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Yu R, Cai L, Cao Q, Liu P, Gong Y, Li K, Wu Q, Zhang Y, Li P, Yang X, Lu Q. Development and Validation of an MRI-Based Nomogram for Preoperative Detection of Muscle Invasion in VI-RADS 3. J Magn Reson Imaging 2024; 60:448-457. [PMID: 37902432 DOI: 10.1002/jmri.29103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND The relationship between tumor and muscle layer in the vesical imaging-reporting and data system (VI-RADS) 3 is ambiguous, and there is a lack of preoperative and non-invasive procedures to detect muscle invasion in VI-RADS 3. PURPOSE To develop a nomogram based on MRI features for detecting muscle invasion in VI-RADS 3. STUDY TYPE Retrospective. POPULATION 235 cases (Age: 67.5 ± 11.5 years) with 11.9% females were randomly divided into a training cohort (n = 164) and a validation cohort (n = 71). FIELD STRENGTH/SEQUENCE 3T, T2-weighted imaging (turbo spin-echo), diffusion-weighted imaging (breathing-free spin echo), and dynamic contrast-enhanced imaging (gradient echo). ASSESSMENT 3 features were selected from the training cohort, including tumor contact length greater than maximum tumor diameter (TCL > Dmax), flat tumor morphology, and lower standard deviation of apparent diffusion coefficient (ADCSD). Three readers assessed VI-RADS scores and the tumor morphology. STATISTICAL TESTS Interobserver agreement was assessed by Kappa analysis. Features for final analysis were selected by logistic regression. The performance of the nomogram was evaluated by the receiver operating characteristic curve, decision curve analysis, and calibration curve. RESULTS TCL > Dmax, flat morphology, and lower ADCSD were the independent risk factors for muscle invasive in VI-RADS 3. The AUCs, accuracy, sensitivity, and specificity of the nomogram 1 composed of three features for detecting muscle invasion were 0.852 (95% CI: 0.793-0.912), 0.756, 0.917, and 0.663 in the training cohort, and 0.885 (95% CI: 0.801-0.969), 0.817, 0.900, and 0.784 in the validation cohort. The nomogram 2 without ADCSD has nearly the same performance as the nomogram 1. DATA CONCLUSION Nomogram can be an efficient tool for preoperative detection of muscle invasion in VI-RADS 3. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ruixi Yu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lingkai Cai
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Urology, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Qiang Cao
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Peikun Liu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yuxi Gong
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Kai Li
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qikai Wu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yudong Zhang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Pengchao Li
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao Yang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qiang Lu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Zhao Y, You C, Zhou X, Li X, Zhang C, Wu Y, Shen W. The volumetric ADC histogram analysis in differentiating stage IA endometrial carcinoma from endometrial polyp. Br J Radiol 2024; 97:1139-1145. [PMID: 38662891 PMCID: PMC11135793 DOI: 10.1093/bjr/tqae081] [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: 02/07/2023] [Revised: 07/06/2023] [Accepted: 04/02/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE This study aimed to explore the value of apparent diffusion coefficient (ADC) histogram based on whole lesion volume in distinguishing stage IA endometrial carcinoma from the endometrial polyp. METHODS MRI of 108 patients with endometrial lesions confirmed by pathology were retrospectively analysed, including 65 cases of stage IA endometrial carcinoma and 43 cases of endometrial polyp. The volumetric ADC histogram metrics and general imaging features were evaluated and measured simultaneously. All the features were compared between the 2 groups. The receiver operating characteristic curve was utilized to evaluate the diagnostic performance. RESULTS The mean, max, min, and percentiles (10th, 25th, 50th, 75th, 95th) ADC values of endometrial carcinoma were significantly lower than that of polyp (all P < .05). The skewness and kurtosis of ADC values in the endometrial carcinoma group were significantly higher than those in the endometrial polyp group, and the variance of ADC values in the endometrial carcinoma group was lower than those in the endometrial polyp group (all P < .05). Endometrial carcinoma demonstrated more obvious myometrial invasion combined with intralesion haemorrhage than polyp (all P < .05). The 25th percentile of ADC values achieved the largest areas under the curve (0.861) among all the ADC histogram metrics and general imaging features, and the sensitivity and specificity were 83.08% and 76.74%, with the cut-off value of 1.01 × 10-3 mm2/s. CONCLUSION The volumetric ADC histogram analysis was an effective method in differentiating endometrial carcinoma from an endometrial polyp. The 25th percentile of ADC values has satisfactory performance for detecting malignancy in the endometrium. ADVANCES IN KNOWLEDGE The ADC histogram metric based on whole lesion is a promising imaging-maker in differentiating endometrial benign and malignant lesions.
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Affiliation(s)
- Yujiao Zhao
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, 300192, China
| | - Cong You
- Department of Radiology, The First Central Clinical College of Tianjin Medical University, Tianjin, 300192, China
| | - Xin Zhou
- Department of Radiology, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, 300052, China
| | - Xiaotian Li
- The School of Medicine, Nankai University, Tianjin, 300071, China
| | - Cheng Zhang
- Department of Radiology, The First Central Clinical College of Tianjin Medical University, Tianjin, 300192, China
| | - Yanhong Wu
- Department of Obstetrics, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, 300192, China
| | - Wen Shen
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, 300192, China
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He K, Meng X, Wang Y, Feng C, Liu Z, Li Z, Niu Y. Progress of Multiparameter Magnetic Resonance Imaging in Bladder Cancer: A Comprehensive Literature Review. Diagnostics (Basel) 2024; 14:442. [PMID: 38396481 PMCID: PMC10888296 DOI: 10.3390/diagnostics14040442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/25/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
Magnetic resonance imaging (MRI) has been proven to be an indispensable imaging method in bladder cancer, and it can accurately identify muscular invasion of bladder cancer. Multiparameter MRI is a promising tool widely used for preoperative staging evaluation of bladder cancer. Vesical Imaging-Reporting and Data System (VI-RADS) scoring has proven to be a reliable tool for local staging of bladder cancer with high accuracy in preoperative staging, but VI-RADS still faces challenges and needs further improvement. Artificial intelligence (AI) holds great promise in improving the accuracy of diagnosis and predicting the prognosis of bladder cancer. Automated machine learning techniques based on radiomics features derived from MRI have been utilized in bladder cancer diagnosis and have demonstrated promising potential for practical implementation. Future work should focus on conducting more prospective, multicenter studies to validate the additional value of quantitative studies and optimize prediction models by combining other biomarkers, such as urine and serum biomarkers. This review assesses the value of multiparameter MRI in the accurate evaluation of muscular invasion of bladder cancer, as well as the current status and progress of its application in the evaluation of efficacy and prognosis.
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Affiliation(s)
- Kangwen He
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China (X.M.); (Z.L.)
| | - Xiaoyan Meng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China (X.M.); (Z.L.)
| | - Yanchun Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China (X.M.); (Z.L.)
| | - Cui Feng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China (X.M.); (Z.L.)
| | - Zheng Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China (X.M.); (Z.L.)
| | - Yonghua Niu
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Volumetric apparent diffusion coefficient histogram analysis of the testes in nonobstructive azoospermia: a noninvasive fingerprint of impaired spermatogenesis? Eur Radiol 2022; 32:7522-7531. [PMID: 35484338 DOI: 10.1007/s00330-022-08817-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/03/2022] [Accepted: 04/13/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To explore the association between testicular volumetric apparent diffusion coefficient (ADC) histogram analysis metrics and histologic categories in nonobstructive azoospermia (NOA). The role of ADC histogram analysis in predicting the presence of spermatozoa, prior to testicular sperm extraction (TESE), was also investigated. METHODS Forty-one NOA men and 17 age-matched controls underwent scrotal MRI with diffusion-weighted imaging. Histogram analysis of ADC data of the whole testis was performed. Metrics including mean, standard deviation, median, mode, 25th percentile, 75th percentile, skewness, kurtosis, and entropy of volumetric ADC histograms were calculated. Nonparametric statistical tests were used to assess differences in ADC histogram parameters between NOA histologic categories (hypospermatogenesis, severe hypospermatogenesis, early maturation arrest, and Sertoli cell-only syndrome) and normal testes and, between NOA with positive and negative sperm retrieval. RESULTS Normal testes had a lower mean, median, mode, 25th percentile (p < 0.001), and 75th percentile of ADC (p = 0.001), compared to NOA histologic phenotypes. NOA with hypospermatogenesis had a lower 25th percentile of ADC compared to NOA with severe hypospermatogenesis. Regression analysis revealed that the 25th percentile of ADC had a moderately negative correlation with NOA histologic phenotype. The median ADC proved the most significant metric (p = 0.007) to predict the presence of sperm. CONCLUSIONS Testicular volumetric ADC histogram parameters may contribute in the identification of the subpopulation of NOA men with a specific type of spermatogenic arrest. KEY POINTS • Volumetric ADC histogram analysis metrics may be used as noninvasive markers of impaired spermatogenesis in nonobstructive azoospermia. • The 25th percentile of ADC proved useful in discriminating between NOA testes with hypospermatogenesis and severe hypospermatogenesis. • The median ADC proved the most significant parameter to predict the presence of viable spermatozoa prior to TESE.
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Wang F, Xu Y, Xiang Y, Wu P, Shen A, Wang P. The feasibility of amide proton transfer imaging at 3 T for bladder cancer: a preliminary study. Clin Radiol 2022; 77:776-783. [PMID: 35985845 DOI: 10.1016/j.crad.2022.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/31/2022] [Accepted: 07/04/2022] [Indexed: 11/03/2022]
Abstract
AIM To investigate the optimal amide proton transfer (APT) imaging parameters for bladder cancer (BCa), the influence of different protein concentrations and pH values on APT imaging, and to establish the reliability of APT imaging in healthy volunteers and patients with BCa. MATERIALS AND METHODS The optimal APT imaging parameters for BCa were experimentally optimised using cross-linked bovine serum albumin (BSA) phantoms. BSA phantoms were scanned with different values for the saturation power, saturation duration and number of excitations. Meanwhile, BSA phantoms containing different protein concentrations and solutions of different pH levels were scanned. The interobserver agreement of the asymmetric magnetisation transfer ratio (MTRasym) was assessed in 11 healthy volunteers and 18 patients with BCa. RESULTS The optimal scanning scheme consisted of 1 excitation, a saturation power of 2 μT, and a saturation time of 2 s. The APT signal intensity increased as the protein concentration increased and as the pH decreased. The MTRasym showed good concordance for all subjects. The MTRasym of BCa tissue was significantly higher (1.81 ± 0.71) than that of bladder wall in healthy volunteers (0.34 ± 0.12) and normal bladder wall in patients with BCa (0.31 ± 0.11; p<0.001). There was no significant difference between the bladder wall of healthy volunteers and the normal bladder wall of patients with BCa. CONCLUSION APT imaging showed potential value for application in BCa.
