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Qiu YJ, Zhou LL, Li J, Zhang YF, Wang Y, Yang YS. The repeatability and consistency of different methods for measuring the volume parameters of the primary rectal cancer on diffusion weighted images. Front Oncol 2023; 13:993888. [PMID: 36969078 PMCID: PMC10034158 DOI: 10.3389/fonc.2023.993888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundTo determine the reproducibility of measuring the gross total volume (GTV) of primary rectal tumor with manual and semi-automatic delineation on the diffusion-weighted image (DWI), examine the consistency of using the same delineation method on DWI images with different high b-values, and find the optimal delineation method to measure the GTV of rectal cancer.Methods41 patients who completed rectal MR examinations in our hospital from January 2020 to June 2020 were prospectively enrolled in this study. The post-operative pathology confirmed the lesions were rectal adenocarcinoma. The patients included 28 males and 13 females, with an average age of (63.3 ± 10.6) years old. Two radiologists used LIFEx software to manually delineate the lesion layer by layer on the DWI images (b=1000 s/mm2 and 1500 s/mm2) and used 10% to 90% of the highest signal intensity as thresholds to semi-automatically delineate the lesion and measure the GTV. After one month, Radiologist 1 performed the same delineation work again to obtain the corresponding GTV.ResultsThe inter- and intra-observer interclass correlation coefficients (ICC) of measuring GTV using semi-automatic delineation with 30% to 90% as thresholds were all >0.900. There was a positive correlation between manual delineation and semi-automatic delineation with 10% to 50% thresholds (P < 0.05). However, the manual delineation was not correlated with the semi-automatic delineation with 60%, 70%, 80%, and 90% thresholds. On the DWI images with b=1000 s/mm2 and 1500 s/mm2, the 95% limit of agreement (LOA%) of measuring GTV using semi-automatic delineation with 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, and 90% thresholds were -41.2~67.4, -17.8~51.5, -16.1~49.3, -26.2~50.1, -42.3~57.6, -57.1~65.4, -67.3~66.5, -101.6~91.1, -129.4~136.0, and -15.3~33.0, respectively. The time required for GTV measurement by semi-automatic delineation was significantly shorter than that of manual delineation (12.9 ± 3.6s vs 40.2 ± 13.1s).ConclusionsThe semi-automatic delineation of rectal cancer GTV with 30% threshold had high repeatability and consistency, and it was positively correlated with the GTV measured by manual delineation. Therefore, the semi-automatic delineation with 30% threshold could be a simple and feasible method for measuring rectal cancer GTV.
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Yu ZY, Gao D, Tang Z, Zhou HY, Ou J, Li KY, Chen XQ, Yang D, Yan LL, Li R, Zhang XM, Chen TW. A quantitative model based on gross tumor volume of gastric adenocarcinoma corresponding to N-stage measured at multidetector computed tomography for preoperative determination of resectability: A case control study. Front Oncol 2022; 12:1001593. [PMID: 36276081 PMCID: PMC9579338 DOI: 10.3389/fonc.2022.1001593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/20/2022] [Indexed: 12/05/2022] Open
Abstract
Purpose To develop and validate a quantitative model based on gross tumor volume (GTV) of gastric adenocarcinoma (GA) corresponding to N-stage measured at multidetector computed tomography (CT) for preoperative determination of resectability Materials and methods 493 consecutive patients with confirmed GA undergoing contrast-enhanced CT two weeks before treatments were randomly enrolled into the training cohort (TC, n = 271), internal validation cohort (IVC, n = 107) and external validation cohort (EVC, n = 115). GTV was measured on CT by multiplying sums of all tumor areas by section thickness. In TC, univariate and multivariate analyses were performed to select factors associated with resectability. Receiver operating characteristic (ROC) analysis was to determine if N-stage based GTV could identify resectability. In IVC and EVC, unweighted Cohen’s Kappa tests were to evaluate performances of the ROC models. Results According to univariate analysis, age, cT stage, cN stage and GTV were related to resectability in TC (all P-values < 0.05), and multivariate analysis suggested that cN stage and GTV were independent risk factors with odds ratios of 1.594 (95% confidence interval [CI]: 1.105–2.301) and 1.055 (95%CI: 1.035–1.076), respectively. ROC analysis in TC revealed the cutoffs of 21.81, 21.70 and 36.93 cm3 to differentiate between resectable and unresectable cancers in stages cN0-3, cN2 and cN3 with areas under the curves of more than 0.8, respectively, which was validated in IVC and EVC with average Cohen k-values of more than 0.72. Conclusions GTV and cN stage can be independent risk factors of unresectable GA, and N-stage based GTV can help determine resectability.
