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Oh G, Moon Y, Moon WJ, Ye JC. Unpaired deep learning for pharmacokinetic parameter estimation from dynamic contrast-enhanced MRI without AIF measurements. Neuroimage 2024; 291:120571. [PMID: 38518829 DOI: 10.1016/j.neuroimage.2024.120571] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 03/24/2024] Open
Abstract
DCE-MRI provides information about vascular permeability and tissue perfusion through the acquisition of pharmacokinetic parameters. However, traditional methods for estimating these pharmacokinetic parameters involve fitting tracer kinetic models, which often suffer from computational complexity and low accuracy due to noisy arterial input function (AIF) measurements. Although some deep learning approaches have been proposed to tackle these challenges, most existing methods rely on supervised learning that requires paired input DCE-MRI and labeled pharmacokinetic parameter maps. This dependency on labeled data introduces significant time and resource constraints and potential noise in the labels, making supervised learning methods often impractical. To address these limitations, we present a novel unpaired deep learning method for estimating pharmacokinetic parameters and the AIF using a physics-driven CycleGAN approach. Our proposed CycleGAN framework is designed based on the underlying physics model, resulting in a simpler architecture with a single generator and discriminator pair. Crucially, our experimental results indicate that our method does not necessitate separate AIF measurements and produces more reliable pharmacokinetic parameters than other techniques.
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Affiliation(s)
- Gyutaek Oh
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291, Daehak-ro, Yuseong-gu, 34141, Daejeon, Republic of Korea
| | - Yeonsil Moon
- Department of Neurology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, 05030, Seoul, Republic of Korea
| | - Won-Jin Moon
- Department of Radiology, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, 05030, Seoul, Republic of Korea.
| | - Jong Chul Ye
- Kim Jaechul Graduate School of AI, Korea Advanced Institute of Science and Technology (KAIST), 291, Daehak-ro, Yuseong-gu, 34141, Daejeon, Republic of Korea.
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Yang J, Dong X, Wang F, Jin S, Zhang B, Zhang H, Pan W, Gan M, Duan S, Zhang L, Hu H, Ji W. A deep learning model based on MRI for prediction of vessels encapsulating tumour clusters and prognosis in hepatocellular carcinoma. Abdom Radiol (NY) 2024; 49:1074-1083. [PMID: 38175256 DOI: 10.1007/s00261-023-04141-3] [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: 09/19/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE This study aimed to build and evaluate a deep learning (DL) model to predict vessels encapsulating tumor clusters (VETC) and prognosis preoperatively in patients with hepatocellular carcinoma (HCC). METHODS 320 pathologically confirmed HCC patients (58 women and 262 men) from two hospitals were included in this retrospective study. Institution 1 (n = 219) and Institution 2 (n = 101) served as the training and external test cohorts, respectively. Tumors were evaluated three-dimensionally and regions of interest were segmented manually in the arterial, portal venous, and delayed phases (AP, PP, and DP). Three ResNet-34 DL models were developed, consisting of three models based on a single sequence. The fusion model was developed by inputting the prediction probability of the output from the three single-sequence models into logistic regression. The area under the receiver operating characteristic curve (AUC) was used to compare performance, and the Delong test was used to compare AUCs. Early recurrence (ER) was defined as recurrence within two years of surgery and early recurrence-free survival (ERFS) rate was evaluated by Kaplan-Meier survival analysis. RESULTS Among the 320 HCC patients, 227 were VETC- and 93 were VETC+ . In the external test cohort, the fusion model showed an AUC of 0.772, a sensitivity of 0.80, and a specificity of 0.61. The fusion model-based prediction of VETC high-risk and low-risk categories exhibits a significant difference in ERFS rates, akin to the outcomes observed in VETC + and VETC- confirmed through pathological analyses (p < 0.05). CONCLUSIONS A DL framework based on ResNet-34 has demonstrated potential in facilitating non-invasive prediction of VETC as well as patient prognosis.
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Affiliation(s)
- Jiawen Yang
- Department of Radiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen St, Linhai, Taizhou, 317000, Zhejiang, China
| | - Xue Dong
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fang Wang
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, People's Republic of China
| | - Shengze Jin
- Department of Radiology, Taizhou Hospital of Zhejiang Province, Shaoxing University, Taizhou, 318000, Zhejiang, China
| | - Binhao Zhang
- Department of Radiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen St, Linhai, Taizhou, 317000, Zhejiang, China
| | - Huangqi Zhang
- Department of Radiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen St, Linhai, Taizhou, 317000, Zhejiang, China
| | - Wenting Pan
- Department of Radiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen St, Linhai, Taizhou, 317000, Zhejiang, China
| | - Meifu Gan
- Department of Pathology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, 317000, Zhejiang, China
| | - Shaofeng Duan
- GE Healthcare, Precision Health Institution, Pudong New Town, No.1, Huatuo Road, Shanghai, 210000, China
| | - Limin Zhang
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongjie Hu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, People's Republic of China
| | - Wenbin Ji
- Department of Radiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen St, Linhai, Taizhou, 317000, Zhejiang, China.
- Department of Radiology, Taizhou Hospital, Zhejiang University, Taizhou, 318000, Zhejiang, China.
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Löffler MT, Wu PH, Pirmoazen AM, Joseph GB, Stewart JM, Saeed I, Liu J, Schafer AL, Schwartz AV, Link TM, Kazakia GJ. Microvascular disease not type 2 diabetes is associated with increased cortical porosity: A study of cortical bone microstructure and intracortical vessel characteristics. Bone Rep 2024; 20:101745. [PMID: 38444830 PMCID: PMC10912053 DOI: 10.1016/j.bonr.2024.101745] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/05/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction Fracture risk is elevated in type 2 diabetes (T2D) despite normal or even high bone mineral density (BMD). Microvascular disease (MVD) is a diabetic complication, but also associated with other diseases, for example chronic kidney disease. We hypothesize that increased fracture risk in T2D could be due to increased cortical porosity (Ct.Po) driven by expansion of the vascular network in MVD. The purpose of this study was to investigate associations of T2D and MVD with cortical microstructure and intracortical vessel parameters. Methods The study group consisted of 75 participants (38 with T2D and 37 without T2D). High-resolution peripheral quantitative CT (HR-pQCT) and dynamic contrast-enhanced MRI (DCE-MRI) of the ultra-distal tibia were performed to assess cortical bone and intracortical vessels (outcomes). MVD was defined as ≥1 manifestation including neuropathy, nephropathy, or retinopathy based on clinical exams in all participants. Adjusted means of outcomes were compared between groups with/without T2D or between participants with/without MVD in both groups using linear regression models adjusting for age, sex, BMI, and T2D as applicable. Results MVD was found in 21 (55 %) participants with T2D and in 9 (24 %) participants without T2D. In T2D, cortical pore diameter (Ct.Po.Dm) and diameter distribution (Ct.Po.Dm.SD) were significantly higher by 14.6 μm (3.6 %, 95 % confidence interval [CI]: 2.70, 26.5 μm, p = 0.017) and by 8.73 μm (4.8 %, CI: 0.79, 16.7 μm, p = 0.032), respectively. In MVD, but not in T2D, cortical porosity was significantly higher by 2.25 % (relative increase = 12.9 %, CI: 0.53, 3.97 %, p = 0.011) and cortical BMD (Ct.BMD) was significantly lower by -43.6 mg/cm3 (2.6 %, CI: -77.4, -9.81 mg/cm3, p = 0.012). In T2D, vessel volume and vessel diameter were significantly higher by 0.02 mm3 (13.3 %, CI: 0.004, 0.04 mm3, p = 0.017) and 15.4 μm (2.9 %, CI: 0.42, 30.4 μm, p = 0.044), respectively. In MVD, vessel density was significantly higher by 0.11 mm-3 (17.8 %, CI: 0.01, 0.21 mm-3, p = 0.033) and vessel volume and diameter were significantly lower by -0.02 mm3 (13.7 %, CI: -0.04, -0.004 mm3, p = 0.015) and - 14.6 μm (2.8 %, CI: -29.1, -0.11 μm, p = 0.048), respectively. Conclusions The presence of MVD, rather than T2D, was associated with increased cortical porosity. Increased porosity in MVD was coupled with a larger number of smaller vessels, which could indicate upregulation of neovascularization triggered by ischemia. It is unclear why higher variability and average diameters of pores in T2D were accompanied by larger vessels.
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Affiliation(s)
- Maximilian T. Löffler
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg im Breisgau, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Po-hung Wu
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Amir M. Pirmoazen
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Gabby B. Joseph
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Jay M. Stewart
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Isra Saeed
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Jing Liu
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Anne L. Schafer
- Department of Medicine, University of California, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Ann V. Schwartz
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
| | - Galateia J. Kazakia
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA 94107, USA
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Kalisvaart GM, Van Den Berghe T, Grootjans W, Lejoly M, Huysse WCJ, Bovée JVMG, Creytens D, Gelderblom H, Speetjens FM, Lapeire L, van de Sande MAJ, Sys G, de Geus-Oei LF, Verstraete KL, Bloem JL. Evaluation of response to neoadjuvant chemotherapy in osteosarcoma using dynamic contrast-enhanced MRI: development and external validation of a model. Skeletal Radiol 2024; 53:319-328. [PMID: 37464020 PMCID: PMC10730632 DOI: 10.1007/s00256-023-04402-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE To identify which dynamic contrast-enhanced (DCE-)MRI features best predict histological response to neoadjuvant chemotherapy in patients with an osteosarcoma. METHODS Patients with osteosarcoma who underwent DCE-MRI before and after neoadjuvant chemotherapy prior to resection were retrospectively included at two different centers. Data from the center with the larger cohort (training cohort) was used to identify which method for region-of-interest selection (whole slab or focal area method) and which change in DCE-MRI features (time to enhancement, wash-in rate, maximum relative enhancement and area under the curve) gave the most accurate prediction of histological response. Models were created using logistic regression and cross-validated. The most accurate model was then externally validated using data from the other center (test cohort). RESULTS Fifty-five (27 poor response) and 30 (19 poor response) patients were included in training and test cohorts, respectively. Intraclass correlation coefficient of relative DCE-MRI features ranged 0.81-0.97 with the whole slab and 0.57-0.85 with the focal area segmentation method. Poor histological response was best predicted with the whole slab segmentation method using a single feature threshold, relative wash-in rate <2.3. Mean accuracy was 0.85 (95%CI: 0.75-0.95), and area under the receiver operating characteristic curve (AUC-index) was 0.93 (95%CI: 0.86-1.00). In external validation, accuracy and AUC-index were 0.80 and 0.80. CONCLUSION In this study, a relative wash-in rate of <2.3 determined with the whole slab segmentation method predicted histological response to neoadjuvant chemotherapy in osteosarcoma. Consistent performance was observed in an external test cohort.
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Affiliation(s)
- Gijsbert M Kalisvaart
- Department of Radiology and Nuclear Medicine, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands.
| | - Thomas Van Den Berghe
- Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium
| | - Willem Grootjans
- Department of Radiology and Nuclear Medicine, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Maryse Lejoly
- Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium
| | - Wouter C J Huysse
- Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium
| | - Judith V M G Bovée
- Department of Pathology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - David Creytens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Frank M Speetjens
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Lore Lapeire
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Michiel A J van de Sande
- Department of Orthopedics, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Gwen Sys
- Department of Orthopedics, Ghent University Hospital, Ghent, Belgium
| | - Lioe-Fee de Geus-Oei
- Department of Radiology and Nuclear Medicine, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Koenraad L Verstraete
- Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium
| | - Johan L Bloem
- Department of Radiology and Nuclear Medicine, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
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Kåstad Høiskar M, Sæther O, Delange Alsaker M, Røe Redalen K, Winter RM. Quantitative dynamic contrast-enhanced magnetic resonance imaging in head and neck cancer: A systematic comparison of different modelling approaches. Phys Imaging Radiat Oncol 2024; 29:100548. [PMID: 38380153 PMCID: PMC10876686 DOI: 10.1016/j.phro.2024.100548] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/24/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024] Open
Abstract
Background and purpose Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) describes tissue microvasculature and has prognostic and predictive potential in radiotherapy for head and neck cancer (HNC). However, lack in standardization of DCE-MRI hinders comparison of studies and clinical implementation. This study investigated the accuracy and robustness of the population arterial input function (AIF), correlations between pharmacokinetic parameters and their association to T stage and human papillomavirus (HPV) status for HNC. Materials and methods DCE-MRI was acquired for 44 HNC patients. Population AIFs were calculated with six different approaches. DCE-MRI was analysed in primary and lymph node tumours using Tofts model (TM) with population AIFs and individual AIFs, extended TM (ETM) with individual AIFs, Brix model (BM), and areas under the curve (AUCs). Intraclass correlation, concordance correlation, Pearson correlation and Whitney Mann U test helped examining the robustness and accuracy of population AIF, correlations between DCE-MRI parameters and their association to T stage and HPV status, respectively. Results The population AIF was robust but differed from individual AIFs. There was significant correlation between KtransTM/ETM and ve, TM/ETM, and KtransTM/ETM and Kep, TM/ETM. ABrix and AUCs correlated for lymph nodes. Kep, Brix correlated with ABrix, KtransTM/ETM and Kep, TM/ETM for primary tumours. Kep, TM significantly decreased with increasing T stage. Both the correlations and the parameters' association to T stage were stronger for HPV negative lesions. Conclusions Individual AIF was preferred for accurate pharmacokinetic modelling of DCE-MRI. DCE-MRI parameters and their correlations were affected by the lesion type, HPV status and T staging.
