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Wang X, Cao YY, Jiang Y, Jia M, Tian G, Bu CQ, Zhao N, Yue XZ, Shen ZW, Ji Y, Han YD. Effects of Breathing Patterns on Amide Proton Transfer MRI in the Kidney: A Preliminary Comparative Study in Healthy Volunteers and Patients With Tumors. J Magn Reson Imaging 2024; 60:222-230. [PMID: 37888865 DOI: 10.1002/jmri.29099] [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: 08/01/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The amide proton transfer-weighted (APTw) imaging for kidney diseases is important. However, the breathing patterns on APTw imaging remains unexplored. PURPOSE This study aimed to investigate the effects of intermittent breath-hold (IBH) and free breathing (FB) on renal 3D-APTw imaging. STUDY TYPE Healthy volunteers were enrolled prospectively, and renal clear cell carcinoma (RCCC) patients were included retrospectively. POPULATION 58 healthy volunteers and 10 RCCC patients. FIELD STRENGTH/SEQUENCE 3-T, turbo spin echo, and fast field echo. ASSESSMENT 3D-APTw imaging was scanned using the IBH and FB methods in volunteers and using the IBH method in RCCC patients. The image quality was evaluated by three observers according to the 5-point Likert scale. Optimal images rated at three points or higher were used to measure the APT values. STATISTICAL ANALYSIS The measurement repeatability was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot. The APT values were analyzed using McNemar's test, one-way analysis of variance, and t test. RESULTS 50 healthy volunteers and 8 RCCC patients were enrolled. Renal 3D-APTw imaging using the IBH method revealed a higher success rate (88% vs 78%). The ICCs were excellent in the IBH group (ICCs > 0.74) and were good in the FB group (ICCs < 0.74). No significant differences in the APT values among various zones using the IBH (P = 0.263) or FB method (P = 0.506). The mean APT value using the IBH method (2.091% ± 0.388%) was slightly lower than the FB method (2.176% ± 0.292%), but no significant difference (P = 0.233). The APT value of RCCC (4.832% ± 1.361%) was considerably higher than normal renal using the IBH method. CONCLUSIONS The study demonstrated that the IBH method substantially increased the image quality of renal 3D-APTw imaging. Furthermore, APT values may vary between normal and tumor tissues. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- X Wang
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - Y Y Cao
- Department of Imaging Center, First Affiliated Hospital, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Y Jiang
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - M Jia
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - G Tian
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - C Q Bu
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - N Zhao
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
| | - X Z Yue
- Philips Healthcare, Beijing, China
| | - Z W Shen
- Philips Healthcare, Beijing, China
| | - Y Ji
- Department of Imaging Center, First Affiliated Hospital, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Y D Han
- Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China
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Martín-Noguerol T, Santos-Armentia E, Fernandez-Palomino J, López-Úbeda P, Paulano-Godino F, Luna A. Role of advanced MRI sequences for thyroid lesions assessment. A narrative review. Eur J Radiol 2024; 176:111499. [PMID: 38735157 DOI: 10.1016/j.ejrad.2024.111499] [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: 11/24/2023] [Revised: 04/12/2024] [Accepted: 05/05/2024] [Indexed: 05/14/2024]
Abstract
Despite not being the first imaging modality for thyroid gland assessment, Magnetic Resonance Imaging (MRI), thanks to its optimal tissue contrast and spatial resolution, has provided some advancements in detecting and characterizing thyroid abnormalities. Recent research has been focused on improving MRI sequences and employing advanced techniques for a more comprehensive understanding of thyroid pathology. Although not yet standard practice, advanced MRI sequences have shown high accuracy in preliminary studies, correlating well with histopathological results. They particularly show promise in determining malignancy risk in thyroid lesions, which may reduce the need for invasive procedures like biopsies. In this line, functional MRI sequences like Diffusion Weighted Imaging (DWI), Dynamic Contrast-Enhanced MRI (DCE-MRI), and Arterial Spin Labeling (ASL) have demonstrated their potential usefulness in evaluating both diffuse thyroid conditions and focal lesions. Multicompartmental DWI models, such as Intravoxel Incoherent Motion (IVIM) and Diffusion Kurtosis Imaging (DKI), and novel methods like Amide Proton Transfer (APT) imaging or artificial intelligence (AI)-based analyses are being explored for their potential valuable insights into thyroid diseases. This manuscript reviews the critical physical principles and technical requirements for optimal functional MRI sequences of the thyroid and assesses the clinical utility of each technique. It also considers future prospects in the context of advanced MR thyroid imaging and analyzes the current role of advanced MRI sequences in routine practice.
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Affiliation(s)
| | | | | | | | | | - Antonio Luna
- MRI unit, Radiology department. HT medica, Carmelo Torres 2, 23007 Jaén, Spain.
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Li Y, Lin L, Zhang Y, Ren C, Zhang W, Cheng J. Preliminary exploration of amide proton transfer weighted imaging in differentiation between benign and malignant bone tumors. Front Oncol 2024; 14:1402628. [PMID: 38903728 PMCID: PMC11187086 DOI: 10.3389/fonc.2024.1402628] [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: 03/18/2024] [Accepted: 05/23/2024] [Indexed: 06/22/2024] Open
Abstract
Purpose To explore the value of 3D amide proton transfer weighted imaging (APTWI) in the differential diagnosis between benign and malignant bone tumors, and to compare the diagnostic performance of APTWI with traditional diffusion-weighted imaging (DWI). Materials and methods Patients with bone tumors located in the pelvis or lower limbs confirmed by puncture or surgical pathology were collected from January 2021 to July 2023 in the First Affiliated Hospital of Zhengzhou University. All patients underwent APTWI and DWI examinations. The magnetization transfer ratio with asymmetric analysis at the frequency offset of 3.5 ppm [MTRasym(3.5 ppm)] derived by APTWI and the apparent diffusion coefficient (ADC) derived by DWI for the tumors were measured. The Kolmogorou-Smirnou and Levene normality test was used to confirm the normal distribution of imaging parameters; and the independent sample t test was used to compare the differences in MTRasym(3.5 ppm) and ADC between benign and malignant bone tumors. In addition, the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of different imaging parameters in differentiation between benign and malignant bone tumors. P<0.05 means statistically significant. Results Among 85 bone tumor patients, 33 were benign and 52 were malignant. The MTRasym(3.5 ppm) values of malignant bone tumors were significantly higher than those of benign tumors, while the ADC values were significantly lower in benign tumors. ROC analysis shows that MTRasym(3.5 ppm) and ADC values perform well in the differential diagnosis of benign and malignant bone tumors, with the area under the ROC curve (AUC) of 0.798 and 0.780, respectively. Combination of MTRasym(3.5 ppm) and ADC values can further improve the diagnostic performance with the AUC of 0.849 (sensitivity = 84.9% and specificity = 73.1%). Conclusion MTRasym(3.5 ppm) of malignant bone tumors was significantly higher than that of benign bone tumors, reflecting the abnormal increase of protein synthesis in malignant tumors. APTWI combined with DWI can achieve a high diagnostic efficacy in differentiation between benign and malignant bone tumors.
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Affiliation(s)
- Ying Li
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liangjie Lin
- Clinical and Technical Support, Philips Healthcare, Beijing, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Cuiping Ren
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenhua Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Xiang X, Li X, Lin H, Wang X. Amide proton transfer-weighted MRI in predicting pathological types of brain metastases in lung Cancer. Magn Reson Imaging 2024; 108:59-66. [PMID: 38330724 DOI: 10.1016/j.mri.2024.01.014] [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: 10/28/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
Most brain metastases originate from lung cancer. The majority of cases of lung cancer can be categorized into squamous carcinoma and adenocarcinoma,necessitating distinct clinical treatments and yielding diverse prognoses.Therefore,accurate preoperative evaluation of pathological types through imaging techniques is essential. The objective of this study is to assess the capability of amide proton transfer-weighted(APTw) MRI in predicting the pathological types of brain metastases in lung cancer.Additionally,it seeks to evaluate whether APTw MRI can provide additional value to diffusion-weighted imaging(DWI) at MRI·In this study,a total of 32 participants(mean age,60 ± 9 years;14 men) underwent evaluation,comprising 9 with squamous carcinoma and 23 with adenocarcinoma.Interestingly,adenocarcinoma demonstrated elevated APTw values(2.70 ± 0.81% vs 1.82 ± 0.47%;P = 0.001) and a higher apparent diffusion coefficient(ADC) value(1.00 ± 0.40 × 10-3 mm2/s vs 0.77 ± 0.13 × 10-3 mm2/s;P<0.05) in comparison to squamous carcinoma. The area under the receiver operating characteristic curve(AUC) of APTw and ADC in distinguishing between squamous carcinoma and adenocarcinoma were found to be 0.84 and 0.63,respectively.Moreover,the combined area under the receiver operating characteristic curve of the two techniques is 0.84. Amide proton transfer-weighted has the potential to predict the pathological types of brain metastases in lung cancer.
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Affiliation(s)
- Xuyang Xiang
- The First Clinical Medical College of Gansu University of Chinese Medicine, Postal address:No.732 Jiayuguan West Road, Lanzhou 730,000, China
| | - Xiaozhong Li
- Department of Magnetic Resonance Imaging, Medical Imaging Center, Postal address:No.732 Jiayuguan West Road, Lanzhou 730,020, China.
| | - Huiting Lin
- The First Clinical Medical College of Gansu University of Chinese Medicine, Postal address:No.732 Jiayuguan West Road, Lanzhou 730,020, China
| | - Xufang Wang
- The First Clinical Medical College of Gansu University of Chinese Medicine, Postal address:No.732 Jiayuguan West Road, Lanzhou 730,020, China
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Xiang Y, Zhang Q, Chen X, Sun H, Li X, Wei X, Zhong J, Gao B, Huang W, Liang W, Sun H, Yang Q, Ren X. Synthetic MRI and amide proton transfer-weighted MRI for differentiating between benign and malignant sinonasal lesions. Eur Radiol 2024:10.1007/s00330-024-10696-6. [PMID: 38491129 DOI: 10.1007/s00330-024-10696-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES To explore the value of the synthetic MRI (SyMRI), combined with amide proton transfer-weighted (APTw) MRI for quantitative and morphologic assessment of sinonasal lesions, which could provide relative scale for the quantitative assessment of tissue properties. METHODS A total of 80 patients (31 malignant and 49 benign) with sinonasal lesions, who underwent the SyMRI and APTw examination, were retrospectively analyzed. Quantitative parameters (T1, T2, proton density (PD)) and APT % were obtained through outlining the region of interest (ROI) and comparing the two groups utilizing independent Student t test or a Wilcoxon test. Receiver operating characteristic curve (ROC), Delong test, and logistic regression analysis were performed to assess the diagnostic efficiency of one-parameter and multiparametric models. RESULTS SyMRI-derived mean T1, T2, and PD were significantly higher and APT % was relatively lower in benign compared to malignant sinonasal lesions (p < 0.05). The ROC analysis showed that the AUCs of the SyMRI-derived quantitative (T1, T2, PD) values and APT % ranged from 0.677 to 0.781 for differential diagnosis between benign and malignant sinonasal lesions. The T2 values showed the best diagnostic performance among all single parameters for differentiating these two masses. The AUCs of combined SyMRI-derived multiple parameters with APT % (AUC = 0.866) were the highest than that of any single parameter, which was significantly improved (p < 0.05). CONCLUSION The combination of SyMRI and APTw imaging has the potential to reflect intrinsic tissue characteristics useful for differentiating benign from malignant sinonasal lesions. CLINICAL RELEVANCE STATEMENT Combining synthetic MRI with amide proton transfer-weighted imaging could function as a quantitative and contrast-free approach, significantly enhancing the differentiation of benign and malignant sinonasal lesions and overcoming the limitations associated with the superficial nature of endoscopic nasal sampling. KEY POINTS • Synthetic MRI and amide proton transfer-weighted MRI could differentiate benign from malignant sinonasal lesions based on quantitative parameters. • The diagnostic efficiency could be significantly improved through synthetic MRI + amide proton transfer-weighted imaging. • The combination of synthetic MRI and amide proton transfer-weighted MRI is a noninvasive method to evaluate sinonasal lesions.
