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Galizia MS, Attili AK, Truesdell WR, Smith ED, Helms AS, Sulaiman AMA, Madamanchi C, Agarwal PP. Imaging Features of Arrhythmogenic Cardiomyopathies. Radiographics 2024; 44:e230154. [PMID: 38512728 PMCID: PMC10995833 DOI: 10.1148/rg.230154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/09/2023] [Accepted: 08/28/2023] [Indexed: 03/23/2024]
Abstract
Arrhythmogenic cardiomyopathy (ACM) is a genetic disease characterized by replacement of ventricular myocardium with fibrofatty tissue, predisposing the patient to ventricular arrhythmias and/or sudden cardiac death. Most cases of ACM are associated with pathogenic variants in genes that encode desmosomal proteins, an important cell-to-cell adhesion complex present in both the heart and skin tissue. Although ACM was first described as a disease predominantly of the right ventricle, it is now acknowledged that it can also primarily involve the left ventricle or both ventricles. The original right-dominant phenotype is traditionally diagnosed using the 2010 task force criteria, a multifactorial algorithm divided into major and minor criteria consisting of structural criteria based on two-dimensional echocardiographic, cardiac MRI, or right ventricular angiographic findings; tissue characterization based on endomyocardial biopsy results; repolarization and depolarization abnormalities based on electrocardiographic findings; arrhythmic features; and family history. Shortfalls in the task force criteria due to the modern understanding of the disease have led to development of the Padua criteria, which include updated criteria for diagnosis of the right-dominant phenotype and new criteria for diagnosis of the left-predominant and biventricular phenotypes. In addition to incorporating cardiac MRI findings of ventricular dilatation, systolic dysfunction, and regional wall motion abnormalities, the new Padua criteria emphasize late gadolinium enhancement at cardiac MRI as a key feature in diagnosis and imaging-based tissue characterization. Conditions to consider in the differential diagnosis of the right-dominant phenotype include various other causes of right ventricular dilatation such as left-to-right shunts and variants of normal right ventricular anatomy that can be misinterpreted as abnormalities. The left-dominant phenotype can mimic myocarditis at imaging and clinical examination. Additional considerations for the differential diagnosis of ACM, particularly for the left-dominant phenotype, include sarcoidosis and dilated cardiomyopathy. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.
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Affiliation(s)
- Mauricio S. Galizia
- From the Department of Radiology (M.S.G., A.K.A., W.R.T., P.P.A.) and
Division of Cardiovascular Medicine, Department of Internal Medicine (E.D.S.,
A.S.H., A.M.A.S., C.M.), Michigan Medicine, University of Michigan, 1500 E
Medical Center Dr, Ann Arbor, MI 48109
| | - Anil K. Attili
- From the Department of Radiology (M.S.G., A.K.A., W.R.T., P.P.A.) and
Division of Cardiovascular Medicine, Department of Internal Medicine (E.D.S.,
A.S.H., A.M.A.S., C.M.), Michigan Medicine, University of Michigan, 1500 E
Medical Center Dr, Ann Arbor, MI 48109
| | - William R. Truesdell
- From the Department of Radiology (M.S.G., A.K.A., W.R.T., P.P.A.) and
Division of Cardiovascular Medicine, Department of Internal Medicine (E.D.S.,
A.S.H., A.M.A.S., C.M.), Michigan Medicine, University of Michigan, 1500 E
Medical Center Dr, Ann Arbor, MI 48109
| | - Eric D. Smith
- From the Department of Radiology (M.S.G., A.K.A., W.R.T., P.P.A.) and
Division of Cardiovascular Medicine, Department of Internal Medicine (E.D.S.,
A.S.H., A.M.A.S., C.M.), Michigan Medicine, University of Michigan, 1500 E
Medical Center Dr, Ann Arbor, MI 48109
| | - Adam S. Helms
- From the Department of Radiology (M.S.G., A.K.A., W.R.T., P.P.A.) and
Division of Cardiovascular Medicine, Department of Internal Medicine (E.D.S.,
A.S.H., A.M.A.S., C.M.), Michigan Medicine, University of Michigan, 1500 E
Medical Center Dr, Ann Arbor, MI 48109
| | - Abdulbaset M. A. Sulaiman
- From the Department of Radiology (M.S.G., A.K.A., W.R.T., P.P.A.) and
Division of Cardiovascular Medicine, Department of Internal Medicine (E.D.S.,
A.S.H., A.M.A.S., C.M.), Michigan Medicine, University of Michigan, 1500 E
Medical Center Dr, Ann Arbor, MI 48109
| | - Chaitanya Madamanchi
- From the Department of Radiology (M.S.G., A.K.A., W.R.T., P.P.A.) and
Division of Cardiovascular Medicine, Department of Internal Medicine (E.D.S.,
A.S.H., A.M.A.S., C.M.), Michigan Medicine, University of Michigan, 1500 E
Medical Center Dr, Ann Arbor, MI 48109
| | - Prachi P. Agarwal
- From the Department of Radiology (M.S.G., A.K.A., W.R.T., P.P.A.) and
Division of Cardiovascular Medicine, Department of Internal Medicine (E.D.S.,
A.S.H., A.M.A.S., C.M.), Michigan Medicine, University of Michigan, 1500 E
Medical Center Dr, Ann Arbor, MI 48109
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Tappa K, Bird JE, Arribas EM, Santiago L. Multimodality Imaging for 3D Printing and Surgical Rehearsal in Complex Spine Surgery. Radiographics 2024; 44:e230116. [PMID: 38386600 PMCID: PMC10924222 DOI: 10.1148/rg.230116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/11/2023] [Accepted: 08/10/2023] [Indexed: 02/24/2024]
Abstract
Surgery is the mainstay treatment of symptomatic spinal tumors. It aids in restoring functionality, managing pain and tumor growth, and improving overall quality of life. Over the past decade, advancements in medical imaging techniques combined with the use of three-dimensional (3D) printing technology have enabled improvements in the surgical management of spine tumors by significantly increasing the precision, accuracy, and safety of the surgical procedures. For complex spine surgical cases, the use of multimodality imaging is necessary to fully visualize the extent of disease, including both soft-tissue and bone involvement. Integrating the information provided by these examinations in a cohesive manner to facilitate surgical planning can be challenging, particularly when multiple surgical specialties work in concert. The digital 3-dimensional (3D) model or 3D rendering and the 3D printed model created from imaging examinations such as CT and MRI not only facilitate surgical planning but also allow the placement of virtual and physical surgical or osteotomy planes, further enhancing surgical planning and rehearsal. The authors provide practical information about the 3D printing workflow, from image acquisition to postprocessing of a 3D printed model, as well as optimal material selection and incorporation of quality management systems, to help surgeons utilize 3D printing for surgical planning. The authors also highlight the process of surgical rehearsal, how to prescribe digital osteotomy planes, and integration with intraoperative surgical navigation systems through a case-based discussion. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.
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Affiliation(s)
- Karthik Tappa
- From the Department of Breast Imaging, Division of Diagnostic Imaging
(K.T.), Department of Orthopedic Oncology, Division of Surgery (J.E.B.), and
Department of Breast Imaging, Division of Diagnostic Imaging (E.M.A., L.S.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX
77030
| | - Justin E. Bird
- From the Department of Breast Imaging, Division of Diagnostic Imaging
(K.T.), Department of Orthopedic Oncology, Division of Surgery (J.E.B.), and
Department of Breast Imaging, Division of Diagnostic Imaging (E.M.A., L.S.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX
77030
| | - Elsa M. Arribas
- From the Department of Breast Imaging, Division of Diagnostic Imaging
(K.T.), Department of Orthopedic Oncology, Division of Surgery (J.E.B.), and
Department of Breast Imaging, Division of Diagnostic Imaging (E.M.A., L.S.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX
77030
| | - Lumarie Santiago
- From the Department of Breast Imaging, Division of Diagnostic Imaging
(K.T.), Department of Orthopedic Oncology, Division of Surgery (J.E.B.), and
Department of Breast Imaging, Division of Diagnostic Imaging (E.M.A., L.S.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX
77030
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Albuquerque J, Lin YM, Paolucci I, O’Connor CS, Tzeng CW, Vauthey JN, Brock KK, Odisio BC. Incidental Ring-hyperenhancing Liver Micronodules at CT Hepatic Arteriography-guided Percutaneous Thermal Ablation of Colorectal Liver Metastases. Radiol Imaging Cancer 2024; 6:e230099. [PMID: 38363196 PMCID: PMC10988328 DOI: 10.1148/rycan.230099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/03/2023] [Accepted: 01/02/2024] [Indexed: 02/17/2024]
Abstract
CT during hepatic arteriography (CTHA) is a highly sensitive imaging method for detecting colorectal liver metastases (CLMs), which supports its use during percutaneous thermal liver ablation. In contrast to its high sensitivity, its specificity for incidental small CLMs not detected at preablation cross-sectional imaging is believed to be low given the absence of specific imaging signatures and the common presence of pseudolesions. In this retrospective study of 22 patients (mean age, 55 years ± 10.6 [SD]; 63.6% male, 36.4% female) with CLMs undergoing CTHA-guided microwave percutaneous thermal ablation between November 2017 and October 2022, the authors provided a definition of incidental ring-hyperenhancing liver micronodules (RHLMs) and investigated whether there is a correlation of RHLMs with histologic analysis or intrahepatic tumor progression at imaging follow-up after applying a biomechanical deformable image registration method. The analysis revealed 25 incidental RHLMs in 41.7% (10 of 24) of the CTHA images from the respective guided ablation sessions. Of those, four RHLMs were ablated. Among the remaining 21 RHLMs, 71.4% (15 of 21) were confirmed to be CLM with either histology (n = 3) or imaging follow-up (n = 12). The remaining 28.6% (six of 21) of RHLMs were not observed at follow-up imaging. This suggests that RHLMs at CTHA may be an early indicator of incidental small CLMs. Keywords: Colorectal Neoplasms, Liver, Angiography, CT, Incidental Findings, Ablation Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Jessica Albuquerque
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Yuan-Mao Lin
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Iwan Paolucci
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Caleb S. O’Connor
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Ching-Wei Tzeng
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Jean-Nicolas Vauthey
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Kristy K. Brock
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Bruno C. Odisio
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
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Baran TM, Bass DA, Christensen L, Longbine E, Favella MD, Foster TH, Sharma AK. Safety and Feasibility of Photodynamic Therapy for Percutaneous Image-guided Abdominopelvic Abscess Drainage: Phase 1 Trial. Radiology 2024; 310:e232667. [PMID: 38501946 PMCID: PMC10982828 DOI: 10.1148/radiol.232667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/19/2023] [Accepted: 01/23/2024] [Indexed: 03/20/2024]
Abstract
Background Standard-of-care abscess management includes image-guided percutaneous drainage and antibiotics; however, cure rates vary, and concern for antibiotic-resistant bacteria is growing. Photodynamic therapy (PDT), which uses light-activated dyes to generate cytotoxic reactive oxygen species, could complement the standard of care by sterilizing the abscess at the time of drainage. Purpose To evaluate safety and feasibility of PDT with methylene blue (hereafter, MB-PDT) at the time of percutaneous abscess drainage. Materials and Methods This prospective, open-label, dose-escalation, first-in-humans, registered phase 1 clinical study of MB-PDT included participants who underwent percutaneous abdominal or pelvic abscess drainage with CT or US guidance from January 2015 to March 2020 and September 2022 to September 2023. Following drainage, MB-PDT was performed with laser illumination at a fluence rate of 20 mW/cm2, with fluence groups of 6, 12, 18, 24, 30, and 36 J/cm2 (n = 3 each). The primary outcome was safety, indicated by absence of fat embolism, MB escape, abscess wall damage, and need for surgery to remove optical fibers. Preliminary efficacy end points included the time to drainage catheter removal, drainage catheter output volume, and clinical symptom and fever duration. Relationships between fluence and outcomes were analyzed with Spearman correlation and linear regression analyses, and ordinary one-way analysis of variance was used for group comparisons. Results MB-PDT was safe and feasible in all 18 participants (mean age, 60.1 years ± 18.3 [SD]; 10 female), with no negative safety outcomes observed for any participant. No study-related adverse events were encountered, and the procedure did not increase reported pain (P = .1). Clinical symptom and fever duration was shorter in participants receiving higher fluences (30 and 36 J/cm2 vs 6 J/cm2) (P = .03). The presence of antibiotic-resistant bacteria was not predictive of clinical symptom and fever duration (β = 0.13, P = .37). Conclusion MB-PDT was a safe and feasible adjunct to image-guided percutaneous abscess drainage. Clinical measures indicated a dose-dependent response to PDT. ClinicalTrials.gov registration no.: NCT02240498 © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Johnston and Goldberg in this issue.
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Affiliation(s)
- Timothy M. Baran
- From the Department of Imaging Sciences (T.M.B., D.A.B., L.C., E.L.,
M.D.F., T.H.F., A.K.S.) and Clinical & Translational Science Institute
(E.L.), University of Rochester Medical Center, 601 Elmwood Ave, Box 648,
Rochester, NY 14642; and Department of Biomedical Engineering and Institute of
Optics, University of Rochester, Rochester, NY (T.M.B.)
| | - David A. Bass
- From the Department of Imaging Sciences (T.M.B., D.A.B., L.C., E.L.,
M.D.F., T.H.F., A.K.S.) and Clinical & Translational Science Institute
(E.L.), University of Rochester Medical Center, 601 Elmwood Ave, Box 648,
Rochester, NY 14642; and Department of Biomedical Engineering and Institute of
Optics, University of Rochester, Rochester, NY (T.M.B.)
| | - Laurie Christensen
- From the Department of Imaging Sciences (T.M.B., D.A.B., L.C., E.L.,
M.D.F., T.H.F., A.K.S.) and Clinical & Translational Science Institute
(E.L.), University of Rochester Medical Center, 601 Elmwood Ave, Box 648,
Rochester, NY 14642; and Department of Biomedical Engineering and Institute of
Optics, University of Rochester, Rochester, NY (T.M.B.)
| | - Erica Longbine
- From the Department of Imaging Sciences (T.M.B., D.A.B., L.C., E.L.,
M.D.F., T.H.F., A.K.S.) and Clinical & Translational Science Institute
(E.L.), University of Rochester Medical Center, 601 Elmwood Ave, Box 648,
Rochester, NY 14642; and Department of Biomedical Engineering and Institute of
Optics, University of Rochester, Rochester, NY (T.M.B.)
| | - Maria D. Favella
- From the Department of Imaging Sciences (T.M.B., D.A.B., L.C., E.L.,
M.D.F., T.H.F., A.K.S.) and Clinical & Translational Science Institute
(E.L.), University of Rochester Medical Center, 601 Elmwood Ave, Box 648,
Rochester, NY 14642; and Department of Biomedical Engineering and Institute of
Optics, University of Rochester, Rochester, NY (T.M.B.)
| | - Thomas H. Foster
- From the Department of Imaging Sciences (T.M.B., D.A.B., L.C., E.L.,
M.D.F., T.H.F., A.K.S.) and Clinical & Translational Science Institute
(E.L.), University of Rochester Medical Center, 601 Elmwood Ave, Box 648,
Rochester, NY 14642; and Department of Biomedical Engineering and Institute of
Optics, University of Rochester, Rochester, NY (T.M.B.)
| | - Ashwani K. Sharma
- From the Department of Imaging Sciences (T.M.B., D.A.B., L.C., E.L.,
M.D.F., T.H.F., A.K.S.) and Clinical & Translational Science Institute
(E.L.), University of Rochester Medical Center, 601 Elmwood Ave, Box 648,
Rochester, NY 14642; and Department of Biomedical Engineering and Institute of
Optics, University of Rochester, Rochester, NY (T.M.B.)
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Diwanji D, Onishi N, Hathi DK, Lawhn-Heath C, Kornak J, Li W, Guo R, Molina-Vega J, Seo Y, Flavell RR, Heditsian D, Brain S, Esserman LJ, Joe BN, Hylton NM, Jones EF, Ray KM. 18F-FDG Dedicated Breast PET Complementary to Breast MRI for Evaluating Early Response to Neoadjuvant Chemotherapy. Radiol Imaging Cancer 2024; 6:e230082. [PMID: 38551406 PMCID: PMC10988337 DOI: 10.1148/rycan.230082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/30/2023] [Accepted: 02/16/2024] [Indexed: 04/02/2024]
Abstract
Purpose To compare quantitative measures of tumor metabolism and perfusion using fluorine 18 (18F) fluorodeoxyglucose (FDG) dedicated breast PET (dbPET) and breast dynamic contrast-enhanced (DCE) MRI during early treatment with neoadjuvant chemotherapy (NAC). Materials and Methods Prospectively collected DCE MRI and 18F-FDG dbPET examinations were analyzed at baseline (T0) and after 3 weeks (T1) of NAC in 20 participants with 22 invasive breast cancers. FDG dbPET-derived standardized uptake value (SUV), metabolic tumor volume, and total lesion glycolysis (TLG) and MRI-derived percent enhancement (PE), signal enhancement ratio (SER), and functional tumor volume (FTV) were calculated at both time points. Differences between FDG dbPET and MRI parameters were evaluated after stratifying by receptor status, Ki-67 index, and residual cancer burden. Parameters were compared using Wilcoxon signed rank and Mann-Whitney U tests. Results High Ki-67 tumors had higher baseline SUVmean (difference, 5.1; P = .01) and SUVpeak (difference, 5.5; P = .04). At T1, decreases were observed in FDG dbPET measures (pseudo-median difference T0 minus T1 value [95% CI]) of SUVmax (-6.2 [-10.2, -2.6]; P < .001), SUVmean (-2.6 [-4.9, -1.3]; P < .001), SUVpeak (-4.2 [-6.9, -2.3]; P < .001), and TLG (-29.1 mL3 [-71.4, -6.8]; P = .005) and MRI measures of SERpeak (-1.0 [-1.3, -0.2]; P = .02) and FTV (-11.6 mL3 [-22.2, -1.7]; P = .009). Relative to nonresponsive tumors, responsive tumors showed a difference (95% CI) in percent change in SUVmax of -34.3% (-55.9%, 1.5%; P = .06) and in PEpeak of -42.4% (95% CI: -110.5%, 8.5%; P = .08). Conclusion 18F-FDG dbPET was sensitive to early changes during NAC and provided complementary information to DCE MRI that may be useful for treatment response evaluation. Keywords: Breast, PET, Dynamic Contrast-enhanced MRI Clinical trial registration no. NCT01042379 Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Devan Diwanji
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Natsuko Onishi
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Deep K. Hathi
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Courtney Lawhn-Heath
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - John Kornak
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Wen Li
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Ruby Guo
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Julissa Molina-Vega
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Youngho Seo
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Robert R. Flavell
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Diane Heditsian
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Susie Brain
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Laura J. Esserman
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Bonnie N. Joe
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Nola M. Hylton
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Ella F. Jones
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
| | - Kimberly M. Ray
- From the Departments of Radiology and Biomedical Imaging (D.D., N.O.,
D.K.H., C.L.H., W.L., R.G., Y.S., R.R.F., B.N.J., N.M.H., E.F.J., K.M.R.),
Epidemiology and Biostatistics (J.K.), and Surgery (J.M.V., L.J.E.), University
of California San Francisco, 550 16th St, San Francisco, CA 94158; and
I-SPY 2 Advocacy Group, San Francisco, Calif (D.H., S.B.)
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Moura Cunha G, Fan B, Navin PJ, Olivié D, Venkatesh SK, Ehman RL, Sirlin CB, Tang A. Interpretation, Reporting, and Clinical Applications of Liver MR Elastography. Radiology 2024; 310:e231220. [PMID: 38470236 PMCID: PMC10982829 DOI: 10.1148/radiol.231220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 03/13/2024]
Abstract
Chronic liver disease is highly prevalent and often leads to fibrosis or cirrhosis and complications such as liver failure and hepatocellular carcinoma. The diagnosis and staging of liver fibrosis is crucial to determine management and mitigate complications. Liver biopsy for histologic assessment has limitations such as sampling bias and high interreader variability that reduce precision, which is particularly challenging in longitudinal monitoring. MR elastography (MRE) is considered the most accurate noninvasive technique for diagnosing and staging liver fibrosis. In MRE, low-frequency vibrations are applied to the abdomen, and the propagation of shear waves through the liver is analyzed to measure liver stiffness, a biomarker for the detection and staging of liver fibrosis. As MRE has become more widely used in clinical care and research, different contexts of use have emerged. This review focuses on the latest developments in the use of MRE for the assessment of liver fibrosis; provides guidance for image acquisition and interpretation; summarizes diagnostic performance, along with thresholds for diagnosis and staging of liver fibrosis; discusses current and emerging clinical applications; and describes the latest technical developments.
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Affiliation(s)
- Guilherme Moura Cunha
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Boyan Fan
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Patrick J. Navin
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Damien Olivié
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Sudhakar K. Venkatesh
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Richard L. Ehman
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - Claude B. Sirlin
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
| | - An Tang
- From the Department of Radiology, University of Washington, Seattle,
Wash (G.M.C.); Department of Radiology, Université Laval, Québec,
Québec, Canada (B.F.); Department of Radiology, Mayo Clinic, Rochester,
Minn (P.J.N., S.K.V., R.L.E.); Department of Radiology, Centre Hospitalier de
l'Université de Montréal, 1058 Rue Saint-Denis,
Montréal, QC, Canada H2X 3J4 (D.O., A.T.); and Department of Radiology,
University of California San Diego, San Diego, Calif (C.B.S.)
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7
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Dou Q, Grant AK, Coutinto de Souza P, Moussa M, Nasser I, Ahmed M, Tsai LL. Characterizing Metabolic Heterogeneity of Hepatocellular Carcinoma with Hyperpolarized 13C Pyruvate MRI and Mass Spectrometry. Radiol Imaging Cancer 2024; 6:e230056. [PMID: 38426887 PMCID: PMC10988335 DOI: 10.1148/rycan.230056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/16/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024]
Abstract
Purpose To characterize the metabolomic profiles of two hepatocellular carcinoma (HCC) rat models, track evolution of these profiles to a stimulated tumor state, and assess their effect on lactate flux with hyperpolarized (HP) carbon 13 (13C) MRI. Materials and Methods Forty-three female adult Fischer rats were implanted with N1S1 or McA-RH7777 HCC tumors. In vivo lactate-to-pyruvate ratio (LPR) was measured with HP 13C MRI at 9.4 T. Ex vivo mass spectrometry was used to measure intratumoral metabolites, and Ki67 labeling was used to quantify proliferation. Tumors were first compared with three normal liver controls. The tumors were then compared with stimulated variants via off-target hepatic thermal ablation treatment. All comparisons were made using the Mann-Whitney test. Results HP 13C pyruvate MRI showed greater LPR in N1S1 tumors compared with normal liver (mean [SD], 0.564 ± 0.194 vs 0.311 ± 0.057; P < .001 [n = 9]), but not for McA-RH7777 (P = .44 [n = 8]). Mass spectrometry confirmed that the glycolysis pathway was increased in N1S1 tumors and decreased in McA-RH7777 tumors. The pentose phosphate pathway was also decreased only in McA-RH7777 tumors. Increased proliferation in stimulated N1S1 tumors corresponded to a net increase in LPR (six stimulated vs six nonstimulated, 0.269 ± 0.148 vs 0.027 ± 0.08; P = .009), but not in McA-RH7777 (eight stimulated vs six nonstimulated, P = .13), despite increased proliferation and metastases. Mass spectrometry demonstrated relatively increased lactate production with stimulation in N1S1 tumors only. Conclusion Two HCC subtypes showed divergent glycolytic dependency at baseline and during transformation to a high proliferation state. This metabolic heterogeneity in HCC should be considered with use of HP 13C MRI for diagnosis and tracking. Keywords: Molecular Imaging-Probe Development, Liver, Abdomen/GI, Oncology, Hepatocellular Carcinoma © RSNA, 2024 See also commentary by Ohliger in this issue.
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Affiliation(s)
- Qianhui Dou
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Aaron K. Grant
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Patricia Coutinto de Souza
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Marwan Moussa
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Imad Nasser
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Muneeb Ahmed
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Leo L. Tsai
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
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Etter L, Betke M, Camelo IY, Gill CJ, Pieciak R, Thompson R, Demi L, Khan U, Wheelock A, Katanga J, Setty BN, Castro-Aragon I. Curated and Annotated Dataset of Lung US Images in Zambian Children with Clinical Pneumonia. Radiol Artif Intell 2024; 6:e230147. [PMID: 38381039 PMCID: PMC10982815 DOI: 10.1148/ryai.230147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 01/10/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
See also the commentary by Sitek in this issue. Supplemental material is available for this article.
