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Guo L, Zhang R, Xu Y, Wu W, Zheng Q, Li J, Wang J, Niu J. Predicting the status of lymphovascular space invasion using quantitative parameters from synthetic MRI in cervical squamous cell carcinoma without lymphatic metastasis. Front Oncol 2024; 14:1304793. [PMID: 38380361 PMCID: PMC10876895 DOI: 10.3389/fonc.2024.1304793] [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: 09/30/2023] [Accepted: 01/16/2024] [Indexed: 02/22/2024] Open
Abstract
Purpose To investigate the value of quantitative longitudinal relaxation time (T1), transverse relaxation time (T2), and proton density (PD) maps derived from synthetic magnetic resonance imaging (MRI) for evaluating the status of lymphovascular space invasion (LVSI) in cervical squamous cell carcinoma (CSCC) without lymph node metastasis (LNM). Material and methods Patients with suspected cervical cancer who visited our hospital from May 2020 to March 2023 were collected. All patients underwent preoperative MRI, including routine sequences and synthetic MRI. Patients with pathologically confirmed CSCC without lymphatic metastasis were included in this study. The subjects were divided into negative- and positive-LVSI groups based on the status of LVSI. Quantitative parameters of T1, T2, and PD values derived from synthetic MRI were compared between the two groups using independent samples t-test. Receiver operating characteristic curves were used to determine the diagnostic efficacy of the parameters. Results 59 patients were enrolled in this study and were classified as positive (n = 32) and negative LVSI groups (n = 27). T1 and T2 values showed significant differences in differentiating negative-LVSI from positive-LVSI CSCC (1307.39 ± 122.02 vs. 1193.03 ± 107.86, P<0.0001; 88.42 ± 7.24 vs. 80.99 ± 5.50, P<0.0001, respectively). The area under the curve (AUC) for T1, T2 values and a combination of T1 and T2 values were 0.756, 0.799, 0.834 respectively, and there is no statistically significant difference in the diagnostic efficacy between individual and combined diagnosis of each parameter. Conclusions Quantitative parameters derived from synthetic MRI can be used to evaluate the LVSI status in patients with CSCC without LNM.
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Affiliation(s)
| | | | | | | | | | | | | | - Jinliang Niu
- Department of Radiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
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Li J, Kou P, Lin L, Xiao Y, Jin H, Zhang Y, Cheng J. T1 mapping in evaluation of clinicopathologic factors for rectal adenocarcinoma. Abdom Radiol (NY) 2024; 49:279-287. [PMID: 37839066 DOI: 10.1007/s00261-023-04045-2] [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: 06/08/2023] [Revised: 08/31/2023] [Accepted: 09/03/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE T1 mapping has been increasingly applied in the study of tumor. The purpose of this study was to evaluate the value of T1 mapping in evaluating clinicopathologic factors for rectal adenocarcinoma. MATERIALS AND METHODS Eighty-six patients with rectal adenocarcinoma confirmed by surgical pathology who underwent preoperative pelvic MRI were retrospectively analyzed. High-resolution T2-weighted imaging (T2WI), T1 mapping, and diffusion-weighted imaging (DWI) were performed. T1 and apparent diffusion coefficient (ADC) parameters were compared among different associated tumor markers, tumor grades, stages, and structure invasion statuses. A receiver operating characteristic (ROC) analysis was estimated. RESULTS T1 value showed significant difference between high- and low-grade tumors ([1531.5 ± 84.7 ms] vs. [1437.1 ± 80.3 ms], P < 0.001). T1 value was significant higher in positive than in negative perineural invasion ([1495.7 ± 89.2 ms] vs. [1449.4 ± 88.8 ms], P < 0.05). No significant difference of T1 or ADC was observed in different CEA, CA199, T stage, N stage, lymphovascular invasions, extramural vascular invasion (EMVI), and circumferential resection margin (CRM) (P > 0.05). The AUC under ROC curve of T1 value were 0.796 in distinguishing high- from low-grade rectal adenocarcinoma. The AUC of T1 value in distinguishing perineural invasion was 0.637. CONCLUSION T1 value was helpful in assessing pathologic grade and perineural invasion correlated with rectal cancer.
