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Willemse JRJ, Lambregts DMJ, Balduzzi S, Schats W, Snaebjornsson P, Marchetti S, Vollebergh MA, van Golen LW, Cheung Z, Vogel WV, Bodalal Z, Rostami S, Gerke O, Sivakumaran T, Beets-Tan RGH, Lahaye MJ. Identifying the primary tumour in patients with cancer of unknown primary (CUP) using [ 18F]FDG PET/CT: a systematic review and individual patient data meta-analysis. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06860-1. [PMID: 39141069 DOI: 10.1007/s00259-024-06860-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 07/26/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE In this systematic review and individual patient data (IPD) meta-analysis, we analysed the diagnostic performance of [18F]FDG PET/CT in detecting primary tumours in patients with CUP and evaluated whether the location of the predominant metastatic site influences the diagnostic performance. METHODS A systematic literature search from January 2005 to February 2024 was performed to identify articles describing the diagnostic performance of [18F]FDG PET/CT for primary tumour detection in CUP. Individual patient data retrieved from original articles or obtained from corresponding authors were grouped by the predominant metastatic site. The diagnostic performance of [18F]FDG PET/CT in detecting the underlying primary tumour was compared between predominant metastatic sites. RESULTS A total of 1865 patients from 32 studies were included. The largest subgroup included patients with predominant bone metastases (n = 622), followed by liver (n = 369), lymph node (n = 358), brain (n = 316), peritoneal (n = 70), lung (n = 67), and soft tissue (n = 23) metastases, leaving a small group of other/undefined metastases (n = 40). [18F]FDG PET/CT resulted in pooled detection rates to identify the primary tumour of 0.74 (for patients with predominant brain metastases), 0.54 (liver-predominant), 0.49 (bone-predominant), 0.46 (lung-predominant), 0.38 (peritoneal-predominant), 0.37 (lymph node-predominant), and 0.35 (soft-tissue-predominant). CONCLUSION This individual patient data meta-analysis suggests that the ability of [18F]FDG PET/CT to identify the primary tumour in CUP depends on the distribution of metastatic sites. This finding emphasises the need for more tailored diagnostic approaches in different patient populations. In addition, alternative diagnostic tools, such as new PET tracers or whole-body (PET/)MRI, should be investigated.
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Affiliation(s)
- Jeroen R J Willemse
- Department of Radiology, the Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, The Netherlands
- GROW Research Institute for Oncology and Reproduction - Maastricht University, Maastricht, Netherlands
| | - Doenja M J Lambregts
- Department of Radiology, the Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, The Netherlands
- GROW Research Institute for Oncology and Reproduction - Maastricht University, Maastricht, Netherlands
| | - Sara Balduzzi
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Winnie Schats
- Department of Scientific Information Service, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Petur Snaebjornsson
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, Netherlands
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Serena Marchetti
- Department of Medical Oncology and Clinical Pharmacology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Marieke A Vollebergh
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Larissa W van Golen
- Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Zing Cheung
- Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Wouter V Vogel
- Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, Netherlands
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Zuhir Bodalal
- Department of Radiology, the Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, The Netherlands
- GROW Research Institute for Oncology and Reproduction - Maastricht University, Maastricht, Netherlands
| | - Sajjad Rostami
- Department of Radiology, the Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, The Netherlands
- GROW Research Institute for Oncology and Reproduction - Maastricht University, Maastricht, Netherlands
| | - Oke Gerke
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Tharani Sivakumaran
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne VIC, Melbourne, VIC, Australia
| | - Regina G H Beets-Tan
- Department of Radiology, the Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, The Netherlands
- GROW Research Institute for Oncology and Reproduction - Maastricht University, Maastricht, Netherlands
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Max J Lahaye
- Department of Radiology, the Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, The Netherlands.
- GROW Research Institute for Oncology and Reproduction - Maastricht University, Maastricht, Netherlands.
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Crafa F, Vanella S, Catalano OA, Pomykala KL, Baiamonte M. Role of one-step nucleic acid amplification in colorectal cancer lymph node metastases detection. World J Gastroenterol 2022; 28:4019-4043. [PMID: 36157105 PMCID: PMC9403438 DOI: 10.3748/wjg.v28.i30.4019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/03/2022] [Accepted: 07/22/2022] [Indexed: 02/06/2023] Open
Abstract
Current histopathological staging procedures in colorectal cancer (CRC) depend on midline division of the lymph nodes (LNs) with one section of hematoxylin and eosin staining. Cancer cells outside this transection line may be missed, which could lead to understaging of Union for International Cancer Control Stage II high-risk patients. The one-step nucleic acid amplification (OSNA) assay has emerged as a rapid molecular diagnostic tool for LN metastases detection. It is a molecular technique that can analyze the entire LN tissue using a reverse-transcriptase loop-mediated isothermal amplification reaction to detect tumor-specific cytokeratin 19 mRNA. Our findings suggest that the OSNA assay has a high diagnostic accuracy in detecting metastatic LNs in CRC and a high negative predictive value. OSNA is a standardized, observer-independent technique, which may lead to more accurate staging. It has been suggested that in stage II CRC, the upstaging can reach 25% and these patients can access postoperative adjuvant chemotherapy. Moreover, intraoperative OSNA sentinel node evaluation may allow early CRC to be treated with organ-preserving surgery, while in more advanced-stage disease, a tailored lymphadenectomy can be performed considering the presence of aberrant lymphatic drainage and skip metastases.
