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Wassenaar NPM, Gurney-Champion OJ, van Schelt AS, Bruijnen T, van Laarhoven HWM, Stoker J, Nederveen AJ, Runge JH, Schrauben EM. Optimizing pseudo-spiral sampling for abdominal DCE MRI using a digital anthropomorphic phantom. Magn Reson Med 2024. [PMID: 39004838 DOI: 10.1002/mrm.30213] [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: 12/20/2023] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE For reliable DCE MRI parameter estimation, k-space undersampling is essential to meet resolution, coverage, and signal-to-noise requirements. Pseudo-spiral (PS) sampling achieves this by sampling k-space on a Cartesian grid following a spiral trajectory. The goal was to optimize PS k-space sampling patterns for abdomin al DCE MRI. METHODS The optimal PS k-space sampling pattern was determined using an anthropomorphic digital phantom. Contrast agent inflow was simulated in the liver, spleen, pancreas, and pancreatic ductal adenocarcinoma (PDAC). A total of 704 variable sampling and reconstruction approaches were created using three algorithms using different parametrizations to control sampling density, halfscan and compressed sensing regularization. The sampling patterns were evaluated based on image quality scores and the accuracy and precision of the DCE pharmacokinetic parameters. The best and worst strategies were assessed in vivo in five healthy volunteers without contrast agent administration. The best strategy was tested in a DCE scan of a PDAC patient. RESULTS The best PS reconstruction was found to be PS-diffuse based, with quadratic distribution of readouts on a spiral, without random shuffling, halfscan factor of 0.8, and total variation regularization of 0.05 in the spatial and temporal domains. The best scoring strategy showed sharper images with less prominent artifacts in healthy volunteers compared to the worst strategy. Our suggested DCE sampling strategy also showed high quality DCE images in the PDAC patient. CONCLUSION Using an anthropomorphic digital phantom, we identified an optimal PS sampling strategy for abdominal DCE MRI, and demonstrated feasibility in a PDAC patient.
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Affiliation(s)
- Nienke P M Wassenaar
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Oliver J Gurney-Champion
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Anne-Sophie van Schelt
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Tom Bruijnen
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
- Computational Imaging Group for MRI diagnostics and Therapy, Centre for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hanneke W M van Laarhoven
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap Stoker
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology, Metabolism, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jurgen H Runge
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Eric M Schrauben
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Fukukura Y, Kanki A. Quantitative Magnetic Resonance Imaging for the Pancreas: Current Status. Invest Radiol 2024; 59:69-77. [PMID: 37433065 DOI: 10.1097/rli.0000000000001002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
ABSTRACT Magnetic resonance imaging (MRI) is important for evaluating pancreatic disorders, and anatomical landmarks play a major role in the interpretation of results. Quantitative MRI is an effective diagnostic modality for various pathologic conditions, as it allows the investigation of various physical parameters. Recent advancements in quantitative MRI techniques have significantly improved the accuracy of pancreatic MRI. Consequently, this method has become an essential tool for the diagnosis, treatment, and monitoring of pancreatic diseases. This comprehensive review article presents the currently available evidence on the clinical utility of quantitative MRI of the pancreas.
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Affiliation(s)
- Yoshihiko Fukukura
- From the Department of Radiology, Kawasaki Medical School, Kurashiki City, Okayama, Japan
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Lu Y, Zhang T, Yang S, Yang B, Li J, Liu H, Yao D, Ren G, Wang D. Dynamic Contrast-Enhanced MRI Assessing Antifibrotic Therapeutic Effects of Pancreatic Fibrosis with Curcumin - An Experimental Study at 11.7 T. Acad Radiol 2023; 30 Suppl 1:S230-S237. [PMID: 37453883 DOI: 10.1016/j.acra.2023.05.028] [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: 03/14/2023] [Revised: 05/24/2023] [Accepted: 05/27/2023] [Indexed: 07/18/2023]
Abstract
RATIONALE AND OBJECTIVES Pancreatic fibrosis is the hallmark of chronic pancreatitis (CP), which is associated with microcirculatory disturbance. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can assess the perfusion and permeability of the pancreas by providing information about microcirculation. We hypothesize that DCE-MRI parameters can be utilized to assess pancreatic fibrosis and may furthermore provide an opportunity to evaluate response to antifibrotic treatment with curcumin. Our study was to evaluate the feasibility of quantitative DCE-MRI in assessing pancreatic fibrosis and the antifibrotic effect of curcumin in a rat model of CP. MATERIALS AND METHODS Pancreatic fibrosis was induced by injecting dibutyltin dichloride (DBTC). Seventy rats were randomized to five groups: the control group (n = 10); DBTC for 2 weeks (n = 15); DBTC for 4 weeks (n = 15); DBTC + curcumin for 2 weeks (n = 15); DBTC + curcumin for 4 weeks (n = 15). DCE-MRI was performed at an 11.7 T MR scanner. DCE-MRI quantitative parameters (Ktrans, Ve, and Vp) were derived from an extended Tofts model. Fibrosis content and DCE-MRI parameters were compared among the above groups (one-way analysis of variance). The correlations between DCE-MRI parameters and pancreatic fibrosis content as well as the expression of α-SMA were computed by Spearman correlation coefficients. RESULTS Fifty-three rats survived and underwent MR imaging. Ktrans in rats 4 weeks after DBTC injection was significantly lower than DBTC 2 weeks rats and control rats (0.30 ± 0.06 min vs 0.49 ± 0.09 vs 0.62 ± 0.09, respectively). Vp in DBTC 4 weeks rats was also significantly lower than control rats (0.048 ± 0.010 min-1 vs 0.065 ± 0.011 min-1, respectively). Ktrans and Vp significantly correlated with fibrosis content of pancreas (r = -0.619 and -0.450, all P < 0.001), and the expression of α-SMA (r = -0.688 and -0.402, all P < 0.01). Ktrans and Vp in rats with daily curcumin treatment for 4 weeks were significantly higher than DBTC 4 weeks rats (Ktrans, 0.51 ± 0.09 vs 0.30 ± 0.06; Vp, 0.064 ± 0.015 vs 0.048 ± 0.010). CONCLUSION DCE-MRI parameters (Ktrans and Vp) have the potential to noninvasively assess pancreatic fibrosis and the antifibrotic treatment response of curcumin.
