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Cinar HG, Memis KB, Oztepe MF, Fatihoglu E, Aydin S, Kantarci M. Effectiveness of Apparent Diffusion Coefficient Values in Predicting Pathologic Subtypes and Grade in Non-Small-Cell Lung Cancer. Diagnostics (Basel) 2024; 14:1795. [PMID: 39202283 PMCID: PMC11354131 DOI: 10.3390/diagnostics14161795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Revised: 08/08/2024] [Accepted: 08/14/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVE The aim of this study is to evaluate the effectiveness of apparent diffusion coefficient (ADC) values in predicting pathologic subtypes and grade in non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS From January 2018 to March 2020, 48 surgically diagnosed NSCLC cases were included in this study. To obtain ADC values, ADC maps were constructed, and a region of interest was put on the tumor. The values were measured three times from different places of the lesion, and the mean value of these measurements was recorded. All MRI scans were evaluated by two radiologists in consensus. RESULTS A total of 14 cases were squamous cell cancer, 32 cases were adenocarcinoma, and 2 cases were large cell carcinoma. The mean ADC values of adenocarcinoma, squamous cell carcinoma, and large cell cancer were 1.51 ± 0.19 × 10-3 mm2/s, 1.32 ± 0.15 × 10-3 mm2/s, and 1.39 ± 0.25 × 10-3 mm2/s, respectively. There were 11 grade 1, 27 grade 2, and 10 grade 3 NSCLC cases. The mean ADC value was 1.44 ± 0.14 × 10-3 mm2/s in grade 1 tumors, 1.25 ± 0.10 × 10-3 mm2/s in grade 2 tumors, and 1.07 ± 0.15 × 10-3 mm2/s in grade 3 tumors. The cut-off value to discriminate grade 2 from grade 1 tumors was 1.31 ± 0.11 × 10-3 mm2/s (85% sensitivity, 75% specificity). The cut-off value to discriminate grade 3 from grade 2 tumors was 1.11 ± 0.15 × 10-3 mm2/s (87% sensitivity, 69% specificity). CONCLUSIONS ADC values can accurately predict NSCLC histopathologic subtypes and tumor grade.
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Affiliation(s)
- Hasibe Gokce Cinar
- Department of Pediatric Radiology, Etlik City Hospital, 06170 Ankara, Turkey;
| | - Kemal Bugra Memis
- Department of Radiology, Erzincan Binali Yildirim University, 24100 Erzincan, Turkey; (K.B.M.); (E.F.); (M.K.)
| | - Muhammet Firat Oztepe
- Department of Radiology, Batman Training and Research Hospital, 72000 Batman, Turkey;
| | - Erdem Fatihoglu
- Department of Radiology, Erzincan Binali Yildirim University, 24100 Erzincan, Turkey; (K.B.M.); (E.F.); (M.K.)
| | - Sonay Aydin
- Department of Radiology, Erzincan Binali Yildirim University, 24100 Erzincan, Turkey; (K.B.M.); (E.F.); (M.K.)
| | - Mecit Kantarci
- Department of Radiology, Erzincan Binali Yildirim University, 24100 Erzincan, Turkey; (K.B.M.); (E.F.); (M.K.)
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Gill RR, Richards WG, Heiling H, Mazzola E, Hung YP, Seethamraju RT, Chirieac LR, Bueno R. Predictive potential of MRI in differentiating the predominant component in biphasic pleural mesothelioma. Eur J Radiol 2024; 176:111527. [PMID: 38810438 DOI: 10.1016/j.ejrad.2024.111527] [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: 03/05/2024] [Revised: 04/30/2024] [Accepted: 05/23/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE To assess the potential of apparent diffusion coefficient (ADC) values derived from diffusion weighted (DW) MRI preoperatively to predict the predominant histologic component among biphasic pleural mesothelioma (PM) tumors. METHODS ADC maps were generated from DW MRI scans. Histology and predominant component of biphasic PM were confirmed following surgical resection. Statistical analyses were done with R (R Foundation for Statistical Computing, Vienna, Austria). Average ADC values corresponding to epithelioid- and sarcomatoid-predominant tumors were compared. ADC thresholding was accomplished by recursive partitioning and confirmed with ROC analysis. RESULTS Eighty-four patients with biphasic PM's, 69 (82 %) epithelioid-predominant (BE) and 15(18 %) sarcomatoid-predominant (BS) tumors were evaluated. Thirty-eight (45 %) patients underwent extrapleural pneumonectomy (EPP), 39 (46 %) had extended pleural decortication (ePDC) and 7 (8 %) had pleural decortication (PDC). ADC values ranged between 0.696 x 10-3 to 1.921 x 10-3 mm2/s. BE tumors demonstrated significantly higher ADC values than BS tumors (p = 0.026). ADC values above 0.94 x 10-3 mm2/s were associated with a significant increase of relative risk of being in group BE over group BS (relative risk: 1.47, 95 %CI: 1.05-2.06, p = 0.027) CONCLUSION: Average ADC values of BE tumors were higher than BS tumors and the two groups can be separated by a cut off value of 0.94 X 10-3 mm2/s.
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Affiliation(s)
- Ritu R Gill
- Beth Israel Deaconess Medical Center, Boston, MA, United States.
| | | | | | | | - Yin P Hung
- Masschussets General Hospital, Boston, MA, United States
| | | | | | - Raphael Bueno
- Brigham and Women's Hospital, Boston, MA, United States
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Moon JW, Yang E, Kim JH, Kwon OJ, Park M, Yi CA. Predicting Non-Small-Cell Lung Cancer Survival after Curative Surgery via Deep Learning of Diffusion MRI. Diagnostics (Basel) 2023; 13:2555. [PMID: 37568918 PMCID: PMC10417371 DOI: 10.3390/diagnostics13152555] [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: 06/27/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND the objective of this study is to evaluate the predictive power of the survival model using deep learning of diffusion-weighted images (DWI) in patients with non-small-cell lung cancer (NSCLC). METHODS DWI at b-values of 0, 100, and 700 sec/mm2 (DWI0, DWI100, DWI700) were preoperatively obtained for 100 NSCLC patients who underwent curative surgery (57 men, 43 women; mean age, 62 years). The ADC0-100 (perfusion-sensitive ADC), ADC100-700 (perfusion-insensitive ADC), ADC0-100-700, and demographic features were collected as input data and 5-year survival was collected as output data. Our survival model adopted transfer learning from a pre-trained VGG-16 network, whereby the softmax layer was replaced with the binary classification layer for the prediction of 5-year survival. Three channels of input data were selected in combination out of DWIs and ADC images and their accuracies and AUCs were compared for the best performance during 10-fold cross validation. RESULTS 66 patients survived, and 34 patients died. The predictive performance was the best in the following combination: DWI0-ADC0-100-ADC0-100-700 (accuracy: 92%; AUC: 0.904). This was followed by DWI0-DWI700-ADC0-100-700, DWI0-DWI100-DWI700, and DWI0-DWI0-DWI0 (accuracy: 91%, 81%, 76%; AUC: 0.889, 0.763, 0.711, respectively). Survival prediction models trained with ADC performed significantly better than the one trained with DWI only (p-values < 0.05). The survival prediction was improved when demographic features were added to the model with only DWIs, but the benefit of clinical information was not prominent when added to the best performing model using both DWI and ADC. CONCLUSIONS Deep learning may play a role in the survival prediction of lung cancer. The performance of learning can be enhanced by inputting precedented, proven functional parameters of the ADC instead of the original data of DWIs only.
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Affiliation(s)
- Jung Won Moon
- Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University School of Medicine, Seoul 07441, Republic of Korea;
| | - Ehwa Yang
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - Jae-Hun Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - O Jung Kwon
- Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - Minsu Park
- Department of Information and Statistics, Chungnam National University, Daejeon 34134, Republic of Korea;
| | - Chin A Yi
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
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Bak SH, Kim C, Kim CH, Ohno Y, Lee HY. Magnetic resonance imaging for lung cancer: a state-of-the-art review. PRECISION AND FUTURE MEDICINE 2022. [DOI: 10.23838/pfm.2021.00170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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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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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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Curcean S, Cheng L, Picchia S, Tunariu N, Collins D, Blackledge M, Popat S, O'Brien M, Minchom A, Leach MO, Koh DM. Early Response to Chemotherapy in Malignant Pleural Mesothelioma Evaluated Using Diffusion-Weighted Magnetic Resonance Imaging: Initial Observations. JTO Clin Res Rep 2021; 2:100253. [PMID: 34870249 PMCID: PMC8626584 DOI: 10.1016/j.jtocrr.2021.100253] [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: 08/03/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction We compared the magnetic resonance imaging total tumor volume (TTV) and median apparent diffusion coefficient (ADC) of malignant pleural mesothelioma (MPM) before and at 4 weeks after chemotherapy, to evaluate whether these are potential early markers of treatment response. Methods Diffusion-weighted magnetic resonance imaging was performed in 23 patients with MPM before and after 4 weeks of chemotherapy. The TTV was measured by semiautomatic segmentation (GrowCut) and transferred onto ADC maps to record the median ADC. Test-retest repeatability of TTV and ADC was evaluated in eight patients. TTV and median ADC changes were compared between responders and nonresponders, defined using modified Response Evaluation Criteria In Solid Tumors on computed tomography (CT) at 12 weeks after treatment. TTV and median ADC were also correlated with CT size measurement and disease survival. Results The test-retest 95% limits of agreement for TTV were -13.9% to 16.2% and for median ADC -1.2% to 3.3%. A significant increase in median ADC in responders was observed at 4 weeks after treatment (p = 0.02). Correlation was found between CT tumor size change at 12 weeks and median ADC changes at 4 weeks post-treatment (r = -0.560, p = 0.006). An increase in median ADC greater than 5.1% at 4 weeks has 100% sensitivity and 90% specificity for responders (area under the curve = 0.933, p < 0.001). There was also moderate correlation between median tumor ADC at baseline and overall survival (r = 0.45, p = 0.03). Conclusions Diffusion-weighted magnetic resonance imaging measurements of TTV and median ADC in MPM have good measurement repeatability. Increase in ADC at 4 weeks post-treatment has the potential to be an early response biomarker.
