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Wei M, Yang H, Li Z, Hu W, Qin Y, Wan L. The value of synthetic MRI for quantitative analysis in the diagnosis of cervical lymph node metastasis in thyroid cancer. Acta Radiol 2024; 65:744-752. [PMID: 38870345 DOI: 10.1177/02841851241257775] [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] [Indexed: 06/15/2024]
Abstract
BACKGROUND Preoperative effective assessment of cervical lymph node metastasis in thyroid cancer plays an important role in formulating the surgical plan. PURPOSE To investigate the significance of synthetic magnetic resonance imaging (MRI) for quantitatively analyzing cervical lymph node metastasis in thyroid cancer. MATERIAL AND METHODS A retrospective analysis was conducted on 30 patients with thyroid cancer, consisting of 19 thyroid cancer nodules, 45 metastatic lymph nodes, and 47 non-metastatic lymph nodes. Regions of interest (ROIs) for each type of nodule were manually delineated using a workstation. Quantitative parameters, such as T1, T2, and proton density (PD) values, were automatically extracted from synthetic MRI scans. Statistical tests and regression analysis were performed to assess differences and correlations among the quantitative parameters. RESULTS There were no significant differences in the quantitative parameter values between the primary tumor and metastatic lymph node tissues (P > 0.05). However, significant differences were observed in the quantitative parameters between the primary tumor and non-metastatic lymph node tissues and between the metastatic and non-metastatic lymph node tissues (P < 0.05). The diagnostic accuracy for cervical lymph node metastasis in thyroid cancer was 94.4% for the T1 and T2 combined index, 91.9% for T2, 86.8% for T1, and 71.7% for PD values. CONCLUSION The application of quantitative parameters from synthetic MRI can assist clinicians in accurately planning surgical interventions for thyroid cancer patients before surgery.
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Affiliation(s)
- Mei Wei
- Department of Radiology, Bishan Hospital affiliated to Chongqing Medical University, Chongqing, PR China
| | - Haitao Yang
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Zhihua Li
- Department of Radiology, Bishan Hospital affiliated to Chongqing Medical University, Chongqing, PR China
| | - Wei Hu
- Department of Radiology, Bishan Hospital affiliated to Chongqing Medical University, Chongqing, PR China
| | - Yong Qin
- Department of Radiology, Bishan Hospital affiliated to Chongqing Medical University, Chongqing, PR China
| | - Liangbin Wan
- Department of Radiology, Bishan Hospital affiliated to Chongqing Medical University, Chongqing, PR China
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Yang X, Lu Z, Tan X, Shao L, Shi J, Dou W, Sun Z. Evaluating the added value of synthetic magnetic resonance imaging in predicting sentinel lymph node status in breast cancer. Quant Imaging Med Surg 2024; 14:3789-3802. [PMID: 38846281 PMCID: PMC11151255 DOI: 10.21037/qims-24-1] [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: 01/01/2024] [Accepted: 03/29/2024] [Indexed: 06/09/2024]
Abstract
Background The noninvasive prediction of sentinel lymph node (SLN) metastasis using quantitative magnetic resonance imaging (MRI), particularly with synthetic MRI (syMRI), is an emerging field. This study aimed to explore the potential added benefits of syMRI over conventional MRI and diffusion-weighted imaging (DWI) in predicting metastases in SLNs. Methods This retrospective study consecutively enrolled 101 patients who were diagnosed with breast cancer (BC) and underwent SLN biopsy from December 2022 to October 2023 at the Affiliated Hospital of Jiangnan University. These patients underwent preoperative MRI including conventional MRI, DWI, and syMRI and were categorized into two groups according to the postoperative pathological results: those with and without metastatic SLNs. MRI morphological features, DWI, and syMRI-derived quantitative parameters of breast tumors were statistically compared between these two groups. Binary logistic regression was used to separately develop predictive models for determining the presence of SLN involvement, with variables that exhibited significant differences being incorporated. The performance of each model was evaluated through receiver operating characteristic (ROC) curve analysis, including the area under the curve (AUC), sensitivity, and specificity. Results Compared to the group of 54 patients with BC but no metastatic SLNs, the group of 47 patients with BC and metastatic SLNs had a significantly larger maximum axis diameter [metastatic SLNs: median 2.40 cm, interquartile range (IQR) 1.50-3.00 cm; no metastatic SLNs: median 1.80 cm, IQR 1.37-2.50 cm; P=0.03], a higher proton density (PD) (78.44±11.92 vs. 69.20±10.63 pu; P<0.001), and a lower apparent diffusion coefficient (ADC) (metastatic SLNs: median 0.91×10-3 mm2/s, IQR 0.79-1.01 mm2/s; no metastatic SLNs: median 1.02×10-3 mm2/s, IQR 0.92-1.12 mm2/s; P=0.001). Moreover, the prediction model with maximum axis diameter and ADC yielded an AUC of 0.71 [95% confidence interval (CI): 0.618-0.802], with a sensitivity of 78.72% and a specificity of 51.85%; After addition of syMRI-derived PD to the prediction model, the AUC increased significantly to 0.86 (AUC: 0.86 vs. 0.71; 95% CI: 0.778-0.922; P=0.002), with a sensitivity of 80.85% and a specificity of 81.50%. Conclusions Combined with conventional MRI and DWI, syMRI can offer additional value in enhancing the predictive performance of determining SLN status before surgery in patients with BC.
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Affiliation(s)
- Xiao Yang
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Zhou Lu
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Xiaoying Tan
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Lin Shao
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Jie Shi
- GE Healthcare, MR Research China, Beijing, China
| | - Weiqiang Dou
- GE Healthcare, MR Research China, Beijing, China
| | - Zongqiong Sun
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, China
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Chen Y, Meng T, Cao W, Zhang W, Ling J, Wen Z, Qian L, Guo Y, Lin J, Wang H. Histogram analysis of MR quantitative parameters: are they correlated with prognostic factors in prostate cancer? Abdom Radiol (NY) 2024; 49:1534-1544. [PMID: 38546826 DOI: 10.1007/s00261-024-04227-6] [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: 11/15/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE To investigate the correlation between quantitative MR parameters and prognostic factors in prostate cancer (PCa). METHOD A total of 186 patients with pathologically confirmed PCa who underwent preoperative multiparametric MRI (mpMRI), including synthetic MRI (SyMRI), were enrolled from two medical centers. The histogram metrics of SyMRI [T1, T2, proton density (PD)] and apparent diffusion coefficient (ADC) values were extracted. The Mann‒Whitney U test or Student's t test was employed to determine the association between these histogram features and the prognostically relevant factors. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the differentiation performance. Spearman's rank correlation coefficients were calculated to determine the correlations between histogram parameters and the International Society of Urological Pathology (ISUP) grade group as well as pathological T stage. RESULTS Significant correlations were found between the histogram parameters and the ISUP grade as well as pathological T stage of PCa. Among these histogram parameters, ADC_minimum had the strongest correlation with the ISUP grade (r = - 0.481, p < 0.001), and ADC_Median showed the strongest association with pathological T stage (r = - 0.285, p = 0.008). The ADC_10th percentile exhibited the highest performance in identifying clinically significant prostate cancer (csPCa) (AUC 0.833; 95% CI 0.771-0.883). When discriminating between the status of different prognostically relevant factors, a significant difference was observed between extraprostatic extension-positive and -negative cancers with regard to histogram parameters of the ADC map (10th percentile, 90th percentile, mean, median, minimum) and T1 map (minimum) (p = 0.002-0.032). Moreover, histogram parameters of the ADC map (90th percentile, maximum, mean, median), T2 map (10th percentile, median), and PD map (10th percentile, median) were significantly lower in PCa with perineural invasion (p = 0.009-0.049). The T2 values were significantly lower in patients with seminal vesicle invasion (minimum, p = 0.036) and positive surgical margin (10th percentile, 90th percentile, mean, median, and minimum, p = 0.015-0.025). CONCLUSION Quantitative histogram parameters derived from synthetic MRI and ADC maps may have great potential for predicting the prognostic features of PCa.
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Affiliation(s)
- Yanling Chen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Tiebao Meng
- Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, Guangdong, People's Republic of China
| | - Wenxin Cao
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Weijing Zhang
- Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, Guangdong, People's Republic of China
| | - Jian Ling
- Department of Radiology, The Eastern Hospital of the First Affiliated Hospital, Sun Yat-sen University, No.183 Huangpu Eastern Road, Guangzhou, Guangdong, People's Republic of China
| | - Zhihua Wen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Long Qian
- MR Research, GE Healthcare, Beijing, People's Republic of China
| | - Yan Guo
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China.
| | - Jinhua Lin
- Division of Interventional Ultrasound, Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, Guangdong, People's Republic of China.
| | - Huanjun Wang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China.
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Xiang Y, Zhang Q, Chen X, Sun H, Li X, Wei X, Zhong J, Gao B, Huang W, Liang W, Sun H, Yang Q, Ren X. Synthetic MRI and amide proton transfer-weighted MRI for differentiating between benign and malignant sinonasal lesions. Eur Radiol 2024:10.1007/s00330-024-10696-6. [PMID: 38491129 DOI: 10.1007/s00330-024-10696-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES To explore the value of the synthetic MRI (SyMRI), combined with amide proton transfer-weighted (APTw) MRI for quantitative and morphologic assessment of sinonasal lesions, which could provide relative scale for the quantitative assessment of tissue properties. METHODS A total of 80 patients (31 malignant and 49 benign) with sinonasal lesions, who underwent the SyMRI and APTw examination, were retrospectively analyzed. Quantitative parameters (T1, T2, proton density (PD)) and APT % were obtained through outlining the region of interest (ROI) and comparing the two groups utilizing independent Student t test or a Wilcoxon test. Receiver operating characteristic curve (ROC), Delong test, and logistic regression analysis were performed to assess the diagnostic efficiency of one-parameter and multiparametric models. RESULTS SyMRI-derived mean T1, T2, and PD were significantly higher and APT % was relatively lower in benign compared to malignant sinonasal lesions (p < 0.05). The ROC analysis showed that the AUCs of the SyMRI-derived quantitative (T1, T2, PD) values and APT % ranged from 0.677 to 0.781 for differential diagnosis between benign and malignant sinonasal lesions. The T2 values showed the best diagnostic performance among all single parameters for differentiating these two masses. The AUCs of combined SyMRI-derived multiple parameters with APT % (AUC = 0.866) were the highest than that of any single parameter, which was significantly improved (p < 0.05). CONCLUSION The combination of SyMRI and APTw imaging has the potential to reflect intrinsic tissue characteristics useful for differentiating benign from malignant sinonasal lesions. CLINICAL RELEVANCE STATEMENT Combining synthetic MRI with amide proton transfer-weighted imaging could function as a quantitative and contrast-free approach, significantly enhancing the differentiation of benign and malignant sinonasal lesions and overcoming the limitations associated with the superficial nature of endoscopic nasal sampling. KEY POINTS • Synthetic MRI and amide proton transfer-weighted MRI could differentiate benign from malignant sinonasal lesions based on quantitative parameters. • The diagnostic efficiency could be significantly improved through synthetic MRI + amide proton transfer-weighted imaging. • The combination of synthetic MRI and amide proton transfer-weighted MRI is a noninvasive method to evaluate sinonasal lesions.
