1
|
Raspe J, Harder FN, Rupp S, McTavish S, Peeters JM, Weiss K, Makowski MR, Braren RF, Karampinos DC, Van AT. Retrospective Motion Artifact Reduction by Spatial Scaling of Liver Diffusion-Weighted Images. Tomography 2023; 9:1839-1856. [PMID: 37888738 PMCID: PMC10610678 DOI: 10.3390/tomography9050146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/28/2023] Open
Abstract
Cardiac motion causes unpredictable signal loss in respiratory-triggered diffusion-weighted magnetic resonance imaging (DWI) of the liver, especially inside the left lobe. The left liver lobe may thus be frequently neglected in the clinical evaluation of liver DWI. In this work, a data-driven algorithm that relies on the statistics of the signal in the left liver lobe to mitigate the motion-induced signal loss is presented. The proposed data-driven algorithm utilizes the exclusion of severely corrupted images with subsequent spatially dependent image scaling based on a signal-loss model to correctly combine the multi-average diffusion-weighted images. The signal in the left liver lobe is restored and the liver signal is more homogeneous after applying the proposed algorithm. Furthermore, overestimation of the apparent diffusion coefficient (ADC) in the left liver lobe is reduced. The proposed algorithm can therefore contribute to reduce the motion-induced bias in DWI of the liver and help to increase the diagnostic value of DWI in the left liver lobe.
Collapse
Affiliation(s)
- Johannes Raspe
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
- School of Natural Sciences, Technical University of Munich, 85748 Garching, Germany
| | - Felix N. Harder
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Selina Rupp
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Sean McTavish
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | | | - Kilian Weiss
- Philips GmbH Market DACH, 22335 Hamburg, Germany
| | - Marcus R. Makowski
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Rickmer F. Braren
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Dimitrios C. Karampinos
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| | - Anh T. Van
- School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany (D.C.K.); (A.T.V.)
| |
Collapse
|
2
|
Qi LP, Zhong Z, Sun YS, Li XT, Tang L, Zhou XJ. Optimal selection of b-values for differential diagnosis of mediastinal lymph nodes using diffusion-weighted imaging. Heliyon 2023; 9:e16702. [PMID: 37484276 PMCID: PMC10360569 DOI: 10.1016/j.heliyon.2023.e16702] [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: 09/06/2022] [Revised: 04/16/2023] [Accepted: 05/24/2023] [Indexed: 07/25/2023] Open
Abstract
This study proposed to investigate the optimal selection of b-values in diffusion-weighted imaging for distinguishing malignant from benign mediastinal lymph nodes. Diffusion-weighted imaging with six b-values was performed on 35 patients at 1.5 T. Image quality score, signal-to-noise ratio, and relative contrast ratio of lymph node to chest muscle were compared between the diffusion-weighted images with a b-value up to 800 and 1000 s/mm2. Using a lower and an upper b-value in the range of 0-1000 s/mm2, eight apparent diffusion coefficient maps were obtained from a mono-exponential model. Receiver operating characteristic analysis was employed to evaluate the performance of the apparent diffusion coefficients for distinguishing malignant from benign mediastinal lymph nodes by using the area under the curve as a criterion. The mean image quality score and the relative contrast ratio showed no difference between b-values of 800 and 1000 s/mm2. In the receiver operating characteristic analysis, the areas under the curve of apparent diffusion coefficient with b-value pairs of (0, 800), (0, 1000), and (50, 800) s/mm2 were significantly higher than those from the other b-value pairs. No significant difference was observed among the three b-value pairs. Apparent diffusion coefficient obtained from b-value pairs of (0, 800), (0, 1000), and (50, 800) s/mm2 showed superior diagnostic performance compared to the other b-value combinations. Based on several practical considerations, the b-value pair of (50, 800) s/mm2 is recommended for differential diagnosis of mediastinal lymph nodes.
Collapse
Affiliation(s)
- Li-Ping Qi
- Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University Cancer Hospital and Institute, Beijing, China
- Center for Magnetic Resonance Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Zheng Zhong
- Center for Magnetic Resonance Research, University of Illinois at Chicago, Chicago, IL, USA
- Department of Biomedcial Engineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Ying-Shi Sun
- Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University Cancer Hospital and Institute, Beijing, China
| | - Xiao-Ting Li
- Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University Cancer Hospital and Institute, Beijing, China
| | - Lei Tang
- Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University Cancer Hospital and Institute, Beijing, China
| | - Xiaohong Joe Zhou
- Center for Magnetic Resonance Research, University of Illinois at Chicago, Chicago, IL, USA
- Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA
- Department of Biomedcial Engineering, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
3
|
Li W. Non-Gaussian Diffusion MRI for Evaluating Hepatic Fibrosis. Acad Radiol 2022; 29:964-966. [PMID: 35597754 DOI: 10.1016/j.acra.2022.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 11/01/2022]
|
4
|
Obata T. EIC Remarks for a Special 20th Anniversary Issue of MRMS. Magn Reson Med Sci 2022; 21:1-5. [PMID: 35228486 PMCID: PMC9199973 DOI: 10.2463/mrms.e.2021-3000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Takayuki Obata
- The Editorial Committee of Magnetic Resonance in Medical Sciences
| |
Collapse
|
5
|
Daldrup-Link HE, Theruvath AJ, Baratto L, Hawk KE. One-stop local and whole-body staging of children with cancer. Pediatr Radiol 2022; 52:391-400. [PMID: 33929564 PMCID: PMC10874282 DOI: 10.1007/s00247-021-05076-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/04/2021] [Accepted: 03/30/2021] [Indexed: 12/19/2022]
Abstract
Accurate staging and re-staging of cancer in children is crucial for patient management. Currently, children with a newly diagnosed cancer must undergo a series of imaging tests, which are stressful, time-consuming, partially redundant, expensive, and can require repetitive anesthesia. New approaches for pediatric cancer staging can evaluate the primary tumor and metastases in a single session. However, traditional one-stop imaging tests, such as CT and positron emission tomography (PET)/CT, are associated with considerable radiation exposure. This is particularly concerning for children because they are more sensitive to ionizing radiation than adults and they live long enough to experience secondary cancers later in life. In this review article we discuss child-tailored imaging tests for tumor detection and therapy response assessment - tests that can be obtained with substantially reduced radiation exposure compared to traditional CT and PET/CT scans. This includes diffusion-weighted imaging (DWI)/MRI and integrated [F-18]2-fluoro-2-deoxyglucose (18F-FDG) PET/MRI scans. While several investigators have compared the value of DWI/MRI and 18F-FDG PET/MRI for staging pediatric cancer, the value of these novel imaging technologies for cancer therapy monitoring has received surprisingly little attention. In this article, we share our experiences and review existing literature on this subject.
Collapse
Affiliation(s)
- Heike E Daldrup-Link
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Lucile Packard Children's Hospital, Stanford University, 725 Welch Road, Room 1665, Stanford, CA, 94305-5614, USA.
- Department of Pediatrics, Stanford University, Stanford, CA, USA.
- Cancer Imaging and Early Detection Program, Stanford Cancer Institute, Stanford, CA, USA.
| | - Ashok J Theruvath
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Lucile Packard Children's Hospital, Stanford University, 725 Welch Road, Room 1665, Stanford, CA, 94305-5614, USA
- Cancer Imaging and Early Detection Program, Stanford Cancer Institute, Stanford, CA, USA
| | - Lucia Baratto
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Lucile Packard Children's Hospital, Stanford University, 725 Welch Road, Room 1665, Stanford, CA, 94305-5614, USA
- Cancer Imaging and Early Detection Program, Stanford Cancer Institute, Stanford, CA, USA
| | - Kristina Elizabeth Hawk
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Lucile Packard Children's Hospital, Stanford University, 725 Welch Road, Room 1665, Stanford, CA, 94305-5614, USA
- Cancer Imaging and Early Detection Program, Stanford Cancer Institute, Stanford, CA, USA
| |
Collapse
|
6
|
Larsen SKA, Sivesgaard K, Pedersen EM. Multi-band whole-body diffusion-weighted imaging with inversion recovery fat saturation: Effects of respiratory compensation. Eur J Radiol Open 2021; 8:100374. [PMID: 34485628 PMCID: PMC8403743 DOI: 10.1016/j.ejro.2021.100374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 10/25/2022] Open
Abstract
Purpose To prospectively compare artefacts and image quality in testicular stage I cancer patients using different combinations of breathing schemes and Multi-band (MB) in whole-body DWIBS at 1.5 T.Diffusion-Weighted whole-body Imaging with Background body signal Suppression (DWIBS) using inversion recovery (IR) fat saturation is a cornerstone in oncologic whole-body MRI, but implementation is restrained by long acquisition times. The new Multi-Band (MB) technique reduces scan time which can be reinvested in respiratory compensation. Methods Thirty testicular cancer stage I patients were included. Three variations of whole-body DWIBS were tested: Standard free Breathing (FB)-DWIBS, FB-MB-DWIBS and Respiratory triggered (RT)-MB-DWIBS. Artefacts and image quality of b = 800 s/mm2 images were evaluated using a Likert scale. No pathology was revealed. SNR was calculated in a healthy volunteer. Results RT-MB-DWIBS was rated significantly better than FB-DWIBS in the thorax (p < 0.001) and abdomen (p < 0.001), but not in the pelvis (p = 0.569). FB-MB-DWIBS was ranked significantly lower than both FB-DWIBS (p < 0.001) and RT-MB-DWIBS (p < 0.001) at all locations. However, FB-MB-DWIBS was scanned in half the time without being less than "satisfactory". Few artefacts were encountered. SNR was similar for low-intensity tissues, but the SNR in high-intensity and respiratory-prone tissue (spleen) was slightly lower for FB-DWIBS than the other sequences. Conclusion Images produced by the sequences were similar. MB enables the use of respiratory trigger or can be used to produce very fast free-breathing DWI with acceptable image quality.
Collapse
Key Words
- ADC, apparent diffusion coefficient
- CT, computed tomography
- DWI, diffusion-weighted imaging
- DWIBS, diffusion-weighted whole-body imaging with background body signal suppression
- Diffusion magnetic resonance imaging
- EPI, echo planar imaging
- FB, free-breathing
- IR, inversion recovery
- MB, multi-band
- MRI, magnetic resonance imaging
- Multi-band
- NSA, number of signal averages
- Pet, positron emission tomography
- RF, radio frequency
- ROI, region of interest
- RT, respiratory triggered
- Respiratory compensation
- SAR, specific absorption rate
- SMS, simultaneous multislice
- SNR, signal-to-noise ratio
- SPAIR, spectral attenuated inversion recovery
- T, tesla
- TE, echo time
- TR, repetition time
- Testicular neoplasm
- WB, whole-body
Collapse
Affiliation(s)
| | - Kim Sivesgaard
- Department of Radiology, Aarhus University Hospital, Denmark
| | | |
Collapse
|
7
|
Feng CH, Conlin CC, Batra K, Rodríguez-Soto AE, Karunamuni R, Simon A, Kuperman J, Rakow-Penner R, Hahn ME, Dale AM, Seibert TM. Voxel-level Classification of Prostate Cancer on Magnetic Resonance Imaging: Improving Accuracy Using Four-Compartment Restriction Spectrum Imaging. J Magn Reson Imaging 2021; 54:975-984. [PMID: 33786915 DOI: 10.1002/jmri.27623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Diffusion magnetic resonance imaging (MRI) is integral to detection of prostate cancer (PCa), but conventional apparent diffusion coefficient (ADC) cannot capture the complexity of prostate tissues and tends to yield noisy images that do not distinctly highlight cancer. A four-compartment restriction spectrum imaging (RSI4 ) model was recently found to optimally characterize pelvic diffusion signals, and the model coefficient for the slowest diffusion compartment, RSI4 -C1 , yielded greatest tumor conspicuity. PURPOSE To evaluate the slowest diffusion compartment of a four-compartment spectrum imaging model (RSI4 -C1 ) as a quantitative voxel-level classifier of PCa. STUDY TYPE Retrospective. SUBJECTS Forty-six men who underwent an extended MRI acquisition protocol for suspected PCa. Twenty-three men had benign prostates, and the other 23 men had PCa. FIELD STRENGTH/SEQUENCE A 3 T, multishell diffusion-weighted and axial T2-weighted sequences. ASSESSMENT High-confidence cancer voxels were delineated by expert consensus, using imaging data and biopsy results. The entire prostate was considered benign in patients with no detectable cancer. Diffusion images were used to calculate RSI4 -C1 and conventional ADC. Classifier images were also generated. STATISTICAL TESTS Voxel-level discrimination of PCa from benign prostate tissue was assessed via receiver operating characteristic (ROC) curves generated by bootstrapping with patient-level case resampling. RSI4 -C1 was compared to conventional ADC for two metrics: area under the ROC curve (AUC) and false-positive rate for a sensitivity of 90% (FPR90 ). Statistical significance was assessed using bootstrap difference with two-sided α = 0.05. RESULTS RSI4 -C1 outperformed conventional ADC, with greater AUC (mean 0.977 [95% CI: 0.951-0.991] vs. 0.922 [0.878-0.948]) and lower FPR90 (0.032 [0.009-0.082] vs. 0.201 [0.132-0.290]). These improvements were statistically significant (P < 0.05). DATA CONCLUSION RSI4 -C1 yielded a quantitative, voxel-level classifier of PCa that was superior to conventional ADC. RSI classifier images with a low false-positive rate might improve PCa detection and facilitate clinical applications like targeted biopsy and treatment planning. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
Collapse
Affiliation(s)
- Christine H Feng
- Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California, USA
| | - Christopher C Conlin
- Department of Radiology, UC San Diego School of Medicine, La Jolla, California, USA
| | - Kanha Batra
- Department of Electrical and Computer Engineering, UC San Diego, La Jolla, California, USA
| | - Ana E Rodríguez-Soto
- Department of Radiology, UC San Diego School of Medicine, La Jolla, California, USA
| | - Roshan Karunamuni
- Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California, USA
| | - Aaron Simon
- Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California, USA
| | - Joshua Kuperman
- Department of Radiology, UC San Diego School of Medicine, La Jolla, California, USA
| | - Rebecca Rakow-Penner
- Department of Radiology, UC San Diego School of Medicine, La Jolla, California, USA
| | - Michael E Hahn
- Department of Radiology, UC San Diego School of Medicine, La Jolla, California, USA
| | - Anders M Dale
- Department of Radiology, UC San Diego School of Medicine, La Jolla, California, USA
| | - Tyler M Seibert
- Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California, USA.,Department of Radiology, UC San Diego School of Medicine, La Jolla, California, USA.,Department of Bioengineering, UC San Diego, La Jolla, California, USA
| |
Collapse
|
8
|
De Vuysere S, Vandecaveye V, De Bruecker Y, Carton S, Vermeiren K, Tollens T, De Keyzer F, Dresen RC. Accuracy of whole-body diffusion-weighted MRI (WB-DWI/MRI) in diagnosis, staging and follow-up of gastric cancer, in comparison to CT: a pilot study. BMC Med Imaging 2021; 21:18. [PMID: 33546626 PMCID: PMC7866710 DOI: 10.1186/s12880-021-00550-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/19/2021] [Indexed: 02/06/2023] Open
Abstract
Background Accurate staging of patients with gastric cancer is necessary for selection of the most appropriate and personalized therapy. Computed tomography (CT) is currently used as primary staging tool, being widely available with a relatively high accuracy for the detection of parenchymal metastases, but with low sensitivity for the detection of peritoneal metastases. Magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) has a very high contrast resolution, suggesting a higher diagnostic performance in the detection of small peritoneal lesions. The aim of this study was to retrospectively evaluate the added value of whole-body diffusion-weighted MRI (WB-DWI/MRI) to CT for detection of peritoneal carcinomatosis (PC) and distant metastases in the preoperative staging of gastric cancer. Methods This retrospective study included thirty-two patients with a suspicion of gastric cancer/recurrence, who underwent WB-DWI/MRI at 1.5 T, in addition to CT of thorax and abdomen. Images were evaluated by two experienced abdominal radiologists in consensus. Histopathology, laparoscopy and/or 1-year follow-up were used as reference standard. Results For overall tumour detection (n = 32), CT sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) was 83.3%, 100%, 100% and 82.4% respectively. For WB-DWI/MRI these values were 100%, 92.9%, 94.7% and 100%, respectively. For staging (n = 18) malignant lymph nodes and metastases, CT had a sensitivity, specificity/PPV/NPV of 50%/100%/100%/71.4%, and 15.4%/100%/100%/31.3% respectively. For WB-DWI/MRI, all values were 100%, for both malignant lymph nodes and metastases. WB-DWI/MRI was significantly better than CT in detecting tumour infiltration of the mesenteric root, serosal involvement of the small bowel and peritoneal metastases for which WB-DWI/MRI was correct in 100% of these cases, CT 0%. Conclusions WB-DWI/MRI is highly accurate for diagnosis, staging and follow-up of patients with suspected gastric cancer.
