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Li H, Gong G, Wang L, Su Y, Lu J, Yin Y. The therapeutic utility of combining dynamic contrast-enhanced magnetic resonance imaging with arterial spin labeling in the staging of nasopharyngeal carcinoma. BMC Med Imaging 2023; 23:61. [PMID: 37138205 PMCID: PMC10155316 DOI: 10.1186/s12880-023-01016-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/19/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND To research the pathological and clinical staging uses of arterial spin labeling (ASL) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). MATERIALS AND METHODS 64 newly diagnosed nasopharyngeal carcinoma (NPC) patients were enrolled from December 2020 to January 2022, and 3.0 T MRI (Discovery 750W, GE Healthcare, USA) were used for ASL and DCE-MRI scans. The DCE-MRI and ASL raw data were processed post-acquisition on the GE image processing workstation (GE Healthcare, ADW 4.7, USA). The volume transfer constant (Ktrans), blood flow (BF), and accompanying pseudo-color images were generated automatically. Draw the region of interest (ROIs), and the Ktrans and BF values for each ROI were recorded separately. Based on pathological information and the most recent AJCC staging criteria, patients were divided into low T stage groups = T1-2 and high T stage groups = T3-4, low N stage groups = N0-1 and high N stage groups = N2-3, and low AJCC stage group = stage I-II and high AJCC stage group = stage III-IV. The association between the Ktranst and BF parameters and the T, N, and AJCC stages was compared using an independent sample t-test. Using a receiver operating characteristic (ROC) curve, the sensitivity, specificity, and AUC of Ktranst, BFt, and their combined use in T and AJCC staging of NPC were investigated and assessed. RESULT The tumor-BF (BFt) (t = - 4.905, P < 0.001) and tumor-Ktrans (Ktranst) (t = - 3.113, P = 0.003) in the high T stage group were significantly higher than those in the low T stage group. The Ktranst in the high N stage group was significantly higher than that in the low N stage group (t = - 2.071, P = 0.042). The BFt (t = - 3.949, P < 0.001) and Ktranst (t = - 4.467, P < 0.001) in the high AJCC stage group were significantly higher than those in the low AJCC stage group. BFt was moderately positively correlated with the T stage (r = 0.529, P < 0.001) and AJCC stage (r = 0.445, P < 0.001). Ktranst was moderately positively correlated with T staging (r = 0.368), N staging (r = 0.254), and AJCC staging (r = 0.411). There was also a positive correlation between BF and Ktrans in gross tumor volume (GTV) (r = 0.540, P < 0.001), parotid (r = 0.323, P < 0.009) and lateral pterygoid muscle (r = 0.445, P < 0.001). The sensitivity of the combined application of Ktranst and BFt for AJCC staging increased from 76.5 and 78.4 to 86.3%, and the AUC value increased from 0.795 and 0.819 to 0.843, respectively. CONCLUSION Combining Ktrans and BF measures may make it possible to identify the clinical stages in NPC patients.
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Affiliation(s)
- Haodong Li
- Department of Graduate, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan, 250000, China
- Department of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Guanzhong Gong
- Department of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Lizhen Wang
- Department of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Ya Su
- Department of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Jie Lu
- Department of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Yong Yin
- Department of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, China.
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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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Ermongkonchai T, Khor R, Wada M, Lau E, Xing DT, Ng SP. A review of diffusion-weighted magnetic resonance imaging in head and neck cancer patients for treatment evaluation and prediction of radiation-induced xerostomia. Radiat Oncol 2023; 18:20. [PMID: 36710364 PMCID: PMC9885695 DOI: 10.1186/s13014-022-02178-0] [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: 11/18/2021] [Accepted: 12/06/2022] [Indexed: 01/31/2023] Open
Abstract
The incidence of head and neck cancers (HNC) is rising worldwide especially with HPV-related oropharynx squamous cell carcinoma. The standard of care for the majority of patients with locally advanced pharyngeal disease is curative-intent radiotherapy (RT) with or without concurrent chemotherapy. RT-related toxicities remain a concern due to the close proximity of critical structures to the tumour, with xerostomia inflicting the most quality-of-life burden. Thus, there is a paradigm shift towards research exploring the use of imaging biomarkers in predicting treatment outcomes. Diffusion-weighted imaging (DWI) is a functional MRI feature of interest, as it quantifies cellular changes through computation of apparent diffusion coefficient (ADC) values. DWI has been used in differentiating HNC lesions from benign tissues, and ADC analyses can be done to evaluate tumour responses to RT. It is also useful in healthy tissues to identify the heterogeneity and physiological changes of salivary glands to better understand the inter-individual differences in xerostomia severity. Additionally, DWI is utilised in irradiated salivary glands to produce ADC changes that correlate to clinical xerostomia. The implementation of DWI into multi-modal imaging can help form prognostic models that identify patients at risk of severe xerostomia, and thus guide timely interventions to mitigate these toxicities.
