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Liu B, Gao H, Zhou F, Zhao W, Yang Y. Dynamic contrast-enhanced magnetic resonance imaging in cervical cancer: correlation between quantitative parameters and molecular markers hypoxia-inducible factors-1-alpha, vascular endothelial growth factor, and Ki-67. Clin Radiol 2024; 79:e826-e833. [PMID: 38582634 DOI: 10.1016/j.crad.2024.01.039] [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: 11/23/2023] [Revised: 01/17/2024] [Accepted: 01/31/2024] [Indexed: 04/08/2024]
Abstract
AIM To investigate whether dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has the potential to non-invasively detect microenvironmental condition by quantitatively measuring blood perfusion, vessel wall permeability, and vascularity, and to elucidate the possible correlations between DCE-MRI quantitative parameters and the expression level of hypoxia, vascularity, and cell proliferation related molecular biomarkers. MATERIALS AND METHODS In this prospective single center clinical study, 58 patients diagnosed with cervical cancer underwent DCE-MRI before anticancer treatment were enrolled. Ktrans, Kep, Ve, and Vp were generated from Extended Toft's model. Then patients conducted colposcopy biopsy within 1 week after DCE-MRI. Pretreatment expression levels of HIF-1α, VEGF and Ki-67 were assessed and scored by immunohistochemistry on colposcopy obtained tumor specimens. RESULTS In HIF-1α low-expression group, Ktrans (p=0.031) and Kep (p=0.012) values were significantly higher than the high-expression group. In VEGF high-expression group, Ktrans (p=0.044) and Ve values (p=0.021) were significantly higher than the low-expression group. In Ki-67 high-expression group, Ktrans (p=0.026) and Kep (p=0.033) were significantly higher than the low-expression group. Multiple linear regression analyses and Pearson correlation revealed that Ktrans independently negatively correlated with HIF-1α expression, Ve independently positively correlated with VEGF, and Kep independently positively correlated with Ki-67. The area under the ROC curves of Ktrans for HIF-1α, Ve for VEGF, and Kep for Ki-67 were 0.728, 0.743, 0.730, respectively. CONCLUSION Our results suggest that DCE-MRI quantitative parameters could be potentially used as imaging markers for non-invasively detecting microenvironmental hypoxia, vascularity and proliferation in cervical cancer patients.
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Affiliation(s)
- B Liu
- Department of Radiology, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, 710000, China.
| | - H Gao
- Department of Pathology, Shaanxi Provincial Cancer Hospital, Xi'an, 710061, China
| | - F Zhou
- Department of Gynecology and Obstetrics, Xijing Hospital, Airforce Military Medical University, Xi'an, 710032, China
| | - W Zhao
- Department of Radiology, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, 710000, China
| | - Y Yang
- Department of Radiology, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, 710000, China
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Cheng Y, Wang H, Yuan W, Wang H, Zhu Y, Chen H, Jiang W. Combined radiomics of primary tumour and bone metastasis improve the prediction of EGFR mutation status and response to EGFR-TKI therapy for NSCLC. Phys Med 2023; 116:103177. [PMID: 38000098 DOI: 10.1016/j.ejmp.2023.103177] [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: 12/16/2022] [Revised: 10/08/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
PURPOSE To develop radiomics models of primary tumour and spinal metastases to predict epidermal growth factor receptor (EGFR) mutations and therapeutic response to EGFR-tyrosine kinase inhibitor (TKI) in patients with metastatic non-small-cell lung cancer (NSCLC). METHODS We enrolled 203 patients with spinal metastases between December 2017 and September 2021, classified as patients with the EGFR mutation or EGFR wild-type. All patients underwent thoracic CT and spinal MRI scans before any treatment. Radiomics analysis was performed to extract features from primary tumour and metastases images and identify predictive features with the least absolute shrinkage and selection operator. Radiomics signatures (RS) were constructed based on primary tumour (RS-Pri), metastases (RS-Met), and in combination (RS-Com) to predict EGFR mutation status and response to EGFR-TKI. Receiver operating characteristic (ROC) curve analysis with 10-fold cross-validation was applied to assess the performance of the models. RESULTS To predict the EGFR mutation status, the RS based on the combination of primary tumour and metastases improved the prediction AUCs compared to those based on the primary tumour or metastasis alone in the training (RS-Com-EGFR: 0.927) and validation (RS-Com-EGFR: 0.812) cohorts. To predict response to EGFR-TKI, the developed RS based on combined primary tumour and metastasis generated the highest AUCs in the training (RS-Com-TKI: 0.880) and validation (RS-Com-TKI: 0.798) cohort. CONCLUSIONS Primary NSCLC and spinal metastases can provide complementary information to predict the EGFR mutation status and response to EGFR-TKI. The developed models that integrate primary lesions and metastases may be potential imaging markers to guide individual treatment decisions.
