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El-Morsy A, Elmokadem AH, Abdel Razek A, Ezzat Mousa A, Sakrana AA, Abdel-Wahab RM. Utility of diffusion tensor imaging in differentiating benign from malignant thyroid nodules. Neuroradiol J 2024:19714009241260807. [PMID: 38864496 DOI: 10.1177/19714009241260807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
Purpose: To assess diffusion tensor imaging (DTI) in differentiating benign from malignant thyroid nodules. Methods: A retrospective analysis was done on 55 patients with thyroid nodules who had undergone DTI. The fraction anisotropy (FA) and mean diffusivity (MD) of the thyroid nodules were measured using region of interest (ROI) by two observers. The final diagnosis was malignant and benign, as proved by pathological examination. Results: The mean MD of benign thyroid nodules (1.84 ± 0.42 and 1.90 ± 0.37 × 10-3mm2/s) was significantly higher (p < .001) than malignant nodules (0.95 ± 0.46 and 0.97 ± 0.41 × 10-3mm2/s) as scored by both observers. The cut-off values of 1.45 and 1.50 × 10-3mm2/s were used to differentiate malignant from benign thyroid nodules with the areas under the curve (AUC) of 0.926 and 0.937, respectively. The mean FA of benign thyroid nodules (0.23 ± 0.07 and 0.24 ± 0.08) was significantly lower (p < .001) than malignant nodules (0.48 ± 0.21 and 0.49 ± 0.18). The FA cut-off value of ≤0.32 and 0.33 was used for differentiating malignant from benign thyroid nodules with an AUC of 0.877 and 0.881, respectively. A combination of MD and FA values was used to differentiate benign from malignant thyroid nodules with an AUC of 0.932 and an accuracy of 87%. There was an excellent agreement between both observers for FA and MD (K = 0.939, 0.929). Conclusion: The DTI is a non-invasive, non-contrast imaging tool that can differentiate benign from malignant thyroid nodules.
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Affiliation(s)
- Ahmed El-Morsy
- Department of Radiology, Mansoura University, Mansoura, Egypt
| | - Ali H Elmokadem
- Department of Radiology, Mansoura University, Mansoura, Egypt
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Khedr D, Razek AAKA, Talaat M. Multi-parametric arterial spin labeling and diffusion-weighted imaging of paranasal sinuses masses. Oral Radiol 2023; 39:321-328. [PMID: 35900660 DOI: 10.1007/s11282-022-00640-z] [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: 03/27/2021] [Accepted: 07/07/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate arterial spin labeling (ASL) and diffusion-weighted imaging (DWI) in discrimination of benign from malignant paranasal sinus (PNS) tumors. MATERIAL AND METHODS A prospective study was done upon 42 cases of PNS masses that underwent magnetic resonance ASL and DWI of the head. Tumor blood flow (TBF) and apparent diffusion coefficient (ADC) of the masses were calculated by two observers. The pathological diagnosis was malignant (n = 28) and benign (n = 14) cases. RESULTS For both observers, the malignant PNS masses had significantly higher TBF (P < 0.001, 0.001) and lower ADC (P < 0.001, 0.001) than in benign masses. The ROC curve analysis of TBF, The threshed TBF was (121.45, 122.68 mL/100 g/min) used for differentiation between benign and malignant PNS masses, revealed sensitivity (92.9%, 89.3%), specificity (85.7%, 85.7%), accuracy (90.5%, 88.1%) and the AUC was 0.87 and 0.86 by both observers. the ROC curve analysis of ADC, The threshold ADC (1.215, 1.205 X10-3mm2/s) was used for differentiation between benign and malignant PNS masses, revealed sensitivity (96.4%, 89.3%), specificity (78.6%, 78.6%), accuracy of (90.5%, 85.7%) and the AUC was 0.93 and 0.92 by both observers. Combined analysis of TBF and ADC used for differentiation between benign and malignant PNS masses had revealed sensitivity (96.4%, 89.3%), specificity (92.9%, 85.7%) accuracy of (95.2%, 88.1%) and AUC. (0.995, 0.985) for both observers. CONCLUSION Combined using of TBF and ADC have a role in differentiation malignant from benign PNS masses.
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Affiliation(s)
- Doaa Khedr
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Elgomheryia street, Mansoura, 35511, Egypt.
| | | | - Mona Talaat
- Department of Diagnostic Radiology, Kafr Elsheak Faculty of Medicine, Kafrelsheikh, Egypt
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Li R, Li J, Wang Z. Quantitative assessment of the intraorbital segment of the optic nerve in patients with thyroid orbitopathy using diffusion tensor imaging. Acta Radiol 2023; 64:725-731. [PMID: 35291830 DOI: 10.1177/02841851221082419] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND It is difficult to detect optic nerve changes in patients with thyroid-associated ophthalmopathy (TAO) before the development of optic neuropathy. PURPOSE To detect changes in the intraorbital segment of the optic nerve in patients with TAO using diffusion tensor imaging (DTI) and determine any correlations with disease severity. MATERIAL AND METHODS A total of 74 participants (17 normal, 22 mild, and 35 moderate-severe TAO) were organized to be given 3-T DTI to measure fractional anisotropy (FA) and mean diffusivity (MD) for the orbital segments of their optic nerves. All underwent ophthalmological examinations for visual acuity, intraocular pressure, exophthalmos, and fundoscopy, and were assessed based on the Clinical Activity Score (CAS). Univariate analysis of variance and Pearson's correlation coefficients were carried out. RESULTS Patients with moderate-to-severe TAO had significantly lower FA values and higher MD values (P < 0.05). FA values were negatively correlated with CAS but had no obvious correlations with the degree of exophthalmos. MD values had no obvious correlations with CAS or the degree of exophthalmos. CONCLUSION DTI parameters of the intraorbital optic nerves were significantly altered in moderate-to-severe patients before onset of clinical optic nerve dysfunction and may, therefore, be used as an imaging biomarker for assessing the disease.
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Affiliation(s)
- Rui Li
- Beijing Friendship Hospital, 26455Capital Medical University, Beijing, PR China
| | - Jing Li
- Beijing Friendship Hospital, 26455Capital Medical University, Beijing, PR China
| | - Zhenchang Wang
- Beijing Friendship Hospital, 26455Capital Medical University, Beijing, PR China
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Elmongui A, AbdelRazek A, Abou-Elsaad T, Belal T, Ibrahim N, Alnaghy E. Diffusion tensor imaging of dorsal stream language areas in patients with post-stroke aphasia. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-021-00690-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Aphasia complicating stroke occurs due to language deficits that decrease communication abilities and functional independence. Our study aims to assess fractional anisotropy (FA) and mean diffusivity (MD) parameters of diffusion tensor imaging (DTI) of the dorsal stream language areas in patients with post-stroke aphasia. It was conducted on 27 patients with post-stroke aphasia and 27 age- and sex-matched controls who underwent DTI of the brain. FA and MD values of Broca's area (BA), Wernick's area (WA), superior longitudinal fasciculus (SLF), and arcuate fasciculus (AF), and number of tract fibers (TF) of AF and SLF were calculated. Results were correlated with National Institutes of Health Stroke Scale (NIHSS), Arabic version of Comprehensive Aphasia Test (Arabic CAT), and Mansoura Arabic Screening Aphasia Test (MASAT).
Results
FA of AF and SLF in patients was significantly lower (P = 0.001) than controls. MD of AF and SLF in patients was significantly higher (P = 0.001) than controls. The mean volume TF of AF and SLF in patients was significantly (P = 0.001) lower than the mean volume in controls for AF and SLF. FA cutoff for AF was 0.34 and for SLF, it was 0.35 with sensitivity, specificity, and accuracy (85.2%, 62.1%, 73.2%) for AF, (74.1%, 69%, 71.4%) for SLF, respectively. MD cutoff value for AF was 0.87, and 0.84 for SLF with sensitivity, specificity, and accuracy (63%, 72.4%, 67.8%) for AF, (81.5%, 79.3%, 80.4%) for SLF, respectively. Cutoff TF of AF was 1728 and for SLF it was 601 with sensitivity, specificity, and accuracy (88.9%, 72.4%, 80.4%) for AF and (85.2%, 85.2%, 78.6%) for SLF, respectively.
Conclusions
DTI is a non-invasive promising method that can be used to assess language areas in patients with post-stroke aphasia.
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Razek AAKA, Regal MEE, El-Shabrawi M, Abdeltawwab MM, Megahed A, Elzeny S, Tantawi NE, Taman SE. Diffusion Tensor Imaging of Auditory Pathway in Patients With Crigler-Najjar Syndrome Type I: Correlation With Auditory Brainstem Response. J Child Neurol 2022; 37:119-126. [PMID: 34961382 DOI: 10.1177/08830738211025865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To evaluate the role of diffusion tensor imaging of the auditory pathway in patients with Crigler Najjar syndrome type I and its relation to auditory brainstem response. METHODS Prospective study was done including 12 patients with Crigler Najjar syndrome type I and 10 age- and sex-matched controls that underwent diffusion tensor imaging of brain. Mean diffusivity and fractional anisotropy at 4 regions of the brain and brainstem on each side were measured and correlated with the results of auditory brainstem response for patients. RESULTS There was significantly higher mean diffusivity of cochlear nucleus, superior olivary nucleus, inferior colliculus, and auditory cortex of patients versus controls on both sides for all regions (P = .001). The fractional anisotropy of cochlear nucleus, superior olivary nucleus, inferior colliculus, and auditory cortex of patients versus controls was significantly lower, with P values of, respectively, .001, .001, .003, and .001 on the right side and .001, .001, .003, and .001 on left side, respectively. Also, a negative correlation was found between the maximum bilirubin level and fractional anisotropy of the left superior olivary nucleus and inferior colliculus of both sides. A positive correlation was found between the mean diffusivity and auditory brainstem response wave latency of the right inferior colliculus and left cochlear nucleus. The fractional anisotropy and auditory brainstem response wave latency of the right superior olivary nucleus, left cochlear nucleus, and inferior colliculus of both sides were negatively correlated. CONCLUSION Diffusion tensor imaging can detect microstructural changes in the auditory pathway in Crigler Najjar syndrome type I that can be correlated with auditory brainstem response.