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Affiliation(s)
- Tai Ermongkonchai
- grid.410678.c0000 0000 9374 3516Department of Radiation Oncology, Olivia-Newton John Cancer and Wellness Centre, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC 3084 Australia
| | - Richard Khor
- grid.410678.c0000 0000 9374 3516Department of Radiation Oncology, Olivia-Newton John Cancer and Wellness Centre, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC 3084 Australia
| | - Morikatsu Wada
- grid.410678.c0000 0000 9374 3516Department of Radiation Oncology, Olivia-Newton John Cancer and Wellness Centre, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC 3084 Australia
| | - Eddie Lau
- grid.410678.c0000 0000 9374 3516Department of Radiology, Austin Health, Heidelberg, Melbourne, Australia ,grid.410678.c0000 0000 9374 3516Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Radiology, The University of Melbourne, Parkville, Melbourne, Australia
| | - Daniel Tao Xing
- grid.410678.c0000 0000 9374 3516Department of Radiation Oncology, Olivia-Newton John Cancer and Wellness Centre, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC 3084 Australia
| | - Sweet Ping Ng
- grid.410678.c0000 0000 9374 3516Department of Radiation Oncology, Olivia-Newton John Cancer and Wellness Centre, Austin Health, 145 Studley Road, Heidelberg, Melbourne, VIC 3084 Australia
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Baba A, Kurokawa R, Kurokawa M, Hassan O, Ota Y, Srinivasan A. ADC for Differentiation between Posttreatment Changes and Recurrence in Head and Neck Cancer: A Systematic Review and Meta-analysis. AJNR Am J Neuroradiol 2022; 43:442-447. [PMID: 35210272 PMCID: PMC8910821 DOI: 10.3174/ajnr.a7431] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/31/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Previous studies reported that the ADC values of recurrent head and neck cancer lesions are lower than those of posttreatment changes, however, the utility of ADC to differentiate them has not been definitively summarized and established. PURPOSE Our aim was to evaluate the diagnostic benefit of ADC calculated from diffusion-weighted imaging in differentiating recurrent lesions from posttreatment changes in head and neck cancer. DATA SOURCES MEDLINE, Scopus, and EMBASE data bases were searched for studies. STUDY SELECTION The review identified 6 prospective studies with a total of 365 patients (402 lesions) who were eligible for the meta-analysis. DATA ANALYSIS Forest plots were used to assess the mean difference in ADC values. Heterogeneity among the studies was evaluated using the Cochrane Q test and the I2 statistic. DATA SYNTHESIS Among included studies, the overall mean of ADC values of recurrent lesions was 1.03 × 10-3mm2/s and that of the posttreatment changes was 1.51 × 10-3mm2/s. The ADC value of recurrence was significantly less than that of posttreatment changes in head and neck cancer (pooled mean difference: -0.45; 95% CI, -0.59-0.32, P < .0001) with heterogeneity among studies. The threshold of ADC values between recurrent lesions and posttreatment changes was suggested to be 1.10 × 10-3mm2/s. LIMITATIONS Given the heterogeneity of the data of the study, the conclusions should be interpreted with caution. CONCLUSIONS The ADC values in recurrent head and neck cancers are lower than those of posttreatment changes, and the threshold of ADC values between them was suggested.
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Affiliation(s)
- A. Baba
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - R. Kurokawa
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - M. Kurokawa
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - O. Hassan
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Y. Ota
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - A. Srinivasan
- From the Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
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Abdel Razek AAK, Baky KA, Helmy E. Diffusion Tensor Imaging in Characterization of Mediastinal Lymphadenopathy. Acad Radiol 2022; 29 Suppl 2:S165-S172. [PMID: 34736860 DOI: 10.1016/j.acra.2021.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/20/2021] [Accepted: 06/28/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the efficacy of diffusion-weighted MRI (DWI) and diffusion tensor imaging (DTI) in the characterization of mediastinal lymphadenopathy and the differentiation between malignant and benign lymph nodes (LNs). METHODS a retrospective evaluation of 58 patients with mediastinal lymphadenopathy that underwent DWI and DTI with calculation of apparent diffusion coefficient (ADC), fractional anisotropy (FA), and mean diffusivity (MD) values of LNs. Final diagnosis was made by the histopathology and proved metastatic (n = 21), lymphomatous (n = 14), granulomatous (n = 11) and reactive (n = 12) LNs. RESULTS Malignant mediastinal LNs had remarkably lower ADC and MD; (p = 0.001) and higher FA; (p = 0.001) than in benign LNs. The threshold of ADC, MD, and FA at (1.48, 1.32 × 10-3 mm2/s), (1.31, 1.33 × 10-3 mm2/s), (0.62, 0.52) to differentiate malignant from benign LNs has AUC of (0.89, 0.94), (0.96, 0.95), (0.72, 0.82), accuracy of (87%, 86%), (89%, 86%), (70%, 72%) by both observers respectively. The threshold of ADC, MD, and FA at (1.47, 1.32 × 10-3 mm2/s), (1.31, 1.3 × 10-3 mm2/s), (0.62, 0.67) used to differentiate metastatic from reactive LNs revealed AUC of (0.90, 0.94), (0.96, 0.96), (0.73, 0.77), accuracy of (87%, 81%), (87%, 81%), (72%, 66%) by both observers respectively. The mean ADC and MD values of metastatic LNs were statistically significant (p = 0.001) and (p = 0.002, 0.02) respectively when compared with that of lymphoma. The threshold of ADC, and MD (0.94, 0.97 × 10-3 mm2/s) and (0.87, 0.91 × 10-3 mm2/s) used to differentiates metastatic from lymphomatous nodes revealed AUC of (0.90, 0.91), (0.81, 0.74), an accuracy of (85%, 91%), (71%, 71%), by both observers respectively. The inter-class correlation between two observers for all nodes for ADC, MD and FA was r= 0.931, 0.956 and 0.885 respectively. CONCLUSION Using ADC, MD, and FA can help in the characterization of mediastinal lymphadenopathy noninvasively.
