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Chen J, Tang Q, Song Y, Tao X, Chen J, Zhao J, Jiang Z. Comparison of lung lesion assessment using free-breathing dynamic contrast-enhanced 1.5-T MRI with a golden-angle radial stack-of-stars VIBE sequence and CT. Acta Radiol 2024:2841851241259924. [PMID: 38881364 DOI: 10.1177/02841851241259924] [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: 06/18/2024]
Abstract
BACKGROUND Few studies have investigated the feasibility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using a free-breathing golden-angle radial stack-of-stars volume-interpolated breath-hold examination (FB radial VIBE) sequence in the lung. PURPOSE To investigate whether DCE-MRI using the FB radial VIBE sequence can assess morphological and kinetic parameters in patients with pulmonary lesions, with computed tomography (CT) as the reference. MATERIAL AND METHODS In total, 43 patients (30 men; mean age = 64 years) with one lesion each were prospectively enrolled. Morphological and kinetic features on MRI were calculated. The diagnostic performance of morphological MR features was evaluated using a receiver operating characteristic (ROC) curve. Kinetic features were compared among subgroups based on histopathological subtype, lesion size, and lymph node metastasis. RESULTS The maximum diameter was not significantly different between CT and MRI (3.66 ± 1.62 cm vs. 3.64 ± 1.72 cm; P = 0.663). Spiculation, lobulation, cavitation or bubble-like areas of low attenuation, and lymph node enlargement had an area under the ROC curve (AUC) >0.9, while pleural indentation yielded an AUC of 0.788. The lung cancer group had significantly lower Ktrans, Ve, and initial AUC values than the other cause inflammation group (0.203, 0.158, and 0.589 vs. 0.597, 0.385, and 1.626; P < 0.05) but significantly higher values than the tuberculosis group (P < 0.05). CONCLUSION Morphology features derived from FB radial VIBE have high correlations with CT, and kinetic analyses show significant differences between benign and malignant lesions. DCE-MRI with FB radial VIBE could serve as a complementary quantification tool to CT for radiation-free assessments of lung lesions.
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Affiliation(s)
- Jiliang Chen
- Department of Radiology, Wuxi People's Hospital Affiliated Nanjing Medical University, Wuxi, PR China
- Siemens Healthineers China, Shanghai, PR China
| | - Qunfeng Tang
- Department of Radiology, Wuxi People's Hospital Affiliated Nanjing Medical University, Wuxi, PR China
| | - Yang Song
- Siemens Healthineers China, Shanghai, PR China
| | - Xinwei Tao
- Bayer Healthcare China, Shanghai, PR China
| | - Jingwen Chen
- Department of Radiology, Wuxi People's Hospital Affiliated Nanjing Medical University, Wuxi, PR China
| | - Jun Zhao
- Department of Radiology, Wuxi People's Hospital Affiliated Nanjing Medical University, Wuxi, PR China
| | - Zhen Jiang
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, PR China
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Li J, Wu B, Huang Z, Zhao Y, Zhao S, Guo S, Xu S, Wang X, Tian T, Wang Z, Zhou J. Whole-lesion histogram analysis of multiple diffusion metrics for differentiating lung cancer from inflammatory lesions. Front Oncol 2023; 12:1082454. [PMID: 36741699 PMCID: PMC9890049 DOI: 10.3389/fonc.2022.1082454] [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: 10/28/2022] [Accepted: 12/21/2022] [Indexed: 01/19/2023] Open
Abstract
Background Whole-lesion histogram analysis can provide comprehensive assessment of tissues by calculating additional quantitative metrics such as skewness and kurtosis; however, few studies have evaluated its value in the differential diagnosis of lung lesions. Purpose To compare the diagnostic performance of conventional diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) and diffusion kurtosis imaging (DKI) in differentiating lung cancer from focal inflammatory lesions, based on whole-lesion volume histogram analysis. Methods Fifty-nine patients with solitary pulmonary lesions underwent multiple b-values DWIs, which were then postprocessed using mono-exponential, bi-exponential and DKI models. Histogram parameters of the apparent diffusion coefficient (ADC), true diffusivity (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f), apparent diffusional kurtosis (Kapp) and kurtosis-corrected diffusion coefficient (Dapp) were calculated and compared between the lung cancer and inflammatory lesion groups. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic performance. Results The ADCmean, ADCmedian, D mean and D median values of lung cancer were significantly lower than those of inflammatory lesions, while the ADCskewness, Kapp mean, Kapp median, Kapp SD, Kapp kurtosis and Dapp skewness values of lung cancer were significantly higher than those of inflammatory lesions (all p < 0.05). ADCskewness (p = 0.019) and D median (p = 0.031) were identified as independent predictors of lung cancer. D median showed the best performance for differentiating lung cancer from inflammatory lesions, with an area under the ROC curve of 0.777. Using a D median of 1.091 × 10-3 mm2/s as the optimal cut-off value, the sensitivity, specificity, positive predictive value and negative predictive value were 69.23%, 85.00%, 90.00% and 58.62%, respectively. Conclusions Whole-lesion histogram analysis of DWI, IVIM and DKI parameters is a promising approach for differentiating lung cancer from inflammatory lesions, and D median shows the best performance in the differential diagnosis of solitary pulmonary lesions.