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Affiliation(s)
- Ying Xiang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qiujuan Zhang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xin Chen
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Honghong Sun
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaohui Li
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | | | - Jinman Zhong
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bo Gao
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wei Huang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wenbin Liang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Haiqiao Sun
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Quanxin Yang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
| | - Xiaoyong Ren
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Zeng F, Yang Z, Tang X, Lin L, Lin H, Wu Y, Wang Z, Chen M, Chen L, Chen L, Wu PY, Wang C, Xue Y. Whole-tumor histogram models based on quantitative maps from synthetic MRI for predicting axillary lymph node status in invasive ductal breast cancer. Eur J Radiol 2024; 172:111325. [PMID: 38262156 DOI: 10.1016/j.ejrad.2024.111325] [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: 10/06/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 01/25/2024]
Abstract
PURPOSE To investigate the potential of using histogram analysis of synthetic MRI (SyMRI) images before and after contrast enhancement to predict axillary lymph node (ALN) status in patients with invasive ductal carcinoma (IDC). METHODS From January 2022 to October 2022, a total of 212 patients with IDC underwent breast MRI examination including SyMRI. Standard T2 weight images, DCE-MRI and quantitative maps of SyMRI were obtained. 13 features of the entire tumor were extracted from these quantitative maps, standard T2 weight images and DCE-MRI. Statistical analyses, including Student's t-test, Mann-Whiney U test, logistic regression, and receiver operating characteristic (ROC) curves, were used to evaluate the data. The mean values of SyMRI quantitative parameters derived from the conventional 2D region of interest (ROI) were also evaluated. RESULTS The combined model based on T1-Gd quantitative map (energy, minimum, and variance) and clinical features (age and multifocality) achieved the best diagnostic performance in the prediction of ALN between N0 (with non-metastatic ALN) and N+ group (metastatic ALN ≥ 1) with the AUC of 0.879. Among individual quantitative maps and standard sequence-derived models, the synthetic T1-Gd model showed the best performance for the prediction of ALN between N0 and N+ groups (AUC = 0.823). Synthetic T2_entropy and PD-Gd_energy were useful for distinguishing N1 group (metastatic ALN ≥ 1 and ≤ 3) from the N2-3 group (metastatic ALN > 3) with an AUC of 0.722. CONCLUSIONS Whole-tumor histogram features derived from quantitative parameters of SyMRI can serve as a complementary noninvasive method for preoperatively predicting ALN metastases.
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Affiliation(s)
- Fang Zeng
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China
| | - Zheting Yang
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China
| | - Xiaoxue Tang
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China
| | - Lin Lin
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China
| | - Hailong Lin
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China
| | - Yue Wu
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China
| | - Zongmeng Wang
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China
| | - Minyan Chen
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China; Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province 350001, China
| | - Lili Chen
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China; Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province 350001, China
| | - Lihong Chen
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China
| | - Pu-Yeh Wu
- GE Healthcare, Beijing 100176, China
| | - Chuang Wang
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China; Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province 350001, China.
| | - Yunjing Xue
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province 350001, China; School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, Fujian Province 350004, China; Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), China.
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He H, Song M, Tian Z, Gao N, Ma J, Wang Z. Multiparametric MRI model with synthetic MRI, DWI multi-quantitative parameters, and differential sub-sampling with cartesian ordering enables BI-RADS 4 lesions diagnosis with high accuracy. Front Oncol 2024; 13:1180131. [PMID: 38250550 PMCID: PMC10797086 DOI: 10.3389/fonc.2023.1180131] [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: 04/28/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Objective To assess the feasibility and diagnostic performances of synthetic magnetic resonance imaging (SyMRI) combined with diffusion-weighted imaging (DWI) and differential subsampling with cartesian ordering (DISCO) in breast imaging reporting and data system (BI-RADS) 4 lesions. Methods A total of 98 BI-RADS 4 patients, including 68 cases assigned to a malignant group and 33 cases assigned to a benign group, were prospectively enrolled, and their MRI and clinical information were collected. Two physicians jointly analyzed the characteristics of conventional MRI. T1, T2, proton density (PD), and ADC values were obtained from three different regions of interest (ROIs). Logistic regression analyses were used to select features and build models, and a nomogram was constructed with the best model. Results Using the ROI delineation method at the most obvious enhancement to measure the ADC value revealed the best diagnostic performance in diagnosing BI-RADS type 4 mass lesions. The diagnostic efficiency of the maximum level drawing method of the quantitative relaxation model was better than that of the whole drawing method and the most obvious enhancement method. The best relaxation model (model A) was composed of two parameters: T2stand and ΔT1%stand (AUC=0.887), and the BI-RADS model (model B) was constructed by two MRI features of edge and TIC curve (AUC=0.793). Using the quantitative parameters of SyMRI and DWI of the best ROC method combined with DISCO enhanced MRI features to establish a joint diagnostic model (model C: edge, TIC curve type, ADClocal, T2stand, ΔT1%stand) showed the best diagnostic efficiency (AUC=0.953). The nomogram also had calibration curves with good overlap. Conclusions The combined diagnosis model of SyMRI and DWI quantitative parameters combined with DISCO can improve the diagnostic efficiency of BI-RADS 4 types of mass lesions. Also, the line diagram based on this model can be used as an auxiliary diagnostic tool.
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Affiliation(s)
- Hua He
- Department of Radiology, General Hospital of First Clinical Medical College, Ningxia Medical University, Yinchuan, China
- First Clinical Medical College, Ningxia Medical University, Yinchuan, China
| | - Meina Song
- Department of Radiology, General Hospital of First Clinical Medical College, Ningxia Medical University, Yinchuan, China
- First Clinical Medical College, Ningxia Medical University, Yinchuan, China
| | - Zhaorong Tian
- Department of Radiology, General Hospital of First Clinical Medical College, Ningxia Medical University, Yinchuan, China
- First Clinical Medical College, Ningxia Medical University, Yinchuan, China
| | - Na Gao
- Department of Radiology, General Hospital of First Clinical Medical College, Ningxia Medical University, Yinchuan, China
- First Clinical Medical College, Ningxia Medical University, Yinchuan, China
| | - Jiale Ma
- Department of Radiology, General Hospital of First Clinical Medical College, Ningxia Medical University, Yinchuan, China
| | - Zhijun Wang
- Department of Radiology, General Hospital of First Clinical Medical College, Ningxia Medical University, Yinchuan, China
- First Clinical Medical College, Ningxia Medical University, Yinchuan, China
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Zhang H, Zhao J, Dai J, Chang J, Hu S, Wang P. Synthetic MRI quantitative parameters in discriminating stage T1 nasopharyngeal carcinoma and benign hyperplasia: Combination with morphological features. Eur J Radiol 2024; 170:111264. [PMID: 38103492 DOI: 10.1016/j.ejrad.2023.111264] [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: 09/27/2023] [Revised: 11/23/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE To investigate the feasibility of synthetic MRI (syMRI) quantitative parameters and its combination with morphological features in discriminating stage T1 nasopharyngeal carcinoma (T1-NPC) and benign hyperplasia (BH). MATERIAL AND METHODS Eighty-eight patients with nasopharyngeal lesions (T1-NPC, n = 54; BH, n = 34) were retrospectively enrolled between October 2020 and May 2022. The syMRI quantitative parameters of nasopharyngeal lesions (T1, T2, PD, T1SD, T2SD, PDSD) and longus capitis (T1, T2, PD) were measured, and T1ratio, T2ratio and PDratio were calculated (lesion/longus capitis). The morphological features (lesion pattern, retention cyst, serrated protrusion, middle ear effusion, tumor volume, and retropharyngeal lymph node) were compared. Statistical analyses were performed using the independent sample t test, Chi-square test, logistic regression analysis, receiver operating characteristic curve (ROC), and DeLong test. RESULTS The T1, T2, PD, T1SD, T1ratio, and T2ratio values of T1-NPC were significantly lower than those of BH. The morphological features (lesion pattern, retention cyst, retropharyngeal lymph node) were significant difference between these two entities. T2 value has the highest AUC in all syMRI quantitative parameters, followed by T1, T1ratio, PD, T2ratio and T1SD. Combined syMRI quantitative parameters (T2, PD, T1ratio) can further improve the diagnosis efficiency. Combined syMRI parameters and morphological feature (T2, PD, lesion pattern, retropharyngeal lymph node) has the excellent diagnostic efficiency, with AUC, sensitivity, specificity, and accuracy of 0.979, 96.30%, 97.06%, 96.77%. CONCLUSIONS Synthetic MRI was helpful in distinguishing T1-NPC from BH, and combined syMRI quantitative parameters and morphological features has the optimal diagnostic performance.
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Affiliation(s)
- Heng Zhang
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi 214122, PR China
| | - Jing Zhao
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi 214122, PR China
| | - Jiankun Dai
- GE Healthcare, MR Research China, Beijing 100176, PR China
| | - Jun Chang
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi 214122, PR China
| | - Shudong Hu
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi 214122, PR China.
| | - Peng Wang
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi 214122, PR China.
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Wáng YXJ, Aparisi Gómez MP, Ruiz Santiago F, Bazzocchi A. The relevance of T2 relaxation time in interpreting MRI apparent diffusion coefficient (ADC) map for musculoskeletal structures. Quant Imaging Med Surg 2023; 13:7657-7666. [PMID: 38106333 PMCID: PMC10722044 DOI: 10.21037/qims-23-1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/17/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Yi Xiang J. Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland District Health Board, Auckland, New Zealand
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Department of Radiology, IMSKE, Valencia, Spain
| | - Fernando Ruiz Santiago
- Department of Radiology and Physical Medicine, Faculty of Medicine, University of Granada, Granada, Spain
- Musculoskeletal Radiology Unit, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Li X, Fan Z, Jiang H, Niu J, Bian W, Wang C, Wang Y, Zhang R, Zhang H. Synthetic MRI in breast cancer: differentiating benign from malignant lesions and predicting immunohistochemical expression status. Sci Rep 2023; 13:17978. [PMID: 37864025 PMCID: PMC10589282 DOI: 10.1038/s41598-023-45079-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/16/2023] [Indexed: 10/22/2023] Open
Abstract
To evaluate and compare the performance of synthetic magnetic resonance imaging (SyMRI) in classifying benign and malignant breast lesions and predicting the expression status of immunohistochemistry (IHC) markers. We retrospectively analysed 121 patients with breast lesions who underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and SyMRI before surgery in our hospital. DCE-MRI was used to assess the lesions, and then regions of interest (ROIs) were outlined on SyMRI (before and after enhancement), and apparent diffusion coefficient (ADC) maps to obtain quantitative values. After being grouped according to benign and malignant status, the malignant lesions were divided into high and low expression groups according to the expression status of IHC markers. Logistic regression was used to analyse the differences in independent variables between groups. The performance of the modalities in classification and prediction was evaluated by receiver operating characteristic (ROC) curves. In total, 57 of 121 lesions were benign, the other 64 were malignant, and 56 malignant lesions performed immunohistochemical staining. Quantitative values from proton density-weighted imaging prior to an injection of the contrast agent (PD-Pre) and T2-weighted imaging (T2WI) after the injection (T2-Gd), as well as its standard deviation (SD of T2-Gd), were valuable SyMRI parameters for the classification of benign and malignant breast lesions, but the performance of SyMRI (area under the curve, AUC = 0.716) was not as good as that of ADC values (AUC = 0.853). However, ADC values could not predict the expression status of breast cancer markers, for which SyMRI had excellent performance. The AUCs of androgen receptor (AR), estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), p53 and Ki-67 were 0.687, 0.890, 0.852, 0.746, 0.813 and 0.774, respectively. SyMRI had certain value in distinguishing between benign and malignant breast lesions, and ADC values were still the ideal method. However, to predict the expression status of IHC markers, SyMRI had an incomparable value compared with ADC values.
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Affiliation(s)
- Xiaojun Li
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
- Department of Radiology, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Center, Shenzhen, China
| | - Zhichang Fan
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Hongnan Jiang
- Department of Breast Surgery, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Center, Shenzhen, China
| | - Jinliang Niu
- Department of Radiology, The 2nd Affiliated Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Wenjin Bian
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chen Wang
- Department of Pathology, The 2nd Affiliated Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Ying Wang
- Department of Pathology, The 2nd Affiliated Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Runmei Zhang
- Department of Radiology, The 2nd Affiliated Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Hui Zhang
- Department of Radiology, First Hospital of Shanxi Medical University, No. 85, South Jiefang Road, Yingze District, Taiyuan, 030001, Shanxi, China.
