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Li Y, Lin L, Zhang Y, Ren C, Zhang W, Cheng J. Preliminary exploration of amide proton transfer weighted imaging in differentiation between benign and malignant bone tumors. Front Oncol 2024; 14:1402628. [PMID: 38903728 PMCID: PMC11187086 DOI: 10.3389/fonc.2024.1402628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/23/2024] [Indexed: 06/22/2024] Open
Abstract
Purpose To explore the value of 3D amide proton transfer weighted imaging (APTWI) in the differential diagnosis between benign and malignant bone tumors, and to compare the diagnostic performance of APTWI with traditional diffusion-weighted imaging (DWI). Materials and methods Patients with bone tumors located in the pelvis or lower limbs confirmed by puncture or surgical pathology were collected from January 2021 to July 2023 in the First Affiliated Hospital of Zhengzhou University. All patients underwent APTWI and DWI examinations. The magnetization transfer ratio with asymmetric analysis at the frequency offset of 3.5 ppm [MTRasym(3.5 ppm)] derived by APTWI and the apparent diffusion coefficient (ADC) derived by DWI for the tumors were measured. The Kolmogorou-Smirnou and Levene normality test was used to confirm the normal distribution of imaging parameters; and the independent sample t test was used to compare the differences in MTRasym(3.5 ppm) and ADC between benign and malignant bone tumors. In addition, the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of different imaging parameters in differentiation between benign and malignant bone tumors. P<0.05 means statistically significant. Results Among 85 bone tumor patients, 33 were benign and 52 were malignant. The MTRasym(3.5 ppm) values of malignant bone tumors were significantly higher than those of benign tumors, while the ADC values were significantly lower in benign tumors. ROC analysis shows that MTRasym(3.5 ppm) and ADC values perform well in the differential diagnosis of benign and malignant bone tumors, with the area under the ROC curve (AUC) of 0.798 and 0.780, respectively. Combination of MTRasym(3.5 ppm) and ADC values can further improve the diagnostic performance with the AUC of 0.849 (sensitivity = 84.9% and specificity = 73.1%). Conclusion MTRasym(3.5 ppm) of malignant bone tumors was significantly higher than that of benign bone tumors, reflecting the abnormal increase of protein synthesis in malignant tumors. APTWI combined with DWI can achieve a high diagnostic efficacy in differentiation between benign and malignant bone tumors.
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Affiliation(s)
- Ying Li
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liangjie Lin
- Clinical and Technical Support, Philips Healthcare, Beijing, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Cuiping Ren
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenhua Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Lloret I, Hompland I, Lobmaier IV, Sundseth J, Server A. Ewing sarcoma of the temporal bone with aneurysmal bone cyst-like changes: A rare case report with an unusual radiological presentation. Neuroradiol J 2023:19714009231212358. [PMID: 37923348 DOI: 10.1177/19714009231212358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Ewing sarcoma (ES) is a malignant small round cell tumor, accounting for 10-15% of all primary bone tumors and approximately 3% of all pediatric cancers. Primary ES of the cranial bone is unusual with reported incidence from 1% to 6% of all ES cases. This report shows a rare case of primary ES of the squamous temporal bone in a 12-year-old boy with a history of swelling of the right temporal region and symptoms of increased intracranial pressure. We illustrate the extremely unusual radiological presentation of this primary ES of temporal bone associated with large aneurysmal bone cyst-like (ABC-like) changes. The boy was successfully treated according to Euro Ewing 2012 protocol. He is alive with no evidence of recurrence and metastasis after 16 months of completed treatment.