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Affiliation(s)
- Jiaxin Li
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Baolin Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Zhun Huang
- Department of Radiology, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yixiang Zhao
- Department of Critical Care Medicine, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Sen Zhao
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Shuaikang Guo
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Shufei Xu
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Xiaolei Wang
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Tiantian Tian
- Department of Radiology, Huaihe Hospital of Henan University, Kaifeng, China
| | - Zhixue Wang
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China,*Correspondence: Zhixue Wang, ; Jun Zhou,
| | - Jun Zhou
- Interventional Diagnostic and Therapeutic Center, Zhongnan Hospital of Wuhan University, Wuhan, China,*Correspondence: Zhixue Wang, ; Jun Zhou,
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Chen Y, Han Q, Huang Z, Lyu M, Ai Z, Liang Y, Yan H, Wang M, Xiang Z. Value of IVIM in Differential Diagnoses between Benign and Malignant Solitary Lung Nodules and Masses: A Meta-analysis. Front Surg 2022; 9:817443. [PMID: 36017515 PMCID: PMC9396547 DOI: 10.3389/fsurg.2022.817443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 05/09/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose This study aims to evaluate the accuracy of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in distinguishing malignant and benign solitary pulmonary nodules and masses. Methods Studies investigating the diagnostic accuracy of IVIM-DWI in lung lesions published through December 2020 were searched. The standardized mean differences (SMDs) of the apparent diffusion coefficient (ADC), tissue diffusivity (D), pseudo-diffusivity (D*), and perfusion fraction (f) were calculated. The sensitivity, specificity, area under the curve (AUC), publication bias, and heterogeneity were then summarized, and the source of heterogeneity and the reliability of combined results were explored by meta-regression and sensitivity analysis. Results A total of 16 studies including 714 malignant and 355 benign lesions were included. Significantly lower ADC, D, and f values were found in malignant pulmonary lesions compared to those in benign lesions. The D value showed the best diagnostic performance (sensitivity = 0.90, specificity = 0.71, AUC = 0.91), followed by ADC (sensitivity = 0.84, specificity = 0.75, AUC = 0.88), f (sensitivity = 0.70, specificity = 0.62, AUC = 0.71), and D* (sensitivity = 0.67, specificity = 0.61, AUC = 0.67). There was an inconspicuous publication bias in ADC, D, D* and f values, moderate heterogeneity in ADC, and high heterogeneity in D, D*, and f values. Subgroup analysis suggested that both ADC and D values had a significant higher sensitivity in “nodules or masses” than that in “nodules.” Conclusions The parameters derived from IVIM-DWI, especially the D value, could further improve the differential diagnosis between malignant and benign solitary pulmonary nodules and masses. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier: CRD42021226664
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Affiliation(s)
- Yirong Chen
- Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Qijia Han
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Zhiwei Huang
- Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Mo Lyu
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- School of Life Sciences, South China Normal University, Guangzhou, China
| | - Zhu Ai
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Yuying Liang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Haowen Yan
- Department of Oncology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Mengzhu Wang
- Department of MR Scientific Marketing, Siemens Healthineers, Guangzhou, China
| | - Zhiming Xiang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Correspondence: Zhiming Xiang