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Affiliation(s)
- Yimei Lu
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Tingting Zhang
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Shuyan Yang
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Baofeng Yang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China (B.Y.); Human Phenome Institute, Fudan University, Shanghai 200433, China (B.Y.).
| | - Jinning Li
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Huanhuan Liu
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Defan Yao
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Gang Ren
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Dengbin Wang
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
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Choi M, Yoon S, Lee Y, Han D. Evaluation of Perfusion Change According to Pancreatic Cancer and Pancreatic Duct Dilatation Using Free-Breathing Golden-Angle Radial Sparse Parallel (GRASP) Magnetic Resonance Imaging. Diagnostics (Basel) 2023; 13:diagnostics13040731. [PMID: 36832219 PMCID: PMC9955363 DOI: 10.3390/diagnostics13040731] [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: 12/19/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
PURPOSE To evaluate perfusion changes in the pancreas with pancreatic cancer and pancreatic duct dilatation using dynamic contrast-enhanced MRI (DCE-MRI). METHOD We evaluate the pancreas DCE-MRI of 75 patients. The qualitative analysis includes pancreas edge sharpness, motion artifacts, streak artifacts, noise, and overall image quality. The quantitative analysis includes measuring the pancreatic duct diameter and drawing six regions of interest (ROIs) in the three areas of the pancreas (head, body, and tail) and three vessels (aorta, celiac axis, and superior mesenteric artery) to measure the peak-enhancement time, delay time, and peak concentration. We evaluate the differences in three quantitative parameters among the ROIs and between patients with and without pancreatic cancer. The correlations between pancreatic duct diameter and delay time are also analyzed. RESULTS The pancreas DCE-MRI demonstrates good image quality, and respiratory motion artifacts show the highest score. The peak-enhancement time does not differ among the three vessels or among the three pancreas areas. The peak-enhancement time and concentrations in the pancreas body and tail and the delay time in the three pancreas areas are significantly longer (p < 0.05) in patients with pancreatic cancer than in those without pancreatic cancer. The delay time was significantly correlated with the pancreatic duct diameters in the head (p < 0.02) and body (p < 0.001). CONCLUSION DCE-MRI can display the perfusion change in the pancreas with pancreatic cancer. A perfusion parameter in the pancreas is correlated with the pancreatic duct diameter reflecting a morphological change in the pancreas.
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Affiliation(s)
- Moonhyung Choi
- Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Seungbae Yoon
- Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
- Correspondence: ; Tel.: +82-2-2030-4317
| | - Youngjoon Lee
- Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Dongyeob Han
- Siemens Healthineers Ltd., Seoul 06620, Republic of Korea
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Chaika M, Afat S, Wessling D, Afat C, Nickel D, Kannengiesser S, Herrmann J, Almansour H, Männlin S, Othman AE, Gassenmaier S. Deep learning-based super-resolution gradient echo imaging of the pancreas: Improvement of image quality and reduction of acquisition time. Diagn Interv Imaging 2023; 104:53-59. [PMID: 35843839 DOI: 10.1016/j.diii.2022.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the impact of a deep learning-based super-resolution technique on T1-weighted gradient-echo acquisitions (volumetric interpolated breath-hold examination; VIBE) on the assessment of pancreatic MRI at 1.5 T compared to standard VIBE imaging (VIBESTD). MATERIALS AND METHODS This retrospective single-center study was conducted between April 2021 and October 2021. Fifty patients with a total of 50 detectable pancreatic lesion entities were included in this study. There were 27 men and 23 women, with a mean age of 69 ± 13 (standard deviation [SD]) years (age range: 33-89 years). VIBESTD (precontrast, dynamic, postcontrast) was retrospectively processed with a deep learning-based super-resolution algorithm including a more aggressive partial Fourier setting leading to a simulated acquisition time reduction (VIBESR). Image analysis was performed by two radiologists regarding lesion detectability, noise levels, sharpness and contrast of pancreatic edges, as well as regarding diagnostic confidence using a 5-point Likert-scale with 5 being the best. RESULTS VIBESR was rated better than VIBESTD by both readers regarding lesion detectability (5 [IQR: 5, 5] vs. 5 [IQR: 4, 5], for reader 1; 5 [IQR: 5, 5] vs. 4 [IQR: 4, 5]) for reader 2; both P <0.001), noise levels (5 [IQR: 5, 5] vs. 5 [IQR: 4, 5] for reader 1; 5 [IQR: 5, 5] vs. 4 [IQR: 4, 5] for reader 2; both P <0.001), sharpness and contrast of pancreatic edges (5 [IQR: 5, 5] vs. 5 [IQR: 4, 5] for reader 1; 5 [IQR: 5, 5] vs. 4 [IQR: 4, 5] for reader 2; both P <0.001), as well as regarding diagnostic confidence (5 [IQR: 5, 5] vs. 5 [IQR: 4, 5] for reader 1; 5 [IQR: 5, 5] vs. 4 [IQR: 4, 5] for reader 2; both P <0.001). There were no significant differences between lesion sizes as measured by the two readers on VIBESR and VIBESTD images (P > 0.05). The mean acquisition time for VIBESTD (15 ± 1 [SD] s; range: 11-16 s) was longer than that for VIBESR (13 ± 1 [SD] s; range: 11-14 s) (P < 0.001). CONCLUSION Our results indicate that the newly developed deep learning-based super-resolution algorithm adapted to partial Fourier acquisitions has a positive influence not only on shortening the examination time but also on improvement of image quality in pancreatic MRI.
