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Qin X, Mu R, Zheng W, Li X, Liu F, Zhuang Z, Yang P, Zhu X. Comparison and combination of amide proton transfer magnetic resonance imaging and the apparent diffusion coefficient in differentiating the grades of prostate cancer. Quant Imaging Med Surg 2023; 13:812-824. [PMID: 36819246 PMCID: PMC9929395 DOI: 10.21037/qims-22-721] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
Background More effective risk stratification of prostate cancer (PCa) than that possible with current methods can reduce undertreatment and guard against overtreatment. The aim of this study is to validate the differences and combined effects of amide proton transfer (APT) imaging and apparent diffusion coefficient (ADC) in discriminating the PCa grade group (GG) ≤2 from GG ≥3 PCa. Methods This is an ongoing prospective study conducted in the radiology department of Nanxishan Hospital of Guangxi Zhuang Autonomous Region. Patients pathologically diagnosed with PCa were enrolled consecutively according to the eligibility criteria. A total of 180 patients (age range, 42-92 years) were included in this study. Using histopathology as the reference standard, we placed 71 cases in GG ≤2 (mean age 67.03±8.696 years) and 109 cases in GG ≥3 (age 69.60±9.638 years). Magnetic resonance imaging (MRI) parameters, including APT and ADC values, were analyzed using an independent samples t-test and binary logistic regression analysis stratified with GG. Receiver operating characteristic curve was used to analyze the diagnostic performance for different parameters distinguishing GG ≤2 and GG ≥3. Results APT [odds ratio (OR) for the transitional zone (TZ) PCa: 3.20, 95% CI: 1.14-8.98, P=0.02; OR for the peripheral zone (PZ) PCa: 86.32, 95% CI: 13.24-562.88, P=0.003] and ADC values (OR for TZ PCa: 89.79; 95% CI: 2.85-2,827.99, P=0.01; OR for PZ PCa: 39.92; 95% CI: 3.22-494.18, P=0.004) were independent predictors that differentiated the GG of patients. The sensitivity and specificity of the APT values were 61.1% and 81.0%, respectively, while the sensitivity and specificity of the ADC values were 83.3% and 61.9%, respectively. The optimal cutoff value of APT was 3.35% and which of ADC was 1.25×10-3 mm2/s in TZ origin PCa. At the optimal cutoff values of 3.31% (APT) and 0.79×10-3 mm2/s (ADC) in PZ PCa, the sensitivity and specificity of the APT values were 74.0% and 83.6%, respectively, while the sensitivity and specificity of the ADC values were 94.0% and 53.4%, respectively. The area under the curve of the combination of APT and ADC was significantly higher than either of APT or ADC alone in Delong test (TZ: P=0.002 and P=0.020; PZ: P=0.033 and P<0.001). Conclusions APT and ADC have complementary effects on the sensitivity and specificity for identifying different PCa GGs. A combination model of APT and ADC could improve the diagnostic efficacy of PCa differentiation.
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Affiliation(s)
- Xiaoyan Qin
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Ronghua Mu
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Wei Zheng
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China;,Department of Radiology, Graduate School of Guilin Medical University, Guilin, China
| | - Xin Li
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Fuzhen Liu
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Zeyu Zhuang
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China;,Department of Radiology, Graduate School of Guilin Medical University, Guilin, China
| | - Peng Yang
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Xiqi Zhu
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
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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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Cimadamore A, Cheng L, Lopez-Beltran A, Mazzucchelli R, Lucianò R, Scarpelli M, Montorsi F, Montironi R. Added Clinical Value of Whole-mount Histopathology of Radical Prostatectomy Specimens: A Collaborative Review. Eur Urol Oncol 2020; 4:558-569. [PMID: 32883645 DOI: 10.1016/j.euo.2020.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/29/2020] [Accepted: 08/10/2020] [Indexed: 12/12/2022]
Abstract
CONTEXT Whole-mount histopathology, that is, large format histology or whole-mount sectioning, refers to the histopathological examination of tissue sections from specimens processed with large tissue cassette. In some institutions, it is applied routinely to specimens with genitourinary cancers. OBJECTIVE To give an overview of the application of the large format histology to the morphological examination of the radical prostatectomy (RP) specimens. EVIDENCE ACQUISITION A comprehensive PubMed search was performed up to May 2020, using the keywords "prostate carcinoma," "radical prostatectomy specimens," "whole-mount histopathology," "whole mount sectioning," "large format histology," "macrosectioning," "diagnostic criteria," and "prognosis." The search, supplemented with a hand search, was restricted to articles published in the English language. No limitations were placed on the publication year. References in relevant articles were also reviewed. EVIDENCE SYNTHESIS Even though the whole-mount sections of RPs appear not to be superior to regular sections in detecting adverse pathological features, their use has the advantage of displaying the architecture of the prostate gland and identifying and locating tumor nodule(s) more clearly, with particular reference to the index tumor. Further, it is easier to compare the pathological features with clinical findings derived, for instance, from digital rectal examination, transrectal ultrasound, multiparametric magnetic resonance imaging, surgical operation, and prostate biopsies. CONCLUSIONS Urologists, radiologists, and oncologists are updated about the step forward made by pathologists when diagnostic and prognostic information is derived from an approach that closely resembles that used by the clinicians when dealing with imaging findings. PATIENT SUMMARY Adoption of the whole-mount histopathology adds clinical value in correlation with clinical/imaging findings of radical prostatectomy specimens.
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Affiliation(s)
- Alessia Cimadamore
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Antonio Lopez-Beltran
- Department of Pathology and Surgery, Faculty of Medicine, University of Cordoba, Cordoba, Spain
| | - Roberta Mazzucchelli
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
| | - Roberta Lucianò
- Pathological Anatomy Service, Ospedale San Raffaele, Milan, Italy
| | - Marina Scarpelli
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
| | - Francesco Montorsi
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Rodolfo Montironi
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy.
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