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Affiliation(s)
- Lauren Etter
- From the Department of Global Health, School of Public Health, Boston
University Medical Campus, 801 Massachusetts Ave, Boston, MA 02118-2526 (L.E.,
C.J.G., R.P., A.W.); Department of Computer Science, College of Arts and
Sciences, Boston University, Boston, Mass (M.B.); Pediatric Infectious Diseases
Section, Augusta University, Medical College of Georgia, Augusta, Ga (I.Y.C.);
Department of Computer Science, Worcester Polytechnic Institute, Worcester, Mass
(R.T.); Ultrasound Laboratory Trento, University of Trento, Trento, Italy (L.D.,
U.K.); University Teaching Hospital, Lusaka, Zambia (J.K.); and Department of
Radiology, Boston Medical Center, Boston, Mass (B.N.S., I.C.A.)
| | - Margrit Betke
- From the Department of Global Health, School of Public Health, Boston
University Medical Campus, 801 Massachusetts Ave, Boston, MA 02118-2526 (L.E.,
C.J.G., R.P., A.W.); Department of Computer Science, College of Arts and
Sciences, Boston University, Boston, Mass (M.B.); Pediatric Infectious Diseases
Section, Augusta University, Medical College of Georgia, Augusta, Ga (I.Y.C.);
Department of Computer Science, Worcester Polytechnic Institute, Worcester, Mass
(R.T.); Ultrasound Laboratory Trento, University of Trento, Trento, Italy (L.D.,
U.K.); University Teaching Hospital, Lusaka, Zambia (J.K.); and Department of
Radiology, Boston Medical Center, Boston, Mass (B.N.S., I.C.A.)
| | - Ingrid Y. Camelo
- From the Department of Global Health, School of Public Health, Boston
University Medical Campus, 801 Massachusetts Ave, Boston, MA 02118-2526 (L.E.,
C.J.G., R.P., A.W.); Department of Computer Science, College of Arts and
Sciences, Boston University, Boston, Mass (M.B.); Pediatric Infectious Diseases
Section, Augusta University, Medical College of Georgia, Augusta, Ga (I.Y.C.);
Department of Computer Science, Worcester Polytechnic Institute, Worcester, Mass
(R.T.); Ultrasound Laboratory Trento, University of Trento, Trento, Italy (L.D.,
U.K.); University Teaching Hospital, Lusaka, Zambia (J.K.); and Department of
Radiology, Boston Medical Center, Boston, Mass (B.N.S., I.C.A.)
| | - Christopher J. Gill
- From the Department of Global Health, School of Public Health, Boston
University Medical Campus, 801 Massachusetts Ave, Boston, MA 02118-2526 (L.E.,
C.J.G., R.P., A.W.); Department of Computer Science, College of Arts and
Sciences, Boston University, Boston, Mass (M.B.); Pediatric Infectious Diseases
Section, Augusta University, Medical College of Georgia, Augusta, Ga (I.Y.C.);
Department of Computer Science, Worcester Polytechnic Institute, Worcester, Mass
(R.T.); Ultrasound Laboratory Trento, University of Trento, Trento, Italy (L.D.,
U.K.); University Teaching Hospital, Lusaka, Zambia (J.K.); and Department of
Radiology, Boston Medical Center, Boston, Mass (B.N.S., I.C.A.)
| | - Rachel Pieciak
- From the Department of Global Health, School of Public Health, Boston
University Medical Campus, 801 Massachusetts Ave, Boston, MA 02118-2526 (L.E.,
C.J.G., R.P., A.W.); Department of Computer Science, College of Arts and
Sciences, Boston University, Boston, Mass (M.B.); Pediatric Infectious Diseases
Section, Augusta University, Medical College of Georgia, Augusta, Ga (I.Y.C.);
Department of Computer Science, Worcester Polytechnic Institute, Worcester, Mass
(R.T.); Ultrasound Laboratory Trento, University of Trento, Trento, Italy (L.D.,
U.K.); University Teaching Hospital, Lusaka, Zambia (J.K.); and Department of
Radiology, Boston Medical Center, Boston, Mass (B.N.S., I.C.A.)
| | - Russell Thompson
- From the Department of Global Health, School of Public Health, Boston
University Medical Campus, 801 Massachusetts Ave, Boston, MA 02118-2526 (L.E.,
C.J.G., R.P., A.W.); Department of Computer Science, College of Arts and
Sciences, Boston University, Boston, Mass (M.B.); Pediatric Infectious Diseases
Section, Augusta University, Medical College of Georgia, Augusta, Ga (I.Y.C.);
Department of Computer Science, Worcester Polytechnic Institute, Worcester, Mass
(R.T.); Ultrasound Laboratory Trento, University of Trento, Trento, Italy (L.D.,
U.K.); University Teaching Hospital, Lusaka, Zambia (J.K.); and Department of
Radiology, Boston Medical Center, Boston, Mass (B.N.S., I.C.A.)
| | - Libertario Demi
- From the Department of Global Health, School of Public Health, Boston
University Medical Campus, 801 Massachusetts Ave, Boston, MA 02118-2526 (L.E.,
C.J.G., R.P., A.W.); Department of Computer Science, College of Arts and
Sciences, Boston University, Boston, Mass (M.B.); Pediatric Infectious Diseases
Section, Augusta University, Medical College of Georgia, Augusta, Ga (I.Y.C.);
Department of Computer Science, Worcester Polytechnic Institute, Worcester, Mass
(R.T.); Ultrasound Laboratory Trento, University of Trento, Trento, Italy (L.D.,
U.K.); University Teaching Hospital, Lusaka, Zambia (J.K.); and Department of
Radiology, Boston Medical Center, Boston, Mass (B.N.S., I.C.A.)
| | - Umair Khan
- From the Department of Global Health, School of Public Health, Boston
University Medical Campus, 801 Massachusetts Ave, Boston, MA 02118-2526 (L.E.,
C.J.G., R.P., A.W.); Department of Computer Science, College of Arts and
Sciences, Boston University, Boston, Mass (M.B.); Pediatric Infectious Diseases
Section, Augusta University, Medical College of Georgia, Augusta, Ga (I.Y.C.);
Department of Computer Science, Worcester Polytechnic Institute, Worcester, Mass
(R.T.); Ultrasound Laboratory Trento, University of Trento, Trento, Italy (L.D.,
U.K.); University Teaching Hospital, Lusaka, Zambia (J.K.); and Department of
Radiology, Boston Medical Center, Boston, Mass (B.N.S., I.C.A.)
| | - Alyse Wheelock
- From the Department of Global Health, School of Public Health, Boston
University Medical Campus, 801 Massachusetts Ave, Boston, MA 02118-2526 (L.E.,
C.J.G., R.P., A.W.); Department of Computer Science, College of Arts and
Sciences, Boston University, Boston, Mass (M.B.); Pediatric Infectious Diseases
Section, Augusta University, Medical College of Georgia, Augusta, Ga (I.Y.C.);
Department of Computer Science, Worcester Polytechnic Institute, Worcester, Mass
(R.T.); Ultrasound Laboratory Trento, University of Trento, Trento, Italy (L.D.,
U.K.); University Teaching Hospital, Lusaka, Zambia (J.K.); and Department of
Radiology, Boston Medical Center, Boston, Mass (B.N.S., I.C.A.)
| | - Janet Katanga
- From the Department of Global Health, School of Public Health, Boston
University Medical Campus, 801 Massachusetts Ave, Boston, MA 02118-2526 (L.E.,
C.J.G., R.P., A.W.); Department of Computer Science, College of Arts and
Sciences, Boston University, Boston, Mass (M.B.); Pediatric Infectious Diseases
Section, Augusta University, Medical College of Georgia, Augusta, Ga (I.Y.C.);
Department of Computer Science, Worcester Polytechnic Institute, Worcester, Mass
(R.T.); Ultrasound Laboratory Trento, University of Trento, Trento, Italy (L.D.,
U.K.); University Teaching Hospital, Lusaka, Zambia (J.K.); and Department of
Radiology, Boston Medical Center, Boston, Mass (B.N.S., I.C.A.)
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9
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Youn I, Biswas D, Hippe DS, Winter AM, Kazerouni AS, Javid SH, Lee JM, Rahbar H, Partridge SC. Diagnostic Performance of Point-of-Care Apparent Diffusion Coefficient Measures to Reduce Biopsy in Breast Lesions at MRI: Clinical Validation. Radiology 2024; 310:e232313. [PMID: 38349238 PMCID: PMC10902596 DOI: 10.1148/radiol.232313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/20/2023] [Accepted: 12/29/2023] [Indexed: 02/15/2024]
Abstract
Background The Eastern Cooperative Oncology Group-American College of Radiology Imaging Network Cancer Research Group multicenter A6702 trial identified an optimal apparent diffusion coefficient (ADC) cutoff to potentially reduce biopsies by 21% without affecting sensitivity. Whether this performance can be achieved in clinical settings has not yet been established. Purpose To validate the performance of point-of-care ADC measurements with the A6702 trial ADC cutoff for reducing unnecessary biopsies in lesions detected at breast MRI. Materials and Methods Consecutive breast MRI examinations performed from May 2015 to January 2019 at a single medical center and showing biopsy-confirmed Breast Imaging Reporting and Data System category 4 or 5 lesions, without ipsilateral cancer, were identified. Point-of-care lesion ADC measurements collected at clinical interpretation were retrospectively evaluated. MRI examinations included axial T2-weighted, diffusion-weighted, and dynamic contrast-enhanced sequences. Sensitivity and biopsy reduction rates were calculated by applying the A6702 optimal (ADC, 1.53 × 10-3 mm2/sec) and alternate conservative (1.68 × 10-3 mm2/sec) cutoffs. Lesion pathologic outcomes were the reference standard. To assess reproducibility, one radiologist repeated ADC measurements, and agreement was summarized using the intraclass correlation coefficient. Results A total of 240 lesions in 201 women (mean age, 49 years ± 13 [SD]) with pathologic outcomes (63 malignant and 177 benign) were included. Applying the optimal ADC cutoff produced an overall biopsy reduction rate of 15.8% (38 of 240 lesions [95% CI: 11.2, 20.9]), with a sensitivity of 92.1% (58 of 63 lesions [95% CI: 82.4, 97.4]; sensitivity was 97.2% [35 of 36 lesions] [95% CI: 82.7, 99.6] for invasive cancers). Results were similar for screening versus diagnostic examinations (P = .92 and .40, respectively). Sensitivity was higher for masses than for nonmass enhancements (NMEs) (100% vs 85.3%; P = .009). Applying the conservative ADC cutoff achieved a sensitivity of 95.2% (60 of 63 lesions [95% CI: 86.7, 99.0]), with a biopsy reduction rate of 10.4% (25 of 240 lesions [95% CI: 6.7, 14.5]). Repeated single-reader measurements showed good agreement with clinical ADCs (intraclass correlation coefficient, 0.72 [95% CI: 0.58, 0.81]). Conclusion This study validated the clinical use of ADC cutoffs to reduce MRI-prompted biopsies by up to 16%, with a suggested tradeoff of lowered sensitivity for in situ and microinvasive disease manifesting as NME. Clinical trial registration no. NCT02022579 © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Honda and Iima in this issue.
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Affiliation(s)
| | - Debosmita Biswas
- From the Departments of Radiology (I.Y., D.B., A.M.W., A.S.K.,
J.M.L., H.R., S.C.P.) and Surgery (S.H.J.), University of Washington School of
Medicine, 1144 Eastlake Ave E, LG2-200, Seattle, WA 98109; and Clinical Research
Division, Fred Hutchinson Cancer Center (D.S.H.)
| | - Daniel S. Hippe
- From the Departments of Radiology (I.Y., D.B., A.M.W., A.S.K.,
J.M.L., H.R., S.C.P.) and Surgery (S.H.J.), University of Washington School of
Medicine, 1144 Eastlake Ave E, LG2-200, Seattle, WA 98109; and Clinical Research
Division, Fred Hutchinson Cancer Center (D.S.H.)
| | - Andrea M. Winter
- From the Departments of Radiology (I.Y., D.B., A.M.W., A.S.K.,
J.M.L., H.R., S.C.P.) and Surgery (S.H.J.), University of Washington School of
Medicine, 1144 Eastlake Ave E, LG2-200, Seattle, WA 98109; and Clinical Research
Division, Fred Hutchinson Cancer Center (D.S.H.)
| | - Anum S. Kazerouni
- From the Departments of Radiology (I.Y., D.B., A.M.W., A.S.K.,
J.M.L., H.R., S.C.P.) and Surgery (S.H.J.), University of Washington School of
Medicine, 1144 Eastlake Ave E, LG2-200, Seattle, WA 98109; and Clinical Research
Division, Fred Hutchinson Cancer Center (D.S.H.)
| | - Sara H. Javid
- From the Departments of Radiology (I.Y., D.B., A.M.W., A.S.K.,
J.M.L., H.R., S.C.P.) and Surgery (S.H.J.), University of Washington School of
Medicine, 1144 Eastlake Ave E, LG2-200, Seattle, WA 98109; and Clinical Research
Division, Fred Hutchinson Cancer Center (D.S.H.)
| | - Janie M. Lee
- From the Departments of Radiology (I.Y., D.B., A.M.W., A.S.K.,
J.M.L., H.R., S.C.P.) and Surgery (S.H.J.), University of Washington School of
Medicine, 1144 Eastlake Ave E, LG2-200, Seattle, WA 98109; and Clinical Research
Division, Fred Hutchinson Cancer Center (D.S.H.)
| | - Habib Rahbar
- From the Departments of Radiology (I.Y., D.B., A.M.W., A.S.K.,
J.M.L., H.R., S.C.P.) and Surgery (S.H.J.), University of Washington School of
Medicine, 1144 Eastlake Ave E, LG2-200, Seattle, WA 98109; and Clinical Research
Division, Fred Hutchinson Cancer Center (D.S.H.)
| | - Savannah C. Partridge
- From the Departments of Radiology (I.Y., D.B., A.M.W., A.S.K.,
J.M.L., H.R., S.C.P.) and Surgery (S.H.J.), University of Washington School of
Medicine, 1144 Eastlake Ave E, LG2-200, Seattle, WA 98109; and Clinical Research
Division, Fred Hutchinson Cancer Center (D.S.H.)
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10
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Shewarega A, Santana JG, Nam D, Berz A, Tefera J, Kahl V, Mishra SK, Coman D, Duncan J, Roberts SJ, Wetter A, Madoff DC, Chapiro J. Effect of Incomplete Cryoablation and Matrix Metalloproteinase Inhibition on Intratumoral CD8 + T-Cell Infiltration in Murine Hepatocellular Carcinoma. Radiology 2024; 310:e232365. [PMID: 38349244 PMCID: PMC10902598 DOI: 10.1148/radiol.232365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/09/2023] [Accepted: 12/27/2023] [Indexed: 02/15/2024]
Abstract
Background Image-guided tumor ablation is the first-line therapy for early-stage hepatocellular carcinoma (HCC), with ongoing investigations into its combination with immunotherapies. Matrix metalloproteinase (MMP) inhibition demonstrates immunomodulatory potential and reduces HCC tumor growth when combined with ablative treatment. Purpose To evaluate the effect of incomplete cryoablation with or without MMP inhibition on the local immune response in residual tumors in a murine HCC model. Materials and Methods Sixty 8- to 10-week-old female BALB/c mice underwent HCC induction with use of orthotopic implantation of syngeneic Tib-75 cells. After 7 days, mice with a single lesion were randomized into treatment groups: (a) no treatment, (b) MMP inhibitor, (c) incomplete cryoablation, and (d) incomplete cryoablation and MMP inhibitor. Macrophage and T-cell subsets were assessed in tissue samples with use of immunohistochemistry and immunofluorescence (cell averages calculated using five 1-μm2 fields of view [FOVs]). C-X-C motif chemokine receptor type 3 (CXCR3)- and interferon γ (IFNγ)-positive T cells were assessed using flow cytometry. Groups were compared using unpaired Student t tests, one-way analysis of variance with Tukey correction, and the Kruskal-Wallis test with Dunn correction. Results Mice treated with incomplete cryoablation (n = 6) showed greater infiltration of CD206+ tumor-associated macrophages (mean, 1.52 cells per FOV vs 0.64 cells per FOV; P = .03) and MMP9-expressing cells (mean, 0.89 cells per FOV vs 0.11 cells per FOV; P = .03) compared with untreated controls (n = 6). Incomplete cryoablation with MMP inhibition (n = 6) versus without (n = 6) led to greater CD8+ T-cell (mean, 15.8% vs 8.29%; P = .04), CXCR3+CD8+ T-cell (mean, 11.64% vs 8.47%; P = .004), and IFNγ+CD8+ T-cell infiltration (mean, 11.58% vs 5.18%; P = .02). Conclusion In a mouse model of HCC, incomplete cryoablation and systemic MMP inhibition showed increased cytotoxic CD8+ T-cell infiltration into the residual tumor compared with either treatment alone. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Gemmete in this issue.
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Affiliation(s)
- Annabella Shewarega
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - Jessica G. Santana
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - David Nam
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - Antonia Berz
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - Jonathan Tefera
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - Vinzent Kahl
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - Sandeep K. Mishra
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - Daniel Coman
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - James Duncan
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - Scott J. Roberts
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - Axel Wetter
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - David C. Madoff
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
| | - Julius Chapiro
- From the Department of Radiology and Biomedical Imaging (A.S.,
J.G.S., D.N., J.T., S.K.M., D.C., J.D., D.C.M., J.C.), Section of Digestive
Diseases, Department of Internal Medicine (S.J.R., J.C.), Section of Medical
Oncology, Department of Medicine (D.C.M.), and Section of Surgical Oncology,
Department of Surgery (D.C.M.), Yale University School of Medicine, 300 Cedar
St, The Anlyan Center, N312A, New Haven, CT 06520; Department of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (A.S., A.W.); Department of Radiology,
Charité-Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin and Humboldt-Universität, Berlin, Germany
(A.B., V.K.); Department of Biomedical Engineering, School of Engineering
& Applied Science, Yale University, New Haven, Conn (D.C., J.D., J.C.);
and Department of Diagnostic and Interventional Radiology and Neuroradiology,
Asklepios Clinic Altona, Hamburg, Germany (A.W.)
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11
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DeSimone AK, Byrne SC, Hammer MM. Comparison of Lung-RADS Version 1.1 and Lung-RADS Version 2022 in Classifying Airway Nodules Detected at Lung Cancer Screening CT. Radiol Cardiothorac Imaging 2024; 6:e230149. [PMID: 38300115 PMCID: PMC10912868 DOI: 10.1148/ryct.230149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/08/2023] [Accepted: 12/15/2023] [Indexed: 02/02/2024]
Abstract
Purpose To compare the Lung Imaging Reporting and Data System (Lung-RADS) version 1.1 with version 2022 classification of airway nodules detected at lung cancer screening CT examinations. Materials and Methods This retrospective study included all patients who underwent a lung cancer screening CT examination in the authors' health care network between 2015 and 2021 with a reported airway or endobronchial nodule. A fellowship-trained cardiothoracic radiologist reviewed these CT images and characterized the airway nodules by size, location, multiplicity, morphology, dependent portions of airway, internal air, fluid attenuation, distal changes, outcome at follow-up, and final pathologic diagnosis, if malignant. Sensitivity and specificity of Lung-RADS version 1.1 in detecting malignant nodules were compared with those of Lung-RADS version 2022 using the McNemar test. Results A total of 174 patients were included. Of these, 163 (94%) had airway nodules that were deemed benign, while 11 (6%) had malignant nodules. Airway nodules in the trachea and mainstem bronchi were all benign, while lobar and segmental airway nodules had the highest risk for lung cancer (17.2% and 11.1%, respectively). Of the 12 subsegmental airway nodules that were obstructive, three (25%) were malignant and nine (75%) were benign. Nodules with nonobstructive morphologies, dependent portions of airway, internal air, or fluid attenuation were all benign. Only 10 of the 92 (10.9%) patients with positive Lung-RADS by clinical report had cancer. Lung-RADS version 2022 resulted in higher specificity than version 1.1 (82% vs 50%, P < .001), without sacrificing sensitivity (91% for both). Conclusion Compared with the previous version, Lung-RADS version 2022 reduced the number of false-positive screening CT examinations while still identifying malignant airway nodules. Keywords: CT, Lung, Primary Neoplasms, Pulmonary, Lung Cancer Screening, Lung-RADS, Nodule Risk, Airway Nodule, Endobronchial Nodule © RSNA, 2024.
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Affiliation(s)
- Ariadne K. DeSimone
- From the Department of Radiology, Brigham and Women's
Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115
| | - Suzanne C. Byrne
- From the Department of Radiology, Brigham and Women's
Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115
| | - Mark M. Hammer
- From the Department of Radiology, Brigham and Women's
Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115
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12
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Fan L, Hong K, Allen BD, Paul R, Carr JC, Zhang S, Passman R, Robinson JD, Lee DC, Rigsby CK, Kim D. Ultra-rapid, Free-breathing, Real-time Cardiac Cine MRI Using GRASP Amplified with View Sharing and KWIC Filtering. Radiol Cardiothorac Imaging 2024; 6:e230107. [PMID: 38358330 PMCID: PMC10912880 DOI: 10.1148/ryct.230107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 12/06/2023] [Accepted: 01/02/2024] [Indexed: 02/16/2024]
Abstract
Purpose To achieve ultra-high temporal resolution (approximately 20 msec) in free-breathing, real-time cardiac cine MRI using golden-angle radial sparse parallel (GRASP) reconstruction amplified with view sharing (VS) and k-space-weighted image contrast (KWIC) filtering. Materials and Methods Fourteen pediatric patients with congenital heart disease (mean age [SD], 9 years ± 2; 13 male) and 10 adult patients with arrhythmia (mean age, 62 years ± 8; nine male) who underwent both standard breath-hold cine and free-breathing real-time cine using GRASP were retrospectively identified. To achieve high temporal resolution, each time frame was reconstructed using six radial spokes, corresponding to acceleration factors ranging from 24 to 32. To compensate for loss in spatial resolution resulting from over-regularization in GRASP, VS and KWIC filtering were incorporated. The blur metric, visual image quality scores, and biventricular parameters were compared between clinical and real-time cine images. Results In pediatric patients, the incorporation of VS and KWIC into GRASP (ie, GRASP + VS + KWIC) produced significantly (P < .05) sharper x-y-t (blur metric: 0.36 ± 0.03, 0.41 ± 0.03, 0.48 ± 0.03, respectively) and x-y-f (blur metric: 0.28 ± 0.02, 0.31 ± 0.03, 0.37 ± 0.03, respectively) component images compared with GRASP + VS and conventional GRASP. Only the noise score differed significantly between GRASP + VS + KWIC and clinical cine; all visual scores were above the clinically acceptable (3.0) cutoff point. Biventricular volumetric parameters strongly correlated (R2 > 0.85) between clinical and real-time cine images reconstructed with GRASP + VS + KWIC and were in good agreement (relative error < 6% for all parameters). In adult patients, the visual scores of all categories were significantly lower (P < .05) for clinical cine compared with real-time cine with GRASP + VS + KWIC, except for noise (P = .08). Conclusion Incorporating VS and KWIC filtering into GRASP reconstruction enables ultra-high temporal resolution (approximately 20 msec) without significant loss in spatial resolution. Keywords: Cine, View Sharing, k-Space-weighted Image Contrast Filtering, Radial k-Space, Pediatrics, Arrhythmia, GRASP, Compressed Sensing, Real-Time, Free-Breathing Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Lexiaozi Fan
- From the Department of Radiology (L.F., K.P.H., B.D.A., R.P., J.C.C.,
S.Z., J.D.R., C.K.R., D.K.), Department of Preventive Medicine, Bluhm
Cardiovascular Institute (R.P.), Department of Pediatrics (J.D.R., C.K.R.), and
Division of Cardiology, Department of Internal Medicine (D.C.L.), Northwestern
University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago,
IL 60611; Department of Biomedical Engineering, Northwestern University,
Evanston, Ill (L.F., D.K.); and Division of Cardiology (J.D.R.) and Department
of Medical Imaging (C.K.R.), Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, Ill
| | - KyungPyo Hong
- From the Department of Radiology (L.F., K.P.H., B.D.A., R.P., J.C.C.,
S.Z., J.D.R., C.K.R., D.K.), Department of Preventive Medicine, Bluhm
Cardiovascular Institute (R.P.), Department of Pediatrics (J.D.R., C.K.R.), and
Division of Cardiology, Department of Internal Medicine (D.C.L.), Northwestern
University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago,
IL 60611; Department of Biomedical Engineering, Northwestern University,
Evanston, Ill (L.F., D.K.); and Division of Cardiology (J.D.R.) and Department
of Medical Imaging (C.K.R.), Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, Ill
| | - Bradley D. Allen
- From the Department of Radiology (L.F., K.P.H., B.D.A., R.P., J.C.C.,
S.Z., J.D.R., C.K.R., D.K.), Department of Preventive Medicine, Bluhm
Cardiovascular Institute (R.P.), Department of Pediatrics (J.D.R., C.K.R.), and
Division of Cardiology, Department of Internal Medicine (D.C.L.), Northwestern
University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago,
IL 60611; Department of Biomedical Engineering, Northwestern University,
Evanston, Ill (L.F., D.K.); and Division of Cardiology (J.D.R.) and Department
of Medical Imaging (C.K.R.), Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, Ill
| | - Rupsa Paul
- From the Department of Radiology (L.F., K.P.H., B.D.A., R.P., J.C.C.,
S.Z., J.D.R., C.K.R., D.K.), Department of Preventive Medicine, Bluhm
Cardiovascular Institute (R.P.), Department of Pediatrics (J.D.R., C.K.R.), and
Division of Cardiology, Department of Internal Medicine (D.C.L.), Northwestern
University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago,
IL 60611; Department of Biomedical Engineering, Northwestern University,
Evanston, Ill (L.F., D.K.); and Division of Cardiology (J.D.R.) and Department
of Medical Imaging (C.K.R.), Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, Ill
| | - James C. Carr
- From the Department of Radiology (L.F., K.P.H., B.D.A., R.P., J.C.C.,
S.Z., J.D.R., C.K.R., D.K.), Department of Preventive Medicine, Bluhm
Cardiovascular Institute (R.P.), Department of Pediatrics (J.D.R., C.K.R.), and
Division of Cardiology, Department of Internal Medicine (D.C.L.), Northwestern
University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago,
IL 60611; Department of Biomedical Engineering, Northwestern University,
Evanston, Ill (L.F., D.K.); and Division of Cardiology (J.D.R.) and Department
of Medical Imaging (C.K.R.), Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, Ill
| | - Sarah Zhang
- From the Department of Radiology (L.F., K.P.H., B.D.A., R.P., J.C.C.,
S.Z., J.D.R., C.K.R., D.K.), Department of Preventive Medicine, Bluhm
Cardiovascular Institute (R.P.), Department of Pediatrics (J.D.R., C.K.R.), and
Division of Cardiology, Department of Internal Medicine (D.C.L.), Northwestern
University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago,
IL 60611; Department of Biomedical Engineering, Northwestern University,
Evanston, Ill (L.F., D.K.); and Division of Cardiology (J.D.R.) and Department
of Medical Imaging (C.K.R.), Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, Ill
| | - Rod Passman
- From the Department of Radiology (L.F., K.P.H., B.D.A., R.P., J.C.C.,
S.Z., J.D.R., C.K.R., D.K.), Department of Preventive Medicine, Bluhm
Cardiovascular Institute (R.P.), Department of Pediatrics (J.D.R., C.K.R.), and
Division of Cardiology, Department of Internal Medicine (D.C.L.), Northwestern
University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago,
IL 60611; Department of Biomedical Engineering, Northwestern University,
Evanston, Ill (L.F., D.K.); and Division of Cardiology (J.D.R.) and Department
of Medical Imaging (C.K.R.), Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, Ill
| | - Joshua D. Robinson
- From the Department of Radiology (L.F., K.P.H., B.D.A., R.P., J.C.C.,
S.Z., J.D.R., C.K.R., D.K.), Department of Preventive Medicine, Bluhm
Cardiovascular Institute (R.P.), Department of Pediatrics (J.D.R., C.K.R.), and
Division of Cardiology, Department of Internal Medicine (D.C.L.), Northwestern
University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago,
IL 60611; Department of Biomedical Engineering, Northwestern University,
Evanston, Ill (L.F., D.K.); and Division of Cardiology (J.D.R.) and Department
of Medical Imaging (C.K.R.), Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, Ill
| | - Daniel C. Lee
- From the Department of Radiology (L.F., K.P.H., B.D.A., R.P., J.C.C.,
S.Z., J.D.R., C.K.R., D.K.), Department of Preventive Medicine, Bluhm
Cardiovascular Institute (R.P.), Department of Pediatrics (J.D.R., C.K.R.), and
Division of Cardiology, Department of Internal Medicine (D.C.L.), Northwestern
University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago,
IL 60611; Department of Biomedical Engineering, Northwestern University,
Evanston, Ill (L.F., D.K.); and Division of Cardiology (J.D.R.) and Department
of Medical Imaging (C.K.R.), Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, Ill
| | - Cynthia K. Rigsby
- From the Department of Radiology (L.F., K.P.H., B.D.A., R.P., J.C.C.,
S.Z., J.D.R., C.K.R., D.K.), Department of Preventive Medicine, Bluhm
Cardiovascular Institute (R.P.), Department of Pediatrics (J.D.R., C.K.R.), and
Division of Cardiology, Department of Internal Medicine (D.C.L.), Northwestern
University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago,
IL 60611; Department of Biomedical Engineering, Northwestern University,
Evanston, Ill (L.F., D.K.); and Division of Cardiology (J.D.R.) and Department
of Medical Imaging (C.K.R.), Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, Ill
| | - Daniel Kim
- From the Department of Radiology (L.F., K.P.H., B.D.A., R.P., J.C.C.,
S.Z., J.D.R., C.K.R., D.K.), Department of Preventive Medicine, Bluhm
Cardiovascular Institute (R.P.), Department of Pediatrics (J.D.R., C.K.R.), and
Division of Cardiology, Department of Internal Medicine (D.C.L.), Northwestern
University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago,
IL 60611; Department of Biomedical Engineering, Northwestern University,
Evanston, Ill (L.F., D.K.); and Division of Cardiology (J.D.R.) and Department
of Medical Imaging (C.K.R.), Ann & Robert H. Lurie Children’s
Hospital of Chicago, Chicago, Ill
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13
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Esposito C, Machado P, McDonald ME, Savage MP, Fischman D, Mehrotra P, Cohen IS, Ruggiero N, Walinsky P, Vishnevsky A, Dickie K, Davis M, Forsberg F, Dave JK. Evaluation of Intracardiac Pressures Using Subharmonic-aided Pressure Estimation with Sonazoid Microbubbles. Radiol Cardiothorac Imaging 2024; 6:e230153. [PMID: 38358329 PMCID: PMC10912883 DOI: 10.1148/ryct.230153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/13/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024]
Abstract
Purpose To investigate if the right ventricular (RV) systolic and left ventricular (LV) diastolic pressures can be obtained noninvasively using the subharmonic-aided pressure estimation (SHAPE) technique with Sonazoid microbubbles. Materials and Methods Individuals scheduled for a left and/or right heart catheterization were prospectively enrolled in this institutional review board-approved clinical trial from 2017 to 2020. A standard-of-care catheterization procedure was performed by advancing fluid-filled pressure catheters into the LV and aorta (n = 25) or RV (n = 22), and solid-state high-fidelity pressure catheters into the LV and aorta in a subset of participants (n = 18). Study participants received an infusion of Sonazoid microbubbles (GE HealthCare), and SHAPE data were acquired using a validated interface developed on a SonixTablet (BK Medical) US scanner, synchronously with the pressure catheter data. A conversion factor, derived using cuff-based pressure measurements with a SphygmoCor XCEL PWA (ATCOR) and subharmonic signal from the aorta, was used to convert the subharmonic signal into pressure values. Errors between the pressure measurements obtained using the SHAPE technique and pressure catheter were compared. Results The mean errors in pressure measurements obtained with the SHAPE technique relative to those of the fluid-filled pressure catheter were 1.6 mm Hg ± 1.5 [SD] (P = .85), 8.4 mm Hg ± 6.2 (P = .04), and 7.4 mm Hg ± 5.7 (P = .09) for RV systolic, LV minimum diastolic, and LV end-diastolic pressures, respectively. Relative to the measurements with the solid-state high-fidelity pressure catheter, the mean errors in LV minimum diastolic and LV end-diastolic pressures were 7.2 mm Hg ± 4.5 and 6.8 mm Hg ± 3.3 (P ≥ .44), respectively. Conclusion These results indicate that SHAPE with Sonazoid may have the potential to provide clinically relevant RV systolic and LV diastolic pressures. Keywords: Ultrasound-Contrast, Cardiac, Aorta, Left Ventricle, Right Ventricle ClinicalTrials.gov registration no.: NCT03245255 © RSNA, 2024.