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Affiliation(s)
| | - Khaled Abdel Baky
- Department of Diagnostic Radiology. Port Said University. Faculty of medicine. Port Said. Egypt
| | - Eman Helmy
- Department of Diagnostic Radiology. Mansoura University. faculty of medicine. Mansoura, Egypt
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6
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Diffusion tensor magnetic resonance imaging: is it valuable in the detection of brain microstructural changes in patients having migraine without aura? Pol J Radiol 2021; 86:e548-e556. [PMID: 34820031 PMCID: PMC8607831 DOI: 10.5114/pjr.2021.110645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 08/20/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose The aim of this study is to assess the diagnostic value of diffusion tensor magnetic resonance imaging (MRI) in the detection of brain microstructural changes in patients having migraine without aura. Material and methods Our prospective study included 33 patients having migraine without aura and 15 volunteers with matched age and sex, who underwent brain MRI with diffusion tensor imaging (DTI). The fractional anisotropy (FA) and mean diffusivity (MD) of selected grey and white matter regions on both sides were measured and correlated with the neurological clinical examination. Results Significant differences were detected in MD values in the thalamus, globus pallidus, and hippocampus head on the right side of patients versus controls. Also, significant differences of the FA values were detected in the thalamus, globus pallidus, and hippocampus head on the right side of patients versus controls. Regarding the FA values of the same regions on the left side, a significant difference in the FA value was detected only in the hippocampus head. There was a statistically significant difference in the FA values on both sides of the white matter of the frontal lobes, posterior limbs of the internal capsules, and cerebellar hemispheres in patients compared to controls. There was a statistically significant difference in MD values in the white matter of both frontal lobes, posterior limb of the right internal capsule, and both cerebellar hemispheres in patients compared to controls. Conclusions DTI can detect microstructural changes of the grey and white matter in patients having migraine without aura that could not be detected by conventional MRI.
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7
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Lobo R, Turk S, Bapuraj JR, Srinivasan A. Advanced CT and MR Imaging of the Posttreatment Head and Neck. Neuroimaging Clin N Am 2021; 32:133-144. [PMID: 34809834 DOI: 10.1016/j.nic.2021.08.013] [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: 11/26/2022]
Abstract
Advances in MR and computed tomography (CT) techniques have resulted in greater fidelity in the assessment of treatment response and residual tumor on one hand and the assessment of recurrent head and neck malignancies on the other hand. The advances in MR techniques primarily are related to diffusion and perfusion imaging which rely on the intrinsic architecture of the tissues and organ systems. The techniques exploit the density of the cellular architecture; and the vascularity of benign and malignant lesions which in turn affect the changes in the passage of contrast through the vascular bed. Dual-energy CT and CT perfusion are the major advances in CT techniques that have found significant applications in the assessment of treatment response and tumor recurrence.
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Affiliation(s)
- Remy Lobo
- Neuroradiology Division, Radiology, Michigan Medicine, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Sevcan Turk
- Neuroradiology Division, Radiology, Michigan Medicine, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA
| | - J Rajiv Bapuraj
- Neuroradiology Division, Radiology, Michigan Medicine, 1500 E Medical Center Drive, B2A209, Ann Arbor, MI 48109, USA
| | - Ashok Srinivasan
- Neuroradiology Division, Radiology, Michigan Medicine, 1500 E Medical Center Drive, B2A209, Ann Arbor, MI 48109, 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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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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10
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Posttreatment Magnetic Resonance Imaging Surveillance of Head and Neck Cancers. Magn Reson Imaging Clin N Am 2021; 30:109-120. [PMID: 34802574 DOI: 10.1016/j.mric.2021.06.018] [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] [Indexed: 12/24/2022]
Abstract
Treatment strategies and recommended surveillance imaging differ for head and neck cancers depending on subsite and neoplasm type, and pose confusion for referring physicians and interpreting radiologists. The superior soft tissue resolution offered by magnetic resonance imaging is most useful in the surveillance of cancers with high propensities for intraorbital, intracranial, or perineural disease spread, which most commonly include those arising from the sinonasal cavities, nasopharynx, orbits, salivary glands, and the skin. This article discusses recommended surveillance protocoling and reviews treatment approaches, common posttreatment changes, and pearls for identifying disease recurrence in a subsite-based approach.
