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Malyarenko D, Ono S, Lynch TJE, Swanson SD. Technical note: hydrogel-based mimics of prostate cancer with matched relaxation, diffusion and kurtosis for validating multi-parametric MRI. Med Phys 2024; 51:3590-3596. [PMID: 38128027 PMCID: PMC11138133 DOI: 10.1002/mp.16908] [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: 09/14/2023] [Revised: 11/16/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Protocol standardization and optimization for clinical translation of emerging quantitative multiparametric (mp)MRI biomarkers of high-risk prostate cancer requires imaging references that mimic realistic tissue value combinations for bias assessment in derived relaxation and diffusion parameters. PURPOSE This work aimed to develop a novel class of hydrogel-based synthetic materials with simultaneously controlled quantitative relaxation, diffusion, and kurtosis parameters that mimic in vivo prostate value combinations in the same spatial compartment and allow stable assemblies of adjacent structures. METHODS A set of materials with tunable T2, diffusion, and kurtosis were assembled to create quantitative biomimetic (mp)MRI references. T2 was controlled with variable agarose concentration, monoexponential diffusion by polyvinylpyrrolidone (PVP), and kurtosis by addition of lamellar vesicles. The materials were mechanically stabilized by UV cross-linked polyacrylamide gels (PAG) to allow biomimetic morphologies. The reference T2 were measured on a 3T scanner using multi-echo CPMG, and diffusion kurtosis-with multi-b DWI. RESULTS Agarose concentration controls T2 values which are nominally independent of PVP or vesicle concentration. For agarose PVP hydrogels, monoexponential diffusion values are a function of PVP concentration and independent of agarose concentration. Compared to free vesicles, for agarose-PAG combined with vesicles, diffusion was predominantly controlled by vesicles and PAG, while kurtosis was affected by agarose and vesicle concentration. Both hydrogel classes achieved image voxel parameter values (T2, Da, Ka) for relaxation (T2: 65-255 ms), apparent diffusion (Da: 0.8-1.7 μm2/ms), and kurtosis (Ka: 0.5-1.25) within the target literature ranges for normal prostate zones and cancer lesions. Relaxation and diffusion parameters remained stable for over 6 months for layered material assemblies. CONCLUSION A stable biomimetic mpMR reference based on hydrogels has been developed with a range of multi-compartment diffusion and relaxation parameter combinations observed in cancerous and healthy prostate tissue.
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Affiliation(s)
- Dariya Malyarenko
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Shigeto Ono
- Computerized Imaging Reference Systems (Sun Nuclear), Mirion Technologies Inc., Norfolk, VA 23513, USA
| | - Ted J. E. Lynch
- Computerized Imaging Reference Systems (Sun Nuclear), Mirion Technologies Inc., Norfolk, VA 23513, USA
| | - Scott D. Swanson
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
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Gaur S, Panda A, Fajardo JE, Hamilton J, Jiang Y, Gulani V. Magnetic Resonance Fingerprinting: A Review of Clinical Applications. Invest Radiol 2023; 58:561-577. [PMID: 37026802 PMCID: PMC10330487 DOI: 10.1097/rli.0000000000000975] [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] [Indexed: 04/08/2023]
Abstract
ABSTRACT Magnetic resonance fingerprinting (MRF) is an approach to quantitative magnetic resonance imaging that allows for efficient simultaneous measurements of multiple tissue properties, which are then used to create accurate and reproducible quantitative maps of these properties. As the technique has gained popularity, the extent of preclinical and clinical applications has vastly increased. The goal of this review is to provide an overview of currently investigated preclinical and clinical applications of MRF, as well as future directions. Topics covered include MRF in neuroimaging, neurovascular, prostate, liver, kidney, breast, abdominal quantitative imaging, cardiac, and musculoskeletal applications.
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Affiliation(s)
- Sonia Gaur
- Department of Radiology, Michigan Medicine, Ann Arbor, MI
| | - Ananya Panda
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | | | - Jesse Hamilton
- Department of Radiology, Michigan Medicine, Ann Arbor, MI
| | - Yun Jiang
- Department of Radiology, Michigan Medicine, Ann Arbor, MI
| | - Vikas Gulani
- Department of Radiology, Michigan Medicine, Ann Arbor, MI
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Micek M, Aebisher D, Surówka J, Bartusik-Aebisher D, Madera M. Applications of T 1 and T 2 relaxation time calculation in tissue differentiation and cancer diagnostics-a systematic literature review. Front Oncol 2022; 12:1010643. [PMID: 36531030 PMCID: PMC9749890 DOI: 10.3389/fonc.2022.1010643] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/31/2022] [Indexed: 01/07/2024] Open
Abstract
INTRODUCTION The purpose of this review was to summarize current applications of non-contrast-enhanced quantitative magnetic resonance imaging (qMRI) in tissue differentiation, considering healthy tissues as well as comparisons of malignant and benign samples. The analysis concentrates mainly on the epithelium and epithelial breast tissue, especially breast cancer. METHODS A systematic review has been performed based on current recommendations by publishers and foundations. An exhaustive overview of currently used techniques and their potential in medical sciences was obtained by creating a search strategy and explicit inclusion and exclusion criteria. RESULTS AND DISCUSSION PubMed and Elsevier (Scopus & Science Direct) search was narrowed down to studies reporting T1 or T2 values of human tissues, resulting in 404 initial candidates, out of which roughly 20% were found relevant and fitting the review criteria. The nervous system, especially the brain, and connective tissue such as cartilage were the most frequently analyzed, while the breast remained one of the most uncommon subjects of studies. There was little agreement between published T1 or T2 values, and methodologies and experimental setups differed strongly. Few contemporary (after 2000) resources have been identified that were dedicated to studying the relaxation times of tissues and their diagnostic applications. Most publications concentrate on recommended diagnostic standards, for example, breast acquisition of T1- or T2-weighted images using gadolinium-based contrast agents. Not enough data is available yet to decide how repeatable or reliable analysis of relaxation times is in diagnostics, so it remains mainly a research topic. So far, qMRI might be recommended as a diagnostic help providing general insight into the nature of lesions (benign vs. malignant). However, additional means are generally necessary to differentiate between specific lesion types.