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Affiliation(s)
- Ying Xiang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qiujuan Zhang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xin Chen
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Honghong Sun
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaohui Li
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | | | - Jinman Zhong
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bo Gao
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wei Huang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wenbin Liang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Haiqiao Sun
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Quanxin Yang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
| | - Xiaoyong Ren
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Zhou L, Pan W, Huang R, Wang T, Wei Z, Wang H, Zhang Y, Li Y. Amide Proton Transfer-Weighted MRI, Associations with Clinical Severity and Prognosis in Ischemic Strokes. J Magn Reson Imaging 2024. [PMID: 38426606 DOI: 10.1002/jmri.29333] [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: 01/11/2024] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin scale (mRS) scores have important shortcomings. Amide proton transfer-weighted (APTw) imaging might offer more valuable information in ischemic strokes assessment. PURPOSE To utilize APTw, apparent diffusion coefficient (ADC), and computed tomography perfusion (CTP) for the assessment of clinical symptom severity and 90-day prognosis in patients diagnosed with ischemic stroke. STUDY TYPE Prospective. SUBJECTS 61 patients (mean age 63.2 ± 9.7 years; 46 males, 15 females) with ischemic strokes were included in the study. FIELD STRENGTH/SEQUENCE 3T/turbo spin echo (TSE) T1 -weighted imaging, T2 -weighted imaging, T2 -fluid attenuated inversion recovery (T2 -FLAIR), diffusion-weighted imaging (DWI), and single-shot TSE APTw imaging. ASSESSMENT APTw, ADC, and CTP were used to compare patient subgroups and construct a prognostic nomogram model. STATISTICAL TESTS Kolmogorov-Smirnov test, t-test, Mann-Whitney U test, chi-square test, Pearson correlation analysis, multivariate logistic regression analysis, decision curve analysis (DCA), receiver operating characteristic curves (ROCs). The significance threshold was set at P < 0.05. RESULTS Correlation analysis revealed that APTw and NIHSS exhibit the highest correlation (r = -0.634, 95% confidence interval [CI] -0.418 to -0.782), surpassing that of ADC and lesion size. Multivariable analysis revealed APTw (odds ratio [OR] 0.905, 95% CI 0.845-0.970), ADC (OR 0.745, 95% CI 0.609-0.911), and infarct core-cerebral blood volume (IC-CBV) (OR 0.547, 95% CI 0.310-0.964) as potential risk factors associated with a poor prognosis. The nomogram model demonstrated the highest predictive efficacy, with an area under the curve (AUC) of 0.960 (95% CI 0.911-0.988), exceeding that of APTw, ADC, and IC-CBV individually. DATA CONCLUSION The APTw technique holds potential value in categorizing and managing patients with ischemic stroke, offering guidance for the implementation of clinical treatment strategies. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Le Zhou
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou city, Jiangsu Province, China
| | - Wanqian Pan
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Renjun Huang
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou city, Jiangsu Province, China
| | - Tianye Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Zifan Wei
- Suzhou Medical College of Soochow University, Suzhou, China
| | - Hui Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Yi Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yonggang Li
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou city, Jiangsu Province, China
- Institute of Medical Imaging, Soochow University, Suzhou city, Jiangsu Province, China
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Wu X, Su T, Chen Y, Xu Z, Wang X, Hu G, Wang Y, Wong LM, Zhang Z, Zhang T, Jin Z. B1 Power Modification for Amide Proton Transfer Imaging in Parotid Glands: A Strategy for Image Quality Accommodation and Evaluation of Tumor Detection Feasibility. Cancers (Basel) 2024; 16:888. [PMID: 38473250 DOI: 10.3390/cancers16050888] [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: 01/09/2024] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND In the application of APTw protocols for evaluating tumors and parotid glands, inhomogeneity and hyperintensity artifacts have remained an obstacle. This study aimed to improve APTw imaging quality and evaluate the feasibility of difference B1 values to detect parotid tumors. METHODS A total of 31 patients received three APTw sequences to acquire 32 lesions and 30 parotid glands (one patient had lesions on both sides). Patients received T2WI and 3D turbo-spin-echo (TSE) APTw imaging on a 3.0 T scanner for three sequences (B1 = 2 μT, 1 μT, and 0.7 μT in APTw 1, 2, and 3, respectively). APTw image quality was evaluated using four-point Likert scales in terms of integrity and hyperintensity artifacts. Image quality was compared between the three sequences. An evaluable group and a trustable group were obtained for APTmean value comparison. RESULTS Tumors in both APT2 and APT3 had fewer hyperintensity artifacts than in APT1. With B1 values decreasing, tumors had less integrity in APTw imaging. APTmean values of tumors were higher than parotid glands in traditional APT1 sequence though not significant, while the APTmean subtraction value was significantly different. CONCLUSIONS Applying a lower B1 value could remove hyperintensity but could also compromise its integrity. Combing different APTw sequences might increase the feasibility of tumor detection.
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Affiliation(s)
- Xiaoqian Wu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Tong Su
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Yu Chen
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Zhentan Xu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xiaoqi Wang
- Yangtze Delta Region Institute of Tsinghua University, Jiaxing 314006, China
| | - Geli Hu
- Department of Clinical and Technical Support, Philips Healthcare, Beijing 100600, China
| | - Yunting Wang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Lun M Wong
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Zhuhua Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Tao Zhang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
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Xu Y, Wan Q, Ren X, Jiang Y, Wang F, Yao J, Wu P, Shen A, Wang P. Amide proton transfer-weighted MRI for renal tumors: Comparison with diffusion-weighted imaging. Magn Reson Imaging 2024; 106:104-109. [PMID: 38135260 DOI: 10.1016/j.mri.2023.12.002] [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: 08/24/2023] [Revised: 12/07/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE To investigate the potential of amide proton transfer-weighted (APTw) MRI in identifying benign and malignant renal tumors and to evaluate whether APTw MRI can add diagnostic value to diffusion-weighted imaging (DWI). MATERIALS AND METHODS Participants with renal tumor underwent preoperative multiparametric MRI, including APTw MRI and DWI. The APTw and apparent diffusion coefficient (ADC) of malignant tumors and benign tumors were calculated independently by two radiologists and compared. The value of the mean APTw and the mean ADC for differentiating malignant and benign tumors was evaluated by receiver operating characteristic analysis. RESULTS In total, 65 participants (mean age, 59 years ±14; 41 men) were evaluated: 54 with malignant and 11 with benign renal tumors. Malignant renal tumors showed higher mean APTw values [2.03% (1.63) vs 1.00% (1.60); P < 0.01] and lower mean ADC values (1.22 × 10-3 mm2/s ± 0.37 vs 1.51 × 10-3 mm2/s ± 0.37; P < 0.05) than benign renal tumors. The area under the receiver operating characteristic curve (AUC) of APTw, ADC and the combination of them for the identification of benign and malignant renal tumors was 0.78(95% CI: 0.66, 0.87; P < 0.001),0.70(95% CI: 0.54, 0.86; P < 0.05) and 0.79 (95% CI: 0.67, 0.88; P < 0.001). The optimal cutoff value for mean APTw was 2.14% (sensitivity, 74%; specificity, 73%). There was no difference between these three parameters for differentiating malignant from benign renal tumors (P > 0.05). CONCLUSION The APTw MRI has the potential use as an imaging biomarker for renal malignant and benign tumors.
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Affiliation(s)
- Yun Xu
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China; Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai 200065, China
| | - Qingxuan Wan
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China; Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai 200065, China
| | - Xihui Ren
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China; Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai 200065, China
| | - Yutao Jiang
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China; Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai 200065, China
| | - Fang Wang
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China; Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai 200065, China
| | - Jing Yao
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China; Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai 200065, China
| | - Peng Wu
- Philips Healthcare, Shanghai 200072, China
| | - Aijun Shen
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China; Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai 200065, China.
| | - Peijun Wang
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China; Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai 200065, China.
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Teng M, Wang M, He F, Liang W, Zhang G. Arterial Spin Labeling and Amide Proton Transfer Imaging can Differentiate Glioblastoma from Brain Metastasis: A Systematic Review and Meta-Analysis. World Neurosurg 2024; 182:e702-e711. [PMID: 38072160 DOI: 10.1016/j.wneu.2023.12.023] [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: 11/25/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Currently, arterial spin labeling (ASL) and amide proton transfer (APT) imaging have shown potential for distinguishing glioblastoma from brain metastases. Thus, a meta-analysis was conducted to investigate this further. METHODS An extensive and comprehensive search was conducted in 6 English and Chinese databases according to predefined inclusion and exclusion criteria, encompassing data up to July 2023. Data from eligible literature were extracted, and bivariate models were employed to calculate pooled sensitivities, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) of the summary receiver operating characteristic curve. RESULTS The meta-analysis included 11 articles. For ASL, the pooled sensitivity was 0.77 (95% confidence interval [CI], 0.63-0.87), and the pooled specificity was 0.87 (95% CI, 0.77-0.93). The pooled PLR was 5.89 (95% CI, 2.97-11.69), the pooled NLR was 0.26 (95% CI, 0.15-0.47), the pooled DOR was 22.33 (95% CI, 6.89-72.34), and AUC was 0.90 (95% CI, 0.87-0.92). For APT imaging, the pooled sensitivity was 0.78 (95% CI, 0.70-0.85), and the pooled specificity was 0.86 (95% CI, 0.77-0.92). The pooled PLR was 5.51 (95% CI, 3.24-9.37), the pooled NLR was 0.25 (95% CI, 0.17-0.37), the pooled DOR was 21.99 (95% CI, 10.28-47.03), and the AUC was 0.90 (95% CI, 0.87-0.92). CONCLUSIONS This meta-analysis suggest that both ASL and APT imaging exhibit high accuracy in distinguishing between glioblastoma and brain metastasis.
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Affiliation(s)
- Minghao Teng
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, Hubei, China; Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases, Enshi, Hubei, China; Hubei Provincial Clinical Medical Research Center for Nephropathy, Enshi, Hubei, China
| | - Minshu Wang
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, Hubei, China; Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases, Enshi, Hubei, China; Hubei Provincial Clinical Medical Research Center for Nephropathy, Enshi, Hubei, China
| | - Feng He
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, Hubei, China; Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases, Enshi, Hubei, China; Hubei Provincial Clinical Medical Research Center for Nephropathy, Enshi, Hubei, China
| | - Wu Liang
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, Hubei, China; Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases, Enshi, Hubei, China; Hubei Provincial Clinical Medical Research Center for Nephropathy, Enshi, Hubei, China
| | - Guisheng Zhang
- Department of Neurosurgery, Minda Hospital of Hubei Minzu University, Enshi, Hubei, China; Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases, Enshi, Hubei, China; Hubei Provincial Clinical Medical Research Center for Nephropathy, Enshi, Hubei, China.
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Kong L, Wen Z, Cai Q, Lin Y, Chen Y, Cao W, Li M, Qian L, Chen J, Guo Y, Wang H. Amide Proton Transfer-Weighted MRI and Diffusion-Weighted Imaging in Bladder Cancer: A Complementary Tool to the VI-RADS. Acad Radiol 2024; 31:564-571. [PMID: 37821347 DOI: 10.1016/j.acra.2023.09.005] [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: 08/08/2023] [Revised: 08/27/2023] [Accepted: 09/03/2023] [Indexed: 10/13/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate the feasibility of amide proton transfer-weighted (APTw) and diffusion-weighted Magnetic Resonance Imaging (MRI) as a means by which to add value to the Vesical Imaging Reporting and Data System (VI-RADS) for discriminating muscle invasive bladder cancer (MIBC) from nonmuscle invasive bladder cancer (NMIBC). MATERIALS AND METHODS This prospective study enrolled participants with pathologically confirmed bladder cancer (BCa) who underwent preoperative multiparametric MRI, including APTw and diffusion-weighted MRI, from July 2020 to January 2023. The exclusion criteria were lesions smaller than 10 mm, missing smooth muscle layer in the operation specimen, neoadjuvant therapy before MRI, inadequate image quality, and malignancy other than urothelial neoplasm. Two radiologists independently assigned the VI-RADS score for each participant. Quantitative parameters derived from APTw and diffusion-weighted MRI were obtained by another two radiologists. Receiver operating characteristic (ROC) curve analysis with the area under the ROC curve (AUC) was performed to evaluate the diagnostic performances of quantitative parameters for discriminating BCa detrusor muscle invasion status. RESULTS A total of 106 participants were enrolled (mean age, 64 ± 12 years [SD]; 90 men): 32 with MIBC and 74 with NMIBC. Lower apparent diffusion coefficient (ADC) values (0.88 × 10-3 mm2/s ± 0.12 vs. 1.08 × 10-3 mm2/s ± 0.25; P < 0.001) and higher APTw values (6.89% [interquartile range {IQR}, 5.05%-12.17%] vs. 3.61% [IQR, 2.23%-6.83%]; P < 0.001) were observed in the MIBC group. Compared to VI-RADS alone, both APTw (P = 0.003) and ADC (P = 0.020) values could improve the diagnostic performance of VI-RADS in differentiating MIBC from NMIBC. The combination of the three yielded the highest diagnostic performance (AUC, 0.93; 95% CI:0.87,0.97) for evaluating muscle invasion status. The addition of the APTw values to the combination of VI-RADS and ADC values notably improved the diagnostic performance for differentiating NMIBC from MIBC (VI-RADS+ADC vs. VI-RADS+APTw+ADC, P = 0.046). CONCLUSION MRI parameters derived from APTw and diffusion-weighted MRI can be used to accurately assess muscle invasion status in BCa and provide additional value to VI-RADS.
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Affiliation(s)
- Lingmin Kong
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China (L.K., Z.W., Q.C., Y.L., Y.C., W.C., M.L., Y.G., H.W.)
| | - Zhihua Wen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China (L.K., Z.W., Q.C., Y.L., Y.C., W.C., M.L., Y.G., H.W.)
| | - Qian Cai
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China (L.K., Z.W., Q.C., Y.L., Y.C., W.C., M.L., Y.G., H.W.)
| | - Yingyu Lin
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China (L.K., Z.W., Q.C., Y.L., Y.C., W.C., M.L., Y.G., H.W.)
| | - Yanling Chen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China (L.K., Z.W., Q.C., Y.L., Y.C., W.C., M.L., Y.G., H.W.)
| | - Wenxin Cao
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China (L.K., Z.W., Q.C., Y.L., Y.C., W.C., M.L., Y.G., H.W.)
| | - Meiqin Li
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China (L.K., Z.W., Q.C., Y.L., Y.C., W.C., M.L., Y.G., H.W.)
| | - Long Qian
- MR Research, GE Healthcare, Beijing, China (L.Q.)
| | - Junxing Chen
- Department of Urology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China (J.C.)
| | - Yan Guo
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China (L.K., Z.W., Q.C., Y.L., Y.C., W.C., M.L., Y.G., H.W.)
| | - Huanjun Wang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China (L.K., Z.W., Q.C., Y.L., Y.C., W.C., M.L., Y.G., H.W.).