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Affiliation(s)
- Juan Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou, 450052, China.
| | - Peisi Kou
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou, 450052, China
| | - Liangjie Lin
- Advanced Technical Support, Philips Healthcare, Beijing, China
| | - Yunfei Xiao
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou, 450052, China
| | - Hongrui Jin
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou, 450052, China
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou, 450052, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe Dong Road, Zhengzhou, 450052, China
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Liu J, Li S, Cao Q, Zhang Y, Nickel MD, Zhu J, Cheng J. Prediction of Recurrent Cervical Cancer in 2-Year Follow-Up After Treatment Based on Quantitative and Qualitative Magnetic Resonance Imaging Parameters: A Preliminary Study. Ann Surg Oncol 2023; 30:5577-5585. [PMID: 37355522 DOI: 10.1245/s10434-023-13756-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/28/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE This study investigated predictors of cervical cancer (CC) recurrence from native T1 mapping, conventional imaging, and clinicopathologic metrics. PATIENTS AND METHODS In total, 144 patients with histopathologically confirmed CC (90 with and 54 without surgical treatment) were enrolled in this prospective study. Native T1 relaxation time, conventional imaging, and clinicopathologic characteristics were acquired. The association of quantitative and qualitative parameters with post-treatment tumor recurrence was assessed using univariate and multivariate Cox proportional hazard regression analyses. Independent risk factors were combined into a model and individual prognostic index equation for predicting recurrence risk. The receiver operating characteristic (ROC) curve determined the optimal cutoff point. RESULTS In total, 12 of 90 (13.3%) surgically treated patients experienced tumor recurrence. Native T1 values (X1) [hazard ratio (HR) 1.008; 95% confidence interval (CI) 1.001-1.016], maximum tumor diameter (X2) (HR 1.065; 95% CI 1.020-1.113), and parametrial invasion (X3) (HR 3.930; 95% CI 1.013-15.251) were independent tumor recurrence risk factors. The individual prognostic index (PI) of the established recurrence risk model was PI = 0.008X1 + 0.063X2 + 1.369X3. The area under the ROC curve (AUC) of the Cox regression model was 0.923. A total of 20 of 54 (37.0%) non-surgical patients experienced tumor recurrence. Native T1 values (X1) (HR 1.012; 95% CI 1.007-1.016) and lymph node metastasis (X2) (HR 4.064; 95% CI 1.378-11.990) were independent tumor recurrence risk factors. The corresponding PI was calculated as follows: PI = 0.011X1 + 1.402X2; the Cox regression model AUC was 0.921. CONCLUSIONS Native T1 values combined with conventional imaging and clinicopathologic variables could facilitate the pretreatment prediction of CC recurrence.
