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Martín-Noguerol T, Santos-Armentia E, Fernandez-Palomino J, López-Úbeda P, Paulano-Godino F, Luna A. Role of advanced MRI sequences for thyroid lesions assessment. A narrative review. Eur J Radiol 2024; 176:111499. [PMID: 38735157 DOI: 10.1016/j.ejrad.2024.111499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/12/2024] [Accepted: 05/05/2024] [Indexed: 05/14/2024]
Abstract
Despite not being the first imaging modality for thyroid gland assessment, Magnetic Resonance Imaging (MRI), thanks to its optimal tissue contrast and spatial resolution, has provided some advancements in detecting and characterizing thyroid abnormalities. Recent research has been focused on improving MRI sequences and employing advanced techniques for a more comprehensive understanding of thyroid pathology. Although not yet standard practice, advanced MRI sequences have shown high accuracy in preliminary studies, correlating well with histopathological results. They particularly show promise in determining malignancy risk in thyroid lesions, which may reduce the need for invasive procedures like biopsies. In this line, functional MRI sequences like Diffusion Weighted Imaging (DWI), Dynamic Contrast-Enhanced MRI (DCE-MRI), and Arterial Spin Labeling (ASL) have demonstrated their potential usefulness in evaluating both diffuse thyroid conditions and focal lesions. Multicompartmental DWI models, such as Intravoxel Incoherent Motion (IVIM) and Diffusion Kurtosis Imaging (DKI), and novel methods like Amide Proton Transfer (APT) imaging or artificial intelligence (AI)-based analyses are being explored for their potential valuable insights into thyroid diseases. This manuscript reviews the critical physical principles and technical requirements for optimal functional MRI sequences of the thyroid and assesses the clinical utility of each technique. It also considers future prospects in the context of advanced MR thyroid imaging and analyzes the current role of advanced MRI sequences in routine practice.
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Affiliation(s)
| | | | | | | | | | - Antonio Luna
- MRI unit, Radiology department. HT medica, Carmelo Torres 2, 23007 Jaén, Spain.
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Meng N, Song C, Sun J, Liu X, Shen L, Zhou Y, Dai B, Yu X, Wu Y, Yuan J, Yang Y, Wang Z, Wang M. Amide proton transfer-weighted imaging and stretch-exponential model DWI based 18F-FDG PET/MRI for differentiation of benign and malignant solitary pulmonary lesions. Cancer Imaging 2024; 24:33. [PMID: 38439101 PMCID: PMC10910843 DOI: 10.1186/s40644-024-00677-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVES To differentiate benign and malignant solitary pulmonary lesions (SPLs) by amide proton transfer-weighted imaging (APTWI), mono-exponential model DWI (MEM-DWI), stretched exponential model DWI (SEM-DWI), and 18F-FDG PET-derived parameters. METHODS A total of 120 SPLs patients underwent chest 18F-FDG PET/MRI were enrolled, including 84 in the training set (28 benign and 56 malignant) and 36 in the test set (13 benign and 23 malignant). MTRasym(3.5 ppm), ADC, DDC, α, SUVmax, MTV, and TLG were compared. The area under receiver-operator characteristic curve (AUC) was used to assess diagnostic efficacy. The Logistic regression analysis was used to identify independent predictors and establish prediction model. RESULTS SUVmax, MTV, TLG, α, and MTRasym(3.5 ppm) values were significantly lower and ADC, DDC values were significantly higher in benign SPLs than malignant SPLs (all P < 0.01). SUVmax, ADC, and MTRasym(3.5 ppm) were independent predictors. Within the training set, the prediction model based on these independent predictors demonstrated optimal diagnostic efficacy (AUC, 0.976; sensitivity, 94.64%; specificity, 92.86%), surpassing any single parameter with statistical significance. Similarly, within the test set, the prediction model exhibited optimal diagnostic efficacy. The calibration curves and DCA revealed that the prediction model not only had good consistency but was also able to provide a significant benefit to the related patients, both in the training and test sets. CONCLUSION The SUVmax, ADC, and MTRasym(3.5 ppm) were independent predictors for differentiation of benign and malignant SPLs, and the prediction model based on them had an optimal diagnostic efficacy.
