1
|
Zheng G, Wei F, Lu P, Yang G, Li C, Lin C, Zhou Y, Chen Y, Tian J, Wang X, Wang L, Liu W, Zhang G, Cai Q, Huang H, Yun Y. IDEAL-IQ measurement can distinguish dysplastic nodule from early hepatocellular carcinoma: a case-control study. Quant Imaging Med Surg 2024; 14:3901-3913. [PMID: 38846285 PMCID: PMC11151266 DOI: 10.21037/qims-23-1593] [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: 11/09/2023] [Accepted: 03/25/2024] [Indexed: 06/09/2024]
Abstract
Background Previous studies have confirmed that malignant transformation of dysplastic nodule (DN) into hepatocellular carcinoma (HCC) is accompanied by reduction of iron content in nodules. This pathological abnormality can serve as the basis for magnetic resonance imaging (MRI). This study was designed to identify the feasibility of iterative decomposition of water and fat with echo asymmetry and least squares estimation-iron quantitative (IDEAL-IQ) measurement to distinguish early hepatocellular carcinoma (eHCC) from DN. Methods We reviewed MRI studies of 35 eHCC and 23 DN lesions (46 participants with 58 lesions total, 37 males, 9 females, 31-80 years old). The exams include IDEAL-IQ sequence and 3.0T MR conventional scan [including T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and Gadopentic acid (Gd-GDPA)-enhanced]. Then, 3 readers independently diagnosed eHCC, DN, or were unable to distinguish eHCC from DN using conventional MRI (CMRI), and then assessed R2* value of nodules [R2* value represents the nodule iron content (NIC)] and R2* value of liver background [R2* value represents the liver background iron content (LBIC)] with IDEAL-IQ. Statistical analysis was conducted using the t-test for comparison of means, the Mann-Whitney test for comparison of medians, the chi-square test for comparison of frequencies, and diagnostic efficacy was evaluated by using receiver operating characteristic (ROC) curve. Results This study evaluated 35 eHCC participants (17 males, 6 females, 34-81 years old, nodule size: 10.5-27.6 mm, median 18.0 mm) and 23 DN participants (20 males, 3 females, 31-76 years old, nodule size: 16.30±4.095 mm). The NIC and ratio of NIC to LIBC (NIC/LBIC) of the eHCC group (35.926±12.806 sec-1, 0.327±0.107) was lower than that of the DN group (176.635±87.686 sec-1, 1.799±0.629) (P<0.001). Using NIC and NIC/LBIC to distinguish eHCC from DN, the true positive/false positive rates were 91.3%/94.3% and 87.0%/97.1%, respectively. The rates of CMRI, NIC and NIC/LBIC in diagnosis of eHCC were 77.1%, and 94.3%, 97.1%, respectively, and those of DN were 65.2%, 91.3%, and 87.0%, respectively. The diagnosis rate of eHCC and DN by CMRI was lower than that of NIC and NIC/LBIC (eHCC: P=0.03, 0.04, DN: P=0.02, 0.04). Conclusions Using IDEAL-IQ measurement can distinguish DN from eHCC.