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Pellat A, Dohan A, Soyer P, Veziant J, Coriat R, Barret M. The Role of Magnetic Resonance Imaging in the Management of Esophageal Cancer. Cancers (Basel) 2022; 14:cancers14051141. [PMID: 35267447 PMCID: PMC8909473 DOI: 10.3390/cancers14051141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 02/01/2023] Open
Abstract
Esophageal cancer (EC) is the eighth more frequent cancer worldwide, with a poor prognosis. Initial staging is critical to decide on the best individual treatment approach. Current modalities for the assessment of EC are irradiating techniques, such as computed tomography (CT) and positron emission tomography/CT, or invasive techniques, such as digestive endoscopy and endoscopic ultrasound. Magnetic resonance imaging (MRI) is a non-invasive and non-irradiating imaging technique that provides high degrees of soft tissue contrast, with good depiction of the esophageal wall and the esophagogastric junction. Various sequences of MRI have shown good performance in initial tumor and lymph node staging in EC. Diffusion-weighted MRI has also demonstrated capabilities in the evaluation of tumor response to chemoradiotherapy. To date, there is not enough data to consider whole body MRI as a routine investigation for the detection of initial metastases or for prediction of distant recurrence. This narrative review summarizes the current knowledge on MRI for the management of EC.
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Affiliation(s)
- Anna Pellat
- Department of Gastroenterology and Digestive Oncology, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint Jacques, 75014 Paris, France; (A.P.); (R.C.)
- Université de Paris, 75006 Paris, France; (A.D.); (P.S.); (J.V.)
| | - Anthony Dohan
- Université de Paris, 75006 Paris, France; (A.D.); (P.S.); (J.V.)
- Department of Radiology, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint Jacques, 75014 Paris, France
| | - Philippe Soyer
- Université de Paris, 75006 Paris, France; (A.D.); (P.S.); (J.V.)
- Department of Radiology, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint Jacques, 75014 Paris, France
| | - Julie Veziant
- Université de Paris, 75006 Paris, France; (A.D.); (P.S.); (J.V.)
- Department of Digestive Surgery, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint Jacques, 75014 Paris, France
| | - Romain Coriat
- Department of Gastroenterology and Digestive Oncology, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint Jacques, 75014 Paris, France; (A.P.); (R.C.)
- Université de Paris, 75006 Paris, France; (A.D.); (P.S.); (J.V.)
| | - Maximilien Barret
- Department of Gastroenterology and Digestive Oncology, Hôpital Cochin, AP-HP, 27 rue du Faubourg Saint Jacques, 75014 Paris, France; (A.P.); (R.C.)
- Université de Paris, 75006 Paris, France; (A.D.); (P.S.); (J.V.)
- Correspondence:
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Wu YP, Tang S, Tan BG, Yang LQ, Lu FL, Chen TW, Ou J, Zhang XM, Gao D, Li KY, Yu ZY, Tang Z. Tumor Stage-Based Gross Tumor Volume of Resectable Esophageal Squamous Cell Carcinoma Measured on CT: Association With Early Recurrence After Esophagectomy. Front Oncol 2021; 11:753797. [PMID: 34745986 PMCID: PMC8569516 DOI: 10.3389/fonc.2021.753797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/04/2021] [Indexed: 01/18/2023] Open
Abstract
Objective To investigate relationship of tumor stage-based gross tumor volume (GTV) of esophageal squamous cell carcinoma (ESCC) measured on computed tomography (CT) with early recurrence (ER) after esophagectomy. Materials and Methods Two hundred and four consecutive patients with resectable ESCC including 159 patients enrolled in the training cohort (TC) and 45 patients in validation cohort (VC) underwent contrast-enhanced CT less than 2 weeks before esophagectomy. GTV was retrospectively measured by multiplying sums of all tumor areas by section thickness. For the TC, univariate and multivariate analyses were performed to determine factors associated with ER. Mann-Whitney U test was conducted to compare GTV in patients with and without ER. Receiver operating characteristic (ROC) analysis was performed to determine if tumor stage-based GTV could predict ER. For the VC, unweighted Cohen’s Kappa tests were used to evaluate the performances of the previous ROC predictive models. Results ER occurred in 63 of 159 patients (39.6%) in the TC. According to the univariate analysis, histologic differentiation, cT stage, cN stage, and GTV were associated with ER after esophagectomy (all P-values < 0.05). Multivariate analysis revealed that cT stage and GTV were independent risk factors with hazard ratios of 3.382 [95% confidence interval (CI): 1.533–7.459] and 1.222 (95% CI: 1.125–1.327), respectively (all P-values < 0.05). Mann-Whitney U tests showed that GTV could help differentiate between ESCC with and without ER in stages cT1-4a, cT2, and cT3 (all P-values < 0.001), and the ROC analysis demonstrated the corresponding cutoffs of 13.31, 17.22, and 17.83 cm3 with areas under the curve of more than 0.8, respectively. In the VC, the Kappa tests validated that the ROC predictive models had good performances for differentiating between ESCC with and without ER in stages cT1-4a, cT2, and cT3 with Cohen k of 0.696 (95% CI, 0.498–0.894), 0.733 (95% CI, 0.386–1.080), and 0.862 (95% CI, 0.603–1.121), respectively. Conclusion GTV and cT stage can be independent risk factors of ER in ESCC after esophagectomy, and tumor stage-based GTV measured on CT can help predict ER.