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Affiliation(s)
- Jie Liu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
| | - Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Qinchen Cao
- Department of Radiotreatment, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | | | - Jinxia Zhu
- MR Collaboration, Siemens Healthineers Ltd., Xicheng District, Beijing, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
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Qiu G, Chen J, Liao W, Liu Y, Wen Z, Zhao Y. Gadoxetic acid-enhanced MRI combined with T1 mapping and clinical factors to predict Ki-67 expression of hepatocellular carcinoma. Front Oncol 2023; 13:1134646. [PMID: 37456233 PMCID: PMC10348748 DOI: 10.3389/fonc.2023.1134646] [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: 12/30/2022] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Objectives To explore the predictive value of gadoxetic acid-enhanced magnetic resonance imaging (MRI) combined with T1 mapping and clinical factors for Ki-67 expression in hepatocellular carcinoma (HCC). Methods A retrospective study was conducted on 185 patients with pathologically confirmed solitary HCC from two institutions. All patients underwent preoperative T1 mapping on gadoxetic acid-enhanced MRI. Patients from institution I (n = 124) and institution II (n = 61) were respectively assigned to the training and validation sets. Univariable and multivariable analyses were performed to assess the correlation of clinico-radiological factors with Ki-67 labeling index (LI). Based on the significant factors, a predictive nomogram was developed and validated for Ki-67 LI. The performance of the nomogram was evaluated on the basis of its calibration, discrimination, and clinical utility. Results Multivariable analysis showed that alpha-fetoprotein (AFP) levels > 20ng/mL, neutrophils to lymphocyte ratio > 2.25, non-smooth margin, tumor-to-liver signal intensity ratio in the hepatobiliary phase ≤ 0.6, and post-contrast T1 relaxation time > 705 msec were the independent predictors of Ki-67 LI. The nomogram based on these variables showed the best predictive performance with area under the receiver operator characteristic curve (AUROC) 0.899, area under the precision-recall curve (AUPRC) 0.946 and F1 score of 0.912; the respective values were 0.823, 0.879 and 0.857 in the validation set. The Kaplan-Meier curves illustrated that the cumulative recurrence probability at 2 years was significantly higher in patients with high Ki-67 LI than in those with low Ki-67 LI (39.6% [53/134] vs. 19.6% [10/51], p = 0.011). Conclusions Gadoxetic acid-enhanced MRI combined with T1 mapping and several clinical factors can preoperatively predict Ki-67 LI with high accuracy, and thus enable risk stratification and personalized treatment of HCC patients.
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Affiliation(s)
- Ganbin Qiu
- Imaging Department of Zhaoqing Medical College, Zhaoqing, China
- Department of Radiology, The First People’s Hospital of Zhaoqing, Zhaoqing, China
| | - Jincan Chen
- Department of Radiology, The First People’s Hospital of Zhaoqing, Zhaoqing, China
| | - Weixiong Liao
- Imaging Department of Zhaoqing Medical College, Zhaoqing, China
| | - Yonghui Liu
- Department of Radiology, The First People’s Hospital of Zhaoqing, Zhaoqing, China
| | - Zhongyan Wen
- Department of Radiology, The First People’s Hospital of Zhaoqing, Zhaoqing, China
| | - Yue Zhao
- Department of Radiology, Central People’s Hospital of Zhanjiang, Zhanjiang, China
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Liu J, Li S, Cao Q, Zhang Y, Nickel MD, Wu Y, Zhu J, Cheng J. Risk factors for the recurrence of cervical cancer using MR-based T1 mapping: A pilot study. Front Oncol 2023; 13:1133709. [PMID: 37007135 PMCID: PMC10061013 DOI: 10.3389/fonc.2023.1133709] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectivesThis study aimed to identify risk factors for recurrence in patients with cervical cancer (CC) through quantitative T1 mapping.MethodsA cohort of 107 patients histopathologically diagnosed with CC at our institution between May 2018 and April 2021 was categorized into surgical and non-surgical groups. Patients in each group were further divided into recurrence and non-recurrence subgroups depending on whether they showed recurrence or metastasis within 3 years of treatment. The longitudinal relaxation time (native T1) and apparent diffusion coefficient (ADC) value of the tumor were calculated. The differences between native T1 and ADC values of the recurrence and non-recurrence subgroups were analyzed, and receiver operating characteristic (ROC) curves were drawn for parameters with statistical differences. Logistic regression was performed for analysis of significant factors affecting CC recurrence. Recurrence-free survival rates were estimated by Kaplan–Meier analysis and compared using the log-rank test.ResultsThirteen and 10 patients in the surgical and non-surgical groups, respectively, showed recurrence after treatment. There were significant differences in native T1 values between the recurrence and non-recurrence subgroups in the surgical and non-surgical groups (P<0.05); however, there was no difference in ADC values (P>0.05). The areas under the ROC curve of native T1 values for discriminating recurrence of CC after surgical and non-surgical treatment were 0.742 and 0.780, respectively. Logistic regression analysis indicated that native T1 values were risk factors for tumor recurrence in the surgical and non-surgical groups (P=0.004 and 0.040, respectively). Compared with cut-offs, recurrence-free survival curves of patients with higher native T1 values of the two groups were significantly different from those with lower ones (P=0.000 and 0.016, respectively).ConclusionQuantitative T1 mapping could help identify CC patients with a high risk of recurrence, supplementing information on tumor prognosis other than clinicopathological features and providing the basis for individualized treatment and follow-up schemes.
