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Deng HZ, Zhang HW, Huang B, Deng JH, Luo SP, Li WH, Lei Y, Liu XL, Lin F. Advances in diffuse glioma assessment: preoperative and postoperative applications of chemical exchange saturation transfer. Front Neurosci 2024; 18:1424316. [PMID: 39148521 PMCID: PMC11325484 DOI: 10.3389/fnins.2024.1424316] [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: 04/27/2024] [Accepted: 07/16/2024] [Indexed: 08/17/2024] Open
Abstract
Chemical Exchange Saturation Transfer (CEST) is a technique that uses specific off-resonance saturation pulses to pre-saturate targeted substances. This process influences the signal intensity of free water, thereby indirectly providing information about the pre-saturated substance. Among the clinical applications of CEST, Amide Proton Transfer (APT) is currently the most well-established. APT can be utilized for the preoperative grading of gliomas. Tumors with higher APTw signals generally indicate a higher likelihood of malignancy. In predicting preoperative molecular typing, APTw values are typically lower in tumors with favorable molecular phenotypes, such as isocitrate dehydrogenase (IDH) mutations, compared to IDH wild-type tumors. For differential diagnosis, the average APTw values of meningiomas are significantly lower than those of high-grade gliomas. Various APTw measurement indices assist in distinguishing central nervous system lesions with similar imaging features, such as progressive multifocal leukoencephalopathy, central nervous system lymphoma, solitary brain metastases, and glioblastoma. Regarding prognosis, APT effectively differentiates between tumor recurrence and treatment effects, and also possesses predictive capabilities for overall survival (OS) and progression-free survival (PFS).
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Affiliation(s)
- Hua-Zhen Deng
- Shantou University Medical College, Shantou City, China
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Han-Wen Zhang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Biao Huang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Jin-Huan Deng
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Si-Ping Luo
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Wei-Hua Li
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yi Lei
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xiao-Lei Liu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Fan Lin
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
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Su Y, Cheng R, Guo J, Zhang M, Wang J, Ji H, Wang C, Hao L, He Y, Xu C. Differentiation of glioma and solitary brain metastasis: a multi-parameter magnetic resonance imaging study using histogram analysis. BMC Cancer 2024; 24:805. [PMID: 38969990 PMCID: PMC11225204 DOI: 10.1186/s12885-024-12571-5] [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: 08/09/2023] [Accepted: 06/27/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Differentiation of glioma and solitary brain metastasis (SBM), which requires biopsy or multi-disciplinary diagnosis, remains sophisticated clinically. Histogram analysis of MR diffusion or molecular imaging hasn't been fully investigated for the differentiation and may have the potential to improve it. METHODS A total of 65 patients with newly diagnosed glioma or metastases were enrolled. All patients underwent DWI, IVIM, and APTW, as well as the T1W, T2W, T2FLAIR, and contrast-enhanced T1W imaging. The histogram features of apparent diffusion coefficient (ADC) from DWI, slow diffusion coefficient (Dslow), perfusion fraction (frac), fast diffusion coefficient (Dfast) from IVIM, and MTRasym@3.5ppm from APTWI were extracted from the tumor parenchyma and compared between glioma and SBM. Parameters with significant differences were analyzed with the logistics regression and receiver operator curves to explore the optimal model and compare the differentiation performance. RESULTS Higher ADCkurtosis (P = 0.022), frackurtosis (P<0.001),and fracskewness (P<0.001) were found for glioma, while higher (MTRasym@3.5ppm)10 (P = 0.045), frac10 (P<0.001),frac90 (P = 0.001), fracmean (P<0.001), and fracentropy (P<0.001) were observed for SBM. frackurtosis (OR = 0.431, 95%CI 0.256-0.723, P = 0.002) was independent factor for SBM differentiation. The model combining (MTRasym@3.5ppm)10, frac10, and frackurtosis showed an AUC of 0.857 (sensitivity: 0.857, specificity: 0.750), while the model combined with frac10 and frackurtosis had an AUC of 0.824 (sensitivity: 0.952, specificity: 0.591). There was no statistically significant difference between AUCs from the two models. (Z = -1.14, P = 0.25). CONCLUSIONS The frac10 and frackurtosis in enhanced tumor region could be used to differentiate glioma and SBM and (MTRasym@3.5ppm)10 helps improving the differentiation specificity.