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Fang T, Meng N, Feng P, Huang Z, Li Z, Fu F, Yuan J, Yang Y, Liu H, Roberts N, Wang M. A Comparative Study of Amide Proton Transfer Weighted Imaging and Intravoxel Incoherent Motion MRI Techniques Versus (18) F-FDG PET to Distinguish Solitary Pulmonary Lesions and Their Subtypes. J Magn Reson Imaging 2021; 55:1376-1390. [PMID: 34723413 DOI: 10.1002/jmri.27977] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Amide proton transfer weighted imaging (APTw), intravoxel incoherent motion (IVIM), and positron emission tomography (PET) imaging all have the potential to characterize solitary pulmonary lesions (SPLs). PURPOSE To compare APTw and IVIM with PET imaging for distinguishing between benign and malignant SPLs and their subtypes. STUDY TYPE Prospective. POPULATION Ninety-five patients, 78 with malignant SPLs (including 48 with adenocarcinoma [AC] and 17 with squamous cell carcinoma [SCC]), and 17 with benign SPLs. FIELD STRENGTH/SEQUENCE Fast spin-echo (FSE) T2WI, FSE APTw and echo-planar imaging IVIM, MR-base attenuation correction (MRAC), and PET imaging on a 3-T whole-body PET/MR system. ASSESSMENT The magnetization transfer ratio asymmetry (MTRasym) at 3.5 ppm, diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), and the maximum standardized uptake value (SUVmax) were analyzed. STATISTICAL TESTS Individual sample t-test, Delong test, Pearson's correlation analysis, and area under the receiver operating characteristic curve (AUC). P < 0.05 indicated statistical significance. RESULTS The MTRasym and SUVmax were significantly higher, and D was significantly lower in the malignant group (3.3 ± 2.6 [%], 7.8 ± 5, and 1.2 ± 0.3 [×10-3 mm2 /second]) compared to the benign group (-0.3 ± 1.6 [%], 3.1 ± 3.8, and 1.6 ± 0.3 [×10-3 mm2 /second]). The MTRasym and D were significantly lower, and SUVmax was significantly higher in the SCC group (0.8 ± 1.0 [%], 1.0 ± 0.2 [×10-3 mm2 /second] than in the AC group (4.1 ± 2.6 [%], 1.3 ± 0.3 [×10-3 mm2 /second], 6.7 ± 4.6). Besides, the combination (AUC = 0.964) of these three methods showed higher diagnostic efficacy than any individual method (AUC = 0.917, 0.851, 0.82, respectively) in identifying malignant and benign SPLs. However, APTw showed better diagnostic efficacy than the combination of three methods or PET imaging alone in distinguishing SCC and AC groups (AUC = 0.934, 0.781, 0.725, respectively). DATA CONCLUSION APTw, IVIM, and PET imaging are all effective methods to distinguish benign and malignant SPLs and their subtypes. APTw is potentially more capable than PET imaging of distinguishing lung SCC from AC. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ting Fang
- Department of Medical Imaging, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Nan Meng
- Department of Medical Imaging, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Pengyang Feng
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China.,Department of Medical Imaging, Henan University People's Hospital, Zhengzhou, China
| | - Zhun Huang
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China.,Department of Medical Imaging, Henan University People's Hospital, Zhengzhou, China
| | - Ziqiang Li
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China.,Department of Medical Imaging, Xinxiang Medical University, Xinxiang, China
| | - Fangfang Fu
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jianmin Yuan
- Central Research Institute, UIH Group, Shanghai, China
| | - Yang Yang
- Beijing United Imaging Research Institute of Intelligent Imaging, UIH Group, Beijing, China
| | - Hui Liu
- UIH America, Inc, Houston, Texas, USA
| | - Neil Roberts
- Clinical Research Imaging Centre, School of Clinical Sciences and Community Health, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Meiyun Wang
- Department of Medical Imaging, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Medical Imaging, Henan University People's Hospital, Zhengzhou, China.,Department of Medical Imaging, Xinxiang Medical University, Xinxiang, China
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Zhu Q, Ren C, Xu JJ, Li MJ, Yuan HS, Wang XH. Whole-lesion histogram analysis of mono-exponential and bi-exponential diffusion-weighted imaging in differentiating lung cancer from benign pulmonary lesions using 3 T MRI. Clin Radiol 2021; 76:846-853. [PMID: 34376284 DOI: 10.1016/j.crad.2021.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 07/05/2021] [Indexed: 01/03/2023]
Abstract
