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Dou Y, Liu Y, Kong X, Yang S. T staging with functional and radiomics parameters of computed tomography in colorectal cancer patients. Medicine (Baltimore) 2022; 101:e29244. [PMID: 35623068 PMCID: PMC9276127 DOI: 10.1097/md.0000000000029244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 04/20/2022] [Indexed: 01/04/2023] Open
Abstract
Preoperative T staging is closely related to operation planning and prognosis of colorectal cancer (CRC). This study aimed to re-investigate the value of computed tomography (CT) in T stage evaluation of CRC patients with both functional and radiomics parameters.The functional and radiomics parameters of CT images and the clinical information were collected from 32 CRC patients. The radiomics parameters were measured based on manually labelled 5-mm circles using software Syngo. The radiomics parameters were computed based on labelled tumor regions using Python software package.A total of 125 parameters were collected and analyzed by using decision tree analysis. The decision tree analysis identified 6 rules. Based on the rules, the shape elongation, flow extraction of nodule and blood volume of tumor region were found to be of significance and could define a high-risk group and a low-risk group.This study shows the combination of functional parameters and radiomics parameters of CT is helpful for the diagnosis and T staging of CRC.
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Affiliation(s)
- Yafang Dou
- Department of Radiology, Shuguang Hospital of Shanghai Traditional Chinese Medicine University, Shanghai, China
| | - Yingying Liu
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Xiancheng Kong
- Department of General Surgery, Shuguang Hospital of Shanghai Traditional Chinese Medicine University, Shanghai, China
| | - Shangying Yang
- Department of Gastroscope, Shuguang Hospital of Shanghai Traditional Chinese Medicine University, Shanghai, China
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2
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Association Between Histopathology and Magnetic Resonance Imaging Texture in Grading Gliomas Based on Intraoperative Magnetic Resonance Navigated Stereotactic Biopsy. J Comput Assist Tomogr 2021; 45:728-735. [PMID: 34347700 DOI: 10.1097/rct.0000000000001201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore the value of magnetic resonance imaging (MRI) textures and its correlation with histopathological malignancy of gliomas by magnetic resonance (MR) navigated stereotactic biopsy. METHODS A total of 36 diffuse glioma cases and 64 puncture targets were included. All patients underwent a preoperative MR scan and intraoperative MR-navigated stereotactic biopsy. The histopathological diagnosis was grade II or grade III diffuse glioma. Regions of interest consistent with puncture targets were delineated on T1-weighted brain volume with gadolinium contrast enhancement images, and textures were extracted using Omni Kinetics software. Mann-Whitney rank sum test was used to analyze texture differences between grade II and grade III samples. False discovery rate (FDR) correction was applied to correct for multiple comparisons. Receiver operating characteristic curves evaluated the diagnostic value of textural analysis for grading gliomas. Correlation between MRI textures and histopathology was examined by Spearman correlation test. RESULTS Texture features, including max intensity, 95th quantile, range, variance, standard deviation, sum variance, and cluster prominence were higher in grade III glioma targets than grade IIs, grade II gliomas showed increased uniformity and short run low gray-level emphasis values (P and qFDRcorr < 0.05). Area under the curve was 0.887 (95% confidence interval, 0.805-0.969; P < 0.001) with combined textures in glioma grading. The listed first-order and gray-level cooccurrence matrix textures were correlated with Ki-67 labeling index. Gray-level cooccurrence matrix and gray-level run length matrix textures were correlated with isocitrate dehydrogenase 1 mutation. CONCLUSIONS Textures on T1-weighted brain volume with gadolinium contrast enhancement images differ between grade III and II gliomas and are correlated with Ki-67 labeling index and isocitrate dehydrogenase 1 mutation.