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Affiliation(s)
- Cara Esposito
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Priscilla Machado
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Maureen E. McDonald
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Michael P. Savage
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - David Fischman
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Praveen Mehrotra
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Ira S. Cohen
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Nicholas Ruggiero
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Paul Walinsky
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Alec Vishnevsky
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Kristopher Dickie
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Marguerite Davis
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Flemming Forsberg
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
| | - Jaydev K. Dave
- From the Departments of Radiology (C.E., P.M., F.F., J.K.D.), Medical
Imaging and Radiation Sciences (M.E.M.), and Medicine (M.P.S., D.F., P.M.,
I.S.C., N.R., P.W., A.V., M.D.), Thomas Jefferson University, Philadelphia, Pa;
Clarius Mobile Health, Vancouver, Canada (K.D.); and Department of Radiology,
Mayo Clinic, Rochester, Minn (J.K.D)
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14
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Li W, Partridge SC, Newitt DC, Steingrimsson J, Marques HS, Bolan PJ, Hirano M, Bearce BA, Kalpathy-Cramer J, Boss MA, Teng X, Zhang J, Cai J, Kontos D, Cohen EA, Mankowski WC, Liu M, Ha R, Pellicer-Valero OJ, Maier-Hein K, Rabinovici-Cohen S, Tlusty T, Ozery-Flato M, Parekh VS, Jacobs MA, Yan R, Sung K, Kazerouni AS, DiCarlo JC, Yankeelov TE, Chenevert TL, Hylton NM. Breast Multiparametric MRI for Prediction of Neoadjuvant Chemotherapy Response in Breast Cancer: The BMMR2 Challenge. Radiol Imaging Cancer 2024; 6:e230033. [PMID: 38180338 PMCID: PMC10825718 DOI: 10.1148/rycan.230033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/13/2023] [Accepted: 11/02/2023] [Indexed: 01/06/2024]
Abstract
Purpose To describe the design, conduct, and results of the Breast Multiparametric MRI for prediction of neoadjuvant chemotherapy Response (BMMR2) challenge. Materials and Methods The BMMR2 computational challenge opened on May 28, 2021, and closed on December 21, 2021. The goal of the challenge was to identify image-based markers derived from multiparametric breast MRI, including diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) MRI, along with clinical data for predicting pathologic complete response (pCR) following neoadjuvant treatment. Data included 573 breast MRI studies from 191 women (mean age [±SD], 48.9 years ± 10.56) in the I-SPY 2/American College of Radiology Imaging Network (ACRIN) 6698 trial (ClinicalTrials.gov: NCT01042379). The challenge cohort was split into training (60%) and test (40%) sets, with teams blinded to test set pCR outcomes. Prediction performance was evaluated by area under the receiver operating characteristic curve (AUC) and compared with the benchmark established from the ACRIN 6698 primary analysis. Results Eight teams submitted final predictions. Entries from three teams had point estimators of AUC that were higher than the benchmark performance (AUC, 0.782 [95% CI: 0.670, 0.893], with AUCs of 0.803 [95% CI: 0.702, 0.904], 0.838 [95% CI: 0.748, 0.928], and 0.840 [95% CI: 0.748, 0.932]). A variety of approaches were used, ranging from extraction of individual features to deep learning and artificial intelligence methods, incorporating DCE and DWI alone or in combination. Conclusion The BMMR2 challenge identified several models with high predictive performance, which may further expand the value of multiparametric breast MRI as an early marker of treatment response. Clinical trial registration no. NCT01042379 Keywords: MRI, Breast, Tumor Response Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Wen Li
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Savannah C. Partridge
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - David C. Newitt
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Jon Steingrimsson
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Helga S. Marques
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Patrick J. Bolan
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Michael Hirano
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Benjamin Aaron Bearce
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Jayashree Kalpathy-Cramer
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Michael A. Boss
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Xinzhi Teng
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Jiang Zhang
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Jing Cai
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Despina Kontos
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Eric A. Cohen
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Walter C. Mankowski
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Michael Liu
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Richard Ha
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Oscar J. Pellicer-Valero
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Klaus Maier-Hein
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Simona Rabinovici-Cohen
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Tal Tlusty
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Michal Ozery-Flato
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Vishwa S. Parekh
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Michael A. Jacobs
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Ran Yan
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Kyunghyun Sung
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Anum S. Kazerouni
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Julie C. DiCarlo
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Thomas E. Yankeelov
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Thomas L. Chenevert
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
| | - Nola M. Hylton
- From the Department of Radiology & Biomedical Imaging,
University of California San Francisco, San Francisco, Calif (W.L., D.C.N.,
N.M.H.); Department of Radiology, University of Washington, Fred Hutchinson
Cancer Center, 1100 Fairview Ave N, Seattle, WA 98109 (S.C.P., M.H., A.S.K.);
Center for Statistical Sciences, Brown University, Providence, RI (J.S.,
H.S.M.); Center for Magnetic Resonance Research, University of Minnesota,
Minneapolis, Minn (P.J.B.); Athinoula A. Martinos Center for Biomedical Imaging,
Harvard University, Charlestown, Mass (B.A.B., J.K.C.); Center for Research and
Innovation, American College of Radiology, Philadelphia, Pa (M.A.B.); Department
of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung
Hom, Kowloon, Hong Kong SAR (X.T., J.Z., J.C.); Department of Radiology,
University of Pennsylvania, Philadelphia, Pa (D.K., E.A.C., W.C.M.); Department
of Radiology, Columbia University Medical Center, New York, NY (M.L., R.H.);
Division of Medical Image Computing, German Cancer Research Center, Heidelberg,
Germany (O.J.P.V., K.M.H.); Department of Radiation Oncology, Heidelberg
University Hospital, Heidelberg, Germany (K.M.H.); IBM Research-Israel, Haifa
University Campus, Mount Carmel, Haifa, Israel (S.R.C., T.T., M.O.F.);
University of Maryland Medical Intelligent Imaging (UM2ii) Center and Department
of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of
Medicine, Baltimore, Md (V.S.P.); The Russell H. Morgan Department of Radiology
and Radiological Science, The Johns Hopkins School of Medicine, Sidney Kimmel
Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, Md
(V.S.P., M.A.J.); Department of Diagnostic and Interventional Imaging, UT Health
at Houston, Houston, Tex (M.A.J.); Department of Radiological Sciences, David
Geffen School of Medicine, University of California, Los Angeles, Calif (R.Y.,
K.S.); Department of Bioengineering, Henry Samueli School of Engineering,
University of California, Los Angeles, Calif (R.Y., K.S.); Livestrong Cancer
Institutes (J.C.D., T.E.Y.), Departments of Biomedical Engineering, Diagnostic
Medicine, and Oncology (T.E.Y.), and The Oden Institute for Computational
Engineering and Sciences, The University of Texas at Austin, Austin, Tex
(J.C.D., T.E.Y.); Department of Imaging Physics, The University of Texas MD
Anderson Cancer Center, Houston, Tex (T.E.Y.); and Department of Radiology,
University of Michigan, Ann Arbor, Mich (T.L.C.)
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15
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Chae A, Yao MS, Sagreiya H, Goldberg AD, Chatterjee N, MacLean MT, Duda J, Elahi A, Borthakur A, Ritchie MD, Rader D, Kahn CE, Witschey WR, Gee JC. Strategies for Implementing Machine Learning Algorithms in the Clinical Practice of Radiology. Radiology 2024; 310:e223170. [PMID: 38259208 PMCID: PMC10831483 DOI: 10.1148/radiol.223170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 01/24/2024]
Abstract
Despite recent advancements in machine learning (ML) applications in health care, there have been few benefits and improvements to clinical medicine in the hospital setting. To facilitate clinical adaptation of methods in ML, this review proposes a standardized framework for the step-by-step implementation of artificial intelligence into the clinical practice of radiology that focuses on three key components: problem identification, stakeholder alignment, and pipeline integration. A review of the recent literature and empirical evidence in radiologic imaging applications justifies this approach and offers a discussion on structuring implementation efforts to help other hospital practices leverage ML to improve patient care. Clinical trial registration no. 04242667 © RSNA, 2024 Supplemental material is available for this article.
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Affiliation(s)
| | | | - Hersh Sagreiya
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Ari D. Goldberg
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Neil Chatterjee
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Matthew T. MacLean
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Jeffrey Duda
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Ameena Elahi
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Arijitt Borthakur
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Marylyn D. Ritchie
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Daniel Rader
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Charles E. Kahn
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
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16
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Choi HH, Kim S, Shum DJ, Huang CY, Shui A, Fox RK, Khalili M. Assessing Adherence to US LI-RADS Follow-up Recommendations in Vulnerable Patients Undergoing Hepatocellular Carcinoma Surveillance. Radiol Imaging Cancer 2024; 6:e230118. [PMID: 38214600 PMCID: PMC10825700 DOI: 10.1148/rycan.230118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/01/2023] [Accepted: 11/29/2023] [Indexed: 01/13/2024]
Abstract
Purpose To assess adherence to the US Liver Imaging Reporting and Data System (LI-RADS) recommendations for hepatocellular carcinoma (HCC) surveillance and associated patient-level factors in a vulnerable, diverse patient sample. Materials and Methods The radiology report database was queried retrospectively for patients who underwent US LI-RADS-based surveillance examinations at a single institution between June 1, 2020, and February 28, 2021. Initial US and follow-up liver imaging were included. Sociodemographic and clinical data were captured from electronic medical records. Adherence to radiologist recommendation was defined as imaging (US, CT, or MRI) follow-up in 5-7 months for US-1, imaging follow-up in 3-6 months for US-2, and CT or MRI follow-up in 2 months for US-3. Descriptive analysis and multivariable modeling that adjusted for age, sex, race, and time since COVID-19 pandemic onset were performed. Results Among 936 patients, the mean age was 59.1 years; 531 patients (56.7%) were male and 544 (58.1%) were Asian or Pacific Islander, 91 (9.7%) were Black, 129 (13.8%) were Hispanic, 147 (15.7%) were White, and 25 (2.7%) self-reported as other race. The overall adherence rate was 38.8% (95% CI: 35.7, 41.9). The most common liver disease etiology was hepatitis B (60.6% [657 of 936 patients]); 19.7% of patients (183 of 936) had current or past substance use disorder, and 44.8% (416 of 936) smoked. At adjusted multivariable analysis, older age (odds ratio [OR], 1.20; P = .02), male sex (OR, 1.62; P = .003), hepatology clinic attendance (OR, 3.81; P < .001), and recent prior US examination (OR, 2.44; P < .001) were associated with full adherence, while current smoking (OR, 0.39; P < .001) was negatively associated. Conclusion Adherence to HCC imaging surveillance was suboptimal, despite US LI-RADS implementation. Keywords: Liver, Ultrasound, Screening, Abdomen/GI, Cirrhosis, Metabolic Disorders, Socioeconomic Issues Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Hailey H. Choi
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, Zuckerberg San Francisco General Hospital, 505
Parnassus Ave, Box 0628, Room 255, San Francisco, CA 94143 (H.H.C., D.J.S.); and
Department of Medicine, Division of General Internal Medicine (S.K., R.K.F.),
Department of Epidemiology and Biostatistics (C.Y.H., A.S.), and Department of
Medicine, Division of Gastroenterology and Hepatology (M.K.), University of
California San Francisco, San Francisco, Calif
| | - Stephanie Kim
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, Zuckerberg San Francisco General Hospital, 505
Parnassus Ave, Box 0628, Room 255, San Francisco, CA 94143 (H.H.C., D.J.S.); and
Department of Medicine, Division of General Internal Medicine (S.K., R.K.F.),
Department of Epidemiology and Biostatistics (C.Y.H., A.S.), and Department of
Medicine, Division of Gastroenterology and Hepatology (M.K.), University of
California San Francisco, San Francisco, Calif
| | - Dorothy J. Shum
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, Zuckerberg San Francisco General Hospital, 505
Parnassus Ave, Box 0628, Room 255, San Francisco, CA 94143 (H.H.C., D.J.S.); and
Department of Medicine, Division of General Internal Medicine (S.K., R.K.F.),
Department of Epidemiology and Biostatistics (C.Y.H., A.S.), and Department of
Medicine, Division of Gastroenterology and Hepatology (M.K.), University of
California San Francisco, San Francisco, Calif
| | - Chiung-Yu Huang
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, Zuckerberg San Francisco General Hospital, 505
Parnassus Ave, Box 0628, Room 255, San Francisco, CA 94143 (H.H.C., D.J.S.); and
Department of Medicine, Division of General Internal Medicine (S.K., R.K.F.),
Department of Epidemiology and Biostatistics (C.Y.H., A.S.), and Department of
Medicine, Division of Gastroenterology and Hepatology (M.K.), University of
California San Francisco, San Francisco, Calif
| | - Amy Shui
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, Zuckerberg San Francisco General Hospital, 505
Parnassus Ave, Box 0628, Room 255, San Francisco, CA 94143 (H.H.C., D.J.S.); and
Department of Medicine, Division of General Internal Medicine (S.K., R.K.F.),
Department of Epidemiology and Biostatistics (C.Y.H., A.S.), and Department of
Medicine, Division of Gastroenterology and Hepatology (M.K.), University of
California San Francisco, San Francisco, Calif
| | - Rena K. Fox
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, Zuckerberg San Francisco General Hospital, 505
Parnassus Ave, Box 0628, Room 255, San Francisco, CA 94143 (H.H.C., D.J.S.); and
Department of Medicine, Division of General Internal Medicine (S.K., R.K.F.),
Department of Epidemiology and Biostatistics (C.Y.H., A.S.), and Department of
Medicine, Division of Gastroenterology and Hepatology (M.K.), University of
California San Francisco, San Francisco, Calif
| | - Mandana Khalili
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, Zuckerberg San Francisco General Hospital, 505
Parnassus Ave, Box 0628, Room 255, San Francisco, CA 94143 (H.H.C., D.J.S.); and
Department of Medicine, Division of General Internal Medicine (S.K., R.K.F.),
Department of Epidemiology and Biostatistics (C.Y.H., A.S.), and Department of
Medicine, Division of Gastroenterology and Hepatology (M.K.), University of
California San Francisco, San Francisco, Calif
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17
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Arefan D, Zuley ML, Berg WA, Yang L, Sumkin JH, Wu S. Assessment of Background Parenchymal Enhancement at Dynamic Contrast-enhanced MRI in Predicting Breast Cancer Recurrence Risk. Radiology 2024; 310:e230269. [PMID: 38259203 PMCID: PMC10831474 DOI: 10.1148/radiol.230269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 11/17/2023] [Accepted: 12/07/2023] [Indexed: 01/24/2024]
Abstract
Background Background parenchymal enhancement (BPE) at dynamic contrast-enhanced (DCE) MRI of cancer-free breasts increases the risk of developing breast cancer; implications of quantitative BPE in ipsilateral breasts with breast cancer are largely unexplored. Purpose To determine whether quantitative BPE measurements in one or both breasts could be used to predict recurrence risk in women with breast cancer, using the Oncotype DX recurrence score as the reference standard. Materials and Methods This HIPAA-compliant retrospective single-institution study included women diagnosed with breast cancer between January 2007 and January 2012 (development set) and between January 2012 and January 2017 (internal test set). Quantitative BPE was automatically computed using an in-house-developed computer algorithm in both breasts. Univariable logistic regression was used to examine the association of BPE with Oncotype DX recurrence score binarized into high-risk (recurrence score >25) and low- or intermediate-risk (recurrence score ≤25) categories. Models including BPE measures were assessed for their ability to distinguish patients with high risk versus those with low or intermediate risk and the actual recurrence outcome. Results The development set included 127 women (mean age, 58 years ± 10.2 [SD]; 33 with high risk and 94 with low or intermediate risk) with an actual local or distant recurrence rate of 15.7% (20 of 127) at a minimum 10 years of follow-up. The test set included 60 women (mean age, 57.8 years ± 11.6; 16 with high risk and 44 with low or intermediate risk). BPE measurements quantified in both breasts were associated with increased odds of a high-risk Oncotype DX recurrence score (odds ratio range, 1.27-1.66 [95% CI: 1.02, 2.56]; P < .001 to P = .04). Measures of BPE combined with tumor radiomics helped distinguish patients with a high-risk Oncotype DX recurrence score from those with a low- or intermediate-risk score, with an area under the receiver operating characteristic curve of 0.94 in the development set and 0.79 in the test set. For the combined models, the negative predictive values were 0.97 and 0.93 in predicting actual distant recurrence and local recurrence, respectively. Conclusion Ipsilateral and contralateral DCE MRI measures of BPE quantified in patients with breast cancer can help distinguish patients with high recurrence risk from those with low or intermediate recurrence risk, similar to Oncotype DX recurrence score. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Zhou and Rahbar in this issue.
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Affiliation(s)
- Dooman Arefan
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
| | - Margarita L. Zuley
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
| | - Wendie A. Berg
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
| | - Lu Yang
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
| | - Jules H. Sumkin
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
| | - Shandong Wu
- From the Department of Radiology, University of Pittsburgh School of
Medicine, 3240 Craft Pl, Room 322, Pittsburgh, PA 15213 (D.A., M.L.Z., W.A.B.,
L.Y., J.H.S., S.W.); Department of Radiology, Magee-Womens Hospital, University
of Pittsburgh Medical Center, Pittsburgh, PA, 15213 (M.L.Z., W.A.B., J.H.S.);
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and
Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
(L.Y.); and Department of Biomedical Informatics (S.W.), Department of
Bioengineering (S.W.), and Intelligent Systems Program (S.W.), University of
Pittsburgh, Pittsburgh, Pa
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18
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Zhu Y, Yip R, Zhang J, Cai Q, Sun Q, Li P, Paksashvili N, Triphuridet N, Henschke CI, Yankelevitz DF. Radiologic Features of Nodules Attached to the Mediastinal or Diaphragmatic Pleura at Low-Dose CT for Lung Cancer Screening. Radiology 2024; 310:e231219. [PMID: 38165250 PMCID: PMC10831475 DOI: 10.1148/radiol.231219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/08/2023] [Accepted: 11/16/2023] [Indexed: 01/03/2024]
Abstract
Background Pulmonary noncalcified nodules (NCNs) attached to the fissural or costal pleura with smooth margins and triangular or lentiform, oval, or semicircular (LOS) shapes at low-dose CT are recommended for annual follow-up instead of immediate workup. Purpose To determine whether management of mediastinal or diaphragmatic pleura-attached NCNs (M/DP-NCNs) with the same features as fissural or costal pleura-attached NCNs at low-dose CT can follow the same recommendations. Materials and Methods This retrospective study reviewed chest CT examinations in participants from two databases. Group A included 1451 participants who had lung cancer that was first present as a solid nodule with an average diameter of 3.0-30.0 mm. Group B included 345 consecutive participants from a lung cancer screening program who had at least one solid nodule with a diameter of 3.0-30.0 mm at baseline CT and underwent at least three follow-up CT examinations. Radiologists reviewed CT images to identify solid M/DP-NCNs, defined as nodules 0 mm in distance from the mediastinal or diaphragmatic pleura, and recorded average diameter, margin, and shape. General descriptive statistics were used. Results Among the 1451 participants with lung cancer in group A, 163 participants (median age, 68 years [IQR, 61.5-75.0 years]; 92 male participants) had 164 malignant M/DP-NCNs 3.0-30.0 mm in average diameter. None of the 164 malignant M/DP-NCNs had smooth margins and triangular or LOS shapes (upper limit of 95% CI of proportion, 0.02). Among the 345 consecutive screening participants in group B, 146 participants (median age, 65 years [IQR, 59-71 years]; 81 female participants) had 240 M/DP-NCNs with average diameter 3.0-30.0 mm. None of the M/DP-NCNs with smooth margins and triangular or LOS shapes were malignant after a median follow-up of 57.8 months (IQR, 46.3-68.1 months). Conclusion For solid M/DP-NCNs with smooth margins and triangular or LOS shapes at low-dose CT, the risk of lung cancer is extremely low, which supports the recommendation of Lung Imaging Reporting and Data System version 2022 for annual follow-up instead of immediate workup. © RSNA, 2024 See also the editorial by Goodman and Baruah in this issue.
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Affiliation(s)
- Yeqing Zhu
- From the Department of Radiology, Icahn School of Medicine at Mount
Sinai, 1 Gustave L. Levy Pl, New York, NY 10029 (Y.Z., R.Y., J.Z., Q.C., Q.S.,
P.L., N.P., N.T., C.I.H., D.F.Y.); Department of Radiology, Shanxi Provincial
People’s Hospital, Taiyuan, China (Q.C.); Department of Radiology, Harbin
Medical University Cancer Hospital, Harbin, China (Q.S., P.L.); and Department
of Pulmonary Medicine, Faculty of Medicine and Public Health, HRH Princess
Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok,
Thailand (N.T.)
| | - Rowena Yip
- From the Department of Radiology, Icahn School of Medicine at Mount
Sinai, 1 Gustave L. Levy Pl, New York, NY 10029 (Y.Z., R.Y., J.Z., Q.C., Q.S.,
P.L., N.P., N.T., C.I.H., D.F.Y.); Department of Radiology, Shanxi Provincial
People’s Hospital, Taiyuan, China (Q.C.); Department of Radiology, Harbin
Medical University Cancer Hospital, Harbin, China (Q.S., P.L.); and Department
of Pulmonary Medicine, Faculty of Medicine and Public Health, HRH Princess
Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok,
Thailand (N.T.)
| | - Jiafang Zhang
- From the Department of Radiology, Icahn School of Medicine at Mount
Sinai, 1 Gustave L. Levy Pl, New York, NY 10029 (Y.Z., R.Y., J.Z., Q.C., Q.S.,
P.L., N.P., N.T., C.I.H., D.F.Y.); Department of Radiology, Shanxi Provincial
People’s Hospital, Taiyuan, China (Q.C.); Department of Radiology, Harbin
Medical University Cancer Hospital, Harbin, China (Q.S., P.L.); and Department
of Pulmonary Medicine, Faculty of Medicine and Public Health, HRH Princess
Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok,
Thailand (N.T.)
| | - Qiang Cai
- From the Department of Radiology, Icahn School of Medicine at Mount
Sinai, 1 Gustave L. Levy Pl, New York, NY 10029 (Y.Z., R.Y., J.Z., Q.C., Q.S.,
P.L., N.P., N.T., C.I.H., D.F.Y.); Department of Radiology, Shanxi Provincial
People’s Hospital, Taiyuan, China (Q.C.); Department of Radiology, Harbin
Medical University Cancer Hospital, Harbin, China (Q.S., P.L.); and Department
of Pulmonary Medicine, Faculty of Medicine and Public Health, HRH Princess
Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok,
Thailand (N.T.)
| | - Qi Sun
- From the Department of Radiology, Icahn School of Medicine at Mount
Sinai, 1 Gustave L. Levy Pl, New York, NY 10029 (Y.Z., R.Y., J.Z., Q.C., Q.S.,
P.L., N.P., N.T., C.I.H., D.F.Y.); Department of Radiology, Shanxi Provincial
People’s Hospital, Taiyuan, China (Q.C.); Department of Radiology, Harbin
Medical University Cancer Hospital, Harbin, China (Q.S., P.L.); and Department
of Pulmonary Medicine, Faculty of Medicine and Public Health, HRH Princess
Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok,
Thailand (N.T.)
| | - Pengfei Li
- From the Department of Radiology, Icahn School of Medicine at Mount
Sinai, 1 Gustave L. Levy Pl, New York, NY 10029 (Y.Z., R.Y., J.Z., Q.C., Q.S.,
P.L., N.P., N.T., C.I.H., D.F.Y.); Department of Radiology, Shanxi Provincial
People’s Hospital, Taiyuan, China (Q.C.); Department of Radiology, Harbin
Medical University Cancer Hospital, Harbin, China (Q.S., P.L.); and Department
of Pulmonary Medicine, Faculty of Medicine and Public Health, HRH Princess
Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok,
Thailand (N.T.)
| | - Natela Paksashvili
- From the Department of Radiology, Icahn School of Medicine at Mount
Sinai, 1 Gustave L. Levy Pl, New York, NY 10029 (Y.Z., R.Y., J.Z., Q.C., Q.S.,
P.L., N.P., N.T., C.I.H., D.F.Y.); Department of Radiology, Shanxi Provincial
People’s Hospital, Taiyuan, China (Q.C.); Department of Radiology, Harbin
Medical University Cancer Hospital, Harbin, China (Q.S., P.L.); and Department
of Pulmonary Medicine, Faculty of Medicine and Public Health, HRH Princess
Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok,
Thailand (N.T.)
| | - Natthaya Triphuridet
- From the Department of Radiology, Icahn School of Medicine at Mount
Sinai, 1 Gustave L. Levy Pl, New York, NY 10029 (Y.Z., R.Y., J.Z., Q.C., Q.S.,
P.L., N.P., N.T., C.I.H., D.F.Y.); Department of Radiology, Shanxi Provincial
People’s Hospital, Taiyuan, China (Q.C.); Department of Radiology, Harbin
Medical University Cancer Hospital, Harbin, China (Q.S., P.L.); and Department
of Pulmonary Medicine, Faculty of Medicine and Public Health, HRH Princess
Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok,
Thailand (N.T.)
| | - Claudia I. Henschke
- From the Department of Radiology, Icahn School of Medicine at Mount
Sinai, 1 Gustave L. Levy Pl, New York, NY 10029 (Y.Z., R.Y., J.Z., Q.C., Q.S.,
P.L., N.P., N.T., C.I.H., D.F.Y.); Department of Radiology, Shanxi Provincial
People’s Hospital, Taiyuan, China (Q.C.); Department of Radiology, Harbin
Medical University Cancer Hospital, Harbin, China (Q.S., P.L.); and Department
of Pulmonary Medicine, Faculty of Medicine and Public Health, HRH Princess
Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok,
Thailand (N.T.)
| | - David F. Yankelevitz
- From the Department of Radiology, Icahn School of Medicine at Mount
Sinai, 1 Gustave L. Levy Pl, New York, NY 10029 (Y.Z., R.Y., J.Z., Q.C., Q.S.,
P.L., N.P., N.T., C.I.H., D.F.Y.); Department of Radiology, Shanxi Provincial
People’s Hospital, Taiyuan, China (Q.C.); Department of Radiology, Harbin
Medical University Cancer Hospital, Harbin, China (Q.S., P.L.); and Department
of Pulmonary Medicine, Faculty of Medicine and Public Health, HRH Princess
Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok,
Thailand (N.T.)
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19
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Vegas Sánchez-Ferrero G, Díaz AA, Ash SY, Baraghoshi D, Strand M, Crapo JD, Silverman EK, Humphries SM, Washko GR, Lynch DA, San José Estépar R. Quantification of Emphysema Progression at CT Using Simultaneous Volume, Noise, and Bias Lung Density Correction. Radiology 2024; 310:e231632. [PMID: 38165244 PMCID: PMC10831481 DOI: 10.1148/radiol.231632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 01/03/2024]
Abstract
Background CT attenuation is affected by lung volume, dosage, and scanner bias, leading to inaccurate emphysema progression measurements in multicenter studies. Purpose To develop and validate a method that simultaneously corrects volume, noise, and interscanner bias for lung density change estimation in emphysema progression at CT in a longitudinal multicenter study. Materials and Methods In this secondary analysis of the prospective Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) study, lung function data were obtained from participants who completed baseline and 5-year follow-up visits from January 2008 to August 2017. CT emphysema progression was measured with volume-adjusted lung density (VALD) and compared with the joint volume-noise-bias-adjusted lung density (VNB-ALD). Reproducibility was studied under change of dosage protocol and scanner model with repeated acquisitions. Emphysema progression was visually scored in 102 randomly selected participants. A stratified analysis of clinical characteristics was performed that considered groups based on their combined lung density change measured by VALD and VNB-ALD. Results A total of 4954 COPDGene participants (mean age, 60 years ± 9 [SD]; 2511 male, 2443 female) were analyzed (1329 with repeated reduced-dose acquisition in the follow-up visit). Mean repeatability coefficients were 30 g/L ± 0.46 for VALD and 14 g/L ± 0.34 for VNB-ALD. VALD measurements showed no evidence of differences between nonprogressors and progressors (mean, -5.5 g/L ± 9.5 vs -8.6 g/L ± 9.6; P = .11), while VNB-ALD agreed with visual readings and showed a difference (mean, -0.67 g/L ± 4.8 vs -4.2 g/L ± 5.5; P < .001). Analysis of progression showed that VNB-ALD progressors had a greater decline in forced expiratory volume in 1 second (-42 mL per year vs -32 mL per year; Tukey-adjusted P = .002). Conclusion Simultaneously correcting volume, noise, and interscanner bias for lung density change estimation in emphysema progression at CT improved repeatability analyses and agreed with visual readings. It distinguished between progressors and nonprogressors and was associated with a greater decline in lung function metrics. Clinical trial registration no. NCT00608764 © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Goo in this issue.
