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Tang C, Li F, He L, Hu Q, Qin Y, Yan X, Ai T. Comparison of continuous-time random walk and fractional order calculus models in characterizing breast lesions using histogram analysis. Magn Reson Imaging 2024; 108:47-58. [PMID: 38307375 DOI: 10.1016/j.mri.2024.01.012] [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: 08/11/2023] [Revised: 11/11/2023] [Accepted: 01/22/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To compare the diagnostic performance of different mathematical models for DWI and explore whether parameters reflecting spatial and temporal heterogeneity can demonstrate better diagnostic accuracy than the diffusion coefficient parameter in distinguishing benign and malignant breast lesions, using whole-tumor histogram analysis. METHODS This retrospective study was approved by the institutional ethics committee and included 104 malignant and 42 benign cases. All patients underwent breast magnetic resonance imaging (MRI) with a 3.0 T MR scanner using the simultaneous multi-slice (SMS) readout-segment ed echo-planar imaging (rs-EPI). Histogram metrics of Mono- apparent diffusion coefficient (ADC), CTRW, and FROC-derived parameters were compared between benign and malignant breast lesions, and the diagnostic performance of each diffusion parameter was evaluated. Statistical analysis was performed using Mann-Whitney U test and receiver operating characteristic (ROC) curve. RESULTS The DFROC-median exhibited the highest AUC for distinguishing benign and malignant breast lesions (AUC = 0.965). The temporal heterogeneity parameter αCTRW-median generated a statistically higher AUC compared to the spatial heterogeneity parameter βCTRW-median (AUC = 0.850 and 0.741, respectively; p = 0.047). Finally, the combination of median values of CTRW parameters displayed a slightly higher AUC than that of FROC parameters, with no significant difference however (AUC = 0.971 and 0.965, respectively; p = 0.172). CONCLUSIONS The diffusion coefficient parameter exhibited superior diagnostic performance in distinguishing breast lesions when compared to the temporal and spatial heterogeneity parameters.
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Affiliation(s)
- Caili Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Feng Li
- Department of Radiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei 441021, China
| | - Litong He
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Qilan Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yanjin Qin
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xu Yan
- MR Research Collaboration Team, Siemens Healthineers Ltd, 278, Zhouzhu Road, Nanhui, Shanghai 201318, China
| | - Tao Ai
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Acosta-Falomir MJ, Angulo-Lozano JC, Sanchez-Musi LF, Soria Céspedes D, Fernández de Lara Barrera Y. Detection of High-Grade Prostate Cancer With a Super High B-value (4000 s/mm2) in Diffusion-Weighted Imaging Sequences by Magnetic Resonance Imaging. Cureus 2022; 14:e22807. [PMID: 35399424 PMCID: PMC8980248 DOI: 10.7759/cureus.22807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: High-grade adenocarcinoma of the prostate tends to have denser glandular structures and a prominent desmoplastic reaction, which could be detected by magnetic resonance imaging (MRI) with a super-high b-value in diffusion-weighted imaging (DWI) sequence, to differentiate it from low-grade carcinomas. Objective: To evaluate the diagnostic validity of the diffusion sequence with values of b4000 s/mm2 for the diagnosis of high-grade prostate cancer (Gleason score ≥ 7). Materials and methods: It is a retrospective analytical study of male patients who have undergone a prostate biopsy and count with a prostate MRI with a DWI sequence of a super-high b-value (4000 s/mm2). Results: The sensitivity of the diffusion sequence with b4000 s/mm2 values to classify as positive for prostate cancer was 57.14% as compared to biopsy. The specificity of the diffusion sequence with b4000 s/mm2 values classifying patients with prostate carcinoma as negative was 84.62%. The probability that the diffusion sequence with b4000 s/mm2 values classifies patients with prostate cancer was 80%. The probability that the diffusion sequence with b4000 s/mm2 values does not classify patients with prostate cancer was 64.71%. The proportion of patients adequately classified with prostate cancer using the diffusion sequence with b4000 s/mm2 values was 70.37%. Conclusions: The study shows that using the diffusion sequence with values of b4000 s/mm2 is an optimal value that serves as a tool to be able to decant those high-risk carcinomas with those of low risk; however, it is not a definitive method of diagnosis that could replace the performance of a biopsy. Since the study sample was limited, these results cannot be interpreted as reliable for diagnosing high-grade prostate cancer and should encourage future studies on a larger scale population to obtain significant evidence for a non-invasive diagnostic tool with a better cost-benefit for the patient.