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Affiliation(s)
- Yuan Cheng
- Department of Biomedical Engineering, School of Intelligent Medicine, China Medical University, Liaoning 110122, PR China
| | - Huan Wang
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning 110042, PR China
| | - Wendi Yuan
- Department of Biomedical Engineering, School of Intelligent Medicine, China Medical University, Liaoning 110122, PR China
| | - Haotian Wang
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning 110042, PR China
| | - Yuheng Zhu
- Department of Biomedical Engineering, School of Intelligent Medicine, China Medical University, Liaoning 110122, PR China
| | - Huanhuan Chen
- Department of Oncology, Shengjing Hospital of China Medical University, 110004 Shenyang, PR China.
| | - Wenyan Jiang
- Department of Scientific Research and Academic, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning 110042, PR China.
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Zheng Y, Huang WJ, Han N, Jiang YL, Ma LY, Zhang J. MRI features and whole-lesion apparent diffusion coefficient histogram analysis of brain metastasis from non-small cell lung cancer for differentiating epidermal growth factor receptor mutation status. Clin Radiol 2023; 78:e243-e250. [PMID: 36577557 DOI: 10.1016/j.crad.2022.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/08/2022] [Accepted: 11/18/2022] [Indexed: 12/27/2022]
Abstract
AIM To explore the utility of magnetic resonance imaging (MRI) characteristics and whole-lesion apparent diffusion coefficient histogram analysis of brain metastasis from non-small cell lung cancer (NSCLC) in the differentiation of epidermal growth factor receptor (EGFR) mutation status. MATERIALS AND METHODS Forty-eight patients with brain metastases from NSCLC were enrolled in this retrospective study. Patients were subtyped into EGFR mutation (23 cases) and wild-type (25 cases) groups. Whole-lesion histogram metrics were derived from the apparent diffusion coefficient (ADC) maps, and imaging features were evaluated according to conventional MRI. Student's t-test or Mann-Whitney U-test, chi-squared test, and receiver operating characteristic (ROC) curve analysis were performed to discriminate the two groups and to determine the diagnostic efficacy of ADC histogram parameters. RESULTS EGFR mutation group had more multiple brain metastases, less peritumoural brain oedema (PTBO), and lower peritumoural brain oedema index (PTBO-I) than EGFR wild-type group (all p<0.05). In addition, 90th and 75th percentiles of ADC and maximum ADC in the EGFR mutation group were significantly higher than in the EGFR wild-type group (all p<0.05). Ninetieth percentile of ADC had the highest area under the curve (AUC; 0.711), and it was found to outperform 75th percentile of ADC (AUC, 0.662; p=0.039) and maximum ADC (AUC, 0.681). CONCLUSIONS Whole-lesion ADC histogram analysis and MRI features of brain metastasis from NSCLC are expected to be potential biomarkers to non-invasively differentiate the EGFR mutation status.
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Affiliation(s)
- Y Zheng
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - W-J Huang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - N Han
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - Y-L Jiang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - L-Y Ma
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - J Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China.
