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Liu X, Zeng S, Tao T, Yang Z, Wu X, Zhao J, Zhang N. A comparative study of diffusion kurtosis imaging and diffusion tensor imaging in detecting corticospinal tract impairment in diffuse glioma patients. Neuroradiology 2024; 66:785-796. [PMID: 38478062 DOI: 10.1007/s00234-024-03332-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 03/04/2024] [Indexed: 04/21/2024]
Abstract
PURPOSE This study aimed to investigate the diagnostic performance of diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) in identifying aberrations in the corticospinal tract (CST), whilst elucidating the relationship between abnormalities of CST and patients' motor function. METHODS Altogether 21 patients with WHO grade II or grade IV glioma were enrolled and divided into Group 1 and Group 2, according to the presence or absence of preoperative paralysis. DKI and DTI metrics were generated and projected onto the CST. Histograms of the CST along x, y, and z axes were developed based on DKI and DTI metrics, and compared subsequently to determine regions of aberrations on the fibers. The receiver operating characteristic curve was performed to investigate the diagnostic efficacy of DKI and DTI metrics. RESULTS In Group 1, a significantly lower fractional anisotropy, radial kurtosis and mean kurtosis, and a higher mean diffusivity were found in the ipsilateral CST as compared to the contralateral CST. Significantly higher relative axial diffusivity, relative radial diffusivity, and relative mean diffusivity (rMD) were found in Group 1, as compared to Group 2. The relative volume of ipsilateral CST abnormalities higher than the maximum value of mean kurtosis combined with rMD exhibited the best diagnostic performance in distinguishing dysfunction of CST with an AUC of 0.93. CONCLUSION DKI is sensitive in detecting subtle changes of CST distal from the tumor. The combination of DKI and DTI is feasible for evaluating the impairment of the CST.
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Affiliation(s)
- Xinman Liu
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Province, Guangzhou, China
| | - Shanmei Zeng
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Province, Guangzhou, China
| | - Tao Tao
- Department of Informatics, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Province, Guangzhou, China
| | - Zhiyun Yang
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Province, Guangzhou, China
| | - Xinjian Wu
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Province, Guangzhou, China
| | - Jing Zhao
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Province, Guangzhou, China.
| | - Nu Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Province, Guangzhou, China.
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Zhang N, Peng K, Guo JX, Liu Q, Xiao AL, Jing H. Microstructural brain abnormalities and associated neurocognitive dysfunction in obstructive sleep apnea: a pilot study with diffusion kurtosis imaging. J Clin Sleep Med 2024. [PMID: 38656791 DOI: 10.5664/jcsm.11184] [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] [Indexed: 04/26/2024]
Abstract
STUDY OBJECTIVES To assess the possible brain abnormalities in adult patients with moderate and severe obstructive sleep apnea (OSA) using the mean kurtosis (MK) from diffusion kurtosis imaging (DKI) and analyze the correlation between MK and cognitive function. METHODS A total of 30 patients with moderate and severe OSA and 30 healthy controls (HCs) evaluated by the Montreal Cognitive Assessment (MoCA) scale were enrolled. All subjects underwent DKI and 3D T1-weighted imaging (T1WI) on a 3.0T MR scanner. The MK values of gray and white matter brain regions were compared. Partial correlation analysis was used to analyze the correlation between respiratory sleep parameters/cognitive score and MK values in different brain regions. RESULTS Compared with the HCs, the MK of 20 brain regions (13 after false discovery rate (FDR) correction) and cognitive scores in the OSA group were significantly lower. In the OSA group, the apnea-hypopnea index (AHI) was negatively correlated with the MK in the white matter of the right occipital lobe; the LSpO2 was positively correlated with the MK in the bilateral parietal, precentral, and right postcentral cortex; the total score of MoCA scale was positively correlated with MK in the left hippocampus; the language function was positively correlated with MK in the white matter of left parietal lobe, and the delayed recall was positively correlated with the MK in right insula cortex and bilateral cingulate. After FDR correction, only the correlations of LSpO2 with right precentral gyrus cortex, and bilateral parietal cortex were significant. CONCLUSIONS MK values of DKI imaging may provide valuable information in assessing the neurological impacts of obstructive sleep apnea.
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Affiliation(s)
- Ning Zhang
- Department of Radiology, The Sixth Hospital of Shanxi Medical University(General Hospital of TISCO), Taiyuan, P.R. China
| | - Kun Peng
- Department of Radiology, The Sixth Hospital of Shanxi Medical University(General Hospital of TISCO), Taiyuan, P.R. China
| | | | - Qing Liu
- College of Medical Imaging, Shanxi Medical University, Taiyuan, P.R. China
| | - Ai-Lian Xiao
- Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Shanxi Medical University (General Hospital of TISCO), Taiyuan, P.R. China
| | - Hui Jing
- Department of Radiology, The Sixth Hospital of Shanxi Medical University(General Hospital of TISCO), Taiyuan, P.R. China
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Fislage M, Winzeck S, Woodrow R, Lammers‐Lietz F, Stamatakis EA, Correia MM, Preller J, Feinkohl I, Hendrikse J, Pischon T, Spies CD, Slooter AJC, Winterer G, Menon DK, Zacharias N. Structural disconnectivity in postoperative delirium: A perioperative two-center cohort study in older patients. Alzheimers Dement 2024; 20:2861-2872. [PMID: 38451782 PMCID: PMC11032567 DOI: 10.1002/alz.13749] [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: 09/01/2023] [Revised: 11/26/2023] [Accepted: 01/21/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Structural disconnectivity was found to precede dementia. Global white matter abnormalities might also be associated with postoperative delirium (POD). METHODS We recruited older patients (≥65 years) without dementia that were scheduled for major surgery. Diffusion kurtosis imaging metrics were obtained preoperatively, after 3 and 12 months postoperatively. We calculated fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK), and free water (FW). A structured and validated delirium assessment was performed twice daily. RESULTS Of 325 patients, 53 patients developed POD (16.3%). Preoperative global MD (standardized beta 0.27 [95% confidence interval [CI] 0.21-0.32] p < 0.001) was higher in patients with POD. Preoperative global MK (-0.07 [95% CI -0.11 to (-0.04)] p < 0.001) and FA (0.07 [95% CI -0.10 to (-0.04)] p < 0.001) were lower. When correcting for baseline diffusion, postoperative MD was lower after 3 months (0.05 [95% CI -0.08 to (-0.03)] p < 0.001; n = 183) and higher after 12 months (0.28 [95% CI 0.20-0.35] p < 0.001; n = 45) among patients with POD. DISCUSSION Preoperative structural disconnectivity was associated with POD. POD might lead to white matter depletion 3 and 12 months after surgery.