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Affiliation(s)
- Sebastian Curcean
- Department of Radiation Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Radiation Oncology, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania.,Department of Radiology, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Lin Cheng
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, United Kingdom
| | - Simona Picchia
- Department of Radiology, Bordet Institute, Bruxelles, Belgium
| | - Nina Tunariu
- Department of Radiology, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - David Collins
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, United Kingdom
| | - Matthew Blackledge
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, United Kingdom
| | - Sanjay Popat
- Department of Medical Oncology, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Mary O'Brien
- Department of Medical Oncology, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Anna Minchom
- Department of Medical Oncology, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Martin O Leach
- Department of Radiology, Royal Marsden NHS Foundation Trust, London, United Kingdom.,Division of Radiotherapy and Imaging, Institute of Cancer Research, London, United Kingdom
| | - Dow-Mu Koh
- Department of Radiology, Royal Marsden NHS Foundation Trust, London, United Kingdom.,Division of Radiotherapy and Imaging, Institute of Cancer Research, London, United Kingdom
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Coronary artery disease imaging reporting and data system (CAD-RADS): what radiologists need to know? Emerg Radiol 2021; 28:1185-1203. [PMID: 34387783 DOI: 10.1007/s10140-021-01973-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/16/2021] [Indexed: 11/09/2022]
Abstract
The aim of this work is to review Coronary Artery Disease Imaging Reporting and Data System (CAD-RADS) that was designed to standardize reporting language and improve the communication of data among radiologists and clinicians. Stenotic lesions are graded into 5 grades ranging from 0 (no stenosis) to 5 (total occlusion), where the highest grade represents the final score. The expert consensus platform has added 4 special modifiers (non-diagnostic, stent, graft, and vulnerability) to aid patient management through linking these scores with decision algorithm and treatment plan. Adherence to standard imaging protocol; knowledge of normal, variant, and anomalous anatomy; and skillful evaluation of stenosis are important for proper utilization of this reporting system. Lastly, radiologists should be aware of the inherited benefits, limitations, and common pitfalls of this classification system.
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Khan NU, Lin J, Younas MR, Liu X, Shen L. Synthesis of gold nanorods and their performance in the field of cancer cell imaging and photothermal therapy. Cancer Nanotechnol 2021. [DOI: 10.1186/s12645-021-00092-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
AbstractCancer is one of the most common incident in the world, with malignant tumors having a death rate of up to 19%. A new method of treating cancer cells effectively with minimal cytotoxicity is needed. In the field of biomedicine with unique shape-dependent optical properties, gold nanorods (GNRs) have attracted worldwide interest. These nanorods have two distinct plasmon bands. One is transverse plasmon band in the area of visible light, and the other is longitudinal band of plasmons in near infrared region. These specific characters provide promise for the design of new optically active reagents that simultaneously perform light-mediated imaging and photothermal cancer treatment. We begin our review by summarizing the latest developments in gold nanorods synthesis with a focus on seed-mediated growth method. Nanorods spontaneous self-assembly, polymer-based alignment and its applications as a novel agent for simultaneous bioimaging and photothermal cancer therapy are listed in particular.
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10
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Xu X. Diagnosis of hilar cholangiocarcinoma using intravoxel incoherent motion diffusion-weighted magnetic resonance imaging. Abdom Radiol (NY) 2021; 46:3159-3167. [PMID: 33660039 DOI: 10.1007/s00261-021-02997-x] [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: 11/30/2020] [Revised: 02/02/2021] [Accepted: 02/11/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate the value of intravoxel incoherent motion diffusion-weighed magnetic resonance imaging (IVIM-DWI) in discriminating the pathological grades of hilar cholangiocarcinoma (HC). PATIENTS AND METHODS Thirty-seven HC patients were enrolled and received routine and advanced DWI scanning with multiple b-values. IVIM-DWI images were obtained using echo-planar imaging sequence. RESULTS The consistency of the maximum cross-sectional area ROI measuring method was higher than that of the repeated sampling ROI measuring method. ADCslow values were closely correlated with the pathological grades of HC. The degrees of biliary dilatation and MELD scores had no influence on the negative correlation between ADCslow values and the pathological degrees of HC patients. CONCLUSIONS ADCslow values could be applied in indicating the pathological grades of HC, which was independent on the extent of biliary dilatation.
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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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Kim C, Cho HH, Choi JY, Franks TJ, Han J, Choi Y, Lee SH, Park H, Lee KS. Pleomorphic carcinoma of the lung: Prognostic models of semantic, radiomics and combined features from CT and PET/CT in 85 patients. Eur J Radiol Open 2021; 8:100351. [PMID: 34041307 PMCID: PMC8141891 DOI: 10.1016/j.ejro.2021.100351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/03/2021] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
Introduction To demonstrate semantic, radiomics, and the combined risk models related to the prognoses of pulmonary pleomorphic carcinomas (PCs). Methods We included 85 patients (M:F = 71:14; age, 35–88 [mean, 63 years]) whose imaging features were divided into training (n = 60) and test (n = 25) sets. Nineteen semantic and 142 radiomics features related to tumors were computed. Semantic risk score (SRS) model was built using the Cox-least absolute shrinkage and selection operator (LASSO) approach. Radiomics risk score (RRS) from CT and PET features and combined risk score (CRS) adopting both semantic and radiomics features were also constructed. Risk groups were stratified by the median of the risk scores of the training set. Survival analysis was conducted with the Kaplan-Meier plots. Results Of 85 PCs, adenocarcinoma was the most common epithelial component found in 63 (73 %) tumors. In SRS model, four features were stratified into high- and low-risk groups (HR, 4.119; concordance index ([C-index], 0.664) in the test set. In RRS model, five features helped improve the stratification (HR, 3.716; C-index, 0.591) and in CRS model, three features helped perform the best stratification (HR, 4.795; C-index, 0.617). The two significant features of CRS models were the SUVmax and the histogram feature of energy ([CT Firstorder Energy]). Conclusion In PCs of the lungs, the combined model leveraging semantic and radiomics features provides a better prognosis compared to using semantic and radiomics features separately. The high SUVmax of solid portion (CT Firstorder Energy) of tumors is associated with poor prognosis in lung PCs.