Collapse
Affiliation(s)
- Sofie De Vuysere
- Department of Radiology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium. .,Department of Radiology, Imelda Hospital Bonheiden, Imeldalaan 9, 2820, Bonheiden, Belgium.
| | - Vincent Vandecaveye
- Department of Radiology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Yves De Bruecker
- Department of Radiology, Imelda Hospital Bonheiden, Imeldalaan 9, 2820, Bonheiden, Belgium
| | - Saskia Carton
- Department of Gastroenterology, Imelda Hospital Bonheiden, Imeldalaan 9, 2820, Bonheiden, Belgium
| | - Koen Vermeiren
- Department of Surgery, Imelda Hospital Bonheiden, Imeldalaan 9, 2820, Bonheiden, Belgium
| | - Tim Tollens
- Department of Surgery, Imelda Hospital Bonheiden, Imeldalaan 9, 2820, Bonheiden, Belgium
| | - Frederik De Keyzer
- Department of Radiology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Raphaëla Carmen Dresen
- Department of Radiology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| |
Collapse
|
9
|
Irimia A, Van Horn JD. Mapping the rest of the human connectome: Atlasing the spinal cord and peripheral nervous system. Neuroimage 2021; 225:117478. [PMID: 33160086 PMCID: PMC8485987 DOI: 10.1016/j.neuroimage.2020.117478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 09/15/2020] [Accepted: 10/13/2020] [Indexed: 12/13/2022] Open
Abstract
The emergence of diffusion, structural, and functional neuroimaging methods has enabled major multi-site efforts to map the human connectome, which has heretofore been defined as containing all neural connections in the central nervous system (CNS). However, these efforts are not structured to examine the richness and complexity of the peripheral nervous system (PNS), which arguably forms the (neglected) rest of the connectome. Despite increasing interest in an atlas of the spinal cord (SC) and PNS which is simultaneously stereotactic, interactive, electronically dissectible, scalable, population-based and deformable, little attention has thus far been devoted to this task of critical importance. Nevertheless, the atlasing of these complete neural structures is essential for neurosurgical planning, neurological localization, and for mapping those components of the human connectome located outside of the CNS. Here we recommend a modification to the definition of the human connectome to include the SC and PNS, and argue for the creation of an inclusive atlas to complement current efforts to map the brain's human connectome, to enhance clinical education, and to assist progress in neuroscience research. In addition to providing a critical overview of existing neuroimaging techniques, image processing methodologies and algorithmic advances which can be combined for the creation of a full connectome atlas, we outline a blueprint for ultimately mapping the entire human nervous system and, thereby, for filling a critical gap in our scientific knowledge of neural connectivity.
Collapse
Affiliation(s)
- Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue, Los Angeles CA 90089, United States; Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, 1042 Downey Way, Los Angeles, CA 90089, United States.
| | - John Darrell Van Horn
- Department of Psychology, University of Virginia, 485 McCormick Road, Gilmer Hall, Room 102, Charlottesville, Virginia 22903, United States; School of Data Science, University of Virginia, Dell 1, Charlottesville, Virginia 22903, United States.
| |
Collapse
|
10
|
Wang X, Song J, Zhou S, Lu Y, Lin W, Koh TS, Hou Z, Yan Z. A comparative study of methods for determining Intravoxel incoherent motion parameters in cervix cancer. Cancer Imaging 2021; 21:12. [PMID: 33446273 PMCID: PMC7807761 DOI: 10.1186/s40644-020-00377-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/18/2020] [Indexed: 11/21/2022] Open
Abstract
Background To compare different fitting methods for determining IVIM (Intravoxel Incoherent Motion) parameters and to determine whether the use of different IVIM fitting methods would affect differentiation of cervix cancer from normal cervix tissue. Methods Diffusion-weighted echo-planar imaging of 30 subjects was performed on a 3.0 T scanner with b-values of 0, 30, 100, 200, 400, 1000 s/mm2. IVIM parameters were estimated using the segmented (two-step) fitting method and by simultaneous fitting of a bi-exponential function. Segmented fitting was performed using two different cut-off b-values (100 and 200 s/mm2) to study possible variations due to the choice of cut-off. Friedman’s test and Student’s t-test were respectively used to compare IVIM parameters derived from different methods, and between cancer and normal tissues. Results No significant difference was found between IVIM parameters derived from the segmented method with b-value cutoff of 200 s/mm2 and the simultaneous fitting method (P>0.05). Tissue diffusivity (D) and perfusion fraction (f) were significantly lower in cervix cancer than normal tissue (P< 0.05). Conclusions IVIM parameters derived using fitting methods with small cutoff b-values could be different, however, the segmented method with b-value cutoff of 200 s/mm2 are consistent with the simultaneous fitting method and both can be used to differentiate between cervix cancer and normal tissue.
Collapse
Affiliation(s)
- Xue Wang
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325027, China
| | - Jiao Song
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325027, China
| | - Shengfa Zhou
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325027, China
| | - Yi Lu
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325027, China
| | - Wenxiao Lin
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325027, China
| | - Tong San Koh
- Department of Oncologic Imaging, National Cancer Center, Singapore 169610 and Duke-NUS Graduate Medical School, Singapore, 169547, Singapore
| | - Zujun Hou
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, 25163, China
| | - Zhihan Yan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325027, China.
| |
Collapse
|
11
|
Perucho JAU, Chang HCC, Vardhanabhuti V, Wang M, Becker AS, Wurnig MC, Lee EYP. B-Value Optimization in the Estimation of Intravoxel Incoherent Motion Parameters in Patients with Cervical Cancer. Korean J Radiol 2020; 21:218-227. [PMID: 31997597 PMCID: PMC6992446 DOI: 10.3348/kjr.2019.0232] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 10/30/2019] [Indexed: 12/25/2022] Open
Abstract
Objective This study aimed to find the optimal number of b-values for intravoxel incoherent motion (IVIM) imaging analysis, using simulated and in vivo data from cervical cancer patients. Materials and Methods Simulated data were generated using literature pooled means, which served as reference values for simulations. In vivo data from 100 treatment-naïve cervical cancer patients with IVIM imaging (13 b-values, scan time, 436 seconds) were retrospectively reviewed. A stepwise b-value fitting algorithm calculated optimal thresholds. Feed forward selection determined the optimal subsampled b-value distribution for biexponential IVIM fitting, and simplified IVIM modeling using monoexponential fitting was attempted. IVIM parameters computed using all b-values served as reference values for in vivo data. Results In simulations, parameters were accurately estimated with six b-values, or three b-values for simplified IVIM, respectively. In vivo data showed that the optimal threshold was 40 s/mm2 for patients with squamous cell carcinoma and a subsampled acquisition of six b-values (scan time, 198 seconds) estimated parameters were not significantly different from reference parameters (individual parameter error rates of less than 5%). In patients with adenocarcinoma, the optimal threshold was 100 s/mm2, but an optimal subsample could not be identified. Irrespective of the histological subtype, only three b-values were needed for simplified IVIM, but these parameters did not retain their discriminative ability. Conclusion Subsampling of six b-values halved the IVIM scan time without significant losses in accuracy and discriminative ability. Simplified IVIM is possible with only three b-values, at the risk of losing diagnostic information.
Collapse
Affiliation(s)
| | | | | | - Mandi Wang
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong
| | - Anton Sebastian Becker
- Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
| | - Moritz Christoph Wurnig
- Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
| | | |
Collapse
|
12
|
Ding X, Xu H, Zhou J, Xu J, Mei H, Long Q, Wang Y. Reproducibility of normalized apparent diffusion coefficient measurements on 3.0-T diffusion-weighted imaging of normal pancreas in a healthy population. Medicine (Baltimore) 2019; 98:e15104. [PMID: 30946375 PMCID: PMC6456113 DOI: 10.1097/md.0000000000015104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
To prospectively compare the reproducibility of normal pancreas-normalized apparent diffusion coefficient (ADC) measurements for the normal pancreas and mean normalized ADCs at different pancreas anatomic locations.In total, 22 healthy volunteers underwent pancreatic 3.0-T magnetic resonance (MR) imaging, including axial diffusion-weighted (DW) imaging with 3 b values used (0, 400, and 800 s/mm) and with the respiratory-triggered (RT) technique. The mean ADCs from 3 regions of interest (ROIs) in 5 anatomic locations (head [H], body [B], and tail [T] of pancreas and spleen [S] and erector spinae muscles [M]) were calculated. The pancreas-normalized ADC was defined as the ratio of the ADC for the pancreas to the ADC for the spleen or erector spinae muscle. Reproducibility of ADCs and normalized ADCs was assessed by the Bland-Altman method. The ADC and normalized ADC data were analyzed by repeated-measures ANOVA.Mean ADC and normalized ADC values did not differ (P >.05) with repeated measurements at the different pancreas anatomic locations. Reproducibility of pancreas-normalized ADC measurements in each of the 3 pancreatic anatomic locations was better with the erector spinae muscle rather than the spleen used as a reference. Mean ADC and normalized ADC values significantly differed between the 3 pancreatic segments (H: 1.36 × 10 mm/s, B: 1.38 × 10 mm/s, T: 1.25 × 10 mm/s, P = .022; H/S: 1.75, B/S: 1.78, T/S: 1.59, P = .009; H/M: 0.91, B/M: 0.95, T/M: 0.85, P = .008). Mean ADC values and normalized ADC values showed a trend to decrease from the pancreatic head to tail.Our preliminary results suggest that normalized ADC measurements for the pancreas show good intra- and interobserver reproducibility, the erector spinae muscle is a better choice than the spleen for calculating normalized ADC values for the pancreas, and the normalized ADC values are lower for the pancreatic tail than other pancreatic segments.
Collapse
|
13
|
Carceller F, Jerome NP, Fowkes LA, Khabra K, Mackinnon A, Bautista F, Marshall LV, Vaidya S, Mandeville H, Morgan V, Leach MO, Koh DM. Post-radiotherapy apparent diffusion coefficient (ADC) in children and young adults with high-grade gliomas and diffuse intrinsic pontine gliomas. Pediatr Hematol Oncol 2019; 36:103-112. [PMID: 30978130 DOI: 10.1080/08880018.2019.1592267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 03/05/2019] [Indexed: 01/14/2023]
Abstract
Objectives: Diffusion-weighted magnetic resonance imaging (DW-MRI) offers potential to monitor response and predict survival in high-grade gliomas (HGG) and diffuse intrinsic pontine gliomas (DIPG). We hypothesized that post-radiotherapy DW-MRI may provide prognostic imaging biomarkers in children and young adults with these tumors. Methods: Patients aged ≤21 years diagnosed between 2005 and 2012 were eligible. The tumor median apparent diffusion coefficient (ADC) and its 5th percentile (C5-ADC) were determined at the first post-radiotherapy scan and at the time of radiological progression. DW-MRI parameters were correlated with survival endpoints, temozolomide use and pseudoprogression, when it occurred. Results: Out of 40 patients (20 HGG, 20 DIPG), 23 had evaluable DW-MRI post-radiotherapy and 25 at radiological progression. There were 6 episodes of pseudoprogression. Hazard ratios (95%CI) for progression-free survival were 0.998 (0.993-1.003) for median ADC and 1.003 (0.996-1.010) for C5-ADC. Hazard ratios (95%CI) for overall survival were 1.0009 (0.996-1.006) for median ADC and 0.998 (0.992-1.004) for C5-ADC. Post-radiotherapy median and C5-ADC values were not significantly different between patients treated with radiotherapy alone versus radiotherapy/temozolomide. The median and C5-ADC values were not significantly different at the time of pseudoprogression compared to those at tumor progression. Conclusions: Post-radiotherapy median ADC and C5-ADC were not prognostic, nor able to differentiate radiosensitization with temozolomide or occurrence of pseudoprogression in this cohort of HGG and DIPG patients. Further exploration of alternative DW parameters, study timepoints or data modeling may contribute to the development of prognostic/predictive imaging biomarkers for children and young adults with HGG or DIPG.