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Affiliation(s)
| | - Mohamed Ezz El Regal
- Gastroenterology and Hepatology Unit, Mansoura Children Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Mortada El-Shabrawi
- Faculty of Medicine, Pediatric Hepatology Unit, Pediatric Department, Cairo University, Cairo, Egypt
| | | | - Ahmed Megahed
- Gastroenterology and Hepatology Unit, Mansoura Children Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Sherine Elzeny
- Gastroenterology and Hepatology Unit, Mansoura Children Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Noha El Tantawi
- Pediatric Neurology Unit, Mansoura Children Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Saher Ebrahiem Taman
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
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6
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Guzmán Pérez-Carrillo GJ, Ivanidze J. PET/CT and PET/MR Imaging of the Post-treatment Head and Neck: Traps and Tips. Neuroimaging Clin N Am 2021; 32:111-132. [PMID: 34809833 DOI: 10.1016/j.nic.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PET/computed tomography and PET/MR imaging are used to evaluate the post-treatment neck. Although 18F-FDG is helpful in the staging and treatment response assessment of head and neck cancer, recently developed PET radiotracers targeting specific surface markers are promising for applications of diagnostic problem solving and improved extent delineation. Diffusion-weighted MR imaging is helpful in the differential diagnosis of head and neck neoplasms, and improves the sensitivity and specificity for the detection of certain pathologies. Following standardized imaging parameters for PET/computed tomography and diffusion-weighted imaging in PET/MR imaging improves diagnostic accuracy and allows for future research data mining.
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Affiliation(s)
- Gloria J Guzmán Pérez-Carrillo
- Neuroradiology Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway, Campus Box 8131, St Louis, MO 63110, USA.
| | - Jana Ivanidze
- Division of Molecular Imaging & Therapeutics, Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Starr Building, 2nd Floor, New York, NY 10065, USA; Division of Neuroradiology, Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Starr Building, 2nd Floor, New York, NY 10065, USA
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Abdel Razek AAK, Saleh GA, Denever AT, Mukherji SK. Preimaging and Postimaging of Graft and Flap in Head and Neck Reconstruction. Magn Reson Imaging Clin N Am 2021; 30:121-133. [PMID: 34802575 DOI: 10.1016/j.mric.2021.07.004] [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] [Indexed: 11/19/2022]
Abstract
Head and neck reconstructive surgical techniques are complex; now the microvascular free tissue transfer is the most frequently used. The postreconstruction imaging interpretation is challenging due to the altered anatomy and flap variability. We aim to improve radiologists' knowledge with diverse methods of flap reconstruction for an accurate appreciation of their expected cross-sectional imaging appearance and early detection of tumor recurrence and other complication.
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Affiliation(s)
| | - Gehad A Saleh
- Faculty of Medicine, Department of Diagnostic Radiology, Mansoura University, Elgomhoria Street, Mansoura 35512, Egypt
| | - Adel T Denever
- Faculty of Medicine, Department of Surgery, Mansoura University, Elgomhoria Street, Mansoura 35512, Egypt
| | - Suresh K Mukherji
- Marian University, Head and Neck Radiology, ProScan Imaging, Carmel, IN, USA.
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Rodriguez JD, Selleck AM, Abdel Razek AAK, Huang BY. Update on MR Imaging of Soft Tissue Tumors of Head and Neck. Magn Reson Imaging Clin N Am 2021; 30:151-198. [PMID: 34802577 DOI: 10.1016/j.mric.2021.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article reviews soft tissue tumors of the head and neck following the 2020 revision of WHO Classification of Soft Tissue and Bone Tumours. Common soft tissue tumors in the head and neck and tumors are discussed, along with newly added entities to the classification system. Salient clinical and imaging features that may allow for improved diagnostic accuracy or to narrow the imaging differential diagnosis are covered. Advanced imaging techniques are discussed, with a focus on diffusion-weighted and dynamic contrast imaging and their potential to help characterize soft tissue tumors and aid in distinguishing malignant from benign tumors.
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Affiliation(s)
- Justin D Rodriguez
- Department of Radiology, Duke University, 2301 Erwin Rd, Durham, NC 27705, USA
| | - A Morgan Selleck
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, 170 Manning Drive, CB 7070, Physicians Office Building, Rm G190A, Chapel Hill, NC 27599, USA
| | | | - Benjamin Y Huang
- Department of Radiology, UNC School of Medicine, 101 Manning Drive, CB#7510, Chapel Hill, NC 27599, USA.
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Abdel Razek AAK, Mansour M, Kamal E, Mukherji SK. MR imaging of Oral Cavity and Oropharyngeal Cancer. Magn Reson Imaging Clin N Am 2021; 30:35-51. [PMID: 34802580 DOI: 10.1016/j.mric.2021.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
MR imaging is the modality of choice in the evaluation of oral cavity and oropharyngeal cancer. Routine postcontrast MR imaging is important for the accurate localization and characterization of the locoregional extension of oral cavity and oropharyngeal cancers. The anatomy of the oral cavity and oropharynx is complex; accurate interpretation is vital for description of the extension of the masses. Understanding the new changes in the eighth edition of the American Joint Committee on Cancer staging system. MR imaging is the imaging modality of choice for detection of perineural spread.
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Affiliation(s)
| | - Manar Mansour
- Faculty of Medicine, Department of Diagnostic Radiology, Mansoura University, Elgomhoria Street, Mansoura 35512, Egypt
| | - Elsharawy Kamal
- Faculty of Medicine, Department of Otorhinolaryngology Head and Neck Surgery, Mansoura University, Elgomhoria Street, Mansoura 35512, Egypt
| | - Suresh K Mukherji
- Marian University, Head and Neck Radiology, ProScan Imaging, Carmel, IN, USA.
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10
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Abdel Razek AAK, Elsebaie NA, Gamaleldin OA, AbdelKhalek A, Mukherji SK. Role of MR Imaging in Head and Neck Squamous Cell Carcinoma. Magn Reson Imaging Clin N Am 2021; 30:1-18. [PMID: 34802573 DOI: 10.1016/j.mric.2021.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Routine and advanced MR imaging sequences are used for locoregional spread, nodal, and distant staging of head and neck squamous cell carcinoma, aids treatment planning, predicts treatment response, differentiates recurrence for postradiation changes, and monitors patients after chemoradiotherapy.
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Affiliation(s)
| | - Nermeen A Elsebaie
- Department of Radiology, Alexandria Faculty of Medicine, Champollion Street, El-Khartoum Square, El Azareeta Medical Campus, Alexandria 21131, Egypt
| | - Omneya A Gamaleldin
- Department of Radiology, Alexandria Faculty of Medicine, Champollion Street, El-Khartoum Square, El Azareeta Medical Campus, Alexandria 21131, Egypt
| | - Amro AbdelKhalek
- Internship at Mansoura University Hospital, Mansoura Faculty of Medicine, 60 Elgomheryia Street, Mansoura 35512, Egypt
| | - Suresh K Mukherji
- Marian University, Head and Neck Radiology, ProScan Imaging, Carmel, IN, USA.
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The role of diffusion tensor imaging of the liver in children with autoimmune hepatitis. Pol J Radiol 2021; 86:e461-e467. [PMID: 34567291 PMCID: PMC8449556 DOI: 10.5114/pjr.2021.108171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/15/2021] [Indexed: 12/04/2022] Open
Abstract
Purpose To evaluate the role of diffusion tensor imaging (DTI) of the liver in children with autoimmune hepatitis (AIH). Material and methods A prospective study was done on 42 children with AIH (30 girls and 12 boys, with a mean age of 13 years) and 20 age- and sex-matched healthy control children. They underwent DTI of the liver and laboratory tests. Liver biopsy was done for the patients. The mean diffusivity (MD) and fractional anisotropy (FA) of the liver were calculated and correlated with the pathological results. Results The mean MD and FA of the liver in children with AIH were 1.42 ± 0.06 × 10-3 mm2/s and 0.37 ± 0.11; and in the control children they were 1.55 ± 0.07 × 10-3 mm2/s and 0.25 ± 0.03, respectively. The MD and FA were significantly different in the children with AIH compared to the control children (p = 0.001). The cutoff MD and FA used to differentiate patients from controls were 1.50 × 10-3 mm2/s, 0.31 with AUC of 0.919 and 0.813, sensitivity of 97.6% and 66.7%, a specificity of 80% and 70%, an accuracy of 94.2% and 67.3%, PPV of 95.3 and 90.3, and NPV of 88.9 and 33.3, respectively. There was significantly lower MD and higher FA of the liver in children with AIH type I (n = 31) than type II (n = 11) (p = 0.001), and patients with (n = 9) and without (n = 33) overlap syndrome (p = 0.005). Conclusions We concluded that DTI parameters can help to diagnose AIH, detect its phenotyping, and give clues as to the presence of associated overlap syndrome.
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12
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Diffusion tensor imaging of renal cortex in lupus nephritis. Jpn J Radiol 2021; 39:1069-1076. [PMID: 34125367 DOI: 10.1007/s11604-021-01154-0] [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: 04/20/2021] [Accepted: 06/08/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the diagnostic value of diffusion tensor imaging (DTI) of renal cortex in assessment of lupus nephritis (LN) and prediction of its pathological subtypes. METHODS Prospective study was performed upon 39 female patients with pathologically proven LN and 16 sex- and age-matched healthy controls. Patients and controls underwent DTI of kidney. Mean diffusivity (MD) and fractional anisotropy (FA) of renal cortex were calculated by two radiologists. LN patients were pathologically classified into either non-proliferative (n = 15) or proliferative (n = 24). RESULTS Mean MD of renal cortex in LN was significantly lower (p = 0.001) than that of controls with cut-off (2.16 and 2.2 X10-3mm2/s), area under curve (AUC) of (0.92, 0.94) and accuracy of (91%, 89%) for both observers. Mean FA of renal cortex in LN was significantly higher (p = 0.001) than that of controls with cut-off (0.20, 0.21), AUC of (0.86, 0.82) and accuracy of (86%, 84%) for both observers. Renal cortex MD and FA in non-proliferative LN were significantly different (p = 0.001) from that of proliferative LN for both observers. There was excellent inter-observer agreement of MD and FA (ICC = 0.96 and 0.81). CONCLUSION MD and FA of renal cortex may help to assess renal affection in LN patients and predict its pathological subtypes.
