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Lu Z, Xia K, Jiang H, Weng X, Wu M. Improved effects of the b-value for 2000 sec/mm 2 DWI on an accurate qualitative and quantitative assessment of rectal cancer. Arab J Gastroenterol 2023; 24:230-237. [PMID: 37989671 DOI: 10.1016/j.ajg.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 04/21/2023] [Accepted: 09/03/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND AND STUDY OBJECTIVES A higher b-value Diffusion-weighted imaging (DWI) would improve the contrast between cancerous and noncancerous tissue. Apparent diffusion coefficient (ADC)-histogram analysis is a method that can provide statistical data and quantitative information on tumor heterogeneity. This study aimed to compare two high b-values (1000 and 2000 sec/mm2) DWI in tumor detection and diagnostic performance in identifying early-stage tumor rectal cancer. PATIENTS AND METHODS This blinded and blinded retrospective study involved 56 patients with rectal cancer and 45 patients. Two radiologists evaluated the qualitative detection parameters and quantitative parameters of the ADC evaluated histogram and compared them between two DWI sequences (b-value for 1000 sec/mm2 and 2000 sec/mm2). The characteristic curves were used to assess diagnostic administration for the ADC histogram in discriminating early-stage tumors. RESULTS The b-value for 2000 sec/mm2 DWI significantly improved AUCs, sensitivity, specificity, and precision and decreased false-positive rate for detection compared to the b-value for 1000 sec/mm2 (p < 0.05). The mean and fifth percentile ADC value for stage I using the b-value for 1000 sec/mm2 DWI was significantly higher than stage ≥ II (p = 0.036II and 0.016 respectively), as the well as fifth, 10th, mean ADC of the fifth, 10th, and 25th ADC percentile at b-value for 2000 sec/mm2 (p = 0.031, 0.014, 0.035 and 0.025 respectively). The AUCs of the fifth percentile ADC at b-value for 2000 sec/mm2 DWI in both readers in differentiating the stage Ⅰ tumor were the highest (0.732 and 0.751). CONCLUSION The b-value for 2000 sec/mm2 DWI could improve the accurate detection of rectal cancer. The fifth percentile ADC at b-value for 2000 sec/mm2 sec/mm2 DWI was more useful for discriminating early stage than the b-value for 1000 sec/mm2 DWI.
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Affiliation(s)
- Zhihua Lu
- Department of Radiology, Dushu Lake Hospital Affiliated to Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, China.
| | - Kaijian Xia
- Department of Information, Changshu No.1 People's Hospital, Affiliated Changshu Hospital of Soochow University, Suzhou, China
| | - Heng Jiang
- Department of Radiology, Changshu No.1 People's Hospital, Affiliated Changshu Hospital of Soochow University, Suzhou, China
| | - Xiaoyan Weng
- Department of Radiology, Changshu No.1 People's Hospital, Affiliated Changshu Hospital of Soochow University, Suzhou, China
| | - Mei Wu
- Department of Pathology, Changshu No.1 People's Hospital, Affiliated Changshu Hospital of Soochow University, Suzhou, China
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Abdul-Latif M, Tharmalingam H, Tsang Y, Hoskin PJ. Functional Magnetic Resonance Imaging in Cervical Cancer Diagnosis and Treatment. Clin Oncol (R Coll Radiol) 2023; 35:598-610. [PMID: 37246040 DOI: 10.1016/j.clon.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/12/2023] [Indexed: 05/30/2023]
Abstract
Cervical Cancer is the fourth most common cancer in women worldwide. Treatment with chemoradiotherapy followed by brachytherapy achieves high local control, but recurrence with metastatic disease impacts survival. This highlights the need for predictive and prognostic biomarkers identifying populations at risk of poorer treatment response and survival. Magnetic resonance imaging (MRI) is routinely used in cervical cancer and is a potential source for biomarkers. Functional MRI (fMRI) can characterise tumour beyond anatomical MRI, which is limited to the assessment of morphology. This review summarises fMRI techniques used in cervical cancer and examines the role of fMRI parameters as predictive or prognostic biomarkers. Different techniques characterise different tumour factors, which helps to explain the variation in patient outcomes. These can impact simultaneously on outcomes, making biomarker identification challenging. Most studies are small, focussing on single MRI techniques, which raises the need to investigate combined fMRI approaches for a more holistic characterisation of tumour.
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Affiliation(s)
| | | | - Y Tsang
- Mount Vernon Cancer Centre, Northwood, UK; Radiation Medicine Programme, Princess Margaret Cancer Centre, Toronto, Canada
| | - P J Hoskin
- Mount Vernon Cancer Centre, Northwood, UK; Division of Cancer Sciences, University of Manchester, Manchester, UK
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Li S, Liu J, Zhang W, Lu H, Wang W, Lin L, Zhang Y, Cheng J. T1 mapping and multimodel diffusion-weighted imaging in the assessment of cervical cancer: a preliminary study. Br J Radiol 2023; 96:20220952. [PMID: 37183908 PMCID: PMC10392640 DOI: 10.1259/bjr.20220952] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/22/2023] [Accepted: 04/23/2023] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVE To evaluate the clinical feasibility of T1 mapping and multimodel diffusion-weighted imaging (DWI) for assessing the histological type, grade, and lymphovascular space invasion (LVSI) of cervical cancer. METHODS Eighty patients with cervical cancer and 43 patients with a normal cervix underwent T1 mapping and DWI with 11 b-values (0-2000 s/mm2). Monoexponential, biexponential, and kurtosis models were fitted to calculate the apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion (D*), perfusion fraction (f), mean diffusivity (MD), and mean kurtosis (MK). Native T1 and DWI-derived parameters (ADCmean, ADCmin, Dmean, Dmin, D*, f, MDmean, MDmin, MKmean, and MKmax) were compared based on histological type, grade, and LVSI status. RESULTS Native T1 and DWI-derived parameters differed significantly between cervical cancer and normal cervix (all p < 0.05), except D* (p = 0.637). Native T1 and MKmean varied significantly between squamous cell carcinoma (SCC) and adenocarcinoma (both p < 0.05). ADCmin, Dmin, and MDmin were significantly lower while MKmax was significantly higher in the high-grade SCC group than in the low-grade SCC group (all p < 0.05). LVSI-positive SCC had a significantly higher MKmean than LVSI-negative SCC (p < 0.05). CONCLUSION Both T1 mapping and multimodel DWI can effectively differentiate cervical cancer from a normal cervix and cervical adenocarcinoma from SCC. Furthermore, multimodel DWI may provide quantitative metrics for non-invasively predicting histological grade and LVSI status in SCC patients. ADVANCES IN KNOWLEDGE Combined use of T1 mapping and multimodel DWI may provide more comprehensive information for non-invasive pre-operative evaluation of cervical cancer.
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Affiliation(s)
- Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Liu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenhua Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huifang Lu
- Department of Gynecology and Obstetrics, Huaihe Hospital of Henan University, Kaifeng, China
| | - Weijian Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liangjie Lin
- Advanced Technical Support, Philips Healthcare, Beijing, China
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Cheng JM, Luo WX, Tan BG, Pan J, Zhou HY, Chen TW. Whole-tumor histogram analysis of apparent diffusion coefficients for predicting lymphovascular space invasion in stage IB-IIA cervical cancer. Front Oncol 2023; 13:1206659. [PMID: 37404753 PMCID: PMC10315646 DOI: 10.3389/fonc.2023.1206659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/01/2023] [Indexed: 07/06/2023] Open
Abstract
Objectives To investigate the value of apparent diffusion coefficient (ADC) histogram analysis based on whole tumor volume for the preoperative prediction of lymphovascular space invasion (LVSI) in patients with stage IB-IIA cervical cancer. Methods Fifty consecutive patients with stage IB-IIA cervical cancer were stratified into LVSI-positive (n = 24) and LVSI-negative (n = 26) groups according to the postoperative pathology. All patients underwent pelvic 3.0T diffusion-weighted imaging with b-values of 50 and 800 s/mm2 preoperatively. Whole-tumor ADC histogram analysis was performed. Differences in the clinical characteristics, conventional magnetic resonance imaging (MRI) features, and ADC histogram parameters between the two groups were analyzed. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of ADC histogram parameters in predicting LVSI. Results ADCmax, ADCrange, ADC90, ADC95, and ADC99 were significantly lower in the LVSI-positive group than in the LVSI-negative group (all P-values < 0.05), whereas no significant differences were reported for the remaining ADC parameters, clinical characteristics, and conventional MRI features between the groups (all P-values > 0.05). For predicting LVSI in stage IB-IIA cervical cancer, a cutoff ADCmax of 1.75×10-3 mm2/s achieved the largest area under ROC curve (Az) of 0.750, followed by a cutoff ADCrange of 1.36×10-3 mm2/s and ADC99 of 1.75×10-3 mm2/s (Az = 0.748 and 0.729, respectively), and the cutoff ADC90 and ADC95 achieved an Az of <0.70. Conclusion Whole-tumor ADC histogram analysis has potential value for preoperative prediction of LVSI in patients with stage IB-IIA cervical cancer. ADCmax, ADCrange, and ADC99 are promising prediction parameters.
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Affiliation(s)
- Jin-mei Cheng
- Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Wei-xiao Luo
- Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Bang-guo Tan
- Department of Radiology, Panzhihua Central Hospital, Panzhihua, Sichuan, China
| | - Jian Pan
- Department of General Practice, Taiping Town Central Health Center, Leshan, Sichuan, China
| | - Hai-ying Zhou
- Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Tian-wu Chen
- Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
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Li S, Liu J, Guo R, Nickel MD, Zhang Y, Cheng J, Zhu J. T 1 mapping and extracellular volume fraction measurement to evaluate the poor-prognosis factors in patients with cervical squamous cell carcinoma. NMR IN BIOMEDICINE 2023:e4918. [PMID: 36914267 DOI: 10.1002/nbm.4918] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE To evaluate the clinical feasibility of T1 mapping and extracellular volume fraction (ECV) measurement in assessing prognostic factors in patients with cervical squamous cell carcinoma (CSCC). MATERIALS AND METHODS A total of 117 CSCC patients and 59 healthy volunteers underwent T1 mapping and diffusion-weighted imaging (DWI) on a 3 T system. Native T1 , contrast-enhanced T1 , ECV, and apparent diffusion coefficient (ADC) were calculated and compared based on surgico-pathologically verified deep stromal infiltration, parametrial invasion (PMI), lymphovascular space invasion (LVSI), lymph node metastasis, stage, histologic grade, and the Ki-67 labeling index (LI). RESULTS Native T1 , contrast-enhanced T1 , ECV, and ADC values were significantly different between CSCC and the normal cervix (all p < 0.05). No significant differences were observed in any parameters of CSCC when the tumors were grouped by stromal infiltration or lymph node status, respectively (all p > 0.05). In subgroups of the tumor stage and PMI, native T1 was significantly higher for advanced-stage (p = 0.032) and PMI-positive CSCC (p = 0.001). In subgroups of the grade and Ki-67 LI, contrast-enhanced T1 was significantly higher for high-grade (p = 0.012) and Ki-67 LI ≥ 50% tumors (p = 0.027). ECV was significantly higher in LVSI-positive CSCC than in LVSI-negative CSCC (p < 0.001). ADC values showed a significant difference for the grade (p < 0.001) but none for the other subgroups. CONCLUSION Both T1 mapping and DWI could stratify the CSCC histologic grade. In addition, T1 mapping and ECV measurement might provide more quantitative metrics for noninvasively predicting poor prognostic factors and aiding in preoperative risk assessment in CSCC patients.