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Affiliation(s)
| | - David Aebisher
- Department of Photomedicine and Physical Chemistry, Medical College of The University of Rzeszow, Rzeszow, Poland
| | | | - Dorota Bartusik-Aebisher
- Department of Biochemistry and General Chemistry, Medical College of The University of Rzeszow, Rzeszow, Poland
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Lo W, Bittencourt LK, Panda A, Jiang Y, Tokuda J, Seethamraju R, Tempany‐Afdhal C, Obmann V, Wright K, Griswold M, Seiberlich N, Gulani V. Multicenter Repeatability and Reproducibility of MR Fingerprinting in Phantoms and in Prostatic Tissue. Magn Reson Med 2022; 88:1818-1827. [PMID: 35713379 PMCID: PMC9469467 DOI: 10.1002/mrm.29264] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 02/15/2022] [Accepted: 03/22/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE To evaluate multicenter repeatability and reproducibility of T1 and T2 maps generated using MR fingerprinting (MRF) in the International Society for Magnetic Resonance in Medicine/National Institute of Standards and Technology MRI system phantom and in prostatic tissues. METHODS MRF experiments were performed on 5 different 3 Tesla MRI scanners at 3 different institutions: University Hospitals Cleveland Medical Center (Cleveland, OH), Brigham and Women's Hospital (Boston, MA) in the United States, and Diagnosticos da America (Rio de Janeiro, RJ) in Brazil. Raw MRF data were reconstructed using a Gadgetron-based MRF online reconstruction pipeline to yield quantitative T1 and T2 maps. The repeatability of T1 and T2 values over 6 measurements in the International Society for Magnetic Resonance in Medicine/National Institute of Standards and Technology MRI system phantom was assessed to demonstrate intrascanner variation. The reproducibility between the 4 clinical scanners was assessed to demonstrate interscanner variation. The same-day test-retest normal prostate mean T1 and T2 values from peripheral zone and transitional zone were also compared using the intraclass correlation coefficient and Bland-Altman analysis. RESULTS The intrascanner variation of values measured using MRF was less than 2% for T1 and 4.7% for T2 for relaxation values, within the range of 307.7 to 2360 ms for T1 and 19.1 to 248.5 ms for T2 . Interscanner measurements showed that the T1 variation was less than 4.9%, and T2 variation was less than 8.1% between multicenter scanners. Both T1 and T2 values in in vivo prostatic tissue demonstrated high test-retest reliability (intraclass correlation coefficient > 0.92) and strong linear correlation (R2 > 0.840). CONCLUSION Prostate MRF measurements of T1 and T2 are repeatable and reproducible between MRI scanners at different centers on different continents for the above measurement ranges.
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Affiliation(s)
- Wei‐Ching Lo
- Department of Biomedical EngineeringCase Western Reserve UniversityClevelandOhio
- Siemens Medical Solutions IncBostonMassachusetts
| | - Leonardo Kayat Bittencourt
- Department of RadiologyUniversity Hospital and Case Western Reserve UniversityClevelandOhio
- DASA companyRio de JaneiroRJBrazil
| | - Ananya Panda
- Department of RadiologyMayo ClinicRochesterMinnesota
| | - Yun Jiang
- Department of RadiologyUniversity of MichiganAnn ArborMichigan
| | - Junichi Tokuda
- Department of Radiology, Harvard Medical SchoolHarvard UniversityBostonMassachusetts
- Department of RadiologyBrigham and Women's HospitalBostonMassachusetts
| | | | - Clare Tempany‐Afdhal
- Department of Radiology, Harvard Medical SchoolHarvard UniversityBostonMassachusetts
- Department of RadiologyBrigham and Women's HospitalBostonMassachusetts
| | - Verena Obmann
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital BernUniversity of BernBerneSwitzerland
| | | | - Mark Griswold
- Department of Biomedical EngineeringCase Western Reserve UniversityClevelandOhio
- Department of RadiologyUniversity Hospital and Case Western Reserve UniversityClevelandOhio
| | | | - Vikas Gulani
- Department of RadiologyUniversity of MichiganAnn ArborMichigan
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Lo WC, Panda A, Jiang Y, Ahad J, Gulani V, Seiberlich N. MR fingerprinting of the prostate. MAGMA (NEW YORK, N.Y.) 2022; 35:557-571. [PMID: 35419668 DOI: 10.1007/s10334-022-01012-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 06/03/2023]
Abstract
Multiparametric magnetic resonance imaging (mpMRI) has been adopted as the key tool for detection, localization, characterization, and risk stratification of patients suspected to have prostate cancer. Despite advantages over systematic biopsy, the interpretation of prostate mpMRI has limitations including a steep learning curve, leading to considerable interobserver variation. There is growing interest in clinical translation of quantitative imaging techniques for more objective lesion assessment. However, traditional mapping techniques are slow, precluding their use in the clinic. Magnetic resonance fingerprinting (MRF) is an efficient approach for quantitative maps of multiple tissue properties simultaneously. The T1 and T2 values obtained with MRF have been validated with phantom studies as well as in normal volunteers and patients. Studies have shown that MRF-derived T1 and T2 along with ADC values are all significant independent predictors in the differentiation between normal prostate tissue and prostate cancer, and hold promise in differentiating low and intermediate/high-grade cancers. This review seeks to introduce the basics of the prostate MRF technique, discuss the potential applications of prostate MRF for the characterization of prostate cancer, and describes ongoing areas of research.
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Affiliation(s)
- Wei-Ching Lo
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- Siemens Medical Solutions USA, Boston, Massachusetts, USA
| | - Ananya Panda
- Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA
| | - Yun Jiang
- Department of Radiology, University of Michigan, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5030, USA
| | - James Ahad
- Case Western Reserve University, Cleveland, OH, USA
| | - Vikas Gulani
- Department of Radiology, University of Michigan, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5030, USA
| | - Nicole Seiberlich
- Department of Radiology, University of Michigan, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5030, USA.
- Case Western Reserve University, Cleveland, OH, USA.