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Affiliation(s)
- F Wang
- Department of Radiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Y Xu
- Department of Radiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Y Xiang
- Department of Radiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - P Wu
- Philips Healthcare, Shanghai, 200072, China
| | - A Shen
- Department of Radiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - P Wang
- Department of Radiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.
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Yu B, Huang C, Liu S, Li T, Guan Y, Zheng X, Ding J. Application of first-order feature analysis of DWI-ADC in rare malignant mesenchymal tumours of the maxillofacial region. BMC Oral Health 2021; 21:463. [PMID: 34556116 PMCID: PMC8459531 DOI: 10.1186/s12903-021-01835-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To research the first-order features of apparent diffusion coefficient (ADC) values on diffusion-weighted magnetic resonance imaging (DWI) in maxillofacial malignant mesenchymal tumours. METHODS The clinical data of 12 patients with rare malignant mesenchymal tumours of the maxillofacial region (6 cases of sarcoma and 6 cases of lymphoma) treated in the hospital from May 2018 to June 2020 and were confirmed by postoperative pathology were retrospectively analyzed. The patients were all examined by 1.5T magnetic resonance imaging. PyRadiomics were used to extract radiomics imaging first-order features. Group differences in quantitative variables were examined using independent-samples t-tests. RESULTS The voxels number of ADCmean and ADCmedian of sarcoma tissues were 44.9124 and 44.2064, respectively, significantly higher than those in lymphoma tissues (ADCmean (- 68.8379) and ADCmedian (- 74.0045)), the difference considered statistically significant, so do the ADCkurt and ADCskew. CONCLUSIONS The statistical difference of ADCmean and ADCmedian is significant, it is consistent with the outcome of the manual measurement of the ADC mean value of the most significant cross-section of twelve cases of lymphoma. Development of tumour volume based on the ADC parameter map of DWI demonstrates that the first-order ADC radiomics features analysis can provide new imaging markers for the differentiation of maxillofacial sarcoma and lymphoma. Therefore, first-order ADC features of ADCkurt combined ADCskew may improve the diagnosis level.
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Affiliation(s)
- Baoting Yu
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China
| | - Chencui Huang
- Department of Research Collaboration, R&D Center, Beijing Deepwise and League of PHD Technology Co. Ltd., Beijing, 100080, China
| | - Shuo Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China
| | - Tong Li
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China
| | - Yuyao Guan
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China
| | - Xuewei Zheng
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China
| | - Jun Ding
- Department of Radiology, China-Japan Union Hospital of Jilin University, No. 829 of Xinmin Street, Chaoyang District, Changchun, 130021, China.
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Li S, Liang P, Wang Y, Feng C, Shen Y, Hu X, Hu D, Meng X, Li Z. Combining volumetric apparent diffusion coefficient histogram analysis with vesical imaging reporting and data system to predict the muscle invasion of bladder cancer. Abdom Radiol (NY) 2021; 46:4301-4310. [PMID: 33909091 DOI: 10.1007/s00261-021-03091-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/06/2021] [Accepted: 04/10/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The objective of this study was to explore whether volumetric apparent diffusion coefficient (ADC) histogram analysis can provide additional value to Vesical Imaging Reporting and Data System (VI-RADS) in differentiating muscle-invasive bladder cancer (MIBC) from non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS 80 patients were retrospectively reviewed with pathologically proven NMIBC (n = 53) or MIBC (n = 27). All patients underwent MRI including diffusion-weighted imaging (DWI) (b = 0, 800 s/mm2), and the VI-RADS score was evaluated based on DWI. Volumetric ADC histogram parameters were calculated from the volumetric of interest (VOI) on DWI, including the min ADC, mean ADC, median ADC, max ADC, 10th, 25th, 75th, 90th percentiles ADC, skewness, kurtosis, and entropy. The Mann-Whitney U-test was used to compare histogram parameters between NMIBC and MIBC. Receiver operating characteristic analysis was used to evaluate the diagnostic value of each significant parameter. RESULTS Among all parameters, the VI-RADS yield the highest Area Under the Curve (AUC, 0.88; sensitivity, 88.89%; specificity, 83.61%). MIBC had significantly lower min ADC, mean ADC, median ADC, 10th, 25th, 75th, and 90th percentiles ADC than NMIBC (p = 0.002, p < 0.001, p < 0.001, p = 0.003, p = 0.004, p < 0.001, p < 0.001). Skewness and kurtosis of MIBC were significantly higher than those of NMIBC (p < 0.001, p < 0.001). The combination of VI-RADS and skewness showed significantly higher AUC (AUC 0.923; 95% CI 0.847-0.969) than only with VI-RADS (AUC 0.880; 95% CI 0.793-0.940). CONCLUSION Volumetric ADC histogram analysis and VI-RADS are both useful methods in differentiating MIBC from NMIBC, and the volumetric ADC histogram analysis can provide additional value to VI-RADS.
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Affiliation(s)
- Shichao Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave., Wuhan, 430030, Hubei, China
| | - Ping Liang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave., Wuhan, 430030, Hubei, China
| | - Yanchun Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave., Wuhan, 430030, Hubei, China
| | - Cui Feng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave., Wuhan, 430030, Hubei, China
| | - Yaqi Shen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave., Wuhan, 430030, Hubei, China
| | - Xuemei Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave., Wuhan, 430030, Hubei, China
| | - Daoyu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave., Wuhan, 430030, Hubei, China
| | - Xiaoyan Meng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave., Wuhan, 430030, Hubei, China.
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave., Wuhan, 430030, Hubei, China
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Xu M, Tang Q, Li M, Liu Y, Li F. An analysis of Ki-67 expression in stage 1 invasive ductal breast carcinoma using apparent diffusion coefficient histograms. Quant Imaging Med Surg 2021; 11:1518-1531. [PMID: 33816188 DOI: 10.21037/qims-20-615] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background To investigate the value of apparent diffusion coefficient (ADC) histograms in differentiating Ki-67 expression in T1 stage invasive ductal breast carcinoma (IDC). Methods The records of 111 patients with pathologically confirmed T1 stage IDC who underwent magnetic resonance imaging prior to surgery were retrospectively reviewed. The expression of Ki-67 in tumor tissue samples from the patients was assessed using immunohistochemical (IHC) staining, with a cut-off value of 25% for high Ki-67 labeling index (LI). ADC images of the maximum lay of tumors were selected, and the region of interest (ROI) of each lay was delineated using the MaZda software and analyzed by histogram. The correlations between the histogram characteristic parameters and the Ki-67 LI were investigated. Additionally, the histogram characteristic parameters of the high Ki-67 group (n=54) and the low Ki-67 group (n=57) were statistically analyzed to determine the characteristic parameters with significant difference. Receiver operator characteristic (ROC) analyses were further performed for the significant parameters. Results The mean value, and the 1st, 10th, 50th, 90th, and 99th percentiles were found to be negatively correlated with the expression of Ki-67 (all P values <0.001), with a correlation coefficient of -0.624, -0.749, -0.717, -0.621, -0.500, and -0.410, respectively. In the high Ki-67 group, the mean value, and the 1st, 10th, 50th, 90th, and 99th percentiles extracted by the histogram were significantly lower (all P values <0.05) than that of the low Ki-67 group, with areas under the ROC curves ranging from 0.717-0.856. However, the variance, skewness, and kurtosis did not differ between the two groups (all P values >0.05). Conclusions Histogram-derived parameters for ADC images can serve as a reliable tool in the prediction of Ki-67 proliferation status in patients with T1 stage IDC. Among the significant ADC histogram values, the 1st and 10th percentiles showed the best predictive values.
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Affiliation(s)
- Maolin Xu
- Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Tang
- Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Manxiu Li
- Department of Breast Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yulin Liu
- Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Li
- Department of Ultrasound, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Noninvasive Assessment of Liver Parenchyma Using Gray-Scale Ultrasound-Based Histogram Analysis in Patients With Chronic Hepatitis B Infection. Ultrasound Q 2020; 36:69-73. [PMID: 30855417 DOI: 10.1097/ruq.0000000000000438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The aims of this study were to examine the alterations of liver echo-intensity histogram parameters in chronic hepatitis B (CHB) patients and to assess the potential role of histogram parameters in the evaluation of hepatic fibrosis. A total of 52 patients with CHB who underwent liver biopsies were included in the study. The control group consisted of 30 healthy individuals. Histogram parameters were obtained from histogram analysis of gray-scale ultrasound images of both groups. The histogram parameters of the groups were compared. The association of histogram parameters with the grading and staging of histological activity index (HAI) in patients with CHB were evaluated. The patient group had statistically significant lower skewness, kurtosis, and higher variance, mean, 50th, and 90th percentile values compared with control group. When patients with CHB were divided into subgroups according to HAI stage, there was the increasing trend in skewness values and decreasing trend in kurtosis values across subgroups. The first percentile values showed negative correlation with HAI staging in patients with CHB. Ultrasound is a fast, inexpensive, and reproducible imaging method; histogram analysis of gray-scale ultrasound images may provide useful information for evaluation of hepatic fibrosis in CHB patients.
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Hirata A, Hayano K, Ohira G, Imanishi S, Hanaoka T, Toyozumi T, Murakami K, Aoyagi T, Shuto K, Matsubara H. Volumetric Histogram Analysis of Apparent Diffusion Coefficient as a Biomarker to Predict Survival of Esophageal Cancer Patients. Ann Surg Oncol 2020; 27:3083-3089. [PMID: 32100222 DOI: 10.1245/s10434-020-08270-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND The purpose of this study was to investigate whether histogram analysis of an apparent diffusion coefficient (ADC) can serve as a prognostic biomarker for esophageal squamous cell carcinoma (ESCC). METHODS This retrospective study enrolled 116 patients with ESCC who received curative surgery from 2006 to 2015 (including 70 patients who received neoadjuvant chemotherapy). Diffusion-weighted magnetic resonance imaging (DWI) was performed prior to treatment. The ADC maps were generated by DWIs at b = 0 and 1000 (s/mm2), and analyzed to obtain ADC histogram-derived parameters (mean ADC, kurtosis, and skewness) of the primary tumor. Associations of these parameters with pathological features were analyzed, and Cox regression and Kaplan-Meier analyses were performed to compare these parameters with recurrence-free survival (RFS) and disease-specific survival (DSS). RESULTS Kurtosis was significantly higher in tumors with lymphatic invasion (p = 0.005) with respect to the associations with pathological features. In univariate Cox regression analysis, tumor depth, lymph node status, mean ADC, and kurtosis were significantly correlated with RFS (p = 0.047, p < 0.001, p = 0.037, and p < 0.001, respectively), while lymph node status and kurtosis were also correlated with DSS (p = 0.002 and p = 0.017, respectively). Furthermore, multivariate analysis demonstrated that kurtosis was the independent prognostic factor for both RFS and DSS (p < 0.001 and p = 0.015, respectively). In Kaplan-Meier analysis, patients with higher kurtosis tumors (> 3.24) showed a significantly worse RFS and DFS (p < 0.001 and p = 0.006, respectively). CONCLUSIONS Histogram analysis of ADC may serve as a useful biomarker for ESCC, reflecting pathological features and prognosis.