Collapse
Affiliation(s)
- Guangping Zheng
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Fangjun Wei
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Puxuan Lu
- Department of Radiology, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Gendong Yang
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Cuizu Li
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Chunming Lin
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Yun Zhou
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Yixin Chen
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Jianing Tian
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Xiaolei Wang
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Linjing Wang
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Wenhao Liu
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Guangfeng Zhang
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Qingxian Cai
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Hua Huang
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| | - Yongxing Yun
- Department of Radiology, Shenzhen Third People’s Hospital, Shenzhen, China
| |
Collapse
|
2
|
Greene CJ, Attwood K, Sharma NJ, Balderman B, Deng R, Muhitch JB, Smith GJ, Gross KW, Xu B, Kauffman EC. Iron accumulation typifies renal cell carcinoma tumorigenesis but abates with pathological progression, sarcomatoid dedifferentiation, and metastasis. Front Oncol 2022; 12:923043. [PMID: 35992801 PMCID: PMC9389085 DOI: 10.3389/fonc.2022.923043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Iron is a potent catalyst of oxidative stress and cellular proliferation implicated in renal cell carcinoma (RCC) tumorigenesis, yet it also drives ferroptosis that suppresses cancer progression and represents a novel therapeutic target for advanced RCC. The von Hippel Lindau (VHL)/hypoxia-inducible factor-α (HIF-α) axis is a major regulator of cellular iron, and its inactivation underlying most clear cell (cc) RCC tumors introduces both iron dependency and ferroptosis susceptibility. Despite the central role for iron in VHL/HIF-α signaling and ferroptosis, RCC iron levels and their dynamics during RCC initiation/progression are poorly defined. Here, we conducted a large-scale investigation into the incidence and prognostic significance of total tissue iron in ccRCC and non-ccRCC patient primary tumor cancer cells, tumor microenvironment (TME), metastases and non-neoplastic kidneys. Prussian Blue staining was performed to detect non-heme iron accumulation in over 1600 needle-core sections across multiple tissue microarrays. We found that RCC had significantly higher iron staining scores compared with other solid cancers and, on average, >40 times higher than adjacent renal epithelium. RCC cell iron levels correlated positively with TME iron levels and inversely with RCC levels of the main iron uptake protein, transferrin receptor 1 (TfR1/TFRC/CD71). Intriguingly, RCC iron levels, including in the TME, decreased significantly with pathologic (size/stage/grade) progression, sarcomatoid dedifferentiation, and metastasis, particularly among patients with ccRCC, despite increasing TfR1 levels, consistent with an increasingly iron-deficient tumor state. Opposite to tumor iron changes, adjacent renal epithelial iron increased significantly with RCC/ccRCC progression, sarcomatoid dedifferentiation, and metastasis. Lower tumor iron and higher renal epithelial iron each predicted significantly shorter ccRCC patient metastasis-free survival. In conclusion, iron accumulation typifies RCC tumors but declines toward a relative iron-deficient tumor state during progression to metastasis, despite precisely opposite dynamics in adjacent renal epithelium. These findings raise questions regarding the historically presumed selective advantage for high iron during all phases of cancer evolution, suggesting instead distinct tissue-specific roles during RCC carcinogenesis and early tumorigenesis versus later progression. Future study is warranted to determine how the relative iron deficiency of advanced RCC contributes to ferroptosis resistance and/or introduces a heightened susceptibility to iron deprivation that might be therapeutically exploitable.
Collapse
Affiliation(s)
- Christopher J. Greene
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
- Department of Biological Sciences, University at Buffalo, Buffalo, NY, United States
| | - Kristopher Attwood
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Nitika J. Sharma
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Benjamin Balderman
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Rongia Deng
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Jason B. Muhitch
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Gary J. Smith
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Kenneth W. Gross
- Department of Molecular and Cellular Biology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Bo Xu
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Eric C. Kauffman
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
- Department of Cancer Genetics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
- *Correspondence: Eric C. Kauffman,
| |
Collapse
|
3
|
Ma L, Li J, Azamuddin M, Zheng S, Wang W, Wang P. Detection of tumour boundary in metastatic liver disease with 2D multibreath-hold susceptibility-weighted imaging. Magn Reson Imaging 2022; 92:26-32. [PMID: 35623417 DOI: 10.1016/j.mri.2022.05.011] [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: 12/02/2021] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the feasibility of susceptibility weighted imaging (SWI) in detecting tumour boundaries in metastatic liver disease (MLD) without contrast agent, and whether SWI can provide pathophysiologic information for preoperative evaluation. METHODS Thirty patients with MLD underwent tumour resection. All patients underwent conventional MRI (T1-weighted and T2-weighted imaging), contrast-enhanced (CE) MRI and multibreath-hold 2D SWI. The conspicuity of the tumour boundary was assessed using a 4-grade scale. The detection rate of tumour boundaries and areas were reviewed and measured. The longest dimension was used to estimate the tumour size from the MR image. The conspicuity of the tumour boundary and area were compared using a nonparametric multi-group comparison (Friedman M). The McNemar test was applied to examine differences in the detection rate of tumour boundaries. RESULTS Among four different MRI sequences, SWI exhibited increased conspicuity of the tumour boundary than the conventional MRI (P < 0.001). SWI (91.8%) and CE-MRI (64.4%) exhibited higher detection rates of the tumour boundary than T1WI and T2WI (6.8% and 12.3% respectively). Longer tumour maximum diameters were measured with SWI (29.1 ± 17.2 mm) and CE-MRI (28.2 ± 16.8) compared to conventional MRI (P < 0.05). CONCLUSION 2D multibreath-hold SWI enables enhanced noninvasive detection of tumour boundaries in patients with MLD compared with conventional MRI and CE-MRI without using an exogenous contrast agent. SWI has the potential to become a preoperative assessment standard that complements conventional MRI.
