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Schmid W, Danstrom IA, Crespo Echevarria M, Adkinson J, Mattar L, Banks GP, Sheth SA, Watrous AJ, Heilbronner SR, Bijanki KR, Alabastri A, Bartoli E. A biophysically constrained brain connectivity model based on stimulation-evoked potentials. J Neurosci Methods 2024; 405:110106. [PMID: 38453060 DOI: 10.1016/j.jneumeth.2024.110106] [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: 11/03/2023] [Revised: 01/24/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Single-pulse electrical stimulation (SPES) is an established technique used to map functional effective connectivity networks in treatment-refractory epilepsy patients undergoing intracranial-electroencephalography monitoring. While the connectivity path between stimulation and recording sites has been explored through the integration of structural connectivity, there are substantial gaps, such that new modeling approaches may advance our understanding of connectivity derived from SPES studies. NEW METHOD Using intracranial electrophysiology data recorded from a single patient undergoing stereo-electroencephalography (sEEG) evaluation, we employ an automated detection method to identify early response components, C1, from pulse-evoked potentials (PEPs) induced by SPES. C1 components were utilized for a novel topology optimization method, modeling 3D electrical conductivity to infer neural pathways from stimulation sites. Additionally, PEP features were compared with tractography metrics, and model results were analyzed with respect to anatomical features. RESULTS The proposed optimization model resolved conductivity paths with low error. Specific electrode contacts displaying high error correlated with anatomical complexities. The C1 component strongly correlated with additional PEP features and displayed stable, weak correlations with tractography measures. COMPARISON WITH EXISTING METHOD Existing methods for estimating neural signal pathways are imaging-based and thus rely on anatomical inferences. CONCLUSIONS These results demonstrate that informing topology optimization methods with human intracranial SPES data is a feasible method for generating 3D conductivity maps linking electrical pathways with functional neural ensembles. PEP-estimated effective connectivity is correlated with but distinguished from structural connectivity. Modeled conductivity resolves connectivity pathways in the absence of anatomical priors.
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Affiliation(s)
- William Schmid
- Department of Electrical and Computer Engineering, Rice University, 6100 Main Street, Houston, TX 77005, USA
| | - Isabel A Danstrom
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Maria Crespo Echevarria
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Joshua Adkinson
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Layth Mattar
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Garrett P Banks
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Andrew J Watrous
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Sarah R Heilbronner
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Kelly R Bijanki
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Alessandro Alabastri
- Department of Electrical and Computer Engineering, Rice University, 6100 Main Street, Houston, TX 77005, USA.
| | - Eleonora Bartoli
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA.
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Cencini M, Lancione M, Pasquariello R, Peretti L, Pirkl CM, Schulte RF, Buonincontri G, Arduino A, Zilberti L, Biagi L, Tosetti M. Fast high-resolution electric properties tomography using three-dimensional quantitative transient-state imaging-based water fraction estimation. NMR IN BIOMEDICINE 2024; 37:e5039. [PMID: 37714527 DOI: 10.1002/nbm.5039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 09/17/2023]
Abstract
In this study, we aimed to develop a fast and robust high-resolution technique for clinically feasible electrical properties tomography based on water content maps (wEPT) using Quantitative Transient-state Imaging (QTI), a multiparametric transient state-based method that is similar to MR fingerprinting. Compared with the original wEPT implementation based on standard spin-echo acquisition, QTI provides robust electrical properties quantification towards B1 + inhomogeneities and full quantitative relaxometry data. To validate the proposed approach, 3D QTI data of 12 healthy volunteers were acquired on a 1.5 T scanner. QTI-provided T1 maps were used to compute water content maps of the tissues using an empirical relationship based on literature ex-vivo measurements. Assuming that electrical properties are modulated mainly by tissue water content, the water content maps were used to derive electrical conductivity and relative permittivity maps. The proposed technique was compared with a conventional phase-only Helmholtz EPT (HH-EPT) acquisition both within whole white matter, gray matter, and cerebrospinal fluid masks, and within different white and gray matter subregions. In addition, QTI-based wEPT was retrospectively applied to four multiple sclerosis adolescent and adult patients, compared with conventional contrast-weighted imaging in terms of lesion delineation, and quantitatively assessed by measuring the variation of electrical properties in lesions. Results obtained with the proposed approach agreed well with theoretical predictions and previous in vivo findings in both white and gray matter. The reconstructed maps showed greater anatomical detail and lower variability compared with standard phase-only HH-EPT. The technique can potentially improve delineation of pathology when compared with conventional contrast-weighted imaging and was able to detect significant variations in lesions with respect to normal-appearing tissues. In conclusion, QTI can reliably measure conductivity and relative permittivity of brain tissues within a short scan time, opening the way to the study of electric properties in clinical settings.