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Razek AAKA, Taman S, Gamal W, El Ayouty M, Ali KM, Barakat TE. Diffusion tensor imaging of vertebral bone marrow in children with Gaucher's disease type I and III: Pre- and post-therapy. Clin Imaging 2021; 79:207-212. [PMID: 34116297 DOI: 10.1016/j.clinimag.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 05/30/2021] [Accepted: 06/02/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To assess diffusion tensor imaging (DTI) of the vertebral bone marrow (BM) in children with Gaucher's disease (GD) types I and III before and after therapy. METHODS Prospective study was conducted upon 25 children with GD type I (n = 17) and III (n = 8) and 13 age and sex-matched controls underwent DTI of vertebral BM. Mean diffusivity (MD) and fractional anisotropy (FA) of vertebral BM was calculated and correlated with genotyping, chitotriosidase, hemoglobin (HB) and, platelet count. RESULTS There was a statistically significant difference in MD and FA of BM between patients and controls (P = 0.001 and 0.02). The area under the curve (AUC) of MD and FA used to differentiate untreated patients from controls was 0.902 and 0.68 with sensitivity, specificity, and, accuracy 92%, 84.6%, and, 89.5% respectively. There was a significant difference in MD and FA of BM between untreated and treated patients (P = 0.001 and 0.02). AUC of MD and FA used to differentiate untreated from treated patients was 0.93 and 0.649 with sensitivity, specificity, and accuracy of 92%, 80%, and 86% respectively. There was a significant difference in MD and FA (P = 0.03, 0.001 respectively) of BM in GD with homozygous L444P mutation (n = 9) and other mutations (n = 14). Chiotriptase, HB and platelet count of patients was correlated with MD (r = -0.36, 0.42, -0.41) and FA (r = -0.47, -0.37, -0.46) respectively. CONCLUSION DTI of vertebral BM can help in diagnosis and monitoring patients with GD after therapy and correlated with genotyping, and hematological biomarkers of GD.
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Affiliation(s)
| | - Saher Taman
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Walaa Gamal
- Gastroenterology and Hepatology Unit, Department of Pediatrics, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Mostafa El Ayouty
- Gastroenterology and Hepatology Unit, Department of Pediatrics, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Khadiga M Ali
- Department of Pathology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Tarik Elsayed Barakat
- Gastroenterology and Hepatology Unit, Department of Pediatrics, Mansoura Faculty of Medicine, Mansoura, Egypt
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Razek AAKA, El-Diasty T, Elhendy A, Fahmy D, El-Adalany MA. Prostate Imaging Reporting and Data System (PI-RADS): What the radiologists need to know? Clin Imaging 2021; 79:183-200. [PMID: 34098371 DOI: 10.1016/j.clinimag.2021.05.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 01/14/2023]
Abstract
We aim to review the new modifications in MR imaging technique, image interpretation, lexicon, and scoring system of the last version of Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) in a simple and practical way. This last version of PI-RADS v2.1 describes the new technical modifications in the protocol of Multiparametric MRI (MpMRI) including T2, diffusion-weighted imaging (DWI), and dynamic contrast enhancement (DCE) parameters. It includes also; new guidelines in the image interpretation specifications in new locations (lesions located in the central zone and anterior fibromuscular stroma), clarification of T2 scoring of lesions of the transition zone, the distinction between DWI score 2 and 3 lesions in the transition zone and peripheral zone, as well as between positive and negative enhancement in DCE. Biparametric MRI (BpMRI) along with simplified PI-RADS is gaining more acceptances in the assessment of clinically significant prostatic cancer.
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Affiliation(s)
| | - Tarek El-Diasty
- Department of Diagnostic Radiology, Mansoura Urology and Nephrology Center, Mansoura, Egypt
| | - Ahmed Elhendy
- Department of Diagnostic Radiology, Mansoura Urology and Nephrology Center, Mansoura, Egypt
| | - Dalia Fahmy
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
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Razek AAKA, Hafez MM, Mahmoud W, Ismail AR, Ali KM, Barakat TE. Diffusion tensor imaging of the spleen in prediction and grading of esophageal varices in cirrhotic children with portal hypertension. Jpn J Radiol 2021; 39:907-913. [PMID: 33914254 DOI: 10.1007/s11604-021-01123-7] [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: 01/30/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To assess diffusion tensor imaging (DTI) of spleen in prediction and grading of esophageal varices (OV) in cirrhotic children. METHODS This prospective study was conducted upon 30 children with cirrhotic children with OV and 10 age-gender matched controls that underwent DTI of abdomen. Mean diffusivity (MD) and fractional anisotropy (FA) of spleen were calculated and matched with the grading of OV at endoscopy and laboratory biomarkers of portal hypertension. RESULTS Mean ADC of spleen in patient was significantly different (p = 0.001) from that of controls by both reviewers respectively. The cutoff ADC measurement of the spleen used for prediction of OV was ≥ 0.75 and ≥ 0.76 × 10-3mm2/s with AUC was 0.993 and 0.997 for both reviewers respectively. The FA of the spleen in patient was different (p = 0.01) from of controls of both reviewers respectively. Cutoff FA of spleen used for prediction of OV was ≤ 0.35 and ≤ 0.36 for both observers respectively. ADC and FA of spleen was correlated with platelets count (r = - 0.713, 0.392; p = 0.001, 0.012) and prothrombin time (r = 0.518, - 0.380; p = 0.001, 0.016). CONCLUSION DTI metrics of spleen can predict and grade OV and correlated with laboratory biomarkers of portal hypertension.
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Affiliation(s)
| | - Mona Mohamed Hafez
- Cardiology Unit, Department of Pediatrics, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Walaa Mahmoud
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, 13551, Egypt
| | - Ahmed Ramadan Ismail
- Gastroenterology and Hepatology Unit, Department of Pediatrics, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Khadiga M Ali
- Department of Pathology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Tarek Elsayed Barakat
- Gastroenterology and Hepatology Unit, Department of Pediatrics, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Abdel Khalek Abdel Razek A, Abou Elatta H. Differentiation Between Phenotypes of Polycystic Ovarian Syndrome With Sonography. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2021. [DOI: 10.1177/8756479321996676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: To differentiate between the classic (A/B) from the nonclassic (C/D) phenotypes of the polycystic ovarian syndrome (PCOS) with sonography. Materials & Methods: Retrospective analysis was performed upon 72 female patients with PCOS. All patients underwent transvaginal sonography. The patients were classified into classic and nonclassic phenotypes of PCOS. Image analysis was performed for the ovarian volume, follicle counts, follicle size, and endometrial plate thickness. Results: There were significant differences in the ovarian volume ( P = .001), follicle counts ( P = .001), follicle size ( P = .001), and endometrial plate thickness ( P = .001) between classic and nonclassic phenotypes of PCOS. The threshold value for ovarian volume, follicle count, follicle size, and endometrial plate thickness used to differentiate classic from nonclassic phenotypes were 12.5, 10.5, 5.25, and 5.75, respectively, with an area under the curve of 0.79, 0.82, 0.83, 0.77 and an accuracy of 75%, 73.6%, 79.2%, and 68.1%, respectively. The serum testosterone level and the body mass index were significantly higher in patients with classic than nonclassic phenotypes of PCOS ( P = .001, .04), respectively. Conclusion: Sonography findings can differentiate classic from nonclassic phenotypes of PCOS.
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Affiliation(s)
| | - Heba Abou Elatta
- Department of Diagnostic Radiology, Student Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt
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Abdel Razek AAK. Bone-related disorders of the jaw: A clinico-radiological diagnostic algorithm. Neuroradiol J 2021; 34:289-299. [PMID: 33678062 DOI: 10.1177/1971400921998967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Bone-related disorders of the jaw (BRDJ) include a spectrum of non-neoplastic and neoplastic lesions of the maxillofacial region that have been recently classified into fibro-osseous lesions, giant cell lesions and osseous tumours. The histopathological features of BRDJ can be similar and overlie each other. Imaging is important in order to reach a specific diagnosis. However, the appearance of BRDJ on imaging is non-specific in some cases. Computed tomography (CT) and magnetic resonance imaging (MRI) are used for accurate localisation, characterisation of the tumour matrix, delineation of the lesion extension and establishment of the relation of BRDJ to the surrounding structures. Imaging is usually done to detect the relationship with the adjacent surrounding vital structures and to diagnose aggressive forms, malignant transformation and associated syndromes. The correlation of the demographic findings, the location and the clinical presentations with the imaging features are important for the diagnosis of BRDJ. The proposed clinico-radiological diagnostic algorithm with CT and MRI helps a specific diagnosis to be reached in some cases.
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Johnson M, Sreela LS, Mathew P, Prasad TS. Actual applications of magnetic resonance imaging in dentomaxillofacial region. Oral Radiol 2021; 38:17-28. [PMID: 33635492 DOI: 10.1007/s11282-021-00521-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 02/13/2021] [Indexed: 11/24/2022]
Abstract
Magnetic resonance imaging (MRI) is a versatile imaging modality utilized in various medical fields. Specifically used for evaluation of soft tissues, with non-ionizing radiation and multiplanar sections that has provided great guidance to diagnosis. Nowadays, use of MRI in dental practice is becoming more pervasive, especially for the evaluation of head-and-neck cancer, detection of salivary gland lesions, lymphadenopathy, and temporomandibular joint disorders. Understanding the basic principles, its recent advances, and multiple applications in dentomaxillofacial region helps significantly in the diagnostic decision making. In this article, the principle of MRI and its recent advances are reviewed, with further discussion on the appearance of various maxillofacial pathosis.
