1
|
Xie T, Zhao Q, Fu C, Grimm R, Dominik Nickel M, Hu X, Yue L, Peng W, Gu Y. Quantitative analysis from ultrafast dynamic contrast-enhanced breast MRI using population-based versus individual arterial input functions, and comparison with semi-quantitative analysis. Eur J Radiol 2024; 176:111501. [PMID: 38788607 DOI: 10.1016/j.ejrad.2024.111501] [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: 05/22/2023] [Revised: 04/27/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024]
Abstract
PURPOSE To evaluate the value of inline quantitative analysis of ultrafast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using a population-based arterial input function (P-AIF) compared with offline quantitative analysis with an individual AIF (I-AIF) and semi-quantitative analysis for diagnosing breast cancer. METHODS This prospective study included 99 consecutive patients with 109 lesions (85 malignant and 24 benign). Model-based parameters (Ktrans, kep, and ve) and model-free parameters (washin and washout) were derived from CAIPIRINHA-Dixon-TWIST-VIBE (CDTV) DCE-MRI. Univariate analysis and multivariate logistic regression analysis with forward stepwise covariate selection were performed to identify significant variables. The AUC and F1 score were assessed for semi-quantitative and two quantitative analyses. RESULTS kep from inline quantitative analysis with P-AIF for diagnosing breast cancer provided an AUC similar to kep from offline quantitative analysis with I-AIF (0.782 vs 0.779, p = 0.954), higher compared to washin from semi-quantitative analysis (0.782 vs 0.630, p = 0.034). Furthermore, the inline quantitative analysis with P-AIF achieved the larger F1 score (0.920) compared with offline quantitative analysis with I-AIF (0.780) and semi-quantitative analysis (0.480). There were no statistically significant differences for kep values between the two quantitative analysis schemes (p = 0.944). CONCLUSION The inline quantitative analysis with P-AIF from CDTV in characterizing breast lesions could offer similar diagnostic accuracy to offline quantitative analysis with I-AIF, and higher diagnostic accuracy to semi-quantitative analysis.
Collapse
Affiliation(s)
- Tianwen Xie
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Qiufeng Zhao
- Department of Radiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Caixia Fu
- MR Applications Development, Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Robert Grimm
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | | | - Xiaoxin Hu
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Lei Yue
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Weijun Peng
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
| | - Yajia Gu
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
| |
Collapse
|
2
|
Fan X, Chatterjee A, Pittman JM, Yousuf A, Antic T, Karczmar GS, Oto A. Effectiveness of Dynamic Contrast Enhanced MRI with a Split Dose of Gadoterate Meglumine for Detection of Prostate Cancer. Acad Radiol 2022; 29:796-803. [PMID: 34583866 DOI: 10.1016/j.acra.2021.07.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/19/2021] [Accepted: 07/31/2021] [Indexed: 01/08/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate whether dynamic contrast enhanced (DCE) MRI with a split injection of 30% followed by 70% of a standard dose (30PSD and 70PSD) of gadoterate meglumine (DOTAREM) can improve diagnosis of prostate cancer (PCa). MATERIALS AND METHODS MRI for twenty patients was performed on a Philips Ingenia 3T scanner without an endorectal coil followed by subsequent radical prostatectomy. DCE 3D T1-FFE data were acquired with injection of 0.03 mmol/kg followed after 2 minutes by 0.07 mmol/kg of DOTAREM. Regions-of-interest on histologically verified PCa and normal tissue in different prostate zones and the iliac artery were drawn. Average signal intensity as function of time was calculated for each ROI and fitted by using the signal intensity form of the Tofts (SI-Tofts) model to extract physiological parameters (Ktrans and ve). In addition, the scaled arterial input function (AIF) obtained from 30PSD data was used to analyze 70PSD data. RESULTS The AIF obtained from 30PSD data showed both first and second passes clearly and had much higher peak magnitude than AIFs from 70PSD data. Ktrans was significantly (p < 0.05) larger in PCa than in normal tissue in peripheral zone (PZ) and central zone (CZ) for both 70PSD and 70PSD data analyzed with a scaled AIF. Ktrans in cancer overlapped with that of normal tissue in the transition zone (TZ). There was no statistical difference in ve between cancer and normal tissue. Receiver operating characteristic analysis showed that use of the AIF from 30PSD data to analyze 70PSD data increased the diagnostic efficacy of Ktrans in the PZ and CZ. CONCLUSION The split dose protocol for injection of Dotarem increased diagnostic accuracy of quantitative analysis with the SI-Tofts model.