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10
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Wen B, Zhang Z, Zhu J, Liu L, Liu Z, Ma X, Wang K, Xie L, Zhang Y, Cheng J. Synthetic MRI plus FSE-PROPELLER DWI for differentiating malignant from benign head and neck tumors: a preliminary study. Front Oncol 2023; 13:1225420. [PMID: 37829331 PMCID: PMC10565487 DOI: 10.3389/fonc.2023.1225420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/04/2023] [Indexed: 10/14/2023] Open
Abstract
Background Preoperative classification of head and neck (HN) tumors remains challenging, especially distinguishing early cancerogenic masses from benign lesions. Synthetic MRI offers a new way for quantitative analysis of tumors. The present study investigated the application of synthetic MRI and stimulus and fast spin echo diffusion-weighted imaging with periodically rotated overlapping parallel lines with enhanced reconstruction (FSE-PROPELLER DWI) to differentiate malignant from benign HN tumors. Materials and methods Forty-eight patients with pathologically confirmed HN tumors were retrospectively recruited between August 2022 and October 2022. The patients were divided into malignant (n = 28) and benign (n = 20) groups. All patients were scanned using synthetic MRI and FSE-PROPELLER DWI. T1, T2, and proton density (PD) values were acquired on the synthetic MRI and ADC values on the FSE-PROPELLER DWI. Results Benign tumors (ADC: 2.03 ± 0.31 × 10-3 mm2/s, T1: 1741.13 ± 662.64 ms, T2: 157.43 ± 72.23 ms) showed higher ADC, T1, and T2 values compared to malignant tumors (ADC: 1.46 ± 0.37 × 10-3 mm2/s, T1: 1390.06 ± 241.09 ms, T2: 97.64 ± 14.91 ms) (all P<0.05), while no differences were seen for PD values. ROC analysis showed that T2+ADC (cut-off value, > 0.55; AUC, 0.950) had optimal diagnostic performance vs. T1 (cut-off value, ≤ 1675.84 ms; AUC, 0.698), T2 (cut-off value, ≤ 113.24 ms; AUC, 0.855) and PD (cut off value, > 80.67 pu; AUC, 0.568) alone in differentiating malignant from benign lesions (all P<0.05); yet, the difference in AUC between ADC and T2+ADC or T2 did not reach statistical significance. Conclusion Synthetic MRI and FSE-PROPELLER DWI can quantitatively differentiate malignant from benign HN tumors. T2 value is comparable to ADC value, and T2+ADC values could improve diagnostic efficacy., apparent diffusion coeffificient, head and neck tumors.
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Affiliation(s)
- Baohong Wen
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zanxia Zhang
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Zhu
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liang Liu
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zijun Liu
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoyue Ma
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kaiyu Wang
- MR Research China, GE Healthcare, Beijing, China
| | - Lizhi Xie
- MR Research China, GE Healthcare, Beijing, China
| | - Yong Zhang
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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11
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Huang BS, Hsieh CY, Chai WY, Lin Y, Huang YL, Lu KY, Chiang HJ, Schulte RF, Lin CYE, Lin G. Comparing Magnetic Resonance Fingerprinting (MRF) and the MAGiC Sequence for Simultaneous T1 and T2 Quantitative Measurements in the Female Pelvis: A Prospective Study. Diagnostics (Basel) 2023; 13:2147. [PMID: 37443541 DOI: 10.3390/diagnostics13132147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/29/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
The aim of this study was to explore the potential of magnetic resonance fingerprinting (MRF), an emerging quantitative MRI technique, in measuring relaxation values of female pelvic tissues compared to the conventional magnetic resonance image compilation (MAGiC) sequence. The study included 32 female patients who underwent routine pelvic MRI exams using anterior and posterior array coils on a 3T clinical scanner. Our findings demonstrated significant correlations between MRF and MAGiC measured T1 and T2 values (p < 0.0001) for various pelvic tissues, including ilium, femoral head, gluteus, obturator, iliopsoas, erector spinae, uterus, cervix, and cutaneous fat. The tissue contrasts generated from conventional MRI and synthetic MRF also showed agreement in bone, muscle, and uterus for both T1-weighted and T2-weighted images. This study highlights the strengths of MRF in providing simultaneous T1 and T2 mapping. MRF offers distinct tissue contrast and has the potential for accurate diagnosis of female pelvic diseases, including tumors, fibroids, endometriosis, and pelvic inflammatory disease. Additionally, MRF shows promise in monitoring disease progression or treatment response. Overall, the study demonstrates the potential of MRF in the field of female pelvic organ imaging and suggests that it could be a valuable addition to the clinical practice of pelvic MRI exams. Further research is needed to establish the clinical utility of MRF and to develop standardized protocols for its implementation in clinical practice.
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Affiliation(s)
- Bo-Syuan Huang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 33382, Taiwan
| | - Ching-Yi Hsieh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 33382, Taiwan
- Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan
| | - Wen-Yen Chai
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 33382, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, 5 Fuhsing St., Guishan, Taoyuan 33382, Taiwan
| | - Yenpo Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 33382, Taiwan
| | - Yen-Ling Huang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 33382, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, 5 Fuhsing St., Guishan, Taoyuan 33382, Taiwan
| | - Kuan-Ying Lu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 33382, Taiwan
- Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St., Guishan, Taoyuan 33382, Taiwan
| | - Hsin-Ju Chiang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 33382, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St., Guishan, Taoyuan 33382, Taiwan
| | | | | | - Gigin Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 33382, Taiwan
- Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, 5 Fuhsing St., Guishan, Taoyuan 33382, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St., Guishan, Taoyuan 33382, Taiwan
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12
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Wang P, Hu S, Wang X, Ge Y, Zhao J, Qiao H, Chang J, Dou W, Zhang H. Synthetic MRI in differentiating benign from metastatic retropharyngeal lymph node: combination with diffusion-weighted imaging. Eur Radiol 2023; 33:152-161. [PMID: 35951044 DOI: 10.1007/s00330-022-09027-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/29/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to evaluate the synthetic MRI (syMRI), its combination with diffusion-weighted imaging (DWI), and morphological features for discriminating benign from metastatic retropharyngeal lymph nodes (RLNs). METHODS Fifty-eight patients with a total of 63 RLNs (21 benign and 42 metastatic) were enrolled. The mean and standard deviation of syMRI-derived relaxometry parameters (T1, T2, PD; T1SD, T2SD, PDSD) were obtained from two different regions of interest (namely, partial-lesion and full-lesion ROI). The parameters derived from benign and metastatic RLNs were compared using Student's t or chi-square tests. Logistic regression analysis was used to construct a multi-parameter model of syMRI, syMRI + DWI, and syMRI + DWI + morphological features. Areas under the curve (AUC) were compared using the DeLong test to determine the best diagnostic approach. RESULTS Benign RLNs had significantly higher T1, T2, PD, and T1SD values compared with metastatic RLNs in both partial-lesion and full-lesion ROI (all p < 0.05). The T1SD obtained from full-lesion ROI showed the best diagnostic performance among all syMRI-derived single parameters. The AUC of combined syMRI multiple parameters (T1, T2, PD, T1SD) were higher than those of any single parameter from syMRI. The combination of synthetic MRI and DWI can improve the AUC regardless of ROI delineation. Furthermore, the combination of synthetic MRI, DWI-derived quantitative parameters, and morphological features can significantly improve the overall diagnostic performance. CONCLUSIONS The value of syMRI has been validated in differential diagnosis of benign and metastatic RLNs, and syMRI + DWI + morphological features can further improve the diagnostic efficiency for discriminating these two entities. KEY POINTS • Synthetic MRI was useful in differential diagnosis of benign and metastatic RLNs. • The combination of syMRI, DWI, and morphological features can significantly improve the diagnostic efficiency.
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Affiliation(s)
- Peng Wang
- Department of Radiology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, People's Republic of China
| | - Shudong Hu
- Department of Radiology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, People's Republic of China
| | - Xiuyu Wang
- Department of Radiology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, People's Republic of China
| | - Yuxi Ge
- Department of Radiology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, People's Republic of China
| | - Jing Zhao
- Department of Radiology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, People's Republic of China
| | - Hongyan Qiao
- Department of Radiology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, People's Republic of China
| | - Jun Chang
- Department of Radiology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, People's Republic of China
| | - Weiqiang Dou
- GE Healthcare, MR Research China, Beijing, 100176, People's Republic of China
| | - Heng Zhang
- Department of Radiology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, 214122, People's Republic of China.
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Zhang L, Hao J, Guo J, Zhao X, Yin X. Predicting of Ki-67 Expression Level Using Diffusion-Weighted and Synthetic Magnetic Resonance Imaging in Invasive Ductal Breast Cancer. Breast J 2023; 2023:6746326. [PMID: 37063453 PMCID: PMC10098409 DOI: 10.1155/2023/6746326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/26/2023] [Accepted: 03/27/2023] [Indexed: 04/18/2023]
Abstract
Objectives To investigate the association between quantitative parameters generated using synthetic magnetic resonance imaging (SyMRI) and diffusion-weighted imaging (DWI) and Ki-67 expression level in patients with invasive ductal breast cancer (IDC). Method We retrospectively reviewed the records of patients with IDC who underwent SyMRI and DWI before treatment. Precontrast and postcontrast relaxation times (T1, longitudinal; T2, transverse), proton density (PD) parameters, and apparent diffusion coefficient (ADC) values were measured in breast lesions. Univariate and multivariate regression analyses were performed to screen for statistically significant variables to differentiate the high (≥30%) and low (<30%) Ki-67 expression groups. Their performance was evaluated by receiver operating characteristic (ROC) curve analysis. Results We analyzed 97 patients. Multivariate regression analysis revealed that the high Ki-67 expression group (n = 57) had significantly higher parameters generated using SyMRI (pre-T1, p=0.001) and lower ADC values (p=0.036) compared with the low Ki-67 expression group (n = 40). Pre-T1 showed the best diagnostic performance for predicting the Ki-67 expression level in patients with invasive ductal breast cancer (areas under the ROC curve (AUC), 0.711; 95% confidence interval (CI), 0.609-0.813). Conclusions Pre-T1 could be used to predict the pretreatment Ki-67 expression level in invasive ductal breast cancer.
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Affiliation(s)
- Liying Zhang
- Third Affiliated Hospital of Zhengzhou University, Department of Radiology, Zhengzhou, China
| | - Jisen Hao
- Third Affiliated Hospital of Zhengzhou University, Department of Radiology, Zhengzhou, China
| | - Jia Guo
- Third Affiliated Hospital of Zhengzhou University, Department of Radiology, Zhengzhou, China
| | - Xin Zhao
- Third Affiliated Hospital of Zhengzhou University, Department of Radiology, Zhengzhou, China
| | - Xing Yin
- Third Affiliated Hospital of Zhengzhou University, Department of Radiology, Zhengzhou, China
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Kazama T, Takahara T, Kwee TC, Nakamura N, Kumaki N, Niikura N, Niwa T, Hashimoto J. Quantitative Values from Synthetic MRI Correlate with Breast Cancer Subtypes. Life (Basel) 2022; 12:life12091307. [PMID: 36143344 PMCID: PMC9501941 DOI: 10.3390/life12091307] [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: 07/31/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study is to correlate quantitative T1, T2, and proton density (PD) values with breast cancer subtypes. Twenty-eight breast cancer patients underwent MRI of the breast including synthetic MRI. T1, T2, and PD values were correlated with Ki-67 and were compared between ER-positive and ER-negative cancers, and between Luminal A and Luminal B cancers. The effectiveness of T1, T2, and PD in differentiating the ER-negative from the ER-positive group and Luminal A from Luminal B cancers was evaluated using receiver operating characteristic analysis. Mean T2 relaxation of ER-negative cancers was significantly higher than that of ER-positive cancers (p < 0.05). The T1, T2, and PD values exhibited a strong positive correlation with Ki-67 (Pearson’s r = 0.75, 0.69, and 0.60 respectively; p < 0.001). Among ER-positive cancers, T1, T2, and PD values of Luminal A cancers were significantly lower than those of Luminal B cancers (p < 0.05). The area under the curve (AUC) of T2 for discriminating ER-negative from ER-positive cancers was 0.87 (95% CI: 0.69−0.97). The AUC of T1 for discriminating Luminal A from Luminal B cancers was 0.83 (95% CI: 0.61−0.95). In conclusion, quantitative values derived from synthetic MRI show potential for subtyping of invasive breast cancers.
