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Liu Z, Wen B, Zhang Z, Qu F, Wu Y, Grimm R, Zhang Y, Cheng J, Zhang Y. The value of diffusion kurtosis imaging and dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of parotid gland tumors. Gland Surg 2024; 13:1254-1268. [PMID: 39175702 PMCID: PMC11336784 DOI: 10.21037/gs-24-78] [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: 03/07/2024] [Accepted: 07/10/2024] [Indexed: 08/24/2024]
Abstract
Background Parotid gland tumors (PGTs) are the most common benign tumors of salivary gland tumors. However, the diagnostic value of relative values of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion kurtosis imaging (DKI) parameters for PGTs has not been extensively studied. Therefore, this study aimed to evaluate the diagnostic performance of combined DKI and DCE-MRI for differentiating PGTs by introducing the concept of relative value. Methods The DCE-MRI and DKI imaging data of 142 patients with PGTs between June 2018 and August 2022 were collected. Patients were divided into four groups by histopathology: malignant tumors (MTs), pleomorphic adenomas (PAs), Warthin tumors (WTs), and basal cell adenomas (BCAs). All MRI examinations were conducted using a 3 T MRI scanner with a 20-channel head and neck coil. Quantitative parameters of DCE-MRI and DKI and their relative values were determined. Kruskal-Wallis H test, post-hoc test with Bonferroni correction, one-way analysis of variance (ANOVA) and post-hoc test with least significant difference (LSD) method, and the receiver operating characteristic (ROC) curve were used for statistical analysis. Statistical significance was set at P<0.05. Results Only the combination of DKI and DCE-MRI parameters could reliably distinguish BCAs from other PGTs. PAs demonstrated the lowest transfer constant from plasma to extravascular extracellular space (Ktrans) value [0.09 (0.06, 0.20) min-1], relative Ktrans (rKtrans) [-0.24 (-0.64, 1.00)], rate constant from extravascular extracellular space to plasma (Kep) value [0.32 (0.22, 0.53) min-1], relative Kep (rKep) [0.32 (0.22, 0.53) min-1], and initial area under curve (iAUC) value [0.15 (0.09, 0.26) mmol·s/kg] compared with WTs, BCAs, and MTs (all P<0.05). The Ktrans values for MTs were substantially lower [0.17 (0.10, 0.31) min-1] than those for WTs (P=0.01). The Kep values for MTs [0.71 (0.52, 1.28) min-1] were substantially lower (all P<0.05) than those for WTs and BCAs. PAs and BCAs had higher diffusion coefficient (D) values and lower diffusion kurtosis (K) values and relative K (rK) values than MTs and WTs. However, the D and K values did not differ significantly even in their relative values of PAs and BCAs (all P>0.05). By using logistic regression, the combination of K value and rKep value further enhanced their discriminatory power between PAs and WTs [area under the ROC curve (AUC), 0.986], the combination of K and rKep value further enhanced their discriminatory power between PAs and MTs (AUC, 0.915), and the combination of D and Kep value further enhanced their discriminatory power between BCAs and MTs (AUC, 0.909). Conclusions DKI and DCE-MRI can be used to differentiate PGTs quantitatively and can complement each other. The combined use of DKI and DCE-MRI parameters can improve the diagnostic accuracy of distinguishing PGTs.