AIM To investigate whether whole-lesion histogram analysis of apparent diffusion coefficient (ADC) values derived from mono-exponential and bi-exponential diffusion-weighted imaging (DWI) can differentiate lung cancer from benign pulmonary lesions. MATERIALS AND METHODS Thirty-two patients with lung cancer and 17 patients with benign pulmonary lesions were included retrospectively. All patients underwent DWI before surgery or biopsy. ADC histogram parameters, including mean, percentile values (10th and 90th), kurtosis, and skewness, were calculated independently by two radiologists. The histogram parameters were compared between patients with lung cancer and benign lesions. Receiver operating characteristic curves were constructed to evaluate the diagnostic performance. RESULTS The ADCMean, ADC10th, DMean, D10th were significantly lower in lung cancer (1.187 ± 0.144 × 10-3; 0.440 ± 0.062 × 10-3; 1.068 ± 0.108 × 10-3; and 0.422 ± 0.049 × 10-3 mm/s) compared to benign lesions (1.418 ± 0.274 × 10-3; 0.555 ± 0.113 × 10-3; 1.216 ± 0.149 × 10-3; and 0.490 ± 0.044 × 10-3 mm/s; p<0.05). The ADCSkewness and DSkewness were significantly different between lung cancer (2.35 ± 0.72; 2.58 ± 1.14) and benign lesions (1.85 ± 0.54; 1.59 ± 1.47; p<0.05). D10th was robust in differentiating lung cancer from benign lesions. Using 0.453 × 10-3 mm/s as the optimal threshold, the sensitivity, specificity, and accuracy of D10th were 78.12%, 82.35%, and 79.6%, respectively. CONCLUSION Whole-lesion histogram analysis of ADC values derived by mono-exponential and bi-exponential DWI using 3 T magnetic resonance imaging helps distinguish lung cancer from benign pulmonary lesions.
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Affiliation(s)
- Q Zhu
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, 100191, People's Republic of China
| | - C Ren
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, 100191, People's Republic of China
| | - J-J Xu
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, 100191, People's Republic of China
| | - M-J Li
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, 100191, People's Republic of China
| | - H-S Yuan
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, 100191, People's Republic of China
| | - X-H Wang
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, 100191, People's Republic of China.
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Meng F, Zou B, Yang R, Duan Q, Qian T. The diagnostic efficiency of the perfusion-related parameters in assessing the vascular disrupting agent (CA4P) response in a rabbit VX2 liver tumor model. Acta Radiol 2021; 63:1147-1156. [PMID: 34279135 DOI: 10.1177/02841851211032450] [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: 11/15/2022]
Abstract
BACKGROUND There are inconsistencies when concomitantly using dynamic contrast enhancement (DCE) and intravoxel incoherent motion (IVIM) to evaluate diagnostic efficiency. PURPOSE To evaluate the diagnostic efficiency of perfusion-related parameters in assessing the effect of Combretastatin-A4-phosphate (CA4P) in a rabbit VX2 liver tumor model using DCE and IVIM. MATERIAL AND METHODS Twenty rabbits implanted with VX2 tumors were included in the study. The perfusion-parameters of DCE (Ktrans and iAUC60) and IVIM (f and D*) were measured at baseline and 4 h after administration of CA4P. Subsequently, the rabbits were euthanized. Pre- and post-treatment perfusion parameters were analyzed using paired t-test. Correlation between the various perfusion parameters and correlation of perfusion parameters with microvascular density (MVD) were assessed using Pearson correlation analysis. The diagnostic efficiency was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS All perfusion parameters (Ktrans, iAUC60, f and D*) showed significant decrease after 4 h of CA4P administration (all P < 0.001). Post-treatment perfusion parameters showed a moderate correlation with MVD (r = 0.663, r = 0.567, r = 0.685, r = 0.618, respectively; all P < 0.05). At baseline and after treatment, Ktrans values and iAUC60 showed correlation with f and D* (all P < 0.05). Concomitant use of perfusion parameters of DCE and IVIM showed the best diagnostic performance, which was slightly greater than that observed with individual application of DCE or IVIM (AUC = 0.915, 0.880, and 0.895, respectively). CONCLUSION Although concomitant application of DCE and IVIM can slightly improve the diagnostic value in assessing the effect of CA4P, the values were relatively small.