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Affiliation(s)
- Yifei Su
- The Neurosurgery Department of Shanxi Provincial People's Hospital, Shanxi Medical University, Taiyuan, Shanxi, 030012, PR China
- Provincial Key Cultivation Laboratory of Intelligent Big Data Digital Neurosurgery of Shanxi Province, Taiyuan, Shanxi, PR China
| | - Rui Cheng
- The Neurosurgery Department of Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, PR China
- Provincial Key Cultivation Laboratory of Intelligent Big Data Digital Neurosurgery of Shanxi Province, Taiyuan, Shanxi, PR China
| | | | | | - Junhao Wang
- The Neurosurgery Department of Shanxi Provincial People's Hospital, Shanxi Medical University, Taiyuan, Shanxi, 030012, PR China
- Provincial Key Cultivation Laboratory of Intelligent Big Data Digital Neurosurgery of Shanxi Province, Taiyuan, Shanxi, PR China
| | - Hongming Ji
- The Neurosurgery Department of Shanxi Provincial People's Hospital, Shanxi Medical University, Taiyuan, Shanxi, 030012, PR China.
- Provincial Key Cultivation Laboratory of Intelligent Big Data Digital Neurosurgery of Shanxi Province, Taiyuan, Shanxi, PR China.
| | - Chunhong Wang
- The Neurosurgery Department of Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, PR China
- Provincial Key Cultivation Laboratory of Intelligent Big Data Digital Neurosurgery of Shanxi Province, Taiyuan, Shanxi, PR China
| | - Liangliang Hao
- The Radiology Department of Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, PR China
| | - Yexin He
- The Radiology Department of Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, PR China
| | - Cheng Xu
- The Radiology Department of Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, PR China.
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Tanaka F, Maeda M, Nakayama R, Inoue K, Kishi S, Kogue R, Umino M, Kitano Y, Obara M, Sakuma H. A Combination of Amide Proton Transfer, Tumor Blood Flow, and Apparent Diffusion Coefficient Histogram Analysis Is Useful for Differentiating Malignant from Benign Intracranial Tumors in Young Patients: A Preliminary Study. Diagnostics (Basel) 2024; 14:1236. [PMID: 38928651 PMCID: PMC11202847 DOI: 10.3390/diagnostics14121236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/06/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
PURPOSE To evaluate the amide proton transfer (APT), tumor blood flow (TBF), and apparent diffusion coefficient (ADC) combined diagnostic value for differentiating intracranial malignant tumors (MTs) from benign tumors (BTs) in young patients, as defined by the 2021 World Health Organization classification of central nervous system tumors. METHODS Fifteen patients with intracranial MTs and 10 patients with BTs aged 0-30 years underwent MRI with APT, pseudocontinuous arterial spin labeling (pCASL), and diffusion-weighted imaging. All tumors were evaluated through the use of histogram analysis and the Mann-Whitney U test to compare 10 parameters for each sequence between the groups. The diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS The APT maximum, mean, 10th, 25th, 50th, 75th, and 90th percentiles were significantly higher in MTs than in BTs; the TBF minimum (min) was significantly lower in MTs than in BTs; TBF kurtosis was significantly higher in MTs than in BTs; the ADC min, 10th, and 25th percentiles were significantly lower in MTs than in BTs (all p < 0.05). The APT 50th percentile (0.900), TBF min (0.813), and ADC min (0.900) had the highest area under the curve (AUC) values of the parameters in each sequence. The AUC for the combination of these three parameters was 0.933. CONCLUSIONS The combination of APT, TBF, and ADC evaluated through histogram analysis may be useful for differentiating intracranial MTs from BTs in young patients.