Collapse
|
3
|
Surrogate vascular input function measurements from the superior sagittal sinus are repeatable and provide tissue-validated kinetic parameters in brain DCE-MRI. Sci Rep 2022; 12:8737. [PMID: 35610281 PMCID: PMC9130284 DOI: 10.1038/s41598-022-12582-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 04/27/2022] [Indexed: 01/08/2023] Open
Abstract
Accurate vascular input function (VIF) derivation is essential in brain dynamic contrast-enhanced (DCE) MRI. The optimum site for VIF estimation is, however, debated. This study sought to compare VIFs extracted from the internal carotid artery (ICA) and its branches with an arrival-corrected vascular output function (VOF) derived from the superior sagittal sinus (VOFSSS). DCE-MRI datasets from sixty-six patients with different brain tumours were retrospectively analysed and plasma gadolinium-based contrast agent (GBCA) concentration-time curves used to extract VOF/VIFs from the SSS, the ICA, and the middle cerebral artery. Semi-quantitative parameters across each first-pass VOF/VIF were compared and the relationship between these parameters and GBCA dose was evaluated. Through a test-retest study in 12 patients, the repeatability of each semiquantitative VOF/VIF parameter was evaluated; and through comparison with histopathological data the accuracy of kinetic parameter estimates derived using each VOF/VIF and the extended Tofts model was also assessed. VOFSSS provided a superior surrogate global input function compared to arteries, with greater contrast-to-noise (p < 0.001), higher peak (p < 0.001, repeated-measures ANOVA), and a greater sensitivity to interindividual plasma GBCA concentration. The repeatability of VOFSSS derived semi-quantitative parameters was good to excellent (ICC = 0.717-0.888) outperforming arterial based approaches. In contrast to arterial VIFs, kinetic parameters obtained using a SSS derived VOF permitted detection of intertumoural differences in both microvessel surface area and cell density within resected tissue specimens. These results support the usage of an arrival-corrected VOFSSS as a surrogate vascular input function for kinetic parameter mapping in brain DCE-MRI.
Collapse
|
4
|
Zhou X, Fan X, Mustafi D, Pineda F, Markiewicz E, Zamora M, Sheth D, Olopade OI, Oto A, Karczmar GS. Comparison of DCE-MRI of murine model cancers with a low dose and high dose of contrast agent. Phys Med 2021; 81:31-39. [PMID: 33373779 DOI: 10.1016/j.ejmp.2020.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/27/2020] [Accepted: 11/19/2020] [Indexed: 02/08/2023] Open
Abstract
There are increasing concerns regarding intracellular accumulation of gadolinium (Gd) after multiple dynamic contrast enhanced (DCE) MRI scans. We investigated whether a low dose (LD) of Gd-based contrast agent is as effective as a high dose (HD) for quantitative analysis of DCE-MRI data, and evaluated the use of a split dose protocol to obtain new diagnostic parameters. Female C3H mice (n = 6) were injected with mammary carcinoma cells in the hind leg. MRI experiments were performed on 9.4 T scanner. DCE-MRI data were acquired with 1.5 s temporal resolution before and after a LD (0.04 mmol/kg), then again after 30 min followed by a HD (0.2 mmol/kg) bolus injection of Omniscan. The standard Tofts model was used to extract physiological parameters (Ktrans and ve) with the arterial input function derived from muscle reference tissue. In addition, an empirical mathematical model was used to characterize maximum contrast agent uptake (A), contrast agent uptake rate (α) and washout rate (β and γ). There were moderate to strong correlations (r = 0.69-0.97, p < 0001) for parameters Ktrans, ve, A, α and β from LD versus HD data. On average, tumor parameters obtained from LD data were significantly larger (p < 0.05) than those from HD data. The parameter ratios, Ktrans, ve, A and α calculated from the LD data divided by the HD data, were all significantly larger than 1.0 (p < 0.003) for tumor. T2* changes following contrast agent injection affected parameters calculated from HD data, but this was not the case for LD data. The results suggest that quantitative analysis of LD data may be at least as effective for cancer characterization as quantitative analysis of HD data. In addition, the combination of parameters from two different doses may provide useful diagnostic information.
Collapse
Affiliation(s)
- Xueyan Zhou
- School of Technology, Harbin University, Harbin, China; Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Xiaobing Fan
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Devkumar Mustafi
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Federico Pineda
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Erica Markiewicz
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Marta Zamora
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Deepa Sheth
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | | | - Aytekin Oto
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Gregory S Karczmar
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States.
| |
Collapse
|
5
|
McMahon D, Oakden W, Hynynen K. Investigating the effects of dexamethasone on blood-brain barrier permeability and inflammatory response following focused ultrasound and microbubble exposure. Am J Cancer Res 2020; 10:1604-1618. [PMID: 32042325 PMCID: PMC6993222 DOI: 10.7150/thno.40908] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 11/04/2019] [Indexed: 12/14/2022] Open
Abstract
Rationale: Clinical trials are currently underway to test the safety and efficacy of delivering therapeutic agents across the blood-brain barrier (BBB) using focused ultrasound and microbubbles (FUS+MBs). While acoustic feedback control strategies have largely minimized the risk of overt tissue damage, transient induction of inflammatory processes have been observed following sonication in preclinical studies. The goal of this work was to explore the potential of post-sonication dexamethasone (DEX) administration as a means to mitigate treatment risk. Vascular permeability, inflammatory protein expression, blood vessel growth, and astrocyte activation were assessed. Methods: A single-element focused transducer (transmit frequency = 580 kHz) and DefinityTM microbubbles were used to increase BBB permeability unilaterally in the dorsal hippocampi of adult male rats. Sonicating pressure was calibrated based on ultraharmonic emissions. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was used to quantitatively assess BBB permeability at 15 min (baseline) and 2 hrs following sonication. DEX was administered following baseline imaging and at 24 hrs post-FUS+MB exposure. Expression of key inflammatory proteins were assessed at 2 days, and astrocyte activation and blood vessel growth were assessed at 10 days post-FUS+MB exposure. Results: Compared to saline-treated control animals, DEX administration expedited the restoration of BBB integrity at 2 hrs, and significantly limited the production of key inflammation-related proteins at 2 days, following sonication. Indications of FUS+MB-induced astrocyte activation and vascular growth were diminished at 10 days in DEX-treated animals, compared to controls. Conclusions: These results suggest that DEX provides a means of modulating the duration of BBB permeability enhancement and may reduce the risk of inflammation-induced tissue damage, increasing the safety profile of this drug-delivery strategy. This effect may be especially relevant in scenarios for which the goal of treatment is to restore or preserve neural function and multiple sonications are required.