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Affiliation(s)
- Isabel Lloret
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, Norway
| | - Ivar Hompland
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Norway
| | - Ingvild Vk Lobmaier
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Norway
| | - Jarle Sundseth
- Department of Neurosurgery, Rikshospitalet, Oslo University Hospital, Norway
| | - Andres Server
- Section of Neuroradiology, Department of Radiology, Rikshospitalet, Oslo University Hospital, Norway
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Nouh M, Doweidar A, Khalil AME. Apparent diffusion coefficient (ADC): A potential in vivo biological surrogate of the incidentally discovered bone lesions at 3T MRI. Eur J Radiol Open 2021; 8:100386. [PMID: 34877369 PMCID: PMC8628214 DOI: 10.1016/j.ejro.2021.100386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/27/2021] [Accepted: 11/08/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To probe the potential of apparent diffusion coefficient (ADC) to rectify the incidentally detected bone lesion on MRI into benign or malignant lesions. MATERIALS AND METHODS We retrospectively recruited 44 patients (24 males and 20 females); with 52 bone lesions, who underwent diffusion weighted (DW) imaging using multiple b-values on 3 T MRI. ADC maps were derived and analyzed by two radiologists; blinded to the final diagnosis. The mean ADC values were used for statistical analyses. The diagnosis was deduced by histopathological confirmation; in 32 lesions and strict clinical and imaging follow-up for at least 12 months; in 20 lesions. RESULTS The mean ADC value (mean±SD) of all malignant tumors (including cartilaginous neoplasms) was [0.92 ± 0.40] × 10-3 mm2/s. This significantly differed from those of both primary benign tumors [1.14 ± 0.24] × 10-3 mm2/s, (p = 0.011), and all non-malignant lesions collectively [1.29 ± 0.44] × 10-3 mm2/s, (p < 0.001). Using mADC value of ≤ 1.1 × 10-3 mm2/s resulted in 86.1% sensitivity and 62.5% specificity for characterizing a lesion as a malignant. The inter-rater reliability was almost perfect (95% CI = 0.954-0.985). CONCLUSION ADC could be a non-invasive in-vivo surrogate that may be able to discern the incidentally discovered osseous lesions into benign and malignant pathologies and guide further diagnostic workup.
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Affiliation(s)
- M.R. Nouh
- Department of Radiology, Faculty of Medicine, Alexandria University, Egypt
| | - Ahmed Doweidar
- Department of Radiology, SWBH NHS TRUST, Birmingham, West Midlands B187QH, UK
| | - Abdullah Mohie-Eddin Khalil
- Department of Radiology and Clinical Imaging, El-Razi Hospital, Gamal Abd El-Nasser Street, Sulibakhat, 13001 Kuwait City, Kuwait
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Shah A, Samet JD. Benign Pediatric Bone Tumors and Tumor-like lesions. Semin Roentgenol 2021; 56:338-356. [PMID: 34281684 DOI: 10.1053/j.ro.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Amisha Shah
- Department of Radiology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
| | - Jonathan D Samet
- Department of Medical Imaging, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
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Setiawati R, Suarnata MS, Rahardjo P, Filippo DG, Guglielmi G. Correlation of quantitative diffusion weighted MR imaging between benign, malignant chondrogenic and malignant non-chondrogenic bone tumors with histopathologic type. Heliyon 2021; 7:e06402. [PMID: 33748474 PMCID: PMC7969897 DOI: 10.1016/j.heliyon.2021.e06402] [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: 10/28/2020] [Revised: 11/14/2020] [Accepted: 02/25/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives This study aims to determine the diffusion on weighted imaging which may help in providing characterization of Apparent Diffusion Coefficient (ADC) values in benign, malignant chondrogenic and malignant non-chondrogenic bone tumors. Material and methods A retrospective study with 84 samples was conducted from October 2017 to December 2019. The samples consisted of 44 males and 40 females; the age range of 10–73 years (mean age of 32.7 years old). A Diffusion-weighted Magnetic Resonance (MR) utilizes a single-shot echo-planar imaging sequence technique with the 3T MR Scanner. We classified the types of tumors into benign, malignant chondrogenic and malignant non-chondrogenic bone tumors. The mean of ADC values from the area with lowest ADC values was selected for statistical analysis. ADC values were compared between benign, malignant chondrogenic and malignant non-chondrogenic bone tumors. Therefore, Receiver Operating Curve (ROC) analysis was done to determine optimal cut-off values. The correlation of ADC values between benign, malignant chondrogenic and malignant non-chondrogenic bone tumor with histopathologic type was also evaluated. Results The mean of ADC values from the area of benign, malignant chondrogenic and malignant non-chondrogenic bone tumor were 1.55 × 10−3 mm2/s, 1.84 × 10−3 mm2/s and 1.12 × 10−3 mm2/s respectively. As a matter of fact, there was a significant difference between benign and malignant bone tumor with cut-off value of 1.15 × 10−3 mm2/s and had a sensitivity of 82%, and a specificity of 92.3%. Moreover, a significant correlation was also found between ADC values with the histopathology type of bone tumors. Conclusion The ADC values of benign and malignant (chondrogenic and non-chondrogenic groups) bone tumors are different. Thus, the measurement of ADC values improves the accuracy of the diagnosis of bone tumors.