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Deep learning for preoperative prediction of the EGFR mutation and subtypes based on the MRI image of spinal metastasis from primary NSCLC. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Fan Y, Dong Y, Sun X, Wang H, Zhao P, Wang H, Jiang X. Development and validation of MRI-based radiomics signatures as new markers for preoperative assessment of EGFR mutation and subtypes from bone metastases. BMC Cancer 2022; 22:889. [PMID: 35964032 PMCID: PMC9375915 DOI: 10.1186/s12885-022-09985-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to develop and externally validate contrast-enhanced (CE) T1-weighted MRI-based radiomics for the identification of epidermal growth factor receptor (EGFR) mutation, exon-19 deletion and exon-21 L858R mutation from MR imaging of spinal bone metastasis from primary lung adenocarcinoma. Methods A total of 159 patients from our hospital between January 2017 and September 2021 formed a primary set, and 24 patients from another center between January 2017 and October 2021 formed an independent validation set. Radiomics features were extracted from the CET1 MRI using the Pyradiomics method. The least absolute shrinkage and selection operator (LASSO) regression was applied for selecting the most predictive features. Radiomics signatures (RSs) were developed based on the primary training set to predict EGFR mutations and differentiate between exon-19 deletion and exon-21 L858R. The RSs were validated on the internal and external validation sets using the Receiver Operating Characteristic (ROC) curve analysis. Results Eight, three, and five most predictive features were selected to build RS-EGFR, RS-19, and RS-21 for predicting EGFR mutation, exon-19 deletion and exon-21 L858R, respectively. The RSs generated favorable prediction efficacies for the primary (AUCs, RS-EGFR vs. RS-19 vs. RS-21, 0.851 vs. 0.816 vs. 0.814) and external validation (AUCs, RS-EGFR vs. RS-19 vs. RS-21, 0.807 vs. 0.742 vs. 0.792) sets. Conclusions Radiomics features from the CE MRI could be used to detect the EGFR mutation, increasing the certainty of identifying exon-19 deletion and exon-21 L858R mutations based on spinal metastasis MR imaging. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09985-4.
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Affiliation(s)
- Ying Fan
- School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, 110122, People's Republic of China
| | - Yue Dong
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, 110042, People's Republic of China
| | - Xinyan Sun
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, 110042, People's Republic of China
| | - Huan Wang
- Radiation Oncology Department of Thoracic Cancer, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, 110042, People's Republic of China
| | - Peng Zhao
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, 110042, People's Republic of China
| | - Hongbo Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Xiran Jiang
- School of Intelligent Medicine, China Medical University, Shenyang, Liaoning, 110122, People's Republic of China.
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Huang W, Zhang Q, Wu G, Chen PP, Li J, McCabe Gillen K, Spincemaille P, Chiang GC, Gupta A, Wang Y, Chen F. DCE-MRI quantitative transport mapping for noninvasively detecting hypoxia inducible factor-1α, epidermal growth factor receptor overexpression, and Ki-67 in nasopharyngeal carcinoma patients. Radiother Oncol 2021; 164:146-154. [PMID: 34592360 DOI: 10.1016/j.radonc.2021.09.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 08/13/2021] [Accepted: 09/20/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has the potential to noninvasively detect expression of hypoxia inducible factor-1-alpha (HIF-1α), epidermal growth factor receptor (EGFR), and Ki-67 in nasopharyngeal carcinoma (NPC) by quantitatively measuring tumor blood flow, vascularity, and permeability. PURPOSE We aim to explore the utility of DCE-MRI in detecting HIF-1α, EGFR, and Ki-67 expression levels using traditional Kety's/Tofts' modeling and quantitative transport mapping (QTM). MATERIALS AND METHODS Eighty-nine NPC patients underwent DCE-MRI before treatment were enrolled. DCE-MRI was processed to generate the following kinetic parameters: |u| and D from the QTM model, tumor blood flow (TBF) from Kety's model, and Ktrans, Ve, and Kep from Tofts' model. Pretreatment levels of HIF-1α, EGFR, and Ki-67 were assessed by immunohistochemistry and classified into low and high expression groups. RESULTS |u| (p < 0.001) and TBF (p = 0.015) values were significantly higher in the HIF-1α high-expression group compared to low-expression group. Only Ktrans (p = 0.016) was significantly higher in the EGFR high-expression group. Only |u| (p < 0.001) values were significantly higher in the Ki-67 high-expression group compared to low-expression group. Multiple linear regression analyses showed that |u| independently correlated with HIF-1α and Ki-67 expression, and Ktrans independently correlated with EGFR. The areas under the ROC curves of |u| for HIF-1α and Ki-67, and Ktrans for EGFR were 0.83, 0.74, and 0.70, respectively. CONCLUSION |u| and Ktrans derived from DCE-MRI may be considered as noninvasive imaging markers for detecting hypoxia and proliferation in NPC patients.