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3
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Ren XJ. CT and MRI assessment of intestinal blood flow. Shijie Huaren Xiaohua Zazhi 2019; 27:851-856. [DOI: 10.11569/wcjd.v27.i14.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The accuracy of multi-slice computed tomography (CT) in the diagnosis of acute mesenteric ischemia is very high, however, it cannot demonstrate the small embolus of blood vessels and abnormal intestinal blood flow. The intestinal blood flow in chronic mesenteric ischemia decreases whereas there are few morphology changes, which leads to a high misdiagnosis rate of CT and CT angiography. In addition, inflammatory bowel disease, intestinal tumors, and portal hypertension can be diagnosed definitely by conventional CT, but the hemodynamics and microcirculation in these conditions cannot be assessed, which affects the accuracy of clinical staging and the assessment of therapeutic effect. For intestinal diseases, especially mesenteric ischemia, therefore, it is needed not only to make CT morphologic diagnosis but also to further assess the abnormal intestinal blood flow. In recent years, more and more CT and magnetic resonance imaging (MRI)-related new techniques for assessing blood flow have emerged, including CT perfusion, spectral CT imaging, magnetic resonance perfusion imaging, and phase contrast MRI. This paper reviews the clinical application and progress of these techniques for assessing intestinal blood flow.
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Affiliation(s)
- Xiao-Jun Ren
- Department of Radiology, Xidian Group Hospital Affiliated Shaanxi University of Chinese Medicine, Xi'an 710077, Shaanxi Province, China
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4
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Sun F, Zhuo R, Ma W, Yang D, Su T, Ye L, Xu D, Wang W. From clinic to mechanism: Proteomics-based assessment of angiogenesis in adrenal pheochromocytoma. J Cell Physiol 2019; 234:22057-22070. [PMID: 31106414 DOI: 10.1002/jcp.28769] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/13/2019] [Accepted: 04/17/2019] [Indexed: 01/05/2023]
Abstract
Adrenal pheochromocytoma (PCC) is a very rare tumor that stems from chromaffin cells, which can develop into malignant tumor. During the operation, abundant blood vessels were often observed in PCC than other adrenal tumors, which increases the difficulty and risk of the surgery. Therefore, it is important to investigate the mechanism of PCC angiogenesis. Twelve surgical specimens of PCC from Ruijin Hospital, Shanghai Jiaotong University were grouped into high and low microvessel density (MVD) group. They were also divided into rich blood supply and nonenriched blood supply group, according to computed tomography (CT) manifestation. Comparative proteomic analysis based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) and bioinformatics analysis revealed that 206 proteins differentially regulated in the high MVD group compared with low MVD group (p < 0.05). Besides, 61 proteins were discovered to be significantly changed when the 12 samples were grouped according to CT manifestation. By intersecting the differentially changed protein from MVD and CT grouping, 25 proteins were filtered out, with pathological function. COX4I2 was verified to be increased gradually with angiogenesis with increasing severity, and PLAT was shown to be decreased with angiogenesis in PCC, by quantitative reverse-transcription polymerase chain reaction and immunohistochemistry. The quantitative proteomics result indicated that the tumor angiogenesis in PCC is associated with hypoxia. COX4I2 and PLAT were highly correlated with blood supply in PCC which contribute to angiogenesis in PCC, which could be used as biomarkers to better indicate tumor angiogenesis, or targets to regress tumor angiogenesis as treatment.