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Affiliation(s)
- Matteo Cencini
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
| | | | | | | | | | | | | | | | - Luca Zilberti
- Istituto Nazionale di Ricerca Metrologica (INRiM), Torino, Italy
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Schmid W, Danstrom IA, Echevarria MC, Adkinson J, Mattar L, Banks GP, Sheth SA, Watrous AJ, Heilbronner SR, Bijanki KR, Alabastri A, Bartoli E. A biophysically constrained brain connectivity model based on stimulation-evoked potentials. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.03.565525. [PMID: 37986830 PMCID: PMC10659345 DOI: 10.1101/2023.11.03.565525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background Single-pulse electrical stimulation (SPES) is an established technique used to map functional effective connectivity networks in treatment-refractory epilepsy patients undergoing intracranial-electroencephalography monitoring. While the connectivity path between stimulation and recording sites has been explored through the integration of structural connectivity, there are substantial gaps, such that new modeling approaches may advance our understanding of connectivity derived from SPES studies. New Method Using intracranial electrophysiology data recorded from a single patient undergoing sEEG evaluation, we employ an automated detection method to identify early response components, C1, from pulse-evoked potentials (PEPs) induced by SPES. C1 components were utilized for a novel topology optimization method, modeling 3D conductivity propagation from stimulation sites. Additionally, PEP features were compared with tractography metrics, and model results were analyzed with respect to anatomical features. Results The proposed optimization model resolved conductivity paths with low error. Specific electrode contacts displaying high error correlated with anatomical complexities. The C1 component strongly correlates with additional PEP features and displayed stable, weak correlations with tractography measures. Comparison with existing methods Existing methods for estimating conductivity propagation are imaging-based and thus rely on anatomical inferences. Conclusions These results demonstrate that informing topology optimization methods with human intracranial SPES data is a feasible method for generating 3D conductivity maps linking electrical pathways with functional neural ensembles. PEP-estimated effective connectivity is correlated with but distinguished from structural connectivity. Modeled conductivity resolves connectivity pathways in the absence of anatomical priors.
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Affiliation(s)
- William Schmid
- Department of Electrical and Computer Engineering, Rice University, 6100 Main Street, Houston 77005, Texas, USA
| | - Isabel A. Danstrom
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston 77030, Texas, USA
| | - Maria Crespo Echevarria
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston 77030, Texas, USA
| | - Joshua Adkinson
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston 77030, Texas, USA
| | - Layth Mattar
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston 77030, Texas, USA
| | - Garrett P. Banks
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston 77030, Texas, USA
| | - Sameer A. Sheth
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston 77030, Texas, USA
| | - Andrew J. Watrous
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston 77030, Texas, USA
| | - Sarah R. Heilbronner
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston 77030, Texas, USA
| | - Kelly R. Bijanki
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston 77030, Texas, USA
| | - Alessandro Alabastri
- Department of Electrical and Computer Engineering, Rice University, 6100 Main Street, Houston 77005, Texas, USA
| | - Eleonora Bartoli
- Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston 77030, Texas, USA
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Katoch N, Kim Y, Choi BK, Ha SW, Kim TH, Yoon EJ, Song SG, Kim JW, Kim HJ. Estimation of brain tissue response by electrical stimulation in a subject-specific model implemented by conductivity tensor imaging. Front Neurosci 2023; 17:1197452. [PMID: 37287801 PMCID: PMC10242016 DOI: 10.3389/fnins.2023.1197452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/09/2023] [Indexed: 06/09/2023] Open
Abstract
Electrical stimulation such as transcranial direct current stimulation (tDCS) is widely used to treat neuropsychiatric diseases and neurological disorders. Computational modeling is an important approach to understand the mechanisms underlying tDCS and optimize treatment planning. When applying computational modeling to treatment planning, uncertainties exist due to insufficient conductivity information inside the brain. In this feasibility study, we performed in vivo MR-based conductivity tensor imaging (CTI) experiments on the entire brain to precisely estimate the tissue response to the electrical stimulation. A recent CTI method was applied to obtain low-frequency conductivity tensor images. Subject-specific three-dimensional finite element models (FEMs) of the head were implemented by segmenting anatomical MR images and integrating a conductivity tensor distribution. The electric field and current density of brain tissues following electrical stimulation were calculated using a conductivity tensor-based model and compared to results using an isotropic conductivity model from literature values. The current density by the conductivity tensor was different from the isotropic conductivity model, with an average relative difference |rD| of 52 to 73%, respectively, across two normal volunteers. When applied to two tDCS electrode montages of C3-FP2 and F4-F3, the current density showed a focused distribution with high signal intensity which is consistent with the current flowing from the anode to the cathode electrodes through the white matter. The gray matter tended to carry larger amounts of current densities regardless of directional information. We suggest this CTI-based subject-specific model can provide detailed information on tissue responses for personalized tDCS treatment planning.
