1
|
Xu YK, Chai TT, Wang JW, Su GY, Si Y, Wu FY, Xu XQ. Optimal virtual monochromatic images for assessing metastatic lateral cervical lymph nodes in patients with papillary thyroid carcinoma using dual‑layer spectral detector computed tomography. Eur J Radiol 2024; 178:111623. [PMID: 39018649 DOI: 10.1016/j.ejrad.2024.111623] [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: 05/18/2024] [Revised: 06/26/2024] [Accepted: 07/11/2024] [Indexed: 07/19/2024]
Abstract
PURPOSE To determine the optimal virtual monochromatic images (VMIs) from dual-layer spectral detector computed tomography for the visualization and diagnosis of metastatic lateral cervical lymph nodes (LNs) in patients with papillary thyroid carcinoma (PTC). METHODS Ninety-five lateral cervical LNs (49 metastatic and 46 non-metastatic) derived from 24 patients (16 females; mean age, 40.0 ± 13.4 years) were included. 40-100 kiloelectron voltage (keV) VMIs, 120 keV VMI and conventional 120 kV peak (kVp) polyenergetic image (PI) were reconstructed. Five-point scale of subjective image quality, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of LNs were assessed and compared among each VMI and 120 kVp PI. Receiver operating characteristic (ROC) curves and Delong tests were used to assess and compare the diagnostic efficacy of arterial enhancement fraction (AEF) based on each VMI and 120 kVp PI. RESULTS 40 keV VMI showed significantly higher SNR and CNR in both arterial and venous phases, and better image quality in arterial phase than 70-100 keV VMIs, 120 keV VMI, and 120 kVp PI (all p < 0.05). In all sets of images, AEF values of metastatic LNs were significantly higher than those of non-metastatic LNs (all p < 0.05). When using AEF value of 40 keV VMI to diagnose metastatic lateral cervical LNs, an area under ROC curve (AUC) of 0.878, sensitivity of 87.8 % and specificity of 80.4 % could be obtained, while the AUC of AEF value of 120 kVp PI was 0.815 (p = 0.154). CONCLUSION 40 keV VMI might be optimal for displaying and diagnosing the metastatic lateral cervical LNs in patients with PTC.
Collapse
Affiliation(s)
- Yong-Kang Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ting-Ting Chai
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jing-Wei Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guo-Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yan Si
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| |
Collapse
|
2
|
Yang J, Deng L, Jing M, Xu M, Liu X, Li S, Zhang L, Xi H, Yuan L, Zhou J. Added value of spectral computed tomography quantitative parameters for differentiating tuberculosis-associated fibrosing mediastinitis from endobronchial lung cancer: initial results. Clin Radiol 2024; 79:526-535. [PMID: 38658213 DOI: 10.1016/j.crad.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The objective of this study was to explore the added value of spectral computed tomography (CT) parameters to conventional CT features for differentiating tuberculosis-associated fibrosing mediastinitis (TB-associated FM) from endobronchial lung cancer (EBLC). METHODS Chest spectral CT enhancement images from 109 patients with atelectasis were analyzed retrospectively. These patients were divided into two distinct categories: the TB-associated FM group (n = 77) and the EBLC group (n = 32), based on bronchoscopy and/or pathological findings. The selection of spectrum parameters was optimized with the least absolute shrinkage and selection operator regression analysis. The relationship between the spectrum parameters and conventional parameters was explored using Pearson's correlation. Multivariate logistic regression analysis was used to build spectrum model. The spectrum parameters in the spectrum model were replaced with their corresponding conventional parameters to build the conventional model. Diagnostic performances were evaluated using receiver operating characteristic curve analyses. RESULTS There was a moderate correlation between the parameters ㏒(L-AEFNIC) - ㏒(L-AEFC) (r= 0.419; p< 0.0001), ㏒(O-AEF40KeV) - ㏒(O-AEFC) (r= 0.475; p< 0.0001), [L-A-hydroxyapatite {HAP}(I)] - (L-U-CT) (r= 0.604; p< 0.0001), {arterial enhancement fraction (AEF) derived from normalized iodine concentration (NIC) of lymph node (L-AEFNIC), AEF derived from CT40KeV of bronchial obstruction (O-AEF40KeV), arterial-phase Hydroxyapatite (Iodine) concentration of lymph node [L-A-HAP(I)], AEF derived from conventional CT (AEFC), unenhanced CT value (U-CT)}. Spectrum model could improve diagnostic performances compared to conventional model (area under curve: 0.965 vs 0.916, p= 0.038). CONCLUSION There was a moderate correlation between spectrum parameters and conventional parameters. Integrating conventional CT features with spectrum parameters could further improve the ability in differentiating TB-associated FM from EBLC.
