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Tang G, Zhou H, Zeng C, Jiang Y, Li Y, Hou L, Liao K, Tan Z, Wu H, Tang Y, Cheng Y, Ling X, Guo Q, Xu H. Alterations of apparent diffusion coefficient from ultra high b-values in the bilateral thalamus and striatum in MRI-negative drug-resistant epilepsy. Epilepsia Open 2024. [PMID: 38943548 DOI: 10.1002/epi4.12990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 04/01/2024] [Accepted: 05/26/2024] [Indexed: 07/01/2024] Open
Abstract
OBJECTIVE Subcortical nuclei such as the thalamus and striatum have been shown to be related to seizure modulation and termination, especially in drug-resistant epilepsy. Enhance diffusion-weighted imaging (eDWI) technique and tri-component model have been used in previous studies to calculate apparent diffusion coefficient from ultra high b-values (ADCuh). This study aimed to explore the alterations of ADCuh in the bilateral thalamus and striatum in MRI-negative drug-resistant epilepsy. METHODS Twenty-nine patients with MRI-negative drug-resistant epilepsy and 18 healthy controls underwent eDWI scan with 15 b-values (0-5000 s/mm2). The eDWI parameters including standard ADC (ADCst), pure water diffusion (D), and ADCuh were calculated from the 15 b-values. Regions-of-interest (ROIs) analyses were conducted in the bilateral thalamus, caudate nucleus, putamen, and globus pallidus. ADCst, D, and ADCuh values were compared between the MRI-negative drug-resistant epilepsy patients and controls using multivariate generalized linear models. Inter-rater reliability was assessed using the intra-class correlation coefficient (ICC) and Bland-Altman (BA) analysis. False discovery rate (FDR) method was applied for multiple comparisons correction. RESULTS ADCuh values in the bilateral thalamus, caudate nucleus, putamen, and globus pallidus in MRI-negative drug-resistant epilepsy were significantly higher than those in the healthy control subjects (all p < 0.05, FDR corrected). SIGNIFICANCE The alterations of the ADCuh values in the bilateral thalamus and striatum in MRI-negative drug-resistant epilepsy might reflect abnormal membrane water permeability in MRI-negative drug-resistant epilepsy. ADCuh might be a sensitive measurement for evaluating subcortical nuclei-related brain damage in epilepsy patients. PLAIN LANGUAGE SUMMARY This study aimed to explore the alterations of apparent diffusion coefficient calculated from ultra high b-values (ADCuh) in the subcortical nuclei such as the bilateral thalamus and striatum in MRI-negative drug-resistant epilepsy. The bilateral thalamus and striatum showed higher ADCuh in epilepsy patients than healthy controls. These findings may add new evidences of subcortical nuclei abnormalities related to water and ion hemostasis in epilepsy patients, which might help to elucidate the underlying epileptic neuropathophysiological mechanisms and facilitate the exploration of therapeutic targets.
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Affiliation(s)
- Guixian Tang
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Hailing Zhou
- Department of Radiology, Central People's Hospital of Zhanjiang, Zhanjiang, China
| | - Chunyuan Zeng
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yuanfang Jiang
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ying Li
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lu Hou
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Kai Liao
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhiqiang Tan
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Huanhua Wu
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yongjin Tang
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yong Cheng
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xueying Ling
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Qiang Guo
- Epilepsy Center, Guangdong 999 Brain Hospital, Affiliated Brain Hospital of Jinan University, Guangzhou, China
| | - Hao Xu