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11
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Wang DJJ, Le Bihan D, Krishnamurthy R, Smith M, Ho ML. Noncontrast Pediatric Brain Perfusion: Arterial Spin Labeling and Intravoxel Incoherent Motion. Magn Reson Imaging Clin N Am 2021; 29:493-513. [PMID: 34717841 DOI: 10.1016/j.mric.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] [Indexed: 12/23/2022]
Abstract
Noncontrast magnetic resonance imaging techniques for measuring brain perfusion include arterial spin labeling (ASL) and intravoxel incoherent motion (IVIM). These techniques provide noninvasive and repeatable assessment of cerebral blood flow or cerebral blood volume without the need for intravenous contrast. This article discusses the technical aspects of ASL and IVIM with a focus on normal physiologic variations, technical parameters, and artifacts. Multiple pediatric clinical applications are presented, including tumors, stroke, vasculopathy, vascular malformations, epilepsy, migraine, trauma, and inflammation.
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Affiliation(s)
- Danny J J Wang
- USC Institute for Neuroimaging and Informatics, SHN, 2025 Zonal Avenue, Health Sciences Campus, Los Angeles, CA 90033, USA
| | - Denis Le Bihan
- NeuroSpin, Centre d'études de Saclay, Bâtiment 145, Gif-sur-Yvette 91191, France
| | - Ram Krishnamurthy
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mark Smith
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA.
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12
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Jankowski M, Wysocki WM, Las-Jankowska M, Tkaczyński K, Wiśniewski D, Bała D, Zegarski W. Efficacy of endoscopic surveillance in the detection of local recurrence after radical rectal cancer surgery is limited? A retrospective study. World J Surg Oncol 2021; 19:308. [PMID: 34670554 PMCID: PMC8529797 DOI: 10.1186/s12957-021-02413-0] [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: 01/23/2021] [Accepted: 09/30/2021] [Indexed: 01/19/2023] Open
Abstract
Background Rectal cancer, one of most common neoplasms, is characterized by an overall survival rate exceeding 60%. Nonetheless, local recurrence (LR) following surgery for rectal cancer remains a formidable clinical problem. The aim of this study was to assess the value of postoperative endoscopic surveillance (PES) for the early detection of LR in rectal cancer after radical anterior resection with sigmoid-rectal anastomosis. Methods We performed an anterior resection in 228 patients with stages I‑III rectal cancer who had undergone surgery from 2001 to 2008 in the Oncology Center in Bydgoszcz, Poland. Of these patients, 169 had perioperative radiotherapy or radiochemotherapy. All patients underwent PES with abdominal and pelvic imaging (abdominal ultrasound, computed tomography, magnetic resonance) and clinical examination. Sensitivities, specificities, positive likelihood ratios, negative likelihood ratios, and receiver operating characteristic curves were calculated to compare the value of colonoscopy versus imaging techniques for the diagnosis of LR. Results During the 5-year follow-up, recurrences occurred in 49 (21%) patients; of these, 15 (6%) had LR, which was most often located outside the intestinal lumen (n = 10, 4%). Anastomotic LR occurred in 5 (2%) patients. The mean time to anastomotic LR was 30 months after initial surgery, similar to that of other locations (29 months). Both imaging and endoscopy were shown to be efficient techniques for the diagnosis of LR in anastomotic sites. In the study group, endoscopy did not provide any additional benefit in patients who were receiving radiation therapy. Conclusions The benefit of PES for the detection of LR after curative treatment of rectal cancer is limited and not superior to imaging techniques. It remains a useful method, however, for the histopathological confirmation of suspected or confirmed recurrence. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-021-02413-0.
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Affiliation(s)
- Michal Jankowski
- Chair of Surgical Oncology, Ludwik Rydygier's Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland. .,Department of Surgical Oncology, Oncology Center-Prof Franciszek Łukaszczyk Memorial Hospital, Romanowskiej 2 Street, 85-796, Bydgoszcz, Poland.
