1
|
Yao F, Li J, Huang M, Gao X, Zhang Y. Comparison of computed versus acquired readout-segmented diffusion-weighted imaging in visualizing scrotal or testicular lesions. Clin Radiol 2024:S0009-9260(24)00396-9. [PMID: 39122632 DOI: 10.1016/j.crad.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/26/2024] [Accepted: 07/15/2024] [Indexed: 08/12/2024]
Abstract
PURPOSE Combining computed diffusion-weighted imaging (DWI) with readout-segmented echo-planar-imaging may shorten acquisition time and improve imaging quality. This study aimed to compare computed vs. acquired DWI qualitatively and quantitatively in visualizing scrotal or testicular lesions. MATERIALS AND METHODS We retrospectively enrolled 57 consecutive men who underwent scrotal MRI. Four computed DWI sets (cDWI800, cDWI1000, cDWI1200, and cDWI1400) were generated from acquired DWI with two lower b-values (150 and 600 s/mm2). Acquired DWI (DWI800 and DWI1000) and computed DWI were compared through qualitative (susceptibility artifact, signal loss artifact, anatomic clarity, and lesion conspicuity) and quantitative assessment (signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and lesion-to-testicular parenchyma contrast ratio (CR)). RESULTS Computed DWI was prone to signal loss artifact and slightly lower assessment scores in terms of anatomic clarity and lesion conspicuity, comparing with acquired DWI. The SNR of computed and acquired DWI decreased with increasing b value. Under the same b-values (800 and 1,000 s/mm2), there was no difference in the median SNR and CR between computed and acquired DWI. The median CR of cDWI1400 was significantly higher than that of the other DWI sets excepting cDWI1200 (P=1.000). The median CNR tended to be lower for computed vs. acquired DWI, while no significant difference (P=0.233). CONCLUSIONS Computed and acquired DWI were nearly equivalent in both qualitative and quantitative evaluations at the b values of 800 and 1,000 s/mm2. Computed DWI could enhance the contrast of scrotal or testicular lesions.
Collapse
Affiliation(s)
- F Yao
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, China.
| | - J Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, China
| | - M Huang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, China
| | - X Gao
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, China
| | - Y Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, China
| |
Collapse
|
2
|
Kallis K, Conlin CC, Zhong AY, Hussain TS, Chatterjee A, Karczmar GS, Rakow-Penner R, Dale AM, Seibert TM. Comparison of synthesized and acquired high b-value diffusion-weighted MRI for detection of prostate cancer. Cancer Imaging 2024; 24:89. [PMID: 38972972 PMCID: PMC11229343 DOI: 10.1186/s40644-024-00723-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND High b-value diffusion-weighted images (DWI) are used for detection of clinically significant prostate cancer (csPCa). This study qualitatively and quantitatively compares synthesized DWI (sDWI) to acquired (aDWI) for detection of csPCa. METHODS One hundred fifty-one consecutive patients who underwent prostate MRI and biopsy were included in the study. Axial DWI with b = 0, 500, 1000, and 2000 s/mm2 using a 3T clinical scanner using a 32-channel phased-array body coil were acquired. We retrospectively synthesized DWI for b = 2000 s/mm2 via extrapolation based on mono-exponential decay, using b = 0 and b = 500 s/mm2 (sDWI500) and b = 0, b = 500 s/mm2, and b = 1000 s/mm2 (sDWI1000). Differences in signal intensity between sDWI and aDWI were evaluated within different regions of interest (prostate alone, prostate plus 5 mm, 30 mm and 70 mm margin and full field of view). The maximum DWI value within each ROI was evaluated for prediction of csPCa. Classification accuracy was compared to Restriction Spectrum Imaging restriction score (RSIrs), a previously validated biomarker based on multi-exponential DWI. Discrimination of csPCa was evaluated via area under the receiver operating characteristic curve (AUC). RESULTS Within the prostate, mean ± standard deviation of percent mean differences between sDWI and aDWI signal were -46 ± 35% for sDWI1000 and -67 ± 24% for sDWI500. AUC for aDWI, sDWI500, sDWI1000, and RSIrs within the prostate 0.62[95% confidence interval: 0.53, 0.71], 0.63[0.54, 0.72], 0.65[0.56, 0.73] and 0.78[0.71, 0.86], respectively. CONCLUSION sDWI is qualitatively comparable to aDWI within the prostate. However, hyperintense artifacts are introduced with sDWI in the surrounding pelvic tissue that interfere with quantitative cancer detection and might mask metastases. In the prostate, RSIrs yields superior quantitative csPCa detection than sDWI or aDWI.
Collapse
Affiliation(s)
- Karoline Kallis
- Department of Radiation Medicine and Applied Sciences, University of California San Diego Health, La Jolla, CA, USA
| | - Christopher C Conlin
- Department of Radiology, University of California San Diego Health, La Jolla, San Diego, CA, USA
| | - Allison Y Zhong
- Department of Radiation Medicine and Applied Sciences, University of California San Diego Health, La Jolla, CA, USA
| | - Troy S Hussain
- Department of Radiation Medicine and Applied Sciences, University of California San Diego Health, La Jolla, CA, USA
| | - Aritrick Chatterjee
- Department of Radiology, University of Chicago, Chicago, IL, USA
- Sanford J. Grossmann Center of Excellence in Prostate Imaging and Image Guided Therapy, University of Chicago, Chicago, IL, USA
| | - Gregory S Karczmar
- Department of Radiology, University of Chicago, Chicago, IL, USA
- Sanford J. Grossmann Center of Excellence in Prostate Imaging and Image Guided Therapy, University of Chicago, Chicago, IL, USA
| | - Rebecca Rakow-Penner
- Department of Radiology, University of California San Diego Health, La Jolla, San Diego, CA, USA
| | - Anders M Dale
- Department of Radiology, University of California San Diego Health, La Jolla, San Diego, CA, USA
- Department of Neurosciences, University of California San Diego Health, La Jolla, San Diego, CA, USA
- Halıcıoğlu Data Science Institute, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Tyler M Seibert
- Department of Radiology, University of California San Diego Health, La Jolla, San Diego, CA, USA.
- Department of Radiation Medicine and Applied Sciences, University of California San Diego Health, La Jolla, CA, USA.
- Department of Bioengineering, University of California San Diego Jacobs School of Engineering, La Jolla, San Diego, CA, USA.
| |
Collapse
|
3
|
Candito A, Holbrey R, Ribeiro A, Messiou C, Tunariu N, Koh DM, Blackledge MD. Deep Learning for Delineation of the Spinal Canal in Whole-Body Diffusion-Weighted Imaging: Normalising Inter- and Intra-Patient Intensity Signal in Multi-Centre Datasets. Bioengineering (Basel) 2024; 11:130. [PMID: 38391616 PMCID: PMC10885936 DOI: 10.3390/bioengineering11020130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Whole-Body Diffusion-Weighted Imaging (WBDWI) is an established technique for staging and evaluating treatment response in patients with multiple myeloma (MM) and advanced prostate cancer (APC). However, WBDWI scans show inter- and intra-patient intensity signal variability. This variability poses challenges in accurately quantifying bone disease, tracking changes over follow-up scans, and developing automated tools for bone lesion delineation. Here, we propose a novel automated pipeline for inter-station, inter-scan image signal standardisation on WBDWI that utilizes robust segmentation of the spinal canal through deep learning. METHODS We trained and validated a supervised 2D U-Net model to automatically delineate the spinal canal (both the spinal cord and surrounding cerebrospinal fluid, CSF) in an initial cohort of 40 patients who underwent WBDWI for treatment response evaluation (80 scans in total). Expert-validated contours were used as the target standard. The algorithm was further semi-quantitatively validated on four additional datasets (three internal, one external, 207 scans total) by comparing the distributions of average apparent diffusion coefficient (ADC) and volume of the spinal cord derived from a two-component Gaussian mixture model of segmented regions. Our pipeline subsequently standardises WBDWI signal intensity through two stages: (i) normalisation of signal between imaging stations within each patient through histogram equalisation of slices acquired on either side of the station gap, and (ii) inter-scan normalisation through histogram equalisation of the signal derived within segmented spinal canal regions. This approach was semi-quantitatively validated in all scans available to the study (N = 287). RESULTS The test dice score, precision, and recall of the spinal canal segmentation model were all above 0.87 when compared to manual delineation. The average ADC for the spinal cord (1.7 × 10-3 mm2/s) showed no significant difference from the manual contours. Furthermore, no significant differences were found between the average ADC values of the spinal cord across the additional four datasets. The signal-normalised, high-b-value images were visualised using a fixed contrast window level and demonstrated qualitatively better signal homogeneity across scans than scans that were not signal-normalised. CONCLUSION Our proposed intensity signal WBDWI normalisation pipeline successfully harmonises intensity values across multi-centre cohorts. The computational time required is less than 10 s, preserving contrast-to-noise and signal-to-noise ratios in axial diffusion-weighted images. Importantly, no changes to the clinical MRI protocol are expected, and there is no need for additional reference MRI data or follow-up scans.
Collapse
Affiliation(s)
- Antonio Candito
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SM2 5NG, UK
| | - Richard Holbrey
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SM2 5NG, UK
| | - Ana Ribeiro
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Christina Messiou
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SM2 5NG, UK
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Nina Tunariu
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SM2 5NG, UK
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Dow-Mu Koh
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SM2 5NG, UK
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Matthew D Blackledge
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SM2 5NG, UK
| |
Collapse
|
4
|
Xia Y, Zhu L, Cai G, Du L, Wang L, Feng W, Fu C, Ma Q, Dong Y, Pan Z, Yan F, Shen H, Li W, Zhang H. Computed Diffusion-Weighted Images of Rectal Cancer: Image Quality, Restaging, and Treatment Response after Neoadjuvant Therapy. J Magn Reson Imaging 2024; 59:297-308. [PMID: 37165908 DOI: 10.1002/jmri.28766] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Computed diffusion-weighted images (cDWI) of random b value could be derived from acquired DWI (aDWI) with at least two different b values. However, its comparison between aDWI and cDWI images in locally advanced rectal cancer (LARC) patients after neoadjuvant therapy (NT) is needed. PURPOSE To compare the cDWI and aDWI in image quality, restaging, and treatment response of LARC after NT. STUDY TYPE Retrospective. POPULATION Eighty-seven consecutive patients. FIELD STRENGTH/SEQUENCE 3.0 T/DWI. ASSESSMENT All patients underwent two DWI sequences, including conventional acquisition with b = 0 and 1000 s/mm2 (aDWIb1000 ) and another with b = 0 and 700 s/mm2 on a 3.0-T MR scanner. The images of the latter were used to compute the diffusion images with b = 1000 s/mm2 (cDWIb1000 ). Four radiologists with 3, 4, 14, and 25 years of experience evaluated the images to compare the image quality, TN restaging performance, and treatment response between aDWIb1000 and cDWIb1000 . STATISTICAL TESTS Interclass correlation coefficients, weighted κ coefficient, paired Wilcoxon, and McNemar or Fisher test were used. A significance level of 0.05 was used. RESULTS The cDWIb1000 images were superior to the aDWIb1000 ones in both subjective and objective image quality. In T restaging, the overall diagnostic accuracy of cDWIb1000 images was higher than that of aDWIb1000 images (57.47% vs. 49.43%, P = 0.289 for the inexperienced radiologist; 77.01% vs. 63.22%, significant for the experienced radiologist), with better sensitivity in determining ypT0-Tis tumors. Additionally, it increased the sensitivity in detecting ypT2 tumors for the inexperienced radiologist and ypT3 tumors for the experienced radiologist. N restaging and treatment response were found to be similar between two sequences for both radiologists. DATA CONCLUSION Compared to aDWIb1000 images, the computed ones might serve as a wise approach, providing comparable or better image quality, restaging performance, and treatment response assessment for LARC after NT. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY STAGE: 2.
Collapse
Affiliation(s)
- Yihan Xia
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Lan Zhu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Gang Cai
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Lianjun Du
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Lingyun Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Weiming Feng
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Caixia Fu
- Department of MR Application Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China
| | - Qianchen Ma
- Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Yihan Dong
- Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Zilai Pan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Hailin Shen
- Department of Radiology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University of Medicine, Suzhou, China
| | - Weiguang Li
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| |
Collapse
|
5
|
Karaman M, Zhou XJ. Editorial for "Computed Diffusion-Weighted Images of Rectal Cancer: Image Quality, Restaging, and Treatment Response after Neoadjuvant Therapy". J Magn Reson Imaging 2024; 59:309-310. [PMID: 37194671 DOI: 10.1002/jmri.28769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 05/18/2023] Open
Abstract
Level of Evidence5Technical Efficacy Stage2
Collapse
Affiliation(s)
- Muge Karaman
- Center for Magnetic Resonance Research, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Xiaohong Joe Zhou
- Center for Magnetic Resonance Research, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, Illinois, USA
- Departments of Radiology and Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA
| |
Collapse
|
6
|
Ceranka J, Wuts J, Chiabai O, Lecouvet F, Vandemeulebroucke J. Computer-aided diagnosis of skeletal metastases in multi-parametric whole-body MRI. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 242:107811. [PMID: 37742486 DOI: 10.1016/j.cmpb.2023.107811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023]
Abstract
The confident detection of metastatic bone disease is essential to improve patients' comfort and increase life expectancy. Multi-parametric magnetic resonance imaging (MRI) has been successfully used for monitoring of metastatic bone disease, allowing for comprehensive and holistic evaluation of the total tumour volume and treatment response assessment. The major challenges of radiological reading of whole-body MRI come from the amount of data to be reviewed and the scattered distribution of metastases, often of complex shapes. This makes bone lesion detection and quantification demanding for a radiologist and prone to error. Additionally, whole-body MRI are often corrupted with multiple spatial and intensity distortions, which further degrade the performance of image reading and image processing algorithms. In this work we propose a fully automated computer-aided diagnosis system for the detection and segmentation of metastatic bone disease using whole-body multi-parametric MRI. The system consists of an extensive image preprocessing pipeline aiming at enhancing the image quality, followed by a deep learning framework for detection and segmentation of metastatic bone disease. The system outperformed state-of-the-art methodologies, achieving a detection sensitivity of 63% with a mean of 6.44 false positives per image, and an average lesion Dice coefficient of 0.53. A provided ablation study performed to investigate the relative importance of image preprocessing shows that introduction of region of interest mask and spatial registration have a significant impact on detection and segmentation performance in whole-body MRI. The proposed computer-aided diagnosis system allows for automatic quantification of disease infiltration and could provide a valuable tool during radiological examination of whole-body MRI.