Collapse
Affiliation(s)
- Liang Ma
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China; Department of Radiology, Children's Hospital of Fudan University, National Children's Medical Center, No. 399, Wanyuan Road, Minhang District, Shanghai 201102, China
| | - Jinglu Li
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China
| | - Mohammed Azamuddin
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China
| | - Shaoqiang Zheng
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China
| | - Wei Wang
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China.
| | - Peijun Wang
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China.
| |
Collapse
|
4
|
Zhang Y, Deng Q, Sun B, Chen L, Huang X, Pan J, Huang X, Zhang J, Chen W. Differentiation of Malignant and Benign Orbital Space-Occupying Lesions Using Contrast-Enhanced Ultrasound: Added Value From a Time-Intensity Curve-Based Quantitative Analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:2477-2486. [PMID: 33470432 DOI: 10.1002/jum.15636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/23/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To evaluate the value of time-intensity curve (TIC) analysis of contrast-enhanced ultrasound (CEUS) signal to differentiate malignant from benign orbital space-occupying lesions. METHODS The CEUS signal of 111 patients with orbital space-occupying lesions was retrospectively analyzed using SonoLiver software. TIC-related parameters such as the arrival time (AT), rise time (RT), time to peak (TTP), maximum intensity (IMAX), mean transit time (mTT), slope of the increase (RS), and slope of the decrease (DS) were compared between the malignant and benign groups. Receiver operating characteristic (ROC) curve analysis was used to acquire the cutoff values of these parameters for differential diagnosis. RESULTS TIC patterns were characterized by fast increase and fast decrease in signal intensity in the malignant group, fast increase and a slow decrease in signal intensity in the benign group. The differences in the IMAX, RS, DS, mTT, TTP, and RT between the 2 groups were statistically significant (p <.01), while the difference in the AT were not (p = .672). ROC curve analysis showed that IMAX = 427.20, DS = 34.72, and mTT = 33.55 were the best cutoff values for differential diagnosis of malignant and benign space-occupying lesions. The accuracy rate of CEUS visual evaluation for differential diagnosis was 66.67% (74/111), while TIC quantitative analysis could effectively improve the accuracy to 89.19% (99/111). CONCLUSIONS TIC analysis can improve CEUS efficiency to differentiate malignant from benign orbital space-occupying lesions.
