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Payne MM, Mali I, Shrestha TB, Basel MT, Timmerman S, Pyle M, Sebek J, Prakash P, Bossmann SH. T 1-mapping characterization of two tumor types. BIOPHYSICAL REPORTS 2024; 4:100157. [PMID: 38795740 PMCID: PMC11229382 DOI: 10.1016/j.bpr.2024.100157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/25/2024] [Accepted: 05/14/2024] [Indexed: 05/28/2024]
Abstract
T1 mapping is a quantitative method to characterize tissues with magnetic resonance imaging in a quick and efficient manner. It utilizes the relaxation rate of protons to depict the underlying structures within the imaging frame. While T1-mapping techniques are used with some frequency in areas such as cardiac imaging, their application for understanding malignancies and identifying tumor structures has yet to be thoroughly investigated. Utilizing a saturation recovery method to acquire T1 maps for two different tumor models has revealed that longitudinal relaxation mapping is sensitive enough to distinguish between normal and malignant tissue. This is seen even with decreased signal/noise ratios using small voxel sizes to obtain high-resolution images. In both tumor models, it was revealed that relaxation mapping recorded significantly different relaxation values between regions encapsulating the tumor, muscle, kidney, or spleen, as well as between the cell lines themselves. This indicates a potential future application of relaxation mapping as a method to fingerprint various stages of tumor development and may prove a useful measure to identify micro-metastases.
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Affiliation(s)
- Macy Marie Payne
- Department of Cancer Biology, University of Kansas Medical Center, Kansas City, Kansas
| | - Ivina Mali
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Tej B Shrestha
- Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - Matthew T Basel
- Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - Sarah Timmerman
- College of Veterinary Medicine, Kansas State University, Manhattan, Kansas
| | - Marla Pyle
- Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - Jan Sebek
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas
| | - Punit Prakash
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas
| | - Stefan H Bossmann
- Department of Cancer Biology, University of Kansas Medical Center, Kansas City, Kansas.
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2
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Palumbo P, Martinese A, Antenucci MR, Granata V, Fusco R, De Muzio F, Brunese MC, Bicci E, Bruno A, Bruno F, Giovagnoni A, Gandolfo N, Miele V, Di Cesare E, Manetta R. Diffusion kurtosis imaging and standard diffusion imaging in the magnetic resonance imaging assessment of prostate cancer. Gland Surg 2023; 12:1806-1822. [PMID: 38229839 PMCID: PMC10788566 DOI: 10.21037/gs-23-53] [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: 02/12/2023] [Accepted: 11/09/2023] [Indexed: 01/18/2024]
Abstract
Background and Objective In recent years, magnetic resonance imaging (MRI) has shown excellent results in the study of the prostate gland. MRI has indeed shown to be advantageous in the prostate cancer (PCa) detection, as in guiding targeting biopsy, improving its diagnostic yield. Although current acquisition protocols provide for multiparametric acquisition, recent evidence has shown that biparametric protocols can be non-inferior in PCa detection. Diffusion-weighted imaging (DWI) sequence, in particular, plays a key role, particularly in the peripheral zone which accounts for the larger part of the prostate. High b-values are generally recommended, although with the possibility of obtaining non-Gaussian diffusion effects, which requires a more sophisticated model for the analysis, namely through the diffusion kurtosis imaging (DKI). Purpose of this narrative review was to analyze the current applications and clinical evidence regarding the use of DKI with a main focus on PCa detection, also in comparison with DWI. Methods This narrative review synthesized the findings of literature retrieved from main researches, narrative and systematic reviews, and meta-analyses obtained from PubMed. Key Content and Findings DKI analyses the non-Gaussian water diffusivity and describe the effect of signal intensity decay related to high b-value through two main metrics (Dapp and Kapp). Differently from DWI-apparent diffusion coefficient (DWI-ADC) which reflects only water restriction outside of cells, DKI metrics are supposed to represent also the direct interaction of water molecules with cell membranes and intracellular compounds. This review describes current evidence on ADC and DKI metrics in clinical imaging, and finally collect the results derived from the main articles focused on DWI and DKI models in detecting PCa. Conclusions DKI advantages, compared to conventional ADC analysis, still remain controversial. Wider application and greater technical knowledge of DKI, however, may help in proving its intrinsic validity in the field of oncology and therefore in the study of clinically significant PCa. Finally, a deep understanding of DKI is important for radiologists to better understand what Kapp and Dapp mean in the context of different cancer and how these metrics may vary specifically in PCa imaging.
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Affiliation(s)
- Pierpaolo Palumbo
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, L’Aquila, Italy
| | - Andrea Martinese
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
| | - Maria Rosaria Antenucci
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
| | - Vincenza Granata
- Division of Radiology, “Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli”, Naples, Italy
| | | | - Federica De Muzio
- Diagnostic Imaging Section, Department of Medical and Surgical Sciences & Neurosciences, University of Molise, Campobasso, Italy
| | - Maria Chiara Brunese
- Diagnostic Imaging Section, Department of Medical and Surgical Sciences & Neurosciences, University of Molise, Campobasso, Italy
| | - Eleonora Bicci
- Department of Emergency Radiology, University Hospital Careggi, Florence, Italy
| | - Alessandra Bruno
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Ancona, Italy
- Department of Radiology, University Hospital “Azienda Ospedaliera Universitaria delle Marche”, Ancona, Italy
| | - Federico Bruno
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, L’Aquila, Italy
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Ancona, Italy
- Department of Radiology, University Hospital “Azienda Ospedaliera Universitaria delle Marche”, Ancona, Italy
| | - Nicoletta Gandolfo
- Diagnostic Imaging Department, Villa Scassi Hospital-ASL 3, Genoa, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, University Hospital Careggi, Florence, Italy
| | - Ernesto Di Cesare
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Rosa Manetta
- Radiology Unit, San Salvatore Hospital, Abruzzo Health Unit 1, L’Aquila, Italy
- Prostate Unit, San Salvatore Hospital, Abruzzo Health Unit 1, L’Aquila, Italy
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3
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Fokkinga E, Hernandez-Tamames JA, Ianus A, Nilsson M, Tax CMW, Perez-Lopez R, Grussu F. Advanced Diffusion-Weighted MRI for Cancer Microstructure Assessment in Body Imaging, and Its Relationship With Histology. J Magn Reson Imaging 2023. [PMID: 38032021 DOI: 10.1002/jmri.29144] [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: 08/11/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Diffusion-weighted magnetic resonance imaging (DW-MRI) aims to disentangle multiple biological signal sources in each imaging voxel, enabling the computation of innovative maps of tissue microstructure. DW-MRI model development has been dominated by brain applications. More recently, advanced methods with high fidelity to histology are gaining momentum in other contexts, for example, in oncological applications of body imaging, where new biomarkers are urgently needed. The objective of this article is to review the state-of-the-art of DW-MRI in body imaging (ie, not including the nervous system) in oncology, and to analyze its value as compared to reference colocalized histology measurements, given that demonstrating the histological validity of any new DW-MRI method is essential. In this article, we review the current landscape of DW-MRI techniques that extend standard apparent diffusion coefficient (ADC), describing their acquisition protocols, signal models, fitting settings, microstructural parameters, and relationship with histology. Preclinical, clinical, and in/ex vivo studies were included. The most used techniques were intravoxel incoherent motion (IVIM; 36.3% of used techniques), diffusion kurtosis imaging (DKI; 16.7%), vascular, extracellular, and restricted diffusion for cytometry in tumors (VERDICT; 13.3%), and imaging microstructural parameters using limited spectrally edited diffusion (IMPULSED; 11.7%). Another notable category of techniques relates to innovative b-tensor diffusion encoding or joint diffusion-relaxometry. The reviewed approaches provide histologically meaningful indices of cancer microstructure (eg, vascularization/cellularity) which, while not necessarily accurate numerically, may still provide useful sensitivity to microscopic pathological processes. Future work of the community should focus on improving the inter-/intra-scanner robustness, and on assessing histological validity in broader contexts. LEVEL OF EVIDENCE: NA TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ella Fokkinga
- Biomedical Engineering, Track Medical Physics, Delft University of Technology, Delft, The Netherlands
- Radiomics Group, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Juan A Hernandez-Tamames
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Andrada Ianus
- Champalimaud Research, Champalimaud Foundation, Lisbon, Portugal
| | - Markus Nilsson
- Department of Diagnostic Radiology, Clinical Sciences Lund, Lund, Sweden
| | - Chantal M W Tax
- Cardiff University Brain Research Imaging Center (CUBRIC), School of Physics and Astronomy, Cardiff University, Cardiff, United Kingdom
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Raquel Perez-Lopez
- Radiomics Group, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Francesco Grussu
- Radiomics Group, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
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Guljaš S, Dupan Krivdić Z, Drežnjak Madunić M, Šambić Penc M, Pavlović O, Krajina V, Pavoković D, Šmit Takač P, Štefančić M, Salha T. Dynamic Contrast-Enhanced Study in the mpMRI of the Prostate-Unnecessary or Underutilised? A Narrative Review. Diagnostics (Basel) 2023; 13:3488. [PMID: 37998624 PMCID: PMC10670922 DOI: 10.3390/diagnostics13223488] [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: 08/26/2023] [Revised: 10/30/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
The aim of this review is to summarise recent scientific literature regarding the clinical use of DCE-MRI as a component of multiparametric resonance imaging of the prostate. This review presents the principles of DCE-MRI acquisition and analysis, the current role of DCE-MRI in clinical practice with special regard to its role in presently available categorisation systems, and an overview of the advantages and disadvantages of DCE-MRI described in the current literature. DCE-MRI is an important functional sequence that requires intravenous administration of a gadolinium-based contrast agent and gives information regarding the vascularity and capillary permeability of the lesion. Although numerous studies have confirmed that DCE-MRI has great potential in the diagnosis and monitoring of prostate cancer, its role is still inadequate in the PI-RADS categorisation. Moreover, there have been numerous scientific discussions about abandoning the intravenous application of gadolinium-based contrast as a routine part of MRI examination of the prostate. In this review, we summarised the recent literature on the advantages and disadvantages of DCE-MRI, focusing on an overview of currently available data on bpMRI and mpMRI, as well as on studies providing information on the potential better usability of DCE-MRI in improving the sensitivity and specificity of mpMRI examinations of the prostate.