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Affiliation(s)
- Marinus Fislage
- Department of Anesthesiology and Intensive Care MedicineCharité – Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Department of NeurologyNational Taiwan University HospitalTaipei CityTaiwan
| | - Stefan Winzeck
- Department of ComputingImperial College LondonBioMedIA GroupLondonUK
- University Division of Anaesthesia, Department of MedicineUniversity of Cambridge, Addenbrooke's HospitalCambridgeUK
| | - Rebecca Woodrow
- University Division of Anaesthesia, Department of MedicineUniversity of Cambridge, Addenbrooke's HospitalCambridgeUK
- Department of Clinical NeurosciencesUniversity of Cambridge; Addenbrooke's HospitalCambridgeUK
| | - Florian Lammers‐Lietz
- Department of Anesthesiology and Intensive Care MedicineCharité – Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Emmanuel A. Stamatakis
- University Division of Anaesthesia, Department of MedicineUniversity of Cambridge, Addenbrooke's HospitalCambridgeUK
- Department of Clinical NeurosciencesUniversity of Cambridge; Addenbrooke's HospitalCambridgeUK
| | - Marta M. Correia
- MRC Cognition and Brain Sciences Unit, University of CambridgeCambridgeUK
| | - Jacobus Preller
- Addenbrooke's Cambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Insa Feinkohl
- Faculty of Health/School of MedicineWitten/Herdecke UniversityWittenGermany
- Max‐Delbrueck‐Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research GroupBerlinGermany
| | - Jeroen Hendrikse
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Tobias Pischon
- Max‐Delbrueck‐Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research GroupBerlinGermany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Max‐Delbrueck‐Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology PlatformBerlinGermany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Core Facility BiobankBerlinGermany
| | - Claudia D. Spies
- Department of Anesthesiology and Intensive Care MedicineCharité – Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Arjen J. C. Slooter
- Departments of Psychiatry and Intensive Care Medicine, and UMC Utrecht Brain CenterUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
- Department of NeurologyUZ Brussel and Vrije Universiteit BrusselBrusselsBelgium
| | - Georg Winterer
- Department of Anesthesiology and Intensive Care MedicineCharité – Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Pharmaimage Biomarker Solutions GmbHBerlinGermany
| | - David K. Menon
- University Division of Anaesthesia, Department of MedicineUniversity of Cambridge, Addenbrooke's HospitalCambridgeUK
| | - Norman Zacharias
- Department of Anesthesiology and Intensive Care MedicineCharité – Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Pharmaimage Biomarker Solutions GmbHBerlinGermany
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Gao E, Wang P, Bai J, Ma X, Gao Y, Qi J, Zhao K, Zhang H, Yan X, Yang G, Zhao G, Cheng J. Radiomics Analysis of Diffusion Kurtosis Imaging: Distinguishing Between Glioblastoma and Single Brain Metastasis. Acad Radiol 2024; 31:1036-1043. [PMID: 37690885 DOI: 10.1016/j.acra.2023.07.023] [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: 03/28/2023] [Revised: 07/10/2023] [Accepted: 07/21/2023] [Indexed: 09/12/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to assess the value of diffusion kurtosis imaging (DKI)-based radiomics models in differentiating glioblastoma (GB) from single brain metastasis (SBM) and compare their diagnostic performance with that of routine magnetic resonance imaging (MRI) models. MATERIALS AND METHODS A total of 110 patients who underwent DKI and were pathologically diagnosed with GB (n = 58) or SBM (n = 52) were enrolled in this study. Radiomics features were extracted from the manually delineated region of interest of the lesion. A training set for model development was constructed from the images of 88 random patients, and 22 patients were reserved for independent validation. Seven single-DKI-parametric models and a multi-DKI-parametric model were constructed using six classifiers, whereas four single-routine-sequence models (based on T2 weighted imaging, apparent diffusion coefficient, T2-dark-fluid, and contrast-enhanced T1 magnetization prepared rapid gradient echo) and a multisequence routine MRI model were constructed for comparison. Receiver operating characteristic curve analysis was conducted to assess the diagnostic performance. The areas under the curve (AUCs) of different models were compared using the DeLong test. RESULTS The AUCs of the single-DKI-parametric models ranged from 0.800 to 0.933 (mean kurtosis [MK] model). The multi-DKI-parametric model had a slightly higher AUC (0.958) than the MK model; however, the difference was not statistically significant (P = 0.688). In comparison, the AUCs of the routine MRI models ranged from 0.633 to 0.733 (multisequence routine MRI model). The AUC of the multi-DKI-parametric model was significantly higher than that of the multisequence routine MRI model (P = 0.042). CONCLUSION The multi-DKI-parametric radiomics model exhibited better performance than that of the single-DKI-parametric models and routine MRI models in distinguishing GB from SBM.
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Affiliation(s)
- Eryuan Gao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.); Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.)
| | - Peipei Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.); Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.)
| | - Jie Bai
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.); Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.)
| | - Xiaoyue Ma
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.); Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.)
| | - Yufei Gao
- School of Cyber Science and Engineering, Zhengzhou University, Zhengzhou, Henan, China (Y.G.)
| | - Jinbo Qi
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.); Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.)
| | - Kai Zhao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.); Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.)
| | - Huiting Zhang
- MR Scientific Marketing, Siemens Healthineers China, Shanghai, China (H.Z., X.Y.)
| | - Xu Yan
- MR Scientific Marketing, Siemens Healthineers China, Shanghai, China (H.Z., X.Y.)
| | - Guang Yang
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China (G.Y.)
| | - Guohua Zhao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.); Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.)
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.); Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, Henan, China (E.G., P.W., J.B., X.M., J.Q., K.Z., G.Z., J.C.).
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Gao J, Pan P, Li J, Tang M, Yan X, Zhang X, Wang M, Ai K, Lei X, Zhang X, Zhang D. Analysis of white matter tract integrity using diffusion kurtosis imaging reveals the correlation of white matter microstructural abnormalities with cognitive impairment in type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2024; 15:1327339. [PMID: 38487342 PMCID: PMC10937453 DOI: 10.3389/fendo.2024.1327339] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/13/2024] [Indexed: 03/17/2024] Open
Abstract
Background This study aimed to identify disruptions in white matter integrity in type 2 diabetes mellitus (T2DM) patients by utilizing the white matter tract integrity (WMTI) model, which describes compartment-specific diffusivities in the intra- and extra-axonal spaces, and to investigate the relationship between WMTI metrics and clinical and cognitive measurements. Methods A total of 73 patients with T2DM and 57 healthy controls (HCs) matched for age, sex, and education level were enrolled and underwent diffusional kurtosis imaging and cognitive assessments. Tract-based spatial statistics (TBSS) and atlas-based region of interest (ROI) analysis were performed to compare group differences in diffusional metrics, including fractional anisotropy (FA), mean diffusivity (MD), axonal water fraction (AWF), intra-axonal diffusivity (Daxon), axial extra-axonal space diffusivity (De,//), and radial extra-axonal space diffusivity (De,⊥) in multiple white matter (WM) regions. Relationships between diffusional metrics and clinical and cognitive functions were characterized. Results In the TBSS analysis, the T2DM group exhibited decreased FA and AWF and increased MD, De,∥, and De,⊥ in widespread WM regions in comparison with the HC group, which involved 56.28%, 32.07%, 73.77%, 50.47%, and 75.96% of the mean WM skeleton, respectively (P < 0.05, TFCE-corrected). De,⊥ detected most of the WM changes, which were mainly located in the corpus callosum, internal capsule, external capsule, corona radiata, posterior thalamic radiations, sagittal stratum, cingulum (cingulate gyrus), fornix (stria terminalis), superior longitudinal fasciculus, and uniform fasciculus. Additionally, De,⊥ in the genu of the corpus callosum was significantly correlated with worse performance in TMT-A (β = 0.433, P < 0.001) and a longer disease duration (β = 0.438, P < 0.001). Conclusions WMTI is more sensitive than diffusion tensor imaging in detecting T2DM-related WM microstructure abnormalities and can provide novel insights into the possible pathological changes underlying WM degeneration in T2DM. De,⊥ could be a potential imaging marker in monitoring disease progression in the brain and early intervention treatment for the cognitive impairment in T2DM.