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Affiliation(s)
- Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Liu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rufei Guo
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Ltd., Beijing, China
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Volumetric apparent diffusion coefficient histogram analysis of the testes in nonobstructive azoospermia: a noninvasive fingerprint of impaired spermatogenesis? Eur Radiol 2022; 32:7522-7531. [PMID: 35484338 DOI: 10.1007/s00330-022-08817-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/03/2022] [Accepted: 04/13/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To explore the association between testicular volumetric apparent diffusion coefficient (ADC) histogram analysis metrics and histologic categories in nonobstructive azoospermia (NOA). The role of ADC histogram analysis in predicting the presence of spermatozoa, prior to testicular sperm extraction (TESE), was also investigated. METHODS Forty-one NOA men and 17 age-matched controls underwent scrotal MRI with diffusion-weighted imaging. Histogram analysis of ADC data of the whole testis was performed. Metrics including mean, standard deviation, median, mode, 25th percentile, 75th percentile, skewness, kurtosis, and entropy of volumetric ADC histograms were calculated. Nonparametric statistical tests were used to assess differences in ADC histogram parameters between NOA histologic categories (hypospermatogenesis, severe hypospermatogenesis, early maturation arrest, and Sertoli cell-only syndrome) and normal testes and, between NOA with positive and negative sperm retrieval. RESULTS Normal testes had a lower mean, median, mode, 25th percentile (p < 0.001), and 75th percentile of ADC (p = 0.001), compared to NOA histologic phenotypes. NOA with hypospermatogenesis had a lower 25th percentile of ADC compared to NOA with severe hypospermatogenesis. Regression analysis revealed that the 25th percentile of ADC had a moderately negative correlation with NOA histologic phenotype. The median ADC proved the most significant metric (p = 0.007) to predict the presence of sperm. CONCLUSIONS Testicular volumetric ADC histogram parameters may contribute in the identification of the subpopulation of NOA men with a specific type of spermatogenic arrest. KEY POINTS • Volumetric ADC histogram analysis metrics may be used as noninvasive markers of impaired spermatogenesis in nonobstructive azoospermia. • The 25th percentile of ADC proved useful in discriminating between NOA testes with hypospermatogenesis and severe hypospermatogenesis. • The median ADC proved the most significant parameter to predict the presence of viable spermatozoa prior to TESE.
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Liu YF, Shu X, Qiao XF, Ai GY, Liu L, Liao J, Qian S, He XJ. Radiomics-Based Machine Learning Models for Predicting P504s/P63 Immunohistochemical Expression: A Noninvasive Diagnostic Tool for Prostate Cancer. Front Oncol 2022; 12:911426. [PMID: 35795067 PMCID: PMC9252170 DOI: 10.3389/fonc.2022.911426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 05/19/2022] [Indexed: 01/31/2023] Open
Abstract
Objective To develop and validate a noninvasive radiomic-based machine learning (ML) model to identify P504s/P63 status and further achieve the diagnosis of prostate cancer (PCa). Methods A retrospective dataset of patients with preoperative prostate MRI examination and P504s/P63 pathological immunohistochemical results between June 2016 and February 2021 was conducted. As indicated by P504s/P63 expression, the patients were divided into label 0 (atypical prostatic hyperplasia), label 1 (benign prostatic hyperplasia, BPH) and label 2 (PCa) groups. This study employed T2WI, DWI and ADC sequences to assess prostate diseases and manually segmented regions of interest (ROIs) with Artificial Intelligence Kit software for radiomics feature acquisition. Feature dimensionality reduction and selection were performed by using a mutual information algorithm. Based on screened features, P504s/P63 prediction models were established by random forest (RF), gradient boosting decision tree (GBDT), logistic regression (LR), adaptive boosting (AdaBoost) and k-nearest neighbor (KNN) algorithms. The performance was evaluated by the area under the ROC curve (AUC) and accuracy. Results A total of 315 patients were enrolled. Among the 851 radiomic features, the 32 top features were derived from T2WI, in which the gray-level run length matrix (GLRLM) and gray-level cooccurrence matrix (GLCM) features accounted for the largest proportion. Among the five models, the RF algorithm performed best in general evaluations (microaverage AUC=0.920, macroaverage AUC=0.870) and provided the most accurate result in further sublabel prediction (the accuracies of label 0, 1, and 2 were 0.831, 0.831, and 0.932, respectively). In comparative sequence analyses, T2WI was the best single-sequence candidate (microaverage AUC=0.94 and macroaverage AUC=0.78). The merged datasets of T2WI, DWI, and ADC yielded optimal AUCs (microaverage AUC=0.930 and macroaverage AUC=0.900). Conclusions The radiomic-based RF classifier has the potential to be used to evaluate the presurgical P504s/P63 status and further diagnose PCa noninvasively and accurately.
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Affiliation(s)
- Yun-Fan Liu
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Shu
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao-Feng Qiao
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guang-Yong Ai
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Liu
- Big Data and Software Engineering College, Chongqing University, Chongqing, China
| | - Jun Liao
- Big Data and Software Engineering College, Chongqing University, Chongqing, China
| | - Shuang Qian
- Big Data and Software Engineering College, Chongqing University, Chongqing, China
| | - Xiao-Jing He
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Xiao-Jing He,
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Wang W, Jiao Y, Zhang L, Fu C, Zhu X, Wang Q, Gu Y. Multiparametric MRI-based radiomics analysis: differentiation of subtypes of cervical cancer in the early stage. Acta Radiol 2022; 63:847-856. [PMID: 33975448 DOI: 10.1177/02841851211014188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND There are significant differences in outcomes for different histological subtypes of cervical cancer (CC). Yet, it is difficult to distinguish CC subtypes using non-invasive methods. PURPOSE To investigate whether multiparametric magnetic resonance imaging (MRI)-based radiomics analysis can differentiate CC subtypes and explore tumor heterogeneity. MATERIAL AND METHODS This study retrospectively analyzed 96 patients with CC (squamous cell carcinoma [SCC] = 50, adenocarcinoma [AC] = 46) who underwent pelvic MRI before surgery. Radiomics features were extracted from the tumor volumes on five sequences (sagittal T2-weighted imaging [T2SAG], transverse T2-weighted imaging [T2TRA], sagittal contrast-enhanced T1-weighted imaging [CESAG], transverse contrast-enhanced T1-weighted imaging [CETRA], and apparent diffusion coefficient [ADC]). Clustering and logistic regression were used to examine the distinguishing capabilities of radiomics features extracted from five different MR sequences. RESULTS Among the 105 extracted radiomics features, there were 51, 38, 37, and 2 features that showed intergroup differences for T2SAG, T2TRA, ADC, and CESAG, respectively (all P < 0.05). AC had greater textural heterogeneity than SCC (P < 0.05). Upon unsupervised clustering of significantly different features, T2SAG achieved the highest accuracy (0.844; sensitivity = 0.920; specificity = 0.761). The largest area under the curve (AUC) for classification ability was 0.86 for T2SAG. Hence, the radiomics model from five combined MR sequences (AUC = 0.89; accuracy = 0.81; sensitivity = 0.67; specificity = 0.94) exhibited better differentiation ability than any MR sequence alone. CONCLUSION Multiparametric MRI-based radiomics models may be a promising method to differentiate AC and SCC. AC showed more heterogeneous features than SCC.
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Affiliation(s)
- Wei Wang
- Department of Radiology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai, PR China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - YiNing Jiao
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, PR China
| | - LiChi Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, PR China
| | - Caixia Fu
- MR Applications Development, Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, PR China
| | - XiaoLi Zhu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China
- Department of Pathology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai, PR China
| | - Qian Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, PR China
| | - Yajia Gu
- Department of Radiology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai, PR China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China
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A Combination Analysis of IVIM-DWI Biomarkers and T2WI-Based Texture Features for Tumor Differentiation Grade of Cervical Squamous Cell Carcinoma. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:2837905. [PMID: 35360261 PMCID: PMC8947887 DOI: 10.1155/2022/2837905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 02/18/2022] [Indexed: 11/18/2022]
Abstract
Purpose To explore the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and texture analysis on T2-weighted imaging (T2WI) for evaluating pathological differentiation of cervical squamous cell carcinoma. Method This retrospective study included a total of 138 patients with pathologically confirmed poor/moderate/well-differentiated (71/49/18) who underwent conventional MRI and IVIM-DWI scans. The values of ADC, D, D∗, and f and 58 T2WI-based texture features (18 histogram features, 24 gray-level co-occurrence matrix features, and 16 gray-level run length matrix features) were obtained. Multiple comparison, correlation, and regression analyses were used. Results For IVIM-DWI, the ADC, D, D∗, and f were significantly different among the three groups (p < 0.05). ADC, D, and D∗ were positively correlated with pathological differentiation (r = 0.262, 0.401, 0.401; p < 0.05), while the correlation was negative for f (r = −0.221; p < 0.05). The comparison of 52 parameters of texture analysis on T2WI reached statistically significant levels (p < 0.05). Multivariate logistic regression analysis incorporated significant IVIM-DWI, and texture features on T2WI showed good diagnostic performance both in the four differentiation groups (poorly vs. moderately, area under the curve(AUC) = 0.797; moderately vs. well, AUC = 0.954; poorly vs. moderately and well, AUC = 0.795; and well vs. moderately and poorly, AUC = 0.952). The AUCs of each parameters alone were smaller than that of each regression model (0.503∼0.684, 0.547∼0.805, 0.511∼0.712, and 0.636∼0.792, respectively; pairwise comparison of ROC curves between regression model and individual variables, p < 0.05). Conclusions IVIM-DWI biomarkers and T2WI-based texture features had potential to evaluate the pathological differentiation of cervical squamous cell carcinoma. The combination of IVIM-DWI with texture analysis improved the predictive performance.
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Harry VN, Persad S, Bassaw B, Parkin D. Diffusion-weighted MRI to detect early response to chemoradiation in cervical cancer: A systematic review and meta-analysis. Gynecol Oncol Rep 2021; 38:100883. [PMID: 34926764 PMCID: PMC8651768 DOI: 10.1016/j.gore.2021.100883] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/26/2021] [Accepted: 10/11/2021] [Indexed: 12/16/2022] Open
Abstract
Objective Diffusion-weighted magnetic resonance imaging (DWI) has shown promise in predicting response to therapy in several malignancies. This systematic review and meta-analysis aimed to evaluate DWI in the prediction of response to treatment in patients with cervical cancer. Methods A systematic search was conducted on PubMed, Web of Science, Cochrane and Google Scholar databases Studies that evaluated DWI and apparent diffusion coefficient (ADC) for response evaluation before, during and after treatment with a correlation to conventional response criteria were included. The primary endpoint was the mean ADC values of cervical cancer at these timepoints. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used to assess the quality of the studies. Results Nine studies, comprising 270 patients, were included. Pre-treatment ADC values showed no correlation with eventual response. However, in our meta-analysis, there was a significant correlation with early treatment ADC values obtained within the first 3 weeks of therapy and response, as well as a significant correlation with the percentage change in ADC (ΔADC) and response. In addition, the pooled mean ΔADC percentage was also significantly higher in responders than in non-responders (49.7% vs 19.7%, respectively, p = 0.016). Conclusion DWI shows potential as a biomarker of early treatment response in patients with cervical carcinoma. Use of the change in ADC particularly within the first 3 weeks of therapy seems to be predictive of response and may serve as a suitable marker in the determination of early response.
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Affiliation(s)
- Vanessa N Harry
- Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago
| | - Sunil Persad
- Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago
| | - Bharat Bassaw
- Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago
| | - David Parkin
- Department of Gynecological Oncology, NHS Grampian, UK
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Li H, Wang L, Zhang J, Duan Q, Xu Y, Xue Y. Evaluation of microvascular invasion of hepatocellular carcinoma using whole-lesion histogram analysis with the stretched-exponential diffusion model. Br J Radiol 2021; 95:20210631. [PMID: 34928172 DOI: 10.1259/bjr.20210631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the potential role of histogram analysis of stretched exponential model (SEM) through whole-tumor volume for preoperative prediction of microvascular invasion (MVI) in single hepatocellular carcinoma (HCC). METHODS This study included 43 patients with pathologically proven HCCs by surgery who underwent multiple b-values diffusion-weighted imaging (DWI) and contrast-enhanced MRI.The histogram metrics of distributed diffusion coefficient (DDC) and heterogeneity index (α) from SEM were compared between HCCs with and without MVI, by using the independent t-test. Morphologic features of conventional MRI and clinical data were evaluated with chi-squared or Fisher's exact tests. Receiver operating characteristic (ROC) and multivariable logistic regression analyses were performed to evaluate the diagnostic performance of different parameters for predicting MVI. RESULTS The tumor size and non-smooth tumor margin were significantly associated with MVI (all p < 0.05). The mean, fifth, 25th, 50th percentiles of DDC, and the fifth percentile of ADC between HCCs with and without MVI were statistically significant differences (all p < 0.05). The histogram parameters of α showed no statistically significant differences (all p > 0.05). At multivariate analysis,the fifth percentile of DDC was independent risk factor for MVI of HCC(p = 0.006). CONCLUSIONS Histogram parameters DDC and ADC, but not the α value, are useful predictors of MVI. The fifth percentile of DDC was the most useful value to predict MVI of HCC. ADVANCES IN KNOWLEDGE There is limited literature addressing the role of SEM for evaluating MVI of HCC. Our findings suggest that histogram analysis of SEM based on whole-tumor volume can be useful for MVI prediction.