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Affiliation(s)
- Fumine Tanaka
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu 5148507, Mie, Japan
| | - Masayuki Maeda
- Department of Neuroradiology, Mie University School of Medicine, 2-174 Edobashi, Tsu 5148507, Mie, Japan
| | - Ryohei Nakayama
- Department of Electronic and Computer Engineering, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu 5250058, Shiga, Japan
| | - Katsuhiro Inoue
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu 5148507, Mie, Japan
| | - Seiya Kishi
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu 5148507, Mie, Japan
| | - Ryota Kogue
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu 5148507, Mie, Japan
| | - Maki Umino
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu 5148507, Mie, Japan
| | - Yotaro Kitano
- Department of Neurosurgery, Mie University School of Medicine, 2-174 Edobashi, Tsu 5148507, Mie, Japan
| | - Makoto Obara
- MR Clinical Science, Philips Japan, 2-13-37 Konan, Minato 1088507, Tokyo, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu 5148507, Mie, Japan
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Li Y, Zhang Y, Tian L, Li J, Li H, Wang X, Wang C. 3D amide proton transfer-weighted imaging may be useful for diagnosing early-stage breast cancer: a prospective monocentric study. Eur Radiol Exp 2024; 8:41. [PMID: 38584248 PMCID: PMC10999404 DOI: 10.1186/s41747-024-00439-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/17/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND We investigated the value of three-dimensional amide proton transfer-weighted imaging (3D-APTWI) in the diagnosis of early-stage breast cancer (BC) and its correlation with the immunohistochemical characteristics of malignant lesions. METHODS Seventy-eight women underwent APTWI and dynamic contrast-enhanced (DCE)-MRI. Pathological results were categorized as either benign (n = 43) or malignant (n = 37) lesions. The parameters of APTWI and DCE-MRI were compared between the benign and malignant groups. The diagnostic value of 3D-APTWI was evaluated using the area under the receiver operating characteristic curve (ROC-AUC) to establish a diagnostic threshold. Pearson's correlation was used to analyze the correlation between the magnetization transfer asymmetry (MTRasym) and immunohistochemical characteristics. RESULTS The MTRasym and time-to-peak of malignancies were significantly lower than those of benign lesions (all p < 0.010). The volume transfer constant, rate constant, and wash-in and wash-out rates of malignancies were all significantly greater than those of benign lesions (all p < 0.010). ROC-AUCs of 3D-APTWI, DCE-MRI, and 3D-APTWI+DCE to differential diagnosis between early-stage BC and benign lesions were 0.816, 0.745, and 0.858, respectively. Only the difference between AUCAPT+DCE and AUCDCE was significant (p < 0.010). When a threshold of MTRasym for malignancy for 2.42%, the sensitivity and specificity of 3D-APTWI for BC diagnosis were 86.5% and 67.6%, respectively; MTRasym was modestly positively correlated with pathological grade (r = 0.476, p = 0.003) and Ki-67 (r = 0.419, p = 0.020). CONCLUSIONS 3D-APTWI may be used as a supplementary method for patients with contraindications of DCE-MRI. MTRasym can imply the proliferation activities of early-stage BC. RELEVANCE STATEMENT 3D-APTWI can be an alternative diagnostic method for patients with early-stage BC who are not suitable for contrast injection. KEY POINTS • 3D-APTWI reflects the changes in the microenvironment of early-stage breast cancer. • Combined 3D-APTWI is superior to DCE-MRI alone for early-stage breast cancer diagnosis. • 3D-APTWI improves the diagnostic accuracy of early-stage breast cancer.