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Affiliation(s)
- Nan Meng
- Department of Medical Imaging, Henan Provincial People's Hospital & Zhengzhou University People's Hospital, Zhengzhou, China.
- Laboratory of Brain Science and Brain-Like Intelligence Technology, Institute for Integrated Medical Science and Engineering, Henan Academy of Sciences, Zhengzhou, China.
- Biomedical Research Institute, Henan Academy of Sciences, Zhengzhou, China.
| | - Chen Song
- Hematology Laboratory, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Jing Sun
- Department of Pediatrics, Zhengzhou Central Hospital Affiliated to Zhengzhou University & Zhengzhou Central Hospital, Zhengzhou, China
| | - Xue Liu
- Department of Medical Imaging, Henan Provincial People's Hospital & Zhengzhou University People's Hospital, Zhengzhou, China
| | - Lei Shen
- Department of Medical Imaging, Henan Provincial People's Hospital & Zhengzhou University People's Hospital, Zhengzhou, China
| | - Yihang Zhou
- Department of Medical Imaging, Xinxiang Medical University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China
| | - Bo Dai
- Department of Medical Imaging, Henan Provincial People's Hospital & Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xuan Yu
- Department of Medical Imaging, Henan Provincial People's Hospital & Zhengzhou University People's Hospital, Zhengzhou, China
| | - Yaping Wu
- Department of Medical Imaging, Henan Provincial People's Hospital & Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jianmin Yuan
- Central Research Institute, United Imaging Healthcare Group, Shanghai, China
| | - Yang Yang
- Beijing United Imaging Research Institute of Intelligent Imaging, United Imaging Healthcare Group, Beijing, China
| | - Zhe Wang
- Central Research Institute, United Imaging Healthcare Group, Shanghai, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People's Hospital & Zhengzhou University People's Hospital, Zhengzhou, China.
- Laboratory of Brain Science and Brain-Like Intelligence Technology, Institute for Integrated Medical Science and Engineering, Henan Academy of Sciences, Zhengzhou, China.
- Biomedical Research Institute, Henan Academy of Sciences, Zhengzhou, China.
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Wu X, Su T, Chen Y, Xu Z, Wang X, Hu G, Wang Y, Wong LM, Zhang Z, Zhang T, Jin Z. B1 Power Modification for Amide Proton Transfer Imaging in Parotid Glands: A Strategy for Image Quality Accommodation and Evaluation of Tumor Detection Feasibility. Cancers (Basel) 2024; 16:888. [PMID: 38473250 DOI: 10.3390/cancers16050888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND In the application of APTw protocols for evaluating tumors and parotid glands, inhomogeneity and hyperintensity artifacts have remained an obstacle. This study aimed to improve APTw imaging quality and evaluate the feasibility of difference B1 values to detect parotid tumors. METHODS A total of 31 patients received three APTw sequences to acquire 32 lesions and 30 parotid glands (one patient had lesions on both sides). Patients received T2WI and 3D turbo-spin-echo (TSE) APTw imaging on a 3.0 T scanner for three sequences (B1 = 2 μT, 1 μT, and 0.7 μT in APTw 1, 2, and 3, respectively). APTw image quality was evaluated using four-point Likert scales in terms of integrity and hyperintensity artifacts. Image quality was compared between the three sequences. An evaluable group and a trustable group were obtained for APTmean value comparison. RESULTS Tumors in both APT2 and APT3 had fewer hyperintensity artifacts than in APT1. With B1 values decreasing, tumors had less integrity in APTw imaging. APTmean values of tumors were higher than parotid glands in traditional APT1 sequence though not significant, while the APTmean subtraction value was significantly different. CONCLUSIONS Applying a lower B1 value could remove hyperintensity but could also compromise its integrity. Combing different APTw sequences might increase the feasibility of tumor detection.