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Affiliation(s)
- Hongxiang Li
- Department of Radiology, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, Fujian, PR China
| | - LiLi Wang
- Department of Radiology, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, Fujian, PR China
| | - Jing Zhang
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Qing Duan
- Department of Radiology, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, Fujian, PR China
| | - Yikai Xu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Yunjing Xue
- Department of Radiology, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, Fujian, PR China
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Li X, Jiang N, Zhang C, Luo X, Zhong P, Fang J. Value of conventional magnetic resonance imaging texture analysis in the differential diagnosis of benign and borderline/malignant phyllodes tumors of the breast. Cancer Imaging 2021; 21:29. [PMID: 33712070 PMCID: PMC7953576 DOI: 10.1186/s40644-021-00398-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine the potential value of magnetic resonance imaging (MRI) texture analysis (TA) in differentiating between benign and borderline/malignant phyllodes tumors of the breast. METHODS The preoperative MRI data of 25 patients with benign phyllodes tumors (BPTs) and 19 patients with borderline/malignant phyllodes tumors (BMPTs) were retrospectively analyzed. A gray-level histogram and gray-level cooccurrence matrix (GLCM) were used for TA with fat-suppressed T2-weighted imaging (FS-T2WI), diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) images, and 2- and 7-min postcontrast T1W images on dynamic contrast-enhanced MRI (DCE-T1WI2min and DCE-T1WI7min) between BPTs and BMPTs. Independent sample t-test and Mann-Whitney U test were performed for intergroup comparison. A regression model was established by using binary logistic regression analysis, and receiver operating characteristic (ROC) curve analysis was carried out to evaluate diagnostic efficiency. RESULTS For ADC images, the texture parameters angular second moment (ASM), correlation, contrast, entropy and the minimum gray values of ADC images (ADCMinimum) showed significant differences between the BPT group and BMPT group (all p<0.05). The parameter entropy of FS-T2WI and the maximum gray values and kurtosis of the tumor solid region of DCE-T1WI7min also showed significant differences between these two groups. Except for ADCMinimum, angular second moment of FS-T2WI (FS-T2WIASM), and the maximum gray values of DCE-T1WI7min (DCE-T1WI7min-Maximum) of the tumor solid region, the AUC values of other positive texture parameters mentioned above were greater than 0.75. Binary logistic regression analysis demonstrated that the contrast of ADC images (ADCContrast) and entropy of FS-T2WI (FS-T2WIEntropy) could be considered independent texture variables for the differential diagnosis of BPTs and BMPTs. Combined, the AUC of these parameters was 0.891 (95% CI: 0.793-0.988), with a sensitivity of 84.2% and a specificity of up to 89.0%. CONCLUSION Texture analysis could be helpful in improving the diagnostic efficacy of conventional MR images in differentiating BPTs and BMPTs.
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Affiliation(s)
- Xiaoguang Li
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Nianping Jiang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Chunlai Zhang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Xiangguo Luo
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Peng Zhong
- Department of Pathology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Jingqin Fang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China.
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Wang Y, Yang F, Zhu M, Yang M. Machine Learning Models on ADC Features to Assess Brain Changes of Children With Pierre Robin Sequence. Front Neurol 2021; 12:580440. [PMID: 33746868 PMCID: PMC7969993 DOI: 10.3389/fneur.2021.580440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 02/08/2021] [Indexed: 12/02/2022] Open
Abstract
In order to evaluate brain changes in young children with Pierre Robin sequence (PRs) using machine learning based on apparent diffusion coefficient (ADC) features, we retrospectively enrolled a total of 60 cases (42 in the training dataset and 18 in the testing dataset) which included 30 PRs and 30 controls from the Children's Hospital Affiliated to the Nanjing Medical University from January 2017–December 2019. There were 21 and nine PRs cases in each dataset, with the remainder belonging to the control group in the same age range. A total of 105 ADC features were extracted from magnetic resonance imaging (MRI) data. Features were pruned using least absolute shrinkage and selection operator (LASSO) regression and seven ADC features were developed as the optimal signatures for training machine learning models. Support vector machine (SVM) achieved an area under the receiver operating characteristic curve (AUC) of 0.99 for the training set and 0.85 for the testing set. The AUC of the multivariable logistic regression (MLR) and the AdaBoost for the training and validation dataset were 0.98/0.84 and 0.94/0.69, respectively. Based on the ADC features, the two groups of cases (i.e., the PRs group and the control group) could be well-distinguished by the machine learning models, indicating that there is a significant difference in brain development between children with PRs and normal controls.
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Affiliation(s)
- Ying Wang
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Feng Yang
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Meijiao Zhu
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ming Yang
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
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Dong Y, Dong RT, Zhang XM, Song QL, Yu T, Hong Luo Y. Influence of menstrual status and pathological type on the apparent diffusion coefficient in cervical cancer: a primary study. Acta Radiol 2021; 62:430-436. [PMID: 32536261 DOI: 10.1177/0284185120926897] [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: 11/16/2022]
Abstract
BACKGROUND Apparent diffusion coefficient (ADC) value is an important quantitative parameter in the research of cervical cancer, affected by some factors. PURPOSE To investigate the effect of pathological type and menstrual status on the ADC value of cervical cancer. MATERIAL AND METHODS A total of 352 individuals with pathologically confirmed cervical cancer between January 2015 to December 2017 were retrospectively enrolled in this study, including 317 cases with squamous cell carcinomas (SCC) and 35 cases with adenocarcinomas (AC); 177 patients were non-menopausal and 175 were menopausal. All patients underwent a routine 3.0-T magnetic resonance imaging (MRI) scan and diffusion-weighted imaging (DWI) examination using b-values of 0, 800, and 1000 s/mm2. Three parameters including mean ADC (ADCmean), maximum ADC (ADCmax), and minimum ADC (ADCmin) of cervical cancer lesions were measured and retrospectively analyzed. Independent samples t-test was used to compare the difference of ADC values in different menstrual status and pathological types. RESULTS In all menopausal and non-menopausal patients, the ADCmean and ADCmin values of SCC were lower than those of AC (P<0.05), the ADCmax of two pathological types showed no statistical difference (P > 0.05). In menopausal patients, the ADCmean, ADCmax, and ADCmin values of SCC were not statistically different compared with those of AC (P > 0.05). The ADCmean, ADCmax, and ADCmin values of different pathological types cervical cancers in non-menopausal patients were all higher than those in menopausal patients (P<0.05). CONCLUSION The ADC values of the cervical cancers were different in different pathological types and were also affected by menstrual status.
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Affiliation(s)
- Yue Dong
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
| | - Rui Tong Dong
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
| | - Xiao Miao Zhang
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
| | - Qing Ling Song
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
| | - Tao Yu
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
| | - Ya Hong Luo
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
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Zhu M, Zhao D, Wang Y, Zhou Q, Wang S, Mo X, Yang M, Sun Y. Multi-Slice Radiomic Analysis of Apparent Diffusion Coefficient Metrics Improves Evaluation of Brain Alterations in Neonates With Congenital Heart Diseases. Front Neurol 2020; 11:586518. [PMID: 33362694 PMCID: PMC7759540 DOI: 10.3389/fneur.2020.586518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/19/2020] [Indexed: 11/13/2022] Open
Abstract
Apparent diffusion coefficients (ADC) can provide phenotypic information of brain lesions, which can aid the diagnosis of brain alterations in neonates with congenital heart diseases (CHDs). However, the corresponding clinical significance of quantitative descriptors of brain tissue remains to be elucidated. By using ADC metrics and texture features, this study aimed to investigate the diagnostic value of single-slice and multi-slice measurements for assessing brain alterations in neonates with CHDs. ADC images were acquired from 60 neonates with echocardiographically confirmed non-cyanotic CHDs and 22 healthy controls (HCs) treated at Children's Hospital of Nanjing Medical University from 2012 to 2016. ADC metrics and texture features for both single and multiple slices of the whole brain were extracted and analyzed to the gestational age. The diagnostic performance of ADC metrics for CHDs was evaluated by using analysis of covariance and receiver operating characteristic. For both the CHD and HC groups, ADC metrics were inversely correlated with the gestational age in single and multi-slice measurements (P < 0.05). Histogram metrics were significant for identifying CHDs (P < 0.05), while textural features were insignificant. Multi-slice ADC (P < 0.01) exhibited greater diagnostic performance for CHDs than single-slice ADC (P < 0.05). These findings indicate that radiomic analysis based on ADC metrics can objectively provide more quantitative information regarding brain development in neonates with CHDs. ADC metrics for the whole brain may be more clinically significant in identifying atypical brain development in these patients. Of note, these results suggest that multi-slice ADC can achieve better diagnostic performance for CHD than single-slice.
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Affiliation(s)
- Meijiao Zhu
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Dadi Zhao
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ying Wang
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Qinghua Zhou
- Department of Informatics, University of Leicester, Leicester, United Kingdom
| | - Shujie Wang
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xuming Mo
- Department of Cardio-Thoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ming Yang
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Sun
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
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Mi H, Yuan M, Suo S, Cheng J, Li S, Duan S, Lu Q. Impact of different scanners and acquisition parameters on robustness of MR radiomics features based on women's cervix. Sci Rep 2020; 10:20407. [PMID: 33230228 PMCID: PMC7684312 DOI: 10.1038/s41598-020-76989-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 10/16/2020] [Indexed: 12/12/2022] Open
Abstract
MR Radiomics based on cervical lesions from one single scanner has achieved promising results. However, it is a challenge to achieve clinical translation. Considering multi-scanners and non-uniform scanning parameters from different centers in a real-world medical scenario, we should first identify the influence of such conditions on the robustness of MR radiomics features (RFs) based on the female cervix. In this study, 9 healthy female volunteers were enrolled and 3 kiwis were selected as references. Each of them underwent T2 weighted imaging in three different 3.0-T MR scanners with uniform acquisition parameters, and in one MR scanner with various scanning parameters. A total of 396 RFs were extracted from their images with and without decile intensity normalization. The RFs’ reproducibility was evaluated by coefficient of variation (CV) and quartile coefficient of dispersion (QCD). Representative features were selected using the hierarchical cluster analysis and their discrimination abilities were estimated by ROC analysis through retrospective comparison with the junctional zone and the outer muscular layer of healthy cervix in patients (n = 58) with leiomyoma. This study showed that only a few RFs were robust across different MR scanners and acquisition parameters based on females’ cervix, which might be improved by decile intensity normalization method.
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Affiliation(s)
- Honglan Mi
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China
| | - Mingyuan Yuan
- Department of Radiology, Affiliated Zhoupu Hospital, Shanghai University of Medicine & Health Sciences College, 1500 Zhouyuan Road, PongDong New District, Shanghai, 201318, China
| | - Shiteng Suo
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China
| | - Jiejun Cheng
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China
| | - Suqin Li
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China
| | - Shaofeng Duan
- GE Healthcare China, Pudong new town, No1, Huatuo road, Shanghai, 210000, China
| | - Qing Lu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Rd, Shanghai, 200127, China.