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Key Words
- C-index, Concordance index
- CRS, Combined risk score
- DL, Deep learning
- GCLM, Gray-level co-occurrence matrix
- HR, Hazard ration
- ICC, Intra-class correlation
- ISZM, Intensity size zone matrix
- KRAS, Kirsten rat sarcoma viral oncogene homolog
- LASSO, Least absolute shrinkage and selection operator
- LDA, Low density area
- Lung
- MRI, Magnetic resonance imaging
- MTV, Metabolic tumor volume
- Non-small cell carcinoma
- PC, Pleomorphic carcinoma
- PET/CT, Positron emission tomography/Computed tomography
- Pleomorphic carcinoma
- Prognosis
- ROI, Region of interest
- RRS, Radiomics risk score
- Radiomics
- SRS, Semantic risk score
- SUVavg, Average standardized uptake value
- SUVmax, Maximum standardized uptake value
- TLG, Total lesion glycolysis
- VOI, Volume of interest
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Affiliation(s)
- Chohee Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Hwan-Ho Cho
- Department of Electronic and Computer Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Teri J Franks
- Department of Pulmonary and Mediastinal Pathology, Department of Defense, The Joint Pathology Center, Silver Spring, MD, USA
| | - Joungho Han
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Yeonu Choi
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Se-Hoon Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
| | - Hyunjin Park
- School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, South Korea.,Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea
| | - Kyung Soo Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea
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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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Gui Y, Liu X, Wang C, Yang P. Overexpressing PTTG family genes predict poor prognosis in kidney renal clear cell carcinoma. World J Surg Oncol 2021; 19:111. [PMID: 33845847 PMCID: PMC8042860 DOI: 10.1186/s12957-021-02225-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/01/2021] [Indexed: 12/23/2022] Open
Abstract
Background Pituitary tumor transforming genes (PTTG1, PTTG2, and PTTG3P) play key roles in the pathogenesis and development of human cancers. The studies show that overexpression of the PTTG genes is associated with tumor progression and migration. However, the function of the PTTG genes in the prognostic value of kidney renal clear cell carcinoma is rarely known by people. Methods The expression of PTTG family genes was analyzed by the ONCOMINE, Human Protein Atlas, GEPIA2, and UALCAN database. The relationship between PTTG family genes expression level and clinical indicators including prognostic data in kidney renal clear cell carcinoma was analyzed by GEPIA2, TCGA portal, and UALCAN. cBioPortal database was used to analyze the genetic mutations of differentially expressed PTTG family members. Similar genes of the PTTG family (90 in total) obtained from GEPIA2 and Metascape were used for GO enrichment to explore the interaction among similar genes. The online tools of Metascape and STRING were used for functional and pathway enrichment analysis. Results PTTG1, 2, and 3P mRNA and protein expression upregulated in kidney renal clear cell carcinoma kidney renal clear cell carcinoma patients compared with normal tissues. And higher expression level of PTTG family genes was associated with shorter overall survival (OS) and disease-free survival (DFS). Furthermore, overexpression of the PTTG family genes had been found correlated with individual cancer stages and pathological tumor grades. In addition, 18% of mutations in the PTTG family genes were associated with short-term survival in kidney renal clear cell carcinoma patients. Conclusions A single PTTG gene or PTTG family genes as a whole may be a potential prognostic biomarker for kidney renal clear cell carcinoma.
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Affiliation(s)
- Yonghui Gui
- Department of Blood Transfusion, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230032, Anhui, China
| | - Xueni Liu
- Department of Blood Transfusion, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230032, Anhui, China
| | - Chao Wang
- Department of Blood Transfusion, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230032, Anhui, China
| | - Peng Yang
- Department of Blood Transfusion, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230032, Anhui, China.
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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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Computed tomography of the chest in patients with COVID-19: what do radiologists want to know? Pol J Radiol 2021; 86:e122-e135. [PMID: 33758638 PMCID: PMC7976235 DOI: 10.5114/pjr.2021.104049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 08/15/2020] [Indexed: 12/14/2022] Open
Abstract
We aim in the current study to review pulmonary and extra-pulmonary imaging features in patients infected with COVID-19. COVID-19 appears to be a highly contagious viral disease that attacks the respiratory system causing pneumonia. Since the beginning of the outbreak, several reports have been published describing various radiological patterns related to COVID-19. Radiological features of COVID-19 are classified into; pulmonary signs of which ground glass opacities are considered the characteristic followed by consolidation, and extra-pulmonary signs such as pulmonary embolism and pneumothorax, which are far less common and appear later in progressive disease. We review the different structured reporting systems that are published by different groups of radiologists using simple unified terms to enable good communication between the radiologist and the referring physician. Computed tomography of the chest is beneficial for early diagnosis of COVID-19 pneumonia, assessment of disease progression and guide to therapy, surveillance of patients with response to therapy, prediction of overlying bacterial infection, differentiation from simulating lesions, and screening with prevention and controls of the disease.
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19
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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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Zheng Y, Huang W, Zhang X, Lu C, Fu C, Li S, Lin G. A Noninvasive Assessment of Tumor Proliferation in Lung cancer Patients using Intravoxel Incoherent Motion Magnetic Resonance Imaging. J Cancer 2021; 12:190-197. [PMID: 33391415 PMCID: PMC7738818 DOI: 10.7150/jca.48589] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 10/26/2020] [Indexed: 12/15/2022] Open
Abstract
Ki-67 is a nuclear antigen widely used in routine pathologic analyses as a tumor cell proliferation marker for lung cancer. However, Ki-67 expression analyses using immunohistochemistry (IHC) are invasive and frequently influenced by tissue sampling quality. In this study, we assessed the feasibility of noninvasive magnetic resonance imaging (MRI) in predicting the Ki-67 labeling indices (LIs). A total of 51 lung cancer patients, including 42 non-small cell lung cancer (NSCLC) cases and nine small cell lung cancer (SCLC) cases, were enrolled in this study. Quantitative MRI parameters from conventional diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM), and diffusion kurtosis imaging (DKI) were obtained, and their correlations with tumor tissue Ki-67 expression were analyzed. We found that the true diffusion coefficient (D value) from IVIM was negatively correlated with Ki-67 expression (Spearman r = -0.76, P < 0.001). The D values in the high Ki-67 group were significantly lower than those in the low Ki-67 group (0.90 ± 0.21 × 10-3 mm2/s vs. 1.22 ± 0.30 × 10-3 mm2/s). Among three MRI techniques used, D values from IVIM showed the best performance for distinguishing the high Ki-67 group from low Ki-67 group in receiver operating characteristic (ROC) analysis with an area under the ROC curve (AUROC) of 0.85 (95% CI: 0.73-0.97, P < 0.05). Moreover, D values performed well for differentiating SCLC from NSCLC with an AUROC of 0.82 (95% CI: 0.68-0.90), Youden index of 0.72, and F1 score of 0.81. In conclusion, D values were negatively correlated with Ki-67 expression in lung cancer tissues and can be used to distinguish high from low proliferation statuses, as well as SCLC from NSCLC.
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Affiliation(s)
- Yu Zheng
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Wenjun Huang
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Xuelin Zhang
- Department of Thoracic Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Chen Lu
- Department of Pathology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Caixia Fu
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, Guangdong Province, 518057, China
| | - Shihong Li
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Guangwu Lin
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
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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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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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Wang S, Chen Y, Chai Y. Prognostic role of targeting protein for Xklp2 in solid tumors: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e13018. [PMID: 30412141 PMCID: PMC6221728 DOI: 10.1097/md.0000000000013018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The prognostic role of targeting protein for Xklp2 (TPX2) in solid tumors has been investigated in several researches, but the results remain controversial. Here we present a meta-analysis to systematically review the association between TPX2 expression levels and prognosis of human solid tumors. METHODS Studies published until December 2017 were searched in PubMed, Web of Science, and EBSCO, 13 studies (2134 patients) were collected for analysis. Odds ratios (ORs) for overall survival (OS) and disease-free survival (DFS) from individual studies were calculated by the application of Mantel-Haenszel random effect model. Pooled ORs were estimated by Z test. Publication bias and interstudy heterogeneity analyses were also performed. RESULTS TPX2 overexpression was associated with poor OS at 3 and 5 years [OR = 4.63, 95% confidence interval (CI): 3.27-6.56, P < .00001; OR = 4.05, 95% CI: 2.32-7.07, P < .00001, respectively] of solid tumors. Similar results were observed with DFS at 3 and 5 years (OR = 3.35, 95% CI: 1.83-6.14, P < .0001; OR = 2.94, 95% CI: 1.74-4.98, P < .0001, respectively). Subgroup analysis revealed that increased TPX2 expression was related to worse prognosis of gastric cancer and hepatocellular cancer, while irrelevant to esophageal squamous cell cancer at 5-year survival rate. CONCLUSIONS Overexpression of TPX2 is related to poor survival rate in most solid tumors, which indicates that the expression level of TPX2 is a significant prognostic parameter and potential therapeutic target in various solid tumors.
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Karam MB, Doroudinia A, Behzadi B, Mehrian P, Koma AY. Correlation of quantified metabolic activity in nonsmall cell lung cancer with tumor size and tumor pathological characteristics. Medicine (Baltimore) 2018; 97:e11628. [PMID: 30095621 PMCID: PMC6133455 DOI: 10.1097/md.0000000000011628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to evaluate the relationship between maximum standardized uptake value (SUVmax) with tumor size and tumor pathological characteristics as well as suggesting equations between SUVmax and tumor size in patients with nonsmall cell lung cancer (NSCLC) to help differentiate between pathology types.We retrospectively analyzed the fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) findings of 98 patients with NSCLC. Statistical differences were considered significant when P < .05. Correlation between SUVmax and other variables was determined by Pearson and Spearman correlation. Both linear and nonlinear regression analysis were used to determine equations between SUVmax and tumor size to help differentiate between pathology types.The mean SUVmax in patients with squamous cell carcinoma was significantly higher than that of adenocarcinoma (21.35 ± 1.73 vs 13.75 ± 0.89, P = .000). The results of regression analysis indicated that among all equations determined with relative accuracy, the "cubic equation" has the highest accuracy when considering the relationship between SUVmax and tumor size in patients with adenocarcinoma. In patients with squamous cell carcinoma, the most accurate equation was obtained using the "quadratic equation."There was a significant correlation between SUVmax and tumor differentiation and tumor size in patients with adenocarcinoma. SUVmax of patients with squamous cell carcinoma also had a significant correlation with tumor size. Overall SUVmax of patients with NSCLC could be predicted by tumor size value. In patients with squamous cell carcinoma compared with those with adenocarcinoma, SUVmax with less accuracy can be determined by tumor size. Linear regression analysis line slope can be used as an index for distinguishing adenocarcinoma from squamous cell carcinoma.