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Affiliation(s)
- Silva Guljaš
- Clinical Department of Radiology, University Hospital Centre, 31000 Osijek, Croatia; (S.G.); (Z.D.K.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
| | - Zdravka Dupan Krivdić
- Clinical Department of Radiology, University Hospital Centre, 31000 Osijek, Croatia; (S.G.); (Z.D.K.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
| | - Maja Drežnjak Madunić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Oncology, University Hospital Centre, 31000 Osijek, Croatia
| | - Mirela Šambić Penc
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Oncology, University Hospital Centre, 31000 Osijek, Croatia
| | - Oliver Pavlović
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Urology, University Hospital Centre, 31000 Osijek, Croatia
| | - Vinko Krajina
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Urology, University Hospital Centre, 31000 Osijek, Croatia
| | - Deni Pavoković
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Urology, University Hospital Centre, 31000 Osijek, Croatia
| | - Petra Šmit Takač
- Clinical Department of Surgery, Osijek University Hospital Centre, 31000 Osijek, Croatia;
| | - Marin Štefančić
- Department of Radiology, National Memorial Hospital Vukovar, 32000 Vukovar, Croatia;
| | - Tamer Salha
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.D.M.); (M.Š.P.); (O.P.); (V.K.); (D.P.)
- Department of Teleradiology and Artificial Intelligence, Health Centre Osijek-Baranja County, 31000 Osijek, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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5
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Li S, Wang KX, Li JL, He Y, Wang XY, Tang WR, Xie WH, Zhu W, Wu PS, Wang XP. AI-predicted mpMRI image features for the prediction of clinically significant prostate cancer. Int Urol Nephrol 2023; 55:2703-2715. [PMID: 37553543 PMCID: PMC10560153 DOI: 10.1007/s11255-023-03722-x] [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: 06/08/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023]
Abstract
PURPOSE To evaluate the feasibility of using mpMRI image features predicted by AI algorithms in the prediction of clinically significant prostate cancer (csPCa). MATERIALS AND METHODS This study analyzed patients who underwent prostate mpMRI and radical prostatectomy (RP) at the Affiliated Hospital of Jiaxing University between November 2017 and December 2022. The clinical data collected included age, serum prostate-specific antigen (PSA), and biopsy pathology. The reference standard was the prostatectomy pathology, and a Gleason Score (GS) of 3 + 3 = 6 was considered non-clinically significant prostate cancer (non-csPCa), while a GS ≥ 3 + 4 was considered csPCa. A pre-trained AI algorithm was used to extract the lesion on mpMRI, and the image features of the lesion and the prostate gland were analyzed. Two logistic regression models were developed to predict csPCa: an MR model and a combined model. The MR model used age, PSA, PSA density (PSAD), and the AI-predicted MR image features as predictor variables. The combined model used biopsy pathology and the aforementioned variables as predictor variables. The model's effectiveness was evaluated by comparing it to biopsy pathology using the area under the curve (AUC) of receiver operation characteristic (ROC) analysis. RESULTS A total of 315 eligible patients were enrolled with an average age of 70.8 ± 5.9. Based on RP pathology, 18 had non-csPCa, and 297 had csPCa. PSA, PSAD, biopsy pathology, and ADC value of the prostate outside the lesion (ADCprostate) varied significantly across different ISUP grade groups of RP pathology (P < 0.001). Other clinical variables and image features did not vary significantly across different ISUP grade groups (P > 0.05). The MR model included PSAD, the ratio of ADC value between the lesion and the prostate outside the lesion (ADClesion/prostate), the signal intensity ratio of DWI between the lesion and the prostate outside the lesion (DWIlesion/prostate), and the ratio of DWIlesion/prostate to ADClesion/prostate. The combined model included biopsy pathology, ADClesion/prostate, mean signal intensity of the lesion on DWI (DWIlesion), DWI signal intensity of the prostate outside the lesion (DWIprostate), and signal intensity ratio of DWI between the lesion and the prostate outside the lesion (DWIlesion/prostate). The AUC of the MR model (0.830, 95% CI 0.743, 0.916) was not significantly different from that of biopsy pathology (0.820, 95% CI 0.728, 0.912, P = 0.884). The AUC of the combined model (0.915, 95% CI 0.849, 0.980) was higher than that of the biopsy pathology (P = 0.042) and MR model (P = 0.031). CONCLUSION The aggressiveness of prostate cancer can be effectively predicted using AI-extracted image features from mpMRI images, similar to biopsy pathology. The prediction accuracy was improved by combining the AI-extracted mpMRI image features with biopsy pathology, surpassing the performance of biopsy pathology alone.
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Affiliation(s)
- Song Li
- Zhejiang Chinese Medical University, China, The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Ke-Xin Wang
- School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Jia-Lei Li
- Zhejiang Chinese Medical University, China, The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Yi He
- The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Xiao-Ying Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Wen-Rui Tang
- The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Wen-Hua Xie
- The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Wei Zhu
- The Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Peng-Sheng Wu
- Beijing Smart Tree Medical Technology Co. Ltd., Beijing, China
| | - Xiang-Peng Wang
- Beijing Smart Tree Medical Technology Co. Ltd., Beijing, China
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Spadarotto N, Sauck A, Hainc N, Keller I, John H, Hohmann J. Quantitative Evaluation of Apparent Diffusion Coefficient Values, ISUP Grades and Prostate-Specific Antigen Density Values of Potentially Malignant PI-RADS Lesions. Cancers (Basel) 2023; 15:5183. [PMID: 37958357 PMCID: PMC10648562 DOI: 10.3390/cancers15215183] [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: 09/17/2023] [Revised: 10/08/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
The aim of this study was to demonstrate the correlation between ADC values and the ADC/PSAD ratio for potentially malignant prostate lesions classified into ISUP grades and to determine threshold values to differentiate benign lesions (noPCa), clinically insignificant (nsPCa) and clinically significant prostate cancer (csPCa). We enrolled a total of 403 patients with 468 prostate lesions, of which 46 patients with 50 lesions were excluded for different reasons. Therefore, 357 patients with a total of 418 prostate lesions remained for the final evaluation. For all lesions, ADC values were measured; they demonstrated a negative correlation with ISUP grades (p < 0.001), with a significant difference between csPCa and a combined group of nsPCa and noPCa (ns-noPCa, p < 0.001). The same was true for the ADC/PSAD ratio, but only the ADC/PSAD ratio proved to be a significant discriminator between nsPCa and noPCa (p = 0.0051). Using the calculated threshold values, up to 31.6% of biopsies could have been avoided. Furthermore, the ADC/PSAD ratio, with the ability to distinguish between nsPCa and noPCa, offers possible active surveillance without prior biopsy.
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Affiliation(s)
- Nadine Spadarotto
- Institute of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, 8401 Winterthur, Switzerland;
| | - Anja Sauck
- Clinic of Urology, Cantonal Hospital Winterthur, 8401 Winterthur, Switzerland; (A.S.); (I.K.); (H.J.)
| | - Nicolin Hainc
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Isabelle Keller
- Clinic of Urology, Cantonal Hospital Winterthur, 8401 Winterthur, Switzerland; (A.S.); (I.K.); (H.J.)
| | - Hubert John
- Clinic of Urology, Cantonal Hospital Winterthur, 8401 Winterthur, Switzerland; (A.S.); (I.K.); (H.J.)
- Medical Faculty, University of Zurich, 8032 Zurich, Switzerland
| | - Joachim Hohmann
- Institute of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, 8401 Winterthur, Switzerland;
- Medical Faculty, University of Basel, 4056 Basel, Switzerland
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Lucarelli NM, Villanova I, Maggialetti N, Greco S, Tarantino F, Russo R, Trabucco SMR, Stabile Ianora AA, Scardapane A. Quantitative ADC: An Additional Tool in the Evaluation of Prostate Cancer? J Pers Med 2023; 13:1378. [PMID: 37763146 PMCID: PMC10533005 DOI: 10.3390/jpm13091378] [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: 07/29/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Prostate cancer is one of the most common tumors among the male population. Magnetic resonance imaging (MRI), standardized by the PI-RADS version 2.1 scoring system, has a fundamental role in detecting prostate cancer and evaluating its aggressiveness. Diffusion-weighted imaging sequences and apparent diffusion coefficient values, in particular, are considered fundamental for the detection and characterization of lesions. In 2016 the International Society of Urological Pathology introduced a new anatomopathological 5-grade scoring system for prostate cancer. The aim of this study is to evaluate the correlation between quantitative apparent diffusion coefficient values (ADC) derived from diffusion-weighted imaging (DWI) sequences and the International Society of Urological Pathology (ISUP) and PI-RADS groups. Our retrospective study included 143 patients with 154 suspicious lesions, observed on prostate magnetic resonance imaging and compared with the histological results of the biopsy. We observed that ADC values can aid in discriminating between not clinically significant (ISUP 1) and clinically significant (ISUP 2-5) prostate cancers. In fact, ADC values were lower in ISUP 5 lesions than in negative lesions. We also found a correlation between ADC values and PI-RADS groups; we noted lower ADC values in the PI-RADS 5 and PI-RADS 4 groups than in the PI-RADS 3 group. In conclusion, quantitative apparent diffusion coefficient values can be useful to assess the aggressiveness of prostate cancer.
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Affiliation(s)
- Nicola Maria Lucarelli
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (N.M.L.); (I.V.); (N.M.); (S.G.); (R.R.); (A.A.S.I.); (A.S.)
| | - Ilaria Villanova
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (N.M.L.); (I.V.); (N.M.); (S.G.); (R.R.); (A.A.S.I.); (A.S.)
| | - Nicola Maggialetti
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (N.M.L.); (I.V.); (N.M.); (S.G.); (R.R.); (A.A.S.I.); (A.S.)
| | - Sara Greco
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (N.M.L.); (I.V.); (N.M.); (S.G.); (R.R.); (A.A.S.I.); (A.S.)
| | - Francesca Tarantino
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (N.M.L.); (I.V.); (N.M.); (S.G.); (R.R.); (A.A.S.I.); (A.S.)
| | - Roberto Russo
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (N.M.L.); (I.V.); (N.M.); (S.G.); (R.R.); (A.A.S.I.); (A.S.)
| | - Senia Maria Rosaria Trabucco
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Amato Antonio Stabile Ianora
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (N.M.L.); (I.V.); (N.M.); (S.G.); (R.R.); (A.A.S.I.); (A.S.)
| | - Arnaldo Scardapane
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (N.M.L.); (I.V.); (N.M.); (S.G.); (R.R.); (A.A.S.I.); (A.S.)