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Lee YS, Choi MH, Lee YJ, Han D, Kim DH. Magnetic resonance fingerprinting in prostate cancer before and after contrast enhancement. Br J Radiol 2022; 95:20210479. [PMID: 34415785 PMCID: PMC8978224 DOI: 10.1259/bjr.20210479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To assess the apparent diffusion coefficient (ADC) values and the T1 and T2 values derived from nonenhanced (NE) and contrast-enhanced (CE) magnetic resonance fingerprinting (MRF) in the prostate gland and to evaluate differences in values among prostate cancer, the normal peripheral zone (PZ) and the normal transition zone (TZ). METHODS Fifty-seven patients (median age, 73 years; range, 48-86) with prostate cancer who underwent multiparametric MRI including NE and CE MRF were included in this study. T1 and T2 values were extracted from NE and CE MRF, respectively. Five quantitative values (the ADC, NE T1, NE T2, CE T1 and CE T2 values) were measured in three areas: prostate cancer, PZ and TZ. We compared the values among the three areas and evaluated the differences between NE MRF and CE MRF values. RESULTS ADC values and MRF-derived values were significantly higher in PZ than prostate cancer or TZ (p < 0.001). TZ had a significantly lower CE T1 but significantly higher values of the other variables than prostate cancer (p < 0.001). The T1 values in all three areas and the T2 values in prostate cancer and TZ were significantly lower on CE MRF than on NE MRF (p < 0.001). CONCLUSIONS Quantitative analysis of NE and CE MRI can be conducted by using the MRF technique. The ADC value and the T1 and T2 values from CE MRF and NE MRF were found to be significantly different between prostate cancer and normal prostate tissue. ADVANCES IN KNOWLEDGE The T1 and T2 values from contrast-enhanced MR fingerprinting are significantly different between prostate cancer and normal prostate tissue.
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Affiliation(s)
- Young Sub Lee
- Department of Hospital Pathology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Moon Hyung Choi
- Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Joon Lee
- Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dongyeob Han
- Siemens Healthineers Ltd., Seoul, Republic of Korea
| | - Dong-Hyun Kim
- School of Electrical and Electronic Engineering, Yonsei University, Seoul, Korea
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Maier SE, Wallström J, Langkilde F, Johansson J, Kuczera S, Hugosson J, Hellström M. Prostate Cancer Diffusion-Weighted Magnetic Resonance Imaging: Does the Choice of Diffusion-Weighting Level Matter? J Magn Reson Imaging 2021; 55:842-853. [PMID: 34535940 DOI: 10.1002/jmri.27895] [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: 03/16/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging plays an important role in multiparametric assessment of prostate lesions. The derived apparent diffusion coefficient (ADC) could be a useful quantitative biomarker for malignant growth, but lacks acceptance because of low reproducibility. PURPOSE To investigate the impact of the choice of diffusion-weighting levels (b-values) on contrast-to-noise ratio and quantitative measures in prostate diffusion-weighted MRI. STUDY TYPE Retrospective and simulation based on published data. SUBJECTS Patient cohort (21 men with Prostate Imaging-Reporting and Data System (PI-RADS) version 2 score ≥3) from a single-center study. FIELD STRENGTH/SEQUENCE 3 T/diffusion-weighted imaging with single-shot echo-planar imaging. ASSESSMENT Both clinical data and simulations based on previously acquired data were used to quantify the influence of b-value choice in normal peripheral zone (PZ) and PZ tumor lesions. For clinical data, ADC was determined for different combinations of b-values. Contrast-to-noise ratio and quantitative diffusion measures were simulated for a wide range of b-values. STATISTICAL TESTS Tissue ADC and the lesion-to-normal tissue ADC ratios of different b-value combinations were compared with paired two-tailed Student's t-tests. A P-value <0.05 was considered statistically significant. RESULTS Findings about b-value dependence derived from clinical data and from simulations agreed with each other. Provided measurement was limited to two b-values, simulation-derived optimal b-value choices coincided with PI-RADSv2 recommendations. For two-point measurements, ADC decreased by 15% when the maximum b-value increased from 1000 to 1500 seconds/mm2 , but corresponding lesion-to-normal tissue ADC ratio showed no significant change (P = 0.86 for acquired data). Simulations with three or more measurement points produced ADCs that declined by only 8% over this range of maximum b-value. Corresponding ADC ratios declined between 2.6% (three points) and 3.8% (21 points). Simulations also revealed an ADC reduction of about 19% with the shorter echo and diffusion time evaluated. DATA CONCLUSION The comprehensive assessment of b-value dependence permits better formulation of protocol and analysis recommendations for obtaining reproducible results in prostate cancer diffusion-weighted MRI. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Stephan E Maier
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jonas Wallström
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Fredrik Langkilde
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Jens Johansson
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Kuczera
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jonas Hugosson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Urology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Mikael Hellström
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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Wang YF, Tadimalla S, Hayden AJ, Holloway L, Haworth A. Artificial intelligence and imaging biomarkers for prostate radiation therapy during and after treatment. J Med Imaging Radiat Oncol 2021; 65:612-626. [PMID: 34060219 DOI: 10.1111/1754-9485.13242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/18/2021] [Accepted: 05/02/2021] [Indexed: 12/15/2022]
Abstract
Magnetic resonance imaging (MRI) is increasingly used in the management of prostate cancer (PCa). Quantitative MRI (qMRI) parameters, derived from multi-parametric MRI, provide indirect measures of tumour characteristics such as cellularity, angiogenesis and hypoxia. Using Artificial Intelligence (AI), relevant information and patterns can be efficiently identified in these complex data to develop quantitative imaging biomarkers (QIBs) of tumour function and biology. Such QIBs have already demonstrated potential in the diagnosis and staging of PCa. In this review, we explore the role of these QIBs in monitoring treatment response during and after PCa radiotherapy (RT). Recurrence of PCa after RT is not uncommon, and early detection prior to development of metastases provides an opportunity for salvage treatments with curative intent. However, the current method of monitoring treatment response using prostate-specific antigen levels lacks specificity. QIBs, derived from qMRI and developed using AI techniques, can be used to monitor biological changes post-RT providing the potential for accurate and early diagnosis of recurrent disease.
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Affiliation(s)
- Yu-Feng Wang
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Sirisha Tadimalla
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Amy J Hayden
- Sydney West Radiation Oncology, Westmead Hospital, Wentworthville, New South Wales, Australia
- Faculty of Medicine, Western Sydney University, Sydney, New South Wales, Australia
- Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Lois Holloway
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Liverpool and Macarthur Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Annette Haworth
- Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
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Han D, Choi MH, Lee YJ, Kim DH. Feasibility of Novel Three-Dimensional Magnetic Resonance Fingerprinting of the Prostate Gland: Phantom and Clinical Studies. Korean J Radiol 2021; 22:1332-1340. [PMID: 34047506 PMCID: PMC8316768 DOI: 10.3348/kjr.2020.1362] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/08/2021] [Accepted: 03/17/2021] [Indexed: 01/24/2023] Open
Abstract
Objective To evaluate the feasibility of a new three-dimensional (3D) MR fingerprinting (MRF) technique for the prostate gland by conducting phantom and clinical studies. Materials and Methods The new 3D MRF technique used in this study enables quick data acquisition and has a high resolution. For the phantom study, the MRF T1 and T2 values in an in-house phantom were compared with those of gold-standard mapping methods using linear regression analysis. For the clinical study, we evaluated 90 patients who underwent prostate imaging with MRF for suspected prostate cancer between September 2019 and February 2020. The mean T1 and T2 values were compared in the peripheral zone, transition zone, and focal lesions using paired t tests. The differences in the T1 and T2 values according to cancer aggressiveness were evaluated using one-way analysis of variance. Results In the phantom study, the MRF T1 and T2 values showed a perfect correlation with the gold-standard T1 and T2 values (R > 0.99). In the clinical study, the T1 and T2 values in the peripheral zone were significantly higher than those in the transitional zone (p < 0.001, both). The T1 and T2 values in prostate cancer were significantly lower than those in the peripheral and transitional zones. The higher the grade of cancer, the lower the T2 values. Conclusion The T1 and T2 values obtained from the 3D MRF showed a perfect correlation with the gold standard values in the phantom study. Differences in the T1 and T2 values among the different zones of the prostate gland were identified using 3D MRF in patients.