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Affiliation(s)
- Weiyuan Huang
- Department of Radiology, Weill Medical College of Cornell University, New York, USA; Department of Radiology, Hainan General Hospital (Affiliated Hainan Hospital of Hainan Medical University), China.
| | - Qihao Zhang
- Department of Radiology, Weill Medical College of Cornell University, New York, USA; Meinig School of Biomedical Engineering, Cornell University, Ithaca, USA
| | - Gang Wu
- Department of Radiotherapy, Hainan General Hospital (Affiliated Hainan Hospital of Hainan Medical University), China
| | - Pian Pian Chen
- Department of Pathology, Hainan General Hospital (Affiliated Hainan Hospital of Hainan Medical University), China
| | - Jiao Li
- Department of Pathology, Hainan General Hospital (Affiliated Hainan Hospital of Hainan Medical University), China
| | - Kelly McCabe Gillen
- Department of Radiology, Weill Medical College of Cornell University, New York, USA
| | - Pascal Spincemaille
- Department of Radiology, Weill Medical College of Cornell University, New York, USA
| | - Gloria C Chiang
- Departments of Radiology, Weill Medical College of Cornell University/New York-Presbyterian Hospital, New York, USA
| | - Ajay Gupta
- Departments of Radiology, Weill Medical College of Cornell University/New York-Presbyterian Hospital, New York, USA
| | - Yi Wang
- Department of Radiology, Weill Medical College of Cornell University, New York, USA; Meinig School of Biomedical Engineering, Cornell University, Ithaca, USA.
| | - Feng Chen
- Department of Radiology, Hainan General Hospital (Affiliated Hainan Hospital of Hainan Medical University), China.
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Ren M, Yang H, Lai Q, Shi D, Liu G, Shuang X, Su J, Xie L, Dong Y, Jiang X. MRI-based radiomics analysis for predicting the EGFR mutation based on thoracic spinal metastases in lung adenocarcinoma patients. Med Phys 2021; 48:5142-5151. [PMID: 34318502 DOI: 10.1002/mp.15137] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/08/2021] [Accepted: 07/21/2021] [Indexed: 11/11/2022] Open
Abstract
PURPOSE This study aims to develop and evaluate multi-parametric MRI-based radiomics for preoperative identification of epidermal growth factor receptor (EGFR) mutation, which is important in treatment planning for patients with thoracic spinal metastases from primary lung adenocarcinoma. METHODS A total of 110 patients were enrolled between January 2016 and March 2019 as a primary cohort. A time-independent validation cohort was conducted containing 52 patients consecutively enrolled from July 2019 to April 2021. The patients were pathologically diagnosed with thoracic spinal metastases from primary lung adenocarcinoma; all underwent T1-weighted (T1W), T2-weighted (T2W), and T2-weighted fat-suppressed (T2FS) MRI scans of the thoracic spinal. Handcrafted and deep learning-based features were extracted and selected from each MRI modality, and used to build the radiomics signature. Various machine learning classifiers were developed and compared. A clinical-radiomics nomogram integrating the combined rad signature and the most important clinical factor was constructed with receiver operating characteristic (ROC), calibration, and decision curves analysis (DCA) to evaluate the prediction performance. RESULTS The combined radiomics signature derived from the joint of three modalities can effectively classify EGFR mutation and EGFR wild-type patients, with an area under the ROC curve (AUC) of 0.886 (95% confidence interval [CI]: 0.826-0.947, SEN =0.935, SPE =0.688) in the training group and 0.803 (95% CI: 0.682-0.924, SEN = 0.700, SPE = 0.818) in the time-independent validation group. The nomogram incorporating the combined radiomics signature and smoking status achieved the best prediction