Collapse
|
6
|
Pineda F, Sheth D, Abe H, Medved M, Karczmar GS. Low-dose imaging technique (LITE) MRI: initial experience in breast imaging. Br J Radiol 2019; 92:20190302. [PMID: 31271535 PMCID: PMC6849684 DOI: 10.1259/bjr.20190302] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/19/2019] [Accepted: 07/01/2019] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To compare a low-dose dynamic contrast-enhanced breast MRI protocol (LITE MRI) to standard-dosage using a dual-dose injection technique. METHODS 8 females with a total of 10 lesions with imaging features compatible with fibroadenoma were imaged using a dual-dose dynamic contrast-enhanced-MRI (DCE-MRI) technique. After pre-contrast scans, 15% of a standard dose of contrast was administered; approximately 10 min later, the remaining 85% of the standard dose was administered. Enhancement kinetic parameters, conspicuity and signal-to-noise ratio were measured quantitatively. RESULTS One lesion showed no enhancement in either DCE series. All nine of the enhancing lesions were visualized in both the low-dose and standard-dose images. While the (low-to-standard) ratio of contrast doses was roughly 0.18, this did not match the ratios of kinetic parameters. Lesion conspicuity and enhancement rate were both higher in the low-dose images, with (low-to-standard) ratios 1.5 ± 0.1 and 1.2 ± 0.4, respectively. The upper limit of enhancement (ratio 0.3 ± 0.1) and signal-to-noise ratio (ratio 0.5 ± 0.1) were higher in the standard-dose images, but less than expected based on the ratio of the doses. CONCLUSIONS This preliminary study demonstrates that LITE MRI has the potential to match standard DCE-MRI in the detection of enhancing lesions. Additionally, LITE MRI may enhance sensitivity to contrast media dynamics. ADVANCES IN KNOWLEDGE Lower doses of MRI contrast media may be equally effective in the detection of breast lesions, and increase sensitivity to contrast media dynamics. LITE MRI may help increase screening compliance and long-term patient safety.
Collapse
Affiliation(s)
- Federico Pineda
- Department of Radiology, The University of Chicago, Chicago, IL
| | - Deepa Sheth
- Department of Radiology, The University of Chicago, Chicago, IL
| | - Hiroyuki Abe
- Department of Radiology, The University of Chicago, Chicago, IL
| | - Milica Medved
- Department of Radiology, The University of Chicago, Chicago, IL
| | | |
Collapse
|
7
|
Ikoma Y, Kishimoto R, Tachibana Y, Omatsu T, Kasuya G, Makishima H, Higashi T, Obata T, Tsuji H. Reference region extraction by clustering for the pharmacokinetic analysis of dynamic contrast-enhanced MRI in prostate cancer. Magn Reson Imaging 2019; 66:185-192. [PMID: 31487532 DOI: 10.1016/j.mri.2019.08.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/13/2019] [Accepted: 08/31/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) measures changes in the concentration of an administered contrast agent to quantitatively evaluate blood circulation in a tumor or normal tissues. This method uses a pharmacokinetic analysis based on the time course of a reference region, such as muscle, rather than arterial input function. However, it is difficult to manually define a homogeneous reference region. In the present study, we developed a method for automatic extraction of the reference region using a clustering algorithm based on a time course pattern for DCE-MRI studies of patients with prostate cancer. METHODS Two feature values related to the shape of the time course were extracted from the time course of all voxels in the DCE-MRI images. Each voxel value of T1-weighted images acquired before administration were also added as anatomical data. Using this three-dimensional feature vector, all voxels were segmented into five clusters by the Gaussian mixture model, and one of these clusters that included the gluteus muscle was selected as the reference region. RESULTS Each region of arterial vessel, muscle, and fat was segmented as a different cluster from the tumor and normal tissues in the prostate. In the extracted reference region, other tissue elements including scattered fat and blood vessels were removed from the muscle region. CONCLUSIONS Our proposed method can automatically extract the reference region using the clustering algorithm with three types of features based on the time course pattern and anatomical data. This method may be useful for evaluating tumor circulatory function in DCE-MRI studies.