Collapse
Affiliation(s)
- Yao Zhang
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Qing Deng
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Bin Sun
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Liao Chen
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xin Huang
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Juhong Pan
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xingyue Huang
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jun Zhang
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Wenwei Chen
- Department of Ultrasuond, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| |
Collapse
|
5
|
Hou ZB, Zhao F, Zhang B, Zhang CZ. Study on clinical application of susceptibility weighted imaging ombined with diffusion weighted imaging in patients with Liver Cirrhosis complicated with small Hepatocellular Carcinoma. Pak J Med Sci 2021; 37:800-804. [PMID: 34104168 PMCID: PMC8155423 DOI: 10.12669/pjms.37.3.3822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objectives To evaluate the clinical value of susceptibility weighted imaging (SWI) combined with diffusion weighted imaging (DWI) in patients with liver cirrhosis complicated with small hepatocellular carcinoma (SHCC). Methods A total of 40 patients with liver cirrhosis and 44 nodules were treated with conventional nuclear magnetic scanning (T1WI, T2WI) and SWI combined with DWI; the results were judged by two senior physicians; the t test, χ2 test, rank sum test, and other methods were used for contrastive analysis of the pathological results of different scanning methods after operation or puncture. Results Contrast analysis of the different MRI scanning methods and pathological results showed that among the 32 nodules of small hepatocellular carcinoma, 24 cases were diagnosed by conventional MRI, with the coincidence rate being 75%, 30 cases were diagnosed by SWI DWI, with the coincidence rate being 96%; significant difference was found between the two groups (p=0. 04). Significant differences were found in the specificity, sensitivity and accuracy of different scanning methods in the diagnosis of small hepatocellular carcinoma (specificity, accuracy, p=0.04; sensitivity p=0.01). The SWI of small hepatocellular carcinoma nodules showed hyperintensity, and the degree of iron deposition was low. Significant difference was found between small hepatocellular carcinoma nodules and other nodules (comparison of SWI signal degree, p=0.01; comparison of iron deposition degree, p=0.00). Conclusion The SWI of small hepatocellular carcinoma nodules showed hyperintensity, and the degree of iron deposition was low. The coincidence rate of SWI+DWI scanning is higher than that of conventional scanning methods in the diagnosis of small hepatocellular carcinoma, and the difference in specificity, sensitivity and accuracy has obvious advantages. SWI+DWI scanning can improve the detection rate of liver cirrhosis complicated with small hepatocellular carcinoma.
Collapse
Affiliation(s)
- Zhi-Bo Hou
- Zhi-bo Hou, Medical Imaging Center, Peking University Shougang Hospital, Beijing, 100144, China
| | - Fei Zhao
- Fei Zhao, Department of Imaging, Aerospace Center Hospital, Beijing, 100049, China
| | - Bin Zhang
- Bin Zhang, Medical Imaging Center, Peking University Shougang Hospital, Beijing, 100144, China
| | - Chun-Zhu Zhang
- Chun-zhu Zhang, Department of Radiology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing, 100040, China
| |
Collapse
|
6
|
Zou LQ, Zhao F, Zhang H, Zhang K, Xing W. Staging liver fibrosis on multiparametric MRI in a rabbit model with elastography, susceptibility-weighted imaging and T1ρ imaging: a preliminary study. Acta Radiol 2021; 62:155-163. [PMID: 32326722 DOI: 10.1177/0284185120917117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Magnetic resonance elastography (MRE), susceptibility-weighted imaging (SWI), and T1ρ are three techniques for staging of liver fibrosis (LF). PURPOSE To assess the value of MRE, SWI, and T1ρ imaging in staging LF. MATERIAL AND METHODS Sixty rabbits were injected with 50% CCl4oil solution, whereas 20 rabbits were given normal saline. All rabbits underwent pathological examination to determine LF stages. The liver stiffness (LS), liver-to-muscle signal intensity ratio (SIR), and T1ρ values were measured from MRE, SWI, and T1ρ imaging, respectively. RESULTS The number of rabbits was 14, 11, 10, 9, and 11 for F0, F1, F2, F3, and F4, respectively. LS (r = 0.91) and T1ρ (r = 0.51) positively correlated with LF stages, while negative correlation was present for SIR (r = -0.81). Among the three parameters, the LS values revealed the best diagnostic efficacy in staging LF, with an AUC value of 0.95 for ≥F1, 0.95 for ≥F2, 0.99 for ≥F3, and 0.98 for ≥F4. The combination of LS and SIR could best predict LF stages ≥F1, ≥F2, ≥F3 and ≥F4, with AUC values of 0.97, 0.98, 0.99, and 0.99, respectively, which were greater than those of the other two-paired parameters. A multiparametric analysis showed that the combination of all three parameters had AUC values of 0.97, 0.98, 1.00, and 1.00 for staging ≥F1, ≥F2, ≥F3, and ≥F4, respectively. CONCLUSION Multiparametric MR imaging was superior to individual imaging for LF staging.