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Affiliation(s)
- Nitish Katoch
- Department of Biomedical Engineering, Kyung Hee University, Seoul, Republic of Korea
| | - Youngsung Kim
- Office of Strategic R&D Planning (MOTIE), Seoul, Republic of Korea
| | - Bup Kyung Choi
- Department of Biomedical Engineering, Kyung Hee University, Seoul, Republic of Korea
| | - Sang Woo Ha
- Department of Neurosurgery, Chosun University Hospital and Chosun University College of Medicine, Gwangju, Republic of Korea
| | - Tae Hoon Kim
- Medical Convergence Research Center, Wonkwang University Hospital, Iksan, Republic of Korea
| | - Eun Ju Yoon
- Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju, Republic of Korea
| | - Sang Gook Song
- Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju, Republic of Korea
| | - Jin Woong Kim
- Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju, Republic of Korea
| | - Hyung Joong Kim
- Department of Biomedical Engineering, Kyung Hee University, Seoul, Republic of Korea
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High frequency conductivity decomposition by solving physically constraint underdetermined inverse problem in human brain. Sci Rep 2023; 13:3273. [PMID: 36841894 PMCID: PMC9968322 DOI: 10.1038/s41598-023-30344-1] [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: 11/24/2022] [Accepted: 02/21/2023] [Indexed: 02/27/2023] Open
Abstract
The developed magnetic resonance electrical properties tomography (MREPT) can visualize the internal conductivity distribution at Larmor frequency by measuring the B1 transceive phase data from magnetic resonance imaging (MRI). The recovered high-frequency conductivity (HFC) value is highly complex and heterogeneous in a macroscopic imaging voxel. Using high and low b-value diffusion weighted imaging (DWI) data, the multi-compartment spherical mean technique (MC-SMT) characterizes the water molecule movement within and between intra- and extra-neurite compartments by analyzing the microstructures and underlying architectural organization of brain tissues. The proposed method decomposes the recovered HFC into the conductivity values in the intra- and extra-neurite compartments via the recovered intra-neurite volume fraction (IVF) and the diffusion patterns using DWI data. As a form of decomposition of intra- and extra-neurite compartments, the problem to determine the intra- and extra-neurite conductivity values from the HFC is still an underdetermined inverse problem. To solve the underdetermined problem, we use the compartmentalized IVF as a criterion to decompose the electrical properties because the ion-concentration and mobility have different characteristics in the intra- and extra-neurite compartments. The proposed method determines a representative apparent intra- and extra-neurite conductivity values by changing the underdetermined equation for a voxel into an over-determined minimization problem over a local window consisting of surrounding voxels. To suppress the noise amplification and estimate a feasible conductivity, we define a diffusion pattern distance to weight the over-determined system in the local window. To quantify the proposed method, we conducted a simulation experiment. The simulation experiments show the relationships between the noise reduction and the spatial resolution depending on the designed local window sizes and diffusion pattern distance. Human brain experiments (five young healthy volunteers and a patient with brain tumor) were conducted to evaluate and validate the reliability of the proposed method. To quantitatively compare the results with previously developed methods, we analyzed the errors for reconstructed extra-neurite conductivity using existing methods and indirectly verified the feasibility of the proposed method.