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8
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Sánchez Iglesias Á, Morillo Macías V, Picó Peris A, Fuster-Matanzo A, Nogué Infante A, Muelas Soria R, Bellvís Bataller F, Domingo Pomar M, Casillas Meléndez C, Yébana Huertas R, Ferrer Albiach C. Prostate Region-Wise Imaging Biomarker Profiles for Risk Stratification and Biochemical Recurrence Prediction. Cancers (Basel) 2023; 15:4163. [PMID: 37627191 PMCID: PMC10453281 DOI: 10.3390/cancers15164163] [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: 07/21/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Identifying prostate cancer (PCa) patients with a worse prognosis and a higher risk of biochemical recurrence (BCR) is essential to guide treatment choices. Here, we aimed to identify possible imaging biomarker (perfusion/diffusion + radiomic features) profiles extracted from MRIs that were able to discriminate patients according to their risk or the occurrence of BCR 10 years after diagnosis, as well as to evaluate their predictive value with or without clinical data. METHODS Patients with localized PCa receiving neoadjuvant androgen deprivation therapy and radiotherapy were retrospectively evaluated. Imaging features were extracted from MRIs for each prostate region or for the whole gland. Univariate and multivariate analyses were conducted. RESULTS 128 patients (mean [range] age, 71 [50-83] years) were included. Prostate region-wise imaging biomarker profiles mainly composed of radiomic features allowed discriminating risk groups and patients experiencing BCR. Heterogeneity-related radiomic features were increased in patients with worse prognosis and with BCR. Overall, imaging biomarkers profiles retained good predictive ability (AUC values superior to 0.725 in most cases), which generally improved when clinical data were included (particularly evident for the prediction of the BCR, with AUC values ranging from 0.841 to 0.877 for combined models and sensitivity values above 0.960) and when models were built per prostate region vs. the whole gland. CONCLUSIONS Prostate region-aware imaging profiles enable identification of patients with worse prognosis and with a higher risk of BCR, retaining higher predictive values when combined with clinical variables.
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Affiliation(s)
- Ángel Sánchez Iglesias
- Radiation Oncology Department, Hospital Provincial de Castellón, 12002 Castellón, Spain; (Á.S.I.); (V.M.M.); (R.M.S.)
| | - Virginia Morillo Macías
- Radiation Oncology Department, Hospital Provincial de Castellón, 12002 Castellón, Spain; (Á.S.I.); (V.M.M.); (R.M.S.)
| | - Alfonso Picó Peris
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | - Almudena Fuster-Matanzo
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | - Anna Nogué Infante
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | - Rodrigo Muelas Soria
- Radiation Oncology Department, Hospital Provincial de Castellón, 12002 Castellón, Spain; (Á.S.I.); (V.M.M.); (R.M.S.)
| | - Fuensanta Bellvís Bataller
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | - Marcos Domingo Pomar
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | | | - Raúl Yébana Huertas
- Quantitative Imaging Biomarkers in Medicine (Quibim), 46021 Valencia, Spain; (A.P.P.); (A.F.-M.); (A.N.I.); (F.B.B.); (M.D.P.); (R.Y.H.)
| | - Carlos Ferrer Albiach
- Radiation Oncology Department, Hospital Provincial de Castellón, 12002 Castellón, Spain; (Á.S.I.); (V.M.M.); (R.M.S.)
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9
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Rosbach N, Fischer S, Koch V, Vogl TJ, Bochennek K, Lehrnbecher T, Mahmoudi S, Grünewald L, Grünwald F, Bernatz S. Correlation of mean apparent diffusion coefficient (ADC) and maximal standard uptake value (SUVmax) evaluated by diffusion-weighted MRI and 18F-FDG-PET/CT in children with Hodgkin lymphoma: a feasibility study. Radiol Oncol 2023; 57:150-157. [PMID: 37341195 DOI: 10.2478/raon-2023-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/27/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND The objective was to analyse if magnetic resonance imaging (MRI) can act as a non-radiation exposure surrogate for (18)F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in children with histologically confirmed Hodgkin lymphoma (HL) before treatment. This was done by analysing a potential correlation between apparent diffusion coefficient (ADC) in MRI and the maximum standardized uptake value (SUVmax) in FDG-PET/CT. PATIENTS AND METHODS Seventeen patients (six female, eleven male, median age: 16 years, range: 12-20 years) with histologically confirmed HL were retrospectively analysed. The patients underwent both MRI and (18)F-FDG PET/CT before the start of treatment. (18)F-FDG PET/CT data and correlating ADC maps in MRI were collected. For each HL-lesion two readers independently evaluated the SUVmax and correlating meanADC. RESULTS The seventeen patients had a total of 72 evaluable lesions of HL and there was no significant difference in the number of lesions between male and female patients (median male: 15, range: 12-19 years, median female: 17 range: 12-18 years, p = 0.021). The mean duration between MRI and PET/CT was 5.9 ± 5.3 days. The inter-reader agreement as assessed by the intraclass correlation coefficient (ICC) was excellent (ICC = 0.98, 95% CI: 0.97-0.99). The correlated SUVmax and meanADC of all 17 patients (ROIs n = 72) showed a strong negative correlation of -0.75 (95% CI: -0.84, - -0.63, p = 0.001). Analysis revealed a difference in the correlations of the examination fields. The correlated SUVmax and meanADC showed a strong correlation at neck and thoracal examinations (neck: -0.83, 95% CI: -0.93, - -0.63, p < 0.0001, thoracal: -0.82, 95% CI: -0.91, - -0.64, p < 0.0001) and a fair correlation at abdominal examinations of -0.62 (95% CI: -0.83, - -0.28, p = 0.001). CONCLUSIONS SUVmax and meanADC showed a strong negative correlation in paediatric HL lesions. The assessment seemed robust according to inter-reader agreements. Our results suggest that ADC maps and meanADC have the potential to replace PET/CT in the analysis of disease activity in paediatric Hodgkin lymphoma patients. This may help reduce the number of PET/CT examinations and decrease radiation exposure to children.
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Affiliation(s)
- Nicolas Rosbach
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Sebastian Fischer
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Vitali Koch
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Konrad Bochennek
- Division of Paediatric Haematology and Oncology, Hospital for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Thomas Lehrnbecher
- Division of Paediatric Haematology and Oncology, Hospital for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Scherwin Mahmoudi
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Leon Grünewald
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Frank Grünwald
- Department of Nuclear Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Simon Bernatz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
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10
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Prostate and metastasis diffusion volume based on apparent diffusion coefficient as a prognostic factor in Hormone-naïve prostate Cancer. Clin Exp Metastasis 2023; 40:187-195. [PMID: 36914924 DOI: 10.1007/s10585-023-10200-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/20/2023] [Indexed: 03/16/2023]
Abstract
In this study, to assess the utility of whole-body DWI (WB-DWI) as an imaging biomarker for metastatic hormone-naïve prostate cancer (mHNPC), we evaluated tumor diffusion volume based on apparent diffusion coefficient (ADC) values. WB-DWI results obtained from 62 mHNPC patients were evaluated in this retrospective analysis. The association with castration resistant-free survival (CFS) was evaluated for both prostate and metastatic tumor diffusion volume (pDV and mDV, respectively) based on WB-DWI. The usefulness of pDV and mDV based on ADC values to predict CFS was also examined. During the follow-up period, 22 patients progressed to castration-resistant prostate cancer, and the median CFS was 42.6 months. The median mDV and pDV were 6.7 and 12.6 mL, respectively. mDV was a significant predictor of CFS (hazard ratio [HR]: 2.75; p = 0.022), while pDV was not significant. When DV was divided into groups by ADC values (× 10- 3 mm2/s) of 0.4-1.0 and 1.0-1.8 (× 10- 3 mm2/s), mDV with ADC values (× 10- 3 mm2/s) of 0.4-1.0 (mDV0.4-1.0) showed a more favorable association with CFS compared to total mDV. On multivariate analysis, mDV0.4-1.0 and Gleason grade group had a statistically significant association with CFS (HR: 4.0; p = 0.004, and HR: 3.4; p = 0.006, respectively), while pDV with ADC values (× 10- 3 mm2/s) of 0.4-1.0 did not have a significant association. mDV is useful for predicting CFS in mHNPC patients. mDV may be a better imaging biomarker when based on ADC values.
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11
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Bengtsson J, Thimansson E, Baubeta E, Zackrisson S, Sundgren PC, Bjartell A, Flondell-Sité D. Correlation between ADC, ADC ratio, and Gleason Grade group in prostate cancer patients undergoing radical prostatectomy: Retrospective multicenter study with different MRI scanners. Front Oncol 2023; 13:1079040. [PMID: 36890837 PMCID: PMC9986526 DOI: 10.3389/fonc.2023.1079040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/03/2023] [Indexed: 02/22/2023] Open
Abstract
Background MRI is an important tool in the prostate cancer work-up, with special emphasis on the ADC sequence. This study aimed to investigate the correlation between ADC and ADC ratio compared to tumor aggressiveness determined by a histopathological examination after radical prostatectomy. Methods Ninety-eight patients with prostate cancer underwent MRI at five different hospitals prior to radical prostatectomy. Images were retrospectively analyzed individually by two radiologists. The ADC of the index lesion and reference tissues (contralateral normal prostatic, normal peripheral zone, and urine) was recorded. Absolute ADC and different ADC ratios were compared to tumor aggressivity according to the ISUP Gleason Grade Groups extracted from the pathology report using Spearman's rank correlation coefficient (ρ). ROC curves were used to evaluate the ability to discriminate between ISUP 1-2 and ISUP 3-5 and intra class correlation and Bland-Altman plots for interrater reliability. Results All patients had prostate cancer classified as ISUP grade ≥ 2. No correlation was found between ADC and ISUP grade. We found no benefit of using the ADC ratio over absolute ADC. The AUC for all metrics was close to 0.5, and no threshold could be extracted for prediction of tumor aggressivity. The interrater reliability was substantial to almost perfect for all variables analyzed. Conclusions ADC and ADC ratio did not correlate with tumor aggressiveness defined by ISUP grade in this multicenter MRI study. The result of this study is opposite to previous research in the field.