Collapse
Affiliation(s)
- Fernando Carceller
- a Paediatric Neuro-Oncology and Drug Development Teams, Children & Young People's Unit , The Royal Marsden NHS Foundation Trust , London , UK
- b Division of Clinical Studies and Cancer Therapeutics , The Institute of Cancer Research , London , UK
| | - Neil P Jerome
- c Cancer Research UK Cancer Imaging Centre , The Institute of Cancer Research , London , UK
- d Department of Circulation and Medical Imaging , NTNU - Norwegian University of Science and Technology , Trondheim , Norway
| | - Lucy A Fowkes
- e Department of Radiology , The Royal Marsden NHS Foundation Trust , London , UK
| | - Komel Khabra
- f The Royal Marsden NHS Foundation Trust , Research Data Management and Statistics Unit , London , UK
- g MRC Clinical Trials Unit, University College London , London , UK
| | - Andrew Mackinnon
- e Department of Radiology , The Royal Marsden NHS Foundation Trust , London , UK
| | | | - Lynley V Marshall
- a Paediatric Neuro-Oncology and Drug Development Teams, Children & Young People's Unit , The Royal Marsden NHS Foundation Trust , London , UK
- b Division of Clinical Studies and Cancer Therapeutics , The Institute of Cancer Research , London , UK
| | - Sucheta Vaidya
- a Paediatric Neuro-Oncology and Drug Development Teams, Children & Young People's Unit , The Royal Marsden NHS Foundation Trust , London , UK
- b Division of Clinical Studies and Cancer Therapeutics , The Institute of Cancer Research , London , UK
| | - Henry Mandeville
- i Department of Radiotherapy , The Royal Marsden NHS Foundation Trust , London , UK
| | - Veronica Morgan
- e Department of Radiology , The Royal Marsden NHS Foundation Trust , London , UK
| | - Martin O Leach
- c Cancer Research UK Cancer Imaging Centre , The Institute of Cancer Research , London , UK
| | - Dow-Mu Koh
- e Department of Radiology , The Royal Marsden NHS Foundation Trust , London , UK
| |
Collapse
|
14
|
Siddiqui N, Vendrami CL, Chatterjee A, Miller FH. Advanced MR Imaging Techniques for Pancreas Imaging. Magn Reson Imaging Clin N Am 2019; 26:323-344. [PMID: 30376973 DOI: 10.1016/j.mric.2018.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Advances in MR imaging with optimization of hardware, software, and techniques have allowed for an increased role of MR in the identification and characterization of pancreatic disorders. Diffusion-weighted imaging improves the detection and staging of pancreatic neoplasms and aides in the evaluation of acute, chronic and autoimmune pancreatitis. The use of secretin-enhanced MR cholangiography improves the detection of morphologic ductal anomalies, and assists in the characterization of pancreatic cystic lesions and evaluation of acute and chronic pancreatitis. Emerging MR techniques such as MR perfusion, T1 mapping/relaxometry, and MR elastography show promise in further evaluating pancreatic diseases.
Collapse
Affiliation(s)
- Nasir Siddiqui
- Department of Radiology, DuPage Medical Group, 430 Warrenville Road, Lisle, IL 60532, USA
| | - Camila Lopes Vendrami
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street Suite 800, Chicago, IL 60611, USA
| | - Argha Chatterjee
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street Suite 800, Chicago, IL 60611, USA
| | - Frank H Miller
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street Suite 800, Chicago, IL 60611, USA.
| |
Collapse
|
15
|
Albrecht J, Polenz D, Kühl AA, Rogasch JMM, Leder A, Sauer IM, Babos M, Mócsai G, Beindorff N, Steffen IG, Brenner W, Koziolek EJ. Diffusion-weighted magnetic resonance imaging using a preclinical 1 T PET/MRI in healthy and tumor-bearing rats. EJNMMI Res 2019; 9:21. [PMID: 30796555 PMCID: PMC6386759 DOI: 10.1186/s13550-019-0489-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 02/08/2019] [Indexed: 02/07/2023] Open
Abstract
Background Hybrid positron emission tomography and magnetic resonance imaging (PET/MRI) scanners are increasingly used for both clinical and preclinical imaging. Especially functional MRI sequences such as diffusion-weighted imaging (DWI) are of great interest as they provide information on a molecular level, thus, can be used as surrogate biomarkers. Due to technical restrictions, MR sequences need to be adapted for each system to perform reliable imaging. There is, to our knowledge, no suitable DWI protocol for 1 Tesla PET/MRI scanners. We aimed to establish such DWI protocol with focus on the choice of b values, suitable for longitudinal monitoring of tumor characteristics in a rat liver tumor model. Material and methods DWI was first performed in 18 healthy rat livers using the scanner-dependent maximum of 4 b values (0, 100, 200, 300 s/mm2). Apparent diffusion coefficients (ADC) were calculated from different b value combinations and compared to the reference measurement with four b values. T2-weighted MRI and optimized DWI with best agreement between accuracy, scanning time, and system performance stability were used to monitor orthotopic hepatocellular carcinomas (HCC) in five rats of which three underwent additional 2-deoxy-2-(18F)fluoro-d-glucose(FDG)-PET imaging. ADCs were calculated for the tumor and the surrounding liver parenchyma and verified by histopathological analysis. Results Compared to the reference measurements, the combination b = 0, 200, 300 s/mm2 showed the highest correlation coefficient (rs = 0.92) and agreement while reducing the acquisition time. However, measurements with less than four b values yielded significantly higher ADCs (p < 0.001). When monitoring the HCC, an expected drop of the ADC was observed over time. These findings were paralleled by FDG-PET showing both an increase in tumor size and uptake heterogeneity. Interestingly, surrounding liver parenchyma also showed a change in ADC values revealing varying levels of inflammation by immunohistochemistry. Conclusion We established a respiratory-gated DWI protocol for a preclinical 1 T PET/MRI scanner allowing to monitor growth-related changes in ADC values of orthotopic HCC liver tumors. By monitoring the changes in tumor ADCs over time, different cellular stages were described. However, each study needs to adapt the protocol further according to their question to generate best possible results. Electronic supplementary material The online version of this article (10.1186/s13550-019-0489-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Jakob Albrecht
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. .,German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany. .,German Cancer Research Center (DKFZ) Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
| | - Dietrich Polenz
- Department of Surgery, Campus Charité Mitte, Luisenstraße 64, 10117, Berlin, Germany.,Department of Surgery, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Mittelallee 4, 13353, Berlin, Germany
| | - Anja A Kühl
- iPATH.Berlin - Immunopathology for Experimental Models, Charité - Universitätsmedizin Berlin, Berlin Institute of Health, Core Unit, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Julian M M Rogasch
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Annekatrin Leder
- Department of Surgery, Campus Charité Mitte, Luisenstraße 64, 10117, Berlin, Germany.,Department of Surgery, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Mittelallee 4, 13353, Berlin, Germany
| | - Igor M Sauer
- Department of Surgery, Campus Charité Mitte, Luisenstraße 64, 10117, Berlin, Germany.,Department of Surgery, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Mittelallee 4, 13353, Berlin, Germany
| | - Magor Babos
- Mediso Medical Imaging Systems, Laborc utca 3, Budapest, 1037, Hungary
| | - Gabor Mócsai
- Mediso Medical Imaging Systems, Laborc utca 3, Budapest, 1037, Hungary
| | - Nicola Beindorff
- Berlin Experimental Radionuclide Imaging Center (BERIC), Charité - Universitätsmedizin Berlin, Südstraße 3, 13353, Berlin, Germany
| | - Ingo G Steffen
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Winfried Brenner
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,Berlin Experimental Radionuclide Imaging Center (BERIC), Charité - Universitätsmedizin Berlin, Südstraße 3, 13353, Berlin, Germany
| | - Eva J Koziolek
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,German Cancer Research Center (DKFZ) Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| |
Collapse
|
16
|
Dresen RC, De Vuysere S, De Keyzer F, Van Cutsem E, Prenen H, Vanslembrouck R, De Hertogh G, Wolthuis A, D'Hoore A, Vandecaveye V. Whole-body diffusion-weighted MRI for operability assessment in patients with colorectal cancer and peritoneal metastases. Cancer Imaging 2019; 19:1. [PMID: 30616608 PMCID: PMC6322317 DOI: 10.1186/s40644-018-0187-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 12/26/2018] [Indexed: 02/06/2023] Open
Abstract
Background Correct staging of patients with colorectal cancer is of utmost importance for the prediction of operability. Although computed tomography (CT) has a good overall performance, estimation of peritoneal cancer spread is a known weakness, a problem that cannot always be overcome by Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT); especially in infiltrative and miliary disease spread. Due to its high spatial and contrast resolution magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) might have a better performance. Our aim was to evaluate the added value of whole-body diffusion-weighted MRI (WB-DWI/MRI) to CT for prediction of peritoneal cancer spread and operability assessment in colorectal cancer patients with clinically suspected peritoneal carcinomatosis (PC). Methods This institutional review board approved retrospective study included sixty colorectal cancer patients who underwent WB-DWI/MRI in addition to CT for clinically suspected peritoneal metastases. WB-DWI/MRI and CT were assessed for detecting PC following the peritoneal cancer index (PCI), determination of PCI-score categorized as PC < 12, PCI = 12–15 and PCI > 15, detection of nodal and distant metastases and estimation of overall operability. Histopathology after surgery and biopsy and/or 6 months follow-up were used as reference standard. Results For detection of PC, CT had 43.2% sensitivity, 95.6% specificity, 84.5% positive predictive value (PPV) and 75.2% negative predictive value (NPV). WB-DWI/MRI had 97.8% sensitivity, 93.2% specificity, 88.9% PPV and 98.7% NPV. WB-DWI/MRI enabled better detection of inoperable distant metastases (all 12 patients) than CT (2/12 patients) and significantly improved prediction of PCI category [WB-DWI/MRI PCI < 12: 37/39 patients (94.9%); PCI = 12–15: 4/4 patients (100%); PCI > 15: 16/17 patients (94.1%) versus CT PCI < 12: 38/39 patients (97.4%); PCI = 12–15: 0/4 patients (0%); PCI > 15: 2/17 patients (11.8%); p < 0.0001)]. WB-DWI/MRI improved prediction of inoperability over CT with 90.6% sensitivity compared to 25% (p < 0.0001). Conclusions WB-DWI/MRI significantly outperformed CT for estimation of spread of PC, overall staging and prediction of operability. Pending validation in larger prospective trials, WB-DWI/MRI could be used to guide surgical planning and minimize unnecessary exploratory laparotomies.
Collapse
Affiliation(s)
- Raphaëla Carmen Dresen
- Department of Radiology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Sofie De Vuysere
- Department of Radiology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Frederik De Keyzer
- Department of Radiology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Eric Van Cutsem
- Department of Digestive Oncology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Hans Prenen
- Department of Digestive Oncology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Ragna Vanslembrouck
- Department of Radiology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Gert De Hertogh
- Department of Pathology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Albert Wolthuis
- Department of Abdominal Surgery, from the University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - André D'Hoore
- Department of Abdominal Surgery, from the University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Vincent Vandecaveye
- Department of Radiology, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| |
Collapse
|
17
|
Donners R, Blackledge M, Tunariu N, Messiou C, Merkle EM, Koh DM. Quantitative Whole-Body Diffusion-Weighted MR Imaging. Magn Reson Imaging Clin N Am 2018; 26:479-494. [PMID: 30316462 DOI: 10.1016/j.mric.2018.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Whole-body diffusion-weighted MRI has emerged as a powerful diagnostic tool for disease detection and staging mainly used in systemic bone disease. The large field-of-view functional imaging technique highlights cellular tumor and suppresses normal tissue signal, allowing quantification of an estimate of total disease burden, summarized as the total diffusion volume (tDV), as well as global apparent diffusion coefficient (gADC) measurements. Both tDV and gADC have been shown to be repeatable quantitative parameters that indicate tumor heterogeneity and treatment effects, thus potential, noninvasive, imaging biomarkers informing on disease prognosis and therapy response.
Collapse
Affiliation(s)
- Ricardo Donners
- Department of Radiology, University Hospital Basel, Spitalstrasse 21, Basel 4031, Switzerland
| | - Matthew Blackledge
- Cancer Research UK Cancer Imaging Centre, The Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, UK
| | - Nina Tunariu
- Cancer Research UK Cancer Imaging Centre, The Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, UK; Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK
| | - Christina Messiou
- Cancer Research UK Cancer Imaging Centre, The Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, UK; Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK
| | - Elmar M Merkle
- Department of Radiology, University Hospital Basel, Spitalstrasse 21, Basel 4031, Switzerland
| | - Dow-Mu Koh
- Cancer Research UK Cancer Imaging Centre, The Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, UK; Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK.
| |
Collapse
|
18
|
Jacobs MA, Macura KJ, Zaheer A, Antonarakis ES, Stearns V, Wolff AC, Feiweier T, Kamel IR, Wahl RL, Pan L. Multiparametric Whole-body MRI with Diffusion-weighted Imaging and ADC Mapping for the Identification of Visceral and Osseous Metastases From Solid Tumors. Acad Radiol 2018; 25:1405-1414. [PMID: 29627288 DOI: 10.1016/j.acra.2018.02.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/25/2018] [Accepted: 02/03/2018] [Indexed: 12/31/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of this study was to investigate the use of multiparametric, whole-body, diffusion-weighted imaging (WB-DWI) and apparent diffusion coefficient (ADC) maps with T2-weighted magnetic resonance imaging (MRI) at 3T for the detection and monitoring of metastatic disease in patients. MATERIALS AND METHODS Fifty-four participants (32 healthy subjects and 22 patients) were scanned with WB-DWI methods using a 3T MRI scanner. Axial, sagittal, or coronal fat-suppressed T2-weighted (T2WI), T1-weighted (T1WI), and DWI images were acquired. Total MRI acquisition and set-up time was approximately 45 minutes. Metastatic disease on MRI was confirmed based on T2WI characteristics. The number of lesions was established on computed tomography (CT) or positron emission tomography (PET-CT). Whole-body ADC maps and T2WI were constructed, and region-of-interests were drawn in normal and abnormal-appearing tissue for quantitative analysis. Statistical analysis was performed using a paired t tests and P < .05 was considered statistically significant. RESULTS There were 91 metastatic lesions detected from the CT or PET-CT with a missed recurrent lesion in the prostate. Multiparametric WB-MRI had excellent sensitivity (96%) for detection of metastatic lesions compared to CT. ADC map values and the ADC ratio in metastatic bone lesions were significantly increased (P < .05) compared to normal bone. In soft tissue, ADC map values and ratios in metastatic lesions were decreased compared to normal soft tissue. CONCLUSION We have demonstrated that multiparametric WB-MRI is feasible for oncologic staging to identify bony and visceral metastasis in breast, prostate, pancreatic, and colorectal cancers. WB-MRI can be tailored to fit the patient, such that an "individualized patient sequence" can be developed for a comprehensive evaluation for staging and response during treatment.