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Affiliation(s)
| | - Moon Hyung Choi
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Young Joon Lee
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Hyun Kim
- School of Electrical and Electronic Engineering, Yonsei University, Seoul, Korea
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Murer S, Scheidler J, Mueller-Lisse UL, Helling M, Scherr M, Mueller-Lisse UG. Two-centre comparative experimental study of biparametric MRI at 3.0 T with and without endorectal coil using kiwifruit (Actinidia deliciosa) as a phantom for human prostate. Eur Radiol Exp 2019; 3:30. [PMID: 31410699 PMCID: PMC6692805 DOI: 10.1186/s41747-019-0111-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 07/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Application of an endorectal coil (ERC) for 3.0-T prostate magnetic resonance imaging (MRI) is contentious. We hypothesised that a multicoil phased-array protocol provides T2-weighted images (T2WI) and diffusion-weighted images (DWI) with reduced field-of-view (DWIreduced) and monoexponential apparent diffusion coefficient (ADC) maps that are technically equivalent with ERC or without ERC (noERC). METHODS Axial T2WI (repetition time [TR] 7500 ms, echo time [TE] 98-101 ms) and DWIreduced (field-of-view 149-179 × 71-73 mm2, TR/TE 4500-5500/61-74 ms, b values, 50/800 s/mm2) ERC and noERC images were obtained on identical clinical 3.0-T scanners at two centres and compared for signal-to-noise ratio (SNR) in anterior and posterior outer pericarp (OP) and peripheral placenta (PP) in five green Hayward kiwifruit (Actinidia deliciosa, European Union regulation 543/2011 class 2). Corroboration in 21 patients with benign prostate hyperplasia (negative biopsy, prostate imaging reporting and data system version 2 ≤ 2) involved identical MRI protocols: 10 at site 1, noERC, and 11 at site 2, with ERC. Two-tailed Student's t test was used. RESULTS With few exceptions, signal-to-noise ratio (SNR) was similar in kiwifruits and prostates for ERC and noERC. In T2WI, SNR was higher posteriorly in noERC MRI for peripheral zone (PZ) (p < 0.001). In DWIreduced, SNR was higher posteriorly in ERC-OP (p = 0.013) and ERC-PZ (p = 0.026) for b = 50 s/mm2; noERC-OP (p = 0.044) and ERC-PZ (p = 0.001) for b = 800 s/mm2; and ERC-OP (p = 0.001), noERC-OP (p = 0.001), and ERC-PZ (p = 0.001) for ADC, respectively. Volumes of kiwifruits and prostates were similar (89.2 ± 11.2 versus 90.8 ± 48.5 cm3, p = 0.638-0.920). CONCLUSIONS Findings imply that multicoil phased-array 3.0-T prostate MRI with T2WI and DWIreduced with ADC maps provides equivalent results with and without ERC.
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Affiliation(s)
- Sophie Murer
- Department of Radiology, Faculty of Medicine, University of Munich ("Ludwig-Maximilians-Universität", LMU), Ziemssenstrasse 1, 80336, Muenchen, Germany
| | - Juergen Scheidler
- Department of Radiology, Faculty of Medicine, University of Munich ("Ludwig-Maximilians-Universität", LMU), Ziemssenstrasse 1, 80336, Muenchen, Germany.,Department of Radiology, Radiology Centre Munich (RZM), Muenchen, Germany
| | - Ulrike L Mueller-Lisse
- Department of Urology, Faculty of Medicine, University of Munich (Ludwig-Maximilians-Universität, LMU), Munich, Germany.,Department of Urology, Interdisciplinary Oncology Centre Munich (IOZ), Munich, Germany
| | - Marissa Helling
- Department of Radiology, Faculty of Medicine, University of Munich ("Ludwig-Maximilians-Universität", LMU), Ziemssenstrasse 1, 80336, Muenchen, Germany
| | - Michael Scherr
- Department of Radiology, Faculty of Medicine, University of Munich ("Ludwig-Maximilians-Universität", LMU), Ziemssenstrasse 1, 80336, Muenchen, Germany.,Department of Radiology, BG Unfallklinik Murnau, Murnau am Staffelsee, Germany
| | - Ullrich G Mueller-Lisse
- Department of Radiology, Faculty of Medicine, University of Munich ("Ludwig-Maximilians-Universität", LMU), Ziemssenstrasse 1, 80336, Muenchen, Germany.