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Affiliation(s)
- Francesco Crafa
- Division of General and Surgical Oncology, St. Giuseppe Moscati Hospital, Center of National Excellence and High Specialty, Avellino 83100, Italy
| | - Serafino Vanella
- Division of General and Surgical Oncology, St. Giuseppe Moscati Hospital, Center of National Excellence and High Specialty, Avellino 83100, Italy
| | - Onofrio A Catalano
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Kelsey L Pomykala
- Department of Nuclear Medicine, Department of Radiological Sciences, David Geffen School of Medicine at University of California, Los Angeles, University Hospital Essen, University of Duisburg-Essen, Essen 45141, Germany
| | - Mario Baiamonte
- Division of General and Surgical Oncology, St. Giuseppe Moscati Hospital, Center of National Excellence and High Specialty, Avellino 83100, Italy
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Tavakoli AA, Dreher C, Mlynarska A, Kuder TA, Gnirs R, Schlemmer HP, Bickelhaupt S. Pancreatic imaging using diffusivity mapping - Influence of sequence technique on qualitative and quantitative analysis. Clin Imaging 2021; 83:33-40. [PMID: 34953309 DOI: 10.1016/j.clinimag.2021.11.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/08/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To compare image quality of an optimized diffusion weighted imaging (DWI) sequence with advanced post-processing and motion correction (advanced-EPI) to a standard DWI protocol (standard-EPI) in pancreatic imaging. MATERIALS AND METHODS 62 consecutive patients underwent abdominal MRI at 1.5 T were included in this retrospective analysis of data collected as part of an IRB approved study. All patients received a standard-EPI and an advanced-EPI DWI with advanced post-processing and motion correction. Two blinded radiologists evaluated the parameters image quality, detail of parenchyma, sharpness of boundaries and discernibility from adjacent structures on b = 900 s/mm2 images using a Likert-like scale. Segmentation of pancreatic head, body and tail were obtained and apparent diffusion coefficient (ADC) was calculated separately for each region. Apparent tissue-to-background ratio (TBR) was calculated at b = 50 s/mm2 and at b = 900 s/mm2. RESULTS The advanced-EPI yielded significantly higher scores for pancreatic parameters of image quality, detail level of parenchyma, sharpness of boundaries and discernibility from adjacent structures in comparison to standard-EPI (p < 0.001 for all, kappa = [0.46,0.71]) and was preferred in 96% of the cases when directly compared. ADC of the pancreas was 7% lower in advanced-EPI (1.236 ± 0.152 vs. 1.146 ± 0.126 μm2/ms, p < 0.001). ADC in the pancreatic tail was significantly lower for both sequences compared to head and body (all p < 0.001). There was comparable TBR for both sequences at b = 50 s/mm2 (standard-EPI: 19.0 ± 5.9 vs. advanced-EPI: 19.0 ± 6.4, p = 0.96), whereas at b = 900 s/mm2, TBR was 51% higher for advanced-EPI (standard-EPI: 7.1 ± 2.5 vs. advanced-EPI: 10.8 ± 5.1, p < 0.001). CONCLUSION An advanced DWI sequence might increase image quality for focused imaging of the pancreas and providing improved parenchymal detail levels compared to a standard DWI.
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Affiliation(s)
- Anoshirwan Andrej Tavakoli
- German Cancer Research Center (DKFZ), Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Constantin Dreher
- German Cancer Research Center (DKFZ), Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Radiation Oncology, University Medical Center Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| | - Anna Mlynarska
- German Cancer Research Center (DKFZ), Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Tristan Anselm Kuder
- German Cancer Research Center (DKFZ), Medical Physics in Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Regula Gnirs
- German Cancer Research Center (DKFZ), Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Heinz-Peter Schlemmer
- German Cancer Research Center (DKFZ), Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Sebastian Bickelhaupt
- German Cancer Research Center (DKFZ), Medical Imaging and Radiology - Cancer Prevention, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; University Hospital Erlangen, Institute of Radiology, Maximiliansplatz 3, 91054 Erlangen, Germany.
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Attenberger UI, Tavakoli A, Stocker D, Stieb S, Riesterer O, Turina M, Schoenberg SO, Pilz L, Reiner CS. Reduced and standard field-of-view diffusion weighted imaging in patients with rectal cancer at 3 T-Comparison of image quality and apparent diffusion coefficient measurements. Eur J Radiol 2020; 131:109257. [PMID: 32947092 DOI: 10.1016/j.ejrad.2020.109257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/30/2020] [Accepted: 08/24/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE To compare a zoomed EPI-DWI (z-EPI) with a standard EPI-DWI (s-EPI) in the primary diagnostics of rectal cancer and assess its potential of reduced image artifacts. METHOD 22 therapy-naïve patients with rectal cancer underwent rectal MRI at a 3 T-system. The protocols consisted of a z-EPI DWI and s-EPI DWI sequence. Images were assessed by two independent and experienced readers regarding overall image quality and artifacts on a 5-point Likert scale, as well as overall sequence preference. In a lesion-based analysis, tumor and lymph node detection were rated on a 4-point Likert scale. Apparent diffusion coefficient (ADC) measurements were performed. RESULTS Overall Image quality score for z-EPI and s-EPI showed no statistically significant differences (p = 0.80/0.54, reader 1/2) with a median score of 4 ("good" image quality) for both sequences. The image quality preference rank for z-EPI and s-EPI was given the category 'no preference' in 64 % (reader 1) and 50 % (reader 2). Most artifact-related scores (susceptibility, motion and distortion) did not show reproducible significant differences between z-EPI and s-EPI. The two sequences exhibited comparable, mostly good and excellent quality scores for tumor and lymph node detection (p = 0.19-0.99). ADC values were significantly lower for z-EPI than for s-EPI (p = 0.001/0.002, reader 1/2) with good agreement of ADC measurements between both readers. CONCLUSION Our data showed comparable image quality and lesion detection for the z-EPI and the s-EPI sequence in MRI of rectal cancer, whereas the mean ADC of the tumor was significantly lower in z-EPI compared to s-EPI.