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Affiliation(s)
- Gonzalo Vegas Sánchez-Ferrero
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Alejandro A. Díaz
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Samuel Y. Ash
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - David Baraghoshi
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Matthew Strand
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - James D. Crapo
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Edwin K. Silverman
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Stephen M. Humphries
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - George R. Washko
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - David A. Lynch
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Raúl San José Estépar
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
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20
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Guo J, Goyal M, Xi Y, Hinojosa L, Haddad G, Albayrak E, Pedrosa I. Style Transfer-assisted Deep Learning Method for Kidney Segmentation at Multiphase MRI. Radiol Artif Intell 2023; 5:e230043. [PMID: 38074795 PMCID: PMC10698598 DOI: 10.1148/ryai.230043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/28/2023] [Accepted: 08/30/2023] [Indexed: 02/12/2024]
Abstract
Purpose To develop and validate a semisupervised style transfer-assisted deep learning method for automated segmentation of the kidneys using multiphase contrast-enhanced (MCE) MRI acquisitions. Materials and Methods This retrospective, Health Insurance Portability and Accountability Act-compliant, institutional review board-approved study included 125 patients (mean age, 57.3 years; 67 male, 58 female) with renal masses. Cohort 1 consisted of 102 coronal T2-weighted MRI acquisitions and 27 MCE MRI acquisitions during the corticomedullary phase. Cohort 2 comprised 92 MCE MRI acquisitions (23 acquisitions during four phases each, including precontrast, corticomedullary, early nephrographic, and nephrographic phases). The kidneys were manually segmented on T2-weighted images. A cycle-consistent generative adversarial network (CycleGAN) was trained to generate anatomically coregistered synthetic corticomedullary style images using T2-weighted images as input. Synthetic images for precontrast, early nephrographic, and nephrographic phases were then generated using the synthetic corticomedullary images as input. Mask region-based convolutional neural networks were trained on the four synthetic phase series for kidney segmentation using T2-weighted masks. Segmentation performance was evaluated in a different cohort of 20 originally acquired MCE MRI examinations by using Dice and Jaccard scores. Results The CycleGAN network successfully generated anatomically coregistered synthetic MCE MRI-like datasets from T2-weighted acquisitions. The proposed deep learning approach for kidney segmentation achieved high mean Dice scores in all four phases of the original MCE MRI acquisitions (0.91 for precontrast, 0.92 for corticomedullary, 0.91 for early nephrographic, and 0.93 for nephrographic). Conclusion The proposed deep learning approach achieved high performance in kidney segmentation on different MCE MRI acquisitions.Keywords: Kidney Segmentation, Generative Adversarial Network, CycleGAN, Convolutional Neural Network, Transfer Learning Supplemental material is available for this article. Published under a CC BY 4.0 license.
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Affiliation(s)
| | | | - Yin Xi
- From the Department of Radiology (J.G., M.G., Y.X., L.H., G.H., E.A.,
I.P.), Department of Urology (I.P.), and Advanced Imaging Research Center
(I.P.), University of Texas Southwestern Medical Center, 2201 Inwood Rd, Suite
202, Dallas, TX 75390-9085
| | - Lauren Hinojosa
- From the Department of Radiology (J.G., M.G., Y.X., L.H., G.H., E.A.,
I.P.), Department of Urology (I.P.), and Advanced Imaging Research Center
(I.P.), University of Texas Southwestern Medical Center, 2201 Inwood Rd, Suite
202, Dallas, TX 75390-9085
| | - Gaelle Haddad
- From the Department of Radiology (J.G., M.G., Y.X., L.H., G.H., E.A.,
I.P.), Department of Urology (I.P.), and Advanced Imaging Research Center
(I.P.), University of Texas Southwestern Medical Center, 2201 Inwood Rd, Suite
202, Dallas, TX 75390-9085
| | - Emin Albayrak
- From the Department of Radiology (J.G., M.G., Y.X., L.H., G.H., E.A.,
I.P.), Department of Urology (I.P.), and Advanced Imaging Research Center
(I.P.), University of Texas Southwestern Medical Center, 2201 Inwood Rd, Suite
202, Dallas, TX 75390-9085
| | - Ivan Pedrosa
- From the Department of Radiology (J.G., M.G., Y.X., L.H., G.H., E.A.,
I.P.), Department of Urology (I.P.), and Advanced Imaging Research Center
(I.P.), University of Texas Southwestern Medical Center, 2201 Inwood Rd, Suite
202, Dallas, TX 75390-9085
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21
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Abraham P, Haddad A, Bishay AE, Bishay S, Sonubi C, Jaramillo-Cardoso A, Sava M, Yee J, Flores EJ, Spalluto LB. Social Determinants of Health in Imaging-based Cancer Screening: A Case-based Primer with Strategies for Care Improvement. Radiographics 2023; 43:e230008. [PMID: 37824411 PMCID: PMC10612293 DOI: 10.1148/rg.230008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/05/2023] [Accepted: 05/24/2023] [Indexed: 10/14/2023]
Abstract
Health disparities, preventable differences in the burden of disease and disease outcomes often experienced by socially disadvantaged populations, can be found in nearly all areas of radiology, including emergency radiology, neuroradiology, nuclear medicine, image-guided interventions, and imaging-based cancer screening. Disparities in imaging-based cancer screening are especially noteworthy given the far-reaching population health impact. The social determinants of health (SDoH) play an important role in disparities in cancer screening and outcomes. Through improved understanding of how SDoH can drive differences in health outcomes in radiology, radiologists can effectively provide patient-centered, high-quality, and equitable care. Radiologists and radiology practices can become active partners in efforts to assist patients along their imaging journey and overcome existing barriers to equitable cancer screening care for traditionally marginalized populations. As radiology exists at the intersection of diagnostic imaging, image-guided diagnostic intervention, and image-guided treatment, radiologists are uniquely positioned to design these strategies. Cost-effective and socially conscious strategies that address barriers to equitable care can improve both public health and equitable health outcomes. Potential strategies include championing supportive health policy, reducing out-of-pocket costs, increasing price transparency, improving education and outreach efforts, ensuring that appropriate language translation services are available, providing individualized assistance with appointment scheduling, and offering transportation assistance and childcare. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Peter Abraham
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Aida Haddad
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Anthony E. Bishay
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Steven Bishay
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Chiamaka Sonubi
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Adrian Jaramillo-Cardoso
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Melinda Sava
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Judy Yee
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Efren J. Flores
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Lucy B. Spalluto
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
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22
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Chan TJ, Rajapakse CS. A Super-Resolution Diffusion Model for Recovering Bone Microstructure from CT Images. Radiol Artif Intell 2023; 5:e220251. [PMID: 38074790 PMCID: PMC10698592 DOI: 10.1148/ryai.220251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 08/02/2023] [Accepted: 09/01/2023] [Indexed: 02/12/2024]
Abstract
Purpose To use a diffusion-based deep learning model to recover bone microstructure from low-resolution images of the proximal femur, a common site of traumatic osteoporotic fractures. Materials and Methods Training and testing data in this retrospective study consisted of high-resolution cadaveric micro-CT scans (n = 26), which served as ground truth. The images were downsampled prior to use for model training. The model was used to increase spatial resolution in these low-resolution images threefold, from 0.72 mm to 0.24 mm, sufficient to visualize bone microstructure. Model performance was validated using microstructural metrics and finite element simulation-derived stiffness of trabecular regions. Performance was also evaluated across a handful of image quality assessment metrics. Correlations between model performance and ground truth were assessed using intraclass correlation coefficients (ICCs) and Pearson correlation coefficients. Results Compared with popular deep learning baselines, the proposed model exhibited greater accuracy (mean ICC of proposed model, 0.92 vs ICC of next best method, 0.83) and lower bias (mean difference in means, 3.80% vs 10.00%, respectively) across the physiologic metrics. Two gradient-based image quality metrics strongly correlated with accuracy across structural and mechanical criteria (r > 0.89). Conclusion The proposed method may enable accurate measurements of bone structure and strength with a radiation dose on par with current clinical imaging protocols, improving the viability of clinical CT for assessing bone health.Keywords: CT, Image Postprocessing, Skeletal-Appendicular, Long Bones, Radiation Effects, Quantification, Prognosis, Semisupervised Learning Online supplemental material is available for this article. © RSNA, 2023.
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Affiliation(s)
- Trevor J Chan
- From the Departments of Bioengineering (T.J.C.), Radiology (T.J.C., C.S.R.), and Orthopedic Surgery (C.S.R.), University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104-6243
| | - Chamith S Rajapakse
- From the Departments of Bioengineering (T.J.C.), Radiology (T.J.C., C.S.R.), and Orthopedic Surgery (C.S.R.), University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104-6243
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23
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Tanisawa H, Matsumoto H, Cadet S, Higuchi S, Ohya H, Isodono K, Irie D, Kaneko K, Sumida A, Hirano T, Otaki Y, Kitamura R, Slomka PJ, Dey D, Shinke T. Quantification of Low-Attenuation Plaque Burden from Coronary CT Angiography: A Head-to-Head Comparison with Near-Infrared Spectroscopy Intravascular US. Radiol Cardiothorac Imaging 2023; 5:e230090. [PMID: 37908555 PMCID: PMC10613924 DOI: 10.1148/ryct.230090] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 11/02/2023]
Abstract
Purpose To determine the association between low-attenuation plaque (LAP) burden at coronary CT angiography (CCTA) and plaque morphology determined with near-infrared spectroscopy intravascular US (NIRS-IVUS) and to compare the discriminative ability for NIRS-IVUS-verified high-risk plaques (HRPs) between LAP burden and visual assessment of LAP. Materials and Methods This Health Insurance Portability and Accountability Act-compliant retrospective study included consecutive patients who underwent CCTA before NIRS-IVUS between October 2019 and October 2022 at two facilities. LAPs were visually identified as having a central focal area of less than 30 HU using the pixel lens technique. LAP burden was calculated as the volume of voxels with less than 30 HU divided by vessel volume. HRPs were defined as plaques with one of the following NIRS-IVUS-derived high-risk features: maximum 4-mm lipid core burden index greater than 400 (lipid-rich plaque), an echolucent zone (intraplaque hemorrhage), or echo attenuation (cholesterol clefts). Multivariable analysis was performed to evaluate NIRS-IVUS-derived parameters associated with LAP burden. The discriminative ability for NIRS-IVUS-verified HRPs was compared using receiver operating characteristic analysis. Results In total, 273 plaques in 141 patients (median age, 72 years; IQR, 63-78 years; 106 males) were analyzed. All the NIRS-IVUS-derived high-risk features were independently linked to LAP burden (P < .01 for all). LAP burden increased with the number of high-risk features (P < .001) and had better discriminative ability for HRPs than plaque attenuation by visual assessment (area under the receiver operating characteristic curve, 0.93 vs 0.89; P = .02). Conclusion Quantification of LAP burden improved HRP assessment compared with visual assessment. LAP burden was associated with the accumulation of HRP morphology.Keywords: Coronary CT Angiography, Intraplaque Hemorrhage, Lipid-Rich Plaque, Low Attenuation Plaque, Near-Infrared Spectroscopy Intravascular Ultrasound Supplemental material is available for this article. See also the commentary by Ferencik in this issue.© RSNA, 2023.
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Affiliation(s)
- Hiroki Tanisawa
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Hidenari Matsumoto
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Sebastien Cadet
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Satoshi Higuchi
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Hidefumi Ohya
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Koji Isodono
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Daisuke Irie
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Kyoichi Kaneko
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Arihiro Sumida
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Takaho Hirano
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Yuka Otaki
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Ryoji Kitamura
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Piotr J Slomka
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Damini Dey
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
| | - Toshiro Shinke
- From the Division of Cardiology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8555, Japan (H.T., H.M., S.H., K.K., A.S., T.S.); Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif (S.C., P.J.S., D.D.); Department of Cardiology, Ijinkai Takeda General Hospital, Kyoto, Japan (H.O., K.I., D.I., R.K.); Department of Radiological Technology, Showa University Hospital, Tokyo, Japan (T.H.); and Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan (Y.O.)
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24
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Fowler KJ, Venkatesh SK, Obuchowski N, Middleton MS, Chen J, Pepin K, Magnuson J, Brown KJ, Batakis D, Henderson WC, Shankar SS, Kamphaus TN, Pasek A, Calle RA, Sanyal AJ, Loomba R, Ehman R, Samir AE, Sirlin CB, Sherlock SP. Repeatability of MRI Biomarkers in Nonalcoholic Fatty Liver Disease: The NIMBLE Consortium. Radiology 2023; 309:e231092. [PMID: 37815451 PMCID: PMC10625902 DOI: 10.1148/radiol.231092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/30/2023] [Accepted: 08/29/2023] [Indexed: 10/11/2023]
Abstract
Background There is a need for reliable noninvasive methods for diagnosing and monitoring nonalcoholic fatty liver disease (NAFLD). Thus, the multidisciplinary Non-invasive Biomarkers of Metabolic Liver disease (NIMBLE) consortium was formed to identify and advance the regulatory qualification of NAFLD imaging biomarkers. Purpose To determine the different-day same-scanner repeatability coefficient of liver MRI biomarkers in patients with NAFLD at risk for steatohepatitis. Materials and Methods NIMBLE 1.2 is a prospective, observational, single-center short-term cross-sectional study (October 2021 to June 2022) in adults with NAFLD across a spectrum of low, intermediate, and high likelihood of advanced fibrosis as determined according to the fibrosis based on four factors (FIB-4) index. Participants underwent up to seven MRI examinations across two visits less than or equal to 7 days apart. Standardized imaging protocols were implemented with six MRI scanners from three vendors at both 1.5 T and 3 T, with central analysis of the data performed by an independent reading center (University of California, San Diego). Trained analysts, who were blinded to clinical data, measured the MRI proton density fat fraction (PDFF), liver stiffness at MR elastography (MRE), and visceral adipose tissue (VAT) for each participant. Point estimates and CIs were calculated using χ2 distribution and statistical modeling for pooled repeatability measures. Results A total of 17 participants (mean age, 58 years ± 8.5 [SD]; 10 female) were included, of which seven (41.2%), six (35.3%), and four (23.5%) participants had a low, intermediate, or high likelihood of advanced fibrosis, respectively. The different-day same-scanner mean measurements were 13%-14% for PDFF, 6.6 L for VAT, and 3.15 kPa for two-dimensional MRE stiffness. The different-day same-scanner repeatability coefficients were 0.22 L (95% CI: 0.17, 0.29) for VAT, 0.75 kPa (95% CI: 0.6, 0.99) for MRE stiffness, 1.19% (95% CI: 0.96, 1.61) for MRI PDFF using magnitude reconstruction, 1.56% (95% CI: 1.26, 2.07) for MRI PDFF using complex reconstruction, and 19.7% (95% CI: 15.8, 26.2) for three-dimensional MRE shear modulus. Conclusion This preliminary study suggests that thresholds of 1.2%-1.6%, 0.22 L, and 0.75 kPa for MRI PDFF, VAT, and MRE, respectively, should be used to discern measurement error from real change in patients with NAFLD. ClinicalTrials.gov registration no. NCT05081427 © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Kozaka and Matsui in this issue.
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Affiliation(s)
| | | | - Nancy Obuchowski
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Michael S. Middleton
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Jun Chen
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Kay Pepin
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Jessica Magnuson
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Kathy J. Brown
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Danielle Batakis
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Walter C. Henderson
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Sudha S. Shankar
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Tania N. Kamphaus
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Alex Pasek
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Roberto A. Calle
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Arun J. Sanyal
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Rohit Loomba
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Richard Ehman
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
| | - Anthony E. Samir
- From the Liver Imaging Group (K.J.F., M.S.M., D.B., W.C.H., C.B.S.)
and Department of Hepatology (R.L.), University of California–San Diego,
6206 Lakewood St, San Diego, CA 92122; Department of Radiology, Mayo Clinic,
Rochester, Minn (S.K.V., J.C., K.P., J.M., K.J.B., R.E.); Department of
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (N.O.); Pfizer
Research and Development, Pfizer, Inc, Sacramento, Calif (S.S.S.); Foundation
for the National Institutes of Health, North Bethesda, Md (T.N.K., A.P.);
Regeneron Pharmaceuticals, Inc, Tarrytown, NY (R.A.C.); Department of
Gastroenterology, Virginia Commonwealth University, Richmond, Va (A.J.S.);
Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.E.S.);
and Department of Imaging Alliances, Pfizer, Inc, New York, NY (S.P.S.)
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25
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Schabdach JM, Schmitt JE, Sotardi S, Vossough A, Andronikou S, Roberts TP, Huang H, Padmanabhan V, Ortiz-Rosa A, Gardner M, Covitz S, Bedford SA, Mandal AS, Chaiyachati BH, White SR, Bullmore E, Bethlehem RAI, Shinohara RT, Billot B, Iglesias JE, Ghosh S, Gur RE, Satterthwaite TD, Roalf D, Seidlitz J, Alexander-Bloch A. Brain Growth Charts for Quantitative Analysis of Pediatric Clinical Brain MRI Scans with Limited Imaging Pathology. Radiology 2023; 309:e230096. [PMID: 37906015 PMCID: PMC10623207 DOI: 10.1148/radiol.230096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 08/21/2023] [Accepted: 09/12/2023] [Indexed: 11/02/2023]
Abstract
Background Clinically acquired brain MRI scans represent a valuable but underused resource for investigating neurodevelopment due to their technical heterogeneity and lack of appropriate controls. These barriers have curtailed retrospective studies of clinical brain MRI scans compared with more costly prospectively acquired research-quality brain MRI scans. Purpose To provide a benchmark for neuroanatomic variability in clinically acquired brain MRI scans with limited imaging pathology (SLIPs) and to evaluate if growth charts from curated clinical MRI scans differed from research-quality MRI scans or were influenced by clinical indication for the scan. Materials and Methods In this secondary analysis of preexisting data, clinical brain MRI SLIPs from an urban pediatric health care system (individuals aged ≤22 years) were scanned across nine 3.0-T MRI scanners. The curation process included manual review of signed radiology reports and automated and manual quality review of images without gross pathology. Global and regional volumetric imaging phenotypes were measured using two image segmentation pipelines, and clinical brain growth charts were quantitatively compared with charts derived from a large set of research controls in the same age range by means of Pearson correlation and age at peak volume. Results The curated clinical data set included 532 patients (277 male; median age, 10 years [IQR, 5-14 years]; age range, 28 days after birth to 22 years) scanned between 2005 and 2020. Clinical brain growth charts were highly correlated with growth charts derived from research data sets (22 studies, 8346 individuals [4947 male]; age range, 152 days after birth to 22 years) in terms of normative developmental trajectories predicted by the models (median r = 0.979). Conclusion The clinical indication of the scans did not significantly bias the output of clinical brain charts. Brain growth charts derived from clinical controls with limited imaging pathology were highly correlated with brain charts from research controls, suggesting the potential of curated clinical MRI scans to supplement research data sets. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Ertl-Wagner and Pai in this issue.
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Affiliation(s)
- Jenna M. Schabdach
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - J. Eric Schmitt
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Susan Sotardi
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Arastoo Vossough
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Savvas Andronikou
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Timothy P. Roberts
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Hao Huang
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Viveknarayanan Padmanabhan
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Alfredo Ortiz-Rosa
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Margaret Gardner
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Sydney Covitz
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Saashi A. Bedford
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Ayan S. Mandal
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Barbara H. Chaiyachati
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Simon R. White
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Edward Bullmore
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Richard A. I. Bethlehem
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Russell T. Shinohara
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Benjamin Billot
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - J. Eugenio Iglesias
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Satrajit Ghosh
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Raquel E. Gur
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Theodore D. Satterthwaite
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - David Roalf
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Jakob Seidlitz
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - Aaron Alexander-Bloch
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
| | - for the Lifespan Brain Chart Consortium
- From the Lifespan Brain Institute (LiBI) of the Children’s
Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, Pa (J.M.S.,
A.O.R., M.G., A.S.M., B.H.C., R.E.G., T.D.S., J.S., A.A.B.); Department of Child
and Adolescent Psychiatry and Behavioral Science (J.M.S., J.S., A.A.B.),
Department of Radiology (S.S., A.V., S.A., T.P.R., H.H.), PolicyLab and Clinical
Futures, CHOP Research Institute (B.H.C.), and Department of Biomedical and
Health Informatics (J.E.S., S.S., V.P.), Children’s Hospital of
Philadelphia, Philadelphia, Pa; Department of Psychiatry (J.E.S., R.E.G.,
T.D.S., D.R., J.S., A.A.B.), Department of Radiology (J.E.S., S.S., A.V., S.A.,
T.P.R., H.H.), Lifespan Informatics and Neuroimaging Center (PennLINC),
Department of Psychiatry (S.C., T.D.S.), and Department of Pediatrics (B.H.C.),
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;
Departments of Psychiatry (S.A.B., S.R.W., E.B., R.A.I.B.) and Psychology
(R.A.I.B.), University of Cambridge, Cambridge, United Kingdom; Center for
Biomedical Image Computation and Analytics (R.T.S.), Penn Statistics in Imaging
and Visualization Center, Department of Biostatistics, Epidemiology and
Informatics (R.T.S.), and Lifespan Brain Chart Consortium (S.R.W., E.B.,
R.A.I.B., R.T.S., T.D.S., J.S., A.A.B.), University of Pennsylvania,
Philadelphia, Pa; Centre for Medical Image Computing, Department of Medical
Physics and Biomedical Engineering, University College London, London, United
Kingdom (B.B., J.E.I.); Martinos Center for Biomedical Imaging and Department of
Radiology (J.E.I.) and Department of Otolaryngology–Head and Neck Surgery
(S.G.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass;
and McGovern Institute for Brain Research (S.G.) and Computer Science &
Artificial Intelligence Laboratory (B.B., J.E.I.), Massachusetts Institute of
Technology, Cambridge, Mass
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Savsani E, Shaw CM, Forsberg F, Wessner CE, Lyshchik A, O'Kane P, Liu JB, Balasubramanya R, Roth CG, Naringrekar H, Keith SW, Tan A, Anton K, Bradigan K, Civan J, Schultz S, Shamimi-Noori S, Hunt S, Soulen MC, Mattrey RF, Kono Y, Eisenbrey JR. Contrast-enhanced US Evaluation of Hepatocellular Carcinoma Response to Chemoembolization: A Prospective Multicenter Trial. Radiology 2023; 309:e230727. [PMID: 37847138 PMCID: PMC10623205 DOI: 10.1148/radiol.230727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/04/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023]
Abstract
Background Contrast-enhanced (CE) US has been studied for use in the detection of residual viable hepatocellular carcinoma (HCC) after locoregional therapy, but multicenter data are lacking. Purpose To compare two-dimensional (2D) and three-dimensional (3D) CE US diagnostic performance with that of CE MRI or CT, the current clinical standard, in the detection of residual viable HCC after transarterial chemoembolization (TACE) in a prospective multicenter trial. Materials and Methods Participants aged at least 21 years with US-visible HCC scheduled for TACE were consecutively enrolled at one of three participating academic medical centers from May 2016 to March 2022. Each underwent baseline 2D and 3D CE US before TACE, 2D and 3D CE US 1-2 weeks and/or 4-6 weeks after TACE, and CE MRI or CT 4-6 weeks after TACE. CE US and CE MRI or CT were evaluated by three fellowship-trained radiologists for the presence or absence of viable tumors and were compared with reference standards of pathology (18%), angiography on re-treatment after identification of residual disease at 1-2-month follow-up imaging (31%), 4-8-month CE MRI or CT (42%), or short-term (approximately 1-2 months) CE MRI or CT if clinically decompensated and estimated viability was greater than 50% at imaging (9%). Diagnostic performance criteria, including sensitivity and specificity, were obtained for each modality and time point with generalized estimating equation analysis. Results A total of 132 participants were included (mean age, 64 years ± 7 [SD], 87 male). Sensitivity of 2D CE US 4-6 weeks after TACE was 91% (95% CI: 84, 95), which was higher than that of CE MRI or CT (68%; 95% CI: 58, 76; P < .001). Sensitivity of 3D CE US 4-6 weeks after TACE was 89% (95% CI: 81, 94), which was higher than that of CE MRI or CT (P < .001), with no evidence of a difference from 2D CE US (P = .22). CE MRI or CT had 85% (95% CI: 76, 91) specificity, higher than that of 4-6-week 2D and 3D CE US (70% [95% CI: 56, 80] and 67% [95% CI: 53, 78], respectively; P = .046 and P = .023, respectively). No evidence of differences in any diagnostic criteria were observed between 1-2-week and 4-6-week 2D CE US (P > .21). Conclusion The 2D and 3D CE US examinations 4-6 weeks after TACE revealed higher sensitivity in the detection of residual HCC than CE MRI or CT, albeit with lower specificity. Importantly, CE US performance was independent of follow-up time. Clinical trial registration no. NCT02764801 © RSNA, 2023 Supplemental material is available for this article.