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Affiliation(s)
- Marte Kåstad Høiskar
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Oddbjørn Sæther
- Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | | | - Kathrine Røe Redalen
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - René M. Winter
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
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Sun R, Wei L, Hou X, Chen Y, Han B, Xie Y, Nie S. Molecular-subtype guided automatic invasive breast cancer grading using dynamic contrast-enhanced MRI. Comput Methods Programs Biomed 2023; 242:107804. [PMID: 37716219 DOI: 10.1016/j.cmpb.2023.107804] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 04/05/2023] [Accepted: 09/05/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Histological grade and molecular subtype have presented valuable references in assigning personalized or precision medicine as the significant prognostic indicators representing biological behaviors of invasive breast cancer (IBC). To evaluate a two-stage deep learning framework for IBC grading that incorporates with molecular-subtype (MS) information using DCE-MRI. METHODS In Stage I, an innovative neural network called IOS2-DA is developed, which includes a dense atrous-spatial pyramid pooling block with a pooling layer (DA) and inception-octconved blocks with double kernel squeeze-and-excitations (IOS2). This method focuses on the imaging manifestation of IBC grades and performs preliminary prediction using a novel class F1-score loss function. In Stage II, a MS attention branch is introduced to fine-tune the integrated deep vectors from IOS2-DA via Kullback-Leibler divergence. The MS-guided information is weighted with preliminary results to obtain classification values, which are analyzed by ensemble learning for tumor grade prediction on three MRI post-contrast series. Objective assessment is quantitatively evaluated by receiver operating characteristic curve analysis. DeLong test is applied to measure statistical significance (P < 0.05). RESULTS The molecular-subtype guided IOS2-DA performs significantly better than the single IOS2-DA in terms of accuracy (0.927), precision (0.942), AUC (0.927, 95% CI: [0.908, 0.946]), and F1-score (0.930). The gradient-weighted class activation maps show that the feature representations extracted from IOS2-DA are consistent with tumor areas. CONCLUSIONS IOS2-DA elucidates its potential in non-invasive tumor grade prediction. With respect to the correlation between MS and histological grade, it exhibits remarkable clinical prospects in the application of relevant clinical biomarkers to enhance the diagnostic effectiveness of IBC grading. Therefore, DCE-MRI tends to be a feasible imaging modality for the thorough preoperative assessment of breast biological behavior and carcinoma prognosis.
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Affiliation(s)
- Rong Sun
- School of Health Science and Engineering, University of Shanghai for Science and Technology, No. 516 Jun-Gong Road, Shanghai 200093, China
| | - Long Wei
- School of Computer Science and Technology, Shandong Jianzhu University, Shandong, China
| | - Xuewen Hou
- School of Health Science and Engineering, University of Shanghai for Science and Technology, No. 516 Jun-Gong Road, Shanghai 200093, China
| | - Yang Chen
- School of Health Science and Engineering, University of Shanghai for Science and Technology, No. 516 Jun-Gong Road, Shanghai 200093, China
| | - Baosan Han
- Department of General Surgery, Xinhua Hospital, Affiliated with Shanghai Jiao Tong University School of Medicine, China.
| | - Yuanzhong Xie
- Medical Imaging Center, Tai'an Central Hospital, No. 29 Long-Tan Road, Shandong 271099, China.
| | - Shengdong Nie
- School of Health Science and Engineering, University of Shanghai for Science and Technology, No. 516 Jun-Gong Road, Shanghai 200093, China.
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Fotouhi M, Samadi Khoshe Mehr F, Delazar S, Shahidi R, Setayeshpour B, Toosi MN, Arian A. Assessment of LI-RADS efficacy in classification of hepatocellular carcinoma and benign liver nodules using DCE-MRI features and machine learning. Eur J Radiol Open 2023; 11:100535. [PMID: 37964787 PMCID: PMC10641154 DOI: 10.1016/j.ejro.2023.100535] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 11/16/2023] Open
Abstract
Purpose The current study aimed to evaluate the efficiency of dynamic contrast-enhanced (DCE) MRI visual features in classifying benign liver nodules and hepatocellular carcinoma (HCC) using a machine learning model. Methods 115 LI-RADS3, 137 LI-RADS4, and 140 LI-RADS5 nodules were included (392 nodules from 245 patients), which were evaluated by follow-up imaging for LR-3 and pathology results for LR-4 and LR-5 nodules. Data was collected retrospectively from 3 T and 1.5 T MRI scanners. All the lesions were categorized into 124 benign and 268 HCC lesions. Visual features included tumor size, arterial-phase hyper-enhancement (APHE), washout, lesion segment, mass/mass-like, and capsule presence. Gini-importance method extracted the most important features to prevent over-fitting. Final dataset was split into training(70%), validation(10%), and test dataset(20%). The SVM model was used to train the classifying algorithm. For model validation, 5-fold cross-validation was utilized, and the test data set was used to assess the final accuracy. The area under the curve and receiver operating characteristic curves were used to assess the performance of the classifier model. Results For test dataset, the accuracy, sensitivity, and specificity values for classifying benign and HCC lesions were 82%,84%, and 81%, respectively. APHE, washout, tumor size, and mass/mass-like features significantly differentiated benign and HCC lesions with p-value < .001. Conclusions The developed classification model employing DCE-MRI features showed significant performance of visual features in classifying benign and HCC lesions. Our study also highlighted the significance of mass and mass-like features in addition to LI-RADS categorization. For future work, this study suggests developing a deep-learning algorithm for automatic lesion segmentation and feature assessment to reduce lesion categorization errors.
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Affiliation(s)
- Maryam Fotouhi
- Advanced Diagnostic and Interventional Radiology (ADIR), Radiology department, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Iran
| | - Fardin Samadi Khoshe Mehr
- Research Centre for Molecular and Cellular Imaging (RCMCI), Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Delazar
- Advanced Diagnostic and Interventional Radiology (ADIR), Radiology department, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Iran
| | - Ramin Shahidi
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Mohssen Nassiri Toosi
- Imam Khomeini Hospital Complex, Liver Transplantation Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Arvin Arian
- Advanced Diagnostic and Interventional Radiology (ADIR), Radiology department, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Iran
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Goto M, Sakai K, Toyama Y, Nakai Y, Yamada K. Use of a deep learning algorithm for non-mass enhancement on breast MRI: comparison with radiologists' interpretations at various levels. Jpn J Radiol 2023; 41:1094-1103. [PMID: 37071250 PMCID: PMC10543141 DOI: 10.1007/s11604-023-01435-w] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/11/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE To evaluate the diagnostic performance of deep learning using the Residual Networks 50 (ResNet50) neural network constructed from different segmentations for distinguishing malignant and benign non-mass enhancement (NME) on breast magnetic resonance imaging (MRI) and conduct a comparison with radiologists with various levels of experience. MATERIALS AND METHODS A total of 84 consecutive patients with 86 lesions (51 malignant, 35 benign) presenting NME on breast MRI were analyzed. Three radiologists with different levels of experience evaluated all examinations, based on the Breast Imaging-Reporting and Data System (BI-RADS) lexicon and categorization. For the deep learning method, one expert radiologist performed lesion annotation manually using the early phase of dynamic contrast-enhanced (DCE) MRI. Two segmentation methods were applied: a precise segmentation was carefully set to include only the enhancing area, and a rough segmentation covered the whole enhancing region, including the intervenient non-enhancing area. ResNet50 was implemented using the DCE MRI input. The diagnostic performance of the radiologists' readings and deep learning were then compared using receiver operating curve analysis. RESULTS The ResNet50 model from precise segmentation achieved diagnostic accuracy equivalent [area under the curve (AUC) = 0.91, 95% confidence interval (CI) 0.90, 0.93] to that of a highly experienced radiologist (AUC = 0.89, 95% CI 0.81, 0.96; p = 0.45). Even the model from rough segmentation showed diagnostic performance equivalent to a board-certified radiologist (AUC = 0.80, 95% CI 0.78, 0.82 vs. AUC = 0.79, 95% CI 0.70, 0.89, respectively). Both ResNet50 models from the precise and rough segmentation exceeded the diagnostic accuracy of a radiology resident (AUC = 0.64, 95% CI 0.52, 0.76). CONCLUSION These findings suggest that the deep learning model from ResNet50 has the potential to ensure accuracy in the diagnosis of NME on breast MRI.
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Affiliation(s)
- Mariko Goto
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyoku, Kyoto, 602-8566, Japan.
| | - Koji Sakai
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyoku, Kyoto, 602-8566, Japan
| | - Yasuchiyo Toyama
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyoku, Kyoto, 602-8566, Japan
| | - Yoshitomo Nakai
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyoku, Kyoto, 602-8566, Japan
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyoku, Kyoto, 602-8566, Japan
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Guo W, Lv B, Yang T, Tian M, Liu M, Lin X, Zhao P. Role of Dynamic Contrast-Enhanced Magnetic Resonance Imaging Parameters and Extracellular Volume Fraction as Predictors of Lung Cancer Subtypes and Lymph Node Status in Non-Small-Cell Lung Cancer Patients. J Cancer 2023; 14:3108-3116. [PMID: 37859821 PMCID: PMC10583593 DOI: 10.7150/jca.88367] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/05/2023] [Indexed: 10/21/2023] Open
Abstract
Objective: The aim of this study is to determine whether dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)-based quantitative parameters and the extracellular volume fraction (ECV) can differentiate small-cell lung cancer (SCLC) from non-small-cell lung cancer (NSCLC), squamous-cell carcinoma (SCC) from adenocarcinoma (Adeno-Ca), and NSCLC with lymph node metastasis from NSCLC without lymph node metastasis. Materials and methods: We prospectively enrolled patients with lung cancer (41 Adeno-Ca, 29 SCC, and 23 SCLC) who underwent DCE-MRI and enhanced T1 mapping prior to histopathological confirmation. Quantitative parameters based on DCE-MRI and ECV based on T1 mapping were compared between SCLC and NSCLC patients, between SCC and Adeno-Ca patients, and between NSCLC patients with and without lymph node metastasis. The area under the receiver-operating characteristic curve (AUC) was used to evaluate the diagnostic performance of each parameter. Spearman rank correlation was used to clarify the associations between ECV and DCE-MRI-derived parameters. Results: Ktrans, Kep, Ve, and ECV all performed well in differentiating SCLC from NSCLC (AUC > 0.729). Ktrans showed the best performance in differentiating SCC from Adeno-Ca (AUC = 0.836). ECV could differentiate NSCLCs with and without lymph node metastases (AUC = 0.764). ECV showed a significant positive correlation with both Ktrans and Ve. Conclusions: Ktrans is the most promising imaging parameter to differentiate SCLC from NSCLC, and Adeno-Ca from SCC. ECV was helpful in detecting lymph node metastasis in NSCLC. These imaging parameters may help guide the selection of lung cancer treatment.
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Affiliation(s)
- Wenxiu Guo
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250021, China
| | - Binglin Lv
- Department of Radiology, QiLu Hospital of Shandong University, Jinan, Shandong Province, 250012, China
| | - Tao Yang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong Province, 250021, China
| | - Mimi Tian
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250021, China
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong Province, 250021, China
| | - MengXiao Liu
- MR Scientific Marketing, Diagnostic Imaging, Siemens Healthineers Ltd., Shanghai, 200126, China
| | - XiangTao Lin
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250021, China
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong Province, 250021, China
| | - Peng Zhao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250021, China
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong Province, 250021, China
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Lu Y, Zhang T, Yang S, Yang B, Li J, Liu H, Yao D, Ren G, Wang D. Dynamic Contrast-Enhanced MRI Assessing Antifibrotic Therapeutic Effects of Pancreatic Fibrosis with Curcumin - An Experimental Study at 11.7 T. Acad Radiol 2023; 30 Suppl 1:S230-S237. [PMID: 37453883 DOI: 10.1016/j.acra.2023.05.028] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/24/2023] [Accepted: 05/27/2023] [Indexed: 07/18/2023]
Abstract
RATIONALE AND OBJECTIVES Pancreatic fibrosis is the hallmark of chronic pancreatitis (CP), which is associated with microcirculatory disturbance. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can assess the perfusion and permeability of the pancreas by providing information about microcirculation. We hypothesize that DCE-MRI parameters can be utilized to assess pancreatic fibrosis and may furthermore provide an opportunity to evaluate response to antifibrotic treatment with curcumin. Our study was to evaluate the feasibility of quantitative DCE-MRI in assessing pancreatic fibrosis and the antifibrotic effect of curcumin in a rat model of CP. MATERIALS AND METHODS Pancreatic fibrosis was induced by injecting dibutyltin dichloride (DBTC). Seventy rats were randomized to five groups: the control group (n = 10); DBTC for 2 weeks (n = 15); DBTC for 4 weeks (n = 15); DBTC + curcumin for 2 weeks (n = 15); DBTC + curcumin for 4 weeks (n = 15). DCE-MRI was performed at an 11.7 T MR scanner. DCE-MRI quantitative parameters (Ktrans, Ve, and Vp) were derived from an extended Tofts model. Fibrosis content and DCE-MRI parameters were compared among the above groups (one-way analysis of variance). The correlations between DCE-MRI parameters and pancreatic fibrosis content as well as the expression of α-SMA were computed by Spearman correlation coefficients. RESULTS Fifty-three rats survived and underwent MR imaging. Ktrans in rats 4 weeks after DBTC injection was significantly lower than DBTC 2 weeks rats and control rats (0.30 ± 0.06 min vs 0.49 ± 0.09 vs 0.62 ± 0.09, respectively). Vp in DBTC 4 weeks rats was also significantly lower than control rats (0.048 ± 0.010 min-1 vs 0.065 ± 0.011 min-1, respectively). Ktrans and Vp significantly correlated with fibrosis content of pancreas (r = -0.619 and -0.450, all P < 0.001), and the expression of α-SMA (r = -0.688 and -0.402, all P < 0.01). Ktrans and Vp in rats with daily curcumin treatment for 4 weeks were significantly higher than DBTC 4 weeks rats (Ktrans, 0.51 ± 0.09 vs 0.30 ± 0.06; Vp, 0.064 ± 0.015 vs 0.048 ± 0.010). CONCLUSION DCE-MRI parameters (Ktrans and Vp) have the potential to noninvasively assess pancreatic fibrosis and the antifibrotic treatment response of curcumin.
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Affiliation(s)
- Yimei Lu
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Tingting Zhang
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Shuyan Yang
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Baofeng Yang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China (B.Y.); Human Phenome Institute, Fudan University, Shanghai 200433, China (B.Y.).
| | - Jinning Li
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Huanhuan Liu
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Defan Yao
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Gang Ren
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
| | - Dengbin Wang
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Y.L., T.Z., S.Y., J.L., H.L., D.Y., G.R., D.W.).