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Affiliation(s)
- Yu-Ping Wu
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Sun Tang
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Bang-Guo Tan
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Li-Qin Yang
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Fu-Lin Lu
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Tian-Wu Chen
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jing Ou
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiao-Ming Zhang
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Dan Gao
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ke-Ying Li
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Zi-Yi Yu
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Zhao Tang
- Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Lee SL, Yadav P, Starekova J, Christensen L, Chandereng T, Chappell R, Reeder SB, Bassetti MF. Diagnostic Performance of MRI for Esophageal Carcinoma: A Systematic Review and Meta-Analysis. Radiology 2021; 299:583-594. [PMID: 33787334 DOI: 10.1148/radiol.2021202857] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Although CT, endoscopic US, and PET are critical in determining the appropriate management of esophageal carcinoma (squamous cell carcinoma and adenocarcinoma), previous reports show that staging accuracy remains low, particularly for nodal involvement sensitivity. Purpose To perform a systematic review and meta-analysis to determine the diagnostic performance of MRI for multiple staging thresholds in patients with biopsy-proven esophageal carcinoma (differentiation of stage T0 disease from stage T1 or higher disease, differentiation of stage T2 or lower disease from stage T3 or higher disease, and differentiation of stage N0 disease from stage N1 or higher disease [where T refers to tumor stage and N refers to nodal stage]). Materials and Methods Studies of the diagnostic performance of MRI in determining the stage of esophageal carcinoma in patients before esophagectomy and pathologic staging between 2000 and 2019 were searched in PubMed, Scopus, Web of Science, and Cochrane Library by a librarian and radiation oncologist. Pooled diagnostic performance of MRI was calculated with a bivariate random effects model. Bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (version 2) tool. Results Twenty studies with a total of 984 patients were included in the analysis. Pooled accuracy for stage T0 versus stage T1 or higher had a sensitivity of 92% (95% CI: 82, 96) and a specificity of 67% (95% CI: 51, 81). Pooled accuracy for stage T2 or lower versus stage T3 or higher had a sensitivity of 86% (95% CI: 76, 92) and a specificity of 86% (95% CI: 75, 93). Pooled accuracy for stage N0 versus stage N1 or higher had a sensitivity of 71% (95% CI: 60, 80) and a specificity of 72% (95% CI: 64, 79). The concern for applicability was low for the patient selection, index test, and reference test domains, except for 10% of studies (two of 20) that had unclear concern for patient selection applicability. Conclusion MRI has high sensitivity but low specificity for the detection of esophageal carcinoma, which shows promise for determining neoadjuvant therapy response and for detecting locally advanced disease for potential trimodality therapy. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Leeflang in this issue.
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Affiliation(s)
- Sangjune Laurence Lee
- From the Department of Oncology, Division of Radiation Oncology, University of Calgary, 1331 29 St NW, Calgary, AB, Canada T2N 4N2 (S.L.L.); Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, Wis (S.L.L., P.Y., M.F.B.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (J.S., S.B.R.); Departments of Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine, University of Wisconsin-Madison, Madison, Wis (S.B.R); University of Wisconsin School of Medicine and Public Health, Madison, Wis (L.C.); Department of Statistics and Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis (T.C., R.C.)
| | - Poonam Yadav
- From the Department of Oncology, Division of Radiation Oncology, University of Calgary, 1331 29 St NW, Calgary, AB, Canada T2N 4N2 (S.L.L.); Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, Wis (S.L.L., P.Y., M.F.B.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (J.S., S.B.R.); Departments of Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine, University of Wisconsin-Madison, Madison, Wis (S.B.R); University of Wisconsin School of Medicine and Public Health, Madison, Wis (L.C.); Department of Statistics and Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis (T.C., R.C.)