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Affiliation(s)
- Zijun Liu
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Baohong Wen
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zanxia Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Feifei Qu
- MR Collaboration, Siemens Healthineer Ltd., Shanghai, China
| | - Yanglei Wu
- MR Collaboration, Siemens Healthineer Ltd., Beijing, China
| | - Robert Grimm
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Wang Y, Hu H, Ban X, Jiang Y, Su Y, Yang L, Shi G, Yang L, Han R, Duan X. Evaluation of Quantitative Dual-Energy Computed Tomography Parameters for Differentiation of Parotid Gland Tumors. Acad Radiol 2024; 31:2027-2038. [PMID: 37730491 DOI: 10.1016/j.acra.2023.08.024] [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: 06/27/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 09/22/2023]
Abstract
RATIONALE AND OBJECTIVES To assess the diagnostic performance of quantitative parameters from dual-energy CT (DECT) in differentiating parotid gland tumors (PGTs). MATERIALS AND METHODS 101 patients with 108 pathologically proved PGTs were enrolled and classified into four groups: pleomorphic adenomas (PAs), warthin tumors (WTs), other benign tumors (OBTs), and malignant tumors (MTs). Conventional CT attenuation and DECT quantitative parameters, including iodine concentration (IC), normalized iodine concentration (NIC), effective atomic number (Zeff), electron density (Rho), double energy index (DEI), and the slope of the spectral Hounsfield unit curve (λHU), were obtained and compared between benign tumors (BTs) and MTs, and further compared among the four subgroups. Logistic regression analysis was used to assess the independent parameters and the receiver operating characteristic (ROC) curves were used to analyze the diagnostic performance. RESULTS Attenuation, Zeff, DEI, IC, NIC, and λHU in the arterial phase (AP) and venous phase (VP) were higher in MTs than in BTs (p < 0.001-0.047). λHU in VP and Zeff in AP were independent predictors with an area under the curve (AUC) of 0.84 after the combination. Furthermore, attenuation, Zeff, DEI, IC, NIC, and λHU in the AP and VP of MTs were higher than those of PAs (p < 0.001-0.047). Zeff and NIC in AP and λHU in VP were independent predictors with an AUC of 0.93 after the combination. Attenuation and Rho in the precontrast phase; attenuation, Rho, Zeff, DEI, IC, NIC, and λHU in AP; and the Rho in the VP of PAs were lower than those of WTs (p < 0.001-0.03). Rho in the precontrast phase and attenuation in AP were independent predictors with an AUC of 0.89 after the combination. MTs demonstrated higher Zeff, DEI, IC, NIC, and λHU in VP and lower Rho in the precontrast phase compared with WTs (p < 0.001-0.04); but no independent predictors were found. CONCLUSION DECT quantitative parameters can help to differentiate PGTs.
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Affiliation(s)
- Yu Wang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China (Y.W., H.H., Y.J., Y.S., L.Y., G.S., L.Y., R.H., X.D.)
| | - Huijun Hu
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China (Y.W., H.H., Y.J., Y.S., L.Y., G.S., L.Y., R.H., X.D.)
| | - Xiaohua Ban
- Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong, China (X.B.)
| | - Yusong Jiang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China (Y.W., H.H., Y.J., Y.S., L.Y., G.S., L.Y., R.H., X.D.)
| | - Yun Su
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China (Y.W., H.H., Y.J., Y.S., L.Y., G.S., L.Y., R.H., X.D.)
| | - Lingjie Yang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China (Y.W., H.H., Y.J., Y.S., L.Y., G.S., L.Y., R.H., X.D.)
| | - Guangzi Shi
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China (Y.W., H.H., Y.J., Y.S., L.Y., G.S., L.Y., R.H., X.D.); Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong, China (G.S., X.D.)
| | - Lu Yang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China (Y.W., H.H., Y.J., Y.S., L.Y., G.S., L.Y., R.H., X.D.)
| | - Riyu Han
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China (Y.W., H.H., Y.J., Y.S., L.Y., G.S., L.Y., R.H., X.D.)
| | - Xiaohui Duan
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong, China (Y.W., H.H., Y.J., Y.S., L.Y., G.S., L.Y., R.H., X.D.); Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong, China (G.S., X.D.).