performance in the training (AUC = 0.888, 95% CI: 0.849-0.958, SEN = 0.839, SPE = 0.792) and time-independent validation (AUC = 0.821, 95% CI: 0.692-0.929, SEN = 0.667, SPE = 0.909) cohorts. The DCA confirmed potential clinical usefulness of our nomogram. CONCLUSION Our study demonstrated the potential of multi-parametric MRI-based radiomics on preoperatively predicting the EGFR mutation. The proposed nomogram model can be considered as a new biomarker to guide the selection of individual treatment strategies for patients with thoracic spinal metastases from primary lung adenocarcinoma.
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Affiliation(s)
- Meihong Ren
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, Shenyang, P.R. China
| | - Huazhe Yang
- Department of Biophysics, School of Fundamental Sciences, China Medical University, Shenyang, P.R. China
| | - Qingyuan Lai
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, P.R. China
| | - Dabao Shi
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, P.R. China
| | - Guanyu Liu
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, P.R. China
| | - Xue Shuang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, Shenyang, P.R. China
| | - Juan Su
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, Shenyang, P.R. China
| | - Liping Xie
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, P.R. China
| | - Yue Dong
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, P.R. China
| | - Xiran Jiang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, Shenyang, P.R. China
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Lee JH, Yoo GS, Yoon YC, Park HC, Kim HS. Diffusion-weighted and dynamic contrast-enhanced magnetic resonance imaging after radiation therapy for bone metastases in patients with hepatocellular carcinoma. Sci Rep 2021; 11:10459. [PMID: 34001997 PMCID: PMC8128906 DOI: 10.1038/s41598-021-90065-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/04/2021] [Indexed: 12/24/2022] Open
Abstract
The objectives of this study were to assess changes in apparent diffusion coefficient (ADC) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) parameters after radiation therapy (RT) for bone metastases from hepatocellular carcinoma (HCC) and to evaluate their prognostic value. This prospective study was approved by the Institutional Review Board. Fourteen patients with HCC underwent RT (30 Gy in 10 fractions once daily) for bone metastases. The ADC and DCE-MRI parameters and the volume of the target lesions were measured before (baseline) and one month after RT (post-RT). The Wilcoxon signed-rank test was used to compare the parameters between the baseline and post-RT MRI. The parameters were compared between patients with or without disease progression in RT fields using the Mann–Whitney test. Intraclass correlation coefficients were used to evaluate the interobserver agreement. The medians of the ADC, rate constant [kep], and volume fraction of the extravascular extracellular matrix [ve] in the baseline and post-RT MRI were 0.67 (range 0.61–0.72) and 0.75 (range 0.63–1.43) (× 10–3 mm2/s) (P = 0.027), 836.33 (range 301.41–1082.32) and 335.80 (range 21.86–741.87) (× 10–3/min) (P = 0.002), and 161.54 (range 128.38–410.13) and 273.99 (range 181.39–1216.95) (× 10–3) (P = 0.027), respectively. The medians of the percent change in the ADC of post-RT MRI in patients with progressive disease and patients without progressive disease were − 1.35 (range − 6.16 to 6.79) and + 46.71 (range 7.71–112.81) (%) (P = 0.011), respectively. The interobserver agreements for all MRI parameters were excellent (intraclass correlation coefficients > 0.8). In conclusion, the ADC, kep, and ve of bone metastases changed significantly after RT. The percentage change in the ADC was closely related to local tumor progression.