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Affiliation(s)
- Jie Gao
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Peichun Pan
- Department of Graduate, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Jing Li
- Department of Graduate, Xi’an Medical University, Xi’an, China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Xuejiao Yan
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Xin Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Man Wang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Kai Ai
- Department of Clinical Science, Philips Healthcare, Xi’an, China
| | - Xiaoyan Lei
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
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Li T, Qin R, Li C, Li L, Wang X, Wang L. Diffusion kurtosis imaging of brain white matter alteration in patients with coronary artery disease based on the TBSS method. Front Aging Neurosci 2024; 16:1301826. [PMID: 38425783 PMCID: PMC10901985 DOI: 10.3389/fnagi.2024.1301826] [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: 09/25/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Object The aim of our study was to examine the alterations in microstructure in patients with coronary artery disease (CAD) and cognitive impairment (CI) using diffusion kurtosis imaging (DKI). Additionally, we aimed to investigate the potential correlation between DKI parameters and cognitive function. Materials and methods A total of 28 CAD patients and 30 healthy controls (HC) were prospectively enrolled in our study. All participants underwent routine and diffusion sequences of head imaging. DKE software was utilized to generate various diffusion kurtosis imaging parameters (DKI), including kurtosis fractional anisotropy (KFA), mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), fractional anisotropy (FA), and mean diffusivity (MD). Nonparametric tests were conducted using tract-based spatial statistics (TBSS) to compare the parameter values between the two groups. The parameter values of the significantly different fiber tracts were extracted and correlated with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Results Compared to the HC group, patients with coronary artery disease exhibited significant reductions in FA values in the bilateral Superior corona radiata, bilateral Anterior corona radiata, bilateral Posterior corona radiata, corpus callosum, left Posterior thalamic radiation, right Posterior limb of internal capsule, Anterior limb of internal capsule, and Cerebral peduncle, as well as in the left Superior longitudinal fasciculus. Additionally, KFA values decreased in the bilateral Anterior corona radiata, bilateral Anterior limb of internal capsule, and Genu of the corpus callosum. The MK values decreased in the right Posterior corona radiata, Retrolenticular part of the internal capsule, Posterior thalamic radiation (including optic radiation), Superior longitudinal fasciculus, and left Posterior thalamic radiation (including optic radiation). Moreover, the RK values decreased in the bilateral Retrolenticular part of the internal capsule, right Posterior thalamic radiation (including optic radiation), and Superior longitudinal fasciculus, as well as in the left Superior longitudinal fasciculus and Posterior thalamic radiation (including optic radiation) (p < 0.01, TFCE corrected), while no significant differences were observed in other parameter values (p > 0.01, TFCE corrected). The FA values of the right posterior limb of the internal capsule (r = 0.610, p = 0.001) and the right cerebral peduncle (r = 0.622, p < 0.001) were positively correlated with MMSE scores. Additionally, a significant correlation between kurtosis and diffusion coefficient parameters (FA and KFA) was observed. Conclusion CAD patients showed radial shrinkage and complexity of brain white matter microstructure. Whole-brain white matter analysis based on TBSS DKI can objectively reflect the characteristics of white matter damage in CAD patients, providing a basis for the auxiliary diagnosis of CAD with CI.
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Affiliation(s)
- Tong Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Rui Qin
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Cuicui Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Lin Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Li Wang
- Department of Health Management Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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Foesleitner O, Sturm V, Hayes J, Weiler M, Sam G, Wildemann B, Wick W, Bendszus M, Heiland S, Jäger LB. Microstructural changes of peripheral nerves in early multiple sclerosis: A prospective magnetic resonance neurography study. Eur J Neurol 2024; 31:e16126. [PMID: 37932921 DOI: 10.1111/ene.16126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 10/07/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND AND PURPOSE Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system (CNS). However, there is increasing evidence of peripheral nerve involvement. This study aims to characterize the pattern of peripheral nerve changes in patients with newly diagnosed MS using quantitative magnetic resonance (MR) neurography. METHODS In this prospective study, 25 patients first diagnosed with MS according to the revised McDonald criteria (16 female, mean age = 32.8 ± 10.6 years) and 14 healthy controls were examined with high-resolution 3-T MR neurography of the sciatic nerve using diffusion kurtosis imaging (DKI; 20 diffusional directions, b = 0, 700, 1200 s/mm2 ) and magnetization transfer imaging (MTI). In total, 15 quantitative MR biomarkers were analyzed and correlated with clinical symptoms, intrathecal immunoglobulin synthesis, electrophysiology, and lesion load on brain and spine MR imaging. RESULTS Patients showed decreased fractional anisotropy (mean = 0.51 ± 0.04 vs. 0.56 ± 0.03, p < 0.001), extra-axonal tortuosity (mean = 2.32 ± 0.17 vs. 2.49 ± 0.17, p = 0.008), and radial kurtosis (mean = 1.40 ± 0.23 vs. 1.62 ± 0.23, p = 0.014) and higher radial diffusivity (mean = 1.09 ∙ 10-3 mm2 /s ± 0.16 vs. 0.98 ± 0.11 ∙ 10-3 mm2 /s, p = 0.036) than controls. Groups did not differ in MTI. No significant association was found between MR neurography markers and clinical/laboratory parameters or CNS lesion load. CONCLUSIONS This study provides further evidence of peripheral nerve involvement in MS already at initial diagnosis. The characteristic pattern of DKI parameters indicates predominant demyelination and suggests a primary coaffection of the peripheral nervous system in MS. This first human study using DKI for peripheral nerves shows its potential and clinical feasibility in providing novel biomarkers.
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Affiliation(s)
- Olivia Foesleitner
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Volker Sturm
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jennifer Hayes
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Markus Weiler
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuro-oncology, German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany
| | - Georges Sam
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Brigitte Wildemann
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Wick
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuro-oncology, German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Laura Bettina Jäger
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
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Zhu S, Wang L, Lv X, Xu Y, Dou W, Zhang H, Ye J. Application of diffusional kurtosis imaging for insights into structurally aberrant topology in Parkinson's disease. Acta Radiol 2024; 65:233-240. [PMID: 38017711 DOI: 10.1177/02841851231216039] [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] [Indexed: 11/30/2023]
Abstract
BACKGROUND Parkinson's disease (PD) has been regarded as a disconnection syndrome with functional and structural disturbances. However, as the anatomic determinants, the structural disconnections in PD have yet to be fully elucidated. PURPOSE To non-invasively construct structural networks based on microstructural complexity and to further investigate their potential topological abnormalities in PD given the technical superiority of diffusion kurtosis imaging (DKI) to the quantification of microstructure. MATERIAL AND METHODS The microstructural data of gray matter in both the PD group and the healthy control (HC) group were acquired using DKI. The structural networks were constructed at the group level by a covariation approach, followed by the calculation of topological properties based on graph theory and statistical comparisons between groups. RESULTS A total of 51 patients with PD and 50 HCs were enrolled. Individuals were matched between groups with respect to demographic characteristics (P >0.05). The constructed structural networks in both the PD and HC groups featured small-world properties. In comparison with the HC group, the PD group exhibited significantly altered global properties, with higher normalized characteristic path lengths, clustering coefficients, local efficiency values, and characteristic path lengths and lower global efficiency values (P <0.05). In terms of nodal centralities, extensive nodal disruptions were observed in patients with PD (P <0.05); these disruptions were mainly distributed in the sensorimotor network, default mode network, frontal-parietal network, visual network, and subcortical network. CONCLUSION These findings contribute to the technical application of DKI and the elucidation of disconnection syndrome in PD.
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Affiliation(s)
- Siying Zhu
- Department of Medical imaging center, Clinical Medical College, Yangzhou University, Yangzhou, PR China
| | - Lijuan Wang
- Department of Radiology, Jintang First People's Hospital, Sichuan University, Chengdu, PR China
| | - Xiang Lv
- Department of Neurology, Clinical Medical College, Yangzhou University, Yangzhou, PR China
| | - Yao Xu
- Department of Neurology, Clinical Medical College, Yangzhou University, Yangzhou, PR China
| | - Weiqiang Dou
- MR Research China, GE Healthcare, Beijing, PR China
| | - Hongying Zhang
- Department of Medical imaging center, Clinical Medical College, Yangzhou University, Yangzhou, PR China
| | - Jing Ye
- Department of Medical imaging center, Clinical Medical College, Yangzhou University, Yangzhou, PR China
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Xiong Y, Xiong X, Yang S, Tian T, Zhu W, Zhang Q. Bilateral brain microstructural alterations in patients with left-sided classic trigeminal neuralgia: a diffusion kurtosis imaging study. J Neurosurg 2024; 140:498-506. [PMID: 37877989 DOI: 10.3171/2023.6.jns232] [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: 01/03/2023] [Accepted: 06/06/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE White matter microstructural abnormalities in patients with classic trigeminal neuralgia (TN) have been observed. However, the impact of classic TN in both hemispheres, the difference and extent of alterations in bilateral hemispheres, and the relationship between the impaired area and pain conduction are not fully understood. The purpose of this study was to investigate brain microstructural alterations and compare the bilateral hemispheres in patients with unilateral classic TN, as well as to explore their clinical implications. METHODS The authors performed a cross-sectional study of 36 patients with left classic TN (TN group; age 40-66 years) and 36 healthy controls (HC group; age 40-66 years). Diffusion kurtosis imaging (DKI; b-values = 0, 1250, and 2500 sec/mm2) was performed in all patients using a 3T MRI scanner. The FMRIB Software Library with tract-based spatial statistics was used to analyze intergroup differences in both hemispheres. Atlas-based region of interest analysis was conducted in fiber tracts and gray matter structures. RESULTS Decreased fractional anisotropy (FA) and increased mean diffusivity in 2.70% and 5.34% of white matter regions, such as the corona radiata, corpus callosum, internal capsule, superior longitudinal fasciculus, and cingulum, were detected in the TN group compared with the HC group (p < 0.05, family-wise error correction). Reduced mean kurtosis (MK), axial kurtosis, and radial kurtosis were detected in the bilateral thalamus in TN patients. The FA and MK values decreased asymmetrically in both cerebral hemispheres. Atlas-based region of interest analysis revealed more pronounced FA and MK reductions in the left thalamus and posterior corona radiata. There were negative associations of disease duration and pain intensity with the MK values in the thalamus, internal capsule, and superior corona radiata. CONCLUSIONS The authors concluded that unilateral TN could have asymmetrical microstructural alterations in bilateral hemispheres, which might be due to the compromised fiber tract integrity and abnormal neurons and synapses. The thalamus could be an important relay station in the pain conduction and modulation pathway and could have microstructural abnormalities in both the left and right sides. DKI could provide important information on the CNS pathophysiology of TN and assist in prognostic evaluation.