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Affiliation(s)
- Yeqin Li
- Department of Radiology, Shandong Province Hospital of Traditional Chinese Medicine, Jinan, 250014, China
| | - Yan Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China
| | - Liwen Tian
- Department of Radiology, Shandong Public Health Clinical Center, Jinan, 250100, China
| | - Ju Li
- Department of Radiology, Shandong Public Health Clinical Center, Jinan, 250100, China
- Binzhou Medical University, Yantai, 264003, China
| | - Huihua Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China
| | - Cuiyan Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China.
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Hu W, Chen L, Lin L, Wang J, Wang N, Liu A. Three-dimensional amide proton transfer-weighted and intravoxel incoherent motion imaging for predicting bone metastasis in patients with prostate cancer: A pilot study. Magn Reson Imaging 2023; 96:8-16. [PMID: 36375760 DOI: 10.1016/j.mri.2022.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/25/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE To explore the value of 3-dimensional amide proton transfer-weighted (APTw) and intravoxel incoherent motion (IVIM) imaging in predicting bone metastasis (BM) of prostate cancer (PCa) in addition to routine diffusion-weighted imaging (DWI). METHODS The clinical and imaging data of 39 PCa patients who were pathologically confirmed in our hospital from March 2019 to February 2022 were retrospectively analyzed, and they were divided into BM-negative (27 patients) and BM-positive (12 patients) groups. MR examination included APTw, DWI and IVIM imaging. The IVIM data was fitted by single-exponential IVIM model (IVIMmono) and double-exponential IVIM model (IVIMbi), respectively. The APTw, ADC, IVIMmono (Dmono, D*mono, and fmono), and IVIMbi (Dbi, D*bi, and fbi) parameters were independently measured by two radiologists. The synthetic minority oversampling technique (SMOTE) was conducted to balance the minority group. Mann-Whitney U test or Student's t-test was used to compare above values between the BM-negative and BM-positive groups. The diagnostic performance was evaluated with receiver operating characteristic (ROC) analysis of each parameter and their combination. The Delong test was used for ROC curve comparison.The relationship between APTw and IVIM was explored through Spearman's rank correlation analysis. RESULTS The APTw and D*mono values were higher, and the ADC, fmono, and fbi values were lower in the BM-positive group than in the BM-negative group (all P < 0.05). Among the individual parameters, the AUC of fmono was the highest (AUC = 0.865), and AUC (fmono) was significantly higher than AUC (fbi), AUC (D*mono), and AUC (ADC) (all P < 0.05). The AUC (IVIMmono) was higher than the AUC (IVIMbi) (P = 0.0068). The combination of APTw and IVIMmono further improved diagnostic capability, and the AUC of APTw+IVIMmono was significantly higher than those of APTw and DWI (all P < 0.05). No correlation was found between IVIM-derived parameters and APTw value. CONCLUSION Both 3D APTw and IVIM imaging could predict BM of PCa. IVIM showed better performance than APTw and DWI, and the single-exponential IVIM model was superior to the double-exponential IVIM model. The combination of APTw and IVIM could further improve diagnostic performance.
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Affiliation(s)
- Wenjun Hu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, PR China
| | - Lihua Chen
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, PR China; Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, Liaoning, 116011, PR China
| | | | | | - Nan Wang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, PR China; Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, Liaoning, 116011, PR China
| | - Ailian Liu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, PR China; Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, Liaoning, 116011, PR China.