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Choi BK, Katoch N, Park JA, Kim JW, Oh TI, Kim HJ, Woo EJ. Measurement of extracellular volume fraction using magnetic resonance-based conductivity tensor imaging. Front Physiol 2023. [DOI: 10.3389/fphys.2023.132911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Conductivity tensor imaging (CTI) using MRI is an advanced method that can non-invasively measure the electrical properties of living tissues. The contrast of CTI is based on underlying hypothesis about the proportionality between the mobility and diffusivity of ions and water molecules inside tissues. The experimental validation of CTI in both in vitro and in vivo settings is required as a reliable tool to assess tissue conditions. The changes in extracellular space can be indicators for disease progression, such as fibrosis, edema, and cell swelling. In this study, we conducted a phantom imaging experiment to test the feasibility of CTI for measuring the extracellular volume fraction in biological tissue. To mimic tissue conditions with different extracellular volume fractions, four chambers of giant vesicle suspension (GVS) with different vesicle densities were included in the phantom. The reconstructed CTI images of the phantom were compared with the separately-measured conductivity spectra of the four chambers using an impedance analyzer. Moreover, the values of the estimated extracellular volume fraction in each chamber were compared with those measured by a spectrophotometer. As the vesicle density increased, we found that the extracellular volume fraction, extracellular diffusion coefficient, and low-frequency conductivity decreased, while the intracellular diffusion coefficient slightly increased. On the other hand, the high-frequency conductivity could not clearly distinguish the four chambers. The extracellular volume fraction measured by the spectrophotometer and CTI method in each chamber were quite comparable, i.e., (1.00, 0.98 ± 0.01), (0.59, 0.63 ± 0.02), (0.40, 0.40 ± 0.05), and (0.16, 0.18 ± 0.02). The prominent factor influencing the low-frequency conductivity at different GVS densities was the extracellular volume fraction. Further studies are needed to validate the CTI method as a tool to measure the extracellular volume fractions in living tissues with different intracellular and extracellular compartments.
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Choi BK, Katoch N, Park JA, Kim JW, Oh TI, Kim HJ, Woo EJ. Measurement of extracellular volume fraction using magnetic resonance-based conductivity tensor imaging. Front Physiol 2023; 14:1132911. [PMID: 36875031 PMCID: PMC9983119 DOI: 10.3389/fphys.2023.1132911] [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: 01/05/2023] [Accepted: 02/02/2023] [Indexed: 02/19/2023] Open
Abstract
Conductivity tensor imaging (CTI) using MRI is an advanced method that can non-invasively measure the electrical properties of living tissues. The contrast of CTI is based on underlying hypothesis about the proportionality between the mobility and diffusivity of ions and water molecules inside tissues. The experimental validation of CTI in both in vitro and in vivo settings is required as a reliable tool to assess tissue conditions. The changes in extracellular space can be indicators for disease progression, such as fibrosis, edema, and cell swelling. In this study, we conducted a phantom imaging experiment to test the feasibility of CTI for measuring the extracellular volume fraction in biological tissue. To mimic tissue conditions with different extracellular volume fractions, four chambers of giant vesicle suspension (GVS) with different vesicle densities were included in the phantom. The reconstructed CTI images of the phantom were compared with the separately-measured conductivity spectra of the four chambers using an impedance analyzer. Moreover, the values of the estimated extracellular volume fraction in each chamber were compared with those measured by a spectrophotometer. As the vesicle density increased, we found that the extracellular volume fraction, extracellular diffusion coefficient, and low-frequency conductivity decreased, while the intracellular diffusion coefficient slightly increased. On the other hand, the high-frequency conductivity could not clearly distinguish the four chambers. The extracellular volume fraction measured by the spectrophotometer and CTI method in each chamber were quite comparable, i.e., (1.00, 0.98 ± 0.01), (0.59, 0.63 ± 0.02), (0.40, 0.40 ± 0.05), and (0.16, 0.18 ± 0.02). The prominent factor influencing the low-frequency conductivity at different GVS densities was the extracellular volume fraction. Further studies are needed to validate the CTI method as a tool to measure the extracellular volume fractions in living tissues with different intracellular and extracellular compartments.