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Affiliation(s)
| | - Xiaoxiao Xiong
- 2Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; and
| | - Shaolin Yang
- 3Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | | | | | - Qiang Zhang
- 2Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; and
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Luo L, Zhang L, Huang H, Guan J, Zhang X, Lin Y, Wu R. 3.0 T multi-parametric MRI reveals metabolic and microstructural abnormalities in the posterior visual pathways in patients with thyroid eye disease. Front Neurosci 2024; 17:1306364. [PMID: 38274503 PMCID: PMC10809795 DOI: 10.3389/fnins.2023.1306364] [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: 10/03/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction We aim to explore the microstructural and metabolic changes in visual pathways in patients with thyroid eye disease (TED) using 3T multi-parametric MRI. Methods Thirty-four TED patients (inactive group = 20; active group = 14; acute group = 18; chronic group = 16) and 12 healthy controls (HC) were recruited from November 2020 to July 2021. Proton magnetic resonance spectroscopy (1H-MRS), glutamate chemical exchange saturation transfer (GluCEST) and diffusion kurtosis imaging (DKI) were performed on 3.0T MR scanner. Data analysis and group comparisons were performed after MR data processing. Results As compare to HC group, the levels of total choline (tCh) in optic radiation (OR) in active group ([1.404 ± 0.560] vs. [1.022 ± 0.260]; p < 0.05), together with tCh ([1.415 ± 0.507] vs. [1.022 ± 0.260]; p < 0.05) in OR in acute group were significantly increased. Glutamine (Gln) levels were higher in OR in the chronic group than those in HCs and were positively correlated with the levels of thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), free triiodothyronine (FT3) and FT4 in chronic group. Glutamate (Glu) levels by 1H-MRS did not show significant differences between any two groups. Interestingly, MTRasym (3.0 ppm) was higher in OL in inactive group, active group, acute group and chronic group than those in HCs, and was positively correlated with Glu levels in OL in 1H-MRS. Fractional anisotropy (FA) values from DKI in OR in acute group were significantly lower than those in HCs. Discussion Our initial study demonstrate that GluCEST performs better than 1H-MRS to monitor Glu alterations in visual pathway in TED patients. Changes of brain glutamine levels in TED patients are closely related to their associated hormones alterations, indicating that disease injury status could be reflected through non-invasive metabolites detection by brain 1H-MRS. FA is the most sensitive DKI index to reveal the visual pathway impairment in TED patients. Altogether, our study revealed that 3T multiparametric MR techniques are useful to demonstrate metabolic and microstructural alterations in visual pathways in TED patients. We found that damage to visual pathways occurs in mild TED cases, which not only offers a new approach to the diagnosis of dysthyroid optic neuropathy, but also demonstrates neuropathy in TED is a gradual and continuous spatio-emporal progression.
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Affiliation(s)
- Lan Luo
- Radiology Department, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
- Radiology Department, Huizhou Central People’s Hospital, Huizhou, Guangdong Province, China
| | - Liling Zhang
- Endocrinology Department, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Huaidong Huang
- Radiology Department, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Jitian Guan
- Radiology Department, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Xiaolei Zhang
- Radiology Department, Huizhou Central People’s Hospital, Huizhou, Guangdong Province, China
| | - Yan Lin
- Radiology Department, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Renhua Wu
- Radiology Department, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
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Bergamino M, Keeling E, McElvogue M, Schaefer SY, Burke A, Prigatano G, Stokes AM. White Matter Microstructure Analysis in Subjective Memory Complaints and Cognitive Impairment: Insights from Diffusion Kurtosis Imaging and Free-Water DTI. J Alzheimers Dis 2024; 98:863-884. [PMID: 38461504 DOI: 10.3233/jad-230952] [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] [Indexed: 03/12/2024]
Abstract
Background Dementia is characterized by a cognitive decline in memory and other domains that lead to functional impairments. As people age, subjective memory complaints (SMC) become common, where individuals perceive cognitive decline without objective deficits on assessments. SMC can be an early sign and may precede amnestic mild cognitive impairment (MCI), which frequently advances to Alzheimer's disease (AD). Objective This study aims to investigate white matter microstructure in individuals with SMC, in cognitively impaired (CI) cohorts, and in cognitively normal individuals using diffusion kurtosis imaging (DKI) and free water imaging (FWI). The study also explores voxel-based correlations between DKI/FWI metrics and cognitive scores to understand the relationship between brain microstructure and cognitive function. Methods Twelve healthy controls (HCs), ten individuals with SMC, and eleven CI individuals (MCI or AD) were enrolled in this study. All participants underwent MRI 3T scan and the BNI Screen (BNIS) for Higher Cerebral Functions. Results The mean kurtosis tensor and anisotropy of the kurtosis tensor showed significant differences across the three groups, indicating altered white matter microstructure in CI and SMC individuals. The free water volume fraction (f) also revealed group differences, suggesting changes in extracellular water content. Notably, these metrics effectively discriminated between the CI and HC/SMC groups. Additionally, correlations between imaging metrics and BNIS scores were found for CI and SMC groups. Conclusions These imaging metrics hold promise in discriminating between individuals with CI and SMC. The observed differences indicate their potential as sensitive and specific biomarkers for early detection and differentiation of cognitive decline.
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Affiliation(s)
| | - Elizabeth Keeling
- Barrow Neurological Institute, Phoenix, AZ, USA
- Arizona State University, Phoenix, AZ, USA
| | | | | | - Anna Burke
- Barrow Neurological Institute, Phoenix, AZ, USA
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12
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Tang S, Liu X, Nie L, Qian F, Chen W, He L, Yang M. Diffusion kurtosis imaging reveals abnormal gray matter and white matter development in some brain regions of children with attention-deficit/hyperactivity disorder. J Neurosci Res 2024; 102:e25284. [PMID: 38284864 DOI: 10.1002/jnr.25284] [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: 03/14/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 01/30/2024]
Abstract
In this study, we explored the application of diffusion kurtosis imaging (DKI) technology in the brains of children with attention-deficit/hyperactivity disorder (ADHD). Seventy-two children with ADHD and 79 age- and sex-matched healthy controls were included in the study. All children were examined by means of 3D T1-weighted image, DKI, and conventional sequence scanning. The volume and DKI parameters of each brain region were obtained by software postprocessing (GE ADW 4.6 workstation) and compared between the two groups of children to determine the imaging characteristics of children with ADHD. The result showed the total brain volume was lower in children with ADHD than in healthy children (p < .05). The gray and white matter volumes in the frontal lobe, temporal lobe, hippocampus, caudate nucleus, putamen, globus pallidus, and other brain regions were lower in children with ADHD than in healthy children (p < .05). The axial kurtosis (Ka), mean kurtosis (MK), fractional anisotropy (FA), and radial kurtosis(Kr) values in the frontal lobe, temporal lobe, and caudate nucleus of children with ADHD were lower than those of healthy children, while the mean diffusivity(MD) and fractional anisotropy of kurtosis (FAK) values were higher than those of healthy children (p < .05). Additionally, the Ka, MK, FA, and Kr values in the frontal lobe, caudate nucleus, and temporal lobe could be used to distinguish children with ADHD (AUC > .05, p < .05). In conclusion, DKI showed abnormal gray matter and white matter development in some brain regions of children with ADHD.