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Affiliation(s)
- Migi Johnson
- Department of Oral Medicine and Radiology, Government Dental College Kottayam, Gandhinagar, Kottayam, 686008, Kerala, India.
| | - L S Sreela
- Department of Oral Medicine and Radiology, Government Dental College Kottayam, Gandhinagar, Kottayam, 686008, Kerala, India
| | - Philips Mathew
- Department of Oral Medicine and Radiology, Government Dental College Kottayam, Gandhinagar, Kottayam, 686008, Kerala, India
| | - Twinkle S Prasad
- Department of Oral Medicine and Radiology, Government Dental College Kottayam, Gandhinagar, Kottayam, 686008, Kerala, India
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Razek AAKA, Elsebaie NA. Imaging of vascular cognitive impairment. Clin Imaging 2021; 74:45-54. [PMID: 33434866 DOI: 10.1016/j.clinimag.2020.12.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/21/2020] [Accepted: 12/30/2020] [Indexed: 12/15/2022]
Abstract
Vascular cognitive impairment (VCI) is a major health challenge and represents the second most common cause of dementia. We review the updated imaging classification and imaging findings of different subtypes of VCI. We will focus on the magnetic resonance imaging (MRI) markers of each subtype and highlight the role of advanced MR imaging sequences in the evaluation of these patients. Small vessel dementia appears as white matter hyperintensity, lacunae, microinfarcts, and microbleeds. Large vessel dementia includes strategic infarction and multi-infarction dementias. Hypoperfusion dementia can be seen as watershed infarcts and cortical laminar necrosis. Hemorrhagic dementia results from cerebral amyloid angiopathy and cortical superficial siderosis. Hereditary forms of VCI, caused by gene mutations such as CADASIL, should be suspected when dementia presents in young patients. Mixed dementia is seen in patients with Alzheimer's disease and the coexistence of cerebrovascular disease.
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Affiliation(s)
- Ahmed Abdel Khalek Abdel Razek
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt; Department of Radiology, Alexandria Faculty of Medicine, Alexandria, Egypt.
| | - Nermeen A Elsebaie
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt; Department of Radiology, Alexandria Faculty of Medicine, Alexandria, Egypt.
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Peripheral Nerve Sheath Tumors of Head and Neck: Imaging-Based Review of World Health Organization Classification. J Comput Assist Tomogr 2020; 44:928-940. [DOI: 10.1097/rct.0000000000001109] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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21
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Multi-parametric arterial spin labeling and diffusion-weighted imaging in differentiation of metastatic from reactive lymph nodes in head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 2020; 278:2529-2535. [DOI: 10.1007/s00405-020-06390-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 09/20/2020] [Indexed: 12/19/2022]
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22
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Razek AAKA, El Badrawy MK, Alnaghy E. Interstitial Lung Fibrosis Imaging Reporting and Data System: What Radiologist Wants to Know? J Comput Assist Tomogr 2020; 44:656-666. [PMID: 32842067 DOI: 10.1097/rct.0000000000001075] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The aim of this work is to review interstitial lung fibrosis Imaging Reporting and Data System (ILF-RADS) that was designed for reporting of interstitial lung fibrosis (ILF). Findings include pulmonary and extrapulmonary findings and is subsequently designed into 4 categories. Pulmonary findings included lung volume, reticulations, traction bronchiectasis, honeycomb, nodules, cysts, ground glass, consolidation, mosaic attenuation and emphysema, and distribution of pulmonary lesions; axial (central, peripheral and diffuse), and zonal distribution (upper, middle, and lower zones). Complications in the form of acute infection, acute exacerbation, and malignancy were also assessed. Extrapulmonary findings included mediastinal, pleural, tracheal, and bone or soft tissue lesions. The lexicon of usual interstitial pneumonia (UIP) was classified into 4 categories designated as belonging in 1 of 4 categories. Lexicon of ILF-RADS-1 (typical UIP), ILF-RADS-2 (possible UIP), ILF-RADS-3 (indeterminate for UIP), and ILF-RADS-4 (inconsistent with UIP).
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Quantitative ultrasound delta-radiomics during radiotherapy for monitoring treatment responses in head and neck malignancies. Future Sci OA 2020; 6:FSO624. [PMID: 33235811 PMCID: PMC7668124 DOI: 10.2144/fsoa-2020-0073] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Aim: We investigated quantitative ultrasound (QUS) in patients with node-positive head and neck malignancies for monitoring responses to radical radiotherapy (RT). Materials & methods: QUS spectral and texture parameters were acquired from metastatic lymph nodes 24 h, 1 and 4 weeks after starting RT. K-nearest neighbor and naive-Bayes machine-learning classifiers were used to build prediction models for each time point. Response was detected after 3 months of RT, and patients were classified into complete and partial responders. Results: Single-feature naive-Bayes classification performed best with a prediction accuracy of 80, 86 and 85% at 24 h, week 1 and 4, respectively. Conclusion: QUS-radiomics can predict RT response at 3 months as early as 24 h with reasonable accuracy, which further improves into 1 week of treatment. Patients with head and neck cancer are often treated with radiation, which usually spans over 6–7 weeks. The response is usually measured 3 months after treatment completion. In this study, we had performed ultrasound scans from the patient’s neck node during radiation treatment (after 24 h, 1 and 4 weeks). Artificial intelligence was used to interpret the ultrasound imaging and predict the response to radiation at the end of 3 months. The scans obtained after the first week were able to predict the treatment response with reasonable accuracy (86%).
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Schroeder C, Lee JH, Tetzner U, Seidel S, Kim SY. Comparison of diffusion-weighted MR imaging and 18F Fluorodeoxyglucose PET/CT in detection of residual or recurrent tumors and delineation of their local spread after (chemo) radiotherapy for head and neck squamous cell carcinoma. Eur J Radiol 2020; 130:109157. [PMID: 32652403 DOI: 10.1016/j.ejrad.2020.109157] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/19/2020] [Accepted: 06/26/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE To compare the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DW-MRI) and fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in detection of residual or recurrent tumors and their local extension in patients with head and neck squamous cell carcinoma after treatment with (chemo) radiotherapy (CRT). METHOD Twenty-five patients (17 men, 8 women, median age 64 years, range 49-79) who underwent surgical salvage for residual or recurrent tumors after CRT were included. The histopathologic analysis after the surgical salvage served as the gold standard. RESULTS Both DW-MRI and 18F-FDG PET/CT had a sensitivity of 92 % (23/25) in the detection of residual or recurrent tumors. MRI had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting perineural spread of 62 % (5/8), 88 % (15/17), 71 % (5/7) and 83 % (15/18), respectively; in comparison, PET/CT did not detect any cases of perineural spread. The sensitivity, specificity, PPV and NPV of MRI in detecting muscle infiltration was 75 % (9/12), 77 % (10/13), 75 % (9/12) and 77 % (10/13) respectively, while the values for 18F-FDG PET/CT were 58 % (7/12), 69 % (9/13), 64 % (7/11) and 64 % (9/14). CONCLUSIONS DW-MRI- and 18F-FDG PET/CT-imaging have an identical detection rate of residual or recurrent tumors after (chemo) radiotherapy. MRI has a higher sensitivity in detecting local perineural spread, has a better accuracy in the detection of muscle infiltration and more accurately correlates the lesion size to the histopathologic specimen.
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Affiliation(s)
- Christophe Schroeder
- University Institute for Diagnostic, Interventional and Paediatric Radiology, Inselspital University Hospital Bern, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland.
| | - Jung-Hyun Lee
- Department of Microbiology, The University of Chicago, Chicago, IL 60637, USA
| | - Ulrich Tetzner
- BG Klinikum Halle, Institute for Radiology and Neuroradiology, Merseburger Strasse 165, 06112 Halle (Saale), Germany
| | - Stefan Seidel
- Spitäler Schaffhausen, Radiology and Nuclear Medicine, Geissbergstrasse 81, 8208 Schaffhausen, Switzerland
| | - Soung Yung Kim
- Spitäler Schaffhausen, Radiology and Nuclear Medicine, Geissbergstrasse 81, 8208 Schaffhausen, Switzerland
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Norris CD, Quick SE, Parker JG, Koontz NA. Diffusion MR Imaging in the Head and Neck: Principles and Applications. Neuroimaging Clin N Am 2020; 30:261-282. [PMID: 32600630 DOI: 10.1016/j.nic.2020.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Diffusion imaging is a functional MR imaging tool that creates tissue contrast representative of the random, microscopic translational motion of water molecules within human body tissues. Long considered a cornerstone MR imaging sequence for brain imaging, diffusion-weighted imaging (DWI) increasingly is used for head and neck imaging. This review reports the current state of diffusion techniques for head and neck imaging, including conventional DWI, DWI trace with apparent diffusion coefficient map, diffusion tensor imaging, intravoxel incoherent motion, and diffusion kurtosis imaging. This article describes background physics, reports supportive evidence and potential pitfalls, highlights technical advances, and details practical clinical applications.
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Affiliation(s)
- Carrie D Norris
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 North University Boulevard, Room 0663, Indianapolis, IN 46202, USA. https://twitter.com/CarrieDNorrisMD
| | - Sandra E Quick
- Department of Radiology, Richard L. Roudebush VA Medical Center, 1481 West 10th Street, Indianapolis, IN 46202, USA
| | - Jason G Parker
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 North University Boulevard, Room 0663, Indianapolis, IN 46202, USA
| | - Nicholas A Koontz
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 North University Boulevard, Room 0663, Indianapolis, IN 46202, USA; Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
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Prediction of skull base osteomyelitis in necrotising otitis externa with diffusion-weighted imaging. The Journal of Laryngology & Otology 2020; 134:404-408. [PMID: 32498734 DOI: 10.1017/s0022215120001073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To predict skull base osteomyelitis in patients with necrotising otitis externa using diffusion-weighted imaging. METHODS A retrospective analysis was conducted of 25 necrotising otitis externa patients with skull base osteomyelitis (n = 10) or without skull base involvement (n = 14) who underwent a single-shot diffusion-weighted imaging of the skull base. RESULTS The respective mean apparent diffusion coefficient values of the skull base, as determined by two reviewers, were 0.851 ± 0.15 and 0.841 ± 0.14 ×10-3mm2/s for the skull base osteomyelitis patients, and 1.065 ± 0.19 and 1.045 ± 0.20 ×10-3mm2/s for the necrotising otitis externa patients without skull base involvement. The difference in apparent diffusion coefficients between the groups was significant, for both reviewers (p = 0.008 and 0.012). The optimal threshold apparent diffusion coefficient for predicting skull base osteomyelitis in necrotising otitis externa patients was 0.945 ×10-3mm2/s and 0.915 ×10-3mm2/s, with an area under the curve of 0.825 and 0.800, accuracy of 87.5 and 83.3 per cent, sensitivity of 85.7 and 90.0 per cent, and specificity of 90.0 and 78.6 per cent, for each reviewer respectively. CONCLUSION Apparent diffusion coefficient is a non-invasive imaging parameter useful for predicting skull base osteomyelitis in necrotising otitis externa patients.
