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Qu J, Pan B, Su T, Chen Y, Zhang T, Chen X, Zhu X, Xu Z, Wang T, Zhu J, Zhang Z, Feng F, Jin Z. T1 and T2 mapping for identifying malignant lymph nodes in head and neck squamous cell carcinoma. Cancer Imaging 2023; 23:125. [PMID: 38105217 PMCID: PMC10726506 DOI: 10.1186/s40644-023-00648-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND This study seeks to assess the utility of T1 and T2 mapping in distinguishing metastatic lymph nodes from reactive lymphadenopathy in patients with head and neck squamous cell carcinoma (HNSCC), using diffusion-weighted imaging (DWI) as a comparison. METHODS Between July 2017 and November 2019, 46 HNSCC patients underwent neck MRI inclusive of T1 and T2 mapping and DWI. Quantitative measurements derived from preoperative T1 and T2 mapping and DWI of metastatic and non-metastatic lymph nodes were compared using independent samples t-test or Mann-Whitney U test. Receiver operating characteristic curves and the DeLong test were employed to determine the most effective diagnostic methodology. RESULTS We examined a total of 122 lymph nodes, 45 (36.9%) of which were metastatic proven by pathology. Mean T2 values for metastatic lymph nodes were significantly lower than those for benign lymph nodes (p < 0.001). Conversely, metastatic lymph nodes exhibited significantly higher apparent diffusion coefficient (ADC) and standard deviation of T1 values (T1SD) (p < 0.001). T2 generated a significantly higher area under the curve (AUC) of 0.890 (0.826-0.954) compared to T1SD (0.711 [0.613-0.809]) and ADC (0.660 [0.562-0.758]) (p = 0.007 and p < 0.001). Combining T2, T1SD, ADC, and lymph node size achieved an AUC of 0.929 (0.875-0.983), which did not significantly enhance diagnostic performance over using T2 alone (p = 0.089). CONCLUSIONS The application of T1 and T2 mapping is feasible in differentiating metastatic from non-metastatic lymph nodes in HNSCC and can improve diagnostic efficacy compared to DWI.
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Affiliation(s)
- Jiangming Qu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Boju Pan
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Tong Su
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yu Chen
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
| | - Tao Zhang
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Xingming Chen
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Xiaoli Zhu
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Zhentan Xu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Tianjiao Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Jinxia Zhu
- MR Research Collaboration, Siemens Healthineers Ltd, Beijing, China
| | - Zhuhua Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
| | - Feng Feng
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
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Li X, Tian S, Ma C, Chen L, Qin J, Wang N, Lin L, Liu A. Multimodal MRI for Estimating Her-2 Gene Expression in Endometrial Cancer. Bioengineering (Basel) 2023; 10:1399. [PMID: 38135990 PMCID: PMC10740753 DOI: 10.3390/bioengineering10121399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
PURPOSE To assess the value of multimodal MRI, including amide proton transfer-weighted imaging (APT), diffusion kurtosis imaging (DKI), and T2 mapping sequences for estimating human epidermal growth factor receptor-2 (Her-2) expression in patients with endometrial cancer (EC). METHODS A total of 54 patients with EC who underwent multimodal pelvic MRI followed by biopsy were retrospectively selected and divided into the Her-2 positive (n = 24) and Her-2 negative (n = 30) groups. Her-2 expression was confirmed by immunohistochemistry (IHC). Two observers measured APT, mean kurtosis (MK), mean diffusivity (MD), and T2 values for EC lesions. RESULTS The Her-2 (+) group showed higher APT values and lower MD and T2 values than the Her-2 (-) group (all p < 0.05); there was no significant difference in MK values (p > 0.05). The area under the receiver operating characteristic curve (AUC) of APT, MD, T2, APT + T2, APT + MD, T2 + MD, and APT + MD + T2 models to identify the two groups of cases were 0.824, 0.695, 0.721, 0.824, 0.858, 0.782, and 0.860, respectively, and the diagnostic efficacy after combined APT + MD + T2 value was significantly higher than those of MD and T2 values individually (p = 0.018, 0.028); the diagnostic efficacy of the combination of APT + T2 values was significantly higher than that of T2 values separately (p = 0.028). Weak negative correlations were observed between APT and T2 values (r = -0.365, p = 0.007), moderate negative correlations between APT and MD values (r = -0.560, p < 0.001), and weak positive correlations between MD and T2 values (r = 0.336, p = 0.013). The APT values were independent predictors for assessing Her-2 expression in EC patients. CONCLUSION The APT, DKI, and T2 mapping sequences can be used to preoperatively assess the Her-2 expression in EC, which can contribute to more precise treatment for clinical preoperative.