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Ando S, Ito S, Kawabata K, Kanagaki M, Hijikata Y, Kiso M, Tsuzuki S, Kimura H. Dynamic contrast-enhanced MRI and sequential CT findings of metaplastic breast carcinoma in neurofibromatosis type 1: A case report. Radiol Case Rep 2023; 18:2224-2228. [PMID: 37123039 PMCID: PMC10139865 DOI: 10.1016/j.radcr.2023.03.039] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 05/02/2023] Open
Abstract
Metaplastic breast carcinoma in neurofibromatosis type 1 is extremely rare. There are few reports about dynamic contrast-enhanced MRI findings and sequential CT findings of metaplastic breast carcinoma in neurofibromatosis type 1. Herein, we report imaging findings, including dynamic contrast-enhanced MRI and sequential CT, of metaplastic breast carcinoma in an 82-year-old woman with neurofibromatosis type 1. Short tau inversion recovery image revealed an oval mass with a circumscribed margin that exhibited moderate intensity with partially hyperintense area inside, and T1-weighted imaging revealed a spotty hyperintense area. The solid component of the mass showed heterogeneous enhancement and the time-intensity curve had a fast/washout pattern with restricted diffusion. In addition, multiple neurofibromas were observed. Sequential CT revealed that the diameter of the mass doubled in 3 months without apparent lymph node metastasis. Because detection of metaplastic breast carcinoma in neurofibromatosis type 1 tends to be delayed due to multiple neurofibromas, characteristic MRI findings suggestive of metaplastic breast carcinoma and sequential CT findings are important for early treatment of metaplastic breast carcinoma in patients with neurofibromatosis type 1.
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Affiliation(s)
- Saya Ando
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Higashinaniwa-cho 2-17-77, Amagasaki 660-8550, Hyogo, Japan
- Corresponding author.
| | - Shuichi Ito
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuna Kawabata
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Higashinaniwa-cho 2-17-77, Amagasaki 660-8550, Hyogo, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Higashinaniwa-cho 2-17-77, Amagasaki 660-8550, Hyogo, Japan
| | - Yoichiro Hijikata
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Higashinaniwa-cho 2-17-77, Amagasaki 660-8550, Hyogo, Japan
| | - Marina Kiso
- Department of Breast Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Sadatoshi Tsuzuki
- Department of Pathology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Hiroyuki Kimura
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Higashinaniwa-cho 2-17-77, Amagasaki 660-8550, Hyogo, Japan
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Xu WJ, Zheng BJ, Lu J, Liu SY, Li HL. Identification of triple-negative breast cancer and androgen receptor expression based on histogram and texture analysis of dynamic contrast-enhanced MRI. BMC Med Imaging 2023; 23:70. [PMID: 37264313 DOI: 10.1186/s12880-023-01022-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/23/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) is highly malignant and has a poor prognosis due to the lack of effective therapeutic targets. Androgen receptor (AR) has been investigated as a possible therapeutic target. This study quantitatively assessed intratumor heterogeneity by histogram analysis of pharmacokinetic parameters and texture analysis on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to discriminate TNBC from non-triple-negative breast cancer (non-TNBC) and to identify AR expression in TNBC. METHODS This retrospective study included 99 patients with histopathologically proven breast cancer (TNBC: 36, non-TNBC: 63) who underwent breast DCE-MRI before surgery. The pharmacokinetic parameters of DCE-MRI (Ktrans, Kep and Ve) and their corresponding texture parameters were calculated. The independent t-test, or Mann-Whitney U-test was used to compare quantitative parameters between TNBC and non-TNBC groups, and AR-positive (AR+) and AR-negative (AR-) TNBC groups. The parameters with significant difference between two groups were further involved in logistic regression analysis to build a prediction model for TNBC. The ROC analysis was conducted on each independent parameter and the TNBC predicting model for evaluating the discrimination performance. The area under the ROC curve (AUC), sensitivity and specificity were derived. RESULTS The binary logistic regression analysis revealed that Kep_Range (p = 0.032) and Ve_SumVariance (p = 0.005) were significantly higher in TNBC than in non-TNBC. The AUC of the combined model for identifying TNBC was 0.735 (p < 0.001) with a cut-off value of 0.268, and its sensitivity and specificity were 88.89% and 52.38%, respectively. The value of Kep_Compactness2 (p = 0.049), Kep_SphericalDisproportion (p = 0.049), and Ve_GlcmEntropy (p = 0.008) were higher in AR + TNBC group than in AR-TNBC group. CONCLUSION Histogram and texture analysis of breast lesions on DCE-MRI showed potential to identify TNBC, and the specific features can be possible predictors of AR expression, enhancing the ability to individualize the treatment of patients with TNBC.
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Affiliation(s)
- Wen-Juan Xu
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Bing-Jie Zheng
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Jun Lu
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Si-Yun Liu
- GE healthcare (China), Beijing, 100176, China
| | - Hai-Liang Li
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, China.
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Cui E, Kersche G, Grubic N, Hétu MF, Pang SC, Sillesen H, Johri AM. Effect of pharmacologic anti-atherosclerotic therapy on carotid intraplaque neovascularization: A systematic review. J Clin Lipidol 2023:S1933-2874(23)00075-2. [PMID: 37173161 DOI: 10.1016/j.jacl.2023.04.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 04/07/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023]
Abstract
Intraplaque neovascularization (IPN), a key feature of vulnerable carotid plaque, is associated with adverse cardiovascular (CV) events. Statin therapy has been shown to diminish and stabilize atherosclerotic plaque, but its effect on IPN is uncertain. This review investigated the effects of common pharmacologic anti-atherosclerotic therapies on carotid IPN. Electronic databases (MEDLINE, EMBASE and Cochrane Library) were searched from inception until July 13, 2022. Studies evaluating the effect of anti-atherosclerotic therapy on carotid IPN among adults with carotid atherosclerosis were included. Sixteen studies were eligible for inclusion. Contrast-enhanced ultrasound (CEUS) was the most common IPN assessment modality (n=8), followed by dynamic contrast-enhanced MRI (DCE-MRI) (n=4), excised plaque histology (n=3) and superb microvascular imaging (n=2). In fifteen studies, statins were the therapy of interest and one study assessed PCSK9 inhibitors. Among CEUS studies, baseline statin use was associated with a lower frequency of carotid IPN (median OR = 0.45). Prospective studies showed regression of IPN after 6-12 months of lipid-lowering therapy, with more regression observed in treated participants compared to untreated controls. Our findings suggest that lipid-lowering therapy with statins or PCSK9 inhibitors is associated with IPN regression. However, there was no correlation between change in IPN parameters and change in serum lipids and inflammatory markers in statin-treated participants, so it is unclear whether these factors are mediators in the observed IPN changes. Lastly, this review was limited by study heterogeneity and small sample sizes, so larger trials are needed to validate findings.
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Affiliation(s)
- Edward Cui
- Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Kingston, Canada (Drs Cui, Kersche, Grubic, Hétu, Johri)
| | - Georgia Kersche
- Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Kingston, Canada (Drs Cui, Kersche, Grubic, Hétu, Johri)
| | - Nicholas Grubic
- Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Kingston, Canada (Drs Cui, Kersche, Grubic, Hétu, Johri)
| | - Marie-France Hétu
- Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Kingston, Canada (Drs Cui, Kersche, Grubic, Hétu, Johri)
| | - Stephen C Pang
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada (Dr Pang)
| | - Henrik Sillesen
- Department of Vascular Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Dr Sillesen); Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Dr Sillesen)
| | - Amer M Johri
- Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Kingston, Canada (Drs Cui, Kersche, Grubic, Hétu, Johri).
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Liu Y, Wang S, Qu J, Tang R, Wang C, Xiao F, Pang P, Sun Z, Xu M, Li J. High-temporal resolution DCE-MRI improves assessment of intra- and peri-breast lesions categorized as BI-RADS 4. BMC Med Imaging 2023; 23:58. [PMID: 37076817 PMCID: PMC10116788 DOI: 10.1186/s12880-023-01015-4] [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: 03/14/2022] [Accepted: 04/06/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND BI-RADS 4 breast lesions are suspicious for malignancy with a range from 2 to 95%, indicating that numerous benign lesions are unnecessarily biopsied. Thus, we aimed to investigate whether high-temporal-resolution dynamic contrast-enhanced MRI (H_DCE-MRI) would be superior to conventional low-temporal-resolution DCE-MRI (L_DCE-MRI) in the diagnosis of BI-RADS 4 breast lesions. METHODS This single-center study was approved by the IRB. From April 2015 to June 2017, patients with breast lesions were prospectively included and randomly assigned to undergo either H_DCE-MRI, including 27 phases, or L_DCE-MRI, including 7 phases. Patients with BI-RADS 4 lesions were diagnosed by the senior radiologist in this study. Using a two-compartment extended Tofts model and a three-dimensional volume of interest, several pharmacokinetic parameters reflecting hemodynamics, including Ktrans, Kep, Ve, and Vp, were obtained from the intralesional, perilesional and background parenchymal enhancement areas, which were labeled the Lesion, Peri and BPE areas, respectively. Models were developed based on hemodynamic parameters, and the performance of these models in discriminating between benign and malignant lesions was evaluated by receiver operating characteristic (ROC) curve analysis. RESULTS A total of 140 patients were included in the study and underwent H_DCE-MRI (n = 62) or L_DCE-MRI (n = 78) scans; 56 of these 140 patients had BI-RADS 4 lesions. Some pharmacokinetic parameters from H_DCE-MRI (Lesion_Ktrans, Kep, and Vp; Peri_Ktrans, Kep, and Vp) and from L_DCE-MRI (Lesion_Kep, Peri_Vp, BPE_Ktrans and BPE_Vp) were significantly different between benign and malignant breast lesions (P < 0.01). ROC analysis showed that Lesion_Ktrans (AUC = 0.866), Lesion_Kep (AUC = 0.929), Lesion_Vp (AUC = 0.872), Peri_Ktrans (AUC = 0.733), Peri_Kep (AUC = 0.810), and Peri_Vp (AUC = 0.857) in the H_DCE-MRI group had good discrimination performance. Parameters from the BPE area showed no differentiating ability in the H_DCE-MRI group. Lesion_Kep (AUC = 0.767), Peri_Vp (AUC = 0.726), and BPE_Ktrans and BPE_Vp (AUC = 0.687 and 0.707) could differentiate between benign and malignant breast lesions in the L_DCE-MRI group. The models were compared with the senior radiologist's assessment for the identification of BI-RADS 4 breast lesions. The AUC, sensitivity and specificity of Lesion_Kep (0.963, 100.0%, and 88.9%, respectively) in the H_DCE-MRI group were significantly higher than those of the same parameter in the L_DCE-MRI group (0.663, 69.6% and 75.0%, respectively) for the assessment of BI-RADS 4 breast lesions. The DeLong test was conducted, and there was a significant difference only between Lesion_Kep in the H_DCE-MRI group and the senior radiologist (P = 0.04). CONCLUSIONS Pharmacokinetic parameters (Ktrans, Kep and Vp) from the intralesional and perilesional regions on high-temporal-resolution DCE-MRI, especially the intralesional Kep parameter, can improve the assessment of benign and malignant BI-RADS 4 breast lesions to avoid unnecessary biopsy.
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Affiliation(s)
- Yufeng Liu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, China
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shiwei Wang
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, China
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Jingjing Qu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, China
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Rui Tang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Chundan Wang
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
- Department of Pathology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Fengchun Xiao
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
- Department of Pathology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Peipei Pang
- GE Healthcare, Precision Health Institution, Hangzhou, China
| | - Zhichao Sun
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, China
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Maosheng Xu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, China.
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China.
| | - Jiaying Li
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, China.
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China.
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15
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Griffith JF, van der Heijden RA. Bone marrow MR perfusion imaging and potential for tumor evaluation. Skeletal Radiol 2023; 52:477-91. [PMID: 36271181 DOI: 10.1007/s00256-022-04202-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/19/2022] [Accepted: 10/04/2022] [Indexed: 02/02/2023]
Abstract
The physiology of bone perfusion is reviewed outlining how it can be measured with dynamic contrast-enhanced MRI as well as intravoxel incoherent imaging. Evaluation of bone perfusion provides a potential means of assessing tumor activity and treatment response beyond that possible with standard MR imaging.
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16
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Jamshidi G, Abbasian Ardakani A, Ghafoori M, Babapour Mofrad F, Saligheh Rad H. Radiomics-based machine-learning method to diagnose prostate cancer using mp-MRI: a comparison between conventional and fused models. MAGMA 2023; 36:55-64. [PMID: 36114898 DOI: 10.1007/s10334-022-01037-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/11/2022] [Accepted: 08/08/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Multiparametric MRI (mp-MRI) has been significantly used for detection, localization and staging of Prostate cancer (PCa). However, all the assessment suffers from poor reproducibility among the readers. The aim of this study was to evaluate radiomics models to diagnose PCa using high-resolution T2-weighted (T2-W) and dynamic contrast-enhanced (DCE) MRI. MATERIALS AND METHODS Thirty two patients who had high prostate specific antigen level were recruited. The prostate biopsies considered as the reference to differentiate between 66 benign and 36 malignant prostate lesions. 181 features were extracted from each modality. K-nearest neighbors, artificial neural network, decision tree, and linear discriminant analysis were used for machine-learning study. The leave-one-out cross-validation method was used to prevent overfitting and build robust models. RESULTS Radiomics analysis showed that T2-W images were more effective in PCa detection compare to DCE images. Local binary pattern features and speeded up robust features had the highest ability for prediction in T2-W and DCE images, respectively. The classifier fusion using decision template method showed the highest performance with accuracy, specificity, and sensitivity of 100%. DISCUSSION The findings of this framework provide researchers on PCa with a promising method for reliable detection of prostate lesions in MR images by fused model.
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Affiliation(s)
- Ghazaleh Jamshidi
- Department of Medical Radiation Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Ali Abbasian Ardakani
- Department of Radiology Technology, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahyar Ghafoori
- Department of Radiology, School of Medicine, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farshid Babapour Mofrad
- Department of Medical Radiation Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Hamidreza Saligheh Rad
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran.
- Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Van Den Berghe T, Candries E, Everaert N, Saerens M, Van Dorpe J, Verstraete K. Erdheim-Chester disease: diffusion-weighted imaging and dynamic contrast-enhanced MRI provide useful information. Skeletal Radiol 2023:10.1007/s00256-022-04265-5. [PMID: 36602575 DOI: 10.1007/s00256-022-04265-5] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023]
Abstract
This is, to our knowledge, the first case report with in-depth analysis of bone marrow and bone lesions with diffusion-weighted imaging and dynamic contrast-enhanced MRI in Erdheim-Chester disease to date. We present a case of a 70-year-old woman who was referred for an X-ray of the pelvis, right femur and right knee after complaints of migratory arthralgia in hip and knee five months after an initial hip and knee trauma. Bone lesions on X-ray were identified. This case report highlights the strength and complementary use of modern multimodality multiparametric imaging techniques in the clinical radiological manifestations of Erdheim-Chester disease, in the differential diagnosis and in treatment response assessment, which is classically performed using 18FDG PET-CT. Erdheim-Chester disease is a rare form of non-Langerhans' cell histiocytosis, mainly affecting individuals in their fifth-seventh decade of life and without sex predominance. Apart from the typical bilateral symmetric lesions in long bone diaphyseal and metaphyseal regions and classically sparing the epiphyses, this multisystemic disease causes significant morbidity by infiltrating critical organs (the central nervous system, cardiovascular system, retroperitoneum, lungs and skin). With non-traumatic bone pain being the most common complaint, Erdheim-Chester disease is diagnosed most often in an incidental setting on imaging. The imaging workup classically consists of a multimodality approach using conventional radiography, CT, MRI, bone scintigraphy and 18FDG PET-CT. This case report extends this evaluation with diffusion-weighted imaging and dynamic contrast-enhanced imaging techniques.