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Affiliation(s)
- Esika Savsani
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Colette M. Shaw
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Flemming Forsberg
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Corinne E. Wessner
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Andrej Lyshchik
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Patrick O'Kane
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Ji-Bin Liu
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Rashmi Balasubramanya
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Christopher G. Roth
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Haresh Naringrekar
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Scott W. Keith
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Allison Tan
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Kevin Anton
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Kristen Bradigan
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Jesse Civan
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Susan Schultz
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Susan Shamimi-Noori
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Stephen Hunt
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Michael C. Soulen
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Robert F. Mattrey
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Yuko Kono
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - John R. Eisenbrey
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
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Adrada BE, Moseley TW, Kapoor MM, Scoggins ME, Patel MM, Perez F, Nia ES, Khazai L, Arribas E, Rauch GM, Guirguis MS. Triple-Negative Breast Cancer: Histopathologic Features, Genomics, and Treatment. Radiographics 2023; 43:e230034. [PMID: 37792593 PMCID: PMC10560981 DOI: 10.1148/rg.230034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/09/2023] [Accepted: 06/01/2023] [Indexed: 10/06/2023]
Abstract
Triple-negative breast cancer (TNBC) is a heterogeneous and aggressive group of tumors that are defined by the absence of estrogen and progesterone receptors and lack of ERBB2 (formerly HER2 or HER2/neu) overexpression. TNBC accounts for 8%-13% of breast cancers. In addition, it accounts for a higher proportion of breast cancers in younger women compared with those in older women, and it disproportionately affects non-Hispanic Black women. TNBC has high metastatic potential, and the risk of recurrence is highest during the 5 years after it is diagnosed. TNBC exhibits benign morphologic imaging features more frequently than do other breast cancer subtypes. Mammography can be suboptimal for early detection of TNBC owing to factors that include the fast growth of this cancer, increased mammographic density in young women, and lack of the typical features of malignancy at imaging. US is superior to mammography for TNBC detection, but benign-appearing features can lead to misdiagnosis. Breast MRI is the most sensitive modality for TNBC detection. Most cases of TNBC are treated with neoadjuvant chemotherapy, followed by surgery and radiation. MRI is the modality of choice for evaluating the response to neoadjuvant chemotherapy. Survival rates for individuals with TNBC are lower than those for persons with hormone receptor-positive and human epidermal growth factor receptor 2-positive cancers. The 5-year survival rates for patients with localized, regional, and distant disease at diagnosis are 91.3%, 65.8%, and 12.0%, respectively. The early success of immunotherapy has raised hope regarding the development of personalized strategies to treat TNBC. Imaging and tumor biomarkers are likely to play a crucial role in the prediction of TNBC treatment response and TNBC patient survival in the future. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Beatriz E. Adrada
- From the Departments of Breast Imaging (B.E.A., T.W.M., M.M.K.,
M.E.S., M.M.P., F.P., E.S.N., E.A., G.M.R., M.S.G.), Breast Surgical Oncology
(T.W.M.), Pathology-Anatomical (L.K.), and Abdominal Imaging (G.M.R.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350,
Houston, TX 77030
| | - Tanya W. Moseley
- From the Departments of Breast Imaging (B.E.A., T.W.M., M.M.K.,
M.E.S., M.M.P., F.P., E.S.N., E.A., G.M.R., M.S.G.), Breast Surgical Oncology
(T.W.M.), Pathology-Anatomical (L.K.), and Abdominal Imaging (G.M.R.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350,
Houston, TX 77030
| | - Megha M. Kapoor
- From the Departments of Breast Imaging (B.E.A., T.W.M., M.M.K.,
M.E.S., M.M.P., F.P., E.S.N., E.A., G.M.R., M.S.G.), Breast Surgical Oncology
(T.W.M.), Pathology-Anatomical (L.K.), and Abdominal Imaging (G.M.R.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350,
Houston, TX 77030
| | - Marion E. Scoggins
- From the Departments of Breast Imaging (B.E.A., T.W.M., M.M.K.,
M.E.S., M.M.P., F.P., E.S.N., E.A., G.M.R., M.S.G.), Breast Surgical Oncology
(T.W.M.), Pathology-Anatomical (L.K.), and Abdominal Imaging (G.M.R.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350,
Houston, TX 77030
| | - Miral M. Patel
- From the Departments of Breast Imaging (B.E.A., T.W.M., M.M.K.,
M.E.S., M.M.P., F.P., E.S.N., E.A., G.M.R., M.S.G.), Breast Surgical Oncology
(T.W.M.), Pathology-Anatomical (L.K.), and Abdominal Imaging (G.M.R.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350,
Houston, TX 77030
| | - Frances Perez
- From the Departments of Breast Imaging (B.E.A., T.W.M., M.M.K.,
M.E.S., M.M.P., F.P., E.S.N., E.A., G.M.R., M.S.G.), Breast Surgical Oncology
(T.W.M.), Pathology-Anatomical (L.K.), and Abdominal Imaging (G.M.R.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350,
Houston, TX 77030
| | - Emily S. Nia
- From the Departments of Breast Imaging (B.E.A., T.W.M., M.M.K.,
M.E.S., M.M.P., F.P., E.S.N., E.A., G.M.R., M.S.G.), Breast Surgical Oncology
(T.W.M.), Pathology-Anatomical (L.K.), and Abdominal Imaging (G.M.R.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350,
Houston, TX 77030
| | - Laila Khazai
- From the Departments of Breast Imaging (B.E.A., T.W.M., M.M.K.,
M.E.S., M.M.P., F.P., E.S.N., E.A., G.M.R., M.S.G.), Breast Surgical Oncology
(T.W.M.), Pathology-Anatomical (L.K.), and Abdominal Imaging (G.M.R.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350,
Houston, TX 77030
| | - Elsa Arribas
- From the Departments of Breast Imaging (B.E.A., T.W.M., M.M.K.,
M.E.S., M.M.P., F.P., E.S.N., E.A., G.M.R., M.S.G.), Breast Surgical Oncology
(T.W.M.), Pathology-Anatomical (L.K.), and Abdominal Imaging (G.M.R.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350,
Houston, TX 77030
| | - Gaiane M. Rauch
- From the Departments of Breast Imaging (B.E.A., T.W.M., M.M.K.,
M.E.S., M.M.P., F.P., E.S.N., E.A., G.M.R., M.S.G.), Breast Surgical Oncology
(T.W.M.), Pathology-Anatomical (L.K.), and Abdominal Imaging (G.M.R.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350,
Houston, TX 77030
| | - Mary S. Guirguis
- From the Departments of Breast Imaging (B.E.A., T.W.M., M.M.K.,
M.E.S., M.M.P., F.P., E.S.N., E.A., G.M.R., M.S.G.), Breast Surgical Oncology
(T.W.M.), Pathology-Anatomical (L.K.), and Abdominal Imaging (G.M.R.), The
University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350,
Houston, TX 77030
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28
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Lew CO, Zhou L, Mazurowski MA, Doraiswamy PM, Petrella JR. MRI-based Deep Learning Assessment of Amyloid, Tau, and Neurodegeneration Biomarker Status across the Alzheimer Disease Spectrum. Radiology 2023; 309:e222441. [PMID: 37815445 PMCID: PMC10623183 DOI: 10.1148/radiol.222441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 09/03/2023] [Accepted: 09/11/2023] [Indexed: 10/11/2023]
Abstract
Background PET can be used for amyloid-tau-neurodegeneration (ATN) classification in Alzheimer disease, but incurs considerable cost and exposure to ionizing radiation. MRI currently has limited use in characterizing ATN status. Deep learning techniques can detect complex patterns in MRI data and have potential for noninvasive characterization of ATN status. Purpose To use deep learning to predict PET-determined ATN biomarker status using MRI and readily available diagnostic data. Materials and Methods MRI and PET data were retrospectively collected from the Alzheimer's Disease Imaging Initiative. PET scans were paired with MRI scans acquired within 30 days, from August 2005 to September 2020. Pairs were randomly split into subsets as follows: 70% for training, 10% for validation, and 20% for final testing. A bimodal Gaussian mixture model was used to threshold PET scans into positive and negative labels. MRI data were fed into a convolutional neural network to generate imaging features. These features were combined in a logistic regression model with patient demographics, APOE gene status, cognitive scores, hippocampal volumes, and clinical diagnoses to classify each ATN biomarker component as positive or negative. Area under the receiver operating characteristic curve (AUC) analysis was used for model evaluation. Feature importance was derived from model coefficients and gradients. Results There were 2099 amyloid (mean patient age, 75 years ± 10 [SD]; 1110 male), 557 tau (mean patient age, 75 years ± 7; 280 male), and 2768 FDG PET (mean patient age, 75 years ± 7; 1645 male) and MRI pairs. Model AUCs for the test set were as follows: amyloid, 0.79 (95% CI: 0.74, 0.83); tau, 0.73 (95% CI: 0.58, 0.86); and neurodegeneration, 0.86 (95% CI: 0.83, 0.89). Within the networks, high gradients were present in key temporal, parietal, frontal, and occipital cortical regions. Model coefficients for cognitive scores, hippocampal volumes, and APOE status were highest. Conclusion A deep learning algorithm predicted each component of PET-determined ATN status with acceptable to excellent efficacy using MRI and other available diagnostic data. © RSNA, 2023 Supplemental material is available for this article.
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Affiliation(s)
- Christopher O. Lew
- From the Department of Radiology, Division of Neuroradiology,
Alzheimer Disease Imaging Research Laboratory (C.O.L., J.R.P.), and
Neurocognitive Disorders Program, Departments of Psychiatry and Medicine
(P.M.D.), Duke University Medical Center, DUMC-Box 3808, Durham, NC 27710-3808;
and Duke Institute for Brain Sciences (P.M.D.) and Department of Electrical and
Computer Engineering, Department of Computer Science, Department of
Biostatistics and Bioinformatics (L.Z., M.A.M.), Duke University, Durham,
NC
| | - Longfei Zhou
- From the Department of Radiology, Division of Neuroradiology,
Alzheimer Disease Imaging Research Laboratory (C.O.L., J.R.P.), and
Neurocognitive Disorders Program, Departments of Psychiatry and Medicine
(P.M.D.), Duke University Medical Center, DUMC-Box 3808, Durham, NC 27710-3808;
and Duke Institute for Brain Sciences (P.M.D.) and Department of Electrical and
Computer Engineering, Department of Computer Science, Department of
Biostatistics and Bioinformatics (L.Z., M.A.M.), Duke University, Durham,
NC
| | - Maciej A. Mazurowski
- From the Department of Radiology, Division of Neuroradiology,
Alzheimer Disease Imaging Research Laboratory (C.O.L., J.R.P.), and
Neurocognitive Disorders Program, Departments of Psychiatry and Medicine
(P.M.D.), Duke University Medical Center, DUMC-Box 3808, Durham, NC 27710-3808;
and Duke Institute for Brain Sciences (P.M.D.) and Department of Electrical and
Computer Engineering, Department of Computer Science, Department of
Biostatistics and Bioinformatics (L.Z., M.A.M.), Duke University, Durham,
NC
| | - P. Murali Doraiswamy
- From the Department of Radiology, Division of Neuroradiology,
Alzheimer Disease Imaging Research Laboratory (C.O.L., J.R.P.), and
Neurocognitive Disorders Program, Departments of Psychiatry and Medicine
(P.M.D.), Duke University Medical Center, DUMC-Box 3808, Durham, NC 27710-3808;
and Duke Institute for Brain Sciences (P.M.D.) and Department of Electrical and
Computer Engineering, Department of Computer Science, Department of
Biostatistics and Bioinformatics (L.Z., M.A.M.), Duke University, Durham,
NC
| | - Jeffrey R. Petrella
- From the Department of Radiology, Division of Neuroradiology,
Alzheimer Disease Imaging Research Laboratory (C.O.L., J.R.P.), and
Neurocognitive Disorders Program, Departments of Psychiatry and Medicine
(P.M.D.), Duke University Medical Center, DUMC-Box 3808, Durham, NC 27710-3808;
and Duke Institute for Brain Sciences (P.M.D.) and Department of Electrical and
Computer Engineering, Department of Computer Science, Department of
Biostatistics and Bioinformatics (L.Z., M.A.M.), Duke University, Durham,
NC
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Pasquini L, Peck KK, Jenabi M, Holodny A. Functional MRI in Neuro-Oncology: State of the Art and Future Directions. Radiology 2023; 308:e222028. [PMID: 37668519 PMCID: PMC10546288 DOI: 10.1148/radiol.222028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 05/15/2023] [Accepted: 05/26/2023] [Indexed: 09/06/2023]
Abstract
Since its discovery in the early 1990s, functional MRI (fMRI) has been used to study human brain function. One well-established application of fMRI in the clinical setting is the neurosurgical planning of patients with brain tumors near eloquent cortical areas. Clinical fMRI aims to preoperatively identify eloquent cortices that serve essential functions in daily life, such as hand movement and language. The primary goal of neurosurgery is to maximize tumor resection while sparing eloquent cortices adjacent to the tumor. When a lesion presents in the vicinity of an eloquent cortex, surgeons may use fMRI to plan their best surgical approach by determining the proximity of the lesion to regions of activation, providing guidance for awake brain surgery and intraoperative brain mapping. The acquisition of fMRI requires patient preparation prior to imaging, determination of functional paradigms, monitoring of patient performance, and both processing and analysis of images. Interpretation of fMRI maps requires a strong understanding of functional neuroanatomy and familiarity with the technical limitations frequently present in brain tumor imaging, including neurovascular uncoupling, patient compliance, and data analysis. This review discusses clinical fMRI in neuro-oncology, relevant ongoing research topics, and prospective future developments in this exciting discipline.
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Affiliation(s)
- Luca Pasquini
- From the Neuroradiology Service, Department of Radiology (L.P.,
K.K.P., M.J., A.H.), Department of Medical Physics (K.K.P.), and Brain Tumor
Center (A.H.), Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York,
NY 10065; Neuroradiology Unit, NESMOS Department, Sant'Andrea Hospital,
La Sapienza University, Rome, Italy (L.P.); Department of Radiology, Weill
Medical College of Cornell University, New York, NY (A.H.); and Department of
Neuroscience, Weill Cornell Medicine Graduate School of Medical Sciences, New
York, NY (A.H.)
| | - Kyung K. Peck
- From the Neuroradiology Service, Department of Radiology (L.P.,
K.K.P., M.J., A.H.), Department of Medical Physics (K.K.P.), and Brain Tumor
Center (A.H.), Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York,
NY 10065; Neuroradiology Unit, NESMOS Department, Sant'Andrea Hospital,
La Sapienza University, Rome, Italy (L.P.); Department of Radiology, Weill
Medical College of Cornell University, New York, NY (A.H.); and Department of
Neuroscience, Weill Cornell Medicine Graduate School of Medical Sciences, New
York, NY (A.H.)
| | - Mehrnaz Jenabi
- From the Neuroradiology Service, Department of Radiology (L.P.,
K.K.P., M.J., A.H.), Department of Medical Physics (K.K.P.), and Brain Tumor
Center (A.H.), Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York,
NY 10065; Neuroradiology Unit, NESMOS Department, Sant'Andrea Hospital,
La Sapienza University, Rome, Italy (L.P.); Department of Radiology, Weill
Medical College of Cornell University, New York, NY (A.H.); and Department of
Neuroscience, Weill Cornell Medicine Graduate School of Medical Sciences, New
York, NY (A.H.)
| | - Andrei Holodny
- From the Neuroradiology Service, Department of Radiology (L.P.,
K.K.P., M.J., A.H.), Department of Medical Physics (K.K.P.), and Brain Tumor
Center (A.H.), Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York,
NY 10065; Neuroradiology Unit, NESMOS Department, Sant'Andrea Hospital,
La Sapienza University, Rome, Italy (L.P.); Department of Radiology, Weill
Medical College of Cornell University, New York, NY (A.H.); and Department of
Neuroscience, Weill Cornell Medicine Graduate School of Medical Sciences, New
York, NY (A.H.)
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30
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Isikbay M, Carrodeguas E, Tatem A, Cha S. Challenges of Preparing for Diagnostic Radiology Call. Radiology 2023; 308:e230421. [PMID: 37724966 PMCID: PMC10546280 DOI: 10.1148/radiol.230421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 09/21/2023]
Affiliation(s)
- Masis Isikbay
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA
94143
| | - Emmanuel Carrodeguas
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA
94143
| | - Alexia Tatem
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA
94143
| | - Soonmee Cha
- From the Department of Radiology and Biomedical Imaging, University
of California San Francisco, 505 Parnassus Ave, M-396, San Francisco, CA
94143
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31
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Gottumukkala RV, Lee LK, Tu W, Tempany CM, Fennessy FM. Local Staging of Prostate Cancer at MRI: What the Urologist and Radiation Oncologist Want to Know. Radiographics 2023; 43:e220100. [PMID: 37561642 PMCID: PMC10506065 DOI: 10.1148/rg.220100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 03/02/2023] [Accepted: 03/14/2023] [Indexed: 08/12/2023]
Abstract
This slide presentation provides an overview of prostate cancer risk stratification and management, reviews key anatomic and imaging principles pertaining to local staging of prostate cancer, and highlights inflection points where MRI findings regarding local staging may modify clinical management.
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Affiliation(s)
- Ravi V. Gottumukkala
- From the Department of Radiology, Brigham and Women’s
Hospital, 75 Francis St, Boston, MA 02115 (R.V.G, L.K.L., C.M.T., F.M.F); and
Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton,
Alberta, Canada (W.T.)
| | - Leslie K. Lee
- From the Department of Radiology, Brigham and Women’s
Hospital, 75 Francis St, Boston, MA 02115 (R.V.G, L.K.L., C.M.T., F.M.F); and
Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton,
Alberta, Canada (W.T.)
| | - Wendy Tu
- From the Department of Radiology, Brigham and Women’s
Hospital, 75 Francis St, Boston, MA 02115 (R.V.G, L.K.L., C.M.T., F.M.F); and
Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton,
Alberta, Canada (W.T.)
| | - Clare M. Tempany
- From the Department of Radiology, Brigham and Women’s
Hospital, 75 Francis St, Boston, MA 02115 (R.V.G, L.K.L., C.M.T., F.M.F); and
Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton,
Alberta, Canada (W.T.)
| | - Fiona M. Fennessy
- From the Department of Radiology, Brigham and Women’s
Hospital, 75 Francis St, Boston, MA 02115 (R.V.G, L.K.L., C.M.T., F.M.F); and
Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton,
Alberta, Canada (W.T.)
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32
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Lin HM, Colak E, Richards T, Kitamura FC, Prevedello LM, Talbott J, Ball RL, Gumeler E, Yeom KW, Hamghalam M, Simpson AL, Strika J, Bulja D, Angkurawaranon S, Pérez-Lara A, Gómez-Alonso MI, Ortiz Jiménez J, Peoples JJ, Law M, Dogan H, Altinmakas E, Youssef A, Mahfouz Y, Kalpathy-Cramer J, Flanders AE. The RSNA Cervical Spine Fracture CT Dataset. Radiol Artif Intell 2023; 5:e230034. [PMID: 37795143 PMCID: PMC10546361 DOI: 10.1148/ryai.230034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/17/2023] [Accepted: 08/10/2023] [Indexed: 10/06/2023]
Abstract
This dataset is composed of cervical spine CT images with annotations related to fractures; it is available at https://www.kaggle.com/competitions/rsna-2022-cervical-spine-fracture-detection/.
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Affiliation(s)
- Hui Ming Lin
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Errol Colak
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Tyler Richards
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Felipe C. Kitamura
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Luciano M. Prevedello
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Jason Talbott
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Robyn L. Ball
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Ekim Gumeler
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Kristen W. Yeom
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Mohammad Hamghalam
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Amber L. Simpson
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Jasna Strika
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Deniz Bulja
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Salita Angkurawaranon
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Almudena Pérez-Lara
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - María Isabel Gómez-Alonso
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Johanna Ortiz Jiménez
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Jacob J. Peoples
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Meng Law
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Hakan Dogan
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Emre Altinmakas
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Ayda Youssef
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Yasser Mahfouz
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Jayashree Kalpathy-Cramer
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
| | - Adam E. Flanders
- From the Department of Medical Imaging, St Michael’s Hospital,
Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8 (H.M.L., E.C.);
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
(E.C.); Department of Radiology and Imaging Sciences, University of Utah, Salt
Lake City, Utah (T.R.); Dasa, Universidade Federal de São Paulo
(Unifesp), São Paulo, Brazil (F.C.K.); Department of Radiology, The Ohio
State University, Columbus, Ohio (L.M.P.); Department of Radiology and
Biomedical Imaging, University of California, San Francisco, San Francisco,
Calif (J.T.); The Jackson Laboratory, Bar Harbor, Maine (R.L.B.); Department of
Radiology, Hacettepe University, Ankara, Turkey (E.G.); Standard School of
Medicine, Stanford University, Stanford, Calif (K.W.Y.); School of Computing
(M.H., A.L.S., J.J.P.), Department of Biomedical and Molecular Sciences
(A.L.S.), and Department of Diagnostic Radiology (J.O.J.), Queen’s
University, Kingston, Ontario, Canada; Department of Biomedical Engineering,
Qazvin Branch, Islamic Azad University, Qazin, Iran (M.H.); Department of
Radiology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina (J.S.);
Clinic of Radiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia
and Herzegovina (D.B.); Department of Radiology, Chiang Mai University, Chiang
Mai, Thailand (S.A.); Department of Radiology, Hospital Regional Universitario
de Málaga, Málaga, Spain (A.P.L.); Department of Radiology,
Hospital Quirónsalud Málaga, Málaga, Spain (M.I.G.A.);
Department of Radiology and Nuclear Medicine, Alfred Health, Monash University,
Melbourne, Australia (M.L.); Department of Radiology, Koç University
School of Medicine, Istanbul, Turkey (H.D., E.A.); Department of Diagnostic,
Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai,
New York, NY (E.A.); Department of Radiology, National Cancer Institute, Cairo
University, Cairo, Egypt (A.Y.); Department of Radiology, Sultan Qaboos
University Hospital, Muscat, Oman (Y.M.); Department of Ophthalmology,
University of Colorado Anschutz Medical Campus, Aurora, Colo (J.K.C.);
Department of Radiology and Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, Mass (J.K.C.); and Department of
Radiology, Division of Neuroradiology, Thomas Jefferson University,
Philadelphia, Pa (A.E.F.)
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Lawson MB, Partridge SC, Hippe DS, Rahbar H, Lam DL, Lee CI, Lowry KP, Scheel JR, Parsian S, Li I, Biswas D, Bryant ML, Lee JM. Comparative Performance of Contrast-enhanced Mammography, Abbreviated Breast MRI, and Standard Breast MRI for Breast Cancer Screening. Radiology 2023; 308:e230576. [PMID: 37581498 PMCID: PMC10481328 DOI: 10.1148/radiol.230576] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 08/16/2023]
Abstract
Background Contrast-enhanced mammography (CEM) and abbreviated breast MRI (ABMRI) are emerging alternatives to standard MRI for supplemental breast cancer screening. Purpose To compare the diagnostic performance of CEM, ABMRI, and standard MRI. Materials and Methods This single-institution, prospective, blinded reader study included female participants referred for breast MRI from January 2018 to June 2021. CEM was performed within 14 days of standard MRI; ABMRI was produced from standard MRI images. Two readers independently interpreted each CEM and ABMRI after a washout period. Examination-level performance metrics calculated were recall rate, cancer detection, and false-positive biopsy recommendation rates per 1000 examinations and sensitivity, specificity, and positive predictive value of biopsy recommendation. Bootstrap and permutation tests were used to calculate 95% CIs and compare modalities. Results Evaluated were 492 paired CEM and ABMRI interpretations from 246 participants (median age, 51 years; IQR, 43-61 years). On 49 MRI scans with lesions recommended for biopsy, nine lesions showed malignant pathology. No differences in ABMRI and standard MRI performance were identified. Compared with standard MRI, CEM demonstrated significantly lower recall rate (14.0% vs 22.8%; difference, -8.7%; 95% CI: -14.0, -3.5), lower false-positive biopsy recommendation rate per 1000 examinations (65.0 vs 162.6; difference, -97.6; 95% CI: -146.3, -50.8), and higher specificity (87.8% vs 80.2%; difference, 7.6%; 95% CI: 2.3, 13.1). Compared with standard MRI, CEM had significantly lower cancer detection rate (22.4 vs 36.6; difference, -14.2; 95% CI: -28.5, -2.0) and sensitivity (61.1% vs 100%; difference, -38.9%; 95% CI: -66.7, -12.5). The performance differences between CEM and ABMRI were similar to those observed between CEM and standard MRI. Conclusion ABMRI had comparable performance to standard MRI and may support more efficient MRI screening. CEM had lower recall and higher specificity compared with standard MRI or ABMRI, offset by lower cancer detection rate and sensitivity compared with standard MRI. These trade-offs warrant further consideration of patient population characteristics before widespread screening with CEM. Clinical trial registration no. NCT03517813 © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Chang in this issue.
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Affiliation(s)
- Marissa B. Lawson
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - Savannah C. Partridge
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - Daniel S. Hippe
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - Habib Rahbar
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - Diana L. Lam
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - Christoph I. Lee
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - Kathryn P. Lowry
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - John R. Scheel
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - Sana Parsian
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - Isabella Li
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - Debosmita Biswas
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - Mary Lynn Bryant
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
| | - Janie M. Lee
- From the Department of Radiology, University of Washington, Seattle,
Wash (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L., D.B., M.L.B., J.M.L.);
Department of Radiology (M.B.L., S.C.P., H.R., D.L.L., C.I.L., K.P.L., I.L.,
D.B., M.L.B., J.M.L.) and Clinical Research Division (D.S.H.), Fred Hutchinson
Cancer Center, 825 Eastlake Eve E, LG-200, Seattle, WA 98109; Department of
Radiology, Vanderbilt University, Nashville, Tenn (J.R.S.); and Department of
Radiology, Kaiser Permanente, Seattle, Wash (S.P.)
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Bird E, Hasenstab K, Kim N, Madani M, Malhotra A, Hahn L, Kligerman S, Hsiao A, Contijoch F. Mapping the Spatial Extent of Hypoperfusion in Chronic Thromboembolic Pulmonary Hypertension Using Multienergy CT. Radiol Cardiothorac Imaging 2023; 5:e220221. [PMID: 37693197 PMCID: PMC10483250 DOI: 10.1148/ryct.220221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 06/05/2023] [Accepted: 07/03/2023] [Indexed: 09/12/2023]
Abstract
Purpose To assess if a novel automated method to spatially delineate and quantify the extent of hypoperfusion on multienergy CT angiograms can aid the evaluation of chronic thromboembolic pulmonary hypertension (CTEPH) disease severity. Materials and Methods Multienergy CT angiograms obtained between January 2018 and December 2020 in 51 patients with CTEPH (mean age, 47 years ± 17 [SD]; 27 women) were retrospectively compared with those in 110 controls with no imaging findings suggestive of pulmonary vascular abnormalities (mean age, 51 years ± 16; 81 women). Parenchymal iodine values were automatically isolated using deep learning lobar lung segmentations. Low iodine concentration was used to delineate areas of hypoperfusion and calculate hypoperfused lung volume (HLV). Receiver operating characteristic curves, correlations with preoperative and postoperative changes in invasive hemodynamics, and comparison with visual assessment of lobar hypoperfusion by two expert readers were evaluated. Results Global HLV correctly separated patients with CTEPH from controls (area under the receiver operating characteristic curve = 0.84; 10% HLV cutoff: 90% sensitivity, 72% accuracy, and 64% specificity) and correlated moderately with hemodynamic severity at time of imaging (pulmonary vascular resistance [PVR], ρ = 0.67; P < .001) and change after surgical treatment (∆PVR, ρ = -0.61; P < .001). In patients surgically classified as having segmental disease, global HLV correlated with preoperative PVR (ρ = 0.81) and postoperative ∆PVR (ρ = -0.70). Lobar HLV correlated moderately with expert reader lobar assessment (ρHLV = 0.71 for reader 1; ρHLV = 0.67 for reader 2). Conclusion Automated quantification of hypoperfused areas in patients with CTEPH can be performed from clinical multienergy CT examinations and may aid clinical evaluation, particularly in patients with segmental-level disease.Keywords: CT-Spectral Imaging (Multienergy), Pulmonary, Pulmonary Arteries, Embolism/Thrombosis, Chronic Thromboembolic Pulmonary Hypertension, Multienergy CT, Hypoperfusion© RSNA, 2023.
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Affiliation(s)
- Elizabeth Bird
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Kyle Hasenstab
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Nick Kim
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Michael Madani
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Atul Malhotra
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Lewis Hahn
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Seth Kligerman
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Albert Hsiao
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
| | - Francisco Contijoch
- From the Department of Bioengineering (E.B., A.H., F.C.), Department
of Radiology (K.H., L.H., S.K., A.H., F.C.), Department of Medicine, Division of
Pulmonary, Critical Care, and Sleep Medicine (N.K., A.M.), and Department of
Surgery (M.M.), University of California San Diego, 9500 Gilman Dr, MC 0412, La
Jolla, CA 92093
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Suri A, Tang S, Kargilis D, Taratuta E, Kneeland BJ, Choi G, Agarwal A, Anabaraonye N, Xu W, Parente JB, Terry A, Kalluri A, Song K, Rajapakse CS. Conquering the Cobb Angle: A Deep Learning Algorithm for Automated, Hardware-Invariant Measurement of Cobb Angle on Radiographs in Patients with Scoliosis. Radiol Artif Intell 2023; 5:e220158. [PMID: 37529207 PMCID: PMC10388214 DOI: 10.1148/ryai.220158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 05/16/2023] [Accepted: 06/05/2023] [Indexed: 08/03/2023]
Abstract
Scoliosis is a disease estimated to affect more than 8% of adults in the United States. It is diagnosed with use of radiography by means of manual measurement of the angle between maximally tilted vertebrae on a radiograph (ie, the Cobb angle). However, these measurements are time-consuming, limiting their use in scoliosis surgical planning and postoperative monitoring. In this retrospective study, a pipeline (using the SpineTK architecture) was developed that was trained, validated, and tested on 1310 anterior-posterior images obtained with a low-dose stereoradiographic scanning system and radiographs obtained in patients with suspected scoliosis to automatically measure Cobb angles. The images were obtained at six centers (2005-2020). The algorithm measured Cobb angles on hold-out internal (n = 460) and external (n = 161) test sets with less than 2° error (intraclass correlation coefficient, 0.96) compared with ground truth measurements by two experienced radiologists. Measurements, produced in less than 0.5 second, did not differ significantly (P = .05 cutoff) from ground truth measurements, regardless of the presence or absence of surgical hardware (P = .80), age (P = .58), sex (P = .83), body mass index (P = .63), scoliosis severity (P = .44), or image type (low-dose stereoradiographic image vs radiograph; P = .51) in the patient. These findings suggest that the algorithm is highly robust across different clinical characteristics. Given its automated, rapid, and accurate measurements, this network may be used for monitoring scoliosis progression in patients. Keywords: Cobb Angle, Convolutional Neural Network, Deep Learning Algorithms, Pediatrics, Machine Learning Algorithms, Scoliosis, Spine Supplemental material is available for this article. © RSNA, 2023.