Collapse
Affiliation(s)
- J Yang
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - L Deng
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - M Jing
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - M Xu
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - X Liu
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - S Li
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - L Zhang
- Zhang Ye People's Hospital Affiliated to Hexi University, Zhangye, 73400, China.
| | - H Xi
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - L Yuan
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - J Zhou
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| |
Collapse
|
3
|
Xu Z, Huang L, Yang Y, Cai Z, Chen M, Lu R, Ouyang Y, Hong Z, Huang W, Xu Z. Discriminating atypical parotid carcinoma and pleomorphic adenoma utilizing extracellular volume fraction and arterial enhancement fraction derived from contrast-enhanced CT imaging: A multicenter study. Cancer Med 2024; 13:e7407. [PMID: 38899534 PMCID: PMC11187748 DOI: 10.1002/cam4.7407] [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: 02/29/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVES To investigate the added value of extracellular volume fraction (ECV) and arterial enhancement fraction (AEF) derived from enhanced CT to conventional image and clinical features for differentiating between pleomorphic adenoma (PA) and atypical parotid adenocarcinoma (PCA) pre-operation. METHODS From January 2010 to October 2023, a total of 187 cases of parotid tumors were recruited, and divided into training cohort (102 PAs and 51 PCAs) and testing cohort (24 PAs and 10 atypical PCAs). Clinical and CT image features of tumor were assessed. Both enhanced CT-derived ECV and AEF were calculated. Univariate analysis identified variables with statistically significant differences between the two subgroups in the training cohort. Multivariate logistic regression analysis with the forward variable selection method was used to build four models (clinical model, clinical model+ECV, clinical model+AEF, and combined model). Diagnostic performances were evaluated using receiver operating characteristic (ROC) curve analyses. Delong's test compared model differences, and calibration curve and decision curve analysis (DCA) assessed calibration and clinical application. RESULTS Age and boundary were chosen to build clinical model, and to construct its ROC curve. Amalgamating the clinical model, ECV, and AEF to establish a combined model demonstrated superior diagnostic effectiveness compared to the clinical model in both the training and test cohorts (AUC = 0.888, 0.867). There was a significant statistical difference between the combined model and the clinical model in the training cohort (p = 0.0145). CONCLUSIONS ECV and AEF are helpful in differentiating PA and atypical PCA, and integrating clinical and CT image features can further improve the diagnostic performance.
Collapse
Affiliation(s)
- Zhen‐Yu Xu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Lin‐Wen Huang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Yun‐Jun Yang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Zhi‐Ping Cai
- Department of RadiologyShunde Hospital, Southern Medical University (The First People's Hospital of Shunde)FoshanChina
| | - Mei‐Lin Chen
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Rui‐Liang Lu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Yong‐Xi Ouyang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Zhen‐Kai Hong
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Wei‐Jun Huang
- Department of UltrasoundThe First People's Hospital of FoshanFoshanChina
| | - Zhi‐Feng Xu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| |
Collapse
|
4
|
Zhou Y, Xu YK, Geng D, Wang JW, Chen XB, Si Y, Shen MP, Su GY, Xu XQ, Wu FY. Added value of arterial enhancement fraction derived from dual-energy computed tomography for preoperative diagnosis of cervical lymph node metastasis in papillary thyroid cancer: initial results. Eur Radiol 2024; 34:1292-1301. [PMID: 37589903 DOI: 10.1007/s00330-023-10109-0] [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: 01/29/2023] [Revised: 06/09/2023] [Accepted: 06/29/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVES To explore the added value of arterial enhancement fraction (AEF) derived from dual-energy computed tomography CT (DECT) to conventional image features for diagnosing cervical lymph node (LN) metastasis in papillary thyroid cancer (PTC). METHODS A total of 273 cervical LNs (153 non-metastatic and 120 metastatic) were recruited from 92 patients with PTC. Qualitative image features of LNs were assessed. Both single-energy CT (SECT)-derived AEF (AEFS) and DECT-derived AEF (AEFD) were calculated. Correlation between AEFD and AEFS was determined using Pearson's correlation coefficient. Multivariate logistic regression analysis with the forward variable selection method was used to build three models (conventional features, conventional features + AEFS, and conventional features + AEFD). Diagnostic performances were evaluated using receiver operating characteristic (ROC) curve analyses. RESULTS Abnormal enhancement, calcification, and cystic change were chosen to build model 1 and the model provided moderate diagnostic performance with an area under the ROC curve (AUC) of 0.675. Metastatic LNs demonstrated both significantly higher AEFD (1.14 vs 0.48; p < 0.001) and AEFS (1.08 vs 0.38; p < 0.001) than non-metastatic LNs. AEFD correlated well with AEFS (r = 0.802; p < 0.001), and exhibited comparable performance with AEFS (AUC, 0.867 vs 0.852; p = 0.628). Combining CT image features with AEFS (model 2) and AEFD (model 3) could significantly improve diagnostic performances (AUC, 0.865 vs 0.675; AUC, 0.883 vs 0.675; both p < 0.001). CONCLUSIONS AEFD correlated well with AEFS, and exhibited comparable performance with AEFS. Integrating qualitative CT image features with both AEFS and AEFD could further improve the ability in diagnosing cervical LN metastasis in PTC. CLINICAL RELEVANCE STATEMENT Arterial enhancement fraction (AEF) values, especially AEF derived from dual-energy computed tomography, can help to diagnose cervical lymph node metastasis in patients with papillary thyroid cancer, and complement conventional CT image features for improved clinical decision making. KEY POINTS • Metastatic cervical lymph nodes (LNs) demonstrated significantly higher arterial enhancement fraction (AEF) derived from dual-energy computed tomography (DECT) and single-energy CT (SECT)-derived AEF (AEFS) than non-metastatic LNs in patients with papillary thyroid cancer. • DECT-derived AEF (AEFD) correlated significantly with AEFS, and exhibited comparable performance with AEFS. • Integrating qualitative CT images features with both AEFS and AEFD could further improve the differential ability.