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Affiliation(s)
| | | | | | | | - Abbas Yousefi Koma
- Lung Transplantation Research Center (LTRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Diffusion-weighted MRI in solitary pulmonary lesions: associations between apparent diffusion coefficient and multiple histopathological parameters. Sci Rep 2018; 8:11248. [PMID: 30050167 PMCID: PMC6062570 DOI: 10.1038/s41598-018-29534-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 07/12/2018] [Indexed: 01/20/2023] Open
Abstract
Apparent diffusion coefficient (ADC) from diffusion-weighted imaging (DWI) has gained wide attention as potential tool for differentiating between malignant and benign solitary pulmonary lesions (SPLs). The overall effects of multiple histopathological parameters on ADC have not been elucidated, which may help to explain the overlapping of ADC between malignant and benign SPLs. The study sought to explore associations between ADC and histopathological parameters in SPLs, and to compare diagnostic capability of ADC among different types of SPLs. Multiple histopathological parameters (cell density, nuclear-to-cytoplasm ratio, necrotic fraction, presence of mucus and grade of differentiation) were quantified in 52 malignant and 13 benign SPLs with surgical pathology available. Cell density (β = −0.40) and presence of mucus (β = 0.77) were independently correlated with ADC in malignant SPLs. The accurate diagnosis rate of squamous carcinomas, adenocarcinomas without mucus and malignant tumors with mucus was 100%, 82% and 0%, respectively. Our study suggested that cell density and presence of mucus are independently correlated with ADC in malignant SPLs. Squamous carcinoma maybe more accurately diagnosed as malignancy by ADC value. Malignant SPLs with mucus and adenocarcinomas with low cell density should be kept in mind in differentiating SPLs using ADC because of insufficient diagnostic capability.
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Scialpi M, Malaspina CM, Rondoni V, Orlandi E, Coppola L, Pusiol T, Palumbo B. Solitary pulmonary nodule: Increasing diagnosis and accuracy of biopsy by biparametric MR imaging. Lung India 2018; 35:182-183. [PMID: 29487262 PMCID: PMC5846276 DOI: 10.4103/lungindia.lungindia_424_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Michele Scialpi
- Department of Surgical and Biomedical Sciences, Division of Radiology 2 and Nuclear Medicine, S. Maria Della Misericordia Hospital, University of Perugia, 06156 Perugia, Italy
| | - Corrado Maria Malaspina
- Department of Surgical and Biomedical Sciences, Division of Radiology 2 and Nuclear Medicine, S. Maria Della Misericordia Hospital, University of Perugia, 06156 Perugia, Italy
| | - Valeria Rondoni
- Department of Surgical and Biomedical Sciences, Division of Radiology 2 and Nuclear Medicine, S. Maria Della Misericordia Hospital, University of Perugia, 06156 Perugia, Italy
| | - Emanuele Orlandi
- Department of Surgical and Biomedical Sciences, Division of Radiology 2 and Nuclear Medicine, S. Maria Della Misericordia Hospital, University of Perugia, 06156 Perugia, Italy
| | - Luigia Coppola
- Department of Surgical and Biomedical Sciences, Division of Radiology 2 and Nuclear Medicine, S. Maria Della Misericordia Hospital, University of Perugia, 06156 Perugia, Italy
| | - Teresa Pusiol
- Provincial Health Care Services, Institute of Anatomic Pathology, Rovereto Hospital, 38100 Rovereto, Italy
| | - Barbara Palumbo
- Department of Surgical and Biomedical Sciences, Division of Radiology 2 and Nuclear Medicine, S. Maria Della Misericordia Hospital, University of Perugia, 06156 Perugia, Italy
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Hibino M, Otsuka Y, Maeda K, Horiuchi S, Fukuda M, Kondo T. Diffusion-weighted magnetic resonance imaging-directed biopsy of a metastatic bone tumor: Lung adenocarcinoma with ALK rearrangement. Respir Med Case Rep 2018; 24:170-172. [PMID: 29977788 PMCID: PMC6010640 DOI: 10.1016/j.rmcr.2018.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 05/18/2018] [Accepted: 05/23/2018] [Indexed: 11/25/2022] Open
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Yan DF, Zhang WB, Ke SB, Zhao F, Yan SX, Wang QD, Teng LS. The prognostic value of pretreatment tumor apparent diffusion coefficient values in nasopharyngeal carcinoma. BMC Cancer 2017; 17:678. [PMID: 29020937 PMCID: PMC5637091 DOI: 10.1186/s12885-017-3658-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 09/26/2017] [Indexed: 11/10/2022] Open
Abstract
Background Diffusion-weighted MR imaging (DWI) has increasingly contributed to the management of nasopharyngeal carcinoma (NPC) patients. The objective of this paper was to explore the prognostic significance of apparent diffusion coefficient (ADC) values in 93 NPC patients. Methods This retrospective study included 93 newly diagnosed NPC patients. Pretreatment ADC values were determined and compared with patients’ age, gender, alcohol intake, smoking, tumor volume, pathological type, tumor stage, and nodal stage. Using the Kaplan-Meier method, overall survival (OS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were calculated and the values compared between the low and high ADC groups. Multivariate analysis of ADC values and other 9 clinical parameters was performed using a Cox proportional hazards model to test the independent significance for OS, LRFS and DMFS. Results The mean ADC value for the initial nasopharyngeal tumors was 0.72 × 10−3 mm2/s (range: 0.48–0.97 × 10−3 mm2/s). There was no significant difference between pretreatment ADCs and patient’ gender, age, smoking, alcohol intake, or tumor stage. A significant difference in the ADCs for different N stages (P = 0.022) and correlation with initial tumor volume (r = −0.26, P = 0.012) were observed. In comparison, the ADC value for undifferentiated carcinoma was lower than that for other 3 pathological types. With a median follow-up period of 50 months, the 3-year and 5-year OS rates were 88.2% and 83.3%, respectively, 3-year and 5-year LRFS rates were 93.5% and 93.3%, respectively, and 3-year and 5-year DMFS rates were 83.9% and 83.3%, respectively. Patients with tumor ADC values ≥0.72 × 10−3 mm2/s exhibited longer OS and LRFS periods compared with tumor ADC values <0.72 × 10−3 mm2/s, with P values 0.036 and 0.018, respectively. In addition, patients with deaths or recurrences or distant metastasis had significant lower ADC values than those without disease failures. According to a multivariate analysis using the Cox proportional hazard test, ADC values showed a significant correlation with OS (P = 0.0004), LRFS (P = 0.0009), and DMFS (P < 0.0001), respectively. Conclusions Pretreatment tumor ADC values supposed to be a noninvasive important prognostic parameter for NPC.
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Affiliation(s)
- Dan-Fang Yan
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Wen-Bao Zhang
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Shan-Bao Ke
- Department of Radiation Oncology, Henan Province People's Hospital, Zhengzhou, Henan, 450000, China
| | - Feng Zhao
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Sen-Xiang Yan
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China.
| | - Qi-Dong Wang
- Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310003, China
| | - Li-Song Teng
- Department of Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Zhejiang, Hangzhou, 310003, China.
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Razek AAKA, Ashmalla GA. Assessment of paraspinal neurogenic tumors with diffusion-weighted MR imaging. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 27:841-846. [PMID: 28821978 DOI: 10.1007/s00586-017-5265-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 08/09/2017] [Accepted: 08/12/2017] [Indexed: 12/15/2022]
Abstract
PURPOSE To assess paraspinal neurogenic tumors with diffusion-weighted MR imaging. METHODS Retrospective analysis was done upon 34 patients with paraspinal neurogenic tumors that underwent diffusion-weighted MR imaging. The ADC values of the mediastinal neurogenic tumors were calculated and correlated with biopsy results. RESULTS The ADC of benign paraspinal neurogenic tumors (1.5 ± 0.28 × 10-3 mm2/s) was significantly higher (P = 0.001) than that of malignant peripheral nerve sheath tumors (0.995 ± 0.198 × 10-3 mm2/s). Selection of 1.15 × 10-3 mm2/s as a cut-off point for differentiating malignant from benign neurogenic tumors revealed an area under the curve of 0.885, an accuracy of 91.1%, a sensitivity of 90.9%, and specificity of 91.3%. There was significant difference (P = 0.04) in the ADC of schwannomas (1.55 ± 0.29 × 10-3 mm2/s) from neurofibromas (1.33 ± 0.08 × 10-3 mm2/s). The cut-off ADC value of 1.44 × 10-3 mm2/s was used to differentiate schwannomas and neurofibromas with an area under the curve of 0.86, an accuracy of 82.6%, a sensitivity of 100%, and a specificity of 76.5%. CONCLUSION Diffusion-weighted MR imaging is imaging parameter that can be used for differentiation of benign from malignant paraspinal neurogenic tumors.