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11
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Panda A, O’Connor G, Lo WC, Jiang Y, Margevicius S, Schluchter M, Ponsky LE, Gulani V. Targeted Biopsy Validation of Peripheral Zone Prostate Cancer Characterization With Magnetic Resonance Fingerprinting and Diffusion Mapping. Invest Radiol 2019; 54:485-493. [PMID: 30985480 PMCID: PMC6602844 DOI: 10.1097/rli.0000000000000569] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aims for targeted biopsy validation of magnetic resonance fingerprinting (MRF) and diffusion mapping for characterizing peripheral zone (PZ) prostate cancer and noncancers. MATERIALS AND METHODS One hundred four PZ lesions in 85 patients who underwent magnetic resonance imaging were retrospectively analyzed with apparent diffusion coefficient (ADC) mapping, MRF, and targeted biopsy (cognitive or in-gantry). A radiologist blinded to pathology drew regions of interest on targeted lesions and visually normal peripheral zone on MRF and ADC maps. Mean T1, T2, and ADC were analyzed using linear mixed models. Generalized estimating equations logistic regression analyses were used to evaluate T1 and T2 relaxometry combined with ADC in differentiating pathologic groups. RESULTS Targeted biopsy revealed 63 cancers (low-grade cancer/Gleason score 6 = 10, clinically significant cancer/Gleason score ≥7 = 53), 15 prostatitis, and 26 negative biopsies. Prostate cancer T1, T2, and ADC (mean ± SD, 1660 ± 270 milliseconds, 56 ± 20 milliseconds, 0.70 × 10 ± 0.24 × 10 mm/s) were significantly lower than prostatitis (mean ± SD, 1730 ± 350 milliseconds, 77 ± 36 milliseconds, 1.00 × 10 ± 0.30 × 10 mm/s) and negative biopsies (mean ± SD, 1810 ± 250 milliseconds, 71 ± 37 milliseconds, 1.00 × 10 ± 0.33 × 10 mm/s). For cancer versus prostatitis, ADC was sensitive and T2 specific with comparable area under curve (AUC; (AUCT2 = 0.71, AUCADC = 0.79, difference between AUCs not significant P = 0.37). T1 + ADC (AUCT1 + ADC = 0.83) provided the best separation between cancer and negative biopsies. Low-grade cancer T2 and ADC (mean ± SD, 75 ± 29 milliseconds, 0.96 × 10 ± 0.34 × 10 mm/s) were significantly higher than clinically significant cancers (mean ± SD, 52 ± 16 milliseconds, 0.65 ± 0.18 × 10 mm/s), and T2 + ADC (AUCT2 + ADC = 0.91) provided the best separation. CONCLUSIONS T1 and T2 relaxometry combined with ADC mapping may be useful for quantitative characterization of prostate cancer grades and differentiating cancer from noncancers for PZ lesions seen on T2-weighted images.
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Affiliation(s)
- Ananya Panda
- Department of Radiology, Mayo Clinic, Rochester, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Gregory O’Connor
- Department of Case Western University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Wei-Ching Lo
- Department of Biomedical Engineering, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Yun Jiang
- Department of Radiology, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Seunghee Margevicius
- Department of Epidemiology and Biostatistics, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Mark Schluchter
- Department of Epidemiology and Biostatistics, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Lee E. Ponsky
- Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Vikas Gulani
- Department of Case Western University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Department of Biomedical Engineering, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
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12
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Muehlematter UJ, Rupp NJ, Mueller J, Eberli D, Burger IA. 68Ga-PSMA PET/MR–Positive, Histopathology-Proven Prostate Cancer in a Patient With Negative Multiparametric Prostate MRI. Clin Nucl Med 2018; 43:e282-e284. [DOI: 10.1097/rlu.0000000000002143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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13
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Papadopoulos I, Phillips J, Evans R, Fenn N, Shermer S. Evaluation of diffusion weighted imaging in the context of multi-parametric MRI of the prostate in the assessment of suspected low volume prostatic carcinoma. Magn Reson Imaging 2017; 47:131-136. [PMID: 29183816 DOI: 10.1016/j.mri.2017.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 11/21/2017] [Indexed: 01/14/2023]
Abstract
Data from a multi-parametric MRI study of patients with possible early-stage prostate cancer was assessed with a view to creating a more efficient clinical protocol. Based on a correlation analysis suggesting that diffusion-weighted imaging (DWI) scores are more strongly correlated with overall PIRADS scores than other modalities such as dynamic contrast enhanced imaging or spectroscopy, we investigate the combination of T2-weighted imaging (T2w) and DWI as a potential diagnostic tool for prostate cancer detection, staging and guided biopsies. Quantification of the noise floor in the DWI images and careful fitting of the data suggests that the mono-exponential model provides a very good fit to the data and there is no evidence of non-Gaussian diffusion for b-values up to 1000s/mm2. This precludes the use of kurtosis or other non-Gaussian measures as a biomarker for prostate cancer in our case. However, the ADC scores for healthy and probably malignant regions are significantly lower for the latter in all 20 but one patient. The results suggest that a simplified mp-MRI protocol combining T2w and DWI may be a good compromise for a cost and time efficient, early-stage prostate cancer diagnostic programme, combining robust MR biomarkers for prostate cancer that can be reliably quantified and appear well-suited for general clinical practice.
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Affiliation(s)
- Ioannis Papadopoulos
- College of Science (Physics), Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom; Institute of Life Science, Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom.
| | - Jonathan Phillips
- Institute of Life Science, Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom
| | - Rhodri Evans
- Institute of Life Science, Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom
| | - Neil Fenn
- Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea SA6 6NL, United Kingdom
| | - Sophie Shermer
- College of Science (Physics), Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom
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14
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Giganti F, Gambarota G, Moore CM, Robertson NL, McCartan N, Jameson C, Bott SRJ, Winkler M, Whitcher B, Castro-Santamaria R, Emberton M, Allen C, Kirkham A. Prostate cancer detection using quantitative T 2 and T 2 -weighted imaging: The effects of 5-alpha-reductase inhibitors in men on active surveillance. J Magn Reson Imaging 2017; 47:1646-1653. [PMID: 29135073 DOI: 10.1002/jmri.25891] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/25/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND T2 -weighted imaging (T2 -WI) information has been used in a qualitative manner in the assessment of prostate cancer. Quantitative derivatives (T2 relaxation time) can be generated from T2 -WI. These outputs may be useful in helping to discriminate clinically significant prostate cancer from background signal. PURPOSE/HYPOTHESIS To investigate changes in quantitative T2 parameters in lesions and noncancerous tissue of men on active surveillance for prostate cancer taking dutasteride 0.5 mg or placebo daily for 6 months. STUDY TYPE Retrospective. POPULATION/SUBJECTS Forty men randomized to 6 months of daily dutasteride (n = 20) or placebo (n = 20). FIELD STRENGTH/SEQUENCE Multiparametric 3T MRI at baseline and 6 months. This included a multiecho MR sequence for quantification of the T2 relaxation times, in three regions of interest (index lesion, noncancerous peripheral [PZ] and transitional [TZ] zones). A synthetic signal contrast (T2 Q contrast) between lesion and noncancerous tissue was assessed using quantitative T2 values. Signal contrast was calculated using the T2 -weighted sequence (T2 W contrast). ASSESSMENT Two radiologists reviewed the scans in consensus according to Prostate Imaging Reporting and Data System (PI-RADS v. 2) guidelines. STATISTICAL TESTS Wilcoxon and Mann-Whitney U-tests, Spearman's correlation. RESULTS When compared to noncancerous tissue, shorter T2 values were observed within lesions at baseline (83.5 and 80.5 msec) and 6 months (81.5 and 81.9 msec) in the placebo and dutasteride arm, respectively. No significant differences for T2 W contrast at baseline and after 6 months were observed, both in the placebo (0.40 [0.29-0.49] vs. 0.43 [0.25-0.49]; P = 0.881) and dutasteride arm (0.35 [0.24-0.47] vs. 0.37 [0.22-0.44]; P = 0.668). There was a significant, positive correlation between the T2 Q contrast and the T2 W contrast values (r = 0.786; P < 0.001). DATA CONCLUSION The exposure to antiandrogen therapy did not significantly influence the T2 contrast or the T2 relaxation values in men on active surveillance for prostate cancer. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1646-1653.