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Affiliation(s)
- U I Attenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany.
| | - A Tavakoli
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Germany.
| | - D Stocker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
| | - S Stieb
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland
| | - O Riesterer
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland.
| | - M Turina
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
| | - S O Schoenberg
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany.
| | - L Pilz
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - C S Reiner
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
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Improved Liver Diffusion-Weighted Imaging at 3 T Using Respiratory Triggering in Combination With Simultaneous Multislice Acceleration. Invest Radiol 2020; 54:744-751. [PMID: 31335634 DOI: 10.1097/rli.0000000000000594] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this study was to retrospectively compare optimized respiratory-triggered diffusion-weighted imaging with simultaneous multislice acceleration (SMS-RT-DWI) of the liver with a standard free-breathing echo-planar DWI (s-DWI) protocol at 3 T with respect to the imaging artifacts inherent to DWI. MATERIALS AND METHODS Fifty-two patients who underwent a magnetic resonance imaging study of the liver were included in this retrospective study. Examinations were performed on a 3 T whole-body magnetic resonance system (MAGNETOM Skyra; Siemens Healthcare, Erlangen, Germany). In all patients, both s-DWI and SMS-RT-DWI of the liver were obtained. Images were qualitatively evaluated by 2 independent radiologists with regard to overall image quality, liver edge sharpness, sequence-related artifacts, and overall scan preference. For quantitative evaluation, signal-to-noise ratio was measured from signal-to-noise ratio maps. The mean apparent diffusion coefficient (ADC) was measured in each liver quadrant. The Wilcoxon rank-sum test was used for analysis of the qualitative parameters and the paired Student t test for quantitative parameters. RESULTS Overall image quality, liver edge sharpness, and sequence-related artifacts of SMS-RT-DWI received significantly better ratings compared with s-DWI (P < 0.05 for all). For 90.4% of the examinations, both readers overall preferred SMS-RT-DWI to s-DWI. Acquisition time for SMS-RT-DWI was 34% faster than s-DWI. Signal-to-noise ratio values were significantly higher for s-DWI at b50 but did not statistically differ at b800, and they were more homogenous for SMS-RT-DWI, with a significantly lower standard deviation at b50. Mean ADC values decreased from the left to right hepatic lobe as well as from cranial to caudal for s-DWI. With SMS-RT-DWI, mean ADC values were homogeneous throughout the liver. CONCLUSIONS Optimized, multislice, respiratory-triggered DWI of the liver at 3 T substantially improves image quality with a reduced scan acquisition time compared with s-DWI.
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Engbersen MP, Aalbers AGJ, Van't Sant-Jansen I, Velsing JDR, Lambregts DMJ, Beets-Tan RGH, Kok NFM, Lahaye MJ. Extent of Peritoneal Metastases on Preoperative DW-MRI is Predictive of Disease-Free and Overall Survival for CRS/HIPEC Candidates with Colorectal Cancer. Ann Surg Oncol 2020; 27:3516-3524. [PMID: 32239338 DOI: 10.1245/s10434-020-08416-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether the extent of peritoneal metastases (PMs) on preoperative diffusion-weighted magnetic resonance imaging (DW-MRI) can be used as a biomarker of disease-free and overall survival in patients with colorectal cancer who are considered for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). METHODS For this retrospective cohort study, patients with PMs considered for CRS/HIPEC who underwent DW-MRI for preoperative staging in 2016-2017 were included. The DW-MRI protocol consisted of diffusion-weighted, T2-weighted, and pre- and post-gadolinium T1-weighted imaging of the chest, abdomen, and pelvis. DW-MRI images were evaluated by two independent readers to determine the extent of PMs represented by the Peritoneal Cancer Index (MRI-PCI), as well as extraperitoneal metastases. Cox regression and Kaplan-Meier analysis was performed to determine the prognostic value of DW-MRI for overall and disease-free survival. RESULTS Seventy-eight patients were included. CRS/HIPEC was planned for 53 patients and completed in 50 patients (60.5%). Median follow-up after DW-MRI was 23 months (interquartile range 13-24). The MRI-PCI of both readers showed prognostic value for overall survival, independently of whether R1 resection was achieved (hazard ratio [HR] 1.06-1.08; p < 0.05). For the patients who received successful CRS/HIPEC, the MRI-PCI also showed independent prognostic value for disease-free survival for both readers (HR 1.09-1.10; p < 0.05). CONCLUSION The extent of PMs on preoperative DW-MRI is an independent predictor of overall and disease-free survival and should therefore be considered as a non-invasive prognostic biomarker.
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Affiliation(s)
- Maurits P Engbersen
- Department of Radiology, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands.,GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Arend G J Aalbers
- Department of Surgery, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Iris Van't Sant-Jansen
- Department of Radiology, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jeroen D R Velsing
- Department of Radiology, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Doenja M J Lambregts
- Department of Radiology, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands.,GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Niels F M Kok
- Department of Surgery, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Max J Lahaye
- Department of Radiology, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Lee K, Park HY, Kim KW, Lee AJ, Yoon MA, Chae EJ, Lee JH, Chung HW. Advances in whole body MRI for musculoskeletal imaging: Diffusion-weighted imaging. J Clin Orthop Trauma 2019; 10:680-686. [PMID: 31316239 PMCID: PMC6611843 DOI: 10.1016/j.jcot.2019.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 02/07/2023] Open
Abstract
Recent advances in imaging technology have enabled the acquisition of anatomical and functional imaging from head to toe in a reasonably short scan time. Accordingly, whole body magnetic resonance imaging (WB-MRI) and diffusion-weighted imaging (WB-DWI) have gained recent attention for the management of musculoskeletal problems such as bone tumors and rheumatologic diseases. WB-MRI is especially useful in diagnosing systemic or widespread disease requiring whole body evaluation, such as bone metastases, multiple myeloma, lymphoma, neurofibromatosis, and spondyloarthropathies. Among WB-MRI sequences, the WB-DWI technique greatly increases the value of WB-MRI in the evaluation of disease extent and characterization as well as treatment monitoring. In support of the utilization of WB-MRI and WB-DWI in orthopedic clinics for various musculoskeletal diseases, we provide an overview of the technical aspects of WB-MRI and WB-DWI and their clinical applications in musculoskeletal tumors and rheumatic diseases.