| | - Jitka Starekova
- From the Department of Oncology, Division of Radiation Oncology, University of Calgary, 1331 29 St NW, Calgary, AB, Canada T2N 4N2 (S.L.L.); Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, Wis (S.L.L., P.Y., M.F.B.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (J.S., S.B.R.); Departments of Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine, University of Wisconsin-Madison, Madison, Wis (S.B.R); University of Wisconsin School of Medicine and Public Health, Madison, Wis (L.C.); Department of Statistics and Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis (T.C., R.C.)
| | - Leslie Christensen
- From the Department of Oncology, Division of Radiation Oncology, University of Calgary, 1331 29 St NW, Calgary, AB, Canada T2N 4N2 (S.L.L.); Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, Wis (S.L.L., P.Y., M.F.B.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (J.S., S.B.R.); Departments of Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine, University of Wisconsin-Madison, Madison, Wis (S.B.R); University of Wisconsin School of Medicine and Public Health, Madison, Wis (L.C.); Department of Statistics and Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis (T.C., R.C.)
| | - Thevaa Chandereng
- From the Department of Oncology, Division of Radiation Oncology, University of Calgary, 1331 29 St NW, Calgary, AB, Canada T2N 4N2 (S.L.L.); Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, Wis (S.L.L., P.Y., M.F.B.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (J.S., S.B.R.); Departments of Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine, University of Wisconsin-Madison, Madison, Wis (S.B.R); University of Wisconsin School of Medicine and Public Health, Madison, Wis (L.C.); Department of Statistics and Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis (T.C., R.C.)
| | - Richard Chappell
- From the Department of Oncology, Division of Radiation Oncology, University of Calgary, 1331 29 St NW, Calgary, AB, Canada T2N 4N2 (S.L.L.); Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, Wis (S.L.L., P.Y., M.F.B.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (J.S., S.B.R.); Departments of Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine, University of Wisconsin-Madison, Madison, Wis (S.B.R); University of Wisconsin School of Medicine and Public Health, Madison, Wis (L.C.); Department of Statistics and Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis (T.C., R.C.)
| | - Scott B Reeder
- From the Department of Oncology, Division of Radiation Oncology, University of Calgary, 1331 29 St NW, Calgary, AB, Canada T2N 4N2 (S.L.L.); Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, Wis (S.L.L., P.Y., M.F.B.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (J.S., S.B.R.); Departments of Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine, University of Wisconsin-Madison, Madison, Wis (S.B.R); University of Wisconsin School of Medicine and Public Health, Madison, Wis (L.C.); Department of Statistics and Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis (T.C., R.C.)
| | - Michael F Bassetti
- From the Department of Oncology, Division of Radiation Oncology, University of Calgary, 1331 29 St NW, Calgary, AB, Canada T2N 4N2 (S.L.L.); Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, Wis (S.L.L., P.Y., M.F.B.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (J.S., S.B.R.); Departments of Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine, University of Wisconsin-Madison, Madison, Wis (S.B.R); University of Wisconsin School of Medicine and Public Health, Madison, Wis (L.C.); Department of Statistics and Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wis (T.C., R.C.)
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Elsherif SB, Andreou S, Virarkar M, Soule E, Gopireddy DR, Bhosale PR, Lall C. Role of precision imaging in esophageal cancer. J Thorac Dis 2020; 12:5159-5176. [PMID: 33145093 PMCID: PMC7578477 DOI: 10.21037/jtd.2019.08.15] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Esophageal cancer is a major cause of morbidity and mortality worldwide. Recent advancements in the management of esophageal cancer have allowed for earlier detection, improved ability to monitor progression, and superior treatment options. These innovations allow treatment teams to formulate more customized management plans and have led to an increase in patient survival rates. For example, in order for the most effective management plan to be constructed, accurate staging must be performed to determine tumor resectability. This article reviews the multimodality imaging approach involved in making a diagnosis, staging, evaluating treatment response and detecting recurrence in esophageal cancer.
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Affiliation(s)
- Sherif B Elsherif
- Department of Radiology, University of Florida College of Medicine, Jacksonville, FL, USA.,Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sonia Andreou
- Department of Radiology, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Mayur Virarkar
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Erik Soule
- Department of Radiology, University of Florida College of Medicine, Jacksonville, FL, USA
| | | | - Priya R Bhosale
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chandana Lall
- Department of Radiology, University of Florida College of Medicine, Jacksonville, FL, USA
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