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Affiliation(s)
- Toshiki Kazama
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara 259-1193, Japan
- Correspondence: ; Tel.: +81-463-93-1121
| | - Taro Takahara
- Department of Biomedical Engineering, Tokai University School of Engineering, Hiratsuka 259-1207, Japan
| | - Thomas C. Kwee
- Department of Radiology, Nuclear Medicine, and Molecular Imaging, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Noriko Nakamura
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara 259-1193, Japan
| | - Nobue Kumaki
- Department of Pathology, Tokai University School of Medicine, Isehara 259-1193, Japan
| | - Naoki Niikura
- Department of Breast Oncology, Tokai University School of Medicine, Isehara 259-1193, Japan
| | - Tetsu Niwa
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara 259-1193, Japan
| | - Jun Hashimoto
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara 259-1193, Japan
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Konar AS, Paudyal R, Shah AD, Fung M, Banerjee S, Dave A, Lee N, Hatzoglou V, Shukla-Dave A. Qualitative and Quantitative Performance of Magnetic Resonance Image Compilation (MAGiC) Method: An Exploratory Analysis for Head and Neck Imaging. Cancers (Basel) 2022; 14:cancers14153624. [PMID: 35892883 PMCID: PMC9331960 DOI: 10.3390/cancers14153624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 01/27/2023] Open
Abstract
The present exploratory study investigates the performance of a new, rapid, synthetic MRI method for diagnostic image quality assessment and measurement of relaxometry metric values in head and neck (HN) tumors and normal-appearing masseter muscle. The multi-dynamic multi-echo (MDME) sequence was used for data acquisition, followed by synthetic image reconstruction on a 3T MRI scanner for 14 patients (3 untreated and 11 treated). The MDME enables absolute quantification of physical tissue properties, including T1 and T2, with a shorter scan time than the current state-of-the-art methods used for relaxation measurements. The vendor termed the combined package MAGnetic resonance imaging Compilation (MAGiC). In total, 48 regions of interest (ROIs) were analyzed, drawn on normal-appearing masseter muscle and tumors in the HN region. Mean T1 and T2 values obtained from normal-appearing muscle were 880 ± 52 ms and 46 ± 3 ms, respectively. Mean T1 and T2 values obtained from tumors were 1930 ± 422 ms and 77 ± 13 ms, respectively, for the untreated group, 1745 ± 410 ms and 107 ± 61 ms, for the treated group. A total of 1552 images from both synthetic MRI and conventional clinical imaging were assessed by the radiologists to provide the rating for T1w and T2w image contrasts. The synthetically generated qualitative T2w images were acceptable and comparable to conventional diagnostic images (93% acceptability rating for both). The acceptability ratings for MAGiC-generated T1w, and conventional images were 64% and 100%, respectively. The benefit of MAGiC in HN imaging is twofold, providing relaxometry maps in a clinically feasible time and the ability to generate a different combination of contrast images in a single acquisition.
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Affiliation(s)
- Amaresha Shridhar Konar
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.S.K.); (R.P.)
| | - Ramesh Paudyal
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.S.K.); (R.P.)
| | - Akash Deelip Shah
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.D.S.); (V.H.)
| | - Maggie Fung
- General Electric Health Care, New York, NY 10065, USA; (M.F.); (S.B.)
| | | | - Abhay Dave
- Touro College of Osteopathic Medicine, New York, NY 10027, USA;
| | - Nancy Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - Vaios Hatzoglou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.D.S.); (V.H.)
| | - Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.S.K.); (R.P.)
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.D.S.); (V.H.)
- Correspondence: ; Tel.: +1-212-639-3184
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16
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Ma L, Lian S, Liu H, Meng T, Zeng W, Zhong R, Zhong L, Xie C. Diagnostic performance of synthetic magnetic resonance imaging in the prognostic evaluation of rectal cancer. Quant Imaging Med Surg 2022; 12:3580-3591. [PMID: 35782274 PMCID: PMC9246756 DOI: 10.21037/qims-22-24] [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: 01/10/2022] [Accepted: 03/22/2022] [Indexed: 11/06/2022]
Abstract
Background Numerous factors are related to the prognosis of rectal cancer, including T stage, N stage, metastasis, extramural venous invasion (EMVI), circumferential resection margin (CRM), and tumor differentiation. However, it is still a challenge to precisely evaluate them before therapy; therefore, we investigate whether synthetic magnetic resonance imaging and apparent diffusion coefficient (ADC) values could help predict the prognostic factors of rectal cancer. Methods Eighty-seven patients (55 men and 32 women; mean age, 59±11 years) with pathologically confirmed rectal cancer were enrolled. Preoperative quantitative metrics, including T1, T2, proton density (PD), and ADC values, were measured with diffusion-weighted imaging (DWI) acquired by a single-shot echo-planar sequence and synthetic magnetic resonance imaging acquired by a multi-dynamic multi-echo sequence at 3.0 T, in patients with rectal cancer by two radiologists. We evaluated the diagnostic performance of synthetic magnetic resonance imaging using the independent sample t-test or Mann-Whitney U test and receiver operating characteristic (ROC) curve and multivariate logistic regression analyses and compared the area under the ROC curve of quantitative values using the DeLong test. Results The T2 and PD values showed a significant reduction among patients with poor differentiation and lymph node metastasis in rectal cancer. The area under the ROC curve values of T2 and PD values for predicting magnetic resonance imaging N stage and differentiation were 0.734, 0.682, and 0.673, 0.686, respectively. Moreover, combining T2 and PD values for magnetic resonance imaging N stage slightly improved the area under the ROC curve value of 0.774 (95% CI, 0.673-0.876). In the present study, the ADC and T1 values were not significant in the differentiation or clinical stage of rectal cancer (RC). Conclusions Quantitative T2 and PD values obtained by synthetic magnetic resonance imaging might be used for evaluating prognostic factors of rectal cancer noninvasively. Furthermore, combining T2 and PD values further improved the diagnostic performance of magnetic resonance imaging N staging in rectal cancer. The ADC and T1 values were not significant in the differentiation or clinical stage of RC.
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Affiliation(s)
- Lidi Ma
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
| | - Shanshan Lian
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
| | - Huimin Liu
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
| | - Tiebao Meng
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
| | - Weilong Zeng
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
| | - Rui Zhong
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
| | - Linchang Zhong
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
| | - Chuanmiao Xie
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China
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Park SB. Quantitative relaxation maps from synthetic MRI for prostate cancer. Acta Radiol 2022; 63:982-983. [PMID: 35200049 DOI: 10.1177/02841851221077405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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Quantitative Synthetic Magnetic Resonance Imaging for Brain Metastases: A Feasibility Study. Cancers (Basel) 2022; 14:cancers14112651. [PMID: 35681631 PMCID: PMC9179589 DOI: 10.3390/cancers14112651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/16/2022] [Accepted: 05/20/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary This preliminary study aims to characterize brain metastases (BM) using T1 and T2 maps generated from newer, rapid, synthetic MRI (MAGnetic resonance image Compilation; MAGiC) in a clinical setting. In addition, synthetic MR could provide contrast images analogous to standard T1- and T2-weighted images. The reproducibility and repeatability of this method have been previously established for brain imaging. This study reports and analyzes the quantitative T1 and T2 values for 11 BM patients (17 BM lesions) with a total of 82 regions of interest (ROIs) delineated by an experienced neuroradiologist. The initial results, which need to be further validated in a larger patient cohort, demonstrated the ability of T1 and T2 metric values to characterize BMs and normal-appearing brain tissues. The T1 and T2 metrics could be potential surrogate biomarkers for BM free water content (cellularity) and tumor morphology, respectively. Abstract The present preliminary study aims to characterize brain metastases (BM) using T1 and T2 maps generated from newer, rapid, synthetic MRI (MAGnetic resonance image Compilation; MAGiC) in a clinical setting. We acquired synthetic MRI data from 11 BM patients on a 3T scanner. A multiple-dynamic multiple-echo (MDME) sequence was used for data acquisition and synthetic image reconstruction, including post-processing. MDME is a multi-contrast sequence that enables absolute quantification of physical tissue properties, including T1 and T2, independent of the scanner settings. In total, 82 regions of interest (ROIs) were analyzed, which were obtained from both normal-appearing brain tissue and BM lesions. The mean values obtained from the 48 normal-appearing brain tissue regions and 34 ROIs of BM lesions (T1 and T2) were analyzed using standard statistical methods. The mean T1 and T2 values were 1143 ms and 78 ms, respectively, for normal-appearing gray matter, 701 ms and 64 ms for white matter, and 4206 ms and 390 ms for cerebrospinal fluid. For untreated BMs, the mean T1 and T2 values were 1868 ms and 100 ms, respectively, and 2211 ms and 114 ms for the treated group. The quantitative T1 and T2 values generated from synthetic MRI can characterize BM and normal-appearing brain tissues.
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Zheng Z, Yang J, Zhang D, Ma J, Yin H, Liu Y, Wang Z. The effect of scan parameters on T1, T2 relaxation times measured with multi-dynamic multi-echo sequence: a phantom study. Phys Eng Sci Med 2022; 45:657-664. [PMID: 35553390 PMCID: PMC9239947 DOI: 10.1007/s13246-022-01128-0] [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: 01/08/2022] [Accepted: 04/18/2022] [Indexed: 11/23/2022]
Abstract
Multi-Dynamic Multi-Echo (MDME) Sequence is a new method which can acquire various contrast-weighted images using quantitative relaxometric parameters measured from multicontrast images. The purpose of our study was to investigate the effect of scan parameters of MDME Sequence on measured T1, T2 values of phantoms at 3.0 T MRI scanner. Gray matter, white matter and cerebrospinal fluid simulation phantoms with different relaxation times (named GM, WM, CSF, respectively) were used in our study. All the phantoms were scanned 9 times on different days using MDME sequence with variations of echo train length, matrix, and acceleration factor. The T1, T2 measurements were acquired after each acquisition. The repeatability was characterized as the intragroup coefficient of variation (CV) of measured values over 9 times, and the discrepancies of measurements across different groups were characterized as intergroup CVs. The highest intragroup CVs of T1-GM, T2-GM, T1-WM, T2-WM, T1-CSF, T2-SCF were 1.36%, 1.75%, 0.74%, 1.41%, 1.70%, 7.79%, respectively. The highest intergroup CVs of T1-GM, T2-GM, T1-WM, T2-WM, T1-CSF, T2-SCF were 0.54%, 1.86%, 1.70%, 0.94%, 1.00%, 2.17%, respectively. Quantitative T1, T2 measurements of gray matter, white matter and cerebrospinal fluid simulation phantoms derived from the MDME sequence were not obviously affected by variations of scanning parameters, such as echo train length, matrix, and acceleration factor on 3T scanner.