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Affiliation(s)
- Bup Kyung Choi
- Department of Biomedical Engineering, Kyung Hee University, Seoul, Republic of Korea
| | - Nitish Katoch
- Department of Biomedical Engineering, Kyung Hee University, Seoul, Republic of Korea
| | - Ji Ae Park
- Division of Applied RI, Korea Institute of Radiological and Medical Science, Seoul, Republic of Korea
| | - Jin Woong Kim
- Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju, Republic of Korea
| | - Tong In Oh
- Department of Biomedical Engineering, Kyung Hee University, Seoul, Republic of Korea
| | - Hyung Joong Kim
- Department of Biomedical Engineering, Kyung Hee University, Seoul, Republic of Korea
| | - Eung Je Woo
- Department of Biomedical Engineering, Kyung Hee University, Seoul, Republic of Korea
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Sasaki K, Porter E, Rashed EA, Farrugia L, Schmid G. Measurement and image-based estimation of dielectric properties of biological tissues —past, present, and future—. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac7b64] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 06/22/2022] [Indexed: 12/23/2022]
Abstract
Abstract
The dielectric properties of biological tissues are fundamental pararmeters that are essential for electromagnetic modeling of the human body. The primary database of dielectric properties compiled in 1996 on the basis of dielectric measurements at frequencies from 10 Hz to 20 GHz has attracted considerable attention in the research field of human protection from non-ionizing radiation. This review summarizes findings on the dielectric properties of biological tissues at frequencies up to 1 THz since the database was developed. Although the 1996 database covered general (normal) tissues, this review also covers malignant tissues that are of interest in the research field of medical applications. An intercomparison of dielectric properties based on reported data is presented for several tissue types. Dielectric properties derived from image-based estimation techniques developed as a result of recent advances in dielectric measurement are also included. Finally, research essential for future advances in human body modeling is discussed.
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Zhang B, Bian B, Zhang Y, Zhang L, Zhang R, Wang J. The Apparent Diffusion Coefficient of Diffusion-Weighted Whole-Body Magnetic Resonance Imaging Affects the Survival of Multiple Myeloma Independently. Front Oncol 2022; 12:780078. [PMID: 35311101 PMCID: PMC8931198 DOI: 10.3389/fonc.2022.780078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/07/2022] [Indexed: 02/03/2023] Open
Abstract
Background Diffusion-weighted whole-body MRI (DW-MRI) is increasingly used to evaluate bone diseases of multiple myeloma (MM), but there is lack of quantitative indicator for DW-MRI to reflect the prognosis of MM. Apparent diffusion coefficient (ADC) values in DW-MRI has potential correlations between some indexes of MM, but the influence of ADC on MM survival needs to be further verified. Methods A total of 381 newly diagnosed MM patients were enrolled in the study to analyze the effect of ADC values in DW-MRI on progression-free survival (PFS) and overall survival (OS). The Kaplan–Meier method was used to perform univariate survival analysis, and the Cox proportional hazards model was used for multivariate analysis. In addition to the ADC value, genetic and serological indexes were also included. Results The survivals were observed in univariate ADC stratification with median PFS of 52.0, 45.0, 34.0, and 26.0 months (the unit of ADC value was 10−3 mm2/s; the ADC ranges were ADC < 0.4886, 0.4886 ≤ ADC < 0.6545, 0.6545 ≤ ADC < 0.7750, and ADC ≥ 0.7750; 95% CI, 43.759–62.241, 46.336–53.664, 39.753–46.247, and 27.812–32.188). The OS were 81.0, 61.0, 47.0, and 36.0 months (p < 0.001; 95% CI, 71.356–82.644, 67.630–70.370, 57.031–60.969, and 36.107–43.893). In Cox proportional hazards model, the ADC value was considered to be an independent risk factor affecting PFS and OS of MM (both p < 0.001). Conclusions This study supports that ADC in DW-MRI may independently stratify MM patients and better predict their prognosis. The combined use of DW-MRI and other parameters allows more accurate evaluation of MM survival. Trial Registration http://www.chictr.org.cn/showproj.aspx?proj=49012, ChiCTR2000029587.
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Affiliation(s)
- Bei Zhang
- Department of Radiology, First Hospital of Jilin University, Changchun, China
| | - Bingyang Bian
- Department of Radiology, First Hospital of Jilin University, Changchun, China
| | - Yanjiao Zhang
- Department of Radiology, First Hospital of Jilin University, Changchun, China
| | - Li Zhang
- Department of Radiology, First Hospital of Jilin University, Changchun, China
| | - Rongkui Zhang
- Department of Hematology, First Hospital of Jilin University, Changchun, China
| | - Jiping Wang
- Department of Radiology, First Hospital of Jilin University, Changchun, China
- *Correspondence: Jiping Wang,
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