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Affiliation(s)
- Koeun Lee
- Asan Image Metrics, Clinical Trial Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ho Young Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyung Won Kim
- Asan Image Metrics, Clinical Trial Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea,Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea,Corresponding author. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - Amy Junghyun Lee
- Asan Image Metrics, Clinical Trial Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Min A. Yoon
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eun Jin Chae
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hye Won Chung
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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García-Figueiras R, Baleato-González S, Padhani AR, Luna-Alcalá A, Marhuenda A, Vilanova JC, Osorio-Vázquez I, Martínez-de-Alegría A, Gómez-Caamaño A. Advanced Imaging Techniques in Evaluation of Colorectal Cancer. Radiographics 2018; 38:740-765. [PMID: 29676964 DOI: 10.1148/rg.2018170044] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Imaging techniques are clinical decision-making tools in the evaluation of patients with colorectal cancer (CRC). The aim of this article is to discuss the potential of recent advances in imaging for diagnosis, prognosis, therapy planning, and assessment of response to treatment of CRC. Recent developments and new clinical applications of conventional imaging techniques such as virtual colonoscopy, dual-energy spectral computed tomography, elastography, advanced computing techniques (including volumetric rendering techniques and machine learning), magnetic resonance (MR) imaging-based magnetization transfer, and new liver imaging techniques, which may offer additional clinical information in patients with CRC, are summarized. In addition, the clinical value of functional and molecular imaging techniques such as diffusion-weighted MR imaging, dynamic contrast material-enhanced imaging, blood oxygen level-dependent imaging, lymphography with contrast agents, positron emission tomography with different radiotracers, and MR spectroscopy is reviewed, and the advantages and disadvantages of these modalities are evaluated. Finally, the future role of imaging-based analysis of tumor heterogeneity and multiparametric imaging, the development of radiomics and radiogenomics, and future challenges for imaging of patients with CRC are discussed. Online supplemental material is available for this article. ©RSNA, 2018.
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Affiliation(s)
- Roberto García-Figueiras
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Sandra Baleato-González
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Anwar R Padhani
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Antonio Luna-Alcalá
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Ana Marhuenda
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Joan C Vilanova
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Iria Osorio-Vázquez
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Anxo Martínez-de-Alegría
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Antonio Gómez-Caamaño
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
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Fitzpatrick JJ, Ryan MA, Bruzzi JF. Diagnostic accuracy of diffusion-weighted imaging- magnetic resonance imaging compared to positron emission tomography/computed tomography in evaluating and assessing pathological response to treatment in adult patients with lymphoma: A systematic review. J Med Imaging Radiat Oncol 2018; 62:530-539. [PMID: 29577630 DOI: 10.1111/1754-9485.12723] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 02/20/2018] [Indexed: 12/19/2022]
Abstract
The use of Positron emission tomography/computerised tomography (PET/CT) is well established in the staging and assessment of treatment response of lymphoma. Recent studies have suggested that whole body diffusion-weighted imaging -magnetic resonance imaging (WB-DW-MRI) may be an alternative to PET/CT in both staging and assessment of treatment response. A systematic review was performed to assess the ability of DW-MRI in the assessment of treatment response in lymphoma. Pubmed, Medline, Web of Science and Embase databases were queried for studies examining whole body DW-MRI compared to PET/CT in adult patients using a protocol of search terms. We carried out an extensive assessment of titles, abstracts and full texts of relevant paper as well as quality assessment with the Quality Assessment of Diagnostic Accuracy (QUADAS-2) tool. Eight studies were found to meet the criteria and were included in our review and analysis. Overall, the quality of studies was found to be moderate, with good inter-rater agreement (K = 0.74). Data analysis showed that lesion-based assessment in 5 studies with pooled results had a sensitivity and specificity of 94.7% and 99.3%. Assessment with Cohen's Kappa coefficient showed agreement to be excellent (K = 0.88). Three studies were included for qualitative analysis, two of which showed good equivalence between PET/CT and DW-MRI. WB-DWI-MRI can be considered a sensitive and specific method for assessing treatment response in Lymphoma without the use of ionising radiation or administration of F-18 Flurodeoxyglucose. Further studies are needed to evaluate the optimum b-values in assessing treatment response.
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10
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Teixeira SR, Elias PCL, Leite AFDM, de Oliveira TMG, Muglia VF, Elias Junior J. Apparent diffusion coefficient of normal adrenal glands. Radiol Bras 2017; 49:363-368. [PMID: 28057963 PMCID: PMC5210033 DOI: 10.1590/0100-3984.2015.0045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective To assess the feasibility and reliability of apparent diffusion coefficient
(ADC) measurements of normal adrenal glands. Materials and methods This was a retrospective study involving 32 healthy subjects, divided into
two groups: prepubertal (PreP, n = 12), aged from 2 months
to 12.5 years (4 males; 8 females); and postpubertal (PostP,
n = 20), aged from 11.9 to 61 years (5 males; 15
females). Diffusion-weighted magnetic resonance imaging (DW-MRI) sequences
were acquired at a 1.5 T scanner using b values of 0, 20,
500, and 1000 s/mm2. Two radiologists evaluated the images. ADC
values were measured pixel-by-pixel on DW-MRI scans, and automatic
co-registration with the ADC map was obtained. Results Mean ADC values for the right adrenal glands were 1.44 ×
10-3 mm2/s for the PreP group and 1.23 ×
10-3 mm2/s for the PostP group, whereas they were
1.58 × 10-3 mm2/s and 1.32 ×
10-3 mm2/s, respectively, for the left glands. ADC
values were higher in the PreP group than in the PostP group
(p < 0.05). Agreement between readers was almost
perfect (intraclass correlation coefficient, 0.84-0.94; p
< 0.05). Conclusion Our results demonstrate the feasibility and reliability of performing DW-MRI
measurements of normal adrenal glands. They could also support the
feasibility of ADC measurements of small structures.
