1
|
Zhang N, Song Q, Liang H, Wang Z, Wu Q, Zhang H, Zhang L, Liu A, Wang H, Wang J, Lin L. Early prediction of pathological response to neoadjuvant chemotherapy of breast tumors: a comparative study using amide proton transfer-weighted, diffusion weighted and dynamic contrast enhanced MRI. Front Med (Lausanne) 2024; 11:1295478. [PMID: 38298813 PMCID: PMC10827983 DOI: 10.3389/fmed.2024.1295478] [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: 09/16/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
Objective To examine amide proton transfer-weighted (APTw) combined with diffusion weighed (DWI) and dynamic contrast enhanced (DCE) MRI for early prediction of pathological response to neoadjuvant chemotherapy in invasive breast cancer. Materials In this prospective study, 50 female breast cancer patients (49.58 ± 10.62 years old) administered neoadjuvant chemotherapy (NAC) were enrolled with MRI carried out both before NAC (T0) and at the end of the second cycle of NAC (T1). The patients were divided into 2 groups based on tumor response according to the Miller-Payne Grading (MPG) system. Group 1 included patients with a greater degree of decrease in major histologic responder (MHR, Miller-Payne G4-5), while group 2 included non-MHR cases (Miller-Payne G1-3). Traditional imaging protocols (T1 weighted, T2 weighted, diffusion weighted, and DCE-MRI) and APTw imaging were scanned for each subject before and after treatment. APTw value (APTw0 and APTw1), Dmax (maximum diameter, Dmax0 and Dmax1), V (3D tumor volume, V0 and V1), and ADC (apparent diffusion coefficient, ADC0 and ADC1) before and after treatment, as well as changes between the two times points (ΔAPT, ΔDmax, ΔV, ΔADC) for breast tumors were compared between the two groups. Results APT0 and APT1 values significantly differed between the two groups (p = 0.034 and 0.01). ΔAPTw values were significantly lower in non-MHR tumors compared with MHR tumors (p = 0.015). ΔDmax values were significantly higher in MHR tumors compared with non-MHR tumors (p = 0.005). ADC0 and ADC1 values were significantly higher in MHR tumors than in non-MHR tumors (p = 0.038 and 0.035). AUC (Dmax+DWI + APTw) = AUC (Dmax+APTw) > AUC (APTw) > AUC (Dmax+DWI) > AUC (Dmax). Conclusion APTw imaging along with change of tumor size showed a significant potential in early prediction of MHR for NAC treatment in breast cancer, which might allow timely regimen refinement before definitive surgical treatment.
Collapse
Affiliation(s)
- Nan Zhang
- Department of Radiology, First Affiliated Hospital, Dalian Medical University, Dalian, China
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qingwei Song
- Department of Radiology, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Hongbing Liang
- Department of Radiology, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Zhuo Wang
- Department of Radiology, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Qi Wu
- Department of Radiology, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Haonan Zhang
- Department of Radiology, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Lina Zhang
- Department of Radiology, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Ailian Liu
- Department of Radiology, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Huali Wang
- Department of Pathology, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Jiazheng Wang
- MSC Clinical and Technical Solutions, Philips Healthcare, Beijing, China
| | - Liangjie Lin
- MSC Clinical and Technical Solutions, Philips Healthcare, Beijing, China
| |
Collapse
|
2
|
Shifeng T, Yue W, Wen Z, Lihua C, Nan W, Liangjie L, Ailian L. The value of multimodal functional magnetic resonance imaging in differentiating p53abn from p53wt endometrial carcinoma. Acta Radiol 2023; 64:2948-2956. [PMID: 37661630 DOI: 10.1177/02841851231198911] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND Endometrial carcinoma (EC) is the sixth most common cancer in women. P53 gene expression in patients with endometrial cancer can predict the efficacy and prognosis of patients with neoadjuvant therapy. PURPOSE To explore the value of multimodal magnetic resonance imaging (MRI) in differentiating p53 abnormal (p53abn) from p53 wild-type (p53wt) EC. MATERIAL AND METHODS Data from 47 EC patients, including 14 p53abn cases and 33 p53wt cases, were retrospectively analyzed. The preoperative MRI sequences included amide proton transfer weighted (APTw) imaging, T2 mapping, mDIXON-Quant imaging and diffusion-weighted imaging (DWI). After post-processing, APT, T2, transverse relaxation rate (R2*), fat fraction (FF) and apparent diffusion coefficient (ADC) maps were obtained. The APT, T2, R2*, FF and ADC values for lesions of the two groups of cases were measured by two observers who were blind to the pathological data. RESULTS The APT value and R2* value in the p53abn group were higher than those in the p53wt group, while the ADC value was lower (all P < 0.05). There was no statistically significant difference in T2 value and FF value between the two groups (all P > 0.05). The area under curve of APT, R2*, ADC and combined APT + R2*+ADC values for identification of p53abn and p53wt EC were 0.739, 0.689, 0.718 and 0.820, respectively (all P > 0.05). CONCLUSION APTw, mDIXON-Quant and DWI techniques can be usedfor quantitative identification of p53abn and p53wt EC. The multimodal MRI provides a new way for preoperative quantitative evaluation of EC molecular typing, which has certain clinical application value.
