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Zanon C, Quaia E, Crimì F. Introduction to Special Issue Imaging in Cancer Diagnosis. Tomography 2024; 10:101-104. [PMID: 38250955 PMCID: PMC10820471 DOI: 10.3390/tomography10010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
In the field of oncology, the precision of cancer imaging is the cornerstone of oncological patient care [...].
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Affiliation(s)
| | | | - Filippo Crimì
- Institute of Radiology, Department of Medicine—DIMED, University of Padua, 35128 Padua, Italy; (C.Z.); (E.Q.)
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Antoniou A, Damianou C. Feasibility of Ultrasonic Heating through Skull Phantom Using Single-element Transducer. J Med Ultrasound 2024; 32:32-40. [PMID: 38665339 PMCID: PMC11040484 DOI: 10.4103/jmu.jmu_3_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/14/2023] [Accepted: 03/31/2023] [Indexed: 04/28/2024] Open
Abstract
Background Noninvasive neurosurgery has become possible through the use of transcranial focused ultrasound (FUS). This study assessed the heating ability of single element spherically focused transducers operating at 0.4 and 1.1 MHz through three-dimensional (3D) printed thermoplastic skull phantoms. Methods Phantoms with precise skull bone geometry of a male patient were 3D printed using common thermoplastic materials following segmentation on a computed tomography head scan image. The brain tissue was mimicked by an agar-based gel phantom developed in-house. The selection of phantom materials was mainly based on transmission-through attenuation measurements. Phantom sonications were performed through water, and then, with the skull phantoms intervening the beam path. In each case, thermometry was performed at the focal spot using thermocouples. Results The focal temperature change in the presence of the skull phantoms was reduced to less than 20 % of that recorded in free field when using the 0.4 MHz transducer, whereas the 1.1 MHz trans-skull sonication produced minimal or no change in focal temperature. The 0.4 MHz transducer showed better performance in trans-skull transmission but still not efficient. Conclusion The inability of both tested single element transducers to steer the beam through the high attenuating skull phantoms and raise the temperature at the focus was confirmed, underlying the necessity to use a correction technique to compensate for energy losses, such those provided by phased arrays. The proposed phantom could be used as a cost-effective and ergonomic tool for trans-skull FUS preclinical studies.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering and Informatics, Cyprus University of Technology, Limassol, Cyprus
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Longitudinal diffusion and volumetric kinetics of head and neck cancer magnetic resonance on a 1.5 T MR-linear accelerator hybrid system: A prospective R-IDEAL stage 2a imaging biomarker characterization/pre-qualification study. Clin Transl Radiat Oncol 2023; 42:100666. [PMID: 37583808 PMCID: PMC10424120 DOI: 10.1016/j.ctro.2023.100666] [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: 05/20/2023] [Revised: 07/18/2023] [Accepted: 07/22/2023] [Indexed: 08/17/2023] Open
Abstract
Objectives We aim to characterize the serial quantitative apparent diffusion coefficient (ADC) changes of the target disease volume using diffusion-weighted imaging (DWI) acquired weekly during radiation therapy (RT) on a 1.5 T MR-Linac and correlate these changes with tumor response and oncologic outcomes for head and neck squamous cell carcinoma (HNSCC) patients as part of a programmatic R-IDEAL biomarker characterization effort. Methods Thirty patients with HNSCC who received curative-intent RT at MD Anderson Cancer Center, were included. Baseline and weekly MRI were obtained, and various ADC parameters were extracted from the regions of interest (ROIs). Baseline and weekly ADC parameters were correlated with response during and after RT, and the recurrence using the Mann-Whitney U test. The Wilcoxon signed-rank test was used to compare the weekly ADC versus baseline values. Weekly volumetric changes (Δvolume) for each ROI were correlated with ΔADC using Spearman's Rho test. Recursive partitioning analysis (RPA) identified the optimal ΔADC threshold associated with different oncologic outcomes. Results There was a significant rise in all ADC parameters at different time points of RT compared to baseline for both gross primary disease (GTV-P) and gross nodal disease volumes (GTV-N). The increased ADC values for GTV-P were statistically significant only for primary tumors achieving complete remission (CR) during RT. RPA identified GTV-P ΔADC 5th percentile > 13% at the mid-RT as the most significant parameter associated with primary tumors' CR during RT (p < 0.001). There was a significant decrease in residual volume of both GTV-P & GTV-N throughout the course of RT. A significant negative correlation between mean ΔADC and Δvolume for GTV-P at the 3rd and 4th week of RT was detected (r = -0.39, p = 0.044 & r = -0.45, p = 0.019, respectively). Conclusion Assessment of ADC kinetics at regular intervals throughout RT seems to be correlated with RT response. Further studies with larger cohorts and multi-institutional data are needed for validation of ΔADC as a model for prediction of response to RT.