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Onishi N, Bareng TJ, Gibbs J, Li W, Price ER, Joe BN, Kornak J, Esserman LJ, Newitt DC, Hylton NM. Effect of Longitudinal Variation in Tumor Volume Estimation for MRI-guided Personalization of Breast Cancer Neoadjuvant Treatment. Radiol Imaging Cancer 2023; 5:e220126. [PMID: 37505107 PMCID: PMC10413289 DOI: 10.1148/rycan.220126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 05/02/2023] [Accepted: 06/03/2023] [Indexed: 07/29/2023]
Abstract
Purpose To investigate the impact of longitudinal variation in functional tumor volume (FTV) underestimation and overestimation in predicting pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC). Materials and Methods Women with breast cancer who were enrolled in the prospective I-SPY 2 TRIAL (Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging and Molecular Analysis 2) from May 2010 to November 2016 were eligible for this retrospective analysis. Participants underwent four MRI examinations during NAC treatment. FTV was calculated based on automated segmentation. Baseline FTV before treatment (FTV0) and the percentage of FTV change at early treatment and inter-regimen time points relative to baseline (∆FTV1 and ∆FTV2, respectively) were classified into high-standard or standard groups based on visual assessment of FTV under- and overestimation. Logistic regression models predicting pCR using single predictors (FTV0, ∆FTV1, and ∆FTV2) and multiple predictors (all three) were developed using bootstrap resampling with out-of-sample data evaluation with the area under the receiver operating characteristic curve (AUC) independently in each group. Results This study included 432 women (mean age, 49.0 years ± 10.6 [SD]). In the FTV0 model, the high-standard and standard groups showed similar AUCs (0.61 vs 0.62). The high-standard group had a higher estimated AUC compared with the standard group in the ∆FTV1 (0.74 vs 0.63), ∆FTV2 (0.79 vs 0.62), and multiple predictor models (0.85 vs 0.64), with a statistically significant difference for the latter two models (P = .03 and P = .01, respectively). Conclusion The findings in this study suggest that longitudinal variation in FTV estimation needs to be considered when using early FTV change as an MRI-based criterion for breast cancer treatment personalization. Keywords: Breast, Cancer, Dynamic Contrast-enhanced, MRI, Tumor Response ClinicalTrials.gov registration no. NCT01042379 Supplemental material is available for this article. © RSNA, 2023 See also the commentary by Ram in this issue.
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Affiliation(s)
| | | | - Jessica Gibbs
- From the Department of Radiology and Biomedical Imaging (N.O.,
T.J.B., J.G., W.L., E.R.P., B.N.J., D.C.N., N.M.H.), Department of Epidemiology
and Biostatistics (J.K.), and Department of Surgery (L.J.E.), University of
California San Francisco, 550 16th Street, San Francisco, CA 94158
| | - Wen Li
- From the Department of Radiology and Biomedical Imaging (N.O.,
T.J.B., J.G., W.L., E.R.P., B.N.J., D.C.N., N.M.H.), Department of Epidemiology
and Biostatistics (J.K.), and Department of Surgery (L.J.E.), University of
California San Francisco, 550 16th Street, San Francisco, CA 94158
| | - Elissa R. Price
- From the Department of Radiology and Biomedical Imaging (N.O.,
T.J.B., J.G., W.L., E.R.P., B.N.J., D.C.N., N.M.H.), Department of Epidemiology
and Biostatistics (J.K.), and Department of Surgery (L.J.E.), University of
California San Francisco, 550 16th Street, San Francisco, CA 94158
| | - Bonnie N. Joe
- From the Department of Radiology and Biomedical Imaging (N.O.,
T.J.B., J.G., W.L., E.R.P., B.N.J., D.C.N., N.M.H.), Department of Epidemiology
and Biostatistics (J.K.), and Department of Surgery (L.J.E.), University of
California San Francisco, 550 16th Street, San Francisco, CA 94158
| | - John Kornak
- From the Department of Radiology and Biomedical Imaging (N.O.,
T.J.B., J.G., W.L., E.R.P., B.N.J., D.C.N., N.M.H.), Department of Epidemiology
and Biostatistics (J.K.), and Department of Surgery (L.J.E.), University of
California San Francisco, 550 16th Street, San Francisco, CA 94158
| | - Laura J. Esserman
- From the Department of Radiology and Biomedical Imaging (N.O.,
T.J.B., J.G., W.L., E.R.P., B.N.J., D.C.N., N.M.H.), Department of Epidemiology
and Biostatistics (J.K.), and Department of Surgery (L.J.E.), University of
California San Francisco, 550 16th Street, San Francisco, CA 94158
| | - David C. Newitt
- From the Department of Radiology and Biomedical Imaging (N.O.,
T.J.B., J.G., W.L., E.R.P., B.N.J., D.C.N., N.M.H.), Department of Epidemiology
and Biostatistics (J.K.), and Department of Surgery (L.J.E.), University of
California San Francisco, 550 16th Street, San Francisco, CA 94158
| | - Nola M. Hylton
- From the Department of Radiology and Biomedical Imaging (N.O.,
T.J.B., J.G., W.L., E.R.P., B.N.J., D.C.N., N.M.H.), Department of Epidemiology
and Biostatistics (J.K.), and Department of Surgery (L.J.E.), University of
California San Francisco, 550 16th Street, San Francisco, CA 94158
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Pedrosa I. Invited Commentary: MRI Clear Cell Likelihood Score for Indeterminate Solid Renal Masses: Is There a Path for Broad Clinical Adoption? Radiographics 2023; 43:e230042. [PMID: 37319027 PMCID: PMC10323227 DOI: 10.1148/rg.230042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Ivan Pedrosa
- From the Department of Radiology, University of Texas Southwestern
Medical Center, 2201 Inwood Rd, 2nd Floor, Ste 202, Dallas, TX 75390-9085
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Hwang KP, Elshafeey NA, Kotrotsou A, Chen H, Son JB, Boge M, Mohamed RM, Abdelhafez AH, Adrada BE, Panthi B, Sun J, Musall BC, Zhang S, Candelaria RP, White JB, Ravenberg EE, Tripathy D, Yam C, Litton JK, Huo L, Thompson AM, Wei P, Yang WT, Pagel MD, Ma J, Rauch GM. A Radiomics Model Based on Synthetic MRI Acquisition for Predicting Neoadjuvant Systemic Treatment Response in Triple-Negative Breast Cancer. Radiol Imaging Cancer 2023; 5:e230009. [PMID: 37505106 PMCID: PMC10413296 DOI: 10.1148/rycan.230009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/18/2023] [Accepted: 06/03/2023] [Indexed: 07/29/2023]
Abstract
Purpose To determine if a radiomics model based on quantitative maps acquired with synthetic MRI (SyMRI) is useful for predicting neoadjuvant systemic therapy (NAST) response in triple-negative breast cancer (TNBC). Materials and Methods In this prospective study, 181 women diagnosed with stage I-III TNBC were scanned with a SyMRI sequence at baseline and at midtreatment (after four cycles of NAST), producing T1, T2, and proton density (PD) maps. Histopathologic analysis at surgery was used to determine pathologic complete response (pCR) or non-pCR status. From three-dimensional tumor contours drawn on the three maps, 310 histogram and textural features were extracted, resulting in 930 features per scan. Radiomic features were compared between pCR and non-pCR groups by using Wilcoxon rank sum test. To build a multivariable predictive model, logistic regression with elastic net regularization and cross-validation was performed for texture feature selection using 119 participants (median age, 52 years [range, 26-77 years]). An independent testing cohort of 62 participants (median age, 48 years [range, 23-74 years]) was used to evaluate and compare the models by area under the receiver operating characteristic curve (AUC). Results Univariable analysis identified 15 T1, 10 T2, and 12 PD radiomic features at midtreatment that predicted pCR with an AUC greater than 0.70 in both the training and testing cohorts. Multivariable radiomics models of maps acquired at midtreatment demonstrated superior performance over those acquired at baseline, achieving AUCs as high as 0.78 and 0.72 in the training and testing cohorts, respectively. Conclusion SyMRI-based radiomic features acquired at midtreatment are potentially useful for identifying early NAST responders in TNBC. Keywords: MR Imaging, Breast, Outcomes Analysis ClinicalTrials.gov registration no. NCT02276443 Supplemental material is available for this article. © RSNA, 2023 See also the commentary by Houser and Rapelyea in this issue.
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Affiliation(s)
- Ken-Pin Hwang
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Nabil A. Elshafeey
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Aikaterini Kotrotsou
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Huiqin Chen
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Jong Bum Son
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Medine Boge
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Rania M. Mohamed
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Abeer H. Abdelhafez
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Beatriz E. Adrada
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Bikash Panthi
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Jia Sun
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Benjamin C. Musall
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Shu Zhang
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Rosalind P. Candelaria
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Jason B. White
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Elizabeth E. Ravenberg
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Debu Tripathy
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Clinton Yam
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Jennifer K. Litton
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Lei Huo
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Alastair M. Thompson
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Peng Wei
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Wei T. Yang
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Mark D. Pagel
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Jingfei Ma
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
| | - Gaiane M. Rauch
- From the Departments of Imaging Physics (K.P.H., A.K., J.B.S., B.P.,
B.C.M., J.M.), Breast Imaging (N.A.E., M.B., R.M.M., A.H.A., B.E.A., R.P.C.,
W.T.Y., G.M.R.), Biostatistics (H.C., J.S., P.W.), Cancer Systems Imaging (S.Z.,
M.D.P.), Moon Shots Operations (J.B.W.), Breast Medical Oncology (E.E.R., D.T.,
C.Y.), Clinical Research (J.K.L.), Pathology (L.H.), and Abdominal Imaging
(G.M.R.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd,
Houston, TX 77030; and Division of Surgical Oncology, Baylor College of
Medicine, Houston, Tex (A.M.T.)
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Parkins KM, Krishnamachary B, Jacob D, Kakkad SM, Solaiyappan M, Mishra A, Mironchik Y, Penet MF, McMahon MT, Knopf P, Pichler BJ, Nimmagadda S, Bhujwalla ZM. PET/MRI and Bioluminescent Imaging Identify Hypoxia as a Cause of Programmed Cell Death Ligand 1 Image Heterogeneity. Radiol Imaging Cancer 2023; 5:e220138. [PMID: 37389448 PMCID: PMC10413302 DOI: 10.1148/rycan.220138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/17/2023] [Accepted: 04/24/2023] [Indexed: 07/01/2023]
Abstract
Purpose To examine the association between hypoxia and programmed cell death ligand 1 (PD-L1) expression using bioluminescence imaging (BLI) and PET/MRI in a syngeneic mouse model of triple-negative breast cancer (TNBC). Materials and Methods PET/MRI and optical imaging were used to determine the role of hypoxia in altering PD-L1 expression using a syngeneic TNBC model engineered to express luciferase under hypoxia. Results Imaging showed a close spatial association between areas of hypoxia and increased PD-L1 expression in the syngeneic murine (4T1) tumor model. Mouse and human TNBC cells exposed to hypoxia exhibited a significant increase in PD-L1 expression, consistent with the in vivo imaging data. The role of hypoxia in increasing PD-L1 expression was further confirmed by using The Cancer Genome Atlas analyses of different human TNBCs. Conclusion These results have identified the potential role of hypoxia in contributing to PD-L1 heterogeneity in tumors by increasing cancer cell PD-L1 expression. Keywords: Hypoxia, PD-L1, Triple-Negative Breast Cancer, PET/MRI, Bioluminescence Imaging Supplemental material is available for this article. © RSNA, 2023.
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Affiliation(s)
| | | | - Desmond Jacob
- From the Russell H. Morgan Department of Radiology and Radiological
Science (K.M.P., B.K., D.J., S.M.K., M.S., A.M., Y.M., M.F.P., M.T.M., S.N.,
Z.M.B.), Sidney Kimmel Comprehensive Cancer Center (M.F.P., S.N., Z.M.B.), and
Department of Radiation Oncology and Molecular Radiation Sciences (Z.M.B.), The
Johns Hopkins University School of Medicine, 720 Rutland Ave, Rm 208C Traylor
Building, Baltimore, MD 21205; The F.M. Kirby Research Center for Functional
Brain Imaging, Kennedy Krieger Institute, Baltimore, Md (M.T.M.); and Werner
Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy,
Eberhard Karls University Tuebingen, Tuebingen, Germany (P.K., B.J.P.)
| | - Samata M. Kakkad
- From the Russell H. Morgan Department of Radiology and Radiological
Science (K.M.P., B.K., D.J., S.M.K., M.S., A.M., Y.M., M.F.P., M.T.M., S.N.,
Z.M.B.), Sidney Kimmel Comprehensive Cancer Center (M.F.P., S.N., Z.M.B.), and
Department of Radiation Oncology and Molecular Radiation Sciences (Z.M.B.), The
Johns Hopkins University School of Medicine, 720 Rutland Ave, Rm 208C Traylor
Building, Baltimore, MD 21205; The F.M. Kirby Research Center for Functional
Brain Imaging, Kennedy Krieger Institute, Baltimore, Md (M.T.M.); and Werner
Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy,
Eberhard Karls University Tuebingen, Tuebingen, Germany (P.K., B.J.P.)
| | - Meiyappan Solaiyappan
- From the Russell H. Morgan Department of Radiology and Radiological
Science (K.M.P., B.K., D.J., S.M.K., M.S., A.M., Y.M., M.F.P., M.T.M., S.N.,
Z.M.B.), Sidney Kimmel Comprehensive Cancer Center (M.F.P., S.N., Z.M.B.), and
Department of Radiation Oncology and Molecular Radiation Sciences (Z.M.B.), The
Johns Hopkins University School of Medicine, 720 Rutland Ave, Rm 208C Traylor
Building, Baltimore, MD 21205; The F.M. Kirby Research Center for Functional
Brain Imaging, Kennedy Krieger Institute, Baltimore, Md (M.T.M.); and Werner
Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy,
Eberhard Karls University Tuebingen, Tuebingen, Germany (P.K., B.J.P.)
| | - Akhilesh Mishra
- From the Russell H. Morgan Department of Radiology and Radiological
Science (K.M.P., B.K., D.J., S.M.K., M.S., A.M., Y.M., M.F.P., M.T.M., S.N.,
Z.M.B.), Sidney Kimmel Comprehensive Cancer Center (M.F.P., S.N., Z.M.B.), and
Department of Radiation Oncology and Molecular Radiation Sciences (Z.M.B.), The
Johns Hopkins University School of Medicine, 720 Rutland Ave, Rm 208C Traylor
Building, Baltimore, MD 21205; The F.M. Kirby Research Center for Functional
Brain Imaging, Kennedy Krieger Institute, Baltimore, Md (M.T.M.); and Werner
Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy,
Eberhard Karls University Tuebingen, Tuebingen, Germany (P.K., B.J.P.)
| | - Yelena Mironchik
- From the Russell H. Morgan Department of Radiology and Radiological
Science (K.M.P., B.K., D.J., S.M.K., M.S., A.M., Y.M., M.F.P., M.T.M., S.N.,
Z.M.B.), Sidney Kimmel Comprehensive Cancer Center (M.F.P., S.N., Z.M.B.), and
Department of Radiation Oncology and Molecular Radiation Sciences (Z.M.B.), The
Johns Hopkins University School of Medicine, 720 Rutland Ave, Rm 208C Traylor
Building, Baltimore, MD 21205; The F.M. Kirby Research Center for Functional
Brain Imaging, Kennedy Krieger Institute, Baltimore, Md (M.T.M.); and Werner
Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy,
Eberhard Karls University Tuebingen, Tuebingen, Germany (P.K., B.J.P.)
| | - Marie-France Penet
- From the Russell H. Morgan Department of Radiology and Radiological
Science (K.M.P., B.K., D.J., S.M.K., M.S., A.M., Y.M., M.F.P., M.T.M., S.N.,
Z.M.B.), Sidney Kimmel Comprehensive Cancer Center (M.F.P., S.N., Z.M.B.), and
Department of Radiation Oncology and Molecular Radiation Sciences (Z.M.B.), The
Johns Hopkins University School of Medicine, 720 Rutland Ave, Rm 208C Traylor
Building, Baltimore, MD 21205; The F.M. Kirby Research Center for Functional
Brain Imaging, Kennedy Krieger Institute, Baltimore, Md (M.T.M.); and Werner
Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy,
Eberhard Karls University Tuebingen, Tuebingen, Germany (P.K., B.J.P.)
| | - Michael T. McMahon
- From the Russell H. Morgan Department of Radiology and Radiological
Science (K.M.P., B.K., D.J., S.M.K., M.S., A.M., Y.M., M.F.P., M.T.M., S.N.,
Z.M.B.), Sidney Kimmel Comprehensive Cancer Center (M.F.P., S.N., Z.M.B.), and
Department of Radiation Oncology and Molecular Radiation Sciences (Z.M.B.), The
Johns Hopkins University School of Medicine, 720 Rutland Ave, Rm 208C Traylor
Building, Baltimore, MD 21205; The F.M. Kirby Research Center for Functional
Brain Imaging, Kennedy Krieger Institute, Baltimore, Md (M.T.M.); and Werner
Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy,
Eberhard Karls University Tuebingen, Tuebingen, Germany (P.K., B.J.P.)
| | - Philipp Knopf
- From the Russell H. Morgan Department of Radiology and Radiological
Science (K.M.P., B.K., D.J., S.M.K., M.S., A.M., Y.M., M.F.P., M.T.M., S.N.,
Z.M.B.), Sidney Kimmel Comprehensive Cancer Center (M.F.P., S.N., Z.M.B.), and
Department of Radiation Oncology and Molecular Radiation Sciences (Z.M.B.), The
Johns Hopkins University School of Medicine, 720 Rutland Ave, Rm 208C Traylor
Building, Baltimore, MD 21205; The F.M. Kirby Research Center for Functional
Brain Imaging, Kennedy Krieger Institute, Baltimore, Md (M.T.M.); and Werner
Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy,
Eberhard Karls University Tuebingen, Tuebingen, Germany (P.K., B.J.P.)
| | - Bernd J. Pichler
- From the Russell H. Morgan Department of Radiology and Radiological
Science (K.M.P., B.K., D.J., S.M.K., M.S., A.M., Y.M., M.F.P., M.T.M., S.N.,
Z.M.B.), Sidney Kimmel Comprehensive Cancer Center (M.F.P., S.N., Z.M.B.), and
Department of Radiation Oncology and Molecular Radiation Sciences (Z.M.B.), The
Johns Hopkins University School of Medicine, 720 Rutland Ave, Rm 208C Traylor
Building, Baltimore, MD 21205; The F.M. Kirby Research Center for Functional
Brain Imaging, Kennedy Krieger Institute, Baltimore, Md (M.T.M.); and Werner
Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy,
Eberhard Karls University Tuebingen, Tuebingen, Germany (P.K., B.J.P.)
| | - Sridhar Nimmagadda
- From the Russell H. Morgan Department of Radiology and Radiological
Science (K.M.P., B.K., D.J., S.M.K., M.S., A.M., Y.M., M.F.P., M.T.M., S.N.,
Z.M.B.), Sidney Kimmel Comprehensive Cancer Center (M.F.P., S.N., Z.M.B.), and
Department of Radiation Oncology and Molecular Radiation Sciences (Z.M.B.), The
Johns Hopkins University School of Medicine, 720 Rutland Ave, Rm 208C Traylor
Building, Baltimore, MD 21205; The F.M. Kirby Research Center for Functional
Brain Imaging, Kennedy Krieger Institute, Baltimore, Md (M.T.M.); and Werner
Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy,
Eberhard Karls University Tuebingen, Tuebingen, Germany (P.K., B.J.P.)
| | - Zaver M. Bhujwalla
- From the Russell H. Morgan Department of Radiology and Radiological
Science (K.M.P., B.K., D.J., S.M.K., M.S., A.M., Y.M., M.F.P., M.T.M., S.N.,
Z.M.B.), Sidney Kimmel Comprehensive Cancer Center (M.F.P., S.N., Z.M.B.), and
Department of Radiation Oncology and Molecular Radiation Sciences (Z.M.B.), The
Johns Hopkins University School of Medicine, 720 Rutland Ave, Rm 208C Traylor
Building, Baltimore, MD 21205; The F.M. Kirby Research Center for Functional
Brain Imaging, Kennedy Krieger Institute, Baltimore, Md (M.T.M.); and Werner
Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy,
Eberhard Karls University Tuebingen, Tuebingen, Germany (P.K., B.J.P.)
| |
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40
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Jansen RW, de Bloeme CM, Cardoen L, Göricke S, van Elst S, Jessen JL, Ramasubramanian A, Skalet AH, Miller AK, Maeder P, Uner OE, Hubbard GB, Grossniklaus H, Boldt HC, Nichols KE, Brennan RC, Sen S, Sirin S, Brisse HJ, Galluzzi P, Dommering CJ, Castelijns JA, van der Valk P, Boellaard R, Dorsman J, Moll AC, de Jong MC, de Graaf P. MRI Features for Identifying MYCN-amplified RB1 Wild-type Retinoblastoma. Radiology 2023; 307:e222264. [PMID: 37191489 PMCID: PMC10315525 DOI: 10.1148/radiol.222264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 05/17/2023]
Abstract
Background MYCN-amplified RB1 wild-type (MYCNARB1+/+) retinoblastoma is a rare but clinically important subtype of retinoblastoma due to its aggressive character and relative resistance to typical therapeutic approaches. Because biopsy is not indicated in retinoblastoma, specific MRI features might be valuable to identify children with this genetic subtype. Purpose To define the MRI phenotype of MYCNARB1+/+ retinoblastoma and evaluate the ability of qualitative MRI features to help identify this specific genetic subtype. Materials and Methods In this retrospective, multicenter, case-control study, MRI scans in children with MYCNARB1+/+ retinoblastoma and age-matched children with RB1-/- subtype retinoblastoma were included (case-control ratio, 1:4; scans acquired from June 2001 to February 2021; scans collected from May 2018 to October 2021). Patients with histopathologically confirmed unilateral retinoblastoma, genetic testing (RB1/MYCN status), and MRI scans were included. Associations between radiologist-scored imaging features and diagnosis were assessed with the Fisher exact test or Fisher-Freeman-Halton test, and Bonferroni-corrected P values were calculated. Results A total of 110 patients from 10 retinoblastoma referral centers were included: 22 children with MYCNARB1+/+ retinoblastoma and 88 control children with RB1-/- retinoblastoma. Children in the MYCNARB1+/+ group had a median age of 7.0 months (IQR, 5.0-9.0 months) (13 boys), while children in the RB1-/- group had a median age of 9.0 months (IQR, 4.6-13.4 months) (46 boys). MYCNARB1+/+ retinoblastomas were typically peripherally located (in 10 of 17 children; specificity, 97%; P < .001) and exhibited plaque or pleomorphic shape (in 20 of 22 children; specificity, 51%; P = .011) with irregular margins (in 16 of 22 children; specificity, 70%; P = .008) and extensive retina folding with vitreous enclosure (specificity, 94%; P < .001). MYCNARB1+/+ retinoblastomas showed peritumoral hemorrhage (in 17 of 21 children; specificity, 88%; P < .001), subretinal hemorrhage with a fluid-fluid level (in eight of 22 children; specificity, 95%; P = .005), and strong anterior chamber enhancement (in 13 of 21 children; specificity, 80%; P = .008). Conclusion MYCNARB1+/+ retinoblastomas show distinct MRI features that could enable early identification of these tumors. This may improve patient selection for tailored treatment in the future. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Rollins in this issue.
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Affiliation(s)
- Robin W. Jansen
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Christiaan M. de Bloeme
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Liesbeth Cardoen
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Sophia Göricke
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Sabien van Elst
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Jaime Lyn Jessen
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Aparna Ramasubramanian
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Alison H. Skalet
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Audra K. Miller
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Philippe Maeder
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Ogul E. Uner
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - G. Baker Hubbard
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Hans Grossniklaus
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - H. Culver Boldt
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Kim E. Nichols
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Rachel C. Brennan
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Saugata Sen
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Selma Sirin
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Hervé J. Brisse
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Paolo Galluzzi
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Charlotte J. Dommering
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Jonas A. Castelijns
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Paul van der Valk
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Ronald Boellaard
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Josephine Dorsman
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Annette C. Moll
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Marcus C. de Jong
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
| | - Pim de Graaf
- From the Departments of Radiology and Nuclear Medicine (R.W.J.,
C.M.d.B., S.v.E., J.A.C., R.B., M.C.d.J., P.d.G.), Human Genetics (C.J.D.),
Pathology (P.v.d.V.), Oncogenetics (J.D.), and Ophthalmology (A.C.M.), Amsterdam
University Medical Center, Vrije Universiteit, Office PK-1X012, De Boelelaan
1117, 1081 HV Amsterdam, the Netherlands; Cancer Center Amsterdam, Amsterdam,
the Netherlands (R.W.J., C.M.d.B., S.v.E., J.D., A.C.M., M.C.d.J., P.d.G.);
European Retinoblastoma Imaging Collaboration (R.W.J., C.M.d.B., L.C., S.G.,
P.M., H.C.B., P.G., J.A.C., M.C.d.J., P.d.G.); Imaging Department, Institut
Curie Paris, Paris, France (L.C., H.J.B.); Institute of Diagnostic and
Interventional Radiology and Neuroradiology, University Hospital Essen, Essen,
Germany (S.G.); Impact Genetics–Dynacare, Brampton, Canada (J.L.J.);
Department of Ophthalmology, Phoenix Children’s Hospital, Phoenix, Ariz
(A.R.); Casey Eye Institute & Knight Cancer Institute, Oregon Health
& Science University, Portland, Ore (A.H.S., A.K.M.); Department of
Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(P.M.); Department of Ophthalmology, Casey Eye Institute, Oregon Health &
Science University, Portland, Ore (O.E.U.); Ocular Oncology Service, Emory Eye
Center, Atlanta, Ga (O.E.U., G.B.H., H.G.); Department of Ophthalmology,
University of Iowa Hospitals & Clinics, Iowa City, Iowa (H.C.B.);
Department of Oncology, St Jude Children’s Research Hospital, Memphis,
Tenn (K.E.N., R.C.B.); Department of Pediatric Hematology/Oncology, Logan
Health, Kalispell, Mont (R.C.B.); Department of Radiology and Imaging Sciences,
Tata Medical Center, Kolkata, India (S. Sen); Department of Diagnostic Imaging,
University Children’s Hospital Zürich, Zürich, Switzerland
(S. Sirin); and Azienda Ospedaliera Universitaria Senese, Siena, Italy
(P.G.)
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Garrison WJ, Qing K, He M, Zhao L, Tustison NJ, Patrie JT, Mata JF, Shim YM, Ropp AM, Altes TA, Mugler JP, Miller GW. Lung Volume Dependence and Repeatability of Hyperpolarized 129Xe MRI Gas Uptake Metrics in Healthy Volunteers and Participants with COPD. Radiol Cardiothorac Imaging 2023; 5:e220096. [PMID: 37404786 PMCID: PMC10316289 DOI: 10.1148/ryct.220096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 04/05/2023] [Accepted: 05/08/2023] [Indexed: 07/06/2023]
Abstract
Purpose To assess the effect of lung volume on measured values and repeatability of xenon 129 (129Xe) gas uptake metrics in healthy volunteers and participants with chronic obstructive pulmonary disease (COPD). Materials and Methods This Health Insurance Portability and Accountability Act-compliant prospective study included data (March 2014-December 2015) from 49 participants (19 with COPD [mean age, 67 years ± 9 (SD)]; nine women]; 25 older healthy volunteers [mean age, 59 years ± 10; 20 women]; and five young healthy women [mean age, 23 years ± 3]). Thirty-two participants underwent repeated 129Xe and same-breath-hold proton MRI at residual volume plus one-third forced vital capacity (RV+FVC/3), with 29 also undergoing one examination at total lung capacity (TLC). The remaining 17 participants underwent imaging at TLC, RV+FVC/3, and residual volume (RV). Signal ratios between membrane, red blood cell (RBC), and gas-phase compartments were calculated using hierarchical iterative decomposition of water and fat with echo asymmetry and least-squares estimation (ie, IDEAL). Repeatability was assessed using coefficient of variation and intraclass correlation coefficient, and volume relationships were assessed using Spearman correlation and Wilcoxon rank sum tests. Results Gas uptake metrics were repeatable at RV+FVC/3 (intraclass correlation coefficient = 0.88 for membrane/gas; 0.71 for RBC/gas, and 0.88 for RBC/membrane). Relative ratio changes were highly correlated with relative volume changes for membrane/gas (r = -0.97) and RBC/gas (r = -0.93). Membrane/gas and RBC/gas measured at RV+FVC/3 were significantly lower in the COPD group than the corresponding healthy group (P ≤ .001). However, these differences lessened upon correction for individual volume differences (P = .23 for membrane/gas; P = .09 for RBC/gas). Conclusion Dissolved-phase 129Xe MRI-derived gas uptake metrics were repeatable but highly dependent on lung volume during measurement.Keywords: Blood-Air Barrier, MRI, Chronic Obstructive Pulmonary Disease, Pulmonary Gas Exchange, Xenon Supplemental material is available for this article © RSNA, 2023.