Collapse
Affiliation(s)
- Jakub Ceranka
- Vrije Universiteit Brussel, Department of Electronics and Informatics, Pleinlaan 2, Brussels, 1050, Belgium; imec, Kapeldreef 75, Leuven, B-3001, Belgium.
| | - Joris Wuts
- Vrije Universiteit Brussel, Department of Electronics and Informatics, Pleinlaan 2, Brussels, 1050, Belgium; imec, Kapeldreef 75, Leuven, B-3001, Belgium; Cliniques universitaires Saint Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, Brussels, 1200, Belgium.
| | - Ophélye Chiabai
- Cliniques universitaires Saint Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, Brussels, 1200, Belgium
| | - Frédéric Lecouvet
- Cliniques universitaires Saint Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, Brussels, 1200, Belgium
| | - Jef Vandemeulebroucke
- Vrije Universiteit Brussel, Department of Electronics and Informatics, Pleinlaan 2, Brussels, 1050, Belgium; imec, Kapeldreef 75, Leuven, B-3001, Belgium; Universitair Ziekenhuis Brussel, Department of Radiology, Laarbeeklaan 101, Brussels, 1090, Belgium
| |
Collapse
|
7
|
Kazama T, Takahara T, Endo J, Yamamuro H, Sekiguchi T, Niwa T, Niikura N, Okamura T, Kumaki N, Hashimoto J. Computed diffusion-weighted imaging with a low-apparent diffusion coefficient-pixel cut-off technique for breast cancer detection. Br J Radiol 2023; 96:20220951. [PMID: 37393536 PMCID: PMC10607411 DOI: 10.1259/bjr.20220951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 06/15/2023] [Accepted: 06/24/2023] [Indexed: 07/03/2023] Open
Abstract
OBJECTIVE This study aimed to compare the image quality and diagnostic performance of computed diffusion-weighted imaging (DWI) with low-apparent diffusion coefficient (ADC)-pixel cut-off technique (cDWI cut-off) and actual measured DWI (mDWI). METHODS Eighty-seven consecutive patients with malignant breast lesions and 72 with negative breast lesions who underwent breast MRI were retrospectively evaluated. Computed DWI with high b-values of 800, 1200, and 1500 s/mm2 and ADC cut-off thresholds of none, 0, 0.3, and 0.6 (×10-3 mm2/s) were generated from DWI with two b-values (0 and 800 s/mm2). To identify the optimal conditions, two radiologists evaluated the fat suppression and lesion reduction failure using a cut-off technique. The contrast between breast cancer and glandular tissue was evaluated using region of interest analysis. Three other board-certified radiologists independently assessed the optimised cDWI cut-off and mDWI data sets. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis. RESULTS When an ADC cut-off threshold of 0.3 or 0.6 (× 10-3 mm2/s) was applied, fat suppression improved significantly (p < .05). The contrast of the cDWI cut-off with a b-value of 1200 or 1500 s/mm2 was better than the mDWI (p < .01). The ROC area under the curve for breast cancer detection was 0.837 for the mDWI and 0.909 for the cDWI cut-off (p < .01). CONCLUSION The cDWI cut-off provided better diagnostic performance than mDWI for breast cancer detection. ADVANCES IN KNOWLEDGE Using the low-ADC-pixel cut-off technique, computed DWI can improve diagnostic performance by increasing contrast and eliminating un-suppressed fat signals.
Collapse
Affiliation(s)
- Toshiki Kazama
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan
| | - Taro Takahara
- Department of Biomedical Engineering, Tokai University School of Engineering, Hiratsuka, Japan
| | - Jun Endo
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan
| | - Hiroshi Yamamuro
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan
| | - Tatsuya Sekiguchi
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsu Niwa
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan
| | - Naoki Niikura
- Department of Breast Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Takuho Okamura
- Department of Breast Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Nobue Kumaki
- Department of Pathology, Tokai University School of Medicine, Isehara, Japan
| | - Jun Hashimoto
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan
| |
Collapse
|
8
|
Lu Z, Xia K, Jiang H, Weng X, Wu M. Improved effects of the b-value for 2000 sec/mm 2 DWI on an accurate qualitative and quantitative assessment of rectal cancer. Arab J Gastroenterol 2023; 24:230-237. [PMID: 37989671 DOI: 10.1016/j.ajg.2023.09.001] [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] [Received: 11/28/2020] [Revised: 04/21/2023] [Accepted: 09/03/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND AND STUDY OBJECTIVES A higher b-value Diffusion-weighted imaging (DWI) would improve the contrast between cancerous and noncancerous tissue. Apparent diffusion coefficient (ADC)-histogram analysis is a method that can provide statistical data and quantitative information on tumor heterogeneity. This study aimed to compare two high b-values (1000 and 2000 sec/mm2) DWI in tumor detection and diagnostic performance in identifying early-stage tumor rectal cancer. PATIENTS AND METHODS This blinded and blinded retrospective study involved 56 patients with rectal cancer and 45 patients. Two radiologists evaluated the qualitative detection parameters and quantitative parameters of the ADC evaluated histogram and compared them between two DWI sequences (b-value for 1000 sec/mm2 and 2000 sec/mm2). The characteristic curves were used to assess diagnostic administration for the ADC histogram in discriminating early-stage tumors. RESULTS The b-value for 2000 sec/mm2 DWI significantly improved AUCs, sensitivity, specificity, and precision and decreased false-positive rate for detection compared to the b-value for 1000 sec/mm2 (p < 0.05). The mean and fifth percentile ADC value for stage I using the b-value for 1000 sec/mm2 DWI was significantly higher than stage ≥ II (p = 0.036II and 0.016 respectively), as the well as fifth, 10th, mean ADC of the fifth, 10th, and 25th ADC percentile at b-value for 2000 sec/mm2 (p = 0.031, 0.014, 0.035 and 0.025 respectively). The AUCs of the fifth percentile ADC at b-value for 2000 sec/mm2 DWI in both readers in differentiating the stage Ⅰ tumor were the highest (0.732 and 0.751). CONCLUSION The b-value for 2000 sec/mm2 DWI could improve the accurate detection of rectal cancer. The fifth percentile ADC at b-value for 2000 sec/mm2 sec/mm2 DWI was more useful for discriminating early stage than the b-value for 1000 sec/mm2 DWI.
Collapse
Affiliation(s)
- Zhihua Lu
- Department of Radiology, Dushu Lake Hospital Affiliated to Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, China.
| | - Kaijian Xia
- Department of Information, Changshu No.1 People's Hospital, Affiliated Changshu Hospital of Soochow University, Suzhou, China
| | - Heng Jiang
- Department of Radiology, Changshu No.1 People's Hospital, Affiliated Changshu Hospital of Soochow University, Suzhou, China
| | - Xiaoyan Weng
- Department of Radiology, Changshu No.1 People's Hospital, Affiliated Changshu Hospital of Soochow University, Suzhou, China
| | - Mei Wu
- Department of Pathology, Changshu No.1 People's Hospital, Affiliated Changshu Hospital of Soochow University, Suzhou, China
| |
Collapse
|
9
|
Harder FN, Jung E, Weiss K, Graf MM, Kamal O, McTavish S, Van AT, Demir IE, Friess H, Phillip V, Schmid RM, Lohöfer FK, Kaissis GA, Makowski MR, Karampinos DC, Braren RF. Computed high-b-value high-resolution DWI improves solid lesion detection in IPMN of the pancreas. Eur Radiol 2023; 33:6892-6901. [PMID: 37133518 PMCID: PMC10511579 DOI: 10.1007/s00330-023-09661-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 02/15/2023] [Accepted: 02/26/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES To examine the effect of high-b-value computed diffusion-weighted imaging (cDWI) on solid lesion detection and classification in pancreatic intraductal papillary mucinous neoplasm (IPMN), using endoscopic ultrasound (EUS) and histopathology as a standard of reference. METHODS Eighty-two patients with known or suspected IPMN were retrospectively enrolled. Computed high-b-value images at b = 1000 s/mm2 were calculated from standard (b = 0, 50, 300, and 600 s/mm2) DWI images for conventional full field-of-view (fFOV, 3 × 3 × 4 mm3 voxel size) DWI. A subset of 39 patients received additional high-resolution reduced-field-of-view (rFOV, 2.5 × 2.5 × 3 mm3 voxel size) DWI. In this cohort, rFOV cDWI was compared against fFOV cDWI additionally. Two experienced radiologists evaluated (Likert scale 1-4) image quality (overall image quality, lesion detection and delineation, fluid suppression within the lesion). In addition, quantitative image parameters (apparent signal-to-noise ratio (aSNR), apparent contrast-to-noise ratio (aCNR), contrast ratio (CR)) were assessed. Diagnostic confidence regarding the presence/absence of diffusion-restricted solid nodules was assessed in an additional reader study. RESULTS High-b-value cDWI at b = 1000 s/mm2 outperformed acquired DWI at b = 600 s/mm2 regarding lesion detection, fluid suppression, aCNR, CR, and lesion classification (p = < .001-.002). Comparing cDWI from fFOV and rFOV revealed higher image quality in high-resolution rFOV-DWI compared to conventional fFOV-DWI (p ≤ .001-.018). High-b-value cDWI images were rated non-inferior to directly acquired high-b-value DWI images (p = .095-.655). CONCLUSIONS High-b-value cDWI may improve the detection and classification of solid lesions in IPMN. Combining high-resolution imaging and high-b-value cDWI may further increase diagnostic precision. CLINICAL RELEVANCE STATEMENT This study shows the potential of computed high-resolution high-sensitivity diffusion-weighted magnetic resonance imaging for solid lesion detection in pancreatic intraductal papillary mucinous neoplasia (IPMN). The technique may enable early cancer detection in patients under surveillance. KEY POINTS • Computed high-b-value diffusion-weighted imaging (cDWI) may improve the detection and classification of intraductal papillary mucinous neoplasms (IPMN) of the pancreas. • cDWI calculated from high-resolution imaging increases diagnostic precision compared to cDWI calculated from conventional-resolution imaging. • cDWI has the potential to strengthen the role of MRI for screening and surveillance of IPMN, particularly in view of the rising incidence of IPMNs combined with now more conservative therapeutic approaches.
Collapse
Affiliation(s)
- Felix N Harder
- Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany.
| | - Eva Jung
- Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Kilian Weiss
- Philips GmbH Market DACH, Röntgenstrasse 22, 22335, Hamburg, Germany
| | - Markus M Graf
- Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Omar Kamal
- Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Sean McTavish
- Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Anh T Van
- Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Ihsan E Demir
- Department of Surgery, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Helmut Friess
- Department of Medicine II, University Hospital Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Veit Phillip
- Department of Medicine II, University Hospital Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Roland M Schmid
- Department of Medicine II, University Hospital Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Fabian K Lohöfer
- Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Georgios A Kaissis
- Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany
- Department of Computing, Faculty of Engineering, Imperial College of Science, Technology and Medicine, London, SW7 2AZ, UK
- Institute for Artificial Intelligence in Medicine, Technical University of Munich, Munich, Germany
| | - Marcus R Makowski
- Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Dimitrios C Karampinos
- Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, Germany
| | - Rickmer F Braren
- Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany.
| |
Collapse
|
10
|
Caporale AS, Nezzo M, Di Trani MG, Maiuro A, Miano R, Bove P, Mauriello A, Manenti G, Capuani S. Acquisition Parameters Influence Diffusion Metrics Effectiveness in Probing Prostate Tumor and Age-Related Microstructure. J Pers Med 2023; 13:jpm13050860. [PMID: 37241031 DOI: 10.3390/jpm13050860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/18/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
This study aimed to investigate the Diffusion-Tensor-Imaging (DTI) potential in the detection of microstructural changes in prostate cancer (PCa) in relation to the diffusion weight (b-value) and the associated diffusion length lD. Thirty-two patients (age range = 50-87 years) with biopsy-proven PCa underwent Diffusion-Weighted-Imaging (DWI) at 3T, using single non-zero b-value or groups of b-values up to b = 2500 s/mm2. The DTI maps (mean-diffusivity, MD; fractional-anisotropy, FA; axial and radial diffusivity, D// and D┴), visual quality, and the association between DTI-metrics and Gleason Score (GS) and DTI-metrics and age were discussed in relation to diffusion compartments probed by water molecules at different b-values. DTI-metrics differentiated benign from PCa tissue (p ≤ 0.0005), with the best discriminative power versus GS at b-values ≥ 1500 s/mm2, and for b-values range 0-2000 s/mm2, when the lD is comparable to the size of the epithelial compartment. The strongest linear correlations between MD, D//, D┴, and GS were found at b = 2000 s/mm2 and for the range 0-2000 s/mm2. A positive correlation between DTI parameters and age was found in benign tissue. In conclusion, the use of the b-value range 0-2000 s/mm2 and b-value = 2000 s/mm2 improves the contrast and discriminative power of DTI with respect to PCa. The sensitivity of DTI parameters to age-related microstructural changes is worth consideration.
Collapse
Affiliation(s)
- Alessandra Stella Caporale
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, 66100 Chieti, Italy
- Institute for Advanced Biomedical Technologies (ITAB), 'G. d'Annunzio' University of Chieti-Pescara, 66100 Chieti, Italy
| | - Marco Nezzo
- Interventional Radiology Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Maria Giovanna Di Trani
- Centro Fermi-Museo Storico della Fisica e Centro Studi e Ricerche Enrico Fermi, 00184 Rome, Italy
| | - Alessandra Maiuro
- CNR ISC, c/o Physics Department, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
- Physics Department, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Roberto Miano
- Division of Urology, Department of Surgical Sciences, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Pierluigi Bove
- Division of Urology, Department of Surgical Sciences, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Alessandro Mauriello
- Anatomic Pathology, Department of Experimental Medicine, PTV Foundation, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Guglielmo Manenti
- Department of Biomedicine and Prevention, UOC Radiology PTV Foundation, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Silvia Capuani
- CNR ISC, c/o Physics Department, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
- Physics Department, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| |
Collapse
|
11
|
Kim M, Lee TY, Kang BS, Kwon WJ, Lim S, Park GM, Bang M. Evaluating Biliary Malignancy with Measured and Calculated Ultra-high b-value Diffusion-weighted MR Imaging at 3T. Magn Reson Med Sci 2023. [PMID: 37183027 DOI: 10.2463/mrms.mp.2022-0144] [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: 05/16/2023] Open
Abstract
PURPOSE Although diffusion-weighted imaging (DWI) with ultra-high b-values is reported to be advantageous in the detection of some tumors, its applicability is not yet known in biliary malignancy. Therefore, this study aimed to evaluate the impact of measured b = 1400 s/mm2 (M1400) and calculated b = 1400 s/mm2 (C1400) DWI on image quality and quality of lesion discernibility using a modern 3T MR system compared to conventional b = 800 s/mm2 DWI (M800). METHODS We evaluated 56 patients who had pathologically proven biliary malignancy. All the patients underwent preoperative or baseline 3T MRI using DWI (b = 50, 400, 800, and 1400 s/mm2). The calculated DWI was obtained using a conventional DWI set (b = 50, 400, and 800). The tumor-to-bile contrast ratio (CR) and tumor SNR were compared between the different DWI images. Likert scores were given on a 5-point scale to assess the overall image quality, overall artifacts, ghost artifacts, misregistration artifacts, margin sharpness, and lesion discernibility. Repeated-measures analysis of variance with post hoc analyses was used for statistical evaluations. RESULTS The CR of the tumor-to-bile was significantly higher in both M1400 and C1400 than in M800 (Pa < 0.01). SNRs were significantly higher in M800, followed by C1400 and M1400 (Pa < 0.01). Lesion discernibility was significantly improved for M1400, followed by C1400 and M800 for both readers (Pa < 0.01). CONCLUSION Using a 3T MRI, both measured and calculated DWI with an ultra-high b-value offer superior lesion discernibility for biliary malignancy compared to the conventional DWI.
