1
|
Yan X, Ma K, Zhu L, Pan Y, Wang Y, Shi J, Mai X. The value of apparent diffusion coefficient values in predicting Gleason grading of low to intermediate-risk prostate cancer. Insights Imaging 2024; 15:137. [PMID: 38853212 PMCID: PMC11162992 DOI: 10.1186/s13244-024-01684-x] [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: 10/23/2023] [Accepted: 03/30/2024] [Indexed: 06/11/2024] Open
Abstract
OBJECTIVES To investigate the diagnostic performance of the apparent diffusion coefficient (ADC) for low to intermediate-risk prostate cancer (PCa), as well as its correlation with the prognostic Gleason score (GS). MATERIALS AND METHODS Retrospective analysis of MRI images and relevant clinical data from patients with prostate disease. The differences in ADC between different GS groups were compared, and the efficacy of ADC in PCa diagnosis were analyzed. Furthermore, the diagnostic performance of the mean ADC (ADCmean) and minimum ADC (ADCmin) values was compared. RESULTS There were 1414 patients with 1631 lesions. In terms of GS, both ADCmin and ADCmean values of the GS 4 + 3 group were significantly lower than those of the GS 3 + 4 group, GS 3 + 3 group, and the benign group, with all differences being statistically significant (p < 0.01). The AUC values for diagnosing PCa based on ADCmin and ADCmean were 0.914 and 0.944, respectively. The corresponding diagnostic thresholds were 0.703 × 10-3 mm2/s for ADCmin and 0.927 × 10-3 mm2/s for ADCmean. The magnitudes of ADCmin and ADCmean values exhibited a negative correlation with GS values (ρ = -0.750, p < 0.001; ρ = -0.752, p < 0.001). CONCLUSIONS ADC values demonstrate an inverse relationship with the invasiveness of PCa, indicating that higher invasiveness is associated with lower ADC values. Additionally, ADC values exhibit high diagnostic potential, sensitivity, and specificity for distinguishing between GS 3 + 4 and GS 4 + 3 lesions. Moreover, the diagnostic value of ADCmean is even more significant, highlighting its crucial role in the diagnosis of low to intermediate-risk PCa. CRITICAL RELEVANCE STATEMENT ADC values are a valuable tool for distinguishing different levels of aggressiveness in PCa. They help in the preoperative assessment of the biological characteristics of PCa, allowing clinicians to develop personalized treatment strategies, effectively mitigating the risk of unnecessary interventions. KEY POINTS The preoperative GS is crucial for planning the clinical treatment of PCa. The invasiveness of PCa is inversely correlated with ADC values. ADC values play a crucial role in the accurate preoperative evaluation of low to intermediate-risk PCa, thus aiding clinicians in developing tailored treatment plans.
Collapse
Affiliation(s)
- Xu Yan
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University, Nanjing, 210008, China
| | - Ke Ma
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University, Nanjing, 210008, China
| | - Li Zhu
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China
| | - Yiqi Pan
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, China
| | - Yuting Wang
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, China
| | - Jiong Shi
- Department of Pathology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China
| | - Xiaoli Mai
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China.
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University, Nanjing, 210008, China.
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, China.
| |
Collapse
|
2
|
Sheng L, Yuan E, Yuan F, Song B. Amide proton transfer-weighted imaging of the abdomen: Current progress and future directions. Magn Reson Imaging 2024; 107:88-99. [PMID: 38242255 DOI: 10.1016/j.mri.2024.01.006] [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: 10/17/2023] [Revised: 01/13/2024] [Accepted: 01/14/2024] [Indexed: 01/21/2024]
Abstract
The chemical exchange saturation transfer technique serves as a valuable tool for generating in vivo image contrast based on the content of various proton groups, including amide protons, amine protons, and aliphatic protons. Among these, amide proton transfer-weighted (APTw) imaging has seen extensive development as a means to assess the biochemical status of lesions. The exchange from saturated amide protons to bulk water protons during and following the saturation ratio frequency pulse contributes to detectable APT signals. While APTw imaging has garnered significant attention in the central nervous system, demonstrating noteworthy findings in cerebral neoplasia, stroke, and Alzheimer's disease over the past decade, its application in the abdomen has been a relatively recent progression. Notably, studies have explored its utility in hepatocellular carcinoma, prostate cancer, and cervical carcinoma within the abdominal context. Despite these advancements, there is a paucity of reviews on APTw imaging in abdominal applications. This paper aims to fill this gap by providing a concise overview of the fundamental theories underpinning APTw imaging. Additionally, we systematically summarize its diverse clinical applications in the abdomen, with a particular focus on the digestive and urogenital systems. Finally, the manuscript concludes by discussing technical limitations and factors influencing APTw imaging in abdominal applications, along with prospects for future research.
Collapse
Affiliation(s)
- Liuji Sheng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Enyu Yuan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fang Yuan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiology, Sanya People's Hospital, Sanya, Hainan, China.