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Affiliation(s)
- Shilong Tang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xianfan Liu
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Lisha Nie
- GE Healthcare, MR Research China, Beijing, China
| | - Fangfang Qian
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Wushuang Chen
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Ling He
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Mei Yang
- Department of Neonatal Diagnosis and Treatment Center, Children's Hospital of Chongqing Medical University, Chongqing, China
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Minh Duc N. The effectiveness of diffusion kurtosis imaging metrics for distinguishing between brainstem glioma and cerebellar medulloblastoma. Clin Ter 2024; 175:20-25. [PMID: 38358473 DOI: 10.7417/ct.2024.5029] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Background In some clinical situations, distinguishing between cerebellar medulloblastoma and brainstem glioma is important. We assessed whether diffusion kurtosis imaging (DKI) metrics could be used to distinguish cerebellar medulloblastomas from brainstem gliomas in children. Patients and methods This prospective study was approved by the institutional review board. Seventy patients were separated into two groups according to eventual diagnosis: brainstem glioma (n = 30) and cerebellar medulloblastoma (n = 40). Both groups underwent brain magnetic resonance imaging (MRI), including DKI. The Kurtosis value for the tumor region and the ratio between Kurtosis values between the tumor and the normal parenchyma (rKurtosis) were compared between groups using the Mann-Whitney U test. Receiver operating characteristic curve analysis and the Youden's Index were applied to identify a cutoff value for distinguishing between the two tumor types, and the area under the curve (AUC), sensitivity, and specificity for the selected cutoff value were calculated. Results Compared with brainstem gliomas, cerebellar medulloblastomas had significantly higher Kurtosis and rKurtosis values (p < 0.05). Medulloblastoma could be differentiated from brainstem gliomas using a Kurtosis value of 0.91 or an rKurtosis value of 0.90, both of which achieved 100% sensitivity, 96.7% specificity, and AUC values of 0.990. Conclusions DKI measurements can contribute to distinguishing between cerebellar medulloblastoma and brainstem glioma in children.
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Affiliation(s)
- N Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
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14
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Fukumura Y, Kuroda M, Yoshida S, Nakamura Y, Nakamitsu Y, Al-Hammad WE, Kuroda K, Kamizaki R, Shimizu Y, Tanabe Y, Sugimoto K, Oita M, Sugianto I, Barham M, Tekiki N, Kamaruddin NN, Yanagi Y, Asaumi J. Characteristic Mean Kurtosis Values in Simple Diffusion Kurtosis Imaging of Dentigerous Cysts. Diagnostics (Basel) 2023; 13:3619. [PMID: 38132203 PMCID: PMC10742570 DOI: 10.3390/diagnostics13243619] [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: 10/31/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
We evaluated the usefulness of simple diffusion kurtosis (SD) imaging, which was developed to generate diffusion kurtosis images simultaneously with an apparent diffusion coefficient (ADC) map for 27 cystic disease lesions in the head and neck region. The mean kurtosis (MK) and ADC values were calculated for the cystic space. The MK values were dentigerous cyst (DC): 0.74, odontogenic keratocyst (OKC): 0.86, ranula (R): 0.13, and mucous cyst (M): 0, and the ADC values were DC: 1364 × 10-6 mm2/s, OKC: 925 × 10-6 mm2/s, R: 2718 × 10-6 mm2/s, and M: 2686 × 10-6 mm2/s. The MK values of DC and OKC were significantly higher than those of R and M, whereas their ADC values were significantly lower. One reason for the characteristic signal values in diffusion-weighted images of DC may be related to content components such as fibrous tissue and exudate cells. When imaging cystic disease in the head and neck region using SD imaging, the maximum b-value setting at the time of imaging should be limited to approximately 1200 s/mm2 for accurate MK value calculation. This study is the first to show that the MK values of DC are characteristically higher than those of other cysts.
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Affiliation(s)
- Yuka Fukumura
- Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (Y.F.)
| | - Masahiro Kuroda
- Radiological Technology, Graduate School of Health Sciences, Okayama University, Okayama 700-8558, Japan
| | - Suzuka Yoshida
- Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (Y.F.)
| | - Yoshihide Nakamura
- Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (Y.F.)
| | - Yuki Nakamitsu
- Radiological Technology, Graduate School of Health Sciences, Okayama University, Okayama 700-8558, Japan
| | - Wlla E. Al-Hammad
- Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (Y.F.)
- Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Kazuhiro Kuroda
- Radiological Technology, Graduate School of Health Sciences, Okayama University, Okayama 700-8558, Japan
- Department of Health and Welfare Science, Graduate School of Health and Welfare Science, Okayama Prefectural University, Okayama 719-1197, Japan
| | - Ryo Kamizaki
- Radiological Technology, Graduate School of Health Sciences, Okayama University, Okayama 700-8558, Japan
| | - Yudai Shimizu
- Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (Y.F.)
| | - Yoshinori Tanabe
- Radiological Technology, Graduate School of Health Sciences, Okayama University, Okayama 700-8558, Japan
| | - Kohei Sugimoto
- Radiological Technology, Graduate School of Health Sciences, Okayama University, Okayama 700-8558, Japan
- Graduate School of Interdisciplinary Sciences and Engineering in Health Systems, Okayama University, Okayama 770-8558, Japan
| | - Masataka Oita
- Graduate School of Interdisciplinary Sciences and Engineering in Health Systems, Okayama University, Okayama 770-8558, Japan
| | - Irfan Sugianto
- Department of Oral Radiology, Faculty of Dentistry, Hasanuddin University, Sulawesi 90245, Indonesia
| | - Majd Barham
- Department of Dentistry and Dental Surgery, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Nouha Tekiki
- Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (Y.F.)
| | - Nurul N. Kamaruddin
- Department of Oral Rehabilitation and Regenerative Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
- Department of Dental Materials, Faculty of dentistry, Hasanuddin University, Sulawesi 90245, Indonesia
| | - Yoshinobu Yanagi
- Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (Y.F.)
| | - Junichi Asaumi
- Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (Y.F.)
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Li X, Tian S, Ma C, Chen L, Qin J, Wang N, Lin L, Liu A. Multimodal MRI for Estimating Her-2 Gene Expression in Endometrial Cancer. Bioengineering (Basel) 2023; 10:1399. [PMID: 38135990 PMCID: PMC10740753 DOI: 10.3390/bioengineering10121399] [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: 10/16/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
PURPOSE To assess the value of multimodal MRI, including amide proton transfer-weighted imaging (APT), diffusion kurtosis imaging (DKI), and T2 mapping sequences for estimating human epidermal growth factor receptor-2 (Her-2) expression in patients with endometrial cancer (EC). METHODS A total of 54 patients with EC who underwent multimodal pelvic MRI followed by biopsy were retrospectively selected and divided into the Her-2 positive (n = 24) and Her-2 negative (n = 30) groups. Her-2 expression was confirmed by immunohistochemistry (IHC). Two observers measured APT, mean kurtosis (MK), mean diffusivity (MD), and T2 values for EC lesions. RESULTS The Her-2 (+) group showed higher APT values and lower MD and T2 values than the Her-2 (-) group (all p < 0.05); there was no significant difference in MK values (p > 0.05). The area under the receiver operating characteristic curve (AUC) of APT, MD, T2, APT + T2, APT + MD, T2 + MD, and APT + MD + T2 models to identify the two groups of cases were 0.824, 0.695, 0.721, 0.824, 0.858, 0.782, and 0.860, respectively, and the diagnostic efficacy after combined APT + MD + T2 value was significantly higher than those of MD and T2 values individually (p = 0.018, 0.028); the diagnostic efficacy of the combination of APT + T2 values was significantly higher than that of T2 values separately (p = 0.028). Weak negative correlations were observed between APT and T2 values (r = -0.365, p = 0.007), moderate negative correlations between APT and MD values (r = -0.560, p < 0.001), and weak positive correlations between MD and T2 values (r = 0.336, p = 0.013). The APT values were independent predictors for assessing Her-2 expression in EC patients. CONCLUSION The APT, DKI, and T2 mapping sequences can be used to preoperatively assess the Her-2 expression in EC, which can contribute to more precise treatment for clinical preoperative.