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Abstract
This review article is written as a contribution to the special issue presented in conjunction with the 100th anniversary of Acta Radiologica.An overview is given of what has happened with and in the journal during the 15 years from 2003 to 2017 and a resume is provided concerning the handling and flow of manuscripts, manuscript publication, scientific prizes awarded by the journal, and finally the process leading up to establishing the new open-access journal Acta Radiologica Short Reports/Acta Radiologica Open.
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Affiliation(s)
- Arnulf Skjennald
- Professor Emeritus, University of Oslo, University Hospital, Oslo, Norway
- Chief Editor Emeritus, Acta Radiologica, Oslo, Norway
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Walker SM, Fernandez M, Turkbey B. Advances in Prostate Magnetic Resonance Imaging. Magn Reson Imaging Clin N Am 2020; 28:407-414. [PMID: 32624158 DOI: 10.1016/j.mric.2020.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Prostate magnetic resonance (MR) imaging is a widely used imaging technique to detect intraprostatic lesions and guide prostate biopsies, with continuous technical advances for better accuracy in prostate cancer diagnosis. Current evaluation of prostate multiparametric MR imaging mainly depends on qualitative evaluation, which is prone to inter-reader variation. Recent advances in prostate MR imaging, such as quantitative T2 mapping and abbreviated MR imaging protocols (eg, biparametric MR imaging), are designed to simplify prostate MR imaging acquisition and interpretation.
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Affiliation(s)
- Stephanie M Walker
- Molecular Imaging Program, NCI, NIH, 10 Center Drive, Building 10, Room B3B85, Bethesda, MD 20814, USA
| | - Martina Fernandez
- Molecular Imaging Program, NCI, NIH, 10 Center Drive, Building 10, Room B3B85, Bethesda, MD 20814, USA; Department of Radiology, Hospital Alemán, Buenos Aires, Argentina
| | - Baris Turkbey
- Molecular Imaging Program, NCI, NIH, 10 Center Drive, Building 10, Room B3B85, Bethesda, MD 20814, USA.
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Engels RR, Israël B, Padhani AR, Barentsz JO. Multiparametric Magnetic Resonance Imaging for the Detection of Clinically Significant Prostate Cancer: What Urologists Need to Know. Part 1: Acquisition. Eur Urol 2020; 77:457-468. [DOI: 10.1016/j.eururo.2019.09.021] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/11/2019] [Indexed: 12/12/2022]
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Hectors SJ, Said D, Gnerre J, Tewari A, Taouli B. Luminal Water Imaging: Comparison With Diffusion-Weighted Imaging (DWI) and PI-RADS for Characterization of Prostate Cancer Aggressiveness. J Magn Reson Imaging 2020; 52:271-279. [PMID: 31961049 DOI: 10.1002/jmri.27050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/14/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Luminal water imaging (LWI), a multicomponent T2 mapping technique, has shown promise for prostate cancer (PCa) detection and characterization. PURPOSE To 1) quantify LWI parameters and apparent diffusion coefficient (ADC) in PCa and benign peripheral zone (PZ) tissues; and 2) evaluate the diagnostic performance of LWI, ADC, and PI-RADS parameters for differentiation between low- and high-grade PCa lesions. STUDY TYPE Prospective. SUBJECTS Twenty-six PCa patients undergoing prostatectomy (mean age 59 years, range 46-72 years). FIELD STRENGTH/SEQUENCE Multiparametric MRI at 3.0T, including diffusion-weighted imaging (DWI) and LWI T2 mapping. ASSESSMENT LWI parameters and ADC were quantified in index PCa lesions and benign PZ. STATISTICAL TESTS Differences in MRI parameters between PCa and benign PZ were assessed using Wilcoxon signed tests. Spearman correlation of pathological grade group (GG) with LWI parameters, ADC, and PI-RADS was evaluated. The utility of each of the parameters for differentiation between low-grade (GG ≤2) and high-grade (GG ≥3) PCa was determined by Mann-Whitney U tests and ROC analyses. RESULTS Twenty-six index lesions were analyzed (mean size 1.7 ± 