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Affiliation(s)
- Xiaoqian Wu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Tong Su
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Yu Chen
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Zhentan Xu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xiaoqi Wang
- Yangtze Delta Region Institute of Tsinghua University, Jiaxing 314006, China
| | - Geli Hu
- Department of Clinical and Technical Support, Philips Healthcare, Beijing 100600, China
| | - Yunting Wang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Lun M Wong
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Zhuhua Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Tao Zhang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
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Chen Y, Huang N, Zheng Y, Wang F, Cao D, Chen T. Characterization of parotid gland tumors: Whole-tumor histogram analysis of diffusion weighted imaging, diffusion kurtosis imaging, and intravoxel incoherent motion - A pilot study. Eur J Radiol 2024; 170:111199. [PMID: 38104494 DOI: 10.1016/j.ejrad.2023.111199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/13/2023] [Accepted: 11/13/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE To investigate the diagnostic performance of histogram features of diffusion parameters in characterizating parotid gland tumors. METHOD From December 2018 to January 2023, patients who underwent diffusion weighted imaging (DWI), diffusion kurtosis imaging (DKI), and intravoxel incoherent motion (IVIM) were consecutively enrolled in this retrospective study. The histogram features of diffusion parameters, including apparent diffusion coefficient (ADC), diffusion coefficient (Dk), diffusion kurtosis (K), pure diffusion coefficient (D), pseudo-diffusion coefficient (DP), and perfusion fraction (FP) were analyzed. The Mann-Whitney U test was used for comparison between benign parotid gland tumors (BPGTs) and malignant parotid gland tumors (MPGTs). Receiver operating characteristic curve and logistic regression analysis were used to identify the differential diagnostic performance. The Spearman's correlation coefficient was used to analyze the correlation between diffusion parameters and Ki-67 labeling index. RESULTS For diffusion MRI, twenty-three histogram features of diffusion parameters showed significant differences between BPGTs and MPGTs (all P < 0.05). Compared with the DWI model, the IVIM model and combined model had better diagnostic specificity (58 %, 94 %, and 88 %, respectively; both corrected P < 0.001) and accuracy (64 %, 89 %, and 86 %, respectively; both corrected P = 0.006). The combined model was superior to the single DWI model with improved IDI (IDI improvement 0.25). Significant correlations were found between Ki-67 and ADCmean, Dkmean, Kmean, and Dmean (r = -0.57 to 0.53; all P < 0.05). CONCLUSIONS Whole-tumor histogram analysis of IVIM and combined diffusion model could further improve the diagnostic performance for differentiating BPGTs from MPGTs.
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Affiliation(s)
- Yu Chen
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China
| | - Nan Huang
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China
| | - Yingyan Zheng
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China
| | - Feng Wang
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China
| | - Dairong Cao
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Radiology, Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China.
| | - Tanhui Chen
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China.
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Wang Y, Wang L, Huang H, Ma J, Lin L, Liu L, Song Q, Liu A. Amide proton transfer-weighted magnetic resonance imaging for the differentiation of parotid gland tumors. Front Oncol 2023; 13:1223598. [PMID: 37664057 PMCID: PMC10471989 DOI: 10.3389/fonc.2023.1223598] [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: 05/16/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose To assess the usefulness of amide proton transfer-weighted (APTw) imaging in the differentiation of parotid gland tumors. Materials and methods Patients with parotid gland tumors who underwent APTw imaging were retrospectively enrolled and divided into groups according to pathology. Two radiologists evaluated the APTw image quality independently, and APTw images with quality score ≥3 were enrolled. The maximum and average values of APTw imaging for tumor lesions (APTmax and APTmean) were measured. The differences in APTmax and APTmean were compared between malignant tumors (MTs) and benign tumors (BTs), as well as between MTs and pleomorphic adenomas (PAs) and between MTs and Warthin tumors (WTs). Independent-samples t-test, Kruskal-Wallis H test, and receiver operating characteristic (ROC) curve analyses were used for statistical analysis. Results Seventy-three patients were included for image quality evaluation. In this study, 32/73 and 29/73 parotid tumors were scored as 4 and 3, respectively. After excluding lesions with quality score ≤2 (12/73), the APTmean and APTmax of MTs were 4.15% ± 1.33% and 7.43% ± 1.61%, higher than those of BTs 2.74% ± 1.04% and 5.25% ± 1.54%, respectively (p < 0.05). The areas under the ROC curve (AUCs) of the APTmean and APTmax for differentiation between MTs and BTs were 0.819 and 0.821, respectively. MTs indicated significantly higher APTmean and APTmax values than those of PAs (p < 0.05) and WTs (p < 0.05). The AUCs of the APTmean and APTmax for differentiation between MTs and PAs were 0.830 and 0.815 and between MTs and WTs were 0.847 and 0.920, respectively. Conclusion Most APTw images for parotid tumors had acceptable image quality for APTw value evaluation. Both APTmax and APTmean can be used to differentiate MTs from BTs and to differentiate MTs from subtype parotid gland tumors.