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Affiliation(s)
- Atsushi Hirata
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Koichi Hayano
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
| | - Gaku Ohira
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shunsuke Imanishi
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Toshiharu Hanaoka
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takeshi Toyozumi
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kentaro Murakami
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomoyoshi Aoyagi
- Department of Surgery, Funabashi Municipal Medical Center, Chiba, Japan
| | - Kiyohiko Shuto
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
| | - Hisahiro Matsubara
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
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Exploratory Study of Apparent Diffusion Coefficient Histogram Metrics in Assessing Pancreatic Malignancy. Can Assoc Radiol J 2019; 70:416-423. [PMID: 31604596 DOI: 10.1016/j.carj.2019.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/01/2019] [Accepted: 07/10/2019] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To evaluate whole-lesion 3D-histogram apparent diffusion coefficient (ADC) metrics for assessment of pancreatic malignancy. METHODS Forty-two pancreatic malignancies (36 pancreatic adenocarcinoma [PDAC], 6 pancreatic neuroendocrine [PanNET]) underwent abdominal magnetic resonance imaging (MRI) with diffusion-weighted imaging before endoscopic ultrasound biopsy or surgical resection. Two radiologists independently placed 3D volumes of interest to derive whole-lesion histogram ADC metrics. Mann-Whitney tests and receiver operating characteristic analyses were used to assess metrics' diagnostic performance for lesion histology, T-stage, N-stage, and grade. RESULTS Whole-lesion ADC histogram metrics lower in PDACs than PanNETs for both readers (P ≤ .026) were mean ADC (area under the curve [AUC] = 0.787-0.792), mean of the bottom 10th percentile (mean0-10) (AUC = 0.787-0.880), mean of the 10th-25th percentile (mean10-25) (AUC = 0.884-0.917) and mean of the 25th-50th percentile (mean25-50) (AUC = 0.829-0.829). For mean10-25 (metric with highest AUC for identifying PDAC), for reader 1 a threshold > 0.94 × 10-3 mm2/s achieved sensitivity 94% and specificity 83%, and for reader 2 a threshold > 0.82 achieved sensitivity 97% and specificity 67%. Metrics lower in nodal status ≥ N1 than N0 for both readers (P ≤ .043) were mean0-10 (AUC = 0.789-0.822) and mean10-25 (AUC = 0.800-0.822). For mean10-25 (metric with highest AUC for identifying N0), for reader 1 a threshold <1.17 achieved sensitivity 87% and specificity 67%, and for reader 2 a threshold <1.04 achieved sensitivity 87% and specificity 83%. No metric was associated with T-stage (P > .195) or grade (P > .215). CONCLUSION Volumetric ADC histogram metrics may serve as non-invasive biomarkers of pancreatic malignancy. Mean10-25 outperformed standard mean for lesion histology and nodal status, supporting the role of histogram analysis.
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Hirata A, Hayano K, Ohira G, Imanishi S, Hanaoka T, Murakami K, Aoyagi T, Shuto K, Matsubara H. Volumetric histogram analysis of apparent diffusion coefficient for predicting pathological complete response and survival in esophageal cancer patients treated with chemoradiotherapy. Am J Surg 2019; 219:1024-1029. [PMID: 31387687 DOI: 10.1016/j.amjsurg.2019.07.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/23/2019] [Accepted: 07/27/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The purpose of the study was to evaluate whether histogram analysis of apparent diffusion coefficient (ADC) can predict pathological complete response (pCR) and survival in patients with esophageal squamous cell carcinoma (ESCC) after chemoradiotherapy (CRT). METHODS We retrospectively identified 58 patients with ESCC who underwent surgery after CRT between 2007 and 2016. Associations of pretreatment histogram derived ADC parameters with pathological response and survival were analyzed. RESULTS Tumors achieved pCR (10 patients, 17.2%) showed significant lower ADC, higher kurtosis, and higher skewness than those of non-pCR (p = 0.005, 0.007, <0.001, respectively). Receiver operating characteristics analysis demonstrated skewness was the best predictor for pCR (AUC = 0.86), with a cut off value of 0.50 (accuracy, 86.2%). In Kaplan-Meier analysis, patients with higher skewness tumors (≥0.50) showed a significantly better recurrence free survival (p = 0.032, log-rank). CONCLUSIONS Histogram analysis of ADC can enable prediction of pCR and survival in ESCC patients treated with preoperative CRT. A SHORT SUMMARY ADC histogram analysis can be an imaging biomarker for esophageal cancer patients treated with CRT.
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Affiliation(s)
- Atsushi Hirata
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Japan
| | - Koichi Hayano
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Japan.
| | - Gaku Ohira
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Japan
| | - Shunsuke Imanishi
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Japan
| | - Toshiharu Hanaoka
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Japan
| | - Kentaro Murakami
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Japan
| | - Tomoyoshi Aoyagi
- Department of Surgery, Funabashi Municipal Medical Center, Japan
| | - Kiyohiko Shuto
- Department of Surgery, Teikyo University Chiba Medical Center, Japan
| | - Hisahiro Matsubara
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, Japan
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Han L, Wang S, Miao Y, Shen H, Guo Y, Xie L, Shang Y, Dong J, Li X, Wang W, Song Q. MRI texture analysis based on 3D tumor measurement reflects the IDH1 mutations in gliomas - A preliminary study. Eur J Radiol 2019; 112:169-179. [PMID: 30777207 DOI: 10.1016/j.ejrad.2019.01.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 01/10/2019] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate the differentiation efficiency of texture analysis of T1WI, T2WI and contrasted-enhanced T1WI MRI sequences in gliomas with and without IDH1 mutation based on entire tumor region. MATERIALS AND METHODS A total of 42 patients with histopathologically confirmed gliomas, including 21 patients carrying IDH1 mutation (IDH1mutation group) and 21 with wild-type IDH1 (IDH1wt group) were included in this study. The preoperative MRI and clinical data were collected. The regions of interest (ROIs) covering the entire tumor and edema were manually delineated on axial slices using O.K. (Omni Kinetics, GE Healthcare, China) software; and the histogram and GLCM features based on T1WI, T2WI and contrasted-enhanced T1WI sequences were automatically generated. RESULTS Based on contrasted-enhanced T1WI features, the inertia resulted as the best feature for diagnosis, with the AUC of 0.844. Furthermore, the AUC for gliomas prediction with IDH1mutation was 0.800 for cluster prominence. IDH1-mutation was differentiated on T2WI with the highest AUC of 0.848, which corresponded to GLCM Entropy. After modeling, the accuracy of the contrasted-enhanced T1WI, T1WI, and T2WI features model was 0.952, 0.857, and 0.738, respectively. The AUC of Joint VariableT1WI+C for predicting IDH1mutation was 0.984, while the AUC of Joint VariableT1WI for predicting the same mutation was 0.927. The diagnostic efficiency of Joint VariableT2WI was also desirable. CONCLUSION MRI texture analysis could be used as a new noninvasive method for identification of gliomas with IDH1 mutation. The present results show that the Joint Variable derived from conventional MR imaging histogram and GLCM features is suitable for precise detection of IDH1-mutated gliomas.
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Affiliation(s)
- Liang Han
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China.
| | - Siyu Wang
- College of medical imaging, Dalian Medical University, Dalian, 116044, China.
| | - Yanwei Miao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China.
| | - Huicong Shen
- Department of Radiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China.
| | - Yan Guo
- Life science, GE Healthcare, Shenyang, 110000, China
| | - Lizhi Xie
- GE Healthcare, MR Research China, Beijing, China
| | - Yuqing Shang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Junyi Dong
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Xiaoxin Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Weiwei Wang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Qingwei Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
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Usefulness of diffusion-weighted magnetic resonance imaging for evaluating the effect of hemostatic radiotherapy for unresectable gastric cancer. Clin J Gastroenterol 2018; 12:269-273. [PMID: 30446953 DOI: 10.1007/s12328-018-0923-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 11/12/2018] [Indexed: 10/27/2022]
Abstract
There are several reports that vouch for the usefulness of diffusion-weighted image (DWI) in making a diagnosis before treatment. However, no study has evaluated the effect of radiotherapy (RT) for unresectable gastric cancer. In the present case report, we evaluated the effectiveness of RT using DWI. An 81-year-old man was hospitalized with a broken bone and then diagnosed with advanced gastric cancer with breeding. He had chorionic renal failure and surgery was impossible. Further, contrast-enhanced computed tomography and magnetic resonance imaging (MRI) were not performed due to renal failure, whereas palliative RT was performed. We followed up the patient using blood test and MRI (DWI) to estimate whether bleeding had stopped or not after radiotherapy. Hemostasis effect was found after 2 weeks of RT. In DWI examination, there was a decrease in the tumor signal intensity 30 days after RT. Similarly, at day 60, the tumor signal intensity further decreased on DWI and the blood test results indicated no progression of anemia. At 4 months after the RT, the patient died because of respiratory failure without any bleeding. DWI is useful not only for the initial diagnosis but also for evaluating the effectiveness of RT.Trial registration: National clinical study registered number: UMIN000026362.