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Martucci M, Russo R, Schimperna F, D’Apolito G, Panfili M, Grimaldi A, Perna A, Ferranti AM, Varcasia G, Giordano C, Gaudino S. Magnetic Resonance Imaging of Primary Adult Brain Tumors: State of the Art and Future Perspectives. Biomedicines 2023; 11:biomedicines11020364. [PMID: 36830900 PMCID: PMC9953338 DOI: 10.3390/biomedicines11020364] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/20/2023] [Accepted: 01/22/2023] [Indexed: 01/28/2023] Open
Abstract
MRI is undoubtedly the cornerstone of brain tumor imaging, playing a key role in all phases of patient management, starting from diagnosis, through therapy planning, to treatment response and/or recurrence assessment. Currently, neuroimaging can describe morphologic and non-morphologic (functional, hemodynamic, metabolic, cellular, microstructural, and sometimes even genetic) characteristics of brain tumors, greatly contributing to diagnosis and follow-up. Knowing the technical aspects, strength and limits of each MR technique is crucial to correctly interpret MR brain studies and to address clinicians to the best treatment strategy. This article aimed to provide an overview of neuroimaging in the assessment of adult primary brain tumors. We started from the basilar role of conventional/morphological MR sequences, then analyzed, one by one, the non-morphological techniques, and finally highlighted future perspectives, such as radiomics and artificial intelligence.
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Affiliation(s)
- Matia Martucci
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico “A. Gemelli” IRCCS, 00168 Rome, Italy
- Correspondence:
| | - Rosellina Russo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico “A. Gemelli” IRCCS, 00168 Rome, Italy
| | | | - Gabriella D’Apolito
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Marco Panfili
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Alessandro Grimaldi
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Alessandro Perna
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Giuseppe Varcasia
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Carolina Giordano
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Simona Gaudino
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico “A. Gemelli” IRCCS, 00168 Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Yang L, Wang L, Tan Y, Dan H, Xian P, Zhang Y, Tan Y, Lin M, Zhang J. Amide Proton Transfer-weighted MRI combined with serum prostate-specific antigen levels for differentiating malignant prostate lesions from benign prostate lesions: a retrospective cohort study. Cancer Imaging 2023; 23:3. [PMID: 36611191 PMCID: PMC9826590 DOI: 10.1186/s40644-022-00515-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Early diagnosis of prostate cancer improves its prognosis, while it is essential to upgrade screening tools. This study aimed to explore the value of a novel functional magnetic resonance imaging (MRI) technique, namely amide proton transfer (APT)-weighted MRI, combined with serum prostate-specific antigen (PSA) levels to differentiate malignant prostate lesions from benign prostate lesions. METHODS Data of patients who underwent prostate examinations at Chongqing University Cancer Hospital between July 2019 and March 2022 were retrospectively analyzed. All patients underwent T2-weighted imaging (T2WI), APT, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) MRI. Two radiologists analyzed the images independently. The ability of the quantitative parameters alone or in different combinations in differentiating malignant prostate lesions from benign prostate lesions were compared by using receiver operating characteristic (ROC) curves. According to the DeLong test, the combined parameters were significantly different from the corresponding single parameter (P < 0.05). RESULTS A total of 79 patients were finally enrolled, including 52 patients in the malignant group and 27 patients in the benign group. The separate assessment of indexes revealed that APTmax, APTmean, mean apparent diffusion coefficient (ADCmean), ADCmax, ADCmin, tPAD, free prostate-specific antigen (FPSA), FPSA/total prostate-specific antigen (tPSA), and PSA density (PSAD) were significantly different between the two groups (P < 0.05), while APTmin was not significantly different between the two groups (P > 0.05). APTmax and APTmean had the high values of area under the ROC curve (AUC), which were 0.780 and 0.710, respectively. APTmax had a high sensitivity, and APTmean had a high specificity. The combination of APTmax, APTmean, ADCmean, and PSAD had the highest AUC value (AUC: 0.880, sensitivity: 86.540, specificity: 78.260). CONCLUSION APTmax, APTmean, ADCmean, ADCmin, tPAD, FPSA, and PSAD showed to have a high value in differentiating malignant prostate lesions from benign prostate lesions in the separate assessment of indexes. The combination of APTmax, APTmean, ADCmean, and PSAD had the highest diagnostic value.