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Affiliation(s)
- Rosy Setiawati
- Department of Radiology, Faculty of Medicine Airlangga University, Surabaya, Indonesia
| | - M S Suarnata
- Department of Radiology, Faculty of Medicine Airlangga University, Surabaya, Indonesia
| | - Paulus Rahardjo
- Department of Radiology, Faculty of Medicine Airlangga University, Surabaya, Indonesia
| | - Del Grande Filippo
- Department of Radiology, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Giuseppe Guglielmi
- Department of Clinical and Experimental Medicine, School of Medicine, Foggia University, Foggia, Italy.,Department of Radiology, School of Medicine, Foggia University, Foggia, Italy
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Sun W, Liu S, Guo J, Liu S, Hao D, Hou F, Wang H, Xu W. A CT-based radiomics nomogram for distinguishing between benign and malignant bone tumours. Cancer Imaging 2021; 21:20. [PMID: 33549151 PMCID: PMC7866630 DOI: 10.1186/s40644-021-00387-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 01/27/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND We sought to evaluate the performance of a computed tomography (CT)-based radiomics nomogram we devised in distinguishing benign from malignant bone tumours. METHODS Two hundred and six patients with bone tumours were spilt into two groups: a training set (n = 155) and a validation set (n = 51). A feature extraction process based on 3D Slicer software was used to extract the radiomics features from unenhanced CT images, and least absolute shrinkage and selection operator logistic regression was used to calculate the radiomic score to generate a radiomics signature. A clinical model comprised demographics and CT features. A radiomics nomogram combined with the clinical model and the radiomics signature was constructed. The performance of the three models was comprehensively evaluated from three aspects: identification ability, accuracy, and clinical value, allowing for generation of an optimal prediction model. RESULTS The radiomics nomogram comprised clinical and radiomics signature features. The nomogram model displayed good performance in training and validation sets with areas under the curve of 0.917 and 0.823, respectively. The areas under the curve, decision curve analysis, and net reclassification improvement showed that the radiomics nomogram model could obtain better diagnostic performance than the clinical model and achieve greater clinical net benefits than the clinical and radiomics signature models alone. CONCLUSIONS We constructed a combined nomogram comprising a clinical model and radiomics signature as a noninvasive preoperative prediction method to distinguish between benign and malignant bone tumours and assist treatment planning.
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Affiliation(s)
- Weikai Sun
- Department of Radiology, The Affiliated Hospital of Qingdao University Qingdao, 16 Jiangsu Road, Qingdao, Shandong, China
| | - Shunli Liu
- Department of Radiology, The Affiliated Hospital of Qingdao University Qingdao, 16 Jiangsu Road, Qingdao, Shandong, China
| | - Jia Guo
- Department of Radiology, The Affiliated Hospital of Qingdao University Qingdao, 16 Jiangsu Road, Qingdao, Shandong, China
| | - Song Liu
- Department of Radiology, The Affiliated Hospital of Qingdao University Qingdao, 16 Jiangsu Road, Qingdao, Shandong, China
| | - Dapeng Hao
- Department of Radiology, The Affiliated Hospital of Qingdao University Qingdao, 16 Jiangsu Road, Qingdao, Shandong, China
| | - Feng Hou
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Hexiang Wang
- Department of Radiology, The Affiliated Hospital of Qingdao University Qingdao, 16 Jiangsu Road, Qingdao, Shandong, China.
| | - Wenjian Xu
- Department of Radiology, The Affiliated Hospital of Qingdao University Qingdao, 16 Jiangsu Road, Qingdao, Shandong, China.