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Affiliation(s)
- Fukang Sun
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Ran Zhuo
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Wenming Ma
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Da Yang
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Tingwei Su
- Shanghai Key Laboratory for Endocrine Tumors, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Laboratory for Endocrine and Metabolic Diseases of Institute of Health Science, Shanghai Jiao Tong University School of Medicine and Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, People's Republic of China
| | - Lei Ye
- Shanghai Key Laboratory for Endocrine Tumors, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Laboratory for Endocrine and Metabolic Diseases of Institute of Health Science, Shanghai Jiao Tong University School of Medicine and Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, People's Republic of China
| | - Danfeng Xu
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Weiqing Wang
- Shanghai Key Laboratory for Endocrine Tumors, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Laboratory for Endocrine and Metabolic Diseases of Institute of Health Science, Shanghai Jiao Tong University School of Medicine and Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, People's Republic of China
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Demené C, Payen T, Dizeux A, Barrois G, Gennisson JL, Bridal L, Tanter M. 3-D Longitudinal Imaging of Tumor Angiogenesis in Mice in Vivo Using Ultrafast Doppler Tomography. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1284-1296. [PMID: 30799125 DOI: 10.1016/j.ultrasmedbio.2018.12.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 11/09/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
Angiogenesis, the formation of new vessels, is one of the key mechanisms in tumor development and an appealing target for therapy. Non-invasive, high-resolution, high-sensitivity, quantitative 3-D imaging techniques are required to correctly depict tumor heterogeneous vasculature over time. Ultrafast Doppler was recently introduced and provides an unprecedented combination of resolution, penetration depth and sensitivity without requiring any contrast agents. The technique was further extended to three dimensions with ultrafast Doppler tomography (UFD-T). In this work, UFD-T was applied to the monitoring of tumor angiogenesis in vivo, providing structural and functional information at different stages of development. UFD-T volume renderings revealed that our murine model's vasculature stems from pre-existing vessels and sprouts to perfuse the whole volume as the tumor grows until a critical size is reached. Then, as the network becomes insufficient, the tumor core is no longer irrigated because the vasculature is concentrated mainly in the periphery. In addition to spatial distribution and growth patterns, UFD-T allowed a quantitative analysis of vessel size and length, revealing that the diameter distribution of vessels remained relatively constant throughout tumor growth. The network is dominated by small vessels at all stages of tumor development, with more than 74% of the vessels less than 200 µm in diameter. This study also found that cumulative vessel length is more closely related to tumor radius than volume, indicating that the vascularization becomes insufficient when a critical mass is reached. UFD-T was also compared with dynamic contrast-enhanced ultrasound and found to provide complementary information regarding the link between structure and perfusion. In conclusion, UFD-T is capable of in vivo quantitative assessment of the development of tumor vasculature (vessels with blood speed >1 mm/s [sensitivity limit] assessed with a resolution limit of 80 µm) in 3 dimensions. The technique has very interesting potential as a tool for treatment monitoring, response assessment and treatment planning for optimal drug efficiency.
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Affiliation(s)
- Charlie Demené
- Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Paris, France; Inserm Accélérateur de Recherche Technologique en Ultrasons biomédicaux, Paris, France.
| | - Thomas Payen
- Sorbonnne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Alexandre Dizeux
- Sorbonnne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Guillaume Barrois
- Sorbonnne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Jean-Luc Gennisson
- Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Paris, France
| | - Lori Bridal
- Sorbonnne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Mickael Tanter
- Inserm Accélérateur de Recherche Technologique en Ultrasons biomédicaux, Paris, France
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6
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Di N, Cheng W, Jiang X, Liu X, Zhou J, Xie Q, Chu Z, Chen H, Wang B. Can dynamic contrast-enhanced MRI evaluate VEGF expression in brain glioma? An MRI-guided stereotactic biopsy study. J Neuroradiol 2018; 46:186-192. [PMID: 29752976 DOI: 10.1016/j.neurad.2018.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 02/16/2018] [Accepted: 04/21/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE To investigate whether pharmacokinetic parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can be used to evaluate vascular endothelial growth factor (VEGF) expression in brain glioma based on a point-to-point basis. MATERIALS AND METHODS Forty-seven patients with treatment-naïve glioma received preoperative DCE-MRI before stereotactic biopsy. We histologically quantified VEGF from section of stereotactic biopsies, and co-registered biopsy locations with localized measurements of DCE-MRI parameters including volume transfer coefficient (Ktrans), reverse reflux rate constant (Kep), extracellular extravascular volume fraction (Ve) and blood plasma volume (Vp). The correlations between DCE-MRI parameters (Ktrans, Kep, Ve and Vp) and VEGF were determined using Spearman correlation coefficient. P≤.05 was considered statistically significant. RESULTS Seventy-nine biopsy samples were obtained and graded into 45 high-grade gliomas (HGGs) and 34 low-grade gliomas (LGGs). Ktrans showed a significant positive correlation with VEGF expression in HGGs group (ρ=0.505, P<0.001) and in combined group (LGGs+HGGs) (ρ=0.549, P<0.001), but not in LGGs group (P>0.05). Kep, Ve or Vp was not correlated with VEGF even though a positive trend showed (P>0.05). CONCLUSIONS DCE-MRI is a useful, non-invasive imaging technique for quantitative evaluation of VEGF, and its parameter Ktrans other than Kep, Ve or Vp may be used as a surrogate for VEGF expression in brain gliomas.