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Affiliation(s)
- Lu Yang
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Lei Wang
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Yuchuan Tan
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Hanli Dan
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Peng Xian
- grid.452285.cDepartment of Urology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, 400030 China
| | - Yipeng Zhang
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Yong Tan
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Meng Lin
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Jiuquan Zhang
- grid.452285.cDepartment of Radiology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
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Cao Y, Xiao N, Hu S, Tang Q, Zhou H. Role of Magnetic Resonance Three-Dimensional Arterial Spin Labeling Perfusion in Diagnosis and Follow-Up of Viral Encephalitis in Children. Int J Gen Med 2022; 15:8557-8565. [DOI: 10.2147/ijgm.s390929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
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Arterial Spin Labeling Perfusion in Determining the IDH1 Status and Ki-67 Index in Brain Gliomas. Diagnostics (Basel) 2022; 12:diagnostics12061444. [PMID: 35741254 PMCID: PMC9221904 DOI: 10.3390/diagnostics12061444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/30/2022] [Accepted: 06/10/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of the study was to evaluate the relationship between tumor blood flow (TBF) measured by the pseudo-continuous arterial spin labeling (PCASL) method and IDH1 mutation status of gliomas as well as Ki-67 proliferative index. Methods. The study included 116 patients with newly diagnosed gliomas of various grades. They received no chemotherapy or radiotherapy before MRI. IDH1 status assessment was performed after tumor removal in 106 cases—48 patients were diagnosed with wildtype gliomas (Grade 1−2—6 patients, Grade 3−4—42 patients) and 58 patients were diagnosed with mutant forms of gliomas (Grade 1−2—28 patients, Grade 3−4—30 patients). In 64 cases out of 116 Ki-67 index was measured. Absolute and normalized tumor blood flow values were measured on 3D PCASL maps. Results. TBF and normalized TBF (nTBF) in wildtype gliomas were significantly higher than in IDH1-mutant gliomas (p < 0.001). ASL perfusion showed high values of sensitivity and specificity in the differential diagnosis of gliomas with distinct IDH1 status (for TBF: specificity 75%, sensitivity 77.6%, AUC 0.783, cutoff 80.57 mL/100 g/min, for nTBF: specificity 77.1%, sensitivity 79.3%, AUC 0.791, cutoff 4.7). TBF and nTBF in wildtype high-grade gliomas (HGG) were significantly higher than in mutant forms (p < 0.001). ASL perfusion showed the following values of sensitivity and specificity in the diagnosis of mutant HGG and wildtype HGG (for TBF: specificity 83.3%, sensitivity 60%, AUC 0.719, cutoff 84.18 mL/100 g/min, for nTBF: specificity 88.1%, sensitivity 60%, AUC 0.729, cutoff 4.7). There was a significant positive correlation between tumor blood flow and Ki-67 (for TBF Rs = 0.63, for nTBF Rs = 0.61). Conclusion. ASL perfusion may be an informative factor in determining the IDH1 status in brain gliomas preoperative and tumor proliferative activity.
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Grading of IDH-mutant astrocytoma using diffusion, susceptibility and perfusion-weighted imaging. BMC Med Imaging 2022; 22:105. [PMID: 35644621 PMCID: PMC9150301 DOI: 10.1186/s12880-022-00832-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/24/2022] [Indexed: 01/16/2023] Open
Abstract
Background The accurate grading of IDH-mutant astrocytoma is essential to make therapeutic strategies and assess the prognosis of patients. The purpose of this study was to investigate the usefulness of DWI, SWI and DSC-PWI in grading IDH-mutant astrocytoma. Methods One hundred and seven patients with IDH-mutant astrocytoma who underwent DWI, SWI and DSC-PWI were retrospectively reviewed. Minimum apparent diffusion coefficient (ADCmin), intratumoral susceptibility signal intensity(ITSS) and maximum relative cerebral blood volume (rCBVmax) values were assessed. ADCmin, ITSS and rCBVmax values were compared between grade 2 vs. grade 3, grade 3 vs. grade 4 and grade 2 + 3 vs. grade 4 tumors. Logistic regression, tenfold cross-validation,and receiver operating characteristic (ROC) curve analyses were used to assess their diagnostic performances. Results Grade 4 IDH-mutant astrocytomas showed significantly lower ADCmin and higher rCBVmax as compared to grade 3 tumors (adjusted P < 0.001). IDH-mutant grade 3 astrocytomas showed significantly lower ITSS levels as compared with grade 4 tumors (adjusted P < 0.001). ITSS levels between IDH-mutant grade 2 and grade 3 astrocytomas were significantly different (adjusted P = 0.002). Combined the ADCmin, ITSS and rCBVmax resulted in the highest AUC for differentiation grade 2 and grade 3 tumors from grade 4 tumors. Conclusion ADCmin, rCBVmax and ITSS can be used for grading the IDH-mutant astrocytomas. The combination of ADCmin, ITSS and rCBVmax could improve the diagnostic performance in grading of IDH-mutant astrocytoma.