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Li C, Jin C, Liang T, Li X, Wang R, Zhang Y, Yang J. Magnetic resonance-guided high-intensity focused ultrasound of uterine fibroids: whole-tumor quantitative perfusion for prediction of immediate ablation response. Acta Radiol 2020; 61:1125-1133. [PMID: 31779469 PMCID: PMC7406966 DOI: 10.1177/0284185119891692] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background In magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) treatment of uterine fibroids, the immediate ablation response is significantly affected by blood perfusion. The variability of measurement for blood perfusion is critical due to the inherent non-uniformity of tumor perfusion and its dependence on reproducible region of interest (ROI) placement. Purpose To investigate the value of whole-tumor ROI (ROIwt) analysis for quantitative perfusion in predicting immediate ablation response of uterine fibroids in MR-HIFU. Material and Methods Thirty-one fibroids in 28 eligible patients were treated with MR-HIFU. Quantitative perfusion parameters (Ktrans, Kep, and Vp) derived from dynamic contrast-enhanced MRI were obtained before MR-HIFU treatment. The ROIwt and single-layer ROI (ROIsl) were used for quantitative perfusion analysis. T1 contrast-enhanced MRI immediately after MR-HIFU treatment was conducted to determine the non-perfused volume ratio (NPVR). Intraclass correlation coefficient (ICC) was used for consistency test. Spearman’s correlation and multivariate linear regression were used to investigate the predictors of the NPVR. Received operating characteristic (ROC) curve was used to test the predictive efficacy of quantitative perfusion parameter. Results The intra- and inter-observer ICC of the quantitative perfusion parameters from ROIwt were higher than those from ROIsl. Multivariate analysis showed that the Ktrans of ROIwt was a predictor of the immediate ablation response. ROC analysis displayed that the AUC of Ktrans of ROIwt is 0.817 in predicting the ablation response. Conclusion Pretreatment Ktrans of ROIwt is more reliable and stable than that of ROIsl. It could be a predictor for the immediate ablation response of uterine fibroids in MR-HIFU.
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Affiliation(s)
- Chenxia Li
- Department of Biomedical Engineering, the Key Laboratory of Biomedical Information Engineering of the Ministry of Education, School of Life Science and Technology, Xi’an Jiaotong University. Xi’an, PR China
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University. Xi’an, PR China
| | - Chao Jin
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University. Xi’an, PR China
| | - Ting Liang
- Department of Biomedical Engineering, the Key Laboratory of Biomedical Information Engineering of the Ministry of Education, School of Life Science and Technology, Xi’an Jiaotong University. Xi’an, PR China
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University. Xi’an, PR China
| | - Xiang Li
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University. Xi’an, PR China
| | - Rong Wang
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University. Xi’an, PR China
| | - Yuelang Zhang
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University. Xi’an, PR China
| | - Jian Yang
- Department of Biomedical Engineering, the Key Laboratory of Biomedical Information Engineering of the Ministry of Education, School of Life Science and Technology, Xi’an Jiaotong University. Xi’an, PR China
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University. Xi’an, PR China
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Bozdağ M, Er A, Çinkooğlu A. Histogram Analysis of ADC Maps for Differentiating Brain Metastases From Different Histological Types of Lung Cancers. Can Assoc Radiol J 2020; 72:271-278. [PMID: 32602365 DOI: 10.1177/0846537120933837] [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: 02/06/2023] Open
Abstract
PURPOSE Our study aimed to investigate the role of histogram analysis derived from apparent diffusion coefficient (ADC) maps in brain metastases (BMs) from lung cancer for differentiating histological subtype. METHODS A total of 61 BMs (45 non-small cell lung cancer [NSCLC] comprising 32 adenocarcinoma [AC], 13 squamous cell carcinoma [SCC], and 16 small-cell lung cancer [SCLC]) in 50 patients with histopathologically confirmed lung cancer were retrospectively included in this study. Pretreatment cranial diffusion-weighted imaging was performed, and the corresponding ADC maps were generated. Regions of interest were drawn on solid components of the BM on all slices of the ADC maps to obtain parameters, including ADCmax, ADCmean, ADCmin, ADCmedian, ADCrange, skewness, kurtosis, entropy, ADC10, ADC25, ADC75, and ADC90. Apparent diffusion coefficient histogram parameters were compared among histological type groups. Kruskal-Wallis, Mann-Whitney U, chi-square tests, and receiver-operating characteristic (ROC) curve were used for statistical assessment. RESULTS ADCmin, ADC10, and ADC25 were found to be significantly different among AC, SCC, and SCLC groups; these parameters were higher for AC group, moderate for SCC group, and significantly lower for SCLC group. Skewness and kurtosis were not significantly different among all groups. The ROC analysis for differentiating BMs of NSCLC from SCLC showed that ADC25 achieved the highest area under the curve at 0.922 with 93.02% sensitivity and 81.25% specificity. CONCLUSION Apparent diffusion coefficient histogram analysis of BMs from lung cancer has significant prognostic value in differentiating histological subtypes of lung cancer.
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Affiliation(s)
- Mustafa Bozdağ
- Department of Radiology, 64205Tepecik Training and Research Hospital, Konak, Izmir, Turkey
| | - Ali Er
- Department of Radiology, 64205Tepecik Training and Research Hospital, Konak, Izmir, Turkey
| | - Akın Çinkooğlu
- Department of Radiology, 60521Ege University Faculty of Medicine, Bornova, Izmir, Turkey
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He Y, Rong Y, Chen H, Zhang Z, Qiu J, Zheng L, Benedict S, Niu X, Pan N, Liu Y, Yuan Z. Impact of different b-value combinations on radiomics features of apparent diffusion coefficient in cervical cancer. Acta Radiol 2020; 61:568-576. [PMID: 31466457 DOI: 10.1177/0284185119870157] [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] [Indexed: 12/26/2022]
Abstract
Background The impact of variable b-value combinations on apparent diffusion coefficient (ADC)-based radiomics features has not been fully addressed in literature. Purpose To investigate the correlation between radiomics features extracted from ADC maps and various b-value combinations in cervical cancer. Material and Methods Diffusion-weighted images (b-values: 0, 600, 800, and 1000 s/mm2) of 20 patients with cervical cancer were included. Tumors were identified with the largest transversal cross-section and manually segmented by radiologist. For each b-value combination, 92 radiomics features were extracted and coefficient of variance (CV) was used to evaluate the robustness of radiomics features with different b-value combinations. Features with CV > 5% were normalized by the mean feature variation across the group. Results Out of a total of 92 radiomics features, 18 were classified as robust features with CV ≤5%. Among the rest (CV > 5%), 11, 23, and 40 features demonstrated 5%< CV ≤10%, 10%< CV ≤20%, and CV > 20%, respectively. A subset of features in each category (CV > 5%) showed strong correlation with the b-value combination variation, including 44% (7/16) features in gray level co-occurrence matrix, 62% (8/13) features in gray level dependence matrix, 64% (9/14) features in first order, 50% (8/16) features in gray level run length matrix, 57% (8/14) features in gray level size matrix, and 20% (1/5) features in neighborhood gray-tone difference matrix. Conclusions Variations in b-value combinations demonstrated impact on radiomics features extracted from ADC maps for cervical cancer. The radiomics features with CV <5% can be considered as robust features and are recommended to be used in multicenter radiomics studies.
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Affiliation(s)
- Yaoyao He
- Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
- Medical Engineering and Technology Center, Taishan Medical University, Taian, PR China
| | - Yi Rong
- Department of Radiation Oncology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Hao Chen
- Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Zhaoxi Zhang
- Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Jianfeng Qiu
- Medical Engineering and Technology Center, Taishan Medical University, Taian, PR China
| | - Lili Zheng
- Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Stanley Benedict
- Department of Radiation Oncology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Xiaohui Niu
- College of Informatics, Huazhong Agricultural University, Wuhan, PR China
| | - Ning Pan
- College of Biomedical Engineering, South Central University for Nationalities, Wuhan, PR China
- Hubei Key Laboratory of Medical Information Analysis and Tumor Diagnosis & Treatment, Wuhan, PR China
| | - Yulin Liu
- Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Zilong Yuan
- Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
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Zhou G, Chen X, Shen R, Xu J, Wang Y, Yu H. Apparent diffusion coefficients are closely related with high-risk human papilloma virus infection in cervical squamous cell carcinoma patients. Acta Radiol 2019; 60:1372-1379. [PMID: 30722670 DOI: 10.1177/0284185119828202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Guoxing Zhou
- Department of Radiology, East Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Xiao Chen
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, PR China
| | - Ru Shen
- Department of Radiology, East Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Jun Xu
- Department of Radiology, East Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Yibin Wang
- Department of Radiology, East Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Hong Yu
- Department of Radiology, East Hospital, Tongji University School of Medicine, Shanghai, PR China
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Mongula J, Bakers F, Slangen B, van Kuijk S, Kruitwagen R, Mihl C. Evaluation of various apparent diffusion coefficient measurement techniques in pre-operative staging of early cervical carcinoma. Eur J Radiol 2019; 118:101-106. [DOI: 10.1016/j.ejrad.2019.06.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 06/21/2019] [Accepted: 06/25/2019] [Indexed: 02/08/2023]
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Meyer HJ, Hamerla G, Höhn AK, Surov A. Whole Lesion Histogram Analysis Derived From Morphological MRI Sequences Might be Able to Predict EGFR- and Her2-Expression in Cervical Cancer. Acad Radiol 2019; 26:e208-e215. [PMID: 30318289 DOI: 10.1016/j.acra.2018.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 08/31/2018] [Accepted: 09/09/2018] [Indexed: 01/10/2023]
Abstract
RATIONALE AND OBJECTIVES Histogram analysis is an imaging analysis in which a whole tumor can be assessed, and every voxel of a radiological image is issued into a histogram. Thereby, statistically information about tumor can be obtained. The purpose of the study was to analyze possible relationships between histogram parameters derived from conventional MRI sequences and several histopathological features in cervical squamous cell carcinomas. METHODS A total of 18 female patients (age range 32-79 years) with squamous cell cervical carcinoma were retrospectively enrolled into the study. In all cases, pelvic MRI with a clinically protocol was performed. Histogram analysis was performed as a whole lesion measurement, calculating several percentils, minimum, mean, median, mode, maximum, kurtosis, skewness, and entropy. Histopathological parameters included expression of epidermal-growth factor (EGFR), vascular endothelial growth factor, hypoxia-inducible factor 1-alpha, Her2, and Histone 3. Spearman's correlation coefficient was used to analyze associations between investigated parameters. RESULTS Several pre- and postcontrast derived T1-weighted parameters correlated inversely with EGFR expression. For precontrast T1-weighted images, the strongest correlation was found for p90 (ρ = -0.77, p = 0.004). For postcontrast T1-weighted images, the strongest correlation was observed for minimum (ρ = -0.64, p = 0.021). Several parameters derived from T2-weighted images were statistically significant different between Her2-positive and Her2 negative tumors. Skewness had the best p-value ( p = 0.004). CONCLUSIONS Histogram analysis parameters of T1-weighted and T2-weighted images reflect HER2 status and EGFR expression in cervical cancer. Histogram parameters cannot predict cell count, proliferation index, or angiogenesis related histopathological features.
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Affiliation(s)
- Hans-Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany.
| | - Gordian Hamerla
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | | | - Alexey Surov
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
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Nikolic O, Basta Nikolic M, Spasic A, Otero-Garcia MM, Stojanovic S. Systematic radiological approach to utero-ovarian pathologies. Br J Radiol 2019; 92:20180439. [PMID: 31169406 PMCID: PMC6636271 DOI: 10.1259/bjr.20180439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 12/13/2018] [Accepted: 01/16/2019] [Indexed: 12/19/2022] Open
Abstract
Ultrasound is the first-line imaging modality for the evaluation of suspected adnexal masses, endometriosis and uterine tumors, whereas MRI is used as a secondary diagnostic tool to better characterize these lesions. The aim of this review is to summarize the latest advances in the imaging of these utero-ovarian pathologies.