- Department of Nuclear Medicine, PET/CT-MRI Center, Center of Cyclotron and PET Radiopharmaceuticals, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Wang X, Shu X, He P, Cai Y, Geng Y, Hu X, Sun Y, Xiao H, Zheng W, Song Y, Xue Y, Jiang R. Ultra-high b-value DWI accurately identifies isocitrate dehydrogenase genotypes and tumor subtypes of adult-type diffuse gliomas. Eur Radiol 2024:10.1007/s00330-024-10708-5. [PMID: 38528135 DOI: 10.1007/s00330-024-10708-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/08/2024] [Accepted: 02/23/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVES To distinguish isocitrate dehydrogenase (IDH) genotypes and tumor subtypes of adult-type diffuse gliomas based on the fifth edition of the World Health Organization classification of central nervous system tumors (WHO CNS5) in 2021 using standard, high, and ultra-high b-value diffusion-weighted imaging (DWI). MATERIALS AND METHODS This prospective study enrolled 70 patients with adult-type diffuse gliomas who underwent multiple b-value DWI. Apparent diffusion coefficient (ADC) values including ADCb500/b1000, ADCb500/b2000, ADCb500/b3000, ADCb500/b4000, ADCb500/b6000, ADCb500/b8000, and ADCb500/b10000 in tumor parenchyma (TP) and contralateral normal-appearing white matter (NAWM) were calculated. The ADC ratios of TP/NAWM were assessed for correlations with IDH genotypes, tumor subtypes, and Ki-67 status; diagnostic performances were compared. RESULTS All ADCs were significantly higher in IDH mutant gliomas than in IDH wild-type gliomas (p < 0.01 for all); ADCb500/b8000 had the highest area under the curve (AUC) of 0.866. All ADCs were significantly lower in glioblastoma than in astrocytoma (p < 0.01 for all). ADCs other than ADCb500/b1000 were significantly lower in glioblastoma than in oligodendroglioma (p < 0.05 for all). ADCb500/b8000 and ADCb500/b10000 were significantly higher in oligodendroglioma than in astrocytoma (p = 0.034 and 0.023). The highest AUCs were 0.818 for ADCb500/b6000 when distinguishing glioblastoma from astrocytoma, 0.979 for ADCb500/b8000 and ADCb500/b10000 when distinguishing glioblastoma from oligodendroglioma, and 0.773 for ADCb500/b10000 when distinguishing astrocytoma from oligodendroglioma. Additionally, all ADCs were negatively correlated with Ki-67 status (p < 0.05 for all). CONCLUSION Ultra-high b-value DWI can reliably separate IDH genotypes and tumor subtypes of adult-type diffuse gliomas using WHO CNS5 criteria. CLINICAL RELEVANCE STATEMENT Ultra-high b-value diffusion-weighted imaging can accurately distinguish isocitrate dehydrogenase genotypes and tumor subtypes of adult-type diffuse gliomas, which may facilitate personalized treatment and prognostic assessment for patients with glioma. KEY POINTS • Ultra-high b-value diffusion-weighted imaging can accurately distinguish subtle differences in water diffusion among biological tissues. • Ultra-high b-value diffusion-weighted imaging can reliably separate isocitrate dehydrogenase genotypes and tumor subtypes of adult-type diffuse gliomas. • Compared with standard b-value diffusion-weighted imaging, high and ultra-high b-value diffusion-weighted imaging demonstrate better diagnostic performances.
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Affiliation(s)
- Xueqin Wang
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
- School of Medical Imaging, Fujian Medical University, Fuzhou, 350004, China
| | - Xinru Shu
- School of Basic Medical Sciences, Fujian Medical University, Fuzhou, 350004, China
| | - Pingping He
- School of Medical Imaging, Fujian Medical University, Fuzhou, 350004, China
| | - Yiting Cai
- School of Medical Imaging, Fujian Medical University, Fuzhou, 350004, China
| | - Yingqian Geng
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Xiaomei Hu
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Yifan Sun
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Huinan Xiao
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Wanyi Zheng
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Yang Song
- MR Scientific Marketing, Siemens Healthcare, Shanghai, China
| | - Yunjing Xue
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Rifeng Jiang
- Department of Radiology, Fujian Medical University Union Hospital, NO.29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China.
- School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, 350004, China.