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Diffusion Tensor Imaging of Microstructural Changes in the Gray and White Matter in Patients With Crigler-Najjar Syndrome Type I. J Comput Assist Tomogr 2020; 44:393-398. [PMID: 32217895 DOI: 10.1097/rct.0000000000001008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE This study aimed to evaluate the role of diffusion tensor imaging of microstructural changes in gray and white matter in Crigler-Najjar syndrome type I. PATIENT AND METHODS A prospective study was conducted on 10 patients with Crigler-Najjar syndrome type I and 10 age- and sex-matched children who underwent diffusion tensor imaging of the brain. Mean diffusivity (MD) and fractional anisotropy (FA) of gray and white matter were measured. RESULTS There was a significantly higher MD of the gray matter regions including the globus pallidus, thalamus, caudate head, substantia nigra, and dentate nucleus in patients versus controls (P = 0.007, 0.001, 0.014, 0.003, and 0.002), respectively. The areas under the curve (AUC) of MD of the globus pallidus and thalamus used to differentiate patients from controls were 0.93 and 0.925, respectively. There was a significant difference in MD of the frontal white matter and posterior limb of the internal capsule in patients versus controls (P = 0.001 and 0.02), respectively. The AUCs of MD of these regions used to differentiate patients from controls were 0.82 and 0.8. There was a significant difference in FA of the frontal white matter and posterior limb of the internal capsule in patients versus controls (P = 0.006 and 0.006), respectively. The AUCs of FA of these regions were 0.83 and 0.85, respectively. The MD of the globus pallidus correlated with serum bilirubin (r = 0.87 and P = 0.001). CONCLUSION Diffusion tensor imaging can detect microstructural changes of deep gray matter and some regions of white matter in Crigler-Najjar syndrome type I.
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Neck Imaging Reporting and Data System: What Does Radiologist Want to Know? J Comput Assist Tomogr 2020; 44:527-532. [DOI: 10.1097/rct.0000000000001032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mahajan A, Ahuja A, Sable N, Stambuk HE. Imaging in oral cancers: A comprehensive review. Oral Oncol 2020; 104:104658. [PMID: 32208340 DOI: 10.1016/j.oraloncology.2020.104658] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/11/2020] [Accepted: 03/17/2020] [Indexed: 02/08/2023]
Abstract
This review aims at simplifying the relevant imaging anatomy, guiding the optimal imaging method and highlighting the key imaging findings that influence prognosis and management of oral cavity squamous cell carcinoma (OSCC). Early OSCC can be treated with either surgery alone while advanced cancers are treated with a combination of surgery, radiotherapy and/or chemotherapy. Considering the complex anatomy of the oral cavity and its surrounding structures, imaging plays an indispensable role not only in locoregional staging but also in the distant metastatic work-up and post treatment follow-up. Knowledge of the anatomy with understanding of common routes of spread of cancer, allows the radiologist to accurately determine disease extent and augment clinical findings to plan appropriate therapy. This review aims at simplifying the relevant imaging anatomy, guiding the optimal imaging method and highlighting the key imaging findings that influence prognosis and management.
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Affiliation(s)
- Abhishek Mahajan
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Mumbai 400012, India.
| | - Ankita Ahuja
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Mumbai 400012, India
| | - Nilesh Sable
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Mumbai 400012, India
| | - Hilda E Stambuk
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
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Vidiri A, Panfili M, Boellis A, Cristalli G, Gangemi E, Pellini R, Marzi S, Covello R. The role of MRI-derived depth of invasion in staging oral tongue squamous cell carcinoma: inter-reader and radiological-pathological agreement. Acta Radiol 2020; 61:344-352. [PMID: 31319692 DOI: 10.1177/0284185119862946] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background The 8th edition of tumor, node, metastasis (TNM) classification incorporates depth of invasion evaluation in the staging of oral cavity squamous cell carcinoma, since it is a predictor of nodal metastasis and an independent prognostic factor. Although the histopathological definition of depth of invasion is clear, an accurate method for its radiological assessment has not yet been validated. Purpose To investigate the role of MRI-derived depth of invasion evaluation in staging oral tongue squamous cell carcinoma and to assess the inter-reader agreement and the radiological–pathological correlation. Material and Methods We retrospectively reviewed 43 patients with oral tongue squamous cell carcinoma who underwent preoperative MRI. The MRI-derived depth of invasion was measured by two radiologists, each with a different degree of experience in head and neck imaging. The pathological depth of invasion was recorded from histopathological reports. The inter-reader and the radiological–histopathological correlations for the depth of invasion were evaluated with Bland–Altman plots, the intraclass correlation coefficients (ICC), and the paired samples test; agreements for T staging were assessed using the Kappa coefficient. Results Inter-reader reliability was excellent for the MRI-derived depth of invasion (ICC = 0.91), very good between MRI-derived depth of invasion and pathological depth of invasion (ICC = 0.89 for the experienced reader, 0.86 for the inexperienced reader). Both readers reached a good agreement regarding T staging (kappa value = 0.70). Furthermore, the agreement between radiological and pathological T staging was good (kappa value = 0.74 for the experienced reader, 0.60 for the inexperienced reader). Conclusion MRI-derived depth of invasion should be measured in the pretreatment assessment of oral tongue squamous cell carcinoma as it has an excellent inter-reader reliability and nearly excellent radiological–pathological correlation.
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Affiliation(s)
- Antonello Vidiri
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Marco Panfili
- Department of Radiological Science, Radiotherapy and Hematology, Institute of Radiology, Fondazione Policlinico A. Gemelli IRCCS – Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Boellis
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giovanni Cristalli
- Department of Otolaryngology & Head and Neck Surgery, Regina Elena National Cancer Institute, Rome, Italy
| | - Emma Gangemi
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Raul Pellini
- Department of Otolaryngology & Head and Neck Surgery, Regina Elena National Cancer Institute, Rome, Italy
| | - Simona Marzi
- Medical Physics Laboratory, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Renato Covello
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Multi-parametric arterial spin labelling and diffusion-weighted magnetic resonance imaging in differentiation of grade II and grade III gliomas. Pol J Radiol 2020; 85:e110-e117. [PMID: 32467745 PMCID: PMC7247019 DOI: 10.5114/pjr.2020.93397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/20/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose To assess arterial spin labelling (ASL) perfusion and diffusion MR imaging (DWI) in the differentiation of grade II from grade III gliomas. Material and methods A prospective cohort study was done on 36 patients (20 male and 16 female) with diffuse gliomas, who underwent ASL and DWI. Diffuse gliomas were classified into grade II and grade III. Calculation of tumoural blood flow (TBF) and apparent diffusion coefficient (ADC) of the tumoral and peritumoural regions was made. The ROC curve was drawn to differentiate grade II from grade III gliomas. Results There was a significant difference in TBF of tumoural and peritumoural regions of grade II and III gliomas (p = 0.02 and p =0.001, respectively). Selection of 26.1 and 14.8 ml/100 g/min as the cut-off for TBF of tumoural and peritumoural regions differentiated between both groups with area under curve (AUC) of 0.69 and 0.957, and accuracy of 77.8% and 88.9%, respectively. There was small but significant difference in the ADC of tumoural and peritumoural regions between grade II and III gliomas (p = 0.02 for both). The selection of 1.06 and 1.36 × 10-3 mm2/s as the cut-off of ADC of tumoural and peritumoural regions was made, to differentiate grade II from III with AUC of 0.701 and 0.748, and accuracy of 80.6% and 80.6%, respectively. Combined TBF and ADC of tumoural regions revealed an AUC of 0.808 and accuracy of 72.7%. Combined TBF and ADC for peritumoural regions revealed an AUC of 0.96 and accuracy of 94.4%. Conclusion TBF and ADC of tumoural and peritumoural regions are accurate non-invasive methods of differentiation of grade II from grade III gliomas.
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Zhang H, Zhou Y, Li J, Zhang P, Li Z, Guo J. The value of DWI in predicting the response to synchronous radiochemotherapy for advanced cervical carcinoma: comparison among three mathematical models. Cancer Imaging 2020; 20:8. [PMID: 31937371 PMCID: PMC6961298 DOI: 10.1186/s40644-019-0285-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/30/2019] [Indexed: 12/14/2022] Open
Abstract
Background Diffusion weighted imaging(DWI) mode mainly includes intravoxel incoherent motion (IVIM), stretched exponential model (SEM) and Gaussian diffusion model, but it is still unclear which mode is the most valuable in predicting the response to radiochemotherapy for cervical cancer. This study aims to compare the values of three mathematical models in predicting the response to synchronous radiochemotherapy for cervical cancer. Methods Eighty-four patients with cervical cancer were enrolled into this study. They underwent DWI examination by using 12 b-values prior to treatment. The imaging parameters were calculated on the basis of IVIM, SEM and Gaussian diffusion models respectively. The imaging parameters derived from three mathematical modes were compared between responders and non-responders groups. The repeatability of each imaging parameter was assessed. Results The ADC, D or DDC value was lower in responders than in non-responders groups (P = 0.03, 0.02, 0.01). The α value was higher in responders group than in non-responders group (P = 0.03). DDC had the largest area under curves (AUC) (=0.948) in predicting the response to treatment. The imaging parameters derived from SEM had better repeatability (CCC for DDC and α were 0.969 and 0.924 respectively) than that derived from other exponential models. Conclusion Three exponential modes of DWI are useful for predicting the response to radiochemotherapy for cervical cancer, and SEM may be used as a potential optimal model for predicting treatment effect.