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El-Habashy DM, Wahid KA, He R, McDonald B, Rigert J, Mulder SJ, Lim TY, Wang X, Yang J, Ding Y, Naser MA, Ng SP, Bahig H, Salzillo TC, Preston KE, Abobakr M, Shehata MA, Elkhouly EA, Alagizy HA, Hegazy AH, Mohammadseid M, Terhaard C, Philippens M, Rosenthal DI, Wang J, Lai SY, Dresner A, Christodouleas JC, Mohamed ASR, Fuller CD. Longitudinal diffusion and volumetric kinetics of head and neck cancer magnetic resonance on a 1.5T MR-Linear accelerator hybrid system: A prospective R-IDEAL Stage 2a imaging biomarker characterization/ pre-qualification study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.04.23289527. [PMID: 37205359 PMCID: PMC10187456 DOI: 10.1101/2023.05.04.23289527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Objectives We aim to characterize the serial quantitative apparent diffusion coefficient (ADC) changes of the target disease volume using diffusion-weighted imaging (DWI) acquired weekly during radiation therapy (RT) on a 1.5T MR-Linac and correlate these changes with tumor response and oncologic outcomes for head and neck squamous cell carcinoma (HNSCC) patients as part of a programmatic R-IDEAL biomarker characterization effort. Methods Thirty patients with pathologically confirmed HNSCC who received curative-intent RT at the University of Texas MD Anderson Cancer Center, were included in this prospective study. Baseline and weekly Magnetic resonance imaging (MRI) (weeks 1-6) were obtained, and various ADC parameters (mean, 5 th , 10 th , 20 th , 30 th , 40 th , 50 th , 60 th , 70 th , 80 th , 90 th and 95 th percentile) were extracted from the target regions of interest (ROIs). Baseline and weekly ADC parameters were correlated with response during RT, loco-regional control, and the development of recurrence using the Mann-Whitney U test. The Wilcoxon signed-rank test was used to compare the weekly ADC versus baseline values. Weekly volumetric changes (Δvolume) for each ROI were correlated with ΔADC using Spearman's Rho test. Recursive partitioning analysis (RPA) was performed to identify the optimal ΔADC threshold associated with different oncologic outcomes. Results There was an overall significant rise in all ADC parameters during different time points of RT compared to baseline values for both gross primary disease volume (GTV-P) and gross nodal disease volumes (GTV-N). The increased ADC values for GTV-P were statistically significant only for primary tumors achieving complete remission (CR) during RT. RPA identified GTV-P ΔADC 5 th percentile >13% at the 3 rd week of RT as the most significant parameter associated with CR for primary tumor during RT (p <0.001). Baseline ADC parameters for GTV-P and GTV-N didn't significantly correlate with response to RT or other oncologic outcomes. There was a significant decrease in residual volume of both GTV-P & GTV-N throughout the course of RT. Additionally, a significant negative correlation between mean ΔADC and Δvolume for GTV-P at the 3 rd and 4 th week of RT was detected (r = -0.39, p = 0.044 & r = -0.45, p = 0.019, respectively). Conclusion Assessment of ADC kinetics at regular intervals throughout RT seems to be correlated with RT response. Further studies with larger cohorts and multi-institutional data are needed for validation of ΔADC as a model for prediction of response to RT.
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Affiliation(s)
- Dina M El-Habashy
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Clinical Oncology and Nuclear Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Kareem A Wahid
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Renjie He
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Brigid McDonald
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jillian Rigert
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Samuel J. Mulder
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Tze Yee Lim
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Xin Wang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jinzhong Yang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yao Ding
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mohamed A Naser
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sweet Ping Ng
- Department of Radiation Oncology, Austin Health Melbourne, Australia
| | - Houda Bahig
- Department of radiology, radiation oncology and nuclear medicine, Université de Montréal, Canada
| | - Travis C Salzillo
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kathryn E Preston
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- University of Houston College of Pharmacy, Houston, Texas, USA
| | - Moamen Abobakr
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mohamed A Shehata
- Department of Clinical Oncology and Nuclear Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Enas A Elkhouly
- Department of Clinical Oncology and Nuclear Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Hagar A Alagizy
- Department of Clinical Oncology and Nuclear Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Amira H Hegazy
- Department of Clinical Oncology and Nuclear Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Mustefa Mohammadseid
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Chris Terhaard
- Department of Radiation Therapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marielle Philippens
- Department of Radiation Therapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - David I. Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jihong Wang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Stephen Y. Lai
- Department of Head and Neck Surgery, Division of Surgery,The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alex Dresner
- Philips Healthcare MR Oncology, Cleveland, Ohio, USA
| | | | | | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Wijethilake N, MacCormac O, Vercauteren T, Shapey J. Imaging biomarkers associated with extra-axial intracranial tumors: a systematic review. Front Oncol 2023; 13:1131013. [PMID: 37182138 PMCID: PMC10167010 DOI: 10.3389/fonc.2023.1131013] [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: 12/24/2022] [Accepted: 03/27/2023] [Indexed: 05/16/2023] Open
Abstract
Extra-axial brain tumors are extra-cerebral tumors and are usually benign. The choice of treatment for extra-axial tumors is often dependent on the growth of the tumor, and imaging plays a significant role in monitoring growth and clinical decision-making. This motivates the investigation of imaging biomarkers for these tumors that may be incorporated into clinical workflows to inform treatment decisions. The databases from Pubmed, Web of Science, Embase, and Medline were searched from 1 January 2000 to 7 March 2022, to systematically identify relevant publications in this area. All studies that used an imaging tool and found an association with a growth-related factor, including molecular markers, grade, survival, growth/progression, recurrence, and treatment outcomes, were included in this review. We included 42 studies, comprising 22 studies (50%) of patients with meningioma; 17 studies (38.6%) of patients with pituitary tumors; three studies (6.8%) of patients with vestibular schwannomas; and two studies (4.5%) of patients with solitary fibrous tumors. The included studies were explicitly and narratively analyzed according to tumor type and imaging tool. The risk of bias and concerns regarding applicability were assessed using QUADAS-2. Most studies (41/44) used statistics-based analysis methods, and a small number of studies (3/44) used machine learning. Our review highlights an opportunity for future work to focus on machine learning-based deep feature identification as biomarkers, combining various feature classes such as size, shape, and intensity. Systematic Review Registration: PROSPERO, CRD42022306922.