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Hemodynamic Imaging in Cerebral Diffuse Glioma-Part A: Concept, Differential Diagnosis and Tumor Grading. Cancers (Basel) 2022; 14:cancers14061432. [PMID: 35326580 PMCID: PMC8946242 DOI: 10.3390/cancers14061432] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/01/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
Diffuse gliomas are the most common primary malignant intracranial neoplasms. Aside from the challenges pertaining to their treatment-glioblastomas, in particular, have a dismal prognosis and are currently incurable-their pre-operative assessment using standard neuroimaging has several drawbacks, including broad differentials diagnosis, imprecise characterization of tumor subtype and definition of its infiltration in the surrounding brain parenchyma for accurate resection planning. As the pathophysiological alterations of tumor tissue are tightly linked to an aberrant vascularization, advanced hemodynamic imaging, in addition to other innovative approaches, has attracted considerable interest as a means to improve diffuse glioma characterization. In the present part A of our two-review series, the fundamental concepts, techniques and parameters of hemodynamic imaging are discussed in conjunction with their potential role in the differential diagnosis and grading of diffuse gliomas. In particular, recent evidence on dynamic susceptibility contrast, dynamic contrast-enhanced and arterial spin labeling magnetic resonance imaging are reviewed together with perfusion-computed tomography. While these techniques have provided encouraging results in terms of their sensitivity and specificity, the limitations deriving from a lack of standardized acquisition and processing have prevented their widespread clinical adoption, with current efforts aimed at overcoming the existing barriers.
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Ge X, Wang M, Ma H, Zhu K, Wei X, Li M, Zhai X, Shen Y, Huang X, Hou M, Liu W, Wang M, Wang X. Investigated diagnostic value of synthetic relaxometry, three-dimensional pseudo-continuous arterial spin labelling and diffusion-weighted imaging in the grading of glioma. Magn Reson Imaging 2021; 86:20-27. [PMID: 34808303 DOI: 10.1016/j.mri.2021.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/27/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND To investigate the performance of synthetic relaxometry, three-dimensional pseudo-continuous arterial spin labelling (pCASL) and diffusion-weighted imaging (DWI) in differentiating high-grade gliomas (HGGs) from low-grade gliomas (LGGs) and to compare with the conventional MRI. METHODS Seventy-two patients with gliomas (including 27 LGGs and 45 HGGs) were studied using synthetic magnetic resonance imaging (sy-MRI), pCASL, and DWI with a 3.0 T MR scanner. T1 relaxometry (T1), T2 relaxometry (T2), as well as proton density (PD) from sy-MRI, cerebral blood flow (CBF) from pCASL, apparent diffusion coefficient (ADC) from DWI and enhancement quality (EQ), proportion enhancing (PE) from conventional contrast enhanced image based Visually-Accessible-Rembrandt-Images (VASARI) scoring system, were all analyzed by two radiologists. The Student's t-test, Mann-Whitney U test or Fisher's exact test was used to compare the parameters between LGGs and HGGs. The diagnostic performance of each parameter and their combination for glioma grading were analyzed. RESULTS Significant statistical differences in T1, PD, CBF, ADC, EQ and PE are observed between LGGs and HGGs (all P < 0.001). The ADC values have higher discrimination abilities compared with other univariable parameters, with the AUC of 0.905. AUC values for conventional contrast-enhanced method, EQ and PE from VASARI, and conventional contrast-free method, CBF + ADC, are 0.873 and 0.912 respectively. The combined T1, PD, CBF and ADC model had the best performance for differentiating LGGs and HGGs with AUC, sensitivity and specificity of 0.993, 95.5%, 100%, respectively. CONCLUSIONS Relaxometry parameters derived from synthetic MRI contributed to the discrimination of low-grade gliomas from high-grade gliomas. Proposed contrast-free approach combining T1, PD, CBF and ADC showed a strong discriminative power, and outperformed conventional approaches.