Collapse
Affiliation(s)
- Minkyeong Kim
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine
| | - Tae Young Lee
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine
| | - Byeong Seong Kang
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine
| | - Woon Jung Kwon
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine
| | - Soyeoun Lim
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine
| | - Gyeong Min Park
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine
| | - Minseo Bang
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine
| |
Collapse
|
12
|
Klingebiel M, Weiland E, Boschheidgen M, Ullrich T, Arsov C, Radtke JP, Benkert T, Nickel M, Strecker R, Wittsack HJ, Albers P, Antoch G, Schimmöller L. Improved diffusion-weighted imaging of the prostate: Comparison of readout-segmented and zoomed single-shot imaging. Magn Reson Imaging 2023; 98:55-61. [PMID: 36649807 DOI: 10.1016/j.mri.2023.01.010] [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: 09/24/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Diffusion weighted imaging (DWI) is the most important sequence for detection and grading prostate cancer (PCa), but it is considerably prone to artifacts. New approaches like zoomed single-shot imaging (z-EPI) with advanced image processing or multi-shot readout segmentation (rs-EPI) try to improve DWI quality. This study evaluates objective and subjective image quality (IQ) of rs-EPI and z-EPI with and without advanced processing. MATERIALS AND METHODS Fifty-six consecutive patients (67 ± 8 years; median PSA 8.3 ng/ml) with mp-MRI performed at 3 Tesla between February and October 2019 and subsequently verified PCa by targeted plus systematic MRI/US-fusion biopsy were included in this retrospective single center cohort study. Rs-EPI and z-EPI were prospectively acquired in every patient. Signal intensities (SI) of PCa and benign tissue in ADC, b1000, and calculated high b-value images were analyzed. Endpoints were signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), PCa contrast intensity (CI), and subjective IQ on a 5-point scale evaluated by three blinded readers. Wilcoxon signed rank test, Friedman test and Cohen's kappa coefficient was calculated. RESULTS SNR, CNR, and PCa CI of z-EPI with and without advanced processing was superior to rs-EPI (p < 0.01), whereas no significant differences were observed between z-EPI with and without advanced processing. Subjective IQ was significantly higher for z-EPI with advanced processing compared rs-EPI for ADC, b1000, and calculated high b-values (p < 0.01). Compared to z-EPI without advanced processing, z-EPI with advanced processing was superior for ADC and calculated high b-values (p < 0.01), but no significant differences were shown for b1000 images. CONCLUSIONS Z-EPI with and without advanced processing was superior to rs-EPI regarding objective imaging parameters and z-EPI with advanced processing was superior to rs-EPI regarding subjective imaging parameters for the detection of PCa.
Collapse
Affiliation(s)
- M Klingebiel
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - E Weiland
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany.
| | - M Boschheidgen
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - T Ullrich
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - C Arsov
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany.
| | - J P Radtke
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany.
| | - T Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany.
| | - M Nickel
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany.
| | - R Strecker
- Siemens Healthcare GmbH, Europe, Middle East & Africa, Karlheinz-Kaske-Str. 2, 91052 Erlangen, Germany.
| | - H J Wittsack
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - P Albers
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany.
| | - G Antoch
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - L Schimmöller
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| |
Collapse
|
13
|
Kuczera S, Langkilde F, Maier SE. Truly reproducible uniform estimation of the ADC with multi-b diffusion data- Application in prostate diffusion imaging. Magn Reson Med 2023; 89:1586-1600. [PMID: 36426737 PMCID: PMC10100221 DOI: 10.1002/mrm.29533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The ADC is a well-established parameter for clinical diagnostic applications, but lacks reproducibility because it is also influenced by the choice diffusion weighting level. A framework is evaluated that is based on multi-b measurement over a wider range of diffusion-weighting levels and higher order tissue diffusion modeling with retrospective, fully reproducible ADC calculation. METHODS Averaging effect from curve fitting for various model functions at 20 linearly spaced b-values was determined by means of simulations and theoretical calculations. Simulation and patient multi-b image data were used to compare the new approach for diffusion-weighted image and ADC map reconstruction with and without Rician bias correction to an active clinical trial protocol probing three non-zero b-values. RESULTS Averaging effect at a certain b-value varies for model function and maximum b-value used. Images and ADC maps from the novel procedure are on-par with the clinical protocol. Higher order modeling and Rician bias correction is feasible, but comes at the cost of longer computation times. CONCLUSIONS Application of the new framework makes higher order modeling more feasible in a clinical setting while still providing patient images and reproducible ADC maps of adequate quality.
Collapse
Affiliation(s)
- Stefan Kuczera
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,MedTech West, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Fredrik Langkilde
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stephan E Maier
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Brigham Women's Hospital, Harvard Medical School Boston, Boston, Massachusetts, USA
| |
Collapse
|
14
|
Yang T, Li Y, Ye Z, Yao S, Li Q, Yuan Y, Song B. Diffusion Weighted Imaging of the Abdomen and Pelvis: Recent Technical Advances and Clinical Applications. Acad Radiol 2023; 30:470-482. [PMID: 36038417 DOI: 10.1016/j.acra.2022.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 01/25/2023]
Abstract
Diffusion weighted imaging (DWI) serves as one of the most important functional magnetic resonance imaging techniques in abdominal and pelvic imaging. It is designed to reflect the diffusion of water molecules and is particularly sensitive to the malignancies. Yet, the limitations of image distortion and artifacts in single-shot DWI may hamper its widespread use in clinical practice. With recent technical advances in DWI, such as simultaneous multi-slice excitation, computed or reduced field-of-view techniques, as well as advanced shimming methods, it is possible to achieve shorter acquisition time, better image quality, and higher robustness in abdominopelvic DWI. This review discussed the recent advances of each DWI approach, and highlighted its future perspectives in abdominal and pelvic imaging, hoping to familiarize physicians and radiologists with the technical improvements in this field and provide future research directions.
Collapse
Affiliation(s)
- Ting Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Zheng Ye
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Shan Yao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Qing Li
- MR Collaborations, Siemens Healthcare, Shanghai, China
| | - Yuan Yuan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Department of Radiology, Sanya People's Hospital, Sanya, Hainan, China.
| |
Collapse
|
15
|
Kallis K, Conlin CC, Zhong AY, Hussain TS, Chatterjee A, Karczmar GS, Rakow-Penner R, Dale A, Seibert T. Comparison of synthesized and acquired high b -value diffusion-weighted MRI for detection of prostate cancer. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.17.23286100. [PMID: 36824958 PMCID: PMC9949172 DOI: 10.1101/2023.02.17.23286100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Background High b -value diffusion-weighted images (DWI) are used for detection of clinically significant prostate cancer (csPCa). To decrease scan time and improve signal-to-noise ratio, high b -value (>1000 s/mm 2 ) images are often synthesized instead of acquired. Purpose Qualitatively and quantitatively compare synthesized DWI (sDWI) to acquired (aDWI) for detection of csPCa. Study Type Retrospective. Subjects 151 consecutive patients who underwent prostate MRI and biopsy. Sequence Axial DWI with b =0, 500, 1000, and 2000 s/mm 2 using a 3T clinical scanner using a 32-channel phased-array body coil. Assessment We synthesized DWI for b =2000 s/mm 2 via extrapolation based on monoexponential decay, using b =0 and b =500 s/mm 2 (sDWI 500 ) and b =0, b =500, and b =1000 s/mm 2 (sDWI 1000 ). Differences between sDWI and aDWI were evaluated within regions of interest (ROIs). The maximum DWI value within each ROI was evaluated for prediction of csPCa. Classification accuracy was also compared to Restriction Spectrum Imaging restriction score (RSIrs), a previously validated biomarker based on multi-exponential DWI. Statistical Tests Discrimination of csPCa was evaluated via area under the receiver operating characteristic curve (AUC). Statistical significance was assessed using bootstrap difference (two-sided α=0.05). Results Within the prostate, mean ± standard deviation of percent mean differences between sDWI and aDWI signal were -46±35% for sDWI 1000 and -67±24% for sDWI 500 . AUC for aDWI, sDWI 500, sDWI 1000 , and RSIrs within the prostate 0.62[95% confidence interval: 0.53, 0.71], 0.63[0.54, 0.72], 0.65[0.56, 0.73] and 0.78[0.71, 0.86], respectively. When considering the whole field of view, classification accuracy and qualitative image quality decreased notably for sDWI compared to aDWI and RSIrs. Data Conclusion sDWI is qualitatively comparable to aDWI within the prostate. However, hyperintense artifacts are introduced with sDWI in the surrounding pelvic tissue that interfere with quantitative cancer detection and might mask metastases. In the prostate, RSIrs yields superior quantitative csPCa detection than sDWI or aDWI.
Collapse
|
16
|
Tang Q, Zhou Q, Chen W, Sang L, Xing Y, Liu C, Wang K, Liu WV, Xu L. A feasibility study of reduced full-of-view synthetic high-b-value diffusion-weighted imaging in uterine tumors. Insights Imaging 2023; 14:12. [PMID: 36645541 PMCID: PMC9842823 DOI: 10.1186/s13244-022-01350-0] [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: 06/12/2022] [Accepted: 12/05/2022] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the feasibility of reduced full-of-view synthetic high-b value diffusion-weighted images (rFOV-syDWIs) in the clinical application of cervical cancer based on image quality and diagnostic efficacy. METHODS We retrospectively evaluated the data of 35 patients with cervical cancer and 35 healthy volunteers from May to November 2021. All patients and volunteers underwent rFOV-DWI scans, including a 13b-protocol: b = 0, 25, 50, 75, 100, 150, 200, 400, 600, 800, 1000, 1200, and 1500 s/mm2 and a 5b-protocol: b = 0, 100, 400, 800,1500 s/mm2. rFOV-syDWIs with b values of 1200 (rFOV-syDWIb=1200) and 1500 (rFOV-syDWIb=1500) were generated from two different multiple-b-value image datasets using a mono-exponential fitting algorithm. According to homoscedasticity and normality assessed by the Levene's test and Shapiro-Wilk test, the inter-modality differences of quantitative measurements were, respectively, examined by Wilcoxon signed-rank test or paired t test and the inter-group differences of ADC values were examined by independent t test or Mann-Whitney U test. RESULTS A higher inter-reader agreement between SNRs and CNRs was found in 13b-protocol and 5b-protocol rFOV-syDWIb=1200/1500 compared to 13b-protocol rFOV-sDWIb=1200/1500 (p < 0.05). AUC of 5b-protocol syADCmean,b=1200/1500 and syADCminimum,b=1200/1500 was equal or higher than that of 13b-protocol sADCmean,b=1200/1500 and sADCminimum,b=1200/1500. CONCLUSIONS rFOV-syDWIs provide better lesion clarity and higher image quality than rFOV-sDWIs. 5b-protocol rFOV-syDWIs shorten scan time, and synthetic ADCs offer reliable diagnosis value as scanned 13b-protocol DWIs.