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Saleh MM, Abdelrahman TM, Madney Y, Mohamed G, Shokry AM, Moustafa AF. Multiparametric MRI with diffusion-weighted imaging in predicting response to chemotherapy in cases of osteosarcoma and Ewing's sarcoma. Br J Radiol 2020; 93:20200257. [PMID: 32706980 DOI: 10.1259/bjr.20200257] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To evaluate the multiparametric MRI in predicting chemotherapy response in pathologically proven cases of osteosarcoma and Ewing's sarcoma. Correlation between the tumor size changes and internal breakdown using RECIST 1.1, modified RECIST, quantitative apparent diffusion coefficient (ADC) and tumor volume as well as dynamic contrast-enhanced MRI (DCE-MRI). METHODS The study included 104 patients pathologically proved osteosarcoma (53) and Ewing`s sarcoma (51) underwent MRI examinations; before and after chemotherapy. All patients were assessed using the RECIST 1.1 criteria, m-RECIST, quantitative ADC, and tumor volume evaluation. 21 patients underwent DCE-MRI curve type with quantitative parameters. Correlation between the different evaluations was carried out. Results were correlated with the post-operative pathology in 42 patients who underwent surgery and for statistical evaluation, Those patients were classified into responders (≥90% necrosis) and non-responders (<90% necrosis). RESULTS The initial mean ADC of 104 patients of osteosarcoma and Ewing's sarcoma (0.90 ± 0.29) and (0.71 ± 0.16) respectively, differed significantly from that after treatment (1.62 ± 0.46) and (1.6 ± 0.39) respectively with (p<0.001).ADC variations (ADC%) in the non-progressive group were higher than those of the progressive group (128.3 ± 63.49 vs 36.34 ± 78.7) % with (p<0.001).ADC values and ADC variations were inversely correlated with morphologic changes, regardless of the effectiveness of chemotherapy expressed as changes in tumor size based on (RECIST 1.1, RECIST, and 3D volume). Linear regression analysis revealed a Pearson correlation coefficient of r=-0.427, -0.498 and -0.408, respectively with (p<0.001).An increase in the ADC value was not always associated with a reduction in tumor volume. The disease control rate (defined as the percentage of CR+PR+SD patients) was 89.4% and 93.9% according to RECIST 1.1 and m-RECIST respectively.42 out of the 104 patients had postsurgical histological evaluation as regards the chemotherapeutic response divided into two groups. ADC values showed a statistically significant difference between Group A and Group B being more evident with minimum ADC% (p<0.001). CONCLUSION Quantitative diffusion-weighted imaging with ADC mapping and ADC % after chemotherapy allows a detailed analysis of the treatment response in osteosarcoma and Ewing's sarcoma. The therapeutic response can be underestimated using RECIST 1.1, so the modified RECIST should be also considered. ADVANCES IN KNOWLEDGE Quantitative ADC especially ADC% provided an accurate non-invasive tool in the assessment of post-therapeutic cases of osteosarcoma and Ewing's sarcoma.
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Affiliation(s)
- Mahmoud Mohamed Saleh
- Department of diagnostic and interventional radiology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Tamer Moustafa Abdelrahman
- Department of diagnostic and interventional radiology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Youusef Madney
- Department of pediatric oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ghada Mohamed
- Department of surgical pathology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ahmed Mohammed Shokry
- Department of diagnostic and interventional radiology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Amr Farouk Moustafa
- Department of diagnostic and interventional radiology, National Cancer Institute, Cairo University, Cairo, Egypt
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Wu G, Liu X, Xiong Y, Ran J, Li X. Intravoxel incoherent motion and diffusion kurtosis imaging for discriminating soft tissue sarcoma from vascular anomalies. Medicine (Baltimore) 2018; 97:e13641. [PMID: 30558056 PMCID: PMC6320121 DOI: 10.1097/md.0000000000013641] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
To investigate the feasibility of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in discriminating soft tissue sarcoma from vascular anomalies.Twenty-two patients with lower extremity soft tissue sarcoma and 15 patients with lower extremity vascular anomalies underwent IVIM-DWI and DKI. IVIM model generated true diffusion (D), perfusion fraction (f), and pseudo-diffusion coefficient (D). DKI model generated mean kurtosis (MK) and mean diffusion (MD). These parameters were measured by 2 radiologists separately through drawing region of interest. Intraclass correlation coefficient (ICC) was calculated to evaluate the inter-reader viability in measurement. The Mann-Whitney test was used to compare the parameters between vascular anomalies and soft tissue sarcoma. Receiver operating characteristic curves were constructed for assessing diagnostic accuracies.ICC was more than 0.8 for apparent diffusion coefficient (ADC), D, D, f, MK, and MD. Mean ADC, D, and MD were significantly lower in soft tissue sarcoma versus vascular anomalies (P < .05). Mean D and f were not significantly different (P > .05). Soft tissue sarcoma had significantly higher MK than vascular anomalies (P < .05). Areas under curve for ADC, D, MK, and MD were 0.876, 0.885, 0.894, and 0.812, respectively.IVIM and DKI are feasible in discriminating soft tissue sarcoma from vascular anomalies.
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