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Affiliation(s)
- Francesco Giganti
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK.,Division of Surgery & Interventional Science, University College London, London, UK
| | - Giulio Gambarota
- INSERM, U1099, Rennes, France.,Université de Rennes 1, LTSI, Rennes, France
| | - Caroline M Moore
- Division of Surgery & Interventional Science, University College London, London, UK.,Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - Nicola L Robertson
- Division of Surgery & Interventional Science, University College London, London, UK.,Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - Neil McCartan
- Division of Surgery & Interventional Science, University College London, London, UK
| | - Charles Jameson
- Department of Pathology, University College London Hospital NHS Foundation Trust, London, UK
| | - Simon R J Bott
- Department of Urology, Frimley Park Hospital, Surrey, UK
| | - Mathias Winkler
- Department of Urology, Charing Cross Hospital, Imperial College NHS Trust, London, UK
| | - Brandon Whitcher
- Klarismo, London, UK.,Department of Mathematics, Imperial College London, UK
| | | | - Mark Emberton
- Division of Surgery & Interventional Science, University College London, London, UK.,Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - Clare Allen
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
| | - Alex Kirkham
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
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15
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Incorporating Oxygen-Enhanced MRI into Multi-Parametric Assessment of Human Prostate Cancer. Diagnostics (Basel) 2017; 7:diagnostics7030048. [PMID: 28837092 PMCID: PMC5617948 DOI: 10.3390/diagnostics7030048] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/13/2017] [Accepted: 08/21/2017] [Indexed: 12/18/2022] Open
Abstract
Hypoxia is associated with prostate tumor aggressiveness, local recurrence, and biochemical failure. Magnetic resonance imaging (MRI) offers insight into tumor pathophysiology and recent reports have related transverse relaxation rate (R2*) and longitudinal relaxation rate (R1) measurements to tumor hypoxia. We have investigated the inclusion of oxygen-enhanced MRI for multi-parametric evaluation of tumor malignancy. Multi-parametric MRI sequences at 3 Tesla were evaluated in 10 patients to investigate hypoxia in prostate cancer prior to radical prostatectomy. Blood oxygen level dependent (BOLD), tissue oxygen level dependent (TOLD), dynamic contrast enhanced (DCE), and diffusion weighted imaging MRI were intercorrelated and compared with the Gleason score. The apparent diffusion coefficient (ADC) was significantly lower in tumor than normal prostate. Baseline R2* (BOLD-contrast) was significantly higher in tumor than normal prostate. Upon the oxygen breathing challenge, R2* decreased significantly in the tumor tissue, suggesting improved vascular oxygenation, however changes in R1 were minimal. R2* of contralateral normal prostate decreased in most cases upon oxygen challenge, although the differences were not significant. Moderate correlation was found between ADC and Gleason score. ADC and R2* were correlated and trends were found between Gleason score and R2*, as well as maximum-intensity-projection and area-under-the-curve calculated from DCE. Tumor ADC and R2* have been associated with tumor hypoxia, and thus the correlations are of particular interest. A multi-parametric approach including oxygen-enhanced MRI is feasible and promises further insights into the pathophysiological information of tumor microenvironment.
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16
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Skorpil M, Brynolfsson P, Engström M. Motion corrected DWI with integrated T2-mapping for simultaneous estimation of ADC, T2-relaxation and perfusion in prostate cancer. Magn Reson Imaging 2017; 39:162-167. [DOI: 10.1016/j.mri.2017.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 03/08/2017] [Accepted: 03/08/2017] [Indexed: 01/05/2023]
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17
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Cai K, Tain RW, Zhou XJ, Damen FC, Scotti AM, Hariharan H, Poptani H, Reddy R. Creatine CEST MRI for Differentiating Gliomas with Different Degrees of Aggressiveness. Mol Imaging Biol 2017; 19:225-232. [PMID: 27541025 PMCID: PMC5824619 DOI: 10.1007/s11307-016-0995-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Creatine (Cr) is a major metabolite in the bioenergetic system. Measurement of Cr using conventional MR spectroscopy (MRS) suffers from low spatial resolution and relatively long acquisition times. Creatine chemical exchange saturation transfer (CrCEST) magnetic resonance imaging (MRI) is an emerging molecular imaging method for tissue Cr measurements. Our previous study showed that the CrCEST contrast, obtained through multicomponent Z-spectral fitting, was lower in tumors compared to normal brain, which further reduced with tumor progression. The current study was aimed to investigate if CrCEST MRI can also be useful for differentiating gliomas with different degrees of aggressiveness. PROCEDURES Intracranial 9L gliosarcoma and F98 glioma bearing rats with matched tumor size were scanned with a 9.4 T MRI scanner at two time points. CEST Z-spectra were collected using a customized sequence with a frequency-selective rectangular saturation pulse (B1 = 50 Hz, duration = 3 s) followed by a single-shot readout. Z spectral data were fitted pixel-wise with five Lorentzian functions, and maps of CrCEST peak amplitude, linewidth, and integral were produced. For comparison, single-voxel proton MR spectroscopy (1H-MRS) was performed to quantify and compare the total Cr concentration in the tumor. RESULTS CrCEST contrasts decreased with tumor progression from weeks 3 to 4 in both 9L and F98 phenotypes. More importantly, F98 tumors had significantly lower CrCEST integral compared to 9L tumors. On the other hand, integrals of other Z-spectral components were unable to differentiate both tumor progression and phenotype with limited sample size. CONCLUSIONS Given that F98 is a more aggressive tumor than 9L, this study suggests that CrCEST MRI may help differentiate gliomas with different aggressiveness.