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Li X, Yuan Y, Ren J, Shi Y, Tao X. Incremental Prognostic Value of Apparent Diffusion Coefficient Histogram Analysis in Head and Neck Squamous Cell Carcinoma. Acad Radiol 2018; 25:1433-1438. [PMID: 29599009 DOI: 10.1016/j.acra.2018.02.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/31/2018] [Accepted: 02/15/2018] [Indexed: 11/20/2022]
Abstract
RATIONALE AND OBJECTIVES We aimed to investigate the incremental prognostic value of apparent diffusion coefficient (ADC) histogram analysis in patients with head and neck squamous cell carcinoma (HNSCC) and integrate it into a multivariate prognostic model. MATERIALS AND METHODS A retrospective review of magnetic resonance imaging findings was conducted in patients with pathologically confirmed HNSCC between June 2012 and December 2015. For each tumor, six histogram parameters were derived: the 10th, 50th, and 90th percentiles of ADC (ADC10, ADC50, and ADC90); mean ADC values (ADCmean); kurtosis; and skewness. The clinical variables included age, sex, smoking status, tumor volume, and tumor node metastasis stage. The association of these histogram and clinical variables with overall survival (OS) was determined. Further validation of the histogram parameters as independent biomarkers was performed using multivariate Cox proportional hazard models combined with clinical variables, which was compared to the clinical model. Models were assessed with C index and receiver operating characteristic curve analyses for the 12- and 36-month OS. RESULTS Ninety-six patients were eligible for analysis. Median follow-up was 877 days (range, 54-1516 days). A total of 29 patients died during follow-up (30%). Patients with higher ADC values (ADC10 > 0.958 × 10-3 mm2/s, ADC50 > 1.089 × 10-3 mm2/s, ADC90 > 1.152 × 10-3 mm2/s, ADCmean > 1.047 × 10-3 mm2/s) and lower kurtosis (≤0.967) were significant predictors of poor OS (P < .100 for all). After adjusting for sex and tumor node metastasis stage, the ADC90 and kurtosis are both significant predictors of OS with hazard ratios = 1.00 (95% confidence interval: 1.001-1.004) and 0.58 (95% confidence interval: 0.37-0.90), respectively. By adding the ADC parameters into the clinical model, the C index and diagnostic accuracies for the 12- and 36-month OS showed significant improvement. CONCLUSIONS ADC histogram analysis has incremental prognostic value in patients with HNSCC and increases the performance of a multivariable prognostic model in addition to clinical variables.
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Affiliation(s)
- Xiaoxia Li
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to JiaoTong University School of Medicine, Number 639, Zhizaoju Road, Shanghai, Huangpu District 200011, China
| | - Ying Yuan
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to JiaoTong University School of Medicine, Number 639, Zhizaoju Road, Shanghai, Huangpu District 200011, China
| | - Jiliang Ren
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to JiaoTong University School of Medicine, Number 639, Zhizaoju Road, Shanghai, Huangpu District 200011, China
| | - Yiqian Shi
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to JiaoTong University School of Medicine, Number 639, Zhizaoju Road, Shanghai, Huangpu District 200011, China
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to JiaoTong University School of Medicine, Number 639, Zhizaoju Road, Shanghai, Huangpu District 200011, China.
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Pang G, Duan Z, Shao C, Zhao F, Zhong H, Shao G. Heterogeneity analysis of triphasic CT scan perfusion parameters in differential diagnosis of hepatocellular carcinoma and hemangioma. Medicine (Baltimore) 2018; 97:e12512. [PMID: 30235766 PMCID: PMC6160147 DOI: 10.1097/md.0000000000012512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
This study is to investigate quantitative measures and heterogeneity of perfusion parameters in the differential diagnosis of hepatocellular carcinoma (HCC) and hemangioma.In total, 32 HCC and 44 hemangioma (types 1, 2, and 3) cases were included in this retrospective study. Hepatic artery coefficient (HAC), portal vein coefficient (PVC), and arterial enhancement fraction (AEF) were calculated. Tumor heterogeneity was analyzed. Perfusion parameters and corresponding percentiles were compared between the HCC and hemangioma (especially atypical hemangioma) cases, as well as between the substantial lesion part and surrounding normal tissue.The mean value, and the 10th, 50th, 75th, and 90th percentiles of PVC were significantly lower in the HCC cases than the types 1 and 2 hemangioma cases (P < .01). Moreover, the 90th percentile PVC in the HCC cases was also significantly lower than the type 3 hemangioma case (P < .01), while the mean value, and all the percentiles of AEF in the HCC cases were higher than the types 2 and 3 hemangioma cases (P < .01). The 10th percentile HAC in the HCC cases was higher than the type 2 hemangioma cases (P < .05). The mean value, and the 10th and 50th percentile HAC in the HCC cases were higher than the type 3 hemangioma case (P < .05). However, there was no statistically significant difference in HAC between the HCC and type 1 hemangioma cases (P > .05).Quantitative measurement of perfusion parameters and heterogeneity analysis show significance differences in the early detection and differential diagnosis of HCC and hemangioma cases, which might contribute to increasing the diagnostic accuracy.
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Affiliation(s)
- Guodong Pang
- Department of Radiology, The Second Hospital of Shandong University, Jinan
| | - Zuyun Duan
- Department of Radiology, The Second People's Hospital of Dongying, Dongying
| | - Chunchun Shao
- Department of Evidence-Based Medicine, The Second Hospital of Shandong University
| | - Fang Zhao
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Hai Zhong
- Department of Radiology, The Second Hospital of Shandong University, Jinan
| | - Guangrui Shao
- Department of Radiology, The Second Hospital of Shandong University, Jinan
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Abdelsalam EM, EL Adalany MA, Fouda MEA. Value of diffusion weighted magnetic resonance imaging in grading of urinary bladder carcinoma. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018. [DOI: 10.1016/j.ejrnm.2018.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Salmanoglu E, Halpern E, Trabulsi EJ, Kim S, Thakur ML. A glance at imaging bladder cancer. Clin Transl Imaging 2018; 6:257-269. [PMID: 30456208 DOI: 10.1007/s40336-018-0284-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Purpose Early and accurate diagnosis of Bladder cancer (BCa) will contribute extensively to the management of the disease. The purpose of this review was to briefly describe the conventional imaging methods and other novel imaging modalities used for early detection of BCa and outline their pros and cons. Methods Literature search was performed on Pubmed, PMC, and Google scholar for the period of January 2014 to February 2018 and using such words as "bladder cancer, bladder tumor, bladder cancer detection, diagnosis and imaging". Results A total of 81 published papers were retrieved and are included in the review. For patients with hematuria and suspected of BCa, cystoscopy and CT are most commonly recommended. Ultrasonography, MRI, PET/CT using 18F-FDG or 11C-choline and recently PET/MRI using 18F-FDG also play a prominent role in detection of BCa. Conclusion For initial diagnosis of BCa, cystoscopy is generally performed. However, cystoscopy can not accurately detect carcinoma insitu (CIS) and can not distinguish benign masses from malignant lesions. CT is used in two modes, CT and computed tomographic urography (CTU), both for dignosis and staging of BCa. However, they cannot differentiate T1 and T2 BCa. MRI is performed to diagnose invasive BCa and can differentiate muscle invasive bladder carcinoma (MIBC) from non-muscle invasive bladder carcinoma (NMIBC). However, CT and MRI have low sensitivity for nodal staging. For nodal staging PET/CT is preferred. PET/MRI provides better differentiation of normal and pathologic structures as compared with PET/CT. Nonetheless none of the approaches can address all issues related for the management of BCa. Novel imaging methods that target specific biomarkers, image BCa early and accurately, and stage the disease are warranted.
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Affiliation(s)
- Ebru Salmanoglu
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107
- Department of Nuclear Medicine, Kahramanmaras Sutcu Imam University Faculty of Medicine, Avsar Kampus, Kahramanmaras, Turkey 46040
| | - Ethan Halpern
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107
| | - Edouard J Trabulsi
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107
- Department of Urology, Thomas Jefferson University, Philadelphia, PA 19107
| | - Sung Kim
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107
| | - Mathew L Thakur
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107
- Department of Urology, Thomas Jefferson University, Philadelphia, PA 19107
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107
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Zarinabad N, Meeus EM, Manias K, Foster K, Peet A. Automated Modular Magnetic Resonance Imaging Clinical Decision Support System (MIROR): An Application in Pediatric Cancer Diagnosis. JMIR Med Inform 2018; 6:e30. [PMID: 29720361 PMCID: PMC5956158 DOI: 10.2196/medinform.9171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/10/2018] [Accepted: 01/26/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Advances in magnetic resonance imaging and the introduction of clinical decision support systems has underlined the need for an analysis tool to extract and analyze relevant information from magnetic resonance imaging data to aid decision making, prevent errors, and enhance health care. OBJECTIVE The aim of this study was to design and develop a modular medical image region of interest analysis tool and repository (MIROR) for automatic processing, classification, evaluation, and representation of advanced magnetic resonance imaging data. METHODS The clinical decision support system was developed and evaluated for diffusion-weighted imaging of body tumors in children (cohort of 48 children, with 37 malignant and 11 benign tumors). Mevislab software and Python have been used for the development of MIROR. Regions of interests were drawn around benign and malignant body tumors on different diffusion parametric maps, and extracted information was used to discriminate the malignant tumors from benign tumors. RESULTS Using MIROR, the various histogram parameters derived for each tumor case when compared with the information in the repository provided additional information for tumor characterization and facilitated the discrimination between benign and malignant tumors. Clinical decision support system cross-validation showed high sensitivity and specificity in discriminating between these tumor groups using histogram parameters. CONCLUSIONS MIROR, as a diagnostic tool and repository, allowed the interpretation and analysis of magnetic resonance imaging images to be more accessible and comprehensive for clinicians. It aims to increase clinicians' skillset by introducing newer techniques and up-to-date findings to their repertoire and make information from previous cases available to aid decision making. The modular-based format of the tool allows integration of analyses that are not readily available clinically and streamlines the future developments.