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Affiliation(s)
- Thomas Van Den Berghe
- Department of Radiology, Ghent University Hospital and Ghent University, Ghent, Belgium.
| | - Esther Candries
- Department of Radiology, Ghent University Hospital and Ghent University, Ghent, Belgium
| | - Nicolas Everaert
- Department of Radiology, Ghent University Hospital and Ghent University, Ghent, Belgium
| | - Michael Saerens
- Department of Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital and Ghent University, Ghent, Belgium
| | - Koenraad Verstraete
- Department of Radiology, Ghent University Hospital and Ghent University, Ghent, Belgium
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Bakhtiari A, Vestergaard MB, Benedek K, Fagerlund B, Mortensen EL, Osler M, Lauritzen M, Larsson HBW, Lindberg U. Changes in hippocampal volume during a preceding 10-year period do not correlate with cognitive performance and hippocampal blood‒brain barrier permeability in cognitively normal late-middle-aged men. GeroScience 2022; 45:1161-1175. [PMID: 36534276 PMCID: PMC9886720 DOI: 10.1007/s11357-022-00712-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Hippocampal blood-brain barrier (BBB) permeability may increase in normal healthy ageing and contribute to neurodegenerative disease. To examine this hypothesis, we investigated the correlation between blood-brain barrier (BBB) permeability, regional brain volume, memory functions and health and lifestyle factors in The Metropolit 1953 Danish Male Birth Cohort. We used dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with a gadolinium-based contrast agent to assess BBB permeability in 77 participants in the cohort. BBB permeability was measured as Ki values in the hippocampus, thalamus and white matter. Over a 10-year period, we observed progressive atrophy of both the left and right hippocampus (p = 0.001). There was no significant correlation between current BBB permeability and hippocampal volume, prior atrophy or cognition. The hippocampus volume ratio was associated with better visual and verbal memory scores (p < 0.01). Regional BBB differences revealed higher Ki values in the hippocampus and white matter than in the thalamus (p < 0.001). Participants diagnosed with type II diabetes had significantly higher BBB permeability in the white matter (p = 0.015) and thalamus (p = 0.016), which was associated with a higher Fazekas score (p = 0.024). We do not find evidence that BBB integrity is correlated with age-related hippocampal atrophy or cognitive functions. The association between diabetes, white matter hyperintensities and increased BBB permeability is consistent with the idea that cerebrovascular disease compromises BBB integrity. Our findings suggest that the hippocampus is particularly prone to age-related atrophy, which may explain some of the cognitive changes that accompany older age, but this prior atrophy is not correlated with current BBB permeability.
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Affiliation(s)
- Aftab Bakhtiari
- Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. .,Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. .,Faculty of Health and Medical Sciences, Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark. .,Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Mark B. Vestergaard
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Krisztina Benedek
- Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Fagerlund
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark ,Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | | | - Merete Osler
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark ,Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Martin Lauritzen
- Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark ,Faculty of Health and Medical Sciences, Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark ,Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik B. W. Larsson
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark ,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ulrich Lindberg
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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19
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Marino MA, Avendano D, Sevilimedu V, Thakur S, Martinez D, Lo Gullo R, Horvat JV, Helbich TH, Baltzer PAT, Pinker K. Limited value of multiparametric MRI with dynamic contrast-enhanced and diffusion-weighted imaging in non-mass enhancing breast tumors. Eur J Radiol 2022; 156:110523. [PMID: 36122521 PMCID: PMC10014485 DOI: 10.1016/j.ejrad.2022.110523] [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: 04/18/2022] [Revised: 08/14/2022] [Accepted: 09/09/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the diagnostic value of multiparametric MRI (mpMRI) including dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) in non-mass enhancing breast tumors. METHOD Patients who underwent mpMRI, who were diagnosed with a suspicious non-mass enhancement (NME) on DCE-MRI (BI-RADS 4/5), and who subsequently underwent image-guided biopsy were retrospectively included. Two radiologists independently evaluated all NMEs, on both DCE-MR images and high-b-value DW images. Different mpMRI reading approaches were evaluated: 1) with a fixed apparent diffusion coefficient (ADC) threshold (<1.3 malignant, ≥1.3 benign) based on the recommendation by the European Society of Breast Imaging (EUSOBI); 2) with a fixed ADC threshold (<1.5 malignant, ≥1.5 benign) based on recently published trial data; 3) with an ADC threshold adapted to the assigned BI-RADS classification using a previously published reading method; and 4) with individually determined best thresholds for each reader. RESULTS The final study sample consisted of 66 lesions in 66 patients. DCE-MRI alone had the highest sensitivity for breast cancer detection (94.8-100 %), outperforming all mpMRI reading approaches (R1 74.4-87.1 %, R2 71.7-94.8 %) and DWI alone (R1 74.4 %, R2 79.4 %). The adapted approach achieved the best specificity for both readers (85.1 %), resulting in the best diagnostic accuracy for R1 (86.5 %) but a moderate diagnostic accuracy for R2 (77.2 %). CONCLUSION mpMRI has limited added diagnostic value to DCE-MRI in the assessment of NME.
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Affiliation(s)
- Maria Adele Marino
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Breast Imaging Service, New York, NY, USA; Department of Biomedical Sciences and Morphologic and Functional Imaging, University of Messina, Messina, Italy
| | - Daly Avendano
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Breast Imaging Service, New York, NY, USA; Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
| | - Varadan Sevilimedu
- Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY, USA
| | - Sunitha Thakur
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Breast Imaging Service, New York, NY, USA; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA
| | - Danny Martinez
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Breast Imaging Service, New York, NY, USA
| | - Roberto Lo Gullo
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Breast Imaging Service, New York, NY, USA
| | - Joao V Horvat
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Breast Imaging Service, New York, NY, USA
| | - Thomas H Helbich
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Structural Preclinical Imaging, Medical University of Vienna, Vienna, Austria
| | - Pascal A T Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Structural Preclinical Imaging, Medical University of Vienna, Vienna, Austria
| | - Katja Pinker
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Breast Imaging Service, New York, NY, USA.
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Ware JB, Sinha S, Morrison J, Walter AE, Gugger JJ, Schneider ALC, Dabrowski C, Zamore H, Wesley L, Magdamo B, Petrov D, Kim JJ, Diaz-Arrastia R, Sandsmark DK. Dynamic contrast enhanced MRI for characterization of blood-brain-barrier dysfunction after traumatic brain injury. Neuroimage Clin 2022; 36:103236. [PMID: 36274377 PMCID: PMC9668646 DOI: 10.1016/j.nicl.2022.103236] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/30/2022] [Accepted: 10/16/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE Dysfunction of the blood-brain-barrier (BBB) is a recognized pathological consequence of traumatic brain injury (TBI) which may play an important role in chronic TBI pathophysiology. We hypothesized that BBB disruption can be detected with dynamic contrast-enhanced (DCE) MRI not only in association with focal traumatic lesions but also in normal-appearing brain tissue of TBI patients, reflecting microscopic microvascular injury. We further hypothesized that BBB integrity would improve but not completely normalize months after TBI. MATERIALS AND METHODS DCE MRI was performed in 40 adult patients a median of 23 days after hospitalized TBI and in 21 healthy controls. DCE data was analyzed using Patlak and linear models, and derived metrics of BBB leakage including the volume transfer constant (Ktrans) and the normalized permeability index (NPI) were compared between groups. BBB metrics were compared with focal lesion distribution as well as with contemporaneous measures of symptomatology and cognitive function in TBI patients. Finally, BBB metrics were examined longitudinally among 18 TBI patients who returned for a second MRI a median of 204 days postinjury. RESULTS TBI patients exhibited higher mean Ktrans (p = 0.0028) and proportion of suprathreshold NPI voxels (p = 0.001) relative to controls. Tissue-based analysis confirmed greatest TBI-related BBB disruption in association with focal lesions, however elevated Ktrans was also observed in perilesional (p = 0.011) and nonlesional (p = 0.044) regions. BBB disruption showed inverse correlation with quality of life (rho = -0.51, corrected p = 0.016). Among the subset of TBI patients who underwent a second MRI several months after the initial evaluation, metrics of BBB disruption did not differ significantly at the group level, though variable longitudinal changes were observed at the individual subject level. CONCLUSIONS This pilot investigation suggests that TBI-related BBB disruption is detectable in the early post-injury period in association with focal and diffuse brain injury.
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Affiliation(s)
- Jeffrey B Ware
- Division of Neuroradiology, Department of Radiology, Hospital of University of Pennsylvania, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
| | - Saurabh Sinha
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Justin Morrison
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Alexa E Walter
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - James J Gugger
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Andrea L C Schneider
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Cian Dabrowski
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Hannah Zamore
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Leroy Wesley
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Brigid Magdamo
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Dmitriy Petrov
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Junghoon J Kim
- Department of Molecular, Cellular, and Biomedical Sciences, CUNY School of Medicine at The City College of New York, Townsend Harris Hall, 160 Convent Avenue, New York, NY 10031, USA
| | - Ramon Diaz-Arrastia
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Danielle K Sandsmark
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Chang YW, Lee EJ, Hwang J, Nickel D, Sung JK. Analysis of Volumetric Perfusion Quantitative Parameters Using CS-VIBE Breast Dynamic Contrast Enhanced MR Imaging. Curr Med Imaging 2022:CMIR-EPUB-126556. [PMID: 36165524 DOI: 10.2174/1573405618666220926144938] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/02/2022] [Accepted: 08/25/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the diagnostic performance of three-dimensional volume of interest (3D-VOI) perfusion quantitative parameters using CS-VIBE DCE-MRI, and investigate the relationship of the prognostic factors. PATIENTS AND METHODS The volumetric perfusion quantitative parameters of Ktrans, Kep, Ve, Vp, of 124 pathologically proven breast masses in 93 patients were obtained using the two-compartment extended Tofts model. Also, the perfusion parameters of AUC, TTP, Emax, wash-in, and washout were automatically calculated using post-processing software. The relationship between the perfusion quantitative parameters and lesion size, pathology, and prognostic factors of malignancy was evaluated. RESULTS Ktrans and Kep were significantly higher in the malignant than the benign lesions (p < 0.001), and the AUROC of Ktrans and Kep were 0.802 and 0.815, respectively. The area under DCE curve, TTP, Emax, wash-in, and wash-out were significantly different between the benign and malignant lesion (p < 0.05). In multiple linear regression analysis, Ktrans and Kep were significantly different between benign and malignant tumors. Malignant tumors larger than 2cm were significantly different from those smaller than 2cm in Ktrans, Kep, Vp, area under DCE curve, TTP, Emax, and wash-in values (p < 0.05). TTP was significantly lower in higher Ki-67 index (p < 0.05). CONCLUSION Perfusion quantitative parameters may be applied as a feasible imaging biomarker to discriminate malignant from benign tumors. In malignant lesions, perfusion parameters were not associated with histopathological results, but only in tumor size.
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Affiliation(s)
- Yun-Woo Chang
- Department of Radiology, Soonchunhyang University Hospital, 59dasakwanro youngsanku seoul, Korea
| | - Eun Ji Lee
- Department of Radiology, Soonchunhyang University Hospital, Korea
| | - Jiyoung Hwang
- Department of Radiology, Soonchunhyang University Hospital, Korea
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22
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Fernandes MC, Yildirim O, Woo S, Vargas HA, Hricak H. The role of MRI in prostate cancer: current and future directions. MAGMA 2022; 35:503-521. [PMID: 35294642 PMCID: PMC9378354 DOI: 10.1007/s10334-022-01006-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/16/2022] [Accepted: 03/03/2022] [Indexed: 06/14/2023]
Abstract
There has been an increasing role of magnetic resonance imaging (MRI) in the management of prostate cancer. MRI already plays an essential role in the detection and staging, with the introduction of functional MRI sequences. Recent advancements in radiomics and artificial intelligence are being tested to potentially improve detection, assessment of aggressiveness, and provide usefulness as a prognostic marker. MRI can improve pretreatment risk stratification and therefore selection of and follow-up of patients for active surveillance. MRI can also assist in guiding targeted biopsy, treatment planning and follow-up after treatment to assess local recurrence. MRI has gained importance in the evaluation of metastatic disease with emerging technology including whole-body MRI and integrated positron emission tomography/MRI, allowing for not only better detection but also quantification. The main goal of this article is to review the most recent advances on MRI in prostate cancer and provide insights into its potential clinical roles from the radiologist's perspective. In each of the sections, specific roles of MRI tailored to each clinical setting are discussed along with its strengths and weakness including already established material related to MRI and the introduction of recent advancements on MRI.
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Affiliation(s)
- Maria Clara Fernandes
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Onur Yildirim
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Sungmin Woo
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA.
| | - Hebert Alberto Vargas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Hedvig Hricak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
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Yoshida K, Kawashima H, Kannon T, Tajima A, Ohno N, Terada K, Takamatsu A, Adachi H, Ohno M, Miyati T, Ishikawa S, Ikeda H, Gabata T. Prediction of pathological complete response to neoadjuvant chemotherapy in breast cancer using radiomics of pretreatment dynamic contrast-enhanced MRI. Magn Reson Imaging 2022; 92:19-25. [PMID: 35636571 DOI: 10.1016/j.mri.2022.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE To investigate if the pretreatment dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)-based radiomics machine learning predicts the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer patients. METHODS Seventy-eight breast cancer patients who underwent DCE-MRI before NAC and confirmed as pCR or non-pCR were enrolled. Early enhancement mapping images of pretreatment DCE-MRI were created using subtraction formula as follows: Early enhancement mapping = (Signal 1 min - Signal pre)/Signal pre. Images of the whole tumors were manually segmented and radiomics features extracted. Five prediction models were built using five scenarios that included clinical information, subjective radiological findings, first order texture features, second order texture features, and their combinations. In texture analysis workflow, the corresponding variables were identified by mutual information for feature selection and random forest was used for model prediction. In five models, the area under the receiver operating characteristic curves (AUC) to predict the pCR and several metrics for model evaluation were analyzed. RESULTS The best diagnostic performance based on F-score was achieved when both first and second order texture features with clinical information and subjective radiological findings were used (AUC = 0.77). The second best diagnostic performance was achieved with an AUC of 0.76 for first order texture features followed by an AUC of 0.76 for first and second order texture features. CONCLUSIONS Pretreatment DCE-MRI can improve the prediction of pCR in breast cancer patients when all texture features with clinical information and subjective radiological findings are input to build the prediction model.