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Affiliation(s)
- Jie Liu
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Jie Liu,
| | - Shujian Li
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qinchen Cao
- Department of Radiotreatment, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Marcel Dominik Nickel
- Magnetic Resonance (MR) Application Predevelopment, Siemens Healthcare Gesellschaft mit beschrankter Haftung (GmbH), Erlangen, Germany
| | - Yanglei Wu
- Magnetic Resonance (MR) Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Jinxia Zhu
- Magnetic Resonance (MR) Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Jingliang Cheng
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Li S, Liu J, Guo R, Nickel MD, Zhang Y, Cheng J, Zhu J. T 1 mapping and extracellular volume fraction measurement to evaluate the poor-prognosis factors in patients with cervical squamous cell carcinoma. NMR IN BIOMEDICINE 2023:e4918. [PMID: 36914267 DOI: 10.1002/nbm.4918] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE To evaluate the clinical feasibility of T1 mapping and extracellular volume fraction (ECV) measurement in assessing prognostic factors in patients with cervical squamous cell carcinoma (CSCC). MATERIALS AND METHODS A total of 117 CSCC patients and 59 healthy volunteers underwent T1 mapping and diffusion-weighted imaging (DWI) on a 3 T system. Native T1 , contrast-enhanced T1 , ECV, and apparent diffusion coefficient (ADC) were calculated and compared based on surgico-pathologically verified deep stromal infiltration, parametrial invasion (PMI), lymphovascular space invasion (LVSI), lymph node metastasis, stage, histologic grade, and the Ki-67 labeling index (LI). RESULTS Native T1 , contrast-enhanced T1 , ECV, and ADC values were significantly different between CSCC and the normal cervix (all p < 0.05). No significant differences were observed in any parameters of CSCC when the tumors were grouped by stromal infiltration or lymph node status, respectively (all p > 0.05). In subgroups of the tumor stage and PMI, native T1 was significantly higher for advanced-stage (p = 0.032) and PMI-positive CSCC (p = 0.001). In subgroups of the grade and Ki-67 LI, contrast-enhanced T1 was significantly higher for high-grade (p = 0.012) and Ki-67 LI ≥ 50% tumors (p = 0.027). ECV was significantly higher in LVSI-positive CSCC than in LVSI-negative CSCC (p < 0.001). ADC values showed a significant difference for the grade (p < 0.001) but none for the other subgroups. CONCLUSION Both T1 mapping and DWI could stratify the CSCC histologic grade. In addition, T1 mapping and ECV measurement might provide more quantitative metrics for noninvasively predicting poor prognostic factors and aiding in preoperative risk assessment in CSCC patients.