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Affiliation(s)
- Navodini Wijethilake
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Oscar MacCormac
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Jonathan Shapey
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, United Kingdom
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Laothamatas I, Al Mubarak H, Reddy A, Wax R, Badani K, Taouli B, Bane O, Lewis S. Multiparametric MRI of Solid Renal Masses: Principles and Applications of Advanced Quantitative and Functional Methods for Tumor Diagnosis and Characterization. J Magn Reson Imaging 2023. [PMID: 37052601 DOI: 10.1002/jmri.28718] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 04/14/2023] Open
Abstract
Solid renal masses (SRMs) are increasingly detected and encompass both benign and malignant masses, with renal cell carcinoma (RCC) being the most common malignant SRM. Most patients with SRMs will undergo management without a priori pathologic confirmation. There is an unmet need to noninvasively diagnose and characterize RCCs, as significant variability in clinical behavior is observed and a wide range of differing management options exist. Cross-sectional imaging modalities, including magnetic resonance imaging (MRI), are increasingly used for SRM characterization. Multiparametric (mp) MRI techniques can provide insight into tumor biology by probing different physiologic/pathophysiologic processes noninvasively. These include sequences that probe tissue microstructure, including intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and T1 relaxometry; oxygen metabolism (blood oxygen level dependent [BOLD-MRI]); as well as vascular flow and perfusion (dynamic contrast-enhanced MRI [DCE-MRI] and arterial spin labeling [ASL]). In this review, we will discuss each mpMRI method in terms of its principles, roles, and discuss the results of human studies for SRM assessment. Future validation of these methods may help to enable a personalized management approach for patients with SRM in the emerging era of precision medicine. EVIDENCE LEVEL: 5. TECHNICAL EFFICACY: 2.
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Affiliation(s)
- Indira Laothamatas
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Haitham Al Mubarak
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Arthi Reddy
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rebecca Wax
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ketan Badani
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bachir Taouli
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Octavia Bane
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sara Lewis
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Antoniou A, Evripidou N, Panayiotou S, Spanoudes K, Damianou C. Treatment of canine and feline sarcoma using MR-guided focused ultrasound system. J Ultrasound 2022; 25:895-904. [PMID: 35277843 PMCID: PMC9705640 DOI: 10.1007/s40477-022-00672-5] [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: 10/25/2021] [Accepted: 02/27/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE In recent years, veterinary medicine has enhanced its applications beyond traditional approaches, progressively incorporating the Focused Ultrasound (FUS) technology. This study investigated the ability of FUS to precisely ablate naturally occurring canine and feline soft tissue sarcomas (STS). METHODS Six dogs and four cats with superficial tumours were enrolled in the study. The tumours were treated with a Magnetic Resonance guided FUS (MRgFUS) robotic system featuring a single element spherically focused transducer of 2.6 MHz. The tumours were then removed by surgery and sent for hematoxylin and eosin (H&E) staining. RESULTS The MRgFUS system was capable of inflicting well-defined overlapping lesions in the tumours. The anatomical sites of the treated tumours were the neck, leg, face, back and belly. Coagulative necrosis was evidenced by histopathology assessment in 80% of cases. CONCLUSION Therefore, this technology can be a therapeutic solution for veterinary cancer and a model for advancing the knowledge on human STS.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036, Limassol, Cyprus
| | - Nikolas Evripidou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036, Limassol, Cyprus
| | - Stelios Panayiotou
- SGS Diagnostic Centre of Histopathology and Cytology Limited, 21 Thessalonikis, 3025, Limassol, Cyprus
| | - Kyriakos Spanoudes
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036, Limassol, Cyprus.