Collapse
|
19
|
Yacoub JH, Elsayes KM, Fowler KJ, Hecht EM, Mitchell DG, Santillan C, Szklaruk J. Pitfalls in liver MRI: Technical approach to avoiding misdiagnosis and improving image quality. J Magn Reson Imaging 2018; 49:41-58. [DOI: 10.1002/jmri.26343] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 12/27/2022] Open
Affiliation(s)
- Joseph H Yacoub
- Department of Radiology; Medstar Georgetown University Hospital; Washington DC USA
| | - Khaled M. Elsayes
- Department of Diagnostic Radiology; University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Kathryn J. Fowler
- University of California San Diego Health System, Department of Radiology; San Diego California USA
| | - Elizabeth M. Hecht
- Department of Radiology; New York Presbyterian-Columbia University Medical Center; New York New York
| | - Donald G. Mitchell
- Department of Radiology; Thomas Jefferson University; Philadelphia Pennsylvania USA
| | - Cynthia Santillan
- Liver Imaging Group; University of California San Diego; San Diego California USA
| | - Janio Szklaruk
- Department of Diagnostic Radiology; University of Texas MD Anderson Cancer Center; Houston Texas USA
| |
Collapse
|
20
|
Imaging modalities in synchronous oligometastatic prostate cancer. World J Urol 2018; 37:2573-2583. [PMID: 30069582 PMCID: PMC6868105 DOI: 10.1007/s00345-018-2416-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/18/2018] [Indexed: 02/06/2023] Open
Abstract
Purpose Along with a number of other malignancies, the term “oligometastatic” prostate cancer has recently emerged. It represents an attempt to define a subtype of cancer with a limited metastatic load that might perform more favorably than a distinctly disseminated disease, or even one that may be managed in a potentially curative way. Since there is currently a knowledge gap of what imaging modalities should be utilized to classify patients as having this type of tumor, we aimed to shed light on the role of conventional and marker-based imaging in the setting of synchronous oligometastatic prostate cancer as well as summarize the available evidence for its clinical application. Methods A literature search on December 15th 2017 was conducted using the Pubmed database. Results Functional imaging techniques like 68Ga PSMA. 68Ga PSMA PET-CT has currently been shown the best detection rates for the assessment of nodal, bone and visceral metastases, especially for smaller lesions at low PSA levels. Conclusions Functional imaging helps detect low-burden disease metastatic patients. However, these imaging modalities are not available in every center and thus clinicians may be prone to prescribe systemic treatment rather than referring patients for cytoreductive treatments. We hope that the ongoing prospective trials will help guide clinicians in making a more personalized management of synchronous metastatic patients.
Collapse
|
21
|
Vargas Paris R, Skorpil M, Westerlund E, Lindholm P, Nyrén S. Diffusion-weighted imaging in acute pulmonary embolism: a feasibility study. Acta Radiol Open 2018; 7:2058460118783013. [PMID: 30013795 PMCID: PMC6039903 DOI: 10.1177/2058460118783013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/19/2018] [Indexed: 11/21/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) can be an alternative method to computed tomography angiography (CTA) for pulmonary embolism. Purpose To evaluate the feasibility of diffusion-weighted imaging (DWI) detecting acute pulmonary embolism (PE) in free-breathing humans. Material and Methods Twenty patients with PE verified by CTA and 20 controls were investigated with MRI (1.5 Aera, Siemens Healthcare). All sequences were performed in the transversal plane using free-breathing without gating. The protocol consisted of a two-dimensional steady-state free precession (SSFP) and a single-shot DWI echo-planar imaging sequence with a voxel resolution of 2 × 2 × 5 mm. Three b values were used: 50, 400, and 800 s/mm2. Images were analyzed in two orders: an open source analysis (OSA); and a blinded only DWI analysis (BDA) simulating clinical work. Results OSA of corresponding images showed 370 findings on CTA (i.e. one elongated emboli could be represented in multiple images). SSFP identified 237 of those (64%). DWI with b values of 50, 400, and 800 identified 327 (88%), 245 (66%), and 138 (37%), respectively. In BDA we found 160 true emboli (according to CTA) on b50, 78 on b400, and 54 on b800. Fifty-two of these findings at the subsegmental level could be correlated to PE on CTA but were not visible on SSFP. Conclusions DWI has a high sensitivity for detecting PE but suffers from poor specificity. It could potentially be used as an eye catcher, i.e. where to look for PE in other MRI sequences.
Collapse
Affiliation(s)
- Roberto Vargas Paris
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Abdominal Radiology, Imaging and Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Mikael Skorpil
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - Eli Westerlund
- Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.,Division of Medicine, Danderyd Hospital, Stockholm, Sweden
| | - Peter Lindholm
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Thoracic Radiology, Imaging and Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Sven Nyrén
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Thoracic Radiology, Imaging and Physiology, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
22
|
Kim BR, Song JS, Choi EJ, Hwang SB, Hwang HP. Diffusion-Weighted Imaging of Upper Abdominal Organs Acquired with Multiple B-Value Combinations: Value of Normalization Using Spleen as the Reference Organ. Korean J Radiol 2018; 19:389-396. [PMID: 29713216 PMCID: PMC5904465 DOI: 10.3348/kjr.2018.19.3.389] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 10/28/2017] [Indexed: 01/26/2023] Open
Abstract
Objective To compare apparent diffusion coefficient (ADC) of the upper abdominal organs acquired with multiple b-value combinations and to investigate usefulness of normalization. Materials and Methods We retrospectively analyzed data, including 3T diffusion-weighted images, of 100 patients (56 men, 44 women; mean age, 63.9) that underwent liver magnetic resonance imaging. An ADC map was derived with the following six b-value combinations: b1 = 0, 50, 400, 800; b2 = 0, 800; b3 = 0, 50, 800; b4 = 0, 400, 800; b5 = 50, 800; and b6 = 50, 400, 800 s/mm2. ADC values of the right liver lobe, left liver lobe, spleen, pancreas, right kidney, and left kidney were measured. ADC values of the spleen were used for normalization. Intraclass correlation coefficients (ICCs), comparison of dependent ICCs, and repeated-measures analysis of variance were used for statistical analysis. Results Intraclass correlation coefficients of the original ADC revealed moderate to substantial agreement (0.5145-0.6509), while normalized ADCs revealed almost perfect agreement (0.8014-0.8569). ICC of normalized ADC for all anatomical regions revealed significantly less variability than that of the original ADC (p < 0.05). Coefficient of variance for normalized ADC was significantly lower than that for the original ADC (3.0.3.8% vs. 4.8.8.8%, p < 0.05). Conclusion Normalization of the ADC values of the upper abdominal organs using the spleen as the reference organ significantly decreased variability in ADC measurement acquired with multiple b-value combinations.
Collapse
Affiliation(s)
- Bo Ram Kim
- Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Korea
| | - Ji Soo Song
- Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Korea.,Research Institute of Clinical Medicine of Chonbuk National University, Jeonju 54907, Korea.,Biomedical Research Institute of Chonbuk National University Hospital, Jeonju 54907, Korea
| | - Eun Jung Choi
- Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Korea.,Research Institute of Clinical Medicine of Chonbuk National University, Jeonju 54907, Korea.,Biomedical Research Institute of Chonbuk National University Hospital, Jeonju 54907, Korea
| | - Seung Bae Hwang
- Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Korea.,Research Institute of Clinical Medicine of Chonbuk National University, Jeonju 54907, Korea.,Biomedical Research Institute of Chonbuk National University Hospital, Jeonju 54907, Korea
| | - Hong Pil Hwang
- Department of Surgery, Chonbuk National University Medical School, Jeonju 54907, Korea
| |
Collapse
|
23
|
Advanced imaging to predict response to chemotherapy in colorectal liver metastases - a systematic review. HPB (Oxford) 2018; 20:120-127. [PMID: 29196021 DOI: 10.1016/j.hpb.2017.10.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/24/2017] [Accepted: 10/27/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The assessment of colorectal liver metastases (CRLM) after treatment with chemotherapy is challenging due to morphological and/or functional change without changes in size. The aim of this review was to assess the value of FDG-PET, FDG-PET-CT, CT and MRI in predicting response to chemotherapy in CRLM. METHODS A systematic review was undertaken based on PRISMA statement. PubMed and Embase were searched up to October 2016 for studies on the accuracy of PET, PET-CT, CT and MRI in predicting RECIST or metabolic response to chemotherapy and/or survival in patients with CRLM. Articles evaluating the assessment of response after chemotherapy were excluded. RESULTS Sixteen studies met the inclusion criteria and were included for further analysis. Study results were available for 6 studies for FDG-PET(-CT), 6 studies for CT and 9 studies for MRI. Generally, features predicting RECIST or metabolic response often predicted shorter survival. The ADC (apparent diffusion coefficient, on MRI) seems to be the most promising predictor of response and survival. In CT-related studies, few attenuation-related parameters and texture features show promising results. In FDG-PET(-CT), findings were ambiguous. CONCLUSION Radiological data on the prediction of response to chemotherapy for CRLM is relatively sparse and heterogeneous. Despite that, a promising parameter might be ADC. Second, there seems to be a seemingly counterintuitive correlation between parameters that predict a good response and also predict poor survival.
Collapse
|
24
|
Kambadakone AR, Fung A, Gupta RT, Hope TA, Fowler KJ, Lyshchik A, Ganesan K, Yaghmai V, Guimaraes AR, Sahani DV, Miller FH. LI-RADS technical requirements for CT, MRI, and contrast-enhanced ultrasound. Abdom Radiol (NY) 2018; 43:56-74. [PMID: 28940042 DOI: 10.1007/s00261-017-1325-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Accurate detection and characterization of liver observations to enable HCC diagnosis and staging using LI-RADS requires a technically adequate imaging exam. To help achieve this objective, LI-RADS has proposed technical requirements for CT, MR, and contrast-enhanced ultrasound of liver. This article reviews the technical requirements for liver imaging, including the description of minimum acceptable technical standards, such as the scanner hardware requirements, recommended dynamic imaging phases, and common technical challenges of liver imaging.
Collapse
Affiliation(s)
- Avinash R Kambadakone
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA.
| | - Alice Fung
- Department of Diagnostic Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Rajan T Gupta
- Department of Radiology, Duke University School of Medicine, Durham, NC, USA
| | - Thomas A Hope
- Department of Radiology, University of California San Francisco, San Francisco, CA, USA
| | - Kathryn J Fowler
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Karthik Ganesan
- Department of Radiology, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, India
| | - Vahid Yaghmai
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alexander R Guimaraes
- Department of Diagnostic Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Dushyant V Sahani
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA
| | - Frank H Miller
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
25
|
van Griethuysen JJM, Bus EM, Hauptmann M, Lahaye MJ, Maas M, Ter Beek LC, Beets GL, Bakers FCH, Beets-Tan RGH, Lambregts DMJ. Gas-induced susceptibility artefacts on diffusion-weighted MRI of the rectum at 1.5 T - Effect of applying a micro-enema to improve image quality. Eur J Radiol 2017; 99:131-137. [PMID: 29362144 DOI: 10.1016/j.ejrad.2017.12.020] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 12/20/2017] [Accepted: 12/25/2017] [Indexed: 12/20/2022]
Abstract
PURPOSE Assess whether application of a micro-enema can reduce gas-induced susceptibility artefacts in Single-shot Echo Planar Imaging (EPI) Diffusion-weighted imaging of the rectum at 1.5 T. MATERIALS AND METHODS Retrospective analysis of n = 50 rectal cancer patients who each underwent multiple DWI-MRIs (1.5 T) from 2012 to 2016 as part of routine follow-up during a watch-and-wait approach after chemoradiotherapy. From March 2014 DWI-MRIs were routinely acquired after application of a preparatory micro-enema (Microlax®; 5 ml; self-administered shortly before acquisition); before March 2014 no bowel preparation was given. In total, 335 scans were scored by an experienced reader for the presence/severity of gas-artefacts (on b1000 DWI), ranging from 0 (no artefact) to 5 (severe artefact). A score ≥3 (moderate-severe) was considered a clinically relevant artefact. A random sample of 100 scans was re-assessed by a second independent reader to study inter-observer effects. Scores were compared between the scans performed without and with a preparatory micro-enema using univariable and multivariable logistic regression taking into account potential confounding factors (age/gender, acquisition parameters, MRI-hardware, rectoscopy prior to MRI). RESULTS Clinically relevant gas-artefacts were seen in 24.3% (no micro-enema) vs. 3.7% (micro-enema), odds ratios were 0.118 in univariable and 0.230 in multivariable regression (P = 0.0005 and 0.0291). Mean severity score (±SD) was 1.19 ± 1.71 (no-enema) vs 0.32 ± 0.77 (micro-enema), odds ratios were 0.321 (P < 0.0001) and 0.489 (P = 0.0461) in uni- and multivariable regression, respectively. Inter-observer agreement was excellent (κ0.85). CONCLUSION Use of a preparatory micro-enema shortly before rectal EPI-DWI examinations performed at 1.5 T MRI significantly reduces both the incidence and severity of gas-induced artefacts, compared to examinations performed without bowel preparation.