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Affiliation(s)
| | - Germeen Albair Ashmalla
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Elgomheryia Street, Mansoura, 3512, Egypt
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Ye X, Chen S, Tian Y, You B, Zhang W, Zhao Y, Jiang T, Hu B, Li H. A preliminary exploration of the intravoxel incoherent motion applied in the preoperative evaluation of mediastinal lymph node metastasis of lung cancer. J Thorac Dis 2017; 9:1073-1080. [PMID: 28523162 DOI: 10.21037/jtd.2017.03.110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND The aim of this study was to investigate the diagnostic value of the intravoxel incoherent motion (IVIM) for distinguishing non-metastatic from metastatic mediastinal lymph nodes in lung cancer. METHODS IVIM-diffusion weighted imaging (DWI) exams were performed preoperatively on 66 patients with lung cancer from October 2015 to June 2016 in Beijing Chao-Yang Hospital, Capital Medical University. Fifty patients underwent enhanced chest computed tomography (CT) in our hospital, while the other 16 patients already had enhanced chest CT images when they were admitted. The patients' complete preoperative examination included chest magnetic resonance imaging (MRI), enhanced chest CT, head MRI, bone scanning and cardiopulmonary function testing. None of the patients were receiving any treatment for their cancer prior to their evaluation and surgery, including neoadjuvant chemotherapy, radiation therapy, immunotherapy or gene targeted therapy. The following IVIM parameters of the mediastinal lymph nodes were measured: the short axis diameter, apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f). All of the patients underwent lobectomy and lymph node dissection. We compared the CT and MRI results and analysed the IVIM parameters of the pathologically determined non-metastatic and metastatic mediastinal lymph nodes in our 50 patients to generate the ROC curves and determine the best cut-off value for diagnosis. The remaining 16 patients' IVIM parameters were used to verify the diagnostic cut-off value. This study was approved by the institutional research ethics committee of Beijing Chao-Yang Hospital (2014-S-166), and all the patients signed the MRI informed consent. RESULTS In this study, MRI was used to measure 140 groups of mediastinal lymph nodes in 50 cases, and the results showed that 19 groups of mediastinal lymph nodes were metastatic, while 121 groups of mediastinal lymph nodes were non-metastatic. The pathological analysis showed that 20 groups of mediastinal lymph nodes were metastatic and 120 groups of mediastinal lymph nodes were non-metastatic. CT was used to measure 273 groups of mediastinal lymph nodes, and the result showed that 34 groups of mediastinal lymph nodes were metastatic, while 239 groups of mediastinal lymph nodes were non-metastatic. The pathological analysis showed that 20 groups of mediastinal lymph nodes were metastatic and 253 groups of mediastinal lymph nodes were non-metastatic. The ADC, D, D*, f values and the short axis diameters of the non-metastatic lymph nodes (n=121) were 2.9370±0.743×10-3, 0.533±0.175×10-3, 0.384±0.121×10-3 mm2/s, 0.426±0.120, 6.903±1.831 mm, respectively, and 1.863±0.691×10-3, 0.454±0.204×10-3, 0.358±0.106×10-3 mm2/s, 0.413±0.085, 7.705±2.213 mm, respectively, for the metastatic lymph nodes (n=19). The ADC and D values of the non-metastatic lymph nodes were significantly higher than the values for the metastatic lymph nodes (P<0.01); the other parameters (D*, f, and short axis diameter) did not show significantly different results between the two groups. The optimal cut-off values [area under the curve (AUC), sensitivity, and specificity] for distinguishing metastatic from non-metastatic lymph nodes were as follows: ADC =1.890×10-3 mm2/s (0.897, 93.3%, 80.0%), Youden index 0.733; and D =0.344×10-3 mm2/s (0.651, 90.8%, 50.0%), Youden index 0.651. When these cut-off values were applied as the diagnostic criteria in the remaining cases and compared with the pathology results, the diagnostic performance was good. CONCLUSIONS IVIM is useful to distinguish metastatic from non-metastatic lymph nodes in lung cancer. The ADC and the D values are significantly lower in metastatic lymph nodes, making these parameters more sensitive than the other parameters (D*, f, and short axis diameter). As a result, IVIM can be used in the N-stage diagnosis of lung cancer.
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Affiliation(s)
- Xin Ye
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Shuo Chen
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Yaru Tian
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Bin You
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Wenqian Zhang
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Yan Zhao
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Tao Jiang
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Bin Hu
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Çakmak V, Ufuk F, Karabulut N. Diffusion-weighted MRI of pulmonary lesions: Comparison of apparent diffusion coefficient and lesion-to-spinal cord signal intensity ratio in lesion characterization. J Magn Reson Imaging 2016; 45:845-854. [DOI: 10.1002/jmri.25426] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 08/02/2016] [Indexed: 12/14/2022] Open
Affiliation(s)
- Vefa Çakmak
- Department of Diagnostic Radiology; University of Pamukkale; Turkey
| | - Furkan Ufuk
- Department of Diagnostic Radiology; University of Pamukkale; Turkey
| | - Nevzat Karabulut
- Department of Diagnostic Radiology; University of Pamukkale; Turkey
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Weiss E, Ford JC, Olsen KM, Karki K, Saraiya S, Groves R, Hugo GD. Apparent diffusion coefficient (ADC) change on repeated diffusion-weighted magnetic resonance imaging during radiochemotherapy for non-small cell lung cancer: A pilot study. Lung Cancer 2016; 96:113-9. [DOI: 10.1016/j.lungcan.2016.04.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 02/11/2016] [Accepted: 04/03/2016] [Indexed: 12/12/2022]
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Razek AAKA, Nada N. Correlation of Choline/Creatine and Apparent Diffusion Coefficient values with the prognostic parameters of Head and Neck Squamous Cell Carcinoma. NMR IN BIOMEDICINE 2016; 29:483-489. [PMID: 26867020 DOI: 10.1002/nbm.3472] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/26/2015] [Accepted: 11/27/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study was to measure choline/creatine (Ch/Cr) levels through (1)H-MRS and apparent diffusion coefficient (ADC) values through diffusion-weighted MRI, and to correlate these values with the prognostic parameters of head and neck squamous cell carcinoma (HNSCC). The institutional review board approved this study and informed written consent was obtained from all study participants. A prospective study of 43 patients (31 men and 12 women; mean age, 65 years) with HNSCC was conducted. Single-voxel (1)H-MRS was performed at the tumor or metastatic cervical lymph node with point-resolved spectroscopy (PRESS) at TE = 135 ms. Diffusion-weighted MR images with b values of 0, 500 and 1000 s/mm(2) and contrast MRI of the head and neck were performed. The Ch/Cr levels and ADC values of HNSCC were calculated. The gross tumor volume (GTV) was also calculated. The degree of tumor differentiation was determined through pathological examination. The HNSCC Ch/Cr level was negatively correlated with the ADC value (r = -0.662, p = 0.001). There was a significant difference in the Ch/Cr and ADC values at different degrees of tumor differentiation (p = 0.003 and p = 0.001) and with different GTVs (p = 0.122 and p = 0.001). The following prognostic parameter categories were used: (i) poorly differentiated and undifferentiated versus well differentiated to moderately differentiated; and (ii) HNSCC with GTV < 30 cm(3) versus GTV > 30 cm(3). The cut-off values for Cho/Cr and ADC for each category were 1.83, 0.95 and 1.94, 0.99, respectively, and the areas under the curve were 0.771, 0.967 and 0.726, 0.795, respectively, for each category. We conclude that the Ch/Cr levels determined using (1)H-MRS and the ADC values are well correlated with several prognostic parameters of HNSCC.
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Affiliation(s)
| | - Nadia Nada
- Department of Pathology, Mansoura Faculty of Medicine, Mansoura, Egypt
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Priola AM, Gned D, Veltri A, Priola SM. Chemical shift and diffusion-weighted magnetic resonance imaging of the anterior mediastinum in oncology: Current clinical applications in qualitative and quantitative assessment. Crit Rev Oncol Hematol 2016; 98:335-57. [DOI: 10.1016/j.critrevonc.2015.11.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 10/04/2015] [Accepted: 11/19/2015] [Indexed: 12/15/2022] Open
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El-Serougy LG, Abdel Razek AAK, Mousa AE, Eldawoody HAF, El-Morsy AEME. Differentiation between high-grade gliomas and metastatic brain tumors using Diffusion Tensor Imaging metrics. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2015. [DOI: 10.1016/j.ejrnm.2015.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abdel Razek AAK, Gaballa G, Elashry R, Elkhamary S. Diffusion-weighted MR imaging of mediastinal lymphadenopathy in children. Jpn J Radiol 2015; 33:449-54. [PMID: 26067466 DOI: 10.1007/s11604-015-0434-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 05/02/2015] [Indexed: 12/16/2022]
Abstract
PURPOSE To assess mediastinal lymphadenopathy in children with diffusion-weighted MR imaging. MATERIALS AND METHODS Retrospective analysis of 29 consecutive children (18 boys and 11 girls aged 2-15 years) with mediastinal lymphadenopathy. They underwent single-shot echo planar diffusion-weighted MR imaging of the mediastinum with b factors of 0, 300, and 600 s/mm(2). The ADC value of the mediastinal lymph nodes was calculated and correlated with biopsy results; statistical analysis was also performed. RESULTS The mean ADC value for malignant mediastinal lymphadenopathy (n = 20) (0.99 ± 0.18 × 10(-3) mm(2)/s) was significantly lower (P = 0.001) than that for benign lymphadenopathy (n = 9) (1.35 ± 0.26 × 10(-3) mm(2)/s). There was significant difference between ADC values for non-Hodgkin lymphoma and metastatic nodes (P = 0.04). For differentiating malignant from benign mediastinal lymphadenopathy, the best result was obtained when an ADC value of 1.22 × 10(-3) mm(2)/s was used as a threshold value; area under the curve was 0.861, accuracy 93.1 %, sensitivity 100 %, specificity of 77.8 %, positive predictive value 90.9 %, and negative predictive value of 100 %. CONCLUSION Diffusion-weighted MR imaging is a promising non-invasive imaging modality that can be used for differentiation of malignant from benign mediastinal lymphadenopathy in children.