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Affiliation(s)
- Ningning Di
- Department of Radiology, Binzhou Medical University Hospital, 661, Huanghe road, 256600 Binzhou, China; Department of Radiology, Huashan Hospital Fudan University, 12, Wulumuqi road Middle, 200040 Shanghai, China.
| | - Wenna Cheng
- Department of Pharmacy, Binzhou Medical University Hospital, 661, Huanghe road, 256600 Binzhou, China.
| | - Xingyue Jiang
- Department of Radiology, Binzhou Medical University Hospital, 661, Huanghe road, 256600 Binzhou, China.
| | - Xinjiang Liu
- Department of Radiology, Binzhou Medical University Hospital, 661, Huanghe road, 256600 Binzhou, China.
| | - Jinliang Zhou
- Department of Radiology, Binzhou Medical University Hospital, 661, Huanghe road, 256600 Binzhou, China.
| | - Qian Xie
- Department of Radiology, Huashan Hospital Fudan University, 12, Wulumuqi road Middle, 200040 Shanghai, China.
| | - Zhihui Chu
- Department of Radiology, Binzhou Medical University Hospital, 661, Huanghe road, 256600 Binzhou, China.
| | - Huacheng Chen
- Department of Radiology, Weifang Traditional Chinese Hospital, 1055, Weizhou road, 256600 Weifang, China.
| | - Bin Wang
- Department of Medical Imaging and Nuclear, Binzhou Medical University, 346, Guanhai road, 264000 Yantai, China.
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7
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García-Figueiras R, Baleato-González S, Padhani AR, Luna-Alcalá A, Marhuenda A, Vilanova JC, Osorio-Vázquez I, Martínez-de-Alegría A, Gómez-Caamaño A. Advanced Imaging Techniques in Evaluation of Colorectal Cancer. Radiographics 2018; 38:740-765. [PMID: 29676964 DOI: 10.1148/rg.2018170044] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Imaging techniques are clinical decision-making tools in the evaluation of patients with colorectal cancer (CRC). The aim of this article is to discuss the potential of recent advances in imaging for diagnosis, prognosis, therapy planning, and assessment of response to treatment of CRC. Recent developments and new clinical applications of conventional imaging techniques such as virtual colonoscopy, dual-energy spectral computed tomography, elastography, advanced computing techniques (including volumetric rendering techniques and machine learning), magnetic resonance (MR) imaging-based magnetization transfer, and new liver imaging techniques, which may offer additional clinical information in patients with CRC, are summarized. In addition, the clinical value of functional and molecular imaging techniques such as diffusion-weighted MR imaging, dynamic contrast material-enhanced imaging, blood oxygen level-dependent imaging, lymphography with contrast agents, positron emission tomography with different radiotracers, and MR spectroscopy is reviewed, and the advantages and disadvantages of these modalities are evaluated. Finally, the future role of imaging-based analysis of tumor heterogeneity and multiparametric imaging, the development of radiomics and radiogenomics, and future challenges for imaging of patients with CRC are discussed. Online supplemental material is available for this article. ©RSNA, 2018.
