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Zhang Q, Luo X, Zhou L, Nguyen TD, Prince MR, Spincemaille P, Wang Y. Fluid Mechanics Approach to Perfusion Quantification: Vasculature Computational Fluid Dynamics Simulation, Quantitative Transport Mapping (QTM) Analysis of Dynamics Contrast Enhanced MRI, and Application in Nonalcoholic Fatty Liver Disease Classification. IEEE Trans Biomed Eng 2023; 70:980-990. [PMID: 36107908 DOI: 10.1109/tbme.2022.3207057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We quantify liver perfusion using quantitative transport mapping (QTM) method that is free of arterial input function (AIF). QTM method is validated in a vasculature computational fluid dynamics (CFD) simulation and is applied for processing dynamic contrast enhanced (DCE) MRI images in differentiating liver with nonalcoholic fatty liver disease (NAFLD) from healthy controls using pathology reference in a preclinical rabbit model. METHODS QTM method was validated on a liver perfusion simulation based on fluid dynamics using a rat liver vasculature model and the mass transport equation. In the NAFLD grading task, DCE MRI images of 7 adult rabbits with methionine choline-deficient diet-induced nonalcoholic steatohepatitis (NASH), 8 adult rabbits with simple steatosis (SS) were acquired and processed using QTM method and dual-input two compartment Kety's method respectively. Statistical analysis was performed on six perfusion parameters: velocity magnitude | u | derived from QTM, liver arterial blood flow LBFa, liver venous blood flow LBFv, permeability Ktrans, blood volume Vp and extravascular space volume Ve averaged in liver ROI. RESULTS In the simulation, QTM method successfully reconstructed blood flow, reduced error by 48% compared to Kety's method. In the preclinical study, only QTM |u| showed significant difference between high grade NAFLD group and low grade NAFLD group. CONCLUSION QTM postprocesses DCE-MRI automatically through deconvolution in space and time to solve the inverse problem of the transport equation. Comparing with Kety's method, QTM method showed higher accuracy and better differentiation in NAFLD classification task. SIGNIFICANCE We propose to apply QTM method in liver DCE MRI perfusion quantification.
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Virostko J, Sorace AG, Slavkova KP, Kazerouni AS, Jarrett AM, DiCarlo JC, Woodard S, Avery S, Goodgame B, Patt D, Yankeelov TE. Quantitative multiparametric MRI predicts response to neoadjuvant therapy in the community setting. Breast Cancer Res 2021; 23:110. [PMID: 34838096 PMCID: PMC8627106 DOI: 10.1186/s13058-021-01489-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine whether advanced quantitative magnetic resonance imaging (MRI) can be deployed outside of large, research-oriented academic hospitals and into community care settings to predict eventual pathological complete response (pCR) to neoadjuvant therapy (NAT) in patients with locally advanced breast cancer. METHODS Patients with stage II/III breast cancer (N = 28) were enrolled in a multicenter study performed in community radiology settings. Dynamic contrast-enhanced (DCE) and diffusion-weighted (DW)-MRI data were acquired at four time points during the course of NAT. Estimates of the vascular perfusion and permeability, as assessed by the volume transfer rate (Ktrans) using the Patlak model, were generated from the DCE-MRI data while estimates of cell density, as assessed by the apparent diffusion coefficient (ADC), were calculated from DW-MRI data. Tumor volume was calculated using semi-automatic segmentation and combined with Ktrans and ADC to yield bulk tumor blood flow and cellularity, respectively. The percent change in quantitative parameters at each MRI scan was calculated and compared to pathological response at the time of surgery. The predictive accuracy of each MRI parameter at different time points was quantified using receiver operating characteristic curves. RESULTS Tumor size and quantitative MRI parameters were similar at baseline between groups that achieved pCR (n = 8) and those that did not (n = 20). Patients achieving a pCR had a larger decline in volume and cellularity than those who did not achieve pCR after one cycle of NAT (p < 0.05). At the third and fourth MRI, changes in tumor volume, Ktrans, ADC, cellularity, and bulk tumor flow from baseline (pre-treatment) were all significantly greater (p < 0.05) in the cohort who achieved pCR compared to those patients with non-pCR. CONCLUSIONS Quantitative analysis of DCE-MRI and DW-MRI can be implemented in the community care setting to accurately predict the response of breast cancer to NAT. Dissemination of quantitative MRI into the community setting allows for the incorporation of these parameters into the standard of care and increases the number of clinical community sites able to participate in novel drug trials that require quantitative MRI.