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Affiliation(s)
- Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Liu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rufei Guo
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Ltd., Beijing, China
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Chartampilas E, Rafailidis V, Georgopoulou V, Kalarakis G, Hatzidakis A, Prassopoulos P. Current Imaging Diagnosis of Hepatocellular Carcinoma. Cancers (Basel) 2022; 14:cancers14163997. [PMID: 36010991 PMCID: PMC9406360 DOI: 10.3390/cancers14163997] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Abstract
Simple Summary The role of imaging in the management of hepatocellular carcinoma (HCC) has significantly evolved and expanded beyond the plain radiological confirmation of the tumor based on the typical appearance in a multiphase contrast-enhanced CT or MRI examination. The introduction of hepatobiliary contrast agents has enabled the diagnosis of hepatocarcinogenesis at earlier stages, while the application of ultrasound contrast agents has drastically upgraded the role of ultrasound in the diagnostic algorithms. Newer quantitative techniques assessing blood perfusion on CT and MRI not only allow earlier diagnosis and confident differentiation from other lesions, but they also provide biomarkers for the evaluation of treatment response. As distinct HCC subtypes are identified, their correlation with specific imaging features holds great promise for estimating tumor aggressiveness and prognosis. This review presents the current role of imaging and underlines its critical role in the successful management of patients with HCC. Abstract Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer related death worldwide. Radiology has traditionally played a central role in HCC management, ranging from screening of high-risk patients to non-invasive diagnosis, as well as the evaluation of treatment response and post-treatment follow-up. From liver ultrasonography with or without contrast to dynamic multiple phased CT and dynamic MRI with diffusion protocols, great progress has been achieved in the last decade. Throughout the last few years, pathological, biological, genetic, and immune-chemical analyses have revealed several tumoral subtypes with diverse biological behavior, highlighting the need for the re-evaluation of established radiological methods. Considering these changes, novel methods that provide functional and quantitative parameters in addition to morphological information are increasingly incorporated into modern diagnostic protocols for HCC. In this way, differential diagnosis became even more challenging throughout the last few years. Use of liver specific contrast agents, as well as CT/MRI perfusion techniques, seem to not only allow earlier detection and more accurate characterization of HCC lesions, but also make it possible to predict response to treatment and survival. Nevertheless, several limitations and technical considerations still exist. This review will describe and discuss all these imaging modalities and their advances in the imaging of HCC lesions in cirrhotic and non-cirrhotic livers. Sensitivity and specificity rates, method limitations, and technical considerations will be discussed.
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Affiliation(s)
- Evangelos Chartampilas
- Radiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
- Correspondence:
| | - Vasileios Rafailidis
- Radiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Vivian Georgopoulou
- Radiology Department, Ippokratio General Hospital of Thessaloniki, 54642 Thessaloniki, Greece
| | - Georgios Kalarakis
- Department of Diagnostic Radiology, Karolinska University Hospital, 14152 Stockholm, Sweden
- Department of Clinical Science, Division of Radiology, Intervention and Technology (CLINTEC), Karolinska Institutet, 14152 Stockholm, Sweden
- Department of Radiology, Medical School, University of Crete, 71500 Heraklion, Greece
| | - Adam Hatzidakis
- Radiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Panos Prassopoulos
- Radiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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Li J, Gao X, Dominik Nickel M, Cheng J, Zhu J. Native T1 mapping for differentiating the histopathologic type, grade, and stage of rectal adenocarcinoma: a pilot study. Cancer Imaging 2022; 22:30. [PMID: 35715848 PMCID: PMC9204907 DOI: 10.1186/s40644-022-00461-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies have indicated that T1 relaxation time could be utilized for the analysis of tissue characteristics. T1 mapping technology has been gradually used on research of body tumor. In this study, the application of native T1 relaxation time for differentiating the histopathologic type, grade, and stage of rectal adenocarcinoma was investigated. Methods One hundred and twenty patients with pathologically confirmed rectal adenocarcinoma were retrospectively evaluated. All patients underwent high-resolution anatomical magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and T1 mapping sequences. Parameters of T1 relaxation time and apparent diffusion coefficient (ADC) were measured between the different groups. The diagnostic power was evaluated though the receiver operating characteristic (ROC) curve. Results The T1 and ADC values varied significantly between rectal mucinous adenocarcinoma (MC) and non-mucinous rectal adenocarcinoma (AC) ([1986.1 ± 163.3 ms] vs. [1562.3 ± 244.2 ms] and [1.38 ± 0.23 × 10−3mm2/s] vs. [1.03 ± 0.15 × 10−3mm2/s], respectively; P < 0.001). In the AC group, T1 relaxation time were significantly different between the low- and high-grade adenocarcinoma cases ([1508.7 ± 188.6 ms] vs. [1806.5 ± 317.5 ms], P < 0.001), while no differences were apparent in the ADC values ([1.03 ± 0.14 × 10−3mm2/s] vs. [1.04 ± 0.18 × 10−3mm2/s], P > 0.05). No significant differences in T1 and ADC values were identified between the different T and N stage groups for both MC and AC (all P > 0.05). Conclusions Native T1 relaxation time can be used to discriminate MC from AC. The T1 relaxation time was helpful for differentiating the low- and high-grade of AC.