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Affiliation(s)
- Ji Hyun Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Gyu Sang Yoo
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Young Cheol Yoon
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Hee Chul Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Hyun Su Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
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Jiang X, Ren M, Shuang X, Yang H, Shi D, Lai Q, Dong Y. Multiparametric MRI-Based Radiomics Approaches for Preoperative Prediction of EGFR Mutation Status in Spinal Bone Metastases in Patients with Lung Adenocarcinoma. J Magn Reson Imaging 2021; 54:497-507. [PMID: 33638577 DOI: 10.1002/jmri.27579] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Preoperative prediction of epidermal growth factor receptor (EGFR) mutation status in patients with spinal bone metastases (SBM) from primary lung adenocarcinoma is potentially important for treatment decisions. PURPOSE To develop and validate multiparametric magnetic resonance imaging (MRI)-based radiomics methods for preoperative prediction of EGFR mutation based on MRI of SBM. STUDY TYPE Retrospective. POPULATION A total of 97 preoperative patients with lumbar SBM from lung adenocarcinoma (77 in training set and 20 in validation set). FIELD STRENGTH/SEQUENCE T1-weighted, T2-weighted, and T2-weighted fat-suppressed fast spin echo sequences at 3.0 T. ASSESSMENT Radiomics handcrafted and deep learning-based features were extracted and selected from each MRI sequence. The abilities of the features to predict EGFR mutation status were analyzed and compared. A radiomics nomogram was constructed integrating the selected features. STATISTICAL TESTS The Mann-Whitney U test and χ2 test were employed for evaluating associations between clinical characteristics and EGFR mutation status for continuous and discrete variables, respectively. Least absolute shrinkage and selection operator was used for selection of predictive features. Sensitivity (SEN), specificity (SPE), and area under the receiver operating characteristic curve (AUC) were used to evaluate the ability of radiomics models to predict the EGFR mutation. Calibration and decision curve analysis (DCA) were performed to assess and validate nomogram results. RESULTS The radiomics signature comprised five handcrafted and one deep learning-based features and achieved good performance for predicting EGFR mutation status, with AUCs of 0.891 (95% confidence interval [CI], 0.820-0.962, SEN = 0.913, SPE = 0.710) in the training group and 0.771 (95% CI, 0.551-0.991, SEN = 0.750, SPE = 0.875) in the validation group. DCA confirmed the potential clinical usefulness of the radiomics models. DATA CONCLUSION Multiparametric MRI-based radiomics is potentially clinical valuable for predicting EGFR mutation status in patients with SBM from lung adenocarcinoma. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: 2.
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Affiliation(s)
- Xiran Jiang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, Shenyang, China
| | - Meihong Ren
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, Shenyang, China
| | - Xue Shuang
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, Shenyang, China
| | - Huazhe Yang
- Department of Biophysics, School of Fundamental Sciences, China Medical University, Shenyang, China
| | - Dabao Shi
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Qingyuan Lai
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Yue Dong
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
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Park S, Park JG, Jun S, Kim H, Kim TS, Kang H. Differentiation of bone metastases from prostate cancer and benign red marrow depositions of the pelvic bone with multiparametric MRI. Magn Reson Imaging 2020; 73:118-124. [PMID: 32860869 DOI: 10.1016/j.mri.2020.08.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/15/2020] [Accepted: 08/23/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To investigate the diagnostic utilities of imaging parameters derived from T1-weighted imaging (T1WI), diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to differentiate bone metastases from prostate cancer and benign red marrow depositions of the pelvic bone. MATERIALS AND METHODS Thirty-six lesions from 36 patients with prostate cancer were analyzed with T1WI, DWI, and DCE-MRI. The lesions were classified in the bone metastases (n = 22) and benign red marrow depositions (n = 14). Lesion-muscle ratio (LMR), apparent diffusion coefficient (ADC), volume transfer constant (Ktrans), reflux rate (Kep), and volume fraction of the extravascular extracellular matrix (Ve) values were obtained from the lesions. The imaging parameters of the both groups were compared using the Mann-Whitney U test, receiver operating characteristics (ROC) curves were analyzed. For the ROC curves, area under the curves (AUCs) were compared. RESULTS The ADC, Ktrans, Kep, and Ve values of bone metastases were significantly higher than those of benign red marrow depositions (Mann-Whitney U test, p < 0.05). However, there was no significant difference in LMR between the two groups (Mann-Whitney U test, p = 0.360). The AUCs of Ktrans, Kep, ADC, Ve, and LMR were 0.896, 0.844, 0.812, 0.724, and 0.448, respectively. In the pairwise comparison of ROC curves, the AUCs of Ktrans and Kep was significantly higher than LMR. CONCLUSIONS Ktrans, Kep, Ve, and ADC values can be used as imaging tools to differentiate bone metastases from prostate cancer and benign red marrow depositions of the pelvic bone.