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Wang R, Xi Y, Yang M, Zhu M, Yang F, Xu H. Whole-volume ADC histogram of the brain as an image biomarker in evaluating disease severity of neonatal hypoxic-ischemic encephalopathy. Front Neurol 2022; 13:918554. [PMID: 35989925 PMCID: PMC9381875 DOI: 10.3389/fneur.2022.918554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose To examine the diagnostic significance of the apparent diffusion coefficient (ADC) histogram in quantifying neonatal hypoxic ischemic encephalopathy (HIE). Methods An analysis was conducted on the MRI data of 90 HIE patients, 49 in the moderate-to-severe group, and the other in the mild group. The 3D Slicer software was adopted to delineate the whole brain region as the region of interest, and 22 ADC histogram parameters were obtained. The interobserver consistency of the two radiologists was assessed by the interclass correlation coefficient (ICC). The difference in parameters (ICC > 0.80) between the two groups was compared by performing the independent sample t-test or the Mann–Whitney U test. In addition, an investigation was conducted on the correlation between parameters and the neonatal behavioral neurological assessment (NBNA) score. The ROC curve was adopted to assess the efficacy of the respective significant parameters. Furthermore, the binary logistic regression was employed to screen out the independent risk factors for determining the severity of HIE. Results The ADCmean, ADCmin, ADCmax,10th−70th, 90th percentile of ADC values of the moderate-to-severe group were smaller than those of the mild group, while the group's variance, skewness, kurtosis, heterogeneity, and mode-value were higher than those of the mild group (P < 0.05). All the mentioned parameters, the ADCmean, ADCmin, and 10th−70th and 90th percentile of ADC displayed positive correlations with the NBNA score, mode-value and ADCmax displayed no correlations with the NBNA score, the rest showed negative correlations with the NBNA score (P < 0.05). The area under the curve (AUC) of variance was the largest (AUC = 0.977; cut-off 972.5, sensitivity 95.1%; specificity 87.8%). According to the logistic regression analysis, skewness, kurtosis, variance, and heterogeneity were independent risk factors for determining the severity of HIE (OR > 1, P < 0.05). Conclusions The ADC histogram contributes to the HIE diagnosis and is capable of indicating the diffusion information of the brain objectively and quantitatively. It refers to a vital method for assessing the severity of HIE.
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Xiao R, Chen J, Zeng C, Feng X, Li T, Das SK, Li B, Zhang C, Yang H. Development of magnetic resonance imaging of brachial plexus neuralgia. Neurol Sci 2022; 43:1685-1693. [DOI: 10.1007/s10072-022-05915-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/20/2022] [Indexed: 11/29/2022]
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Abdel Razek AAK, Elsebaie NA, Gamaleldin OA, AbdelKhalek A, Mukherji SK. Role of MR Imaging in Head and Neck Squamous Cell Carcinoma. Magn Reson Imaging Clin N Am 2021; 30:1-18. [PMID: 34802573 DOI: 10.1016/j.mric.2021.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Routine and advanced MR imaging sequences are used for locoregional spread, nodal, and distant staging of head and neck squamous cell carcinoma, aids treatment planning, predicts treatment response, differentiates recurrence for postradiation changes, and monitors patients after chemoradiotherapy.
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Affiliation(s)
| | - Nermeen A Elsebaie
- Department of Radiology, Alexandria Faculty of Medicine, Champollion Street, El-Khartoum Square, El Azareeta Medical Campus, Alexandria 21131, Egypt
| | - Omneya A Gamaleldin
- Department of Radiology, Alexandria Faculty of Medicine, Champollion Street, El-Khartoum Square, El Azareeta Medical Campus, Alexandria 21131, Egypt
| | - Amro AbdelKhalek
- Internship at Mansoura University Hospital, Mansoura Faculty of Medicine, 60 Elgomheryia Street, Mansoura 35512, Egypt
| | - Suresh K Mukherji
- Marian University, Head and Neck Radiology, ProScan Imaging, Carmel, IN, USA.