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Affiliation(s)
- Xiwei Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
| | - Shifeng Tian
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
| | - Changjun Ma
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
| | - Lihua Chen
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
| | - Jingwen Qin
- Department of Pathology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Nan Wang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
| | - Liangjie Lin
- Clinical and Technical Support, Philips Healthcare, Beijing 100016, China
| | - Ailian Liu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (X.L.)
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Chen J, Chung S, Li T, Fieremans E, Novikov DS, Wang Y, Lui YW. Identifying relevant diffusion MRI microstructure biomarkers relating to exposure to repeated head impacts in contact sport athletes. Neuroradiol J 2023; 36:693-701. [PMID: 37212469 PMCID: PMC10649530 DOI: 10.1177/19714009231177396] [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] [Indexed: 05/23/2023] Open
Abstract
PURPOSE Repeated head impacts (RHI) without concussion may cause long-term sequelae. A growing array of diffusion MRI metrics exist, both empiric and modeled and it is hard to know which are potentially important biomarkers. Common conventional statistical methods fail to consider interactions between metrics and rely on group-level comparisons. This study uses a classification pipeline as a means towards identifying important diffusion metrics associated with subconcussive RHI. METHODS 36 collegiate contact sport athletes and 45 non-contact sport controls from FITBIR CARE were included. Regional/whole brain WM statistics were computed from 7 diffusion metrics. Wrapper-based feature selection was applied to 5 classifiers representing a range of learning capacities. Best 2 classifiers were interpreted to identify the most RHI-related diffusion metrics. RESULTS Mean diffusivity (MD) and mean kurtosis (MK) are found to be the most important metrics for discriminating between athletes with and without RHI exposure history. Regional features outperformed global statistics. Linear approaches outperformed non-linear approaches with good generalizability (test AUC 0.80-0.81). CONCLUSION Feature selection and classification identifies diffusion metrics that characterize subconcussive RHI. Linear classifiers yield the best performance and mean diffusion, tissue microstructure complexity, and radial extra-axonal compartment diffusion (MD, MK, De,⊥) are found to be the most influential metrics. This work provides proof of concept that applying such approach to small, multidimensional dataset can be successful given attention to optimizing learning capacity without overfitting and serves an example of methods that lead to better understanding of the myriad of diffusion metrics as they relate to injury and disease.
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Affiliation(s)
- Junbo Chen
- Department of Electrical and Computer Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA
| | - Sohae Chung
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Tianhao Li
- Department of Electrical and Computer Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA
| | - Els Fieremans
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Dmitry S Novikov
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Yao Wang
- Department of Electrical and Computer Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA
| | - Yvonne W Lui
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
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Wang X, Huang L, Guo W, Tang L, Wu A, Wu P, Zhao X, Lin Q, Yu L. Cerebral Microstructural and Microvascular Changes in Non-Neuropsychiatric Systemic Lupus Erythematosus: A Study Using Diffusion Kurtosis Imaging and 3D Pseudo-Continuous Arterial Spin Labeling. J Inflamm Res 2023; 16:5465-5475. [PMID: 38026250 PMCID: PMC10676653 DOI: 10.2147/jir.s429521] [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] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The purpose of this study was to observe cerebral microstructure and microcirculation features, as well as changes in white matter (WM) and gray matter (GM) among patients with non-neuropsychiatric systemic lupus erythematosus (non-NPSLE). Methods We compared 36 female patients with non-NPSLE and 20 age- and gender-matched healthy controls (HCs) who underwent 3.0T MRI imaging with diffusion kurtosis imaging (DKI) and 3D pseudo-continuous Arterial Spin Labeling (pCASL). Mean kurtosis (MK), mean kurtosis tensor (MKT), and cerebral blood flow (CBF) values were obtained from 25 brain regions, including WM and GM. We analyzed the correlation between imaging indicators and clinical data. Results When compared with HCs, patients with non-NPSLE had reduced MK and MKT values in regional WM, deep GM, and the left frontal lobe cortical GM, and increased CBF in the right parietal lobe WM and right semioval center (SOC). The MK and MKT values were weakly correlated with CBF in some regions, including WM and GM. Complement 3 (C3) and Complement 4 (C4) showed a weak positive correlation with MK and MKT in some regions, including WM and deep GM, while platelet (PLT) was positively correlated with MKT in the left frontal lobe WM; dsDNA antibody was correlated negatively with MK in the right occipital lobe WM; and erythrocyte sedimentation rate (ESR) was correlated negatively with CBF in the left SOC. Conclusion Our findings revealed the presence of brain microstructural and microvascular abnormalities in non-NPSLE patients, indicating microstructural damage in the cortical GM, which was less commonly reported. We found DKI and pCASL useful in detecting early brain lesions, and MK was a more sensitive and beneficial indicator.
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Affiliation(s)
- Xiaojuan Wang
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, 364000, People’s Republic of China
| | - Lingling Huang
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, 364000, People’s Republic of China
| | - Wenbin Guo
- Department of Pathology, Pingtan Comprehensive Experimental Area Hospital, Fuzhou, Fujian, 350400, People’s Republic of China
| | - Langlang Tang
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, 364000, People’s Republic of China
| | - Aiyu Wu
- Department of Rheumatology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, 364000, People’s Republic of China
| | - Peng Wu
- Philips Healthcare, Shanghai, 200000, People’s Republic of China
| | - Xiance Zhao
- Philips Healthcare, Shanghai, 200000, People’s Republic of China
| | - Qi Lin
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, 364000, People’s Republic of China
| | - Lian Yu
- Department of Rheumatology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, 364000, People’s Republic of China
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Stabinska J, Wittsack HJ, Lerman LO, Ljimani A, Sigmund EE. Probing Renal Microstructure and Function with Advanced Diffusion MRI: Concepts, Applications, Challenges, and Future Directions. J Magn Reson Imaging 2023. [PMID: 37991093 DOI: 10.1002/jmri.29127] [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: 08/27/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/23/2023] Open
Abstract
Diffusion measurements in the kidney are affected not only by renal microstructure but also by physiological processes (i.e., glomerular filtration, water reabsorption, and urine formation). Because of the superposition of passive tissue diffusion, blood perfusion, and tubular pre-urine flow, the limitations of the monoexponential apparent diffusion coefficient (ADC) model in assessing pathophysiological changes in renal tissue are becoming apparent and motivate the development of more advanced diffusion-weighted imaging (DWI) variants. These approaches take advantage of the fact that the length scale probed in DWI measurements can be adjusted by experimental parameters, including diffusion-weighting, diffusion gradient directions and diffusion time. This forms the basis by which advanced DWI models can be used to capture not only passive diffusion effects, but also microcirculation, compartmentalization, tissue anisotropy. In this review, we provide a comprehensive overview of the recent advancements in the field of renal DWI. Following a short introduction on renal structure and physiology, we present the key methodological approaches for the acquisition and analysis of renal DWI data, including intravoxel incoherent motion (IVIM), diffusion tensor imaging (DTI), non-Gaussian diffusion, and hybrid IVIM-DTI. We then briefly summarize the applications of these methods in chronic kidney disease and renal allograft dysfunction. Finally, we discuss the challenges and potential avenues for further development of renal DWI. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Julia Stabinska
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Eric E Sigmund
- Bernard and Irene Schwartz Center for Biomedical Imaging Center for Advanced Imaging Innovation and Research (CAI2R), New York University Langone Health, New York City, New York, USA
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Song M, Wang Q, Feng H, Wang L, Zhang Y, Liu H. Preoperative Grading of Rectal Cancer with Multiple DWI Models, DWI-Derived Biological Markers, and Machine Learning Classifiers. Bioengineering (Basel) 2023; 10:1298. [PMID: 38002422 PMCID: PMC10669695 DOI: 10.3390/bioengineering10111298] [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: 08/14/2023] [Revised: 10/05/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
Background: this study aimed to utilize various diffusion-weighted imaging (DWI) techniques, including mono-exponential DWI, intravoxel incoherent motion (IVIM), and diffusion kurtosis imaging (DKI), for the preoperative grading of rectal cancer. Methods: 85 patients with rectal cancer were enrolled in this study. Mann-Whitney U tests or independent Student's t-tests were conducted to identify DWI-derived parameters that exhibited significant differences. Spearman or Pearson correlation tests were performed to assess the relationships among different DWI-derived biological markers. Subsequently, four machine learning classifier-based models were trained using various DWI-derived parameters as input features. Finally, diagnostic performance was evaluated using ROC analysis with 5-fold cross-validation. Results: With the exception of the pseudo-diffusion coefficient (Dp), IVIM-derived and DKI-derived parameters all demonstrated significant differences between low-grade and high-grade rectal cancer. The logistic regression-based machine learning classifier yielded the most favorable diagnostic efficacy (AUC: 0.902, 95% Confidence Interval: 0.754-1.000; Specificity: 0.856; Sensitivity: 0.925; Youden Index: 0.781). Conclusions: utilizing multiple DWI-derived biological markers in conjunction with a strategy employing multiple machine learning classifiers proves valuable for the noninvasive grading of rectal cancer.