Collapse
Affiliation(s)
- Joost J M van Griethuysen
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; GROW School of Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Elyse M Bus
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Michael Hauptmann
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Max J Lahaye
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Monique Maas
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Leon C Ter Beek
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Geerard L Beets
- GROW School of Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Surgery, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Frans C H Bakers
- Department of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; GROW School of Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Doenja M J Lambregts
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| |
Collapse
|
26
|
Mirus M, Tokalov SV, Wolf G, Heinold J, Prochnow V, Abolmaali N. Noninvasive assessment and quantification of tumour vascularisation using MRI and CT in a tumour model with modifiable angiogenesis - An animal experimental prospective cohort study. Eur Radiol Exp 2017; 1:15. [PMID: 29708186 PMCID: PMC5909347 DOI: 10.1186/s41747-017-0014-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 07/11/2017] [Indexed: 12/11/2022] Open
Abstract
Background To investigate vascular-related pathophysiological characteristics of two human lung cancers with modifiable vascularisation using MRI and CT. Methods Tumour xenografts with modifiable vascularisation were established in 71 rats (approval by the Animal Care Committee was obtained) by subcutaneous transplantation of two human non-small-cell lung cancer (NSCLC) cells (A549, H1299) either alone or co-transplanted with vascular growth promoters. The vascularity of the tumours was assessed noninvasively by MRI diffusion-weighted-imaging (DWI), T2-weighted, and time-of-flight (TOF) sequences) as well as contrast-enhanced CT (CE-CT), using clinical scanners. As a reference standard, histological examinations (CD-31, fluorescent beads) were done after explantation. Results Microvessel density (MVD) was higher in co-transplanted tumours (171 ± 19 number/mm2) than in non-co-transplanted tumours (111 ± 11 number/mm2; p = 0.002). Co-transplanted tumours showed higher growth rates and larger tumour vessels at TOF-MRI as well as larger necrotic areas at CE-CT. In co-transplanted tumours, DWI revealed higher cellularity (lower minimal ADCdiff 166 ± 15 versus 346 ± 27 mm2/s × 10−6; p < 0.001), highly necrotic areas (higher maximal ADCdiff 1695 ± 65 versus 1320 ± 59 mm2/s × 10−6; p < 0.001), and better-perfused tumour stroma (higher ADCperf 723 ± 36 versus 636 ± 51 mm2/s × 10−6; p = 0.005). Significant correlations were found using qualitative and quantitative parameters: maximal ADCperf and MVD (r = 0.326); maximal ADCdiff and relative necrotic volume on CE-CT (r = 0.551); minimal ADCdiff and MVD (r = −0.395). Conclusions Pathophysiological differences related to vascular supply in two human lung cancer cell lines with modifiable vascularity are quantifiable with clinical imaging techniques. Imaging parameters of vascularisation correlated with the results of histology. DWI was able to characterise both the extent of necrosis and the level of perfusion.
Collapse
Affiliation(s)
- M Mirus
- Biological and Molecular Imaging, OncoRay - National Center for Radiation Research in Oncology, Dresden, Germany.,Department of Anaesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, University of Technology, Dresden, Germany
| | - S V Tokalov
- Biological and Molecular Imaging, OncoRay - National Center for Radiation Research in Oncology, Dresden, Germany.,3Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - G Wolf
- Biological and Molecular Imaging, OncoRay - National Center for Radiation Research in Oncology, Dresden, Germany.,4Institute of Clinical Chemistry and Laboratory Medicine, Carl Gustav Carus Medical Faculty, University of Technology, Dresden, Germany
| | - J Heinold
- Biological and Molecular Imaging, OncoRay - National Center for Radiation Research in Oncology, Dresden, Germany.,Department of Neurology, Municipal Hospital Dresden-Neustadt, Dresden, Germany
| | - V Prochnow
- Biological and Molecular Imaging, OncoRay - National Center for Radiation Research in Oncology, Dresden, Germany.,6Clinic for Obstetrics and Gynecology, Klinikum Chemnitz, Chemnitz, Germany
| | - N Abolmaali
- Biological and Molecular Imaging, OncoRay - National Center for Radiation Research in Oncology, Dresden, Germany.,Department of Radiology, Municipal Hospital and Academic Hospital of the Technical University Dresden, Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany
| |
Collapse
|
27
|
Baheti AD, Luana Stanescu A, Li N, Chapman T. Contrast-enhanced CT features of hepatoblastoma: Can we predict histopathology? Clin Imaging 2017; 44:33-37. [PMID: 28399447 DOI: 10.1016/j.clinimag.2017.03.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/04/2017] [Accepted: 03/31/2017] [Indexed: 02/09/2023]
Abstract
BACKGROUND Hepatoblastoma is the most common hepatic malignancy occurring in the pediatric population. Intratumoral cellular behavior varies, and the small-cell undifferentiated histopathology carries a poorer prognosis than other tissue subtypes. Neoadjuvant chemotherapy is recommended for this tumor subtype prior to surgical resection in most cases. Early identification of tumors with poor prognosis could have a significant clinical impact. Objective The aim of this work was to identify imaging features of small-cell undifferentiated subtype hepatoblastoma that can help distinguish this subtype from more favorable tumors and potentially guide the clinical management. We also sought to characterize contrast-enhanced CT (CECT) features of hepatoblastoma that correlate with metastatic disease and patient outcome. MATERIALS AND METHODS Our study included 34 patients (24 males, 10 females) with a mean age of 16months (range: 0-46months) with surgically confirmed hepatoblastoma and available baseline abdominal imaging by CECT. Clinical data and CT abdominal images were retrospectively analyzed. RESULTS Five tumors with small-cell undifferentiated components were identified. All of these tumors demonstrated irregular margins on CT imaging. Advanced PRETEXT stage, vascular invasion and irregular margins were associated with metastatic disease and decreased survival. Capsular retraction was also significantly associated with decreased survival. Irregular tumor margins demonstrated statistically significant association with the presence of small-cell undifferentiated components. No other imaging feature showed statistically significant association. CONCLUSION Tumor margin irregularity, vascular invasion, capsular retraction, and PRETEXT stage correlate with worse patient outcomes. Irregular tumor margin was the only imaging feature significantly associated with more aggressive tumor subtype.
Collapse
Affiliation(s)
- Akshay D Baheti
- Department of Radiology, Seattle Children's Hospital, University of Washington, Seattle, WA, United States
| | - A Luana Stanescu
- Department of Radiology, Seattle Children's Hospital, University of Washington, Seattle, WA, United States
| | - Ning Li
- Department of Industrial and System Engineering, University of Washington, Seattle, WA, United States
| | - Teresa Chapman
- Department of Radiology, Seattle Children's Hospital, University of Washington, Seattle, WA, United States.
| |
Collapse
|
28
|
Han X, Li J, Wang X. Comparison and Optimization of 3.0 T Breast Images Quality of Diffusion-Weighted Imaging with Multiple B-Values. Acad Radiol 2017; 24:418-425. [PMID: 27955879 DOI: 10.1016/j.acra.2016.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 11/03/2016] [Accepted: 11/03/2016] [Indexed: 02/04/2023]
Abstract
RATIONALE AND OBJECTIVES Breast 3.0 T magnetic resonance diffusion-weighted imaging (MR-DWI) of benign and malignant lesions were obtained to measure and calculate the signal-to-noise ratio (SNR), signal intensity ratio (SIR), and contrast-to-noise ratio (CNR) of lesions at different b-values. The variation patterns of SNR and SIR were analyzed with different b-values and the images of DWI were compared at four different b-values with higher image quality. The effect of SIR on the differential diagnostic efficiency of benign and malignant lesions was compared using receiver operating characteristic curves to provide a reference for selecting the optimal b-value. MATERIALS AND METHODS A total of 96 qualified patients with 112 lesions and 14 patients with their contralateral 14 normal breasts were included in this study. The single-shot echo planar imaging sequence was used to perform the DWI and a total of 13 b-values were used: 0, 50, 100, 200, 400, 600, 800, 1000, 1200, 1500, 1800, 2000, and 2500 s/mm2. On DWI, the suitable regions of interest were selected. The SNRs of normal breasts (SNRnormal), SNRlesions, SIR, and CNR of benign and malignant lesions were measured on DWI with different b-values and calculated. The variation patterns of SNR, SIR, and CNR values on DWI for normal breasts, benign lesions, and malignant lesions with different b-values were analyzed by using Pearson correlation analysis. The SNR and SIR of benign and malignant lesions with the same b-values were compared using t-tests. The diagnostic efficiencies of SIR with different b-values for benign and malignant lesions were evaluated using receiver operating characteristic curves. RESULTS Breast DWI had higher CNR for b-values ranging from 600 to 1200 s/mm2. It had the best CNR at b = 1000 s/mm2 for the benign lesions and at b = 1200 s/mm2 for the malignant lesions. The signal intensity and SNR values of normal breasts decreased with increasing b-values, with a negative correlation (r = -0.945, P < 0.01). The mean SNR values of benign and malignant lesions were negatively correlated (r = -0.982 and -0.947, respectively, and P < 0.01), gradually decreasing with increasing b-values. The mean SIR value of benign lesions gradually decreased with increasing b-values, a negative correlation (r = -0.991, P < 0.01). The mean SIR values of malignant lesions gradually increased with increasing b-values between 0 and 1200 s/mm2, and gradually decreased with increasing b-values ≥ 1500 s/mm2. For b-values of 600, 800, 1000, and 1200 s/mm2, the sensitivity and specificity of SIR in identifying benign and malignant lesions gradually increased with increasing b-values, peaking at 1200 s/mm2. CONCLUSIONS Breast DWI had higher image quality for b-values ranging from 600 to 1200 s/mm2, and was best for b-values ranging from 1000 to 1200 s/mm2. The SIR had the highest diagnostic efficiency in differentiating benign and malignant lesions for a b-value of 1200 s/mm2.
Collapse
Affiliation(s)
- Xiaowei Han
- Department of Radiology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi City, Shanxi Province, China
| | - Junfeng Li
- Department of Radiology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi City, Shanxi Province, China
| | - Xiaoyi Wang
- Department of Radiology, Xiangya Hospital, Central South University, No.87, Xiangya Road, Changsha City, Hunan Province 410008, China.
| |
Collapse
|
29
|
Choi JW, Lee D, Hyun SH, Han M, Kim JH, Lee SJ. Intratumoural heterogeneity measured using FDG PET and MRI is associated with tumour-stroma ratio and clinical outcome in head and neck squamous cell carcinoma. Clin Radiol 2017; 72:482-489. [PMID: 28285707 DOI: 10.1016/j.crad.2017.01.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/02/2017] [Accepted: 01/31/2017] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the association between the tumour-stroma ratio and intratumoural heterogeneity measured using 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET) and magnetic resonance imaging (MRI), and further investigate the prognostic significance of imaging biomarkers in head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS Textural-based imaging parameters of the primary tumour were extracted in 44 patients. In addition, the difference between the minimum and maximum apparent diffusion coefficient (ADC) values (ADCdiff) was calculated on MRI. The relationships between the tumour-stroma ratio and imaging parameters were evaluated. The associations between imaging parameters and recurrence-free survival (RFS) were assessed using Cox proportional hazard regression models. RESULTS Coarseness (r=-0.382) on PET and ADCdiff (r=0.534) on MRI were significantly correlated with the proportion of stroma. The best imaging biomarkers for the 2-year RFS prediction were coarseness (AUC=0.741) and ADCdiff (AUC=0.779). Multivariate analysis showed that coarseness (hazard ratio=10.549, 95% confidence interval=2.544-43.748, p=0.001) was an independent prognostic factor for RFS. CONCLUSION Heterogeneity imaging parameters are significantly associated with the tumour-stroma ratio. These imaging biomarkers may help to facilitate the risk stratification for tumour recurrence in HNSCC.
Collapse
Affiliation(s)
- J W Choi
- Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - D Lee
- Department of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - S H Hyun
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - M Han
- Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - J-H Kim
- Department of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - S J Lee
- Department of Nuclear Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
| |
Collapse
|
30
|
Guimarães MD, Noschang J, Teixeira SR, Santos MK, Lederman HM, Tostes V, Kundra V, Oliveira AD, Hochhegger B, Marchiori E. Whole-body MRI in pediatric patients with cancer. Cancer Imaging 2017; 17:6. [PMID: 28187778 PMCID: PMC5303228 DOI: 10.1186/s40644-017-0107-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/18/2017] [Indexed: 11/10/2022] Open
Abstract
Cancer is the leading cause of natural death in the pediatric populations of developed countries, yet cure rates are greater than 70% when a cancer is diagnosed in its early stages. Recent advances in magnetic resonance imaging methods have markedly improved diagnostic and therapeutic approaches, while avoiding the risks of ionizing radiation that are associated with most conventional radiological methods, such as computed tomography and positron emission tomography/computed tomography. The advent of whole-body magnetic resonance imaging in association with the development of metabolic- and function-based techniques has led to the use of whole-body magnetic resonance imaging for the screening, diagnosis, staging, response assessment, and post-therapeutic follow-up of children with solid sporadic tumours or those with related genetic syndromes. Here, the advantages, techniques, indications, and limitations of whole-body magnetic resonance imaging in the management of pediatric oncology patients are presented.