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Huang N, Chen Y, She D, Xing Z, Chen T, Cao D. Diffusion kurtosis imaging and dynamic contrast-enhanced MRI for the differentiation of parotid gland tumors. Eur Radiol 2021; 32:2748-2759. [PMID: 34642805 PMCID: PMC8921043 DOI: 10.1007/s00330-021-08312-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To assess the usefulness of combined diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced MRI (DCE-MRI) in the differentiation of parotid gland tumors. METHODS Seventy patients with 80 parotid gland tumors who underwent DKI and DCE-MRI were retrospectively enrolled and divided into four groups: pleomorphic adenomas (PAs), Warthin tumors (WTs), other benign tumors (OBTs), and malignant tumors (MTs). DCE-MRI and DKI quantitative parameters were measured. The Kruskal-Wallis H test and post hoc test with Bonferroni correction and ROC curve were used for statistical analysis. RESULTS WTs demonstrated the highest Kep value (median 1.89, interquartile range [1.46-2.31] min-1) but lowest Ve value (0.20, [0.15-0.25]) compared with PAs (Kep, 0.34 [0.21-0.55] min-1; Ve, 0.36 [0.24-0.43]), OBTs (Kep, 1.22 [0.27-1.67] min-1; Ve, 0.28 [0.25-0.41]), and MTs (Kep, 0.71 [0.50-1.23] min-1; Ve, 0.35 [0.26-0.45]) (all p < .05). MTs had the lower D value (1.10, [0.88-1.29] × 10-3 mm2/s) compared with PAs (1.81, [1.60-2.20] × 10-3 mm2/s) and OBTs (1.57, [1.32-1.89] × 10-3 mm2/s) (both p < .05). PAs had the lower Ktrans value (0.12, [0.07-0.18] min-1) compared with OBTs (0.28, [0.11-0.50] min-1) (p < .05). The cutoff values of combined Kep and Ve, D, and Ktrans to distinguish WTs, MTs, and PAs sequentially were 1.06 min-1, 0.28, 1.46 × 10-3 mm2/s, and 0.21 min-1, respectively (accuracy, 89% [71/80], 91% [73/80], 78% [62/80], respectively). CONCLUSION The combined use of DKI and DCE-MRI may help differentiate parotid gland tumors. KEY POINTS • The combined use of DKI and DCE-MRI could facilitate the understanding of the pathophysiological characteristics of parotid gland tumors. • A stepwise diagnostic diagram based on the combined use of DCE-MRI parameters and the diffusion coefficient is helpful for accurate preoperative diagnosis in parotid gland tumors and may further facilitate the clinical management of patients.
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Affiliation(s)
- Nan Huang
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Yu Chen
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Dejun She
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Zhen Xing
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Tanhui Chen
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
| | - Dairong Cao
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China. .,Department of Radiology, Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, China. .,Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, China.
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Cheng J, Shao S, Chen W, Zheng N. Application of Diffusion Kurtosis Imaging and Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Differentiating Benign and Malignant Head and Neck Lesions. J Magn Reson Imaging 2021; 55:414-423. [PMID: 34378259 DOI: 10.1002/jmri.27885] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Preoperative differentiation of head and neck lesions is important for treatment plan selection. PURPOSE To evaluate the diagnostic value of diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating benign from malignant head and neck lesions and subgroups, including lymphoma subgroup (LS), Warthin's tumor subgroup (WS), malignant tumor subgroup (excluding lymphoma) (MTS), and benign tumor subgroup (excluding Warthin's tumor) (BTS). STUDY TYPE Retrospective. POPULATION Seventy-four patients with 79 head and neck lesions (44 benign, 35 malignant), divided into four subgroups: LS (14), WS (12), MTS (21), and BTS (32). FIELD STRENGTH/SEQUENCES