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Affiliation(s)
- Sara Reis Teixeira
- MD, PhD, Attending Physician at the Centro de Ciências das Imagens e Física Médica (CCIFM), Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | - Paula Condé Lamparelli Elias
- MD, PhD, Endocrinology Division of the Department of Internal Medicine, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | - Andrea Farias de Melo Leite
- MD, PhD, Attending Physician at the Instituto de Medicina Integral Professor Fernando Figueira de Pernambuco (IMIP), Recife, PE, Brazil
| | - Tatiane Mendes Gonçalves de Oliveira
- MD, PhD, Attending Physician at the Centro de Ciências das Imagens e Física Médica (CCIFM), Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | - Valdair Francisco Muglia
- MD, PhD, Associate Professor in the Radiology Division of the Department of Internal Medicine, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Jorge Elias Junior
- MD, PhD, Associate Professor in the Radiology Division of the Department of Internal Medicine, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
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11
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García-Figueiras R, Baleato-González S, Padhani AR, Marhuenda A, Luna A, Alcalá L, Carballo-Castro A, Álvarez-Castro A. Advanced imaging of colorectal cancer: From anatomy to molecular imaging. Insights Imaging 2016; 7:285-309. [PMID: 27136925 PMCID: PMC4877344 DOI: 10.1007/s13244-016-0465-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/30/2015] [Accepted: 01/19/2016] [Indexed: 12/14/2022] Open
Abstract
UNLABELLED Imaging techniques play a key role in the management of patients with colorectal cancer. The introduction of new advanced anatomical, functional, and molecular imaging techniques may improve the assessment of diagnosis, prognosis, planning therapy, and assessment of response to treatment of these patients. Functional and molecular imaging techniques in clinical practice may allow the assessment of tumour-specific characteristics and tumour heterogeneity. This paper will review recent developments in imaging technologies and the evolving roles for these techniques in colorectal cancer. TEACHING POINTS • Imaging techniques play a key role in the management of patients with colorectal cancer. • Advanced imaging techniques improve the evaluation of these patients. • Functional and molecular imaging allows assessment of tumour hallmarks and tumour heterogeneity.
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Affiliation(s)
- Roberto García-Figueiras
- />Department of Radiology, Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Sandra Baleato-González
- />Department of Radiology, Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Anwar R. Padhani
- />Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England, HA6 2RN UK
| | - Ana Marhuenda
- />Department of Radiology, IVO (Instituto Valenciano de Oncología), C/ Beltrán Báguena, 8, 46009 Valencia, Spain
| | - Antonio Luna
- />Department of Radiology, Advanced Medical Imaging, Clinica Las Nieves, SERCOSA, Grupo Health Time, C/ Carmelo Torres 2, 23007 Jaén, Spain
- />Case Western Reserve University, Cleveland, OH USA
| | - Lidia Alcalá
- />Department of Radiology, Advanced Medical Imaging, Clinica Las Nieves, SERCOSA, Grupo Health Time, C/ Carmelo Torres 2, 23007 Jaén, Spain
| | - Ana Carballo-Castro
- />Department of Radiotherapy, Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain
| | - Ana Álvarez-Castro
- />Department of Gastroenterology, Colorectal Cancer Group, Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, Santiago de Compostela, 15706 Spain
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12
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Brendle C, Schwenzer NF, Rempp H, Schmidt H, Pfannenberg C, la Fougère C, Nikolaou K, Schraml C. Assessment of metastatic colorectal cancer with hybrid imaging: comparison of reading performance using different combinations of anatomical and functional imaging techniques in PET/MRI and PET/CT in a short case series. Eur J Nucl Med Mol Imaging 2015. [DOI: 10.1007/s00259-015-3137-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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13
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Du J, Li K, Zhang W, Wang S, Song Q, Liu A, Miao Y, Lang Z, Zhang L, Zheng M. Intravoxel Incoherent Motion MR Imaging: Comparison of Diffusion and Perfusion Characteristics for Differential Diagnosis of Soft Tissue Tumors. Medicine (Baltimore) 2015; 94:e1028. [PMID: 26107671 PMCID: PMC4504541 DOI: 10.1097/md.0000000000001028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We used intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) to explore the possibility of preoperative diagnosis of soft tissue tumors (STTs). This prospective study enrolled 23 patients. Conventional MRI and IVIM examinations were performed on a 3.0T MR imager. Eight (35%) hemangiomas, 11 (47%) benign soft tissue tumors excluding hemangiomas (BSTTEHs) and 4 soft tissue sarcomas (STSs) were assessed. The mean tumor size was about 1652.36 ± 233.66 mm(2). Ten b values (0-800 s/mm(2)) were used to evaluate diffusion and perfusion characteristics of IVIM. IVIM parameters (ADC(standard), ADC(slow), ADC(fast), and f) of STTs were measured and evaluated for differentiating hemangiomas, BSTTEHs, and STSs. ADC(slow) and ADC(fast) value were different for hemangiomas, BSTTEHs, and STSs separately (P < 0.001, P < 0.001, and P = 0.001). ADC(slow), cut-off value smaller than 0.93 × 10(-3) mm(2)/s, was the best parameter to differ STSs (0.689 ± 0.173 × 10 (-3)mm(2)/s) from hemangiomas (0.933 ± 0.237 × 10 (-3)mm(2)/s) and BSTTEHs (1.156 ± 0.120 × 10 (-3)mm(2)/s) (P = 0.001). ADC(slow) (0.93 × 10(-3) mm(2)/s <cut-off value <0.96 × 10(-3) mm(2)/s) was used to distinguish hemangiomas from BSTTs. There were significant difference among hemangiomas, BSTTEHs, and STSs (P = 0.014, P = 0.036, P < 0.001). The ADC(standard), ADC(fast), and f value were different (P < 0.05) for STSs (1.009 ± 0.177 × 10 (-3) mm(2)/s, 15.700 ± 1.992 × 10(-3) mm(2)/s, 0.503 ± 0.068), hemangiomas (1.505 ± 0.226 × 10(-3) mm(2)/s, 11.675 ± 0.456 × 10(-3) mm(2)/s, 0.682 ± 0.060), and BSTTEHs (1.555 ± 0.176 × 10(-3) mm(2)/s, 11.727 ± 0.686 × 10(-3) mm(2)/s, 0.675 ± 0.054). And there was no significant difference for these 3 parameters between hemangiomas and BSTTEHs (P = 0.584, 0.907, and 0.798). IVIM may be of significant value for differential diagnosing hemangiomas, BSTTEHs, and STSs.