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Affiliation(s)
- Sekyoung Park
- Department of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Jung Gu Park
- Department of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea.
| | - Sungmin Jun
- Department of Nuclear Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Heeyoung Kim
- Department of Nuclear Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Taek Sang Kim
- Department of Urology Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Hee Kang
- Department of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
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Fukuda T, Wengler K, de Carvalho R, Boonsri P, Schweitzer ME. MRI biomarkers in osseous tumors. J Magn Reson Imaging 2019; 50:702-718. [PMID: 30701624 DOI: 10.1002/jmri.26672] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/15/2019] [Accepted: 01/15/2019] [Indexed: 12/12/2022] Open
Abstract
Although radiography continues to play a critical role in osseous tumor assessment, there have been remarkable advances in cross-sectional imaging. MRI has taken a lead in this assessment due to high tissue contrast and spatial resolution, which are well suited for bone lesion assessment. More recently, although somewhat lagging other organ systems, quantitative parameters have shown promising potential as biomarkers for osseous tumors. Among these sequences are chemical shift imaging (CSI), apparent diffusion coefficient (ADC), and intravoxel incoherent motion (IVIM) from diffusion-weighted imaging (DWI), quantitative dynamic contrast enhanced (DCE)-MRI, and magnetic resonance spectroscopy (MRS). In this article, we review the background and recent roles of these quantitative MRI biomarkers for osseous tumors. Level of Evidence: 3 Technical Efficacy Stage: 3 J. MAGN. RESON. IMAGING 2019. J. Magn. Reson. Imaging 2019;50:702-718.
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Affiliation(s)
- Takeshi Fukuda
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| | - Kenneth Wengler
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - Ruben de Carvalho
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| | - Pattira Boonsri
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
| | - Mark E Schweitzer
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
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12
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Cook GJ, Goh V. Functional and Hybrid Imaging of Bone Metastases. J Bone Miner Res 2018; 33:961-972. [PMID: 29665140 PMCID: PMC7616187 DOI: 10.1002/jbmr.3444] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 04/02/2018] [Accepted: 04/06/2018] [Indexed: 12/21/2022]
Abstract
Bone metastases are common, cause significant morbidity, and impact on healthcare resources. Although radiography, computed tomography (CT), magnetic resonance imaging (MRI), and bone scintigraphy have frequently been used for staging the skeleton, these methods are insensitive and nonspecific for monitoring treatment response in a clinically relevant time frame. We summarize several recent reports on new functional and hybrid imaging methods including single photon emission CT/CT, positron emission tomography/CT, and whole-body MRI with diffusion-weighted imaging. These modalities generally show improvements in diagnostic accuracy for staging and response assessment over standard imaging methods, with the ability to quantify biological processes related to the bone microenvironment as well as tumor cells. As some of these methods are now being adopted into routine clinical practice and clinical trials, further evaluation with comparative studies is required to guide optimal and cost-effective clinical management of patients with skeletal metastases. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Gary Jr Cook
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, United Kingdom
- King's College London and Guy's & St Thomas' PET Centre, St Thomas' Hospital, London SE1 7EH, United Kingdom