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Affiliation(s)
- Zuofeng Zheng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yong An Road 95, Beijing, 100050, China.,Department of Radiology, Beijing ChuiYangLiu Hospital, Beijing, China
| | - Jiafei Yang
- Department of Radiology, Beijing ChuiYangLiu Hospital, Beijing, China
| | - Dongpo Zhang
- Department of Radiology, Beijing ChuiYangLiu Hospital, Beijing, China
| | - Jun Ma
- Department of Radiology, Beijing ChuiYangLiu Hospital, Beijing, China
| | - Hongxia Yin
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yong An Road 95, Beijing, 100050, China
| | - Yawen Liu
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yong An Road 95, Beijing, 100050, China.
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20
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Kazama T, Takahara T, Hashimoto J. Breast Cancer Subtypes and Quantitative Magnetic Resonance Imaging: A Systemic Review. Life (Basel) 2022; 12:life12040490. [PMID: 35454981 PMCID: PMC9028183 DOI: 10.3390/life12040490] [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: 01/23/2022] [Revised: 02/20/2022] [Accepted: 03/08/2022] [Indexed: 12/12/2022] Open
Abstract
Magnetic resonance imaging (MRI) is the most sensitive imaging modality for breast cancer detection. This systematic review investigated the role of quantitative MRI features in classifying molecular subtypes of breast cancer. We performed a literature search of articles published on the application of quantitative MRI features in invasive breast cancer molecular subtype classification in PubMed from 1 January 2002 to 30 September 2021. Of the 1275 studies identified, 106 studies with a total of 12,989 patients fulfilled the inclusion criteria. Bias was assessed based using the Quality Assessment of Diagnostic Studies. All studies were case-controlled and research-based. Most studies assessed quantitative MRI features using dynamic contrast-enhanced (DCE) kinetic features and apparent diffusion coefficient (ADC) values. We present a summary of the quantitative MRI features and their correlations with breast cancer subtypes. In DCE studies, conflicting results have been reported; therefore, we performed a meta-analysis. Significant differences in the time intensity curve patterns were observed between receptor statuses. In 10 studies, including a total of 1276 lesions, the pooled difference in proportions of type Ⅲ curves (wash-out) between oestrogen receptor-positive and -negative cancers was not significant (95% confidence interval (CI): [−0.10, 0.03]). In nine studies, including a total of 1070 lesions, the pooled difference in proportions of type 3 curves between human epidermal growth factor receptor 2-positive and -negative cancers was significant (95% CI: [0.01, 0.14]). In six studies including a total of 622 lesions, the pooled difference in proportions of type 3 curves between the high and low Ki-67 groups was significant (95% CI: [0.17, 0.44]). However, the type 3 curve itself is a nonspecific finding in breast cancer. Many studies have examined the relationship between mean ADC and breast cancer subtypes; however, the ADC values overlapped significantly between subtypes. The heterogeneity of ADC using kurtosis or difference, diffusion tensor imaging parameters, and relaxation time was reported recently with promising results; however, current evidence is limited, and further studies are required to explore these potential applications.
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Affiliation(s)
- Toshiki Kazama
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara 259-1193, Japan;
- Correspondence: ; Tel.: +81-463-93-1121
| | - Taro Takahara
- Department of Biomedical Engineering, Tokai University School of Engineering, Hiratsuka 259-1207, Japan;
| | - Jun Hashimoto
- Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara 259-1193, Japan;
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21
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Huo M, Ye J, Dong Z, Cai H, Wang M, Yin G, Qian L, Li ZP, Zhong B, Feng ST. Quantification of brown adipose tissue in vivo using synthetic magnetic resonance imaging: an experimental study with mice model. Quant Imaging Med Surg 2022; 12:526-538. [PMID: 34993098 DOI: 10.21037/qims-20-1344] [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: 12/09/2020] [Accepted: 07/20/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The white adipose tissue (WAT) and brown adipose tissue (BAT) are associated with the development of several obesity-associated disorders. The use of imaging techniques to differentiate BAT from WAT and quantify BAT volume remains challenging, due to limitations such as spatial resolution and magnetic field inhomogeneity. This study aimed to investigate the feasibility for differentiating BAT from WAT, and quantify the BAT volume in vivo using synthetic magnetic resonance imaging (MRI). METHODS A total of 16 C57BL/6 mice were scanned using synthetic MRI. Quantitative longitudinal relaxation time (T1) and transverse relaxation time (T2) maps were obtained from the original synthetic MRI data using the synthetic MRI software offline. The T1 and T2 values of interscapular BAT (IBAT) and dorsal subcutaneous WAT were measured. The IBAT volume was calculated using synthetic MRI-derived T2-weighted images (T2WIs) based on its morphological characteristics and quantitative tissue values. The body weight of mice was measured, and the IBAT specimens were excised and weighted. The correlation between IBAT volume and the weight of IBAT gross specimen and between IBAT volume and mouse body weight was analyzed. RESULTS The T1 values of BAT (330.3±19.57 ms) were higher than those of WAT (304.42±4.14 ms) (P<0.001), whereas the T2 values of BAT (66.06±5.06 ms) were lower than those of WAT (88.23±7.68 ms) (P<0.001). The area under the curve (AUC) values of the T1 and T2 for differentiating BAT from WAT was 0.942 and 0.995, respectively. The AUC of the T2 values was higher than that of T1 (P=0.04) using the DeLong test. The optimal cut-off value for T2 was 76 ms for differentiating BAT from WAT (100% sensitivity, 93.7% specificity). A moderate correlation was observed between IBAT volume and the weight of the IBAT gross specimen (r=0.662, P=0.014), and between IBAT volume and mouse body weight (r=0.653, P=0.016). CONCLUSIONS The quantitative parameters derived using synthetic MRI may be used to detect and differentiate BAT from WAT in vivo. Synthetic MRI may help quantify BAT volume in vivo.
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Affiliation(s)
- Mengjuan Huo
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junzhao Ye
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhi Dong
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huasong Cai
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meng Wang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guoping Yin
- GE Healthcare, MR Enhanced Application China, Beijing, China
| | - Long Qian
- MRI Research, GE Healthcare, Beijing, China
| | - Zi-Ping Li
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bihui Zhong
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shi-Ting Feng
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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22
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Feasibility study of 2D Dixon-Magnetic Resonance Fingerprinting (MRF) of breast cancer. Eur J Radiol Open 2022; 9:100453. [DOI: 10.1016/j.ejro.2022.100453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 11/17/2022] Open
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23
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Wang Q, Wang G, Sun Q, Sun DH. Application of MAGnetic resonance imaging compilation in acute ischemic stroke. World J Clin Cases 2021; 9:10828-10837. [PMID: 35047594 PMCID: PMC8678888 DOI: 10.12998/wjcc.v9.i35.10828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/31/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Synthetic magnetic resonance imaging (MRI) MAGnetic resonance imaging compilation (MAGiC) is a new MRI technology. Conventional T1, T2, T2-fluid-attenuated inversion recovery (FLAIR) contrast images, quantitative images of T1 and T2 mapping, and MAGiC phase sensitive inversion recovery (PSIR) Vessel cerebrovascular images can be obtained simultaneously through post-processing at the same time after completing a scan. In recent years, studies have reported that MAGiC can be applied to patients with acute ischemic stroke. We hypothesized that the synthetic MRI vascular screening scheme can evaluate the degree of cerebral artery stenosis in patients with acute ischemic stroke.
AIM To explore the application value of vascular images obtained by synthetic MRI in diagnosing acute ischemic stroke.
METHODS A total of 64 patients with acute ischemic stroke were selected and examined by MRI in the current retrospective cohort study. The scanning sequences included traditional T1, T2, and T2-FLAIR, three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA), diffusion-weighted imaging (DWI), and synthetic MRI. Conventional contrast images (T1, T2, and T2-FLAIR) and intracranial vessel images (MAGiC PSIR Vessel] were automatically reconstructed using synthetic MRI raw data. The contrast-to-noise ratio (CNR) values of traditional T1, T2, and T2-FLAIR images and MAGiC reconstructed T1, T2, and T2-FLAIR images in DWI diffusion restriction areas were measured and compared. MAGiC PSIR Vessel and TOF MRA images were used to measure and calculate the stenosis degree of bilateral middle cerebral artery stenosis areas. The consistency of MAGiC PSIR Vessel and TOF MRA in displaying the degree of vascular stenosis with computed tomography angiography (CTA) was compared.
RESULTS Among the 64 patients with acute ischemic stroke, 79 vascular stenosis areas showed that the correlation between MAGiC PSIR Vessel and CTA (r = 0.90, P < 0.01) was higher than that between TOF MRA and CTA (r = 0.84, P < 0.01). With a degree of vascular stenosis > 50% assessed by CTA as a reference, the area under the receiver operating characteristic (ROC) curve of MAGiC PSIR Vessel [area under the curve (AUC) = 0.906, P < 0.01] was higher than that of TOF MRA (AUC = 0.790, P < 0.01). Among the 64 patients with acute ischemic stroke, 39 were scanned for traditional T1, T2, and T2-FLAIR images and MAGiC images simultaneously, and CNR values in DWI diffusion restriction areas were measured, which were: Traditional T2 = 21.2, traditional T1 = -6.7, and traditional T2-FLAIR = 11.9; and MAGiC T2 = 7.1, MAGiC T1 = -3.9, and MAGiC T2-FLAIR = 4.5.
CONCLUSION The synthetic MRI vascular screening scheme for patients with acute ischemic stroke can accurately evaluate the degree of bilateral middle cerebral artery stenosis, which is of great significance to early thrombolytic interventional therapy and improving patients’ quality of life.
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Affiliation(s)
- Qi Wang
- Department of Radiology, The Stroke Hospital of Liaoning Province, Shenyang 110101, Liaoning Province, China
| | - Gang Wang
- Department of Radiology, The Stroke Hospital of Liaoning Province, Shenyang 110101, Liaoning Province, China
| | - Qiang Sun
- Department of Radiology, The Stroke Hospital of Liaoning Province, Shenyang 110101, Liaoning Province, China
| | - Di-He Sun
- Department of Radiology, The Stroke Hospital of Liaoning Province, Shenyang 110101, Liaoning Province, China
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24
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Sun SY, Ding Y, Li Z, Nie L, Liao C, Liu Y, Zhang J, Zhang D. Multiparameter MRI Model With DCE-MRI, DWI, and Synthetic MRI Improves the Diagnostic Performance of BI-RADS 4 Lesions. Front Oncol 2021; 11:699127. [PMID: 34722246 PMCID: PMC8554332 DOI: 10.3389/fonc.2021.699127] [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: 04/29/2021] [Accepted: 09/27/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives To evaluate the value of synthetic magnetic resonance imaging (syMRI), diffusion-weighted imaging (DWI), DCE-MRI, and clinical features in breast imaging–reporting and data system (BI-RADS) 4 lesions, and develop an efficient method to help patients avoid unnecessary biopsy. Methods A total of 75 patients with breast diseases classified as BI-RADS 4 (45 with malignant lesions and 30 with benign lesions) were prospectively enrolled in this study. T1-weighted imaging (T1WI), T2WI, DWI, and syMRI were performed at 3.0 T. Relaxation time (T1 and T2), apparent diffusion coefficient (ADC), conventional MRI features, and clinical features were assessed. “T” represents the relaxation time value of the region of interest pre-contrast scanning, and “T+” represents the value post-contrast scanning. The rate of change in the T value between pre- and post-contrast scanning was represented by ΔT%. Results ΔT1%, T2, ADC, age, body mass index (BMI), menopause, irregular margins, and heterogeneous internal enhancement pattern were significantly associated with a breast cancer diagnosis in the multivariable logistic regression analysis. Based on the above parameters, four models were established: model 1 (BI-RADS model, including all conventional MRI features recommended by BI-RADS lexicon), model 2 (relaxation time model, including ΔT1% and T2), model 3 [multi-parameter (mp)MRI model, including ΔT1%, T2, ADC, margin, and internal enhancement pattern], and model 4 (combined image and clinical model, including ΔT1%, T2, ADC, margin, internal enhancement pattern, age, BMI, and menopausal state). Among these, model 4 has the best diagnostic performance, followed by models 3, 2, and 1. Conclusions The mpMRI model with DCE-MRI, DWI, and syMRI is a robust tool for evaluating the malignancies in BI-RADS 4 lesions. The clinical features could further improve the diagnostic performance of the model.