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Affiliation(s)
- Niloufar Zarinabad
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom.,Birmingham Children Hospital NHS Trust, Birmingham, United Kingdom
| | - Emma M Meeus
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom.,Birmingham Children Hospital NHS Trust, Birmingham, United Kingdom.,Physical Sciences of Imaging in Biomedical Sciences Doctoral Training Centre, University of Birmingham, Birmingham, United Kingdom
| | - Karen Manias
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom.,Birmingham Children Hospital NHS Trust, Birmingham, United Kingdom
| | - Katharine Foster
- Birmingham Children Hospital NHS Trust, Birmingham, United Kingdom
| | - Andrew Peet
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom.,Birmingham Children Hospital NHS Trust, Birmingham, United Kingdom
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Ren J, Yuan Y, Wu Y, Tao X. Differentiation of orbital lymphoma and idiopathic orbital inflammatory pseudotumor: combined diagnostic value of conventional MRI and histogram analysis of ADC maps. BMC Med Imaging 2018; 18:6. [PMID: 29716527 PMCID: PMC5930683 DOI: 10.1186/s12880-018-0246-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 01/21/2018] [Indexed: 12/25/2022] Open
Abstract
Background The overlap of morphological feature and mean ADC value restricted clinical application of MRI in the differential diagnosis of orbital lymphoma and idiopathic orbital inflammatory pseudotumor (IOIP). In this paper, we aimed to retrospectively evaluate the combined diagnostic value of conventional magnetic resonance imaging (MRI) and whole-tumor histogram analysis of apparent diffusion coefficient (ADC) maps in the differentiation of the two lesions. Methods In total, 18 patients with orbital lymphoma and 22 patients with IOIP were included, who underwent both conventional MRI and diffusion weighted imaging before treatment. Conventional MRI features and histogram parameters derived from ADC maps, including mean ADC (ADCmean), median ADC (ADCmedian), skewness, kurtosis, 10th, 25th, 75th and 90th percentiles of ADC (ADC10, ADC25, ADC75, ADC90) were evaluated and compared between orbital lymphoma and IOIP. Multivariate logistic regression analysis was used to identify the most valuable variables for discriminating. Differential model was built upon the selected variables and receiver operating characteristic (ROC) analysis was also performed to determine the differential ability of the model. Results Multivariate logistic regression showed ADC10 (P = 0.023) and involvement of orbit preseptal space (P = 0.029) were the most promising indexes in the discrimination of orbital lymphoma and IOIP. The logistic model defined by ADC10 and involvement of orbit preseptal space was built, which achieved an AUC of 0.939, with sensitivity of 77.30% and specificity of 94.40%. Conclusions Conventional MRI feature of involvement of orbit preseptal space and ADC histogram parameter of ADC10 are valuable in differential diagnosis of orbital lymphoma and IOIP.
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Affiliation(s)
- Jiliang Ren
- 0000 0004 0368 8293grid.16821.3cDepartment of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Yuan
- 0000 0004 0368 8293grid.16821.3cDepartment of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingwei Wu
- 0000 0004 0368 8293grid.16821.3cDepartment of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaofeng Tao
- 0000 0004 0368 8293grid.16821.3cDepartment of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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De Paepe KN, De Keyzer F, Wolter P, Bechter O, Dierickx D, Janssens A, Verhoef G, Oyen R, Vandecaveye V. Improving lymph node characterization in staging malignant lymphoma using first-order ADC texture analysis from whole-body diffusion-weighted MRI. J Magn Reson Imaging 2018; 48:897-906. [DOI: 10.1002/jmri.26034] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/17/2018] [Indexed: 12/13/2022] Open
Affiliation(s)
| | | | - Pascal Wolter
- Department of Medical Oncology; University Hospitals Leuven; Belgium
| | - Oliver Bechter
- Department of Medical Oncology; University Hospitals Leuven; Belgium
| | - Daan Dierickx
- Department of Hematology; University Hospitals Leuven; Belgium
| | - Ann Janssens
- Department of Hematology; University Hospitals Leuven; Belgium
| | - Gregor Verhoef
- Department of Hematology; University Hospitals Leuven; Belgium
| | - Raymond Oyen
- Deparment of Radiology; University Hospitals Leuven; Belgium
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Nakajo M, Fukukura Y, Hakamada H, Yoneyama T, Kamimura K, Nagano S, Nakajo M, Yoshiura T. Whole-tumor apparent diffusion coefficient (ADC) histogram analysis to differentiate benign peripheral neurogenic tumors from soft tissue sarcomas. J Magn Reson Imaging 2018; 48:680-686. [PMID: 29469942 DOI: 10.1002/jmri.25987] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/03/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Apparent diffusion coefficient (ADC) histogram analyses have been used to differentiate tumor grades and predict therapeutic responses in various anatomic sites with moderate success. PURPOSE To determine the ability of diffusion-weighted imaging (DWI) with a whole-tumor ADC histogram analysis to differentiate benign peripheral neurogenic tumors (BPNTs) from soft tissue sarcomas (STSs). STUDY TYPE Retrospective study, single institution. SUBJECTS In all, 25 BPNTs and 31 STSs. FIELD STRENGTH/SEQUENCE Two-b value DWI (b-values = 0, 1000s/mm2 ) was at 3.0T. ASSESSMENT The histogram parameters of whole-tumor for ADC were calculated by two radiologists and compared between BPNTs and STSs. STATISTICAL TESTS Nonparametric tests were performed for comparisons between BPNTs and STSs. P < 0.05 was considered statistically significant. The ability of each parameter to differentiate STSs from BPNTs was evaluated using area under the curve (AUC) values derived from a receiver operating characteristic curve analysis. RESULTS The mean ADC and all percentile parameters were significantly lower in STSs than in BPNTs (P < 0.001-0.009), with AUCs of 0.703-0.773. However, the coefficient of variation (P = 0.020 and AUC = 0.682) and skewness (P = 0.012 and AUC = 0.697) were significantly higher in STSs than in BPNTs. Kurtosis (P = 0.295) and entropy (P = 0.604) did not differ significantly between BPNTs and STSs. DATA CONCLUSION Whole-tumor ADC histogram parameters except kurtosis and entropy differed significantly between BPNTs and STSs. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
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Affiliation(s)
- Masanori Nakajo
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yoshihiko Fukukura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroto Hakamada
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tomohide Yoneyama
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kiyohisa Kamimura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Satoshi Nagano
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | | | - Takashi Yoshiura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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De Robertis R, Maris B, Cardobi N, Tinazzi Martini P, Gobbo S, Capelli P, Ortolani S, Cingarlini S, Paiella S, Landoni L, Butturini G, Regi P, Scarpa A, Tortora G, D'Onofrio M. Can histogram analysis of MR images predict aggressiveness in pancreatic neuroendocrine tumors? Eur Radiol 2018; 28:2582-2591. [PMID: 29352378 DOI: 10.1007/s00330-017-5236-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/28/2017] [Accepted: 12/01/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To evaluate MRI derived whole-tumour histogram analysis parameters in predicting pancreatic neuroendocrine neoplasm (panNEN) grade and aggressiveness. METHODS Pre-operative MR of 42 consecutive patients with panNEN >1 cm were retrospectively analysed. T1-/T2-weighted images and ADC maps were analysed. Histogram-derived parameters were compared to histopathological features using the Mann-Whitney U test. Diagnostic accuracy was assessed by ROC-AUC analysis; sensitivity and specificity were assessed for each histogram parameter. RESULTS ADCentropy was significantly higher in G2-3 tumours with ROC-AUC 0.757; sensitivity and specificity were 83.3 % (95 % CI: 61.2-94.5) and 61.1 % (95 % CI: 36.1-81.7). ADCkurtosis was higher in panNENs with vascular involvement, nodal and hepatic metastases (p= .008, .021 and .008; ROC-AUC= 0.820, 0.709 and 0.820); sensitivity and specificity were: 85.7/74.3 % (95 % CI: 42-99.2 /56.4-86.9), 36.8/96.5 % (95 % CI: 17.2-61.4 /76-99.8) and 100/62.8 % (95 % CI: 56.1-100/44.9-78.1). No significant differences between groups were found for other histogram-derived parameters (p >.05). CONCLUSIONS Whole-tumour histogram analysis of ADC maps may be helpful in predicting tumour grade, vascular involvement, nodal and liver metastases in panNENs. ADCentropy and ADCkurtosis are the most accurate parameters for identification of panNENs with malignant behaviour. KEY POINTS • Whole-tumour ADC histogram analysis can predict aggressiveness in pancreatic neuroendocrine neoplasms. • ADC entropy and kurtosis are higher in aggressive tumours. • ADC histogram analysis can quantify tumour diffusion heterogeneity. • Non-invasive quantification of tumour heterogeneity can provide adjunctive information for prognostication.
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Affiliation(s)
- Riccardo De Robertis
- Department of Radiology, P. Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy.
| | - Bogdan Maris
- Department of Computer Science, University of Verona, Strada le Grazie 15, 37134, Verona, Italy
| | - Nicolò Cardobi
- Department of Radiology, P. Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy
| | - Paolo Tinazzi Martini
- Department of Radiology, P. Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy
| | - Stefano Gobbo
- Department of Pathology, P. Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy
| | - Paola Capelli
- Department of Pathology, G.B. Rossi Hospital - University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Silvia Ortolani
- Department of Oncology, P. Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy
| | - Sara Cingarlini
- Department of Oncology, G.B. Rossi Hospital - University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Salvatore Paiella
- Department of Pancreatic Surgery, G.B. Rossi Hospital - University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Luca Landoni
- Department of Pancreatic Surgery, G.B. Rossi Hospital - University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Giovanni Butturini
- Department of Pancreatic Surgery, P. Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy
| | - Paolo Regi
- Department of Pancreatic Surgery, P. Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy
| | - Aldo Scarpa
- Department of Pathology, G.B. Rossi Hospital - University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Giampaolo Tortora
- Department of Oncology, G.B. Rossi Hospital - University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Mirko D'Onofrio
- Department of Radiology, G.B. Rossi Hospital - University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
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Nguyen HT, Mortazavi A, Pohar KS, Zynger DL, Wei L, Shah ZK, Jia G, Knopp MV. Quantitative Assessment of Heterogeneity in Bladder Tumor MRI Diffusivity: Can Response be Predicted Prior to Neoadjuvant Chemotherapy? Bladder Cancer 2017; 3:237-244. [PMID: 29152548 PMCID: PMC5676757 DOI: 10.3233/blc-170110] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: It is a critical unmet need to predict chemosensitivity in muscle-invasive bladder cancer patients who receive neoadjuvant chemotherapy (NAC). Quantification of tumor heterogeneity has been shown to be useful in the assessment of therapeutic response. Apparent diffusion coefficient (ADC) is derived from diffusion weighted MRI (DWI) to quantify the water diffusivity which characterizes micro-cellularity in tumor tissues. Objective: The aim of this study is to assess if a quantitative measurement of ADC heterogeneity in bladder tumors can be a predictor of therapeutic response to NAC. Materials and Methods: Twenty patients with pT2 bladder cancer have been included in this study. Patient MRI was performed on a 3T system with DWI prior to NAC. Regions of interest (ROIs) were placed over the whole tumor volume on ADC maps to acquire a data matrix of voxel-wise ADC values for each patient. We performed histogram analysis on each ADC data matrix to calculate uniformity (U) and entropy (E). These quantities were subsequently correlated with the patient’s response to chemotherapy. Statistical significance was found with P < 0.05. Results: Fifteen patients were categorized as responders, and five as non-responders. The data showed that tumors of responders were significantly higher in U (P = 0.01) and lower in E (P < 0.01) than non-responders. This finding indicates that resistant tumors were more heterogeneous in their spatial distribution of ADC values. While this difference in ADC heterogeneity was not always visually recognizable, it could be quantified by the data analytics. Conclusions: This study demonstrates that the quantitative readout of tumor heterogeneity in micro-cellularity is associated with the patient’s defined response to chemotherapy. Quantification of tumor ADC heterogeneity may provide useful information to enable the prediction of chemotherapeutic response prior to the treatment to improve patient outcomes.