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Affiliation(s)
- John Virostko
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, TX, 78712, USA
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, TX, USA
- Department of Oncology, University of Texas at Austin, Austin, TX, USA
- Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, USA
| | - Anna G Sorace
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kalina P Slavkova
- Department of Physics, University of Texas at Austin, Austin, TX, USA
| | - Anum S Kazerouni
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Angela M Jarrett
- Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, USA
| | - Julie C DiCarlo
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, TX, USA
- Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, USA
| | - Stefanie Woodard
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sarah Avery
- Austin Radiological Association, Austin, TX, USA
| | - Boone Goodgame
- Dell Seton Medical Center at the University of Texas, Austin, USA
| | | | - Thomas E Yankeelov
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, TX, 78712, USA.
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, TX, USA.
- Department of Oncology, University of Texas at Austin, Austin, TX, USA.
- Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, USA.
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX, USA.
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX, USA.
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Li W, Newitt DC, Gibbs J, Wilmes LJ, Jones EF, Arasu VA, Strand F, Onishi N, Nguyen AAT, Kornak J, Joe BN, Price ER, Ojeda-Fournier H, Eghtedari M, Zamora KW, Woodard SA, Umphrey H, Bernreuter W, Nelson M, Church AL, Bolan P, Kuritza T, Ward K, Morley K, Wolverton D, Fountain K, Lopez-Paniagua D, Hardesty L, Brandt K, McDonald ES, Rosen M, Kontos D, Abe H, Sheth D, Crane EP, Dillis C, Sheth P, Hovanessian-Larsen L, Bang DH, Porter B, Oh KY, Jafarian N, Tudorica A, Niell BL, Drukteinis J, Newell MS, Cohen MA, Giurescu M, Berman E, Lehman C, Partridge SC, Fitzpatrick KA, Borders MH, Yang WT, Dogan B, Goudreau S, Chenevert T, Yau C, DeMichele A, Berry D, Esserman LJ, Hylton NM. Predicting breast cancer response to neoadjuvant treatment using multi-feature MRI: results from the I-SPY 2 TRIAL. NPJ Breast Cancer 2020; 6:63. [PMID: 33298938 PMCID: PMC7695723 DOI: 10.1038/s41523-020-00203-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023] Open
Abstract
Dynamic contrast-enhanced (DCE) MRI provides both morphological and functional information regarding breast tumor response to neoadjuvant chemotherapy (NAC). The purpose of this retrospective study is to test if prediction models combining multiple MRI features outperform models with single features. Four features were quantitatively calculated in each MRI exam: functional tumor volume, longest diameter, sphericity, and contralateral background parenchymal enhancement. Logistic regression analysis was used to study the relationship between MRI variables and pathologic complete response (pCR). Predictive performance was estimated using the area under the receiver operating characteristic curve (AUC). The full cohort was stratified by hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status (positive or negative). A total of 384 patients (median age: 49 y/o) were included. Results showed analysis with combined features achieved higher AUCs than analysis with any feature alone. AUCs estimated for the combined versus highest AUCs among single features were 0.81 (95% confidence interval [CI]: 0.76, 0.86) versus 0.79 (95% CI: 0.73, 0.85) in the full cohort, 0.83 (95% CI: 0.77, 0.92) versus 0.73 (95% CI: 0.61, 0.84) in HR-positive/HER2-negative, 0.88 (95% CI: 0.79, 0.97) versus 0.78 (95% CI: 0.63, 0.89) in HR-positive/HER2-positive, 0.83 (95% CI not available) versus 0.75 (95% CI: 0.46, 0.81) in HR-negative/HER2-positive, and 0.82 (95% CI: 0.74, 0.91) versus 0.75 (95% CI: 0.64, 0.83) in triple negatives. Multi-feature MRI analysis improved pCR prediction over analysis of any individual feature that we examined. Additionally, the improvements in prediction were more notable when analysis was conducted according to cancer subtype.