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Li JL, Xu Y, Xiang YS, Wu P, Shen AJ, Wang PJ, Wang F. The Value of Amide Proton Transfer MRI in the Diagnosis of Malignant and Benign Urinary Bladder Lesions: Comparison With Diffusion-Weighted Imaging. J Magn Reson Imaging 2024. [PMID: 38174777 DOI: 10.1002/jmri.29199] [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: 10/06/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Conventional magnetic resonance imaging (MRI) has certain limitations in distinguishing between malignant and benign urinary bladder (UB) lesions. Amide proton transfer (APT) imaging may provide more diagnostic information than diffusion-weighted imaging (DWI) to distinguish between malignant and benign UB. PURPOSE To investigate the potential of APT imaging in the diagnosis of malignant and benign UB lesions and to compare its diagnostic efficacy with that of conventional DWI. STUDY TYPE Prospective. SUBJECTS Eighty patients with UB lesions. FIELD STRENGTH/SEQUENCE A 3.0 T/turbo spin echo (TSE) T1-weighted and T2-weighted imaging, single-shot echo planar DWI, and three-dimensional TSE APT imaging. ASSESSMENT Patients underwent radical cystectomy or transurethral resection of the bladder lesions within 2 weeks after CT urography and MRI examination. APT signal intensity in UB lesions was quantified by the asymmetric magnetization transfer ratio (MTRasym ). MTRasym and apparent diffusion coefficient (ADC) values were measured and compared between malignant and benign UB lesions. STATISTICAL TESTS Kolmogorov-Smirnov test, Student's t test or Mann-Whitney U test, Spearman rank correlation coefficient, area under the receiver operating characteristic (ROC) curve (AUC), Delong test, and intraclass correlation coefficient (ICC). The significance threshold was set at P < 0.05. RESULTS Thirty-two patients had pathologically confirmed benign UB lesions, including 2 bladder leiomyomas, 1 submucosal amyloidosis, 1 inflammatory myofibroblastic tumor, and 28 inflammatory lesions, and 48 patients had pathologically confirmed urothelial carcinoma. Urothelial carcinomas showed significantly higher MTRasym values (1.53% [0.74%] vs. 0.85% [0.23%]) and significantly lower ADC values (1.24 ± 0.34 × 10-3 mm2 /s vs. 1.43 ± 0.22 × 10-3 mm2 /s) than benign UB lesions. The MTRasym value (AUC = 0.928) was significantly better in differentiating urothelial carcinoma from benign UB lesions than the ADC value (AUC = 0.722). DATA CONCLUSION APT imaging may have value in discriminating malignant from benign UB lesions and has better diagnostic performance than DWI. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Jing-Lu Li
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai, China
| | - Yun Xu
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai, China
| | - Yong-Sheng Xiang
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai, China
| | - Peng Wu
- Clinical and Technical Support, Philips Healthcare, Shanghai, China
| | - Ai-Jun Shen
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai, China
| | - Pei-Jun Wang
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai, China
| | - Fang Wang
- Department of Medical Imaging, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Institute of Medical Imaging Artificial Intelligence, Tongji University School of Medicine, Shanghai, China
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Wen B, Zhang Z, Zhu J, Liu L, Liu Z, Ma X, Wang K, Xie L, Zhang Y, Cheng J. Synthetic MRI plus FSE-PROPELLER DWI for differentiating malignant from benign head and neck tumors: a preliminary study. Front Oncol 2023; 13:1225420. [PMID: 37829331 PMCID: PMC10565487 DOI: 10.3389/fonc.2023.1225420] [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: 05/24/2023] [Accepted: 09/04/2023] [Indexed: 10/14/2023] Open
Abstract
Background Preoperative classification of head and neck (HN) tumors remains challenging, especially distinguishing early cancerogenic masses from benign lesions. Synthetic MRI offers a new way for quantitative analysis of tumors. The present study investigated the application of synthetic MRI and stimulus and fast spin echo diffusion-weighted imaging with periodically rotated overlapping parallel lines with enhanced reconstruction (FSE-PROPELLER DWI) to differentiate malignant from benign HN tumors. Materials and methods Forty-eight patients with pathologically confirmed HN tumors were retrospectively recruited between August 2022 and October 2022. The patients were divided into malignant (n = 28) and benign (n = 20) groups. All patients were scanned using synthetic MRI and FSE-PROPELLER DWI. T1, T2, and proton density (PD) values were acquired on the synthetic MRI and ADC values on the FSE-PROPELLER DWI. Results Benign tumors (ADC: 2.03 ± 0.31 × 10-3 mm2/s, T1: 1741.13 ± 662.64 ms, T2: 157.43 ± 72.23 ms) showed higher ADC, T1, and T2 values compared to malignant tumors (ADC: 1.46 ± 0.37 × 10-3 mm2/s, T1: 1390.06 ± 241.09 ms, T2: 97.64 ± 14.91 ms) (all P<0.05), while no differences were seen for PD values. ROC analysis showed that T2+ADC (cut-off value, > 0.55; AUC, 0.950) had optimal diagnostic performance vs. T1 (cut-off value, ≤ 1675.84 ms; AUC, 0.698), T2 (cut-off value, ≤ 113.24 ms; AUC, 0.855) and PD (cut off value, > 80.67 pu; AUC, 0.568) alone in differentiating malignant from benign lesions (all P<0.05); yet, the difference in AUC between ADC and T2+ADC or T2 did not reach statistical significance. Conclusion Synthetic MRI and FSE-PROPELLER DWI can quantitatively differentiate malignant from benign HN tumors. T2 value is comparable to ADC value, and T2+ADC values could improve diagnostic efficacy., apparent diffusion coeffificient, head and neck tumors.
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Affiliation(s)
- Baohong Wen
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zanxia Zhang
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Zhu
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liang Liu
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zijun Liu
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoyue Ma
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kaiyu Wang
- MR Research China, GE Healthcare, Beijing, China
| | - Lizhi Xie
- MR Research China, GE Healthcare, Beijing, China
| | - Yong Zhang
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Yu Q, Ning Y, Wang A, Li S, Gu J, Li Q, Chen X, Lv F, Zhang X, Yue Q, Peng J. Deep learning-assisted diagnosis of benign and malignant parotid tumors based on contrast-enhanced CT: a multicenter study. Eur Radiol 2023; 33:6054-6065. [PMID: 37067576 DOI: 10.1007/s00330-023-09568-2] [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: 10/17/2022] [Revised: 01/31/2023] [Accepted: 02/26/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVES To develop deep learning-assisted diagnosis models based on CT images to facilitate radiologists in differentiating benign and malignant parotid tumors. METHODS Data from 573 patients with histopathologically confirmed parotid tumors from center 1 (training set: n = 269; internal-testing set: n = 116) and center 2 (external-testing set: n = 188) were retrospectively collected. Six deep learning models (MobileNet V3, ShuffleNet V2, Inception V3, DenseNet 121, ResNet 50, and VGG 19) based on arterial-phase CT images, and a baseline support vector machine (SVM) model integrating clinical-radiological features with handcrafted radiomics signatures were constructed. The performance of senior and junior radiologists with and without optimal model assistance was compared. The net reclassification index (NRI) and integrated discrimination improvement (IDI) were calculated to evaluate the clinical benefit of using the optimal model. RESULTS MobileNet V3 had the best predictive performance, with sensitivity increases of 0.111 and 0.207 (p < 0.05) in the internal- and external-testing sets, respectively, relative to the SVM model. Clinical benefit and overall efficiency of junior radiologist were significantly improved with model assistance; for the internal- and external-testing sets, respectively, the AUCs improved by 0.128 and 0.102 (p < 0.05), the sensitivity improved by 0.194 and 0.120 (p < 0.05), the NRIs were 0.257 and 0.205 (p < 0.001), and the IDIs were 0.316 and 0.252 (p < 0.001). CONCLUSIONS The developed deep learning models can assist radiologists in achieving higher diagnostic performance and hopefully provide more valuable information for clinical decision-making in patients with parotid tumors. KEY POINTS • The developed deep learning models outperformed the traditional SVM model in predicting benign and malignant parotid tumors. • Junior radiologist can obtain greater clinical benefits with assistance from the optimal deep learning model. • The clinical decision-making process can be accelerated in patients with parotid tumors using the established deep learning model.
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Affiliation(s)
- Qiang Yu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Youquan Ning
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Anran Wang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Shuang Li
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu, 610041, China
| | - Jinming Gu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Quanjiang Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Xinwei Chen
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | | | - Qiang Yue
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu, 610041, China.
| | - Juan Peng
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
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Zhang Z, Li S, Wang W, Zhang Y, Wang K, Cheng J, Wen B. Synthetic MRI for the quantitative and morphologic assessment of head and neck tumors: a preliminary study. Dentomaxillofac Radiol 2023; 52:20230103. [PMID: 37427697 PMCID: PMC10461255 DOI: 10.1259/dmfr.20230103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVES To evaluate the feasibility of synthetic MRI for quantitative and morphologic assessment of head and neck tumors and compare the results with the conventional MRI approach. METHODS AND MATERIALS A total of 92 patients with different head and neck tumor histology who underwent conventional and synthetic MRI were retrospectively recruited. The quantitative T1, T2, proton density (PD), and apparent diffusion coefficient (ADC) values of 38 benign and 54 malignant tumors were measured and compared. Diagnostic efficacy for differentiating malignant and benign tumors was evaluated with receiver operating characteristic (ROC) analysis and integrated discrimination index. The image quality of conventional and synthetic T1W/T2W images on a 5-level Likert scale was also compared with Wilcoxon signed rank test. RESULTS T1, T2 and ADC values of malignant head and neck tumors were smaller than those of benign tumors (all p < 0.05). T2 and ADC values showed better diagnostic efficacy than T1 for distinguishing malignant tumors from benign tumors (both p < 0.05). Adding the T2 value to ADC increased the area under the curve from 0.839 to 0.886, with an integrated discrimination index of 4.28% (p < 0.05). In terms of overall image quality, synthetic T2W images were comparable to conventional T2W images, while synthetic T1W images were inferior to conventional T1W images. CONCLUSIONS Synthetic MRI can facilitate the characterization of head and neck tumors by providing quantitative relaxation parameters and synthetic T2W images. T2 values added to ADC values may further improve the differentiation of tumors.
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Affiliation(s)
- Zanxia Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weijian Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kaiyu Wang
- MR Research China, GE Healthcare, Beijing, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Baohong Wen
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Wang Y, Wang L, Huang H, Ma J, Lin L, Liu L, Song Q, Liu A. Amide proton transfer-weighted magnetic resonance imaging for the differentiation of parotid gland tumors. Front Oncol 2023; 13:1223598. [PMID: 37664057 PMCID: PMC10471989 DOI: 10.3389/fonc.2023.1223598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose To assess the usefulness of amide proton transfer-weighted (APTw) imaging in the differentiation of parotid gland tumors. Materials and methods Patients with parotid gland tumors who underwent APTw imaging were retrospectively enrolled and divided into groups according to pathology. Two radiologists evaluated the APTw image quality independently, and APTw images with quality score ≥3 were enrolled. The maximum and average values of APTw imaging for tumor lesions (APTmax and APTmean) were measured. The differences in APTmax and APTmean were compared between malignant tumors (MTs) and benign tumors (BTs), as well as between MTs and pleomorphic adenomas (PAs) and between MTs and Warthin tumors (WTs). Independent-samples t-test, Kruskal-Wallis H test, and receiver operating characteristic (ROC) curve analyses were used for statistical analysis. Results Seventy-three patients were included for image quality evaluation. In this study, 32/73 and 29/73 parotid tumors were scored as 4 and 3, respectively. After excluding lesions with quality score ≤2 (12/73), the APTmean and APTmax of MTs were 4.15% ± 1.33% and 7.43% ± 1.61%, higher than those of BTs 2.74% ± 1.04% and 5.25% ± 1.54%, respectively (p < 0.05). The areas under the ROC curve (AUCs) of the APTmean and APTmax for differentiation between MTs and BTs were 0.819 and 0.821, respectively. MTs indicated significantly higher APTmean and APTmax values than those of PAs (p < 0.05) and WTs (p < 0.05). The AUCs of the APTmean and APTmax for differentiation between MTs and PAs were 0.830 and 0.815 and between MTs and WTs were 0.847 and 0.920, respectively. Conclusion Most APTw images for parotid tumors had acceptable image quality for APTw value evaluation. Both APTmax and APTmean can be used to differentiate MTs from BTs and to differentiate MTs from subtype parotid gland tumors.
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Affiliation(s)
- Yihua Wang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lijun Wang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Haitao Huang
- Department of Stomatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Juntao Ma
- Department of Stomatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Liangjie Lin
- Clinical and Technical Support, Philips Healthcare, Beijing, China
| | - Lin Liu
- Department of Stomatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qingwei Song
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ailian Liu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
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Li T, Wang J, Yang Y, Glide-Hurst CK, Wen N, Cai J. Multi-parametric MRI for radiotherapy simulation. Med Phys 2023; 50:5273-5293. [PMID: 36710376 PMCID: PMC10382603 DOI: 10.1002/mp.16256] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 09/10/2022] [Accepted: 12/06/2022] [Indexed: 01/31/2023] Open
Abstract
Magnetic resonance imaging (MRI) has become an important imaging modality in the field of radiotherapy (RT) in the past decade, especially with the development of various novel MRI and image-guidance techniques. In this review article, we will describe recent developments and discuss the applications of multi-parametric MRI (mpMRI) in RT simulation. In this review, mpMRI refers to a general and loose definition which includes various multi-contrast MRI techniques. Specifically, we will focus on the implementation, challenges, and future directions of mpMRI techniques for RT simulation.