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Affiliation(s)
- Shi Yun Sun
- Department of Radiology, Yunnan Cancer Center, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Kunming, China
| | - Yingying Ding
- Department of Radiology, Yunnan Cancer Center, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Kunming, China
| | - Zhuolin Li
- Department of Radiology, Yunnan Cancer Center, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Kunming, China
| | - Lisha Nie
- Magnetic Resonance Imaging Research, General Electric Healthcare (China), Beijing, China
| | - Chengde Liao
- Department of Radiology, Yunnan Cancer Center, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Kunming, China
| | - Yifan Liu
- Department of Radiology, Yunnan Cancer Center, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Kunming, China
| | - Jia Zhang
- Department of Radiology, Third People's Hospital of Yunnan Province, Kunming, China
| | - Dongxue Zhang
- Department of Radiology, Yunnan Cancer Center, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Kunming, China
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25
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Zhao L, Liang M, Wu PY, Yang Y, Zhang H, Zhao X. A preliminary study of synthetic magnetic resonance imaging in rectal cancer: imaging quality and preoperative assessment. Insights Imaging 2021; 12:120. [PMID: 34420097 PMCID: PMC8380206 DOI: 10.1186/s13244-021-01063-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/22/2021] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To compare the imaging quality, T stage and extramural venous invasion (EMVI) evaluation between the conventional and synthetic T2-weighted imaging (T2WI), and to investigate the role of quantitative values obtained from synthetic magnetic resonance imaging (MRI) for assessing nodal staging in rectal cancer (RC). METHODS Ninety-four patients with pathologically proven RC who underwent rectal MRI examinations including synthetic MRI were retrospectively recruited. The image quality of conventional and synthetic T2WI was compared regarding signal-to-noise ratio (SNR), contrast-to-noise (CNR), sharpness of the lesion edge, lesion conspicuity, absence of motion artifacts, and overall image quality. The accuracy of T stage and EMVI evaluation on conventional and synthetic T2WI were compared using the Mc-Nemar test. The quantitative T1, T2, and PD values were used to predict the nodal staging of MRI-evaluated node-negative RC. RESULTS There were no statistically significant differences between conventional and synthetic T2WI in SNR, CNR, overall image quality, lesion conspicuity, and absence of motion artifacts (p = 0.058-0.978). There were no significant differences in the diagnostic accuracy of T stage and EMVI between conventional and synthetic T2WI from two observers (p = 0.375 and 0.625 for T stage; p = 0.625 and 0.219 for EMVI). The T2 value showed good diagnostic performance for predicting the nodal staging of RC with the area under the receiver operating characteristic, sensitivity, specificity, and accuracy of 0.854, 90.0%, 71.4%, and 80.3%, respectively. CONCLUSIONS Synthetic MRI may facilitate preoperative staging and EMVI evaluation of RC by providing synthetic T2WI and quantitative maps in one acquisition.
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Affiliation(s)
- Li Zhao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Meng Liang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Pu-Yeh Wu
- GE Healthcare, MR Research China, No. 1 Tongji South Road Beijing Economic Technology Development Area, Beijing, 100176, China
| | - Yang Yang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Hongmei Zhang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
| | - Xinming Zhao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
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26
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Matsuda M, Tsuda T, Ebihara R, Toshimori W, Okada K, Takeda S, Okumura A, Shiraishi Y, Suekuni H, Kamei Y, Kurata M, Kitazawa R, Mochizuki T, Kido T. Triple-negative breast cancer on contrast-enhanced MRI and synthetic MRI: A comparison with non-triple-negative breast carcinoma. Eur J Radiol 2021; 142:109838. [PMID: 34217136 DOI: 10.1016/j.ejrad.2021.109838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE This study aimed to compare the characteristics of triple-negative breast cancer (TNBC) with non-TNBC on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and synthetic MRI. METHOD This retrospective study included 79 patients with histopathologically proven breast cancer (TNBC: 16, non-TNBC: 63) who underwent synthetic MRI. Using synthetic MR images, we obtained T1 and T2 relaxation times in breast lesions before (Pre-T1, Pre-T2, Pre-PD) and after (Gd-T1, Gd-T2, Gd-PD) contrast agent injection. Subsequently, we calculated the ΔT1 (Pre-T1 - Gd-T1), ΔT2 (Pre-T2 - Gd-T2), Pre-T1/T2, and Gd-T1/T2. We compared the aforementioned quantitative values, as well as several morphologic features between TNBCs and non-TNBCs that were identified on DCE-MRI. RESULTS The multivariate analyses revealed that the Pre-T2 (P = 0.037) and the presence of rim enhancement (P-RIM) (P = 0.034) were significant and independent predictors of TNBC. The area under the receiver operating characteristics curve for all breast cancers was greater when a combination of Pre-T2 and P-RIM (Pre-T2+P-RIM; Method 3, AUC (area under the curve) = 0.858) was used to distinguish between TNBCs and non-TNBCs versus the use of either Pre-T2 alone (Method 1, AUC = 0.786) or P-RIM alone (Method 2, AUC = 0.747). CONCLUSIONS Pre-T2 obtained using synthetic MRI and P-RIM identified on DCE-MRI allowed the differentiation between TNBCs and non-TNBCs. However, these results are preliminary and need to be verified by further studies.
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Affiliation(s)
- Megumi Matsuda
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
| | - Takaharu Tsuda
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
| | - Rui Ebihara
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Wataru Toshimori
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Kanako Okada
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Shiori Takeda
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Aya Okumura
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Yasuhiro Shiraishi
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
| | - Hiroshi Suekuni
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Yoshiaki Kamei
- Breast Center, Ehime University Hospital, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Mie Kurata
- Department of Pathology, Ehime University Proteo-Science Center, Shitsukawa, Toon, Ehime 791-0295, Japan; Department of Analytical Pathology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
| | - Riko Kitazawa
- Division of Diagnostic Pathology, Ehime University Hospital, Shitsukawa, Toon, Ehime 791-0295, Japan.
| | - Teruhito Mochizuki
- Department of Radiology, I.M. Sechenov First Moscow State Medical University, 8-2 Trubetskaya str., Moscow 119991, Russian Federation
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
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Cai Q, Wen Z, Huang Y, Li M, Ouyang L, Ling J, Qian L, Guo Y, Wang H. Investigation of Synthetic Magnetic Resonance Imaging Applied in the Evaluation of the Tumor Grade of Bladder Cancer. J Magn Reson Imaging 2021; 54:1989-1997. [PMID: 34080268 DOI: 10.1002/jmri.27770] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 12/16/2022] Open
Affiliation(s)
- Qian Cai
- Department of Radiology The First Affiliated Hospital, Sun Yat‐Sen University Guangzhou Guangdong China
| | - Zhihua Wen
- Department of Radiology The First Affiliated Hospital, Sun Yat‐Sen University Guangzhou Guangdong China
| | - Yiping Huang
- Department of Radiology The First Affiliated Hospital, Sun Yat‐Sen University Guangzhou Guangdong China
| | - Meiqin Li
- Department of Radiology The First Affiliated Hospital, Sun Yat‐Sen University Guangzhou Guangdong China
| | - Longyuan Ouyang
- Department of Radiology The First Affiliated Hospital, Sun Yat‐Sen University Guangzhou Guangdong China
| | - Jian Ling
- Department of Radiology The Eastern Hospital of the First Affiliated Hospital, Sun Yat‐Sen University Guangzhou Guangdong China
| | - Long Qian
- MR Research, GE Healthcare Beijing China
| | - Yan Guo
- Department of Radiology The First Affiliated Hospital, Sun Yat‐Sen University Guangzhou Guangdong China
| | - Huanjun Wang
- Department of Radiology The First Affiliated Hospital, Sun Yat‐Sen University Guangzhou Guangdong China
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28
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Zhao L, Liang M, Shi Z, Xie L, Zhang H, Zhao X. Preoperative volumetric synthetic magnetic resonance imaging of the primary tumor for a more accurate prediction of lymph node metastasis in rectal cancer. Quant Imaging Med Surg 2021; 11:1805-1816. [PMID: 33936966 DOI: 10.21037/qims-20-659] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background An accurate assessment of lymph node (LN) status in patients with rectal cancer is important for treatment planning and an essential factor for predicting local recurrence and overall survival. In this study, we explored the potential value of histogram parameters of synthetic magnetic resonance imaging (SyMRI) in predicting LN metastasis in rectal cancer and compared their predictive performance with traditional morphological characteristics and chemical shift effect (CSE). Methods A total of 70 patients with pathologically proven rectal adenocarcinoma who received direct surgical resection were enrolled in this prospective study. Preoperative rectal MRI, including SyMRI, were performed, and morphological characteristics and CSE of LN were assessed. Histogram parameters were extracted on a T1 map, T2 map, and proton density (PD) map, including mean, variance, maximum, minimum, 10th percentile, median, 90th percentile, energy, kurtosis, entropy, and skewness. Receiver operating characteristic (ROC) curves were used to explore their predictive performance for assessing LN status. Results Significant differences in the energy of the T1, T2, and PD maps were observed between LN-negative and LN-positive groups [all P<0.001; the area under the ROC curve (AUC) was 0.838, 0.858, and 0.823, respectively]. The maximum and kurtosis of the T2 map, maximum, and variance of PD map could also predict LN metastasis with moderate diagnostic power (P=0.032, 0.045, 0.016, and 0.047, respectively). Energy of the T1 map [odds ratio (OR) =1.683, 95% confidence interval (CI): 1.207-2.346, P=0.002] and extramural venous invasion on MRI (mrEMVI) (OR =10.853, 95% CI: 2.339-50.364, P=0.002) were significant predictors of LN metastasis. Moreover, the T1 map energy significantly improved the predictive performance compared to morphological features and CSE (P=0.0002 and 0.0485). Conclusions The histogram parameters derived from SyMRI of the primary tumor were associated with LN metastasis in rectal cancer and could significantly improve the predictive performance compared with morphological features and CSE.
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Affiliation(s)
- Li Zhao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meng Liang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhuo Shi
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lizhi Xie
- GE Healthcare, Magnetic Resonance Research China, Beijing, China
| | - Hongmei Zhang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinming Zhao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Fujioka T, Mori M, Oyama J, Kubota K, Yamaga E, Yashima Y, Katsuta L, Nomura K, Nara M, Oda G, Nakagawa T, Tateishi U. Investigating the Image Quality and Utility of Synthetic MRI in the Breast. Magn Reson Med Sci 2021; 20:431-438. [PMID: 33536401 PMCID: PMC8922358 DOI: 10.2463/mrms.mp.2020-0132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose Synthetic MRI reconstructs multiple sequences in a single acquisition. In the
present study, we aimed to compare the image quality and utility of
synthetic MRI with that of conventional MRI in the breast. Methods We retrospectively collected the imaging data of 37 women (mean age: 55.1
years; range: 20–78 years) who had undergone both synthetic and
conventional MRI of T2-weighted, T1-weighted, and fat-suppressed
(FS)-T2-weighted images. Two independent breast radiologists evaluated the
overall image quality, anatomical sharpness, contrast between tissues, image
homogeneity, and presence of artifacts of synthetic and conventional MRI on
a 5-point scale (5 = very good to 1 =
very poor). The interobserver agreement between the
radiologists was evaluated using weighted kappa. Results For synthetic MRI, the acquisition time was 3 min 28 s. On the 5-point scale
evaluation of overall image quality, although the scores of synthetic
FS-T2-weighted images (4.01 ± 0.56) were lower than that of
conventional images (4.95 ± 0.23; P < 0.001),
the scores of synthetic T1- and T2-weighted images (4.95 ± 0.23 and
4.97 ± 0.16) were comparable with those of conventional images (4.92
± 0.27 and 4.97 ± 0.16; P = 0.484 and
1.000, respectively). The kappa coefficient of conventional MRI was fair
(0.53; P < 0.001), and that of conventional MRI was
fair (0.46; P < 0.001). Conclusion The image quality of synthetic T1- and T2-weighted images was similar to that
of conventional images and diagnostically acceptable, whereas the quality of
synthetic T2-weighted FS images was inferior to conventional images.