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Affiliation(s)
- Johan Bengtsson
- Department of Clinical Sciences, Radiology, Lund, Lund University, Lund, Sweden.,Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Erik Thimansson
- Department of Translational Medicine, Lund University, Malmö, Sweden.,Department of Radiology, Helsingborg Hospital, Helsingborg, Sweden
| | - Erik Baubeta
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.,Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Sophia Zackrisson
- Department of Translational Medicine, Lund University, Malmö, Sweden.,Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
| | - Pia Charlotte Sundgren
- Department of Clinical Sciences, Radiology, Lund, Lund University, Lund, Sweden.,Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.,Lund Bioimaging Center (LBIC), Lund University, Lund, Sweden
| | - Anders Bjartell
- Department of Translational Medicine, Lund University, Malmö, Sweden.,Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Despina Flondell-Sité
- Department of Translational Medicine, Lund University, Malmö, Sweden.,Department of Urology, Skåne University Hospital, Malmö, Sweden
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12
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Automated Patient-level Prostate Cancer Detection with Quantitative Diffusion Magnetic Resonance Imaging. EUR UROL SUPPL 2022; 47:20-28. [PMID: 36601040 PMCID: PMC9806706 DOI: 10.1016/j.euros.2022.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 12/23/2022] Open
Abstract
Background Multiparametric magnetic resonance imaging (mpMRI) improves detection of clinically significant prostate cancer (csPCa), but the subjective Prostate Imaging Reporting and Data System (PI-RADS) system and quantitative apparent diffusion coefficient (ADC) are inconsistent. Restriction spectrum imaging (RSI) is an advanced diffusion-weighted MRI technique that yields a quantitative imaging biomarker for csPCa called the RSI restriction score (RSIrs). Objective To evaluate RSIrs for automated patient-level detection of csPCa. Design setting and participants We retrospectively studied all patients (n = 151) who underwent 3 T mpMRI and RSI (a 2-min sequence on a clinical scanner) for suspected prostate cancer at University of California San Diego during 2017-2019 and had prostate biopsy within 180 d of MRI. Intervention We calculated the maximum RSIrs and minimum ADC within the prostate, and obtained PI-RADS v2.1 from medical records. Outcome measurements and statistical analysis We compared the performance of RSIrs, ADC, and PI-RADS for the detection of csPCa (grade group ≥2) on the best available histopathology (biopsy or prostatectomy) using the area under the curve (AUC) with two-tailed α = 0.05. We also explored whether the combination of PI-RADS and RSIrs might be superior to PI-RADS alone and performed subset analyses within the peripheral and transition zones. Results and limitations AUC values for ADC, RSIrs, and PI-RADS were 0.48 (95% confidence interval: 0.39, 0.58), 0.78 (0.70, 0.85), and 0.77 (0.70, 0.84), respectively. RSIrs and PI-RADS were each superior to ADC for patient-level detection of csPCa (p < 0.0001). RSIrs alone was comparable with PI-RADS (p = 0.8). The combination of PI-RADS and RSIrs had an AUC of 0.85 (0.78, 0.91) and was superior to either PI-RADS or RSIrs alone (p < 0.05). Similar patterns were seen in the peripheral and transition zones. Conclusions RSIrs is a promising quantitative marker for patient-level csPCa detection, warranting a prospective study. Patient summary We evaluated a rapid, advanced prostate magnetic resonance imaging technique called restriction spectrum imaging to see whether it could give an automated score that predicted the presence of clinically significant prostate cancer. The automated score worked about as well as expert radiologists' interpretation. The combination of the radiologists' scores and automated score might be better than either alone.
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13
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Guljaš S, Benšić M, Krivdić Dupan Z, Pavlović O, Krajina V, Pavoković D, Šmit Takač P, Hranić M, Salha T. Dynamic Contrast Enhanced Study in Multiparametric Examination of the Prostate—Can We Make Better Use of It? Tomography 2022; 8:1509-1521. [PMID: 35736872 PMCID: PMC9231365 DOI: 10.3390/tomography8030124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/18/2022] [Accepted: 06/04/2022] [Indexed: 11/16/2022] Open
Abstract
We sought to investigate whether quantitative parameters from a dynamic contrast-enhanced study can be used to differentiate cancer from normal tissue and to determine a cut-off value of specific parameters that can predict malignancy more accurately, compared to the obturator internus muscle as a reference tissue. This retrospective study included 56 patients with biopsy proven prostate cancer (PCa) after multiparametric magnetic resonance imaging (mpMRI), with a total of 70 lesions; 39 were located in the peripheral zone, and 31 in the transition zone. The quantitative parameters for all patients were calculated in the detected lesion, morphologically normal prostate tissue and the obturator internus muscle. Increase in the Ktrans value was determined in lesion-to-muscle ratio by 3.974368, which is a cut-off value to differentiate between prostate cancer and normal prostate tissue, with specificity of 72.86% and sensitivity of 91.43%. We introduced a model to detect prostate cancer that combines Ktrans lesion-to-muscle ratio value and iAUC lesion-to-muscle ratio value, which is of higher accuracy compared to individual variables. Based on this model, we identified the optimal cut-off value with 100% sensitivity and 64.28% specificity. The use of quantitative DCE pharmacokinetic parameters compared to the obturator internus muscle as reference tissue leads to higher diagnostic accuracy for prostate cancer detection.
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Affiliation(s)
- Silva Guljaš
- Clinical Department of Radiology, University Hospital Centre, 31000 Osijek, Croatia; (Z.K.D.); (M.H.)
- Correspondence:
| | - Mirta Benšić
- Department of Mathematics, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Zdravka Krivdić Dupan
- Clinical Department of Radiology, University Hospital Centre, 31000 Osijek, Croatia; (Z.K.D.); (M.H.)
- Department of Radiology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Oliver Pavlović
- Department of Urology, University Hospital Centre Osijek, 31000 Osijek, Croatia; (O.P.); (V.K.); (D.P.)
| | - Vinko Krajina
- Department of Urology, University Hospital Centre Osijek, 31000 Osijek, Croatia; (O.P.); (V.K.); (D.P.)
| | - Deni Pavoković
- Department of Urology, University Hospital Centre Osijek, 31000 Osijek, Croatia; (O.P.); (V.K.); (D.P.)
| | - Petra Šmit Takač
- Clinical Department of Surgery, Osijek University Hospital Centre, 31000 Osijek, Croatia;
| | - Matija Hranić
- Clinical Department of Radiology, University Hospital Centre, 31000 Osijek, Croatia; (Z.K.D.); (M.H.)
| | - Tamer Salha
- Department of Radiology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
- Department of Teleradiology and Artificial Intelligence, Health Centre Osijek-Baranja County, 31000 Osijek, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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14
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Lee CH, Vellayappan B, Tan CH. Comparison of diagnostic performance and inter-reader agreement between PI-RADS v2.1 and PI-RADS v2: systematic review and meta-analysis. Br J Radiol 2022; 95:20210509. [PMID: 34520694 PMCID: PMC8978226 DOI: 10.1259/bjr.20210509] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To perform a systematic review and meta-analysis comparing diagnostic performance and inter reader agreement between PI-RADS v. 2.1 and PI-RADS v. 2 in the detection of clinically significant prostate cancer (csPCa). METHODS A systematic review was performed, searching the major biomedical databases (Medline, Embase, Scopus), using the keywords "PIRADS 2.1" or "PI RADS 2.1" or "PI-RADS 2.1". Studies reporting on head-to-head diagnostic comparison between PI-RADS v. 2.1 and v. 2 were included. Pooled sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were compared between PI-RADS v. 2.1 and v. 2. Summary receiver operator characteristic graphs were plotted. Analysis was performed for whole gland, and pre-planned subgroup analysis was performed by tumour location (whole gland vs transition zone (TZ)), high b-value DWI (b-value ≥1400 s/mm2), and reader experience (<5 years vs ≥5 years with prostate MRI interpretation). Inter-reader agreement and pooled rates of csPCa for PI-RADS 1-3 lesions were compared between PI-RADS v. 2.1 and v. 2. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool v. 2 (QUADAS-2). RESULTS Eight studies (1836 patients, 1921 lesions) were included. Pooled specificity for PI-RADS v. 2.1 was significantly lower than PI-RADS v. 2 for whole gland (0.62 vs 0.66, p = 0.02). Pooled sensitivities, PPVs and NPVs were not significantly different (p = 0.17, 0.31, 0.41). Pooled specificity for PI-RADS v. 2.1 was significantly lower than PI-RADS v. 2 for TZ only (0.67 vs 0.72, p = 0.01). Pooled sensitivities, PPVs and NPVs were not significantly different (p = 0.06, 0.36, 0.17). Amongst studies utilising diffusion-weighted imaging with highest b-value of ≥1400 s/mm2, pooled sensitivities, specificities, PPVs and NPVs were not significantly different (p = 0.52, 0.4, 0.5, 0.47). There were no significant differences in pooled sensitivities, specificities, PPVs and NPVs between PI-RADS v. 2.1 and PI-RADS v. 2 for less-experienced readers (p = 0.65, 0.37, 0.65, 0.81) and for more experienced readers (p = 0.57, 0.90, 0.91, 0.65). For PI-RADS v. 2.1 alone, there were no significant differences in pooled sensitivity, specificity, PPV and NPV between less and more experienced readers (p = 0.38, 0.70, 1, 0.48). Inter-reader agreement was moderate to substantial for both PI-RADS v. 2.1 and v. 2. There were no significant differences between pooled csPCa rates between PI-RADS v. 2.1 and v. 2 for PI-RADS 1-2 lesions (6.6% vs 7.3%, p = 0.53), or PI-RADS 3 lesions (24.1% vs 26.8%, p = 0.28). CONCLUSIONS Diagnostic performance and inter-reader agreement for PI-RADS v. 2.1 is comparable to PI-RADS v. 2, however the significantly lower specificity of PI-RADS v. 2.1 may result in increased number of unnecessary biopsies. ADVANCES IN KNOWLEDGE 1. Compared to PI-RADS v. 2, PI-RADS v. 2.1 has a non-significantly higher sensitivity but a significantly lower specificity for detection of clinically significant prostate cancer.2. PI-RADS v. 2.1 could potentially result in considerable increase in number of negative targeted biopsy rates for PI-RADS 3 lesions, which could have been potentially avoided.