Collapse
Affiliation(s)
- Qian Tang
- grid.443573.20000 0004 1799 2448Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei China ,grid.443573.20000 0004 1799 2448Biomedical Engineering College, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei China
| | - Qiqi Zhou
- grid.443573.20000 0004 1799 2448Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei China
| | - Wen Chen
- grid.443573.20000 0004 1799 2448Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei China
| | - Ling Sang
- grid.443573.20000 0004 1799 2448Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei China
| | - Yu Xing
- grid.443573.20000 0004 1799 2448Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei China
| | - Chao Liu
- grid.443573.20000 0004 1799 2448Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei China
| | - Kejun Wang
- grid.443573.20000 0004 1799 2448Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei China
| | | | - Lin Xu
- grid.443573.20000 0004 1799 2448Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei China
| |
Collapse
|
17
|
Tonosono K, Fujii K, Hasunuma R, Konda Y, Kobayashi H, Kitazawa K, Honda A. Utility of high b-value diffusion-weighted imaging in hemolytic uremic syndrome. Pediatr Int 2023; 65:e15602. [PMID: 37589368 DOI: 10.1111/ped.15602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 08/18/2023]
Affiliation(s)
- Kohei Tonosono
- Department of Pediatrics, Asahi General Hospital, Chiba, Japan
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Katsunori Fujii
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
- Department of Pediatrics, International University of Health and Welfare, Graduate School of Medicine, Chiba, Japan
| | - Ryuji Hasunuma
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yutaka Konda
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | | | - Akihito Honda
- Department of Pediatrics, Asahi General Hospital, Chiba, Japan
| |
Collapse
|
18
|
Ohno Y, Yui M, Takenaka D, Yoshikawa T, Koyama H, Kassai Y, Yamamoto K, Oshima Y, Hamabuchi N, Hanamatsu S, Obama Y, Ueda T, Ikeda H, Hattori H, Murayama K, Toyama H. Computed DWI MRI Results in Superior Capability for N-Stage Assessment of Non-Small Cell Lung Cancer Than That of Actual DWI, STIR Imaging, and FDG-PET/CT. J Magn Reson Imaging 2023; 57:259-272. [PMID: 35753082 DOI: 10.1002/jmri.28288] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Computed diffusion-weighted imaging (cDWI) is a mathematical computation technique that generates DWIs for any b-value by using actual DWI (aDWI) data with at least two different b-values and may improve differentiation of metastatic from nonmetastatic lymph nodes. PURPOSE To determine the appropriate b-value for cDWI to achieve a better diagnostic capability for lymph node staging (N-staging) in non-small cell lung cancer (NSCLC) patients compared to aDWI, short inversion time (TI) inversion recovery (STIR) imaging, or positron emission tomography with 2-[fluorine-18] fluoro-2-deoxy-d-glucose combined with computed tomography (FDG-PET/CT). STUDY TYPE Prospective. SUBJECTS A total of 245 (127 males and 118 females; mean age 72 years) consecutive histopathologically confirmed NSCLC patients. FIELD STRENGTH/SEQUENCE A 3 T, half-Fourier single-shot turbo spin-echo sequence, electrocardiogram (ECG)-triggered STIR fast advanced spin-echo (FASE) sequence with black blood and STIR acquisition and DWI obtained by FASE with b-values of 0 and 1000 sec/mm2 . ASSESSMENT From aDWIs with b-values of 0 and 1000 (aDWI1000 ) sec/mm2 , cDWI using 400 (cDWI400 ), 600 (cDWI600 ), 800 (cDWI800 ), and 2000 (cDWI2000 ) sec/mm2 were generated. Then, 114 metastatic and 114 nonmetastatic nodes (mediastinal and hilar lymph nodes) were selected and evaluated with a contrast ratio (CR) for each cDWI and aDWI, apparent diffusion coefficient (ADC), lymph node-to-muscle ratio (LMR) on STIR, and maximum standard uptake value (SUVmax ). STATISTICAL TESTS Receiver operating characteristic curve (ROC) analysis, Youden index, and McNemar's test. RESULTS Area under the curve (AUC) of CR600 was significantly larger than the CR400 , CR800 , CR2000 , aCR1000 , and SUVmax . Comparison of N-staging accuracy showed that CR600 was significantly higher than CR400 , CR2000 , ADC, aCR1000 , and SUVmax , although there were no significant differences with CR800 (P = 0.99) and LMR (P = 0.99). DATA CONCLUSION cDWI with b-value at 600 sec/mm2 may have potential to improve N-staging accuracy as compared with aDWI, STIR, and PET/CT. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
Collapse
Affiliation(s)
- Yoshiharu Ohno
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan.,Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan.,Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masao Yui
- Canon Medical Systems Corporation, Otawara, Japan
| | | | - Takeshi Yoshikawa
- Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Radiology, Hyogo Cancer Center, Akashi, Japan
| | - Hisanobu Koyama
- Department of Radiology, Osaka Police Hospital, Osaka, Japan
| | | | | | - Yuka Oshima
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Nayu Hamabuchi
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Satomu Hanamatsu
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yuki Obama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Takahiro Ueda
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hirotaka Ikeda
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hidekazu Hattori
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuhiro Murayama
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| |
Collapse
|
19
|
Laue HOA, Persigehl T. Editorial for "Computed DWI Results in Superior Capability for N-Stage Assessment of Non-Small Cell Lung Cancer than that of Actual DWI, STIR Imaging and FDG-PET/CT". J Magn Reson Imaging 2023; 57:273-274. [PMID: 35731616 DOI: 10.1002/jmri.28307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
- Hendrik Oliver Arp Laue
- Clinical Trials & Pharma, Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Str 2, Bremen, 28359, Germany
| | - Thorsten Persigehl
- Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Straße 62, Cologne, 50937, Germany
| |
Collapse
|
20
|
Computed diffusion-weighted magnetic resonance imaging with high b-values in the diagnosis of gallbladder lesions. Abdom Radiol (NY) 2022; 47:3278-3289. [PMID: 35767024 DOI: 10.1007/s00261-022-03586-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE The diagnosis of gallbladder lesions remains challenging. The efficacy of computed diffusion-weighted imaging (DWI) with high b-values and apparent diffusion coefficient (ADC) for the diagnosis of gallbladder cancer remains unknown. We aimed to investigate the usefulness of computed DWI with high b-values and the combination of computed DWI and ADC in differentiating malignant and benign gallbladder lesions. METHODS Sixty patients (comprising 30 malignant and 30 benign lesions) who underwent magnetic resonance imaging for gallbladder lesions were included in this retrospective study. Qualitative evaluations were performed using conventional DWI with b1000, computed DWI with b1500, b1000 DWI/ADC, and computed b1500 DWI/ADC, and their diagnostic performances were compared. RESULTS The sensitivity, specificity, and accuracy of computed b1500 DWI/ADC were 90% (27/30), 80% (24/30), and 85% (51/60), respectively. The accuracy of computed b1500 DWI/ADC was higher than that of conventional b1000 DWI (52%, 31/60, p < 0.001), computed b1500 DWI (72%, 43/60, p = 0.008), and b1000 DWI/ADC (78%, 47/60, p = 0.125). The specificity of computed b1500 DWI/ADC was also higher than that of conventional b1000 DWI (7%, 2/30, p < 0.001), computed b1500 DWI (47%, 14/30, p = 0.002), and b1000 DWI/ADC (67%, 20/30, p = 0.125). No significant difference was observed in the sensitivity between the groups. CONCLUSION This study shows that computed DWI with high b-values combined with ADC can improve diagnostic performance when differentiating malignant and benign gallbladder lesions. Computed diffusion-weighted magnetic resonance imaging with high b-values in the diagnosis of gallbladder lesions. *Computed DWI with b1500 combined with ADC can improve diagnostic performance when differentiating gallbladder lesions compared with conventional methods (b1000 DWI).
Collapse
|
21
|
Improved Visualization of Prostate Cancer Using Multichannel Computed Diffusion Images: Combining ADC and DWI. Diagnostics (Basel) 2022; 12:diagnostics12071592. [PMID: 35885498 PMCID: PMC9324736 DOI: 10.3390/diagnostics12071592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 12/04/2022] Open
Abstract
(1) Background: For the peripheral zone of the prostate, diffusion weighted imaging (DWI) is the most important MRI technique; however, a high b-value image (hbDWI) must always be evaluated in conjunction with an apparent diffusion coefficient (ADC) map. We aimed to unify the important contrast features of both a hbDWI and ADC in one single image, termed multichannel computed diffusion images (mcDI), and evaluate the values of these images in a retrospective clinical study; (2) Methods: Based on the 2D histograms of hbDWI and ADC images of 70 patients with histologically proven prostate cancer (PCa) in the peripheral zone, an algorithm was designed to generate the mcDI. Then, three radiologists evaluated the data of 56 other patients twice in three settings (T2w images +): (1) hbDWI and ADC; (2) mcDI; and (3) mcDI, hbDWI, and ADC. The sensitivity, specificity, and inter-reader variability were evaluated; (3) Results: The overall sensitivity/specificity were 0.91/0.78 (hbDWI + ADC), 0.85/0.88 (mcDI), and 0.97/0.88 (mcDI + hbDWI + ADC). The kappa-values for the inter-reader variability were 0.732 (hbDWI + ADC), 0.800 (mcDI), and 0.853 (mcDI + hbDWI + ADC). (4) Conclusions: By using mcDI, the specificity of the MRI detection of PCa was increased at the expense of the sensitivity. By combining the conventional diffusion data with the mcDI data, both the sensitivity and specificity were improved.
Collapse
|
22
|
Diffusion-Weighted MRI in the Genitourinary System. J Clin Med 2022; 11:jcm11071921. [PMID: 35407528 PMCID: PMC9000195 DOI: 10.3390/jcm11071921] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 12/12/2022] Open
Abstract
Diffusion weighted imaging (DWI) constitutes a major functional parameter performed in Magnetic Resonance Imaging (MRI). The DW sequence is performed by acquiring a set of native images described by their b-values, each b-value representing the strength of the diffusion MR gradients specific to that sequence. By fitting the data with models describing the motion of water in tissue, an apparent diffusion coefficient (ADC) map is built and allows the assessment of water mobility inside the tissue. The high cellularity of tumors restricts the water diffusion and decreases the value of ADC within tumors, which makes them appear hypointense on ADC maps. The role of this sequence now largely exceeds its first clinical apparitions in neuroimaging, whereby the method helped diagnose the early phases of cerebral ischemic stroke. The applications extend to whole-body imaging for both neoplastic and non-neoplastic diseases. This review emphasizes the integration of DWI in the genitourinary system imaging by outlining the sequence's usage in female pelvis, prostate, bladder, penis, testis and kidney MRI. In gynecologic imaging, DWI is an essential sequence for the characterization of cervix tumors and endometrial carcinomas, as well as to differentiate between leiomyosarcoma and benign leiomyoma of the uterus. In ovarian epithelial neoplasms, DWI provides key information for the characterization of solid components in heterogeneous complex ovarian masses. In prostate imaging, DWI became an essential part of multi-parametric Magnetic Resonance Imaging (mpMRI) to detect prostate cancer. The Prostate Imaging-Reporting and Data System (PI-RADS) scoring the probability of significant prostate tumors has significantly contributed to this success. Its contribution has established mpMRI as a mandatory examination for the planning of prostate biopsies and radical prostatectomy. Following a similar approach, DWI was included in multiparametric protocols for the bladder and the testis. In renal imaging, DWI is not able to robustly differentiate between malignant and benign renal tumors but may be helpful to characterize tumor subtypes, including clear-cell and non-clear-cell renal carcinomas or low-fat angiomyolipomas. One of the most promising developments of renal DWI is the estimation of renal fibrosis in chronic kidney disease (CKD) patients. In conclusion, DWI constitutes a major advancement in genitourinary imaging with a central role in decision algorithms in the female pelvis and prostate cancer, now allowing promising applications in renal imaging or in the bladder and testicular mpMRI.
Collapse
|
23
|
Xia Y, Wang L, Wu Z, Tan J, Fu M, Fu C, Pan Z, Zhu L, Yan F, Shen H, Ma Q, Cai G. Comparison of Computed and Acquired DWI in the Assessment of Rectal Cancer: Image Quality and Preoperative Staging. Front Oncol 2022; 12:788731. [PMID: 35371999 PMCID: PMC8971285 DOI: 10.3389/fonc.2022.788731] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe aim of the study was to evaluate the computed diffusion-weighted images (DWI) in image quality and diagnostic performance of rectal cancer by comparing with the acquired DWI.MethodsA total of 103 consecutive patients with primary rectal cancer were enrolled in this study. All patients underwent two DWI sequences, namely, conventional acquisition with b = 0 and 1,000 s/mm2 (aDWIb1,000) and another with b = 0 and 700 s/mm2 on a 3.0T MR scanner (MAGNETOM Prisma; Siemens Healthcare, Germany). The images (b = 0 and 700 s/mm2) were used to compute the diffusion images with b value of 1,000 s/mm2 (cDWIb1,000). Qualitative and quantitative analysis of both computed and acquired DWI images was performed, namely, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and signal intensity ratio (SIR), and also diagnostic staging performance. Interclass correlation coefficients, weighted κ coefficient, Friedman test, Wilcoxon paired test, and McNemar or Fisher test were used for repeatability and comparison assessment.ResultsCompared with the aDWIb1,000 images, the cDWIb1,000 ones exhibited significant higher scores of subjective image quality (all P <0.050). SNR, SIR, and CNR of the cDWIb1,000 images were superior to those of the aDWIb1,000 ones (P <0.001). The overall diagnostic accuracy of computed images was higher than that of the aDWIb1,000 images in T stage (P <0.001), with markedly better sensitivity and specificity in distinguishing T1–2 tumors from the T3–4 ones (P <0.050).ConclusioncDWIb1,000 images from lower b values might be a useful alternative option and comparable to the acquired DWI, providing better image quality and diagnostic performance in preoperative rectal cancer staging.
Collapse
Affiliation(s)
- Yihan Xia
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Lan Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Zhiyuan Wu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Jingwen Tan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Meng Fu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Caixia Fu
- Department of MR Application Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China
| | - Zilai Pan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Lan Zhu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
| | - Hailin Shen
- Department of Radiology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University of Medicine, Suzhou, China
- *Correspondence: Gang Cai, ; Qianchen Ma, ; Hailin Shen,
| | - Qianchen Ma
- Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
- *Correspondence: Gang Cai, ; Qianchen Ma, ; Hailin Shen,
| | - Gang Cai
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China
- *Correspondence: Gang Cai, ; Qianchen Ma, ; Hailin Shen,
| |
Collapse
|
24
|
Ueno Y, Tamada T, Sofue K, Murakami T. Diffusion and quantification of diffusion of prostate cancer. Br J Radiol 2022; 95:20210653. [PMID: 34538094 PMCID: PMC8978232 DOI: 10.1259/bjr.20210653] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
For assessing a cancer treatment, and for detecting and characterizing cancer, Diffusion-weighted imaging (DWI) is commonly used. The key in DWI's use extracranially has been due to the emergence of of high-gradient amplitude and multichannel coils, parallelimaging, and echo-planar imaging. The benefit has been fewer motion artefacts and high-quality prostate images.Recently, new techniques have been developed to improve the signal-to-noise ratio of DWI with fewer artefacts, allowing an increase in spatial resolution. For apparent diffusion coefficient quantification, non-Gaussian diffusion models have been proposed as additional tools for prostate cancer detection and evaluation of its aggressiveness. More recently, radiomics and machine learning for prostate magnetic resonance imaging have emerged as novel techniques for the non-invasive characterisation of prostate cancer. This review presents recent developments in prostate DWI and discusses its potential use in clinical practice.
Collapse
Affiliation(s)
- Yoshiko Ueno
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tsutomu Tamada
- Departmentof Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - Keitaro Sofue
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
25
|
High-Resolution, High b-Value Computed Diffusion-Weighted Imaging Improves Detection of Pancreatic Ductal Adenocarcinoma. Cancers (Basel) 2022; 14:cancers14030470. [PMID: 35158737 PMCID: PMC8833466 DOI: 10.3390/cancers14030470] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 01/13/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Our purpose was to investigate the potential of high-resolution, high b-value computed DWI (cDWI) in pancreatic ductal adenocarcinoma (PDAC) detection. Materials and Methods: We retrospectively enrolled 44 patients with confirmed PDAC. Respiratory-triggered, diffusion-weighted, single-shot echo-planar imaging (ss-EPI) with both conventional (i.e., full field-of-view, 3 × 3 × 4 mm voxel size, b = 0, 50, 300, 600 s/mm2) and high-resolution (i.e., reduced field-of-view, 2.5 × 2.5 × 3 mm voxel size, b = 0, 50, 300, 600, 1000 s/mm2) imaging was performed for suspected PDAC. cDWI datasets at b = 1000 s/mm2 were generated for the conventional and high-resolution datasets. Three radiologists were asked to subjectively rate (on a Likert scale of 1–4) the following metrics: image quality, lesion detection and delineation, and lesion-to-pancreas intensity relation. Furthermore, the following quantitative image parameters were assessed: apparent signal-to-noise ratio (aSNR), contrast-to-noise ratio (aCNR), and lesion-to-pancreas contrast ratio (CR). Results: High-resolution, high b-value computed DWI (r-cDWI1000) enabled significant improvement in lesion detection and a higher incidence of a high lesion-to-pancreas intensity relation (type 1, clear hyperintense) compared to conventional high b-value computed and high-resolution high b-value acquired DWI (f-cDWI1000 and r-aDWI1000, respectively). Image quality was rated inferior in the r-cDWI1000 datasets compared to r-aDWI1000. Furthermore, the aCNR and CR were higher in the r-cDWI1000 datasets than in f-cDWI1000 and r-aDWI1000. Conclusion: High-resolution, high b-value computed DWI provides significantly better visualization of PDAC compared to the conventional high b-value computed and high-resolution high b-value images acquired by DWI.