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Affiliation(s)
- Yihua Wang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lijun Wang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Haitao Huang
- Department of Stomatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Juntao Ma
- Department of Stomatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Liangjie Lin
- Clinical and Technical Support, Philips Healthcare, Beijing, China
| | - Lin Liu
- Department of Stomatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qingwei Song
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ailian Liu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
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Amide proton transfer (APT) imaging of breast cancers and its correlation with biological status. Clin Imaging 2023; 96:38-43. [PMID: 36773531 DOI: 10.1016/j.clinimag.2023.02.002] [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: 10/13/2022] [Revised: 01/12/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE To assess the usefulness of amide proton transfer (APT) imaging to predict the biological status of breast cancers. METHOD Sixty-six patients (age range 31-85 years, mean 58.9 years) with histopathologically proven invasive ductal carcinomas of 2 cm or larger in diameter were included in this study. 3D APT weighted imaging was conducted on a 3 T scanner. Mean APT signal intensity (SI) was analyzed in relation to biological subtypes, Ki-67 labeling index, and nuclear grades (NGs). RESULTS The triple-negative (TN) cancers (n = 10; 2.75 ± 0.42%) showed significantly higher APT SI than the luminal type cancers (n = 48; 1.74 ± 0.83) and HER2 cancers (n = 8; 1.83 ± 0.21) (P = 0.0007, 0.03). APT SI had weakly positive correlation with the Ki-67 labeling index (r = 0.38, P = 0.002). The mean APT SIs were significantly higher for high-Ki-67 (>30%) (n = 31; 2.25 ± 0.70) than low-Ki-67 (≤30%) cancers (n = 35; 1.60 ± 0.79) (P = 0.0007). There was no significant difference in the APT SIs between NG 1-2 (n = 31; 1.71 ± 0.84) and NG 3 (n = 35; 2.08 ± 0.76%) cancers (P = 0.06). CONCLUSIONS TN and high-Ki-67 breast cancers showed high APT SIs. APT imaging can help to predict the biological status of breast cancers.
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Liu Z, Wen J, Wang M, Ren Y, Yang Q, Qian L, Luo H, Feng S, He C, Liu X, Wu Y, Luo D. Breast Amide Proton Transfer Imaging at 3 T: Diagnostic Performance and Association With Pathologic Characteristics. J Magn Reson Imaging 2023; 57:824-833. [PMID: 35816177 DOI: 10.1002/jmri.28335] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Amide proton transfer (APT) imaging has been increasingly applied in tumor characterization. However, its value in evaluating breast cancer remains undetermined. PURPOSE To assess the diagnostic performance of APT imaging in breast cancer and its association with prognostic histopathologic characteristics. STUDY TYPE Prospective. SUBJECTS Eighty-four patients with breast lesions. FIELD STRENGTH/SEQUENCE A 3.0 T/single-shot fast spin echo APT imaging. ASSESSMENT APTw signal in breast lesion was quantified. Lesion malignancy, T stage, grades, Ki-67 index, molecular biomarkers (estrogen receptor [ER] expression, progesterone receptor [PR] expression, human epidermal growth factor receptor [HER-2] expression), molecular subtypes (luminal A, luminal B, triple negative, and HER-2 enriched) were determined. STATISTICAL TESTS Student t-test, one-way analysis of variance, receiver operating characteristic analysis, and Pearson's correlation with P < 0.05 as statistical significance. RESULTS APTw signal was significantly higher in malignant lesions (1.55% ± 1.24%) than in benign lesions (0.54% ± 1.13%), and in grade III lesions than in grade II lesions (1.65% ± 0.84% vs. 0.96% ± 0.96%), and in T2- (1.57% ± 0.64%) and T3-stage lesions (1.54% ± 0.63%) than in T1-stage lesions (0.81% ± 0.64%) for invasive breast carcinoma of no special type. APTw signal significantly correlated with Ki-67 index (r = 0.364) but showed no significant difference in groups of ER (P = 0.069), PR (P = 0.069), HER-2 (P = 0.961), and among molecular subtypes (P = 0.073). DATA CONCLUSION APT imaging shows potential in differentiating breast lesion malignancy and associates with prognosis-related tumor grade, T stage, and proliferative activity. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhou Liu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Jie Wen
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Meng Wang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Ya Ren
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Qian Yang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Long Qian
- MR Research, GE Healthcare, Beijing, China
| | - Honghong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Sha Feng
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Cuiju He
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Xin Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Yin Wu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Dehong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Yang L, Wang L, Tan Y, Dan H, Xian P, Zhang Y, Tan Y, Lin M, Zhang J. Amide Proton Transfer-weighted MRI combined with serum prostate-specific antigen levels for differentiating malignant prostate lesions from benign prostate lesions: a retrospective cohort study. Cancer Imaging 2023; 23:3. [PMID: 36611191 PMCID: PMC9826590 DOI: 10.1186/s40644-022-00515-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Early diagnosis of prostate cancer improves its prognosis, while it is essential to upgrade screening tools. This study aimed to explore the value of a novel functional magnetic resonance imaging (MRI) technique, namely amide proton transfer (APT)-weighted MRI, combined with serum prostate-specific antigen (PSA) levels to differentiate malignant prostate lesions from benign prostate lesions. METHODS Data of patients who underwent prostate examinations at Chongqing University Cancer Hospital between July 2019 and March 2022 were retrospectively analyzed. All patients underwent T2-weighted imaging (T2WI), APT, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) MRI. Two radiologists analyzed the images independently. The ability of the quantitative parameters alone or in different combinations in differentiating malignant prostate lesions from benign prostate lesions were compared by using receiver operating characteristic (ROC) curves. According to the DeLong test, the combined parameters were significantly different from the corresponding single parameter (P < 0.05). RESULTS A total of 79 patients were finally enrolled, including 52 patients in the malignant group and 27 patients in the benign group. The separate assessment of indexes revealed that APTmax, APTmean, mean apparent diffusion coefficient (ADCmean), ADCmax, ADCmin, tPAD, free prostate-specific antigen (FPSA), FPSA/total prostate-specific antigen (tPSA), and PSA density (PSAD) were significantly different between the two groups (P < 0.05), while APTmin was not significantly different between the two groups (P > 0.05). APTmax and APTmean had the high values of area under the ROC curve (AUC), which were 0.780 and 0.710, respectively. APTmax had a high sensitivity, and APTmean had a high specificity. The combination of APTmax, APTmean, ADCmean, and PSAD had the highest AUC value (AUC: 0.880, sensitivity: 86.540, specificity: 78.260). CONCLUSION APTmax, APTmean, ADCmean, ADCmin, tPAD, FPSA, and PSAD showed to have a high value in differentiating malignant prostate lesions from benign prostate lesions in the separate assessment of indexes. The combination of APTmax, APTmean, ADCmean, and PSAD had the highest diagnostic value.