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Affiliation(s)
- Maryanna Chaika
- Department of Diagnostic and Interventional Radiology, Hoppe-Seyler-Strasse 3, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
| | - Saif Afat
- Department of Diagnostic and Interventional Radiology, Hoppe-Seyler-Strasse 3, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
| | - Daniel Wessling
- Department of Diagnostic and Interventional Radiology, Hoppe-Seyler-Strasse 3, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
| | - Carmen Afat
- Department of Internal Medicine I, Otfried-Müller-Straße 10, Eberhard Karls University Tuebingen, 72076, Tuebingen, Germany
| | - Dominik Nickel
- MR Applications Predevelopment, Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Stephan Kannengiesser
- MR Applications Predevelopment, Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Judith Herrmann
- Department of Diagnostic and Interventional Radiology, Hoppe-Seyler-Strasse 3, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
| | - Haidara Almansour
- Department of Diagnostic and Interventional Radiology, Hoppe-Seyler-Strasse 3, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
| | - Simon Männlin
- Department of Diagnostic and Interventional Radiology, Hoppe-Seyler-Strasse 3, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
| | - Ahmed E Othman
- Department of Diagnostic and Interventional Radiology, Hoppe-Seyler-Strasse 3, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany; Department of Neuroradiology, University Medical Center, 55131, Mainz, Germany
| | - Sebastian Gassenmaier
- Department of Diagnostic and Interventional Radiology, Hoppe-Seyler-Strasse 3, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany.
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Afat S, Wessling D, Afat C, Nickel D, Arberet S, Herrmann J, Othman AE, Gassenmaier S. Analysis of a Deep Learning-Based Superresolution Algorithm Tailored to Partial Fourier Gradient Echo Sequences of the Abdomen at 1.5 T: Reduction of Breath-Hold Time and Improvement of Image Quality. Invest Radiol 2022; 57:157-162. [PMID: 34510101 DOI: 10.1097/rli.0000000000000825] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the feasibility and impact of a novel deep learning superresolution algorithm tailored to partial Fourier allowing retrospectively theoretical acquisition time reduction in 1.5 T T1-weighted gradient echo imaging of the abdomen. MATERIALS AND METHODS Fifty consecutive patients who underwent a 1.5 T contrast-enhanced magnetic resonance imaging examination of the abdomen between April and May 2021 were included in this retrospective study. After acquisition of a conventional T1-weighted volumetric interpolated breath-hold examination using Dixon for water-fat separation (VIBEStd), the acquired data were reprocessed including a superresolution algorithm that was optimized for partial Fourier acquisitions (VIBESR). To accelerate theoretically the acquisition process, a more aggressive partial Fourier setting was applied in VIBESR reconstructions practically corresponding to a shorter acquisition for the data included in the retrospective reconstruction. Precontrast, dynamic contrast-enhanced, and postcontrast data sets were processed. Image analysis was performed by 2 radiologists independently in a blinded random order without access to clinical data regarding the following criteria using a Likert scale ranging from 1 to 4 with 4 being the best: noise levels, sharpness and contrast of vessels, sharpness and contrast of organs and lymph nodes, overall image quality, diagnostic confidence, and lesion conspicuity.Wilcoxon signed rank test for paired data was applied to test for significance. RESULTS Mean patient age was 61 ± 14 years. Mean acquisition time for the conventional VIBEStd sequence was 15 ± 1 seconds versus theoretical 13 ± 1 seconds of acquired data used for the VIBESR reconstruction. Noise levels were evaluated to be better in VIBESR with a median of 4 (4-4) versus a median of 3 (3-3) in VIBEStd by both readers (P < 0.001). Sharpness and contrast of vessels as well as organs and lymph nodes were also evaluated to be superior in VIBESR compared with VIBEStd with a median of 4 (4-4) versus a median of 3 (3-3) (P < 0.001). Diagnostic confidence was also rated superior in VIBESR with a median of 4 (4-4) versus a median of 3.5 (3-4) in VIBEStd by reader 1 and with a median of 4 (4-4) for VIBESR and a median of 4 (4-4) for VIBEStd by reader 2 (both P < 0.001). CONCLUSIONS Image enhancement using deep learning-based superresolution tailored to partial Fourier acquisitions of T1-weighted gradient echo imaging of the abdomen provides improved image quality and diagnostic confidence in combination with more aggressive partial Fourier settings leading to shorter scan time.
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Affiliation(s)
- Saif Afat
- From the Departments of Diagnostic and Interventional Radiology
| | - Daniel Wessling
- From the Departments of Diagnostic and Interventional Radiology
| | - Carmen Afat
- Internal Medicine I, Eberhard Karls University Tuebingen, Tuebingen
| | - Dominik Nickel
- MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Simon Arberet
- Digital Technology and Innovation, Siemens Healthineers, Princeton, NJ
| | - Judith Herrmann
- From the Departments of Diagnostic and Interventional Radiology
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Yang Y, Shi XQ, Chen G, Zhou XN, Qian LX. Contrast-enhanced ultrasound for evaluating response to pulsed-wave high-intensity focused ultrasound therapy in advanced pancreatic cancer. Clin Hemorheol Microcirc 2022; 81:57-67. [PMID: 35001881 DOI: 10.3233/ch-211342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To examine whether contrast-enhanced ultrasound (CEUS) parameters in patients with advanced pancreatic cancer could be used to assess response to treatment with pulsed-wave high intensity focused ultrasound (PW-HIFU). METHODS We prospectively recorded the pretreatment and posttreatment CEUS related parameters, CA19-9, pain scores of 30 patients with advanced pancreatic cancer treated with PW-HIFU treatment. Correlation of clinical parameters, tumor characteristics, and PW-HIFU treatment energy with CEUS parameters were analyzed. RESULTS Pain score decreased after treatment (from 4.80±2.14 to 3.28±1.93, p = 0.001). CA19-9 dropped in RT decreased group, 4 weeks after one session PW-HIFU, compared with prolonged group (p = 0.013). According to the display of blood vessels in the mass by CEUS, tumors were classified by vessel grade (VG), VG1: no vessel can be seen; VG 2: vessels diameter < 5 mm; VG 3: vessels diameter > 5 mm. VGs were different between increased and decreased relative rise intensity (rRI) groups (p = 0.008). VG1 group shown a decreased rRI after treatment, while VG3 group showed the opposite trend (p = 0.006). CONCLUSIONS CEUS can evaluating response to PW-HIFU in advanced pancreatic cancer. Quantitative analysis may help to assess the short-term efficacy of patients and help for individualized treatment.