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Affiliation(s)
- Chau Hung Lee
- Department of Radiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Balamurugan Vellayappan
- Department of Radiation Oncology, National University Cancer Institute, National University Health System, Singapore, Singapore
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15
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Ota E, Mori N, Yamashita S, Mugikura S, Ito A, Takase K. Longitudinal evaluation of apparent diffusion coefficient values as a predictor of Prostate Cancer Research International Active Surveillance reclassification. Abdom Radiol (NY) 2022; 47:814-826. [PMID: 34882269 DOI: 10.1007/s00261-021-03372-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE This study aimed to evaluate the effectiveness of apparent diffusion coefficient (ADC) parameters in distinguishing between Prostate Cancer Research International Active Surveillance (PRIAS) non-reclassification and reclassification groups during active surveillance (AS) of prostate cancer. METHODS We included 55 patients who fulfilled the PRIAS criteria and underwent ≥ 2 magnetic resonance imaging (MRI) including diffusion-weighted imaging with an interval of ≤ 3 years between baseline and second MRI. A mono-exponential fitting model was used to automatically create ADC maps with minimum b-values of 0 and maximum of 2000 s/mm2. For detectable lesions on ADC maps, the lesions were manually segmented on each slice of the ADC maps. For undetectable lesions, the corresponding normal-appearing zone of the lobe on each slice of ADC maps was segmented. The ADC data for each slice were summed to obtain the 25th, 50th, and 75th percentile ADC values of the histogram at baseline and second MRI. These ADC parameters at baseline and second MRI, and the changes of ADC parameters from baseline to second MRI were compared between PRIAS non-reclassification and reclassification groups. RESULTS The PRIAS reclassification group had significantly lower 25th, 50th, and 75th percentile ADC values at second MRI compared to the non-reclassification group. The non-reclassification group had significantly lower changes in ADC values in these percentiles compared to the reclassification group. CONCLUSION The ADC parameters at second MRI and the changes from baseline to second MRI may be effective distinguishing factors between PRIAS non-reclassification and reclassification groups.
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Affiliation(s)
- Eri Ota
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Naoko Mori
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
| | - Shinichi Yamashita
- Department of Urology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Shunji Mugikura
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
- Division of Image Statistics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Akihiro Ito
- Department of Urology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
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16
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Gaudiano C, Bianchi L, De Cinque A, Corcioni B, Giunchi F, Schiavina R, Fiorentino M, Brunocilla E, Golfieri R. The impact of multiparametric MRI features to identify the presence of prevalent cribriform pattern in the peripheral zone tumors. Radiol Med 2021; 127:174-182. [PMID: 34850354 DOI: 10.1007/s11547-021-01433-w] [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: 07/16/2021] [Accepted: 11/16/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE To assess the role of the multiparametric Magnetic Resonance Imaging (mpMRI) in predicting the cribriform pattern in both the peripheral and transition zones (PZ and TZ) clinically significant prostate cancers (csPCas). MATERIAL AND METHODS We retrospectively evaluated 150 patients who underwent radical prostatectomy for csPCa and preoperative mpMRI. Patients with negative (n = 25) and positive (n = 125) mpMRI, stratified according to the presence of prevalent cribriform pattern (PCP, ≥ 50%) and non-PCP (< 50%) at specimen, were included. Difference between the two groups were evaluated. Multivariate logistic regression was used to identify predictors of PCP among mpMRI parameters. The receiver operating characteristic (ROC) analysis was performed to evaluate the area under the curve (AUC) of apparent diffusion coefficient (ADC) and ADC ratio in detecting lesions harboring PCP. RESULTS Considering 135 positive lesions at the mpMRI, 30 (22.2%) and 105 (77.8%) harbored PCP and non-PCP PCa. The PCP lesions had more frequently nodular morphology (83.3% vs 62.9%; p = 0.04) and significantly lower mean ADC value (0.87 ± 0.16 vs 0.95 ± 0.18; p = 0.03) and ADC ratio (0.52 ± 0.09 vs 0.60 ± 0.14; p = 0.003) when compared with non-PCP lesions. At univariate and multivariate analyses, mean ADC and ADC ratio resulted as independent predictors of the presence of the PCP of the PZ tumors(OR: 0.025; p = 0.03 and OR: 0.001; p = 0.004, respectively). At the ROC analysis, the AUC of mean ADC and ADC ratio to predict the presence of PCP in patients with PZ suspicious lesion at the mpMRI were 0.69 (95% CI 0.56-0.81P, p = 0.003) and 0.72 (95% CI 0.62-0.82P, p = 0.001), respectively. CONCLUSIONS The mpMRI may correctly identify PCP tumors of the PZ and the mean ADC value and ADC ratio can predict the presence of the cribriform pattern in the PCa.
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Affiliation(s)
- Caterina Gaudiano
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy.
| | - Lorenzo Bianchi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy.,University of Bologna, Bologna, Italy
| | - Antonio De Cinque
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | - Beniamino Corcioni
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | - Francesca Giunchi
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | - Riccardo Schiavina
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy.,University of Bologna, Bologna, Italy
| | - Michelangelo Fiorentino
- Department of Specialty, Diagnostic and Experimental Medicine, University of Bologna, Via Massarenti 9, Bologna, Italy
| | - Eugenio Brunocilla
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy.,University of Bologna, Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
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17
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Ding H, Velasco C, Ye H, Lindner T, Grech-Sollars M, O’Callaghan J, Hiley C, Chouhan MD, Niendorf T, Koh DM, Prieto C, Adeleke S. Current Applications and Future Development of Magnetic Resonance Fingerprinting in Diagnosis, Characterization, and Response Monitoring in Cancer. Cancers (Basel) 2021; 13:4742. [PMID: 34638229 PMCID: PMC8507535 DOI: 10.3390/cancers13194742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/08/2021] [Accepted: 09/16/2021] [Indexed: 11/25/2022] Open
Abstract
Magnetic resonance imaging (MRI) has enabled non-invasive cancer diagnosis, monitoring, and management in common clinical settings. However, inadequate quantitative analyses in MRI continue to limit its full potential and these often have an impact on clinicians' judgments. Magnetic resonance fingerprinting (MRF) has recently been introduced to acquire multiple quantitative parameters simultaneously in a reasonable timeframe. Initial retrospective studies have demonstrated the feasibility of using MRF for various cancer characterizations. Further trials with larger cohorts are still needed to explore the repeatability and reproducibility of the data acquired by MRF. At the moment, technical difficulties such as undesirable processing time or lack of motion robustness are limiting further implementations of MRF in clinical oncology. This review summarises the latest findings and technology developments for the use of MRF in cancer management and suggests possible future implications of MRF in characterizing tumour heterogeneity and response assessment.
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Affiliation(s)
- Hao Ding
- Imperial College School of Medicine, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK;
| | - Carlos Velasco
- School of Biomedical Engineering and Imaging Sciences, St Thomas’ Hospital, King’s College London, London SE1 7EH, UK; (C.V.); (C.P.)
| | - Huihui Ye
- State Key Laboratory of Modern Optical instrumentation, Zhejiang University, Hangzhou 310027, China;
| | - Thomas Lindner
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Hamburg Eppendorf, 20246 Hamburg, Germany;
| | - Matthew Grech-Sollars
- Department of Medical Physics, Royal Surrey NHS Foundation Trust, Surrey GU2 7XX, UK;
- Department of Surgery & Cancer, Imperial College London, London SW7 2AZ, UK
| | - James O’Callaghan
- UCL Centre for Medical Imaging, Division of Medicine, University College London, London W1W 7TS, UK; (J.O.); (M.D.C.)
| | - Crispin Hiley
- Cancer Research UK, Lung Cancer Centre of Excellence, University College London Cancer Institute, London WC1E 6DD, UK;
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London NW1 1AT, UK
| | - Manil D. Chouhan
- UCL Centre for Medical Imaging, Division of Medicine, University College London, London W1W 7TS, UK; (J.O.); (M.D.C.)
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrueck, Center for Molecular Medicine in the Helmholtz Association, 13125 Berlin, Germany;
| | - Dow-Mu Koh
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London SM2 5NG, UK;
- Department of Radiology, Royal Marsden Hospital, London SW3 6JJ, UK
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, St Thomas’ Hospital, King’s College London, London SE1 7EH, UK; (C.V.); (C.P.)