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Affiliation(s)
- Fanhua Meng
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, PR China
| | - Biao Zou
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, PR China
| | - Rong Yang
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, PR China
| | - Qingqing Duan
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, PR China
| | - Ting Qian
- Department of Radiology, International Peace Maternity and Child Health Hospital, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
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Feng H, Shi G, Liu H, Xu Q, Zhang N, Kuang J. Free-breathing radial volumetric interpolated breath-hold examination sequence and dynamic contrast-enhanced MRI combined with diffusion-weighted imaging for assessment of solitary pulmonary nodules. Magn Reson Imaging 2020; 75:100-106. [PMID: 33096226 DOI: 10.1016/j.mri.2020.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/27/2020] [Accepted: 10/18/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To test the performance of free-breathing Dynamic Contrast-Enhanced MRI (DCE-MRI) using a radial volumetric interpolated breath-hold examination (VIBE) sequence combined with diffusion-weighted imaging (DWI) for quantitative solitary pulmonary nodule (SPN) assessment. METHODS A total of 67 SPN cases receiving routine MRI routine scans, DWI, and dynamic-enhanced MRI in our hospital from May 2017 to November 2018 were collected. These cases were divided into a malignant group and a benign group according to the characteristics of the SPNs. The quantitative DCE-MRI parameters (Ktrans, Kep, Ve) and apparent diffusion coefficient (ADC) values of the nodules were measured. RESULTS The Ktrans and Kep values in the malignant group were higher than those in the benign group, while the ADC values in the malignant group were lower than those in the benign group. Furthermore, the Ktrans value of adenocarcinoma was higher than that of squamous cell carcinoma and small cell carcinoma (P < 0.05). The Ve value was significantly different between non-small cell carcinoma and small cell carcinoma (P < 0.05). With an ADC value of 0.98 × 10-3 mm2/s as the threshold, the specificity and sensitivity to diagnose benign and malignant nodules was 90.6% and 80%, respectively. CONCLUSION High-temporal-resolution DCE-MRI using the r-VIBE technique in combination with DWI could contribute to pulmonary nodule analysis and possibly serve as a potential alternative to distinguish malignant from benign nodules as well as differentiate different types of malignancies.
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Affiliation(s)
- Hui Feng
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Gaofeng Shi
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
| | - Hui Liu
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Qian Xu
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Ning Zhang
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Jie Kuang
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
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Wang X, Chen H, Wan Q, Li Y, Cai N, Li X, Peng Y. Motion correction and noise removing in lung diffusion-weighted MRI using low-rank decomposition. Med Biol Eng Comput 2020; 58:2095-2105. [PMID: 32654016 DOI: 10.1007/s11517-020-02224-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/27/2020] [Indexed: 12/30/2022]
Abstract
Lung diffusion-weighted magnetic resonance imaging (DWI) has shown a promising value in lung lesion detection, diagnosis, differentiation, and staging. However, the respiratory and cardiac motion, blood flow, and lung hysteresis may contribute to the blurring, resulting in unclear lung images. The image blurring could adversely affect diagnosis performance. The purpose of this study is to reduce the DWI blurring and assess its positive effect on diagnosis. The retrospective study includes 71 patients. In this paper, a motion correction and noise removal method using low-rank decomposition is proposed, which can reduce the DWI blurring by exploit the spatiotemporal continuity sequences. The deblurring performances are evaluated by qualitative and quantitative assessment, and the performance of diagnosis of lung cancer is measured by area under curve (AUC). In the view of the qualitative assessment, the deformation of the lung mass is reduced, and the blurring of the lung tumor edge is alleviated. Noise in the apparent diffusion coefficient (ADC) map is greatly reduced. For quantitative assessment, mutual information (MI) and Pearson correlation coefficient (Pearson-Coff) are 1.30 and 0.82 before the decomposition and 1.40 and 0.85 after the decomposition. Both the difference in MI and Pearson-Coff are statistically significant (p < 0.05). For the positive effect of deblurring on diagnosis of lung cancer, the AUC was improved from 0.731 to 0.841 using three-fold cross validation. We conclude that the low-rank matrix decomposition method is promising in reducing the errors in DWI lung images caused by noise and artifacts and improving diagnostics. Further investigations are warranted to understand the full utilities of the low-rank decomposition on lung DWI images. Graphical abstract.