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Shen G, Jia Z, Deng H. Apparent diffusion coefficient values of diffusion-weighted imaging for distinguishing focal pulmonary lesions and characterizing the subtype of lung cancer: a meta-analysis. Eur Radiol 2015; 26:556-66. [PMID: 26003791 DOI: 10.1007/s00330-015-3840-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 04/27/2015] [Accepted: 05/08/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The potential performance of apparent diffusion coefficient (ADC) values for distinguishing malignant and benign pulmonary lesions, further characterizing the subtype of lung cancer was assessed. METHODS PubMed, EMBASE, Cochrane Library, EBSCO, and three Chinese databases were searched to identify eligible studies on diffusion-weighted imaging (DWI) of focal pulmonary lesions. ADC values of malignant and benign lesions were extracted by lesion type and statistically pooled based on a linear mixed model. Further analysis for subtype of lung cancer was also performed. The methodological quality was assessed using the quality assessment of diagnostic accuracy studies tool. RESULTS Thirty-four articles involving 2086 patients were included. Malignant pulmonary lesions have significantly lower ADC values than benign lesions [1.21 (95% CI, 1.19-1.22) mm(2)/s vs. 1.76 (95% CI, 1.72-1.80) mm(2)/s; P < 0.05]. There is a significant difference between ADC values of small cell lung cancer and non-small cell lung cancer (P < 0.05), while the differences were not significant among histological subtypes of lung cancer. The methodological quality was relatively high, and the data points from Begg's test indicated that there was probably no obvious publication bias. CONCLUSIONS The ADC value is helpful for distinguishing malignant and benign pulmonary lesions and provides a promising method for differentiation of SCLC from NSCLC. KEY POINTS • This meta-analysis assesses the role of DWI in pulmonary lesions. • Differentiation and classification subtype of lung cancer is essential for treatment decision-making. • ADC values can help distinguish between malignant and benign lesions. • ADC values might help characterize the subtype of lung cancer.
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Affiliation(s)
- Guohua Shen
- Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China.
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China.
| | - Houfu Deng
- Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China
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Kim HS, Lee KS, Ohno Y, van Beek EJ, Biederer J. PET/CT versus MRI for diagnosis, staging, and follow-up of lung cancer. J Magn Reson Imaging 2014; 42:247-60. [DOI: 10.1002/jmri.24776] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 09/27/2014] [Indexed: 12/19/2022] Open
Affiliation(s)
- Hyun Su Kim
- Department of Radiology and Center for Imaging Science; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
| | - Kyung Soo Lee
- Department of Radiology and Center for Imaging Science; Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul Korea
| | - Yoshiharu Ohno
- Division of Functional and Diagnostic Imaging Research; Department of Radiology; and Advanced Biomedical Imaging Research Centre, Kobe University Graduate School of Medicine; Kobe Japan
| | | | - Juergen Biederer
- Radiologie Darmstadt; Gross-Gerau County Hospital; Gross-Gerau Germany
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Chen L, Zhang J, Chen Y, Wang W, Zhou X, Yan X, Wang J. Relationship between apparent diffusion coefficient and tumour cellularity in lung cancer. PLoS One 2014; 9:e99865. [PMID: 24919055 PMCID: PMC4053522 DOI: 10.1371/journal.pone.0099865] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 05/16/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVE To prospectively investigate the relationship between the apparent diffusion coefficient (ADC) and cellularity in lung cancer. METHODS Sixty patients histopathologically confirmed with lung cancer (41 men, 19 women) underwent diffusion-weighted magnetic resonance imaging of the chest (with b values of 50 and 1000 s/mm2). The median mean ADC (ADC mean) value and median minimum ADC (ADC min) value within each primary tumour were calculated and compared with the median nucleo-cytoplasmic ratio (NCR), which was selected to represent the cellularity. The correlation between the NCR and ADC mean/ADC min was calculated with SPSS 18.0 software. RESULTS The mean ADC mean values, ADC min values and median NCR were (1.07 ± 0.12) × 10(-3) mm2/s, (0.86 ± 0.14) × 10(-3) mm2/s, and (14.9 ± 2.6) %, respectively, in adenocarcinoma; (0.88 ± 0.10) × 10(-3) mm2/s, (0.73 ± 0.12) × 10(-3)) mm2/s, and (20.6 ± 4.4) %, respectively, in squamous cell carcinoma; and (0.89 ± 0.13) × 10(-3) mm2/s, (0.67 ± 0.13) × 10(-3) mm2/s, and (18.3 ± 3.5) %, respectively in small cell lung cancer. The NCR of squamous cell carcinoma and small cell lung cancer is greater than that of adenocarcinoma (P < 0.01 and P = 0.002, respectively). There was an inverse relationship between ADC mean/NCR and ADC min/NCR (r = -0.60, P = 0.001 and r = -0.47, P < 0.001, respectively). CONCLUSION There is a significant inverse relationship between tumour cellularity and ADC in lung cancer. However, tumour cellularity most likely is not the sole determinant of the ADC.
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Affiliation(s)
- Lihua Chen
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China
- Department of Radiology, PLA 101st Hospital, Wuxi Jiangsu, China
| | - Jiuquan Zhang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Yongfeng Chen
- Department of Respiratory Medicine, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Wenwei Wang
- Department of Respiratory Medicine, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xiangdong Zhou
- Department of Respiratory Medicine, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xiaochu Yan
- Department of Pathology, Southwest Hospital, Third Military Medical University, Chongqing, China
- * E-mail: (JW); (XY)
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China
- * E-mail: (JW); (XY)
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Abdel Razek AAK, Khairy M, Nada N. Diffusion-weighted MR imaging in thymic epithelial tumors: correlation with World Health Organization classification and clinical staging. Radiology 2014; 273:268-75. [PMID: 24877982 DOI: 10.1148/radiol.14131643] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE To assess thymic epithelial tumors with diffusion-weighted magnetic resonance (MR) imaging. MATERIALS AND METHODS Informed consent from patients and institutional review board approval were obtained. Prospective study was conducted on 30 consecutive patients (21 men and nine women; age range, 35-71 years) with thymic epithelial tumors. They underwent true fast imaging with steady-state precession and single-shot echo-planar diffusion-weighted MR imaging of the mediastinum with b values of 0, 400, and 800 sec/mm(2). Apparent diffusion coefficient (ADC) of the thymic epithelial tumors was calculated by the same observer at two settings and was correlated with World Health Organization classification and clinical staging. RESULTS There was significant difference in longest diameter (P = .001) and necrotic part of the tumor (P = .014) between low-risk thymoma, high-risk thymoma, and thymic carcinoma. Mean ADC value of both readings of thymic epithelial tumors (n = 30) was 1.24 × 10(-3) mm(2)/sec and 1.22 × 10(-3) mm(2)/sec, with good intraobserver agreement (κ = 0.732). There was significant difference in both readings (P = .01 and .20) of low-risk thymoma (1.30 × 10(-3) mm(2)/sec and 1.29 × 10(-3) mm(2)/sec), high-risk thymoma (1.16 × 10(-3) mm(2)/sec and 1.14 × 10(-3) mm(2)/sec), and thymic carcinoma (1.18 × 10(-3) mm(2)/sec and 1.06 × 10(-3) mm(2)/sec). Cutoff ADC values of both readings used to differentiate low-risk thymoma from high-risk thymoma and thymic carcinoma were 1.25 and 1.22 × 10(-3) mm(2)/sec with area under the curve of 0.804 and 0.851, respectively. There was significant difference in both readings of ADC value of early (stage I, II) and advanced stages (stage III, IV) of thymic epithelial tumors (P = .006 and .005, respectively). CONCLUSION ADC value is a noninvasive, reliable, and reproducible imaging parameter that may help to assess and characterize thymic epithelial tumors.