| | - Vicky Goh
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, United Kingdom
- Radiology Department, Guy's & St Thomas' Hospitals, London SE1 7EH, United Kingdom
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13
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Confavreux CB, Pialat JB, Bellière A, Brevet M, Decroisette C, Tescaru A, Wegrzyn J, Barrey C, Mornex F, Souquet PJ, Girard N. Bone metastases from lung cancer: A paradigm for multidisciplinary onco-rheumatology management. Joint Bone Spine 2018; 86:185-194. [PMID: 29631067 DOI: 10.1016/j.jbspin.2018.03.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 03/14/2018] [Indexed: 12/15/2022]
Abstract
Bone is the third metastatic site after liver and lungs. Bone metastases occur in one out of three lung cancers and are usually of osteolytic aspect. Osteolytic bone metastases are responsible of long bone and vertebral fractures leading to restricted mobility, surgery and medullar compression that severely alter quality of life and that have a huge medico-economic impact. In the recent years, Bone Metastatic Multidisciplinary Tumour Board (BM2TB) have been developed to optimize bone metastases management for each patient in harmony with oncology program. In this review, we will go through all the different aspects of bone metastases management including diagnosis and evaluation (CT scan, Tc 99m-MDP bone scan, 18FDG-PET scan and biopsy for molecular diagnosis), systemic bone treatments (zoledronic acid and denosumab) and local treatments (interventional radiology and radiotherapy). Surgical strategies will be discussed elsewhere. Based on the last 2017-Lung Cancer South East French Guidelines, we present a practical decision tree to help the physicians for decision making in order to reach a personalized locomotor strategy for every patient.
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Affiliation(s)
- Cyrille B Confavreux
- Centre expert des métastases et oncologie osseuse secondaire-CEMOS, service de rhumatologie Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France; Université de Lyon, INSERM UMR 1033-Lyos, 69008 Lyon, France.
| | - Jean-Baptiste Pialat
- Université de Lyon, INSERM UMR 1033-Lyos, 69008 Lyon, France; Service de radiologie, centre hospitalier Lyon-Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
| | - Aurélie Bellière
- Centre régional de lutte contre le cancer Jean-Perrin, 63000 Clermont-Ferrand, France
| | - Marie Brevet
- Département d'anatomopathologie, groupement hospitalier Est, Hospices Civils de Lyon, 69500 Bron, France
| | - Chantal Decroisette
- Centre Hospitalier Annecy-Genevois, 1, boulevard de l'hôpital, 74370 Metz-Tessy, France
| | - Agnès Tescaru
- Service de médecine nucléaire, centre hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
| | - Julien Wegrzyn
- Centre expert des métastases et oncologie osseuse secondaire-CEMOS, service de rhumatologie Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France; Université de Lyon, INSERM UMR 1033-Lyos, 69008 Lyon, France; Département de chirurgie orthopédique - Pavillon T, hôpital Edouard-Herriot, Hospices Civils de Lyon, 69003 Lyon, France
| | - Cédric Barrey
- Département de neurochirurgie et chirurgie du Rachis, université Claude-Bernard Lyon I, hôpital Pierre-Wertheimer, Hospices Civils de Lyon, 69500 Bron, France; Laboratoire de biomécanique, ENSAM, Arts et Métiers Paris Tech, 75003 Paris, France
| | - Françoise Mornex
- Département de radiothérapie oncologie, centre hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France; Université Claude-Bernard Lyon 1-EMR 3738, 69921 Oullins, France
| | - Pierre-Jean Souquet
- Service de pneumologie, centre hospitalier Lyon-Sud, Hospices Civils de Lyon, 69310 Pierre-Bénite, France
| | - Nicolas Girard
- Université de Lyon, université Claude-Bernard Lyon 1, Lyon, France; Institut du Thorax Curie Montsouris, Institut Curie, 75005 Paris, France
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