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24
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Gordic S, Wagner M, Zanato R, Hectors S, Besa C, Kihira S, Kim E, Taouli B. Prediction of hepatocellular carcinoma response to 90Yttrium radioembolization using volumetric ADC histogram quantification: preliminary results. Cancer Imaging 2019; 19:29. [PMID: 31142363 PMCID: PMC6541997 DOI: 10.1186/s40644-019-0216-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 05/16/2019] [Indexed: 12/25/2022] Open
Abstract
Purpose To assess the predictive value of volumetric apparent diffusion coefficient (vADC) histogram quantification obtained before and 6 weeks (6w) post-treatment for assessment of hepatocellular carcinoma (HCC) response to 90Yttrium radioembolization (RE). Methods In this retrospective study, 22 patients (M/F 15/7, mean age 65y) who underwent lobar RE were included between October 2013 and November 2014. All patients underwent routine liver MRI pre-treatment and 6w after RE. Two readers assessed index tumor response at 6 months after RE in consensus, using mRECIST criteria. vADC histogram parameters of index tumors at baseline and 6w, and changes in vADC (ΔvADC) histogram parameters were calculated. The predictive value of ADC metrics was assessed by logistic regression with stepwise parameter selection and ROC analyses. Results Twenty two HCC lesions (mean size 3.9 ± 2.9 cm, range 1.2–12.3 cm) were assessed. Response at 6 months was as follows: complete response (CR, n = 6), partial response (PR, n = 3), stable disease (SD, n = 12) and progression (PD, n = 1). vADC median/mode at 6w (1.81–1.82 vs. 1.29–1.35 × 10− 3 mm2/s) and ΔvADC median/max (27–44% vs. 0–10%) were significantly higher in CR/PR vs. SD/PD (p = 0.011–0.036), while there was no significant difference at baseline. Logistic regression identified vADC median at 6w as an independent predictor of response (CR/PR) with odds ratio (OR) of 3.304 (95% CI: 1.099–9.928, p = 0.033) and AUC of 0.77. ΔvADC mean was identified as an independent predictor of CR with OR of 4.153 (95%CI: 1.229–14.031, p = 0.022) and AUC of 0.91. Conclusion Diffusion histogram parameters obtained at 6w and early changes in ADC from baseline are predictive of subsequent response of HCCs treated with RE, while pre-treatment vADC histogram parameters are not. These results need confirmation in a larger study. Trial registration This retrospective study was IRB-approved and the requirement for informed consent was waived.
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Affiliation(s)
- Sonja Gordic
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Mathilde Wagner
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Sorbonne Universités, UPMC, Department of Radiology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Riccardo Zanato
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy
| | - Stefanie Hectors
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cecilia Besa
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Avenida Libertador Bernardo O'Higgins 340, 8331150, Santiago, Chile
| | - Shingo Kihira
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA
| | - Edward Kim
- Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA
| | - Bachir Taouli
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA.
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25
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Onodera K, Hatakenaka M, Yama N, Onodera M, Saito T, Kwee TC, Takahara T. Repeatability analysis of ADC histogram metrics of the uterus. Acta Radiol 2019; 60:526-534. [PMID: 29969050 DOI: 10.1177/0284185118786062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Recently, histogram analysis based on voxel-wise apparent diffusion coefficient (ADC) value distribution has been increasingly performed. However, few studies have been reported regarding its repeatability. PURPOSE To evaluate the repeatability of ADC histogram metrics of the uterus in clinical magnetic resonance imaging (MRI). MATERIAL AND METHODS Thirty-three female patients who underwent pelvic MRI including diffusion-weighted imaging (DWI) were prospectively included after providing informed consent. Two sequential DWI acquisitions with identical parameters and position were obtained. Regions of interest (ROIs) for histologically confirmed uterine lesions (five cervical and three endometrial cancers, and one endometrial hyperplasia) and normal appearing tissues (21 endometrium and 33 myometrium) were assigned on the first DWI dataset and then pasted onto the second DWI dataset. ADC histogram metrics within the ROIs were calculated and repeatability was evaluated by calculating within-subject coefficient of variance (%) (wCV (%)) and Bland-Altman plot (%). RESULTS ADC 10%, 25%, median, 75%, 90%, maximum, mean, and entropy showed high repeatability (wCV (%) < 7, 95% limit of agreement in Bland-Altman plot (%) < ±20), followed by ADC minimum (wCV (%) = 8.12, 95% limit of agreement in Bland-Altman plot (%) < ±30). However, ADC skewness and kurtosis showed very low repeatability in all evaluations. CONCLUSION ADC histogram metrics like ADC 10%, 25%, median, 75%, 90%, maximum, mean, and entropy are robust biomarkers and could be applicable to clinical use. However, ADC skewness and kurtosis lack robustness. Radiologists should keep these characteristics and limitations in mind when interpreting quantitative DWI.
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Affiliation(s)
- Koichi Onodera
- Department of Diagnostic Radiology, Sapporo Medical University, Sapporo, Japan
| | | | - Naoya Yama
- Department of Diagnostic Radiology, Sapporo Medical University, Sapporo, Japan
| | - Maki Onodera
- Department of Diagnostic Radiology, Sapporo Medical University, Sapporo, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Thomas Christian Kwee
- Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Taro Takahara
- Department of Biomedical Engineering, School of Engineering, Tokai University, Hiratsuka, Japan
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Du S, Sun H, Gao S, Xin J, Lu Z, Chen Z, Pan S, Guo Q. Relationship between 18F-FDG PET metabolic parameters and MRI intravoxel incoherent motion (IVIM) histogram parameters and their correlations with clinicopathological features of cervical cancer: evidence from integrated PET/MRI. Clin Radiol 2019; 74:178-186. [DOI: 10.1016/j.crad.2018.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 11/09/2018] [Indexed: 12/14/2022]
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Thapa D, Wang P, Wu G, Wang X, Sun Q. A histogram analysis of diffusion and perfusion features of cervical cancer based on intravoxel incoherent motion magnetic resonance imaging. Magn Reson Imaging 2019; 55:103-111. [PMID: 29953932 DOI: 10.1016/j.mri.2018.06.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/22/2018] [Accepted: 06/24/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate the diagnostic potential based on histogram analysis of IVIM parameters between uterine cervical cancers (CC) - normal myometrium (Myo) versus CC - gluteus maximus muscle (GM) and to study the feasibility of histogram analysis of IVIM parameters to differentiate the early from locally advanced stage CCs. METHODS 64 patients with pathologically confirmed CC were enrolled. Histogram indices mean, median, 25th, and ð 75th percentile of apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) value of entire tumor were statistically analyzed and compared between CC - GM versus CC - Myo, as well as between early and locally advanced stage CCs. A multivariate analysis was performed to identify indices that could best distinguish early from locally advanced stage CC. Receiver operating characteristic curves (ROC) were used to evaluate the diagnostic efficiency of every histogram parameter. RESULTS All the tested histogram indices significantly differed between the patients with CC - GM vs. CC - Myo, nonetheless, CC - GM yielded higher range area under the curve (AUC) value of 0.8-0.99 vs. 0.6-0.99. The additional significant difference was found among all the tested histogram indices of D*, mean, median, and 75th percentile of f, mean and 75th percentile of ADC, and 75th percentile of D discriminating early from locally advanced CCs. ROC curves indicated that the 75th percentile of D* value 28.17 × 10-3 mm2/s could best differentiate early from locally advanced stage CCs, with AUC of 0.776. In the multivariate analysis, ROC indicated the 50th percentile of D* and f was the most significant with AUCs of 0.856. CONCLUSIONS The histogram analysis of IVIM parameters depicted that gluteus maximus served better reference tissue in comparison to myometrium. The histogram index 75th percentile of ADC, D, D*, and f may serve a diagnostic biomarker to differentiate the early from locally advanced stage CCs.
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Affiliation(s)
- Deepa Thapa
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, PR China
| | - Panying Wang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, PR China; Department of Radiology, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen 518060, PR China
| | - Guangyao Wu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, PR China; Department of Radiology, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen 518060, PR China.
| | - Xiangyu Wang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, PR China
| | - Qunqi Sun
- Department of Radiology, Yuebei People's Hospital affiliated to Shantou University Medical College, Shaoguan, 512026, PR China
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Meyer HJ, Gundermann P, Höhn AK, Hamerla G, Surov A. Associations between whole tumor histogram analysis parameters derived from ADC maps and expression of EGFR, VEGF, Hif 1-alpha, Her-2 and Histone 3 in uterine cervical cancer. Magn Reson Imaging 2018; 57:68-74. [PMID: 30367998 DOI: 10.1016/j.mri.2018.10.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/23/2018] [Accepted: 10/22/2018] [Indexed: 12/09/2022]
Abstract
OBJECTIVE Diffusion weighted imaging (DWI) can be quantified by apparent diffusion coefficient (ADC) and can predict tissue microstructure. The aim of the present study was to analyze possible associations between ADC histogram based parameters with different histopathological parameters in cervical squamous cell carcinoma. MATERIALS AND METHODS 18 female patients (age range 32-79 years) with squamous cell cervical carcinoma were retrospectively enrolled. In all cases, pelvic MRI was performed with a DWI (b-values 0 and 1000 s/mm2). Histogram analysis was performed as a whole lesion measurement. Histopathological parameters included expression of EGFR, VEGF, Hif1-alpha, Her2 and Histone 3. Spearman's correlation coefficient was used to analyze associations between investigated parameters. RESULTS Analyze of the investigated ADC histogram parameters showed a good interreader variability, ranging from 0.705 for entropy to 0.959 for ADCmedian. EGFR expression correlated statistically significant with several histogram parameters. The highest correlation was observed for p75 (p = -0.562, P = 0.015). There were several correlations with histone 3, the highest with p25 (p = -0.610, P = 0.007). None of the ADC related parameters correlated statistically significant with expression of VEGF, Hif1-alpha and Her2. CONCLUSION Histogram analysis showed a good interreader agreement. ADC histogram parameters might be able to reflect expression of EGFR and histone 3 in cervical squamous cell carcinomas, but not expression of VEGF, Hif1-alpha and Her2.
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Affiliation(s)
- Hans-Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany.
| | - Peter Gundermann
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany.
| | - Anne Kathrin Höhn
- Department of Pathology, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany.
| | - Gordian Hamerla
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany.
| | - Alexey Surov
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany.
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Cervical Cancer: Associations between Metabolic Parameters and Whole Lesion Histogram Analysis Derived from Simultaneous 18F-FDG-PET/MRI. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:5063285. [PMID: 30154687 PMCID: PMC6098855 DOI: 10.1155/2018/5063285] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/12/2018] [Accepted: 06/25/2018] [Indexed: 01/16/2023]
Abstract
Multimodal imaging has been increasingly used in oncology, especially in cervical cancer. By using a simultaneous positron emission (PET) and magnetic resonance imaging (MRI, PET/MRI) approach, PET and MRI can be obtained at the same time which minimizes motion artefacts and allows an exact imaging fusion, which is especially important in anatomically complex regions like the pelvis. The associations between functional parameters from MRI and 18F-FDG-PET reflecting different tumor aspects are complex with inconclusive results in cervical cancer. The present study correlates histogram analysis and 18F-FDG-PET parameters derived from simultaneous FDG-PET/MRI in cervical cancer. Overall, 18 female patients (age range: 32–79 years) with histopathologically confirmed squamous cell cervical carcinoma were retrospectively enrolled. All 18 patients underwent a whole-body simultaneous 18F-FDG-PET/MRI, including diffusion-weighted imaging (DWI) using b-values 0 and 1000 s/mm2. Apparent diffusion coefficient (ADC) histogram parameters included several percentiles, mean, min, max, mode, median, skewness, kurtosis, and entropy. Furthermore, mean and maximum standardized uptake values (SUVmean and SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were estimated. No statistically significant correlations were observed between SUVmax or SUVmean and ADC histogram parameters. TLG correlated inversely with p25 (r=−0.486, P=0.041), p75 (r=−0.490, P=0.039), p90 (r=−0.513, P=0.029), ADC median (r=−0.497, P=0.036), and ADC mode (r=−0.546, P=0.019). MTV also showed significant correlations with several ADC parameters: mean (r=−0.546, P=0.019), p10 (r=−0.473, P=0.047), p25 (r=−0.569, P=0.014), p75 (r=−0.576, P=0.012), p90 (r=−0.585, P=0.011), ADC median (r=−0.577, P=0.012), and ADC mode (r=−0.597, P=0.009). ADC histogram analysis and volume-based metabolic 18F-FDG-PET parameters are related to each other in cervical cancer.