| | - Wojciech M Wysocki
- Department of Surgery, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Gustawa Herlinga-Grudzińskiego 1 Street, 30-705, Kraków, Poland.,Department of General, Oncological and Vascular Surgery, 5th Military Clinical Hospital in Kraków, Wrocławska 1-3 Street, 30-901, Kraków, Poland.,National Institute of Oncology, Maria Skłodowska-Curie Memorial, Scientific Editorial Office, W.K. Roentgena 5 Street, 02-781, Warszawa, Poland
| | - Manuela Las-Jankowska
- Chair of Surgical Oncology, Ludwik Rydygier's Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.,Department of Clinical Oncology, Oncology Center-Prof Franciszek Łukaszczyk Memorial Hospital, Romanowskiej 2 Street, 85-796, Bydgoszcz, Poland
| | - Karol Tkaczyński
- Chair of Surgical Oncology, Ludwik Rydygier's Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.,Department of Surgical Oncology, Oncology Center-Prof Franciszek Łukaszczyk Memorial Hospital, Romanowskiej 2 Street, 85-796, Bydgoszcz, Poland
| | - Dorian Wiśniewski
- Chair of Surgical Oncology, Ludwik Rydygier's Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.,Department of Surgical Oncology, Oncology Center-Prof Franciszek Łukaszczyk Memorial Hospital, Romanowskiej 2 Street, 85-796, Bydgoszcz, Poland
| | - Dariusz Bała
- Chair of Surgical Oncology, Ludwik Rydygier's Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.,Department of Surgical Oncology, Oncology Center-Prof Franciszek Łukaszczyk Memorial Hospital, Romanowskiej 2 Street, 85-796, Bydgoszcz, Poland
| | - Wojciech Zegarski
- Chair of Surgical Oncology, Ludwik Rydygier's Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.,Department of Surgical Oncology, Oncology Center-Prof Franciszek Łukaszczyk Memorial Hospital, Romanowskiej 2 Street, 85-796, Bydgoszcz, Poland
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Martín-Noguerol T, Kirsch CFE, Montesinos P, Luna A. Arterial spin labeling for head and neck lesion assessment: technical adjustments and clinical applications. Neuroradiology 2021; 63:1969-1983. [PMID: 34427708 DOI: 10.1007/s00234-021-02772-1] [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] [Received: 05/03/2021] [Accepted: 07/12/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Despite, currently, "state-of-the-art" magnetic resonance imaging (MRI) protocols for head and neck (H&N) lesion assessment incorporate perfusion sequences, these acquisitions require the intravenous injection of exogenous gadolinium-based contrast agents (GBCAs), which may have potential risks. Alternative techniques such as arterial spin labeling (ASL) can provide quantitative microvascular information similar to conventional perfusion sequences for H&N lesions evaluation, as a potential alternative without GBCA administration. METHODS We review the existing literature and analyze the latest evidence regarding ASL in H&N area highlighting the technical adjustments needed for a proper ASL acquisition in this challenging region for lesion characterization, treatment monitoring, and tumor recurrence detection. RESULTS ASL techniques, widely used for central nervous system lesions evaluation, can be also applied to the H&N region. Technical adjustments, especially regarding post-labeling delay, are mandatory to obtain robust and reproducible results. Several studies have demonstrated the feasibility of ASL in the H&N area including the orbits, skull base, paranasal sinuses, upper airway, salivary glands, and thyroid. CONCLUSION ASL is a feasible technique for the assessment of H&N lesions without the need of GBCAs. This manuscript reviews ASL's physical basis, emphasizing the technical adjustments necessary for proper ASL acquisition in this unique and challenging anatomical region, and the main applications in evaluating H&N lesions.
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Affiliation(s)
| | - Claudia F E Kirsch
- Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine At Northwell, North Shore University Hospital, 300 Community Drive, Manhasset, NY, 11030, USA
| | - Paula Montesinos
- Philips Iberia, Calle de María de Portugal, 1, 28050, Madrid, Spain
| | - Antonio Luna
- MRI Unit, Radiology Department, HT Medica, Carmelo Torres 2, 23007, Jaén, Spain
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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, 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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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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Eissa L, Abdel Razek AAK, Helmy E. Arterial spin labeling and diffusion-weighted MR imaging: Utility in differentiating idiopathic orbital inflammatory pseudotumor from orbital lymphoma. Clin Imaging 2020; 71:63-68. [PMID: 33171369 DOI: 10.1016/j.clinimag.2020.10.057] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 09/26/2020] [Accepted: 10/26/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess arterial spin-labeling (ASL) and diffusion-weighted imaging (DWI) and in combination for differentiating between idiopathic orbital inflammatory pseudotumor (IOIP) and orbital lymphoma. MATERIAL AND METHODS A retrospective study was done on 37 untreated patients with orbital masses, suspected to be IOIP or orbital lymphoma that underwent ASL and DWI of the orbit. Quantitative measurement of tumor blood flow (TBF) and apparent diffusion coefficient (ADC) of the orbital lesion was done. RESULTS There was a significant difference (P = 0.001) in TBF between patients with IOIP (n = 21) (38.1 ± 6.2, 40.3 ± 7.1 ml/100 g/min) and orbital lymphoma (n = 16) (55.5 ± 7.1, 56.8 ± 7.9 ml/100 g/min) for both observers respectively. Thresholds of TBF used for differentiating IOIP from orbital lymphoma were 48, 46 ml/100 g/min revealed area under the curve (AUC) of (0.958 and 0.921), and accuracy of (86% and 83%) for both observers respectively. There was a significant difference (P = 0.001) in ADC between patients with IOIP (1.04 ± 0.19, 1.12 ± 0.23 × 10-3 mm2/s) and orbital lymphoma (0.69 ± 0.10, 0.72 ± 0.11 × 10-3 mm2/s) for both observers respectively. Thresholds of ADC used for differentiating IOIP from orbital lymphoma were 0.84 and 0.86 × 10-3 mm2/s with AUC of (0.933 and 0.920), and accuracy of 89% and 90% for both observers respectively. The combined TBF and ADC used for differentiating IOIP from orbital lymphoma had AUC of (0.973 and 0.970) and accuracy of (91% and 89%) for both observers respectively. CONCLUSION TBF and ADC alone and in combination are useful for differentiating IOIP from orbital lymphoma.