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Affiliation(s)
- Kejia Cai
- Department of Radiology and the Center for MR Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA.
| | - Rong-Wen Tain
- Department of Radiology and the Center for MR Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Xiaohong Joe Zhou
- Department of Radiology and the Center for MR Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Frederick C Damen
- Department of Radiology and the Center for MR Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Alessandro M Scotti
- Department of Radiology and the Center for MR Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Hari Hariharan
- The Center for Magnetic Resonance and Optical Imaging, Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Harish Poptani
- Centre for Preclinical Imaging, University of Liverpool, Liverpool, UK
| | - Ravinder Reddy
- The Center for Magnetic Resonance and Optical Imaging, Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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18
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Yu AC, Badve C, Ponsky LE, Pahwa S, Dastmalchian S, Rogers M, Jiang Y, Margevicius S, Schluchter M, Tabayoyong W, Abouassaly R, McGivney D, Griswold MA, Gulani V. Development of a Combined MR Fingerprinting and Diffusion Examination for Prostate Cancer. Radiology 2017; 283:729-738. [PMID: 28187264 DOI: 10.1148/radiol.2017161599] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Purpose To develop and evaluate an examination consisting of magnetic resonance (MR) fingerprinting-based T1, T2, and standard apparent diffusion coefficient (ADC) mapping for multiparametric characterization of prostate disease. Materials and Methods This institutional review board-approved, HIPAA-compliant retrospective study of prospectively collected data included 140 patients suspected of having prostate cancer. T1 and T2 mapping was performed with fast imaging with steady-state precession-based MR fingerprinting with ADC mapping. Regions of interest were drawn by two independent readers in peripheral zone lesions and normal-appearing peripheral zone (NPZ) tissue identified on clinical images. T1, T2, and ADC were recorded for each region. Histopathologic correlation was based on systematic transrectal biopsy or cognitively targeted biopsy results, if available. Generalized estimating equations logistic regression was used to assess T1, T2, and ADC in the differentiation of (a) cancer versus NPZ, (b) cancer versus prostatitis, (c) prostatitis versus NPZ, and (d) high- or intermediate-grade tumors versus low-grade tumors. Analysis was performed for all lesions and repeated in a targeted biopsy subset. Discriminating ability was evaluated by using the area under the receiver operating characteristic curve (AUC). Results In this study, 109 lesions were analyzed, including 39 with cognitively targeted sampling. T1, T2, and ADC from cancer (mean, 1628 msec ± 344, 73 msec ± 27, and 0.773 × 10-3 mm2/sec ± 0.331, respectively) were significantly lower than those from NPZ (mean, 2247 msec ± 450, 169 msec ± 61, and 1.711 × 10-3 mm2/sec ± 0.269) (P < .0001 for each) and together produced the best separation between these groups (AUC = 0.99). ADC and T2 together produced the highest AUC of 0.83 for separating high- or intermediate-grade tumors from low-grade cancers. T1, T2, and ADC in prostatitis (mean, 1707 msec ± 377, 79 msec ± 37, and 0.911 × 10-3 mm2/sec ± 0.239) were significantly lower than those in NPZ (P < .0005 for each). Interreader agreement was excellent, with an intraclass correlation coefficient greater than 0.75 for both T1 and T2 measurements. Conclusion This study describes the development of a rapid MR fingerprinting- and diffusion-based examination for quantitative characterization of prostatic tissue. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Alice C Yu
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Chaitra Badve
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Lee E Ponsky
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Shivani Pahwa
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Sara Dastmalchian
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Matthew Rogers
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Yun Jiang
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Seunghee Margevicius
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Mark Schluchter
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - William Tabayoyong
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Robert Abouassaly
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Debra McGivney
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Mark A Griswold
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
| | - Vikas Gulani
- From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106
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Romero-Selas E, Cuadros V, Montáns J, Sánchez E, López-Alcorocho J, Gómez-Sancha F. Transperineal prostate biopsy with ECHO-MRI fusion. Biopsee system. Initial experience. Actas Urol Esp 2016; 40:295-302. [PMID: 26948092 DOI: 10.1016/j.acuro.2015.12.002] [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: 10/20/2015] [Revised: 12/10/2015] [Accepted: 12/10/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study is to present our initial experience with the stereotactic echo-MRI fusion system for diagnosing prostate cancer. MATERIAL AND METHODS Between September 2014 and January 2015, we performed 50 prostate biopsies using the stereotactic echo-MRI fusion system. The 3-Tesla multiparameter MR images were superimposed using this image fusion system on 3D echo images obtained with the Biopsee system for the exact locating of areas suspected of prostate cancer. The lesions were classified using the Prostate Imaging Report and Date System. RESULTS We assessed a total of 50 patients, with a mean age of 63 years (range, 45-79), a mean prostate-specific antigen level of 8 ng/mL (range, 1.9-20) and a mean prostate volume of 52mL (range, 12-118). Prostate cancer was diagnosed in 69% of the patients and intraepithelial neoplasia in 6%. The results of the biopsy were negative for 24% of the patients. The results of the biopsy and MRI were in agreement for 62% of the patients; however, 46% also had a tumour outside of the suspicious lesion. We diagnosed 46% anterior tumours and 33% apical tumours. One patient had a haematuria, another had a haematoma and a third had acute urine retention. CONCLUSIONS Multiparametric prostatic MRI helps identify prostate lesions suggestive of cancer. The Biopsee echo-MRI fusion system provides for guided biopsy and increases the diagnostic performance, reducing the false negatives of classical biopsies and increasing the diagnosis of anterior tumours. Transperineal access minimises the risk of prostatic infection and sepsis.
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20
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Bojorquez JZ, Bricq S, Brunotte F, Walker PM, Lalande A. A novel alternative to classify tissues from T 1 and T 2 relaxation times for prostate MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 29:777-88. [PMID: 27160300 DOI: 10.1007/s10334-016-0562-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/12/2016] [Accepted: 04/22/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To segment and classify the different attenuation regions from MRI at the pelvis level using the T 1 and T 2 relaxation times and anatomical knowledge as a first step towards the creation of PET/MR attenuation maps. MATERIALS AND METHODS Relaxation times were calculated by fitting the pixel-wise intensities of acquired T 1- and T 2-weighted images from eight men with inversion-recovery and multi-echo multi-slice spin-echo sequences. A decision binary tree based on relaxation times was implemented to segment and classify fat, muscle, prostate, and air (within the body). Connected component analysis and an anatomical knowledge-based procedure were implemented to localize the background and bone. RESULTS Relaxation times at 3 T are reported for fat (T 1 = 385 ms, T 2 = 121 ms), muscle (T 1 = 1295 ms, T 2 = 40 ms), and prostate (T 1 = 1700 ms, T 2 = 80 ms). The relaxation times allowed the segmentation-classification of fat, prostate, muscle, and air, and combined with anatomical knowledge, they allowed classification of bone. The good segmentation-classification of prostate [mean Dice similarity score (mDSC) = 0.70] suggests a viable implementation in oncology and that of fat (mDSC = 0.99), muscle (mDSC = 0.99), and bone (mDSCs = 0.78) advocates for its implementation in PET/MR attenuation correction. CONCLUSION Our method allows the segmentation and classification of the attenuation-relevant structures required for the generation of the attenuation map of PET/MR systems in prostate imaging: air, background, bone, fat, muscle, and prostate.