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Prognostic model based on magnetic resonance imaging, whole-tumour apparent diffusion coefficient values and HPV genotyping for stage IB-IV cervical cancer patients following chemoradiotherapy. Eur Radiol 2018; 29:556-565. [PMID: 30051142 DOI: 10.1007/s00330-018-5651-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 06/27/2018] [Accepted: 07/03/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To develop and validate a prognostic model of integrating whole-tumour apparent diffusion coefficient (ADC) from pretreatment diffusion-weighted (DW) magnetic resonance (MR) imaging with human papillomavirus (HPV) genotyping in predicting the overall survival (OS) and disease-free survival (DFS) for women with stage IB-IV cervical cancer following concurrent chemoradiotherapy (CCRT). METHODS We retrospectively analysed three prospectively collected cohorts comprising 300 patients with stage IB-IV cervical cancer treated with CCRT in 2007-2014 and filtered 134 female patients who underwent MR imaging at 3.0 T for final analysis (age, 24-92 years; median, 54 years). Univariate and multivariate Cox regression analyses were used to evaluate the whole-tumour ADC histogram parameters, HPV genotyping and relevant clinical variables in predicting OS and DFS. The dataset was randomly split into training (n = 88) and testing (n = 46) datasets for construction and independent bootstrap validation of the models. RESULTS The median follow-up time for surviving patients was 69 months (range, 9-126 months). Non-squamous cell type, ADC10 <0.77 × 10-3 mm2/s, T3-4, M1 stage and high-risk HPV status were selected to generate a model, in which the OS and DFS for the low, intermediate and high-risk groups were significantly stratified (p < 0.0001). The prognostic model improved the prediction significantly compared with the International Federation of Gynaecology and Obstetrics (FIGO) stage for both the training and independent testing datasets (p < 0.0001). CONCLUSIONS The prognostic model based on integrated clinical and imaging data could be a useful clinical biomarker to predict OS and DFS in patients with stage IB-IV cervical cancer treated with CCRT. KEY POINTS • ADC 10 is the best prognostic factor among ADC parameters in cervical cancer treated with CCRT • A novel prognostic model was built based on histology, ADC 10 , T and M stage and HPV status • The prognostic model outperforms FIGO stage in the survival prediction.
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31
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Li H, Zhang J, Zheng Z, Guo Y, Chen M, Xie C, Zhang Z, Mei Y, Feng Y, Xu Y. Preoperative histogram analysis of intravoxel incoherent motion (IVIM) for predicting microvascular invasion in patients with single hepatocellular carcinoma. Eur J Radiol 2018; 105:65-71. [PMID: 30017300 DOI: 10.1016/j.ejrad.2018.05.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 05/30/2018] [Accepted: 05/31/2018] [Indexed: 02/09/2023]
Abstract
PURPOSE To evaluate the value of intravoxel incoherent motion (IVIM) histogram analysis based on whole tumor volume in predicting microvascular invasion (MVI) of single hepatocellular carcinoma (HCC). MATERIALS AND METHODS The study enrolled 41 patients with pathologically proven HCCs who underwent IVIM diffusion-weighted imaging with nine b values and contrast-enhanced magnetic resonance imaging (MRI). Histogram parameters including mean; skewness; kurtosis; and percentiles (5th, 10th, 25th, 50th, 75th, 90th, 95th) were derived from apparent diffusion coefficient (ADC), perfusion fraction (f), true diffusion coefficient (D), and pseudo diffusion coefficient (D*). Quantitative histogram parameters and clinical data were compared between HCCs with and without MVI. For significant parameters, receiver operating characteristic (ROC) curves were further plotted to compare the diagnosis performance for identifying MVI. RESULTS The mean, 5th, 10th, 25th, 50th, and 75th percentiles of D, and the 5th, 10th, and 25th percentiles of ADC between HCCs with and without MVI were statistically significant (all P<0.05). The histogram parameters of D* and f showed no statistically significant differences between HCCs with and without MVI (all P>0.05). The areas under the ROC curves (AUCs) were 0.707-0.874 for D and 0.668-0.720 for ADC. The largest AUC of D (5th percentile) showed significantly higher accuracy than that of ADC or tumor size (P = 0.009-0.046). With a cut-off of 0.403 × 10-3 mm²/s, the 5th percentile of D value provided a sensitivity of 81% and a specificity of 85% in the prediction of MVI. CONCLUSIONS Histogram analysis of IVIM based on whole tumor volume can be useful for predicting MVI. The 5th percentile of D was most useful value to predict MVI of HCC.
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Affiliation(s)
- Hongxiang Li
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | - Jing Zhang
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | - Zeyu Zheng
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | - Yihao Guo
- School of Biomedical Engineering, Southern Medical University, Guangzhou, PR China.
| | - Maodong Chen
- School of Biomedical Engineering, Southern Medical University, Guangzhou, PR China.
| | - Caiqin Xie
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| | | | - Yingjie Mei
- Philips Intergrated Solution Center, Guangzhou, PR China.
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou, PR China.
| | - Yikai Xu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
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Liu Y, Zhang Y, Cheng R, Liu S, Qu F, Yin X, Wang Q, Xiao B, Ye Z. Radiomics analysis of apparent diffusion coefficient in cervical cancer: A preliminary study on histological grade evaluation. J Magn Reson Imaging 2018; 49:280-290. [PMID: 29761595 DOI: 10.1002/jmri.26192] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 04/26/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The role of apparent diffusion coefficient (ADC)-based radiomics features in evaluating histopathological grade of cervical cancer is unresolved. PURPOSE To determine if there is a difference between radiomics features derived from center-slice 2D versus whole-tumor volumetric 3D for ADC measurements in patients with cervical cancer regarding tumor histopathological grade, and systematically assess the impact of the b value on radiomics analysis in ADC quantifications. STUDY TYPE Prospective. SUBJECTS In all, 160 patients with histopathologically confirmed squamous cell carcinoma of uterine cervix. FIELD STRENGTH/SEQUENCE Conventional and diffusion-weighted MR images (b values = 0, 800, 1000 s/mm2 ) were acquired on a 3.0T MR scanner. ASSESSMENT Regions of interest (ROIs) were drawn manually along the margin of tumor on each slice, and then the center slice of the tumor was selected with naked eyes in the course of whole-tumor segmentation. A total of 624 radiomics features were derived from T2 -weighted images and ADC maps. We randomly selected 50 cases and did the reproducibility analysis. STATISTICAL TESTS Parameters were compared using Wilcoxon signed rank test, Bland-Altman analysis, t-test, and least absolute shrinkage and selection operator (LASSO) regression with crossvalidation. RESULTS In all, 95 radiomics features were insensitive to ROI variation among T2 images, ADC map of b800, and ADC map of b1000 (P > 0.0002). There was a significant statistical difference between the performances of 2D center-slice and 3D whole-tumor radiomics models in both ADC feature sets of b800 and b1000 (P < 0.0001, P < 0.0001). Compared with ADC features of b800 (0.3758 ± 0.0118), the model of b1000 ADC features appeared to be slightly lower in overall misclassification error (0.3642 ± 0.0162) (P = 0.0076). DATA CONCLUSION Several radiomics features extracted from T2 images and ADC maps were highly reproducible. Whole-tumor volumetric 3D radiomics analysis had a better performance than using the 2D center-slice of tumor in stratifying the histological grade of cervical cancer. A b value of 1000 s/mm2 is suggested as the optimal parameter in pelvic DWI scans. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:280-290.
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Affiliation(s)
- Ying Liu
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yuwei Zhang
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China.,School of Medical Imaging, Tianjin Medical University, Tianjin, China
| | - Runfen Cheng
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Shichang Liu
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Fangyuan Qu
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Xiaoyu Yin
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Qin Wang
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Bohan Xiao
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China
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De Paepe KN, De Keyzer F, Wolter P, Bechter O, Dierickx D, Janssens A, Verhoef G, Oyen R, Vandecaveye V. Improving lymph node characterization in staging malignant lymphoma using first-order ADC texture analysis from whole-body diffusion-weighted MRI. J Magn Reson Imaging 2018; 48:897-906. [DOI: 10.1002/jmri.26034] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/17/2018] [Indexed: 12/13/2022] Open
Affiliation(s)
| | | | - Pascal Wolter
- Department of Medical Oncology; University Hospitals Leuven; Belgium
| | - Oliver Bechter
- Department of Medical Oncology; University Hospitals Leuven; Belgium
| | - Daan Dierickx
- Department of Hematology; University Hospitals Leuven; Belgium
| | - Ann Janssens
- Department of Hematology; University Hospitals Leuven; Belgium
| | - Gregor Verhoef
- Department of Hematology; University Hospitals Leuven; Belgium
| | - Raymond Oyen
- Deparment of Radiology; University Hospitals Leuven; Belgium
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Conventional vs. reduced field of view diffusion weighted imaging of the prostate: Comparison of image quality, correlation with histology, and inter-reader agreement. Magn Reson Imaging 2018; 47:67-76. [DOI: 10.1016/j.mri.2017.10.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/10/2017] [Accepted: 10/31/2017] [Indexed: 12/31/2022]
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Reischauer C, Patzwahl R, Koh DM, Froehlich JM, Gutzeit A. Texture analysis of apparent diffusion coefficient maps for treatment response assessment in prostate cancer bone metastases-A pilot study. Eur J Radiol 2018; 101:184-190. [PMID: 29571795 DOI: 10.1016/j.ejrad.2018.02.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/16/2018] [Accepted: 02/17/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To evaluate whole-lesion volumetric texture analysis of apparent diffusion coefficient (ADC) maps for assessing treatment response in prostate cancer bone metastases. MATERIALS AND METHODS Texture analysis is performed in 12 treatment-naïve patients with 34 metastases before treatment and at one, two, and three months after the initiation of androgen deprivation therapy. Four first-order and 19 second-order statistical texture features are computed on the ADC maps in each lesion at every time point. Repeatability, inter-patient variability, and changes in the feature values under therapy are investigated. Spearman rank's correlation coefficients are calculated across time to demonstrate the relationship between the texture features and the serum prostate specific antigen (PSA) levels. RESULTS With few exceptions, the texture features exhibited moderate to high precision. At the same time, Friedman's tests revealed that all first-order and second-order statistical texture features changed significantly in response to therapy. Thereby, the majority of texture features showed significant changes in their values at all post-treatment time points relative to baseline. Bivariate analysis detected significant correlations between the great majority of texture features and the serum PSA levels. Thereby, three first-order and six second-order statistical features showed strong correlations with the serum PSA levels across time. CONCLUSION The findings in the present work indicate that whole-tumor volumetric texture analysis may be utilized for response assessment in prostate cancer bone metastases. The approach may be used as a complementary measure for treatment monitoring in conjunction with averaged ADC values.
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Affiliation(s)
- Carolin Reischauer
- Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Hirslanden Hospital St. Anna, Lucerne, Switzerland; Institute for Biomedical Engineering, ETH and University of Zurich, Zurich, Switzerland.
| | - René Patzwahl
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Dow-Mu Koh
- Academic Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK; CR-UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, Sutton, Surrey, UK
| | - Johannes M Froehlich
- Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Hirslanden Hospital St. Anna, Lucerne, Switzerland
| | - Andreas Gutzeit
- Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Hirslanden Hospital St. Anna, Lucerne, Switzerland; Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland; Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
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Meng J, Zhu L, Zhu L, Ge Y, He J, Zhou Z, Yang X. Histogram analysis of apparent diffusion coefficient for monitoring early response in patients with advanced cervical cancers undergoing concurrent chemo-radiotherapy. Acta Radiol 2017; 58:1400-1408. [PMID: 28273745 DOI: 10.1177/0284185117694509] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Apparent diffusion coefficient (ADC) histogram analysis has been widely used in determining tumor prognosis. Purpose To investigate the dynamic changes of ADC histogram parameters during concurrent chemo-radiotherapy (CCRT) in patients with advanced cervical cancers. Material and Methods This prospective study enrolled 32 patients with advanced cervical cancers undergoing CCRT who received diffusion-weighted (DW) magnetic resonance imaging (MRI) before CCRT, at the end of the second and fourth week during CCRT and one month after CCRT completion. The ADC histogram for the entire tumor volume was generated, and a series of histogram parameters was obtained. Dynamic changes of those parameters in cervical cancers were investigated as early biomarkers for treatment response. Results All histogram parameters except AUClow showed significant changes during CCRT (all P < 0.05). There were three variable trends involving different parameters. The mode, 5th, 10th, and 25th percentiles showed similar early increase rates (33.33%, 33.99%, 34.12%, and 30.49%, respectively) at the end of the second week of CCRT. The pre-CCRT 5th and 25th percentiles of the complete response (CR) group were significantly lower than those of the partial response (PR) group. Conclusion A series of ADC histogram parameters of cervical cancers changed significantly at the early stage of CCRT, indicating their potential in monitoring early tumor response to therapy.