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Affiliation(s)
- Lu Yang
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Lei Wang
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Yuchuan Tan
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Hanli Dan
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Peng Xian
- grid.452285.cDepartment of Urology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, 400030 China
| | - Yipeng Zhang
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Yong Tan
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Meng Lin
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Jiuquan Zhang
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
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Fujima N, Shimizu Y, Yoneyama M, Nakagawa J, Kameda H, Harada T, Hamada S, Suzuki T, Tsushima N, Kano S, Homma A, Kudo K. Amide proton transfer imaging for the determination of human papillomavirus status in patients with oropharyngeal squamous cell carcinoma. Medicine (Baltimore) 2022; 101:e29457. [PMID: 35839055 PMCID: PMC11132395 DOI: 10.1097/md.0000000000029457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/22/2022] [Indexed: 10/14/2022] Open
Abstract
The aim of this study was to investigate the utility of amide proton transfer (APT) imaging for the determination of human papillomavirus (HPV) status in patients with oropharyngeal squamous cell carcinoma (SCC). Thirty-one patients with oropharyngeal SCC were retrospectively evaluated. All patients underwent amide proton transfer imaging using a 3T magnetic resonance (MR) unit. Patients were divided into HPV-positive and -negative groups depending on the pathological findings in their primary tumor. In APT imaging, the primary tumor was delineated with a polygonal region of interest (ROI). Signal information in the ROI was used to calculate the mean, standard deviation (SD) and coefficient of variant (CV) of the APT signals (APT mean, APT SD, and APT CV, respectively). The value of APT CV in the HPV-positive group (0.43 ± 0.04) was significantly lower than that in the HPV-negative group (0.48 ± 0.04) (P = .01). There was no significant difference in APT mean (P = .82) or APT SD (P = .13) between the HPV-positive and -negative groups. Receiver operating characteristic (ROC) curve analysis of APT CV had a sensitivity of 0.75, specificity of 0.8, positive predictive value of 0.75, negative predictive value of 0.8, accuracy of 0.77 and area under the curve (AUC) of 0.8. The APT signal in the HPV-negative group was considered heterogeneous compared to the HPV-positive group. This information might be useful for the determination of HPV status in patients with oropharyngeal SCC.
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Affiliation(s)
- Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Yukie Shimizu
- Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Advanced Diagnostic Imaging Development, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | | | - Junichi Nakagawa
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Hiroyuki Kameda
- Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Taisuke Harada
- Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Seijiro Hamada
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takayoshi Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nayuta Tsushima
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kohsuke Kudo
- Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Advanced Diagnostic Imaging Development, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Sapporo, Japan
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Li J, Lin L, Gao X, Li S, Cheng J. Amide Proton Transfer Weighted and Intravoxel Incoherent Motion Imaging in Evaluation of Prognostic Factors for Rectal Adenocarcinoma. Front Oncol 2022; 11:783544. [PMID: 35047400 PMCID: PMC8761907 DOI: 10.3389/fonc.2021.783544] [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: 09/26/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives To analyze the value of amide proton transfer (APT) weighted and intravoxel incoherent motion (IVIM) imaging in evaluation of prognostic factors for rectal adenocarcinoma, compared with diffusion weighted imaging (DWI). Materials and Methods Preoperative pelvic MRI data of 110 patients with surgical pathologically confirmed diagnosis of rectal adenocarcinoma were retrospectively evaluated. All patients underwent high-resolution T2-weighted imaging (T2WI), APT, IVIM, and DWI. Parameters including APT signal intensity (APT SI), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADC) were measured in different histopathologic types, grades, stages, and structure invasion statuses. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy, and the corresponding area under the curves (AUCs) were calculated. Results APT SI, D and ADC values of rectal mucinous adenocarcinoma (MC) were significantly higher than those of rectal common adenocarcinoma (AC) ([3.192 ± 0.661%] vs. [2.333 ± 0.471%], [1.153 ± 0.238×10-3 mm2/s] vs. [0.792 ± 0.173×10-3 mm2/s], and [1.535 ± 0.203×10-3 mm2/s] vs. [0.986 ± 0.124×10-3 mm2/s], respectively; all P<0.001). In AC group, the APT SI and D values showed significant differences between low- and high-grade tumors ([2.226 ± 0.347%] vs. [2.668 ± 0.638%], and [0.842 ± 0.148×10-3 mm2/s] vs. [0.777 ± 0.178×10-3 mm2/s], respectively, both P<0.05). The D value had significant difference between positive and negative extramural vascular invasion (EMVI) tumors ([0.771 ± 0.175×10-3 mm2/s] vs. [0.858 ± 0.151×10-3 mm2/s], P<0.05). No significant difference of APT SI, D, D*, f or ADC was observed in different T stages, N stages, perineural and lymphovascular invasions (all P>0.05). The ROC curves showed that the AUCs of APT SI, D and ADC values for distinguishing MC from AC were 0.921, 0.893 and 0.995, respectively. The AUCs of APT SI and D values in distinguishing low- from high-grade AC were 0.737 and 0.663, respectively. The AUC of the D value for evaluating EMVI involvement was 0.646. Conclusion APT and IVIM were helpful to assess the prognostic factors related to rectal adenocarcinoma, including histopathological type, tumor grade and the EMVI status.