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Affiliation(s)
- Kotaro Yoshida
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
| | - Hiroko Kawashima
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
| | - Takayuki Kannon
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
| | - Atsushi Tajima
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
| | - Naoki Ohno
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
| | - Kanako Terada
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan
| | - Atsushi Takamatsu
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan
| | - Hayato Adachi
- Division of Radiology, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan
| | - Masako Ohno
- Division of Radiology, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
| | - Tosiaki Miyati
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
| | - Satoko Ishikawa
- Department of Breast Surgery, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
| | - Hiroko Ikeda
- Diagnostic Pathology, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
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Amini Farsani Z, Schmid VJ. Maximum Entropy Technique and Regularization Functional for Determining the Pharmacokinetic Parameters in DCE-MRI. J Digit Imaging 2022; 35:1176-1188. [PMID: 35618849 PMCID: PMC9582183 DOI: 10.1007/s10278-022-00646-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/15/2022] [Accepted: 04/21/2022] [Indexed: 10/31/2022] Open
Abstract
This paper aims to solve the arterial input function (AIF) determination in dynamic contrast-enhanced MRI (DCE-MRI), an important linear ill-posed inverse problem, using the maximum entropy technique (MET) and regularization functionals. In addition, estimating the pharmacokinetic parameters from a DCE-MR image investigations is an urgent need to obtain the precise information about the AIF-the concentration of the contrast agent on the left ventricular blood pool measured over time. For this reason, the main idea is to show how to find a unique solution of linear system of equations generally in the form of [Formula: see text] named an ill-conditioned linear system of equations after discretization of the integral equations, which appear in different tomographic image restoration and reconstruction issues. Here, a new algorithm is described to estimate an appropriate probability distribution function for AIF according to the MET and regularization functionals for the contrast agent concentration when applying Bayesian estimation approach to estimate two different pharmacokinetic parameters. Moreover, by using the proposed approach when analyzing simulated and real datasets of the breast tumors according to pharmacokinetic factors, it indicates that using Bayesian inference-that infer the uncertainties of the computed solutions, and specific knowledge of the noise and errors-combined with the regularization functional of the maximum entropy problem, improved the convergence behavior and led to more consistent morphological and functional statistics and results. Finally, in comparison to the proposed exponential distribution based on MET and Newton's method, or Weibull distribution via the MET and teaching-learning-based optimization (MET/TLBO) in the previous studies, the family of Gamma and Erlang distributions estimated by the new algorithm are more appropriate and robust AIFs.
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Affiliation(s)
- Zahra Amini Farsani
- Bayesian Imaging and Spatial Statistics Group, Institute of Statistics, Ludwig-Maximilian-Universität München, Ludwigstraße 33, 80539, Munich, Germany. .,Statistics Department, School of Science, Lorestan University, 68151-44316, Khorramabad, Iran.
| | - Volker J Schmid
- Bayesian Imaging and Spatial Statistics Group, Institute of Statistics, Ludwig-Maximilian-Universität München, Ludwigstraße 33, 80539, Munich, Germany
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Sharma G, Saran S, Saxena S, Goyal T. Multiparametric evaluation of bone tumors utilising diffusion weighted imaging and dynamic contrast enhanced magnetic resonance imaging. J Clin Orthop Trauma 2022; 30:101899. [PMID: 35664690 PMCID: PMC9157202 DOI: 10.1016/j.jcot.2022.101899] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/08/2022] [Accepted: 05/14/2022] [Indexed: 11/18/2022] Open
Abstract
AIM This study aimed to use multiparametric magnetic resonance imaging (MRI) techniques, namely, diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to evaluate bone tumors. METHODS Thirty-three patients with primary untreated bone tumors were assessed utilizing DWI and DCE-MRI. Various parameters like ADC values from DWI and percentage peak signal intensity (%PSI), the maximum slope of increase (MSI), and time to peak signal intensity (TTP) values were assessed in different cases, and the final correlation was drawn with histopathological findings. RESULT Parameters of semi-quantitative DCE-MRI, i.e., %PSI, MSI and, TTP, correlated significantly with the histopathological characteristics of the tumor (p values < 0.001). Minimum ADC value in the tumor also showed a strong correlation with the tumor characteristic (p values < 0.001). Also, the correlation between parameters of DWI and DCI-MRI is well correlated with each other. CONCLUSION The results of this study provide grounds for the integration of multiparametric pre-treatment evaluation of bone tumors. In our study, we not only tried to utilize different parameters of functional MRI in bone tumors as well as re-explored the semi-quantitative analysis of DCE-MRI.
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Affiliation(s)
- Garima Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India
| | - Sonal Saran
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India
- Corresponding author.
| | - Sudhir Saxena
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India
| | - Tarun Goyal
- Department of Orthopedics, All India Institute of Medical Sciences, Bhatinda, India
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Ye Z, Ning G, Li X, Koh TS, Chen H, Bai W, Qu H. Endometrial carcinoma: use of tracer kinetic modeling of dynamic contrast-enhanced MRI for preoperative risk assessment. Cancer Imaging 2022; 22:14. [PMID: 35264244 PMCID: PMC8908697 DOI: 10.1186/s40644-022-00452-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 02/24/2022] [Indexed: 01/07/2023] Open
Abstract
Background To compare two tracer kinetic models in predicting of preoperative risk types in endometrial carcinoma (EC) using DCE-MRI. Methods A prospective study of patients with EC was conducted with institutional ethics approval and written informed consent. DCE-MRI data was analyzed using the extended Tofts (ET) and the distributed parameter (DP) models. DCE parameters blood flow (F), mean transit time, blood volume (Vp), extravascular extracellular volume (Ve), permeability surface area product (PS), extraction fraction, transfer constant (Ktrans), and efflux rate (Kep) between high- and low-risk EC were compared using the Mann–Whitney test. Bland–Altman analysis was utilized to compare parameter consistency and Spearman test to assess parameter correlation. Diagnostic performance of DCE parameters was analyzed by receiver-operating characteristic curve and compared with traditional MRI assessment. Results Fifty-one patients comprised the study group. Patients with high-risk EC exhibited significantly lower Ktrans, Kep, F, Vp and PS (P < 0.001). ET-derived Ktrans and DP-derived F attained AUC of 0.92 and 0.91, respectively. Bland–Altman analysis showed that the consistency of Ve or Vp between the two models was low (P < 0.001) while Spearman test showed a strong correlation (r = 0.719, 0.871). Both Ktrans and F showed higher accuracy in predicting EC risk types than traditional MRI assessment. Conclusions Kinetic parameters derived from DCE-MRI revealed a more hypovascular microenvironment for high risk EC than to low- risk ones, providing potential imaging biomarkers in preoperative risk assessment that might improve individualized surgical planning and management of EC.
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Affiliation(s)
- Zhijun Ye
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No.20, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Gang Ning
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No.20, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China.
| | - Xuesheng Li
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No.20, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Tong San Koh
- Department of Oncologic Imaging, National Cancer Center, Singapore, 169610, Singapore
| | - Huizhu Chen
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No.20, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Wanjing Bai
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No.20, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Haibo Qu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No.20, Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
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Murase K, Kashiwagi N, Tomiyama N. Quantitative evaluation of simultaneous spatial and temporal regularization in dynamic contrast-enhanced MRI of the liver using Gd-EOB-DTPA. Magn Reson Imaging 2022; 88:25-37. [PMID: 35007694 DOI: 10.1016/j.mri.2022.01.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/02/2022] [Accepted: 01/04/2022] [Indexed: 02/07/2023]
Abstract
The purpose of this study was to quantitatively evaluate the usefulness of simultaneous spatial and temporal regularization using total variation (TV), total generalized variation (TGV), a combination of low-rank decomposition (LRD) and TV (LRD+TV), a combination of LRD and TGV (LRD+TGV), and nuclear norm (NN) when applied to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in rats with concanavalin A (ConA)-induced acute hepatic injury. The rats were divided into three groups: normal control (NC) (n = 10), ConA10 (n = 8), and ConA20 (n = 7). Rats in the ConA10 and ConA20 groups were intravenously injected with 10 and 20 mg/kg of ConA, respectively; those in the NC group were intravenously injected with the same volume of saline. DCE-MRI studies were performed using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA; 0.025 mmol Gd/kg) as a contrast agent (CA), 24 h after the ConA or saline injection. After the DCE-MRI study, we generated zero-filled and undersampled k-space data from the original images using a pseudoradial sampling scheme with 4 to 64 spokes. We subsequently reconstructed images from these data using the above regularizers and calculated the signal-to-error ratio (SERimg) and structural similarity index (SSIM) using the original and reconstructed images. We also calculated the area under the curve (AUC), rate of CA washout (λw), maximum relative enhancement (REmax), and time to REmax (Tmax) from time-intensity curves using an empirical mathematical model (EMM) and the signal-to-error ratio for curve fitting (SERfit) from the original and fit curves. We also compared the parameters obtained using the pseudoradial and Cartesian sampling schemes in the NC group. When using LRD+TV and LRD+TGV, both SERimg and SSIM were greater than those for the other regularizers at all spoke numbers studied; the SERfit for TGV was the greatest. When using TGV and LRD+TGV, in the majority of cases the AUCs did not significantly differ from those obtained from the original images, whereas those for LRD+TV and NN were significantly less at several spoke numbers. The λw for NN was significantly greater at numerous spoke numbers in the NC group; the REmax values for LRD+TV and NN were significantly less at several spoke numbers in all groups. The Tmax values for TV, TGV, and LRD+TGV were significantly greater at numerous spoke numbers in the NC group. Although there were significant differences in SERimg and SSIM between the pseudoradial and Cartesian sampling schemes, the kinetic parameters obtained by the EMM did not significantly differ between the two sampling schemes, with certain exceptions. In conclusion, our results suggest that simultaneous spatial and temporal regularization using TGV or LRD+TGV is useful for accelerating DCE-MRI without significant reduction in the accuracy of the kinetic parameter estimation, even at extremely low sampling factors.
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Affiliation(s)
- Kenya Murase
- Department of Future Diagnostic Radiology, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.
| | - Nobuo Kashiwagi
- Department of Future Diagnostic Radiology, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan
| | - Noriyuki Tomiyama
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan
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Ray LA, Pike M, Simon M, Iliff JJ, Heys JJ. Quantitative analysis of macroscopic solute transport in the murine brain. Fluids Barriers CNS 2021; 18:55. [PMID: 34876169 PMCID: PMC8650464 DOI: 10.1186/s12987-021-00290-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/21/2021] [Indexed: 12/16/2022] Open
Abstract
Background Understanding molecular transport in the brain is critical to care and prevention of neurological disease and injury. A key question is whether transport occurs primarily by diffusion, or also by convection or dispersion. Dynamic contrast-enhanced (DCE-MRI) experiments have long reported solute transport in the brain that appears to be faster than diffusion alone, but this transport rate has not been quantified to a physically relevant value that can be compared to known diffusive rates of tracers. Methods In this work, DCE-MRI experimental data is analyzed using subject-specific finite-element models to quantify transport in different anatomical regions across the whole mouse brain. The set of regional effective diffusivities (\documentclass[12pt]{minimal}
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\begin{document}$$D_{eff}$$\end{document}Deff), a transport parameter combining all mechanisms of transport, that best represent the experimental data are determined and compared to apparent diffusivity (\documentclass[12pt]{minimal}
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\begin{document}$$D_{app}$$\end{document}Dapp), the known rate of diffusion through brain tissue, to draw conclusions about dominant transport mechanisms in each region. Results In the perivascular regions of major arteries, \documentclass[12pt]{minimal}
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\begin{document}$$D_{eff}$$\end{document}Deff for gadoteridol (550 Da) was over 10,000 times greater than \documentclass[12pt]{minimal}
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\begin{document}$$D_{app}$$\end{document}Dapp. In the brain tissue, constituting interstitial space and the perivascular space of smaller blood vessels, \documentclass[12pt]{minimal}
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\begin{document}$$D_{eff}$$\end{document}Deff was 10–25 times greater than \documentclass[12pt]{minimal}
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\begin{document}$$D_{app}$$\end{document}Dapp. Conclusions The analysis concludes that convection is present throughout the brain. Convection is dominant in the perivascular space of major surface and branching arteries (Pe > 1000) and significant to large molecules (> 1 kDa) in the combined interstitial space and perivascular space of smaller vessels (not resolved by DCE-MRI). Importantly, this work supports perivascular convection along penetrating blood vessels. Supplementary Information The online version contains supplementary material available at 10.1186/s12987-021-00290-z.
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Affiliation(s)
- Lori A Ray
- Department of Chemical and Biological Engineering, Montana State University, Bozeman, USA
| | - Martin Pike
- Advanced Imaging Research Center, Oregon Health and Sciences University, Portland, USA
| | - Matthew Simon
- Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, USA.,Neuroscience Graduate Program, Oregon Health and Science University, Portland, USA.,Denali Therapeutics, San Francisco, USA
| | - Jeffrey J Iliff
- VISN 20 Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, USA
| | - Jeffrey J Heys
- Department of Chemical and Biological Engineering, Montana State University, Bozeman, USA.
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Shinya T, Kojima Y, Monobe Y, Fujiwara H, Uehara S, Kato K. MRI and CT features of a malignant myoepithelioma of the scrotum: A case report and literature review. Radiol Case Rep 2021; 16:2962-2968. [PMID: 34401034 PMCID: PMC8350411 DOI: 10.1016/j.radcr.2021.07.013] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 11/07/2022] Open
Abstract
Malignant myoepithelioma of the scrotum is extremely rare. We report the case of a 51-year-old man with malignant myoepithelioma of the scrotum, wherein computed tomography and magnetic resonance imaging revealed a lobulated soft tissue mass with calcification, cystic component, and solid component with gradual contrast enhancement on dynamic contrast-enhanced scans. The patient presented with scrotal induration, and there was no elevation of tumor markers and no evidence of a metastatic lesion on computed tomography and magnetic resonance imaging. Histopathological examination of the resected scrotal specimen confirmed a well-circumscribed solid tumor with septa, a small area of hemorrhage, and necrosis. The subsequent diagnosis was malignant myoepithelioma of the scrotum. This case shows that scrotal malignant myoepithelioma might appear as a well-defined lobulated mass with cystic regions. We conjecture that the enhancement pattern and apparent diffusion coefficient values can be potential markers for scrotal myoepithelial tumors.