Collapse
|
26
|
Mehta P, Antonelli M, Singh S, Grondecka N, Johnston EW, Ahmed HU, Emberton M, Punwani S, Ourselin S. AutoProstate: Towards Automated Reporting of Prostate MRI for Prostate Cancer Assessment Using Deep Learning. Cancers (Basel) 2021; 13:6138. [PMID: 34885246 PMCID: PMC8656605 DOI: 10.3390/cancers13236138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/21/2022] Open
Abstract
Multiparametric magnetic resonance imaging (mpMRI) of the prostate is used by radiologists to identify, score, and stage abnormalities that may correspond to clinically significant prostate cancer (CSPCa). Automatic assessment of prostate mpMRI using artificial intelligence algorithms may facilitate a reduction in missed cancers and unnecessary biopsies, an increase in inter-observer agreement between radiologists, and an improvement in reporting quality. In this work, we introduce AutoProstate, a deep learning-powered framework for automatic MRI-based prostate cancer assessment. AutoProstate comprises of three modules: Zone-Segmenter, CSPCa-Segmenter, and Report-Generator. Zone-Segmenter segments the prostatic zones on T2-weighted imaging, CSPCa-Segmenter detects and segments CSPCa lesions using biparametric MRI, and Report-Generator generates an automatic web-based report containing four sections: Patient Details, Prostate Size and PSA Density, Clinically Significant Lesion Candidates, and Findings Summary. In our experiment, AutoProstate was trained using the publicly available PROSTATEx dataset, and externally validated using the PICTURE dataset. Moreover, the performance of AutoProstate was compared to the performance of an experienced radiologist who prospectively read PICTURE dataset cases. In comparison to the radiologist, AutoProstate showed statistically significant improvements in prostate volume and prostate-specific antigen density estimation. Furthermore, AutoProstate matched the CSPCa lesion detection sensitivity of the radiologist, which is paramount, but produced more false positive detections.
Collapse
Affiliation(s)
- Pritesh Mehta
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- School of Biomedical Engineering Imaging Sciences, King’s College London, London SE1 7EH, UK; (M.A.); (S.O.)
| | - Michela Antonelli
- School of Biomedical Engineering Imaging Sciences, King’s College London, London SE1 7EH, UK; (M.A.); (S.O.)
| | - Saurabh Singh
- Centre for Medical Imaging, University College London, London WC1E 6BT, UK; (S.S.); (S.P.)
| | - Natalia Grondecka
- Department of Medical Radiology, Medical University of Lublin, 20-059 Lublin, Poland;
| | | | - Hashim U. Ahmed
- Imperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK;
| | - Mark Emberton
- Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London WC1E 6BT, UK;
| | - Shonit Punwani
- Centre for Medical Imaging, University College London, London WC1E 6BT, UK; (S.S.); (S.P.)
| | - Sébastien Ourselin
- School of Biomedical Engineering Imaging Sciences, King’s College London, London SE1 7EH, UK; (M.A.); (S.O.)
| |
Collapse
|
27
|
Matsuura K, Inoue K, Hoshino E, Yasuda M, Hasegawa K, Okada Y, Baba Y, Kozawa E. Utility of magnetic resonance imaging for differentiating malignant mesenchymal tumors of the uterus from T2-weighted hyperintense leiomyomas. Jpn J Radiol 2021; 40:385-395. [PMID: 34750737 PMCID: PMC8977266 DOI: 10.1007/s11604-021-01217-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/28/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE To generate a new discrimination method to distinguish between malignant mesenchymal tumors of the uterus and T2-weighted hyperintense leiomyoma based on magnetic resonance imaging findings and clinical features. MATERIALS AND METHODS Data from 32 tumors of 32 patients with malignant mesenchymal tumors of the uterus and from 34 tumors of 30 patients with T2-weighted hyperintense leiomyoma were analyzed. Clinical parameters, qualitative magnetic resonance imaging features, including computed diffusion-weighted imaging, and quantitative characteristics of magnetic resonance imaging of these two tumor types were compared. Predictive values for malignant mesenchymal tumors of the uterus were calculated using variant discriminant analysis. RESULTS The T1 bright area on qualitative assessment and mean apparent diffusion coefficient value on quantitative assessment yielded the most independent magnetic resonance imaging differentiators of malignant mesenchymal tumors of the uterus and T2-weighted hyperintense leiomyoma. The classification accuracy of the variant discriminant analysis based on three selected findings, i.e., a T1 bright area, computed diffusion-weighted imaging with a b-value of 2000s/mm2 (cDWI2000), and T2-hypointense bands, was 84.8% (56/66), indicating high accuracy. CONCLUSIONS Variant discriminant analysis using the T1 bright area, cDWI2000, and T2-hypointense bands yielded high accuracy for differentiating between malignant mesenchymal tumors of the uterus and T2-weighted hyperintense leiomyoma.
Collapse
Affiliation(s)
- Koichiro Matsuura
- Department of Radiology, Saitama Medical University, 38, Morohongo, Moroyamamachi, Saitama, Japan.
| | - Kaiji Inoue
- Department of Radiology, Saitama Medical University, 38, Morohongo, Moroyamamachi, Saitama, Japan
| | - Eri Hoshino
- Department of Radiology, Saitama Medical University, 38, Morohongo, Moroyamamachi, Saitama, Japan
| | - Masanori Yasuda
- Department of Pathology, Saitama Medical University, 38, Morohongo, Moroyamamachi, Saitama, Japan
| | - Kosei Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University, 38, Morohongo, Moroyamamachi, Saitama, Japan
| | - Yoshitaka Okada
- Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, Japan
| | - Yasutaka Baba
- Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, Japan
| | - Eito Kozawa
- Department of Radiology, Saitama Medical University, 38, Morohongo, Moroyamamachi, Saitama, Japan
| |
Collapse
|
28
|
DelPriore MR, Biswas D, Hippe DS, Zecevic M, Parsian S, Scheel JR, Rahbar H, Partridge SC. Breast Cancer Conspicuity on Computed Versus Acquired High b-Value Diffusion-Weighted MRI. Acad Radiol 2021; 28:1108-1117. [PMID: 32307271 DOI: 10.1016/j.acra.2020.03.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/07/2020] [Accepted: 03/08/2020] [Indexed: 12/30/2022]
Abstract
RATIONALE AND OBJECTIVES On unenhanced diffusion-weighted imaging (DWI), computing or synthesizing high b-value images from lower b-value acquisitions can enhance breast cancer visibility. This study aimed to evaluate relative lesion conspicuity on computed versus acquired diffusion-weighted images and investigate clinical characteristics influencing optimal b-values. MATERIALS AND METHODS Women with newly diagnosed breast cancer were prospectively enrolled and underwent 3T breast MRI with DWI. Lesion contrast-to-noise ratio (CNR) was measured across a range of b-values (0-2500 s/mm2) for computed and acquired DWI. Three readers independently compared lesion visibility between computed and acquired DWI and selected the optimal b-value. Computed versus acquired DWI was compared quantitatively based on CNR by paired t-test and qualitatively based on reader preference using a sign test. Optimal b-values by qualitative and quantitative assessment were compared by paired t-test, and associations with clinical characteristics were assessed by Wilcoxon rank sum test. RESULTS The study included 30 women (median age, 48 years); 28 with invasive carcinoma, 2 DCIS. Lesion CNR was higher on acquired versus computed images (p = 0.018), while lesion visibility by reader assessment was not different (p = 0.36). Optimal b-values selected by readers (mean, b = 1411 ± 383 s/mm2) were slightly higher than those based on peak CNR (b = 1233 ± 463 s/mm2, p = 0.023), and were higher for younger (≤50 years) versus older women (p = 0.002) and dense versus nondense breasts (p = 0.015). CONCLUSION Lesion CNR on computed high b-value images was slightly reduced versus acquired images, but our study suggests that this did not significantly impact lesion visibility. Computing high b-value images offers extra flexibility to adjust b-value during interpretation.
Collapse
|
29
|
Kimura T, Yamashita K, Fukatsu K. Diffusion MR Imaging with T2-based Water Suppression (T2wsup-dMRI). Magn Reson Med Sci 2021; 21:499-515. [PMID: 34305080 PMCID: PMC9316139 DOI: 10.2463/mrms.mp.2021-0007] [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] [Indexed: 12/02/2022] Open
Abstract
Purpose: This study proposes and assesses a new diffusion MRI (dMRI) technique to solve problems related to the quantification of parameter maps (apparent diffusion coefficient [ADC] or mean diffusivity [MD], fractional anisotropy [FA]) and misdrawing of fiber tractography (FT) due to cerebrospinal fluid (CSF)-partial volume effects (PVEs) for brain tissues by combining with the T2-based water suppression (T2wsup) technique. Methods: T2wsup–diffusion-weighted imaging (DWI) images were obtained by subtracting those images from the acquired multi-b value (b) DWI images after correcting the signal intensities of multiecho time (TE) images using long TE water signal-dominant images. Quantitative parameter maps and FT were obtained from minimum data points and were compared with those using the standard (without wsup) DWI method, and partly compared with those obtained using other alternative DWI methods of applying fluid attenuation inversion recovery (FLAIR), non-b-zero (NBZ) by theoretical or noise-added simulation and MR images. Results: In the T2wsup-dMRI method, the hyperintense artifacts due to CSF-PVEs in MRI data were dramatically suppressed even at lower b (≲ 500 s/mm2) while keeping the tissue SNR. The quantitative parameter map values became precisely close to the pure tissue values precisely even in water (CSF) PVE voxels in healthy brain tissues (T2 ≲ 100 ms). Furthermore, the fiber tracts were correctly connected, particularly at the fornix in closest contact to the CSF. Conclusion: Solving the problem of CSF-PVE in the current dMRI technique using our proposed T2wsup-dMRI technique is easy, with higher SNR than those obtained with FLAIR or NBZ methods when applying to healthy brain tissues. The proposed T2wsup–dMRI could be useful in clinical settings, although further optimization of the pulse sequence and processing techniques and clinical assessments are required, particularly for long T2 lesions.
Collapse
Affiliation(s)
- Tokunori Kimura
- Department of Radiological Science, Shizuoka College of Medical Care Science
| | - Kousuke Yamashita
- Department of Radiological Science, Shizuoka College of Medical Care Science
| | - Kouta Fukatsu
- Department of Radiological Science, Shizuoka College of Medical Care Science
| |
Collapse
|
30
|
Mehta P, Antonelli M, Ahmed HU, Emberton M, Punwani S, Ourselin S. Computer-aided diagnosis of prostate cancer using multiparametric MRI and clinical features: A patient-level classification framework. Med Image Anal 2021; 73:102153. [PMID: 34246848 DOI: 10.1016/j.media.2021.102153] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 04/03/2021] [Accepted: 06/28/2021] [Indexed: 01/07/2023]
Abstract
Computer-aided diagnosis (CAD) of prostate cancer (PCa) using multiparametric magnetic resonance imaging (mpMRI) is actively being investigated as a means to provide clinical decision support to radiologists. Typically, these systems are trained using lesion annotations. However, lesion annotations are expensive to obtain and inadequate for characterizing certain tumor types e.g. diffuse tumors and MRI invisible tumors. In this work, we introduce a novel patient-level classification framework, denoted PCF, that is trained using patient-level labels only. In PCF, features are extracted from three-dimensional mpMRI and derived parameter maps using convolutional neural networks and subsequently, combined with clinical features by a multi-classifier support vector machine scheme. The output of PCF is a probability value that indicates whether a patient is harboring clinically significant PCa (Gleason score ≥3+4) or not. PCF achieved mean area under the receiver operating characteristic curves of 0.79 and 0.86 on the PICTURE and PROSTATEx datasets respectively, using five-fold cross-validation. Clinical evaluation over a temporally separated PICTURE dataset cohort demonstrated comparable sensitivity and specificity to an experienced radiologist. We envision PCF finding most utility as a second reader during routine diagnosis or as a triage tool to identify low-risk patients who do not require a clinical read.
Collapse
Affiliation(s)
- Pritesh Mehta
- Department of Medical Physics and Biomedical Engineering, University College London, UK.
| | - Michela Antonelli
- Biomedical Engineering & Imaging Sciences School, King's College London, UK
| | - Hashim U Ahmed
- Imperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK
| | - Mark Emberton
- Division of Surgery and Interventional Science, University College London, UK
| | - Shonit Punwani
- Centre for Medical Imaging, University College London, UK
| | - Sébastien Ourselin
- Biomedical Engineering & Imaging Sciences School, King's College London, UK
| |
Collapse
|
31
|
Colombo A, Bombelli L, Summers PE, Saia G, Zugni F, Marvaso G, Grimm R, Jereczek-Fossa BA, Padhani AR, Petralia G. Effects of Sex and Age on Fat Fraction, Diffusion-Weighted Image Signal Intensity and Apparent Diffusion Coefficient in the Bone Marrow of Asymptomatic Individuals: A Cross-Sectional Whole-Body MRI Study. Diagnostics (Basel) 2021; 11:diagnostics11050913. [PMID: 34065459 PMCID: PMC8161193 DOI: 10.3390/diagnostics11050913] [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: 04/28/2021] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 01/23/2023] Open
Abstract
We aimed to describe the relationships between the relative fat fraction (%FF), muscle-normalized diffusion-weighted (DW) image signal intensity and water apparent diffusion coefficient (ADC), sex and age for normal bone marrow, in the normal population. Our retrospective cohort consisted of 100 asymptomatic individuals, equally divided by sex and 10-year age groups, who underwent whole-body MRI at 1.5 T for early cancer detection. Semi-automated segmentation of global bone marrow volume was performed using the DW images and the resulting segmentation masks were projected onto the ADC and %FF maps for extraction of parameter values. Differences in the parameter values between sexes at age ranges were assessed using the Mann–Whitney and Kruskal–Wallis tests. The Spearman correlation coefficient r was used to assess the relationship of each imaging parameter with age, and of %FF with ADC and normalized DW signal intensity values. The average %FF of normal bone marrow was 65.6 ± 7.2%, while nSIb50, nSIb900 and ADC were 1.7 ± 0.5, 3.2 ± 0.9 and 422 ± 67 μm2/s, respectively. The bone marrow %FF values increased with age in both sexes (r = 0.63 and r = 0.64, respectively, p < 0.001). Values of nSIb50 and nSIb900 were higher in younger women compared to men of the same age groups (p < 0.017), but this difference decreased with age. In our cohort of asymptomatic individuals, the values of bone marrow relative %FF, normalized DW image signal intensity and ADC indicate higher cellularity in premenopausal women, with increasing bone marrow fat with aging in both sexes.