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Affiliation(s)
- Ahmed Abdel Khalek Abdel Razek
- From the Departments of Diagnostic Radiology (A.A.K.A.R.), Chest (M.K.), and Pathology (N.N.), Mansoura Faculty of Medicine, Mansoura, Egypt 13351
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Xue H, Ren C, Yang J, Sun Z, Li S, Jin Z, Shen K, Zhou W. Histogram analysis of apparent diffusion coefficient for the assessment of local aggressiveness of cervical cancer. Arch Gynecol Obstet 2014; 290:341-8. [DOI: 10.1007/s00404-014-3221-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 03/14/2014] [Indexed: 10/25/2022]
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Hompland T, Ellingsen C, Galappathi K, Rofstad EK. DW-MRI in assessment of the hypoxic fraction, interstitial fluid pressure, and metastatic propensity of melanoma xenografts. BMC Cancer 2014; 14:92. [PMID: 24528854 PMCID: PMC3930534 DOI: 10.1186/1471-2407-14-92] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 02/12/2014] [Indexed: 01/28/2023] Open
Abstract
Background Cancer patients with primary tumors showing extensive hypoxia and highly elevated interstitial fluid pressure (IFP) have poor prognosis. The potential of diffusion-weighted magnetic resonance imaging (DW-MRI) in assessing the hypoxic fraction, IFP, and metastatic propensity of tumors was investigated in this study. Methods A-07 and R-18 melanoma xenografts were used as general models of human cancer. DW-MRI was performed at 1.5 T, and maps of the apparent diffusion coefficient (ADC) were produced with in-house-made software developed in Matlab. Pimonidazole was used as a hypoxia marker. Tumor cell density and hypoxic fraction were assessed by quantitative analysis of histological sections. IFP was measured with a Millar catheter. Metastatic propensity was determined by examining tumor-bearing mice for pulmonary micrometastases post mortem. Results ADC decreased with increasing tumor cell density, independent of whether the A-07 and R-18 data were analyzed separately or together. In the A-07 line, ADC decreased with increasing hypoxic fraction and increasing IFP and was lower in metastatic than in nonmetastatic tumors, and in the R-18 line, ADC decreased with increasing hypoxic fraction. There was a strong inverse correlation between ADC and hypoxic fraction as well as between ADC and IFP across the two tumor lines, primarily because low ADC as well as high hypoxic fraction and high IFP were associated with high cell density. Conclusion Low ADC is a potentially useful biomarker of poor prognosis in cancer, since low ADC is mainly a consequence of high cell density, and high cell density may lead to increased hypoxia and interstitial hypertension and, therefore, increased microenvironment-associated metastasis.
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Affiliation(s)
| | | | | | - Einar K Rofstad
- Group of Radiation Biology and Tumor Physiology, Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Nydalen, Box 4953, Oslo N-0424, Norway.
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Bernardin L, Douglas NHM, Collins DJ, Giles SL, O'Flynn EAM, Orton M, deSouza NM. Diffusion-weighted magnetic resonance imaging for assessment of lung lesions: repeatability of the apparent diffusion coefficient measurement. Eur Radiol 2014; 24:502-11. [PMID: 24275802 DOI: 10.1007/s00330-013-3048-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 09/25/2013] [Accepted: 09/30/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To establish repeatability of apparent diffusion coefficients (ADCs) acquired from free-breathing diffusion-weighted magnetic resonance imaging (DW-MRI) in malignant lung lesions and investigate effects of lesion size, location and respiratory motion. METHODS Thirty-six malignant lung lesions (eight patients) were examined twice (1- to 5-h interval) using T1-weighted, T2-weighted and axial single-shot echo-planar DW-MRI (b = 100, 500, 800 s/mm(2)) during free-breathing. Regions of interest around target lesions on computed b = 800 s/mm(2) images by two independent observers yielded ADC values from maps (pixel-by-pixel fitting using all b values and a mono-exponential decay model). Intra- and inter-observer repeatability was assessed per lesion, per patient and by lesion size (> or <2 cm) or location. RESULTS ADCs were similar between observers (mean ± SD, 1.15 ± 0.28 × 10(-3) mm(2)/s, observer 1; 1.15 ± 0.29 × 10(-3) mm(2)/s, observer 2). Intra-observer coefficients of variation of the mean [median] ADC per lesion and per patient were 11% [11.4%], 5.7% [5.7%] for observer 1 and 9.2% [9.5%], 3.9% [4.7%] for observer 2 respectively; inter-observer values were 8.9% [9.3%] (per lesion) and 3.0% [3.7%] (per patient). Inter-observer coefficient of variation (CoV) was greater for lesions <2 cm (n = 20) compared with >2 cm (n = 16) (10.8% vs 6.5% ADCmean, 11.3% vs 6.7% ADCmedian) and for mid (n = 14) vs apical (n = 9) or lower zone (n = 13) lesions (13.9%, 2.7%, 3.8% respectively ADCmean; 14.2%, 2.8%, 4.7% respectively ADCmedian). CONCLUSION Free-breathing DW-MRI of whole lung achieves good intra- and inter-observer repeatability of ADC measurements in malignant lung tumours. KEY POINTS • Diffusion-weighted MRI of the lung can be satisfactorily acquired during free-breathing • DW-MRI demonstrates high contrast between primary and metastatic lesions and normal lung • Apparent diffusion coefficient (ADC) measurements in lung tumours are repeatable and reliable • ADC offers potential in assessing response in lung metastases in clinical trials.
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Affiliation(s)
- L Bernardin
- CRUK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK
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Diffusion-weighted MR imaging vs. multi-detector row CT: Direct comparison of capability for assessment of management needs for anterior mediastinal solitary tumors. Eur J Radiol 2014; 83:835-42. [PMID: 24636535 DOI: 10.1016/j.ejrad.2014.01.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 12/27/2013] [Accepted: 01/03/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate and compare the capability of diffusion-weighted MR imaging (DWI) and CT for assessment of management needs for anterior mediastinal solitary tumors. MATERIALS AND METHODS Thirty-five patients with pathologically confirmed anterior mediastinal tumors were enrolled. The tumors were divided into two groups according to need for management: tumors not needing further intervention or treatment (group A; thymoma type A, AB and B1) and tumors needing further intervention and treatment (group B; other thymoma types and malignancies). The apparent diffusion coefficient (ADC) of each tumor was measured, and probabilities of malignancy and need for further intervention and treatment were visually assessed on CT. The differences in ADCs between group A and B and between malignancies and thymomas in group B were evaluated with the Mann-Whitney's U-test. Feasible threshold values for differentiation of group B from group A and distinguishing malignancies from thymomas assessed as group B were determined by the ROC-based positive test, and McNemar's test was used for comparing diagnostic capabilities of DWI with those of CT. RESULTS ADCs for the two groups were significantly different (p<0.001). Application of the threshold value for differentiation of group B from A showed no significant difference (p>0.05). Application of the feasible threshold value for distinguishing malignant from thymomas assessed as group B showed that specificity (76.9%) and accuracy (85.2%) of DWI were significantly better than those of visual score (p<0.05). CONCLUSION DWI has useful potential for the assessment of management needs for anterior mediastinum solitary tumors as well as CT.
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Li B, Li Q, Chen C, Guan Y, Liu S. A systematic review and meta-analysis of the accuracy of diffusion-weighted MRI in the detection of malignant pulmonary nodules and masses. Acad Radiol 2014; 21:21-9. [PMID: 24331261 DOI: 10.1016/j.acra.2013.09.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/29/2013] [Accepted: 09/30/2013] [Indexed: 12/31/2022]
Abstract
RATIONALE AND OBJECTIVES To perform a meta-analysis to assess the diagnostic performance of the diffusion-weighted magnetic resonance imaging (DWI) technique in discrimination of benign and malignant pulmonary nodules or masses. MATERIALS AND METHODS Data sources were studies published in PubMed, MEDLINE, EMBASE, Cochrane Library, and China National Knowledge Infrastructure databases from January 2001 to May 2013. Studies evaluating the diagnostic accuracy of DWI for benign/malignant discrimination of pulmonary nodules in English or Chinese language were considered for inclusion. Methodological quality was assessed by the quality assessment of diagnostic studies instrument. Sensitivities, specificities, predictive values, diagnostic odds ratios (DORs), and areas under the receiver operating characteristic curve (AUCs) were calculated. Potential threshold effect, heterogeneity, and publication bias were investigated. We also evaluated the clinical utility of DWI in diagnosis of lung lesions. RESULTS Seventeen studies comprising 855 malignant and 322 benign lesions were included in this meta-analysis. There was no significant threshold effect. Summary receiver operating characteristic curve showed that AUC was 0.909 (95% confidence interval [CI], 0.862-0.931). Pooled weighted estimates of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were 0.828 (95% CI, 0.801-0.853), 0.801 (95% CI, 0.753-0.843), 4.01 (95% CI, 2.78-5.80), and 0.20 (95% CI, 0.15-0.27), respectively. Heterogeneity was found to have stemmed primarily from study design (retrospective or prospective study). Subgroup analysis showed that diagnostic performance (sensitivity, 0.88; 95% CI, 0.82-0.92 and specificity, 0.89; 95% CI, 0.79-0.96) of retrospectively designed studies was significantly higher than that of prospectively designed studies. The Deeks' funnel plot indicated the absence of publication bias. CONCLUSIONS With respect to the accuracy and DOR, DWI is useful for differentiation between malignant and benign pulmonary nodules or masses. Diagnostic test accuracy is not the be-all and end-all of diagnostic testing. Concerning PLR and NLR, DWI may not help to alter posttest probability compared to pretest probability to sufficiently alter physician's decision making. Future analyses should be conducted in large-scale, high-quality trials to evaluate its clinical value and establish standards of DWI measurement, analysis, and cutoff values of diagnosis.