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Affiliation(s)
- Hui Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhengzhou University, No. 2 Jingba Avenue, Zhengzhou, 450014, Henan Province, China
| | - Yuyang Zhou
- Department of Cardiac Surgery, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450014, Henan Province, China
| | - Jie Li
- Department of Radiology, The Second Affiliated Hospital of Zhengzhou University, No. 2 Jingba Avenue, Zhengzhou, 450014, Henan Province, China
| | - Pengjuan Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhengzhou University, No. 2 Jingba Avenue, Zhengzhou, 450014, Henan Province, China
| | - Zhenzhen Li
- Department of Radiology, The Second Affiliated Hospital of Zhengzhou University, No. 2 Jingba Avenue, Zhengzhou, 450014, Henan Province, China
| | - Junwu Guo
- Department of Radiology, The Second Affiliated Hospital of Zhengzhou University, No. 2 Jingba Avenue, Zhengzhou, 450014, Henan Province, China.
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Reliability of diffusion-weighted magnetic resonance imaging in differentiation of recurrent cholesteatoma and granulation tissue after intact canal wall mastoidectomy. The Journal of Laryngology & Otology 2019; 133:1083-1086. [DOI: 10.1017/s0022215119002421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo assess the reliability of diffusion-weighted magnetic resonance imaging in differentiating recurrent cholesteatoma from granulation tissue after intact canal wall mastoidectomy.MethodsA prospective study was conducted of 56 consecutive patients with suspected cholesteatoma recurrence after intact canal wall mastoidectomy who underwent diffusion-weighted imaging and delayed contrast magnetic resonance imaging of the temporal bone. The final diagnosis was recurrence in 38 patients and granulation tissue in 18 patients.ResultsCholesteatoma detection on diffusion-weighted imaging based on two sets of readings had sensitivity of 94.7 and 94.7 per cent, specificity of 94.4 and 88.9 per cent, and accuracy of 94.6 and 92.8 per cent, with good intra-observer agreement (Κ= 0.72,p= 0.001). Cholesteatoma detection on delayed contrast magnetic resonance imaging had sensitivity of 81.6 and 78.9 per cent, specificity of 77.8 and 66.7 per cent, and accuracy of 80.4 and 75.0 per cent, with fair intra-observer agreement (Κ= 0.57,p= 0.001). The mean cholesteatoma diameter on diffusion-weighted imaging was 7.7 ± 1.8 and 7.9 ± 1.8 mm, with excellent intra-observer agreement (Κ= 0.994,p= 0.001).ConclusionDiffusion-weighted imaging is a reliable method for differentiating recurrent cholesteatoma and granulation tissue after intact canal wall mastoidectomy.
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Xu Y, Xu Q, Ma Y, Duan J, Zhang H, Liu T, Li L, Sun H, Shi K, Xie S, Wang W. Characterizing MRI features of rectal cancers with different KRAS status. BMC Cancer 2019; 19:1111. [PMID: 31727020 PMCID: PMC6857233 DOI: 10.1186/s12885-019-6341-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/06/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND To investigate whether MRI findings, including texture analysis, can differentiate KRAS mutation status in rectal cancer. METHODS Totally, 158 patients with pathologically proved rectal cancers and preoperative pelvic MRI examinations were enrolled. Patients were stratified into two groups: KRAS wild-type group (KRASwt group) and KRAS mutation group (KRASmt group) according to genomic DNA extraction analysis. MRI findings of rectal cancers (including texture features) and relevant clinical characteristics were statistically evaluated to identify the differences between the two groups. The independent samples t test or Mann-Whitney U test were used for continuous variables. The differences of the remaining categorical polytomous variables were analyzed using the Chi-square test or Fisher exact test. A receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminatory power of MRI features. The area under the ROC curve (AUC) and the optimal cut-off values were calculated using histopathology diagnosis as a reference; meanwhile, sensitivity and specificity were determined. RESULTS Mean values of six texture parameters (Mean, Variance, Skewness, Entropy, gray-level nonuniformity, run-length nonuniformity) were significantly higher in KRASmt group compared to KRASwt group (p < 0.0001, respectively). The AUC values of texture features ranged from 0.703~0.813. In addition, higher T stage and lower ADC values were observed in the KRASmt group compared to KRASwt group (t = 7.086, p = 0.029; t = - 2.708, p = 0.008). CONCLUSION The MRI findings of rectal cancer, especially texture features, showed an encouraging value for identifying KRAS status.
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Affiliation(s)
- Yanyan Xu
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Qiaoyu Xu
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Yanhui Ma
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Jianghui Duan
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Haibo Zhang
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Tongxi Liu
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Lu Li
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Hongliang Sun
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, People's Republic of China.
| | - Kaining Shi
- Philips Healthcare, Beijing, 100001, People's Republic of China
| | - Sheng Xie
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Wu Wang
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, People's Republic of China
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Whole-body diffusion-weighted imaging with background body signal suppression in the detection of osseous and extra-osseous metastases. Pol J Radiol 2019; 84:e453-e458. [PMID: 31969965 PMCID: PMC6964352 DOI: 10.5114/pjr.2019.90057] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 10/07/2019] [Indexed: 12/16/2022] Open
Abstract
Purpose To assess the reproducibility of detection of osseous and extra-osseous metastases in cancer patients using whole-body diffusion-weighted imaging with background body signal suppression (WB-DWIBS). Material and methods A prospective study was conducted on 39 consecutive patients (21 females, 18 males; mean age 48 years) with metastases, who underwent WB-DWIBS on a 1.5-T MR scanner. Image analysis was performed independently by two blinded observers. Inter-observer agreement was assessed for the detection of osseous (spinal, appendicular) and extra-osseous (hepatic, pulmonary, nodal, and peritoneal) metastases. Results The overall inter-observer agreement of WB-DWIBS in the detection of osseous and extra-osseous metastases was excellent (κ = 0.887, agreement = 94.44%, p = 0.001). There was excellent inter-observer agreement of both observers for the detection of osseous spinal (κ = 0.846, agreement = 92.3%), osseous appendicular (κ = 0.898, agreement = 94.8 %), hepatic (κ = 0.847, agreement = 92.3%), pulmonary (κ = 0.938, agreement = 97.4%), nodal metastases (κ = 0.856, agreement = 94.9%), and peritoneal metastasis (κ = 0.772, agreement = 94.9%). Conclusion We concluded that WB-DWIBS is reproducible for detection of osseous and extra-osseous metastases in cancer patients.
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Abdel Razek AAK, Sherif FM. Differentiation of sublingual thyroglossal duct cyst from midline dermoid cyst with diffusion weighted imaging. Int J Pediatr Otorhinolaryngol 2019; 126:109623. [PMID: 31400658 DOI: 10.1016/j.ijporl.2019.109623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 01/31/2023]
Abstract
PURPOSE to differentiate sublingual thyroglossal duct cyst (TGDC) from midline dermoid cyst (DC) with diffusion weighted imaging (DWI). MATERIALS AND METHODS Retrospective analysis of 22 consecutive patients (11 male and 11 female aged 5-15 years) with midline cystic lesion at floor of mouth. They underwent DWI of floor of mouth. Apparent diffusion coefficient (ADC) of the cystic lesions was calculated and correlated with surgical findings. RESULTS The mean ADC value of TGDC of 1st observer was (2.20 ± 0.28 × 10-3 mm2/s) and of 2nd observer was (2.28 ± 0.27 × 10-3 mm2/s) was significantly higher than that of DC (P = 0.001) whose ADC of 1st observer was (1.55 ± 0.15 × 10-3 mm2/s) and of 2nd observer was (1.53 ± 0.11 × 10-3 mm2/s). There was excellent inter-observer agreement of both readings (r = 92%, P = 0.001). When ADC of 1.76 and 1.62 × 10-3 mm2/s was used as a threshold value for differentiating TGDC from DC, the best results were obtained with area under the curve of 0.94 and 0.96, accuracy of 90% and 86%, sensitivity of 91% and 91%%, specificity of 90% and 80%, negative predictive value of 90% and 88% and positive predictive value of 92% and 84% of both reviewers respectively. CONCLUSION DWI is reliable and reproducible imaging modality for differentiation sublingual TGDC from DC.
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Affiliation(s)
| | - Fatma Mohamed Sherif
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
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Diagnostic accuracy of diffusion tensor imaging in differentiating malignant from benign compressed vertebrae. Neuroradiology 2019; 61:1291-1296. [DOI: 10.1007/s00234-019-02286-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 08/26/2019] [Indexed: 12/23/2022]
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Differentiating Glioblastomas from Solitary Brain Metastases Using Arterial Spin Labeling Perfusion− and Diffusion Tensor Imaging−Derived Metrics. World Neurosurg 2019; 127:e593-e598. [DOI: 10.1016/j.wneu.2019.03.213] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 12/20/2022]
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Baba A, Okuyama Y, Yamauchi H, Ikeda K, Ogino N, Kozakai A, Suzuki T, Saito H, Ogane S, Yamazoe S, Mogami T, Ojiri H. Magnetic resonance imaging findings of styloglossus and hyoglossus muscle invasion: Relationship to depth of invasion and clinical significance as a predictor of advisability of elective neck dissection in node negative oral tongue cancer. Eur J Radiol 2019; 118:19-24. [PMID: 31439241 DOI: 10.1016/j.ejrad.2019.06.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/17/2019] [Accepted: 06/25/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE By comparing styloglossus and hyoglossus muscle invasion (SHMI) of oral tongue squamous cell cancer (OTSCC) on MR imaging to pathological depth of invasion (DOI) and prognosis, we aimed to evaluate the clinical significance of MR imaging findings of SHMI. METHOD Forty-five, early stages and clinically N0 OTSCCs were retrospectively reviewed. Data included pathological DOI, DOI on MR imagings, two-year potential cervical lymph node positive, locoregional control, disease-free survival, and overall survival. Data were statistically compared between the groups with MR evidence of SHMI (SHMI+) and without MR evidence of SHMI (SHMI-). RESULTS There were 17 SHMI + and 28 SHMI-. Elective neck dissections performed on 13 cases revealed five node positive cases, all of which were SHMI + . Pathological DOI in SHMI + was significantly larger than SHMI- (average 9.0 vs 4.6 mm, p < 0.001). All SHMI + revealed pathological DOI larger than 4 mm. The two-year potential cervical lymph node positive rate of SHMI + was significantly higher than SHMI- (p = 0.01). Locoregional control rate and disease-free survival of SHMI+ were significantly lower than in SHMI- (p = 0.02). There was no significant difference in overall survival. Interobserver agreement in evaluation of SHMI on MR imaging was good (kappa value = 0.72, p < 0.001). CONCLUSIONS Pathological DOIs of SHMI + were all larger than 4 mm, which is the cut-off point that National Comprehensive Cancer Network recommends for neck dissection, and SHMI + had a worse prognosis than SHMI-. SHMI + can be used as a criterion for elective neck dissection.