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Affiliation(s)
- Yu Yang
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xian-Quan Shi
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Guang Chen
- Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Na Zhou
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lin-Xue Qian
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Fukukura Y, Kumagae Y, Fujisaki Y, Nakamura S, Dominik Nickel M, Imai H, Yoshiura T. Extracellular volume fraction with MRI: As an alternative predictive biomarker to dynamic contrast-enhanced MRI for chemotherapy response of pancreatic ductal adenocarcinoma. Eur J Radiol 2021; 145:110036. [PMID: 34814039 DOI: 10.1016/j.ejrad.2021.110036] [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: 09/02/2021] [Revised: 10/21/2021] [Accepted: 11/12/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE To assess the feasibility of extracellular volume (ECV) fraction determined with equilibrium contrast-enhanced MRI for prediction of treatment response to chemotherapy in pancreatic ductal adenocarcinoma (PDAC) in comparison with dynamic contrast-enhanced MRI (DCE-MRI), and to clarify the association between ECV fraction and DCE-MRI-derived pharmacokinetic parameters. METHODS This retrospective study included 58 consecutive patients with histologically confirmed PDAC who underwent DCE-MRI before systemic chemotherapy. Tumor pharmacokinetic parameters, including the volume transfer coefficient (Ktrans), rate constant (kep), and extracellular extravascular volume fraction (ve) of DCE-MRI, and ECV fraction determined with equilibrium contrast-enhanced MRI were compared between the response and non-response groups. The correlation of tumor ECV fraction with each DCE-MRI-derived pharmacokinetic parameter was examined using Spearman's rank correlation coefficient. RESULTS Tumor Ktrans, ve, and ECV fraction were significantly higher in the response group than in the non-response group (all, P < 0.001), whereas no significant difference was found in kep (P = 0.119). Tumor ECV fraction showed the highest area under receiver operating characteristic curve of 0.918, with a sensitivity of 89.3%, specificity of 90.0%, and accuracy of 89.7% (cut off, >37.6%). The ECV fraction showed a significant positive correlation with Ktrans (Spearman's coefficient = 0.66, P < 0.001) and ve (Spearman's coefficient = 0.79, P < 0.001). CONCLUSIONS ECV fraction determined with equilibrium contrast-enhanced MRI was as useful as DCE-MRI-derived pharmacokinetic parameters for predicting treatment response to chemotherapy in patients with PDAC.
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Affiliation(s)
- Yoshihiko Fukukura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan.
| | - Yuichi Kumagae
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
| | - Yosuke Fujisaki
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
| | - Shinya Nakamura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
| | - Marcel Dominik Nickel
- MR Application Predevelopment, Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Hiroshi Imai
- Siemens Healthcare K.K., 1-11-1 Osaki, Shinagawa City, Tokyo, 141-8644, Japan
| | - Takashi Yoshiura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan
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Holland MD, Morales A, Simmons S, Smith B, Misko SR, Jiang X, Hormuth DA, Christenson C, Koomullil RP, Morgan DE, Li Y, Xu J, Yankeelov TE, Kim H. Disposable point-of-care portable perfusion phantom for quantitative DCE-MRI. Med Phys 2021; 49:271-281. [PMID: 34802148 DOI: 10.1002/mp.15372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/12/2021] [Accepted: 11/05/2021] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To develop a disposable point-of-care portable perfusion phantom (DP4) and validate its clinical utility in a multi-institutional setting for quantitative dynamic contrast-enhanced magnetic resonance imaging (qDCE-MRI). METHODS The DP4 phantom was designed for single-use and imaged concurrently with a human subject so that the phantom data can be utilized as the reference to detect errors in qDCE-MRI measurement of human tissues. The change of contrast-agent concentration in the phantom was measured using liquid chromatography-mass spectrometry. The repeatability of the contrast enhancement curve (CEC) was assessed with five phantoms in a single MRI scanner. Five healthy human subjects were recruited to evaluate the reproducibility of qDCE-MRI measurements. Each subject was imaged concurrently with the DP4 phantom at two institutes using three 3T MRI scanners from three different vendors. Pharmacokinetic (PK) parameters in the regions of liver, spleen, pancreas, and paravertebral muscle were calculated based on the Tofts model (TM), extended Tofts model (ETM), and shutter speed model (SSM). The reproducibility of each PK parameter over three measurements was evaluated with the intraclass correlation coefficient (ICC) and compared before and after DP4-based error correction. RESULTS The contrast-agent concentration in the DP4 phantom was linearly increased over 10 min (0.17 mM/min, measurement accuracy: 96%) after injecting gadoteridol (100 mM) at a constant rate (0.24 ml/s, 4 ml). The repeatability of the CEC within the phantom was 0.997 when assessed by the ICC. The reproducibility of the volume transfer constant, Ktrans , was the highest of the PK parameters regardless of the PK models. The ICCs of Ktrans in the TM, ETM, and SSM before DP4-based error correction were 0.34, 0.39, and 0.72, respectively, while those increased to 0.93, 0.98, and 0.86, respectively, after correction. CONCLUSIONS The DP4 phantom is reliable, portable, and capable of significantly improving the reproducibility of qDCE-MRI measurements.