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Affiliation(s)
- Bin Li
- Department of Radiology, Shanghai Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China
| | - Qiong Li
- Department of Radiology, Shanghai Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China
| | - Cong Chen
- Radiation Treatment Center, 100 Hospital of PLA, Suzhou, Jiangsu Province, China
| | - Yu Guan
- Department of Radiology, Shanghai Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China
| | - Shiyuan Liu
- Department of Radiology, Shanghai Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China.
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Schmidt H, Brendle C, Schraml C, Martirosian P, Bezrukov I, Hetzel J, Müller M, Sauter A, Claussen CD, Pfannenberg C, Schwenzer NF. Correlation of Simultaneously Acquired Diffusion-Weighted Imaging and 2-Deoxy-[18F] fluoro-2-D-glucose Positron Emission Tomography of Pulmonary Lesions in a Dedicated Whole-Body Magnetic Resonance/Positron Emission Tomography System. Invest Radiol 2013; 48:247-55. [DOI: 10.1097/rli.0b013e31828d56a1] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Downey K, Riches SF, Morgan VA, Giles SL, Attygalle AD, Ind TE, Barton DPJ, Shepherd JH, deSouza NM. Relationship between imaging biomarkers of stage I cervical cancer and poor-prognosis histologic features: quantitative histogram analysis of diffusion-weighted MR images. AJR Am J Roentgenol 2013; 200:314-20. [PMID: 23345352 DOI: 10.2214/ajr.12.9545] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2024]
Abstract
OBJECTIVE The purpose of this study was to determine whether histogram analysis of apparent diffusion coefficient (ADC) values from diffusion-weighted MRI can be used to differentiate cervical tumors according to their histologic characteristics. SUBJECTS AND METHODS Sixty patients with International Federation of Gynecology stage I cervical cancer underwent MRI at 1.5 T with a 37-mm-diameter endovaginal coil. T2-weighted images (TR/TE, 2000-2368/90) followed by diffusion-weighted images (TR/TE, 2500/69; b values, 0, 100, 300, 500, and 800 s/mm(2)) were acquired. An expert observer drew regions of interest around a histologically confirmed tumor on ADC maps by referring to the T2-weighted images. Pixel-by-pixel ADCs were calculated with a monoexponential fit of data from b values of 100-800 s/mm(2), and ADC histograms were obtained from the entire tumor volume. An independent samples Student t test was used to compare differences in ADC percentile values, skew, and kurtosis between squamous cell carcinoma and adenocarcinoma, well or moderately differentiated and poorly differentiated tumors, and absence and presence of lymphovascular space invasion. RESULTS There was no statistically significant difference in ADC percentiles between squamous cell carcinoma and adenocarcinoma, but the median was significantly higher in well or moderately differentiated tumors (50th percentile, 1113 ± 177 × 10(-6) mm(2)/s) compared with poorly differentiated tumors (50th percentile, 996 ± 184 × 10(-6) mm(2)/s) (p = 0.049). Histogram skew was significantly less positive for adenocarcinoma compared with squamous cell carcinoma (p = 0.016) but did not differ between tumor grades. There was no significant difference between any parameter with regard to lymphovascular space invasion. CONCLUSION Median ADC is lower in poorly compared with well or moderately differentiated tumors, while lower histogram-positive skew in adenocarcinoma compared with squamous cell carcinoma is likely to reflect the glandular content of adenocarcinoma.
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Affiliation(s)
- Kate Downey
- CRUK/EPSRC Cancer Imaging Centre, MRI Unit, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Downs Rd, Sutton, Surrey SM2 5PT, UK.
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Chen L, Zhang J, Bao J, Zhang L, Hu X, Xia Y, Wang J. Meta-analysis of diffusion-weighted MRI in the differential diagnosis of lung lesions. J Magn Reson Imaging 2012; 37:1351-8. [PMID: 23239425 DOI: 10.1002/jmri.23939] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 10/05/2012] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To perform a meta-analysis to evaluate the diagnostic performance of the diffusion-weighted imaging (DWI) technique in differentiating malignant from benign lung lesions. MATERIALS AND METHODS Medical and scientific literature databases were searched for studies that assessed the diagnostic performance of DWI in patients suspected of lung cancer who underwent DWI and biopsy. Only studies in the English or Chinese language and published before September 2011 were considered for inclusion. Methodological quality was assessed by the Quality Assessment of Diagnostic Studies (QUADAS) instrument. Homogeneity was explored by the Chi-square test and inconsistency index. Sensitivities (SEN), specificities, predictive values, diagnostic odds ratio (dOR), and areas under the receiver operator characteristic (ROC) curve were calculated. Potential threshold effect was investigated by using Spearman's correlation coefficient. Publication bias analysis was evaluated by Deeks' asymmetry test. RESULTS Of 33 eligible studies, 11 were included in the meta-analysis, comprising 755 malignant and 294 benign lesions. Heterogeneity was found to have arisen primarily from threshold effect. The data points from the Deeks' funnel plot indicated the presence of publication bias. Methodological quality was moderate. The pooled weighted SEN with corresponding 95% confidence interval (CI) was 0.80 (95% CI: 0.76, 0.83), SPE was 0.93 (95% CI: 0.91, 0.95), positive likelihood ratio was 9.24 (95% CI: 3.58, 23.83), negative likelihood ratio was 0.24 (95% CI: 0.19, 0.29), and dOR was 46.14 (95% CI: 27.56, 77.26). The area under the ROC curve was 0.91 (95% CI: 0.89, 0.93). CONCLUSION DWI is a noninvasive, nonradiative, and accurate technique for distinguishing between malignant and benign lung lesions. However, large-scale randomized control trials are necessary to assess its clinical value and to establish standards of DWI for measurement, analysis, and cutoff values of diagnosis.
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Affiliation(s)
- Lihua Chen
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China
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Abstract
This review provides an overview of the current status of the published data on diffusion magnetic resonance (MR) imaging of chest tumors. Diffusion MR imaging is a non-invasive imaging technique that measures the differences in water mobility in different tissue microstructures and quantifies them based on the apparent diffusion coefficient. Diffusion MR imaging has been used for the characterization, grading and staging of lung cancer as well as for differentiating central tumors from post-obstructive consolidation. In addition, this technique helps in differentiating malignant from benign pulmonary and mediastinal tumors as well as in the characterization of pleural mesothelioma and effusion. Diffusion MR imaging can be incorporated into routine morphological MR imaging to improve radiologist confidence in image interpretation and to provide functional assessments of chest tumors during the same examination. Diffusion MR imaging could be used in the future as a functional imaging technique for tumors of the chest.
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Affiliation(s)
- A A K Abdel Razek
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.
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Li F, Yu T, Li W, Zhang C, Cao Y, Su D, Wang Y, Li D. [Correlation of apparent diffusion coefficient with histologic type and grade of lung cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2012; 15:646-51. [PMID: 23092585 PMCID: PMC6000031 DOI: 10.3779/j.issn.1009-3419.2012.11.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND OBJECTIVE The histologic type and grade of lung cancer are significant in assessing the biological behaviour, prognosis and therapeutic regimen. This study investigates the correlation of apparent diffusion coefficient (ADC) with histologic type and grade of lung cancer. METHODS A total of 115 patients pathologically diagnosed with lung cancer were enrolled in this study. Magnetic resonance (MR)-DWI with a diffusion factor of 500 s/mm2 was performed and the ADC values of lesions were measured. The ADC values among the different histologic types and grades were compared with the values obtained using t-test and one-way ANOVA. The correlation between ADC values and the histologic grades was further evaluated with Spearman correlation coefficient. RESULTS With a b value of 500 s/mm2, the ADC values significantly differed between small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) (P = 0.017). The ADC values of SCLC were significantly different from those of squamous cell carcinoma and adenocarcinoma (P = 0.011, 0.001, respectively). A significant difference was observed in the ADC values among the different histologic grades of lung cancer (P = 0.003), and the ADC value was correlated with the histologic grades (rs = -0.272, P = 0.003). CONCLUSIONS ADC value is significant for judgement of histologic type and grade of lung cancer before surgical operation: SCLC has a low ADC value, and ADC value is low for the tumor with poorly-differentiated grade.
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Affiliation(s)
- Fei Li
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China
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