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Affiliation(s)
- Takayoshi Shinya
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Center, Okayama, Japan.,Division of Radiology, Department of Community Medicine and Medical Science, Tokushima University Graduate School of Biomedical Sciences. 2-50-1, Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan
| | - Yuichi Kojima
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Yasumasa Monobe
- Department of Pathology, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Hideyo Fujiwara
- Department of Pathology, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Shinya Uehara
- Department of Urology, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Katsuya Kato
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Center, Okayama, Japan
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30
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Kleppestø M, Bjørnerud A, Groote IR, Kim M, Vardal J, Larsson C. Operator dependency of arterial input function in dynamic contrast-enhanced MRI. MAGMA 2021. [PMID: 34213687 DOI: 10.1007/s10334-021-00926-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 11/09/2022]
Abstract
Objective To investigate the effect of inter-operator variability in arterial input function (AIF) definition on kinetic parameter estimates (KPEs) from dynamic contrast-enhanced (DCE) MRI in patients with high-grade gliomas. Methods The study included 118 DCE series from 23 patients. AIFs were measured by three domain experts (DEs), and a population AIF (pop-AIF) was constructed from the measured AIFs. The DE-AIFs, pop-AIF and AUC-normalized DE-AIFs were used for pharmacokinetic analysis with the extended Tofts model. AIF-dependence of KPEs was assessed by intraclass correlation coefficient (ICC) analysis, and the impact on relative longitudinal change in Ktrans was assessed by Fleiss’ kappa (κ). Results There was a moderate to substantial agreement (ICC 0.51–0.76) between KPEs when using DE-AIFs, while AUC-normalized AIFs yielded ICC 0.77–0.95 for Ktrans, kep and ve and ICC 0.70 for vp. Inclusion of the pop-AIF did not reduce agreement. Agreement in relative longitudinal change in Ktrans was moderate (κ = 0.591) using DE-AIFs, while AUC-normalized AIFs gave substantial (κ = 0.809) agreement. Discussion AUC-normalized AIFs can reduce the variation in kinetic parameter results originating from operator input. The pop-AIF presented in this work may be applied in absence of a satisfactory measurement.
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31
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Mungai F, Verrone GB, Bonasera L, Bicci E, Pietragalla M, Nardi C, Berti V, Mazzoni LN, Miele V. Imaging biomarkers in the diagnosis of salivary gland tumors: the value of lesion/parenchyma ratio of perfusion-MR pharmacokinetic parameters. Radiol Med 2021. [PMID: 34181206 DOI: 10.1007/s11547-021-01376-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/12/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Morphologic magnetic resonance imaging (MRI) for characterization of salivary gland tumors has limited utility, and the use of perfusion MRI data in the clinical setting is controversial. We examined the potential of tissue-normalized dynamic contrast-enhanced (DCE) MRI pharmacokinetic parameters of salivary gland tumors as imaging biomarkers for characterization and differentiation between benign and malignant lesions. MATERIALS AND METHODS DCE-MR images acquired from 60 patients with parotid and submandibular gland tumors were retrospectively reviewed. Pharmacokinetic parameters as transfer constant (Ktrans), rate constant (Kep), extracellular space volume (Ve), fractional plasma volume (Vp), and AEC (area of all times enhancement curve) were measured on both the lesion and the normal contralateral salivary gland parenchyma. Lesion/parenchyma ratio (L/P) for each parameter was calculated. RESULTS Five groups of lesions were identified (reference: histopathology): pleomorphic adenomas(n = 20), Warthin tumors(n = 16), other benign entities(n = 4), non-Hodgkin lymphomas(n = 4), and malignancies(n = 16). Significant differences were seen for mean values of L/PKtrans (higher in malignancies), L/PKep (lower in adenomas than Warthin tumors), L/PVe (lower in Warthin tumors and lymphomas), L/PVp (higher in Warthin tumors and malignancies than adenomas), and L/PAEC (higher in malignancies). Significant differences were found between benign and malignant (non-lymphoproliferative) lesions in mean value of L/PKtrans (0.485 and 1.581), L/PVp (1.288 and 2.834), and L/PAEC (0.682 and 1.910). ROC analysis demonstrated the highest AUC (0.96) for L/PAEC, with sensitivity and specificity for malignancy of 93.8% and 97.5% (cutoff value = 1.038). CONCLUSION Lesion/parenchyma ratio of DCE-MRI pharmacokinetic data could be helpful for recognizing the principal types of salivary gland tumors; L/PAEC seems a valuable biomarker for differentiating benign from malignant tumors.
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Flouri D, Lesnic D, Chrysochou C, Parikh J, Thelwall P, Sheerin N, Kalra PA, Buckley DL, Sourbron SP. Motion correction of free-breathing magnetic resonance renography using model-driven registration. MAGMA 2021; 34:805-822. [PMID: 34160718 PMCID: PMC8578117 DOI: 10.1007/s10334-021-00936-x] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/24/2021] [Accepted: 06/08/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Model-driven registration (MDR) is a general approach to remove patient motion in quantitative imaging. In this study, we investigate whether MDR can effectively correct the motion in free-breathing MR renography (MRR). MATERIALS AND METHODS MDR was generalised to linear tracer-kinetic models and implemented using 2D or 3D free-form deformations (FFD) with multi-resolution and gradient descent optimization. MDR was evaluated using a kidney-mimicking digital reference object (DRO) and free-breathing patient data acquired at high temporal resolution in multi-slice 2D (5 patients) and 3D acquisitions (8 patients). Registration accuracy was assessed using comparison to ground truth DRO, calculating the Hausdorff distance (HD) between ground truth masks with segmentations and visual evaluation of dynamic images, signal-time courses and parametric maps (all data). RESULTS DRO data showed that the bias and precision of parameter maps after MDR are indistinguishable from motion-free data. MDR led to reduction in HD (HDunregistered = 9.98 ± 9.76, HDregistered = 1.63 ± 0.49). Visual inspection showed that MDR effectively removed motion effects in the dynamic data, leading to a clear improvement in anatomical delineation on parametric maps and a reduction in motion-induced oscillations on signal-time courses. DISCUSSION MDR provides effective motion correction of MRR in synthetic and patient data. Future work is needed to compare the performance against other more established methods.
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Affiliation(s)
- Dimitra Flouri
- Department of Applied Mathematics, University of Leeds, Leeds, UK. .,Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK. .,School of Biomedical Engineering and Imaging Sciences, Kings College London, London, UK. .,Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
| | - Daniel Lesnic
- Department of Applied Mathematics, University of Leeds, Leeds, UK
| | - Constantina Chrysochou
- Department of Renal Medicine, Salford Royal National Health Service Foundation Trust, Salford, UK
| | - Jehill Parikh
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle Magnetic Resonance Centre, Campus for Ageing and Vitality, University of Newcastle, Newcastle upon Tyne, UK
| | - Peter Thelwall
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle Magnetic Resonance Centre, Campus for Ageing and Vitality, University of Newcastle, Newcastle upon Tyne, UK
| | - Neil Sheerin
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Philip A Kalra
- Department of Renal Medicine, Salford Royal National Health Service Foundation Trust, Salford, UK
| | - David L Buckley
- Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Steven P Sourbron
- Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK.,Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
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Brooke JP, Hall IP. Novel Thoracic MRI Approaches for the Assessment of Pulmonary Physiology and Inflammation. Adv Exp Med Biol 2021; 1304:123-145. [PMID: 34019267 DOI: 10.1007/978-3-030-68748-9_8] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Excessive pulmonary inflammation can lead to damage of lung tissue, airway remodelling and established structural lung disease. Novel therapeutics that specifically target inflammatory pathways are becoming increasingly common in clinical practice, but there is yet to be a similar stepwise change in pulmonary diagnostic tools. A variety of thoracic magnetic resonance imaging (MRI) tools are currently in development, which may soon fulfil this emerging clinical need for highly sensitive assessments of lung structure and function. Given conventional MRI techniques are poorly suited to lung imaging, alternate strategies have been developed, including the use of inhaled contrast agents, intravenous contrast and specialized lung MR sequences. In this chapter, we discuss technical challenges of performing MRI of the lungs and how they may be overcome. Key thoracic MRI modalities are reviewed, namely, hyperpolarized noble gas MRI, oxygen-enhanced MRI (OE-MRI), ultrashort echo time (UTE) MRI and dynamic contrast-enhanced (DCE) MRI. Finally, we consider potential clinical applications of these techniques including phenotyping of lung disease, evaluation of novel pulmonary therapeutic efficacy and longitudinal assessment of specific patient groups.
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Affiliation(s)
- Jonathan P Brooke
- Department of Respiratory Medicine, University of Nottingham, Queens Medical Centre, Nottingham, UK.
| | - Ian P Hall
- Department of Respiratory Medicine, University of Nottingham, Queens Medical Centre, Nottingham, UK.
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Bi Q, Chen Y, Chen J, Zhang H, Lei Y, Yang J, Zhang Y, Bi G. Predictive value of T2-weighted imaging and dynamic contrast-enhanced MRI for assessing cervical invasion in patients with endometrial cancer: a meta-analysis. Clin Imaging 2021; 78:206-13. [PMID: 34049140 DOI: 10.1016/j.clinimag.2021.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/30/2021] [Accepted: 05/10/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To obtain the diagnostic accuracy of T2-weighted imaging (T2WI), and dynamic contrast-enhanced MRI (DCE-MRI) in the preoperative assessment of cervical invasion in patients with endometrial cancer (EC). METHODS Databases including PubMed, Embase, Cochrane Library, Web of Science, and Clinical Trials were searched for relevant articles published from January 2000 to August 2020. Pooled estimation data were obtained by statistical analysis. RESULTS In total, 24 articles were included. For assessing cervical invasion of EC, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) for T2WI were 0.70 (0.61-0.77), 0.92 (0.89-0.94), 8.7 (6.5-11.6), 0.33 (0.25-0.43), 26 (17-41), and 0.92 (0.89-0.94), respectively. For DCE-MRI, the pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.75 (0.60-0.85), 0.95 (0.89-0.98), 14.7 (6.6-32.9), 0.27 (0.16-0.44), 55 (18-165), and 0.92 (0.89-0.94), respectively; for T2WI combined with DCE-MRI, they were 0.58 (0.41-0.73), 0.98 (0.95-0.99), 28.1 (12.8-62.1), 0.43 (0.30-0.63), 65 (29-146), and 0.94 (0.91-0.96), respectively. CONCLUSIONS DCE-MRI demonstrated higher diagnostic performance than T2WI in the prediction of cervical invasion in patients with EC. T2WI combined with DCE-MRI improved the pooled specificity, PLR, DOR, and AUC compared to T2WI alone or DCE-MRI alone.
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Shin DJ, Choi SH, Yoo RE, Kang KM, Yun TJ, Kim JH, Sohn CH, Jo SW, Lee EJ. Application of T1 Map Information Based on Synthetic MRI for Dynamic Contrast-Enhanced Imaging: A Comparison Study with the Fixed Baseline T1 Value Method. Korean J Radiol 2021; 22:1352-1368. [PMID: 33987992 PMCID: PMC8316777 DOI: 10.3348/kjr.2020.1201] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/13/2020] [Accepted: 12/31/2020] [Indexed: 11/17/2022] Open
Abstract
Objective For an accurate dynamic contrast-enhanced (DCE) MRI analysis, exact baseline T1 mapping is critical. The purpose of this study was to compare the pharmacokinetic parameters of DCE MRI using synthetic MRI with those using fixed baseline T1 values. Materials and Methods This retrospective study included 102 patients who underwent both DCE and synthetic brain MRI. Two methods were set for the baseline T1: one using the fixed value and the other using the T1 map from synthetic MRI. The volume transfer constant (Ktrans), volume of the vascular plasma space (vp), and the volume of the extravascular extracellular space (ve) were compared between the two methods. The interclass correlation coefficients and the Bland-Altman method were used to assess the reliability. Results In normal-appearing frontal white matter (WM), the mean values of Ktrans, ve, and vp were significantly higher in the fixed value method than in the T1 map method. In the normal-appearing occipital WM, the mean values of ve and vp were significantly higher in the fixed value method. In the putamen and head of the caudate nucleus, the mean values of Ktrans, ve, and vp were significantly lower in the fixed value method. In addition, the T1 map method showed comparable interobserver agreements with the fixed baseline T1 value method. Conclusion The T1 map method using synthetic MRI may be useful for reflecting individual differences and reliable measurements in clinical applications of DCE MRI.
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Affiliation(s)
- Dong Jae Shin
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.,Center for Nanoparticle Research, Institute for Basic Science, Seoul, Korea.,School of Chemical and Biological Engineering, Seoul National University, Seoul, Korea.
| | - Roh Eul Yoo
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Koung Mi Kang
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Jin Yun
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Hoon Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Chul Ho Sohn
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Won Jo
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Eun Jung Lee
- Department of Radiology, Human Medical Imaging & Intervention Center, Seoul, Korea
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Bäuerle T, Roemer FW. Dynamic contrast-enhanced MRI for assessment of subchondral bone marrow vascularization in an experimental osteoarthritis model: a major step towards clinical translation? Osteoarthritis Cartilage 2021; 29:603-606. [PMID: 33716099 DOI: 10.1016/j.joca.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 02/02/2023]
Affiliation(s)
- T Bäuerle
- Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany.
| | - F W Roemer
- Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany; Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3(rd) Floor, 820 Harrison Ave, Boston, MA, 02118, USA
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Song D, Wang Y, Wang W, Cai J, Zhu K, Lv M, Gao Q, Zhou J, Fan J, Rao S, Wang M, Wang X. Using deep learning to predict microvascular invasion in hepatocellular carcinoma based on dynamic contrast-enhanced MRI combined with clinical parameters. J Cancer Res Clin Oncol. 2021 epub ahead of print. [PMID: 33839938 DOI: 10.1007/s00432-021-03617-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/23/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Microvascular invasion (MVI) is a critical determinant of the early recurrence and poor prognosis of patients with hepatocellular carcinoma (HCC). Prediction of MVI status is clinically significant for the decision of treatment strategies and the assessment of patient's prognosis. A deep learning (DL) model was developed to predict the MVI status and grade in HCC patients based on preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and clinical parameters. METHODS HCC patients with pathologically confirmed MVI status from January to December 2016 were enrolled and preoperative DCE-MRI of these patients were collected in this study. Then they were randomly divided into the training and testing cohorts. A DL model with eight conventional neural network (CNN) branches for eight MRI sequences was built to predict the presence of MVI, and further combined with clinical parameters for better prediction. RESULTS Among 601 HCC patients, 376 patients were pathologically MVI absent, and 225 patients were MVI present. To predict the presence of MVI, the DL model based only on images achieved an area under curve (AUC) of 0.915 in the testing cohort as compared to the radiomics model with an AUC of 0.731. The DL combined with clinical parameters (DLC) model yielded the best predictive performance with an AUC of 0.931. For the MVI-grade stratification, the DLC models achieved an overall accuracy of 0.793. Survival analysis demonstrated that the patients with DLC-predicted MVI status were associated with the poor overall survival (OS) and recurrence-free survival (RFS). Further investigation showed that hepatectomy with the wide resection margin contributes to better OS and RFS in the DLC-predicted MVI present patients. CONCLUSION The proposed DLC model can provide a non-invasive approach to evaluate MVI before surgery, which can help surgeons make decisions of surgical strategies and assess patient's prognosis.