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Affiliation(s)
- Roberto García-Figueiras
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Sandra Baleato-González
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Anwar R Padhani
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Antonio Luna-Alcalá
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Ana Marhuenda
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Joan C Vilanova
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Iria Osorio-Vázquez
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Anxo Martínez-de-Alegría
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Antonio Gómez-Caamaño
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
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8
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Bretas EAS, Torres US, Torres LR, Bekhor D, Saito Filho CF, Racy DJ, Faggioni L, D'Ippolito G. Is liver perfusion CT reproducible? A study on intra- and interobserver agreement of normal hepatic haemodynamic parameters obtained with two different software packages. Br J Radiol 2017; 90:20170214. [PMID: 28830195 DOI: 10.1259/bjr.20170214] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To evaluate the agreement between the measurements of perfusion CT parameters in normal livers by using two different software packages. METHODS This retrospective study was based on 78 liver perfusion CT examinations acquired for detecting suspected liver metastasis. Patients with any morphological or functional hepatic abnormalities were excluded. The final analysis included 37 patients (59.7 ± 14.9 y). Two readers (1 and 2) independently measured perfusion parameters using different software packages from two major manufacturers (A and B). Arterial perfusion (AP) and portal perfusion (PP) were determined using the dual-input vascular one-compartmental model. Inter-reader agreement for each package and intrareader agreement between both packages were assessed with intraclass correlation coefficients (ICC) and Bland-Altman statistics. RESULTS Inter-reader agreement was substantial for AP using software A (ICC = 0.82) and B (ICC = 0.85-0.86), fair for PP using software A (ICC = 0.44) and fair to moderate for PP using software B (ICC = 0.56-0.77). Intrareader agreement between software A and B ranged from slight to moderate (ICC = 0.32-0.62) for readers 1 and 2 considering the AP parameters, and from fair to moderate (ICC = 0.40-0.69) for readers 1 and 2 considering the PP parameters. CONCLUSION At best there was only moderate agreement between both software packages, resulting in some uncertainty and suboptimal reproducibility. Advances in knowledge: Software-dependent factors may contribute to variance in perfusion measurements, demanding further technical improvements. AP measurements seem to be the most reproducible parameter to be adopted when evaluating liver perfusion CT.
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Affiliation(s)
- Elisa Almeida Sathler Bretas
- 1 Department of Imaging, Universidade Federal de São Paulo, São Paulo, Brazil.,2 Department of Radiology, Grupo Fleury, São Paulo, Brazil
| | | | - Lucas Rios Torres
- 2 Department of Radiology, Grupo Fleury, São Paulo, Brazil.,3 Department of Imaging, Hospital Beneficência Portuguesa, São Paulo, Brazil
| | - Daniel Bekhor
- 1 Department of Imaging, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Douglas Jorge Racy
- 3 Department of Imaging, Hospital Beneficência Portuguesa, São Paulo, Brazil
| | - Lorenzo Faggioni
- 4 Department of Diagnostic and Interventional Radiology, University Hospital of Pisa, Pisa, Italy
| | - Giuseppe D'Ippolito
- 1 Department of Imaging, Universidade Federal de São Paulo, São Paulo, Brazil.,2 Department of Radiology, Grupo Fleury, São Paulo, Brazil
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9
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Prezzi D, Goh V, Virdi S, Mallett S, Grierson C, Breen D. Adaptive statistical iterative reconstruction improves image quality without affecting perfusion CT quantitation in primary colorectal cancer. Eur J Radiol Open 2017; 4:69-74. [PMID: 28616448 PMCID: PMC5458094 DOI: 10.1016/j.ejro.2017.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/22/2017] [Accepted: 05/22/2017] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To determine the effect of Adaptive Statistical Iterative Reconstruction (ASIR) on perfusion CT (pCT) parameter quantitation and image quality in primary colorectal cancer. METHODS Prospective observational study. Following institutional review board approval and informed consent, 32 patients with colorectal adenocarcinoma underwent pCT (100 kV, 150 mA, 120 s acquisition, axial mode). Tumour regional blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS) were determined using identical regions-of-interests for ASIR percentages of 0%, 20%, 40%, 60%, 80% and 100%. Image noise, contrast-to-noise ratio (CNR) and pCT parameters were assessed across ASIR percentages. Coefficients of variation (CV), repeated measures analysis of variance (rANOVA) and Spearman' rank order correlation were performed with statistical significance at 5%. RESULTS With increasing ASIR percentages, image noise decreased by 33% while CNR increased by 61%; peak tumour CNR was greater than 1.5 with 60% ASIR and above. Mean BF, BV, MTT and PS differed by less than 1.8%, 2.9%, 2.5% and 2.6% across ASIR percentages. CV were 4.9%, 4.2%, 3.3% and 7.9%; rANOVA P values: 0.85, 0.62, 0.02 and 0.81 respectively. CONCLUSIONS ASIR improves image noise and CNR without altering pCT parameters substantially.
