology Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan
| | - Aya Harada-Takeda
- General Thoracic Surgery Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan
| | - Kazuhiro Ueda
- General Thoracic Surgery Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan
| | - Kazuhiro Tabata
- Human Pathology Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan
| | - Takashi Yoshiura
- Departments of Radiology Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan
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Takumi K, Nagano H, Myogasako T, Nakano T, Fukukura Y, Ueda K, Tabata K, Tanimoto A, Yoshiura T. Feasibility of iodine concentration and extracellular volume fraction measurement derived from the equilibrium phase dual-energy CT for differentiating thymic epithelial tumors. Jpn J Radiol 2023; 41:45-53. [PMID: 36029365 PMCID: PMC9813095 DOI: 10.1007/s11604-022-01331-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/15/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE To assess the diagnostic feasibility of iodine concentration (IC) and extracellular volume (ECV) fraction measurement using the equilibrium phase dual-energy CT (DECT) for the evaluation of thymic epithelial tumors (TETs). MATERIALS AND METHODS This study included 33 TETs (11 low-risk thymomas, 11 high-risk thymomas, and 11 thymic carcinomas) that were assessed by pretreatment DECT. IC was measured during the equilibrium phases and ECV fraction was calculated using IC of the thymic lesion and the aorta. IC and ECV fraction were compared among TET subtypes using the Kruskal-Wallis H test and Mann-Whitney U test. Receiver-operating characteristic (ROC) curve analysis was performed to evaluate the ability of IC and ECV fraction to diagnose thymic carcinoma. RESULTS IC during the equilibrium phase and ECV fraction differed among the three TET groups (both p < 0.001). IC during the equilibrium phase and ECV fraction was significantly higher in thymic carcinomas than in thymomas (1.9 mg/mL vs. 1.2 mg/mL, p < 0.001; 38.2% vs. 25.9%, p < 0.001; respectively). The optimal cutoff values of IC during the equilibrium phase and of ECV fraction to diagnose thymic carcinoma were 1.5 mg/mL (AUC, 0.955; sensitivity, 100%; specificity, 90.9%) and 26.8% (AUC, 0.888; sensitivity, 100%; specificity, 72.7%), respectively. CONCLUSION IC and ECV fraction measurement using DECT are helpful in diagnosing TETs. High IC during the equilibrium phase and high ECV fraction are suggestive of thymic carcinoma.
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Affiliation(s)
- Koji Takumi
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Hiroaki Nagano
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Tsuyoshi Myogasako
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Tsubasa Nakano
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Yoshihiko Fukukura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Kazuhiro Ueda
- Department of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Kazuhiro Tabata
- Department of Human Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Akihide Tanimoto
- Department of Human Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Takashi Yoshiura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
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Zhang J, Zeng M. Cardiac metastasis of neuroendocrine tumor of the thymus diagnosed by cardiac magnetic resonance T1 mapping: a case report. J Int Med Res 2021; 48:300060520931678. [PMID: 32558603 PMCID: PMC7307485 DOI: 10.1177/0300060520931678] [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: 11/15/2022] Open
Abstract
Carcinoid heart disease is a late complication of carcinoid syndrome, and imaging can
help in the diagnosis of diffuse cardiac metastasis. We herein report a case of diffuse
cardiac metastasis of a neuroendocrine tumor of the thymus diagnosed using different
imaging modalities. Cardiac magnetic resonance imaging played an important role in the
diagnosis. The patient underwent conservative medical treatment and remained able to
perform his usual activities of daily living.