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Affiliation(s)
- Tian Li
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jihong Wang
- Department of Radiation Physics, Division of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Yingli Yang
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong Univeristy School of Medicine, Shanghai, China
- SJTU-Ruijing-UIH Institute for Medical Imaging Technology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Carri K Glide-Hurst
- Department of Radiation Oncology, University of Wisconsin, Madison, Wisconsin, USA
| | - Ning Wen
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong Univeristy School of Medicine, Shanghai, China
- SJTU-Ruijing-UIH Institute for Medical Imaging Technology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- The Global Institute of Future Technology, Shanghai Jiaotong University, Shanghai, China
| | - Jing Cai
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China
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Liu Z, Wen J, Wang M, Ren Y, Yang Q, Qian L, Luo H, Feng S, He C, Liu X, Wu Y, Luo D. Breast Amide Proton Transfer Imaging at 3 T: Diagnostic Performance and Association With Pathologic Characteristics. J Magn Reson Imaging 2023; 57:824-833. [PMID: 35816177 DOI: 10.1002/jmri.28335] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Amide proton transfer (APT) imaging has been increasingly applied in tumor characterization. However, its value in evaluating breast cancer remains undetermined. PURPOSE To assess the diagnostic performance of APT imaging in breast cancer and its association with prognostic histopathologic characteristics. STUDY TYPE Prospective. SUBJECTS Eighty-four patients with breast lesions. FIELD STRENGTH/SEQUENCE A 3.0 T/single-shot fast spin echo APT imaging. ASSESSMENT APTw signal in breast lesion was quantified. Lesion malignancy, T stage, grades, Ki-67 index, molecular biomarkers (estrogen receptor [ER] expression, progesterone receptor [PR] expression, human epidermal growth factor receptor [HER-2] expression), molecular subtypes (luminal A, luminal B, triple negative, and HER-2 enriched) were determined. STATISTICAL TESTS Student t-test, one-way analysis of variance, receiver operating characteristic analysis, and Pearson's correlation with P < 0.05 as statistical significance. RESULTS APTw signal was significantly higher in malignant lesions (1.55% ± 1.24%) than in benign lesions (0.54% ± 1.13%), and in grade III lesions than in grade II lesions (1.65% ± 0.84% vs. 0.96% ± 0.96%), and in T2- (1.57% ± 0.64%) and T3-stage lesions (1.54% ± 0.63%) than in T1-stage lesions (0.81% ± 0.64%) for invasive breast carcinoma of no special type. APTw signal significantly correlated with Ki-67 index (r = 0.364) but showed no significant difference in groups of ER (P = 0.069), PR (P = 0.069), HER-2 (P = 0.961), and among molecular subtypes (P = 0.073). DATA CONCLUSION APT imaging shows potential in differentiating breast lesion malignancy and associates with prognosis-related tumor grade, T stage, and proliferative activity. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhou Liu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Jie Wen
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Meng Wang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Ya Ren
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Qian Yang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Long Qian
- MR Research, GE Healthcare, Beijing, China
| | - Honghong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Sha Feng
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Cuiju He
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Xin Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Yin Wu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Dehong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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18
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Meng X, Tian S, Ma C, Lin L, Zhang X, Wang J, Song Q, Liu AL. APTw combined with mDixon-Quant imaging to distinguish the differentiation degree of cervical squamous carcinoma. Front Oncol 2023; 13:1105867. [PMID: 36761975 PMCID: PMC9905693 DOI: 10.3389/fonc.2023.1105867] [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: 11/23/2022] [Accepted: 01/05/2023] [Indexed: 01/26/2023] Open
Abstract
Background To investigate the value of amide proton transfer weighted (APTw) imaging combined with modified Dixon fat quantification (mDixon-Quant) imaging in determining the degree of differentiation of cervical squamous carcinoma (CSC) against histopathologic. Methods Magnetic resonance imaging (MRI) data were collected from 52 CSC patients. According to histopathologic results, patients were divided into the poorly differentiated group (37 cases) and the well/moderately differentiated group (15 cases). The APTw value by APTw imaging and the fat fraction (FF) and transverse relaxation rate R 2 * values by mDixon-Quant were independently measured by two radiologists. Intra-class correlation coefficients (ICCs) were used to test the consistency of APTw, FF, and R 2 * values measured by the two observers. The Mann-Whitney U test was used to analyze the difference in each parameter between the two groups. Logistic regression analysis was used to assess the association between the degree of differentiation on histopathology and imaging parameters by APTw and mDixon Quant. The ROC curve was used to evaluate the diagnostic efficacy of various parameters and their combination in distinguishing the degree of CSC differentiation on histopathology. The DeLong test was used to access the differences among the area under the ROC curves (AUCs). The Pearson correlation coefficient was used to evaluate the correlation between APTw and mDixon-Quant imaging parameters. Results The APTw means were 2.95 ± 0.78% and 2.05 (1.85, 2.65)% in the poorly and well/moderately differentiated groups, respectively. The R 2 * values were 26.62 (21.99, 33.31)/s and 22.93 ± 6.09/s in the poorly and well/moderately differentiated groups, respectively (P < 0.05). The AUCs of APTw, R 2 * , and their combination were 0.762, 0.686, and 0.843, respectively. The Delong test suggested statistical significance between R 2 * and the combination of APTw and R 2 * . R 2 * values showed a significant correlation with APTw values in the poorly differentiated group. Conclusions APTw combined with mDixon-Quant can be used to efficiently distinguish the differention degrees of CSC diagnosed on histopathology.
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Affiliation(s)
- Xing Meng
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China,Radiology Department, Dalian Women and Children’s Medical Group, Dalian, Liaoning, China
| | - Shifeng Tian
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China
| | - Changjun Ma
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China
| | - Liangjie Lin
- Radiology Department, Philips (China), Beijing, China
| | | | - Jiazheng Wang
- Radiology Department, Philips (China), Beijing, China
| | - Qingwei Song
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China
| | - Ai Lian Liu
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China,*Correspondence: Ai Lian Liu,
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19
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Mahmoud EM, Howard E, Ahsan H, Cousins JP, Nada A. Cross-sectional imaging evaluation of atypical and uncommon extra-nodal head and neck Non-Hodgkin lymphoma: Case series. J Clin Imaging Sci 2023; 13:6. [PMID: 36751565 PMCID: PMC9899482 DOI: 10.25259/jcis_134_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/14/2023] [Indexed: 01/26/2023] Open
Abstract
Extra-nodal Non-Hodgkin lymphoma (ENHL) of the head and neck is not uncommon and has variable clinical and imaging presentations. It represents about 25% of extra-nodal lymphomas. In addition, lymphoma is the third most common malignancy of the head and neck just after squamous cell carcinoma (SCC) and salivary gland neoplasms. Unlike SCC, ENHL usually presents as a well-defined mass in the oral cavity, along the pharyngeal mucosa, sinonasal cavity, orbit, and other different neck spaces. One of the common presentations of ENHL is the glandular type which can arise within the salivary or thyroid glands as marginal zone non-Hodgkin lymphoma. ENHL can infiltrate the bone resembling high grade osseous malignancies. Rarely, ENHL can present as perineural spread without definitive mass and manifest clinically with several neuropathies. In this case series, we presented different imaging features and presentation of ENHL of the head and neck. The knowledge of various presentations of ENHL of the head and neck can help early diagnosis and prompt management of these patients' population.
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Affiliation(s)
- Esmat M. Mahmoud
- Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo, Egypt
| | - Emily Howard
- Department of Radiology, University of Missouri, Columbia, Missouri, United States
| | - Humera Ahsan
- Department of Radiology, University of Missouri, Columbia, Missouri, United States
| | - Joseph P. Cousins
- Department of Radiology, University of Missouri, Columbia, Missouri, United States
| | - Ayman Nada
- Department of Radiology, University of Missouri, Columbia, Missouri, United States.,Corresponding author: Ayman Nada, Department of Radiology, University of Missouri, Columbia, Missouri, United States.
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20
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Fujima N, Shimizu Y, Yoneyama M, Nakagawa J, Kameda H, Harada T, Hamada S, Suzuki T, Tsushima N, Kano S, Homma A, Kudo K. Amide proton transfer imaging for the determination of human papillomavirus status in patients with oropharyngeal squamous cell carcinoma. Medicine (Baltimore) 2022; 101:e29457. [PMID: 35839055 PMCID: PMC11132395 DOI: 10.1097/md.0000000000029457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/22/2022] [Indexed: 10/14/2022] Open
Abstract
The aim of this study was to investigate the utility of amide proton transfer (APT) imaging for the determination of human papillomavirus (HPV) status in patients with oropharyngeal squamous cell carcinoma (SCC). Thirty-one patients with oropharyngeal SCC were retrospectively evaluated. All patients underwent amide proton transfer imaging using a 3T magnetic resonance (MR) unit. Patients were divided into HPV-positive and -negative groups depending on the pathological findings in their primary tumor. In APT imaging, the primary tumor was delineated with a polygonal region of interest (ROI). Signal information in the ROI was used to calculate the mean, standard deviation (SD) and coefficient of variant (CV) of the APT signals (APT mean, APT SD, and APT CV, respectively). The value of APT CV in the HPV-positive group (0.43 ± 0.04) was significantly lower than that in the HPV-negative group (0.48 ± 0.04) (P = .01). There was no significant difference in APT mean (P = .82) or APT SD (P = .13) between the HPV-positive and -negative groups. Receiver operating characteristic (ROC) curve analysis of APT CV had a sensitivity of 0.75, specificity of 0.8, positive predictive value of 0.75, negative predictive value of 0.8, accuracy of 0.77 and area under the curve (AUC) of 0.8. The APT signal in the HPV-negative group was considered heterogeneous compared to the HPV-positive group. This information might be useful for the determination of HPV status in patients with oropharyngeal SCC.
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Affiliation(s)
- Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Yukie Shimizu
- Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Advanced Diagnostic Imaging Development, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | | | - Junichi Nakagawa
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Hiroyuki Kameda
- Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Taisuke Harada
- Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Seijiro Hamada
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takayoshi Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nayuta Tsushima
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kohsuke Kudo
- Department of Diagnostic Imaging, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Advanced Diagnostic Imaging Development, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Sapporo, Japan
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21
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Wang HJ, Cai Q, Huang YP, Li MQ, Wen ZH, Lin YY, Ouyang LY, Qian L, Guo Y. Amide Proton Transfer-weighted MRI in Predicting Histologic Grade of Bladder Cancer. Radiology 2022; 305:127-134. [PMID: 35762886 DOI: 10.1148/radiol.211804] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Bladder cancer is classified into high and low grades with different clinical treatments and prognoses. Thus, accurate preoperative evaluation of the histologic grade through imaging techniques is essential. Purpose To investigate the potential of amide proton transfer-weighted (APTw) MRI in evaluating the grade of bladder cancer and to evaluate whether APTw MRI can add value to diffusion-weighted imaging (DWI) at MRI. Materials and Methods In this single-center prospective study, participants with pathologic analysis-confirmed bladder cancer with no previous treatment, lesions larger than 10 mm, and adequate MRI quality were enrolled from July 2020 to September 2021 in a university teaching hospital. All participants underwent preoperative multiparametric MRI, including APTw MRI and DWI. The mean APTw and apparent diffusion coefficient (ADC) values of the primary tumor were measured independently by two radiologists. Receiver operating characteristic curves were generated to evaluate the diagnostic performance of these quantitative parameters. Results In total, 83 participants (mean age, 64 years ± 13 [SD]; 72 men) were evaluated: 51 with high-grade and 32 with low-grade bladder cancer. High-grade bladder cancer showed higher APTw values (6% [IQR, 4%-12%] vs 2% [IQR, 1%-3%]; P < .001) and lower ADC values (0.92 × 10-3 mm2/sec ± 0.17 vs 1.21 × 10-3 mm2/sec ± 0.25; P < .001) than low-grade bladder cancer. The area under the receiver operating characteristic curve (AUC) of APTw and ADC for differentiating low- and high-grade bladder cancer was similar (0.84 for both; P = .94). Moreover, the combination of the two techniques improved the diagnostic performance (AUC, 0.93; all P = .01). Conclusion The combination of amide proton transfer-weighted and diffusion-weighted MRI has the potential to improve the histologic characterization of bladder cancer by differentiating low- from high-grade cancers. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Milot in this issue.
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Affiliation(s)
- Huanjun J Wang
- From the Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080, PR China (H.J.W., Q.C., Y.H., M.L., Z.W., Y.L., L.O., Y.G.); and Department of MR Research, GE Healthcare, Beijing, PR China (L.Q.)
| | - Qian Cai
- From the Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080, PR China (H.J.W., Q.C., Y.H., M.L., Z.W., Y.L., L.O., Y.G.); and Department of MR Research, GE Healthcare, Beijing, PR China (L.Q.)
| | - Yiping P Huang
- From the Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080, PR China (H.J.W., Q.C., Y.H., M.L., Z.W., Y.L., L.O., Y.G.); and Department of MR Research, GE Healthcare, Beijing, PR China (L.Q.)
| | - Meiqin Q Li
- From the Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080, PR China (H.J.W., Q.C., Y.H., M.L., Z.W., Y.L., L.O., Y.G.); and Department of MR Research, GE Healthcare, Beijing, PR China (L.Q.)
| | - Zhihua H Wen
- From the Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080, PR China (H.J.W., Q.C., Y.H., M.L., Z.W., Y.L., L.O., Y.G.); and Department of MR Research, GE Healthcare, Beijing, PR China (L.Q.)
| | - Yingyu Y Lin
- From the Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080, PR China (H.J.W., Q.C., Y.H., M.L., Z.W., Y.L., L.O., Y.G.); and Department of MR Research, GE Healthcare, Beijing, PR China (L.Q.)
| | - Longyuan Y Ouyang
- From the Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080, PR China (H.J.W., Q.C., Y.H., M.L., Z.W., Y.L., L.O., Y.G.); and Department of MR Research, GE Healthcare, Beijing, PR China (L.Q.)
| | - Long Qian
- From the Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080, PR China (H.J.W., Q.C., Y.H., M.L., Z.W., Y.L., L.O., Y.G.); and Department of MR Research, GE Healthcare, Beijing, PR China (L.Q.)
| | - Yan Guo
- From the Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080, PR China (H.J.W., Q.C., Y.H., M.L., Z.W., Y.L., L.O., Y.G.); and Department of MR Research, GE Healthcare, Beijing, PR China (L.Q.)