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Affiliation(s)
- Jorge Zavala Bojorquez
- LE2I, UMR 6306, CNRS, Arts et Métiers, Université Bourgogne Franche-Comté, 21000, Dijon, France.
| | - Stéphanie Bricq
- LE2I, UMR 6306, CNRS, Arts et Métiers, Université Bourgogne Franche-Comté, 21000, Dijon, France
| | - François Brunotte
- LE2I, UMR 6306, CNRS, Arts et Métiers, Université Bourgogne Franche-Comté, 21000, Dijon, France
| | - Paul M Walker
- LE2I, UMR 6306, CNRS, Arts et Métiers, Université Bourgogne Franche-Comté, 21000, Dijon, France
| | - Alain Lalande
- LE2I, UMR 6306, CNRS, Arts et Métiers, Université Bourgogne Franche-Comté, 21000, Dijon, France
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Jambor I, Pesola M, Taimen P, Merisaari H, Boström PJ, Minn H, Liimatainen T, Aronen HJ. Rotating frame relaxation imaging of prostate cancer: Repeatability, cancer detection, and Gleason score prediction. Magn Reson Med 2015; 75:337-44. [PMID: 25733132 DOI: 10.1002/mrm.25647] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 12/08/2014] [Accepted: 01/12/2015] [Indexed: 12/31/2022]
Abstract
PURPOSE To investigate relaxation along a fictitious field (RAFF) and continuous wave (cw) T1ρ imaging of prostate cancer (PCa) in the terms of repeatability, PCa detection, and characterization. METHODS Thirty-six patients (PSA 11.6 ± 7.6 ng/mL, mean ± standard deviation) with histologically confirmed PCa underwent two repeated 3T MR examinations using surface array coils before prostatectomy. Relaxation along fictitious field, cw T1ρ, and T2 relaxation times (TRAFF, T1ρcw, T2) were measured and averaged over regions of interest placed in PCa, normal peripheral zone (PZ), and normal central gland (CG) positioned using whole-mount prostatectomy sections and anatomical T2-weighted images. Receiver operating characteristic curve analysis with area under the curve (AUC) was calculated to distinguish PCa from PZ/CG and PCa with Gleason score (GS) of 3+3 from GS of 3+4/≥ 3+4. RESULTS TRAFF and T1ρcw relaxation times were repeatable with coefficients of repeatability as a percentage of median value in the range of 7.8-23.2%. AUC (mean, 95% confidence interval) in the differentiation of PCa with GS of 3+3 from PCa with CS of ≥ 3+4 were 0.88 (0.72-0.99), 0.69 (0.46-0.90), and 0.68 (0.45-0.88), for TRAFF, T1ρcw, and T2, respectively. CONCLUSION In quantitative region of interest based analysis, TRAFF outperformed T1ρcw and T2 in PCa detection and characterization.
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Affiliation(s)
- Ivan Jambor
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
| | - Marko Pesola
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
| | - Pekka Taimen
- Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland
| | - Harri Merisaari
- Department of Information Technology, University of Turku, Turku, Finland.,Turku PET Centre, University of Turku, Turku, Finland
| | - Peter J Boström
- Department of Surgery, Division of Urology, Turku University Hospital, Turku, Finland
| | - Heikki Minn
- Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
| | - Timo Liimatainen
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Hannu J Aronen
- Department of Diagnostic Radiology, University of Turku, Turku, Finland.,Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland
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Boesen L, Chabanova E, Løgager V, Balslev I, Thomsen HS. Apparent diffusion coefficient ratio correlates significantly with prostate cancer gleason score at final pathology. J Magn Reson Imaging 2014; 42:446-53. [PMID: 25408104 DOI: 10.1002/jmri.24801] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/27/2014] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To evaluate the correlation between apparent diffusion coefficient measurements (ADCtumor and ADCratio ) and the Gleason score from radical prostatectomy specimens. MATERIALS AND METHODS Seventy-one patients with clinically localized prostate cancer scheduled for radical prostatectomy were prospectively enrolled. Multiparametric magnetic resonance imaging (MRI) was performed prior to prostatectomy and mean ADC values from both cancerous (ADCtumor ) and benign (ADCbenign ) tissue were measured to calculate the ADCratio (ADCtumor divided by ADCbenign ). The ADC measurements were correlated with the Gleason score from the prostatectomy specimens. RESULTS The association between ADC measurements and Gleason score showed a significant negative correlation (P < 0.001) with Spearman's rho for ADCtumor (-0.421) and ADCratio (-0.649). There was a statistically significant difference between ADC measurements and the Gleason score for all tumors (P = 0.001). Receiver operating characteristic curve analysis showed an overall area under the curve (AUC) of 0.73 (ADCtumor ) to 0.80 (ADCratio ) in discriminating Gleason score 6 from Gleason score ≥7 tumors. The AUC changed to 0.72 (ADCtumor ) and 0.90 (ADCratio ) when discriminating Gleason score ≤7(3+4) from Gleason score ≥7(4+3). CONCLUSION ADC measurements showed a significant correlation with tumor Gleason score at final pathology. The ADCratio demonstrated the best correlation compared to the ADCtumor value and radically improved accuracy in discriminating Gleason score ≤7(3+4) from Gleason score ≥7(4+3) tumors.
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Affiliation(s)
- Lars Boesen
- Department of Urology, Herlev University Hospital, Herlev, Denmark
| | | | - Vibeke Løgager
- Department of Radiology, Herlev University Hospital, Herlev, Denmark
| | - Ingegerd Balslev
- Department of Pathology, Herlev University Hospital, Herlev, Denmark
| | - Henrik S Thomsen
- Department of Radiology, Herlev University Hospital, Herlev, Denmark
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High-b-value diffusion-weighted MRI for the detection of prostate cancer at 3 T. Clin Radiol 2014; 69:1165-70. [DOI: 10.1016/j.crad.2014.07.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 07/11/2014] [Accepted: 07/16/2014] [Indexed: 01/08/2023]
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