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Affiliation(s)
- Xinhui Wang
- School of Electronic and Information Engineering, Beijing Jiaotong University, Beijing, China
| | - Houjin Chen
- School of Electronic and Information Engineering, Beijing Jiaotong University, Beijing, China.
| | - Qi Wan
- Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yanfeng Li
- School of Electronic and Information Engineering, Beijing Jiaotong University, Beijing, China
| | - Naxin Cai
- School of Electronic and Information Engineering, Beijing Jiaotong University, Beijing, China
| | - Xinchun Li
- Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yahui Peng
- School of Electronic and Information Engineering, Beijing Jiaotong University, Beijing, China
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Liang J, Li J, Li Z, Meng T, Chen J, Ma W, Chen S, Li X, Wu Y, He N. Differentiating the lung lesions using Intravoxel incoherent motion diffusion-weighted imaging: a meta-analysis. BMC Cancer 2020; 20:799. [PMID: 32831052 PMCID: PMC7446186 DOI: 10.1186/s12885-020-07308-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/17/2020] [Indexed: 12/24/2022] Open
Abstract
Background and objectives The diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in the differential diagnosis of pulmonary tumors remained debatable among published studies. This study aimed to pool and summary the relevant results to provide more robust evidence in this issue using a meta-analysis method. Materials and methods The researches regarding the differential diagnosis of lung lesions using IVIM-DWI were systemically searched in Pubmed, Embase, Web of science and Wangfang database without time limitation. Review Manager 5.3 was used to calculate the standardized mean difference (SMD) and 95% confidence intervals of apparent diffusion coefficient (ADC), tissue diffusivity (D), pseudo-diffusivity (D*), and perfusion fraction (f). Stata 12.0 was used to pool the sensitivity, specificity, and area under the curve (AUC), as well as publication bias and heterogeneity. Fagan’s nomogram was used to predict the post-test probabilities. Results Eleven studies with 481 malignant and 258 benign lung lesions were included. Most include studies showed a low to unclear risk of bias and low concerns regarding applicability. Lung cancer demonstrated a significant lower ADC (SMD = -1.17, P < 0.001), D (SMD = -1.02, P < 0.001) and f values (SMD = -0.43, P = 0.005) than benign lesions, except D* value (SMD = 0.01, P = 0.96). D value demonstrated the best diagnostic performance (sensitivity = 89%, specificity = 71%, AUC = 0.90) and highest post-test probability (57, 57, 43 and 43% for D, ADC, f and D* values) in the differential diagnosis of lung tumors, followed by ADC (sensitivity = 85%, specificity = 72%, AUC = 0.86), f (sensitivity = 71%, specificity = 61%, AUC = 0.71) and D* values (sensitivity = 70%, specificity = 60%, AUC = 0.66). Conclusion IVIM-DWI parameters show potentially strong diagnostic capabilities in the differential diagnosis of lung tumors based on the tumor cellularity and perfusion characteristics, and D value demonstrated better diagnostic performance compared to mono-exponential ADC.