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Affiliation(s)
- Wen Li
- University of California, San Francisco, CA, USA
| | | | | | | | - Ella F Jones
- University of California, San Francisco, CA, USA
| | | | - Fredrik Strand
- University of California, San Francisco, CA, USA
- Karolinska Institute, Stockholm, Sweden
| | | | | | - John Kornak
- University of California, San Francisco, CA, USA
| | - Bonnie N Joe
- University of California, San Francisco, CA, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Mark Rosen
- University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | - Pulin Sheth
- University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Karen Y Oh
- Oregon Health & Science University, Portland, OR, USA
| | - Neda Jafarian
- Oregon Health & Science University, Portland, OR, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Wei T Yang
- University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA
| | - Basak Dogan
- University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA
| | | | | | | | | | - Don Berry
- Berry Consultants, LLC, Austin, TX, USA
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Krikken E, van der Kemp WJ, Khlebnikov V, van Dalen T, Los M, van Laarhoven HW, Luijten PR, van den Bosch MA, Klomp DW, Wijnen JP. Contradiction between amide-CEST signal and pH in breast cancer explained with metabolic MRI. NMR IN BIOMEDICINE 2019; 32:e4110. [PMID: 31136039 PMCID: PMC6772111 DOI: 10.1002/nbm.4110] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE Metabolic MRI is a noninvasive technique that can give new insights into understanding cancer metabolism and finding biomarkers to evaluate or monitor treatment plans. Using this technique, a previous study has shown an increase in pH during neoadjuvant chemotherapy (NAC) treatment, while recent observation in a different study showed a reduced amide proton transfer (APT) signal during NAC treatment (negative relation). These findings are counterintuitive, given the known intrinsic positive relation of APT signal to pH. METHODS In this study we combined APT MRI and 31 P-MRSI measurements to unravel the relation between the APT signal and pH in breast cancer. Twenty-two breast cancer patients were scanned with a 7 T MRI before and after the first cycle of NAC treatment. pH was determined by the chemical shift of inorganic phosphate (Pi). RESULTS While APT signals have a positive relation to pH and amide content, we observed a direct negative linear correlation between APT signals and pH in breast tumors in vivo. CONCLUSIONS As differentiation of cancer stages was confirmed by observation of a linear correlation between cell proliferation marker PE/Pi (phosphoethanolamine over inorganic phosphate) and pH in the tumor, our data demonstrates that the concentration of mobile proteins likely supersedes the contribution of the exchange rate to the APT signal.
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Affiliation(s)
- Erwin Krikken
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | | | - Vitaliy Khlebnikov
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | | | - Maartje Los
- Department of Medical OncologySt. Antonius ZiekenhuisNieuwegein/UtrechtThe Netherlands
| | - Hanneke W.M. van Laarhoven
- Department of Medical Oncology, Academic Medical Centre AmsterdamCancer Center AmsterdamAmsterdamThe Netherlands
| | - Peter R. Luijten
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | | | - Dennis W.J. Klomp
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Jannie P. Wijnen
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
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Liu F, Wang M, Li H. Role of perfusion parameters on DCE-MRI and ADC values on DWMRI for invasive ductal carcinoma at 3.0 Tesla. World J Surg Oncol 2018; 16:239. [PMID: 30577820 PMCID: PMC6303963 DOI: 10.1186/s12957-018-1538-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 11/30/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The value of apparent diffusion coefficient (ADC) values and quantitative parameters (Ktrans, Kep, Ve) in detecting prognostic factor at 3.0 Tesla remains unclear, especially in predicting prognosis of breast cancer. METHODS A total of 151 patients with IDC underwent breast DCE-MRI and DWI-MRI at 3.0 Tesla following surgery. The ADC values were acquired with b values of 0 and 1000 s/mm2. The relationship between ADC values or DCE-MRI quantitative parameters and size, histologic grade (HG), lymph node metastasis (LNM), ER, PR, and Ki67 was evaluated. The predictive values of ADC, Ktrans, Kep, and Ve to prognosis of IDC were assessed. RESULTS ADC value was positively related to size (P = 0.04) and HER2 (P = 0.046) expression and negatively related to ER (P = 0.012) and PR (P < 0.001) expression. Ktrans value has positive correlation with size (P < 0.001), HG (P < 0.001), LNM (P < 0.001), HER2 (P = 0.007), and Ki67 (P < 0.001) expression and negative correlation with ER (P < 0.001) and PR (P < 0.001) expression. Kep value was positively related to size (P < 0.001) and negatively related to ER (P < 0.001) and PR (P < 0.001) expression. Ve value was negatively related to HER2 expression (P = 0.004). The Cox hazard ratio (HR) of ADC, Ktrans, Kep, and Ve values on survival was 5.26 (P = 0.093), 1.081 (P = 0.002), 1.006 (P = 0.941), and 0.883 (P = 0.926), respectively. CONCLUSIONS Ktrans value was a best predictive indicator of HG, LNM, ER, PR, and Ki67 expression, and ADC value was the best predictive indicator of HER2. Preoperative use of the 3.0 Tesla could provide important information to determine the optimal treatment plan.
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Affiliation(s)
- Fei Liu
- Department of Medical Imaging, The Second Affiliated Hospital of Nanjing Medical University, No.121 Jiangjiayuan, Nanjing, 210011, Jiangsu Province, China
| | - Mei Wang
- Department of Medical Imaging, The Second Affiliated Hospital of Nanjing Medical University, No.121 Jiangjiayuan, Nanjing, 210011, Jiangsu Province, China
| | - Haige Li
- Department of Medical Imaging, The Second Affiliated Hospital of Nanjing Medical University, No.121 Jiangjiayuan, Nanjing, 210011, Jiangsu Province, China.