Collapse
Affiliation(s)
- Yan Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Gulou District, Nanjing, China
| | - Yong-Kang Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Gulou District, Nanjing, China
| | - Di Geng
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Gulou District, Nanjing, China
| | - Jing-Wei Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Gulou District, Nanjing, China
| | - Xing-Biao Chen
- Section of Clinical Research, Philips Healthcare Ltd, Shanghai, China
| | - Yan Si
- Department of Thyroid Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Mei-Ping Shen
- Department of Thyroid Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guo-Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Gulou District, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Gulou District, Nanjing, China.
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Gulou District, Nanjing, China.
| |
Collapse
|
5
|
Taiji R, Lin YM, Chintalapani G, Lin EY, Huang SY, Mahvash A, Avritscher R, Liu CA, Lee RC, Resende V, Nishiofuku H, Tanaka T, Kichikawa K, Klotz E, Gupta S, Odisio BC. A novel method for predicting hepatocellular carcinoma response to chemoembolization using an intraprocedural CT hepatic arteriography-based enhancement mapping: a proof-of-concept analysis. Eur Radiol Exp 2023; 7:4. [PMID: 36717474 PMCID: PMC9886747 DOI: 10.1186/s41747-022-00315-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 12/01/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND To evaluate the feasibility of a novel approach for predicting hepatocellular carcinoma (HCC) response to drug-eluting beads transarterial chemoembolization (DEB-TACE) using computed tomography hepatic arteriography enhancement mapping (CTHA-EM) method. METHODS This three-institution retrospective study included 29 patients with 46 HCCs treated with DEB-TACE between 2017 and 2020. Pre- and posttreatment CTHA-EM images were generated using a prototype deformable registration and subtraction software. Relative tumor enhancement (TPost/pre-RE) defined as the ratio of tumor enhancement to normal liver tissue was calculated to categorize tumor response as residual (TPost-RE > 1) versus non-residual (TPost-RE ≤ 1) enhancement, which was blinded compared to the response assessment on first follow-up imaging using modified RECIST criteria. Additionally, for tumors with residual enhancement, CTHA-EM was evaluated to identify its potential feeding arteries. RESULTS CTHA-EM showed residual enhancement in 18/46 (39.1%) and non-residual enhancement in 28/46 (60.9%) HCCs, with significant differences on TPost-RE (3.05 ± 2.4 versus 0.48 ± 0.23, respectively; p < 0.001). The first follow-up imaging showed non-complete response (partial response or stable disease) in 19/46 (41.3%) and complete response in 27/46 (58.7%) HCCs. CTHA-EM had a response prediction sensitivity of 94.7% (95% CI, 74.0-99.9) and specificity of 100% (95% CI, 87.2-100). Feeding arteries to the residual enhancement areas were demonstrated in all 18 HCCs (20 arteries where DEB-TACE was delivered, 2 newly developed collaterals following DEB-TACE). CONCLUSION CTHA-EM method was highly accurate in predicting initial HCC response to DEB-TACE and identifying feeding arteries to the areas of residual arterial enhancement.
Collapse
Affiliation(s)
- Ryosuke Taiji
- grid.240145.60000 0001 2291 4776Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 USA ,grid.410814.80000 0004 0372 782XDepartment of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Nara, 634-8521 Japan
| | - Yuan-Mao Lin
- grid.240145.60000 0001 2291 4776Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 USA
| | - Gouthami Chintalapani
- Siemens Medical Solutions USA Inc, 501 North Barrington Road, Hoffman Estates, IL 60192 USA
| | - Ethan Y. Lin
- grid.240145.60000 0001 2291 4776Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 USA
| | - Steven Y. Huang
- grid.240145.60000 0001 2291 4776Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 USA
| | - Armeen Mahvash
- grid.240145.60000 0001 2291 4776Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 USA
| | - Rony Avritscher
- grid.240145.60000 0001 2291 4776Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 USA
| | - Chien-An Liu
- grid.278247.c0000 0004 0604 5314Department of Radiology, Taipei Veterans General Hospital, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Rheun-Chuan Lee
- grid.278247.c0000 0004 0604 5314Department of Radiology, Taipei Veterans General Hospital, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Vivian Resende
- grid.8430.f0000 0001 2181 4888Department of Surgery, Federal University of Minas Gerais, Belo Horizonte, MG Brazil
| | - Hideyuki Nishiofuku
- grid.410814.80000 0004 0372 782XDepartment of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Nara, 634-8521 Japan
| | - Toshihiro Tanaka
- grid.410814.80000 0004 0372 782XDepartment of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Nara, 634-8521 Japan
| | - Kimihiko Kichikawa
- grid.410814.80000 0004 0372 782XDepartment of Radiology and Nuclear Medicine, Nara Medical University, Kashihara, Nara, 634-8521 Japan
| | - Ernst Klotz
- grid.481749.70000 0004 0552 4145Siemens Healthineers, Siemensstraße 3, 91301 Forchheim, Germany
| | - Sanjay Gupta
- grid.240145.60000 0001 2291 4776Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 USA
| | - Bruno C. Odisio
- grid.240145.60000 0001 2291 4776Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 USA
| |
Collapse
|
6
|
Sheng X, Qin JM. Clinical features and diagnostic and therapeutic strategies of hepatic dysplastic nodules. Shijie Huaren Xiaohua Zazhi 2022; 30:169-181. [DOI: 10.11569/wcjd.v30.i4.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatic dysplastic nodules (DNs) are a group of neoplastic lesions with a diameter of more than 1 cm that belong to precancerous lesions, with abnormal cytoplasm and cells but without malignant basis in histology. Hepatic DNs lack typical tumor markers and clinical symptoms, and their clinical diagnosis relys mainly on imaging or/and tissue pathological examination. Thanks to the further research on the pathogenesis of hepatic DNs and the development of imaging technology, the combination of medical history, various examinationss, individual tumor markers, and imaging and histopathology techniques can significantly improve the early detection and diagnosis accuracy for hepatic DNs, and reduce the rate of missed and false diagnosis. Due to the potential malignancy risk of hepatic DNs, intervention measures should be carried out on hepatic DNs at all stages, in order to block the transformation process of DNs into hepatocellular carcinoma (HCC), which is of great clinical significance to reduce the incidence and mortality of HCC.