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Affiliation(s)
- D. Prezzi
- Division of Imaging Sciences & Biomedical Engineering, King’s College London, 4th Floor, Lambeth Wing, St. Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, United Kingdom
| | - V. Goh
- Division of Imaging Sciences & Biomedical Engineering, King’s College London, 4th Floor, Lambeth Wing, St. Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, United Kingdom
| | - S. Virdi
- Division of Imaging Sciences & Biomedical Engineering, King’s College London, 4th Floor, Lambeth Wing, St. Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, United Kingdom
| | - S. Mallett
- Institute of Applied Health Research, University of Birmingham, United Kingdom
| | - C. Grierson
- University Hospital Southampton NHS Foundation Trust, United Kingdom
| | - D.J. Breen
- University Hospital Southampton NHS Foundation Trust, United Kingdom
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Perfusion imaging of brain gliomas using arterial spin labeling: correlation with histopathological vascular density in MRI-guided biopsies. Neuroradiology 2016; 59:51-59. [DOI: 10.1007/s00234-016-1756-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/17/2016] [Indexed: 11/25/2022]
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11
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Cidon EU, Alonso P, Masters B. Markers of Response to Antiangiogenic Therapies in Colorectal Cancer: Where Are We Now and What Should Be Next? CLINICAL MEDICINE INSIGHTS-ONCOLOGY 2016; 10:41-55. [PMID: 27147901 PMCID: PMC4849423 DOI: 10.4137/cmo.s34542] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/15/2016] [Accepted: 03/13/2016] [Indexed: 12/17/2022]
Abstract
Despite advances in the treatment of colorectal cancer (CRC), it remains the second most common cause of cancer-related death in the Western world. Angiogenesis is a complex process that involves the formation of new blood vessels from preexisting vessels. It is essential for promoting cancer survival, growth, and dissemination. The inhibition of angiogenesis has been shown to prevent tumor progression experimentally, and several chemotherapeutic targets of tumor angiogenesis have been identified. These include anti-vascular endothelial growth factor (VEGF) treatments, such as bevacizumab (a VEGF-specific binding antibody) and anti-VEGF receptor tyrosine kinase inhibitors, although antiangiogenic therapy has been shown to be effective in the treatment of several cancers, including CRC. However, it is also associated with its own side effects and financial costs. Therefore, the identification of biomarkers that are able to identify patients who are more likely to benefit from antiangiogenic treatment is very important. This article intends to be a concise summary of the potential biomarkers that can predict or prognosticate the benefit of antiangiogenic treatments in CRC, and also what we can expect in the near future.