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Affiliation(s)
- Jun Du
- From the Department of Radiology, First Affiliated Hospital of Dalian Medical University (JD, WZ, QS, AL, YM, ZL, LZ, MZ); Department of Radiology, Second Affiliated Hospital of Dalian Medical University (SW); and Department of orthopedics, Second Affiliated Hospital of Dalian Medical University, Dalian, China (KL)
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14
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Azzedine B, Kahina MB, Dimitri P, Christophe P, Alain D, Claude M. Whole-body diffusion-weighted MRI for staging lymphoma at 3.0T: comparative study with MR imaging at 1.5T. Clin Imaging 2015; 39:104-9. [DOI: 10.1016/j.clinimag.2014.06.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 06/16/2014] [Accepted: 06/30/2014] [Indexed: 11/29/2022]
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15
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Cantisani V, Grazhdani H, Fioravanti C, Rosignuolo M, Calliada F, Messineo D, Bernieri MG, Redler A, Catalano C, D’Ambrosio F. Liver metastases: Contrast-enhanced ultrasound compared with computed tomography and magnetic resonance. World J Gastroenterol 2014; 20:9998-10007. [PMID: 25110428 PMCID: PMC4123379 DOI: 10.3748/wjg.v20.i29.9998] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 11/23/2013] [Accepted: 04/29/2014] [Indexed: 02/06/2023] Open
Abstract
The development of ultrasound contrast agents with excellent tolerance and safety profiles has notably improved liver evaluation with ultrasound (US) for several applications, especially for the detection of metastases. In particular, contrast enhanced ultrasonography (CEUS) allows the display of the parenchymal microvasculature, enabling the study and visualization of the enhancement patterns of liver lesions in real time and in a continuous manner in all vascular phases, which is similar to contrast-enhanced computed tomography (CT) and contrast-enhanced magnetic resonance imaging. Clinical studies have reported that the use of a contrast agent enables the visualization of more metastases with significantly improved sensitivity and specificity compared to baseline-US. Furthermore, studies have shown that CEUS yields sensitivities comparable to CT. In this review, we describe the state of the art of CEUS for detecting colorectal liver metastases, the imaging features, the literature reports of metastases in CEUS as well as its technique, its clinical role and its potential applications. Additionally, the updated international consensus panel guidelines are reported in this review with the inherent limitations of this technique and best practice experiences.
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16
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Ouyang Z, Ouyang Y, Zhu M, Lu Y, Zhang Z, Shi J, Li X, Ren G. Diffusion-weighted imaging with fat suppression using short-tau inversion recovery: Clinical utility for diagnosis of breast lesions. Clin Radiol 2014; 69:e337-44. [DOI: 10.1016/j.crad.2014.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 03/11/2014] [Accepted: 04/07/2014] [Indexed: 12/27/2022]
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17
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Nguyen TLF, Soyer P, Fornès P, Rousset P, Kianmanesh R, Hoeffel C. Diffusion-weighted MR imaging of the rectum: clinical applications. Crit Rev Oncol Hematol 2014; 92:279-95. [PMID: 25132166 DOI: 10.1016/j.critrevonc.2014.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 05/28/2014] [Accepted: 07/22/2014] [Indexed: 02/08/2023] Open
Abstract
Dramatic advances in image quality over the past few years have made diffusion-weighted magnetic resonance imaging (DW-MRI) a promising tool for rectal lesion evaluation. DW-MRI derives its image contrast from differences in the motion of water molecules between tissues. Such imaging can be performed quickly without the need for the administration of exogenous contrast medium. The technique yields qualitative and quantitative information that reflects changes at a cellular level and provides information about tumor cellularity and the integrity of cell membranes. The sensitivity to diffusion is obtained by applying two bipolar diffusion-sensitizing gradients to a standard T2-weighted spin echo sequence. The diffusion-sensitivity can be varied by adjusting the "b-factor", which represents the gradient duration, gradient amplitude and the time interval between the two gradients. The higher the b-value, the greater the signal attenuation from moving water protons. In this review, technical considerations relatively to image acquisition and to quantification methods applied to rectal DW-MRI are discussed. The current clinical applications of DW-MRI, either in the field of inflammatory or neoplastic rectal disease are reviewed. Also, limitations, mainly in terms of persistent lack of standardization or evaluation of tumoral response, and future directions of rectal DW-MRI are discussed. The potential utility of DW-MRI for the evaluation of rectal tumor response is on its way to being admitted but future well-designed and multicenter studies, as well as standardization of DW-MRI, are still required before a consensus can be reached upon how and when to use DW-MRI.