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Affiliation(s)
- Akira Baba
- Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan; Department of Radiology, Ichikawa General Hospital Tokyo Dental College, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan.
| | - Yumi Okuyama
- Department of Radiology, Ichikawa General Hospital Tokyo Dental College, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan
| | - Hideomi Yamauchi
- Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Koshi Ikeda
- Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Nobuhiro Ogino
- Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Ayako Kozakai
- Oral Cancer Center, Tokyo Dental College, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan
| | - Taiki Suzuki
- Oral Cancer Center, Tokyo Dental College, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan
| | - Hirokazu Saito
- Oral Cancer Center, Tokyo Dental College, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan
| | - Satoru Ogane
- Oral Cancer Center, Tokyo Dental College, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan
| | - Shinji Yamazoe
- Department of Radiology, Ichikawa General Hospital Tokyo Dental College, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan
| | - Takuji Mogami
- Department of Radiology, Ichikawa General Hospital Tokyo Dental College, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan
| | - Hiroya Ojiri
- Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
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Apparent Diffusion Coefficient of the Placenta and Fetal Organs in Intrauterine Growth Restriction. J Comput Assist Tomogr 2019; 43:507-512. [PMID: 30762655 DOI: 10.1097/rct.0000000000000844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE This study aimed to assess apparent diffusion coefficient (ADC) of the placenta and fetal organs in intrauterine growth restriction (IUGR). MATERIALS AND METHODS A prospective study of 30 consecutive pregnant women (aged 21-38 years with mean age of 31.5 years and a mean gestational week of 35 ± 2.3) with IUGR and 15 age-matched pregnant women was conducted. All patients and controls underwent diffusion-weighted magnetic resonance imaging. The ADCs of the placenta and fetal brain, kidney, and lung were calculated and correlated with neonates needing intensive care unit (ICU) admission. RESULTS There was a significant difference in ADC of the placenta and fetal brain, lung, and kidney (P = 0.001, 0.001, 0.04, and 0.04, respectively) between the patients and the controls. The cutoff ADCs of the placenta and fetal brain, lung, and kidney used to detect IUGR were 1.45, 1.15, 1.80, and 1.40 × 10 mm/s, respectively, with areas under the curve (AUCs) of 0.865, 0.858, 0.812, and 0.650, respectively, and accuracy values of 75%, 72.5%, 72.5%, and 70%, respectively. Combined ADC of the placenta and fetal organs used to detect IUGR revealed an AUC of 1.00 and an accuracy of 100%. There was a significant difference in ADC of the placenta and fetal brain, lung, and kidney between neonates needing admission and those not needing ICU admission (P = 0.001, 0.001, 0.002, and 0.002, respectively). The cutoff ADCs of the placenta and fetal brain, lung, and kidney used to define neonates needing ICU were 1.35, 1.25, 1.95, and 1.15 × 10 mm/s with AUCs of 0.955, 0.880, 0.884, and 0.793, respectively, and accuracy values of 86.7%, 46.7%, 76.7%, and 70%, respectively. Combined placental and fetal brain ADC used to define neonates needing ICU revealed an AUC of 0.968 and an accuracy of 93.3%. CONCLUSION Combined ADC of the placenta and fetal organs can detect IUGR, and combined ADC of the placenta and fetal brain can define fetuses needing ICU.
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Razek A, Samir S. Differentiation malignant from benign pericardial effusion with diffusion-weighted MRI. Clin Radiol 2019; 74:325.e19-325.e24. [DOI: 10.1016/j.crad.2019.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 01/08/2019] [Indexed: 12/12/2022]
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Assessment of lacrimal glands in thyroid eye disease with diffusion-weighted magnetic resonance imaging. Pol J Radiol 2019; 84:e142-e146. [PMID: 31019608 PMCID: PMC6479144 DOI: 10.5114/pjr.2019.84096] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 02/14/2019] [Indexed: 12/28/2022] Open
Abstract
Purpose To assess the lacrimal glands in patients with thyroid eye disease with diffusion-weighted magnetic resonance (MR) imaging. Material and methods This study was carried out on 44 consecutive patients (17 males, 27 females, with mean age 36 years) with thyroid eye disease and 20 age- and sex-matched volunteers. They underwent diffusion-weighted MR imaging of the orbit. The apparent diffusion coefficient (ADC) values of the lacrimal glands were calculated and correlated with the clinical activity score (CAS). Results The mean ADC of lacrimal glands in thyroid eye disease (1.73 × 10-3 mm2/s) was significantly higher (p = 0.001) than that of volunteers (1.52 × 10-3 mm2/s). The cutoff ADC value of lacrimal gland used for differentiation of thyroid eye disease from volunteers was 1.62 × 10-3 mm2/s with an area under the curve value of 0.95 and an accuracy of 96%. There was significant difference (p = 0.03) in the ADC of the lacrimal glands in patients with active (n = 24) and inactive (n = 20) disease. The cutoff ADC value of the lacrimal gland used to suspect active disease was 1.76 × 10-3 mm2/s with an area under the curve value of 0.80 and an accuracy of 82%. There was positive correlation between the ADC value of the lacrimal glands and CAS (r = 0.73, p = 0.001). Conclusions The ADC of the lacrimal glands is a non-invasive imaging parameter that can be used for diagnosis of thyroid eye disease and to predict the active form of the disease.
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Yue W, Meng N, Wang J, Liu W, Wang X, Yan M, Han D, Cheng J. Comparative analysis of the value of diffusion kurtosis imaging and diffusion-weighted imaging in evaluating the histological features of endometrial cancer. Cancer Imaging 2019; 19:9. [PMID: 30764876 PMCID: PMC6376714 DOI: 10.1186/s40644-019-0196-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 02/07/2019] [Indexed: 01/02/2023] Open
Abstract
Purpose This study evaluated and compared the performances of diffusion kurtosis imaging (DKI) and diffusion-weighted imaging (DWI) for diagnosing and histologically grading endometrial cancer. Materials and methods In this retrospective study, DKI and DWI data for 61 patients with endometrial cancer and 30 patients with a normal endometrium were analyzed, and the mean kurtosis (MK), mean diffusion coefficient (MD) and apparent diffusion coefficient (ADC) values for the endometrial cancer tissue and normal endometrial tissue were acquired. The parameters for the normal endometrium group (G0) and the endometrial cancer groups (G1, G2 and G3) were compared and analyzed. The receiver operating characteristic (ROC) curve was used to evaluate each parameter’s diagnostic accuracy and threshold. Spearman correlation analysis was used to analyze the correlations between all parameters and histological grades. Results The MK values for the G0, G1, G2 and G3 groups increased gradually, while the MD and ADC values decreased gradually. Except for the differences in the ADC values between G0 and G1, the differences among the groups were statistically significant (P < 0.05). The MK values had the highest diagnostic accuracy in differentiating G0 and (G1 + G2 + G3), G0 and G1, G1 and G2, and G2 and G3 (AUC = 0.93, 0.76, 0.91, 0.91, P < 0.05). MK was maximally correlated with histological grade, followed by MD and ADC (MK > MD > ADC; r = − 0.85, + 0.82, + 0.76, P < 0.01). Conclusion Both DKI and DWI can be used to evaluate the diagnosis and histological grading of endometrial cancer. Compared with DWI, the DKI model is a more complete mathematical model with more sensitive parameters, which can more effectively evaluate the pathological and physiological characteristics of endometrial cancer.
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Affiliation(s)
- Wei Yue
- Department of MRI, The First Affiliated Hospital, Zhengzhou University, 1 Janshe East Road, Zhengzhou, 450000, People's Republic of China
| | - Nan Meng
- Department of MRI, The First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui, 453100, People's Republic of China
| | - Jing Wang
- Department of MRI, The First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui, 453100, People's Republic of China
| | - Wenling Liu
- Department of MRI, The First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui, 453100, People's Republic of China
| | - Xuejia Wang
- Department of MRI, The First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui, 453100, People's Republic of China
| | - Minghuan Yan
- Department of MRI, The First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui, 453100, People's Republic of China
| | - Dongming Han
- Department of MRI, The First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui, 453100, People's Republic of China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital, Zhengzhou University, 1 Janshe East Road, Zhengzhou, 450000, People's Republic of China.