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Yoon JH, Strand F, Baltzer PAT, Conant EF, Gilbert FJ, Lehman CD, Morris EA, Mullen LA, Nishikawa RM, Sharma N, Vejborg I, Moy L, Mann RM. Standalone AI for Breast Cancer Detection at Screening Digital Mammography and Digital Breast Tomosynthesis: A Systematic Review and Meta-Analysis. Radiology 2023; 307:e222639. [PMID: 37219445 PMCID: PMC10315526 DOI: 10.1148/radiol.222639] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 05/24/2023]
Abstract
Background There is considerable interest in the potential use of artificial intelligence (AI) systems in mammographic screening. However, it is essential to critically evaluate the performance of AI before it can become a modality used for independent mammographic interpretation. Purpose To evaluate the reported standalone performances of AI for interpretation of digital mammography and digital breast tomosynthesis (DBT). Materials and Methods A systematic search was conducted in PubMed, Google Scholar, Embase (Ovid), and Web of Science databases for studies published from January 2017 to June 2022. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) values were reviewed. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 and Comparative (QUADAS-2 and QUADAS-C, respectively). A random effects meta-analysis and meta-regression analysis were performed for overall studies and for different study types (reader studies vs historic cohort studies) and imaging techniques (digital mammography vs DBT). Results In total, 16 studies that include 1 108 328 examinations in 497 091 women were analyzed (six reader studies, seven historic cohort studies on digital mammography, and four studies on DBT). Pooled AUCs were significantly higher for standalone AI than radiologists in the six reader studies on digital mammography (0.87 vs 0.81, P = .002), but not for historic cohort studies (0.89 vs 0.96, P = .152). Four studies on DBT showed significantly higher AUCs in AI compared with radiologists (0.90 vs 0.79, P < .001). Higher sensitivity and lower specificity were seen for standalone AI compared with radiologists. Conclusion Standalone AI for screening digital mammography performed as well as or better than radiologists. Compared with digital mammography, there is an insufficient number of studies to assess the performance of AI systems in the interpretation of DBT screening examinations. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Scaranelo in this issue.
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Affiliation(s)
- Jung Hyun Yoon
- From the Department of Radiology, Severance Hospital, Research
Institute of Radiological Science, Yonsei University, College of Medicine, 50
Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea (J.H.Y.); Department of Oncology and
Pathology, Karolinska Institute, Stockholm, Sweden (F.S.); Department of
Radiology, Unit of Breast Imaging, Karolinska University Hospital, Stockholm,
Sweden (F.S.); Department of Biomedical Imaging and Image-guided Therapy,
Medical University of Vienna, Vienna, Austria (P.A.T.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (E.F.C.); Department of
Radiology, University of Cambridge, Cambridge, UK (F.J.G.); Department of
Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass
(C.D.L.); Department of Radiology, University of California Davis, Davis, Calif
(E.A.M.); Department of Radiology, Breast Imaging Division, Johns Hopkins
Medicine, Baltimore, Md (L.A.M.); Department of Radiology, University of
Pittsburgh, UPMC Magee-Womens Hospital, Pittsburgh, Pa (R.M.N.); Department of
Radiology, St James Hospital, Leeds, UK (N.S.); Department of Breast
Examinations, Copenhagen University Hospital Herlev-Gentofte, Copenhagen,
Denmark (I.V.); Department of Radiology, Laura and Isaac Perlmutter Cancer
Center, Center for Biomedical Imaging, Center for Advanced Imaging Innovation
and Research, New York University Grossman School of Medicine, New York, NY
(L.M.); Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, the Netherlands (R.M.M.); and Department of Radiology, Netherlands
Cancer Institute, Amsterdam, the Netherlands (R.M.M.)
| | - Fredrik Strand
- From the Department of Radiology, Severance Hospital, Research
Institute of Radiological Science, Yonsei University, College of Medicine, 50
Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea (J.H.Y.); Department of Oncology and
Pathology, Karolinska Institute, Stockholm, Sweden (F.S.); Department of
Radiology, Unit of Breast Imaging, Karolinska University Hospital, Stockholm,
Sweden (F.S.); Department of Biomedical Imaging and Image-guided Therapy,
Medical University of Vienna, Vienna, Austria (P.A.T.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (E.F.C.); Department of
Radiology, University of Cambridge, Cambridge, UK (F.J.G.); Department of
Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass
(C.D.L.); Department of Radiology, University of California Davis, Davis, Calif
(E.A.M.); Department of Radiology, Breast Imaging Division, Johns Hopkins
Medicine, Baltimore, Md (L.A.M.); Department of Radiology, University of
Pittsburgh, UPMC Magee-Womens Hospital, Pittsburgh, Pa (R.M.N.); Department of
Radiology, St James Hospital, Leeds, UK (N.S.); Department of Breast
Examinations, Copenhagen University Hospital Herlev-Gentofte, Copenhagen,
Denmark (I.V.); Department of Radiology, Laura and Isaac Perlmutter Cancer
Center, Center for Biomedical Imaging, Center for Advanced Imaging Innovation
and Research, New York University Grossman School of Medicine, New York, NY
(L.M.); Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, the Netherlands (R.M.M.); and Department of Radiology, Netherlands
Cancer Institute, Amsterdam, the Netherlands (R.M.M.)
| | - Pascal A. T. Baltzer
- From the Department of Radiology, Severance Hospital, Research
Institute of Radiological Science, Yonsei University, College of Medicine, 50
Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea (J.H.Y.); Department of Oncology and
Pathology, Karolinska Institute, Stockholm, Sweden (F.S.); Department of
Radiology, Unit of Breast Imaging, Karolinska University Hospital, Stockholm,
Sweden (F.S.); Department of Biomedical Imaging and Image-guided Therapy,
Medical University of Vienna, Vienna, Austria (P.A.T.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (E.F.C.); Department of
Radiology, University of Cambridge, Cambridge, UK (F.J.G.); Department of
Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass
(C.D.L.); Department of Radiology, University of California Davis, Davis, Calif
(E.A.M.); Department of Radiology, Breast Imaging Division, Johns Hopkins
Medicine, Baltimore, Md (L.A.M.); Department of Radiology, University of
Pittsburgh, UPMC Magee-Womens Hospital, Pittsburgh, Pa (R.M.N.); Department of
Radiology, St James Hospital, Leeds, UK (N.S.); Department of Breast
Examinations, Copenhagen University Hospital Herlev-Gentofte, Copenhagen,
Denmark (I.V.); Department of Radiology, Laura and Isaac Perlmutter Cancer
Center, Center for Biomedical Imaging, Center for Advanced Imaging Innovation
and Research, New York University Grossman School of Medicine, New York, NY
(L.M.); Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, the Netherlands (R.M.M.); and Department of Radiology, Netherlands
Cancer Institute, Amsterdam, the Netherlands (R.M.M.)
| | - Emily F. Conant
- From the Department of Radiology, Severance Hospital, Research
Institute of Radiological Science, Yonsei University, College of Medicine, 50
Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea (J.H.Y.); Department of Oncology and
Pathology, Karolinska Institute, Stockholm, Sweden (F.S.); Department of
Radiology, Unit of Breast Imaging, Karolinska University Hospital, Stockholm,
Sweden (F.S.); Department of Biomedical Imaging and Image-guided Therapy,
Medical University of Vienna, Vienna, Austria (P.A.T.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (E.F.C.); Department of
Radiology, University of Cambridge, Cambridge, UK (F.J.G.); Department of
Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass
(C.D.L.); Department of Radiology, University of California Davis, Davis, Calif
(E.A.M.); Department of Radiology, Breast Imaging Division, Johns Hopkins
Medicine, Baltimore, Md (L.A.M.); Department of Radiology, University of
Pittsburgh, UPMC Magee-Womens Hospital, Pittsburgh, Pa (R.M.N.); Department of
Radiology, St James Hospital, Leeds, UK (N.S.); Department of Breast
Examinations, Copenhagen University Hospital Herlev-Gentofte, Copenhagen,
Denmark (I.V.); Department of Radiology, Laura and Isaac Perlmutter Cancer
Center, Center for Biomedical Imaging, Center for Advanced Imaging Innovation
and Research, New York University Grossman School of Medicine, New York, NY
(L.M.); Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, the Netherlands (R.M.M.); and Department of Radiology, Netherlands
Cancer Institute, Amsterdam, the Netherlands (R.M.M.)
| | - Fiona J. Gilbert
- From the Department of Radiology, Severance Hospital, Research
Institute of Radiological Science, Yonsei University, College of Medicine, 50
Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea (J.H.Y.); Department of Oncology and
Pathology, Karolinska Institute, Stockholm, Sweden (F.S.); Department of
Radiology, Unit of Breast Imaging, Karolinska University Hospital, Stockholm,
Sweden (F.S.); Department of Biomedical Imaging and Image-guided Therapy,
Medical University of Vienna, Vienna, Austria (P.A.T.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (E.F.C.); Department of
Radiology, University of Cambridge, Cambridge, UK (F.J.G.); Department of
Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass
(C.D.L.); Department of Radiology, University of California Davis, Davis, Calif
(E.A.M.); Department of Radiology, Breast Imaging Division, Johns Hopkins
Medicine, Baltimore, Md (L.A.M.); Department of Radiology, University of
Pittsburgh, UPMC Magee-Womens Hospital, Pittsburgh, Pa (R.M.N.); Department of
Radiology, St James Hospital, Leeds, UK (N.S.); Department of Breast
Examinations, Copenhagen University Hospital Herlev-Gentofte, Copenhagen,
Denmark (I.V.); Department of Radiology, Laura and Isaac Perlmutter Cancer
Center, Center for Biomedical Imaging, Center for Advanced Imaging Innovation
and Research, New York University Grossman School of Medicine, New York, NY
(L.M.); Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, the Netherlands (R.M.M.); and Department of Radiology, Netherlands
Cancer Institute, Amsterdam, the Netherlands (R.M.M.)
| | - Constance D. Lehman
- From the Department of Radiology, Severance Hospital, Research
Institute of Radiological Science, Yonsei University, College of Medicine, 50
Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea (J.H.Y.); Department of Oncology and
Pathology, Karolinska Institute, Stockholm, Sweden (F.S.); Department of
Radiology, Unit of Breast Imaging, Karolinska University Hospital, Stockholm,
Sweden (F.S.); Department of Biomedical Imaging and Image-guided Therapy,
Medical University of Vienna, Vienna, Austria (P.A.T.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (E.F.C.); Department of
Radiology, University of Cambridge, Cambridge, UK (F.J.G.); Department of
Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass
(C.D.L.); Department of Radiology, University of California Davis, Davis, Calif
(E.A.M.); Department of Radiology, Breast Imaging Division, Johns Hopkins
Medicine, Baltimore, Md (L.A.M.); Department of Radiology, University of
Pittsburgh, UPMC Magee-Womens Hospital, Pittsburgh, Pa (R.M.N.); Department of
Radiology, St James Hospital, Leeds, UK (N.S.); Department of Breast
Examinations, Copenhagen University Hospital Herlev-Gentofte, Copenhagen,
Denmark (I.V.); Department of Radiology, Laura and Isaac Perlmutter Cancer
Center, Center for Biomedical Imaging, Center for Advanced Imaging Innovation
and Research, New York University Grossman School of Medicine, New York, NY
(L.M.); Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, the Netherlands (R.M.M.); and Department of Radiology, Netherlands
Cancer Institute, Amsterdam, the Netherlands (R.M.M.)
| | - Elizabeth A. Morris
- From the Department of Radiology, Severance Hospital, Research
Institute of Radiological Science, Yonsei University, College of Medicine, 50
Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea (J.H.Y.); Department of Oncology and
Pathology, Karolinska Institute, Stockholm, Sweden (F.S.); Department of
Radiology, Unit of Breast Imaging, Karolinska University Hospital, Stockholm,
Sweden (F.S.); Department of Biomedical Imaging and Image-guided Therapy,
Medical University of Vienna, Vienna, Austria (P.A.T.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (E.F.C.); Department of
Radiology, University of Cambridge, Cambridge, UK (F.J.G.); Department of
Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass
(C.D.L.); Department of Radiology, University of California Davis, Davis, Calif
(E.A.M.); Department of Radiology, Breast Imaging Division, Johns Hopkins
Medicine, Baltimore, Md (L.A.M.); Department of Radiology, University of
Pittsburgh, UPMC Magee-Womens Hospital, Pittsburgh, Pa (R.M.N.); Department of
Radiology, St James Hospital, Leeds, UK (N.S.); Department of Breast
Examinations, Copenhagen University Hospital Herlev-Gentofte, Copenhagen,
Denmark (I.V.); Department of Radiology, Laura and Isaac Perlmutter Cancer
Center, Center for Biomedical Imaging, Center for Advanced Imaging Innovation
and Research, New York University Grossman School of Medicine, New York, NY
(L.M.); Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, the Netherlands (R.M.M.); and Department of Radiology, Netherlands
Cancer Institute, Amsterdam, the Netherlands (R.M.M.)
| | - Lisa A. Mullen
- From the Department of Radiology, Severance Hospital, Research
Institute of Radiological Science, Yonsei University, College of Medicine, 50
Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea (J.H.Y.); Department of Oncology and
Pathology, Karolinska Institute, Stockholm, Sweden (F.S.); Department of
Radiology, Unit of Breast Imaging, Karolinska University Hospital, Stockholm,
Sweden (F.S.); Department of Biomedical Imaging and Image-guided Therapy,
Medical University of Vienna, Vienna, Austria (P.A.T.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (E.F.C.); Department of
Radiology, University of Cambridge, Cambridge, UK (F.J.G.); Department of
Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass
(C.D.L.); Department of Radiology, University of California Davis, Davis, Calif
(E.A.M.); Department of Radiology, Breast Imaging Division, Johns Hopkins
Medicine, Baltimore, Md (L.A.M.); Department of Radiology, University of
Pittsburgh, UPMC Magee-Womens Hospital, Pittsburgh, Pa (R.M.N.); Department of
Radiology, St James Hospital, Leeds, UK (N.S.); Department of Breast
Examinations, Copenhagen University Hospital Herlev-Gentofte, Copenhagen,
Denmark (I.V.); Department of Radiology, Laura and Isaac Perlmutter Cancer
Center, Center for Biomedical Imaging, Center for Advanced Imaging Innovation
and Research, New York University Grossman School of Medicine, New York, NY
(L.M.); Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, the Netherlands (R.M.M.); and Department of Radiology, Netherlands
Cancer Institute, Amsterdam, the Netherlands (R.M.M.)
| | - Robert M. Nishikawa
- From the Department of Radiology, Severance Hospital, Research
Institute of Radiological Science, Yonsei University, College of Medicine, 50
Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea (J.H.Y.); Department of Oncology and
Pathology, Karolinska Institute, Stockholm, Sweden (F.S.); Department of
Radiology, Unit of Breast Imaging, Karolinska University Hospital, Stockholm,
Sweden (F.S.); Department of Biomedical Imaging and Image-guided Therapy,
Medical University of Vienna, Vienna, Austria (P.A.T.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (E.F.C.); Department of
Radiology, University of Cambridge, Cambridge, UK (F.J.G.); Department of
Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass
(C.D.L.); Department of Radiology, University of California Davis, Davis, Calif
(E.A.M.); Department of Radiology, Breast Imaging Division, Johns Hopkins
Medicine, Baltimore, Md (L.A.M.); Department of Radiology, University of
Pittsburgh, UPMC Magee-Womens Hospital, Pittsburgh, Pa (R.M.N.); Department of
Radiology, St James Hospital, Leeds, UK (N.S.); Department of Breast
Examinations, Copenhagen University Hospital Herlev-Gentofte, Copenhagen,
Denmark (I.V.); Department of Radiology, Laura and Isaac Perlmutter Cancer
Center, Center for Biomedical Imaging, Center for Advanced Imaging Innovation
and Research, New York University Grossman School of Medicine, New York, NY
(L.M.); Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, the Netherlands (R.M.M.); and Department of Radiology, Netherlands
Cancer Institute, Amsterdam, the Netherlands (R.M.M.)
| | - Nisha Sharma
- From the Department of Radiology, Severance Hospital, Research
Institute of Radiological Science, Yonsei University, College of Medicine, 50
Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea (J.H.Y.); Department of Oncology and
Pathology, Karolinska Institute, Stockholm, Sweden (F.S.); Department of
Radiology, Unit of Breast Imaging, Karolinska University Hospital, Stockholm,
Sweden (F.S.); Department of Biomedical Imaging and Image-guided Therapy,
Medical University of Vienna, Vienna, Austria (P.A.T.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (E.F.C.); Department of
Radiology, University of Cambridge, Cambridge, UK (F.J.G.); Department of
Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass
(C.D.L.); Department of Radiology, University of California Davis, Davis, Calif
(E.A.M.); Department of Radiology, Breast Imaging Division, Johns Hopkins
Medicine, Baltimore, Md (L.A.M.); Department of Radiology, University of
Pittsburgh, UPMC Magee-Womens Hospital, Pittsburgh, Pa (R.M.N.); Department of
Radiology, St James Hospital, Leeds, UK (N.S.); Department of Breast
Examinations, Copenhagen University Hospital Herlev-Gentofte, Copenhagen,
Denmark (I.V.); Department of Radiology, Laura and Isaac Perlmutter Cancer
Center, Center for Biomedical Imaging, Center for Advanced Imaging Innovation
and Research, New York University Grossman School of Medicine, New York, NY
(L.M.); Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, the Netherlands (R.M.M.); and Department of Radiology, Netherlands
Cancer Institute, Amsterdam, the Netherlands (R.M.M.)
| | - Ilse Vejborg
- From the Department of Radiology, Severance Hospital, Research
Institute of Radiological Science, Yonsei University, College of Medicine, 50
Yonsei-ro, Seodaemun-gu, 03722 Seoul, Korea (J.H.Y.); Department of Oncology and
Pathology, Karolinska Institute, Stockholm, Sweden (F.S.); Department of
Radiology, Unit of Breast Imaging, Karolinska University Hospital, Stockholm,
Sweden (F.S.); Department of Biomedical Imaging and Image-guided Therapy,
Medical University of Vienna, Vienna, Austria (P.A.T.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (E.F.C.); Department of
Radiology, University of Cambridge, Cambridge, UK (F.J.G.); Department of
Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass
(C.D.L.); Department of Radiology, University of California Davis, Davis, Calif
(E.A.M.); Department of Radiology, Breast Imaging Division, Johns Hopkins
Medicine, Baltimore, Md (L.A.M.); Department of Radiology, University of
Pittsburgh, UPMC Magee-Womens Hospital, Pittsburgh, Pa (R.M.N.); Department of
Radiology, St James Hospital, Leeds, UK (N.S.); Department of Breast
Examinations, Copenhagen University Hospital Herlev-Gentofte, Copenhagen,
Denmark (I.V.); Department of Radiology, Laura and Isaac Perlmutter Cancer
Center, Center for Biomedical Imaging, Center for Advanced Imaging Innovation
and Research, New York University Grossman School of Medicine, New York, NY
(L.M.); Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, the Netherlands (R.M.M.); and Department of Radiology, Netherlands
Cancer Institute, Amsterdam, the Netherlands (R.M.M.)
| | | | | |
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Wang Y, Sun C, Ghadimi S, Auger DC, Croisille P, Viallon M, Mangion K, Berry C, Haggerty CM, Jing L, Fornwalt BK, Cao JJ, Cheng J, Scott AD, Ferreira PF, Oshinski JN, Ennis DB, Bilchick KC, Epstein FH. StrainNet: Improved Myocardial Strain Analysis of Cine MRI by Deep Learning from DENSE. Radiol Cardiothorac Imaging 2023; 5:e220196. [PMID: 37404792 PMCID: PMC10316292 DOI: 10.1148/ryct.220196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/16/2023] [Accepted: 03/15/2023] [Indexed: 07/06/2023]
Abstract
Purpose To develop a three-dimensional (two dimensions + time) convolutional neural network trained with displacement encoding with stimulated echoes (DENSE) data for displacement and strain analysis of cine MRI. Materials and Methods In this retrospective multicenter study, a deep learning model (StrainNet) was developed to predict intramyocardial displacement from contour motion. Patients with various heart diseases and healthy controls underwent cardiac MRI examinations with DENSE between August 2008 and January 2022. Network training inputs were a time series of myocardial contours from DENSE magnitude images, and ground truth data were DENSE displacement measurements. Model performance was evaluated using pixelwise end-point error (EPE). For testing, StrainNet was applied to contour motion from cine MRI. Global and segmental circumferential strain (Ecc) derived from commercial feature tracking (FT), StrainNet, and DENSE (reference) were compared using intraclass correlation coefficients (ICCs), Pearson correlations, Bland-Altman analyses, paired t tests, and linear mixed-effects models. Results The study included 161 patients (110 men; mean age, 61 years ± 14 [SD]), 99 healthy adults (44 men; mean age, 35 years ± 15), and 45 healthy children and adolescents (21 males; mean age, 12 years ± 3). StrainNet showed good agreement with DENSE for intramyocardial displacement, with an average EPE of 0.75 mm ± 0.35. The ICCs between StrainNet and DENSE and FT and DENSE were 0.87 and 0.72, respectively, for global Ecc and 0.75 and 0.48, respectively, for segmental Ecc. Bland-Altman analysis showed that StrainNet had better agreement than FT with DENSE for global and segmental Ecc. Conclusion StrainNet outperformed FT for global and segmental Ecc analysis of cine MRI.Keywords: Image Postprocessing, MR Imaging, Cardiac, Heart, Pediatrics, Technical Aspects, Technology Assessment, Strain, Deep Learning, DENSE Supplemental material is available for this article. © RSNA, 2023.
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Affiliation(s)
- Yu Wang
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Changyu Sun
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Sona Ghadimi
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Daniel C. Auger
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Pierre Croisille
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Magalie Viallon
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Kenneth Mangion
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Colin Berry
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Christopher M. Haggerty
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Linyuan Jing
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Brandon K. Fornwalt
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - J. Jane Cao
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Joshua Cheng
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Andrew D. Scott
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Pedro F. Ferreira
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - John N. Oshinski
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Daniel B. Ennis
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Kenneth C. Bilchick
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
| | - Frederick H. Epstein
- From the Department of Biomedical Engineering, University of
Virginia, Biomedical Engineering and Medical Science Building, Room 2013, MR5,
Charlottesville, VA 22903 (Y.W., C.S., S.G., D.C.A., F.H.E.); Department of
Biomedical, Biological and Chemical Engineering and Department of Radiology,
University of Missouri, Columbia, Mo (C.S.); Department of Radiology, University
Hospital of Saint Etienne, Saint Etienne, France (P.C.); CREATIS (UMR CNRS 5220,
U1206 INSERM), INSA Lyon, Lyon, France (P.C., M.V.); BHF Glasgow Cardiovascular
Research Centre, University of Glasgow, Glasgow, Scotland (K.M., C.B.);
Department of Translational Data Science and Informatics, Geisinger Health
System, Danville, Pa (C.M.H., L.J., B.K.F.); Cardiovascular Research Center,
University of Kentucky, Lexington, Ky (C.M.H., L.J., B.K.F.); The Heart Center,
St Francis Hospital, Roslyn, NY (J.J.C., J.C.); Cardiovascular Magnetic
Resonance Unit, The Royal Brompton Hospital and National Heart and Lung
Institute, Imperial College London, London, England (A.D.S., P.F.F.); Department
of Radiology & Imaging Sciences and Biomedical Engineering, Emory
University, Atlanta, Ga (J.N.O.); Department of Radiology, Stanford University,
Stanford, Calif (D.B.E.); Department of Medicine (K.C.B.) and Department of
Radiology and Medical Imaging (F.H.E.), University of Virginia Health System,
Charlottesville, Va
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Roberts GS, Peret A, Jonaitis EM, Koscik RL, Hoffman CA, Rivera-Rivera LA, Cody KA, Rowley HA, Johnson SC, Wieben O, Johnson KM, Eisenmenger LB. Normative Cerebral Hemodynamics in Middle-aged and Older Adults Using 4D Flow MRI: Initial Analysis of Vascular Aging. Radiology 2023; 307:e222685. [PMID: 36943077 PMCID: PMC10140641 DOI: 10.1148/radiol.222685] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/06/2023] [Accepted: 02/06/2023] [Indexed: 03/23/2023]
Abstract
Background Characterizing cerebrovascular hemodynamics in older adults is important for identifying disease and understanding normal neurovascular aging. Four-dimensional (4D) flow MRI allows for a comprehensive assessment of cerebral hemodynamics in a single acquisition. Purpose To establish reference intracranial blood flow and pulsatility index values in a large cross-sectional sample of middle-aged (45-65 years) and older (>65 years) adults and characterize the effect of age and sex on blood flow and pulsatility. Materials and Methods In this retrospective study, patients aged 45-93 years (cognitively unimpaired) underwent cranial 4D flow MRI between March 2010 and March 2020. Blood flow rates and pulsatility indexes from 13 major arteries and four venous sinuses and total cerebral blood flow were collected. Intraobserver and interobserver reproducibility of flow and pulsatility measures was assessed in 30 patients. Descriptive statistics (mean ± SD) of blood flow and pulsatility were tabulated for the entire group and by age and sex. Multiple linear regression and linear mixed-effects models were used to assess the effect of age and sex on total cerebral blood flow and vessel-specific flow and pulsatility, respectively. Results There were 759 patients (mean age, 65 years ± 8 [SD]; 506 female patients) analyzed. For intra- and interobserver reproducibility, median intraclass correlation coefficients were greater than 0.90 for flow and pulsatility measures across all vessels. Regression coefficients β ± standard error from multiple linear regression showed a 4 mL/min decrease in total cerebral blood flow each year (age β = -3.94 mL/min per year ± 0.44; P < .001). Mixed effects showed a 1 mL/min average annual decrease in blood flow (age β = -0.95 mL/min per year ± 0.16; P < .001) and 0.01 arbitrary unit (au) average annual increase in pulsatility over all vessels (age β = 0.011 au per year ± 0.001; P < .001). No evidence of sex differences was observed for flow (β = -1.60 mL/min per male patient ± 1.77; P = .37), but pulsatility was higher in female patients (sex β = -0.018 au per male patient ± 0.008; P = .02). Conclusion Normal reference values for blood flow and pulsatility obtained using four-dimensional flow MRI showed correlations with age. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Steinman in this issue.