Collapse
Affiliation(s)
- Xia Sheng
- Department of Pathology, Minhang Hospital Affiliated to Fudan University, Shanghai 201100, China
| | - Jian-Min Qin
- Department of General Surgery, The Third Hospital Affiliated to Naval Military Medical University, Shanghai 201805, China
| |
Collapse
|
7
|
Mao X, Guo Y, Wen F, Liang H, Sun W, Lu Z. Applying arterial enhancement fraction (AEF) texture features to predict the tumor response in hepatocellular carcinoma (HCC) treated with Transarterial chemoembolization (TACE). Cancer Imaging 2021; 21:49. [PMID: 34384496 PMCID: PMC8359085 DOI: 10.1186/s40644-021-00418-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/19/2021] [Indexed: 12/15/2022] Open
Abstract
Background To evaluate the application of Arterial Enhancement Fraction (AEF) texture features in predicting the tumor response in Hepatocellular Carcinoma (HCC) treated with Transarterial Chemoembolization (TACE) by means of texture analysis. Methods HCC patients treated with TACE in Shengjing Hospital of China Medical University from June 2018 to December 2019 were retrospectively enrolled in this study. Pre-TACE Contrast Enhanced Computed Tomography (CECT) and imaging follow-up within 6 months were both acquired. The tumor responses were categorized according to the modified RECIST (mRECIST) criteria. Based on the CECT images, Region of Interest (ROI) of HCC lesion was drawn, the AEF calculation and texture analysis upon AEF values in the ROI were performed using CT-Kinetics (C.K., GE Healthcare, China). A total of 32 AEF texture features were extracted and compared between different tumor response groups. Multi-variate logistic regression was performed using certain AEF features to build the differential models to predict the tumor response. The Receiver Operator Characteristic (ROC) analysis was implemented to assess the discriminative performance of these models. Results Forty-five patients were finally enrolled in the study. Eight AEF texture features showed significant distinction between Improved and Un-improved patients (p < 0.05). In multi-variate logistic regression, 9 AEF texture features were applied into modeling to predict “Improved” outcome, and 4 AEF texture features were applied into modeling to predict “Un-worsened” outcome. The Area Under Curve (AUC), diagnostic accuracy, sensitivity, and specificity of the two models were 0.941, 0.911, 1.000, 0.826, and 0.824, 0.711, 0.581, 1.000, respectively. Conclusions Certain AEF heterogeneous features of HCC could possibly be utilized to predict the tumor response to TACE treatment.
Collapse
Affiliation(s)
- Xiaonan Mao
- Department of Radiology, ShengJing hospital of China Medical University, 12# floor at 1# building, 39 Huaxiang Road, Shenyang City, 110000, Liaoning Province, China
| | - Yan Guo
- GE Healthcare (China), Shanghai, China
| | - Feng Wen
- Department of Radiology, ShengJing hospital of China Medical University, 12# floor at 1# building, 39 Huaxiang Road, Shenyang City, 110000, Liaoning Province, China
| | - Hongyuan Liang
- Department of Radiology, ShengJing hospital of China Medical University, 12# floor at 1# building, 39 Huaxiang Road, Shenyang City, 110000, Liaoning Province, China
| | - Wei Sun
- Department of Radiology, ShengJing hospital of China Medical University, 12# floor at 1# building, 39 Huaxiang Road, Shenyang City, 110000, Liaoning Province, China
| | - Zaiming Lu
- Department of Radiology, ShengJing hospital of China Medical University, 12# floor at 1# building, 39 Huaxiang Road, Shenyang City, 110000, Liaoning Province, China.