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Affiliation(s)
- Juan Li
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Dong Road, Zhengzhou, 450052, China
| | - Xuemei Gao
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Dong Road, Zhengzhou, 450052, China
| | | | - Jingliang Cheng
- Department of MRI, the First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Dong Road, Zhengzhou, 450052, China.
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Ltd, Beijing, 100000, China
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Zhao QY, Liu SS, Fan MX. Prediction of early recurrence of hepatocellular carcinoma after resection based on Gd-EOB-DTPA enhanced magnetic resonance imaging: a preliminary study. J Gastrointest Oncol 2022; 13:792-801. [PMID: 35557582 PMCID: PMC9086065 DOI: 10.21037/jgo-22-224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/11/2022] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Early recurrence (ER) after radical resection of hepatocellular carcinoma (HCC) affects the prognosis of patients. Gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) can improve the detection rate of small HCC. This study innovatively introduces a new quantitative index combined with qualitative index to compare the differences in clinical and imaging characteristics between ER and non-ER groups and evaluate the feasibility of Gd-EOB-DTPA-enhanced MRI in predicting ER. METHODS A total of 68 patients with HCC confirmed by operation and pathology in the Shandong Cancer Hospital and Institute were included retrospectively. All participants were examined by Gd-EOB-DTPA-enhanced MRI within 3 weeks before surgery. Regular follow-up was performed every 2 months within 1 year after operation. Among them, 18 cases with new lesions were in ER group, and 50 cases without new lesions were in non-ER group. The clinical and imaging data of the 2 groups were collected, and the differences of clinical data and preoperative MRI signs between the ER group and non-ER group were compared. The predictive factors of ER after HCC were analyzed by multivariate logistic regression. RESULTS The quantitative parameter lesion-to-liver contrast enhancement ratio (LLCER) can predict the pathological grade of HCC (P=0.023). The results of univariate analysis between the ER group and non-ER group showed that there were significant differences in pathological grade (P=0.008), lesion morphology (P=0.011), peritumoral low signal intensity in hepatobiliary phase (HBP) (P<0.001), satellite nodules (P<0.001), and LLCER (P<0.001) between the 2 groups. Multivariate logistic regression analysis showed that HBP peritumoral low signal intensity [odds ratio (OR) =7.214, 95% confidence interval (CI): 1.230-42.312, P=0.029], satellite nodules (OR =9.198, 95% CI: 1.402-60.339, P=0.021), and parameter LLCER value (OR =0.906, 95% CI: 0.826-0.995, P=0.039) were independent predictors of ER of HCC after resection. CONCLUSIONS Preoperative Gd-EOB-DTPA enhanced MRI has important predictive value for early recurrence after radical resection of hepatocellular carcinoma.