| | - Sola Adeleke
- High Dimensional Neurology Group, Queen’s Square Institute of Neurology, University College London, London WC1N 3BG, UK
- Department of Oncology, Guy’s & St Thomas’ Hospital, London SE1 9RT, UK
- School of Cancer & Pharmaceutical Sciences, King’s College London, London WC2R 2LS, UK
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18
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Maier SE, Wallström J, Langkilde F, Johansson J, Kuczera S, Hugosson J, Hellström M. Prostate Cancer Diffusion-Weighted Magnetic Resonance Imaging: Does the Choice of Diffusion-Weighting Level Matter? J Magn Reson Imaging 2021; 55:842-853. [PMID: 34535940 DOI: 10.1002/jmri.27895] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging plays an important role in multiparametric assessment of prostate lesions. The derived apparent diffusion coefficient (ADC) could be a useful quantitative biomarker for malignant growth, but lacks acceptance because of low reproducibility. PURPOSE To investigate the impact of the choice of diffusion-weighting levels (b-values) on contrast-to-noise ratio and quantitative measures in prostate diffusion-weighted MRI. STUDY TYPE Retrospective and simulation based on published data. SUBJECTS Patient cohort (21 men with Prostate Imaging-Reporting and Data System (PI-RADS) version 2 score ≥3) from a single-center study. FIELD STRENGTH/SEQUENCE 3 T/diffusion-weighted imaging with single-shot echo-planar imaging. ASSESSMENT Both clinical data and simulations based on previously acquired data were used to quantify the influence of b-value choice in normal peripheral zone (PZ) and PZ tumor lesions. For clinical data, ADC was determined for different combinations of b-values. Contrast-to-noise ratio and quantitative diffusion measures were simulated for a wide range of b-values. STATISTICAL TESTS Tissue ADC and the lesion-to-normal tissue ADC ratios of different b-value combinations were compared with paired two-tailed Student's t-tests. A P-value <0.05 was considered statistically significant. RESULTS Findings about b-value dependence derived from clinical data and from simulations agreed with each other. Provided measurement was limited to two b-values, simulation-derived optimal b-value choices coincided with PI-RADSv2 recommendations. For two-point measurements, ADC decreased by 15% when the maximum b-value increased from 1000 to 1500 seconds/mm2 , but corresponding lesion-to-normal tissue ADC ratio showed no significant change (P = 0.86 for acquired data). Simulations with three or more measurement points produced ADCs that declined by only 8% over this range of maximum b-value. Corresponding ADC ratios declined between 2.6% (three points) and 3.8% (21 points). Simulations also revealed an ADC reduction of about 19% with the shorter echo and diffusion time evaluated. DATA CONCLUSION The comprehensive assessment of b-value dependence permits better formulation of protocol and analysis recommendations for obtaining reproducible results in prostate cancer diffusion-weighted MRI. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Stephan E Maier
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jonas Wallström
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Fredrik Langkilde
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Jens Johansson
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Kuczera
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jonas Hugosson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Urology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Mikael Hellström
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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19
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Evangelista L, Giuliani L, Pagliei V, Varrassi M, Bruno F, Palumbo P, Arrigoni F, Splendiani A, Di Cesare E, Masciocchi C, Barile A. When to perform vertebroplasty? A retrospective analysis from a single center and a review of the literature. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021402. [PMID: 34505841 PMCID: PMC8477064 DOI: 10.23750/abm.v92is5.11955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM To establish an optimal timing for vertebroplasty in order to obtain a clinically important pain reduction and improving quality of live in patients with osteoporotic or traumatic vertebral fractures. METHODS This study includes 22 vertebroplasty procedures performed from October 2018 to July 2020 in 21 patients with traumatic or osteoporotic vertebral fractures (19 female, two men; age between 53 and 89 years). All treatments were executed under fluoroscopic guidance using 11 or 13 G needle through transpedicular or costovertebral unilateral approach. Each patient underwent conscious sedation, continuously monitored by an anesthesiologist. Preoperative MRI images, obtained by 3T or 1.5T MRI scanner, always showed bone marrow edema. The VAS scale and Roland Morris disability questionnaire (RMdq) were administered to patients before and after the treatment to evaluate pain and life quality. RESULTS 7 patients were treated in the first month after the injury, one was treated twice; 8 patients in the second month, 6 in the third. We observed a reduction of: 5.5 points in the vas scale, 10.3 in the RMdq in the first month; 5.6 points vas, 11.6 points RMdq in the second month; 4 points vas and 9.75 points RMdq in the third month. CONCLUSIONS This study demostrated that, in our preliminary experience, vertebroplasty has the best outcome if performed at 2 months from injury.
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Affiliation(s)
- Laura Evangelista
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Luca Giuliani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Valeria Pagliei
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Marco Varrassi
- Neuroradiology and Interventional Radiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM) - SIRM Foundation, via della Signora 2, Milan, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM) - SIRM Foundation, via della Signora 2, Milan, Italy.
| | - Francesco Arrigoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Ernesto Di Cesare
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
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20
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Palumbo P, Daffinà J, Bruno F, Arrigoni F, Splendiani A, Di Cesare E, Barile A, Masciocchi C. Basics in Magnetic Resonance guided Focused Ultrasound: technical basis and clinical application. A brief overview. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021403. [PMID: 34505842 PMCID: PMC8477067 DOI: 10.23750/abm.v92is5.11881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022]
Abstract
First applications of high focused ultrasound as intracranial ablative therapy were firstly described in early 50’. Since then, the technological innovations have shown an increasingly safe and effective face of this technique. And in the last few years, Magnetic Resonance (MR) guided Focused Ultrasound (gFUS) has become a valid minimally invasive technique in the treatment of several diseases, from bone tumors to symptomatic uterine fibroids or essential tremors. MR guidance, through the tomographic view, offers the advantage of an accurate target detection and treatment planning. Moreover, real-time monitoring sequences allow to avoid non-target ablation. An adequate knowledge of FUS is essential to understand its clinical effectiveness. Therefore, this brief review aims to debate the physical characteristics of US and the main fields of clinical application.
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Affiliation(s)
- Pierpaolo Palumbo
- Department of Diagnostic Imaging, area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy.
| | - Julia Daffinà
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy.
| | - Francesco Arrigoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Ernesto Di Cesare
- Department of Clinical Medicine, Public Health, Life and Environmental Science, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
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21
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Sgalambro F, Giordano AV, Carducci S, Varrassi M, Perri M, Arrigoni F, Palumbo P, Bruno F, Bardi L, Mangoni di S Stefano ML, Danti G, Gentili F, Mazzei MA, Di Cesare E, Splendiani A, Masciocchi C, Barile A. The role of interventional radiology in hepatic and renal hemorrhage embolization: single center experience and literature review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021405. [PMID: 34505844 PMCID: PMC8477065 DOI: 10.23750/abm.v92is5.11876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/28/2021] [Indexed: 12/03/2022]
Abstract
Background and aim: Intraabdominal hemorrhage secondary to liver and kidney injury is a major cause of morbidity and mortality. Endovascular arterial embolization is an established interventional radiology technique used to treat active bleeding, and its role in managing abdominal hemorrhages is growing, given the increasing trend for conservative treatment. Our study aims to retrospectively evaluate the technical and clinical results and the possible complications of arterial embolization procedures performed in emergency, in post-traumatic, iatrogenic, and pathological hepatic and renal bleedings. Methods: We performed a ten-year, single-center retrospective survey (from January 2010 to December 2019) of all patients treated in emergency by intra-arterial embolization of liver and kidney bleeding. Preliminary CT angiography studies were evaluated, as well as the angiographic findings. Materials used, procedural data, and clinical outcomes, including complications, were recorded. Results: The diagnostic angiography showed a single source of bleeding in 20 cases (66.7%), two bleeding vessels in 4 cases (13.3%), and multiple hemorrhagic sources in 6 cases (20%). All bleeding sources were successfully embolized; in 12 patients (40%), complete embolization was achieved with coils and 18 patients (60%) with hemostatic sponges. In one case, a second embolization procedure was performed for the persistence of hemodynamic instability. No major post-procedural complications were recorded. The mean procedure duration was 65.1 minutes. Conclusions: Based on our experience and literature data, the treatment of endovascular embolization in acute abdominal bleeding of hepatic and renal origin represents the treatment of choice, as it can provide complete therapeutic success in hemodynamically stable patients. (www.actabiomedica.it)
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Affiliation(s)
- Ferruccio Sgalambro
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
| | - Aldo Victor Giordano
- Interventional Radiology and Neuroradiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Sergio Carducci
- Interventional Radiology and Neuroradiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Marco Varrassi
- Interventional Radiology and Neuroradiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Marco Perri
- Diagnostic and Interventional Radiology, SS. Filippo e Nicola Hospital, Avezzano (AQ), Italy.
| | - Francesco Arrigoni
- Department of Emergency and Interventional Radiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy .
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy.
| | - Luca Bardi
- Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli .
| | | | - Ginevra Danti
- Azienda Ospedaliero Universitaria Careggi, Firenze, Italy.
| | - Francesco Gentili
- Section of Radiology, Unit of Surgical Sciences, University of Parma, Parma, Italy.
| | - Maria Antonietta Mazzei
- Department of Medical, Surgical and Neuro Sciences, University of Siena, Department of Radiological Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy .
| | - Ernesto Di Cesare
- Department of Life, Health and Enviromental Sciences, University of L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
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22
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Predicting the aggressiveness of peripheral zone prostate cancer using a fractional order calculus diffusion model. Eur J Radiol 2021; 143:109913. [PMID: 34464907 DOI: 10.1016/j.ejrad.2021.109913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/01/2021] [Accepted: 08/12/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the performance of parameters D, β, μ from the Fractional Order Calculus (FROC) model at differentiating peripheral zone (PZ) prostate cancer (PCa) MATERIAL AND METHODS: 75 patients who underwent targeted MRI-guided TRUS prostate biopsy within 6 months of MRI were reviewed retrospectively. Regions of interest (ROI) were placed on suspicious lesions on MRI scans. ROIs were then correlated to pathological results based on core biopsy location. The final tumor count is a total: 23 of GS 6 (3 + 3), 36 of GS 7 (3 + 4), 18 of GS 7 (4 + 3), and 19 of GS ≥ 8. Diffusion-weighted imaging (DWI) scans were fitted into the FROC and monoexponential model to calculate ADC and FROC parameters: anomalous diffusion coefficient D, intravoxel diffusion heterogeneity β, and spatial parameter μ. The performance of FROC parameters and ADC at differentiating PCa grade was evaluated with receiver operating characteristic (ROC) analysis. RESULTS In differentiating low (GS 6) vs. intermediate (GS 7) risk PZ PCa, combination of (D, β) provides the best performance with AUC of 0.829 with significance of p = 0.018 when compared to ADC (AUC of 0.655). In differentiating clinically significant (GS 6) vs. clinically significant (GS ≥ 7) PCa, combination of (D, β, μ) provides highest AUC of 0.802 when compared to ADC (AUC of 0.671) with significance of p = 0.038. Stratification of intermediate (GS 7) and high (GS ≥ 8) risk PCa with FROC did not reach a significant difference when compared to ADC. CONCLUSION Combination of FROC parameters shows greater performance than ADC at differentiating low vs. intermediate risk and clinically insignificant vs. significant prostate cancers in peripheral zone lesions. The FROC diffusion model holds promise as a quantitative imaging technique for non-invasive evaluation of PZ PCa.