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22
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Xue C, Yuan J, Zhou Y, Wong OL, Cheung KY, Yu SK. Acquisition repeatability of MRI radiomics features in the head and neck: a dual-3D-sequence multi-scan study. Vis Comput Ind Biomed Art 2022; 5:10. [PMID: 35359245 PMCID: PMC8971276 DOI: 10.1186/s42492-022-00106-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/23/2022] [Indexed: 02/08/2023] Open
Abstract
Radiomics has increasingly been investigated as a potential biomarker in quantitative imaging to facilitate personalized diagnosis and treatment of head and neck cancer (HNC), a group of malignancies associated with high heterogeneity. However, the feature reliability of radiomics is a major obstacle to its broad validity and generality in application to the highly heterogeneous head and neck (HN) tissues. In particular, feature repeatability of radiomics in magnetic resonance imaging (MRI) acquisition, which is considered a crucial confounding factor of radiomics feature reliability, is still sparsely investigated. This study prospectively investigated the acquisition repeatability of 93 MRI radiomics features in ten HN tissues of 15 healthy volunteers, aiming for potential magnetic resonance-guided radiotherapy (MRgRT) treatment of HNC. Each subject underwent four MRI acquisitions with MRgRT treatment position and immobilization using two pulse sequences of 3D T1-weighed turbo spin-echo and 3D T2-weighed turbo spin-echo on a 1.5 T MRI simulator. The repeatability of radiomics feature acquisition was evaluated in terms of the intraclass correlation coefficient (ICC), whereas within-subject acquisition variability was evaluated in terms of the coefficient of variation (CV). The results showed that MRI radiomics features exhibited heterogeneous acquisition variability and uncertainty dependent on feature types, tissues, and pulse sequences. Only a small fraction of features showed excellent acquisition repeatability (ICC > 0.9) and low within-subject variability. Multiple MRI scans improved the accuracy and confidence of the identification of reliable features concerning MRI acquisition compared to simple test-retest repeated scans. This study contributes to the literature on the reliability of radiomics features with respect to MRI acquisition and the selection of reliable radiomics features for use in modeling in future HNC MRgRT applications.
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Affiliation(s)
- Cindy Xue
- Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Jing Yuan
- Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China.
| | - Yihang Zhou
- Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Oi Lei Wong
- Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Kin Yin Cheung
- Medical Physics Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Siu Ki Yu
- Medical Physics Department, Hong Kong Sanatorium & Hospital, Hong Kong, China
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23
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Juan CJ, Huang TY, Liu YJ, Shen WC, Wang CW, Hsu K, Shin N, Chang RF. Improving diagnosing performance for malignant parotid gland tumors using machine learning with multifeatures based on diffusion-weighted magnetic resonance imaging. NMR IN BIOMEDICINE 2022; 35:e4642. [PMID: 34738671 DOI: 10.1002/nbm.4642] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/18/2021] [Accepted: 10/10/2021] [Indexed: 06/13/2023]
Abstract
In this study, the performance of machine learning in classifying parotid gland tumors based on diffusion-related features obtained from the parotid gland tumor, the peritumor parotid gland, and the contralateral parotid gland was evaluated. Seventy-eight patients participated in this study and underwent magnetic resonance diffusion-weighted imaging. Three regions of interest, including the parotid gland tumor, the peritumor parotid gland, and the contralateral parotid gland, were manually contoured for 92 tumors, including 20 malignant tumors (MTs), 42 Warthin tumors (WTs), and 30 pleomorphic adenomas (PMAs). We recorded multiple apparent diffusion coefficient (ADC) features and applied a machine-learning method with the features to classify the three types of tumors. With only mean ADC of tumors, the area under the curve of the classification model was 0.63, 0.85, and 0.87 for MTs, WTs, and PMAs, respectively. The performance metrics were improved to 0.81, 0.89, and 0.92, respectively, with multiple features. Apart from the ADC features of parotid gland tumor, the features of the peritumor and contralateral parotid glands proved advantageous for tumor classification. Combining machine learning and multiple features provides excellent discrimination of tumor types and can be a practical tool in the clinical diagnosis of parotid gland tumors.
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Affiliation(s)
- Chun-Jung Juan
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
- Department of Medical Imaging, China Medical University Hsinchu Hospital, Hsinchu, Taiwan, Republic of China
- Department of Radiology, School of Medicine, China Medical University, Taichung, Taiwan, Republic of China
- Department of Medical Imaging, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Teng-Yi Huang
- Department of Electrical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan, Republic of China
| | - Yi-Jui Liu
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan, Republic of China
| | - Wu-Chung Shen
- Department of Radiology, School of Medicine, China Medical University, Taichung, Taiwan, Republic of China
- Department of Medical Imaging, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Chih-Wei Wang
- Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Kang Hsu
- Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Nieh Shin
- Department of Pathology and Graduate Institute of Pathology and Parasitology, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ruey-Feng Chang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
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24
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Liu Z, Zou L, Yang Q, Qian L, Li T, Luo H, Che C, Lei Y, Chen P, Qiu C, Liu X, Wu Y, Luo D. Baseline Amide Proton Transfer Imaging at 3T Fails to Predict Early Response to Induction Chemotherapy in Nasopharyngeal Carcinoma. Front Oncol 2022; 12:822756. [PMID: 35211414 PMCID: PMC8861375 DOI: 10.3389/fonc.2022.822756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/14/2022] [Indexed: 12/24/2022] Open
Abstract
Background Early identification of nasopharyngeal carcinoma (NPC) patients with high risk of failure to induction chemotherapy (IC) would facilitate prompt individualized treatment decisions and thus reduce toxicity and improve overall survival rate. This study aims to investigate the value of amide proton transfer (APT) imaging in predicting short-term response of NPC to IC and its potential correlation with well-established prognosis-related clinical characteristics. Methods and Materials A total of 80 pathologically confirmed NPC patients receiving pre-treatment APT imaging at 3T were retrospectively enrolled. Using asymmetry analysis, APT maps were calculated with mean (APTmean), 90th percentile (APT90) of APT signals in manually segmented NPC measured. APT values were compared among groups with different histopathological subtypes, clinical stages (namely, T, M, N, and overall stages), EBV-related indices (EBV-DNA), or responses to induction chemotherapy, using Mann–Whitney U test or Kruskal–Wallis H test. Results NPC showed significantly higher APTmean than normal nasopharyngeal tissues (1.81 ± 0.62% vs.1.32 ± 0.56%, P <0.001). APT signals showed no significant difference between undifferentiated and differentiated NPC subtypes groups, different EBV-DNA groups, or among T, N, M stages and overall clinical stages of II, III, IVA and IVB (all P >0.05). Similarly, baseline APT-related parameters did not differ significantly among different treatment response groups after IC, no matter if evaluated with RECIST criteria or sum volumetric regression ratio (SVRR) (all P >0.05). Conclusion NPC showed significantly stronger APT effect than normal nasopharyngeal tissue, facilitating NPC lesion detection and early identification. However, stationary baseline APT values exhibited no significant correlation with histologic subtypes, clinical stages and EBV-related indices, and showed limited value to predict short-term treatment response to IC.
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Affiliation(s)
- Zhou Liu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Liyan Zou
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Qian Yang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Long Qian
- MR Research, GE Healthcare, Beijing, China
| | - Tianran Li
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Honghong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Canwen Che
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Yuanyuan Lei
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Peng Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Chunyan Qiu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Xin Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yin Wu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Dehong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Perlman O, Farrar CT, Heo HY. MR fingerprinting for semisolid magnetization transfer and chemical exchange saturation transfer quantification. NMR IN BIOMEDICINE 2022; 36:e4710. [PMID: 35141967 PMCID: PMC9808671 DOI: 10.1002/nbm.4710] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/18/2022] [Accepted: 02/04/2022] [Indexed: 05/11/2023]
Abstract
Chemical exchange saturation transfer (CEST) MRI has positioned itself as a promising contrast mechanism, capable of providing molecular information at sufficient resolution and amplified sensitivity. However, it has not yet become a routinely employed clinical technique, due to a variety of confounding factors affecting its contrast-weighted image interpretation and the inherently long scan time. CEST MR fingerprinting (MRF) is a novel approach for addressing these challenges, allowing simultaneous quantitation of several proton exchange parameters using rapid acquisition schemes. Recently, a number of deep-learning algorithms have been developed to further boost the performance and speed of CEST and semi-solid macromolecule magnetization transfer (MT) MRF. This review article describes the fundamental theory behind semisolid MT/CEST-MRF and its main applications. It then details supervised and unsupervised learning approaches for MRF image reconstruction and describes artificial intelligence (AI)-based pipelines for protocol optimization. Finally, practical considerations are discussed, and future perspectives are given, accompanied by basic demonstration code and data.
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Affiliation(s)
- Or Perlman
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Christian T. Farrar
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Hye-Young Heo
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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Li J, Lin L, Gao X, Li S, Cheng J. Amide Proton Transfer Weighted and Intravoxel Incoherent Motion Imaging in Evaluation of Prognostic Factors for Rectal Adenocarcinoma. Front Oncol 2022; 11:783544. [PMID: 35047400 PMCID: PMC8761907 DOI: 10.3389/fonc.2021.783544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives To analyze the value of amide proton transfer (APT) weighted and intravoxel incoherent motion (IVIM) imaging in evaluation of prognostic factors for rectal adenocarcinoma, compared with diffusion weighted imaging (DWI). Materials and Methods Preoperative pelvic MRI data of 110 patients with surgical pathologically confirmed diagnosis of rectal adenocarcinoma were retrospectively evaluated. All patients underwent high-resolution T2-weighted imaging (T2WI), APT, IVIM, and DWI. Parameters including APT signal intensity (APT SI), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADC) were measured in different histopathologic types, grades, stages, and structure invasion statuses. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy, and the corresponding area under the curves (AUCs) were calculated. Results APT SI, D and ADC values of rectal mucinous adenocarcinoma (MC) were significantly higher than those of rectal common adenocarcinoma (AC) ([3.192 ± 0.661%] vs. [2.333 ± 0.471%], [1.153 ± 0.238×10-3 mm2/s] vs. [0.792 ± 0.173×10-3 mm2/s], and [1.535 ± 0.203×10-3 mm2/s] vs. [0.986 ± 0.124×10-3 mm2/s], respectively; all P<0.001). In AC group, the APT SI and D values showed significant differences between low- and high-grade tumors ([2.226 ± 0.347%] vs. [2.668 ± 0.638%], and [0.842 ± 0.148×10-3 mm2/s] vs. [0.777 ± 0.178×10-3 mm2/s], respectively, both P<0.05). The D value had significant difference between positive and negative extramural vascular invasion (EMVI) tumors ([0.771 ± 0.175×10-3 mm2/s] vs. [0.858 ± 0.151×10-3 mm2/s], P<0.05). No significant difference of APT SI, D, D*, f or ADC was observed in different T stages, N stages, perineural and lymphovascular invasions (all P>0.05). The ROC curves showed that the AUCs of APT SI, D and ADC values for distinguishing MC from AC were 0.921, 0.893 and 0.995, respectively. The AUCs of APT SI and D values in distinguishing low- from high-grade AC were 0.737 and 0.663, respectively. The AUC of the D value for evaluating EMVI involvement was 0.646. Conclusion APT and IVIM were helpful to assess the prognostic factors related to rectal adenocarcinoma, including histopathological type, tumor grade and the EMVI status.
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Affiliation(s)
- Juan Li
- Department of Magnetic Resonance Imaging (MRI), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liangjie Lin
- Advanced Technical Support, Philips Healthcare, Beijing, China
| | - Xuemei Gao
- Department of Magnetic Resonance Imaging (MRI), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shenglei Li
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging (MRI), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Bae YJ, Kim H, Cha W, Choi BS. Primary pharyngeal synovial sarcoma in a pediatric patient: A case report. Medicine (Baltimore) 2021; 100:e28411. [PMID: 34967377 PMCID: PMC8718205 DOI: 10.1097/md.0000000000028411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/06/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Synovial sarcoma is a rare malignant tumor that typically originates from the soft tissue of the extremities. The occurrence of primary pharyngeal synovial sarcoma is even rarer, and few studies have reported its radiological features. Here, we report a case of pediatric primary pharyngeal synovial sarcoma and describe the conventional and advanced magnetic resonance imaging (MRI) findings with pathologic correlation. PATIENT CONCERNS An 11-year-old girl presented to the otolaryngologic clinic with dysphagia. DIAGNOSIS Laryngoscopy revealed a large mass in the oropharynx. MRI revealed a well-defined soft tissue mass with a maximal diameter of approximately 5 cm originating from the submucosal space of the oropharynx. The mass was primarily solid and showed homogeneous contrast-enhancement. The mass was hypointense on T1-weighted images and hyperintense on T2-weighted images. The mass showed a homogeneously low apparent diffusion coefficient value on diffusion-weighted imaging, which indicated high tumor cellularity. Dynamic contrast-enhanced MRI revealed a hypovascular tumor with low values of the volume transfer constant between the extracellular extravascular space and blood plasma and blood plasma volume per unit tissue volume. Amide proton transfer-weighted MRI revealed a relatively high amide proton transfer signal in the tumor, indicating a high protein/peptide component. The patient underwent partial surgical resection of the tumor, and the diagnosis of biphasic synovial sarcoma was confirmed on postoperative pathological examination. INTERVENTION The patient was started on chemotherapy with vincristine, ifosfamide, doxorubicin, and etoposide. OUTCOMES The tumor did not respond to the 3 cycles of the chemotherapy. Thus, the patient underwent second surgery and subsequent radiation therapy. The patient is now under ifosfamide/carboplatin/etoposide chemotherapy. LESSON Synovial sarcoma should be considered in the differential diagnosis of pediatric oropharyngeal submucosal tumors. Multimodal MRI may aid diagnosis, although the final diagnosis should be based on the postoperative pathological examination findings.