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Affiliation(s)
| | - Philippe Soyer
- Department of Radiology, Hôpital Lariboisière, 2 rue Ambroise Paré, 75010 Paris, France
| | - Paul Fornès
- Department of Histopathology and Cytology, Hôpital Robert Debré, Avenue du Général Koenig, 51092 Reims Cedex, France
| | - Pascal Rousset
- Department of Radiology, Hôpital Hôtel Dieu, 1 place du Parvis de Notre Dame, 75181 Paris Cedex 4, France
| | - Reza Kianmanesh
- Department of Abdominal Surgery, Hôpital Robert Debré, Avenue du Général Koenig, 51092 Reims Cedex, France
| | - Christine Hoeffel
- Department of Radiology, Hôpital Robert Debré, Avenue du Général Koenig, 51092 Reims Cedex, France
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18
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Fayad LM, Blakeley J, Plotkin S, Widemann B, Jacobs MA. Whole Body MRI at 3T with Quantitative Diffusion Weighted Imaging and Contrast-Enhanced Sequences for the Characterization of Peripheral Lesions in Patients with Neurofibromatosis Type 2 and Schwannomatosis. ISRN RADIOLOGY 2013; 2013:627932. [PMID: 24967287 PMCID: PMC4045550 DOI: 10.5402/2013/627932] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 08/13/2013] [Indexed: 12/15/2022]
Abstract
Purpose. WB-MRI is mainly used for tumor detection and surveillance. The purpose of this study is to establish the feasibility of WB-MRI at 3T for lesion characterization, with DWI/ADC-mapping and contrast-enhanced sequences, in patients with neurofibromatosis type 2 (NF-2) and schwannomatosis. Materials and Methods. At 3T, WB-MRI was performed in 11 subjects (10 NF-2 and 1 schwannomatosis) with STIR, T1, contrast-enhanced T1, and DWI/ADC mapping (b = 50, 400, 800 s/mm(2)). Two readers reviewed imaging for the presence and character of peripheral lesions. Lesion size and features (signal intensity, heterogeneity, enhancement characteristics, and ADC values) were recorded. Descriptive statistics were reported. Results. Twenty-three lesions were identified, with average size of 4.6 ± 2.8 cm. Lesions were characterized as tumors (21/23) or cysts (2/23) by contrast-enhancement properties (enhancement in tumors, no enhancement in cysts). On T1, tumors were homogeneously isointense (5/21) or hypointense (16/21); on STIR, tumors were hyperintense and homogeneous (10/21) or heterogeneous (11/21); on postcontrast T1, tumors enhanced homogeneously (14/21) or heterogeneously (7/21); on DWI, tumor ADC values were variable (range 0.8-2.7), suggesting variability in intrinsic tumor properties. Conclusion. WB-MRI with quantitative DWI and contrast-enhanced sequences at 3T is feasible and advances the utility of WB-MRI not only to include detection, but also to provide additional metrics for lesion characterization.
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Affiliation(s)
- Laura M. Fayad
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Jaishri Blakeley
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- The Johns Hopkins Hospital Comprehensive Neurofibromatosis Center, Department of Neurology, The Johns Hopkins Hospital, CRB II, Suite 1M16, 1550 Orleans Street, Baltimore, MD 21231, USA
| | - Scott Plotkin
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Boston, MA, USA
- Neurofibromatosis Clinic, Pappas Center for Neuro-Oncology, Massachusetts General Hospital, 55 Fruit Street, YAW 9, Boston, MA 02114, USA
| | - Brigitte Widemann
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
- Pharmacology & Experimental Therapeutics Section, Pediatric Oncology Branch, NCI, CCR, Room 1-5750, 10 Center Drive, 10-CRC, MSC 1101, Bethesda, MD 20892, USA
| | - Michael A. Jacobs
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Comparison between whole-body MRI and Fluorine-18-Fluorodeoxyglucose PET or PET/CT in oncology: a systematic review. Radiol Oncol 2013; 47:206-18. [PMID: 24133384 PMCID: PMC3794875 DOI: 10.2478/raon-2013-0007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 10/23/2012] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The aim of the article is to systematically review published data about the comparison between positron emission tomography (PET) or PET/computed tomography (PET/CT) using Fluorine-18-Fluorodeoxyglucose (FDG) and whole-body magnetic resonance imaging (WB-MRI) in patients with different tumours. METHODS A comprehensive literature search of studies published in PubMed/MEDLINE, Scopus and Embase databases through April 2012 and regarding the comparison between FDG-PET or PET/CT and WB-MRI in patients with various tumours was carried out. RESULTS Forty-four articles comprising 2287 patients were retrieved in full-text version, included and discussed in this systematic review. Several articles evaluated mixed tumours with both diagnostic methods. Concerning the specific tumour types, more evidence exists for lymphomas, bone tumours, head and neck tumours and lung tumours, whereas there is less evidence for other tumour types. CONCLUSIONS Overall, based on the literature findings, WB-MRI seems to be a valid alternative method compared to PET/CT in oncology. Further larger prospective studies and in particular cost-effectiveness analysis comparing these two whole-body imaging techniques are needed to better assess the role of WB-MRI compared to FDG-PET or PET/CT in specific tumour types.
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Koh DM, Tunariu N, Blackledge M, Collins DJ. Competing Technology for PET/Computed Tomography: Diffusion-weighted Magnetic Resonance Imaging. PET Clin 2013; 8:259-77. [PMID: 27158069 DOI: 10.1016/j.cpet.2013.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Whole-body diffusion-weighted (DW) imaging is a recent development. The image contrast is based on differences in mobility of water between tissues and reflects tissue cellularity and integrity of cell membranes. The tissue water diffusivity is quantified by the apparent diffusion coefficient. By performing imaging at multiple imaging stations, whole-body DW imaging has been applied to improve tumor staging, disease characterization, as well as for the assessment of treatment response. Information from DW imaging studies could be combined with those using PET imaging tracers to further refine and improve the assessment of patients with cancer.