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Affiliation(s)
- Grant S. Roberts
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Anthony Peret
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Erin M. Jonaitis
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Rebecca L. Koscik
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Carson A. Hoffman
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Leonardo A. Rivera-Rivera
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Karly A. Cody
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Howard A. Rowley
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Sterling C. Johnson
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Oliver Wieben
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Kevin M. Johnson
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Laura B. Eisenmenger
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
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Chapiro J. Explainable AI for Prostate MRI: Don't Trust, Verify. Radiology 2023; 307:e230574. [PMID: 37039689 PMCID: PMC10323286 DOI: 10.1148/radiol.230574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 04/12/2023]
Affiliation(s)
- Julius Chapiro
- From the Department of Radiology and Biomedical Imaging, Yale
University School of Medicine, 789 Howard Ave, CB363H, New Haven, CT
06519
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Baraghoshi D, Strand M, Humphries SM, San José Estépar R, Vegas Sanchez-Ferrero G, Charbonnier JP, Latisenko R, Silverman EK, Crapo JD, Lynch DA. Quantitative CT Evaluation of Emphysema Progression over 10 Years in the COPDGene Study. Radiology 2023; 307:e222786. [PMID: 37039685 PMCID: PMC10286952 DOI: 10.1148/radiol.222786] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/02/2023] [Accepted: 02/16/2023] [Indexed: 04/12/2023]
Abstract
Background Long-term studies of chronic obstructive pulmonary disease (COPD) can evaluate emphysema progression. Adjustment for differences in equipment and scanning protocols of individual CT examinations have not been studied extensively. Purpose To evaluate emphysema progression in current and former smokers in the COPDGene cohort over three imaging points obtained at 5-year intervals accounting for individual CT parameters. Materials and Methods Current and former cigarette smokers enrolled between 2008 and 2011 from the COPDGene study were prospectively followed for 10 years between 2008 and 2020. Extent of emphysema as adjusted lung density (ALD) from quantitative CT was measured at baseline and at 5- and 10-year follow-up. Linear mixed models adjusted for CT technical characteristics were constructed to evaluate emphysema progression. Mean annual changes in ALD over consecutive 5-year study periods were estimated by smoking status and baseline emphysema. Results Of 8431 participants at baseline (mean age, 60 years ± 9 [SD]; 3905 female participants), 4913 were at 5-year follow-up and 1544 participants were at 10-year follow-up. There were 4134 (49%) participants who were current smokers, and 4449 (53%) participants had more than trace emphysema at baseline. Current smokers with more than trace emphysema showed the largest decline in ALD, with mean annual decreases of 1.4 g/L (95% CI: 1.2, 1.5) in the first 5 years and 0.9 g/L (95% CI: 0.7, 1.2) in the second 5 years. Accounting for CT noise, field of view, and scanner model improved model fit for estimation of emphysema progression (P < .001 by likelihood ratio test). Conclusion Evaluation at CT of emphysema progression in the COPDGene study showed that, during the span of 10 years, participants with pre-existing emphysema who continued smoking had the largest decline in ALD. Adjusting for CT equipment and protocol factors improved these longitudinal estimates. Clinical trial registration no. NCT00608764 © RSNA, 2023 Supplemental material is available for this article. See the editorial by Parraga and Kirby in this issue.
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Affiliation(s)
- David Baraghoshi
- From the Division of Biostatistics, Environment and Health (D.B.,
M.S.), Department of Radiology (S.M.H., D.A.L.), and Division of Pulmonary and
Critical Care Medicine, Department of Medicine (J.D.C.), National Jewish Health,
1400 Jackson St, Denver, CO 80206; Applied Chest Imaging Laboratory (R.S.J.E.,
G.V.S.F.), Department of Radiology (R.S.J.E., G.V.S.F.), Channing Division of
Network Medicine (E.K.S.), and Division of Pulmonary and Critical Care Medicine,
Department of Medicine (E.K.S.), Brigham and Women’s Hospital, Boston,
Mass; and Thirona, Nijmegen, the Netherlands (J.P.C., R.L.)
| | - Matthew Strand
- From the Division of Biostatistics, Environment and Health (D.B.,
M.S.), Department of Radiology (S.M.H., D.A.L.), and Division of Pulmonary and
Critical Care Medicine, Department of Medicine (J.D.C.), National Jewish Health,
1400 Jackson St, Denver, CO 80206; Applied Chest Imaging Laboratory (R.S.J.E.,
G.V.S.F.), Department of Radiology (R.S.J.E., G.V.S.F.), Channing Division of
Network Medicine (E.K.S.), and Division of Pulmonary and Critical Care Medicine,
Department of Medicine (E.K.S.), Brigham and Women’s Hospital, Boston,
Mass; and Thirona, Nijmegen, the Netherlands (J.P.C., R.L.)
| | - Stephen M. Humphries
- From the Division of Biostatistics, Environment and Health (D.B.,
M.S.), Department of Radiology (S.M.H., D.A.L.), and Division of Pulmonary and
Critical Care Medicine, Department of Medicine (J.D.C.), National Jewish Health,
1400 Jackson St, Denver, CO 80206; Applied Chest Imaging Laboratory (R.S.J.E.,
G.V.S.F.), Department of Radiology (R.S.J.E., G.V.S.F.), Channing Division of
Network Medicine (E.K.S.), and Division of Pulmonary and Critical Care Medicine,
Department of Medicine (E.K.S.), Brigham and Women’s Hospital, Boston,
Mass; and Thirona, Nijmegen, the Netherlands (J.P.C., R.L.)
| | - Raúl San José Estépar
- From the Division of Biostatistics, Environment and Health (D.B.,
M.S.), Department of Radiology (S.M.H., D.A.L.), and Division of Pulmonary and
Critical Care Medicine, Department of Medicine (J.D.C.), National Jewish Health,
1400 Jackson St, Denver, CO 80206; Applied Chest Imaging Laboratory (R.S.J.E.,
G.V.S.F.), Department of Radiology (R.S.J.E., G.V.S.F.), Channing Division of
Network Medicine (E.K.S.), and Division of Pulmonary and Critical Care Medicine,
Department of Medicine (E.K.S.), Brigham and Women’s Hospital, Boston,
Mass; and Thirona, Nijmegen, the Netherlands (J.P.C., R.L.)
| | - Gonzalo Vegas Sanchez-Ferrero
- From the Division of Biostatistics, Environment and Health (D.B.,
M.S.), Department of Radiology (S.M.H., D.A.L.), and Division of Pulmonary and
Critical Care Medicine, Department of Medicine (J.D.C.), National Jewish Health,
1400 Jackson St, Denver, CO 80206; Applied Chest Imaging Laboratory (R.S.J.E.,
G.V.S.F.), Department of Radiology (R.S.J.E., G.V.S.F.), Channing Division of
Network Medicine (E.K.S.), and Division of Pulmonary and Critical Care Medicine,
Department of Medicine (E.K.S.), Brigham and Women’s Hospital, Boston,
Mass; and Thirona, Nijmegen, the Netherlands (J.P.C., R.L.)
| | - Jean-Paul Charbonnier
- From the Division of Biostatistics, Environment and Health (D.B.,
M.S.), Department of Radiology (S.M.H., D.A.L.), and Division of Pulmonary and
Critical Care Medicine, Department of Medicine (J.D.C.), National Jewish Health,
1400 Jackson St, Denver, CO 80206; Applied Chest Imaging Laboratory (R.S.J.E.,
G.V.S.F.), Department of Radiology (R.S.J.E., G.V.S.F.), Channing Division of
Network Medicine (E.K.S.), and Division of Pulmonary and Critical Care Medicine,
Department of Medicine (E.K.S.), Brigham and Women’s Hospital, Boston,
Mass; and Thirona, Nijmegen, the Netherlands (J.P.C., R.L.)
| | - Rudolfs Latisenko
- From the Division of Biostatistics, Environment and Health (D.B.,
M.S.), Department of Radiology (S.M.H., D.A.L.), and Division of Pulmonary and
Critical Care Medicine, Department of Medicine (J.D.C.), National Jewish Health,
1400 Jackson St, Denver, CO 80206; Applied Chest Imaging Laboratory (R.S.J.E.,
G.V.S.F.), Department of Radiology (R.S.J.E., G.V.S.F.), Channing Division of
Network Medicine (E.K.S.), and Division of Pulmonary and Critical Care Medicine,
Department of Medicine (E.K.S.), Brigham and Women’s Hospital, Boston,
Mass; and Thirona, Nijmegen, the Netherlands (J.P.C., R.L.)
| | - Edwin K. Silverman
- From the Division of Biostatistics, Environment and Health (D.B.,
M.S.), Department of Radiology (S.M.H., D.A.L.), and Division of Pulmonary and
Critical Care Medicine, Department of Medicine (J.D.C.), National Jewish Health,
1400 Jackson St, Denver, CO 80206; Applied Chest Imaging Laboratory (R.S.J.E.,
G.V.S.F.), Department of Radiology (R.S.J.E., G.V.S.F.), Channing Division of
Network Medicine (E.K.S.), and Division of Pulmonary and Critical Care Medicine,
Department of Medicine (E.K.S.), Brigham and Women’s Hospital, Boston,
Mass; and Thirona, Nijmegen, the Netherlands (J.P.C., R.L.)
| | - James D. Crapo
- From the Division of Biostatistics, Environment and Health (D.B.,
M.S.), Department of Radiology (S.M.H., D.A.L.), and Division of Pulmonary and
Critical Care Medicine, Department of Medicine (J.D.C.), National Jewish Health,
1400 Jackson St, Denver, CO 80206; Applied Chest Imaging Laboratory (R.S.J.E.,
G.V.S.F.), Department of Radiology (R.S.J.E., G.V.S.F.), Channing Division of
Network Medicine (E.K.S.), and Division of Pulmonary and Critical Care Medicine,
Department of Medicine (E.K.S.), Brigham and Women’s Hospital, Boston,
Mass; and Thirona, Nijmegen, the Netherlands (J.P.C., R.L.)
| | - David A. Lynch
- From the Division of Biostatistics, Environment and Health (D.B.,
M.S.), Department of Radiology (S.M.H., D.A.L.), and Division of Pulmonary and
Critical Care Medicine, Department of Medicine (J.D.C.), National Jewish Health,
1400 Jackson St, Denver, CO 80206; Applied Chest Imaging Laboratory (R.S.J.E.,
G.V.S.F.), Department of Radiology (R.S.J.E., G.V.S.F.), Channing Division of
Network Medicine (E.K.S.), and Division of Pulmonary and Critical Care Medicine,
Department of Medicine (E.K.S.), Brigham and Women’s Hospital, Boston,
Mass; and Thirona, Nijmegen, the Netherlands (J.P.C., R.L.)
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Ji Y, Whitney HM, Li H, Liu P, Giger ML, Zhang X. Differences in Molecular Subtype Reference Standards Impact AI-based Breast Cancer Classification with Dynamic Contrast-enhanced MRI. Radiology 2023; 307:e220984. [PMID: 36594836 PMCID: PMC10068887 DOI: 10.1148/radiol.220984] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/20/2022] [Accepted: 11/01/2022] [Indexed: 01/04/2023]
Abstract
Background Breast cancer tumors can be identified as different luminal molecular subtypes depending on either immunohistochemical (IHC) staining or St Gallen criteria that includes Ki-67. Purpose To characterize molecular subtypes and understand the impact of disagreement among IHC and St Gallen molecular subtype reference standards on artificial intelligence classification of luminal A and luminal B tumors with use of radiomic features extracted from dynamic contrast-enhanced (DCE) MRI scans. Materials and Methods In this retrospective study, 28 radiomic features previously extracted from DCE-MRI scans of breast tumors imaged between February 2015 and October 2017 were examined in the following groups: (a) tumors classified as luminal A by both reference standards ("agreement"), (b) tumors classified as luminal A by IHC and luminal B by St Gallen ("disagreement"), and (c) tumors classified as luminal B by both ("agreement"). Luminal A or luminal B tumor classification with use of radiomic features was conducted with use of three sets: (a) IHC molecular subtyping, (b) St Gallen molecular subtyping, and (c) agreement tumors. The Kruskal-Wallis test was followed by the Mann-Whitney U test to determine pair-wise differences of radiomic features among agreement and disagreement tumors. Fivefold cross-validation with use of stepwise feature selection and linear discriminant analysis classified tumors in each set, with performance measured with use of area under the receiver operating characteristic curve (AUC). Results A total of 877 breast cancer tumors from 872 women (mean age, 48 years [range, 19-75 years]) were analyzed. Six features (sphericity, irregularity, surface area to volume ratio, variance of radial gradient histogram, sum average, volume of most enhancing voxels) were different (P ≤ .001) among agreement and disagreement tumors. AUC (median, 0.74 [95% CI: 0.68, 0.80]) was higher than when using tumors subtyped by either reference standard (IHC, 0.66 [0.60, 0.71], P = .003; St Gallen, 0.62 [0.58, 0.67], P = .001). Conclusion Differences in reference standards can hinder artificial intelligence classification performance of luminal molecular subtypes with dynamic contrast-enhanced MRI. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Bae in this issue.
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Affiliation(s)
- Yu Ji
- From the Department of Radiology, The Second Hospital of Tianjin
Medical University, No. 23 Pingjiang Rd, Hexi District, Tianjin, China 300211
(Y.J., X.Z.); National Clinical Research Center for Cancer, Tianjin Medical
University Cancer Institute and Hospital, Tianjin, China (Y.J., P.L.);
Department of Radiology, The University of Chicago, Chicago, Ill (H.M.W., H.L.,
M.L.G.); and Department of Physics, Wheaton College, Wheaton, Ill
(H.M.W.)
| | - Heather M. Whitney
- From the Department of Radiology, The Second Hospital of Tianjin
Medical University, No. 23 Pingjiang Rd, Hexi District, Tianjin, China 300211
(Y.J., X.Z.); National Clinical Research Center for Cancer, Tianjin Medical
University Cancer Institute and Hospital, Tianjin, China (Y.J., P.L.);
Department of Radiology, The University of Chicago, Chicago, Ill (H.M.W., H.L.,
M.L.G.); and Department of Physics, Wheaton College, Wheaton, Ill
(H.M.W.)
| | - Hui Li
- From the Department of Radiology, The Second Hospital of Tianjin
Medical University, No. 23 Pingjiang Rd, Hexi District, Tianjin, China 300211
(Y.J., X.Z.); National Clinical Research Center for Cancer, Tianjin Medical
University Cancer Institute and Hospital, Tianjin, China (Y.J., P.L.);
Department of Radiology, The University of Chicago, Chicago, Ill (H.M.W., H.L.,
M.L.G.); and Department of Physics, Wheaton College, Wheaton, Ill
(H.M.W.)
| | - Peifang Liu
- From the Department of Radiology, The Second Hospital of Tianjin
Medical University, No. 23 Pingjiang Rd, Hexi District, Tianjin, China 300211
(Y.J., X.Z.); National Clinical Research Center for Cancer, Tianjin Medical
University Cancer Institute and Hospital, Tianjin, China (Y.J., P.L.);
Department of Radiology, The University of Chicago, Chicago, Ill (H.M.W., H.L.,
M.L.G.); and Department of Physics, Wheaton College, Wheaton, Ill
(H.M.W.)
| | - Maryellen L. Giger
- From the Department of Radiology, The Second Hospital of Tianjin
Medical University, No. 23 Pingjiang Rd, Hexi District, Tianjin, China 300211
(Y.J., X.Z.); National Clinical Research Center for Cancer, Tianjin Medical
University Cancer Institute and Hospital, Tianjin, China (Y.J., P.L.);
Department of Radiology, The University of Chicago, Chicago, Ill (H.M.W., H.L.,
M.L.G.); and Department of Physics, Wheaton College, Wheaton, Ill
(H.M.W.)
| | - Xuening Zhang
- From the Department of Radiology, The Second Hospital of Tianjin
Medical University, No. 23 Pingjiang Rd, Hexi District, Tianjin, China 300211
(Y.J., X.Z.); National Clinical Research Center for Cancer, Tianjin Medical
University Cancer Institute and Hospital, Tianjin, China (Y.J., P.L.);
Department of Radiology, The University of Chicago, Chicago, Ill (H.M.W., H.L.,
M.L.G.); and Department of Physics, Wheaton College, Wheaton, Ill
(H.M.W.)
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48
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Yokoo T, Masaki N, Parikh ND, Lane BF, Feng Z, Mendiratta-Lala M, Lee CH, Khatri G, Marsh TL, Shetty K, Dunn CT, Al-Jarrah T, Aslam A, Davenport MS, Gopal P, Rich NE, Lok AS, Singal AG. Multicenter Validation of Abbreviated MRI for Detecting Early-Stage Hepatocellular Carcinoma. Radiology 2023; 307:e220917. [PMID: 36692401 PMCID: PMC10102624 DOI: 10.1148/radiol.220917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 11/12/2022] [Accepted: 11/23/2022] [Indexed: 01/25/2023]
Abstract
Background Abbreviated MRI is a proposed paradigm shift for hepatocellular carcinoma (HCC) surveillance, but data on its performance are lacking for histopathologically confirmed early-stage HCC. Purpose To evaluate the sensitivity and specificity of dynamic contrast-enhanced abbreviated MRI for early-stage HCC detection, using surgical pathologic findings as the reference standard. Materials and Methods This retrospective study was conducted at three U.S. liver transplant centers in patients with cirrhosis who underwent liver resection or transplant between January 2009 and December 2019 and standard "full" liver MRI with and without contrast enhancement within 3 months before surgery. Patients who had HCC-directed treatment before surgery were excluded. Dynamic abbreviated MRI examinations were simulated from the presurgical full MRI by selecting the coronal T2-weighted and axial three-dimensional fat-suppressed T1-weighted dynamic contrast-enhanced sequences at precontrast, late arterial, portal venous, and delayed phases. Two abdominal radiologists at each center independently interpreted the simulated abbreviated examinations with use of the Liver Imaging Reporting and Data System version 2018. Patients with any high-risk liver observations (>LR-3) were classified as positive; otherwise, they were classified as negative. With liver pathologic findings as the reference standard for the presence versus absence of early-stage HCC, the sensitivity, specificity, and their 95% CIs were calculated. Logistic regression was used to identify factors associated with correct classification. Results A total of 161 patients with early-stage HCC (median age, 62 years [IQR, 58-67 years]; 123 men) and 138 patients without HCC (median age, 55 years [IQR, 47-63 years]; 85 men) were confirmed with surgical pathologic findings. The sensitivity and specificity of abbreviated MRI were 88.2% (142 of 161 patients) (95% CI: 83.5, 92.5) and 89.1% (123 of 138 patients) (95% CI: 84.4, 93.8), respectively. Sensitivity was lower for Child-Pugh class B or C versus Child-Pugh class A cirrhosis (64.1% vs 94.2%; P < .001). Conclusion With surgical pathologic findings as the reference standard, dynamic abbreviated MRI had high sensitivity and specificity for early-stage hepatocellular carcinoma detection in patients with compensated cirrhosis but lower sensitivity in those with decompensated cirrhosis. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Kim in this issue.
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Affiliation(s)
- Takeshi Yokoo
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Nobuaki Masaki
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Neehar D. Parikh
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Barton F. Lane
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Ziding Feng
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Mishal Mendiratta-Lala
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Chee Hwee Lee
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Gaurav Khatri
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Tracey L. Marsh
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Kirti Shetty
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Colin T. Dunn
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Taim Al-Jarrah
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Anum Aslam
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Matthew S. Davenport
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Purva Gopal
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Nicole E. Rich
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Anna S. Lok
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
| | - Amit G. Singal
- From the Departments of Radiology (T.Y., G.K.), Internal Medicine
(C.T.D., N.E.R., A.G.S.), and Pathology (P.G.), UT Southwestern Medical Center,
5959 Harry Hines Blvd, POB 1, Ste 420, Dallas, TX 75390-8887; Department of
Biostatistics, University of Washington, Seattle, Wash (N.M.); Departments of
Internal Medicine (N.D.P., T.A.J., A.S.L.) and Radiology (M.M.L., A.A., M.S.D.),
University of Michigan Medical School, Ann Arbor, Mich; Departments of
Diagnostic Radiology (B.F.L., C.H.L.) and Internal Medicine (K.S.), University
of Maryland, Baltimore, Md; and Division of Public Health Sciences, Fred Hutch
Cancer Center, Seattle, Wash (Z.F., T.L.M.)
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Jones BC, Lee H, Cheng CC, al Mukaddam M, Song HK, Snyder PJ, Kamona N, Rajapakse CS, Wehrli FW. MRI Quantification of Cortical Bone Porosity, Mineralization, and Morphologic Structure in Postmenopausal Osteoporosis. Radiology 2023; 307:e221810. [PMID: 36692396 PMCID: PMC10102628 DOI: 10.1148/radiol.221810] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/08/2022] [Accepted: 11/23/2022] [Indexed: 01/25/2023]
Abstract
Background Preclinical studies have suggested that solid-state MRI markers of cortical bone porosity, morphologic structure, mineralization, and osteoid density are useful measures of bone health. Purpose To explore whether MRI markers of cortical bone porosity, morphologic structure, mineralization, and osteoid density are affected in postmenopausal osteoporosis (OP) and to examine associations between MRI markers and bone mineral density (BMD) in postmenopausal women. Materials and Methods In this single-center study, postmenopausal women were prospectively recruited from January 2019 to October 2020 into two groups: participants with OP who had not undergone treatment, defined as having any dual-energy x-ray absorptiometry (DXA) T-score of -2.5 or less, and age-matched control participants without OP (hereafter, non-OP). Participants underwent MRI in the midtibia, along with DXA in the hip and spine, and peripheral quantitative CT in the midtibia. Specifically, MRI measures of cortical bone porosity (pore water and total water), osteoid density (bound water [BW]), morphologic structure (cortical bone thickness), and mineralization (phosphorous [P] density [31P] and 31P-to-BW concentration ratio) were quantified at 3.0 T. MRI measures were compared between OP and non-OP groups and correlations with BMD were assessed. Results Fifteen participants with OP (mean age, 63 years ± 5 [SD]) and 19 participants without OP (mean age, 65 years ± 6) were evaluated. The OP group had elevated pore water (11.6 mol/L vs 9.5 mol/L; P = .007) and total water densities (21.2 mol/L vs 19.7 mol/L; P = .03), and had lower cortical bone thickness (4.8 mm vs 5.6 mm; P < .001) and 31P density (6.4 mol/L vs 7.5 mol/L; P = .01) than the non-OP group, respectively, although there was no evidence of a difference in BW or 31P-to-BW concentration ratio. Pore and total water densities were inversely associated with DXA and peripheral quantitative CT BMD (P < .001), whereas cortical bone thickness and 31P density were positively associated with DXA and peripheral quantitative CT BMD (P = .01). BW, 31P density, and 31P-to-BW concentration ratio were positively associated with DXA (P < .05), but not with peripheral quantitative CT. Conclusion Solid-state MRI of cortical bone was able to help detect potential impairments in parameters reflecting porosity, morphologic structure, and mineralization in postmenopausal osteoporosis. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Bae in this issue.
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Affiliation(s)
- Brandon C. Jones
- From the Department of Radiology, Perelman School of Medicine
(B.C.J., H.L., C.C.C., H.K.S., N.K., C.S.R., F.W.W.), Department of
Bioengineering, School of Engineering and Applied Sciences (B.C.J., N.K.),
Department of Medicine, Division of Endocrinology, Diabetes and Metabolism,
Perelman School of Medicine (M.A.M., P.J.S.), and Department of Orthopedic
Surgery, Perelman School of Medicine (C.S.R.), University of Pennsylvania, 1
Founders Building, 3400 Spruce St, Philadelphia, PA 19104
| | | | | | - Mona al Mukaddam
- From the Department of Radiology, Perelman School of Medicine
(B.C.J., H.L., C.C.C., H.K.S., N.K., C.S.R., F.W.W.), Department of
Bioengineering, School of Engineering and Applied Sciences (B.C.J., N.K.),
Department of Medicine, Division of Endocrinology, Diabetes and Metabolism,
Perelman School of Medicine (M.A.M., P.J.S.), and Department of Orthopedic
Surgery, Perelman School of Medicine (C.S.R.), University of Pennsylvania, 1
Founders Building, 3400 Spruce St, Philadelphia, PA 19104
| | - Hee Kwon Song
- From the Department of Radiology, Perelman School of Medicine
(B.C.J., H.L., C.C.C., H.K.S., N.K., C.S.R., F.W.W.), Department of
Bioengineering, School of Engineering and Applied Sciences (B.C.J., N.K.),
Department of Medicine, Division of Endocrinology, Diabetes and Metabolism,
Perelman School of Medicine (M.A.M., P.J.S.), and Department of Orthopedic
Surgery, Perelman School of Medicine (C.S.R.), University of Pennsylvania, 1
Founders Building, 3400 Spruce St, Philadelphia, PA 19104
| | - Peter J. Snyder
- From the Department of Radiology, Perelman School of Medicine
(B.C.J., H.L., C.C.C., H.K.S., N.K., C.S.R., F.W.W.), Department of
Bioengineering, School of Engineering and Applied Sciences (B.C.J., N.K.),
Department of Medicine, Division of Endocrinology, Diabetes and Metabolism,
Perelman School of Medicine (M.A.M., P.J.S.), and Department of Orthopedic
Surgery, Perelman School of Medicine (C.S.R.), University of Pennsylvania, 1
Founders Building, 3400 Spruce St, Philadelphia, PA 19104
| | - Nada Kamona
- From the Department of Radiology, Perelman School of Medicine
(B.C.J., H.L., C.C.C., H.K.S., N.K., C.S.R., F.W.W.), Department of
Bioengineering, School of Engineering and Applied Sciences (B.C.J., N.K.),
Department of Medicine, Division of Endocrinology, Diabetes and Metabolism,
Perelman School of Medicine (M.A.M., P.J.S.), and Department of Orthopedic
Surgery, Perelman School of Medicine (C.S.R.), University of Pennsylvania, 1
Founders Building, 3400 Spruce St, Philadelphia, PA 19104
| | - Chamith S. Rajapakse
- From the Department of Radiology, Perelman School of Medicine
(B.C.J., H.L., C.C.C., H.K.S., N.K., C.S.R., F.W.W.), Department of
Bioengineering, School of Engineering and Applied Sciences (B.C.J., N.K.),
Department of Medicine, Division of Endocrinology, Diabetes and Metabolism,
Perelman School of Medicine (M.A.M., P.J.S.), and Department of Orthopedic
Surgery, Perelman School of Medicine (C.S.R.), University of Pennsylvania, 1
Founders Building, 3400 Spruce St, Philadelphia, PA 19104
| | - Felix W. Wehrli
- From the Department of Radiology, Perelman School of Medicine
(B.C.J., H.L., C.C.C., H.K.S., N.K., C.S.R., F.W.W.), Department of
Bioengineering, School of Engineering and Applied Sciences (B.C.J., N.K.),
Department of Medicine, Division of Endocrinology, Diabetes and Metabolism,
Perelman School of Medicine (M.A.M., P.J.S.), and Department of Orthopedic
Surgery, Perelman School of Medicine (C.S.R.), University of Pennsylvania, 1
Founders Building, 3400 Spruce St, Philadelphia, PA 19104
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50
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Jayaprakasam VS, Alvarez J, Omer DM, Gollub MJ, Smith JJ, Petkovska I. Watch-and-Wait Approach to Rectal Cancer: The Role of Imaging. Radiology 2023; 307:e221529. [PMID: 36880951 PMCID: PMC10068893 DOI: 10.1148/radiol.221529] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 03/08/2023]
Abstract
The diagnosis and treatment of rectal cancer have evolved dramatically over the past several decades. At the same time, its incidence has increased in younger populations. This review will inform the reader of advances in both diagnosis and treatment. These advances have led to the watch-and-wait approach, otherwise known as nonsurgical management. This review briefly outlines changes in medical and surgical treatment, advances in MRI technology and interpretation, and landmark studies or trials that have led to this exciting juncture. Herein, the authors delve into current state-of-the-art methods to assess response to treatment with MRI and endoscopy. Currently, these methods for avoiding surgery can be used to detect a complete clinical response in as many as 50% of patients with rectal cancer. Finally, the limitations of imaging and endoscopy and future challenges will be discussed.
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Affiliation(s)
- Vetri Sudar Jayaprakasam
- From the Departments of Radiology (V.S.J., M.J.G., I.P.) and Surgery
(J.A., D.M.O., J.J.S.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave,
Box 29, New York, NY 10065
| | - Janet Alvarez
- From the Departments of Radiology (V.S.J., M.J.G., I.P.) and Surgery
(J.A., D.M.O., J.J.S.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave,
Box 29, New York, NY 10065
| | - Dana M. Omer
- From the Departments of Radiology (V.S.J., M.J.G., I.P.) and Surgery
(J.A., D.M.O., J.J.S.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave,
Box 29, New York, NY 10065
| | - Marc J. Gollub
- From the Departments of Radiology (V.S.J., M.J.G., I.P.) and Surgery
(J.A., D.M.O., J.J.S.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave,
Box 29, New York, NY 10065
| | - J. Joshua Smith
- From the Departments of Radiology (V.S.J., M.J.G., I.P.) and Surgery
(J.A., D.M.O., J.J.S.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave,
Box 29, New York, NY 10065
| | - Iva Petkovska
- From the Departments of Radiology (V.S.J., M.J.G., I.P.) and Surgery
(J.A., D.M.O., J.J.S.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave,
Box 29, New York, NY 10065
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