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Affiliation(s)
- Juan Li
- Department of Magnetic Resonance Imaging (MRI), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liangjie Lin
- Advanced Technical Support, Philips Healthcare, Beijing, China
| | - Xuemei Gao
- Department of Magnetic Resonance Imaging (MRI), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shenglei Li
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging (MRI), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Jia X, Wang W, Liang J, Ma X, Chen W, Wu D, Lai C, Zhang Y. Risk stratification of abdominal tumors in children with amide proton transfer imaging. Eur Radiol 2022; 32:2158-2167. [PMID: 35031842 DOI: 10.1007/s00330-021-08376-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/01/2021] [Accepted: 09/30/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the potential of molecular amide proton transfer (APT) MRI for predicting the risk group of abdominal tumors in children, and compare it with quantitative T1 and T2 mapping. METHODS This prospective study enrolled 133 untreated pediatric patients with suspected abdominal tumors from February 2019 to September 2020. APT-weighted (APTw) imaging and quantitative relaxation time mapping sequences were executed for each subject. The region of interest (ROI) was generated with automatic artifact detection and ROI-shrinking algorithms, within which the APTw, T1, and T2 indices were calculated and compared between different risk groups. The prediction performance of different imaging parameters was assessed with the receiver operating characteristics (ROC) analysis and Student's t-test. RESULTS Fifty-seven patients were included in the final analysis, including 24 neuroblastomas (NB), 18 Wilms' tumors (WT), and 15 hepatoblastomas (HB). The APTw signal was significantly (p < .001) higher in patients with high-risk NB than those with low-risk NB, while the difference between patients with low-risk and high-risk WT (p = .69) or HB (p = .35) was not statistically significant. The associated areas under the curve (AUC) for APT to differentiate low-risk and high-risk NB, WT, and HB were 0.93, 0.58, and 0.71, respectively. The quantitative T1 and T2 values generated AUCs of 0.61-0.70 for the risk stratification of abdominal tumors. CONCLUSIONS APT MRI is a potential imaging biomarker for stratifying the risk group of pediatric neuroblastoma in the abdomen preoperatively and provides added value to structural MRI. KEY POINTS • Amide proton transfer (APT) imaging showed significantly (p < .001) higher values in pediatric patients with high-risk neuroblastoma than those with low-risk neuroblastoma, but did not demonstrate a significant difference in patients with Wilms' tumor (p = .69) or hepatoblastoma (p = .35). • The associated areas under the curve (AUC) for APT to differentiate low-risk and high-risk neuroblastoma, Wilms' tumor, and hepatoblastoma were 0.93, 0.58, and 0.71, respectively. • The quantitative T1 and T2 indices generated AUCs of 0.61-0.70 for dichotomizing the risk group of abdominal tumors.
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Affiliation(s)
- Xuan Jia
- Department of Radiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenqi Wang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiawei Liang
- Department of Radiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaohui Ma
- Department of Radiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | | | - Dan Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Can Lai
- Department of Radiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yi Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China.