Collapse
Affiliation(s)
- Yoko Ikoma
- Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Riwa Kishimoto
- Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Yasuhiko Tachibana
- Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Tokuhiko Omatsu
- Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Goro Kasuya
- Department of Charged Particle Therapy Research, National Institute of Radiological Sciences, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Hirokazu Makishima
- Department of Charged Particle Therapy Research, National Institute of Radiological Sciences, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Tatsuya Higashi
- Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Takayuki Obata
- Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan.
| | - Hiroshi Tsuji
- Department of Charged Particle Therapy Research, National Institute of Radiological Sciences, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| |
Collapse
|
8
|
Ahmed Z, Levesque IR. Pharmacokinetic modeling of dynamic contrast-enhanced MRI using a reference region and input function tail. Magn Reson Med 2019; 83:286-298. [PMID: 31393033 DOI: 10.1002/mrm.27913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/18/2019] [Accepted: 06/18/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE Quantitative analysis of dynamic contrast-enhanced MRI (DCE-MRI) requires an arterial input function (AIF) which is difficult to measure. We propose the reference region and input function tail (RRIFT) approach which uses a reference tissue and the washout portion of the AIF. METHODS RRIFT was evaluated in simulations with 100 parameter combinations at various temporal resolutions (5-30 s) and noise levels (σ = 0.01-0.05 mM). RRIFT was compared against the extended Tofts model (ETM) in 8 studies from patients with glioblastoma multiforme. Two versions of RRIFT were evaluated: one using measured patient-specific AIF tails, and another assuming a literature-based AIF tail. RESULTS RRIFT estimated the transfer constant K trans and interstitial volume v e with median errors within 20% across all simulations. RRIFT was more accurate and precise than the ETM at temporal resolutions slower than 10 s. The percentage error of K trans had a median and interquartile range of -9 ± 45% with the ETM and -2 ± 17% with RRIFT at a temporal resolution of 30 s under noiseless conditions. RRIFT was in excellent agreement with the ETM in vivo, with concordance correlation coefficients (CCC) of 0.95 for K trans , 0.96 for v e , and 0.73 for the plasma volume v p using a measured AIF tail. With the literature-based AIF tail, the CCC was 0.89 for K trans , 0.93 for v e and 0.78 for v p . CONCLUSIONS Quantitative DCE-MRI analysis using the input function tail and a reference tissue yields absolute kinetic parameters with the RRIFT method. This approach was viable in simulation and in vivo for temporal resolutions as low as 30 s.
Collapse
Affiliation(s)
- Zaki Ahmed
- Medical Physics Unit, McGill University, Montreal, Canada.,Department of Physics, McGill University, Montreal, Canada
| | - Ives R Levesque
- Medical Physics Unit, McGill University, Montreal, Canada.,Department of Physics, McGill University, Montreal, Canada.,Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada.,Cancer Research Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| |
Collapse
|
9
|
Wang S, Fan X, Zhang Y, Medved M, He D, Yousuf A, Jamison E, Oto A, Karczmar GS. Use of Indicator Dilution Principle to Evaluate Accuracy of Arterial Input Function Measured With Low-Dose Ultrafast Prostate Dynamic Contrast-Enhanced MRI. ACTA ACUST UNITED AC 2019; 5:260-265. [PMID: 31245547 PMCID: PMC6588202 DOI: 10.18383/j.tom.2019.00004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Accurately measuring arterial input function (AIF) is essential for quantitative analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI). We used the indicator dilution principle to evaluate the accuracy of AIF measured directly from an artery following a low-dose contrast media ultrafast DCE-MRI. In total, 15 patients with biopsy-confirmed localized prostate cancers were recruited. Cardiac MRI (CMRI) and ultrafast DCE-MRI were acquired on a Philips 3 T Ingenia scanner. The AIF was measured at iliac arties following injection of a low-dose (0.015 mmol/kg) gadolinium (Gd) contrast media. The cardiac output (CO) from CMRI (COCMRI) was calculated from the difference in ventricular volume at diastole and systole measured on the short axis of heart. The CO from DCE-MRI (CODCE) was also calculated from the AIF and dose of the contrast media used. A correlation test and Bland–Altman plot were used to compare COCMRI and CODCE. The average (±standard deviation [SD]) area under the curve measured directly from local AIF was 0.219 ± 0.07 mM·min. The average (±SD) COCMRI and CODCE were 6.52 ± 1.47 L/min and 6.88 ± 1.64 L/min, respectively. There was a strong positive correlation (r = 0.82, P < .01) and good agreement between COCMRI and CODCE. The CODCE is consistent with the reference standard COCMRI. This indicates that the AIF can be measured accurately from an artery with ultrafast DCE-MRI following injection of a low-dose contrast media.