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6
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Sorace AG, Wu C, Barnes SL, Jarrett AM, Avery S, Patt D, Goodgame B, Luci JJ, Kang H, Abramson RG, Yankeelov TE, Virostko J. Repeatability, reproducibility, and accuracy of quantitative mri of the breast in the community radiology setting. J Magn Reson Imaging 2018; 48:10.1002/jmri.26011. [PMID: 29570895 PMCID: PMC6151298 DOI: 10.1002/jmri.26011] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/02/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Quantitative diffusion-weighted MRI (DW-MRI) and dynamic contrast-enhanced MRI (DCE-MRI) have the potential to impact patient care by providing noninvasive biological information in breast cancer. PURPOSE/HYPOTHESIS To quantify the repeatability, reproducibility, and accuracy of apparent diffusion coefficient (ADC) and T1 -mapping of the breast in community radiology practices. STUDY TYPE Prospective. SUBJECTS/PHANTOM Ice-water DW-MRI and T1 gel phantoms were used to assess accuracy. Normal subjects (n = 3) and phantoms across three sites (one academic, two community) were used to assess reproducibility. Test-retest analysis at one site in normal subjects (n = 12) was used to assess repeatability. FIELD STRENGTH/SEQUENCE 3T Siemens Skyra MRI quantitative DW-MRI and T1 -mapping. ASSESSMENT Quantitative DW-MRI and T1 -mapping parametric maps of phantoms and fibroglandular and adipose tissue of the breast. STATISTICAL TESTS Average values of breast tissue were quantified and Bland-Altman analysis was performed to assess the repeatability of the MRI techniques, while the Friedman test assessed reproducibility. RESULTS ADC measurements were reproducible across sites, with an average difference of 1.6% in an ice-water phantom and 7.0% in breast fibroglandular tissue. T1 measurements in gel phantoms had an average difference of 2.8% across three sites, whereas breast fibroglandular and adipose tissue had 8.4% and 7.5% average differences, respectively. In the repeatability study, we found no bias between first and second scanning sessions (P = 0.1). The difference between repeated measurements was independent of the mean for each MRI metric (P = 0.156, P = 0.862, P = 0.197 for ADC, T1 of fibroglandular tissue, and T1 of adipose tissue, respectively). DATA CONCLUSION Community radiology practices can perform repeatable, reproducible, and accurate quantitative T1 -mapping and DW-MRI. This has the potential to dramatically expand the number of sites that can participate in multisite clinical trials and increase clinical translation of quantitative MRI techniques for cancer response assessment. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
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Affiliation(s)
- Anna G. Sorace
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, Texas, USA
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, Texas, USA
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
| | - Chengyue Wu
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
| | - Stephanie L. Barnes
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Angela M. Jarrett
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Sarah Avery
- Austin Radiological Association, Austin, Texas, USA
| | | | - Boone Goodgame
- Seton Hospital, Austin, Texas, USA
- Department of Internal Medicine, University of Texas at Austin, Austin, Texas, USA
| | - Jeffery J. Luci
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
- Department of Neuroscience, University of Texas at Austin, Austin, Texas, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Richard G. Abramson
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Thomas E. Yankeelov
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, Texas, USA
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, Texas, USA
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, Texas, USA
| | - John Virostko
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, Texas, USA
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, Texas, USA
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Virostko J, Hainline A, Kang H, Arlinghaus LR, Abramson RG, Barnes SL, Blume JD, Avery S, Patt D, Goodgame B, Yankeelov TE, Sorace AG. Dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted magnetic resonance imaging for predicting the response of locally advanced breast cancer to neoadjuvant therapy: a meta-analysis. J Med Imaging (Bellingham) 2017; 5:011011. [PMID: 29201942 PMCID: PMC5701084 DOI: 10.1117/1.jmi.5.1.011011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/06/2017] [Indexed: 12/11/2022] Open
Abstract
This meta-analysis assesses the prognostic value of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted MRI (DW-MRI) performed during neoadjuvant therapy (NAT) of locally advanced breast cancer. A systematic literature search was conducted to identify studies of quantitative DCE-MRI and DW-MRI performed during breast cancer NAT that report the sensitivity and specificity for predicting pathological complete response (pCR). Details of the study population and imaging parameters were extracted from each study for subsequent meta-analysis. Metaregression analysis, subgroup analysis, study heterogeneity, and publication bias were assessed. Across 10 studies that met the stringent inclusion criteria for this meta-analysis (out of 325 initially identified studies), we find that MRI had a pooled sensitivity of 0.91 [95% confidence interval (CI), 0.80 to 0.96] and specificity of 0.81(95% CI, 0.68 to 0.89) when adjusted for covariates. Quantitative DCE-MRI exhibits greater specificity for predicting pCR than semiquantitative DCE-MRI (p<0.001). Quantitative DCE-MRI and DW-MRI are able to predict, early in the course of NAT, the eventual response of breast tumors, with a high level of specificity and sensitivity. However, there is a high degree of heterogeneity in published studies highlighting the lack of standardization in the field.