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Antoniou A, Georgiou A, Evripidou N, Damianou C. Full coverage path planning algorithm for MRgFUS therapy. Int J Med Robot 2022; 18:e2389. [PMID: 35257476 PMCID: PMC9286630 DOI: 10.1002/rcs.2389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 11/17/2022]
Abstract
Background High‐quality methods for Magnetic Resonance guided Focussed Ultrasound (MRgFUS) therapy planning are needed for safe and efficient clinical practices. Herein, an algorithm for full coverage path planning based on preoperative MR images is presented. Methods The software functionalities of an MRgFUS robotic system were enhanced by implementing the developed algorithm. The algorithm's performance in accurate path planning following a Zig‐Zag pathway was assessed on MR images. The planned sonication paths were performed on acrylic films using the robotic system carrying a 2.75 MHz single element transducer. Results Ablation patterns were successfully planned on MR images and produced on acrylic films by overlapping lesions with excellent match between the planned and experimental lesion shapes. Conclusions The advanced software was proven efficient in planning and executing full ablation of any segmented target. The reliability of the algorithm could be enhanced through the development of a fully automated segmentation procedure.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
| | - Andreas Georgiou
- Department of Electrical Engineering Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
| | - Nikolas Evripidou
- Department of Electrical Engineering Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
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Antoniou A, Georgiou L, Christodoulou T, Panayiotou N, Ioannides C, Zamboglou N, Damianou C. MR relaxation times of agar-based tissue-mimicking phantoms. J Appl Clin Med Phys 2022; 23:e13533. [PMID: 35415875 PMCID: PMC9121050 DOI: 10.1002/acm2.13533] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/29/2021] [Indexed: 12/31/2022] Open
Abstract
Agar gels were previously proven capable of accurately replicating the acoustical and thermal properties of real tissue and widely used for the construction of tissue-mimicking phantoms (TMPs) for focused ultrasound (FUS) applications. Given the current popularity of magnetic resonance-guided FUS (MRgFUS), we have investigated the MR relaxation times T1 and T2 of different mixtures of agar-based phantoms. Nine TMPs were constructed containing agar as the gelling agent and various concentrations of silicon dioxide and evaporated milk. An agar-based phantom doped with wood powder was also evaluated. A series of MR images were acquired in a 1.5 T scanner for T1 and T2 mapping. T2 was predominantly affected by varying agar concentrations. A trend toward decreasing T1 with an increasing concentration of evaporated milk was observed. The addition of silicon dioxide decreased both relaxation times of pure agar gels. The proposed phantoms have great potential for use with the continuously emerging MRgFUS technology. The MR relaxation times of several body tissues can be mimicked by adjusting the concentration of ingredients, thus enabling more accurate and realistic MRgFUS studies.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Leonidas Georgiou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | | | - Natalie Panayiotou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Cleanthis Ioannides
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Nikolaos Zamboglou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
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Antoniou A, Giannakou M, Evripidou N, Stratis S, Pichardo S, Damianou C. Robotic system for top to bottom MRgFUS therapy of multiple cancer types. Int J Med Robot 2022; 18:e2364. [DOI: 10.1002/rcs.2364] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 12/18/2022]
Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
| | | | - Nikolas Evripidou
- Department of Electrical Engineering, Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
| | - Stylianos Stratis
- Department of Electrical Engineering, Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
| | - Samuel Pichardo
- Hotchkiss Brain Institute Cumming School of Medicine University of Calgary Calgary Alberta Canada
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics Cyprus University of Technology Limassol Cyprus
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Antoniou A, Damianou C. MR relaxation properties of tissue-mimicking phantoms. ULTRASONICS 2022; 119:106600. [PMID: 34627028 DOI: 10.1016/j.ultras.2021.106600] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
High quality tissue-mimicking phantoms (TMPs) have a critical role in the preclinical testing of emerging modalities for diagnosis and therapy. TMPs capable of accurately mimicking real tissue in Magnetic Resonance guided Focused Ultrasound (MRgFUS) applications should be fabricated with precise T1 and T2 relaxation times. Given the current popularity of the MRgFUS technology, we herein performed a systematic review on the MR relaxation properties of different phantoms types. Polyacrylamide (PAA) and agar based phantoms were proven capable of accurately replicating critical thermal, acoustical, and MR relaxation properties of various body tissues. Although gelatin phantoms were also proven factional in this regard, they lack the capacity to withstand ablation temperatures, and thus, are only recommended for hyperthermia applications. Other gelling agents identified in the literature are Poly-vinyl alcohol (PVA), Polyvinyl Chloride (PVC), silicone, and TX-150/ TX-151; however, their efficacy in thermal studies is yet to be established. PAA gels are favorable in that they offer optical transparency enabling direct visualization of coagulative lesions. On the other hand, agar phantoms have lower preparation costs and were proven very promising for use with the MRgFUS technology, without the toxicity issues related to the preparation and storage of PAA materials. Remarkably, agar turned out to be the prominent modifier of the T2 relaxation time even for phantoms containing other types of gelling agents instead of agar. This review could be useful in manufacturing realistic MRgFUS phantoms while simultaneously indicating an opportunity for further research in the field with a particular focus on the MR behavior of agar-based TMPs.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus.