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Affiliation(s)
- Lamya Eissa
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Ahmed Abdel Khalek Abdel Razek
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.
| | - Eman Helmy
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, 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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19
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Bae S, Choi YS, Sohn B, Ahn SS, Lee SK, Yang J, Kim J. Squamous Cell Carcinoma and Lymphoma of the Oropharynx: Differentiation Using a Radiomics Approach. Yonsei Med J 2020; 61:895-900. [PMID: 32975065 PMCID: PMC7515782 DOI: 10.3349/ymj.2020.61.10.895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/31/2020] [Accepted: 08/17/2020] [Indexed: 02/08/2023] Open
Abstract
The purpose of this study was to evaluate the diagnostic performance of magnetic resonance (MR) radiomics-based machine learning algorithms in differentiating squamous cell carcinoma (SCC) from lymphoma in the oropharynx. MR images from 87 patients with oropharyngeal SCC (n=68) and lymphoma (n=19) were reviewed retrospectively. Tumors were semi-automatically segmented on contrast-enhanced T1-weighted images registered to T2-weighted images, and radiomic features (n=202) were extracted from contrast-enhanced T1- and T2-weighted images. The radiomics classifier was built using elastic-net regularized generalized linear model analyses with nested five-fold cross-validation. The diagnostic abilities of the radiomics classifier and visual assessment by two head and neck radiologists were evaluated using receiver operating characteristic (ROC) analyses for distinguishing SCC from lymphoma. Nineteen radiomics features were selected at least twice during the five-fold cross-validation. The mean area under the ROC curve (AUC) of the radiomics classifier was 0.750 [95% confidence interval (CI), 0.613-0.887], with a sensitivity of 84.2%, specificity of 60.3%, and an accuracy of 65.5%. Two human readers yielded AUCs of 0.613 (95% CI, 0.467-0.759) and 0.663 (95% CI, 0.531-0.795), respectively. The radiomics-based machine learning model can be useful for differentiating SCC from lymphoma of the oropharynx.
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Affiliation(s)
- Sohi Bae
- Department of Radiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Yoon Seong Choi
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Beomseok Sohn
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Koo Lee
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jaemoon Yang
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jinna Kim
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
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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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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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Ma G, Xu XQ, Zhu LN, Jiang JS, Su GY, Hu H, Bu SS, Wu FY. Intravoxel Incoherent Motion Magnetic Resonance Imaging for Assessing Parotid Gland Tumors: Correlation and Comparison with Arterial Spin Labeling Imaging. Korean J Radiol 2020; 22:243-252. [PMID: 32932565 PMCID: PMC7817638 DOI: 10.3348/kjr.2020.0290] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 04/14/2020] [Accepted: 06/06/2020] [Indexed: 12/26/2022] Open
Abstract
Objective To compare and correlate the findings of intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging and arterial spin labeling (ASL) imaging in characterizing parotid gland tumors. Materials and Methods We retrospectively reviewed 56 patients with parotid gland tumors evaluated by MR imaging. The true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and fraction of perfusion (f) values of IVIM imaging and tumor-to-parotid gland signal intensity ratio (SIR) on ASL imaging were calculated. Spearman rank correlation coefficient, chi-squared, Mann-Whitney U, and Kruskal-Wallis tests with the post-hoc Dunn-Bonferroni method and receiver operating characteristic curve assessments were used for statistical analysis. Results Malignant parotid gland tumors showed significantly lower D than benign tumors (p = 0.019). Within subgroup analyses, pleomorphic adenomas (PAs) showed significantly higher D than malignant tumors (MTs) and Warthin's tumors (WTs) (p < 0.001). The D* of WTs was significantly higher than that of PAs (p = 0.031). The f and SIR on ASL imaging of WTs were significantly higher than those of MTs and PAs (p < 0.05). Significantly positive correlation was found between SIR on ASL imaging and f (r = 0.446, p = 0.001). In comparison with f, SIR on ASL imaging showed a higher area under curve (0.853 vs. 0.891) in discriminating MTs from WTs, although the difference was not significant (p = 0.720). Conclusion IVIM and ASL imaging could help differentiate parotid gland tumors. SIR on ASL imaging showed a significantly positive correlation with f. ASL imaging might hold potential to improve the ability to discriminate MTs from WTs.