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Affiliation(s)
- Jie Meng
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Lijing Zhu
- The Comprehensive Cancer Centre of Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Li Zhu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Yun Ge
- School of Electronic Science and Engineering, Nanjing University, Nanjing, PR China
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Xiaofeng Yang
- Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA
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Value of whole-lesion apparent diffusion coefficient (ADC) first-order statistics and texture features in clinical staging of cervical cancers. Clin Radiol 2017; 72:951-958. [DOI: 10.1016/j.crad.2017.06.115] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 06/07/2017] [Accepted: 06/14/2017] [Indexed: 01/20/2023]
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Chen T, Li Y, Lu SS, Zhang YD, Wang XN, Luo CY, Shi HB. Quantitative evaluation of diffusion-kurtosis imaging for grading endometrial carcinoma: a comparative study with diffusion-weighted imaging. Clin Radiol 2017; 72:995.e11-995.e20. [DOI: 10.1016/j.crad.2017.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 06/26/2017] [Accepted: 07/05/2017] [Indexed: 01/07/2023]
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Karunya RJ, Tharani P, John S, Kumar RM, Das S. Role of Functional Magnetic Resonance Imaging Derived Parameters as Imaging Biomarkers and Correlation with Clinicopathological Features in Carcinoma of Uterine Cervix. J Clin Diagn Res 2017; 11:XC06-XC11. [PMID: 28969256 DOI: 10.7860/jcdr/2017/29165.10426] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 06/04/2017] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Magnetic Resonance Imaging (MRI) is emerging as a powerful tool in the evaluation and management of cervical cancer. The role of Diffusion Weighted Imaging (DWI) with Apparent Diffusion Coefficient (ADC) as a non-invasive imaging biomarker is promising in characterization of the tumour and prediction of response. AIM The aim of this study was to evaluate the role of conventional MRI and diffusion weighted MRI in predicting clinicopathological prognostic factors. MATERIALS AND METHODS This was a retrospective study. The data of 100 cervical cancer patients who had MRI with DWI was retrieved from the database and analysed. Clinico pathological details were collected from the computerized hospital information system. SPSS version 15.0 was used for statistical analysis. RESULTS The mean tumour dimensions on MRI in x, y and z axes were 43.04 mm (±13.93, range: 17-85), 37.05mm (±11.83, range: 9-80) and 39.63 mm (±14.81, range: 14 -76). The mean T2W MRI based tumour volume (TV) was 48.18 (±34.3, range: 7-206) and on DWI images was 36.68(±33.72, range: 2.5-200). The mean ADC value in patients with squamous cell carcinoma was 0.694 (±0.125, n=88), adenocarcinoma was 0.989 (±0.309, n=6), adenosquamous was 0.894 (±0.324, n=4). There was statistical significant difference in mean ADC between squamous vs. non squamous histology (p = 0.02). The mean ADC values of well differentiated, moderately differentiated, and poorly differentiated tumours were 0.841(±0.227, n= 26), 0.729 (±0.125, n=28), 0.648 (±0.099, n=46) respectively. There was significant statistical difference of mean ADC between well differentiated, moderately differentiated (p=0.020) and poorly differentiated tumours (p=0.0001). Difference between the mean ADC values between the node positive and node negative disease was statistically significant (p=0.0001). There was no correlation between the tumour volumes on T2W and DWI images and ADC values. Sixteen patients had residual/recurrent disease at a median follow up of 12 months (range: 3-59 months). The mean ADC values in this group was 0.71 (n=16) and was not significantly different from the disease free group (mean ADC =0.72, n=74). CONCLUSION Higher ADC values are associated with favourable histology and differentiation. Adenocarcinomas have higher ADC values followed by adenosquamous followed by squamous cell carcinomas. Well differentiated tumours had higher ADC values than moderately followed by poorly differentiated tumours. DWI with ADC have a potential role as an imaging biomarker for prognostication and needs further studies for routine clinical applications.
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Affiliation(s)
- Ramireddy Jeba Karunya
- Assistant Professor, Department of Radiation Oncology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Putta Tharani
- Assistant Professor, Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Subhashini John
- Professor, Department of Radiation Oncology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ramani Manoj Kumar
- Associate Professor, Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Saikat Das
- Associate Professor, Department of Radiation Oncology, Christian Medical College, Vellore, Tamil Nadu, India
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Erbay G, Onal C, Karadeli E, Guler OC, Arica S, Koc Z. Predicting tumor recurrence in patients with cervical carcinoma treated with definitive chemoradiotherapy: value of quantitative histogram analysis on diffusion-weighted MR images. Acta Radiol 2017; 58:481-488. [PMID: 27445314 DOI: 10.1177/0284185116656492] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Further research is required for evaluating the use of ADC histogram analysis in more advanced stages of cervical cancer treated with definitive chemoradiotherapy (CRT). Purpose To investigate the utility of apparent diffusion coefficient (ADC) histogram derived from diffusion-weighted magnetic resonance images in cervical cancer patients treated with definitive CRT. Material and Methods The clinical and radiological data of 50 patients with histologically proven cervical squamous cell carcinoma treated with definitive CRT were retrospectively analyzed. The impact of clinicopathological factors and ADC histogram parameters on prognostic factors and treatment outcomes was assessed. Results The mean and median ADC values for the cohort were 1.043 ± 0.135 × 10-3 mm2/s and 1.018 × 10-3 mm2/s (range, 0.787-1.443 × 10-3 mm2/s). The mean ADC was significantly lower for patients with advanced stage (≥IIB) or lymph node metastasis compared with patients with stage <IIB or no lymph node metastasis. The mean ADC, 75th percentile ADC (ADC75), 90th percentile ADC (ADC90), and 95th percentile ADC (ADC95) were significantly lower in patients with tumor recurrence compared with patients without recurrence. In multivariate analysis, tumor size, ADC75 and ADC95 were independent prognostic factors for both overall survival and disease-free survival. Conclusion ADC histogram parameters could be markers for disease recurrence and for predicting survival outcomes. ADC75, ADC90, and ADC95 of the primary tumor were significant predictors of disease recurrence in cervical cancer patients treated with definitive CRT.
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Affiliation(s)
- Gurcan Erbay
- 1 Department of Radiology, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Cem Onal
- 2 Department of Radiation Oncology, Baskent University Faculty of Medicine, Adana, Turkey
| | - Elif Karadeli
- 1 Department of Radiology, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Ozan C Guler
- 2 Department of Radiation Oncology, Baskent University Faculty of Medicine, Adana, Turkey
| | - Sami Arica
- 3 Department of Electrical and Electronics Engineering, Cukurova University Faculty of Engineering and Architecture, Adana, Turkey
| | - Zafer Koc
- 1 Department of Radiology, Baskent University Faculty of Medicine, Ankara, Turkey
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Tsuchiya N, Doai M, Usuda K, Uramoto H, Tonami H. Non-small cell lung cancer: Whole-lesion histogram analysis of the apparent diffusion coefficient for assessment of tumor grade, lymphovascular invasion and pleural invasion. PLoS One 2017; 12:e0172433. [PMID: 28207858 PMCID: PMC5313135 DOI: 10.1371/journal.pone.0172433] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 02/04/2017] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Investigating the diagnostic accuracy of histogram analyses of apparent diffusion coefficient (ADC) values for determining non-small cell lung cancer (NSCLC) tumor grades, lymphovascular invasion, and pleural invasion. MATERIALS AND METHODS We studied 60 surgically diagnosed NSCLC patients. Diffusion-weighted imaging (DWI) was performed in the axial plane using a navigator-triggered single-shot, echo-planar imaging sequence with prospective acquisition correction. The ADC maps were generated, and we placed a volume-of-interest on the tumor to construct the whole-lesion histogram. Using the histogram, we calculated the mean, 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of ADC, skewness, and kurtosis. Histogram parameters were correlated with tumor grade, lymphovascular invasion, and pleural invasion. We performed a receiver operating characteristics (ROC) analysis to assess the diagnostic performance of histogram parameters for distinguishing different pathologic features. RESULTS The ADC mean, 10th, 25th, 50th, 75th, 90th, and 95th percentiles showed significant differences among the tumor grades. The ADC mean, 25th, 50th, 75th, 90th, and 95th percentiles were significant histogram parameters between high- and low-grade tumors. The ROC analysis between high- and low-grade tumors showed that the 95th percentile ADC achieved the highest area under curve (AUC) at 0.74. Lymphovascular invasion was associated with the ADC mean, 50th, 75th, 90th, and 95th percentiles, skewness, and kurtosis. Kurtosis achieved the highest AUC at 0.809. Pleural invasion was only associated with skewness, with the AUC of 0.648. CONCLUSIONS ADC histogram analyses on the basis of the entire tumor volume are able to stratify NSCLCs' tumor grade, lymphovascular invasion and pleural invasion.
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Affiliation(s)
- Naoko Tsuchiya
- Department of Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Mariko Doai
- Department of Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Hidetaka Uramoto
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Hisao Tonami
- Department of Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
- * E-mail:
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Moriya T, Saito K, Tajima Y, Harada TL, Araki Y, Sugimoto K, Tokuuye K. 3D analysis of apparent diffusion coefficient histograms in hepatocellular carcinoma: correlation with histological grade. Cancer Imaging 2017; 17:1. [PMID: 28057085 PMCID: PMC5217316 DOI: 10.1186/s40644-016-0103-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/22/2016] [Indexed: 01/07/2023] Open
Abstract
Background To evaluate the usefulness of differentiation of histological grade in hepatocellular carcinoma (HCC) using three-dimensional (3D) analysis of apparent diffusion coefficient (ADC) histograms retrospectively. Methods The subjects consisted of 53 patients with 56 HCCs. The subjects included 12 well-differentiated, 35 moderately differentiated, and nine poorly differentiated HCCs. Diffusion-weighted imaging (b-values of 100 and 800 s/mm2) were obtained within 3 months before surgery. Regions of interest (ROIs) covered the entire tumor. The data acquired from each slice were summated to derive voxel-by-voxel ADCs for the entire tumor. The following parameters were derived from the ADC histogram: mean, standard deviation, minimum, maximum, mode, percentiles (5th, 10th, 25th, 50th, 75th, and 90th), skew, and kurtosis. These parameters were analyzed according to histological grade. After eliminating steatosis lesions, these parameters were re-analyzed. Results A weak correlation was observed in minimum ADC and 5th percentile for each histological grade (r = –0.340 and r = –0.268, respectively). The minimum ADCs of well, moderately, and poorly differentiated HCC were 585 ± 388, 411 ± 278, and 235 ± 102 × 10−6 mm2/s, respectively. Minimum ADC showed significant differences among tumor histological grades (P = 0.009). The minimum ADC of poorly differentiated HCC and that of combined well and moderately differentiated HCC were 236 ± 102 and 437 ± 299 × 10−6 mm2/s. The minimum ADC of poorly differentiated HCC was significantly lower than that of combined well and moderately differentiated HCC (P = 0.001). The sensitivity and specificity, when a minimum ADC of 400 × 10−6 mm2/s or lower was considered to be poorly differentiated HCC, were 100 and 54%, respectively. After exclusion of the effect of steatosis, the sensitivity and specificity did not change, although the statistical differences became strong (P < 0.0001). Conclusion Minimum ADC was most useful to differentiate poorly differentiated HCC in 3D analysis of ADC histograms.
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Affiliation(s)
- Tomohisa Moriya
- Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Kazuhiro Saito
- Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Yu Tajima
- Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Taiyo L Harada
- Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Yoichi Araki
- Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Katsutoshi Sugimoto
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Koichi Tokuuye
- Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
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Guan Y, Li W, Jiang Z, Chen Y, Liu S, He J, Zhou Z, Ge Y. Whole-Lesion Apparent Diffusion Coefficient-Based Entropy-Related Parameters for Characterizing Cervical Cancers: Initial Findings. Acad Radiol 2016; 23:1559-1567. [PMID: 27665235 DOI: 10.1016/j.acra.2016.08.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 08/14/2016] [Accepted: 08/15/2016] [Indexed: 11/27/2022]
Abstract
RATIONALE AND OBJECTIVES This study aimed to develop whole-lesion apparent diffusion coefficient (ADC)-based entropy-related parameters of cervical cancer to preliminarily assess intratumoral heterogeneity of this lesion in comparison to adjacent normal cervical tissues. MATERIALS AND METHODS A total of 51 women (mean age, 49 years) with cervical cancers confirmed by biopsy underwent 3-T pelvic diffusion-weighted magnetic resonance imaging with b values of 0 and 800 s/mm2 prospectively. ADC-based entropy-related parameters including first-order entropy and second-order entropies were derived from the whole tumor volume as well as adjacent normal cervical tissues. Intraclass correlation coefficient, Wilcoxon test with Bonferroni correction, Kruskal-Wallis test, and receiver operating characteristic curve were used for statistical analysis. RESULTS All the parameters showed excellent interobserver agreement (all intraclass correlation coefficients > 0.900). Entropy, entropy(H)0, entropy(H)45, entropy(H)90, entropy(H)135, and entropy(H)mean were significantly higher, whereas entropy(H)range and entropy(H)std were significantly lower in cervical cancers compared to adjacent normal cervical tissues (all P <.0001). Kruskal-Wallis test showed that there were no significant differences among the values of various second-order entropies including entropy(H)0, entropy(H)45, entropy(H)90, entropy(H)135, and entropy(H)mean. All second-order entropies had larger area under the receiver operating characteristic curve than first-order entropy in differentiating cervical cancers from adjacent normal cervical tissues. Further, entropy(H)45, entropy(H)90, entropy(H)135, and entropy(H)mean had the same largest area under the receiver operating characteristic curve of 0.867. CONCLUSION Whole-lesion ADC-based entropy-related parameters of cervical cancers were developed successfully, which showed initial potential in characterizing intratumoral heterogeneity in comparison to adjacent normal cervical tissues.