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Peng Y, Luo Y, Hu X, Shen Y, Hu D, Li Z, Kamel I. Quantitative T2*-Weighted Imaging and Reduced Field-of-View Diffusion-Weighted Imaging of Rectal Cancer: Correlation of R2* and Apparent Diffusion Coefficient With Histopathological Prognostic Factors. Front Oncol 2021; 11:670156. [PMID: 34109120 PMCID: PMC8180870 DOI: 10.3389/fonc.2021.670156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/28/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose To assess T2*-weighted imaging (T2*WI) and reduced field-of-view diffusion-weighted Imaging (rDWI) derived parameters and their relationships with histopathological factors in patients with rectal cancer. Methods Fifty-four patients with pathologically-proven rectal cancer underwent preoperative T2*-weighted imaging and rDWI in this retrospective study. R2* values from T2*-weighted imaging and apparent diffusion coefficient (ADC) values from rDWI were compared in terms of different histopathological prognostic factors using student’s t-test or Mann-Whitney U-test. The correlations of R2* and ADC with prognostic factors were assessed by Spearman correlation analysis. The diagnostic performances of R2* and ADC were analyzed by receiver operating characteristic curves (ROC) separately and jointly. Results Significant positive correlation was found between R2* values and T stage, lymph node involvement, histological grades, CEA level, the presence of EMVI and tumor deposit (r = 0.374 ~ 0.673, p = 0.000–0.006), with the exception of CA19-9 level, CRM status and tumor involvement in the circumference lumen (TIL). Meanwhile, ADC values negatively correlated with almost all the prognostic factors (r = −0.588 to −0.299, p = 0.000–0.030), except CA19-9 level. The AUC range was 0.724–0.907 for R2* and 0.674–0.887 for ADC in discrimination of different prognostic factors. While showing the highest AUC of 0.913 (0.803–1.000) in differentiation of T stage, combination of R2* and ADC with reference to different prognostic factors did not significantly improve the diagnostic performance in comparison with individual R2*/ADC parameter. Conclusions R2* and ADC were associated with important histopathological prognostic factors of rectal cancer. R2* might act as additional quantitative imaging marker for tumor characterization of rectal cancer.
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Affiliation(s)
- Yang Peng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Luo
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuemei Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaqi Shen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Daoyu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Li
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ihab Kamel
- Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, United States
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Padmanabhan D, Kella D, Isath A, Tandon N, Mulpuru S, Deshmukh A, Kapa S, Mehta R, Dalzell C, Olson N, Felmlee J, Jondal ML, Asirvatham SJ, Watson RE, Cha YM, Friedman P. Prospective evaluation of the utility of magnetic resonance imaging in patients with non-MRI-conditional pacemakers and defibrillators. J Cardiovasc Electrophysiol 2020; 31:2931-2939. [PMID: 32757438 DOI: 10.1111/jce.14705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/11/2020] [Accepted: 07/30/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) in patients with legacy cardiovascular implantable electronic devices (CIEDs) in situ is likely underutilized. We hypothesized the clinical benefit of MRI would outweigh the risks in legacy CIED patients. METHODS This is a single-center retrospective study that evaluated and classified the utility of MRI using a prospectively maintained database. The outcomes were classified as aiding in diagnosis, treatment, or both for the patients attributable to the MRI. We then assessed the incidence of adverse effects (AE) when the MRI was performed. RESULTS In 668, MRIs performed on 479 patients, only 13 (1.9%) MRIs did not aid in the diagnosis or treatment of the patient. Power-on reset events without clinical sequelae in three scans (0.45%) were the only AE. The probability of an adverse event happening without any benefit from the MRI scan was 1.1 × 10-4 . A maximum benefit in diagnosis using MRI was obtained in ruling out space-occupying lesions (121/185 scans, 65.4%). Scans performed in patients for elucidating answers to queries in treatment were most frequently done for disease staging at long term follow-up (167/470 scans, 35.5%). Conservative treatment (184/470 scans, 39%) followed by medication changes (153/470 scans, 28.7%) were the most common treatment decisions made. CONCLUSIONS The utility of MRI in patients with non-MRI-conditional CIEDs far outweighs the risk of adverse events when imaging is done in the context of a multidisciplinary program that oversees patient safety.