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Bai Z, Shi J, Yang Z, Zeng W, Hu H, Zhong J, Duan X, Wang X, Shen J. Quantitative kinetic parameters of primary tumor can be used to predict pelvic lymph node metastasis in early-stage cervical cancer. Abdom Radiol (NY) 2021; 46:1129-36. [PMID: 32930831 DOI: 10.1007/s00261-020-02762-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/26/2020] [Accepted: 09/03/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE To investigate the role of kinetic parameters of primary tumor derived from dynamic contrast-enhanced MRI (DCE-MRI) in predicting pelvic lymph node metastasis (PLNM) in patients with cervical cancer. METHODS 66 women with newly diagnosed cervical cancer were included between July 2017 and August 2019. All patients had a FIGO stage IB-IIA cancer and treated with hysterectomy and bilateral lymphadenectomy. Kinetic parameters of the primary tumor were derived from DCE-MRI data. The tumor diameter, ADC value, kinetic parameters, and nodal short-axis diameter were compared between patients with or without PLNM. Logistic regression analysis was used to determine the independent predictors for PLNM and receiver operator characteristic curve was used to evaluate the predictive performance. RESULTS There were 20 patients with PLNM and 46 patients without PLNM. Tumor diameter, the efflux rate constant (Kep), and nodal short-axis diameter were significantly higher in patients with PLNM (P < 0.01). Multivariate logistic regression analysis showed that Kep and short-axis diameter were independent predictors for PLNM. Combining Kep and nodal short-axis diameter yielded the highest area under the curve (AUC) of 0.839. Combined with Kep, the sensitivity, specificity, negative predictive value, and positive predictive value of nodal short-axis diameter increased from 0.500, 0.957, 0.815, and 0.833 to 0.600, 0.978, 0.923, and 0.849, respectively. With 1.113 min-1 as threshold, the sensitivity and specificity values of Kep in predicting PLNM in patients with normal-sized lymph nodes were 0.909 and 0.667, respectively. CONCLUSIONS Kep of primary tumor can be used as a surrogate marker to predict PLNM in cervical cancer.
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Kul S, Metin Y, Bekircavusoglu S, Kul M. Qualitative characterization of breast tumors with diffusion-weighted imaging has comparable accuracy to quantitative analysis. Clin Imaging 2021; 77:17-24. [PMID: 33639496 DOI: 10.1016/j.clinimag.2021.02.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/22/2021] [Accepted: 02/10/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the applicability and accuracy of a new qualitative diffusion-weighted imaging (DWI) assessment method in the characterization of breast tumors compared to quantitative ADC measurement and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). MATERIALS AND METHODS After review board approval, MRIs of 216 consecutive women with final diagnoses (131 malignant, 85 benign) were retrospectively analyzed. Two radiologists independently scored DWI and dynamic contrast-enhanced MRI (DCE-MRI) according to malignancy probability. Qualitative assessments were performed by combined analysis of tumor morphology and diffusion signal. Quantitative data was obtained from apparent diffusion coefficient (ADC) measurements. Lastly, descriptive DWI features were evaluated and recorded. Cohen's kappa, receiver operating characteristic and multivariate analyzes were applied. RESULTS Of malignant tumors, 97% were visible on DWI. Qualitative and quantitative DWI assessments provided comparable sensitivities of 89-94% and 88-92% and specificities of 51-61% and 59-67%, respectively. There was no statistical difference between the accuracies of qualitative and quantitative DWI (p ≥ 0.105). Best diagnostic values were obtained with DCE-MRI (sensitivity, 99-100%; specificity, 69-71%). Inter-reader agreement was moderate (kappa = 0.597) for qualitative DWI and substantial (kappa = 0.689) for DCE-MRI (p < 0.001). Agreement between qualitative DWI and DCE-MRI scores was moderate (kappa = 0.536 and 0.442). Visual diffusion signal, mass margin and shape were the most predictive features of malignancy on multivariate analysis of qualitative assessment. CONCLUSION Qualitative characterization of breast tumors on DWI has comparable accuracy to quantitative ADC analysis. This method might be used to make DWI more widely available with eliminating the need to a predetermined ADC threshold in tumor characterization. However, lower accuracy and inter-reader agreement of it compared to DCE-MRI should be considered.
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Shinya T, Shibamoto K, Maeba K, Kato K, Monobe Y, Fujiwara M, Hongo A. Magnetic resonance imaging findings of a myxoid leiomyosarcoma of the uterus: A case report and literature review. Eur J Radiol Open 2021; 8:100328. [PMID: 33604419 PMCID: PMC7873632 DOI: 10.1016/j.ejro.2021.100328] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/16/2021] [Accepted: 01/28/2021] [Indexed: 11/16/2022] Open
Abstract
Uterine myxoid leiomyosarcomas (MLMSs) are extremely rare. Here, we report a rare case of uterine MLMS with unique and bizarre magnetic resonance imaging (MRI) findings on diffusion-weighted images (DWIs) and dynamic contrast-enhanced (DCE) MRI scans. A 67-year-old woman presented with a uterine MLMS that had a multilocular cystic mass with a septum and solid components. The tumour demonstrated marked hyperintensity on T2-weighted images in a myxoid stroma with gradual partial contrast enhancement and diffusion restriction, which could be a characteristic feature suggestive of a myxoid malignant smooth muscle tumour of the uterus rather than a uterine leiomyoma with myxoid degeneration.
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Affiliation(s)
- Takayoshi Shinya
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Kentaro Shibamoto
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Kiyoka Maeba
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Katsuya Kato
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Yasumasa Monobe
- Department of Pathology, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Michihisa Fujiwara
- Department of Obstetrics and Gynecology 2, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Atsushi Hongo
- Department of Obstetrics and Gynecology 2, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
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Malattia C, Tolend M, Mazzoni M, Panwar J, Zlotnik M, Otobo T, Vidarsson L, Doria AS. Current status of MR imaging of juvenile idiopathic arthritis. Best Pract Res Clin Rheumatol 2020; 34:101629. [PMID: 33281052 DOI: 10.1016/j.berh.2020.101629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common chronic arthropathy in the pediatric population. Although the diagnosis is essentially clinical for many affected joints, MR imaging has become an important tool for the assessment of joints that are difficult to evaluate clinically, such as temporomandibular and sacroiliac joints, and for screening of inflammatory changes in the entire body by whole body MRI (WBMRI) assessment. The utilization of MR imaging is challenging in the pediatric population given the need for discrimination between pathological and physiological changes in the growing skeleton. Several multicentric multidisciplinary organizations have made major efforts over the past decades to standardize, quantify, and validate scoring systems to measure joint changes both cross-sectionally and longitudinally according to rigorous methodological standards. In this paper, we (1) discuss current trends for the diagnosis and management of JIA, (2) review challenges for detecting real pathological changes in growing joints, (3) summarize the current status of standardization of MRI protocols for data acquisition and the quantification of joint pathology in JIA by means of scoring systems, and (4) outline novel MR imaging techniques for the evaluation of anatomy and function of joints in JIA. Optimizing the role of MRI as a robust biomarker and outcome measure remains a priority of future research in this field.
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Affiliation(s)
- Clara Malattia
- Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Italy
| | - Mirkamal Tolend
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Marta Mazzoni
- Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Italy
| | - Jyoti Panwar
- Department of Radiology, Christian Medical College, Vellore, India
| | - Margalit Zlotnik
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Tarimobo Otobo
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Logi Vidarsson
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Andrea S Doria
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
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Park S, Park JG, Jun S, Kim H, Kim TS, Kang H. Differentiation of bone metastases from prostate cancer and benign red marrow depositions of the pelvic bone with multiparametric MRI. Magn Reson Imaging 2020; 73:118-124. [PMID: 32860869 DOI: 10.1016/j.mri.2020.08.019] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/15/2020] [Accepted: 08/23/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To investigate the diagnostic utilities of imaging parameters derived from T1-weighted imaging (T1WI), diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to differentiate bone metastases from prostate cancer and benign red marrow depositions of the pelvic bone. MATERIALS AND METHODS Thirty-six lesions from 36 patients with prostate cancer were analyzed with T1WI, DWI, and DCE-MRI. The lesions were classified in the bone metastases (n = 22) and benign red marrow depositions (n = 14). Lesion-muscle ratio (LMR), apparent diffusion coefficient (ADC), volume transfer constant (Ktrans), reflux rate (Kep), and volume fraction of the extravascular extracellular matrix (Ve) values were obtained from the lesions. The imaging parameters of the both groups were compared using the Mann-Whitney U test, receiver operating characteristics (ROC) curves were analyzed. For the ROC curves, area under the curves (AUCs) were compared. RESULTS The ADC, Ktrans, Kep, and Ve values of bone metastases were significantly higher than those of benign red marrow depositions (Mann-Whitney U test, p < 0.05). However, there was no significant difference in LMR between the two groups (Mann-Whitney U test, p = 0.360). The AUCs of Ktrans, Kep, ADC, Ve, and LMR were 0.896, 0.844, 0.812, 0.724, and 0.448, respectively. In the pairwise comparison of ROC curves, the AUCs of Ktrans and Kep was significantly higher than LMR. CONCLUSIONS Ktrans, Kep, Ve, and ADC values can be used as imaging tools to differentiate bone metastases from prostate cancer and benign red marrow depositions of the pelvic bone.
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Affiliation(s)
- Sekyoung Park
- Department of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Jung Gu Park
- Department of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea.
| | - Sungmin Jun
- Department of Nuclear Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Heeyoung Kim
- Department of Nuclear Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Taek Sang Kim
- Department of Urology Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Hee Kang
- Department of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
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Qin J, Yao Q, Ge X, Zhu J, Yin Z, Li X, Li C. Comparative study of imaging and histology of sacroiliac joint in normal rats based on IVIM-DWI and DCE-MRI. BMC Musculoskelet Disord 2020; 21:472. [PMID: 32689978 PMCID: PMC7370526 DOI: 10.1186/s12891-020-03481-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 07/06/2020] [Indexed: 12/03/2022] Open
Abstract
Background Currently, few studies have described the relationship between functional MRI findings and histology of normal sacroiliac joint (SIJ). Besides, due to the difficulties in access to SIJ, authentic animal models are important in providing opportunities for quantitative parameter extraction on imaging. Aims This study aimed at exploring the parameters of Intravoxel Incoherent Motion Diffusion-Weighted Imaging (IVIM-DWI) and Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) and comparing them with the histology of the SIJ in normal rats with different ages. Methods A total of thirty 7-week-old male Wistar rats were included in the study. The parameters of IVIM-DWI and DCE-MRI in the bone marrow and the joint space of SIJ were measured at 8, 13, 18, 23, 28, and 33 weeks. The histological analysis of the SIJ was examined using light microscopy. One-way ANOVA was used for statistical analysis. Results The D values in the sacral and iliac bone marrow of normal rats decreased with an increase in age. One-way ANOVA analysis indicated a significant difference in D values in different age groups (P<0.005). The normal values of D*, f, Fenh (%), Senh (%/s) in the sacral bone marrow, the iliac bone marrow, and the joint space in SIJ of normal rats were obtained. The results showed that in the six groups of rats of different ages, the histology of the SIJ surface was smooth and clear, the cartilage cells were intact, and no thickening or pannus formation was observed. Conclusions This study obtained the IVIM-DWI and DCE-MRI parameters of the sacral and iliac bone marrow and the synovial area of the joint space in normal rats. The parameters in normal rats can be used in future research to compare to similar parameters in animal models or patients with SIJ diseases. This study serves as a guide for future research in SIJ diseases.
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Affiliation(s)
- Jian Qin
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian City, 271000, Shandong, China
| | - Qianqian Yao
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian City, 271000, Shandong, China
| | - Xubo Ge
- Department of Radiology, The Fourth People's Hospital of Taian, Taian, 271000, Shandong, China
| | - Jianzhong Zhu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian City, 271000, Shandong, China
| | - Zhaoliang Yin
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian City, 271000, Shandong, China
| | - Xiaoqian Li
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian City, 271000, Shandong, China
| | - Changqin Li
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian City, 271000, Shandong, China.
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Verheggen ICM, de Jong JJA, van Boxtel MPJ, Gronenschild EHBM, Palm WM, Postma AA, Jansen JFA, Verhey FRJ, Backes WH. Increase in blood-brain barrier leakage in healthy, older adults. GeroScience 2020; 42:1183-93. [PMID: 32601792 DOI: 10.1007/s11357-020-00211-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/02/2020] [Indexed: 12/22/2022] Open
Abstract
Blood–brain barrier (BBB) breakdown can disrupt nutrient supply and waste removal, which affects neuronal functioning. Currently, dynamic contrast-enhanced (DCE) MRI is the preferred in-vivo method to quantify BBB leakage. Dedicated DCE MRI studies in normal aging individuals are lacking, which could hamper value estimation and interpretation of leakage rate in pathological conditions. Therefore, we applied DCE MRI to investigate the association between BBB disruption and age in a healthy sample. Fifty-seven cognitively and neurologically healthy, middle-aged to older participants (mean age: 66 years, range: 47–91 years) underwent MRI, including DCE MRI with intravenous injection of a gadolinium-based contrast agent. Pharmacokinetic modeling was applied to contrast concentration time-curves to estimate BBB leakage rate in each voxel. Subsequently, leakage rate was calculated in the white and gray matter, and primary (basic sensory and motor functions), secondary (association areas), and tertiary (higher-order cognition) brain regions. A difference in vulnerability to deterioration was expected between these regions, with especially tertiary regions being affected by age. Higher BBB leakage rate was significantly associated with older age in the white and gray matter, and also in tertiary, but not in primary or secondary brain regions. Even in healthy individuals, BBB disruption was stronger in older persons, which suggests BBB disruption is a normal physiologically aging phenomenon. Age-related increase in BBB disruption occurred especially in brain regions most vulnerable to age-related deterioration, which may indicate that BBB disruption is an underlying mechanism of normal age-related decline. Netherlands Trial Register number: NL6358, date of registration: 2017-03-24.