A 3.0 T, single-shot echo-planar sequence with 5 b-values for DKI and enhanced T1 high-resolution isotropic volume excitation (eTHRIVE) sequence for DCE-MRI. ASSESSMENT The mean diffusivity (MD) and mean kurtosis (MK) derived from DKI and the time-signal intensity curve (TIC), peak time (Tpeak ), and washout ratio (WR) based on DCE-MRI were measured. The diagnostic efficiencies of DKI and DCE-MRI, alone and in combination, were calculated and compared. The parameters mentioned above were compared between the four subgroups. STATISTICAL TEST Mann-Whitney U test, chi-square test, receiver operating characteristic curve, Delong test, one-way analysis of variance test, and Kruskal-Wallis H test. A P value < 0.05 was considered statistically significant. RESULTS The combination of TIC and parameters of DKI and DCE-MRI for differentiating benign and malignant lesions with 94.94% accuracy is superior to DKI or DCE-MRI alone with approximately 75% accuracy. MD, MK, Tpeak , and WR showed significant differences among the four subgroups. The accuracy of MD and MK was 91.14% and 92.41% for differentiating BTS from the other three subgroups. WR achieved 100% accuracy for discriminating WS from LS or MTS. MD and MK both differentiated LS from MTS with 97.14% accuracy. DATA CONCLUSION A combination of DKI and DCE-MRI can effectively differentiate head and neck lesions with good accuracy. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Jingfeng Cheng
- Department of Radiology, Wuhu Second People's Hospital, Wuhu, China
| | - Shuo Shao
- Department of Radiology, Jining No.1 People's Hospital, Jining, China
| | | | - Ning Zheng
- Department of Radiology, Jining No.1 People's Hospital, Jining, China
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Hu H, Chen HH, Chen W, Wu Q, Chen L, Zhu H, Xu XQ, Shi HB, Wu FY. T2 mapping histogram at extraocular muscles for predicting the response to glucocorticoid therapy in patients with thyroid-associated ophthalmopathy. Clin Radiol 2020; 76:159.e1-159.e8. [PMID: 33010933 DOI: 10.1016/j.crad.2020.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023]
Abstract
AIM To evaluate the performance of T2 mapping histograms at the extraocular muscles (EOMs) in predicting the response to glucocorticoid therapy in the patients with active and moderate-severe thyroid-associated ophthalmopathy (TAO). MATERIALS AND METHODS Thirty active and moderate-severe TAO patients (responsive group, n=20; unresponsive group, n=10) were enrolled, and evaluated using T2 mapping before treatment. Histogram parameters (mean, median, max, min, 10th, 90th percentiles, skewness, and kurtosis) of T2 relaxation time (T2RT) at the EOMs for each orbit, and clinical variables (age, sex, disease duration, anti-thyroid treatment, smoking habit, pre-treatment thyroid function, thyrotrophin receptor antibody, diplopia presence, activity and severity scores) were collected and compared between groups. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to assess the predictive value of identified independent variables for treatment response. RESULTS The responsive group showed significantly shorter disease duration (p=0.003), while higher T2RTmin than unresponsive group (p<0.001). Multivariate analysis showed that T2RTmin and disease duration were independent predictors for responsive TAOs. ROC curve analyses indicated that setting a cut-off value of ≥54.3 for T2RTmin demonstrated the optimal predicting specificity for responsive TAOs (100%), while a combination of T2RTmin ≥54.3 and disease duration ≤4.5 showed optimal predicting efficiency and sensitivity (area under the curve, 0.820; sensitivity, 65%). CONCLUSIONS Histogram analysis can help to exhibit the heterogeneity of T2RT at the EOMs. T2RTmin, together with disease duration may be the promising marker for predicting response to glucocorticoid therapy in the patients with active and moderate-severe TAO.