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Affiliation(s)
- Yun Jung Bae
- Department of Radiology, Seongnam, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
| | - Hyojin Kim
- Department of Pathology, Seongnam, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
| | - Wonjae Cha
- Department of Otorhinolaryngology-Head and Neck Surgery, Seongnam, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
| | - Byung Se Choi
- Department of Radiology, Seongnam, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
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Li Y, Liu X, Wang X, Lin C, Qi Y, Chen B, Zhou H, Wu Q, Ren J, Zhao J, Yang J, Xiang Y, He Y, Jin Z, Xue H. Using amide proton transfer-weighted MRI to non-invasively differentiate mismatch repair deficient and proficient tumors in endometrioid endometrial adenocarcinoma. Insights Imaging 2021; 12:182. [PMID: 34894294 PMCID: PMC8665952 DOI: 10.1186/s13244-021-01126-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To investigate the utility of three-dimensional (3D) amide proton transfer-weighted (APTw) imaging to differentiate mismatch repair deficient (dMMR) and mismatch repair proficient (pMMR) tumors in endometrioid endometrial adenocarcinoma (EEA). METHODS Forty-nine patients with EEA underwent T1-weighted imaging, T2-weighted imaging, 3D APTw imaging, and diffusion-weighted imaging at 3 T MRI. Image quality and measurement confidence of APTw images were evaluated on a 5-point Likert scale. APTw and apparent diffusion coefficient (ADC) values were calculated and compared between the dMMR and pMMR groups and among the three EEA histologic grades based on the Federation of Gynecology and Obstetrics (FIGO) grading system criteria. Student's t-test, analysis of variance with Scheffe post hoc test, and receiver operating characteristic analysis were performed. Statistical significance was set at p < 0.05. RESULTS Thirty-five EEA patients (9 with dMMR tumors and 26 with pMMR tumors) with good image quality were enrolled in quantitative analysis. APTw values were significantly higher in the dMMR group than in the pMMR group (3.2 ± 0.3% and 2.8 ± 0.5%, respectively; p = 0.019). ADC values of the dMMR and pMMR groups were 0.874 ± 0.104 × 10-3 mm2/s and 0.903 ± 0.100 × 10-3 mm2/s, respectively. No significant between-group difference was noted (p = 0.476). No statistically significant differences were observed in APTw values or ADC values among the three histologic grades (p = 0.766 and p = 0.295, respectively). CONCLUSIONS APTw values may be used as potential imaging markers to differentiate dMMR from pMMR tumors in EEA.
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Affiliation(s)
- Yuan Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, People's Republic of China
| | - Xinyu Liu
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Xiaoqi Wang
- Philips Healthcare China, Beijing, People's Republic of China
| | - Chengyu Lin
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Yafei Qi
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Bo Chen
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Hailong Zhou
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Qiaoling Wu
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Jing Ren
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Jia Zhao
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China
| | - Junjun Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, People's Republic of China
| | - Yang Xiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, People's Republic of China
| | - Yonglan He
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China.
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China.
| | - Huadan Xue
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuai Fu Yuan 1#, Dongcheng Dist., Beijing, 100730, People's Republic of China.
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Song Q, Chen P, Chen X, Sun C, Wang J, Tan B, Liu H, Cheng Y. Dynamic Change of Amide Proton Transfer Imaging in Irradiated Nasopharyngeal Carcinoma and Related Histopathological Mechanism. Mol Imaging Biol 2021; 23:846-853. [PMID: 33876335 DOI: 10.1007/s11307-021-01607-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the dynamic change of amide proton transfer (APT) imaging before and after irradiation in nasopharyngeal carcinoma (NPC) and the underlying histopathological mechanism. MATERIALS AND METHODS Tumor-bearing BALB/C nude mouse models were established and randomly divided into three groups: high-dose group (20 Gy/2 fractions), low-dose group (10 Gy/2 fractions), and control group (0 Gy). MRI scanning was performed before irradiation and 3rd, 6th, and 9th day post-irradiation. Scanning sequence included T1 weighted, T2 weighted, and APT. HE staining and TUNEL immunofluorescence detection were performed to detect necrosis and apoptosis. RESULTS After high-dose irradiation, the mean tumor APT values decreased significantly on the 3rd day and 6th day (from 3.83 before radiotherapy to 2.41%, P < 0.001, 3rd day; from 2.41 to 1.80%, P = 0.001, 6th day). For low-dose irradiation, the mean tumor APT values decreased slightly on the 3rd day and 6th day (from 3.52 to 3.13%, P = 0.109, 3rd day; from 3.13 to 3.05%, P = 0.64, 6th day). The mean APT values of nonirradiated tumor changed slightly. In contrast, the average volume of high-dose irradiated tumors did not decrease obviously until the 9th day post-irradiation (from 290 before radiotherapy to 208 mm3 on the 9th day). The low-dose irradiated tumors showed slow growth, and the nonirradiated tumors showed rapid growth. Subsequent HE staining and TUNEL staining showed obvious necrosis characteristics and higher proportion of positive apoptotic cell nucleus in high-dose irradiated tumors, but not nonirradiated tumors. CONCLUSION The APT signal intensity decreased after irradiation, which is earlier than the change of tumor volume. What is more, the decrease of APT signal intensity is more significant in high-dose group. Histological analysis showed obvious apoptosis and necrosis histological characteristic in irradiated tumor, which may explain the decrease of APT signal intensity. These results indicate that APT imaging has the potential to serve as a reliable biomarker for response assessment in NPC.
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Affiliation(s)
- Qingxu Song
- Department of Radiation Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Pengxiang Chen
- Department of Radiation Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Xin Chen
- Department of MR, Shandong Medical Imaging Research Institute, Jinan, Shandong, People's Republic of China
| | - Cong Sun
- Department of MR, Shandong Medical Imaging Research Institute, Jinan, Shandong, People's Republic of China
| | - Jianbo Wang
- Department of Radiation Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Bingxu Tan
- Department of Radiation Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Hong Liu
- Department of Radiation Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Yufeng Cheng
- Department of Radiation Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China.
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Guo Z, Jiang Y, Qin X, Mu R, Meng Z, Zhuang Z, Liu F, Zhu X. Amide Proton Transfer-Weighted MRI Might Help Distinguish Amnestic Mild Cognitive Impairment From a Normal Elderly Population. Front Neurol 2021; 12:707030. [PMID: 34712196 PMCID: PMC8545995 DOI: 10.3389/fneur.2021.707030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To evaluate whether 3D amide proton transfer weighted (APTw) imaging based on magnetization transfer analysis can be used as a novel imaging marker to distinguish amnestic mild cognitive impairment (aMCI) patients from the normal elderly population by measuring changes in APTw signal intensity in the hippocampus and amygdala. Materials and Methods: Seventy patients with aMCI and 74 age- and sex-matched healthy volunteers were recruited for routine MRI and APT imaging examinations. Magnetic transfer ratio asymmetry (MTRasym) of the amide protons (at 3.5 ppm), or APTw values, were measured in the bilateral hippocampus and amygdala on three consecutive cross-sectional APT images and were compared between the aMCI and control groups. The independent sample t-test was used to evaluate the difference in APTw values of the bilateral hippocampus and amygdala between the aMCI and control groups. Receiver operator characteristic analysis was used to assess the diagnostic performance of the APTw. The paired t-test was used to assess the difference in APTw values between the left and right hippocampus and amygdala, in both the aMCI and control groups. Results: The APTw values of the bilateral hippocampus and amygdala in the aMCI group were significantly higher than those in the control group (left hippocampus 1.01 vs. 0.77% p < 0.001; right hippocampus 1.02 vs. 0.74%, p < 0.001; left amygdala 0.98 vs. 0.70% p < 0.001; right amygdala 0.94 vs. 0.71%, p < 0.001). The APTw values of the left amygdala had the largest AUC (0.875) at diagnosis of aMCI. There was no significant difference in APTw values between the left and right hippocampus and amygdala, in either group. (aMCI group left hippocampus 1.01 vs. right hippocampus 1.02%, p = 0.652; healthy control group left hippocampus 0.77 vs. right hippocampus 0.74%, p = 0.314; aMCI group left amygdala 0.98 vs. right amygdala 0.94%, p = 0.171; healthy control group left amygdala 0.70 vs. right amygdala 0.71%, p = 0.726). Conclusion: APTw can be used as a new imaging marker to distinguish aMCI patients from the normal elderly population by indirectly reflecting the changes in protein content in the hippocampus and amygdala.
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Affiliation(s)
- Zixuan Guo
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Yanchun Jiang
- Department of Neurology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Xiaoyan Qin
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Ronghua Mu
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Zhuoni Meng
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Zeyu Zhuang
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Fuzhen Liu
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Xiqi Zhu
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
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Chen Y, Wang X, Su T, Xu Z, Wang Y, Zhang Z, Xue H, Zhuo Z, Zhu Y, Jin Z, Zhang T. Feasibility evaluation of amide proton transfer-weighted imaging in the parotid glands: a strategy to recognize artifacts and measure APT value. Quant Imaging Med Surg 2021; 11:2279-2291. [PMID: 34079701 DOI: 10.21037/qims-20-675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The feasibility and image quality of three-dimensional (3D) amide proton transfer (APT)-weighted (APTw) in parotid tumor lesions have not been well established in previous studies. This study aimed to evaluate the utility of APT imaging in parotid lesions and glands. Methods Patients with parotid lesions received 3D turbo spin echo (TSE) APTw on a 3.0T scanner. Two radiologists, who were blinded to the clinical data, independently evaluated the APTw image quality using 4-point Likert scales (1= poor, 4= excellent) in terms of integrity and hyperintensity artifacts. An image quality selection protocol was built based on the two scores. Evaluable images (integrity score >1) and trustable images (integrity score >3 and hyperintensity artifacts score >2) were then enrolled for APTw value comparison between parotid lesions and glands. Results Forty consecutive patients were included in this study. Four patients were excluded due to severe motion (n=3) or dental (n=1) artifacts, and 36 patients received the APT sequence. Among these, more parotid tumor lesions (34/36, 94.4%) than normal parotid glands (23/31, 74.2%) revealed excellent integrity scores (score =4) (P=0.034). Most parotid tumor lesions (24/34, 70.6%) and glands (16/28, 57.1%) revealed no or little hyperintensity artifacts for diagnosis (scores 3 and 4). APT values of parotid lesions and glands in the evaluable groups were 2.11%±1.15% and 1.60%±1.56%, respectively, and the difference was not significant (P=0.197). APT values of parotid lesions and glands in the trustable groups were 1.99%±1.18% and 1.03%±1.09%, respectively, and the difference was statistically significant (P=0.018). Conclusions 3D APTw could be used to differentiate parotid tumors and normal parotid glands; however, the technology still needs to be improved to remove artifacts. In our study, most APTw images of tumor lesions in parotid glands had acceptable image quality, and these APTw images are feasible for diagnostic use.
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Affiliation(s)
- Yu Chen
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Tong Su
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhentan Xu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yunting Wang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhuhua Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Huadan Xue
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Yuanli Zhu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Tao Zhang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Mamoune KE, Barantin L, Adriaensen H, Tillet Y. Application of Chemical Exchange Saturation Transfer (CEST) in neuroimaging. J Chem Neuroanat 2021; 114:101944. [PMID: 33716103 DOI: 10.1016/j.jchemneu.2021.101944] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/14/2022]
Abstract
Since the early eighties MRI has become the most powerful technic for in-vivo imaging particularly in the field of brain research. This non-invasive method allows acute anatomical observations of the living brain similar to post-mortem dissected tissues. However, one of the main limitation of MRI is that it does not make possible the neurochemical identification of the tissues conversely to positron emission tomography scanner which can provide a specific molecular characterization of tissue, in spite of poor anatomical definition. To gain neurochemical information using MRI, new categories of contrast agents were developed from the beginning of the 2000's, particularly using the chemical-exchange saturation transfer (CEST) method. This method induces a significant change in the magnitude of the water proton signal and allows the detection of specific molecules within the tissues like sugars, amino acids, transmitters, and nucleosides. This short review presents several CEST contrast agents and their recent developments for in vivo detection of metabolites and neurotransmitters in the brain for research and clinical purposes.