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12
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Takumi K, Nagano H, Kikuno H, Kumagae Y, Fukukura Y, Yoshiura T. Differentiating malignant from benign salivary gland lesions: a multiparametric non-contrast MR imaging approach. Sci Rep 2021; 11:2780. [PMID: 33531644 PMCID: PMC7854671 DOI: 10.1038/s41598-021-82455-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/19/2021] [Indexed: 02/08/2023] Open
Abstract
The purpose of this study is to determine whether multiparametric non-contrast MR imaging including diffusion-weighted imaging (DWI), arterial spin labeling (ASL), and amide proton transfer (APT) weighted imaging can help differentiate malignant from benign salivary gland lesions. The study population consisted of 42 patients, with 31 benign and 11 malignant salivary gland lesions. All patients were evaluated using DWI, three-dimensional pseudo-continuous ASL, and APT-weighted imaging on 3 T MR imaging before treatment. Apparent diffusion coefficient (ADC), tumor blood flow (TBF), and APT-related signal intensity (APTSI) values within the lesion were compared between the malignant and benign lesions by Mann-Whitney U test. For each parameter, optimal cutoff values were chosen using a threshold criterion that maximized the Youden index for predicting malignant lesions. The performance of ADC, TBF, APTSI, individually and combined, was evaluated in terms of diagnostic ability for malignant lesions. Diagnostic performance was compared by McNemar test. APTSI was significantly higher in malignant lesions (2.18 ± 0.89%) than in benign lesions (1.57 ± 1.09%, p = 0.047). There was no significant difference in ADC or TBF between benign and malignant lesions (p = 0.155 and 0.498, respectively). The accuracy of ADC, TBF, and APTSI for diagnosing malignant lesions was 47.6%, 50.0%, and 66.7%, respectively; whereas the accuracy of the three parameters combined was 85.7%, which was significantly higher than that of each parameter alone (p = 0.001, 0.001, and 0.008, respectively). Therefore, the combination of ADC, TBF, and APTSI can help differentiate malignant from benign salivary gland lesions.
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Affiliation(s)
- Koji Takumi
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Hiroaki Nagano
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Hidehiko Kikuno
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Yuichi Kumagae
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Yoshihiko Fukukura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Takashi Yoshiura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
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Ai QYH, Zhang H, Jiang B, So TY, Mo FKF, Qamar S, Chen W, King AD. Test-retest repeatability of T1rho (T1ρ) MR imaging in the head and neck. Eur J Radiol 2020; 135:109489. [PMID: 33395595 DOI: 10.1016/j.ejrad.2020.109489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE T1rho imaging is a new quantitative MRI sequence for head and neck cancer and the repeatability for this region is unknown. This study aimed to evaluate the repeatability of quantitative T1rho imaging in the head and neck. MATERIALS AND METHODS T1rho imaging of the head and neck was prospectively performed in 15 healthy participants on three occasions. Scan 1 and 2 were performed with a time interval of 30 minutes (intra-session) and scan 3 was performed 14 days later (inter-session). T1rho values for normal tissues (parotid glands, palatine tonsils, pterygoid muscles, and tongue) were obtained on each scan. Intra-class coefficients (ICCs), within-subject coefficient of variances (wCoVs), and repeatability coefficient (RCs) of the intra-session scan (scan 1 vs 2) and inter-session scan (scan 1 vs 3) for the normal tissues were calculated. RESULTS The ICCs of T1rho values for normal tissues were almost perfect (0.83-0.97) for intra-session scans and were substantial (0.71-0.80) for inter-session scans. The wCoVs showed a small range (2.46%-3.30%) for intra-session scans, and slightly greater range (3.27%-6.51%) for inter-session scan. The greatest and lowest wCoVs of T1rho were found in the parotid gland and muscles, respectively. The T1rho RCs varied for all tissues between intra- and inter- sessions, and the greatest RC of 10.07 msec was observed for parotid gland on inter-session scan. CONCLUSION T1rho imaging is a repeatable quantitative MRI sequence in the head and neck but variances of T1rho values among tissues should be take into account during analysis.
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Affiliation(s)
- Qi Yong H Ai
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong.
| | - Huimin Zhang
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Baiyan Jiang
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Tiffany Y So
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Frankie K F Mo
- Department of Clinical Oncology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Sahrish Qamar
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Weitian Chen
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Ann D King
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
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