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Affiliation(s)
- H Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - H-H Chen
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - W Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Q Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - L Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - H Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - X-Q Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - H-B Shi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - F-Y Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Panyarak W, Chikui T, Tokumori K, Yamashita Y, Kamitani T, Togao O, Yoshiura K. Utility of a diffusion kurtosis model in the differential diagnosis of orofacial tumours. Clin Radiol 2020; 75:507-519. [DOI: 10.1016/j.crad.2020.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/15/2020] [Indexed: 12/20/2022]
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Yu JY, Zhang D, Huang XL, Ma J, Yang C, Li XJ, Xiong H, Zhou B, Liao RK, Tang ZY. Quantitative Analysis of DCE-MRI and RESOLVE-DWI for Differentiating Nasopharyngeal Carcinoma from Nasopharyngeal Lymphoid Hyperplasia. J Med Syst 2020; 44:75. [PMID: 32103352 DOI: 10.1007/s10916-020-01549-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/18/2020] [Indexed: 02/08/2023]
Abstract
To explore the ability of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) analysis and readout segmentation of long variable echo-trains diffusion weighted imaging (RESOLVE-DWI) to distinguish nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPLH). Twenty-five patients with NPC and 30 patients with NPLH were evaluated. Three quantitative DCE-MRI parameters (Ktrans, Kep and Ve) and the apparent diffusion coeffcient (ADC) of lesions were calculated. The two independent samples t test or Mann-Whitney U test was used to compare the parameters between NPC and NPLH group. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic ability for distinguishing NPC from NPLH. A P value less than 0.05 was considered statistically significant. The difference in Ktrans value between the NPC group and the NPLH group was statistically significant, and the value of the NPC group was larger than that of the NPLH group. There was no statistical difference in Kep and Ve between the two groups. The ADC value of NPC group was smaller than that of NPLH group, and the difference was statistically significant. ROC curve analysis showed that both Ktrans and ADC were effective in diagnosing NPC and the area under the curve (AUC) was 0.773 and 0.704, respectively. In addition, the combination of Ktrans and ADC demonstrated the obviously improved AUC of 0.884. DCE-MRI and RESOLVE-DWI are effective in differentiating NPC from NPLH, especially the combination of the two models.
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Affiliation(s)
- J Y Yu
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - D Zhang
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - X L Huang
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - J Ma
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - C Yang
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - X J Li
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - H Xiong
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - B Zhou
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - R K Liao
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China
| | - Z Y Tang
- Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No.104 Pipashan Rd, Yuzhong District, Chongqing, 400014, China. .,Molecular and Functional Imaging Laboratory, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, 400014, China.
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Wen Z, Chen Y, Yang X, Lu B, Liu Y, Shen B, Yu S. Application of magnetic resonance diffusion kurtosis imaging for distinguishing histopathologic subtypes and grades of rectal carcinoma. Cancer Imaging 2019; 19:8. [PMID: 30744694 PMCID: PMC6371623 DOI: 10.1186/s40644-019-0192-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 01/28/2019] [Indexed: 01/19/2023] Open
Abstract
Background To evaluate the diagnostic performance of diffusion kurtosis imaging (DKI) for distinguishing different histopathological subtypes and grades of rectal carcinoma and to compare DKI with conventional diffusion-weighted imaging (DWI). Methods This prospective study involved 132 patients with rectal carcinoma, comprising 116 with adenocarcinoma not otherwise specified (AC) and 16 with mucinous carcinoma (MC). High spatial resolution magnetic resonance (MR) and DKI sequences (b values of 0, 600, 1000, 1500 and 2000 s/mm2) were performed for pretreatment evaluation. The mean kurtosis (MK) and mean diffusivity (MD) from DKI and the apparent diffusion coefficient (ADC) from DWI were measured by two experienced radiologists. The Mann-Whitney U test was used to evaluate different histopathological subtypes and grades. Receiver operating characteristic (ROC) curve analyses were performed to compare the diagnostic ability of different quantitative parameters. Results The MD and ADC values were significantly higher for MC than for AC (1.94 ± 0.51 vs. 1.33 ± 0.02 and 1.26 ± 0.64 vs. 0.92 ± 0.01, respectively; P < 0.001). The MK values were significantly lower for MC than for AC (0.66 ± 0.02 vs. 0.93 ± 0.09, P < 0.001). The MK and MD values demonstrated higher sensitivity (94%, both) and specificity (96, 93%, respectively) than the ADC values. However, all the parameters derived from both DKI and DWI showed no significant differences between different histological grades. Conclusions DKI is a more valuable imaging biomarker than conventional DWI for differentiating MC from AC. However, it is still debatable whether DKI is useful for distinguishing different histological grades.