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Mujtaba B, Call C, Rowland F, Spear RP, Amini B, Valenzuela R, Nassar S. Desmoid fibromatosis following surgical resection of spinal meningioma. Radiol Case Rep 2020; 15:697-701. [PMID: 32280401 PMCID: PMC7139138 DOI: 10.1016/j.radcr.2020.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/05/2020] [Accepted: 02/13/2020] [Indexed: 11/21/2022] Open
Abstract
A 42-year-old female patient with a history of cervicothoracic junction meningioma World Health Organization grade I, resected in early 2011, was admitted to the hospital with intractable headache and lower extremity weakness. Magnetic resonance imaging (MRI) showed an epidural mass compressing the spinal cord at the prior surgical site, which was interpreted as recurrent meningioma. Following surgical resection, histopathological analysis revealed desmoid fibromatosis (desmoid tumor). In retrospect, dynamic contrast-enhanced magnetic resonance imaging performed prior to surgery should have allowed for prospective exclusion of meningioma as the recurrent mass and suggested an alternative diagnosis such as post-traumatic desmoid fibromatosis or the need for biopsy to confirm diagnosis.
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Kamintsky L, Cairns KA, Veksler R, Bowen C, Beyea SD, Friedman A, Calkin C. Blood-brain barrier imaging as a potential biomarker for bipolar disorder progression. Neuroimage Clin 2019; 26:102049. [PMID: 31718955 PMCID: PMC7229352 DOI: 10.1016/j.nicl.2019.102049] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/05/2019] [Accepted: 10/21/2019] [Indexed: 11/29/2022]
Abstract
Bipolar disorder affects approximately 2% of the population and is typically characterized by recurrent episodes of mania and depression. While some patients achieve remission using mood-stabilizing treatments, a significant proportion of patients show progressive changes in symptomatology over time. Bipolar progression is diverse in nature and may include a treatment-resistant increase in the frequency and severity of episodes, worse psychiatric and functional outcomes, and a greater risk of suicide. The mechanisms underlying bipolar disorder progression remain poorly understood and there are currently no biomarkers for identifying patients at risk. The objective of this study was to explore the potential of blood-brain barrier (BBB) imaging as such a biomarker, by acquiring the first imaging data of BBB leakage in bipolar patients, and evaluating the potential association between BBB dysfunction and bipolar symptoms. To this end, a cohort of 36 bipolar patients was recruited through the Mood Disorders Clinic (Nova Scotia Health Authority, Canada). All patients, along with 14 control subjects (matched for sex, age and metabolic status), underwent contrast-enhanced dynamic MRI scanning for quantitative assessment of BBB leakage as well as clinical and psychiatric evaluations. Outlier analysis has identified a group of 10 subjects with significantly higher percentages of brain volume with BBB leakage (labeled the "extensive BBB leakage" group). This group consisted exclusively of bipolar patients, while the "normal BBB leakage" group included the entire control cohort and the remaining 26 bipolar subjects. Among the bipolar cohort, patients with extensive BBB leakage were found to have more severe depression and anxiety, and a more chronic course of illness. Furthermore, all bipolar patients within this group were also found to have co-morbid insulin resistance, suggesting that insulin resistance may increase the risk of BBB dysfunction in bipolar patients. Our findings demonstrate a clear link between BBB leakage and greater psychiatric morbidity in bipolar patients and highlight the potential of BBB imaging as a mechanism-based biomarker for bipolar disorder progression.
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Affiliation(s)
- Lyna Kamintsky
- Department of Medical Neuroscience, Dalhousie University, Sir Charles Tupper Building, 5850 College Street, Halifax, NS, B3H 4R2, Canada
| | - Kathleen A Cairns
- Nova Scotia Health Authority, Mood Disorders Clinic, 5909 Veterans Memorial Lane, Halifax, NS, B3H 2E2, Canada
| | - Ronel Veksler
- Department of Physiology and Cell Biology, Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Chris Bowen
- Biomedical Translational Imaging Centre (BIOTIC), QEII Health Sciences Centre, and Department of Diagnostic Radiology, Dalhousie University, 1796 Summer Street, Halifax, NS, B3H 3A7, Canada
| | - Steven D Beyea
- Biomedical Translational Imaging Centre (BIOTIC), QEII Health Sciences Centre, and Department of Diagnostic Radiology, Dalhousie University, 1796 Summer Street, Halifax, NS, B3H 3A7, Canada
| | - Alon Friedman
- Department of Medical Neuroscience, Dalhousie University, Sir Charles Tupper Building, 5850 College Street, Halifax, NS, B3H 4R2, Canada; Department of Physiology and Cell Biology, Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Cynthia Calkin
- Departments of Psychiatry and Medical Neuroscience, Dalhousie University, Mood Disorders Clinic, 5909 Veterans Memorial Lane, Halifax, NS, B3H 2E2, Canada
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Sun NN, Ge XL, Liu XS, Xu LL. Histogram analysis of DCE-MRI for chemoradiotherapy response evaluation in locally advanced esophageal squamous cell carcinoma. Radiol Med 2019; 125:165-176. [PMID: 31605354 DOI: 10.1007/s11547-019-01081-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 09/12/2019] [Indexed: 12/11/2022]
Abstract
AIMS The aim of the study was to predict and assess treatment response by histogram analysis of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to patients with locally advanced esophageal squamous cell carcinoma receiving chemoradiotherapy (CRT). MATERIALS AND METHODS Seventy-two patients with locally advanced esophageal squamous cell carcinoma who underwent DCE-MRI before and after chemoradiotherapy were enrolled and divided into the complete response (CR) group and the non-CR group based on RECIST. The histogram parameters (10th percentile, 90th percentile, median, mean, standard deviation, skewness, and kurtosis) of pre-CRT and post-CRT were compared using a paired Student's t test in the CR and non-CR groups, respectively. The histogram parameter differences between the CR and the non-CR groups were compared using an unpaired Student's t test. A receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance. RESULTS The histogram parameters of Ktrans values were observed to have significantly decreased after chemoradiotherapy in the CR group. The CR responders showed significantly higher median, mean, and 10th and 90th percentile of pre-Ktrans values than those of the non-CR group. The histogram analysis indicated the decreased heterogeneity in the CR group after CRT. Esophageal cancer with higher pre-Ktrans and lower post-Ktrans values indicated a good treatment response to CRT. Pre-Ktrans-10th showed the best diagnostic performance in predicting the chemoradiotherapy response. CONCLUSIONS The histogram parameters of Ktrans are useful in the assessment and prediction of the chemoradiotherapy response in patients with advanced esophageal squamous cell carcinoma. DCE-MRI could serve as an adjunctive imaging technique for treatment planning.
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Affiliation(s)
- Na-Na Sun
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210000, China
| | - Xiao-Lin Ge
- Department of Radiotherapy, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Xi-Sheng Liu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210000, China.
| | - Lu-Lu Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210000, China
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Mori N, Abe H, Mugikura S, Takasawa C, Sato S, Miyashita M, Mori Y, Pineda FD, Karczmar GS, Tamura H, Takahashi S, Takase K. Ultrafast Dynamic Contrast-Enhanced Breast MRI: Kinetic Curve Assessment Using Empirical Mathematical Model Validated with Histological Microvessel Density. Acad Radiol 2019; 26:e141-9. [PMID: 30269956 DOI: 10.1016/j.acra.2018.08.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 08/24/2018] [Accepted: 08/24/2018] [Indexed: 01/25/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate whether parameters from empirical mathematical model (EMM) for ultrafast dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) correlate with histological microvessel density (MVD) in invasive breast cancer. MATERIALS AND METHODS Ninety-eight consecutive patients with invasive breast cancer underwent an institutional review board-approved ultrafast DCE-MRI including a pre- and 18 postcontrast whole breast ultrafast scans (3 seconds) followed by four standard scans (60 seconds) using a 3T system. Region of interest was placed within each lesion where the highest signal increase was observed on ultrafast DCE-MRI, and the increase rate of enhancement was calculated as follows: ΔS = (SIpost - SIpre)/SIpre. The kinetic curve obtained from ultrafast DCE-MRI was analyzed using a truncated EMM: ΔS(t) = A(1 - e-αt), where A is the upper limit of the signal intensity, α (min-1) is the rate of signal increase. The initial slope of the kinetic curve is given by Aα. Initial area under curve (AUC30) and time of initial enhancement was calculated. From the standard DCE-MRI, the initial enhancement rate (IER) and the signal enhancement ratio (SER) were calculated as follows: IER = (SIearly - SIpre)/SIpre, SER = (SIearly - SIpre)/(SIdelayed - SIpre). The parameters were compared to MVD obtained from surgical specimens. RESULTS A, α, Aα, AUC30, and time of initial enhancement significantly correlated with MVD (r = 0.29, 0.40, 0.51, 0.43, and -0.32 with p = 0.0027, p < 0.0001, p < 0.0001, p < 0.0001, and p = 0.0012, respectively), whereas IER and SER from standard DCE-MRI did not. CONCLUSION The parameters of the EMM, especially the initial slope or Aα, for ultrafast DCE-MRI correlated with MVD in invasive breast cancer.
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Cattell RF, Kang JJ, Ren T, Huang PB, Muttreja A, Dacosta S, Li H, Baer L, Clouston S, Palermo R, Fisher P, Bernstein C, Cohen JA, Duong TQ. MRI Volume Changes of Axillary Lymph Nodes as Predictor of Pathologic Complete Responses to Neoadjuvant Chemotherapy in Breast Cancer. Clin Breast Cancer 2019; 20:68-79.e1. [PMID: 31327729 DOI: 10.1016/j.clbc.2019.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/24/2019] [Accepted: 06/13/2019] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Longitudinal monitoring of breast tumor volume over the course of chemotherapy is informative of pathologic response. This study aims to determine whether axillary lymph node (aLN) volume by magnetic resonance imaging (MRI) could augment the prediction accuracy of treatment response to neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS Level-2a curated data from the I-SPY-1 TRIAL (2002-2006) were used. Patients had stage 2 or 3 breast cancer. MRI was acquired pre-, during, and post-NAC. A subset with visible aLNs on MRI was identified (N = 132). Prediction of pathologic complete response (PCR) was made using breast tumor volume changes, nodal volume changes, and combined breast tumor and nodal volume changes with sub-stratification with and without large lymph nodes (3 mL or ∼1.79 cm diameter cutoff). Receiver operating characteristic curve analysis was used to quantify prediction performance. RESULTS The rate of change of aLN and breast tumor volume were informative of pathologic response, with prediction being most informative early in treatment (area under the curve (AUC), 0.57-0.87) compared with later in treatment (AUC, 0.50-0.75). Larger aLN volume was associated with hormone receptor negativity, with the largest nodal volume for triple negative subtypes. Sub-stratification by node size improved predictive performance, with the best predictive model for large nodes having AUC of 0.87. CONCLUSION aLN MRI offers clinically relevant information and has the potential to predict treatment response to NAC in patients with breast cancer.
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Affiliation(s)
- Renee F Cattell
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY; Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY
| | - James J Kang
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY
| | - Thomas Ren
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY
| | - Pauline B Huang
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY
| | - Ashima Muttreja
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY
| | - Sarah Dacosta
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY
| | - Haifang Li
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY
| | - Lea Baer
- Department of Medical Oncology, Stony Brook University, Stony Brook, NY
| | - Sean Clouston
- Department of Preventive Medicine and Population Health, Stony Brook University, Stony Brook, NY
| | - Roxanne Palermo
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY
| | - Paul Fisher
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY
| | - Cliff Bernstein
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY
| | - Jules A Cohen
- Department of Medical Oncology, Stony Brook University, Stony Brook, NY
| | - Tim Q Duong
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY.
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Chen Y, Yang X, Wen Z, Liu Y, Lu B, Yu S, Xiao X. Association between high-resolution MRI-detected extramural vascular invasion and tumour microcirculation estimated by dynamic contrast-enhanced MRI in rectal cancer: preliminary results. BMC Cancer 2019; 19:498. [PMID: 31133005 PMCID: PMC6537147 DOI: 10.1186/s12885-019-5732-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/17/2019] [Indexed: 02/07/2023] Open
Abstract
Background To determine whether magnetic resonance imaging (MRI)-detected extramural vascular invasion (mrEMVI) status is associated with quantitative perfusion parameters derived from dynamic contrast-enhanced MRI (DCE-MRI) in rectal cancer. Methods Seventy-two patients with rectal adenocarcinoma who underwent curative surgery alone within 2 weeks following rectal MRI were enrolled in this retrospective study. mrEMVI status was determined based on high-resolution MRI. The quantitative perfusion parameters (Ktrans, kep and ve) derived from DCE-MRI were calculated from all sections containing tumours. DCE-MRI parameters and clinicopathological variables in patients with different mrEMVI statuses were compared. Results For patients who were mrEMVI positive, the tumours demonstrated significantly lower kep values (P = 0.012) and higher ve values (P = 0.021) than tumours of patients who were mrEMVI negative, while the Ktrans value displayed no significant difference (P = 0.390). The patients who were mrEMVI positive had larger tumour size, higher pathological tumour stage and increased regional nodal metastases compared to those who were mrEMVI negative (2.9 cm vs. 3.5 cm, P = 0.011; 63.8% vs. 92.0%, P = 0.010; 36.2% vs. 76.0%, P = 0.001; respectively). Conclusions This study demonstrated for the first time that tumour microcirculation is altered in mrEMVI-positive patients with rectal adenocarcinoma, as evidenced by significantly lower kep and higher ve values. In addition, these patients were more likely to have a larger tumour size, a higher pathological tumour stage and regional nodal metastases than mrEMVI-negative patients.
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Affiliation(s)
- Yan Chen
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xinyue Yang
- Department of Radiology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China
| | - Ziqiang Wen
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yiyan Liu
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Baolan Lu
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shenping Yu
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Xiaojuan Xiao
- Department of Radiology, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518036, China.
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