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Affiliation(s)
- Huyen T Nguyen
- Department of Radiology, Wright Center of Innovation in Biomedical Imaging, The Ohio State University, Columbus, OH, USA
| | - Amir Mortazavi
- Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Kamal S Pohar
- Department of Urology, The Ohio State University, Columbus, OH, USA
| | - Debra L Zynger
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Lai Wei
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Zarine K Shah
- Department of Radiology, Wright Center of Innovation in Biomedical Imaging, The Ohio State University, Columbus, OH, USA
| | - Guang Jia
- Department of Radiology, Wright Center of Innovation in Biomedical Imaging, The Ohio State University, Columbus, OH, USA.,Department of Physics and Astronomy, Louisiana State University, Baton Rouge, LA, USA.,Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Michael V Knopp
- Department of Radiology, Wright Center of Innovation in Biomedical Imaging, The Ohio State University, Columbus, OH, USA
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Liu S, Zhang Y, Chen L, Guan W, Guan Y, Ge Y, He J, Zhou Z. Whole-lesion apparent diffusion coefficient histogram analysis: significance in T and N staging of gastric cancers. BMC Cancer 2017; 17:665. [PMID: 28969606 PMCID: PMC5625824 DOI: 10.1186/s12885-017-3622-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 08/28/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Whole-lesion apparent diffusion coefficient (ADC) histogram analysis has been introduced and proved effective in assessment of multiple tumors. However, the application of whole-volume ADC histogram analysis in gastrointestinal tumors has just started and never been reported in T and N staging of gastric cancers. METHODS Eighty patients with pathologically confirmed gastric carcinomas underwent diffusion weighted (DW) magnetic resonance imaging before surgery prospectively. Whole-lesion ADC histogram analysis was performed by two radiologists independently. The differences of ADC histogram parameters among different T and N stages were compared with independent-samples Kruskal-Wallis test. Receiver operating characteristic (ROC) analysis was performed to evaluate the performance of ADC histogram parameters in differentiating particular T or N stages of gastric cancers. RESULTS There were significant differences of all the ADC histogram parameters for gastric cancers at different T (except ADCmin and ADCmax) and N (except ADCmax) stages. Most ADC histogram parameters differed significantly between T1 vs T3, T1 vs T4, T2 vs T4, N0 vs N1, N0 vs N3, and some parameters (ADC5%, ADC10%, ADCmin) differed significantly between N0 vs N2, N2 vs N3 (all P < 0.05). Most parameters except ADCmax performed well in differentiating different T and N stages of gastric cancers. Especially for identifying patients with and without lymph node metastasis, the ADC10% yielded the largest area under the ROC curve of 0.794 (95% confidence interval, 0.677-0.911). All the parameters except ADCmax showed excellent inter-observer agreement with intra-class correlation coefficients higher than 0.800. CONCLUSION Whole-volume ADC histogram parameters held great potential in differentiating different T and N stages of gastric cancers preoperatively.
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Affiliation(s)
- Song Liu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Yujuan Zhang
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Ling Chen
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Wenxian Guan
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Yue Guan
- School of Electronic Science and Engineering, Nanjing University, Nanjing, 210046, China
| | - Yun Ge
- School of Electronic Science and Engineering, Nanjing University, Nanjing, 210046, China.
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
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Choi Y, Kim SH, Youn IK, Kang BJ, Park WC, Lee A. Rim sign and histogram analysis of apparent diffusion coefficient values on diffusion-weighted MRI in triple-negative breast cancer: Comparison with ER-positive subtype. PLoS One 2017; 12:e0177903. [PMID: 28542297 PMCID: PMC5436838 DOI: 10.1371/journal.pone.0177903] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/04/2017] [Indexed: 12/16/2022] Open
Abstract
Purpose To investigate associations between the clinicopathologic features and MRI features of triple-negative breast cancer (TNBC) and ER-positive breast cancer (BC) via apparent diffusion coefficient (ADC) histogram analysis. Materials and methods In this study, 221 breast cancer patients with pre-operative MRI performed from August 2009 to March 2015 were included in a retrospective analysis. All patients had a pathologically confirmed diagnosis of invasive carcinoma and were grouped into ER-positive (149) or triple-negative (72) subtypes. DWI rim sign and various ADC parameters (mean; mode; 25, 50, and 75 percentiles; skewness; and kurtosis) between ER-positive and TNBC were compared using whole-lesion ADC histogram analysis. Univariate and multivariate regression analyses were used for statistical comparison. Results DWI rim signs were detected in 42.3% and 41.7% of ER-positive subtype and TNBC, respectively (P = 0.931). TNBC had poorer histologic grade (P<0.001) and higher Ki-67 expression (P <0.001) than ER-positive subtype BC. TNBC displayed higher ADC parameters (mean, mode, 50th & 75th percentiles, kurtosis on univariate analysis, all P<0.001; only kurtosis on multivariate anaylsis; P<0.001) than ER-positive subtype BC. TNBC had significantly more recurrence events than ER-positive subtype BC on univarate analysis (9.7% (7/72) vs. 2.7% (4/149), P = 0.035). Conclusion Poorer clinicopathologic outcomes were found in TNBC. Whole-lesion ADC histogram analysis revealed ADC kurtosis to be higher in TNBC than ER-positive subtype BC.
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Affiliation(s)
- Yangsean Choi
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- * E-mail:
| | - In Kyung Youn
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bong Joo Kang
- Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woo-chan Park
- Department of General Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ahwon Lee
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Xu XQ, Hu H, Su GY, Liu H, Hong XN, Shi HB, Wu FY. Utility of histogram analysis of ADC maps for differentiating orbital tumors. Diagn Interv Radiol 2017; 22:161-7. [PMID: 26829400 DOI: 10.5152/dir.2015.15202] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE We aimed to evaluate the role of histogram analysis of apparent diffusion coefficient (ADC) maps for differentiating benign and malignant orbital tumors. METHODS Fifty-two patients with orbital tumors were enrolled from March 2013 to November 2014. Pretreatment diffusion-weighted imaging was performed on a 3T magnetic resonance scanner with b factors of 0 and 800 s/mm2, and the corresponding ADC maps were generated. Whole-tumor regions of interest were drawn on all slices of the ADC maps to obtain histogram parameters, including ADCmean, ADCmedian, standard deviation (SD), skewness, kurtosis, quartile, ADC10, ADC25, ADC75, and ADC90. Histogram parameter differences between benign and malignant orbital tumors were compared. The diagnostic value of each significant parameter in predicting malignant tumors was established. RESULTS Age, ADCmean, ADCmedian, quartile, kurtosis, ADC10, ADC25, ADC75, and ADC90 parameters were significantly different between benign and malignant orbital tumor groups, while gender, location, SD, and skewness were not significantly different. The best diagnostic performance in predicting malignant orbital tumors was achieved at the threshold of ADC10=0.990 (AUC, 0.997; sensitivity, 96.2%; specificity, 100%). CONCLUSION Histogram analysis of ADC maps holds promise for differentiating benign and malignant orbital tumors. ADC10 has the potential to be the most significant parameter for predicting malignant orbital tumors.
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Affiliation(s)
- Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Choi Y, Kim SH, Youn IK, Kang BJ, Park WC, Lee A. Rim sign and histogram analysis of apparent diffusion coefficient values on diffusion-weighted MRI in triple-negative breast cancer: Comparison with ER-positive subtype. PLoS One 2017. [PMID: 28542297 DOI: 10.1371/journalpone0177903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023] Open
Abstract
PURPOSE To investigate associations between the clinicopathologic features and MRI features of triple-negative breast cancer (TNBC) and ER-positive breast cancer (BC) via apparent diffusion coefficient (ADC) histogram analysis. MATERIALS AND METHODS In this study, 221 breast cancer patients with pre-operative MRI performed from August 2009 to March 2015 were included in a retrospective analysis. All patients had a pathologically confirmed diagnosis of invasive carcinoma and were grouped into ER-positive (149) or triple-negative (72) subtypes. DWI rim sign and various ADC parameters (mean; mode; 25, 50, and 75 percentiles; skewness; and kurtosis) between ER-positive and TNBC were compared using whole-lesion ADC histogram analysis. Univariate and multivariate regression analyses were used for statistical comparison. RESULTS DWI rim signs were detected in 42.3% and 41.7% of ER-positive subtype and TNBC, respectively (P = 0.931). TNBC had poorer histologic grade (P<0.001) and higher Ki-67 expression (P <0.001) than ER-positive subtype BC. TNBC displayed higher ADC parameters (mean, mode, 50th & 75th percentiles, kurtosis on univariate analysis, all P<0.001; only kurtosis on multivariate anaylsis; P<0.001) than ER-positive subtype BC. TNBC had significantly more recurrence events than ER-positive subtype BC on univarate analysis (9.7% (7/72) vs. 2.7% (4/149), P = 0.035). CONCLUSION Poorer clinicopathologic outcomes were found in TNBC. Whole-lesion ADC histogram analysis revealed ADC kurtosis to be higher in TNBC than ER-positive subtype BC.