Collapse
Affiliation(s)
- Marcos Duarte Guimarães
- Department of Imaging, AC Camargo Cancer Center, Rua Prof. Antônio Prudente, 211, Liberdade, São Paulo/SP, 01509-010, Brazil.,Universidade Federal do Vale do São Francisco (UNIVASF), Av. José de Sá Maniçoba, Petrolina, PE, 56304-917, Brazil
| | - Julia Noschang
- Department of Imaging, AC Camargo Cancer Center, Rua Prof. Antônio Prudente, 211, Liberdade, Sao Paulo/SP, 01509-010, Brazil.
| | - Sara Reis Teixeira
- Division of Radiology, Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Av. Bandeirantes, 3900, Ribeirao Preto/ SP, 14049-090, Brazil
| | - Marcel Koenigkam Santos
- Division of Radiology, Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Av. Bandeirantes, 3900, Ribeirao Preto/ SP, 14049-090, Brazil
| | - Henrique Manoel Lederman
- Universidade Federal de São Paulo, Departamento de Diagnóstico Por Imagem, Disciplina de Diagnóstico por Imagem em Pediatria, Rua Napoleão de Barros, 800, Vila Clementino, Sao Paulo/SP, 04024002, Brazil
| | - Vivian Tostes
- Universidade Federal de São Paulo, Centro de Diagnóstico por Imagem do Instituto de Oncologia Pediátrica e Médica Radiologista do Centro de Diagnóstico por Imagem do Instituto de Oncologia Pediátrica, Rua Napoleão de Barros, 800, Vila Clementino, Sao Paulo/SP, 04024002, Brazil
| | - Vikas Kundra
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Alex Dias Oliveira
- Department of Imaging, AC Camargo Cancer Center, Rua Prof. Antônio Prudente, 211, Liberdade, Sao Paulo/SP, 01509-010, Brazil
| | - Bruno Hochhegger
- Department of Radiology, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Professor Anes Dias, 285, Centro Histórico, Porto Alegre/RS, 90020-090, Brazil
| | - Edson Marchiori
- Department of Radiology, Universidade Federal do Rio de Janeiro, Rua Thomaz Cameron, 438, Valparaíso, Petrópolis/RJ, 25685-129, Brazil
| |
Collapse
|
31
|
Teixeira SR, Elias PCL, Leite AFDM, de Oliveira TMG, Muglia VF, Elias Junior J. Apparent diffusion coefficient of normal adrenal glands. Radiol Bras 2017; 49:363-368. [PMID: 28057963 PMCID: PMC5210033 DOI: 10.1590/0100-3984.2015.0045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective To assess the feasibility and reliability of apparent diffusion coefficient
(ADC) measurements of normal adrenal glands. Materials and methods This was a retrospective study involving 32 healthy subjects, divided into
two groups: prepubertal (PreP, n = 12), aged from 2 months
to 12.5 years (4 males; 8 females); and postpubertal (PostP,
n = 20), aged from 11.9 to 61 years (5 males; 15
females). Diffusion-weighted magnetic resonance imaging (DW-MRI) sequences
were acquired at a 1.5 T scanner using b values of 0, 20,
500, and 1000 s/mm2. Two radiologists evaluated the images. ADC
values were measured pixel-by-pixel on DW-MRI scans, and automatic
co-registration with the ADC map was obtained. Results Mean ADC values for the right adrenal glands were 1.44 ×
10-3 mm2/s for the PreP group and 1.23 ×
10-3 mm2/s for the PostP group, whereas they were
1.58 × 10-3 mm2/s and 1.32 ×
10-3 mm2/s, respectively, for the left glands. ADC
values were higher in the PreP group than in the PostP group
(p < 0.05). Agreement between readers was almost
perfect (intraclass correlation coefficient, 0.84-0.94; p
< 0.05). Conclusion Our results demonstrate the feasibility and reliability of performing DW-MRI
measurements of normal adrenal glands. They could also support the
feasibility of ADC measurements of small structures.
Collapse
Affiliation(s)
- Sara Reis Teixeira
- MD, PhD, Attending Physician at the Centro de Ciências das Imagens e Física Médica (CCIFM), Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | - Paula Condé Lamparelli Elias
- MD, PhD, Endocrinology Division of the Department of Internal Medicine, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | - Andrea Farias de Melo Leite
- MD, PhD, Attending Physician at the Instituto de Medicina Integral Professor Fernando Figueira de Pernambuco (IMIP), Recife, PE, Brazil
| | - Tatiane Mendes Gonçalves de Oliveira
- MD, PhD, Attending Physician at the Centro de Ciências das Imagens e Física Médica (CCIFM), Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | - Valdair Francisco Muglia
- MD, PhD, Associate Professor in the Radiology Division of the Department of Internal Medicine, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Jorge Elias Junior
- MD, PhD, Associate Professor in the Radiology Division of the Department of Internal Medicine, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| |
Collapse
|
32
|
Computed diffusion-weighted imaging using 1.5-T magnetic resonance imaging for prostate cancer diagnosis. Clin Imaging 2017; 41:78-82. [DOI: 10.1016/j.clinimag.2016.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/25/2016] [Accepted: 10/14/2016] [Indexed: 01/28/2023]
|
33
|
Cheng L, Blackledge MD, Collins DJ, Orton MR, Jerome NP, Feiweier T, Rata M, Morgan V, Tunariu N, Leach MO, Koh DM. T 2-adjusted computed diffusion-weighted imaging: A novel method to enhance tumour visualisation. Comput Biol Med 2016; 79:92-98. [PMID: 27770679 DOI: 10.1016/j.compbiomed.2016.09.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/28/2016] [Accepted: 09/30/2016] [Indexed: 01/22/2023]
Abstract
PURPOSE To introduce T2-adjusted computed DWI (T2-cDWI), a method that provides synthetic images at arbitrary b-values and echo times (TEs) that improve tissue contrast by removing or increasing T2 contrast in diffusion-weighted images. MATERIALS AND METHODS In addition to the standard DWI acquisition protocol T2-weighted echo-planar images at multiple (≥2) echo times were acquired. This allows voxelwise estimation of apparent diffusion coefficient (ADC) and T2 values, permitting synthetic images to be generated at any chosen b-value and echo time. An analytical model is derived for the noise properties in T2-cDWI, and validated using a diffusion test-object. Furthermore, we present T2-cDWI in two example clinical case studies: (i) a patient with mesothelioma demonstrating multiple disease tissue compartments and (ii) a patient with primary ovarian cancer demonstrating solid and cystic disease compartments. RESULTS Measured image noise in T2-cDWI from phantom experiments conformed to the analytical model and demonstrated that T2-cDWI at high computed b-value/TE combinations achieves lower noise compared with conventional DWI. In patients, T2-cDWI with low b-value and long TE enhanced fluid signal while suppressing solid tumour components. Conversely, large b-values and short TEs overcome T2 shine-through effects and increase the contrast between tumour and fluid compared with conventional high-b-value DW images. CONCLUSION T2-cDWI is a promising clinical tool for improving image signal-to-noise, image contrast, and tumour detection through suppression of T2 shine-through effects.
Collapse
Affiliation(s)
- Lin Cheng
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Matthew D Blackledge
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK.
| | - David J Collins
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Matthew R Orton
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Neil P Jerome
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | | | - Mihaela Rata
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | | | - Nina Tunariu
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Radiology, Royal Marsden Hospital, Sutton, UK
| | - Martin O Leach
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Dow-Mu Koh
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Radiology, Royal Marsden Hospital, Sutton, UK
| |
Collapse
|
34
|
Talaat Ali M, Fouad Osman M, Homos MD, Mohamed Nabil D. Role of 3-T diffusion-weighted magnetic resonance imaging in differentiation between benign and malignant hepatic lesions. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
35
|
Herek D, Karabulut N, Kocyıgıt A, Yagcı AB. Evaluation of Free Breathing Versus Breath Hold Diffusion Weighted Imaging in Terms Apparent Diffusion Coefficient (ADC) and Signal-to-Noise Ratio (SNR) Values for Solid Abdominal Organs. Pol J Radiol 2016; 81:502-506. [PMID: 27822326 PMCID: PMC5083043 DOI: 10.12659/pjr.895868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 03/28/2016] [Indexed: 01/23/2023] Open
Abstract
Background Our aim was to compare the apparent diffusion coefficient (ADC) values of normal abdominal parenchymal organs and signal-to-noise ratio (SNR) measurements in the same patients with breath hold (BH) and free breathing (FB) diffusion weighted imaging (DWI). Material/Methods Forty-eight patients underwent both BH and FB DWI. Spherical region of interest (ROI) was placed on the right hepatic lobe, spleen, pancreas, and renal cortices. ADC values were calculated for each organ on each sequence using an automated software. Image noise, defined as the standard deviation (SD) of the signal intensities in the most artifact-free area of the image background was measured by placing the largest possible ROI on either the left or the right side of the body outside the object in the recorded field of view. SNR was calculated using the formula: SNR=signal intensity (SI)(organ)/standard deviation (SD)(noise). Results There were no statistically significant differences in ADC values of the abdominal organs between BH and FB DWI sequences (p>0.05). There were statistically significant differences between SNR values of organs on BH and FB DWIs. SNRs were found to be better on FB DWI than BH DWI (p<0.001). Conclusions Free breathing DWI technique reduces image noise and increases SNR for abdominal examinations. Free breathing technique is therefore preferable to BH DWI in the evaluation of abdominal organs by DWI.
Collapse
Affiliation(s)
- Duygu Herek
- Department of Radiology, Pamukkale University, School of Medicine, Denizli, Turkey
| | - Nevzat Karabulut
- Department of Radiology, Pamukkale University, School of Medicine, Denizli, Turkey
| | - Ali Kocyıgıt
- Department of Radiology, Pamukkale University, School of Medicine, Denizli, Turkey
| | - Ahmet Baki Yagcı
- Department of Radiology, Pamukkale University, School of Medicine, Denizli, Turkey
| |
Collapse
|
36
|
Abstract
Interpreting body MRI cases can seem overwhelming to an uninitiated radiologist. The standard study includes a variety of pulse sequences, the names of which vary depending on the MR vendor. Pulse sequences may be displayed haphazardly on the picture archiving and communication system (PACS), frequently not synchronized with the imaging protocol. Adding to the complexity is the use of different gadolinium-based contrast agents, which may affect the timing and diagnostic yield of each sequence. The following introductory primer for interpreting body MRI cases is meant to create a basic framework for efficiently reviewing body MRI cases to provide high quality interpretations, fully utilizing the diagnostic information of the modality. There are 4 components that need to be mastered when interpreting body MRI cases including: (1) recognizing the key sequences in a basic body MRI protocol, (2) learning how to best display the key pulse sequences on PACS, (3) understanding the technique and clinical utility of each sequence and learning how to utilize sequences to be an "MR Pathologist", and (4) understanding the key features of the different gadolinium based contrast agents.
Collapse
|
37
|
Zhang H, Gan Q, Wu Y, Liu R, Liu X, Huang Z, Yuan F, Kuang M, Song B. Diagnostic performance of diffusion-weighted magnetic resonance imaging in differentiating human renal lesions (benignity or malignancy): a meta-analysis. Abdom Radiol (NY) 2016; 41:1997-2010. [PMID: 27271218 DOI: 10.1007/s00261-016-0790-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE This study aims to quantitatively evaluate the potential of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiating malignant and benign human renal lesions. MATERIALS AND METHODS A systematic literature was performed to identify previous research related to the diagnostic performance of DW-MRI for determining whether human renal lesions were benign or malignant. ADC values were extracted from normal renal tissue and different lesion types. Data were extracted to assess the diagnostic performance of DW-MRI for differentiating malignant and benign human renal lesions, as well as running threshold effect and heterogeneity. RESULTS Nine publications with 11 subsets were eligible for data extraction and diagnostic performance calculation. A total of 988 apparent diffusion coefficient (ADC) measurements were included. The differences in ADC values between benign lesions (2.47 ± 0.81 × 10(-3) mm(2)/s) and malignant lesions (1.81 ± 0.41 × 10(-3) mm(2)/s) were statistically significant (P < 0.001). The diagnostic odds ratio, the overall positive, negative likelihood ratios, pooled weighted sensitivity and specificity with 95% CI were 20.05 (95% CI 12.56-32.02), 3.32 (95% CI 2.13-5.18), 0.20 (95% CI 0.15-0.27), 88% (95% CI 0.84-0.91) and 72% (95% CI 0.67-0.76), respectively. The area under the curve of the summary receiver operating characteristic was 0.90. CONCLUSIONS This meta-analysis indicated that DW-MRI had a relatively good diagnostic accuracy in differentiating malignant and benign human renal lesions. We preliminarily recommend that DW-MRI is performed with a maximum b value ranging from 800 to 1000 s/mm(2) at 3.0 T for imaging protocol, and that DW-MRI should be used with caution when the study population includes children.
Collapse
Affiliation(s)
- Hanmei Zhang
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Qi Gan
- Department of Neurosurgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yinghua Wu
- Department of Radiology, The Second Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, No. 15, Section 4 Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Rongbo Liu
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Xijiao Liu
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Zixing Huang
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Fang Yuan
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Min Kuang
- Department of Radiology, The Second Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, No. 15, Section 4 Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
38
|
Qian Q, Huang HT, Xu L, Jin P, Lin M. Prediction of Infarct Lesion Volumes by Processing Magnetic Resonance Apparent Diffusion Coefficient Maps in Patients with Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2016; 25:2821-2827. [PMID: 27618198 DOI: 10.1016/j.jstrokecerebrovasdis.2016.07.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/27/2016] [Accepted: 07/27/2016] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE We aimed to investigate the diagnostic value of apparent diffusion coefficient (ADC) maps in magnetic resonance imaging (MRI) in the volume of acute cerebral infarction (ACI). METHODS A total of 207 ACI patients were selected in our study. The cerebral infarction (CI) volume in the initial diffusion-weighted imaging examination, minimum ADC value, relative apparent diffusion coefficient (rADC) value, and mean ADC value were measured. The correlations between age, smoking, drinking, hypertension, diabetes, coronary heart disease, clinical stage, the lowest ADC value, the mean ADC value, and the mean rADC value with CI volume were analyzed by logistic regression analysis. A receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of the ADC value in the ACI volume. RESULTS There was a significant difference in the distribution of the CI volume in ACI patients (P <.05). A significant difference was found in the signal intensity and percentage distribution of ADC map in patients of different CI groups with different CI volumes (P <.05). The signal of the ADC map was positively correlated with the CI volume. The mean ADC and rADC values had significant differences between different CI volumes (all P <.05). Logistic regression analysis revealed that the mean ADC value was significantly correlated with the CI volume (P <.05). Analysis of the ROC curve showed that the quantitative value of ADC has a diagnostic value for the ACI volume. CONCLUSION This study has shown that the signal intensity change on the ADC map in MRI and quantitative analysis of the ADC value can be used as a reference for predicting the ACI volume.