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Affiliation(s)
- John Virostko
- University of Texas at Austin, Department of Diagnostics, Austin, Texas, United States.,University of Texas at Austin, Livestrong Cancer Institutes, Austin, Texas, United States
| | - Allison Hainline
- Vanderbilt University, Department of Biostatistics, Nashville, Tennessee, United States
| | - Hakmook Kang
- Vanderbilt University, Department of Biostatistics, Nashville, Tennessee, United States.,Vanderbilt University, Center for Quantitative Sciences, Nashville, Tennessee, United States
| | - Lori R Arlinghaus
- Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, Tennessee, United States
| | - Richard G Abramson
- Vanderbilt University, Center for Quantitative Sciences, Nashville, Tennessee, United States.,Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, Tennessee, United States
| | - Stephanie L Barnes
- University of Texas at Austin, Institute for Computational and Engineering Sciences, Austin, Texas, United States.,University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Jeffrey D Blume
- Vanderbilt University, Department of Biostatistics, Nashville, Tennessee, United States
| | - Sarah Avery
- Austin Radiological Association, Austin, Texas, United States
| | - Debra Patt
- Texas Oncology, Austin, Texas, United States
| | - Boone Goodgame
- Seton Hospital, Austin, Texas, United States.,University of Texas at Austin, Department of Medicine, Austin, Texas, United States
| | - Thomas E Yankeelov
- University of Texas at Austin, Department of Diagnostics, Austin, Texas, United States.,University of Texas at Austin, Livestrong Cancer Institutes, Austin, Texas, United States.,University of Texas at Austin, Institute for Computational and Engineering Sciences, Austin, Texas, United States.,University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Anna G Sorace
- University of Texas at Austin, Department of Diagnostics, Austin, Texas, United States.,University of Texas at Austin, Livestrong Cancer Institutes, Austin, Texas, United States
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Sorace AG, Harvey S, Syed A, Yankeelov TE. Imaging Considerations and Interprofessional Opportunities in the Care of Breast Cancer Patients in the Neoadjuvant Setting. Semin Oncol Nurs 2017; 33:425-439. [PMID: 28927763 DOI: 10.1016/j.soncn.2017.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To discuss standard-of-care and emerging imaging techniques employed for screening and detection, diagnosis and staging, monitoring response to therapy, and guiding cancer treatments. DATA SOURCES Published journal articles indexed in the National Library of Medicine database and relevant websites. CONCLUSION Imaging plays a fundamental role in the care of cancer patients and specifically, breast cancer patients in the neoadjuvant setting, providing an excellent opportunity for interprofessional collaboration between oncologists, researchers, radiologists, and oncology nurses. Quantitative imaging strategies to assess cellular, molecular, and vascular characteristics within the tumor is needed to better evaluate initial diagnosis and treatment response. IMPLICATIONS FOR NURSING PRACTICE Nurses caring for patients in all settings must continue to seek education on emerging imaging techniques. Oncology nurses provide education about the test, ensure the patient has appropriate pre-testing instructions, and manage patient expectations about timing of results availability.
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Furman‐Haran E, Nissan N, Ricart‐Selma V, Martinez‐Rubio C, Degani H, Camps‐Herrero J. Quantitative evaluation of breast cancer response to neoadjuvant chemotherapy by diffusion tensor imaging: Initial results. J Magn Reson Imaging 2017; 47:1080-1090. [DOI: 10.1002/jmri.25855] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/25/2017] [Indexed: 12/31/2022] Open
Affiliation(s)
- Edna Furman‐Haran
- Weizmann Institute of Science, Department of Biological ServicesRehovot Israel
| | - Noam Nissan
- Sheba Medical Center, Radiology DepartmentTel Hashomer Israel
| | | | | | - Hadassa Degani
- Weizmann Institute of Science, Department of Biological RegulationRehovot Israel
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10
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Barnes SL, Sorace AG, Loveless ME, Whisenant JG, Yankeelov TE. Correlation of tumor characteristics derived from DCE-MRI and DW-MRI with histology in murine models of breast cancer. NMR IN BIOMEDICINE 2015; 28:1345-56. [PMID: 26332194 PMCID: PMC4573954 DOI: 10.1002/nbm.3377] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 07/16/2015] [Accepted: 07/19/2015] [Indexed: 05/04/2023]
Abstract
The purpose of this work was to determine the relationship between the apparent diffusion coefficient (ADC, from diffusion-weighted (DW) MRI), the extravascular, extracellular volume fraction (ve , from dynamic contrast-enhanced (DCE) MRI), and histological measurement of the extracellular space fraction. Athymic nude mice were injected with either human epidermal growth factor receptor 2 positive (HER2+) BT474 (n = 15) or triple negative MDA-MB-231 (n = 20) breast cancer cells, treated with either Herceptin (n = 8), Abraxane (low dose n = 7, high dose n = 6), or saline (n = 7 for each cell line), and imaged using DW- and DCE-MRI before, during, and after treatment. After the final imaging acquisition, the tissue was resected and evaluated by histological analysis. H&E-stained central slices were scanned using a digital brightfield microscope and evaluated with thresholding techniques to calculate the extracellular space. For both BT474 and MDA-MB-231, the median ADC of the central slice exhibited a significantly positive correlation with the corresponding central slice extracellular space as measured by H&E (p = 0.03, p < 0.01, respectively). Median ve calculated from the central slice showed differing results between the two cell lines. For BT474, a significant correlation between ve and extracellular space was calculated (p = 0.02), while MDA-MB-231 tumors did not demonstrate a significant correlation (p = 0.64). Additionally, there was no correlation discovered between ADC and ve with either whole tumor analysis or central slice analysis (p > 0.05). While ADC correlates well with the histologically determined fraction of extracellular space, these data add to the growing body of literature that suggests that ve derived from DCE-MRI is not a reliable biomarker of extracellular space for a range of physiological conditions.