0.8 cm, GG: 1 [n = 1; 4%], 2 [n = 14, 54%], 3 [n = 8, 31%], 5 [n = 3, 12%]). LWI parameters and ADC both showed high diagnostic performance for differentiation between benign PZ and PCa (highest area under the curve [AUC] for LWI parameter T2,short [AUC = 0.98, P < 0.001]). The LWI parameters luminal water fraction (LWF) and amplitude of long T2 component Along significantly correlated with GG (r = -0.441, P = 0.024 and r = -0.414, P = 0.036, respectively), while PI-RADS, ADC, and the other LWI parameters did not (P = 0.132-0.869). LWF and Along also showed significant differences between low-grade and high-grade PCa (AUC = 0.776, P = 0.008 and AUC = 0.758, P = 0.027, respectively). Maximum diagnostic performance for discrimination of high-grade PCa was found with combined LWI parameters (AUC 0.891, P = 0.001). DATA CONCLUSION LWI parameters, in particular in combination, showed superior diagnostic performance for differentiation between low-grade and high-grade PCa compared to ADC and PI-RADS assessment. J. Magn. Reson. Imaging 2020;52:271-279.
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Affiliation(s)
- Stefanie J Hectors
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Daniela Said
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Universidad de los Andes, Santiago, Chile
| | - Jeffrey Gnerre
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ashutosh Tewari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bachir Taouli
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Xing NZ, Wang MS, Fu Q, Yang FY, Li CL, Li YJ, Han SJ, Xiao ZJ, Ping H. Feasibility of prostatectomy without prostate biopsy in the era of new imaging technology and minimally invasive techniques. World J Clin Cases 2019; 7:1403-1409. [PMID: 31363468 PMCID: PMC6656670 DOI: 10.12998/wjcc.v7.i12.1403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/25/2019] [Accepted: 05/11/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Routinely, after receiving prostate specific antigen (PSA) testing and digital rectum examination, patients with suspected prostate cancer are required to undergo prostate biopsy. However, the ability of ultrasound-guided prostate biopsy to detect prostate cancer is limited. Nowadays, a variety of diagnostic methods and more sensitive diagnostic methods, such as multi-parameter prostate magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) can be applied clinically. Furthermore, laparoscopic/robot-assisted prostatectomy is also a safe and effective procedure for the treatment of benign prostatic hyperplasia. So maybe it is time to reconsider the necessary to perform prostate biopsy before radical prostatectomy.
AIM To explore the feasibility of radical prostatectomy without prostate biopsy in the era of new imaging technology and minimally invasive techniques.
METHODS From June 2014 to November 2018, 11 cases of laparoscopic radical prostatectomy without prostate biopsy were performed at the three tertiary medical centers involved in this study. All patients received prostate magnetic resonance imaging and prostate cancer was suspected, including six patients with positive 68Ga-PSMA PET/CT results. Laparoscopic radical prostatectomy and pelvic lymph node dissection were performed for all patients.
RESULTS All surgeries were accomplished successfully. The mean age was 69 ± 7.7 year, the mean body mass index was 24.7 ± 1.6 kg/m2, the range of serum PSA was 4.3 to >1000 ng/mL, and the mean prostate volume was 40.9 ± 18.3 mL. The mean operative time was 96 ± 23.3 min, the mean estimated blood loss was 90 ± 90.9 mL, and the median duration of catheter placement was 14 d. The final pathology confirmed that all specimens were prostate cancer except one case of benign prostatic hyperplasia. No major complications occurred in 90 d postoperatively.
CONCLUSION The current practice of mandating a prostatic biopsy before prostatectomy should be reconsidered in the era of new imaging technology and minimally invasive techniques. Radical prostatectomy could be carried out without the evidence of malignancy. Large-sample randomized controlled trials are definitely required to confirm the feasibility of this new concept.