Collapse
Affiliation(s)
- Qi Qian
- Department of Radiology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Hai-Tao Huang
- Department of Radiology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Li Xu
- Department of Radiology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Ping Jin
- Department of Radiology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Min Lin
- Department of Radiology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
| |
Collapse
|
39
|
Karaosmanoglu AD, Onur MR, Ozmen MN, Akata D, Karcaaltincaba M. Magnetic Resonance Imaging of Liver Metastasis. Semin Ultrasound CT MR 2016; 37:533-548. [PMID: 27986172 DOI: 10.1053/j.sult.2016.08.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Liver magnetic resonance imaging (MRI) is becoming the gold standard in liver metastasis detection and treatment response assessment. The most sensitive magnetic resonance sequences are diffusion-weighted images and hepatobiliary phase images after Gd-EOB-DTPA. Peripheral ring enhancement, diffusion restriction, and hypointensity on hepatobiliary phase images are hallmarks of liver metastases. In patients with normal ultrasonography, computed tomography (CT), and positron emission tomography (PET)-CT findings and high clinical suspicion of metastasis, MRI should be performed for diagnosis of unseen metastasis. In melanoma, colon cancer, and neuroendocrine tumor metastases, MRI allows confident diagnosis of treatment-related changes in liver and enables differential diagnosis from primary liver tumors. Focal nodular hyperplasia-like nodules in patients who received platinum-based chemotherapy, hypersteatosis, and focal fat can mimic metastasis. In cancer patients with fatty liver, MRI should be preferred to CT. Although the first-line imaging for metastases is CT, MRI can be used as a problem-solving method. MRI may be used as the first-line method in patients who would undergo curative surgery or metastatectomy. Current limitation of MRI is low sensitivity for metastasis smaller than 3mm. MRI fingerprinting, glucoCEST MRI, and PET-MRI may allow simpler and more sensitive diagnosis of liver metastasis.
Collapse
Affiliation(s)
- Ali Devrim Karaosmanoglu
- Liver Imaging Team, Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Ruhi Onur
- Liver Imaging Team, Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Nasuh Ozmen
- Liver Imaging Team, Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Deniz Akata
- Liver Imaging Team, Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Musturay Karcaaltincaba
- Liver Imaging Team, Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey.
| |
Collapse
|
40
|
Jacobs MA, Wolff AC, Macura KJ, Stearns V, Ouwerkerk R, El Khouli R, Bluemke DA, Wahl R. Multiparametric and Multimodality Functional Radiological Imaging for Breast Cancer Diagnosis and Early Treatment Response Assessment. J Natl Cancer Inst Monogr 2016; 2015:40-6. [PMID: 26063885 DOI: 10.1093/jncimonographs/lgv014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Breast cancer is the second leading cause of cancer death among US women, and the chance of a woman developing breast cancer sometime during her lifetime is one in eight. Early detection and diagnosis to allow appropriate locoregional and systemic treatment are key to improve the odds of surviving its diagnosis. Emerging data also suggest that different breast cancer subtypes (phenotypes) may respond differently to available adjuvant therapies. There is a growing understanding that not all patients benefit equally from systemic therapies, and therapeutic approaches are being increasingly personalized based on predictive biomarkers of clinical benefit. Optimal use of established and novel radiological imaging methods, such as magnetic resonance imaging and positron emission tomography, which have different biophysical mechanisms can simultaneously identify key functional parameters. These methods provide unique multiparametric radiological signatures of breast cancer, that will improve the accuracy of early diagnosis, help select appropriate therapies for early stage disease, and allow early assessment of therapeutic benefit.
Collapse
Affiliation(s)
- Michael A Jacobs
- The Russell H. Morgan Department of Radiology and Radiological Science (MAJ, KJM, RO, REK, DAB, RW), Sidney Kimmel Comprehensive Cancer Center (MAJ, ACW, KJM, VS, RW), and Department of Oncology (ACW, VS), The Johns Hopkins University School of Medicine, Baltimore, MD; National Institute of Diabetes and Digestive and Kidney Diseases (not affialted, RO) and Radiology and Imaging Sciences, National Institutes of Health Clinical Center (DAB), Bethesda, MD.
| | - Antonio C Wolff
- The Russell H. Morgan Department of Radiology and Radiological Science (MAJ, KJM, RO, REK, DAB, RW), Sidney Kimmel Comprehensive Cancer Center (MAJ, ACW, KJM, VS, RW), and Department of Oncology (ACW, VS), The Johns Hopkins University School of Medicine, Baltimore, MD; National Institute of Diabetes and Digestive and Kidney Diseases (not affialted, RO) and Radiology and Imaging Sciences, National Institutes of Health Clinical Center (DAB), Bethesda, MD
| | - Katarzyna J Macura
- The Russell H. Morgan Department of Radiology and Radiological Science (MAJ, KJM, RO, REK, DAB, RW), Sidney Kimmel Comprehensive Cancer Center (MAJ, ACW, KJM, VS, RW), and Department of Oncology (ACW, VS), The Johns Hopkins University School of Medicine, Baltimore, MD; National Institute of Diabetes and Digestive and Kidney Diseases (not affialted, RO) and Radiology and Imaging Sciences, National Institutes of Health Clinical Center (DAB), Bethesda, MD
| | - Vered Stearns
- The Russell H. Morgan Department of Radiology and Radiological Science (MAJ, KJM, RO, REK, DAB, RW), Sidney Kimmel Comprehensive Cancer Center (MAJ, ACW, KJM, VS, RW), and Department of Oncology (ACW, VS), The Johns Hopkins University School of Medicine, Baltimore, MD; National Institute of Diabetes and Digestive and Kidney Diseases (not affialted, RO) and Radiology and Imaging Sciences, National Institutes of Health Clinical Center (DAB), Bethesda, MD
| | - Ronald Ouwerkerk
- The Russell H. Morgan Department of Radiology and Radiological Science (MAJ, KJM, RO, REK, DAB, RW), Sidney Kimmel Comprehensive Cancer Center (MAJ, ACW, KJM, VS, RW), and Department of Oncology (ACW, VS), The Johns Hopkins University School of Medicine, Baltimore, MD; National Institute of Diabetes and Digestive and Kidney Diseases (not affialted, RO) and Radiology and Imaging Sciences, National Institutes of Health Clinical Center (DAB), Bethesda, MD
| | - Riham El Khouli
- The Russell H. Morgan Department of Radiology and Radiological Science (MAJ, KJM, RO, REK, DAB, RW), Sidney Kimmel Comprehensive Cancer Center (MAJ, ACW, KJM, VS, RW), and Department of Oncology (ACW, VS), The Johns Hopkins University School of Medicine, Baltimore, MD; National Institute of Diabetes and Digestive and Kidney Diseases (not affialted, RO) and Radiology and Imaging Sciences, National Institutes of Health Clinical Center (DAB), Bethesda, MD
| | - David A Bluemke
- The Russell H. Morgan Department of Radiology and Radiological Science (MAJ, KJM, RO, REK, DAB, RW), Sidney Kimmel Comprehensive Cancer Center (MAJ, ACW, KJM, VS, RW), and Department of Oncology (ACW, VS), The Johns Hopkins University School of Medicine, Baltimore, MD; National Institute of Diabetes and Digestive and Kidney Diseases (not affialted, RO) and Radiology and Imaging Sciences, National Institutes of Health Clinical Center (DAB), Bethesda, MD
| | - Richard Wahl
- The Russell H. Morgan Department of Radiology and Radiological Science (MAJ, KJM, RO, REK, DAB, RW), Sidney Kimmel Comprehensive Cancer Center (MAJ, ACW, KJM, VS, RW), and Department of Oncology (ACW, VS), The Johns Hopkins University School of Medicine, Baltimore, MD; National Institute of Diabetes and Digestive and Kidney Diseases (not affialted, RO) and Radiology and Imaging Sciences, National Institutes of Health Clinical Center (DAB), Bethesda, MD
| |
Collapse
|
41
|
Evangelista L, Bertoldo F, Boccardo F, Conti G, Menchi I, Mungai F, Ricardi U, Bombardieri E. Diagnostic imaging to detect and evaluate response to therapy in bone metastases from prostate cancer: current modalities and new horizons. Eur J Nucl Med Mol Imaging 2016; 43:1546-62. [PMID: 26956538 DOI: 10.1007/s00259-016-3350-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 02/18/2016] [Indexed: 12/21/2022]
Abstract
Different therapeutic options for the management of prostate cancer (PC) have been developed, and some are successful in providing crucial improvement in both survival and quality of life, especially in patients with metastatic castration-resistant PC. In this scenario, diverse combinations of radiopharmaceuticals (for targeting bone, cancer cells and receptors) and nuclear medicine modalities (e.g. bone scan, SPECT, SPECT/CT, PET and PET/CT) are now available for imaging bone metastases. Some radiopharmaceuticals are approved, currently available and used in the routine clinical setting, while others are not registered and are still under evaluation, and should therefore be considered experimental. On the other hand, radiologists have other tools, in addition to CT, that can better visualize bone localization and medullary involvement, such as multimodal MRI. In this review, the authors provide an overview of current management of advanced PC and discuss the choice of diagnostic modality for the detection of metastatic skeletal lesions in different phases of the disease. In addition to detection of bone metastases, the evaluation of response to therapy is another critical issue, since it remains one of the most important open questions that a multidisciplinary team faces when optimizing the management of PC. The authors emphasize the role of nuclear modalities that can presently be used in clinical practice, and also look at future perspectives based on relevant clinical data with novel radiopharmaceuticals.
Collapse
Affiliation(s)
- Laura Evangelista
- Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padova, Italy
| | - Francesco Bertoldo
- Department of Internal Medicine, School of Medicine, University of Verona, Verona, Italy
| | - Francesco Boccardo
- Academic Unit of Medical Oncology, IRCCS AOU San Martino-IST (San Martino University Hospital and National Cancer Research Institute), Genoa, Italy
| | - Giario Conti
- Department of Urology, Sant' Anna Hospital, Como, Italy
| | - Ilario Menchi
- Department of Diagnostic Imaging, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Francesco Mungai
- Department of Diagnostic Imaging, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Umberto Ricardi
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
| | - Emilio Bombardieri
- Nuclear Medicine Department, Humanitas Gavazzeni, Via Gavazzeni 31, 24125, Bergamo, Italy.
| |
Collapse
|
42
|
Song JS, Hwang SB, Chung GH, Jin GY. Intra-Individual, Inter-Vendor Comparison of Diffusion-Weighted MR Imaging of Upper Abdominal Organs at 3.0 Tesla with an Emphasis on the Value of Normalization with the Spleen. Korean J Radiol 2016; 17:209-17. [PMID: 26957905 PMCID: PMC4781759 DOI: 10.3348/kjr.2016.17.2.209] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 01/13/2016] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To compare the apparent diffusion coefficient (ADC) values of upper abdominal organs with 2 different 3.0 tesla MR systems and to investigate the usefulness of normalization using the spleen. MATERIALS AND METHODS Forty-one patients were enrolled in this prospective study, of which, 35 patients (M:F, 27:8; mean age ± standard deviation, 62.3 ± 12.3 years) were finally analyzed. In addition to the routine liver MR protocol, single-shot spin-echo echo-planar diffusion-weighted imaging using b values of 0, 50, 400, and 800 s/mm(2) in 2 different MR systems was performed. ADC values of the liver, spleen, pancreas, kidney and liver lesion (if present) were measured and analyzed. ADC values of the spleen were used for normalization. The Pearson correlation, Spearman correlation, paired sample t test, Wilcoxon signed rank test and Bland-Altman method were used for statistical analysis. RESULTS For all anatomical regions and liver lesions, both non-normalized and normalized ADC values from 2 different MR systems showed significant correlations (r = 0.5196-0.8488). Non-normalized ADC values of both MR systems differed significantly in all anatomical regions and liver lesions (p < 0.001). However, the normalized ADC of all anatomical regions and liver lesions did not differ significantly (p = 0.065-0.661), with significantly lower coefficient of variance than that of non-normalized ADC (p < 0.009). CONCLUSION Normalization of the abdominal ADC values using the spleen as a reference organ reduces differences between different MR systems, and could facilitate consistent use of ADC as an imaging biomarker for multi-center or longitudinal studies.
Collapse
Affiliation(s)
- Ji Soo Song
- Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Korea.; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju 54907, Korea
| | - Seung Bae Hwang
- Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Korea.; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju 54907, Korea
| | - Gyung Ho Chung
- Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Korea.; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju 54907, Korea
| | - Gong Yong Jin
- Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju 54907, Korea.; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju 54907, Korea
| |
Collapse
|
43
|
Colagrande S, Castellani A, Nardi C, Lorini C, Calistri L, Filippone A. The role of diffusion-weighted imaging in the detection of hepatic metastases from colorectal cancer: A comparison with unenhanced and Gd-EOB-DTPA enhanced MRI. Eur J Radiol 2016; 85:1027-34. [PMID: 27130067 DOI: 10.1016/j.ejrad.2016.02.011] [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: 09/11/2015] [Revised: 12/14/2015] [Accepted: 02/08/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To compare the role of DWI vs. gadoxetic-acid-disodium enhanced MRI in the detection of colorectal hepatic metastases. METHODS Fifty-four patients with 115 hepatic metastases were included in this retrospective study, approved by the Ethical Board. All patients underwent intraoperative-ultrasound and surgical resection within two weeks after MRI. Images were grouped in 4 sets, which were analyzed by two radiologists in different sessions: unenhanced T1-T2w (set A), set A plus DWI (set B), set A plus gadoxetic-acid-disodium (set C), set A plus DWI plus gadoxetic-acid-disodium (set D). For each set, metastases presence/size/site was reported. Interobserver agreement and statistical significance were assessed by Cohen's kappa and Mc-Nemar's test, respectively. RESULTS Readers' agreement was always very good (k>0.80). Mean sensitivity values were 84.3/92.1/95.6/97.3% for set A/B/C/D, respectively. Mean specificity, positive predicted, negative predicted, and accuracy values strongly and progressively increased in the various set too: from 62.5% (set A) to 85.0% as for specificity, from 92.8% to 97.3% as for positive predicted value, from 41.0% to 85.1% as for negative predicted value, and from 81.1% to 95.5% as for accuracy. For each reader from set A to D, the number of false negatives progressively decreases. CONCLUSIONS For both readers, DWI improved all statistical parameters in the unenhanced examinations, as for nodules either smaller or greater than 1cm, while in the EOB-enhanced examinations DWI prevalently increased specificity/negative predictive value.