Collapse
Affiliation(s)
- Shiyang Wang
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Xiaobing Fan
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Yue Zhang
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Milica Medved
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Dianning He
- Department of Radiology, University of Chicago, Chicago, IL and.,Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, China
| | - Ambereen Yousuf
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Ernest Jamison
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Aytekin Oto
- Department of Radiology, University of Chicago, Chicago, IL and
| | | |
Collapse
|
10
|
Geng H, Tong W, Han F, Zhu K, Cao Y, Chen X. The Role of Tumor Oxygenation Tested by Magnetic Resonance Imaging (MRI) in Prostate Cancer Grading. Med Sci Monit 2019; 25:2505-2510. [PMID: 30950457 PMCID: PMC6463617 DOI: 10.12659/msm.913110] [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] [Indexed: 11/25/2022] Open
Abstract
Background Prostate cancer is a common malignant tumor in males. Prostate cancer grading is an important basis for evaluation of invasion. The purpose of this article was to use dynamic enhanced scan magnetic resonance imaging (MRI) to quantitatively investigate the relationship between tumor oxygenation value and prostate cancer pathological Gleason score. Material/Methods A total of 312 prostate cancer patients diagnosed by needle biopsy who received MRI dynamic enhanced scan were enrolled in this study. Multiparameter oxygen concentration image based on MRI was applied to test pO2 in tumors. Multiple spin resonance image relaxation time edit sequence and weak field diffusion model were used to estimate oxygen saturation level and pO2. hematoxylin and eosin staining and Gleason score were used to determine biological behavior and prognosis. Results According to the Gleason score system, there were 28 cases with a score of 10, 112 cases with a score of 9, 56 cases with a score of 8, and 116 cases with a score lower than 7. The enrolled patients were divided into groups: 116 cases into the middle-to-well differentiation group (Gleason score ≤7) and 196 cases into the poorly differentiation group (Gleason score at 8 to 10). Prostate cancer tumor oxygenation value was positively correlated with Gleason score (r=0.349, P<0.05) or PSA (r=0.432, P<0.05). Tumor oxygenation value in Gleason ≤7 group was obviously different from that in the group with Gleason score between 9 and 10 (P<0.05). Conclusions Tumor oxygenation value in prostate cancer was positively correlated with Gleason score. Tumor oxygenation value might be useful in clinics to evaluate prostate cancer grading and prognosis.
Collapse
Affiliation(s)
- Huaizhen Geng
- Department of Urology, Heze Municipal Hospital, Heze, Shandong, China (mainland)
| | - Wen Tong
- Department of Intensive Care Unit (ICU), Heze Municipal Hospital, Heze, Shandong, China (mainland)
| | - Fangzheng Han
- Department of Pathology, Heze Municipal Hospital, Heze, Shandong, China (mainland)
| | - Kunming Zhu
- Department of Radiology, Heze Municipal Hospital, Heze, Shandong, China (mainland)
| | - Yumei Cao
- Department of Cardiac Intervention, Heze Municipal Hospital, Heze, Shandong, China (mainland)
| | - Xiude Chen
- Department of Urology, Provincial Hospital Affiliated to Shandong University, Ji'nan, Shandong, China (mainland)
| |
Collapse
|
11
|
Fukuda T, Wengler K, de Carvalho R, Boonsri P, Schweitzer ME. MRI biomarkers in osseous tumors. J Magn Reson Imaging 2019; 50:702-718. [PMID: 30701624 DOI: 10.1002/jmri.26672] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/15/2019] [Accepted: 01/15/2019] [Indexed: 12/12/2022] Open
Abstract
Although radiography continues to play a critical role in osseous tumor assessment, there have been remarkable advances in cross-sectional imaging. MRI has taken a lead in this assessment due to high tissue contrast and spatial resolution, which are well suited for bone lesion assessment. More recently, although somewhat lagging other organ systems, quantitative parameters have shown promising potential as biomarkers for osseous tumors. Among these sequences are chemical shift imaging (CSI), apparent diffusion coefficient (ADC), and intravoxel incoherent motion (IVIM) from diffusion-weighted imaging (DWI), quantitative dynamic contrast enhanced (DCE)-MRI, and magnetic resonance spectroscopy (MRS). In this article, we review the background and recent roles of these quantitative MRI biomarkers for osseous tumors. Level of Evidence: 3 Technical Efficacy Stage: 3 J. MAGN. RESON. IMAGING 2019. J. Magn. Reson. Imaging 2019;50:702-718.