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Affiliation(s)
- Mengyu Song
- Department of Radiology, Fourth Hospital of Hebei Medical University, No.12 Jiankang Road, Shijiazhuang 050000, China
| | - Qi Wang
- Department of Radiology, Fourth Hospital of Hebei Medical University, No.12 Jiankang Road, Shijiazhuang 050000, China
| | - Hui Feng
- Department of Radiology, Fourth Hospital of Hebei Medical University, No.12 Jiankang Road, Shijiazhuang 050000, China
| | - Lijia Wang
- Department of Radiology, Fourth Hospital of Hebei Medical University, No.12 Jiankang Road, Shijiazhuang 050000, China
| | - Yunfei Zhang
- Central Research Institute, United Imaging Healthcare, Shanghai 201800, China
| | - Hui Liu
- Department of Radiology, Fourth Hospital of Hebei Medical University, No.12 Jiankang Road, Shijiazhuang 050000, China
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Qin C, Tian Q, Zhou H, Qin Y, Zhou S, Wu Y, Tianjiao E, Duan S, Li Y, Wang X, Chen Z, Zheng G, Feng F. Detecting Muscle Invasion of Bladder Cancer: An Application of Diffusion Kurtosis Imaging Ratio and Vesical Imaging-Reporting and Data System. J Magn Reson Imaging 2023. [PMID: 37916908 DOI: 10.1002/jmri.29053] [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: 04/12/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Independent factors are needed to supplement vesical imaging-reporting and data system (VI-RADS) to improve its ability to identify muscle invasive bladder cancer (MIBC). PURPOSE To assess the correlation between MIBC and diffusion kurtosis imaging (DKI) ratio, VI-RADS, and other factors (such as tumor location). STUDY TYPE Retrospective. POPULATION Sixty-eight patients (50 males and 18 females; age: 70.1 ± 9.5 years) with bladder urothelial carcinoma. FIELD STRENGTH/SEQUENCE 1.5 T, conventional diffusion-weighted imaging (DWI), and DKI (single shot echo-planar sequence). ASSESSMENT Three radiologists independently measured the diffusion parameters of each bladder cancer (BCa) and obturator internus, including the mean apparent diffusion coefficient (ADCmean), mean kurtosis (MK), and mean diffusion (MD). And the ratio of diffusion parameters between BCa and obturator internus was calculated (diffusion parameter ratio = bladder cancer:obturator internus). Based on the VI-RADS, the target lesions were independently scored. Furthermore, the actual tumor-wall contact length (ACTCL) and absolute tumor-wall contact length (ABTCL) were measured. STATISTICAL TESTS Multicollinearity among independent variables was evaluated using the variance inflation factor (VIF). Multivariable logistic regression analysis was used to determine the independent risk factors of MIBC. The receiver operating characteristic curve was used to evaluate the efficacy of each variable in detecting MIBC. The DeLong test was used to compare the area under the curve (AUC). A P < 0.05 was considered statistically significant. RESULTS MKratio (median: 0.62) and VI-RADS were independent risk factors for MIBC. AUCs for MKratio, VI-RADS, and MKratio combined with VI-RADS in assessing MIBC were 0.895, 0.871, and 0.973, respectively. MKratio combined with VI-RADS was more effective in diagnosing MIBC than VI-RADS alone. DATA CONCLUSIONS MKratio has potential to assist the assessment of MIBC. MKratio can be used as a supplement to VI-RADS for detecting MIBC. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Cai Qin
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Qi Tian
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Hui Zhou
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Yihan Qin
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Siyu Zhou
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Yutao Wu
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Tianjiao E
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Shufeng Duan
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Yueyue Li
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Xiaolin Wang
- Department of Urology Surgery, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Zhigang Chen
- Department of Urology Surgery, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Guihua Zheng
- Department of Pathology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - Feng Feng
- Department of Radiology, Affiliated Tumor Hospital of Nantong University, Nantong, China
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21
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Xu X, Zhang P, Zhuo Z, Duan Y, Qu L, Cheng D, Sun T, Ding J, Xie C, Liu X, Haller S, Barkhof F, Ye C, Zhang L, Liu Y. Prediction of H3K27M Alteration Status in Brainstem Glioma Using Multi-Shell Diffusion MRI Metrics. J Magn Reson Imaging 2023. [PMID: 37889147 DOI: 10.1002/jmri.29104] [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: 08/14/2023] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Multi-shell diffusion characteristics may help characterize brainstem gliomas (BSGs) and predict H3K27M status. PURPOSE To identify the diffusion characteristics of BSG patients and investigate the predictive values of various diffusion metrics for H3K27M status in BSG. STUDY TYPE Prospective. POPULATION Eighty-four BSG patients (median age 10.5 years [IQR 6.8-30.0 years]) were included, of whom 56 were pediatric and 28 were adult patients. FIELD STRENGTH/SEQUENCE 3 T, multi-shell diffusion imaging. ASSESSMENT Diffusion kurtosis imaging and neurite orientation dispersion and density imaging analyses were performed. Age, gender, and diffusion metrics, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity, radial diffusivity (RD), mean kurtosis (MK), axial kurtosis (AK), radial kurtosis, intracellular volume fraction (ICVF), orientation dispersion index, and isotropic volume fraction (ISOVF), were compared between H3K27M-altered and wildtype BSG patients. STATISTICAL TESTS Chi-square test, Mann-Whitney U test, multivariate analysis of variance (MANOVA), step-wise multivariable logistic regression. P-values <0.05 were considered significant. RESULTS 82.4% pediatric and 57.1% adult patients carried H3K27M alteration. In the whole group, the H3K27M-altered BSGs demonstrated higher FA, AK and lower RD, ISOVF. The combination of age and median ISOVF showed fair performance for H3K27M prediction (AUC = 0.78). In the pediatric group, H3K27M-altered BSGs showed higher FA, AK, MK, ICVF and lower RD, MD, ISOVF. The combinations of median ISOVF, 5th percentile of FA, median MK and median MD showed excellent predictive power (AUC = 0.91). In the adult group, H3K27M-altered BSGs showed higher ICVF and lower RD, MD. The 75th percentile of RD demonstrated fair performance for H3K27M status prediction (AUC = 0.75). DATA CONCLUSION Different alteration patterns of diffusion measures were identified between H3K27M-altered and wildtype BSGs, which collectively had fair to excellent predictive value for H3K27M alteration status, especially in pediatric patients. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Xiaolu Xu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peng Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhizheng Zhuo
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yunyun Duan
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Liying Qu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dan Cheng
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ting Sun
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jinli Ding
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Cong Xie
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xing Liu
- Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Sven Haller
- Department of Imaging and Medical Informatics, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, Geneva, Switzerland
| | - Frederik Barkhof
- UCL Institutes of Neurology and Healthcare Engineering, London, UK
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Chuyang Ye
- School of Information and Electronics, Beijing Institute of Technology, Beijing, China