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Affiliation(s)
- Qi-Yu Zhao
- Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Shi-Shun Liu
- Medical Imaging Department, Jinan Second People’s Hospital, Jinan, China
| | - Ming-Xin Fan
- Department of Radiology, The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), Jinan, China
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Wei H, Jiang H, Zheng T, Zhang Z, Yang C, Ye Z, Duan T, Song B. LI-RADS category 5 hepatocellular carcinoma: preoperative gadoxetic acid-enhanced MRI for early recurrence risk stratification after curative resection. Eur Radiol 2021; 31:2289-2302. [PMID: 33001306 PMCID: PMC7979599 DOI: 10.1007/s00330-020-07303-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/01/2020] [Accepted: 09/15/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To explore the role of preoperative gadoxetic acid-enhanced MRI in stratifying the risk of early recurrence in patients with LR-5 hepatocellular carcinoma (HCC) by LI-RADS v2018 after curative resection. METHODS Between July 2015 and August 2018, this study evaluated consecutive treatment-naïve at-risk LR-5 HCC patients who underwent gadoxetic acid-enhanced MRI examination within 2 weeks before curative resection. The Cox regression analysis was performed to identify potential predictors of early recurrence. Disease-free survival (DFS) rates were analyzed and compared by using the Kaplan-Meier method and log-rank tests. RESULTS Fifty-three of 103 (51.5%) patients experienced early recurrence. Three MRI findings were significantly associated with early recurrence: corona enhancement (hazard ratio [HR]: 2.116; p = 0.013), peritumoral hypointensity on hepatobiliary phase (HBP) (HR: 2.262; p = 0.007), and satellite nodule (HR: 2.777; p = 0.005). An additional risk factor was AFP level > 400 ng/mL (HR: 1.975; p = 0.016). Based on the number of MRI predictors, LR-5 HCC patients were stratified into three subgroups: LR-5a (60/103; no predictor), LR-5b (26/103; one predictor), and LR-5c (17/103; two or three predictors), with low, medium, and high risk of early recurrence, respectively. The 2-year DFS rate of LR-5a, LR-5b, and LR-5c patients was 65.0%, 38.5%, and 5.9%, respectively, while the corresponding median DFS was undefined, 17.1 months, and 5.1 months, respectively (p < 0.001). CONCLUSIONS In at-risk LR-5 HCC patients, corona enhancement, peritumoral hypointensity on HBP, and satellite nodule could be used to preoperatively stratify the risk of early recurrence after hepatectomy. KEY POINTS • Corona enhancement, peritumoral hypointensity on HBP, satellite nodule, and serum AFP level > 400 ng/mL were significant predictors of early recurrence in patients with LR-5 HCC after hepatectomy. • Based on the number of predictive MRI findings, LR-5 HCC patients could be preoperatively stratified into three subgroups: LR-5a, LR-5b, and LR-5c, with significantly different risk of early recurrence and disease-free survival. • Preoperative risk stratification is essential for the identification of patients at increased risk of postoperative early recurrence, which may contribute to risk-based personalized management for LR-5 HCC patients.
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Affiliation(s)
- Hong Wei
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Hanyu Jiang
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Tianying Zheng
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Zhen Zhang
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Caiwei Yang
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Zheng Ye
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Ting Duan
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, China
| | - Bin Song
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, China.
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Li XQ, Wang X, Zhao DW, Sun J, Liu JJ, Lin DD, Yang G, Liu H, Xia ZY, Jia CY, Li HJ. Application of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma. World J Surg Oncol 2020; 18:219. [PMID: 32828123 PMCID: PMC7443289 DOI: 10.1186/s12957-020-01996-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/10/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver, and its morbidity and mortality have been increasing in recent years. The early diagnosis and prompt treatment of small HCC are crucial to improve the prognosis and quality of life of patients. In China, hepatitis B virus infection is the main cause. HCC with a single tumor nodule of ≤ 3 cm in diameter, or HCC with a number of nodules, in which each nodule is ≤ 2 cm in diameter, with a total diameter of ≤ 3 cm, is considered as small HCC. The MRI liver-specific contrast agent can detect small HCC at the early stage. This has important clinical implications for improving the survival rate of patients. MAIN BODY Gd-EOB-DTPA-enhanced MRI can significantly improve the sensitivity and specificity of the detection of HBV-related small hepatocellular carcinoma, providing an important basis for the clinical selection of appropriate personalized treatment. Gd-EOB-DTPA-enhanced MRI can reflect the degree of HCC differentiation, and the evaluation of HCC on Gd-EOB-DTPA-enhanced MRI would be helpful for the selection of the treatment and prognosis of HCC patients. The present study reviews the progress of the application of Gd-EOB-DTPA in the early diagnosis of small HCC, its clinical treatment, the prediction of the degree of differentiation, and the assessment of recurrence and prognosis of HCC, including the pharmacoeconomics and application limitations of Gd-EOB-DTPA. The value of the application of HCC with the Gd-EOB-DTPA was summarized to provide information for improving the quality of life and prolonging the survival of patients. CONCLUSION Gd-EOB-DTPA-enhanced MRI has the diagnostic capability for small HCC with a diameter of ≤ 2 cm. This will have a broader application prospect in the early diagnosis of small liver cancer with a diameter of ≤ 1 cm in the future. The relationship between GD-EOB-DTPA-MRI and the degree of HCC differentiation has a large research space, and Gd-EOB-DTPA is expected to become a potential tool for the preoperative prediction and postoperative evaluation of HCC, which would be beneficial for more appropriate treatments for HCC patients.