| |
Collapse
|
8
|
Huh J, Kim B, Lee JH, Won JH, Kim J, Kwon Y, Kim JK. Added Value of CT Arterial Subtraction Images in Liver Imaging Reporting and Data System Treatment Response Categorization for Transcatheter Arterial Chemoembolization-Treated Hepatocellular Carcinoma. Invest Radiol 2021; 56:109-116. [PMID: 33405431 DOI: 10.1097/rli.0000000000000714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of this study was to assess the benefit of adding arterial subtraction images from computed tomography (CT) to the Liver Imaging Reporting and Data System (LI-RADS) v2018 treatment response (LR-TR) categorization in patients treated with transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). MATERIALS AND METHODS This retrospective study included 115 patients with 151 HCCs treated by TACE using an emulsion of doxorubicin and iodized oil who underwent multiphasic CT protocol that additionally generated arterial subtraction images based on nonrigid anatomic correction algorithm. Of 151 HCCs, 67 (44.4%) were viable and 84 (55.6%) were nonviable. Two independent readers assessed the per-lesion LR-TR categories in set 1 of multiphasic CT images alone and set 2 including both set 1 and CT arterial subtraction images, besides diagnostic confidence, and the quality of subtraction images. The sensitivity and specificity of LR-TR viable category between the sets were compared using the generalized estimating equation. Interobserver agreements of LR-TR categorization in each set and the quality of subtraction images were assessed by Cohen κ. RESULTS The quality of subtraction images was mostly good to perfect (98.7%) with good interobserver agreement (κ = 0.71), and none were nondiagnostic. For detecting viable HCC, LR-TR viable category showed sensitivity of 53.7% to 56.7% and specificity of 96.4% to 98.8% in set 1. In comparison, set 2 showed significantly higher sensitivity of 88.1% to 89.6% (P < 0.002) and equivalent specificity of 94% to 95.2% (P > 0.13) for the same category. In sets 1 and 2, 31.3% to 34.3% and 9% to 10.4% of viable HCC were miscategorized as LR-TR nonviable, respectively. LR-TR equivocal category was less assigned in set 2 (1.3%) than in set 1 (6.6%-7.9%). Set 2 showed slightly higher level of confidence for LR-TR categorization compared with set 1 (3.4 ± 0.8 vs 3.8 ± 0.5). Interobserver agreement was excellent in both sets (κ = 0.85 in set 1 and 0.97 in set 2). CONCLUSIONS The LR-TR viable category is highly specific but inadequately sensitive for detecting viable tumor in TACE-treated HCC on conventional multiphasic CT. Adding arterial subtraction images to the conventional CT images significantly increases sensitivity without compromising the specificity and improves the diagnostic confidence of LR-TR viable category.
Collapse
Affiliation(s)
- Jimi Huh
- From the Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon
| | - Bohyun Kim
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jei Hee Lee
- From the Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon
| | - Je Hwan Won
- From the Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon
| | - Jinoo Kim
- From the Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon
| | - Yohan Kwon
- From the Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon
| | - Jai Keun Kim
- From the Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon
| |
Collapse
|
9
|
Mao X, Guo Y, Lu Z, Wen F, Liang H, Sun W. Enhanced CT Textures Derived From Computer Mathematic Distribution Analysis Enables Arterial Enhancement Fraction Being an Imaging Biomarker Option of Hepatocellular Carcinoma. Front Oncol 2020; 10:1337. [PMID: 32850426 PMCID: PMC7431458 DOI: 10.3389/fonc.2020.01337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/26/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose: This study aims to explore the imaging–clinic relationship and an optional imaging biomarker of hepatocellular carcinoma (HCC) by using texture analysis on arterial enhancement fraction (AEF). Materials and Methods: The HCC patients treated in No. 2 Interventional Ward, ShengJing Hospital of China Medical University from June 2018 to June 2019 were enrolled, for whom tri-phasic enhanced CT scans were acquired. Perfusion analysis and texture analysis were then performed on the tri-phasic enhanced CT images. After the region of interest (ROI) of viable HCC was drawn, 13 AEF textures describing the values distribution were conducted. A between-groups comparison of AEF textures was made where the cases had grouping properties, a correlation analysis was made between AEF textures and alpha-fetoprotein (AFP) as well as other clinical data which were digital, and regression analysis was made when a significant correlation was found. SPSS 19.0 (IBM) was utilized for statistical analysis; a significant difference was considered when P < 0.05. Results: Twenty-five HCC patients were enrolled. Several AEF textures were found to have a correlation with clinical features, including previous surgery history, age, glutamic oxaloacetylase, indirect bilirubin, creatinine, and AFP. The majority of AEF textures (up to 9/13) were found to have a correlation with AFP (SD, variance, uniformity, energy, entropy, inertia, correlation, inverse difference moment, and cluster prominence), while six or seven textures have a linear or cubic relationship with AFP (SD, variance, uniformity, inertia, correlation, cluster prominence, plus inverse difference moment). Conclusion: The AEF textures of HCC are strongly correlated with and are impacted by AFP, which may enable AEF to act as an optional imaging biomarker of HCC.
Collapse
Affiliation(s)
- Xiaonan Mao
- Department of Radiology, ShengJing Hospital of China Medical University, Shenyang, China
| | - Yan Guo
- GE Healthcare, Shanghai, China
| | - Zaiming Lu
- Department of Radiology, ShengJing Hospital of China Medical University, Shenyang, China
| | - Feng Wen
- Department of Radiology, ShengJing Hospital of China Medical University, Shenyang, China
| | - Hongyuan Liang
- Department of Radiology, ShengJing Hospital of China Medical University, Shenyang, China
| | - Wei Sun
- Department of Radiology, ShengJing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
10
|
Xu D, Sheng JQ, Hu PJH, Huang TS, Lee WC. Predicting hepatocellular carcinoma recurrences: A data-driven multiclass classification method incorporating latent variables. J Biomed Inform 2019; 96:103237. [PMID: 31238108 DOI: 10.1016/j.jbi.2019.103237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/30/2019] [Accepted: 06/18/2019] [Indexed: 12/12/2022]
Abstract
Hepatocellular carcinoma (HCC), a malignant form of cancer, is frequently treated with surgical resections, which have relatively high recurrence rates. Effective recurrence predictions enable physicians' timely detections and adequate therapeutic measures that can greatly improve patient care and outcomes. Toward that end, predictions of early versus late HCC recurrences should be considered separately to reflect their distinct onset time horizons, clinical causes, underlying clinical etiology, and pathogenesis. We propose a novel Bayesian network-based method to predict different HCC recurrence outcomes by considering the respective recurrence evolution paths. Typical patient information obtained in early stages is insufficiently informative to predict recurrence outcomes accurately, due to the lack of subsequent patient progression information. Our method alleviates such information deficiency constraints by incorporating an independent latent variable, dominant recurrence type, to regulate recurrence outcome predictions (early, late, or no recurrence). We use a real-world HCC data set to evaluate the proposed method, relative to three prevalent benchmark techniques. Overall, the results show that our method consistently and significantly outperforms all the benchmark techniques in terms of accuracy, precision, recall, and F-measures. For increased robustness, we use another data set to perform an out-of-sample evaluation and obtain similar results. This study thus contributes to HCC recurrence research and offers several implications for clinical practice.