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23
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Papp L, Spielvogel CP, Grubmüller B, Grahovac M, Krajnc D, Ecsedi B, Sareshgi RAM, Mohamad D, Hamboeck M, Rausch I, Mitterhauser M, Wadsak W, Haug AR, Kenner L, Mazal P, Susani M, Hartenbach S, Baltzer P, Helbich TH, Kramer G, Shariat SF, Beyer T, Hartenbach M, Hacker M. Supervised machine learning enables non-invasive lesion characterization in primary prostate cancer with [ 68Ga]Ga-PSMA-11 PET/MRI. Eur J Nucl Med Mol Imaging 2021; 48:1795-1805. [PMID: 33341915 PMCID: PMC8113201 DOI: 10.1007/s00259-020-05140-y] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/29/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Risk classification of primary prostate cancer in clinical routine is mainly based on prostate-specific antigen (PSA) levels, Gleason scores from biopsy samples, and tumor-nodes-metastasis (TNM) staging. This study aimed to investigate the diagnostic performance of positron emission tomography/magnetic resonance imaging (PET/MRI) in vivo models for predicting low-vs-high lesion risk (LH) as well as biochemical recurrence (BCR) and overall patient risk (OPR) with machine learning. METHODS Fifty-two patients who underwent multi-parametric dual-tracer [18F]FMC and [68Ga]Ga-PSMA-11 PET/MRI as well as radical prostatectomy between 2014 and 2015 were included as part of a single-center pilot to a randomized prospective trial (NCT02659527). Radiomics in combination with ensemble machine learning was applied including the [68Ga]Ga-PSMA-11 PET, the apparent diffusion coefficient, and the transverse relaxation time-weighted MRI scans of each patient to establish a low-vs-high risk lesion prediction model (MLH). Furthermore, MBCR and MOPR predictive model schemes were built by combining MLH, PSA, and clinical stage values of patients. Performance evaluation of the established models was performed with 1000-fold Monte Carlo (MC) cross-validation. Results were additionally compared to conventional [68Ga]Ga-PSMA-11 standardized uptake value (SUV) analyses. RESULTS The area under the receiver operator characteristic curve (AUC) of the MLH model (0.86) was higher than the AUC of the [68Ga]Ga-PSMA-11 SUVmax analysis (0.80). MC cross-validation revealed 89% and 91% accuracies with 0.90 and 0.94 AUCs for the MBCR and MOPR models respectively, while standard routine analysis based on PSA, biopsy Gleason score, and TNM staging resulted in 69% and 70% accuracies to predict BCR and OPR respectively. CONCLUSION Our results demonstrate the potential to enhance risk classification in primary prostate cancer patients built on PET/MRI radiomics and machine learning without biopsy sampling.
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Affiliation(s)
- L Papp
- QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - C P Spielvogel
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Christian Doppler Laboratory for Applied Metabolomics, Vienna, Austria
| | - B Grubmüller
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - M Grahovac
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - D Krajnc
- QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - B Ecsedi
- QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - R A M Sareshgi
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - D Mohamad
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - M Hamboeck
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - I Rausch
- QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - M Mitterhauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Ludwig Boltzmann Institute Applied Diagnostics, Vienna, Austria
| | - W Wadsak
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - A R Haug
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Christian Doppler Laboratory for Applied Metabolomics, Vienna, Austria
| | - L Kenner
- Christian Doppler Laboratory for Applied Metabolomics, Vienna, Austria
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
| | - P Mazal
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
| | - M Susani
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
| | | | - P Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Division of Common General and Pediatric Radiology, Medical University of Vienna, Vienna, Austria
| | - T H Helbich
- Department of Biomedical Imaging and Image-guided Therapy, Division of Common General and Pediatric Radiology, Medical University of Vienna, Vienna, Austria
| | - G Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - S F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - T Beyer
- QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - M Hartenbach
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - M Hacker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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24
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Blocker SJ, Cook J, Mowery YM, Everitt JI, Qi Y, Hornburg KJ, Cofer GP, Zapata F, Bassil AM, Badea CT, Kirsch DG, Johnson GA. Ex Vivo MR Histology and Cytometric Feature Mapping Connect Three-dimensional in Vivo MR Images to Two-dimensional Histopathologic Images of Murine Sarcomas. Radiol Imaging Cancer 2021; 3:e200103. [PMID: 34018846 DOI: 10.1148/rycan.2021200103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose To establish a platform for quantitative tissue-based interpretation of cytoarchitecture features from tumor MRI measurements. Materials and Methods In a pilot preclinical study, multicontrast in vivo MRI of murine soft-tissue sarcomas in 10 mice, followed by ex vivo MRI of fixed tissues (termed MR histology), was performed. Paraffin-embedded limb cross-sections were stained with hematoxylin-eosin, digitized, and registered with MRI. Registration was assessed by using binarized tumor maps and Dice similarity coefficients (DSCs). Quantitative cytometric feature maps from histologic slides were derived by using nuclear segmentation and compared with registered MRI, including apparent diffusion coefficients and transverse relaxation times as affected by magnetic field heterogeneity (T2* maps). Cytometric features were compared with each MR image individually by using simple linear regression analysis to identify the features of interest, and the goodness of fit was assessed on the basis of R2 values. Results Registration of MR images to histopathologic slide images resulted in mean DSCs of 0.912 for ex vivo MR histology and 0.881 for in vivo MRI. Triplicate repeats showed high registration repeatability (mean DSC, >0.9). Whole-slide nuclear segmentations were automated to detect nuclei on histopathologic slides (DSC = 0.8), and feature maps were generated for correlative analysis with MR images. Notable trends were observed between cell density and in vivo apparent diffusion coefficients (best line fit: R2 = 0.96, P < .001). Multiple cytoarchitectural features exhibited linear relationships with in vivo T2* maps, including nuclear circularity (best line fit: R2 = 0.99, P < .001) and variance in nuclear circularity (best line fit: R2 = 0.98, P < .001). Conclusion An infrastructure for registering and quantitatively comparing in vivo tumor MRI with traditional histologic analysis was successfully implemented in a preclinical pilot study of soft-tissue sarcomas. Keywords: MRI, Pathology, Animal Studies, Tissue Characterization Supplemental material is available for this article. © RSNA, 2021.
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Affiliation(s)
- Stephanie J Blocker
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
| | - James Cook
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
| | - Yvonne M Mowery
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
| | - Jeffrey I Everitt
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
| | - Yi Qi
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
| | - Kathryn J Hornburg
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
| | - Gary P Cofer
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
| | - Fernando Zapata
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
| | - Alex M Bassil
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
| | - Cristian T Badea
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
| | - David G Kirsch
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
| | - G Allan Johnson
- From the Departments of Radiology (S.J.B., J.C., Y.Q., K.H., G.P.C., F.Z., C.T.B., G.A.J.), Radiation Oncology (Y.M.M., A.M.B., D.G.K.), and Pathology (J.I.E.), Duke University Medical Center, Center for In Vivo Microscopy, Bryan Research Building, 311 Research Dr, Durham, NC 27710
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25
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Li M, Li W. Clinical application and progress of quantitative functional magnetic resonance imaging in prostate cancer. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2021; 46:414-420. [PMID: 33967089 PMCID: PMC10930317 DOI: 10.11817/j.issn.1672-7347.2021.200316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Indexed: 11/03/2022]
Abstract
Magnetic resonance imaging (MRI) is a very important imaging method for diagnosis and treatment of prostate cancer (PCa) in clinical practice. As functional MRI is growing and maturing, its quantitative parameters are expected to enhance the clinical value of MRI furtherly. Intravoxel incoherent motion diffusion imaging, diffusion tensor imaging, and diffusion kurtosis imaging, which were derived from diffusion weighted imaging, have provided richer and more accurate parameters. The newly-developed magnetic resonance elastography can complement the mechanical characteristics of PCa.
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Affiliation(s)
- Mengsi Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, China.
| | - Wenzheng Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, China.
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26
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Yamamoto S, Yoshida S, Ishii C, Takahara T, Arita Y, Fukushima H, Tanaka H, Yokoyama M, Matsuoka Y, Fujii Y. Metastatic Diffusion Volume Based on Apparent Diffusion Coefficient as a Prognostic Factor in Castration-Resistant Prostate Cancer. J Magn Reson Imaging 2021; 54:401-408. [PMID: 33694240 DOI: 10.1002/jmri.27596] [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: 12/28/2020] [Revised: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Whole-body diffusion-weighted MRI (WB-DWI) is useful for assessing disease activity in castration-resistant prostate cancer (CRPC). MET-RADS-P is a subjective assessment-based reporting system proposed to standardize the interpretation of WB-DWI. However, a quantitative evaluation of WB-DWI has not been fully investigated. PURPOSE To investigate the validity, and analyze the prognostic value, of quantitative evaluation of WB-DWI based on apparent diffusion coefficient (ADC) values for CRPC. STUDY TYPE Retrospective. POPULATION Sixty-six patients with CRPC. The median age was 75 years. During the median follow-up period of 25.2 months, 23 of 66 patients (34.8%) died of prostate cancer. FIELD STRENGTH/SEQUENCE A 1.5 T WB-DWI was used with two b-values (0 s/mm2 -1000 s/mm2 ). A single-shot echo-planar imaging sequence was used. ASSESSMENT WB-DWI were evaluated by three readers according to MET-RADS-P scoring system. Using imaging software, Attractive BDScore, tumor diffusion volume (mDV) and ADC value of metastatic lesion (mADC) was calculated by two readers. The mDV was calculated with ADC values (×10-3 mm2 /sec) of 0.4-0.9 (mDV0.4-0.9 ), 0.9-1.4 (mDV0.9-1.4 ), and 1.4-1.8 (mDV1.4-1.8 ), respectively. STATISTICAL TESTS Spearman's rank correlation coefficient was used to assess the correlation. The relationships between the variables with cancer-specific survival (CSS) were evaluated. Multivariate analysis was performed using the Cox proportional hazards model. RESULTS mDVs showed a strong positive correlation with MET-RADS-P scores (r = 0.90/0.87, P < 0.05 for both). mDV showed a statistically significant association with CSS (hazard ratio [HR]: 1.01, P < 0.05). When the mDVs calculated based on the ADC values were included, mDV0.4-0.9 (HR: 1.02, P < 0.05) and the number of therapeutic lines (HR: 1.35, P < 0.05) were significant independent indicators of CSS shortening. CONCLUSION Assessment of metastatic tumor volume based on ADC values can be used in the prognostic evaluation of patients with CRPC. WB-DWI might be a potential prognostic imaging biomarker for CRPC. EVIDENCE LEVEL 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Shimpei Yamamoto
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chikako Ishii
- Department of Radiology, Advanced Imaging Center, Yaesu Clinic, Tokyo, Japan
| | - Taro Takahara
- Department of Radiology, Advanced Imaging Center, Yaesu Clinic, Tokyo, Japan.,Department of Biomedical Engineering, Tokai University School of Engineering, Kanagawa, Japan
| | - Yuki Arita
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Fukushima
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoh Matsuoka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
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Palumbo P, Manetta R, Izzo A, Bruno F, Arrigoni F, De Filippo M, Splendiani A, Di Cesare E, Masciocchi C, Barile A. Biparametric (bp) and multiparametric (mp) magnetic resonance imaging (MRI) approach to prostate cancer disease: a narrative review of current debate on dynamic contrast enhancement. Gland Surg 2020; 9:2235-2247. [PMID: 33447576 DOI: 10.21037/gs-20-547] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Prostate cancer is the most common malignancy in male population. Over the last few years, magnetic resonance imaging (MRI) has proved to be a robust clinical tool for identification and staging of clinically significant prostate cancer. Though suggestions by the European Society of Urogenital Radiology to use complete multiparametric (mp) T2-weighted/diffusion weighted imaging (DWI)/dynamic contrast enhancement (DCE) acquisition for all prostate MRI examinations, the real advantage of functional DCE remains a matter of debate. Recent studies demonstrate that biparametric (bp) and mp approaches have similar accuracy, but controversial evidences remain, and the specific potential benefits of contrast medium administration are still poorly discussed in literature. The bp approach is in fact sufficient in most cases to adequately identify a negative test, or to accurately define the degree of aggressiveness of a lesion, especially if larger or with major characteristics of malignancy. This feature would give the DCE a secondary role, probably limited to a second evaluation of the lesion location, for detecting small cancer or in case of controversy. However, DCE has proved to increase the sensitivity of prostate MRI, though a less specificity. Therefore, an appropriate decision algorithm is needed to standardize the MRI approach. Aim of this review study was to provide a schematic description of bpMRI and mpMRI approaches in the study of prostatic anatomy, focusing on comparative validity and current DCE application. Additional theoretical considerations on prostate MRI are provided.