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Affiliation(s)
- Stephanie L. Barnes
- Vanderbilt Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Anna G. Sorace
- Vanderbilt Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Mary E. Loveless
- Vanderbilt Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Jennifer G. Whisenant
- Vanderbilt Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Thomas E. Yankeelov
- Vanderbilt Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee, USA
- Department of Cancer Biology, Vanderbilt University, Nashville, Tennessee, USA
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11
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Li K, Li H, Zhang XY, Stokes AM, Jiang X, Kang H, Quarles CC, Zu Z, Gochberg DF, Gore JC, Xu J. Influence of water compartmentation and heterogeneous relaxation on quantitative magnetization transfer imaging in rodent brain tumors. Magn Reson Med 2015; 76:635-44. [PMID: 26375875 DOI: 10.1002/mrm.25893] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/24/2015] [Accepted: 07/25/2015] [Indexed: 12/16/2022]
Abstract
PURPOSE The goal of this study was to investigate the influence of water compartmentation and heterogeneous relaxation properties on quantitative magnetization transfer (qMT) imaging in tissues, and in particular whether a two-pool model is sufficient to describe qMT data in brain tumors. METHODS Computer simulations and in vivo experiments with a series of qMT measurements before and after injection of Gd-DTPA were performed. Both off-resonance pulsed saturation (pulsed) and on-resonance selective inversion recovery (SIR) qMT methods were used, and all data were fit with a two-pool model only. RESULTS Simulations indicated that a two-pool fitting of four-pool data yielded accurate measures of pool size ratio (PSR) of macromolecular versus free water protons when there were fast transcytolemmal exchange and slow R1 recovery. The fitted in vivo PSR of both pulsed and SIR qMT methods showed no dependence on R1 variations caused by different concentrations of Gd-DTPA during wash-out, whereas the fitted kex (magnetization transfer exchange rate) changed significantly with R1 . CONCLUSION A two-pool model provides reproducible estimates of PSR in brain tumors independent of relaxation properties in the presence of relatively fast transcytolemmal exchange, whereas estimates of kex are biased by relaxation variations. In addition, estimates of PSR in brain tumors using the pulsed and SIR qMT methods agree well with one another. Magn Reson Med 76:635-644, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Ke Li
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Hua Li
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA
| | - Xiao-Yong Zhang
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Ashley M Stokes
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Xiaoyu Jiang
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, USA
| | - C Chad Quarles
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Zhongliang Zu
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Daniel F Gochberg
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA.,Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA
| | - John C Gore
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA.,Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.,Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | - Junzhong Xu
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA.,Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA
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12
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Truong ML, Harrington MG, Schepkin VD, Chekmenev EY. Sodium 3D COncentration MApping (COMA 3D) using (23)Na and proton MRI. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2014; 247:88-95. [PMID: 25261742 PMCID: PMC4198170 DOI: 10.1016/j.jmr.2014.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 07/21/2014] [Accepted: 08/25/2014] [Indexed: 06/03/2023]
Abstract
Functional changes of sodium 3D MRI signals were converted into millimolar concentration changes using an open-source fully automated MATLAB toolbox. These concentration changes are visualized via 3D sodium concentration maps, and they are overlaid over conventional 3D proton images to provide high-resolution co-registration for easy correlation of functional changes to anatomical regions. Nearly 5000/h concentration maps were generated on a personal computer (ca. 2012) using 21.1T 3D sodium MRI brain images of live rats with spatial resolution of 0.8×0.8×0.8 mm(3) and imaging matrices of 60×60×60. The produced concentration maps allowed for non-invasive quantitative measurement of in vivo sodium concentration in the normal rat brain as a functional response to migraine-like conditions. The presented work can also be applied to sodium-associated changes in migraine, cancer, and other metabolic abnormalities that can be sensed by molecular imaging. The MATLAB toolbox allows for automated image analysis of the 3D images acquired on the Bruker platform and can be extended to other imaging platforms. The resulting images are presented in a form of series of 2D slices in all three dimensions in native MATLAB and PDF formats. The following is provided: (a) MATLAB source code for image processing, (b) the detailed processing procedures, (c) description of the code and all sub-routines, (d) example data sets of initial and processed data. The toolbox can be downloaded at: http://www.vuiis.vanderbilt.edu/~truongm/COMA3D/.