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Affiliation(s)
- Xue-Qin Li
- Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China
| | - Xing Wang
- Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China
| | - Da-Wei Zhao
- Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China
| | - Jun Sun
- Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China
| | - Jiao-Jiao Liu
- Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China
| | - Dong-Dong Lin
- Department of Surgery, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China
| | - Guang Yang
- Department of Surgery, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China
| | - Hui Liu
- Department of Pathology,Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China
| | - Zhen-Ying Xia
- Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China
| | - Cui-Yu Jia
- Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China
| | - Hong-Jun Li
- Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China.
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Rao C, Wang X, Li M, Zhou G, Gu H. Value of T1 mapping on gadoxetic acid-enhanced MRI for microvascular invasion of hepatocellular carcinoma: a retrospective study. BMC Med Imaging 2020; 20:43. [PMID: 32345247 PMCID: PMC7189724 DOI: 10.1186/s12880-020-00433-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/17/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND To evaluate the utility of non-invasive parameters derived from T1 mapping and diffusion-weighted imaging (DWI) on gadoxetic acid-enhanced MRI for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC). METHODS A total of 94 patients with single HCC undergoing partial hepatectomy was analyzed in this retrospective study. Preoperative T1 mapping and DWI on gadoxetic acid-enhanced MRI was performed. The parameters including precontrast, postcontrast and reduction rate of T1 relaxation time and apparent diffusion coefficient (ADC) values were measured for differentiating MVI-positive HCCs (n = 38) from MVI-negative HCCs (n = 56). The receiver operating characteristic curve (ROC) was analyzed to compare the diagnostic performance of the calculated parameters. RESULTS MVI-positive HCCs demonstrated a significantly lower reduction rate of T1 relaxation time than that of MVI-negative HCCs (39.4% vs 49.9, P < 0.001). The areas under receiver operating characteristic curve (AUC) were 0.587, 0.728, 0.824, 0,690 and 0.862 for the precontrast, postcontrast, reduction rate of T1 relaxation time, ADC and the combination of reduction rate and ADC, respectively. The cut-off value of the reduction rate and ADC calculated through maximal Youden index in ROC analyses was 44.9% and 1553.5 s/mm2. To achieve a better diagnostic performance, the criteria of combining the reduction rate lower than 44.9% and the ADC value lower than 1553.5 s/mm2 was proposed with a high specificity of 91.8% and accuracy of 80.9%. CONCLUSIONS The proposed criteria of combining the reduction rate of T1 relaxation time lower than 44.9% and the ADC value lower than 1553.5 s/mm2 on gadoxetic acid-enhanced MRI holds promise for evaluating MVI status of HCC.
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Affiliation(s)
- Chenyi Rao
- Medical College, Nantong University, Nantong, Jiangsu, China
| | - Xinquan Wang
- Medical College, Nantong University, Nantong, Jiangsu, China.,Department of Radiology, Affiliated Hospital of Nantong University, 20 Xisi Rd., Nantong, 226001, Jiangsu, China
| | - Minda Li
- Medical College, Nantong University, Nantong, Jiangsu, China.,Department of Radiology, Affiliated Hospital of Nantong University, 20 Xisi Rd., Nantong, 226001, Jiangsu, China
| | - Guofeng Zhou
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hongmei Gu
- Medical College, Nantong University, Nantong, Jiangsu, China. .,Department of Radiology, Affiliated Hospital of Nantong University, 20 Xisi Rd., Nantong, 226001, Jiangsu, China.
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