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Affiliation(s)
- Deepak Padmanabhan
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Danesh Kella
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Ameesh Isath
- Department of Medicine, Mount Sinai Morningside, New York City, New York, USA
| | - Nidhi Tandon
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Siva Mulpuru
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Abhishek Deshmukh
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Suraj Kapa
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Ramila Mehta
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, Florida, USA
| | - Connie Dalzell
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Nora Olson
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Joel Felmlee
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mary L Jondal
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Robert E Watson
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Yong M Cha
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Paul Friedman
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
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Kalyane D, Raval N, Maheshwari R, Tambe V, Kalia K, Tekade RK. Employment of enhanced permeability and retention effect (EPR): Nanoparticle-based precision tools for targeting of therapeutic and diagnostic agent in cancer. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 98:1252-1276. [PMID: 30813007 DOI: 10.1016/j.msec.2019.01.066] [Citation(s) in RCA: 442] [Impact Index Per Article: 88.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/02/2019] [Accepted: 01/15/2019] [Indexed: 02/07/2023]
Abstract
In tumorous tissues, the absence of vasculature supportive tissues intimates the formation of leaky vessels and pores (100 nm to 2 μm in diameter) and the poor lymphatic system offers great opportunity to treat cancer and the phenomenon is known as Enhanced permeability and retention (EPR) effect. The trends in treating cancer by making use of EPR effect is increasing day by day and generate multitudes of possibility to design novel anticancer therapeutics. This review aimed to present various factors affecting the EPR effect along with important things to know about EPR effect such as tumor perfusion, lymphatic function, interstitial penetration, vascular permeability, nanoparticle retention etc. This manuscript expounds the current advances and cross-talks the developments made in the of EPR effect-based therapeutics in cancer therapy along with a transactional view of its current clinical and industrial aspects.
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Affiliation(s)
- Dnyaneshwar Kalyane
- National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, An Institute of National Importance, Government of India, Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Palaj, Opposite Air Force Station, Gandhinagar, Gujarat 382355, India
| | - Nidhi Raval
- National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, An Institute of National Importance, Government of India, Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Palaj, Opposite Air Force Station, Gandhinagar, Gujarat 382355, India
| | - Rahul Maheshwari
- National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, An Institute of National Importance, Government of India, Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Palaj, Opposite Air Force Station, Gandhinagar, Gujarat 382355, India
| | - Vishakha Tambe
- National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, An Institute of National Importance, Government of India, Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Palaj, Opposite Air Force Station, Gandhinagar, Gujarat 382355, India
| | - Kiran Kalia
- National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, An Institute of National Importance, Government of India, Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Palaj, Opposite Air Force Station, Gandhinagar, Gujarat 382355, India
| | - Rakesh K Tekade
- National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, An Institute of National Importance, Government of India, Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers, Palaj, Opposite Air Force Station, Gandhinagar, Gujarat 382355, India.
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Whole-Body Magnetic Resonance Imaging in the Oncology Setting: An Overview and Update on Recent Advances. J Comput Assist Tomogr 2018; 43:66-75. [PMID: 30015799 DOI: 10.1097/rct.0000000000000772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Whole-body magnetic resonance imaging is becoming an important tool in oncology as a nonirradiating imaging technique since recent technological advances allowed the incorporation of high-quality imaging in an adequate time. Moreover, the noninjection of radioisotope/intravenous contrast, low cost compared with traditional nuclear medicine techniques, and fast acquisition times are another distinct feature. Thus, the purpose of this article is to review the whole-body magnetic resonance imaging protocol and its main applications in the oncology setting.
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Seo M, Ryu JK, Jahng GH, Sohn YM, Rhee SJ, Oh JH, Won KY. Estimation of T2* Relaxation Time of Breast Cancer: Correlation with Clinical, Imaging and Pathological Features. Korean J Radiol 2017; 18:238-248. [PMID: 28096732 PMCID: PMC5240483 DOI: 10.3348/kjr.2017.18.1.238] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/20/2016] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The purpose of this study was to estimate the T2* relaxation time in breast cancer, and to evaluate the association between the T2* value with clinical-imaging-pathological features of breast cancer. MATERIALS AND METHODS Between January 2011 and July 2013, 107 consecutive women with 107 breast cancers underwent multi-echo T2*-weighted imaging on a 3T clinical magnetic resonance imaging system. The Student's t test and one-way analysis of variance were used to compare the T2* values of cancer for different groups, based on the clinical-imaging-pathological features. In addition, multiple linear regression analysis was performed to find independent predictive factors associated with the T2* values. RESULTS Of the 107 breast cancers, 92 were invasive and 15 were ductal carcinoma in situ (DCIS). The mean T2* value of invasive cancers was significantly longer than that of DCIS (p = 0.029). Signal intensity on T2-weighted imaging (T2WI) and histologic grade of invasive breast cancers showed significant correlation with T2* relaxation time in univariate and multivariate analysis. Breast cancer groups with higher signal intensity on T2WI showed longer T2* relaxation time (p = 0.005). Cancer groups with higher histologic grade showed longer T2* relaxation time (p = 0.017). CONCLUSION The T2* value is significantly longer in invasive cancer than in DCIS. In invasive cancers, T2* relaxation time is significantly longer in higher histologic grades and high signal intensity on T2WI. Based on these preliminary data, quantitative T2* mapping has the potential to be useful in the characterization of breast cancer.