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Affiliation(s)
- Milton L Truong
- Department of Radiology, Vanderbilt University Institute of Imaging Science (VUIIS), Nashville, TN 37232, USA.
| | - Michael G Harrington
- Huntington Medical Research Institutes, 99 North El Molino Ave, Pasadena, CA 91101, USA
| | - Victor D Schepkin
- National High Magnetic Field Laboratory (NHMFL), Florida State University, 1800 E Paul Dirac Drive, Tallahassee, FL 32310, USA
| | - Eduard Y Chekmenev
- Department of Radiology, Vanderbilt University Institute of Imaging Science (VUIIS), Nashville, TN 37232, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA; Department of Biochemistry, Vanderbilt University, Nashville, TN 37205, USA; Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN 37232, USA.
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13
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Ou Y, Weinstein SP, Conant EF, Englander S, Da X, Gaonkar B, Hsieh MK, Rosen M, DeMichele A, Davatzikos C, Kontos D. Deformable registration for quantifying longitudinal tumor changes during neoadjuvant chemotherapy. Magn Reson Med 2014; 73:2343-56. [PMID: 25046843 DOI: 10.1002/mrm.25368] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/28/2014] [Accepted: 06/24/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate DRAMMS, an attribute-based deformable registration algorithm, compared to other intensity-based algorithms, for longitudinal breast MRI registration, and to show its applicability in quantifying tumor changes over the course of neoadjuvant chemotherapy. METHODS Breast magnetic resonance images from 14 women undergoing neoadjuvant chemotherapy were analyzed. The accuracy of DRAMMS versus five intensity-based deformable registration methods was evaluated based on 2,380 landmarks independently annotated by two experts, for the entire image volume, different image subregions, and patient subgroups. The registration method with the smallest landmark error was used to quantify tumor changes, by calculating the Jacobian determinant maps of the registration deformation. RESULTS DRAMMS had the smallest landmark errors (6.05 ± 4.86 mm), followed by the intensity-based methods CC-FFD (8.07 ± 3.86 mm), NMI-FFD (8.21 ± 3.81 mm), SSD-FFD (9.46 ± 4.55 mm), Demons (10.76 ± 6.01 mm), and Diffeomorphic Demons (10.82 ± 6.11 mm). Results show that registration accuracy also depends on tumor versus normal tissue regions and different patient subgroups. CONCLUSIONS The DRAMMS deformable registration method, driven by attribute-matching and mutual-saliency, can register longitudinal breast magnetic resonance images with a higher accuracy than several intensity-matching methods included in this article. As such, it could be valuable for more accurately quantifying heterogeneous tumor changes as a marker of response to treatment.
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Affiliation(s)
- Yangming Ou
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Susan P Weinstein
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Emily F Conant
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sarah Englander
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Xiao Da
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bilwaj Gaonkar
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Meng-Kang Hsieh
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark Rosen
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Angela DeMichele
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christos Davatzikos
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Despina Kontos
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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14
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Xu J, Li K, Zu Z, Xia L, Gochberg DF, Gore JC. Quantitative magnetization transfer imaging of rodent glioma using selective inversion recovery. NMR IN BIOMEDICINE 2014; 27:253-60. [PMID: 24338993 PMCID: PMC3947425 DOI: 10.1002/nbm.3058] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 11/07/2013] [Accepted: 11/08/2013] [Indexed: 05/08/2023]
Abstract
Magnetization transfer (MT) provides an indirect means to detect noninvasively variations in macromolecular contents in biological tissues, but, so far, there have been only a few quantitative MT (qMT) studies reported in cancer, all of which used off-resonance pulsed saturation methods. This article describes the first implementation of a different qMT approach, selective inversion recovery (SIR), for the characterization of tumor in vivo using a rodent glioma model. The SIR method is an on-resonance method capable of fitting qMT parameters and T1 relaxation time simultaneously without mapping B0 and B1 , which is very suitable for high-field qMT measurements because of the lower saturation absorption rate. The results show that the average pool size ratio (PSR, the macromolecular pool versus the free water pool) in rat 9 L glioma (5.7%) is significantly lower than that in normal rat gray matter (9.2%) and white matter (17.4%), which suggests that PSR is potentially a sensitive imaging biomarker for the assessment of brain tumor. Despite being less robust, the estimated MT exchange rates also show clear differences from normal tissues (19.7 Hz for tumors versus 14.8 and 10.2 Hz for gray and white mater, respectively). In addition, the influence of confounding effects, e.g. B1 inhomogeneity, on qMT parameter estimates is investigated with numerical simulations. These findings not only help to better understand the changes in the macromolecular contents of tumors, but are also important for the interpretation of other imaging contrasts, such as chemical exchange saturation transfer of tumors.