Collapse
Affiliation(s)
- Takeshi Fukuda
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| | - Kenneth Wengler
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - Ruben de Carvalho
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| | - Pattira Boonsri
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| | - Mark E Schweitzer
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| |
Collapse
|
12
|
Shukla-Dave A, Obuchowski NA, Chenevert TL, Jambawalikar S, Schwartz LH, Malyarenko D, Huang W, Noworolski SM, Young RJ, Shiroishi MS, Kim H, Coolens C, Laue H, Chung C, Rosen M, Boss M, Jackson EF. Quantitative imaging biomarkers alliance (QIBA) recommendations for improved precision of DWI and DCE-MRI derived biomarkers in multicenter oncology trials. J Magn Reson Imaging 2018; 49:e101-e121. [PMID: 30451345 DOI: 10.1002/jmri.26518] [Citation(s) in RCA: 225] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 12/14/2022] Open
Abstract
Physiological properties of tumors can be measured both in vivo and noninvasively by diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging. Although these techniques have been used for more than two decades to study tumor diffusion, perfusion, and/or permeability, the methods and studies on how to reduce measurement error and bias in the derived imaging metrics is still lacking in the literature. This is of paramount importance because the objective is to translate these quantitative imaging biomarkers (QIBs) into clinical trials, and ultimately in clinical practice. Standardization of the image acquisition using appropriate phantoms is the first step from a technical performance standpoint. The next step is to assess whether the imaging metrics have clinical value and meet the requirements for being a QIB as defined by the Radiological Society of North America's Quantitative Imaging Biomarkers Alliance (QIBA). The goal and mission of QIBA and the National Cancer Institute Quantitative Imaging Network (QIN) initiatives are to provide technical performance standards (QIBA profiles) and QIN tools for producing reliable QIBs for use in the clinical imaging community. Some of QIBA's development of quantitative diffusion-weighted imaging and dynamic contrast-enhanced QIB profiles has been hampered by the lack of literature for repeatability and reproducibility of the derived QIBs. The available research on this topic is scant and is not in sync with improvements or upgrades in MRI technology over the years. This review focuses on the need for QIBs in oncology applications and emphasizes the importance of the assessment of their reproducibility and repeatability. Level of Evidence: 5 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019;49:e101-e121.
Collapse
Affiliation(s)
- Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nancy A Obuchowski
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Thomas L Chenevert
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Sachin Jambawalikar
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Lawrence H Schwartz
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Dariya Malyarenko
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Wei Huang
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Susan M Noworolski
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Robert J Young
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mark S Shiroishi
- Division of Neuroradiology, Department of Radiology, University of Southern California, Los Angeles, California, USA
| | - Harrison Kim
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Catherine Coolens
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | | | - Caroline Chung
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Mark Rosen
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael Boss
- Applied Physics Division, National Institute of Standards and Technology, Boulder, Colorado, USA
| | - Edward F Jackson
- Departments of Medical Physics, Radiology, and Human Oncology, University of Wisconsin School of Medicine, Madison, Wisconsin, USA
| |
Collapse
|
13
|
He D, Chatterjee A, Fan X, Wang S, Eggener S, Yousuf A, Antic T, Oto A, Karczmar GS. Feasibility of Dynamic Contrast-Enhanced Magnetic Resonance Imaging Using Low-Dose Gadolinium: Comparative Performance With Standard Dose in Prostate Cancer Diagnosis. Invest Radiol 2018; 53:609-615. [PMID: 29702525 PMCID: PMC6512866 DOI: 10.1097/rli.0000000000000466] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES This study investigates whether administration of low doses of gadolinium-based contrast agent (GBCA) for dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) can be as effective as a standard dose in distinguishing prostate cancer (PCa) from benign tissue. In addition, we evaluated the combination of kinetic parameters from the low- and high-dose injection as a new diagnostic marker. MATERIALS AND METHODS Patients (n = 17) with histologically confirmed PCa underwent preoperative 3 T MRI. Dynamic contrast-enhanced MRI images were acquired at 8.3-second temporal resolution with a low dose (0.015 mmol/kg) and close to the standard dose (0.085 mmol/kg) of gadobentate dimeglumine bolus injections. Low-dose images were acquired for 3.5 minutes, followed by a 5-minute gap before acquiring standard dose images for 8.3 minutes. The data were analyzed qualitatively to investigate whether lesions could be detected based on early focal enhancement and quantitatively by fitting signal intensity as a function of time with an empirical mathematical model to obtain a maximum enhancement projection (MEP) and signal enhancement rate (α). RESULTS Both low- and standard-dose DCE-MRI showed similar sensitivity (13/26 = 50%) and lesion conspicuity score (4.0 ± 1.0 vs 4.2 ± 0.9; P = 0.317) for PCa diagnosis on qualitative analysis. Prostate cancer showed significantly increased α compared with benign tissue for low (9.98 ± 5.84 vs 5.12 ± 2.95 s) but not for standard (4.27 ± 2.20 vs 3.35 ± 1.48 s) dose. The ratio of low-dose α to standard-dose α was significantly greater (P = 0.02) for PCa (2.8 ± 2.3) than for normal prostate (1.6 ± 0.9), suggesting changes in water exchange and T2* effects associated with cancer. In addition, decreases in the percentage change in T1 relaxation rate as a function of increasing contrast media concentration (ie, the "saturation effect") can also contribute to the observed differences in high-dose and low-dose α. Area under the receiver operating characteristic curve for differentiating PCa from benign tissue using α was higher for low dose (0.769) compared with standard dose (0.625). There were no significant differences between MEP calculated for PCa and normal tissue at the low and standard doses. Moderate significant Pearson correlation for DCE parameters, MEP (r = 0.53) and α (r = 0.58), was found between low and standard doses of GBCA. CONCLUSIONS These preliminary results suggest that DCE-MRI with a low GBCA dose distinguishes PCa from benign prostate tissue more effectively than does the standard GBCA dose, based on signal enhancement rate. Diagnostic accuracy is similar on qualitative assessment. Prostate cancer diagnosis may be feasible with DCE-MRI with low-dose GBCA. In addition, comparison of enhancement kinetics after low and high doses of contrast media may provide diagnostically useful information.