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Affiliation(s)
- Yangsean Choi
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - In Kyung Youn
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bong Joo Kang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woo-Chan Park
- Department of General Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ahwon Lee
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Xu X, Su G, Hu H, Wang Y, Hong X, Shi H, Wu F. Effects of regions of interest methods on apparent coefficient measurement of the parotid gland in early Sjögren's syndrome at 3T MRI. Acta Radiol 2017; 58:27-33. [PMID: 26987670 DOI: 10.1177/0284185116637245] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 02/10/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND The apparent diffusion coefficient (ADC) has been used to assess parotid gland abnormalities in Sjögren's syndrome (SS) patients; however, few data exist on the influence of region of interest (ROI) methods on ADC measurements. PURPOSE To assess the influence of ROI methods on ADC measurement, and their diagnostic ability in detecting parotid gland abnormalities in early SS patients. MATERIAL AND METHODS Thirteen early SS patients underwent parotid gland diffusion-weighted imaging scans at a 3.0 T MR unit. Two readers independently measured the parotid gland ADC value using three different ROIs (whole-gland [WG], single-slice [SS], and reader-based circular [RBC]). The ADC value based on three different ROIs (ADC-ROIWG, ADC-ROISS, ADC-ROIRBC) were compared between the SS group and a matched healthy control (HC) group (n = 19). Receiver operating characteristic (ROC) curves and intra-class correlation coefficients (ICC) were used to determine the diagnostic ability and reproducibility of the parameters. RESULTS The ADC-ROIWG, ADC-ROISS, and ADC-ROIRBC in the SS group were all significantly higher than those in HC group (all P < 0.05). The ADC-ROIWG showed better diagnostic ability than did ADC-ROIRBC (P = 0.0200), while no significant difference was found between ADC-ROIWG and ADC-ROISS (P = 0.4636). The ROIWG method showed the best inter- and intra-reader agreement (ICC, 0.902 and 0.928, respectively), followed by ROISS and ROIRBC. CONCLUSION The ROI methods can influence the parotid gland ADC measurements and their diagnostic ability. Considering our results, we suggest using in clinical practice single-slice ROIs to measure the ADC of the parotid gland.
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Affiliation(s)
- Xiaoquan Xu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Guoyi Su
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hao Hu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yanyan Wang
- Department of Rheumatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xunning Hong
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Haibin Shi
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Feiyun Wu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Umanodan T, Fukukura Y, Kumagae Y, Shindo T, Nakajo M, Takumi K, Nakajo M, Hakamada H, Umanodan A, Yoshiura T. ADC histogram analysis for adrenal tumor histogram analysis of apparent diffusion coefficient in differentiating adrenal adenoma from pheochromocytoma. J Magn Reson Imaging 2016; 45:1195-1203. [PMID: 27571307 DOI: 10.1002/jmri.25452] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 08/16/2016] [Indexed: 01/02/2023] Open
Abstract
PURPOSE To determine the diagnostic performance of apparent diffusion coefficient (ADC) histogram analysis in diffusion-weighted (DW) magnetic resonance imaging (MRI) for differentiating adrenal adenoma from pheochromocytoma. MATERIALS AND METHODS We retrospectively evaluated 52 adrenal tumors (39 adenomas and 13 pheochromocytomas) in 47 patients (21 men, 26 women; mean age, 59.3 years; range, 16-86 years) who underwent DW 3.0T MRI. Histogram parameters of ADC (b-values of 0 and 200 [ADC200 ], 0 and 400 [ADC400 ], and 0 and 800 s/mm2 [ADC800 ])-mean, variance, coefficient of variation (CV), kurtosis, skewness, and entropy-were compared between adrenal adenomas and pheochromocytomas, using the Mann-Whitney U-test. Receiver operating characteristic (ROC) curves for the histogram parameters were generated to differentiate adrenal adenomas from pheochromocytomas. Sensitivity and specificity were calculated by using a threshold criterion that would maximize the average of sensitivity and specificity. RESULTS Variance and CV of ADC800 were significantly higher in pheochromocytomas than in adrenal adenomas (P < 0.001 and P = 0.001, respectively). With all b-value combinations, the entropy of ADC was significantly higher in pheochromocytomas than in adrenal adenomas (all P ≤ 0.001), and showed the highest area under the ROC curve among the ADC histogram parameters for diagnosing adrenal adenomas (ADC200 , 0.82; ADC400 , 0.87; and ADC800 , 0.92), with sensitivity of 84.6% and specificity of 84.6% (cutoff, ≤2.82) with ADC200 ; sensitivity of 89.7% and specificity of 84.6% (cutoff, ≤2.77) with ADC400 ; and sensitivity of 94.9% and specificity of 92.3% (cutoff, ≤2.67) with ADC800 . CONCLUSION ADC histogram analysis of DW MRI can help differentiate adrenal adenoma from pheochromocytoma. LEVEL OF EVIDENCE 3 J. Magn. Reson. Imaging 2017;45:1195-1203.
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Affiliation(s)
- Tomokazu Umanodan
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan
| | - Yoshihiko Fukukura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan
| | - Yuichi Kumagae
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan
| | - Toshikazu Shindo
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan
| | - Masatoyo Nakajo
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan
| | - Koji Takumi
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan
| | - Masanori Nakajo
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan
| | - Hiroto Hakamada
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan
| | - Aya Umanodan
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan
| | - Takashi Yoshiura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan
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Non-invasive quantification of tumour heterogeneity in water diffusivity to differentiate malignant from benign tissues of urinary bladder: a phase I study. Eur Radiol 2016; 27:2146-2152. [PMID: 27553924 DOI: 10.1007/s00330-016-4549-2] [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: 02/05/2016] [Revised: 08/03/2016] [Accepted: 08/08/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To quantify the heterogeneity of the tumour apparent diffusion coefficient (ADC) using voxel-based analysis to differentiate malignancy from benign wall thickening of the urinary bladder. METHODS Nineteen patients with histopathological findings of their cystectomy specimen were included. A data set of voxel-based ADC values was acquired for each patient's lesion. Histogram analysis was performed on each data set to calculate uniformity (U) and entropy (E). The k-means clustering of the voxel-wised ADC data set was implemented to measure mean intra-cluster distance (MICD) and largest inter-cluster distance (LICD). Subsequently, U, E, MICD, and LICD for malignant tumours were compared with those for benign lesions using a two-sample t-test. RESULTS Eleven patients had pathological confirmation of malignancy and eight with benign wall thickening. Histogram analysis showed that malignant tumours had a significantly higher degree of ADC heterogeneity with lower U (P = 0.016) and higher E (P = 0.005) than benign lesions. In agreement with these findings, k-means clustering of voxel-wise ADC indicated that bladder malignancy presented with significantly higher MICD (P < 0.001) and higher LICD (P = 0.002) than benign wall thickening. CONCLUSIONS The quantitative assessment of tumour diffusion heterogeneity using voxel-based ADC analysis has the potential to become a non-invasive tool to distinguish malignant from benign tissues of urinary bladder cancer. KEY POINTS • Heterogeneity is an intrinsic characteristic of tumoral tissue. • Non-invasive quantification of tumour heterogeneity can provide adjunctive information to improve cancer diagnosis accuracy. • Histogram analysis and k-means clustering can quantify tumour diffusion heterogeneity. • The quantification helps differentiate malignant from benign urinary bladder tissue.
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Kim YJ, Kim SH, Lee AW, Jin MS, Kang BJ, Song BJ. Histogram analysis of apparent diffusion coefficients after neoadjuvant chemotherapy in breast cancer. Jpn J Radiol 2016; 34:657-666. [DOI: 10.1007/s11604-016-0570-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/21/2016] [Indexed: 12/11/2022]
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Huang YQ, Liang HY, Yang ZX, Ding Y, Zeng MS, Rao SX. Value of MR histogram analyses for prediction of microvascular invasion of hepatocellular carcinoma. Medicine (Baltimore) 2016; 95:e4034. [PMID: 27368028 PMCID: PMC4937942 DOI: 10.1097/md.0000000000004034] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The objective is to explore the value of preoperative magnetic resonance (MR) histogram analyses in predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC).Fifty-one patients with histologically confirmed HCC who underwent diffusion-weighted and contrast-enhanced MR imaging were included. Histogram analyses were performed and mean, variance, skewness, kurtosis, 1th, 10th, 50th, 90th, and 99th percentiles were derived. Quantitative histogram parameters were compared between HCCs with and without MVI. Receiver operating characteristics (ROC) analyses were generated to compare the diagnostic performance of tumor size, histogram analyses of apparent diffusion coefficient (ADC) maps, and MR enhancement.The mean, 1th, 10th, and 50th percentiles of ADC maps, and the mean, variance. 1th, 10th, 50th, 90th, and 99th percentiles of the portal venous phase (PVP) images were significantly different between the groups with and without MVI (P <0.05), with area under the ROC curves (AUCs) of 0.66 to 0.74 for ADC and 0.76 to 0.88 for PVP. The largest AUC of PVP (1th percentile) showed significantly higher accuracy compared with that of arterial phase (AP) or tumor size (P <0.001).MR histogram analyses-in particular for 1th percentile for PVP images-held promise for prediction of MVI of HCC.
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Affiliation(s)
- Ya-Qin Huang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Imaging Institute, Shanghai, China
- Department of Radiology, The Ningbo First Hospital, Ningbo, China
| | - He-Yue Liang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Imaging Institute, Shanghai, China
| | - Zhao-Xia Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Imaging Institute, Shanghai, China
| | - Ying Ding
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Imaging Institute, Shanghai, China
| | - Meng-Su Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Imaging Institute, Shanghai, China
| | - Sheng-Xiang Rao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Imaging Institute, Shanghai, China
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Xu XQ, Li Y, Hong XN, Wu FY, Shi HB. Radiological indeterminate vestibular schwannoma and meningioma in cerebellopontine angle area: differentiating using whole-tumor histogram analysis of apparent diffusion coefficient. Int J Neurosci 2016; 127:183-190. [PMID: 26961388 DOI: 10.3109/00207454.2016.1164157] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess the role of whole-tumor histogram analysis of apparent diffusion coefficient (ADC) maps in differentiating radiological indeterminate vestibular schwannoma (VS) from meningioma in cerebellopontine angle (CPA). MATERIALS AND METHODS Diffusion-weighted (DW) images (b = 0 and 1000 s/mm2) of pathologically confirmed and radiological indeterminate CPA meningioma (CPAM) (n = 27) and VS (n = 12) were retrospectively collected and processed with mono-exponential model. Whole-tumor regions of interest were drawn on all slices of the ADC maps to obtain histogram parameters, including the mean ADC (ADCmean), median ADC (ADCmedian), 10th/25th/75th/90th percentile ADC (ADC10, ADC25, ADC75 and ADC90), skewness and kurtosis. The differences of ADC histogram parameters between CPAM and VS were compared using unpaired t-test. Multiple receiver operating characteristic (ROC) curves analysis was used to determine and compare the diagnostic value of each significant parameter. RESULTS Significant differences were found on the ADCmean, ADCmedian, ADC10, ADC25, ADC75 and ADC90 between CPAM and VS (all p values < 0.001), while no significant difference was found on kurtosis (p = 0.562) and skewness (p = 0.047). ROC curves analysis revealed, a cut-off value of 1.126 × 10-3 mm2/s for the ADC90 value generated highest area under curves (AUC) for differentiating CPAM from VS (AUC, 0.975; sensitivity, 100%; specificity, 88.9%). CONCLUSIONS Histogram analysis of ADC maps based on whole tumor can be a useful tool for differentiating radiological indeterminate CPAM from VS. The ADC90 value was the most promising parameter for differentiating these two entities.