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Affiliation(s)
- Nian-Zeng Xing
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ming-Shuai Wang
- Institute of Urology, Capital Medical University, Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Qiang Fu
- Department of Urology, Shandong Provincial Hospital, Jinan 250021, Shandong Province, China
| | - Fei-Ya Yang
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Chang-Ling Li
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ya-Jian Li
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Su-Jun Han
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ze-Jun Xiao
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Hao Ping
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
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Radiological prizes awarded in 2018. Acta Radiol 2019. [DOI: 10.1177/0284185119835168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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9
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García-Figueiras R, Baleato-González S, Padhani AR, Luna-Alcalá A, Vallejo-Casas JA, Sala E, Vilanova JC, Koh DM, Herranz-Carnero M, Vargas HA. How clinical imaging can assess cancer biology. Insights Imaging 2019; 10:28. [PMID: 30830470 PMCID: PMC6399375 DOI: 10.1186/s13244-019-0703-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/08/2018] [Indexed: 02/07/2023] Open
Abstract
Human cancers represent complex structures, which display substantial inter- and intratumor heterogeneity in their genetic expression and phenotypic features. However, cancers usually exhibit characteristic structural, physiologic, and molecular features and display specific biological capabilities named hallmarks. Many of these tumor traits are imageable through different imaging techniques. Imaging is able to spatially map key cancer features and tumor heterogeneity improving tumor diagnosis, characterization, and management. This paper aims to summarize the current and emerging applications of imaging in tumor biology assessment.
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Affiliation(s)
- Roberto García-Figueiras
- Department of Radiology, Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706, Santiago de Compostela, Spain.
| | - Sandra Baleato-González
- Department of Radiology, Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706, Santiago de Compostela, Spain
| | - Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England, HA6 2RN, UK
| | - Antonio Luna-Alcalá
- Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH, USA
- MRI Unit, Clínica Las Nieves, Health Time, Jaén, Spain
| | - Juan Antonio Vallejo-Casas
- Unidad de Gestión Clínica de Medicina Nuclear. IMIBIC. Hospital Reina Sofía. Universidad de Córdoba, Córdoba, Spain
| | - Evis Sala
- Department of Radiology and Cancer Research UK Cambridge Center, Cambridge, CB2 0QQ, UK
| | - Joan C Vilanova
- Department of Radiology, Clínica Girona and IDI, Lorenzana 36, 17002, Girona, Spain
| | - Dow-Mu Koh
- Department of Radiology, Royal Marsden Hospital & Institute of Cancer Research, Fulham Road, London, SW3 6JJ, UK
| | - Michel Herranz-Carnero
- Nuclear Medicine Department, Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706, Santiago de Compostela, Galicia, Spain
- Molecular Imaging Program, IDIS, USC, Santiago de Compostela, Galicia, Spain
| | - Herbert Alberto Vargas
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, Radiology, 1275 York Av. Radiology Academic Offices C-278, New York, NY, 10065, USA
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10
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Press RH, Shu HKG, Shim H, Mountz JM, Kurland BF, Wahl RL, Jones EF, Hylton NM, Gerstner ER, Nordstrom RJ, Henderson L, Kurdziel KA, Vikram B, Jacobs MA, Holdhoff M, Taylor E, Jaffray DA, Schwartz LH, Mankoff DA, Kinahan PE, Linden HM, Lambin P, Dilling TJ, Rubin DL, Hadjiiski L, Buatti JM. The Use of Quantitative Imaging in Radiation Oncology: A Quantitative Imaging Network (QIN) Perspective. Int J Radiat Oncol Biol Phys 2018; 102:1219-1235. [PMID: 29966725 PMCID: PMC6348006 DOI: 10.1016/j.ijrobp.2018.06.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 05/25/2018] [Accepted: 06/14/2018] [Indexed: 02/07/2023]
Abstract
Modern radiation therapy is delivered with great precision, in part by relying on high-resolution multidimensional anatomic imaging to define targets in space and time. The development of quantitative imaging (QI) modalities capable of monitoring biologic parameters could provide deeper insight into tumor biology and facilitate more personalized clinical decision-making. The Quantitative Imaging Network (QIN) was established by the National Cancer Institute to advance and validate these QI modalities in the context of oncology clinical trials. In particular, the QIN has significant interest in the application of QI to widen the therapeutic window of radiation therapy. QI modalities have great promise in radiation oncology and will help address significant clinical needs, including finer prognostication, more specific target delineation, reduction of normal tissue toxicity, identification of radioresistant disease, and clearer interpretation of treatment response. Patient-specific QI is being incorporated into radiation treatment design in ways such as dose escalation and adaptive replanning, with the intent of improving outcomes while lessening treatment morbidities. This review discusses the current vision of the QIN, current areas of investigation, and how the QIN hopes to enhance the integration of QI into the practice of radiation oncology.