Collapse
Affiliation(s)
- Dianning He
- Department of Radiology, The University of Chicago, Chicago, Illinois, USA,Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, China
| | | | - Xiaobing Fan
- Department of Radiology, The University of Chicago, Chicago, Illinois, USA
| | - Shiyang Wang
- Department of Radiology, The University of Chicago, Chicago, Illinois, USA
| | - Scott Eggener
- Department of Urology, The University of Chicago, Chicago, Illinois, USA
| | - Ambereen Yousuf
- Department of Radiology, The University of Chicago, Chicago, Illinois, USA
| | - Tatjana Antic
- Department of Pathology, The University of Chicago, Chicago, Illinois, USA
| | - Aytekin Oto
- Department of Radiology, The University of Chicago, Chicago, Illinois, USA
| | | |
Collapse
|
14
|
A simulation study comparing nine mathematical models of arterial input function for dynamic contrast enhanced MRI to the Parker model. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2018; 41:507-518. [DOI: 10.1007/s13246-018-0632-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 03/20/2018] [Indexed: 02/06/2023]
|
15
|
Guo B, Xiao J, Li L, Wang S, Wang L, Liu S. Clinical study of prenatal ultrasonography combined with T‑box transcription factor 1 as a biomarker for the diagnosis of congenital heart disease. Mol Med Rep 2018; 17:7346-7350. [PMID: 29568912 DOI: 10.3892/mmr.2018.8742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 05/18/2017] [Indexed: 11/05/2022] Open
Abstract
Congenital heart disease (CHD) seriously threatens fetal health. Therefore, prenatal examination to detect deformity is extremely important. The present study aimed to investigate the clinical application value of prenatal ultrasonography combined with molecular biology methods in the diagnosis of fetal CHD. A total of 1,000 pregnant women who had received fetal ultrasonography to examine fetal CHD were enrolled. Ultrasounds were performed for fetal heart examination and diagnosis, mainly on fetal heart position, size, structure and function, and heart valve morphology and function. These indexes were tested again 2 weeks after birth. Blood samples were collected from pregnant women with fetal CHD. Polymerase chain reaction (PCR) and western blotting were performed to detect the association between heart development and T‑box transcription factor 1 (TBX1) expression. The results revealed that 10 fetuses had CHD (1%), of which ultrasound detected 9 cases. The specificity and sensitivity of ultrasounds were 100 and 90%, respectively. Of the 9 cases were identified by prenatal ultrasound screening, including 2 cases had endocardial cushion defect, 1 case had pulmonary stenosis combined with right ventricular dysplasia, 1 case had tetralogy of Fallot combined with a cleft lip and palate, 2 cases had ventricular septal defect, 1 case had a single ventricle defect, 1 case had Ebstein and 1 case had a triatrial heart. One case of ventricular septal defect was missed prior to delivery. PCR and western blotting demonstrated that TBX1 expression may be associated with CHD. Therefore, ultrasonography combined with laboratory examinations represent efficient, economic and safe methods for fetal CHD detection. These methods may be significant to improve the rate of CHD diagnosis, and require further investigation.
Collapse
Affiliation(s)
- Bingcheng Guo
- Department of Ultrasound, Jining No. 1 People's Hospital, Jining, Shandong 272011, P.R. China
| | - Jing Xiao
- Department of Ultrasound, Jining No. 1 People's Hospital, Jining, Shandong 272011, P.R. China
| | - Long Li
- Department of Ultrasound, Jining No. 1 People's Hospital, Jining, Shandong 272011, P.R. China
| | - Shuanglong Wang
- Department of Ultrasound, Jining No. 1 People's Hospital, Jining, Shandong 272011, P.R. China
| | - Lijuan Wang
- Department of Ultrasound, Jining No. 1 People's Hospital, Jining, Shandong 272011, P.R. China
| | - Shuyong Liu
- Department of Hand and Foot Surgery, Jining No. 1 People's Hospital, Jining, Shandong 272011, P.R. China
| |
Collapse
|
16
|
Wang S, Lu Z, Fan X, Medved M, Jiang X, Sammet S, Yousuf A, Pineda F, Oto A, Karczmar GS. Comparison of arterial input functions measured from ultra-fast dynamic contrast enhanced MRI and dynamic contrast enhanced computed tomography in prostate cancer patients. Phys Med Biol 2018; 63:03NT01. [PMID: 29300175 PMCID: PMC6040820 DOI: 10.1088/1361-6560/aaa51b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The purpose of this study was to evaluate the accuracy of arterial input functions (AIFs) measured from dynamic contrast enhanced (DCE) MRI following a low dose of contrast media injection. The AIFs measured from DCE computed tomography (CT) were used as 'gold standard'. A total of twenty patients received CT and MRI scans on the same day. Patients received 120 ml Iohexol in DCE-CT and a low dose of (0.015 mM kg-1) of gadobenate dimeglumine in DCE-MRI. The AIFs were measured in the iliac artery and normalized to the CT and MRI contrast agent doses. To correct for different temporal resolution and sampling periods of CT and MRI, an empirical mathematical model (EMM) was used to fit the AIFs first. Then numerical AIFs (AIFCT and AIFMRI) were calculated based on fitting parameters. The AIFMRI was convolved with a 'contrast agent injection' function ([Formula: see text]) to correct for the difference between MRI and CT contrast agent injection times (~1.5 s versus 30 s). The results show that the EMMs accurately fitted AIFs measured from CT and MRI. There was no significant difference (p > 0.05) between the maximum peak amplitude of AIFs from CT (22.1 ± 4.1 mM/dose) and MRI after convolution (22.3 ± 5.2 mM/dose). The shapes of the AIFCT and [Formula: see text] were very similar. Our results demonstrated that AIFs can be accurately measured by MRI following low dose contrast agent injection.