Although synthetic MRI images of the breast have the potential to provide
efficient image diagnosis, further validation and improvement are required
for clinical application.
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Affiliation(s)
- Tomoyuki Fujioka
- Department of Diagnostic Radiology, Tokyo Medical and Dental University
| | - Mio Mori
- Department of Diagnostic Radiology, Tokyo Medical and Dental University
| | - Jun Oyama
- Department of Diagnostic Radiology, Tokyo Medical and Dental University
| | - Kazunori Kubota
- Department of Diagnostic Radiology, Tokyo Medical and Dental University.,Department of Radiology, Dokkyo Medical University
| | - Emi Yamaga
- Department of Diagnostic Radiology, Tokyo Medical and Dental University
| | - Yuka Yashima
- Department of Diagnostic Radiology, Tokyo Medical and Dental University
| | - Leona Katsuta
- Department of Diagnostic Radiology, Tokyo Medical and Dental University
| | - Kyoko Nomura
- Department of Diagnostic Radiology, Tokyo Medical and Dental University
| | - Miyako Nara
- Department of Diagnostic Radiology, Tokyo Medical and Dental University.,Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
| | - Goshi Oda
- Department of Surgery, Breast Surgery, Tokyo Medical and Dental University
| | - Tsuyoshi Nakagawa
- Department of Surgery, Breast Surgery, Tokyo Medical and Dental University
| | - Ukihide Tateishi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University
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30
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Meng T, He N, He H, Liu K, Ke L, Liu H, Zhong L, Huang C, Yang A, Zhou C, Qian L, Xie C. The diagnostic performance of quantitative mapping in breast cancer patients: a preliminary study using synthetic MRI. Cancer Imaging 2020; 20:88. [PMID: 33317609 PMCID: PMC7737277 DOI: 10.1186/s40644-020-00365-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 12/04/2020] [Indexed: 01/03/2023] Open
Abstract
Background Previous studies have indicated that quantitative MRI (qMR) is beneficial for diagnosis of breast cancer. As a novel qMR technology, synthetic MRI (syMRI) may be advantageous by offering simultaneous generation of T1 and T2 mapping in one scan within a few minutes and without concern to the deposition of the gadolinium contrast agent in cell nucleus. In this study, the potential of quantitative mapping derived from Synthetic MRI (SyMRI) to diagnose breast cancer was investigated. Methods From April 2018 to May 2019, a total of 87 patients with suspicious breast lesions underwent both conventional and SyMRI before treatment. The quantitative metrics derived from SyMRI, including T1 and T2 values, were measured in breast lesions. The diagnostic performance of SyMRI was evaluated with unpaired Student’s t-tests, receiver operating characteristic curve analysis and multivariate logistic regression analysis. The AUCs of quantitative values were compared using Delong test. Results Among 77 patients who met the inclusion criteria, 48 were diagnosed with histopathological confirmed breast cancers, and the rest had benign lesions. The breast cancers showed significantly higher T1 (1611.61 ± 215.88 ms) values and lower T2 (80.93 ± 7.51 ms) values than benign lesions. The area under the ROC curve (AUC) values were 0.931 (95% CI: 0.874–0.989) and 0.883 (95% CI: 0.810–0.956) for T1 and T2 maps, respectively, in diagnostic discrimination between breast cancers and benign lesions. A slightly increased AUC of 0.978 (95% CI: 0.915–0.993) was achieved by combining those two relaxation-based quantitative metrics. Conclusion In conclusion, our preliminary study showed that the quantitative T1 and T2 values obtained by SyMRI could distinguish effectively between benign and malignant breast lesions, and T1 relaxation time showed the highest diagnostic efficiency. Furthermore, combining the two quantitative relaxation metrics further improved their diagnostic performance.
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Affiliation(s)
- Tiebao Meng
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Ni He
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Haoqiang He
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Kuiyuan Liu
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Liangru Ke
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Huiming Liu
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Linchang Zhong
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Chenghui Huang
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Anli Yang
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Chunyan Zhou
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China
| | - Long Qian
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China
| | - Chuanmiao Xie
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China.
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Du S, Gao S, Zhang L, Yang X, Qi X, Li S. Improved discrimination of molecular subtypes in invasive breast cancer: Comparison of multiple quantitative parameters from breast MRI. Magn Reson Imaging 2020; 77:148-158. [PMID: 33309922 DOI: 10.1016/j.mri.2020.12.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 11/21/2020] [Accepted: 12/06/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To compare multiple quantitative parameters from breast magnetic resonance imaging (MRI) with the synthetic MRI sequence included for discrimination of molecular subtypes of invasive breast cancer. MATERIALS AND METHODS Between March 2019 and September 2020, two hundred breast cancer patients underwent preoperative breast multiparametric MRI examinations including synthetic MRI, diffusion weighted imaging (DWI) and dynamic contrast enhancement (DCE)-MRI sequences. MRI morphological features, T1 and T2 relaxation times (T1, T2) and proton density (PD) values from synthetic MRI, Ktrans, Kep, and Ve from DCE-MRI, mean apparent diffusion coefficient (ADC) from DWI and tumor volume were measured. Quantitative parameters were compared according to molecular markers and subtypes. Logistic regression were performed to find the related MRI parameters and establish combined parameters. The comparison between single and combined quantitative parameters by using DeLong tests. RESULTS T1, T2 values were significantly higher in hormone receptor (HR)- negative and Ki67 > 14% tumors (p < 0.05). Human epidermal growth factor receptor 2 (HER2)-positive tumors demonstrated significantly higher Ktrans and Kep (p < 0.01). Mean ADC values were significantly decreased in HR-positive and Ki67 > 14% tumors (p < 0.01). Tumor volumes were significantly higher in HER2-positive and Ki67 > 14% tumors (p < 0.05). Independent influencing factors were lower T2 values (p < 0.001), smaller tumor volume (p = 0.031) and higher mean ADC (p = 0.002) associated with luminal A subtype, while T1 values (p = 0.007) was the only quantitative parameter associated with triple-negative subtype. The diagnostic efficiency of combined parameters (T2 + mean ADC + volume) (AUC = 0.765) was significantly higher than that of mean ADC (AUC = 0.666, p = 0.031 by DeLong test) and volume (AUC = 0.650, p = 0.008 by DeLong test) for separating luminal A subtype. CONCLUSIONS MRI quantitative parameters could help distinguish molecular markers and subtypes. The emerging synthetic MRI parameters - T1 values were associated with the TN subtype, and combined parameters with added T2 values might improve the discrimination of the luminal A subtype. Application of synthetic MRI can enrich quantitative descriptors from breast MRI.
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Affiliation(s)
- Siyao Du
- Department of Radiology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Si Gao
- Department of Radiology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Lina Zhang
- Department of Radiology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.
| | - Xiaoping Yang
- Department of Radiology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Xixun Qi
- Department of Radiology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Shu Li
- Department of Radiology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
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Investigation of the feasibility of synthetic MRI in the differential diagnosis of non-keratinising nasopharyngeal carcinoma and benign hyperplasia using different contoured methods for delineation of the region of interest. Clin Radiol 2020; 76:238.e9-238.e15. [PMID: 33213835 DOI: 10.1016/j.crad.2020.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 10/21/2020] [Indexed: 12/16/2022]
Abstract
AIM To assess the feasibility and preliminary diagnostic performances of relaxation times derived from synthetic magnetic resonance imaging (syMRI) for differentiating nasopharyngeal carcinoma from nasopharyngeal benign lymphoid hyperplasia, and to assess the influence of tissue segmentation method on relaxation estimates. MATERIALS AND METHODS Fifty participants with nasopharyngeal carcinoma (NPC) and 40 participants with benign hyperplasia (NPH) who underwent syMRI examination were enrolled prospectively. T1, T2, and proton density (PD) values were obtained from four different regions of interest (ROIs), namely, partial-section, single-section, three-sections, and whole-lesion. The metrics between NPC and NPH or among different ROIs were compared using Student's t-test or one-way ANOVA. The area under curve (AUC) was calculated to assess the performance of metrics obtained from different ROIs to differentiate NPC and NPH. RESULTS The T1, T2, and PD values for NPH were significantly higher than those for NPC, regardless of the type of ROI used, except for the PD value obtained from the whole-lesion ROI. The T2 values obtained from the single-section ROI showed the highest diagnostic accuracy in distinguishing NPC from NPH, with an AUC of 0.894, sensitivity of 0.900, and specificity of 0.800. Additionally, the T1, T2, and PD values for nasopharyngeal lesions showed no statistical difference among different kinds of ROI, except for the difference in T1 value between partial-section and other methods. CONCLUSION Quantitative analysis of syMRI has the potential to distinguish NPC from NPH. Moreover, different types of ROI showed limited influence on the relaxation time estimation for nasopharyngeal lesions.
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33
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Gao W, Zhang S, Guo J, Wei X, Li X, Diao Y, Huang W, Yao Y, Shang A, Zhang Y, Yang Q, Chen X. Investigation of Synthetic Relaxometry and Diffusion Measures in the Differentiation of Benign and Malignant Breast Lesions as Compared to BI-RADS. J Magn Reson Imaging 2020; 53:1118-1127. [PMID: 33179809 DOI: 10.1002/jmri.27435] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Breast cancer is the most common malignant tumor in women and a quantitative contrast-free method is highly desirable for its diagnosis. PURPOSE To investigate the performance of quantitative MRI in differentiating malignant from benign breast lesions and to compare with the Breast Imaging Reporting and Data System (BI-RADS). STUDY TYPE Retrospective. SUBJECTS Eighty patients (56 with malignant lesions and 24 with benign lesions). FIELD STRENGTH/SEQUENCE Diffusion-weighted imaging (DWI) with a single-shot echo planar sequence and synthetic MRI with magnetic resonance image compilation (MAGiC) were performed at 3T. ASSESSMENT T1 relaxation time (T1 ), T2 relaxation time (T2 ), and proton density (PD) from synthetic MRI and apparent diffusion coefficient (ADC) from DWI were analyzed by two radiologists (Reader A, Reader B). Univariable and multivariable models were developed to optimize differentiation between malignant and benign lesions and their performances compared to BI-RADS. STATISTICAL TESTS The diagnostic performance was evaluated using multivariate logistic regression analysis and area under the receiver operating characteristic (ROC) curves (AUC). RESULTS T2 , PD, and ADC values for malignant lesions were significantly lower than those in benign breast lesions for both radiologists (all P < 0.05). The combined T2 , PD, and ADC model had the best performance for differentiating malignant and benign lesions with AUC, sensitivity, specificity, positive predictive value, and negative predictive values of 0.904, 94.6%, 87.5%, 94.6%, and 87.5%, respectively. The corresponding results for BI-RADS were no AUC, 94.6%, 75.0%, 89.8%, and 85.7%, respectively. DATA CONCLUSION The approach that combined synthetic MRI and DWI outperformed BI-RADS in the differential diagnosis of malignant and benign breast lesions and was achieved without contrast agents. This approach may serve as an alternative and effective strategy for the improvement of breast lesion differentiation. LEVEL OF EVIDENCE 3. TECHNICAL EFFICACY STAGE 3.