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Affiliation(s)
- Kahina El Mamoune
- Physiologie de la Reproduction et des Comportements, UMR 085 INRAE, CNRS 7247, Université de Tours, IFCE, Centre INRAE Val de Loire, 37380 Nouzilly, France; Siemens Healthcare SAS, Saint Denis, France; SFR FED 4226, Université de Tours, 2 Bd Tonnellé, 37032 Tours, France
| | - Laurent Barantin
- iBrain, UMR 1253 INSERM, Université de Tours, 10 Bd Tonnellé, 37032 Tours, France; SFR FED 4226, Université de Tours, 2 Bd Tonnellé, 37032 Tours, France
| | - Hans Adriaensen
- Physiologie de la Reproduction et des Comportements, UMR 085 INRAE, CNRS 7247, Université de Tours, IFCE, Centre INRAE Val de Loire, 37380 Nouzilly, France; CIRE UMR 085 INRAE, CNRS 7247, Université de Tours, IFCE, Centre INRAE Val de Loire, 37380 Nouzilly, France; SFR FED 4226, Université de Tours, 2 Bd Tonnellé, 37032 Tours, France
| | - Yves Tillet
- Physiologie de la Reproduction et des Comportements, UMR 085 INRAE, CNRS 7247, Université de Tours, IFCE, Centre INRAE Val de Loire, 37380 Nouzilly, France; SFR FED 4226, Université de Tours, 2 Bd Tonnellé, 37032 Tours, France.
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Differentiating malignant from benign salivary gland lesions: a multiparametric non-contrast MR imaging approach. Sci Rep 2021; 11:2780. [PMID: 33531644 PMCID: PMC7854671 DOI: 10.1038/s41598-021-82455-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/19/2021] [Indexed: 02/08/2023] Open
Abstract
The purpose of this study is to determine whether multiparametric non-contrast MR imaging including diffusion-weighted imaging (DWI), arterial spin labeling (ASL), and amide proton transfer (APT) weighted imaging can help differentiate malignant from benign salivary gland lesions. The study population consisted of 42 patients, with 31 benign and 11 malignant salivary gland lesions. All patients were evaluated using DWI, three-dimensional pseudo-continuous ASL, and APT-weighted imaging on 3 T MR imaging before treatment. Apparent diffusion coefficient (ADC), tumor blood flow (TBF), and APT-related signal intensity (APTSI) values within the lesion were compared between the malignant and benign lesions by Mann–Whitney U test. For each parameter, optimal cutoff values were chosen using a threshold criterion that maximized the Youden index for predicting malignant lesions. The performance of ADC, TBF, APTSI, individually and combined, was evaluated in terms of diagnostic ability for malignant lesions. Diagnostic performance was compared by McNemar test. APTSI was significantly higher in malignant lesions (2.18 ± 0.89%) than in benign lesions (1.57 ± 1.09%, p = 0.047). There was no significant difference in ADC or TBF between benign and malignant lesions (p = 0.155 and 0.498, respectively). The accuracy of ADC, TBF, and APTSI for diagnosing malignant lesions was 47.6%, 50.0%, and 66.7%, respectively; whereas the accuracy of the three parameters combined was 85.7%, which was significantly higher than that of each parameter alone (p = 0.001, 0.001, and 0.008, respectively). Therefore, the combination of ADC, TBF, and APTSI can help differentiate malignant from benign salivary gland lesions.
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Ai QYH, Zhang H, Jiang B, So TY, Mo FKF, Qamar S, Chen W, King AD. Test-retest repeatability of T1rho (T1ρ) MR imaging in the head and neck. Eur J Radiol 2020; 135:109489. [PMID: 33395595 DOI: 10.1016/j.ejrad.2020.109489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE T1rho imaging is a new quantitative MRI sequence for head and neck cancer and the repeatability for this region is unknown. This study aimed to evaluate the repeatability of quantitative T1rho imaging in the head and neck. MATERIALS AND METHODS T1rho imaging of the head and neck was prospectively performed in 15 healthy participants on three occasions. Scan 1 and 2 were performed with a time interval of 30 minutes (intra-session) and scan 3 was performed 14 days later (inter-session). T1rho values for normal tissues (parotid glands, palatine tonsils, pterygoid muscles, and tongue) were obtained on each scan. Intra-class coefficients (ICCs), within-subject coefficient of variances (wCoVs), and repeatability coefficient (RCs) of the intra-session scan (scan 1 vs 2) and inter-session scan (scan 1 vs 3) for the normal tissues were calculated. RESULTS The ICCs of T1rho values for normal tissues were almost perfect (0.83-0.97) for intra-session scans and were substantial (0.71-0.80) for inter-session scans. The wCoVs showed a small range (2.46%-3.30%) for intra-session scans, and slightly greater range (3.27%-6.51%) for inter-session scan. The greatest and lowest wCoVs of T1rho were found in the parotid gland and muscles, respectively. The T1rho RCs varied for all tissues between intra- and inter- sessions, and the greatest RC of 10.07 msec was observed for parotid gland on inter-session scan. CONCLUSION T1rho imaging is a repeatable quantitative MRI sequence in the head and neck but variances of T1rho values among tissues should be take into account during analysis.
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Affiliation(s)
- Qi Yong H Ai
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong.
| | - Huimin Zhang
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Baiyan Jiang
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Tiffany Y So
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Frankie K F Mo
- Department of Clinical Oncology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Sahrish Qamar
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Weitian Chen
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Ann D King
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
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Non-invasive Differentiation of Endometrial Adenocarcinoma from Benign Lesions in the Uterus by Utilization of Amide Proton Transfer-Weighted MRI. Mol Imaging Biol 2020; 23:446-455. [PMID: 33185840 DOI: 10.1007/s11307-020-01565-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/16/2020] [Accepted: 11/05/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE To evaluate the utility of three-dimensional (3D) amide proton transfer-weighted (APTw) imaging for differentiation of endometrial adenocarcinoma and uterine benign lesions. PROCEDURES This prospective study enrolled 22 normal volunteers and 113 patients with suspicious uterine lesions, including endometrial adenocarcinoma, leiomyoma, and adenomyosis. Pelvic APTw MRI was performed on a 3-T MRI scanner with default APTw parameters. Two radiologists blindly evaluated uterine lesion APTw image quality by a 3-point Likert scale and independently measured APTw values on images with excellent to good image quality. Inter-reader agreement was evaluated. The Mann-Whitney U test with Bonferroni correction was used to compare the differences among different types of uterine lesions. A receiver operating characteristic analysis was performed. RESULTS A total of 111 lesions (33 endometrial adenocarcinoma, 26 leiomyoma, and 52 adenomyosis lesions) from 99 patients revealing a majority of good quality with excellent inter-reader agreement were included for the image quality evaluation. APTw values of endometrial adenocarcinoma were 2.9 ± 0.1 %, significantly higher than those of leiomyoma (1.9 ± 0.1 %), adenomyosis (2.2 ± 0.1 %), and normal uterine myometrium (1.9 ± 0.1 %) (all p < 0.0001). The area under the receiver operating characteristic curve for differentiating endometrial adenocarcinoma from leiomyoma, adenomyosis, and myometrium was 0.87, 0.85, and 0.91, respectively. Feasible threshold APTw values of each group were determined as 2.4 %, 2.7 %, and 2.4 % with a sensitivity of 83.3 %, 76.7 %, and 83.3 % and a specificity of 83.3 %, 81.6 %, and 86.4 %, respectively. CONCLUSIONS Malignant endometrial adenocarcinoma had significantly higher APTw values than leiomyoma, adenomyosis, and normal uterine myometrium. Our study adds to the growing body of validation on 3D APTw imaging and uterine lesions.
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Three-dimension amide proton transfer MRI of rectal adenocarcinoma: correlation with pathologic prognostic factors and comparison with diffusion kurtosis imaging. Eur Radiol 2020; 31:3286-3296. [PMID: 33125558 DOI: 10.1007/s00330-020-07397-1] [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: 04/15/2020] [Revised: 09/23/2020] [Accepted: 10/08/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To investigate the utility of 3D amide proton transfer (APT) MRI in predicting pathologic factors for rectal adenocarcinoma, in comparison with diffusion kurtosis imaging. METHODS Sixty-one patients with rectal adenocarcinoma were enrolled in this prospective study. 3D APT and diffusion kurtosis imaging (DKI) were performed. Mean APT-weighted signal intensity (APTw SI), mean kurtosis (MK), mean diffusivity (MD), and ADC values of tumors were calculated on these maps. Pathological analysis included WHO grades, pT stages, pN stages, and extramural venous invasion (EMVI) status. Student's t test, Spearman correlation, and receiver operating characteristics (ROC) analysis were used for statistical analysis. RESULTS High-grade rectal adenocarcinoma showed significantly higher mean APTw SI and MK values (2.771 ± 0.384 vs 2.108 ± 0.409, 1.167 ± 0.216 vs 1.045 ± 0.175, respectively; p < 0.05). T3 rectal adenocarcinoma demonstrated higher mean APTw SI and MK than T2 tumors (2.433 ± 0.467 vs 1.900 ± 0.302, p < 0.05). No kurtosis, diffusivity, and ADC differences were found between T2 and T3 tumors. Tumors with lymph node metastasis and EMVI involvement showed significantly higher mean APTw SI, MK. No difference was found in diffusivity and ADC between pN0 and pN1-2 groups, and EMVI-negative and EMVI-positive statuses. Mean APTw SI exhibited a significantly high positive correlation with WHO grades, demonstrating 92.31% sensitivity and 79.17% specificity for distinguishing low- from high-grade rectal adenocarcinoma, providing a better diagnostic capacity than MK, MD, and mean ADC values. CONCLUSION 3D-APT could serve as a non-invasive biomarker for evaluating prognostic factors of rectal adenocarcinoma. KEY POINTS • Mean APTw SI was significantly higher in high-grade compared to low-grade rectal adenocarcinoma. • Mean APTw SI was significantly higher in T3 stage rectal adenocarcinoma, with lymph node metastasis, or in EMVI-positive status. • APTw SI exhibited greater diagnostic capability in discriminating low-grade from high-grade rectal adenocarcinoma, compared with kurtosis, diffusivity, and ADC.
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Li G, Jiang G, Mei Y, Gao P, Liu R, Jiang M, Zhao Y, Li M, Wu Y, Fu S, Liu M, Li L, Li W, Yan J. Applying Amide Proton Transfer-Weighted Imaging (APTWI) to Distinguish Papillary Thyroid Carcinomas and Predominantly Solid Adenomatous Nodules: Comparison With Diffusion-Weighted Imaging. Front Oncol 2020; 10:918. [PMID: 32637356 PMCID: PMC7317983 DOI: 10.3389/fonc.2020.00918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 05/11/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Amide proton transfer-weighted (ATPw) imaging is a novel MRI technique that has been used to identify benign and malignant tumors. The present study evaluated the role of APTw imaging in differentiating papillary thyroid carcinoma from predominantly solid adenomatous nodule. Methods: This study included 24 cases of solitary papillary thyroid carcinoma, and 20 cases of solid adenomatous nodules. Normal thyroid tissues were examined in 12 healthy subjects. The healthy subjects, eight cases of adenomatous nodule with cystic degeneration, and 12 cases of thyroid goiter, were only considered in the descriptive analysis, not included in our statistical analysis. The mean APTw value and the apparent diffusion coefficients (ADCs) of papillary thyroid carcinoma and solid adenomatous nodule were compared via a Mann-Whitney U test and receiver operating characteristic (ROC)-curve analyses. Results: The adenomatous nodule (3.3 ± 1.3%) exhibited significantly higher APTw value (p < 0.05) than that of the papillary thyroid carcinoma (1.8 ± 0.7%). The optimal cut-off value of the mean APTw value in differentiating papillary thyroid carcinoma from adenomatous nodule was 3.15%, with a sensitivity of 60% and a specificity of 100%. The mean ADC of papillary thyroid carcinoma (1.2 ± 0.2 × 10−3 mm2/s) was significantly lower than that of adenomatous nodule (2.0 ± 0.4 × 10−3 mm2/s). The optimal cut-off value of the mean ADC was 1.35 × 10−3 mm2/s, with a sensitivity of 100% and a specificity of 75%. Based on the ROC-curve analysis of APT and ADC, the ADC showed a higher area under the curve (AUC) than that of APT (AUCAPT = 0.84, AUCADC = 0.95). Conclusion: APTw imaging may be as useful as DWI for the differentiation of papillary thyroid carcinoma from predominantly solid adenomatous nodule. Although the sensitivity of ADC was greater than that of APT, APT had greater specificity.
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Affiliation(s)
- Guomin Li
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guihua Jiang
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | | | - Peng Gao
- Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Ruijian Liu
- Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Min Jiang
- Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yue Zhao
- Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Meng Li
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yunfan Wu
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Shishun Fu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Mengchen Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Liming Li
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Wuming Li
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jianhao Yan
- The Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
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Qamar S, King AD, Ai QYH, Mo FKF, Chen W, Poon DMC, Tong M, Ma BB, Yeung DKW, Wang YX, Yuan J. Pre-treatment amide proton transfer imaging predicts treatment outcome in nasopharyngeal carcinoma. Eur Radiol 2020; 30:6339-6347. [DOI: 10.1007/s00330-020-06985-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/25/2020] [Accepted: 05/26/2020] [Indexed: 01/08/2023]
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MRI monitoring of energy storage in vivo using magnetization pathways. Proc Natl Acad Sci U S A 2020; 117:5092-5094. [PMID: 32111689 DOI: 10.1073/pnas.2001048117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Touska P, Connor SEJ. Recent advances in MRI of the head and neck, skull base and cranial nerves: new and evolving sequences, analyses and clinical applications. Br J Radiol 2019; 92:20190513. [PMID: 31529977 PMCID: PMC6913354 DOI: 10.1259/bjr.20190513] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 12/14/2022] Open
Abstract
MRI is an invaluable diagnostic tool in the investigation and management of patients with pathology of the head and neck. However, numerous technical challenges exist, owing to a combination of fine anatomical detail, complex geometry (that is subject to frequent motion) and susceptibility effects from both endogenous structures and exogenous implants. Over recent years, there have been rapid developments in several aspects of head and neck imaging including higher resolution, isotropic 3D sequences, diffusion-weighted and diffusion-tensor imaging as well as permeability and perfusion imaging. These have led to improvements in anatomic, dynamic and functional imaging. Further developments using contrast-enhanced 3D FLAIR for the delineation of endolymphatic structures and black bone imaging for osseous structures are opening new diagnostic avenues. Furthermore, technical advances in compressed sensing and metal artefact reduction have the capacity to improve imaging speed and quality, respectively. This review explores novel and evolving MRI sequences that can be employed to evaluate diseases of the head and neck, including the skull base.