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Affiliation(s)
- Mirinae Seo
- Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Jung Kyu Ryu
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Korea
| | - Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Korea
| | - Yu-Mee Sohn
- Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Sun Jung Rhee
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Korea
| | - Jang-Hoon Oh
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Korea
| | - Kyu-Yeoun Won
- Department of Pathology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Korea
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Park SB. Functional MR imaging in gynecologic malignancies: current status and future perspectives. Abdom Radiol (NY) 2016; 41:2509-2523. [PMID: 27743019 DOI: 10.1007/s00261-016-0924-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Using functional MR imaging techniques, we can approach the functional assessment of gynecologic malignancies. Among them, diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MR imaging (DCE-MRI) are two important techniques. This article provides an overview of functional MR imaging techniques, focusing DWI and DCE-MRI on clinical application in gynecologic malignancies. Functional MR imaging techniques play an important role in detection, characterization, staging, treatment response, and outcome prediction, as well as providing conventional morphologic imaging. Familiarity with the characteristics and imaging features of functional MR imaging in gynecologic malignancies will facilitate prompt and accurate diagnosis and treatment.
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Affiliation(s)
- Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea.
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Anatomical, Physiological, and Molecular Imaging for Pancreatic Cancer: Current Clinical Use and Future Implications. BIOMED RESEARCH INTERNATIONAL 2015; 2015:269641. [PMID: 26146615 PMCID: PMC4471256 DOI: 10.1155/2015/269641] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/18/2015] [Accepted: 05/19/2015] [Indexed: 12/21/2022]
Abstract
Pancreatic adenocarcinoma is one of the deadliest human malignancies. Early detection is difficult and effective treatment is limited. Verifying the presence of micrometastatic dissemination and vessel invasion remains elusive, limiting radiological staging once this diagnosis is made. Diagnostic imaging provides independent tools to evaluate and characterize the biologic behavior of pancreatic cancer. Conventional anatomic imaging alone with either CT or MRI yields useful information on organ involvement but is limited in providing molecular and physiological information. Molecular imaging techniques such as PET or MRS provide information on metabolic and signaling pathways. Advanced MR sequences that target physiological parameters expand imaging options to characterize these tumors. By considering the parametric data from these three imaging approaches (anatomic, molecular, and physiological) we can better define specific tumor signatures. Such parametric characterization can provide insight into tumor metabolism, cellular density, protein expression, focal perfusion, and vascular permeability of these tumors. Radiogenomics research has already demonstrated ability to obtain information about cancer's genotype and phenotype; this is without invasive procedures or surgery. Further advances in these areas of experimental imaging hold promise to enable future clinical advances in detection and therapy of pancreatic cancer.
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Guimaraes MD, Schuch A, Hochhegger B, Gross JL, Chojniak R, Marchiori E. Functional magnetic resonance imaging in oncology: state of the art. Radiol Bras 2015; 47:101-11. [PMID: 25741058 PMCID: PMC4337156 DOI: 10.1590/s0100-39842014000200013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 09/17/2013] [Indexed: 12/20/2022] Open
Abstract
In the investigation of tumors with conventional magnetic resonance imaging, both
quantitative characteristics, such as size, edema, necrosis, and presence of
metastases, and qualitative characteristics, such as contrast enhancement degree, are
taken into consideration. However, changes in cell metabolism and tissue physiology
which precede morphological changes cannot be detected by the conventional technique.
The development of new magnetic resonance imaging techniques has enabled the
functional assessment of the structures in order to obtain information on the
different physiological processes of the tumor microenvironment, such as oxygenation
levels, cellularity and vascularity. The detailed morphological study in association
with the new functional imaging techniques allows for an appropriate approach to
cancer patients, including the phases of diagnosis, staging, response evaluation and
follow-up, with a positive impact on their quality of life and survival rate.