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Affiliation(s)
- Martin D Holland
- Interdisciplinary Engineering, University of Alabama, Birmingham, Alabama, USA
| | - Andres Morales
- Engineering and Innovative Technology Development, University of Alabama, Birmingham, Alabama, USA
| | | | - Brandon Smith
- Engineering and Innovative Technology Development, University of Alabama, Birmingham, Alabama, USA
| | - Samuel R Misko
- Engineering and Innovative Technology Development, University of Alabama, Birmingham, Alabama, USA
| | - Xiaoyu Jiang
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David A Hormuth
- The Oden Institute for Computational Engineering and Sciences, University of Texas, Austin, Texas, USA
| | - Chase Christenson
- The Oden Institute for Computational Engineering and Sciences, University of Texas, Austin, Texas, USA
| | - Roy P Koomullil
- Department of Mechanical Engineering, University of Alabama, Birmingham, Alabama, USA
| | - Desiree E Morgan
- Department of Radiology, University of Alabama, Birmingham, Alabama, USA
| | - Yufeng Li
- Department of Preventive Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Junzhong Xu
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Thomas E Yankeelov
- The Oden Institute for Computational Engineering and Sciences, University of Texas, Austin, Texas, USA
| | - Harrison Kim
- Department of Radiology, University of Alabama, Birmingham, Alabama, USA
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10
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Kaandorp MPT, Barbieri S, Klaassen R, van Laarhoven HWM, Crezee H, While PT, Nederveen AJ, Gurney‐Champion OJ. Improved unsupervised physics-informed deep learning for intravoxel incoherent motion modeling and evaluation in pancreatic cancer patients. Magn Reson Med 2021; 86:2250-2265. [PMID: 34105184 PMCID: PMC8362093 DOI: 10.1002/mrm.28852] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Earlier work showed that IVIM-NETorig , an unsupervised physics-informed deep neural network, was faster and more accurate than other state-of-the-art intravoxel-incoherent motion (IVIM) fitting approaches to diffusion-weighted imaging (DWI). This study presents a substantially improved version, IVIM-NEToptim , and characterizes its superior performance in pancreatic cancer patients. METHOD In simulations (signal-to-noise ratio [SNR] = 20), the accuracy, independence, and consistency of IVIM-NET were evaluated for combinations of hyperparameters (fit S0, constraints, network architecture, number of hidden layers, dropout, batch normalization, learning rate), by calculating the normalized root-mean-square error (NRMSE), Spearman's ρ, and the coefficient of variation (CVNET ), respectively. The best performing network, IVIM-NEToptim was compared to least squares (LS) and a Bayesian approach at different SNRs. IVIM-NEToptim 's performance was evaluated in an independent dataset of 23 patients with pancreatic ductal adenocarcinoma. Fourteen of the patients received no treatment between two repeated scan sessions and nine received chemoradiotherapy between the repeated sessions. Intersession within-subject standard deviations (wSD) and treatment-induced changes were assessed. RESULTS In simulations (SNR = 20), IVIM-NEToptim outperformed IVIM-NETorig in accuracy (NRMSE(D) = 0.177 vs 0.196; NMRSE(f) = 0.220 vs 0.267; NMRSE(D*) = 0.386 vs 0.393), independence (ρ(D*, f) = 0.22 vs 0.74), and consistency (CVNET (D) = 0.013 vs 0.104; CVNET (f) = 0.020 vs 0.054; CVNET (D*) = 0.036 vs 0.110). IVIM-NEToptim showed superior performance to the LS and Bayesian approaches at SNRs < 50. In vivo, IVIM-NEToptim showed significantly less noisy parameter maps with lower wSD for D and f than the alternatives. In the treated cohort, IVIM-NEToptim detected the most individual patients with significant parameter changes compared to day-to-day variations. CONCLUSION IVIM-NEToptim is recommended for accurate, informative, and consistent IVIM fitting to DWI data.
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Affiliation(s)
- Misha P. T. Kaandorp
- Department of Radiology and Nuclear MedicineCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
- Department of Radiology and Nuclear MedicineSt. Olav’s University HospitalTrondheimNorway
- Department of Circulation and Medical ImagingNTNU – Norwegian University of Science and TechnologyTrondheimNorway
| | | | - Remy Klaassen
- Department of Medical OncologyCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Hanneke W. M. van Laarhoven
- Department of Medical OncologyCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Hans Crezee
- Department of Radiology and Nuclear MedicineCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Peter T. While
- Department of Radiology and Nuclear MedicineSt. Olav’s University HospitalTrondheimNorway
- Department of Circulation and Medical ImagingNTNU – Norwegian University of Science and TechnologyTrondheimNorway
| | - Aart J. Nederveen
- Department of Radiology and Nuclear MedicineCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Oliver J. Gurney‐Champion
- Department of Radiology and Nuclear MedicineCancer Center Amsterdam, Amsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
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11
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Longitudinal Monitoring of Simulated Interstitial Fluid Pressure for Pancreatic Ductal Adenocarcinoma Patients Treated with Stereotactic Body Radiotherapy. Cancers (Basel) 2021; 13:cancers13174319. [PMID: 34503129 PMCID: PMC8430878 DOI: 10.3390/cancers13174319] [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: 07/12/2021] [Revised: 08/03/2021] [Accepted: 08/19/2021] [Indexed: 11/25/2022] Open
Abstract
Simple Summary High vessel permeability, poor perfusion, low lymphatic drainage, and dense abundant stroma elevate interstitial fluid pressures (IFP) in pancreatic ductal adenocarcinoma (PDAC). The present study aims to monitor longitudinal changes in simulated tumor IFP and velocity (IFV) values using a dynamic contrast-enhanced (DCE)-MRI-based computational fluid modeling (CFM) approach in PDAC. Nine PDAC patients underwent DCE-MRI acquisition on a 3-Tesla MRI scanner at pre-treatment (TX (0)), immediately after the first fraction of stereotactic body radiotherapy (SBRT, (D1-TX)), and six weeks post-TX (D2-TX). The partial differential equation of IFP formulated from the continuity equation using the Starling Principle of fluid exchange and Darcy velocity–pressure relationship was solved in COMSOL Multiphysics software to generate IFP and IFV parametric maps using relevant tumor tissue physiological parameters. Initial results suggest that after validation, IFP and IFV can be imaging biomarkers of early response to therapy that may guide precision medicine in PDAC. Abstract The present study aims to monitor longitudinal changes in simulated tumor interstitial fluid pressure (IFP) and velocity (IFV) values using dynamic contrast-enhanced (DCE)-MRI-based computational fluid modeling (CFM) in pancreatic ductal adenocarcinoma (PDAC) patients. Nine PDAC patients underwent MRI, including DCE-MRI, on a 3-Tesla MRI scanner at pre-treatment (TX (0)), after the first fraction of stereotactic body radiotherapy (SBRT, (D1-TX)), and six weeks post-TX (D2-TX). The partial differential equation of IFP formulated from the continuity equation, incorporating the Starling Principle of fluid exchange, Darcy velocity, and volume transfer constant (Ktrans), was solved in COMSOL Multiphysics software to generate IFP and IFV maps. Tumor volume (Vt), Ktrans, IFP, and IFV values were compared (Wilcoxon and Spearman) between the time- points. D2-TX Ktrans values were significantly different from pre-TX and D1-TX (p < 0.05). The D1-TX and pre-TX mean IFV values exhibited a borderline significant difference (p = 0.08). The IFP values varying <3.0% between the three time-points were not significantly different (p > 0.05). Vt and IFP values were strongly positively correlated at pre-TX (ρ = 0.90, p = 0.005), while IFV exhibited a strong negative correlation at D1-TX (ρ = −0.74, p = 0.045). Vt, Ktrans, IFP, and IFV hold promise as imaging biomarkers of early response to therapy in PDAC.