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Affiliation(s)
- Xiwei Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
| | - Shifeng Tian
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
| | - Changjun Ma
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
| | - Lihua Chen
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
| | - Jingwen Qin
- Department of Pathology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Nan Wang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
| | - Liangjie Lin
- Clinical and Technical Support, Philips Healthcare, Beijing 100016, China
| | - Ailian Liu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
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Quantitative synthetic MRI for predicting locally advanced rectal cancer response to neoadjuvant chemoradiotherapy. Eur Radiol 2023; 33:1737-1745. [PMID: 36380196 DOI: 10.1007/s00330-022-09191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/08/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate the value of pre-treatment quantitative synthetic MRI (SyMRI) for predicting a good response to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer. METHODS This prospective study enrolled 63 patients with locally advanced rectal cancer scheduled to undergo preoperative chemoradiotherapy from January 2019 to June 2021. T1 relaxation time (T1), T2 relaxation time (T2), proton density (PD) from synthetic MRI, and apparent diffusion coefficient (ADC) from diffusion-weighted imaging (DWI) were measured. Independent-sample t-test, the Mann-Whitney U test, the Delong test, and receiver operating characteristic curve (ROC) analyses were used to predict the pathologic complete response (pCR) and T-downstaging. RESULTS Among the 63 patients, 19 (30%) achieved pCR and 44 (70%) did not, and 24 (38%) achieved T-downstaging, while 44 (62%) did not. The mean T1 and T2 values were significantly lower in the pCR group compared with those in the non-pCR group and in the T-downstage group compared with those in the non-T-downstage group (all p < 0.05). There were no significant differences in the PD and ADC values between the two groups. There were no significant differences between the mean values of T1 and T2 for predicting pCR after CRT (AUC, 0.767 vs. 0.831, p = 0.37). There were no significant differences between the AUC values of T1 and T2 values for the assessment of post-CRT T-downstaging (AUC, 0.746 vs. 0.820, p = 0.506). CONCLUSIONS In patients with locally advanced rectal cancer, the synthetic MRI-derived T1 relaxation time and T2 relaxation time values are promising imaging markers for predicting a good response to neoadjuvant chemoradiotherapy. KEY POINTS • Mean T1 and T2 values were significantly lower in the pathologic complete response group and the T-downstage group. • There were no significant differences in the proton density and apparent diffusion coefficient values between the two groups.
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Zhu K, Chen Z, Cui L, Zhao J, Liu Y, Cao J. The Preoperative Diagnostic Performance of Multi-Parametric Quantitative Assessment in Rectal Carcinoma: A Preliminary Study Using Synthetic Magnetic Resonance Imaging. Front Oncol 2022; 12:682003. [PMID: 35707367 PMCID: PMC9190242 DOI: 10.3389/fonc.2022.682003] [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: 03/17/2021] [Accepted: 04/19/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Synthetic MRI (SyMRI) can reconstruct different contrast-weighted images(T1, T2, PD) and has shorter scan time, easier post-processing and better reproducibility. Some studies have shown splendid correlation with conventional mapping techniques and no degradation in the quality of syMRI images compared with conventional MRI. It is crucial to select an individualized treatment plan based on the preoperative images of rectal carcinoma (RC). We tried to explore the feasibility of syMRI on T, N stage and extramural vascular invasion (EMVI) of rectal cancer. Materials and Methods A total of 100 patients (37 females and 63 males) diagnosed with rectal carcinoma were enrolled. All the patients underwent preoperative pelvic MR examinations including conventional MR sequence and synthetic MRI. Two radiologists evaluated the MRI findings of each rectal carcinoma and EMVI score in consensus. The values for T1, T2 relaxation times and PD value were measured in tumor(ROI-1) and pararectal fat space(ROI-2) and analyzed independently. A receiver operating characteristic (ROC) analysis was performed. Correlations between the T1, T2 and PD values and EMVI score were also evaluated. Results Compared with the normal rectal wall, the values of T1 and T2 relaxation times of the tumor were significantly higher (P <0.001). There was no statistically significant difference in the PD value (P >0.05). As for ROI, the ROI of pararectal fat space(ROI-2) had better significance than rectal cancer lesion (ROI-1). T2 value of ROI-1 and T1 value of ROI-2 were higher in the pEMVI positive group than in the negative group (P=0.002 and 0.001) and T1 value of ROI-2 had better performance with an AUC of 0.787, (95% CI:0.693- 0.882). T1 value, T2 value and PD value from ROI-2 were effective for both T and N stage of rectal cancer. High-grade pathological stage had showed higher T1 value (PT stage=0.013,PN stage=0.035), lower T2 value (PT stage=0.025,PN stage=0.034) and lower PD value (PT stage=0.017). We also enrolled the characteristics with P < 0.05 in the combined model which had better diagnostic efficacy. A significant positive correlation was found between the T1 value of pararectal fat space(ROI-2) and EMVI score (r value = 0.519, P<0.001). The T2 value(r=0.213,P=0.049) and PD value(r=0.354,P=0.001) from ROI-1 was correlated with EMVI score. Correlation analysis did not show any significant associations between T2 value of tumor, T2, PD values of pararectal fat space and EMVI scores. Conclusion Synthetic MRI can provide multi-parameter quantitative image maps with a easier measurement and slightly shorter acquisition time compared with conventional MRI. The measurement of multi-parametric quantitative values contributes to diagnosing the tumor and evaluating T stage, N stage and EMVI. It has the potential to be used as a preoperative diagnostic and grading technique in rectal carcinoma.
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Affiliation(s)
- Kexin Zhu
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhicheng Chen
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lingling Cui
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jinli Zhao
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yi Liu
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jibin Cao
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
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