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Affiliation(s)
- E Una Cidon
- Department of Medical Oncology, Royal Bournemouth Hospital NHS Foundation Trust, Bournemouth, UK
| | - P Alonso
- Department of Clinical Oncology, Clinical University Hospital, Valladolid, Spain
| | - B Masters
- Department of Oncology, Nottingham City Hospital, Nottingham, UK
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12
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Rajendran R, Liang J, Tang MYA, Henry B, Chuang KH. Optimization of arterial spin labeling MRI for quantitative tumor perfusion in a mouse xenograft model. NMR IN BIOMEDICINE 2015; 28:988-997. [PMID: 26104980 DOI: 10.1002/nbm.3330] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 03/18/2015] [Accepted: 04/22/2015] [Indexed: 06/04/2023]
Abstract
Perfusion is an important biomarker of tissue function and has been associated with tumor pathophysiology such as angiogenesis and hypoxia. Arterial spin labeling (ASL) MRI allows noninvasive and quantitative imaging of perfusion; however, the application in mouse xenograft tumor models has been challenging due to the low sensitivity and high perfusion heterogeneity. In this study, flow-sensitive alternating inversion recovery (FAIR) ASL was optimized for a mouse xenograft tumor. To assess the sensitivity and reliability for measuring low perfusion, the lumbar muscle was used as a reference region. By optimizing the number of averages and inversion times, muscle perfusion as low as 32.4 ± 4.8 (mean ± standard deviation) ml/100 g/min could be measured in 20 min at 7 T with a quantification error of 14.4 ± 9.1%. Applying the optimized protocol, heterogeneous perfusion ranging from 49.5 to 211.2 ml/100 g/min in a renal carcinoma was observed. To understand the relationship with tumor pathology, global and regional tumor perfusion was compared with histological staining of blood vessels (CD34), hypoxia (CAIX) and apoptosis (TUNEL). No correlation was observed when the global tumor perfusion was compared with these pathological parameters. Regional analysis shows that areas of high perfusion had low microvessel density, which was due to larger vessel area compared with areas of low perfusion. Nonetheless, these were not correlated with hypoxia or apoptosis. The results suggest that tumor perfusion may reflect certain aspect of angiogenesis, but its relationship with other pathologies needs further investigation.
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Affiliation(s)
- Reshmi Rajendran
- Magnetic Resonance Imaging Group, Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
| | - Jieming Liang
- Magnetic Resonance Imaging Group, Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
| | - Mei Yee Annie Tang
- Magnetic Resonance Imaging Group, Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
| | - Brian Henry
- Translational Medicine Research Centre, MSD, Singapore
| | - Kai-Hsiang Chuang
- Magnetic Resonance Imaging Group, Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
- Clinical Imaging Research Centre, National University of Singapore, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Abstract
Functional imaging techniques enable physiological information to be derived, which, combined with high-resolution anatomical imaging, has the potential to improve the management of patients with intestinal disease. Two of the common pathologies where imaging has a substantial role in depicting disease extent, in staging disease, and assessing therapeutic response and/or disease relapse are cancer and inflammatory bowel disease. In these scenarios, functional imaging may augment assessment of disease activity, therapeutic response/non-response, as well as disease relapse by indicating physiological changes as a result of tumor, inflammation, or fibrosis.
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14
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Sun H, Xu Y, Yang Q, Wang W. Assessment of tumor grade and angiogenesis in colorectal cancer: whole-volume perfusion CT. Acad Radiol 2014; 21:750-7. [PMID: 24809317 DOI: 10.1016/j.acra.2014.02.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 02/09/2014] [Accepted: 02/10/2014] [Indexed: 12/16/2022]
Abstract
RATIONALE AND OBJECTIVES The preoperative evaluation of tumor grading and angiogenesis has important clinical implications in the treatment and prognosis of patients with colorectal cancers (CRCs). The aim of the present study was to assess tumor perfusion with 256-slice computed tomography (CT) using whole-volume perfusion technology before surgery, and to investigate the differences in the perfusion parameters among tumor grades and the correlation between perfusion parameters and pathologic results in CRC. MATERIALS AND METHODS Thirty-seven patients with CRC confirmed by endoscopic pathology underwent whole-volume perfusion CT assessments with a 256-slice CT and surgery. Quantitative values for blood flow, blood volume, and time to peak were determined using commercial software. After surgery, resected specimens were analyzed immunohistochemically with CD105 antibodies for the quantification of microvessel density (MVD). The difference in CT perfusion parameters and MVD among different tumor differentiation grades was evaluated by the Student-Newman-Keuls test. The correlations between CT perfusion parameters and MVD were evaluated using the Pearson correlation analysis. RESULTS The mean blood flow was significantly different among well, moderately, and poorly differentiated groups (61.17 ± 17.97, 34.80 ± 13.06, and 22.24 ± 9.31 mL/minute/100 g, respectively; P < .05). The blood volume in the well-differentiated group was significantly higher than that in the moderately differentiated group (33.96 ± 24.81 vs. 16.93 ± 5.73 mL/100 g; P = .002) and that in the poorly differentiated group (33.96 ± 24.81 vs. 18.05 ± 6.01 mL/100 g; P = .009). The time to peak in the poorly differentiated group was significantly longer than that in the well-differentiated group (27.81 ± 11.95 vs. 17.60 ± 8.53 seconds; P = .016) and that in the moderately differentiated group (27.81 ± 11.95 vs. 18.94 ± 7.47 seconds; P = .028). There was no significant difference in the MVD among well, moderately, and poorly differentiated groups (33.47 ± 14.69, 28.89 ± 11.82, and 29.89 ± 11.02, respectively; P > .05). There was no significant correlation between CT perfusion parameters and MVD (r = 0.201, 0.295, and -0.178, respectively; P = .233, .076, and .292, respectively). CONCLUSIONS CT whole-volume perfusion technology has the potential to evaluate pathologic differentiation grade of CRC before surgery. However, preoperative perfusion CT parameters do not reflect the MVD of CRC.