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Affiliation(s)
- Marcos Duarte Guimaraes
- MSc and PhD Fellow, MD, Radiologist, Specialist in Chest and Oncological Imaging, Hospital Heliópolis and A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Alice Schuch
- MD, Radiologist, Full Member of Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), Specialist in Oncological Imaging, MD, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
| | - Bruno Hochhegger
- Post-PhD, MD, Associate Professor, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Jefferson Luiz Gross
- PhD, MD, Oncological Surgeon, Head of Thoracic Surgery Department, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Rubens Chojniak
- PhD, Head of Imaging Department, A.C.Camargo Cancer Center, São Paulo, SP. Brazil
| | - Edson Marchiori
- PhD, Full Professor, Universidade Federal Fluminense (UFF), Niterói, RJ, Associate Professor, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Characterisation of solitary pulmonary lesions combining visual perfusion and quantitative diffusion MR imaging. Eur Radiol 2013; 24:531-41. [PMID: 24173597 DOI: 10.1007/s00330-013-3053-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 09/14/2013] [Accepted: 10/08/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy of dynamic contrast-enhanced (DCE) magnetic resonance (MR) and diffusion-weighted imaging (DWI) sequences for defining benignity or malignancy of solitary pulmonary lesions (SPL). METHODS First, 54 consecutive patients with SPL, clinically staged (CT and PET or integrated PET-CT) as N0M0, were included in this prospective study. An additional 3-Tesla MR examination including DCE and DWI was performed 1 day before the surgical procedure. Histopathology of the surgical specimen served as the standard of reference. Subsequently, this functional method of SPL characterisation was validated with a second cohort of 54 patients. RESULTS In the feasibility group, 11 benign and 43 malignant SPL were included. Using the combination of conventional MR sequences with visual interpretation of DCE-MR curves resulted in a sensitivity, specificity and accuracy of 100%, 55% and 91%, respectively. These results can be improved by DWI (with a cut-off value of 1.52 × 10(-3) mm(2)/s for ADChigh) leading to a sensitivity, specificity and accuracy of 98%, 82% and 94%, respectively. In the validation group these results were confirmed. CONCLUSION Visual DCE-MR-based curve interpretation can be used for initial differentiation of benign from malignant SPL, while additional quantitative DWI-based interpretation can further improve the specificity. KEY POINTS • Magnetic resonance imaging is increasingly being used to help differentiate lung lesions. • Solitary pulmonary lesions (SPL) are accurately characterised by combining DCE-MRI and DWI. • Visual DCE-MRI assessment facilitates the diagnostic throughput in patients with SPL. • DWI provides additional information in inconclusive DCE-MRI (type B pattern).
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Liu M, Guo X, Wang S, Jin M, Wang Y, Li J, Liu J. BOLD-MRI of breast invasive ductal carcinoma: correlation of R2* value and the expression of HIF-1α. Eur Radiol 2013; 23:3221-7. [PMID: 23835924 DOI: 10.1007/s00330-013-2937-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 05/14/2013] [Accepted: 05/24/2013] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To explore the reliability and feasibility of blood oxygenation level-dependent-based functional magnetic resonance imaging (BOLD-fMRI) to depict hypoxia in breast invasive ductal carcinoma. METHODS A total of 103 women with 104 invasive ductal carcinomas (IDCs) underwent breast BOLD-fMRI at 3.0 T. Histological specimens were analysed for tumour size, grade, axillary lymph nodes and expression of oestrogen receptors, progesterone receptors, human epidermal growth factor receptor 2, p53, Ki-67 and hypoxia inducible factor 1α (HIF-1α). The distribution and reliability of R2* were analysed. Correlations of the R2* value with the prognostic factors and HIF-1α were respectively analysed. RESULTS The R2* map of IDC demonstrated a relatively heterogeneous signal. The mean R2* value was (53.4 ± 18.2) Hz. The Shapiro-Wilk test (W = 0.971, P = 0.020) suggested that the sample did not follow a normal distribution. The inter-rater and intrarater correlation coefficient was 0.967 and 0.959, respectively. The R2* values of IDCs were significantly lower in patients without axillary lymph nodes metastasis. The R2* value had a weak correlation with Ki67 expression (r = 0.208, P = 0.038). The mean R2* value correlated moderately with the level of HIF-1α (r = 0.516, P = 0.000). CONCLUSION BOLD-fMRI is a simple and non-invasive technique that yields hypoxia information on breast invasive ductal carcinomas.
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Affiliation(s)
- Min Liu
- Department of Radiology, Beijing Chao Yang Hospital, Capital Medical University, Beijing, 100020, China,
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Afaq A, Akin O. Imaging assessment of tumor response: past, present and future. Future Oncol 2011; 7:669-77. [PMID: 21568682 DOI: 10.2217/fon.11.38] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Anatomical response assessment criteria have been in use for decades, with the WHO guidelines being replaced by Response Evaluation Criteria in Solid Tumors (RECIST), updated in 2009 to RECIST 1.1. These methods rely on a change in size of a tumor as the main response criteria, but newer cytostatic agents tend to target tumor function at a molecular level before changing the size of a lesion. Recent modifications, such as the Choi criteria, have improved assessment by taking into account density of tumor, but all of these criteria fail to utilize functional imaging parameters, which are becoming increasingly available, including perfusion CT, perfusion MRI, diffusion-weighted imaging, magnetic resonance spectroscopy, dynamic contrast-enhanced ultrasound and combined PET/computed tomography. Developments in these modalities and standardization of imaging acquisition will help to optimize the next set of response criteria, with inclusion of multiparametric, functional modalities, evaluating tumors at the same molecular level at which they are being targeted by therapeutic agents.
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Affiliation(s)
- Asim Afaq
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
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