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Affiliation(s)
- Robert H. Press
- Dept. of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - Hui-Kuo G. Shu
- Dept. of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - Hyunsuk Shim
- Dept. of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - James M. Mountz
- Dept. of Radiology, University of Pittsburgh, Pittsburgh, PA
| | | | | | - Ella F. Jones
- Dept. of Radiology, University of California, San Francisco, San Francisco, CA
| | - Nola M. Hylton
- Dept. of Radiology, University of California, San Francisco, San Francisco, CA
| | - Elizabeth R. Gerstner
- Dept. of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | - Lori Henderson
- Cancer Imaging Program, National Cancer Institute, Bethesda, MD
| | | | - Bhadrasain Vikram
- Radiation Research Program/Division of Cancer Treatment & Diagnosis, National Cancer Institute, Bethesda, MD
| | - Michael A. Jacobs
- Dept. of Radiology and Radiological Science, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore MD
| | - Matthias Holdhoff
- Brain Cancer Program, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore MD
| | - Edward Taylor
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - David A. Jaffray
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | | | - David A. Mankoff
- Dept. of Radiology, University of Pennsylvania, Philadelphia, PA
| | | | | | - Philippe Lambin
- Dept. of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Thomas J. Dilling
- Dept. of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | | | - John M. Buatti
- Dept. of Radiation Oncology, University of Iowa, Iowa City, IA
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Tang L, Zhou XJ. Diffusion MRI of cancer: From low to high b-values. J Magn Reson Imaging 2018; 49:23-40. [PMID: 30311988 DOI: 10.1002/jmri.26293] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 12/14/2022] Open
Abstract
Following its success in early detection of cerebral ischemia, diffusion-weighted imaging (DWI) has been increasingly used in cancer diagnosis and treatment evaluation. These applications are propelled by the rapid development of novel diffusion models to extract biologically valuable information from diffusion-weighted MR signals, and significant advances in MR hardware that has enabled image acquisition with high b-values. This article reviews recent technical developments and clinical applications in cancer imaging using DWI, with a special emphasis on high b-value diffusion models. The article is organized in four sections. First, we provide an overview of diffusion models that are relevant to cancer imaging. The model parameters are discussed in relation to three tissue properties-cellularity, vascularity, and microstructures. An emphasis is placed on characterization of microstructural heterogeneity, given its novelty and close relevance to cancer. Second, we illustrate diffusion MR clinical applications in each of the following three categories: 1) cancer detection and diagnosis; 2) cancer grading, staging, and classification; and 3) cancer treatment response prediction and evaluation. Third, we discuss several practical issues, including selection of image acquisition parameters, reproducibility and reliability, motion management, image distortion, etc., that are commonly encountered when applying DWI to cancer in clinical settings. Lastly, we highlight a few ongoing challenges and provide some possible future directions, particularly in the area of establishing standards via well-organized multicenter clinical trials to accelerate clinical translation of advanced DWI techniques to improving cancer care on a large scale. Level of Evidence: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:23-40.