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Affiliation(s)
- Jiamin Zhang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Mu Zeng
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
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Echocardiographic tissue imaging evaluation of myocardial characteristics and function in cardiomyopathies. Heart Fail Rev 2020; 26:813-828. [PMID: 31950337 DOI: 10.1007/s10741-020-09918-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Current echocardiography techniques have allowed more precise assessment of cardiac structure and function of the several types of cardiomyopathies. Parameters derived from echocardiographic tissue imaging (ETI)-tissue Doppler, strain, strain rate, and others-are extensively used to provide a framework in the evaluation and management of cardiomyopathies. Generally, myocardial function assessed by ETI is depressed in all types of cardiomyopathies, non-ischemic dilated cardiomyopathy (DCM) in particular. In hypertrophic cardiomyopathy (HCM), ETI is useful to identify subclinical disease in family members of HCM, to differentiate HCM from other conditions causing cardiac hypertrophy and to predict cardiac events. ETI also for HCM allows addressing the mechanism behind left ventricular outflow tract obstruction and its improvement after therapeutic options. ETI provides cardiac amyloidosis with unique and specific findings such as "apical sparing." Nevertheless, ETI does not seem to provide as much information amenable to histological findings as recently emerging techniques of cardiac magnetic resonance imaging. This review introduces usefulness of ETI and some other ultrasound techniques for detecting clinical and subclinical characteristics of cardiomyopathies, focusing on DCM, HCM, and cardiac amyloidosis.
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Wu CW, Wu R, Shi RY, An DA, Chen BH, Jiang M, Bacyinski A, Rahim A, Deen JM, Hu J, Han TT, Xu JR, Wu LM. Histogram Analysis of Native T 1 Mapping and Its Relationship to Left Ventricular Late Gadolinium Enhancement, Hypertrophy, and Segmental Myocardial Mechanics in Patients With Hypertrophic Cardiomyopathy. J Magn Reson Imaging 2018; 49:668-677. [PMID: 30142234 DOI: 10.1002/jmri.26272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The use of native T1 mapping for evaluation of hypertrophic cardiomyopathy (HCM) is being explored, and its combination with histogram analysis may benefit the accuracy of such assessments. PURPOSE To investigate the relationship of segmental left ventricular wall thickness (LVWT), myocardial fibrosis, and strain parameters with segmental histogram parameters of native T1 mapping in HCM patients. STUDY TYPE Retrospective. SUBJECTS Ninety-three HCM patients without previous cardiovascular diseases were included. FIELD STRENGTH/SEQUENCE 3.0T cardiac MR. Steady-state free precession cine imaging, modified Look-Locker inversion recovery, phase-sensitive inversion recovery. ASSESSMENT Images were assessed by three experienced radiologists. STATISTICAL TESTS Mann-Whitney U-tests, area under the curve (AUC), Spearman's rank correlation, intraclass correlation coefficient, and Bland-Altman test were used for statistical analysis. RESULTS A higher LVWT value correlated with higher means, minimums, 10th /25th /50th /75th /90th percentiles, maximums, kurtosis, entropy, and lower SD and energy of T1 mapping (P < 0.05 for all), with the correlation being stronger for entropy and energy (Spearman's rho = 0.439 and -0.413, respectively) than other parameters. Late gadolinium enhancement positive (LGE+) segments exhibited higher mean, minimum, 10th /25th /50th /75th /90th percentiles, maximum, entropy, and lower energy of T1 times than late gadolinium enhancement negative (LGE-) segments (P < 0.001 for all). Impaired strain function parameters (peak thickening and thickening rate in radial, circumferential, and longitudinal directions) demonstrated a weak correlation with higher entropy (P < 0.001 for all) and lower energy (P < 0.001 for all). DATA CONCLUSION Histogram parameters of native T1 mapping provide more information than mean T1 times alone. Among these parameters, entropy and energy may correlate better with LVWT, myocardial late gadolinium enhancement, and strain parameters than mean T1 times in HCM patients. LEVEL OF EVIDENCE 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;49:668-677.
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Affiliation(s)
- Chong-Wen Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Rui Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Ruo-Yang Shi
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Dong-Aolei An
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Bing-Hua Chen
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Meng Jiang
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Andrew Bacyinski
- Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Ali Rahim
- Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - James M Deen
- Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Jiani Hu
- Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Tong-Tong Han
- Circle Cardiovascular Imaging, Calgary, Alberta, Canada
| | - Jian-Rong Xu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Lian-Ming Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
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