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Affiliation(s)
- Ziqiang Wen
- Department of Radiology, Sun Yat-sen University First Affiliated Hospital, No. 58, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, China
| | - Yan Chen
- Department of Radiology, Sun Yat-sen University First Affiliated Hospital, No. 58, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, China
| | - Xinyue Yang
- Department of Radiology, Southern Medical University Zhujiang Hospital, Guangzhou, 510282, China
| | - Baolan Lu
- Department of Radiology, Sun Yat-sen University First Affiliated Hospital, No. 58, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, China
| | - Yiyan Liu
- Department of Radiology, Sun Yat-sen University First Affiliated Hospital, No. 58, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, China
| | - Bingqi Shen
- Department of Radiology, Sun Yat-sen University First Affiliated Hospital, No. 58, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, China
| | - Shenping Yu
- Department of Radiology, Sun Yat-sen University First Affiliated Hospital, No. 58, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, China.
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Marzi S, Minosse S, Vidiri A, Piludu F, Giannelli M. Diffusional kurtosis imaging in head and neck cancer: On the use of trace-weighted images to estimate indices of non-Gaussian water diffusion. Med Phys 2018; 45:5411-5419. [PMID: 30317646 DOI: 10.1002/mp.13238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 12/11/2022] Open
Abstract
PURPOSE While previous studies have demonstrated the feasibility and potential usefulness of quantitative non-Gaussian diffusional kurtosis imaging (DKI) of the brain, more recent research has focused on oncological application of DKI in various body regions such as prostate, breast, and head and neck (HN). Given the need to minimize scan time during most routine magnetic resonance imaging (MRI) acquisitions of body regions, diffusion-weighted imaging (DWI) with only three orthogonal diffusion weighting directions (x, y, z) is usually performed. Moreover, as water diffusion within malignant tumors is generically thought to be almost isotropic, DWI with only three diffusion weighting directions is considered sufficient for oncological application and it represents the de facto standard in body DKI. In this context, since the kurtosis tensor and diffusion tensor cannot be obtained, the averages of the three directional (Kx , Ky , Kz ) and (Dx , Dy , Dz ) - namely K and D, respectively - represent the best-possible surrogates of directionless DKI-derived indices of kurtosis and diffusivity, respectively. This would require fitting the DKI model to the diffusion-weighted images acquired along each direction (x, y, z) prior to averaging. However, there is a growing tendency to perform only a single fit of the DKI model to the geometric means of the images acquired with diffusion-sensitizing gradient along (x, y, z), referred to as trace-weighted (TW) images. To the best of our knowledge, no in vivo studies have evaluated how TW images affect estimates of DKI-derived indices of K and D. Thus, the aim of this study was to assess the potential bias and error introduced in estimated K and D by fitting the DKI model to the TW images in HN cancer patients. METHODS Eighteen patients with histologically proven malignant tumors of the HN were enrolled in the study. They underwent pretreatment 3 T MRI, including DWI (b-values: 0, 500, 1000, 1500, 2000 s/mm2 ). Some patients had multiple lesions, and thus a total of 34 lesions were analyzed. DKI-derived indices were estimated, voxel-by-voxel, using single diffusion-weighted images along (x, y, z) as well as TW images. A comparison between the two estimation methods was performed by calculating the percentage error in D (Derr ) and K (Kerr ). Also, diffusivity anisotropy (Danis ) and diffusional kurtosis anisotropy (Kanis ) were estimated. Agreements between the two estimation methods were assessed by Bland-Altman plots. The Spearman rank correlation test was used to study the correlations between Kerr /Derr and Danis /Kanis. RESULTS: The median (95% confidence interval) Kerr and Derr were 5.1% (0.8%, 32.6%) and 1.7% (-2.5%, 5.3%), respectively. A significant relationship was observed between Kerr and Danis (correlation coefficient R = 0.694, P < 0.0001), as well as between Kerr and Kanis (R = 0.848, P < 0.0001). CONCLUSIONS In HN cancer, the fit of the DKI model to TW images can introduce bias and error in the estimation of K and D, which may be non-negligible for single lesions, and should hence be adopted with caution.
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Affiliation(s)
- Simona Marzi
- Medical Physics Laboratory, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Silvia Minosse
- Medical Physics Laboratory, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Antonello Vidiri
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Francesca Piludu
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Marco Giannelli
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", 56126, Pisa, Italy
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