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12
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Gassenmaier S, Herrmann J, Nickel D, Kannengiesser S, Afat S, Seith F, Hoffmann R, Othman AE. Image Quality Improvement of Dynamic Contrast-Enhanced Gradient Echo Magnetic Resonance Imaging by Iterative Denoising and Edge Enhancement. Invest Radiol 2021; 56:465-470. [PMID: 33645949 DOI: 10.1097/rli.0000000000000761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the impact of a novel edge enhancement and iterative denoising algorithm in 1.5-T T1-weighted dynamic contrast-enhanced (DCE) gradient echo (GRE) magnetic resonance imaging of the abdomen on image quality, noise levels, diagnostic confidence, and lesion detectability. MATERIALS AND METHODS Fifty patients who underwent a clinically indicated magnetic resonance imaging with DCE imaging of the abdomen between June and August 2020 were included in this retrospective, monocentric, institutional review board-approved study. For DCE imaging, a series of 3 volume interpolated breath-hold examinations (VIBEs) was performed. The raw data of all DCE imaging studies were processed twice, once using standard reconstruction (DCES) and again using an edge enhancement and iterative denoising approach (DCEDE). All imaging studies were randomly reviewed by 2 radiologists independently regarding noise levels, arterial contrast, sharpness of vessels, overall image quality, and diagnostic confidence using a Likert scale ranging from 1 to 4, with 4 being the best. Furthermore, lesion detectability was evaluated using the same ranking system. RESULTS All 50 imaging studies were successfully reconstructed with both methods. Interreader agreement (Cohen κ) was substantial to perfect for both readers. Arterial contrast and sharpness of vessels were rated superior by both readers with a median of 4 in DCEDE versus a median of 3 in DCES (P < 0.001). Furthermore, noise levels as well as overall image quality were rated higher with a median of 4 in DCEDE compared with a median of 3 in DCES (P < 0.001). Lesion detectability was evaluated to be superior in DCEDE with a median of 4 versus DCES with a median of 3 (P < 0.001). Consequently, diagnostic confidence was also rated to be superior in DCEDE with a median of 4 versus DCES with a median of 3 (P < 0.001). CONCLUSIONS Iterative denoising and edge enhancement are feasible in DCE imaging of the abdomen providing superior arterial contrast, noise levels, and overall image quality. Furthermore, lesion detectability and diagnostic confidence were significantly improved using this novel reconstruction method. Further reduction of acquisition time might be possible via reduction of increased noise levels using this presented method.
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Affiliation(s)
- Sebastian Gassenmaier
- From the Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Tuebingen
| | - Judith Herrmann
- From the Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Tuebingen
| | - Dominik Nickel
- MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | | | - Saif Afat
- From the Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Tuebingen
| | - Ferdinand Seith
- From the Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Tuebingen
| | - Rüdiger Hoffmann
- From the Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Tuebingen
| | - Ahmed E Othman
- From the Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Tuebingen
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13
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Kinh Do R, Reyngold M, Paudyal R, Oh JH, Konar AS, LoCastro E, Goodman KA, Shukla-Dave A. Diffusion-Weighted and Dynamic Contrast-Enhanced MRI Derived Imaging Metrics for Stereotactic Body Radiotherapy of Pancreatic Ductal Adenocarcinoma: Preliminary Findings. ACTA ACUST UNITED AC 2021; 6:261-271. [PMID: 32548304 PMCID: PMC7289241 DOI: 10.18383/j.tom.2020.00015] [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] [Indexed: 01/26/2023]
Abstract
We aimed to assess longitudinal changes in quantitative imaging metric values obtained from diffusion-weighted (DW-) and dynamic contrast-enhanced magnetic resonance imaging (DCE)-MRI at pre-treatment (TX[0]), immediately after the first fraction of stereotactic body radiotherapy (D1-TX[1]), and 6 weeks post-TX (Post-TX[2]) in patients with pancreatic ductal adenocarcinoma. Ten enrolled patients (n = 10) underwent DW- and DCE-MRI examinations on a 3.0 T scanner. The apparent diffusion coefficient, ADC (mm2/s), was derived from DW imaging data using a monoexponential model. The tissue relaxation rate, R 1t, time-course data were fitted with a shutter-speed model, which provides estimates of the volume transfer constant, K trans (min-1), extravascular extracellular volume fraction, ve , and mean lifetime of intracellular water protons, τ i (seconds). Wilcoxon rank-sum test compared the mean values, standard deviation, skewness, kurtosis, and relative percentage (r, %) changes (Δ) in ADC, K trans, ve , and τ i values between the magnetic resonance examinations. rADCΔ2-0 values were significantly greater than rADCΔ1-0 values (P = .009). rK trans Δ2-0 values were significantly lower than rK trans Δ1-0 values (P = .048). rve Δ2-1 and rveΔ2-0 values were significantly different (P = .016). rτ i Δ2-1 values were significantly lower than rτ i Δ2-0 values (P = .008). For group comparison, the pre-TX mean and kurtosis of ADC (P = .18 and P = .14), skewness and kurtosis of K trans values (P = .14 for both) showed a leaning toward significant difference between patients who experienced local control (n = 2) and failed early (n = 4). DW- and DCE-MRI-derived quantitative metrics could be useful biomarkers to evaluate longitudinal changes to stereotactic body radiotherapy in patients with pancreatic ductal adenocarcinoma.