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Affiliation(s)
- Xiao-Quan Xu
- a Department of Radiology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Yan Li
- a Department of Radiology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Xun-Ning Hong
- a Department of Radiology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Fei-Yun Wu
- a Department of Radiology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Hai-Bin Shi
- a Department of Radiology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
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Parekh V, Jacobs MA. Radiomics: a new application from established techniques. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2016; 1:207-226. [PMID: 28042608 PMCID: PMC5193485 DOI: 10.1080/23808993.2016.1164013] [Citation(s) in RCA: 217] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The increasing use of biomarkers in cancer have led to the concept of personalized medicine for patients. Personalized medicine provides better diagnosis and treatment options available to clinicians. Radiological imaging techniques provide an opportunity to deliver unique data on different types of tissue. However, obtaining useful information from all radiological data is challenging in the era of "big data". Recent advances in computational power and the use of genomics have generated a new area of research termed Radiomics. Radiomics is defined as the high throughput extraction of quantitative imaging features or texture (radiomics) from imaging to decode tissue pathology and creating a high dimensional data set for feature extraction. Radiomic features provide information about the gray-scale patterns, inter-pixel relationships. In addition, shape and spectral properties can be extracted within the same regions of interest on radiological images. Moreover, these features can be further used to develop computational models using advanced machine learning algorithms that may serve as a tool for personalized diagnosis and treatment guidance.
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Affiliation(s)
- Vishwa Parekh
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging, The Johns Hopkins University School of Medicine, Baltimore, MD 21205
- Department of Computer Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Michael A. Jacobs
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging, The Johns Hopkins University School of Medicine, Baltimore, MD 21205
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21205
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Xu XQ, Hu H, Su GY, Zhang L, Liu H, Hong XN, Shi HB, Wu FY. Orbital Indeterminate Lesions in Adults: Combined Magnetic Resonance Morphometry and Histogram Analysis of Apparent Diffusion Coefficient Maps for Predicting Malignancy. Acad Radiol 2016; 23:200-8. [PMID: 26625705 DOI: 10.1016/j.acra.2015.10.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/12/2015] [Accepted: 10/13/2015] [Indexed: 01/04/2023]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to evaluate the added value of histogram analysis of apparent diffusion coefficient (ADC) maps in differentiating indeterminate orbital malignant tumors from benign tumors, compared to using magnetic resonance (MR) morphological features alone. MATERIALS AND METHODS We retrospectively evaluated 54 patients with orbital tumors from March 2013 to February 2015. All the patients were assessed by both routine MR and diffusion-weighted imaging, and divided into benign group and malignant group. Routine MR imaging features and histogram parameters derived from ADC maps, including mean ADC (ADCmean), median ADC (ADCmedian), standard deviation, skewness, kurtosis, and 10th and 90th percentiles of ADC (ADC10 and ADC90), were compared between two groups. Univariate and multivariate logistic regression analyses were used to identify the most valuable variables in predicting malignancy. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of significant variables. RESULTS Multivariate logistic regression analysis indicated that two or more quadrants involved, iso-intense on T2-weighted imaging (T2WI), and ADC10 were significant predictors for orbital malignancy. By using model 2 (iso-intense on T2WI + two or more quadrants involved + ADC10 < 0.990) as the criterion, higher AUC and specificity could be achieved than by using model 1 (iso-intense on T2WI + two or more quadrants involved) alone, (model 2 vs model 1; area under curve (AUC), 0.827 vs 0.793; sensitivity, 65.4% vs 69.2%; specificity, 100% vs 89.3%). CONCLUSIONS Iso-intense on T2WI, two or more quadrants involved, and ADC10 are risk factors for orbital malignancy. Histogram analysis of ADC map might provide added value in predicting orbital malignancy.
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Retrospective Assessment of Histogram-Based Diffusion Metrics for Differentiating Benign and Malignant Endometrial Lesions. J Comput Assist Tomogr 2016; 40:723-9. [DOI: 10.1097/rct.0000000000000430] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Shindo T, Fukukura Y, Umanodan T, Takumi K, Hakamada H, Nakajo M, Umanodan A, Ideue J, Kamimura K, Yoshiura T. Histogram Analysis of Apparent Diffusion Coefficient in Differentiating Pancreatic Adenocarcinoma and Neuroendocrine Tumor. Medicine (Baltimore) 2016; 95:e2574. [PMID: 26825900 PMCID: PMC5291570 DOI: 10.1097/md.0000000000002574] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to investigate whether histogram analysis in diffusion-weighted (DW) magnetic resonance imaging (MRI) can help differentiate pancreatic adenocarcinomas from neuroendocrine tumors.Sixty-four patients with histologically confirmed 53 pancreatic adenocarcinomas or 19 neuroendocrine tumors underwent DW MRI. We evaluated the pixel distribution histogram parameters (mean, skewness, kurtosis, and entropy) of the apparent diffusion coefficient (ADC) values derived from b-values of 0 and 200 (ADC200), 0 and 400 (ADC400), or 0 and 800 (ADC800) s/mm(2). Histogram parameters were compared between pancreatic adenocarcinomas and neuroendocrine tumors, and the diagnostic performance was evaluated by using receiver operating characteristic (ROC) analysis.The mean ADC200 and ADC400 were significantly higher in neuroendocrine tumors than in pancreatic adenocarcinomas (P = 0.001 and P = 0.019, respectively). Pancreatic adenocarcinomas showed significantly higher skewness and kurtosis on ADC400 (P = 0.007 and P = 0.001, respectively) and ADC800 (P = 0.001 and P = 0.001, respectively). With all b-value combinations, the entropy of ADC values was significantly higher in pancreatic adenocarcinomas (P < 0.001 for ADC200; P = 0.001 for ADC400; P < 0.001 for ADC800), and showed the highest area under the ROC curve for diagnosing adenocarcinomas (0.77 for ADC200, 0.76 for ADC400, and 0.78 for ADC800).ADC histogram analysis of DW MRI can help differentiate pancreatic adenocarcinomas from neuroendocrine tumors.
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Affiliation(s)
- Toshikazu Shindo
- From the Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima City, Japan
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Suo S, Zhang K, Cao M, Suo X, Hua J, Geng X, Chen J, Zhuang Z, Ji X, Lu Q, Wang H, Xu J. Characterization of breast masses as benign or malignant at 3.0T MRI with whole-lesion histogram analysis of the apparent diffusion coefficient. J Magn Reson Imaging 2015; 43:894-902. [PMID: 26343918 DOI: 10.1002/jmri.25043] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 08/24/2015] [Indexed: 01/22/2023] Open
Affiliation(s)
- Shiteng Suo
- Department of Radiology, Ren Ji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai China
| | - Kebei Zhang
- Department of Radiology, Ren Ji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai China
| | - Mengqiu Cao
- Department of Radiology, Ren Ji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai China
| | - Xinjun Suo
- School of Medical Imaging; Tianjin Medical University; Tianjin China
| | - Jia Hua
- Department of Radiology, Ren Ji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai China
| | - Xiaochuan Geng
- Department of Radiology, Ren Ji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai China
| | - Jie Chen
- Department of Radiology, Ren Ji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai China
| | - Zhiguo Zhuang
- Department of Radiology, Ren Ji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai China
| | - Xiang Ji
- School of Biomedical Engineering; Shanghai Jiao Tong University; Shanghai China
| | - Qing Lu
- Department of Radiology, Ren Ji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai China
| | - He Wang
- Philips Research China; Shanghai China
| | - Jianrong Xu
- Department of Radiology, Ren Ji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai China
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Lin WC, Chen JH. Pitfalls and Limitations of Diffusion-Weighted Magnetic Resonance Imaging in the Diagnosis of Urinary Bladder Cancer. Transl Oncol 2015; 8:217-30. [PMID: 26055180 PMCID: PMC4487794 DOI: 10.1016/j.tranon.2015.04.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/06/2015] [Accepted: 04/09/2015] [Indexed: 12/25/2022] Open
Abstract
Adequately selecting a therapeutic approach for bladder cancer depends on accurate grading and staging. Substantial inaccuracy of clinical staging with bimanual examination, cystoscopy, and transurethral resection of bladder tumor has facilitated the increasing utility of magnetic resonance imaging to evaluate bladder cancer. Diffusion-weighted imaging (DWI) is a noninvasive functional magnetic resonance imaging technique. The high tissue contrast between cancers and surrounding tissues on DWI is derived from the difference of water molecules motion. DWI is potentially a useful tool for the detection, characterization, and staging of bladder cancers; it can also monitor posttreatment response and provide information on predicting tumor biophysical behaviors. Despite advancements in DWI techniques and the use of quantitative analysis to evaluate the apparent diffusion coefficient values, there are some inherent limitations in DWI interpretation related to relatively poor spatial resolution, lack of cancer specificity, and lack of standardized image acquisition protocols and data analysis procedures that restrict the application of DWI and reproducibility of apparent diffusion coefficient values. In addition, inadequate bladder distension, artifacts, thinness of bladder wall, cancerous mimickers of normal bladder wall and benign lesions, and variations in the manifestation of bladder cancer may interfere with diagnosis and monitoring of treatment. Recognition of these pitfalls and limitations can minimize their impact on image interpretation, and carefully applying the analyzed results and combining with pathologic grading and staging to clinical practice can contribute to the selection of an adequate treatment method to improve patient care.
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Affiliation(s)
- Wei-Ching Lin
- Department of Radiology, China Medical University Hospital; No. 2, Yuh-Der Rd, Taichung 40447, Taiwan (R.O.C.); School of Medicine, China Medical University; No.91, Syueshih Rd, Taichung, 40402, Taiwan (R.O.C.)
| | - Jeon-Hor Chen
- Department of Radiology, E-Da Hospital and I-Shou University; No.1, Yida Rd, Kaohsiung 82445, Taiwan; Center for Functional Onco-Imaging, School of Medicine, University of California, Irvine; No. 164, Irvine Hall, Irvine, CA 92697, USA.
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Investigation of the Non-Gaussian Water Diffusion Properties in Bladder Cancer Using Diffusion Kurtosis Imaging. J Comput Assist Tomogr 2015; 39:281-5. [DOI: 10.1097/rct.0000000000000197] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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