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Affiliation(s)
- Lei Tang
- Department of Radiology, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research, Beijing, China
| | - Xiaohong Joe Zhou
- Center for MR Research and Departments of Radiology, Neurosurgery, and Bioengineering, University of Illinois at Chicago, Chicago, Illinois, USA
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12
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Syer TJ, Godley KC, Cameron D, Malcolm PN. The diagnostic accuracy of high b-value diffusion- and T 2-weighted imaging for the detection of prostate cancer: a meta-analysis. Abdom Radiol (NY) 2018; 43:1787-1797. [PMID: 29177924 PMCID: PMC6061488 DOI: 10.1007/s00261-017-1400-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose This study aims to investigate the role of diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI) in combination for the detection of prostate cancer, specifically assessing the role of high b-values (> 1000 s/mm2), with a systematic review and meta-analysis of the existing published data. Methods The electronic databases MEDLINE, EMBASE, and OpenSIGLE were searched between inception and September 1, 2017. Eligible studies were those that reported the sensitivity and specificity of DWI and T2WI for the diagnosis of prostate cancer by visual assessment using a histopathologic reference standard. The QUADAS-2 critical appraisal tool was used to assess the quality of included studies. A meta-analysis with pooling of sensitivity, specificity, likelihood, and diagnostic odds ratios was undertaken, and a summary receiver-operating characteristics (sROC) curve was constructed. Predetermined subgroup analysis was also performed. Results Thirty-three studies were included in the final analysis, evaluating 2949 patients. The pooled sensitivity and specificity were 0.69 (95% CI 0.68–0.69) and 0.84 (95% CI 0.83–0.85), respectively, and the sROC AUC was 0.84 (95% CI 0.81–0.87). Subgroup analysis showed significantly better sensitivity with high b-values (> 1000 s/mm2). There was high statistical heterogeneity between studies. Conclusion The diagnostic accuracy of combined DWI and T2WI is good with high b-values (> 1000 s/mm2) seeming to improve overall sensitivity while maintaining specificity. However, further large-scale studies specifically looking at b-value choice are required before a categorical recommendation can be made. Electronic supplementary material The online version of this article (10.1007/s00261-017-1400-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tom J. Syer
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ UK
| | - Keith C. Godley
- Radiology Department, Norfolk & Norwich University NHS Foundation Trust, Colney Lane, Norfolk Norwich, NR4 7UY UK
| | - Donnie Cameron
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ UK
| | - Paul N. Malcolm
- Radiology Department, Norfolk & Norwich University NHS Foundation Trust, Colney Lane, Norfolk Norwich, NR4 7UY UK
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Min X, Feng Z, Wang L, Cai J, Li B, Ke Z, Zhang P, You H, Yan X. Multi-model Analysis of Diffusion-weighted Imaging of Normal Testes at 3.0 T: Preliminary Findings. Acad Radiol 2018; 25:445-452. [PMID: 29331362 DOI: 10.1016/j.acra.2017.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/01/2017] [Accepted: 11/05/2017] [Indexed: 01/08/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to establish diffusion quantitative parameters (apparent diffusion coefficient [ADC], DDC, α, Dapp, and Kapp) in normal testes at 3.0 T. MATERIALS AND METHODS Sixty-four healthy volunteers in two age groups (A: 10-39 years; B: ≥ 40 years) underwent diffusion-weighted imaging scanning at 3.0 T. ADC1000, ADC2000, ADC3000, DDC, α, Dapp, and Kapp were calculated using the mono-exponential, stretched-exponential, and kurtosis models. The correlations between parameters and the age were analyzed. The parameters were compared between the age groups and between the right and the left testes. RESULTS The average ADC1000, ADC2000, ADC3000, DDC, α, Dapp, and Kapp values did not significantly differ between the right and the left testes (P > .05 for all). The following significant correlations were found: positive correlations between age and testicular ADC1000, ADC2000, ADC3000, DDC, and Dapp (r = 0.516, 0.518, 0.518, 0.521, and 0.516, respectively; P < .01 for all) and negative correlations between age and testicular α and Kapp (r = -0.363, -0.427, respectively; P < .01 for both). Compared to group B, in group A, ADC1000, ADC2000, ADC3000, DDC, and Dapp were significantly lower (P < .05 for all), but α and Kapp were significantly higher (P < .05 for both). CONCLUSIONS Our study demonstrated the applicability of the testicular mono-exponential, stretched-exponential, and kurtosis models. Our results can help establish a baseline for the normal testicular parameters in these diffusion models. The contralateral normal testis can serve as a suitable reference for evaluating the abnormalities of the other side. The effect of age on these parameters requires further attention.
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