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Affiliation(s)
- Junzhong Xu
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, USA
- Corresponding author: Address: Vanderbilt University, Institute of Imaging Science, 1161 21 Avenue South, AA 1105 MCN, Nashville, TN 37232-2310, United States. Fax: +1 615 322 0734. (Junzhong Xu)
| | - Ke Li
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, USA
| | - Zhongliang Zu
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, USA
| | - Li Xia
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, USA
| | - Daniel F. Gochberg
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, USA
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN 37232, USA
| | - John C. Gore
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, USA
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN 37232, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232, USA
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15
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Fennessy FM, McKay RR, Beard CJ, Taplin ME, Tempany CM. Dynamic contrast-enhanced magnetic resonance imaging in prostate cancer clinical trials: potential roles and possible pitfalls. Transl Oncol 2014; 7:120-9. [PMID: 24772215 PMCID: PMC3998683 DOI: 10.1593/tlo.13922] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 03/04/2014] [Accepted: 03/06/2014] [Indexed: 12/21/2022] Open
Abstract
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) evaluates the tissue microvasculature and may have a role in assessing and predicting therapeutic response in prostate cancer (PCa). In this review, we review principles of DCE-MRI and present the potential quantitative information that can be obtained. We discuss how it may be used as a biomarker for treatment with antiangiogenic and antivascular agents and potentially identify patients with PCa who may benefit from this form of therapy. Likewise, DCE-MRI may play a role in assessing response to combined androgen deprivation therapy and radiation therapy and theoretically could be a prognostic biomarker in evaluating second-generation hormone therapies. We also address the challenges of using DCE-MRI in PCa clinical trials and discuss the difficulties with standardization of this methodology to allow for biomarker validation, with particular reference to PCa.
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Affiliation(s)
- Fiona M Fennessy
- Department of Radiology, Brigham and Women's Hospital, Boston, MA ; Department of Radiology, Dana-Farber Cancer Institute, Boston, MA
| | - Rana R McKay
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Clair J Beard
- Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA
| | - Mary-Ellen Taplin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Clare M Tempany
- Department of Radiology, Brigham and Women's Hospital, Boston, MA
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16
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Abramson RG, Li X, Hoyt TL, Su PF, Arlinghaus LR, Wilson KJ, Abramson VG, Chakravarthy AB, Yankeelov TE. Early assessment of breast cancer response to neoadjuvant chemotherapy by semi-quantitative analysis of high-temporal resolution DCE-MRI: preliminary results. Magn Reson Imaging 2013; 31:1457-64. [PMID: 23954320 DOI: 10.1016/j.mri.2013.07.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 05/28/2013] [Accepted: 07/02/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate whether semi-quantitative analysis of high temporal resolution dynamic contrast-enhanced MRI (DCE-MRI) acquired early in treatment can predict the response of locally advanced breast cancer (LABC) to neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS As part of an IRB-approved prospective study, 21 patients with LABC provided informed consent and underwent high temporal resolution 3T DCE-MRI before and after 1cycle of NAC. Using measurements performed by two radiologists, the following parameters were extracted for lesions at both examinations: lesion size (short and long axes, in both early and late phases of enhancement), radiologist's subjective assessment of lesion enhancement, and percentages of voxels within the lesion demonstrating progressive, plateau, or washout kinetics. The latter data were calculated using two filters, one selecting for voxels enhancing ≥50% over baseline and one for voxels enhancing ≥100% over baseline. Pretreatment imaging parameters and parameter changes following cycle 1 of NAC were evaluated for their ability to discriminate patients with an eventual pathological complete response (pCR). RESULTS All 21 patients completed NAC followed by surgery, with 9 patients achieving a pCR. No pretreatment imaging parameters were predictive of pCR. However, change after cycle 1 of NAC in percentage of voxels demonstrating washout kinetics with a 100% enhancement filter discriminated patients with an eventual pCR with an area under the receiver operating characteristic curve (AUC) of 0.77. Changes in other parameters, including lesion size, did not predict pCR. CONCLUSION Semi-quantitative analysis of high temporal resolution DCE-MRI in patients with LABC can discriminate patients with an eventual pCR after one cycle of NAC.
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Affiliation(s)
- Richard G Abramson
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN; Institute of Imaging Science, Vanderbilt University, Nashville, TN; Vanderbilt-Ingram Center, Vanderbilt University, Nashville, TN.
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