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Affiliation(s)
| | | | - Ramesh Paudyal
- Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY; and
| | - Jung Hun Oh
- Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY; and
| | | | - Eve LoCastro
- Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY; and
| | - Karyn A Goodman
- Tisch Cancer Institute at Mount Sinai Hospital, New York, NY
| | - Amita Shukla-Dave
- Departments of Radiology.,Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY; and
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14
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Zuo D, Feng Y, Zhang Q, Qiu YJ, Tian XF, Shi SN, Dong Y, Liu TS, Wang WP. The value of dynamic contrast enhanced ultrasound (DCE-US) in monitoring treatment effect of high-intensity focused ultrasound (HIFU) in locally advanced pancreatic cancer (LAPC). Clin Hemorheol Microcirc 2021; 77:323-333. [PMID: 33252067 DOI: 10.3233/ch-201020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE To evaluate the feasibility of dynamic contrast enhanced ultrasound (DCE-US) in predicting treatment response of high-intensity focused ultrasound (HIFU) in patients with locally advanced pancreatic cancer (LAPC) lesions. PATIENTS AND METHODS In this prospective study, 10 patients with pathologically confirmed LAPC lesions (7 men, 3 women; average age, 61.13±5.80 years) were prospectively enrolled. All patients received HIFU treatment with peak intensity at 12000 W/cm2. Contrast enhanced ultrasound (CEUS) was performed with an ACUSON Oxana 2 ultrasound equipment and a 6 C-1 transducer (1-6 Hz). A dose of 2.4 ml SonoVue was injected for each examination. Time intensity curves (TICs) were generated and quantitative analyses were performed by SonoLiver software. B mode ultrasound (BMUS) features, CEUS enhancement patterns, TICs, CEUS quantitative parameters and serum carcinoma antigen 19-9 (CA19-9) levels were compared before and 4 weeks after HIFU treatment. Statistical analyses were performed with SPSS Version 20.0 and GraphPad Prism 5. RESULTS While comparing before and after HIFU, no significant difference was obtained on mean size of lesion, BMUS or CEUS features. After HIFU treatment, TICs showed decreased and delayed enhancement. Among all CEUS quantitative parameters, significant decrease could be found in maximum intensity (MI) (60.66±23.95% vs 41.31±26.74%) and mean transit time (mTT) (76.66±47.61 s vs 38.42±28.35 s). CA19-9 level decreased significantly after HIFU (2747.92±4237.41 U/ml vs 715.08±1773.90 U/ml) (P = 0.05). CONCLUSION DCE-US combining with quantitative analysis might be a useful imaging method for early treatment response evaluation of HIFU in LAPC lesions.
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Affiliation(s)
- Dan Zuo
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Medical Imaging, Shanghai, China
| | - Yi Feng
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qi Zhang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yi-Jie Qiu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiao-Fan Tian
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shuai-Nan Shi
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Medical Imaging, Shanghai, China
| | - Tian-Shu Liu
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wen-Ping Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Medical Imaging, Shanghai, China
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15
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Kim H, Thomas JV, Nix JW, Gordetsky JB, Li Y, Rais-Bahrami S. Portable Perfusion Phantom Offers Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Accurate Prostate Cancer Grade Stratification: A Pilot Study. Acad Radiol 2021; 28:405-413. [PMID: 32224036 DOI: 10.1016/j.acra.2020.02.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/19/2020] [Accepted: 02/25/2020] [Indexed: 01/10/2023]
Abstract
RATIONALE AND OBJECTIVES The study goal was to test whether the improved accuracy in quantitative dynamic contrast-enhanced magnetic resonance imaging measurement using a point-of-care portable perfusion phantom (P4) leads to better stratification of prostate cancer grade. MATERIALS AND METHODS A prospective clinical study was conducted recruiting 44 patients scheduled for multi-parameter MRI prostate exams. All participants were imaged with the P4 placed under their pelvic regions. Tissue sampling was carried out for 25 patients at 22 ± 18 (mean ± SD) days after multi-parameter MRI. On histologic examination, a total of 31 lesions were confirmed as prostate cancer. Tumors were classified into low grade (n = 14), intermediate grade (n = 10), and high grade (n = 7). Tumor perfusion was assessed by volume transfer constant, Ktrans, before and after P4-based error correction, and the Ktrans of low, intermediate and high-grade tumors were statistically compared. RESULTS After P4-based error correction, the Ktrans of low, intermediate, and high-grade tumors were 0.109 ± 0.026 min-1 (95% CI: 0.0094 to 0.124 min-1), 0.163 ± 0.049 min-1 (95% CI: 0.129 to 0.198 min-1) and 0.356 ± 0.156 min-1 (95% CI: 0.215 to 0.495 min-1), respectively, with statistically significant difference among the groups (low vs intermediate: p = 0.002; intermediate vs high: p = 0.002; low vs high: p < 0.001). The sensitivity and specificity of Ktrans value, 0.14 min-1, to detect the clinically significant prostate cancer were 88% and 93%, respectively, after P4 based error correction, but those before error correction were 88% and 86%, respectively. CONCLUSION The P4 allows to reduce errors in quantitative dynamic contrast-enhanced magnetic resonance imaging measurement, enhancing accuracy in stratification of prostate cancer grade.
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Affiliation(s)
- Harrison Kim
- Department of Radiology, University of Alabama at Birmingham, G082C5 Volker Hall, 1670 University Blvd., Birmingham, AL 35294-0019; O'Neal Comprehensive Cancer Center at UAB, University of Alabama at Birmingham, Birmingham, AL.
| | - John V Thomas
- Department of Radiology, University of Alabama at Birmingham, G082C5 Volker Hall, 1670 University Blvd., Birmingham, AL 35294-0019
| | - Jeffrey W Nix
- Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama; O'Neal Comprehensive Cancer Center at UAB, University of Alabama at Birmingham, Birmingham, AL
| | - Jennifer B Gordetsky
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Yufeng Li
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Soroush Rais-Bahrami
- Department of Radiology, University of Alabama at Birmingham, G082C5 Volker Hall, 1670 University Blvd., Birmingham, AL 35294-0019; Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama; O'Neal Comprehensive Cancer Center at UAB, University of Alabama at Birmingham, Birmingham, AL
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16
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Harrington KA, Shukla-Dave A, Paudyal R, Do RKG. MRI of the Pancreas. J Magn Reson Imaging 2020; 53:347-359. [PMID: 32302044 DOI: 10.1002/jmri.27148] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 02/06/2023] Open
Abstract
MRI has played a critical role in the evaluation of patients with pancreatic pathologies, from screening of patients at high risk for pancreatic cancer to the evaluation of pancreatic cysts and indeterminate pancreatic lesions. The high mortality associated with pancreatic adenocarcinomas has spurred much interest in developing effective screening tools, with MRI using magnetic resonance cholangiopancreatography (MRCP) playing a central role in the hopes of identifying cancers at earlier stages amenable to curative resection. Ongoing efforts to improve the resolution and robustness of imaging of the pancreas using MRI may thus one day reduce the mortality of this deadly disease. However, the increasing use of cross-sectional imaging has also generated a concomitant clinical conundrum: How to manage incidental pancreatic cystic lesions that are found in over a quarter of patients who undergo MRCP. Efforts to improve the specificity of MRCP for patients with pancreatic cysts and with indeterminate pancreatic masses may be achieved with continued technical advances in MRI, including diffusion-weighted and T1 -weighted dynamic contrast-enhanced MRI. However, developments in quantitative MRI of the pancreas remain challenging, due to the small size of the pancreas and its upper abdominal location, adjacent to bowel and below the diaphragm. Further research is needed to improve MRI of the pancreas as a clinical tool, to positively affect the lives of patients with pancreatic abnormalities. This review focuses on various MR techniques such as MRCP, quantitative imaging, and dynamic contrast-enhanced imaging and their clinical applicability in the imaging of the pancreas, with an emphasis on pancreatic malignant and premalignant lesions. Level of Evidence 5 Technical Efficacy Stage 3 J. MAGN. RESON. IMAGING 2021;53:347-359.