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Affiliation(s)
- Gao Ma
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Liu Ning Zhu
- Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jia Suo Jiang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guo Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shou Shan Bu
- Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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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: 4] [Impact Index Per Article: 1.0] [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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Treutlein C, Stollberg A, Scherl C, Agaimy A, Ellmann S, Iro H, Lell M, Uder M, Bäuerle T. Diagnostic value of 3D dynamic contrast-enhanced magnetic resonance imaging in lymph node metastases of head and neck tumors: a correlation study with histology. Acta Radiol Open 2020; 9:2058460120951966. [PMID: 32922960 PMCID: PMC7453466 DOI: 10.1177/2058460120951966] [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: 02/05/2020] [Accepted: 08/01/2020] [Indexed: 12/23/2022] Open
Abstract
Background Accurate staging of cervical lymph nodes (LN) is pivotal for further clinical management of patients with head and neck cancer. Functional magnetic resonance imaging (MRI) such as three-dimensional (3D) dynamic contrast-enhanced (DCE) acquisition might improve the diagnosis of cervical LN metastases. Purpose To evaluate the additional diagnostic value of high-resolution 3D T1-weighted DCE in detecting LN metastasis compared to standard morphological imaging criteria in patients with head and neck tumors as correlated to histopathology. Material and Methods Standard MRI with 3D DCE acquisition at voxel sizes of 1 × 1×1 mm was performed in 15 patients before surgery; 92 LN of the head and neck were histopathologically analyzed. A logistic regression analysis of semi-quantitative DCE parameters, time-intensity curve (TIC) shapes, and morphological criteria was performed to differentiate benign from malignant LN. Results Standard MRI was sufficient for diagnosis of malignancy in LN with a short-axis diameter ≥ 15 mm (n = 17). For LN metastases with a short-axis diameter <15 mm (n = 12), however, the combination of 3D DCE MRI parameters, TIC shapes, and LN diameter significantly increased the sensitivity and specificity of diagnosing metastases (DCE + TIC shape + LN diameter: 92% and 88% vs. DCE only: 83% and 68% (P < 0.01) vs. LN diameter only: 83% and 77% (P = 0.04). Conclusion MRI including isotropic high-resolution 3D DCE acquisition combined with morphological criteria allows an accurate assessment of small cervical LN metastases in patients with head and neck cancer. For LN ≥ 15 mm diameter, morphologic imaging may suffice to diagnose metastatic disease to the LN.
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Affiliation(s)
- Christoph Treutlein
- Department of Radiology, University Hospital Erlangen, Erlangen, Germany
- Christoph Treutlein, Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Adrian Stollberg
- Department of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Claudia Scherl
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Erlangen, Germany
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - Stephan Ellmann
- Department of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Erlangen, Germany
| | - Michael Lell
- Department of Radiology and Nuclear Medicine, Klinikum Nuremberg, Paracelsus Medical University, Nuremberg, Germany
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Tobias Bäuerle
- Department of Radiology, University Hospital Erlangen, Erlangen, Germany
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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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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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Combination of diffusion-weighted imaging and arterial spin labeling at 3.0 T for the clinical staging of nasopharyngeal carcinoma. Clin Imaging 2020; 66:127-132. [PMID: 32480267 DOI: 10.1016/j.clinimag.2020.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 04/27/2020] [Accepted: 05/13/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE To probe the utility of diffusion-weighted imaging (DWI) and 3D arterial spin labeling (ASL) in assessing the clinical stage of nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS This prospective study included sixty-five newly diagnosed NPC patients who underwent DWI and 3D ASL scans on a 3.0-T magnetic resonance imaging (MRI) system. The apparent diffusion coefficient (ADC) and the tumor blood flow (TBF) of NPC were measured. Tumors were classified as low or high T, N and American Joint Committee on Cancer (AJCC) stages. Student's t-test was used to evaluate the differences between tumors with low and high clinical stages. Pearson correlation analyses were performed to determine the correlation between MRI parameters and clinical stages. Receiver operating characteristic (ROC) curves were then used to evaluate diagnostic capability. RESULTS High T stage (T3/4) NPC showed significantly lower ADCmin (P = 0.000) and higher TBFmax (P = 0.003) and TBFmean (P = 0.008) values than low T stage (T1/2) NPC. High N stage (N2/3) NPC showed significantly lower ADCmin values (P = 0.023) than low N stage (N0/1) NPC. High AJCC stage (III/IV) NPC showed significantly lower ADCmin (P = 0.000) and higher TBFmax (P = 0.005) and TBFmean (P = 0.011) values than low AJCC stage (I/II) NPC. ADCmin values showed moderate negative correlations with T stage (r = -0.512, P = 0.000), N stage (r = -0.281, P = 0.023), and AJCC stage (r = -0.494, P = 0.000). TBFmax values showed moderate positive correlations with T stage (r = 0.369, P = 0.003) and AJCC stage (r = 0.346, P = 0.005). Compared with ADCmin and TBFmax alone, the combination of ADCmin and TBFmax improved the accuracy from 72.3% and 75.4% to 78.5%, respectively, for T staging, as well as from 72.3% and 69.2% to 83.1% for AJCC staging. CONCLUSIONS ADCmin and TBFmax values in patients with NPC could help evaluate clinical stages. ADCmin and TBFmax values combined could clearly improve the accuracy in the assessment of AJCC stage.