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Affiliation(s)
- Xin Ge
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Minglei Wang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Hui Ma
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Kai Zhu
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China
| | | | - Min Li
- GE Healthcare, MR Enhancement Application, Beijing, China
| | - Xuefeng Zhai
- Department of Pathology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Ying Shen
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Xueying Huang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Mingli Hou
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Wenxiao Liu
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Minxing Wang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Xiaodong Wang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China.
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Sotirios B, Demetriou E, Topriceanu CC, Zakrzewska Z. The role of APT imaging in gliomas grading: A systematic review and meta-analysis. Eur J Radiol 2020; 133:109353. [PMID: 33120241 DOI: 10.1016/j.ejrad.2020.109353] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/15/2020] [Accepted: 10/11/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE Gliomas are diagnosed and staged by conventional MRI. Although non-conventional sequences such as perfusion-weighted MRI may differentiate low-grade from high-grade gliomas, they are not reliable enough yet. The latter is of paramount importance for patient management. In this regard, we aim to evaluate the role of Amide Proton Transfer (APT) imaging in grading gliomas as a non-invasive tool to provide reliable differentiation across tumour grades. METHODS A systematic search of PubMed, Medline and Embase was conducted to identify relevant publications between 01/01/2008 and 15/09/2020. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to assess studies' quality. A random-effects model standardized mean difference meta-analysis was performed to assess APT's ability to differentiate low-grade gliomas (LGGs) from high-grade gliomas (HGGs), WHO 2-4 grades, wild-type from mutated isocitrate dehydrogenase (IDH) gliomas, methylated from unmethylated O6-methylguanine-DNA methyltransferase (MGMT) gliomas. Area under the curve (AUC) of the Receiver Operating Characteristic (ROC) meta-analysis was employed to assess the diagnostic performance of APT. RESULTS 23 manuscripts met the inclusion criteria and reported the use of APT to differentiate glioma grades with histopathology as reference standard. APT-weighted signal intensity can differentiate LGGs from HGGs with an estimated size effect of (-1.61 standard deviations (SDs), p < 0.0001), grade 2 from grade 3 (-1.83 SDs, p = 0.005), grade 2 from grade 4 (-2.34 SDs, p < 0.0001) and IDH wild-type from IDH mutated (0.94 SDs, p = 0.003) gliomas. The combined AUC of 0.84 highlights the good diagnostic performance of APT-weighted imaging in differentiating LGGs from HGGs. CONCLUSIONS APT imaging is an exciting prospect in differentiating LGGs from HGGs and with potential to predict the histopathological grade. However, more studies are required to optimize and improve its reliability.
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Affiliation(s)
- Bisdas Sotirios
- Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, United Kingdom; Department of Brain Repair & Rehabilitation, Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Eleni Demetriou
- Department of Brain Repair & Rehabilitation, Queen Square Institute of Neurology, University College London, London, United Kingdom
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