| |
Collapse
|
3
|
Qi X, Wang Q, Shen Z, Duan M, Liu X, Pan J, Fan X, Jia L, Wang Y, Du Y. Image quality assessment and feasibility of three-dimensional amide proton transfer-weighted imaging for hepatocellular carcinoma. Quant Imaging Med Surg 2024; 14:1778-1790. [PMID: 38415164 PMCID: PMC10895133 DOI: 10.21037/qims-23-767] [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: 05/30/2023] [Accepted: 01/05/2024] [Indexed: 02/29/2024]
Abstract
Background With the continuous innovation of magnetic resonance imaging (MRI) hardware and software technology, amide proton transfer-weighted (APTw) imaging has been applied in liver cancer. However, to our knowledge, no study has evaluated the feasibility of a three-dimensional amide proton transfer-weighted (3D-APTw) imaging sequence for hepatocellular carcinoma (HCC). This study thus aimed to conduct an image quality assessment of 3D-APTw for HCC and to explore its feasibility. Methods 3D-APTw MRI examinations were completed in 134 patients with clinically suspected HCC. According to the uniformity of APTw signal in the liver and within the lesion and the proportion of artifact and missing signal regions, APTw images were subjectively scored using a 5-point scale. The scanning success rate of liver APTw imaging was calculated as the ratio of the number of cases with a quality assurance measurement of more than 3 to the total number of HCC cases. The intra- and interobserver quality assurance measurements for APTw images were compared via the Kappa consistency test. Within the HCC cases with a minimum image quality threshold of 3 points, the APT values of HCC and the liver parenchyma, signal-to-noise ratio of APT-weighted images (SNRAPTw), and contrast-to-noise ratio of HCC (CNRHCC) were measured by two observers. The intra- and interobserver agreement was assessed using the intraclass correlation coefficient (ICC). The differences in APT values between HCC and liver parenchyma was determined using the Mann-Whitney test. Results Sixty-six HCC cases with a quality assurance measurement of APTw imaging were included in the final analysis, and the calculated success rate was 70.21% (66/94). The subjective APT image quality scores of the two observers were consistent (3.66±1.18, 3.50±1.19, and 3.68±1.18), and no intergroup or intragroup statistical differences were found (P=0.594, and P=0.091), but the consistency of inter- and intraobserver was not as satisfactory (κ=0.594 and κ=0.580). The APT values in HCC lesion were significantly higher than those in liver parenchyma (2.73%±0.91% vs. 1.62%±0.55%; P<0.001). The APT values in HCC showed favorable intra- and interobserver consistency between the two observers (ICC =0.808 and ICC =0.853); the APT values in liver parenchyma, SNRAPTw, and CNRHCC values had moderate intraobserver consistency (ICC =0.578, ICC =0.568, and ICC =0.508) and interobserver consistency (ICC =0.599, ICC =0.199, and ICC =0.650). The coefficients of variation of the APTw values in the HCC lesion and in liver parenchyma were 33.4% and 34.4%, respectively. The SNRAPTw and CNRHCC were 30.75±18.74 and 3.56±3.19, with a coefficient of variation of 60.9% and 74.9%, respectively. Conclusions Liver 3D-APTw imaging was preliminarily demonstrated to be clinically feasible for evaluating HCC.
Collapse
Affiliation(s)
- Xiaohui Qi
- CT & MRI Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qi Wang
- CT & MRI Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhiwei Shen
- Philips (China) Investment Co., Ltd., Beijing, China
| | - Mengting Duan
- CT & MRI Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiang Liu
- CT & MRI Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jiangyang Pan
- CT & MRI Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xueli Fan
- CT & MRI Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Litao Jia
- CT & MRI Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yaning Wang
- CT & MRI Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yu Du
- CT & MRI Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
4
|
Zhuang L, Lian C, Wang Z, Zhang X, Wu Z, Huang R. Breast-lesion assessment using amide proton transfer-weighted imaging and dynamic contrast-enhanced MR imaging. Radiol Oncol 2023; 57:446-454. [PMID: 38038421 PMCID: PMC10690748 DOI: 10.2478/raon-2023-0051] [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: 05/23/2023] [Accepted: 09/01/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Previous studies have indicated that amide proton transfer-weighted imaging (APTWI) could be utilized for differentiating benign and malignant tumors. The APTWI technology has increasingly being applied to breast tumor research in recent years. However, according to the latest literature retrieval, no relevant previous studies compared the value of APTWI and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in distinguishing benign lesions from malignant lesions. In the present study, the application of APTWI and DCE for differentiating the benign and malignant breast lesions was investigated. PATIENTS AND METHODS APTWI was performed on 40 patients (42 lesions) who were enrolled in this prospective study. The lesions were split into two groups, one with malignant breast lesions (n = 28) and the other with benign breast lesions (n = 14), based on the results of the histology. The measured image characteristics (APT value, apparent diffusion coefficient [ADC] value, and time-of-intensity-curve [TIC] type) were compared between the two groups, and the ROC curve was used to quantify the diagnostic performance on the basis of these factors. The correlation between the APT values and the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 expression levels and histological grades was examined using Spearman's correlation coefficient. RESULTS The measured APT and ADC values showed a strong inter-observer agreement according to the intraclass correlation coefficients (0.954 and 0.825). Compared to benign lesions, malignant lesions had significantly higher APT values (3.18 ± 1.07 and 2.01 ± 0.51, p < 0.001). Based on APTWI, DCE, diffusion-weighted imaging (DWI), and ADC + APTWI, ADC + DCE, and DCE + APTWI, the area-under-the-curve values were 0.915, 0.815, 0.878, 0.921, 0.916, and 0.936, respectively. CONCLUSIONS APTWI is a potentially promising method in differentiating benign and malignant breast lesions, and may it become a great substitute for DCE examination in the future.
Collapse
Affiliation(s)
- Lulu Zhuang
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, China
- Shantou University, Shantou University Medical College, Shantou, China
| | - Chun Lian
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, China
- Shantou University, Shantou University Medical College, Shantou, China
| | - Zehao Wang
- Shantou University, Shantou University Medical College, Shantou, China
| | - Ximin Zhang
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, China
- Shantou University, Shantou University Medical College, Shantou, China
| | - Zhigang Wu
- Clinical & Technical Support, Philips Healthcare (Shenzhen) Ltd., China
| | - Rong Huang
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, China
| |
Collapse
|