Collapse
Affiliation(s)
- Da Xu
- Department of Operations and Information Systems, David Eccles School of Business, University of Utah, USA.
| | - Jessica Qiuhua Sheng
- Department of Operations and Information Systems, David Eccles School of Business, University of Utah, USA.
| | - Paul Jen-Hwa Hu
- Department of Operations and Information Systems, David Eccles School of Business, University of Utah, USA.
| | - Ting Shuo Huang
- Department of General Surgery, Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC; Department of Chinese Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan, ROC.
| | - Wei-Chen Lee
- Department of Liver and Transplantation Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC; Department of Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan,Taiwan, ROC.
| |
Collapse
|
11
|
Lee DH, Lee JM, Kim PN, Jang YJ, Kang TW, Rhim H, Seo JW, Lee YJ. Whole tumor ablation of locally recurred hepatocellular carcinoma including retained iodized oil after transarterial chemoembolization improves progression-free survival. Eur Radiol 2019; 29:5052-5062. [PMID: 30770968 DOI: 10.1007/s00330-018-5993-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 12/05/2018] [Accepted: 12/28/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate and compare clinical outcomes of two different radiofrequency ablation (RFA) methods for locally recurred hepatocellular carcinoma (LrHCC) after locoregional treatment. METHODS Our institutional review board approved this study with a waiver of informed consent. A total of 313 patients previously treated with transarterial chemoembolization (TACE) (n = 167) and RFA (n = 146) with a single LrHCC ≤ 3 cm was included from five tertiary referral hospitals. RFA was done for LrHCCs using either viable tumor alone ablation (VTA) method (VTA: n = 61 in the TACE group and n = 127 in the RFA group) or whole tumor ablation (WTA) method which includes both viable tumor and retained iodized oil or previously ablated zone (WTA: n = 106 in the TACE group and n = 19 in the RFA group). Local tumor progression (LTP)-free survival as well as progression-free survival (PFS) were estimated using the Kaplan-Meier method, and prognostic factors were evaluated using the Cox proportional hazards regression model. RESULTS In 167 patients with LrHCC who underwent TACE, the 5-year LTP-free survival after RFA was significantly higher with the VTA method than with the WTA method (26.9% vs. 87.8%; p < 0.001; hazard ratio (HR) = 8.53 [4.16-17.5]). The estimated 5-year PFS after RFA for LrHCC after TACE using the VTA method was 5.7%, which was significantly lower than that with the WTA method (26.4%) (p = 0.014; HR = 1.62 [1.10-2.38]). However, in 146 patients with LrHCC after initial RFA, there were no significant differences in cumulative incidence of LTP (p = 0.514) or PFS (p = 0.905) after RFA between the two ablation methods. CONCLUSIONS For RFA of LrHCC after TACE, the WTA method including both viable tumor and retained iodized oil could significantly lower LTP and improve PFS than VTA. KEY POINTS • Whole tumor ablation (WTA) could provide significantly better local tumor control for locally recurred HCC (LrHCC) after TACE than viable tumor alone ablation (VTA). • WTA for LrHCC after TACE could also provide significantly better progression-free survival than VTA. • Regarding LrHCC after RFA, VTA would provide a comparable clinical outcome to WTA.
Collapse
Affiliation(s)
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, South Korea. .,Institute of Radiation Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
| | - Pyo Nyun Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan, Asan Medical Center, Seoul, South Korea
| | - Yun-Jin Jang
- Department of Radiology and Research Institute of Radiology, University of Ulsan, Asan Medical Center, Seoul, South Korea
| | - Tae Wook Kang
- Department of Radiology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Hyunchul Rhim
- Department of Radiology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Jung Wook Seo
- Department of Radiology, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Young Joon Lee
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| |
Collapse
|
12
|
Kim EH, Oh JS, Chun HJ, Choi BG, Lee HG. Usefulness of fusion images of unenhanced and contrast-enhanced arterial phase cone-beam CT in the detection of viable hepatocellular carcinoma during transarterial chemoembolization. ACTA ACUST UNITED AC 2018; 24:262-267. [PMID: 30211679 DOI: 10.5152/dir.2018.17503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to evaluate the diagnostic efficacy of fusion imaging of unenhanced and arterial phase contrast-enhanced cone-beam computed tomography (CBCT) by comparing with multidetector computed tomography (MDCT) in detection of viable hepatocellular carcinoma (HCC) in patients who have been previously treated with transarterial chemoembolization (TACE). METHODS In this retrospective study, a total of 173 tumors in 33 known HCC patients (21 men, 12 women; mean age, 64±7.6 years; mean tumor size, 2.15±1.70 cm) who had been previously treated with TACE and underwent additional session of TACE were included. The sensitivity and positive predictive values of preprocedural MDCT and fusion CBCT for detection of viable tumor were analyzed with follow-up MDCT images performed 3-4 weeks after TACE, as reference standard. RESULTS A total of 141 remote and 32 marginal viable tumors were included. The sensitivities for detection of remote, marginal, and total viable tumors were 80.9%, 68.8%, and 78.6% for MDCT and 96.5%, 96.9%, and 96.5% for fusion CBCT, respectively. The positive predictive values for detection of remote, marginal, and total viable tumors were 95.0%, 78.6%, and 95.8% for MDCT, and 97.1%, 88.6%, and 97.7% for fusion CBCT, respectively. Fusion CBCT showed statistically higher sensitivity and positive predictive value for detection of viable tumors (P < 0.001). CONCLUSION The diagnostic performance of fusion imaging of unenhanced and contrast-enhanced arterial phase CBCT was superior to MDCT for detection of viable HCCs.