Collapse
Affiliation(s)
- Li-Qiu Zou
- Department of Radiology, The Sixth Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, PR China
| | - Feng Zhao
- Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, PR China
| | - Hao Zhang
- Department of Radiology, Affiliated Shenzhen Sixth Hospital of Guangdong Medical University, Shenzhen, PR China
| | - Kai Zhang
- Department of Radiology, Affiliated Shenzhen Sixth Hospital of Guangdong Medical University, Shenzhen, PR China
| | - Wei Xing
- Department of Radiology, Third Affiliated Hospital of Soochow University & Changzhou First People’s Hospital, Changzhou, Jiangsu, PR China
| |
Collapse
|
7
|
Rao SX, Wang J, Wang J, Jiang XQ, Long LL, Li ZP, Li ZL, Shen W, Zhao XM, Hu DY, Zhang HM, Zhang L, Huan Y, Liang CH, Song B, Zeng MS. Chinese consensus on the clinical application of hepatobiliary magnetic resonance imaging contrast agent: Gadoxetic acid disodium. J Dig Dis 2019; 20:54-61. [PMID: 30693659 DOI: 10.1111/1751-2980.12707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 01/27/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Sheng Xiang Rao
- Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Institute of Medical Imaging, Shanghai, China
| | - Jin Wang
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xin Qing Jiang
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou, Guangdong Province, China
| | - Li Ling Long
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Zi Ping Li
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Zhen Lin Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Wen Shen
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - Xin Ming Zhao
- Department of Diagnostic Imaging, Chinese Academy of Medical Sciences Cancer Hospital, Beijing, China
| | - Dao Yu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Hui Mao Zhang
- Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Lin Zhang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Yi Huan
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Chang Hong Liang
- Department of Radiology, Guangdong Provincial People's Hospital, Guanggong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Meng Su Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Institute of Medical Imaging, Shanghai, China
| |
Collapse
|
8
|
Performance of Magnetic Resonance Susceptibility-Weighted Imaging for Detection of Calcifications in Patients With Hepatic Echinococcosis. J Comput Assist Tomogr 2018; 42:211-215. [PMID: 29189399 DOI: 10.1097/rct.0000000000000687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE We evaluated the performance of susceptibility-weighted imaging (SWI) for identification of hepatic calcifications in alveolar echinococcosis and cystic echinococcosis. METHODS The SWI images of 58 lesions in 40 patients (age, 49 ± 14 y) with alveolar echinococcosis (n = 22) or cystic echinococcosis (n = 18) were reviewed for calcifications. First, calcifications were suggested by visual assessment. Second, ratios of minimum intralesional intensity and mean lumbar muscle intensity were recorded. Computed tomography (CT) served as the criterion standard. RESULTS Thirty-seven lesions showed calcifications on CT. Susceptibility-weighted imaging provided a sensitivity of 89.2% (95% confidence interval [CI], 50.1-75.7) and a specificity of 57.1% (95% CI, 34.4-77.4) for calcifications detected by visual assessment. Receiver operating characteristic curves demonstrated a sensitivity of 67.6% and a specificity of 85.0% for an intensity ratio of 0.61. A specificity of 100% (95% CI, 80.8-100) and a sensitivity of 84.5% (95% CI, 67.3-93.2) were achieved by SWI for calcifications with a density greater than 184 HU in CT. CONCLUSIONS Identification of hepatic calcifications is possible with SWI. Susceptibility-weighted imaging offers the potential to reduce the need for of CT imaging for evaluation of echinococcosis.
Collapse
|