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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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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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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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Razek AAKA. Multi-parametric MR imaging using pseudo-continuous arterial-spin labeling and diffusion-weighted MR imaging in differentiating subtypes of parotid tumors. Magn Reson Imaging 2019; 63:55-59. [DOI: 10.1016/j.mri.2019.08.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/05/2019] [Accepted: 08/15/2019] [Indexed: 12/26/2022]
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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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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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Zhang D, Shi L, Song X, Shi C, Sun P, Lou W, Wang D, Luo L. Neuroimaging endophenotypes of type 2 diabetes mellitus: a discordant sibling pair study. Quant Imaging Med Surg 2019; 9:1000-1013. [PMID: 31367554 DOI: 10.21037/qims.2019.05.18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Type 2 diabetes mellitus (T2DM) is characterized by notable familial aggregation involving common variants of many genes, and its heritability leads to a high prevalence in the siblings of affected individuals compared with the general population. Endophenotypes are objective, heritable, quantitative traits that appear to reflect the genetic risk for polygenic disorders at more biologically tractable levels. Based on a sibling pair design, we aimed to find the neuroimaging endophenotypes of T2DM and investigate the role of inherent neurological disorders in the pathogenesis and deterioration of T2DM. Methods Twenty-six pairs of diagnosed T2DM patients with unaffected siblings and 26 unrelated controls were included in this study. Both high-resolution structural MRI and three-dimensional pseudo-continuous arterial spin labelling (3D-pCASL) MRI data were acquired with a 3.0 T MRI system. Voxel-based morphometry (VBM) analysis was performed on the structural T1W images, and cerebral blood flow (CBF) maps were obtained. All data were processed with the SPM8 package under the MATLAB 7.6 operation environment. Results The T2DM patients and their unaffected siblings shared significant atrophy in the right inferior/middle temporal gyrus, and left insula, in addition to elevated CBF in the right prefrontal lobe. Several regions with abnormal CBF in siblings, including the right inferior/middle temporal gyrus, left insula, left operculum, right supramarginal gyrus, right prefrontal lobe, and bilateral anterior cingulate cortex, also presented significant atrophy in T2DM patients. Conclusions The shared brain regions with grey matter (GM) loss and CBF increases may serve as neuroimaging endophenotypes of T2DM, and the regions with abnormal CBF in siblings indicate an increased risk for T2DM.
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Affiliation(s)
- Dong Zhang
- Department of Medical Imaging Centre, the First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Lin Shi
- Research Centre for Medical Image Computing, Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.,Chow Yuk Ho Technology Centre for Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiubao Song
- Department of Rehabilitation, the First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Changzheng Shi
- Department of Medical Imaging Centre, the First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Pan Sun
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Wutao Lou
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Defeng Wang
- Research Centre for Medical Image Computing, Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.,Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100091, China.,School of Instrumentation Science and Opto-electronics Engineering, Beihang University, Beijing 100091, China.,Shenzhen SmartView MedTech Limited, Shenzhen 518000, China
| | - Liangping Luo
- Department of Medical Imaging Centre, the First Affiliated Hospital, Jinan University, Guangzhou 510630, China
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Li L, Zhao JS, Gao ZF, Ma CY, Dong CH, Zhang HW. [Application of apparent diffusion coefficient in children aged 2-12 years with intellectual disability/global developmental delay who have normal conventional brain MRI findings]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:541-546. [PMID: 31208506 PMCID: PMC7389580 DOI: 10.7499/j.issn.1008-8830.2019.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To study the value of fast spin-echo diffusion weighted imaging (TSE-DWI) apparent diffusion coefficient (ADC) in children aged 2-12 years with intellectual disability (ID)/global developmental delay (GDD) who have normal conventional brain MRI findings. METHODS A total of 578 children with normal conventional brain MRI findings who met the diagnostic criteria for ID/GDD and 375 normal children were enrolled. Their imaging and clinical data were collected. All children underwent scanning with brain TSE-DWI sequence and routine sequence. ADC values of each brain region were compared between normal children with different ages, as well as between children with different degrees of ID/GDD in each age group. The influence of Adaptive Behavior Assessment System-II (ABAS-II) score on ADC values of each brain region was analyzed. RESULTS For the normal children, the ADC values of the frontal and temporal white matter, the corpus callosum, the inner capsule, the centrum semiovale, the cerebellar dentate nucleus, the optic radiation, the thalamus, the lenticular nucleus, and the caudate nucleus gradually decreased with age (P<0.05). ADC values of the deep white matter, the shallow white matter, the deep gray matter nuclei, and the shallow gray matter increased with the increase in the degree of ID/GDD in the ID/GDD children aged 4-6 years (P<0.05). In the children with ID/GDD, the ADC values of the deep white matter, the shallow white matter, and the deep gray matter nuclei decreased with age (P<0.05). The ADC values of the children with ID/GDD decreased with the increase in ABAS-II score (P<0.05). CONCLUSIONS ADC can reflect the subtle structural changes of brain regions in children with ID/GDD who have normal conventional brain MRI findings. It may be associated with social adaptation. It can provide an objective basis for the quantitative diagnosis of ID/GDD in children.
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Affiliation(s)
- Lin Li
- Center of Medical Imaging, Qilu Children's Hospital of Shandong University, Jinan 250022, China.
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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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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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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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