Collapse
Affiliation(s)
- Eu Hyun Kim
- Department of Radiology Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Jung Suk Oh
- Department of Radiology Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Ho Jong Chun
- Department of Radiology Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Byung Gil Choi
- Department of Radiology Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Hae Giu Lee
- Department of Radiology Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
13
|
Rastogi A, Maheshwari S, Shinagare AB, Baheti AD. Computed Tomography Advances in Oncoimaging. Semin Roentgenol 2018; 53:147-156. [PMID: 29861006 DOI: 10.1053/j.ro.2018.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Ashita Rastogi
- Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, India
| | - Sharad Maheshwari
- Department of Radiology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - Atul B Shinagare
- Department of Radiology, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA
| | - Akshay D Baheti
- Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, India.
| |
Collapse
|
14
|
Park JE, Han K, Sung YS, Chung MS, Koo HJ, Yoon HM, Choi YJ, Lee SS, Kim KW, Shin Y, An S, Cho HM, Park SH. Selection and Reporting of Statistical Methods to Assess Reliability of a Diagnostic Test: Conformity to Recommended Methods in a Peer-Reviewed Journal. Korean J Radiol 2017; 18:888-897. [PMID: 29089821 PMCID: PMC5639154 DOI: 10.3348/kjr.2017.18.6.888] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 07/28/2017] [Indexed: 12/13/2022] Open
Abstract
Objective To evaluate the frequency and adequacy of statistical analyses in a general radiology journal when reporting a reliability analysis for a diagnostic test. Materials and Methods Sixty-three studies of diagnostic test accuracy (DTA) and 36 studies reporting reliability analyses published in the Korean Journal of Radiology between 2012 and 2016 were analyzed. Studies were judged using the methodological guidelines of the Radiological Society of North America-Quantitative Imaging Biomarkers Alliance (RSNA-QIBA), and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) initiative. DTA studies were evaluated by nine editorial board members of the journal. Reliability studies were evaluated by study reviewers experienced with reliability analysis. Results Thirty-one (49.2%) of the 63 DTA studies did not include a reliability analysis when deemed necessary. Among the 36 reliability studies, proper statistical methods were used in all (5/5) studies dealing with dichotomous/nominal data, 46.7% (7/15) of studies dealing with ordinal data, and 95.2% (20/21) of studies dealing with continuous data. Statistical methods were described in sufficient detail regarding weighted kappa in 28.6% (2/7) of studies and regarding the model and assumptions of intraclass correlation coefficient in 35.3% (6/17) and 29.4% (5/17) of studies, respectively. Reliability parameters were used as if they were agreement parameters in 23.1% (3/13) of studies. Reproducibility and repeatability were used incorrectly in 20% (3/15) of studies. Conclusion Greater attention to the importance of reporting reliability, thorough description of the related statistical methods, efforts not to neglect agreement parameters, and better use of relevant terminology is necessary.
Collapse
Affiliation(s)
- Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Kyunghwa Han
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Yu Sub Sung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Mi Sun Chung
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Korea
| | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Hee Mang Yoon
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Seung Soo Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Youngbin Shin
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Suah An
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Hyo-Min Cho
- Korea Research Institute of Standards and Science, Daejeon 34113, Korea
| | - Seong Ho Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| |
Collapse
|
15
|
Choi YJ, Chung MS, Koo HJ, Park JE, Yoon HM, Park SH. Does the Reporting Quality of Diagnostic Test Accuracy Studies, as Defined by STARD 2015, Affect Citation? Korean J Radiol 2016; 17:706-14. [PMID: 27587959 PMCID: PMC5007397 DOI: 10.3348/kjr.2016.17.5.706] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 05/29/2016] [Indexed: 01/30/2023] Open
Abstract
Objective To determine the rate with which diagnostic test accuracy studies that are published in a general radiology journal adhere to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015, and to explore the relationship between adherence rate and citation rate while avoiding confounding by journal factors. Materials and Methods All eligible diagnostic test accuracy studies that were published in the Korean Journal of Radiology in 2011–2015 were identified. Five reviewers assessed each article for yes/no compliance with 27 of the 30 STARD 2015 checklist items (items 28, 29, and 30 were excluded). The total STARD score (number of fulfilled STARD items) was calculated. The score of the 15 STARD items that related directly to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 was also calculated. The number of times each article was cited (as indicated by the Web of Science) after publication until March 2016 and the article exposure time (time in months between publication and March 2016) were extracted. Results Sixty-three articles were analyzed. The mean (range) total and QUADAS-2-related STARD scores were 20.0 (14.5–25) and 11.4 (7–15), respectively. The mean citation number was 4 (0–21). Citation number did not associate significantly with either STARD score after accounting for exposure time (total score: correlation coefficient = 0.154, p = 0.232; QUADAS-2-related score: correlation coefficient = 0.143, p = 0.266). Conclusion The degree of adherence to STARD 2015 was moderate for this journal, indicating that there is room for improvement. When adjusted for exposure time, the degree of adherence did not affect the citation rate.