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Zhang G, Xu Z, Zheng J, Wang M, Ren J, Wei X, Huan Y, Zhang J. Ultra-high b-Value DWI in predicting progression risk of locally advanced rectal cancer: a comparative study with routine DWI. Cancer Imaging 2023; 23:59. [PMID: 37308941 DOI: 10.1186/s40644-023-00582-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/02/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND The prognosis prediction of locally advanced rectal cancer (LARC) was important to individualized treatment, we aimed to investigate the performance of ultra-high b-value DWI (UHBV-DWI) in progression risk prediction of LARC and compare with routine DWI. METHODS This retrospective study collected patients with rectal cancer from 2016 to 2019. Routine DWI (b = 0, 1000 s/mm2) and UHBV-DWI (b = 0, 1700 ~ 3500 s/mm2) were processed with mono-exponential model to generate ADC and ADCuh, respectively. The performance of the ADCuh was compared with ADC in 3-year progression free survival (PFS) assessment using time-dependent ROC and Kaplan-Meier curve. Prognosis model was constructed with ADCuh, ADC and clinicopathologic factors using multivariate COX proportional hazard regression analysis. The prognosis model was assessed with time-dependent ROC, decision curve analysis (DCA) and calibration curve. RESULTS A total of 112 patients with LARC (TNM-stage II-III) were evaluated. ADCuh performed better than ADC for 3-year PFS assessment (AUC = 0.754 and 0.586, respectively). Multivariate COX analysis showed that ADCuh and ADC were independent factors for 3-year PFS (P < 0.05). Prognostic model 3 (TNM-stage + extramural venous invasion (EMVI) + ADCuh) was superior than model 2 (TNM-stage + EMVI + ADC) and model 1 (TNM-stage + EMVI) for 3-year PFS prediction (AUC = 0.805, 0.719 and 0.688, respectively). DCA showed that model 3 had higher net benefit than model 2 and model 1. Calibration curve demonstrated better agreement of model 1 than model 2 and model 1. CONCLUSIONS ADCuh from UHBV-DWI performed better than ADC from routine DWI in predicting prognosis of LARC. The model based on combination of ADCuh, TNM-stage and EMVI could help to indicate progression risk before treatment.
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Affiliation(s)
- Guangwen Zhang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No.127, Chang Le West Road, Xi'an, Shaanxi, 710032, China
| | - Ziliang Xu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No.127, Chang Le West Road, Xi'an, Shaanxi, 710032, China
| | - Jianyong Zheng
- Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Mian Wang
- Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Jialiang Ren
- Department of Pharmaceuticals Diagnostics, GE Healthcare China, Beijing, 100176, China
| | - Xiaocheng Wei
- Department of MR Research, GE Healthcare China, Beijing, 100176, China
| | - Yi Huan
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No.127, Chang Le West Road, Xi'an, Shaanxi, 710032, China
| | - Jinsong Zhang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No.127, Chang Le West Road, Xi'an, Shaanxi, 710032, China.
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Silva M, Vivancos C, Duffau H. The Concept of «Peritumoral Zone» in Diffuse Low-Grade Gliomas: Oncological and Functional Implications for a Connectome-Guided Therapeutic Attitude. Brain Sci 2022; 12:brainsci12040504. [PMID: 35448035 PMCID: PMC9032126 DOI: 10.3390/brainsci12040504] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 12/22/2022] Open
Abstract
Diffuse low-grade gliomas (DLGGs) are heterogeneous and poorly circumscribed neoplasms with isolated tumor cells that extend beyond the margins of the lesion depicted on MRI. Efforts to demarcate the glioma core from the surrounding healthy brain led us to define an intermediate region, the so-called peritumoral zone (PTZ). Although most studies about PTZ have been conducted on high-grade gliomas, the purpose here is to review the cellular, metabolic, and radiological characteristics of PTZ in the specific context of DLGG. A better delineation of PTZ, in which glioma cells and neural tissue strongly interact, may open new therapeutic avenues to optimize both functional and oncological results. First, a connectome-based “supratotal” surgical resection (i.e., with the removal of PTZ in addition to the tumor core) resulted in prolonged survival by limiting the risk of malignant transformation, while improving the quality of life, thanks to a better control of seizures. Second, the timing and order of (neo)adjuvant medical treatments can be modulated according to the pattern of peritumoral infiltration. Third, the development of new drugs specifically targeting the PTZ could be considered from an oncological (such as immunotherapy) and epileptological perspective. Further multimodal investigations of PTZ are needed to maximize long-term outcomes in DLGG patients.
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Affiliation(s)
- Melissa Silva
- Department of Neurosurgery, Hospital Garcia de Orta, 2805-267 Almada, Portugal;
| | - Catalina Vivancos
- Department of Neurosurgery, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295 Montpellier, France
- Team “Plasticity of Central Nervous System, Stem Cells and Glial Tumors”, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM) U1191, University of Montpellier, 34295 Montpellier, France
- Correspondence:
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