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Assessment of Liver and Spleen in Children With Gaucher Disease Type 1 With Chemical Shift Imaging. J Comput Assist Tomogr 2019; 43:183-186. [DOI: 10.1097/rct.0000000000000817] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Diffusion Tensor Imaging of the Lateral Rectus Muscle in Duane Retraction Syndrome. J Comput Assist Tomogr 2019; 43:467-471. [DOI: 10.1097/rct.0000000000000859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abdel Razek AAK, Zaky M, Bayoumi D, Taman S, Abdelwahab K, Alghandour R. Diffusion tensor imaging parameters in differentiation recurrent breast cancer from post-operative changes in patients with breast-conserving surgery. Eur J Radiol 2018; 111:76-80. [PMID: 30691669 DOI: 10.1016/j.ejrad.2018.12.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/12/2018] [Accepted: 12/29/2018] [Indexed: 12/12/2022]
Abstract
AIM OF THE WORK To investigate mean diffusivity (MD) and fractional anisotropy (FA) measured by diffusion tensor imaging (DTI) as complementary tools to differentiate recurrent breast cancer from post-operative changes in patients with breast-conserving surgery (BCS). PATIENTS AND METHODS Prospective study was conducted upon 30 patients with BCS that underwent DTI and dynamic contrast MR imaging. DTI was performed using an axial two-dimensional spin-echo echo-planar imaging sequence. The MD and FA of the lesions were calculated by 2 observers. A single pixel seed isotropic region of interest was placed in the solid part of the tumor on the axial color FA map guided by an enhanced part of the tumor. The final diagnosis was done by biopsy for all patients. RESULTS /s) used for differentiation between entities revealed sensitivity (76.9%, 92.3%), specificity (82.4%, 64.7%) and accuracy (80%, 76.7%) of both observers respectively. At ROC curve analysis of FA, the AUC was 0.82 and 0.75 by both observers. The threshold FA (0.82, 0.75) was used for differentiation between entities revealed sensitivity (92.3%, 76.9%), specificity (70.6%, 70.6%) and accuracy of (80.0%, 73.3%) of both observers respectively. There was a strong positive correlation of MD (r = 0.86) and FA (r = 0.73) of both observers. Combined analysis of FA and MD used for differentiation between entities had AUC (0.90, 0.88) revealed sensitivity (92.3%, 92.3%), specificity (82.4%, 70.6%) and accuracy of (86.7%, 80.0%) for both observers respectively. CONCLUSIONS Combined analysis of MD and FA of DTI may play an important role as a non-invasive method for differentiation recurrent breast cancer from post-operative changes in patients with BCS.
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Affiliation(s)
| | - Mona Zaky
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, 13551, Egypt.
| | - Dalia Bayoumi
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, 13551, Egypt.
| | - Saher Taman
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, 13551, Egypt.
| | - Khaled Abdelwahab
- Department of Oncology Surgery, Mansoura faculty of Medicine, Mansoura, 13551, Egypt.
| | - Reham Alghandour
- Department of Medical Oncology, Mansoura Faculty of Medicine, Mansoura, 13551, Egypt.
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Domachevsky L, Kashtan H, Brenner B, Nidam M, Morgenstern S, Kundel Y, Groshar D, Bernstine H. Baseline 18F-FDG PET/CT as predictor of the pathological response to neoadjuvant therapy in esophageal cancer: A retrospective study. Medicine (Baltimore) 2018; 97:e13412. [PMID: 30544419 PMCID: PMC6310504 DOI: 10.1097/md.0000000000013412] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The type of pathological response to neoadjuvant chemoradiation in patients with locally advanced esophageal cancer predicts overall survival (OS).We aimed to assess early 18F-FDG positron emission tomography/computed tomography parameters in predicting the pathological response to neoadjuvant treatment.The cohort included consecutive patients with locally advanced esophageal cancer who underwent baseline 18F-FDG positron emission tomography/computed tomography between September 2006 and February 2015. Positron emission tomography variables of maximum and average standardized uptake values (SUVmax, SUVaverage), metabolic tumor volume (MTV), and total lesion glycolysis were recorded in addition to computed tomography volume. MTV was calculated using cut-off values of 42%, 50% and 60% (MTV 0.42, 0.5, and 0.6) of the tumoral SUVmax. Receiver operating characteristic (ROC) analysis was used to determine sensitivity and specificity.Sixty-one patients (44 male, 17 female) fulfilled the inclusion criteria. Only MTV values of 13.6 mL (MTV 0.42) and 7.4 mL (MTV 0.5) remained significant on ROC analysis, with an area under the curve of 0.690 (confidence interval 0.557-0.823, p = .02] and 0.664 (confidence interval 0.527-0.802, P = .048), respectively in differentiating patients with a complete (n = 44) or incomplete (n = 17) pathological response.MTV at presentation is associated with the pathological response to neoadjuvant chemoradiation in patients with locally advanced esophageal cancer.
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Affiliation(s)
- Liran Domachevsky
- Department of Nuclear Medicine, Rabin Medical Center, Beilinson Hospital
| | - Hanoch Kashtan
- Department of Surgery, Rabin Medical Center, Beilinson Hospital
- Sackler Faculty of Medicine, Tel Aviv University
| | - Baruch Brenner
- Sackler Faculty of Medicine, Tel Aviv University
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital
| | - Meital Nidam
- Department of Nuclear Medicine, Rabin Medical Center, Beilinson Hospital
| | - Sara Morgenstern
- Institute of Pathology, Rabin Medical Center, Beilinson Hospital, Petach Tikva
| | - Yulia Kundel
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital
| | - David Groshar
- Department of Nuclear Medicine, Rabin Medical Center, Beilinson Hospital
- Sackler Faculty of Medicine, Tel Aviv University
- Assuta Medical Center, Tel Aviv, Israel
| | - Hanna Bernstine
- Department of Nuclear Medicine, Rabin Medical Center, Beilinson Hospital
- Sackler Faculty of Medicine, Tel Aviv University
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Abdel Razek AAK, El-Serougy L, Abdelsalam M, Gaballa G, Talaat M. Differentiation of Primary Central Nervous System Lymphoma From Glioblastoma: Quantitative Analysis Using Arterial Spin Labeling and Diffusion Tensor Imaging. World Neurosurg 2018; 123:e303-e309. [PMID: 30502475 DOI: 10.1016/j.wneu.2018.11.155] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/16/2018] [Accepted: 11/18/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Differentiation of primary central nervous system lymphoma (PCNSL) from glioblastoma using arterial spin labeling perfusion and diffusion tensor imaging (DTI). METHODS We performed a prospective study of 31 patients with a provisional diagnosis of PCNSL and glioblastoma who underwent conventional magnetic resonance imaging, DTI, and arterial spin labeling of the brain. The tumor blood flow (TBF), mean diffusivity (MD) plus fractional anisotropy (FA) of the mass were measured. The final diagnosis was confirmed by pathological examination. RESULTS The TBF of PCNSL (26.41 ± 4.03 mL/100 g/minute) was significantly lower than that of glioblastoma (51.08 ± 3.9 mL/100 g/minute; P = 0.001). The TBF cutoff (35.73 mL/100 g/minute) used for differentiation showed area under the curve (AUC) of 0.93, accuracy of 95.2%, sensitivity of 91.7%, and specificity of 100%. The MD of PCNSL (0.87 ± 0.2X 10-3 mm2/second) was significantly lower than that of glioblastoma (0.87 ± 0.2 × 10-3 mm2/second; P = 0.01). The MD cutoff (0.935 × 10-3 mm2/second) used for differentiation showed an AUC of 0.73 and accuracy of 66.7% and a sensitivity of 75% and specificity of 55.6%. The FA of PCNSL (0.253 ± 0.05) was significantly greater than that of glioblastoma (0.135 ± 0.06; P = 0.001). The FA cutoff (0.185) used for differentiation revealed an AUC of 0.944 and accuracy of 85.7% and a sensitivity of 83.3% and specificity of 88.9%. The combined TBF, MD, and FA cutoffs revealed an AUC of 0.96 and accuracy of 95.5% and a sensitivity of 83.3% and specificity of 100%. CONCLUSION The noninvasive imaging parameters using TBF and DTI might help in differentiating PCNSL from glioblastoma.
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Affiliation(s)
| | - Lamiaa El-Serougy
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | | | - Gada Gaballa
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Mona Talaat
- Department of Diagnostic Radiology, Kafr Elsheak Faculty of Medicine, Kafr Elsheak, Egypt
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50
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Liu K, Ma Z, Feng L. Apparent diffusion coefficient as an effective index for the therapeutic efficiency of brain chemoradiotherapy for brain metastases from lung cancer. BMC Med Imaging 2018; 18:30. [PMID: 30223786 PMCID: PMC6142399 DOI: 10.1186/s12880-018-0275-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/07/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The potential of apparent diffusion coefficient (ADC) value alteration before and after chemoradiotherapy as a potential monitor for therapeutic efficiency of treatment for brain metastases from lung cancer were discussed. METHOD Thirty lung cancer patients with brain metastases, conventional magnetic resonance imaging (MRI) examination and diffusion weighted imaging (DWI) were performed one week before chemoradiotherapy and after one treatment cycle and two treatment cycles. 43 tumor lesions were divided into effective group and invalid group according to the changes of the tumor size. The differences in ADC values at different time points before and after treatment in each treatment group were analyzed. RESULT The maximum diameter of the tumor was no difference after one treatment cycle, but decreased after two treatment cycles. ADC values significantly increased after both one and two treatment cycles. In effective group, the ADC values were significantly increased after one and two treatment cycles. While, there are no difference in invalid group after one treatment cycle but decreased after two treatment cycles. ΔADC values in effective group after one and two treatment cycles were both significantly higher than those in the invalid group. ROC curve analysis then revealed that the area under the curve (AUC) of ΔADC after one treatment was 0.872. CONCLUSION ADC values in brain metastases from lung cancer can help monitor and dynamically observe the therapeutic efficiency of whole brain chemoradiotherapy.
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Affiliation(s)
- Kai Liu
- Department of Radiology, The Third Affiliated Hospital of Beijing University of Chinese Medicine, No. 51 Xiaoguan Street, Andingmenwai, Chaoyang District, Beijing, People’s Republic of China
| | - Zenglin Ma
- Department of Radiology, The Third Affiliated Hospital of Beijing University of Chinese Medicine, No. 51 Xiaoguan Street, Andingmenwai, Chaoyang District, Beijing, People’s Republic of China
| | - Lili Feng
- Department of Radiology, The Third Affiliated Hospital of Beijing University of Chinese Medicine, No. 51 Xiaoguan Street, Andingmenwai, Chaoyang District, Beijing, People’s Republic of China
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