Collapse
Affiliation(s)
- Alberto Colombo
- Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.B.); (P.E.S.); (G.S.); (F.Z.)
- Correspondence:
| | - Luca Bombelli
- Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.B.); (P.E.S.); (G.S.); (F.Z.)
| | - Paul E. Summers
- Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.B.); (P.E.S.); (G.S.); (F.Z.)
| | - Giulia Saia
- Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.B.); (P.E.S.); (G.S.); (F.Z.)
| | - Fabio Zugni
- Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (L.B.); (P.E.S.); (G.S.); (F.Z.)
| | - Giulia Marvaso
- Division of Radiotherapy, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy;
| | - Robert Grimm
- MR Applications Pre-Development, Siemens Healthcare, 91052 Erlangen, Germany;
| | - Barbara A. Jereczek-Fossa
- Division of Radiotherapy, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy;
| | - Anwar R. Padhani
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood HA6 2RN, UK;
| | - Giuseppe Petralia
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy;
- Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| |
Collapse
|
32
|
Sartoretti T, Sartoretti E, Wyss M, Mannil M, van Smoorenburg L, Eichenberger B, Reischauer C, Alfieri A, Binkert C, Sartoretti-Schefer S. Diffusion-weighted MRI of ischemic stroke at 3T: Value of synthetic b-values. Br J Radiol 2021; 94:20200869. [PMID: 33596102 DOI: 10.1259/bjr.20200869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Diffusion-weighted imaging (DWI) plays a crucial role in the diagnosis of ischemic stroke. We assessed the value of computed and acquired high b-value DWI in comparison with conventional b = 1000 s mm-2 DWI for ischemic stroke at 3T. METHODS We included 36 patients with acute ischemic stroke who presented with diffusion abnormalities on DWI performed within 24 h of symptom onset. B-values of 0, 500, 1000 and 2000 s mm-2 were acquired. Synthetic images with b-values of 1000, 1500, 2000 and 2500 s mm-2 were computed. Two readers compared synthetic (syn) and acquired (acq) b = 2000 s mm-2 images with acquired b = 1000 s mm-2 images in terms of lesion detection rate, image quality, presence of uncertain hyperintensities and lesion conspicuity. Readers also selected their preferred b-value. Contrast ratio (CR) measurements were performed. Non-parametrical statistical tests and weighted Cohens' κ tests were computed. RESULTS Syn1000 and syn1500 matched acq1000 images in terms of lesion detection rate, image quality and presence of uncertain hyperintensities but presented with significantly improved lesion conspicuity (p < 0.01) and were frequently selected as preferred b-values. Acq2000 images exhibited a similar lesion detection rate and improved lesion conspicuity (p < 0.01) but worse image quality (p < 0.01) than acq1000 images. Syn2000 and syn2500 images performed significantly worse (p < 0.01) than acq1000 images in most or all categories. CR significantly increased with increasing b-values. CONCLUSION Synthetic images at b = 1000 and 1500 s mm-2 and acquired DWI images at b = 2000 s mm-2 may be of clinical value due to improved lesion conspicuity. ADVANCES IN KNOWLEDGE Synthetic b-values enable improved lesion conspicuity for DWI of ischemic stroke.
Collapse
Affiliation(s)
- Thomas Sartoretti
- Institute of Radiology, Kantonsspital Winterthur, Winterthur, Switzerland.,Faculty of Medicine, University of Zürich, Zürich, Switzerland.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Elisabeth Sartoretti
- Institute of Radiology, Kantonsspital Winterthur, Winterthur, Switzerland.,Faculty of Medicine, University of Zürich, Zürich, Switzerland
| | - Michael Wyss
- Institute of Radiology, Kantonsspital Winterthur, Winterthur, Switzerland.,Philips Healthsystems, Zürich, Switzerland
| | - Manoj Mannil
- Institute of Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland
| | | | | | - Carolin Reischauer
- Department of Medicine, University of Fribourg, Fribourg, Switzerland.,Department of Radiology, HFR Fribourg-Hôpital Cantonal, Fribourg, Switzerland
| | - Alex Alfieri
- Department of Neurosurgery, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Christoph Binkert
- Institute of Radiology, Kantonsspital Winterthur, Winterthur, Switzerland
| | | |
Collapse
|
33
|
Winfield JM, Blackledge MD, Tunariu N, Koh DM, Messiou C. Whole-body MRI: a practical guide for imaging patients with malignant bone disease. Clin Radiol 2021; 76:715-727. [PMID: 33934876 DOI: 10.1016/j.crad.2021.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 04/08/2021] [Indexed: 01/09/2023]
Abstract
Whole-body magnetic resonance imaging (MRI) is now a crucial tool for the assessment of the extent of systemic malignant bone disease and response to treatment, and forms part of national and international recommendations for imaging patients with myeloma or metastatic prostate cancer. Recent developments in scanners have enabled acquisition of good-quality whole-body MRI data within 45 minutes on modern MRI systems from all main manufacturers. This provides complimentary morphological and functional whole-body imaging; however, lack of prior experience and acquisition times required can act as a barrier to adoption in busy radiology departments. This article aims to tackle the former by reviewing the indications and providing guidance for technical delivery and clinical interpretation of whole-body MRI for patients with malignant bone disease.
Collapse
Affiliation(s)
- J M Winfield
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK; MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - M D Blackledge
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK; MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - N Tunariu
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK; MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - D-M Koh
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK; MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - C Messiou
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK; MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK.
| |
Collapse
|
34
|
Staging, recurrence and follow-up of uterine cervical cancer using MRI: Updated Guidelines of the European Society of Urogenital Radiology after revised FIGO staging 2018. Eur Radiol 2021; 31:7802-7816. [PMID: 33852049 DOI: 10.1007/s00330-020-07632-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/31/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The recommendations cover indications for MRI examination including acquisition planes, patient preparation, imaging protocol including multi-parametric approaches such as diffusion-weighted imaging (DWI-MR), dynamic contrast-enhanced imaging (DCE-MR) and standardised reporting. The document also underscores the value of whole-body 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) and highlights potential future methods. METHODS In 2019, the ESUR female pelvic imaging working group reviewed the revised 2018 FIGO staging system, the up-to-date clinical management guidelines, and the recent imaging literature. The RAND-UCLA Appropriateness Method (RAM) was followed to develop the current ESUR consensus guidelines following methodological steps: literature research, questionnaire developments, panel selection, survey, data extraction and analysis. RESULTS The updated ESUR guidelines are recommendations based on ≥ 80% consensus among experts. If ≥ 80% agreement was not reached, the action was indicated as optional. CONCLUSIONS The present ESUR guidelines focus on the main role of MRI in the initial staging, response monitoring and evaluation of disease recurrence. Whole-body FDG-PET plays an important role in the detection of lymph nodes (LNs) and distant metastases. KEY POINTS • T2WI and DWI-MR are now recommended for initial staging, monitoring of response and evaluation of recurrence. • DCE-MR is optional; its primary role remains in the research setting. • T2WI, DWI-MRI and whole-body FDG-PET/CT enable comprehensive assessment of treatment response and recurrence.
Collapse
|
35
|
Colombo A, Saia G, Azzena AA, Rossi A, Zugni F, Pricolo P, Summers PE, Marvaso G, Grimm R, Bellomi M, Jereczek-Fossa BA, Padhani AR, Petralia G. Semi-Automated Segmentation of Bone Metastases from Whole-Body MRI: Reproducibility of Apparent Diffusion Coefficient Measurements. Diagnostics (Basel) 2021; 11:diagnostics11030499. [PMID: 33799913 PMCID: PMC7998160 DOI: 10.3390/diagnostics11030499] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 01/15/2023] Open
Abstract
Using semi-automated software simplifies quantitative analysis of the visible burden of disease on whole-body MRI diffusion-weighted images. To establish the intra- and inter-observer reproducibility of apparent diffusion coefficient (ADC) measures, we retrospectively analyzed data from 20 patients with bone metastases from breast (BCa; n = 10; aged 62.3 ± 14.8) or prostate cancer (PCa; n = 10; aged 67.4 ± 9.0) who had undergone examinations at two timepoints, before and after hormone-therapy. Four independent observers processed all images twice, first segmenting the entire skeleton on diffusion-weighted images, and then isolating bone metastases via ADC histogram thresholding (ADC: 650–1400 µm2/s). Dice Similarity, Bland-Altman method, and Intraclass Correlation Coefficient were used to assess reproducibility. Inter-observer Dice similarity was moderate (0.71) for women with BCa and poor (0.40) for men with PCa. Nonetheless, the limits of agreement of the mean ADC were just ±6% for women with BCa and ±10% for men with PCa (mean ADCs: 941 and 999 µm2/s, respectively). Inter-observer Intraclass Correlation Coefficients of the ADC histogram parameters were consistently greater in women with BCa than in men with PCa. While scope remains for improving consistency of the volume segmented, the observer-dependent variability measured in this study was appropriate to distinguish the clinically meaningful changes of ADC observed in patients responding to therapy, as changes of at least 25% are of interest.
Collapse
Affiliation(s)
- Alberto Colombo
- Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.S.); (F.Z.); (P.P.); (P.E.S.); (M.B.)
- Correspondence:
| | - Giulia Saia
- Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.S.); (F.Z.); (P.P.); (P.E.S.); (M.B.)
| | - Alcide A. Azzena
- Postgraduate School in Radiodiagnostics, University of Milan, 20122 Milan, Italy;
| | - Alice Rossi
- Radiology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy;
| | - Fabio Zugni
- Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.S.); (F.Z.); (P.P.); (P.E.S.); (M.B.)
| | - Paola Pricolo
- Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.S.); (F.Z.); (P.P.); (P.E.S.); (M.B.)
| | - Paul E. Summers
- Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.S.); (F.Z.); (P.P.); (P.E.S.); (M.B.)
| | - Giulia Marvaso
- Division of Radiotherapy, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy;
| | - Robert Grimm
- MR Applications Pre-Development, Siemens Healthcare, 91052 Erlangen, Germany;
| | - Massimo Bellomi
- Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.S.); (F.Z.); (P.P.); (P.E.S.); (M.B.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy;
| | - Barbara A. Jereczek-Fossa
- Division of Radiotherapy, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy;
| | - Anwar R. Padhani
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood HA6 2RN, UK;
| | - Giuseppe Petralia
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy;
- Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| |
Collapse
|
36
|
Yoshida S, Takahara T, Arita Y, Sakaino S, Katahira K, Fujii Y. Whole‐body diffusion‐weighted magnetic resonance imaging: Diagnosis and follow up of prostate cancer and beyond. Int J Urol 2021; 28:502-513. [DOI: 10.1111/iju.14497] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Soichiro Yoshida
- Department of Urology Tokyo Medical and Dental University TokyoJapan
| | - Taro Takahara
- Department of Biomedical Engineering Tokai University School of Engineering KanagawaJapan
- Department of Radiology Advanced Imaging Center, Yaesu Clinic TokyoJapan
| | - Yuki Arita
- Department of Radiology Keio University School of Medicine TokyoJapan
| | - Shinjiro Sakaino
- Department of Radiation Therapeutics Suzukake Central Hospital ShizuokaJapan
| | | | - Yasuhisa Fujii
- Department of Urology Tokyo Medical and Dental University TokyoJapan
| |
Collapse
|
37
|
Winfield JM, Wakefield JC, Brenton JD, AbdulJabbar K, Savio A, Freeman S, Pace E, Lutchman-Singh K, Vroobel KM, Yuan Y, Banerjee S, Porta N, Ahmed Raza SE, deSouza NM. Biomarkers for site-specific response to neoadjuvant chemotherapy in epithelial ovarian cancer: relating MRI changes to tumour cell load and necrosis. Br J Cancer 2021; 124:1130-1137. [PMID: 33398064 PMCID: PMC7961011 DOI: 10.1038/s41416-020-01217-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/11/2020] [Accepted: 11/25/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging (DW-MRI) potentially interrogates site-specific response to neoadjuvant chemotherapy (NAC) in epithelial ovarian cancer (EOC). METHODS Participants with newly diagnosed EOC due for platinum-based chemotherapy and interval debulking surgery were recruited prospectively in a multicentre study (n = 47 participants). Apparent diffusion coefficient (ADC) and solid tumour volume (up to 10 lesions per participant) were obtained from DW-MRI before and after NAC (including double-baseline for repeatability assessment in n = 19). Anatomically matched lesions were analysed after surgical excision (65 lesions obtained from 25 participants). A trained algorithm determined tumour cell fraction, percentage tumour and percentage necrosis on histology. Whole-lesion post-NAC ADC and pre/post-NAC ADC changes were compared with histological metrics (residual tumour/necrosis) for each tumour site (ovarian, omental, peritoneal, lymph node). RESULTS Tumour volume reduced at all sites after NAC. ADC increased between pre- and post-NAC measurements. Post-NAC ADC correlated negatively with tumour cell fraction. Pre/post-NAC changes in ADC correlated positively with percentage necrosis. Significant correlations were driven by peritoneal lesions. CONCLUSIONS Following NAC in EOC, the ADC (measured using DW-MRI) increases differentially at disease sites despite similar tumour shrinkage, making its utility site-specific. After NAC, ADC correlates negatively with tumour cell fraction; change in ADC correlates positively with percentage necrosis. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT01505829.
Collapse
Affiliation(s)
- Jessica M Winfield
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
- MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Jennifer C Wakefield
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
- MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - James D Brenton
- Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
- Department of Oncology, University of Cambridge, Cambridge, CB2 0XZ, UK
| | - Khalid AbdulJabbar
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Antonella Savio
- Department of Pathology, Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
| | - Susan Freeman
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Erika Pace
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
- MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Kerryn Lutchman-Singh
- Swansea Gynaecological Oncology Centre, Swansea Bay University Health Board, Singleton Hospital, Swansea, SA2 8QA, UK
| | - Katherine M Vroobel
- Department of Pathology, Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
| | - Yinyin Yuan
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Susana Banerjee
- Gynaecology Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Nuria Porta
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
| | - Shan E Ahmed Raza
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Nandita M deSouza
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK.
- MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK.
| |
Collapse
|
38
|
Ahn HS, Kim SH, Kim JY, Park CS, Grimm R, Son Y. Image quality and diagnostic value of diffusion-weighted breast magnetic resonance imaging: Comparison of acquired and computed images. PLoS One 2021; 16:e0247379. [PMID: 33617567 PMCID: PMC7899336 DOI: 10.1371/journal.pone.0247379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 02/06/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To compare the image quality of acquired diffusion-weighted imaging (DWI) and computed DWI and evaluate the lesion detectability and likelihood of malignancy in these datasets. MATERIALS AND METHODS This prospective study was approved by our institutional review board. A total of 29 women (mean age, 43.5 years) underwent DWI between August 2018 and April 2019 for 32 breast cancers and 16 benign breast lesions. Three radiologists independently reviewed the acquired DWI with b-values of 1000 and 2000 s/mm2 (A-b1000 and A-b2000) and the computed DWI with a b-value of 2000 s/mm2 (C-b2000). Image quality was scored and compared between the three DWI datasets. Lesion detectability was recorded, and the lesion's likelihood for malignancy was scored using a five-point scale. RESULTS The A-b1000 images were superior to the A-b2000 and C-b2000 images in chest distinction, fat suppression, and overall image quality. The A-b2000 and C-b2000 images showed comparable scores for all image quality parameters. C-b2000 showed the highest values for lesion detection among all readers, although there was no statistical difference in sensitivity, specificity, positive predictive value, negative predictive value, and accuracy between the DWI datasets. The malignancy scores of the DWI images were not significantly different among the three readers. CONCLUSIONS A-b1000 DWI is suitable for breast lesion evaluations, considering its better image quality and comparable diagnostic values compared to that of A-b2000 and C-b2000 images. The additional use of computed high b-value DWI may have the potential to increase the detectability of breast masses.
Collapse
Affiliation(s)
- Hye Shin Ahn
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Sung Hun Kim
- Department of Radiology, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
- * E-mail:
| | - Ji Youn Kim
- Department of Radiology, College of Medicine, Yeouido St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Suk Park
- Department of Radiology, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Icheon, Republic of Korea
| | - Robert Grimm
- MR Applications Development, Siemens Healthcare, Erlangen, Germany
| | - Yohan Son
- Siemens Healthineers Ltd., Seoul, Republic of Korea
| |
Collapse
|
39
|
Arita Y, Yoshida S, Waseda Y, Takahara T, Ishii C, Ueda R, Kwee TC, Miyahira K, Ishii R, Okuda S, Jinzaki M, Fujii Y. Diagnostic value of computed high b-value whole-body diffusion-weighted imaging for primary prostate cancer. Eur J Radiol 2021; 137:109581. [PMID: 33578087 DOI: 10.1016/j.ejrad.2021.109581] [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: 11/08/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE To investigate the utility of post-acquisition computed diffusion-weighted imaging (cDWI) for primary prostate cancer (PCa) evaluation in biparametric whole-body MRI (bpWB-MRI). METHODS Patients who underwent pelvic MRI for PCa screening and subsequent bpWB-MRI for staging were included. Two radiologists assessed the diagnostic performance of the following datasets for clinically significant PCa diagnosis (grade group ≥2 according to the Prostate Imaging-Reporting and Data System, version 2.1): bpMRI2000 (axial DWI scans with a b-value of 2,000 s/mm2 + axial T2WI scans from pre-biopsy pelvic MRI), computed bpWB-MRI2000 (computed WB-DWI scans with a b-value of 2,000 s/mm2 + axial WB-T2WI scans), and native bpWB-MRI1000 (native axial WB-DWI scans with a b-value of 1,000 s/mm2 + axial WB-T2WI scans). Systemic biopsy was used as reference standard. RESULTS Fifty-one patients with PCa were included. The areas under the curve (AUCs) of bpMRI2000 (0.89 for reader 1 and 0.86 for reader 2) and computed bpWB-MRI2000 (0.86 for reader 1 and 0.83 for reader 2) were significantly higher (p < 0.001) than those of native bpWB-MRI1000 (0.67 for both readers). No significant difference was observed between the AUCs of bpMRI2000 and computed bpWB-MRI2000 (p = 0.10 for reader 1 and p = 0.25 for reader 2). CONCLUSIONS The diagnostic performance of computed bpWB-MRI2000 was similar to that of dedicated pelvic bpMRI2000 for primary PCa evaluation. cDWI can be recommended for implementation in standard WB-MRI protocols to facilitate a one-step evaluation for concurrent detection of primary and metastatic PCa.
Collapse
Affiliation(s)
- Yuki Arita
- Department of Radiology, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Radiology, Advanced Imaging Center Yaesu Clinic, 2-1-18, Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan.
| | - Soichiro Yoshida
- Department of Radiology, Advanced Imaging Center Yaesu Clinic, 2-1-18, Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan; Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Yuma Waseda
- Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Taro Takahara
- Department of Radiology, Advanced Imaging Center Yaesu Clinic, 2-1-18, Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan; Department of Biomedical Engineering, Tokai University School of Engineering, 143, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Chikako Ishii
- Department of Radiology, Advanced Imaging Center Yaesu Clinic, 2-1-18, Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan.
| | - Ryo Ueda
- Office of Radiation Technology, Keio University Hospital, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Thomas C Kwee
- Department of Radiology, Nuclear Medicine, and Molecular Imaging, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
| | - Kei Miyahira
- Department of Radiology, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Ryota Ishii
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Shigeo Okuda
- Department of Radiology, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| |
Collapse
|
40
|
Jerome NP, Periquito JS. Analysis of Renal Diffusion-Weighted Imaging (DWI) Using Apparent Diffusion Coefficient (ADC) and Intravoxel Incoherent Motion (IVIM) Models. Methods Mol Biol 2021; 2216:611-635. [PMID: 33476027 DOI: 10.1007/978-1-0716-0978-1_37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Analysis of renal diffusion-weighted imaging (DWI) data to derive markers of tissue properties requires careful consideration of the type, extent, and limitations of the acquired data. Alongside data quality and general suitability for quantitative analysis, choice of diffusion model, fitting algorithm, and processing steps can have consequences for the precision, accuracy, and reliability of derived diffusion parameters. Here we introduce and discuss important steps for diffusion-weighted image processing, and in particular give example analysis protocols and pseudo-code for analysis using the apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) models. Following an overview of general principles, we provide details of optional steps, and steps for validation of results. Illustrative examples are provided, together with extensive notes discussing wider context of individual steps, and notes on potential pitfalls.This publication is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This analysis protocol chapter is complemented by two separate chapters describing the basic concepts and experimental procedure.
Collapse
Affiliation(s)
- Neil Peter Jerome
- Institute for Circulation and Diagnostic Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- Department of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim, Norway.
| | - João S Periquito
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
| |
Collapse
|
41
|
Shin HJ, Lee SH, Moon WK. Diffusion-Weighted Imaging as a Stand-Alone Breast Imaging Modality. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2021; 82:29-48. [PMID: 36237448 PMCID: PMC9432391 DOI: 10.3348/jksr.2020.0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 12/03/2022]
Abstract
확산강조영상은 유방암의 진단과 스크리닝에 있어 독립적 검사 방법으로서의 기대되는 결과를 보여주는 빠른 비조영증강 검사 방법이다. 현재까지의 연구 결과 유방암 진단에 있어 독립적 검사 방법으로서 확산강조영상의 민감도는 역동적 조영증강 검사보다는 낮으나 유방촬영술보다는 높으며, 이로써 유방암 스크리닝에 대한 유용한 대안이 될 수 있을 것으로 보인다. 확산강조영상의 표준화된 영상 획득과 판독을 통해 영상 화질이 개선될 수 있고, 판독 결과의 다양성도 감소할 것으로 기대된다. 또한, 최신 기법과 후처리 기법을 사용한 고해상도 확산강조영상을 시행함으로써 1 cm 미만의 작은 암의 발견율을 증가시킬 수 있고, 가음성 및 가양성 결과를 감소시킬 것으로 보인다. 현재 한국에서 진행 중인 고위험군 여성에서의 확산강조영상 스크리닝에 대한 다기관 연구 결과가 나온다면 독립적 검사로서의 확산강조영상의 사용을 촉진시킬 수 있을 것으로 기대된다.
Collapse
Affiliation(s)
- Hee Jung Shin
- Department of Radiology, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Su Hyun Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Woo Kyung Moon
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
42
|
Van Nieuwenhove S, Van Damme J, Padhani AR, Vandecaveye V, Tombal B, Wuts J, Pasoglou V, Lecouvet FE. Whole-body magnetic resonance imaging for prostate cancer assessment: Current status and future directions. J Magn Reson Imaging 2020; 55:653-680. [PMID: 33382151 DOI: 10.1002/jmri.27485] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/08/2020] [Accepted: 12/08/2020] [Indexed: 12/20/2022] Open
Abstract
Over the past decade, updated definitions for the different stages of prostate cancer and risk for distant disease, along with the advent of new therapies, have remarkably changed the management of patients. The two expectations from imaging are accurate staging and appropriate assessment of disease response to therapies. Modern, next-generation imaging (NGI) modalities, including whole-body magnetic resonance imaging (WB-MRI) and nuclear medicine (most often prostate-specific membrane antigen [PSMA] positron emission tomography [PET]/computed tomography [CT]) bring added value to these imaging tasks. WB-MRI has proven its superiority over bone scintigraphy (BS) and CT for the detection of distant metastasis, also providing reliable evaluations of disease response to treatment. Comparison of the effectiveness of WB-MRI and molecular nuclear imaging techniques with regard to indications and the definition of their respective/complementary roles in clinical practice is ongoing. This paper illustrates the evolution of WB-MRI imaging protocols, defines the current state-of-the art, and highlights the latest developments and future challenges. The paper presents and discusses WB-MRI indications in the care pathway of men with prostate cancer in specific key situations: response assessment of metastatic disease, "all in one" cancer staging, and oligometastatic disease.
Collapse
Affiliation(s)
- Sandy Van Nieuwenhove
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Julien Van Damme
- Department of Urology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Anwar R Padhani
- Mount Vernon Cancer Centre, Mount Vernon Hospital, London, UK
| | - Vincent Vandecaveye
- Department of Radiology and Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Bertrand Tombal
- Department of Urology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Joris Wuts
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Brussels, Belgium
| | - Vassiliki Pasoglou
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Frederic E Lecouvet
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| |
Collapse
|
43
|
Choi BH, Baek HJ, Ha JY, Ryu KH, Moon JI, Park SE, Bae K, Jeon KN, Jung EJ. Feasibility Study of Synthetic Diffusion-Weighted MRI in Patients with Breast Cancer in Comparison with Conventional Diffusion-Weighted MRI. Korean J Radiol 2020; 21:1036-1044. [PMID: 32691539 PMCID: PMC7371621 DOI: 10.3348/kjr.2019.0568] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 02/20/2020] [Accepted: 03/17/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To investigate the clinical feasibility of synthetic diffusion-weighted imaging (sDWI) at different b-values in patients with breast cancer by assessing the diagnostic image quality and the quantitative measurements compared with conventional diffusion-weighted imaging (cDWI). MATERIALS AND METHODS Fifty patients with breast cancer were assessed using cDWI at b-values of 800 and 1500 s/mm² (cDWI800 and cDWI1500) and sDWI at b-values of 1000 and 1500 s/mm² (sDWI1000 and sDWI1500). Qualitative analysis (normal glandular tissue suppression, overall image quality, and lesion conspicuity) was performed using a 4-point Likert-scale for all DWI sets and the cancer detection rate (CDR) was calculated. We also evaluated cancer-to-parenchyma contrast ratios for each DWI set in 45 patients with the lesion identified on any of the DWI sets. Statistical comparisons were performed using Friedman test, one-way analysis of variance, and Cochran's Q test. RESULTS All parameters of qualitative analysis, cancer-to-parenchyma contrast ratios, and CDR increased with increasing b-values, regardless of the type of imaging (synthetic or conventional) (p < 0.001). Additionally, sDWI1500 provided better lesion conspicuity than cDWI1500 (3.52 ± 0.92 vs. 3.39 ± 0.90, p < 0.05). Although cDWI1500 showed better normal glandular tissue suppression and overall image quality than sDWI1500 (3.66 ± 0.78 and 3.73 ± 0.62 vs. 3.32 ± 0.90 and 3.35 ± 0.81, respectively; p < 0.05), there was no significant difference in their CDR (90.0%). Cancer-to-parenchyma contrast ratios were greater in sDWI1500 than in cDWI1500 (0.63 ± 0.17 vs. 0.55 ± 0.18, p < 0.001). CONCLUSION sDWI1500 can be feasible for evaluating breast cancers in clinical practice. It provides higher tumor conspicuity, better cancer-to-parenchyma contrast ratio, and comparable CDR when compared with cDWI1500.
Collapse
Affiliation(s)
- Bo Hwa Choi
- Department of Radiology Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea.,Department of Radiology, National Cancer Center, Goyang, Korea
| | - Hye Jin Baek
- Department of Radiology Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea.
| | - Ji Young Ha
- Department of Radiology Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Kyeong Hwa Ryu
- Department of Radiology Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jin Il Moon
- Department of Radiology Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Sung Eun Park
- Department of Radiology Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Kyungsoo Bae
- Department of Radiology Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Kyung Nyeo Jeon
- Department of Radiology Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Eun Jung Jung
- Department of Surgery, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| |
Collapse
|
44
|
Kitazume Y, Tsuchiya J, Takenaka K, Ohtsuka K, Kimura K, Watanabe R, Fujioka T, Fujii T, Watanabe M, Tateisi U. High b-value computed diffusion-weighted imaging for differentiating bowel inflammation in Crohn's disease. Eur J Radiol 2020; 133:109362. [PMID: 33129103 DOI: 10.1016/j.ejrad.2020.109362] [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: 07/13/2020] [Revised: 10/13/2020] [Accepted: 10/18/2020] [Indexed: 11/27/2022]
Abstract
Purpose This study evaluated whether high b-value computed diffusion-weighted imaging (cDWI) can improve detection and differentiation of bowel inflammation in patients with Crohn's disease (CD). Methods Fifty-four consecutive CD patients who had undergone magnetic resonance enterography (MRE) and ileocolonoscopy (ICS) or balloon-assisted enteroscopy (BAE) were retrospectively studied; cDWI with a b-value = 1500s/mm2 (cDWI1500) was generated using DWI acquired with b-values of 0 and 800 s/mm2 (aDWI800). Overall, 366 bowel segments were evaluated. The signal intensities (SIs) of the bowel lumina were visually assessed on DWI. Bowel wall-to-iliopsoas muscle SI ratios on aDWI800 and cDWI1500 images and apparent diffusion coefficient (ADC) values were measured; visual assessments for lesion detection were performed using a 5-point Likert-like scale on plain MRE with aDWI800, plain MRE with cDWI1500, and contrast-enhanced (CE)-MRE without DWI. The area under the receiver-operating characteristic curve (AUC) was calculated to compare quantitative and qualitative assessments. Results SIs of the intraluminal fluid were shown as comparable to, or lower than background SIs on 157 (44.7 %) and 345 (98.3 %) of 351 segments on aDWI800 and cDWI1500, respectively. AUCs of SI ratios on cDWI1500 images (82.0 %, [95 % confidence interval: 76.6-87.3 %]) were greater than on aDWI800 (75.2 %, [68.2-82.3 %]; p < 0.001), and were close to the ADC values (81.5 % [76.3-86.7 %]; p = 0.76). The AUCs of CE-MRE images were largest, followed by plain MRE with cDWI1500, and plain MRE with aDWI800. Conclusions As it suppresses the SIs of intraluminal fluid and improves contrast between severe and non-severe inflammation, cDWI1500 helps with CD evaluation.