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Affiliation(s)
- Dow-Mu Koh
- Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK.
| | - Nina Tunariu
- Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
| | - Matthew Blackledge
- CRUK EPSRC Imaging Centre, Institute of Cancer Research, Sutton, SM2 5NG, UK
| | - David J Collins
- CRUK EPSRC Imaging Centre, Institute of Cancer Research, Sutton, SM2 5NG, UK
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21
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Mosavi F, Ullenhag G, Ahlström H. Whole-body MRI including diffusion-weighted imaging compared to CT for staging of malignant melanoma. Ups J Med Sci 2013; 118:91-7. [PMID: 23570455 PMCID: PMC3633336 DOI: 10.3109/03009734.2013.778375] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Whole-body (WB) magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI), has been increasingly used for the detection of metastatic disease. PURPOSE To assess the value of WB MRI including DWI compared to computed tomography (CT) for staging of malignant melanoma. A second aim was to assess the value of DWI in addition to conventional MR sequences for the detection of lesions. MATERIAL AND METHODS WB MRI with DWI and CT chest, abdomen, and pelvis were performed in 23 patients with histologically confirmed malignant melanoma. CT before and after the MRI examinations and the clinical follow-up was utilized as the standard of reference. RESULTS WB MRI and WB DWI detected 345 and 302 lesions, respectively, compared to 397 lesions with CT. The sensitivity of WB MRI and WB DWI varied considerably in different regions of the body. In the lungs, WB MRI and WB DWI showed 63% and 47% true-positive lesions, respectively. WB MRI and WB DWI detected 56 bone lesions in 12 patients compared to 42 lesions in 8 patients with CT. In addition, WB MRI and WB DWI could detect 68 lesions outside the field of view of CT in six patients. CONCLUSION WB MRI is still not ready to replace CT for staging of malignant melanoma, especially in the thorax region. However, WB MRI is advantageous for detection of bone lesions and lesions outside the investigated volume of the conventional CT. When WB MRI is evaluated, both DWI and conventional MRI sequences must be scrutinized.
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Affiliation(s)
- Firas Mosavi
- Department of Radiology, Uppsala University Hospital, Uppsala, Sweden.
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22
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Jouvet J, Thomas L, Thomson V, Yanes M, Journe C, Morelec I, Bracoud L, Durupt F, Giammarile F, Berthezene Y. Whole-body MRI with diffusion-weighted sequences compared with 18 FDG PET-CT, CT and superficial lymph node ultrasonography in the staging of advanced cutaneous melanoma: a prospective study. J Eur Acad Dermatol Venereol 2013; 28:176-85. [DOI: 10.1111/jdv.12078] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 11/21/2012] [Indexed: 12/27/2022]
Affiliation(s)
- J.C. Jouvet
- Department of Radiology; Centre hospitalier de la Croix-Rousse; Lyon 1 University; Lyon France
| | - L. Thomas
- Department of Dermatology; Centre hospitalier Lyon-Sud; Lyon 1 University; Lyon France
| | - V. Thomson
- Department of Radiology; Centre hospitalier de la Croix-Rousse; Lyon 1 University; Lyon France
| | - M. Yanes
- Department of Radiology; Centre hospitalier de la Croix-Rousse; Lyon 1 University; Lyon France
| | - C. Journe
- Department of Radiology; Centre hospitalier de la Croix-Rousse; Lyon 1 University; Lyon France
| | - I. Morelec
- Department of Nuclear medicine; Centre hospitalier Lyon-Sud; Lyon 1 University; Lyon France
| | | | - F. Durupt
- Department of Dermatology; Centre hospitalier Lyon-Sud; Lyon 1 University; Lyon France
| | - F. Giammarile
- Department of Nuclear medicine; Centre hospitalier Lyon-Sud; Lyon 1 University; Lyon France
| | - Y. Berthezene
- Department of Radiology; Centre hospitalier de la Croix-Rousse; Lyon 1 University; Lyon France
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23
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Dietrich O. Techniques for Diffusion and Perfusion Assessment in Bone-Marrow MRI. MAGNETIC RESONANCE IMAGING OF THE BONE MARROW 2013. [DOI: 10.1007/174_2012_549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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24
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Akin O, Brennan SB, Dershaw DD, Ginsberg MS, Gollub MJ, Schöder H, Panicek DM, Hricak H. Advances in oncologic imaging: update on 5 common cancers. CA Cancer J Clin 2012; 62:364-93. [PMID: 23070605 DOI: 10.3322/caac.21156] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Imaging has become a pivotal component throughout a patient's encounter with cancer, from initial disease detection and characterization through treatment response assessment and posttreatment follow-up. Recent progress in imaging technology has presented new opportunities for improving clinical care. This article provides updates on the latest approaches to imaging of 5 common cancers: breast, lung, prostate, and colorectal cancers, and lymphoma.
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Affiliation(s)
- Oguz Akin
- Weill Medical College of Cornell University, Memorial Hospital for Cancer and Allied Diseases, New York, NY, USA
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25
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Recent advances in medical imaging: anatomical and clinical applications. Surg Radiol Anat 2012; 34:675-86. [DOI: 10.1007/s00276-012-0985-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 05/15/2012] [Indexed: 12/27/2022]
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26
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Debergh I, Vanhove C, Ceelen W. Innovation in cancer imaging. ACTA ACUST UNITED AC 2012; 48:121-30. [PMID: 22538557 DOI: 10.1159/000338193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 03/09/2012] [Indexed: 12/13/2022]
Abstract
Cancer is rapidly becoming the worldwide leading cause of premature death. Iconographic techniques have traditionally provided information on tumor anatomy. The recent introduction of functional and molecular imaging techniques allows probing tumor physiology and biology in addition to mere anatomical description. In addition to the research implications, these novel imaging techniques offer early response assessment and target visualization which, in the era of personalized medicine, may offer significant advances in cancer therapy. Here, we provide an overview of the most important developments in cancer imaging, with a focus on the clinical applications.
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Affiliation(s)
- I Debergh
- Department of Surgery, Ghent University Hospital, Ghent, Belgium
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27
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Abstract
The ongoing diversification of treatment strategies for rectal cancer justifies the demand for highly specialized radiological imaging. Currently, numerous studies have underlined the ability of magnetic resonance imaging (MRI) to determine those parameters that are critical for therapeutic decision-making and prognosis in rectal cancer. Computed tomography (CT) does not meet the criteria of a first line diagnostic procedure with regard to local staging but will remain the workhorse in the search for distant metastases. The increasing acceptance of extended MRI-based concepts will, however, improve cost-effectiveness and simplify patient management. Response evaluation and detection of recurrent disease are the major indications for positron emission tomography (PET)/CT, which is currently not routinely recommended.
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