Collapse
Affiliation(s)
- Tian Shifeng
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Wang Yue
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhu Wen
- Department of Pathology, the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Chen Lihua
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Wang Nan
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lin Liangjie
- Philips (China) Investment Co., Ltd, Dalian, China
| | - Liu Ailian
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China
| |
Collapse
|
3
|
Ma C, Tian S, Song Q, Chen L, Meng X, Wang N, Lin L, Wang J, Liu A, Song Q. Amide Proton Transfer-Weighted Imaging Combined With Intravoxel Incoherent Motion for Evaluating Microsatellite Instability in Endometrial Cancer. J Magn Reson Imaging 2023; 57:493-505. [PMID: 35735273 DOI: 10.1002/jmri.28287] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Microsatellite instability (MSI), caused by mismatch repair (MMR) protein defects that lead to uncorrectable mismatch bases, results in the accumulation of gene mutations and ultimately to tumors. Preoperative prediction of MSI can provide a basis for personalized and precise treatment of endometrial cancer (EC) patients. PURPOSE To investigate amide proton transfer weighting (APTw) imaging combined with intravoxel incoherent motion (IVIM) in the assessment of MSI in EC. STUDY TYPE Retrospective. POPULATION A total of 71 patients with EC (12 classified as the MSI group and 22 as the microsatellite stabilization [MSS] group after entering and leaving the group standard). FIELD STRENGTH/SEQUENCE A 3.0 T/IVIM, diffusion-weighted imaging (DWI) and APTw. ASSESSMENT Amide proton transfer (APT) value, apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo diffusion coefficient (D*), and perfusion fraction (f) were calculated and compared between MSI and MSS groups. STATISTICAL TESTS The Kendall's W test; Mann-Whitney U-test; Chi-square test or Fisher's exact test; logistic regression analysis; Area under the receiver operating characteristic (ROC) curve (AUC); The Delong test; Pearson or Spearman correlation coefficients. The significance threshold was set at P < 0.05. RESULTS APT and D* values of the MSI group were significantly higher than those of the MSS group. While ADC, D, and f values in the MSI group were significantly lower than those in the MSS group. The multivariate analysis revealed that only APT and D* values were independent predictors to evaluate the MSI status. And the ROC curves indicated that the combination of APT and D* values could distinguish the MSI status of EC with the highest diagnostic efficacy (AUC = 0.973), even without significant difference to those by APT (AUC = 0.894) or D* (AUC = 0.920) value separately (P = 0.149 and 0.078, respectively). CONCLUSION Combination of APTw and IVIM imaging may serve as an effective noninvasive method for clinical assessment of MSI in EC. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
Collapse
Affiliation(s)
- Changjun Ma
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Shifeng Tian
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Qingling Song
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Lihua Chen
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Xing Meng
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Women and Children's Medical Group, Dalian, Liaoning, China
| | - Nan Wang
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Liangjie Lin
- Clinical & Technical Support, Philips Healthcare, Beijing, China
| | - Jiazheng Wang
- Clinical & Technical Support, Philips Healthcare, Beijing, China
| | - Ailian Liu
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| | - Qingwei Song
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.,Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian, Liaoning, China
| |
Collapse
|
4
|
Meng X, Tian S, Ma C, Lin L, Zhang X, Wang J, Song Q, Liu AL. APTw combined with mDixon-Quant imaging to distinguish the differentiation degree of cervical squamous carcinoma. Front Oncol 2023; 13:1105867. [PMID: 36761975 PMCID: PMC9905693 DOI: 10.3389/fonc.2023.1105867] [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: 11/23/2022] [Accepted: 01/05/2023] [Indexed: 01/26/2023] Open
Abstract
Background To investigate the value of amide proton transfer weighted (APTw) imaging combined with modified Dixon fat quantification (mDixon-Quant) imaging in determining the degree of differentiation of cervical squamous carcinoma (CSC) against histopathologic. Methods Magnetic resonance imaging (MRI) data were collected from 52 CSC patients. According to histopathologic results, patients were divided into the poorly differentiated group (37 cases) and the well/moderately differentiated group (15 cases). The APTw value by APTw imaging and the fat fraction (FF) and transverse relaxation rate R 2 * values by mDixon-Quant were independently measured by two radiologists. Intra-class correlation coefficients (ICCs) were used to test the consistency of APTw, FF, and R 2 * values measured by the two observers. The Mann-Whitney U test was used to analyze the difference in each parameter between the two groups. Logistic regression analysis was used to assess the association between the degree of differentiation on histopathology and imaging parameters by APTw and mDixon Quant. The ROC curve was used to evaluate the diagnostic efficacy of various parameters and their combination in distinguishing the degree of CSC differentiation on histopathology. The DeLong test was used to access the differences among the area under the ROC curves (AUCs). The Pearson correlation coefficient was used to evaluate the correlation between APTw and mDixon-Quant imaging parameters. Results The APTw means were 2.95 ± 0.78% and 2.05 (1.85, 2.65)% in the poorly and well/moderately differentiated groups, respectively. The R 2 * values were 26.62 (21.99, 33.31)/s and 22.93 ± 6.09/s in the poorly and well/moderately differentiated groups, respectively (P < 0.05). The AUCs of APTw, R 2 * , and their combination were 0.762, 0.686, and 0.843, respectively. The Delong test suggested statistical significance between R 2 * and the combination of APTw and R 2 * . R 2 * values showed a significant correlation with APTw values in the poorly differentiated group. Conclusions APTw combined with mDixon-Quant can be used to efficiently distinguish the differention degrees of CSC diagnosed on histopathology.
Collapse
Affiliation(s)
- Xing Meng
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China,Radiology Department, Dalian Women and Children’s Medical Group, Dalian, Liaoning, China
| | - Shifeng Tian
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China
| | - Changjun Ma
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China
| | - Liangjie Lin
- Radiology Department, Philips (China), Beijing, China
| | | | - Jiazheng Wang
- Radiology Department, Philips (China), Beijing, China
| | - Qingwei Song
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China
| | - Ai Lian Liu
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China,*Correspondence: Ai Lian Liu,
| |
Collapse
|