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Affiliation(s)
- Pierpaolo Palumbo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rosa Manetta
- Radiology Unit, San Salvatore Hospital, L'Aquila, Italy
| | - Antonio Izzo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Francesco Arrigoni
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Massimo De Filippo
- Department of Medicine and Surgery (DiMec), Section of Radiology, University of Parma, Maggiore Hospital, Parma, Italy
| | - Alessandra Splendiani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ernesto Di Cesare
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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28
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Ziglioli F, Maestroni U, Manna C, Negrini G, Granelli G, Greco V, Pagnini F, De Filippo M. Multiparametric MRI in the management of prostate cancer: an update-a narrative review. Gland Surg 2020; 9:2321-2330. [PMID: 33447583 DOI: 10.21037/gs-20-561] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The growing interest in multiparametric MRI is leading to important changes in the diagnostic process of prostate cancer. MRI-targeted biopsy is likely to become a standard for the diagnosis of prostate cancer in the next years. Despite it is well known that MRI has no role as a staging technique, it is clear that multiparametric MRI may be of help in active surveillance protocols. Noteworthy, MRI in active surveillance is not recommended, but a proper understanding of its potential may be of help in achieving the goals of a delayed treatment strategy. Moreover, the development of minimally invasive techniques, like laparoscopic and robotic surgery, has led to greater expectations as regard to the functional outcomes of radical prostatectomy. Multiparametric MRI may play a role in planning surgical strategies, with the aim to provide the highest oncologic outcome with a minimal impact on the quality of life. We maintain that a proper anatomic knowledge of prostate lesions may allow the surgeon to achieve a better result in planning as well as in performing surgery and help the surgeon and the patient engage in a shared decision in planning a more effective strategy for prostate cancer control and treatment. This review highlights the advantages and the limitations of multiparametric MRI in prostate cancer diagnosis, in active surveillance and in planning surgery.
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Affiliation(s)
| | | | - Carmelinda Manna
- Department of Radiology, University-Hospital of Parma, Parma, Italy
| | - Giulio Negrini
- Department of Radiology, University-Hospital of Parma, Parma, Italy
| | - Giorgia Granelli
- Department of Urology, University-Hospital of Parma, Parma, Italy
| | - Valentina Greco
- Department of Radiology, University-Hospital of Parma, Parma, Italy
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29
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Giovagnoni A, De Filippo M, Barile A. Diagnostic and interventional radiology: an update. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:5-8. [PMID: 32945273 PMCID: PMC7944668 DOI: 10.23750/abm.v91i8-s.9995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 11/23/2022]
Abstract
NOT PRESENT.
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Affiliation(s)
- Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Ancona, AN, Italy.
| | - Massimo De Filippo
- Department of Medicine and Surgery (DiMec), Section of Radiology, University of Parma, Maggiore Hospital, Parma, Italy.
| | - Antonio Barile
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila, Italy.
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30
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Diffusion-Weighted Imaging in Oncology: An Update. Cancers (Basel) 2020; 12:cancers12061493. [PMID: 32521645 PMCID: PMC7352852 DOI: 10.3390/cancers12061493] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 02/06/2023] Open
Abstract
To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the "functional" information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment responses, and to identify residual or recurrent tumors in follow-up examinations. In this review, we provide an up-to-date overview on the application of DWI in oncology.
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31
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Gündoğdu E, Emekli E, Kebapçı M. Evaluation of relationships between the final Gleason score, PI-RADS v2 score, ADC value, PSA level, and tumor diameter in patients that underwent radical prostatectomy due to prostate cancer. Radiol Med 2020; 125:827-837. [PMID: 32266690 DOI: 10.1007/s11547-020-01183-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 03/23/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study aimed to investigate the relationship between the serum PSA level, Gleason score (GS), PI-RADS v2 score, tumor ADCmin value, and the largest tumor diameter in patients that underwent radical prostatectomy (RP) due to prostate cancer (PCa) and to comparatively evaluate the variables of these parameters in clinically significant and insignificant PCa groups. MATERIALS AND METHODS The mpMRI examinations of the patients who underwent RP due to PCa were retrospectively evaluated. According to the final GS, the lesions were divided into two groups as clinically significant (GS ≥ 7) and insignificant (GS ≤ 6). The PSA value, tumor ADCmin value, tumor diameter, and PI-RADS score were compared between the clinically significant and nonsignificant PCa groups using Student's t-test. The correlations between the serum PSA level, GS, PI-RADS v2 score, tumor ADCmin value, and tumor diameter were evaluated separately (Pearson's correlation analysis was used for peripheral gland tumors, and Spearman's correlation analysis for central gland tumors). A ROC analysis was undertaken to evaluate the efficacy of the tumor ADCmin, diameter and PSA values in differentiating clinically significant and nonsignificant tumors. RESULTS In both central and peripheral gland tumors, there was a correlation between the PSA level, tumor diameter, PI-RADS score, ADCmin value, and GS at various levels (poor, moderate, and high). In central gland tumors, there was no significant difference between the two groups in terms of the PSA value and PI-RADS scores (p > 0.05), but the ADCmin value and diameter of the tumor significantly differed (p < 0.05). For peripheral gland tumors, significant differences were observed in all parameters (p < 0.05). The cut-off values for the peripheral and central gland tumors are as follows: lesion diameter, 13.5 mm and 19 mm; tumor ADCmin, 0.709 × 10-3 mm2/s and 0.874 × 10-3 mm2/s; and PSA level, 8.47 ng/ml and 11.10 ng/ml, respectively. CONCLUSION The current PI-RADS v2 scoring system can be inadequate in distinguishing clinically significant and insignificant groups in central gland tumors. A separate cut-off value of the tumor diameter should be determined for central and peripheral gland tumors. Tumor ADCmin values can be used as a predictive parameter. The PSA cut-off value should be kept lower in peripheral gland tumors.
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Affiliation(s)
- Elif Gündoğdu
- Department of Radiology, Faculty of Medicine, Eskişehir Osmangazi University, Meşelik Yerleşkesi, 26480, Eskişehir, Turkey.
| | - Emre Emekli
- Department of Radiology, Faculty of Medicine, Eskişehir Osmangazi University, Meşelik Yerleşkesi, 26480, Eskişehir, Turkey
| | - Mahmut Kebapçı
- Department of Radiology, Faculty of Medicine, Eskişehir Osmangazi University, Meşelik Yerleşkesi, 26480, Eskişehir, Turkey
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32
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van Schie MA, van Houdt PJ, Ghobadi G, Pos FJ, Walraven I, de Boer HCJ, van den Berg CAT, Smeenk RJ, Kerkmeijer LGW, van der Heide UA. Quantitative MRI Changes During Weekly Ultra-Hypofractionated Prostate Cancer Radiotherapy With Integrated Boost. Front Oncol 2019; 9:1264. [PMID: 31867266 PMCID: PMC6904955 DOI: 10.3389/fonc.2019.01264] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/31/2019] [Indexed: 01/29/2023] Open
Abstract
Purpose: Quantitative MRI reflects tissue characteristics. As possible changes during radiotherapy may lead to treatment adaptation based on response, we here assessed if such changes during treatment can be detected. Methods and Materials: In the hypoFLAME trial patients received ultra-hypofractionated prostate radiotherapy with an integrated boost to the tumor in 5 weekly fractions. We analyzed T2 and ADC maps of 47 patients that were acquired in MRI exams prior to and during radiotherapy, and performed rigid registrations based on the prostate contour on anatomical T2-weighted images. We analyzed median T2 and ADC values in three regions of interest (ROIs): the central gland (CG), peripheral zone (PZ), and tumor. We analyzed T2 and ADC changes during treatment and compared patients with and without hormonal therapy. We tested changes during treatment for statistical significance with Wilcoxon signed rank tests. Using confidence intervals as recommended from test-retest measurements, we identified persistent T2 and ADC changes during treatment. Results: In the CG, median T2 and ADC values significantly decreased 12 and 8%, respectively, in patients that received hormonal therapy, while in the PZ these values decreased 17 and 18%. In the tumor no statistically significant change was observed. In patients that did not receive hormonal therapy, median ADC values in the tumor increased with 20%, while in the CG and PZ no changes were observed. Persistent T2 changes in the tumor were found in 2 out of 24 patients, while none of the 47 patients had persistent ADC changes. Conclusions: Weekly quantitative MRI could identify statistically significant ADC changes in the tumor in patients without hormonal therapy. On a patient level few persistent T2 changes in the tumor were observed. Long-term follow-up is required to relate the persistent T2 and ADC changes to outcome and evaluate the applicability of quantitative MRI for response based treatment adaptation.
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Affiliation(s)
- Marcel A van Schie
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Petra J van Houdt
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Ghazaleh Ghobadi
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Floris J Pos
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Iris Walraven
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Hans C J de Boer
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Robert Jan Smeenk
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Linda G W Kerkmeijer
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands.,Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Uulke A van der Heide
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands
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