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Affiliation(s)
- Jianye Liang
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No.651, Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Jing Li
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No.651, Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Zhipeng Li
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No.651, Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Tiebao Meng
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No.651, Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Jieting Chen
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No.651, Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Weimei Ma
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No.651, Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Shen Chen
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No.651, Dongfeng Road East, Guangzhou, 510060, Guangdong, China
| | - Xie Li
- Department of Radiology, Maoming People's Hospital, Maoming, 525400, Guangdong, China.
| | - Yaopan Wu
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No.651, Dongfeng Road East, Guangzhou, 510060, Guangdong, China.
| | - Ni He
- Department of Medical Imaging, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No.651, Dongfeng Road East, Guangzhou, 510060, Guangdong, China.
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Weir-McCall JR, Joyce S, Clegg A, MacKay JW, Baxter G, Dendl LM, Rintoul RC, Qureshi NR, Miles K, Gilbert FJ. Dynamic contrast-enhanced computed tomography for the diagnosis of solitary pulmonary nodules: a systematic review and meta-analysis. Eur Radiol 2020; 30:3310-3323. [PMID: 32060716 DOI: 10.1007/s00330-020-06661-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/12/2019] [Accepted: 01/17/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION A systematic review and meta-analysis were performed to determine the diagnostic performance of dynamic contrast-enhanced computed tomography (DCE-CT) for the differentiation between malignant and benign pulmonary nodules. METHODS Ovid MEDLINE and EMBASE were searched for studies published up to October 2018 on the diagnostic accuracy of DCE-CT for the characterisation of pulmonary nodules. For the index test, studies with a minimum of a pre- and post-contrast computed tomography scan were evaluated. Studies with a reference standard of biopsy for malignancy, and biopsy or 2-year follow-up for benign disease were included. Study bias was assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). The sensitivities, specificities, and diagnostic odds ratios were determined along with 95% confidence intervals (CIs) using a bivariate random effects model. RESULTS Twenty-three studies were included, including 2397 study participants with 2514 nodules of which 55.3% were malignant (1389/2514). The pooled accuracy results were sensitivity 94.8% (95% CI 91.5; 96.9), specificity 75.5% (69.4; 80.6), and diagnostic odds ratio 56.6 (24.2-88.9). QUADAS 2 assessment showed intermediate/high risk of bias in a large proportion of the studies (52-78% across the domains). No difference was present in sensitivity or specificity between subgroups when studies were split based on CT technique, sample size, nodule size, or publication date. CONCLUSION DCE-CT has a high diagnostic accuracy for the diagnosis of pulmonary nodules although study quality was indeterminate in a large number of cases. KEY POINTS • The pooled accuracy results were sensitivity 95.1% and specificity 73.8% although individual studies showed wide ranges of values. • This is comparable to the results of previous meta-analyses of PET/CT (positron emission tomography/computed tomography) diagnostic accuracy for the diagnosis of solitary pulmonary nodules. • Robust direct comparative accuracy and cost-effectiveness studies are warranted to determine the optimal use of DCE-CT and PET/CT in the diagnosis of SPNs.
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Affiliation(s)
- Jonathan R Weir-McCall
- Department of Radiology, University of Cambridge School of Clinical Medicine, Box 218, Level 5, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
| | - Stella Joyce
- Department of Radiology, University of Cambridge School of Clinical Medicine, Box 218, Level 5, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Andrew Clegg
- School of Health Sciences, Faculty of Health and Wellbeing, University of Central Lancashire, Lancashire, UK
| | - James W MacKay
- Department of Radiology, University of Cambridge School of Clinical Medicine, Box 218, Level 5, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Gabrielle Baxter
- Department of Radiology, University of Cambridge School of Clinical Medicine, Box 218, Level 5, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | | | - Robert C Rintoul
- Department of Thoracic Oncology, Royal Papworth Hospital, Cambridge, UK.,Department of Oncology, University of Cambridge, Cambridge, UK
| | - Nagmi R Qureshi
- Department of Radiology, Royal Papworth Hospital, Cambridge, UK
| | - Ken Miles
- Institute of Nuclear Medicine, University College London, London, UK
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge School of Clinical Medicine, Box 218, Level 5, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
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