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Affiliation(s)
- Weibo Gao
- Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shuqun Zhang
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jinxia Guo
- GE Healthcare, MR Research, Beijing, China
| | | | - Xiaohui Li
- Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yan Diao
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wei Huang
- Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yue Yao
- Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ali Shang
- Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanyan Zhang
- Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Quanxin Yang
- Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xin Chen
- Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Kulshreshtha M, Sharma U. Editorial for "Enhanced Mass on Contrast-Enhanced Breast MRI: Differentiation Using a Combination of Dynamic Contrast-Enhanced MRI and Quantitative Evaluation With Synthetic MRI". J Magn Reson Imaging 2020; 53:392-393. [PMID: 32969100 DOI: 10.1002/jmri.27379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/11/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Manjari Kulshreshtha
- Department of Electronics and Communication Engineering, G.B. Pant Government Engineering College, New Delhi, India
| | - Uma Sharma
- Department of NMR & MRI Facility, All India Institute of Medical Sciences, New Delhi, India
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Matsuda M, Tsuda T, Ebihara R, Toshimori W, Takeda S, Okada K, Nakasuka K, Shiraishi Y, Suekuni H, Kamei Y, Kurata M, Kitazawa R, Mochizuki T, Kido T. Enhanced Masses on Contrast-Enhanced Breast: Differentiation Using a Combination of Dynamic Contrast-Enhanced MRI and Quantitative Evaluation with Synthetic MRI. J Magn Reson Imaging 2020; 53:381-391. [PMID: 32914921 DOI: 10.1002/jmri.27362] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The addition of synthetic MRI might improve the diagnostic performance of dynamic contrast-enhanced MRI (DCE-MRI) in patients with breast cancer. PURPOSE To evaluate the diagnostic value of a combination of DCE-MRI and quantitative evaluation using synthetic MRI for differentiation between benign and malignant breast masses. STUDY TYPE Retrospective, observational. POPULATION In all, 121 patients with 131 breast masses who underwent DCE-MRI with additional synthetic MRI were enrolled. FIELD STRENGTH/SEQUENCE 3.0 Tesla, T1 -weighted DCE-MRI and synthetic MRI acquired by a multiple-dynamic, multiple-echo sequence. ASSESSMENT All lesions were differentiated as benign or malignant using the following three diagnostic methods: DCE-MRI type based on the Breast Imaging-Reporting and Data System; synthetic MRI type using quantitative evaluation values calculated by synthetic MRI; and a combination of the DCE-MRI + Synthetic MRI types. The diagnostic performance of the three methods were compared. STATISTICAL TESTS Univariate (Mann-Whitney U-test) and multivariate (binomial logistic regression) analyses were performed, followed by receiver-operating characteristic curve (AUC) analysis. RESULTS Univariate and multivariate analyses showed that the mean T1 relaxation time in a breast mass obtained by synthetic MRI prior to injection of contrast agent (pre-T1 ) was the only significant quantitative value acquired by synthetic MRI that could independently differentiate between malignant and benign breast masses. The AUC for all enrolled breast masses assessed by DCE-MRI + Synthetic MRI type (0.83) was significantly greater than that for the DCE-MRI type (0.70, P < 0.05) or synthetic MRI type (0.73, P < 0.05). The AUC for category 4 masses assessed by the DCE-MRI + Synthetic MRI type was significantly greater than that for those assessed by the DCE-MRI type (0.74 vs. 0.50, P < 0.05). DATA CONCLUSION A combination of synthetic MRI and DCE-MRI improves the accuracy of diagnosis of benign and malignant breast masses, especially category 4 masses. Level of Evidence 4 Technical Efficacy Stage 2 J. MAGN. RESON. IMAGING 2021;53:381-391.
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Affiliation(s)
- Megumi Matsuda
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Takaharu Tsuda
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Rui Ebihara
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Wataru Toshimori
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Shiori Takeda
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kanako Okada
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kaori Nakasuka
- Department of Radiology, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Yasuhiro Shiraishi
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Hiroshi Suekuni
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan
| | | | - Mie Kurata
- Department of Pathology, Ehime University Proteo-Science Center, Toon, Japan.,Department of Analytical Pathology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Riko Kitazawa
- Division of Diagnostic Pathology, Ehime University Hospital, Toon, Japan
| | - Teruhito Mochizuki
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan.,Department of Radiology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan
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Zhou Y, Xu XQ, Hu H, Su GY, Liu H, Wu FY. T2 mapping in orbital masses: preliminary study on differential diagnostic ability of T2 relaxation time. Acta Radiol 2020; 61:668-674. [PMID: 31500440 DOI: 10.1177/0284185119874476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background T2 mapping has been proven to be useful in tumor characterization. As to orbital masses, its diagnostic value needs to be investigated. Purpose To evaluate the usefulness of T2 mapping in orbital masses and the ability of T2 relaxation time in differentiating malignant from benign orbital masses. Material and Methods Forty-seven patients with solid orbital masses (33 benign and 14 malignant) who underwent T2 mapping examination for preoperative assessment were enrolled in the current study. T2 mapping was acquired using 16 TE values (range 12–192 ms; delta TE 12 ms). Mean T2 relaxation time was calculated based on the whole mass region of interest and compared between the malignant and benign groups using the unpaired t-test. Receiver operating characteristic curve analysis was adopted to calculate its diagnostic value. Results Malignant orbital masses showed significantly lower T2 relaxation time than benign masses (76.4 ± 13.0 ms vs. 119.1 ± 20.4 ms; P < 0.001). If setting a T2 relaxation time of 89.5 ms as the threshold value, optimal differentiating performance could be achieved (area under the curve 0.936; sensitivity 100.0%; specificity 87.9%; accuracy 91.5%; positive predictive value 77.8%; negative predictive value 100%). Conclusion T2 mapping and its derived T2 relaxation time could provide quantitative information and serve as a supplementary imaging marker for differentiating malignant from benign orbital masses.
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Affiliation(s)
- Yan Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Guo-Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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37
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Cui Y, Han S, Liu M, Wu PY, Zhang W, Zhang J, Li C, Chen M. Diagnosis and Grading of Prostate Cancer by Relaxation Maps From Synthetic MRI. J Magn Reson Imaging 2020; 52:552-564. [PMID: 32027071 DOI: 10.1002/jmri.27075] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The interpretation system for prostate MRI is largely based on qualitative image contrast of different tissue types. Therefore, a fast, standardized, and robust quantitative technique is necessary. Synthetic MRI is capable of quantifying multiple relaxation parameters, which might have potential applications in prostate cancer (PCa). PURPOSE To investigate the use of quantitative relaxation maps derived from synthetic MRI for the diagnosis and grading of PCa. STUDY TYPE Prospective. SUBJECTS In all, 94 men with pathologically confirmed PCa or benign pathological changes. FIELD STRENGTH/SEQUENCE T1 -weighted imaging, T2 -weighted imaging, diffusion-weighted imaging, and synthetic MRI at 3.0T. ASSESSMENT Four kinds of tissue types were identified on pathology, including PCa, stromal hyperplasia (SH), glandular hyperplasia (GH), and noncancerous peripheral zone (PZ). PCa foci were grouped as low-grade (LG, Gleason score ≤6) and intermediate/high-grade (HG, Gleason score ≥7). Regions of interest were manually drawn by two radiologists in consensus on parametric maps according to the pathological results. STATISTICAL TESTS Independent sample t-test, Mann-Whitney U-test, and receiver operating characteristic curve analysis. RESULTS T1 and T2 values of PCa were significantly lower than SH (P = 0.015 and 0.002). The differences of T1 and T2 values between PCa and noncancerous PZ were also significant (P ≤ 0.006). The area under the curve (AUC) of the apparent diffusion coefficient (ADC) value was significantly higher than T1 , T2 , and proton density (PD) values in discriminating PCa from SH and noncancerous PZ (P ≤ 0.025). T2 , PD, and ADC values demonstrated similar diagnostic performance in discriminating LG from HG PCa (AUC = 0.806 [0.640-0.918], 0.717 [0.542-0.854], and 0.817 [0.652-0.925], respectively; P ≥ 0.535). DATA CONCLUSION Relaxation maps derived from synthetic MRI were helpful for discriminating PCa from other benign pathologies. But the overall diagnostic performance was inferior to the ADC values. T2 , PD, and ADC values performed similarly in discriminating LG from HG PCa lesions. LEVEL OF EVIDENCE 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;52:552-564.
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Affiliation(s)
- Yadong Cui
- Department of Radiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing P. R., China.,Graduate School of Peking Union Medical College, Beijing P. R., China
| | - Siyuan Han
- Department of Radiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing P. R., China.,Graduate School of Peking Union Medical College, Beijing P. R., China
| | - Ming Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing P. R., China
| | - Pu-Yeh Wu
- GE Healthcare, MR Research, Beijing P. R., China
| | - Wei Zhang
- Department of Pathology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing P. R., China
| | - Jintao Zhang
- Department of Radiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing P. R., China
| | - Chunmei Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing P. R., China
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing P. R., China.,Graduate School of Peking Union Medical College, Beijing P. R., China
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Matsuda M, Kido T, Tsuda T, Okada K, Shiraishi Y, Suekuni H, Kamei Y, Kitazawa R, Mochizuki T. Utility of synthetic MRI in predicting the Ki-67 status of oestrogen receptor-positive breast cancer: a feasibility study. Clin Radiol 2020; 75:398.e1-398.e8. [PMID: 32019671 DOI: 10.1016/j.crad.2019.12.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 12/31/2019] [Indexed: 01/13/2023]
Abstract
AIM To evaluate the utility of synthetic magnetic resonance imaging (MRI) of the breast in predicting the Ki-67 status in patients with oestrogen receptor (ER)-positive breast cancer. MATERIALS AND METHODS Forty-nine patients with 50 histopathologically proven breast cancers who underwent additional synthetic MRI were enrolled in the present study. Using synthetic MRI images, T1 and T2 relaxation times and their standard deviations (SD) in the breast lesions before (T1-Pre, T2-Pre, PD-Pre, SD of T1-Pre, SD of T2-Pre, SD of PD-Pre) and after (T1-Gd, T2-Gd, PD-Gd, SD of T1-Gd, SD of T2-Gd, SD of PD-Gd) contrast agent injection were obtained. These quantitative values were compared between the low Ki-67 expression (<14%) lesions (low-proliferation group: n=23) and high Ki-67 expression (≥14%) lesions (high-proliferation group: n=27). RESULTS The univariate analysis showed that the SD of T1-Gd (p<0.001) and T2-Gd (p=0.042) were significantly higher in the high-proliferation group than in the low-proliferation group. Multivariate analysis further showed that the SD of T1-Gd was a significant and independent predictor of Ki-67 expression, with an area under the receiver operating characteristic (AUROC) curve of 0.885. The sensitivity, specificity, and accuracy of the SD of T1-Gd with an optimal cut-off value of 98.5 were 77.8%, 87%, and 82%, respectively. CONCLUSION The SD of T1-Gd obtained from synthetic MRI was useful to predict Ki-67 status.
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Affiliation(s)
- M Matsuda
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - T Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
| | - T Tsuda
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - K Okada
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Y Shiraishi
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - H Suekuni
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Y Kamei
- Breast Center, Ehime University Hospital, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - R Kitazawa
- Division of Diagnostic Pathology, Ehime University Hospital, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - T Mochizuki
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan; Department of Radiology, I.M. Sechenov First Moscow State Medical University, 8-2 Trubetskaya Str, Moscow, 119991, Russian Federation
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