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Affiliation(s)
- Philip Touska
- Department of Radiology, Guy’s and St. Thomas’ NHS Foundation Trust, Guy’s Hospital, Great Maze Pond, London, SE1 9RT, United Kingdom
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Variation of amide proton transfer signal intensity and apparent diffusion coefficient values among phases of the menstrual cycle in the normal uterus: A preliminary study. Magn Reson Imaging 2019; 63:21-28. [DOI: 10.1016/j.mri.2019.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 07/13/2019] [Indexed: 12/19/2022]
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Li B, Sun H, Zhang S, Wang X, Guo Q. The utility of APT and IVIM in the diagnosis and differentiation of squamous cell carcinoma of the cervix: A pilot study. Magn Reson Imaging 2019; 63:105-113. [DOI: 10.1016/j.mri.2019.08.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 06/14/2019] [Accepted: 08/15/2019] [Indexed: 11/26/2022]
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Lin Y, Luo X, Yu L, Zhang Y, Zhou J, Jiang Y, Zhang C, Zhang J, Li C, Chen M. Amide proton transfer-weighted MRI for predicting histological grade of hepatocellular carcinoma: comparison with diffusion-weighted imaging. Quant Imaging Med Surg 2019; 9:1641-1651. [PMID: 31728308 DOI: 10.21037/qims.2019.08.07] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver, preoperative grading of HCC is of great clinical significance. Amide proton transfer-weighted (APTw) imaging, as a novel contrast mechanism in the field of molecular imaging, provided new diagnostic ideas for the grading of HCC. Methods Between May 2017 and April 2018, 32 consecutive patients with pathologically confirmed HCC were enrolled, including 19 high-grade HCCs and 13 low-grade HCCs. DWI and APTw scanning was performed on a 3T MRI scanner. Two observers drew regions of interest independently by referring to the axial T2-weighted imaging, and APTw and apparent diffusion coefficient (ADC) values were obtained. Inter- and intra-observer agreements were assessed with the intraclass correlation coefficients (ICCs). The independent sample t test was used to compare the APTw and ADC values between the high- and low-grade HCC tumor parenchyma. The receiver operating characteristic curve was used to analyze the diagnostic efficacy of high- from low-grade HCC tumors. Spearman correlation analysis was used to assess the relationship between APTw and ADC values and HCC histological grades. Results There were significant differences between the APTw or ADC values for the high- and low-grade HCCs (P=0.034 and 0.010). Both APTw and DWI had good diagnostic performance in differentiating the high- from the low-grade HCCs, with areas under the curves of 0.814 and 0.745, respectively. Moderate correlations existed between APTw values and histological grades (r=0.534; P=0.002), as well as ADC values and histological grades (r=-0.417; P=0.018). Conclusions The APTw imaging is a useful imaging biomarker that complements DWI for the more accurate and comprehensive HCC characterization.
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Affiliation(s)
- Yue Lin
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China.,Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Xiaojie Luo
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Lu Yu
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China.,Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Yi Zhang
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou 310058, China
| | - Jinyuan Zhou
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Yuwei Jiang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Chen Zhang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Jintao Zhang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Chunmei Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China.,Graduate School of Peking Union Medical College, Beijing 100730, China
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Amide Proton Transfer-weighted MRI in the Diagnosis of Major Salivary Gland Tumors. Sci Rep 2019; 9:8349. [PMID: 31171835 PMCID: PMC6554276 DOI: 10.1038/s41598-019-44820-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/24/2019] [Indexed: 01/09/2023] Open
Abstract
Amide proton transfer-weighted magnetic resonance imaging (APTw-MRI), which is effective in tumor characterization, has expanded its role in the head and neck. We aimed to evaluate the diagnostic ability of APTw-MRI in differentiating malignant from benign major salivary gland tumors compared with diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE)-MRI. Between December 2017 and November 2018, 38 subjects, who were diagnosed with major salivary gland tumors and who underwent preoperative 3 T MRI, including APTw-MRI, DWI, and DCE-MRI, were included in this retrospective study. Twenty-three subjects had benign tumors, and fifteen had malignancies. APTw-signals of the tumors were measured and compared according to the histopathological diagnosis. Using receiver operating characteristic curve analysis, diagnostic performance of APTw-MRI was evaluated and compared with DWI and DCE-MRI using DeLong test. The maximum, mean, and median APTw-signals were significantly higher in malignant than in benign tumors (P < 0.001). The mean and maximum APTw-signals showed excellent area under the curve for predicting malignant tumors (0.948 and 0.939), which were significantly higher than the combining use of DWI and DCE-MRI (0.780) (P = 0.021 and 0.028). Therefore, APTw-MRI could be a useful tool for differentiating malignant from benign major salivary gland tumors, and can be applicable in the clinical setting.
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Meng N, Wang J, Sun J, Liu W, Wang X, Yan M, Dwivedi A, Zheng D, Wang K, Han D. Using amide proton transfer to identify cervical squamous carcinoma/adenocarcinoma and evaluate its differentiation grade. Magn Reson Imaging 2019; 61:9-15. [PMID: 31071471 DOI: 10.1016/j.mri.2019.05.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/28/2019] [Accepted: 05/04/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE To explore the possibility of using amide proton transfer-weighted imaging (APTWI) for the identification and diagnosis of cervical squamous carcinoma (CSC), cervical adenocarcinoma (CA) and different levels of CSC. MATERIALS AND METHODS Seventy-six patients with newly diagnosed uterine cervical cancer (UCC) were studied prior to treatment, including 20 with poorly differentiated (Grade 3) CSC, 23 with moderately differentiated (Grade 2) CSC, 17 with well-differentiated (Grade 1) CSC, and 16 with CA (13 with poorly differentiated (Grade 3) CA and 3 with moderately differentiated (Grade 2) CA). Differences in the magnetization transfer ratio at 3.5 ppm (MTRasym (3.5 ppm)) were identified between CSC and CA and between high-level (Grade 3) CSC and low-level (Grade 2 and Grade 1) CSC, as well as among all three grades of CSC differentiation. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic thresholds and performance of the parameters. Spearman correlation analysis was used to examine the correlation between the MTRasym (3.5 ppm) and histological grade. RESULTS The MTRasym (3.5 ppm) in CA was higher than that in CSC (P = 0.001). The MTRasym (3.5 ppm) in high-level CSC was higher than that in low-level CSC (P = 0.001). The MTRasym (3.5 ppm) was positively correlated with the grade of CSC differentiation (r = 0.498, P = 0.001). The MTRasym (3.5 ppm) in Grade 3 CSC was higher than that in Grade 2 and Grade 1 CSC (P = 0.02/0.01). No significant difference in the MTRasym (3.5 ppm) was found between Grade 2 CSC and Grade 1 CSC (P = 0.173). The area under the ROC curve (AUC) for the MTRasym (3.5 ppm) in distinguishing CSC and CA was 0.779, with a cut-off, sensitivity, and specificity of 2.97%, 60.0% and 82.5%, respectively. The AUC for distinguishing high-/low-level CSC was 0.756, with a cut-off, sensitivity, and specificity of 3.29%, 68.8% and 83.3%, respectively. CONCLUSION APTWI may be a useful technique for the identification and diagnosis of CSC, CA and different levels of CSC, which may have an important impact on clinical strategies for treating patients with UCC.
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Affiliation(s)
- Nan Meng
- Department of MR, the First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui 453100, PR China
| | - Jing Wang
- Department of MR, the First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui 453100, PR China
| | - Jing Sun
- Department of Pediatrics, Zhengzhou Central Hospital, Zhengzhou University, 195 Tongbai Road, Zhengzhou 450000, PR China
| | - Wenling Liu
- Department of MR, the First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui 453100, PR China
| | - Xuejia Wang
- Department of MR, the First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui 453100, PR China
| | - Minghuan Yan
- Department of MR, the First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui 453100, PR China
| | - Akshay Dwivedi
- Department of MR, the First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui 453100, PR China
| | - Dandan Zheng
- MR Research China, GE Healthcare, Beijing 100000, PR China
| | - Kaiyu Wang
- MR Research China, GE Healthcare, Beijing 100000, PR China.
| | - Dongming Han
- Department of MR, the First Affiliated Hospital, Xinxiang Medical University, 88 Jiankang Road, Weihui 453100, PR China.
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He Y, Li Y, Lin C, Qi Y, Wang X, Zhou H, Yang J, Xiang Y, Xue H, Jin Z. Three‐dimensional turbo‐spin‐echo amide proton transfer‐weighted mri for cervical cancer: A preliminary study. J Magn Reson Imaging 2019; 50:1318-1325. [DOI: 10.1002/jmri.26710] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 12/24/2022] Open
Affiliation(s)
- Yong‐Lan He
- Department of Radiology, Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical Sciences Beijing PR China
| | - Yuan Li
- Department of OB&GYN, Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical Sciences Beijing PR China
| | - Cheng‐Yu Lin
- Department of Radiology, Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical Sciences Beijing PR China
| | - Ya‐Fei Qi
- Department of Radiology, Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical Sciences Beijing PR China
| | | | - Hai‐Long Zhou
- Department of Radiology, Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical Sciences Beijing PR China
| | - Jun‐Jun Yang
- Department of OB&GYN, Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical Sciences Beijing PR China
| | - Yang Xiang
- Department of OB&GYN, Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical Sciences Beijing PR China
| | - Hua‐Dan Xue
- Department of Radiology, Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical Sciences Beijing PR China
| | - Zheng‐Yu Jin
- Department of Radiology, Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical Sciences Beijing PR China
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Qamar S, King AD, Ai QY, Law BKH, Chan JSM, Poon DMC, Tong M, Mo FKF, Chen W, Bhatia KS, Ahuja AT, Ma BBY, Yeung DKW, Wang YX, Yuan J. Amide proton transfer MRI detects early changes in nasopharyngeal carcinoma: providing a potential imaging marker for treatment response. Eur Arch Otorhinolaryngol 2018; 276:505-512. [DOI: 10.1007/s00405-018-5231-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 11/28/2018] [Indexed: 01/05/2023]
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Choi SH. Can Amide Proton Transfer MRI Distinguish Benign and Malignant Head and Neck Tumors? Radiology 2018; 288:791-792. [DOI: 10.1148/radiol.2018180914] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Liu R, Jiang G, Gao P, Li G, Nie L, Yan J, Jiang M, Duan R, Zhao Y, Luo J, Yin Y, Li C. Non-invasive Amide Proton Transfer Imaging and ZOOM Diffusion-Weighted Imaging in Differentiating Benign and Malignant Thyroid Micronodules. Front Endocrinol (Lausanne) 2018; 9:747. [PMID: 30631303 PMCID: PMC6315121 DOI: 10.3389/fendo.2018.00747] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 11/26/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Pre-operative non-invasive differentiation of benign and malignant thyroid nodules is difficult for doctors. This study aims to determine whether amide proton transfer (APT) imaging and zonally oblique multi-slice (ZOOM) diffusion-weighted imaging (DWI) can provide increased accuracy in differentiating benign and malignant thyroid nodules. Methods: This retrospective study was approved by the institutional review board and included 60 thyroid nodules in 50 patients. All of the nodules were classified as malignant (n = 21) or benign (n = 39) based on pathology. It was meaningful to analyze the APT and apparent diffusion coefficient (ADC) values of the two groups by independent t-test to identify the benign and malignant thyroid nodules. The relationship between APT and ZOOM DWI was explored through Pearson correlation analysis. The diagnostic efficacy of APT and ZOOM DWI in determining if thyroid nodules were benign or malignant was compared using receiver operating characteristic (ROC) curve analysis. Results: The mean APTw value of the benign nodules was 2.99 ± 0.79, while that of the malignant nodules was 2.14 ± 0.73. Additionally, there was a significant difference in the APTw values of the two groups (P < 0.05). The mean ADC value of the benign nodules was 1.84 ± 0.41, and was significantly different from that of the malignant nodules, which was 1.21 ± 0.19 (P < 0.05). Scatter point and Pearson test showed a moderate positive correlation between the APT and ADC values (P < 0.05). The ROC curve showed that the area under the curve (AUC) value of ZOOM DWI (AUC = 0.937) was greater than that of APT (AUC = 0.783) (P = 0.028). Conclusion: APT and ZOOM DWI imaging improved the accuracy of distinguishing between benign and malignant thyroid nodules. ZOOM DWI is superior to APTw imaging (Z = 2.198, P < 0.05).
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Affiliation(s)
- Ruijian Liu
- Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guihuang Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Peng Gao
- Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guoming Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Linghui Nie
- Guangdong Traditional Medical and Sports Injury Rehabilitation Research Institute, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jianhao Yan
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Min Jiang
- Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Renpeng Duan
- Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yue Zhao
- Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jinxian Luo
- Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yi Yin
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Cheng Li
- Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China
- Guangdong Traditional Medical and Sports Injury Rehabilitation Research Institute, Guangdong Second Provincial General Hospital, Guangzhou, China
- *Correspondence: Cheng Li
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