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Affiliation(s)
- Kate A Harrington
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Amita Shukla-Dave
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ramesh Paudyal
- Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Richard K G Do
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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17
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Zhang Q, Wu L, Yang D, Qiu Y, Yu L, Dong Y, Wang WP. Clinical application of dynamic contrast enhanced ultrasound in monitoring the treatment response of chemoradiotherapy of pancreatic ductal adenocarcinoma. Clin Hemorheol Microcirc 2020; 75:325-334. [PMID: 31985457 DOI: 10.3233/ch-190786] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To investigate the value of dynamic contrast enhanced ultrasound (D-CEUS) in monitoring the chemoradiotherapy (CRT) therapeutic response of local advanced pancreatic ductal adenocarcinoma (LAPC). PATIENTS AND METHODS From October 2017 to December 2018, 11 patients diagnosed as LAPC were included (7 men, 4 women; mean age: 61.1±8.6 years). The algorithm of CRT was as following: the radiotherapy dose was 50.4 Gy/28Fx with S-1 40 mg bid orally taken in radiotherapy day. Conventional ultrasound scan and CEUS were performed before and 4 weeks after CRT. All ultrasound examinations were performed by an ACUSON Oxana 2 ultrasound equipment (Siemens Medical Solutions, Germany) with a C 6-1 convex array transducer (1-6 MHz). Time intensity curves (TICs) were generated in the region of interests (ROIs) both in LAPC lesions and in its surrounding pancreas parenchyma by SonoLiver software (TOMTEC Imaging Systems). Quantitative perfusion parameters including maximum intensity (MI), rise time (RT), mean transit time (mTT) and time to peak (TTP) were analyzed and compared before and after CRT. RESULTS No significant difference could be found by conventional B mode ultrasound scan after CRT. TICs of CEUS showed lower ascending and descending slopes rate after CRT. Among all perfusion quantitative parameters, MI decreased significantly after CRT (42.1±18.8% vs 27.8±17.2%, P < 0.05). CONCLUSIONS Depending on its unique advantages as non-radiation, effective and convenient, D-CEUS analysis and quantitative parameters, particularly MI, has potential application value in following up of the CRT treatment response in LAPC patients.
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Affiliation(s)
- Qi Zhang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lili Wu
- Department of Radiotherapy, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Daohui Yang
- Shanghai Institute of Medical Imaging, Shanghai, China
| | - Yijie Qiu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lingyun Yu
- Shanghai Institute of Medical Imaging, Shanghai, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wen-Ping Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
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18
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Tang W, Liu W, Li HM, Wang QF, Fu CX, Wang XH, Zhou LP, Peng WJ. Quantitative dynamic contrast-enhanced MR imaging for the preliminary prediction of the response to gemcitabine-based chemotherapy in advanced pancreatic ductal carcinoma. Eur J Radiol 2019; 121:108734. [PMID: 31743881 DOI: 10.1016/j.ejrad.2019.108734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/15/2019] [Accepted: 10/27/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate the role of the quantitative parameters of dynamic contrast-enhanced MR imaging (DCE-MRI) in the prediction of the response to chemotherapy in pancreatic ductal carcinoma (PDC). METHOD Forty patients with histologically confirmed PDC who underwent quantitative DCE-MRI were retrospectively analyzed. All patients were divided into groups of responders and nonresponders. DCE-MRI parameters, including the volume transfer constant (Ktrans), the extracellular extravascular volume fraction (ve), the rate constant (kep) and the initial area under the concentration curve in 60 s (iAUC60), were measured and compared. DCE-MRI parameters were obtained from different ROIs. RESULTS The values of Ktrans in responders with peripheral, whole tumor slice, and adjacent non-tumorous region ROIs were significantly higher than those in nonresponders (P = 0.015, 0.043, and 0.025, respectively). Responders showed a significantly higher kep with peripheral area ROI compared with nonresponders (P = 0.013). Ve and iAUC60 with all ROIs were not significantly different between responders and nonresponders (P = 0.140-0.968). Kep with periphery ROI showed the highest area under the ROC curve (AUC) of 0.806, but there were no statistical differences when compared with values of Ktrans.There were statistically significant differences for DCE-MRI parameters among four ROIs (all P < 0.05). All parameters showed good to excellent intra and interobserver agreement. CONCLUSIONS Quantitative parameters derived from DCE-MRI might be a potential predictor of response to gemcitabine in patients with PDC. Perfusion parameters were diverse depending on the location of the ROI on different tumoral and peritumoral areas.
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Affiliation(s)
- Wei Tang
- Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui District, Shanghai, 200032, China
| | - Wei Liu
- Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui District, Shanghai, 200032, China
| | - Hai-Ming Li
- Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui District, Shanghai, 200032, China
| | - Qi-Feng Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui District, Shanghai, 200032, China
| | - Cai-Xia Fu
- MR Applications Development, Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Xiao-Hong Wang
- Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui District, Shanghai, 200032, China
| | - Liang-Ping Zhou
- Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui District, Shanghai, 200032, China.
| | - Wei-Jun Peng
- Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, 270 Dongan Road, Xuhui District, Shanghai, 200032, China.
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