Collapse
Affiliation(s)
- Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Mi Sun Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Hee Mang Yoon
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Seong Ho Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| |
Collapse
|
16
|
Hoogenboom TC, Thursz M, Aboagye EO, Sharma R. Functional imaging of hepatocellular carcinoma. Hepat Oncol 2016; 3:137-153. [PMID: 30191034 DOI: 10.2217/hep-2015-0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 01/20/2016] [Indexed: 02/06/2023] Open
Abstract
Imaging plays a key role in the clinical management of hepatocellular carcinoma (HCC), but conventional imaging techniques have limited sensitivity in visualizing small tumors and assessing response to locoregional treatments and sorafenib. Functional imaging techniques allow visualization of organ and tumor physiology. Assessment of functional characteristics of tissue, such as metabolism, proliferation and stiffness, may overcome some of the limitations of structural imaging. In particular, novel molecular imaging agents offer a potential tool for early diagnosis of HCC, and radiomics may aid in response assessment and generate prognostic models. Further prospective research is warranted to evaluate emerging techniques and their cost-effectiveness in the context of HCC in order to improve detection and response assessment.
Collapse
Affiliation(s)
- Tim Ch Hoogenboom
- Department of Experimental Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK.,Department of Experimental Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK
| | - Mark Thursz
- Department of Hepatology, Imperial College NHS Trust, 10th Floor, Norfolk Place, St Mary's Hospital, London, UK.,Department of Hepatology, Imperial College NHS Trust, 10th Floor, Norfolk Place, St Mary's Hospital, London, UK
| | - Eric O Aboagye
- Comprehensive Cancer Imaging Centre at Imperial College, Faculty of Medicine, Imperial College London, GN1, Ground Floor, Commonwealth building, Hammersmith Campus, London, UK.,Comprehensive Cancer Imaging Centre at Imperial College, Faculty of Medicine, Imperial College London, GN1, Ground Floor, Commonwealth building, Hammersmith Campus, London, UK
| | - Rohini Sharma
- Department of Experimental Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK.,Department of Experimental Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK
| |
Collapse
|
17
|
Hepatocellular Carcinoma Screening With Computed Tomography Using the Arterial Enhancement Fraction With Radiologic-Pathologic Correlation. Invest Radiol 2016; 51:25-32. [DOI: 10.1097/rli.0000000000000201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
18
|
Park M, Chung YE, Kim KA, Chung WS, Lee HS, Han KH, Kim MJ, Kim KW. Added value of arterial enhancement fraction color maps for the characterization of small hepatic low-attenuating lesions in patients with colorectal cancer. PLoS One 2015; 10:e0114819. [PMID: 25706878 PMCID: PMC4338035 DOI: 10.1371/journal.pone.0114819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 10/19/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess the added value of arterial enhancement fraction (AEF) color maps for the differentiation of small metastases from hepatic benign lesions. SUBJECTS AND METHODS We retrospectively analyzed 46 patients with colorectal cancer who underwent multiphasic liver CT imaging and had low-attenuating liver lesions smaller than 3 cm (123 total lesions; metastasis: benign = 32:91). AEF color maps of the liver were created from multiphasic liver CT images using dedicated software. Two radiologists independently reviewed multiphasic CT image sets alone and in combination with image sets with AEF color maps using a five-point scale. The additional diagnostic value of the color maps was assessed by means of receiver-operating characteristic (ROC) analysis. RESULTS The area under the ROC curve (Az) increased when multiphasic CT images were combined with AEF color map analysis as compared with evaluation based only on multiphasic CT images (from 0.698 to 0.897 for reader 1, and from 0.825 to 0.945 for reader 2; P < 0.001 and 0.002, respectively). The increase Az was especially significant for lesions less than 1 cm (from 0.702 to 0.888 for reader 1, and from 0.768 to 0.958 for reader 2; P = 0.001 and P = 0.001, respectively). The mean AEF of tumor-adjacent parenchyma (35.07 ± 27.2) was significantly higher than that of tumor-free liver parenchyma (27.3 ± 20.6) (P = 0.04). CONCLUSIONS AEF color mapping can improve the diagnostic performance for small hepatic metastases from colorectal cancer and may allow for the elimination of additional examinations.
Collapse
Affiliation(s)
- Mina Park
- Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea
| | - Yong Eun Chung
- Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea
- * E-mail:
| | - Kyung Ah Kim
- Department of Radiology, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea
| | - Woo-Suk Chung
- Department of Radiology, Konyang University College of Medicine, Daejon, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Hwa Han
- Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Myeong-Jin Kim
- Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea
| | - Ki Whang Kim
- Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea
| |
Collapse
|
19
|
Postablation Assessment Using Follow-Up Registration of CT Images Before and After Radiofrequency Ablation (RFA): Prospective Evaluation of Midterm Therapeutic Results of RFA for Hepatocellular Carcinoma. AJR Am J Roentgenol 2014; 203:70-7. [DOI: 10.2214/ajr.13.11709] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|