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Hu XX, Yang ZX, Liang HY, Ding Y, Grimm R, Fu CX, Liu H, Yan X, Ji Y, Zeng MS, Rao SX. Whole-tumor MRI histogram analyses of hepatocellular carcinoma: Correlations with Ki-67 labeling index. J Magn Reson Imaging 2016; 46:383-392. [PMID: 27862582 DOI: 10.1002/jmri.25555] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 10/26/2016] [Accepted: 10/27/2016] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To evaluate whether whole-tumor histogram-derived parameters for an apparent diffusion coefficient (ADC) map and contrast-enhanced magnetic resonance imaging (MRI) could aid in assessing Ki-67 labeling index (LI) of hepatocellular carcinoma (HCC). MATERIALS AND METHODS In all, 57 patients with HCC who underwent pretreatment MRI with a 3T MR scanner were included retrospectively. Histogram parameters including mean, median, standard deviation, skewness, kurtosis, and percentiles (5th , 25th , 75th , 95th ) were derived from the ADC map and MR enhancement. Correlations between histogram parameters and Ki-67 LI were evaluated and differences between low Ki-67 (≤10%) and high Ki-67 (>10%) groups were assessed. RESULTS Mean, median, 5th , 25th , 75th percentiles of ADC, and mean, median, 25th , 75th , 95th percentiles of enhancement of arterial phase (AP) demonstrated significant inverse correlations with Ki-67 LI (rho up to -0.48 for ADC, -0.43 for AP) and showed significant differences between low and high Ki-67 groups (P < 0.001-0.04). Areas under the receiver operator characteristics (ROC) curve for identification of high Ki-67 were 0.78, 0.77, 0.79, 0.82, and 0.76 for mean, median, 5th , 25th , 75th percentiles of ADC, respectively, and 0.74, 0.81, 0.76, 0.82, 0.69 for mean, median, 25th , 75th , 95th percentiles of AP, respectively. CONCLUSION Histogram-derived parameters of ADC and AP were potentially helpful for predicting Ki-67 LI of HCC. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2017;46:383-392.
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Affiliation(s)
- Xin-Xing Hu
- Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Medical Imaging Institute, Shanghai, China
| | - Zhao-Xia Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Medical Imaging Institute, Shanghai, China
| | - He-Yue Liang
- Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Medical Imaging Institute, Shanghai, China
| | - Ying Ding
- Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Medical Imaging Institute, Shanghai, China
| | - Robert Grimm
- MR Application Development, Siemens Healthcare, Erlangen, Germany
| | - Cai-Xia Fu
- Siemens Shenzhen Magnetic Resonance, Shenzhen, China
| | - Hui Liu
- MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China
| | - Xu Yan
- MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China
| | - Yuan Ji
- Department of Pathology, Zhongshan hospital, Fudan University, Shanghai, China
| | - Meng-Su Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Medical Imaging Institute, Shanghai, China
| | - Sheng-Xiang Rao
- Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Medical Imaging Institute, Shanghai, China
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Meng J, Zhu L, Zhu L, Wang H, Liu S, Yan J, Liu B, Guan Y, Ge Y, He J, Zhou Z, Yang X. Apparent diffusion coefficient histogram shape analysis for monitoring early response in patients with advanced cervical cancers undergoing concurrent chemo-radiotherapy. Radiat Oncol 2016; 11:141. [PMID: 27770816 PMCID: PMC5075415 DOI: 10.1186/s13014-016-0715-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 10/13/2016] [Indexed: 12/25/2022] Open
Abstract
Background To explore the role of apparent diffusion coefficient (ADC) histogram shape related parameters in early assessment of treatment response during the concurrent chemo-radiotherapy (CCRT) course of advanced cervical cancers. Methods This prospective study was approved by the local ethics committee and informed consent was obtained from all patients. Thirty-two patients with advanced cervical squamous cell carcinomas underwent diffusion weighted magnetic resonance imaging (b values, 0 and 800 s/mm2) before CCRT, at the end of 2nd and 4th week during CCRT and immediately after CCRT completion. Whole lesion ADC histogram analysis generated several histogram shape related parameters including skewness, kurtosis, s-sDav, width, standard deviation, as well as first-order entropy and second-order entropies. The averaged ADC histograms of 32 patients were generated to visually observe dynamic changes of the histogram shape following CCRT. Results All parameters except width and standard deviation showed significant changes during CCRT (all P < 0.05), and their variation trends fell into four different patterns. Skewness and kurtosis both showed high early decline rate (43.10 %, 48.29 %) at the end of 2nd week of CCRT. All entropies kept decreasing significantly since 2 weeks after CCRT initiated. The shape of averaged ADC histogram also changed obviously following CCRT. Conclusions ADC histogram shape analysis held the potential in monitoring early tumor response in patients with advanced cervical cancers undergoing CCRT.
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Affiliation(s)
- Jie Meng
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 210008
| | - Lijing Zhu
- The Comprehensive Cancer Centre of Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 210008
| | - Li Zhu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 210008
| | - Huanhuan Wang
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 210008
| | - Song Liu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 210008
| | - Jing Yan
- The Comprehensive Cancer Centre of Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 210008
| | - Baorui Liu
- The Comprehensive Cancer Centre of Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 210008
| | - Yue Guan
- School of Electronic Science and Engineering, Nanjing University, Nanjing, China, 210046
| | - Yun Ge
- School of Electronic Science and Engineering, Nanjing University, Nanjing, China, 210046.
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 210008.
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 210008.
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
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Moribata Y, Kido A, Fujimoto K, Himoto Y, Kurata Y, Shitano F, Kiguchi K, Konishi I, Togashi K. Feasibility of Computed Diffusion Weighted Imaging and Optimization of b-value in Cervical Cancer. Magn Reson Med Sci 2016; 16:66-72. [PMID: 27646153 PMCID: PMC5600046 DOI: 10.2463/mrms.mp.2015-0161] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose: To evaluate the feasibility of computed diffusion weighted imaging (DWI) in cervical cancer and investigate the optimal b-value using computed DWI. Methods: The present retrospective study involved 85 patients with cervical cancer in the International Federation of Gynecology and Obstetrics (FIGO) stage IB, IIA or IIB. DWI was obtained with b-values of 0, 100, 500 and 1000 s/mm2. Computed DWI with b-values of 800, 1000, 1300, 1600 and 2000 s/mm2 (cDWI800, cDWI1000, cDWI1300, cDWI1600, cDWI2000) were generated from all measured DWI (mDWI) data. Qualitatively, computed DWI was evaluated in terms of tumor conspicuity, signal suppression of the fat in the imaged area and total image quality by two radiologists independently with reference to mDWI with b-value of 1000 s/mm2. The b-value at which the signal of the endocervical canal was suppressed was recorded. Quantitatively, the signal intensities of tumor, myometrium, endocervical canal, endometrium, and gluteal subcutaneous fat were measured and represented as contrast ratios (CR). Results: Regarding tumor conspicuity and total image quality, significantly higher scores were obtained at cDWI1300 and cDWI1600 compared to the others (post-hoc comparison, P < 0.001), except for the total image quality between cDWI1000 and cDWI1600 in one reader. Signal suppression of the fat was the worst at cDWI2000. The signal intensity of the endocervical canal was suppressed in 24/27 cases on cDWI1600 and in 26/27 cases on cDWI2000. The CRs of tumor to myometrium, cervix, and endometrium increased with higher b-values, while the CRs of tumor to fat decreased and were statistically significant (post-hoc comparison, P < 0.001). Conclusion: Computed DWI with the b-values of 1300 and 1600 would be suitable for the evaluation of cervical cancer due to good tumor conspicuity.
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Affiliation(s)
- Yusaku Moribata
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
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Hao Y, Pan C, Chen W, Li T, Zhu W, Qi J. Differentiation between malignant and benign thyroid nodules and stratification of papillary thyroid cancer with aggressive histological features: Whole-lesion diffusion-weighted imaging histogram analysis. J Magn Reson Imaging 2016; 44:1546-1555. [PMID: 27093648 DOI: 10.1002/jmri.25290] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 04/04/2016] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To explore the usefulness of whole-lesion histogram analysis of apparent diffusion coefficient (ADC) derived from reduced field-of-view (r-FOV) diffusion-weighted imaging (DWI) in differentiating malignant and benign thyroid nodules and stratifying papillary thyroid cancer (PTC) with aggressive histological features. MATERIALS AND METHODS This Institutional Review Board-approved, retrospective study included 93 patients with 101 pathologically proven thyroid nodules. All patients underwent preoperative r-FOV DWI at 3T. The whole-lesion ADC assessments were performed for each patient. Histogram-derived ADC parameters between different subgroups (pathologic type, extrathyroidal extension, lymph node metastasis) were compared. Receiver operating characteristic curve analysis was used to determine optimal histogram parameters in differentiating benign and malignant nodules and predicting aggressiveness of PTC. RESULTS Mean ADC, median ADC, 5th percentile ADC, 25th percentile ADC, 75th percentile ADC, 95th percentile ADC (all P < 0.001), and kurtosis (P = 0.001) were significantly lower in malignant thyroid nodules, and mean ADC achieved the highest AUC (0.919) with a cutoff value of 1842.78 × 10-6 mm2 /s in differentiating malignant and benign nodules. Compared to the PTCs without extrathyroidal extension, PTCs with extrathyroidal extension showed significantly lower median ADC, 5th percentile ADC, and 25th percentile ADC. The 5th percentile ADC achieved the highest AUC (0.757) with cutoff value of 911.5 × 10-6 mm2 /s for differentiating between PTCs with and without extrathyroidal extension. CONCLUSION Whole-lesion ADC histogram analysis might help to differentiate malignant nodules from benign ones and show the PTCs with extrathyroidal extension. J. Magn. Reson. Imaging 2016;44:1546-1555.
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Affiliation(s)
- Yonghong Hao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chu Pan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - WeiWei Chen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Li
- Department of Radiology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - WenZhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - JianPin Qi
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Abstract
Dynamic-contrast enhanced (DCE) and diffusion-weighted (DW) MR imaging are invaluable in the detection, staging, and characterization of uterine and ovarian malignancies, for monitoring treatment response, and for identifying disease recurrence. When used as adjuncts to morphologic T2-weighted (T2-W) MR imaging, these techniques improve accuracy of disease detection and staging. DW-MR imaging is preferred because of its ease of implementation and lack of need for an extrinsic contrast agent. MR spectroscopy is difficult to implement in the clinical workflow and lacks both sensitivity and specificity. If used quantitatively in multicenter clinical trials, standardization of DCE- and DW-MR imaging techniques and rigorous quality assurance is mandatory.
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Affiliation(s)
- Nandita M deSouza
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, The Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK.
| | - Andrea Rockall
- Department of Radiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, DuCane Road, London W12 0HS, UK; Department of Radiology, Imperial College, South Kensington, London SW7 2AZ, UK
| | - Susan Freeman
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK
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Whole-Lesion Histogram Analysis of Apparent Diffusion Coefficient for the Assessment of Cervical Cancer. J Comput Assist Tomogr 2016; 40:212-7. [DOI: 10.1097/rct.0000000000000349] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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