Collapse
Affiliation(s)
- Yoshio Kitazume
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
| | - Junichi Tsuchiya
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Kento Takenaka
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuo Ohtsuka
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koichiro Kimura
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Ryosuke Watanabe
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Tomoyuki Fujioka
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Toshimitsu Fujii
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mamoru Watanabe
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan; TMDU Advanced Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ukihide Tateisi
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| |
Collapse
|
45
|
Klingebiel M, Ullrich T, Quentin M, Bonekamp D, Aissa J, Mally D, Arsov C, Albers P, Antoch G, Schimmöller L. Advanced diffusion weighted imaging of the prostate: Comparison of readout-segmented multi-shot, parallel-transmit and single-shot echo-planar imaging. Eur J Radiol 2020; 130:109161. [DOI: 10.1016/j.ejrad.2020.109161] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 06/30/2020] [Indexed: 01/21/2023]
|
46
|
Lee SH, Shin HJ, Moon WK. Diffusion-Weighted Magnetic Resonance Imaging of the Breast: Standardization of Image Acquisition and Interpretation. Korean J Radiol 2020; 22:9-22. [PMID: 32901461 PMCID: PMC7772373 DOI: 10.3348/kjr.2020.0093] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/06/2020] [Accepted: 05/09/2020] [Indexed: 12/12/2022] Open
Abstract
Diffusion-weighted (DW) magnetic resonance imaging (MRI) is a rapid, unenhanced imaging technique that measures the motion of water molecules within tissues and provides information regarding the cell density and tissue microstructure. DW MRI has demonstrated the potential to improve the specificity of breast MRI, facilitate the evaluation of tumor response to neoadjuvant chemotherapy and can be employed in unenhanced MRI screening. However, standardization of the acquisition and interpretation of DW MRI is challenging. Recently, the European Society of Breast Radiology issued a consensus statement, which described the acquisition parameters and interpretation of DW MRI. The current article describes the basic principles, standardized acquisition protocols and interpretation guidelines, and the clinical applications of DW MRI in breast imaging.
Collapse
Affiliation(s)
- Su Hyun Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Hee Jung Shin
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Kyung Moon
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.
| |
Collapse
|
47
|
Daimiel Naranjo I, Lo Gullo R, Saccarelli C, Thakur SB, Bitencourt A, Morris EA, Jochelson MS, Sevilimedu V, Martinez DF, Pinker-Domenig K. Diagnostic value of diffusion-weighted imaging with synthetic b-values in breast tumors: comparison with dynamic contrast-enhanced and multiparametric MRI. Eur Radiol 2020; 31:356-367. [PMID: 32780207 PMCID: PMC7755636 DOI: 10.1007/s00330-020-07094-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/22/2020] [Accepted: 07/21/2020] [Indexed: 12/24/2022]
Abstract
Objectives To assess DWI for tumor visibility and breast cancer detection by the addition of different synthetic b-values. Methods Eighty-four consecutive women who underwent a breast-multiparametric-MRI (mpMRI) with enhancing lesions on DCE-MRI (BI-RADS 2–5) were included in this IRB-approved retrospective study from September 2018 to March 2019. Three readers evaluated DW acquired b-800 and synthetic b-1000, b-1200, b-1500, and b-1800 s/mm2 images for lesion visibility and preferred b-value based on lesion conspicuity. Image quality (1–3 scores) and breast composition (BI-RADS) were also recorded. Diagnostic parameters for DWI were determined using a 1–5 malignancy score based on qualitative imaging parameters (acquired + preferred synthetic b-values) and ADC values. BI-RADS classification was used for DCE-MRI and quantitative ADC values + BI-RADS were used for mpMRI. Results Sixty-four malignant (average = 23 mm) and 39 benign (average = 8 mm) lesions were found in 80 women. Although b-800 achieved the best image quality score, synthetic b-values 1200–1500 s/mm2 were preferred for lesion conspicuity, especially in dense breast. b-800 and synthetic b-1000/b-1200 s/mm2 values allowed the visualization of 84–90% of cancers visible with DCE-MRI performing better than b-1500/b-1800 s/mm2. DWI was more specific (86.3% vs 65.7%, p < 0.001) but less sensitive (62.8% vs 90%, p < 0.001) and accurate (71% vs 80.7%, p = 0.003) than DCE-MRI for breast cancer detection, where mpMRI was the most accurate modality accounting for less false positive cases. Conclusion The addition of synthetic b-values enhances tumor conspicuity and could potentially improve tumor visualization particularly in dense breast. However, its supportive role for DWI breast cancer detection is still not definite. Key Points • The addition of synthetic b-values (1200–1500 s/mm2) to acquired DWI afforded a better lesion conspicuity without increasing acquisition time and was particularly useful in dense breasts. • Despite the use of synthetic b-values, DWI was less sensitive and accurate than DCE-MRI for breast cancer detection. • A multiparametric MRI modality still remains the best approach having the highest accuracy for breast cancer detection and thus reducing the number of unnecessary biopsies. Electronic supplementary material The online version of this article (10.1007/s00330-020-07094-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Isaac Daimiel Naranjo
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY, 10065, USA
| | - Roberto Lo Gullo
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY, 10065, USA.,Department of Radiology, Breast Imaging Division, Istituto Europeo di Oncologia, Via Giuseppe Ripamonti, 435, 20141, Milano, Italy
| | - Carolina Saccarelli
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY, 10065, USA
| | - Sunitha B Thakur
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY, 10065, USA.,Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Almir Bitencourt
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY, 10065, USA.,Department of Imaging, A.C.Camargo Cancer Center, SP, São Paulo, Brazil
| | - Elizabeth A Morris
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY, 10065, USA
| | - Maxine S Jochelson
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY, 10065, USA
| | - Varadan Sevilimedu
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Danny F Martinez
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY, 10065, USA
| | - Katja Pinker-Domenig
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY, 10065, USA. .,Department of Biomedical Imaging and Image-guided Therapy Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| |
Collapse
|
48
|
Clinical Feasibility of Reduced Field-of-View Diffusion-Weighted Magnetic Resonance Imaging with Computed Diffusion-Weighted Imaging Technique in Breast Cancer Patients. Diagnostics (Basel) 2020; 10:diagnostics10080538. [PMID: 32751723 PMCID: PMC7460410 DOI: 10.3390/diagnostics10080538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/20/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022] Open
Abstract
Background: We evaluated the feasibility of the reduced field-of-view (rFOV) diffusion-weighted imaging (DWI) with computed DWI technique by comparison and analysis of the inter-method agreement among acquired rFOV DWI (rFOVA), rFOV DWI with computed DWI technique (rFOVS), and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in patients with breast cancer. Methods: A total of 130 patients with biopsy-proven breast cancers who underwent breast MRI from April 2017 to December 2017 were included in this study. The rFOVS were reformatted by calculation of the apparent diffusion coefficient curve obtained from rFOVA b = 0 s/mm2 and b = 500 s/mm2. Visual assessment of the image quality of rFOVA b = 1000 s/mm2, rFOVS, and DCE MRI was performed using a four-point grading system. Morphologic analyses of the index cancer was performed on rFOVA, rFOVS, and DCE MRI. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and contrast of tumor-to-parenchyma (TPC) were calculated. Results: Image quality scores with rFOVA, rFOVS, and DCE MRI were not significantly different (p = 0.357). Lesion analysis of shape, margin, and size of the index cancer also did not show significant differences among the three sequences (p = 0.858, p = 0.242, and p = 0.858, respectively). SNR, CNR, and TPC of DCE MRI were significantly higher than those of rFOVA and rFOVS (p < 0.001, p = 0.001, and p = 0.016, respectively). Significant differences were not found between the SNR, CNR, and TPC of rFOVA and those of rFOVS (p > 0.999, p > 0.999, and p > 0.999, respectively). Conclusion: The rFOVA and rFOVS showed nearly equivalent levels of image quality required for morphological analysis of the tumors and for lesion conspicuity compared with DCE MRI.
Collapse
|
49
|
Blackledge MD, Tunariu N, Zungi F, Holbrey R, Orton MR, Ribeiro A, Hughes JC, Scurr ED, Collins DJ, Leach MO, Koh DM. Noise-Corrected, Exponentially Weighted, Diffusion-Weighted MRI (niceDWI) Improves Image Signal Uniformity in Whole-Body Imaging of Metastatic Prostate Cancer. Front Oncol 2020; 10:704. [PMID: 32457842 PMCID: PMC7225292 DOI: 10.3389/fonc.2020.00704] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/15/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose: To characterize the voxel-wise uncertainties of Apparent Diffusion Coefficient (ADC) estimation from whole-body diffusion-weighted imaging (WBDWI). This enables the calculation of a new parametric map based on estimates of ADC and ADC uncertainty to improve WBDWI imaging standardization and interpretation: NoIse-Corrected Exponentially-weighted diffusion-weighted MRI (niceDWI). Methods: Three approaches to the joint modeling of voxel-wise ADC and ADC uncertainty (σADC) are evaluated: (i) direct weighted least squares (DWLS), (ii) iterative linear-weighted least-squares (IWLS), and (iii) smoothed IWLS (SIWLS). The statistical properties of these approaches in terms of ADC/σADC accuracy and precision is compared using Monte Carlo simulations. Our proposed post-processing methodology (niceDWI) is evaluated using an ice-water phantom, by comparing the contrast-to-noise ratio (CNR) with conventional exponentially-weighted DWI. We present the clinical feasibility of niceDWI in a pilot cohort of 16 patients with metastatic prostate cancer. Results: The statistical properties of ADC and σADC conformed closely to the theoretical predictions for DWLS, IWLS, and SIWLS fitting routines (a minor bias in parameter estimation is observed with DWLS). Ice-water phantom experiments demonstrated that a range of CNR could be generated using the niceDWI approach, and could improve CNR compared to conventional methods. We successfully implemented the niceDWI technique in our patient cohort, which visually improved the in-plane bias field compared with conventional WBDWI. Conclusions: Measurement of the statistical uncertainty in ADC estimation provides a practical way to standardize WBDWI across different scanners, by providing quantitative image signals that improve its reliability. Our proposed method can overcome inter-scanner and intra-scanner WBDWI signal variations that can confound image interpretation.
Collapse
Affiliation(s)
- Matthew D Blackledge
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Nina Tunariu
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom.,Department of Radiology, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Fabio Zungi
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom.,Department of Radiology, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Richard Holbrey
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Matthew R Orton
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Ana Ribeiro
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Julie C Hughes
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Erica D Scurr
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - David J Collins
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Martin O Leach
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Dow-Mu Koh
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom.,Department of Radiology, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
50
|
Dulhanty C, Wang L, Cheng M, Gunraj H, Khalvati F, Haider MA, Wong A. Radiomics Driven Diffusion Weighted Imaging Sensing Strategies for Zone-Level Prostate Cancer Sensing. SENSORS 2020; 20:s20051539. [PMID: 32164378 PMCID: PMC7085575 DOI: 10.3390/s20051539] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 03/02/2020] [Accepted: 03/06/2020] [Indexed: 12/21/2022]
Abstract
Prostate cancer is the most commonly diagnosed cancer in North American men; however, prognosis is relatively good given early diagnosis. This motivates the need for fast and reliable prostate cancer sensing. Diffusion weighted imaging (DWI) has gained traction in recent years as a fast non-invasive approach to cancer sensing. The most commonly used DWI sensing modality currently is apparent diffusion coefficient (ADC) imaging, with the recently introduced computed high-b value diffusion weighted imaging (CHB-DWI) showing considerable promise for cancer sensing. In this study, we investigate the efficacy of ADC and CHB-DWI sensing modalities when applied to zone-level prostate cancer sensing by introducing several radiomics driven zone-level prostate cancer sensing strategies geared around hand-engineered radiomic sequences from DWI sensing (which we term as Zone-X sensing strategies). Furthermore, we also propose Zone-DR, a discovery radiomics approach based on zone-level deep radiomic sequencer discovery that discover radiomic sequences directly for radiomics driven sensing. Experimental results using 12,466 pathology-verified zones obtained through the different DWI sensing modalities of 101 patients showed that: (i) the introduced Zone-X and Zone-DR radiomics driven sensing strategies significantly outperformed the traditional clinical heuristics driven strategy in terms of AUC, (ii) the introduced Zone-DR and Zone-SVM strategies achieved the highest sensitivity and specificity, respectively for ADC amongst the tested radiomics driven strategies, (iii) the introduced Zone-DR and Zone-LR strategies achieved the highest sensitivities for CHB-DWI amongst the tested radiomics driven strategies, and (iv) the introduced Zone-DR, Zone-LR, and Zone-SVM strategies achieved the highest specificities for CHB-DWI amongst the tested radiomics driven strategies. Furthermore, the results showed that the trade-off between sensitivity and specificity can be optimized based on the particular clinical scenario we wish to employ radiomic driven DWI prostate cancer sensing strategies for, such as clinical screening versus surgical planning. Finally, we investigate the critical regions within sensing data that led to a given radiomic sequence generated by a Zone-DR sequencer using an explainability method to get a deeper understanding on the biomarkers important for zone-level cancer sensing.
Collapse
Affiliation(s)
- Chris Dulhanty
- Vision and Image Processing Research Group, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
- Correspondence: (C.D.); (L.W.)
| | - Linda Wang
- Vision and Image Processing Research Group, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
- Correspondence: (C.D.); (L.W.)
| | - Maria Cheng
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Hayden Gunraj
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Farzad Khalvati
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON M5G 1X5, Canada; (F.K.); (M.A.H.)
| | - Masoom A. Haider
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON M5G 1X5, Canada; (F.K.); (M.A.H.)
| | - Alexander Wong
- Vision and Image Processing Research Group, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
- Waterloo Artificial Intelligence Institute, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| |
Collapse
|