Collapse
|
17
|
van Schie JJN, Lavini C, van Vliet LJ, Kramer G, Pieters-van den Bos I, Marcus JT, Stoker J, Vos FM. Estimating the arterial input function from dynamic contrast-enhanced MRI data with compensation for flow enhancement (II): Applications in spine diagnostics and assessment of crohn's disease. J Magn Reson Imaging 2017; 47:1197-1204. [PMID: 29193469 DOI: 10.1002/jmri.25905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/16/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Pharmacokinetic (PK) models can describe microvascular density and integrity. An essential component of PK models is the arterial input function (AIF) representing the time-dependent concentration of contrast agent (CA) in the blood plasma supplied to a tissue. PURPOSE/HYPOTHESIS To evaluate a novel method for subject-specific AIF estimation that takes inflow effects into account. STUDY TYPE Retrospective study. SUBJECTS Thirteen clinical patients referred for spine-related complaints; 21 patients from a study into luminal Crohn's disease with known Crohn's Disease Endoscopic Index of Severity (CDEIS). FIELD STRENGTH/SEQUENCE Dynamic fast spoiled gradient echo (FSPGR) at 3T. ASSESSMENT A population-averaged AIF, AIFs derived from distally placed regions of interest (ROIs), and the new AIF method were applied. Tofts' PK model parameters (including vp and Ktrans ) obtained with the three AIFs were compared. In the Crohn's patients Ktrans was correlated to CDEIS. STATISTICAL TESTS The median values of the PK model parameters from the three methods were compared using a Mann-Whitney U-test. The associated variances were statistically assessed by the Brown-Forsythe test. Spearman's rank correlation coefficient was computed to test the correlation of Ktrans to CDEIS. RESULTS The median vp was significantly larger when using the distal ROI approach, compared to the two other methods (P < 0.05 for both comparisons, in both applications). Also, the variances in vp were significantly larger with the ROI approach (P < 0.05 for all comparisons). In the Crohn's disease study, the estimated Ktrans parameter correlated better with the CDEIS (r = 0.733, P < 0.001) when the proposed AIF was used, compared to AIFs from the distal ROI method (r = 0.429, P = 0.067) or the population-averaged AIF (r = 0.567, P = 0.011). DATA CONCLUSION The proposed method yielded realistic PK model parameters and improved the correlation of the Ktrans parameter with CDEIS, compared to existing approaches. LEVEL OF EVIDENCE 3 Technical Efficacy Stage 1 J. Magn. Reson. Imaging 2018;47:1197-1204.
Collapse
Affiliation(s)
- Jeroen J N van Schie
- Quantitative Imaging Group, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Cristina Lavini
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Lucas J van Vliet
- Quantitative Imaging Group, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Gem Kramer
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Indra Pieters-van den Bos
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - J T Marcus
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Jaap Stoker
- Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Frans M Vos
- Quantitative Imaging Group, Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands.,Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
18
|
Thomassin-Naggara I, Soualhi N, Balvay D, Darai E, Cuenod CA. Quantifying tumor vascular heterogeneity with DCE-MRI in complex adnexal masses: A preliminary study. J Magn Reson Imaging 2017; 46:1776-1785. [DOI: 10.1002/jmri.25707] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/02/2017] [Indexed: 01/08/2023] Open
Affiliation(s)
- Isabelle Thomassin-Naggara
- INSERM, UMR970, Parc HEGP Equipe 2, Imagerie de l'angiogenèse; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, IUC; Paris France
- AP-HP, Hôpital Tenon, Department of Radiology; Paris France
| | - Narimane Soualhi
- INSERM, UMR970, Parc HEGP Equipe 2, Imagerie de l'angiogenèse; Paris France
| | - Daniel Balvay
- INSERM, UMR970, Parc HEGP Equipe 2, Imagerie de l'angiogenèse; Paris France
- Plateforme d'Imagerie du Petit Animal; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine; Paris France
| | - Emile Darai
- AP-HP, Hôpital Tenon, Department of Gynaecology and Obstetrics; Paris France
| | | |
Collapse
|