Collapse
Affiliation(s)
- Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy.
| | - Alessandro Castellani
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy.
| | - Cosimo Nardi
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy.
| | - Chiara Lorini
- Department of Health Science, University of Florence, viale GB Morgagni 48, Florence 50134, Italy.
| | - Linda Calistri
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy.
| | - Antonella Filippone
- Departement of Neurosciences and Imaging, Section of Radiological Imaging, "G. d'Annunzio" University-Ospedale SS. Annunziata, Via dei Vestini, Chieti 66013, Italy.
| |
Collapse
|
44
|
Teixeira PAG, Gay F, Chen B, Zins M, Sirveaux F, Felblinger J, Blum A. Diffusion-weighted magnetic resonance imaging for the initial characterization of non-fatty soft tissue tumors: correlation between T2 signal intensity and ADC values. Skeletal Radiol 2016; 45:263-71. [PMID: 26619837 DOI: 10.1007/s00256-015-2302-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 11/16/2015] [Accepted: 11/18/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the performance of quantitative diffusion-weighted imaging (DWI) correlated with T2 signal in differentiating non-fatty benign from malignant tumors. MATERIAL AND METHODS A total of 76 patients with a histologically confirmed non-fatty soft tissue tumors (46 benign and 30 malignant) were prospectively included in this ethics committee approved study. All patients signed an informed consent and underwent MRI with DWI with two b values (0 and 600). ADC values from the solid components of these tumors were obtained and were correlated with the lesion's signal intensity on T2-weighted fat-saturated sequences. ADC values were obtained from adjacent normal muscle to allow calculation of tumor/muscle ADC ratios. RESULTS There were 58 hyperintense and 18 iso or hypointense lesions. All hypointense lesions were benign. The mean ADC values for benign and malignant tumors were 1.47 ± 0.54 × 10(-3) and 1.17 ± 0.38 × 10(-3) mm(2)/s respectively (p < 0.005). The mean ADC ratio in benign iso or hypointense tumors was significantly lower than that of hyperintense ones (0.76 ± 0.21 versus 1.58 ± 0.82 - p < 0.0001). An ADC ratio lower than 0.915 was highly specific for malignancy (96.4 %), whereas an ADC ratio higher than 1.32 was highly sensitive for benign lesions (90 %). CONCLUSION ADC analysis can be useful in the initial characterization of T2 hyperintense non-fatty soft tissue masses, although this technique alone is not likely to change patient management.
Collapse
Affiliation(s)
- Pedro Augusto Gondim Teixeira
- Service d'Imagerie Guilloz, CHU Nancy, 29 Avenue du Maréchal de Lattre de Tassigny, Nancy, 54000, France. .,Université de Lorraine, IADI, UMR S 947, Tour Drouet Rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France.
| | - Frederique Gay
- Service d'Imagerie Guilloz, CHU Nancy, 29 Avenue du Maréchal de Lattre de Tassigny, Nancy, 54000, France
| | - Bailiang Chen
- Université de Lorraine, IADI, UMR S 947, Tour Drouet Rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France
| | - Marie Zins
- University Versailles St-Quentin, 78035, Versailles, France.,Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, 94807, Villejuif, France
| | - François Sirveaux
- Service de Chirurgie Traumatologique et Orthopédique, Centre Chirurgical Emile Gallé, 54000, Nancy, France
| | - Jacques Felblinger
- Université de Lorraine, IADI, UMR S 947, Tour Drouet Rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France
| | - Alain Blum
- Service d'Imagerie Guilloz, CHU Nancy, 29 Avenue du Maréchal de Lattre de Tassigny, Nancy, 54000, France
| |
Collapse
|
45
|
Koh DM, Lee JM, Bittencourt LK, Blackledge M, Collins DJ. Body Diffusion-weighted MR Imaging in Oncology: Imaging at 3 T. Magn Reson Imaging Clin N Am 2016; 24:31-44. [PMID: 26613874 DOI: 10.1016/j.mric.2015.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Advances in hardware and software enable high-quality body diffusion-weighted images to be acquired for oncologic assessment. 3.0 T affords improved signal/noise for higher spatial resolution and smaller field-of-view diffusion-weighted imaging (DWI). DWI at 3.0 T can be applied as at 1.5 T to improve tumor detection, disease characterization, and the assessment of treatment response. DWI at 3.0 T can be acquired on a hybrid PET-MR imaging system, to allow functional MR information to be combined with molecular imaging.
Collapse
Affiliation(s)
- Dow-Mu Koh
- Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
| | - Jeong-Min Lee
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
| | - Leonardo Kayat Bittencourt
- Department of Radiology, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil; CDPI and Multi-Imagem Clinics, Rio de Janeiro, Brazil
| | | | | |
Collapse
|
46
|
Apparent Diffusion Coefficient and Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Pancreatic Cancer. J Comput Assist Tomogr 2016; 40:709-16. [DOI: 10.1097/rct.0000000000000434] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
47
|
Comparison of Free-Breathing With Navigator-Triggered Technique in Diffusion Weighted Imaging for Evaluation of Small Hepatocellular Carcinoma: Effect on Image Quality and Intravoxel Incoherent Motion Parameters. J Comput Assist Tomogr 2015. [PMID: 26196345 DOI: 10.1097/rct.0000000000000278] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate the effect on image quality and intravoxel incoherent motion (IVIM) parameters of small hepatocellular carcinoma (HCC) from choice of either free-breathing (FB) or navigator-triggered (NT) diffusion-weighted (DW) imaging. METHODS Thirty patients with 37 small HCCs underwent IVIM DW imaging using 12 b values (0-800 s/mm) with 2 sequences: NT, FB. A biexponential analysis with the Bayesian method yielded true diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) in small HCCs and liver parenchyma. Apparent diffusion coefficient (ADC) was also calculated. The acquisition time and image quality scores were assessed for 2 sequences. Independent sample t test was used to compare image quality, signal intensity ratio, IVIM parameters, and ADC values between the 2 sequences; reproducibility of IVIM parameters, and ADC values between 2 sequences was assessed with the Bland-Altman method (BA-LA). RESULTS Image quality with NT sequence was superior to that with FB acquisition (P = 0.02). The mean acquisition time for FB scheme was shorter than that of NT sequence (6 minutes 14 seconds vs 10 minutes 21 seconds ± 10 seconds P < 0.01). The signal intensity ratio of small HCCs did not vary significantly between the 2 sequences. The ADC and IVIM parameters from the 2 sequences show no significant difference. Reproducibility of D*and f parameters in small HCC was poor (BA-LA: 95% confidence interval, -180.8% to 189.2% for D* and -133.8% to 174.9% for f). A moderate reproducibility of D and ADC parameters was observed (BA-LA: 95% confidence interval, -83.5% to 76.8% for D and -74.4% to 88.2% for ADC) between the 2 sequences. CONCLUSIONS The NT DW imaging technique offers no advantage in IVIM parameters measurements of small HCC except better image quality, whereas FB technique offers greater confidence in fitted diffusion parameters for matched acquisition periods.
Collapse
|
48
|
Guimaraes MD, Hochhegger B, Santos MK, Santana PRP, Sousa AS, Souza LS, Marchiori E. Magnetic resonance imaging of the chest in the evaluation of cancer patients: state of the art. Radiol Bras 2015. [PMID: 25798006 PMCID: PMC4366027 DOI: 10.1590/0100-3984.2013.1921] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Magnetic resonance imaging (MRI) has several advantages in the evaluation of cancer
patients with thoracic lesions, including involvement of the chest wall, pleura,
lungs, mediastinum, esophagus and heart. It is a quite useful tool in the diagnosis,
staging, surgical planning, treatment response evaluation and follow-up of these
patients. In the present review, the authors contextualize the relevance of MRI in
the evaluation of thoracic lesions in cancer patients. Considering that MRI is a
widely available method with high contrast and spatial resolution and without the
risks associated with the use of ionizing radiation, its use combined with new
techniques such as cine-MRI and functional methods such as perfusion- and
diffusion-weighted imaging may be useful as an alternative tool with performance
comparable or complementary to conventional radiological methods such as radiography,
computed tomography and PET/CT imaging in the evaluation of patients with thoracic
neoplasias.
Collapse
Affiliation(s)
- Marcos Duarte Guimaraes
- PhD, Radiologist, Specialist in Internal Medicine, Responsible for Chest Imaging Units at Hospital Heliópolis and A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Bruno Hochhegger
- PhD, Associate Professor at Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Marcel Koenigkam Santos
- PhD, Radiologist at Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | - Pablo Rydz Pinheiro Santana
- MD, Member of Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), Thoracic Radiologist at Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil
| | - Arthur Soares Sousa
- PhD, Professor and Post-graduation Advisor, Faculdade de Medicina de São José do Rio Preto (Famerp), São José do Rio Preto, SP, Brazil
| | - Luciana Soares Souza
- MD, Radiologist, Faculdade de Medicina São José do Rio Preto (Famerp), São José do Rio Preto, SP, Brazil
| | - Edson Marchiori
- PhD, Adjunct Coordinator of Post-Graduation, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| |
Collapse
|
49
|
Fowkes LA, Koh DM, Collins DJ, Jerome NP, MacVicar D, Chua SC, Pearson ADJ. Childhood extracranial neoplasms: the role of imaging in drug development and clinical trials. Pediatr Radiol 2015; 45:1600-15. [PMID: 26045035 DOI: 10.1007/s00247-015-3342-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/16/2015] [Accepted: 03/16/2015] [Indexed: 12/25/2022]
Abstract
Cancer is the leading cause of death in children older than 1 year of age and new drugs are necessary to improve outcomes. Imaging is crucial to the drug development process and assessment of therapeutic response. In adults, tumours are often assessed with CT using size criteria. Unfortunately, techniques established in adults are not necessarily applicable in children due to differing pathophysiology, ability to cooperate and increased susceptibility to ionising radiation. MRI, in particular quantitative MRI, has to date not been fully utilised in children with extracranial neoplasms. The specific challenges of imaging in children, the potential for functional imaging techniques to inform upon and their inclusion in clinical trials are discussed.
Collapse
Affiliation(s)
- Lucy A Fowkes
- Department of Radiology, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK.
| | - Dow-Mu Koh
- Department of Radiology, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK
| | - David J Collins
- Cancer Research UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, Surrey, UK
| | - Neil P Jerome
- Cancer Research UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, Surrey, UK
| | - David MacVicar
- Department of Radiology, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK
| | - Sue C Chua
- Nuclear Medicine & PET Department, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK
| | - Andrew D J Pearson
- Paediatric Drug Development Unit, Children and Young People's Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK
| |
Collapse
|
50
|
Kanthabalan A, Shah T, Arya M, Punwani S, Bomanji J, Haroon A, Illing RO, Latifoltojar A, Freeman A, Jameson C, van der Meulen J, Charman S, Emberton M, Ahmed HU. The FORECAST study - Focal recurrent assessment and salvage treatment for radiorecurrent prostate cancer. Contemp Clin Trials 2015; 44:175-186. [PMID: 26184343 DOI: 10.1016/j.cct.2015.07.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/29/2015] [Accepted: 07/03/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND One-third of men may experience biochemical failure by 8years following radical radiotherapy for localised prostate cancer. Over 90% of men are started on androgen deprivation therapy (ADT) which is non-curative and confers systemic side-effects. Focal salvage therapy (FST) limits collateral tissue damage and may improve therapeutic ratios. In order to deliver FST, distant disease must be ruled-out and intra-prostatic disease must be accurately detected, localised and characterised. AIM FORECAST - Focal Recurrent Assessment and Salvage Treatment - is a study designed to evaluate a novel imaging-based diagnostic and therapeutic complex intervention pathway for men who fail radiotherapy. METHODS Men with biochemical failure following radical prostate radiotherapy, prior to salvage therapy will be recruited. They will undergo whole-body multi-parametric MRI (WB-MRI), choline PET/CT, bone-scan and pelvic-mpMRI and then MRI transperineal-targeted biopsies (MRI-TB) and Transperineal Template Prostate Mapping Biopsy (TPM). Those suitable for FST will undergo either high intensity focused ultrasound (HIFU) or cryotherapy. RESULTS Primary outcome measures: a) the accuracy of WB-MRI to detect distant metastatic disease; b) accuracy of prostate mpMRI in local detection of radiorecurrent prostate cancer; c) detection accuracy of MRI-TB; and d) rate of urinary incontinence following FST. CONCLUSION Focal salvage therapy may confer lower rates of morbidity whilst retaining disease control. In order to deliver FST, intra- and extra-prostatic disease must be detected early and localised accurately. Novel diagnostic techniques including WB-MRI and MRI-TB may improve the detection of distant and local disease whilst reducing healthcare burdens compared with current imaging and biopsy strategies.
Collapse
Affiliation(s)
- A Kanthabalan
- Division of Surgery and Interventional Science, University College London, UK; Department of Urology, UCLH NHS Foundation Trust, UK.
| | - T Shah
- Division of Surgery and Interventional Science, University College London, UK
| | - M Arya
- Department of Urology, UCLH NHS Foundation Trust, UK
| | - S Punwani
- Department of Radiology, UCLH NHS Foundation Trust, UK; Centre for Medical Imaging, Division of Medicine, University College London, UK
| | - J Bomanji
- Institute of Nuclear Medicine, UCLH NHS Foundation Trust, UK
| | - A Haroon
- Centre for Medical Imaging and Computing, University College London, UK
| | - R O Illing
- Department of Radiology, UCLH NHS Foundation Trust, UK
| | - A Latifoltojar
- Department of Urology, UCLH NHS Foundation Trust, UK; Centre for Medical Imaging, Division of Medicine, University College London, UK
| | - A Freeman
- Department of Pathology, UCLH NHS Foundation Trust, UK
| | - C Jameson
- Department of Pathology, UCLH NHS Foundation Trust, UK
| | | | - S Charman
- London School of Hygiene and Tropical Medicine, London, UK
| | - M Emberton
- Division of Surgery and Interventional Science, University College London, UK; Department of Urology, UCLH NHS Foundation Trust, UK
| | - H U Ahmed
- Division of Surgery and Interventional Science, University College London, UK; Department of Urology, UCLH NHS Foundation Trust, UK
| |
Collapse
|