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Time-intensity curve parameters in rectal cancer measured using endorectal ultrasonography with sterile coupling gels filling the rectum: correlations with tumor angiogenesis and clinicopathological features. BIOMED RESEARCH INTERNATIONAL 2014; 2014:587806. [PMID: 24900973 PMCID: PMC4036556 DOI: 10.1155/2014/587806] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 04/20/2014] [Indexed: 02/08/2023]
Abstract
The primary aim of this study was to investigate the relationship between contrast-enhanced ultrasonography (CEUS) imaging parameters and clinicopathological features of rectal carcinoma and assess their potential as new radiological prognostic predictors. A total of 66 rectal carcinoma patients were analyzed with the time-intensity curve of CEUS. The parameter arrival time (AT), time to peak enhancement (TTP), wash-in time (WIT), enhanced intensity (EI), and ascending slope (AS) were measured. Microvessel density (MVD) was evaluated by immunohistochemical staining of surgical specimens. All findings were analysed prospectively and correlated with tumor staging, histological grading, and MVD. The mean values of AT, TTP, WIT, EI, and AS value of the rectal carcinoma were 10.84 ± 3.28 s, 20.61 ± 5.52 s, 9.78 ± 2.83 s, 28.68 ± 4.67 dB, and 3.20 ± 1.10, respectively. A positive linear correlation was found between the EI and MVD in rectal carcinoma (r = 0.295, P = 0.016), and there was a significant difference for EI among histological grading (r = -0.264, P = 0.007). EI decreased as T stage increased with a trend of association noted (P = 0.096). EI of contrast enhanced endorectal ultrasonography provides noninvasive biomarker of tumor angiogenesis in rectal cancer. CEUS data have the potential to predict patient prognosis.
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Sosna J. Perfusion CT Vascular Parameters and Microvessel Density. Radiology 2014; 270:936-936. [DOI: 10.1148/radiol.13132066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Goh V, Glynne-Jones R. Perfusion CT imaging of colorectal cancer. Br J Radiol 2014; 87:20130811. [PMID: 24434157 PMCID: PMC4064549 DOI: 10.1259/bjr.20130811] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 12/17/2013] [Accepted: 12/20/2013] [Indexed: 12/16/2022] Open
Abstract
Imaging plays an important role in the assessment of colorectal cancer, including diagnosis, staging, selection of treatment, assessment of treatment response, surveillance and investigation of suspected disease relapse. Anatomical imaging remains the mainstay for size measurement and structural evaluation; however, functional imaging techniques may provide additional insights into the tumour microenvironment. With dynamic contrast-enhanced CT techniques, iodinated contrast agent kinetics may inform on regional tumour perfusion, shunting and microvascular function and provide a surrogate measure of tumour hypoxia and angiogenesis. In colorectal cancer, this may be relevant for clinical practice in terms of tumour phenotyping, prognostication, selection of individualized treatment and therapy response assessment.
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Affiliation(s)
- V Goh
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
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