| | - Liwei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yaou Liu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Cheng Q, Ren A, Xu X, Meng Z, Feng X, Pylypenko D, Dou W, Yu D. Application of DKI and IVIM imaging in evaluating histologic grades and clinical stages of clear cell renal cell carcinoma. Front Oncol 2023; 13:1203922. [PMID: 37954085 PMCID: PMC10637387 DOI: 10.3389/fonc.2023.1203922] [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: 04/11/2023] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose To evaluate the value of quantitative parameters derived from diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) in differentiating histologic grades and clinical stages of clear cell renal cell carcinoma (ccRCC). Materials and methods A total of 65 patients who were surgically and pathologically diagnosed as ccRCC were recruited in this study. In addition to routine renal magnetic resonance imaging examination, all patients underwent preoperative IVIM and DKI. The corresponding diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), mean diffusivity (MD), kurtosis anisotropy (KA), and mean kurtosis (MK) values were obtained. Independent-samples t-test or Mann-Whitney U test was used for comparing the differences in IVIM and DKI parameters among different histologic grades and clinical stages. The diagnostic efficacy of IVIM and DKI parameters was evaluated using the receiver operating characteristic (ROC) curve. Spearman's correlation analysis was used to separately analyze the correlation of each parameter with histologic grades and stages of ccRCC. Results The D and MD values were significantly higher in low-grade ccRCC than high-grade ccRCC (all p < 0.001) and in low-stage than high-stage ccRCC (all p < 0.05), and the f value of high-stage ccRCC was lower than that of low-stage ccRCC (p = 0.007). The KA and MK values were significantly higher in low-grade than high-grade ccRCC (p = 0.000 and 0.000, respectively) and in low-stage than high-stage ccRCC (p = 0.000 and 0.000, respectively). The area under the curve (AUC) values of D, D*, f, MD, KA, MK, DKI, and IVIM+DKI values were 0.825, 0.598, 0.626, 0.792, 0.750, 0.754, 0.803, and 0.857, respectively, in grading ccRCC and 0.837, 0.719, 0.710, 0.787, 0.796, 0.784, 0.864, 0.823, and 0.916, respectively, in staging ccRCC. The AUC of IVIM was 0.913 in staging ccRCC. The D, D*, and MD values were negatively correlated with the histologic grades and clinical stages (all p < 0.05), and the KA and MK values showed a positive correlation with histologic grades and clinical stages (all p < 0.05). The f value was also negatively correlated with the ccRCC clinical stage (p = 0.008). Conclusion Both the IVIM and DKI values can be used preoperatively to predict the degree of histologic grades and stages in ccRCC, and the D and MD values have better diagnostic performance in the grading and staging. Also, further slightly enhanced diagnostic efficacy was observed in the model with combined IVIM and DKI parameters.
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Affiliation(s)
- QiChao Cheng
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - AnLi Ren
- Department of Radiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - XingHua Xu
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhao Meng
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Xue Feng
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | | | | | - DeXin Yu
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
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Danilov G, Afandiev R, Pogosbekyan E, Goraynov S, Pronin I, Zakharova N. Radiomics Enhances Diagnostic and Prognostic Value of Diffusion Kurtosis Imaging in Diffuse Axonal Injury. Stud Health Technol Inform 2023; 309:287-291. [PMID: 37869859 DOI: 10.3233/shti230798] [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] [Indexed: 10/24/2023]
Abstract
The aim of our study was to investigate the potential of advanced radiomics in analyzing diffusion kurtosis MRI (DKI) to increase the informativeness of DKI in diffuse axonal injury (DAI). We hypothesized that DKI radiomic features could be used to detect microstructural brain injury and predict outcomes in DAI. The study enrolled 31 patients with DAI (mean age 31.48 ± 11.10 years, 8 (25.8%) female) and 12 healthy volunteers (mean age 33.67 ± 11.06 years, 4 (33.3%) female). A total of 342,300 radiomic features were calculated (2282 features per each combination of 10 parametric DKI maps with 15 ROIs). Our results showed that several radiomic features were capable of distinguishing between healthy and injured brain tissue and accurately predicting outcomes with an accuracy of over 0.9. Advanced DKI radiomic features show high diagnostic and prognostic potential in DAI and may outperform average ROI values in DKI maps.
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Affiliation(s)
- Gleb Danilov
- Laboratory of Biomedical Informatics and Artificial Intelligence, National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
| | - Ramin Afandiev
- Department of Neuroimaging, National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
| | - Eduard Pogosbekyan
- Department of Neuroimaging, National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
| | - Sergey Goraynov
- Department of Neurotrauma, National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
| | - Igor Pronin
- Department of Neuroimaging, National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
| | - Natalia Zakharova
- Department of Neuroimaging, National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
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Zhu Q, Yan Z, Shi Z, Luo D, Ding S, Chen X, Li Y. Increased cortical lesion load contributed to pathological changes beyond focal lesion in cortical gray matter of multiple sclerosis: a diffusion kurtosis imaging analysis. Cereb Cortex 2023; 33:10867-10876. [PMID: 37718158 DOI: 10.1093/cercor/bhad332] [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: 06/18/2023] [Revised: 08/20/2023] [Accepted: 08/22/2023] [Indexed: 09/19/2023] Open
Abstract
Biomarkers specific to cortical gray matter (cGM) pathological changes of multiple sclerosis (MS) are desperately needed to better understand the disease progression. The cGM damage occurs in cortical lesion (CL) and normal-appearing cGM (NAcGM) areas. While the association between CL load and cGM damage has been reported, little is known about how different CL types, i.e. intracortical lesion (ICL) and leukocortical lesion (LCL) would be associated with cGM damage. In our study, relapsing-remitting MS patients and healthy controls were divided into 4 groups according to CL load level. NAcGM diffusion kurtosis imaging (DKI)/diffusion tensor imaging (DTI) values and cGM volume (cGMV) were used to characterize the pathological changes in cGM. Univariate general linear model was used for group comparisons and stepwise regression analysis was used to assess the effects of ICL volume and LCL volume on NAcGM damage. We found peak values in DKI/DTI values, cGMV and neuropsychological scores in high CL load group. Kurtosis fractional anisotropy (KFA) was the most sensitive in characterizing NAcGM damage, and LCL volume related more to NAcGM damage. Our findings suggested KFA could become a surrogate biomarker to cGM damage, and LCL might be the main factor in whole brain NAcGM damage.
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Affiliation(s)
- Qiyuan Zhu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Zichun Yan
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Zhuowei Shi
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Dan Luo
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Shuang Ding
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Xiaoya Chen
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yongmei Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Gao Y, Wang Y, Zhang H, Li X, Han L. The outstanding diagnostic value of DKI in multimodal magnetic resonance imaging for benign and malignant breast tumors: A diagnostic accuracy study. Medicine (Baltimore) 2023; 102:e35337. [PMID: 37800758 PMCID: PMC10553060 DOI: 10.1097/md.0000000000035337] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/31/2023] [Indexed: 10/07/2023] Open
Abstract
To explore the value of applying different magnetic resonance imaging MRI sequences in the differential diagnosis of benign and malignant breast tumors. Routine breast magnetic resonance scans (T1-weighted image, T1WI; T2-weighted image, T2WI), dynamically enhanced scans, diffusion-weighted Imaging, and diffusion kurtosis imaging (DKI) scans were performed on 63 female patients with breast-occupying lesions. The benign and malignant lesions were confirmed by biopsy, excision-histopathology reports. There are 70 lesions, of which 46 are benign and 24 are malignant. Analyze the primary conditions, such as the shape, size, and boundary of the lesion, and determine the apparent diffusion coefficient (ADC), mean kurtosis (MK), and mean diffusion (MD) values. The receiver operating characteristic curve was used to evaluate the value and difference in differentiating benign and malignant lesions. In this study, the results of the 2 testers both showed that the MK of malignant lesions was significantly higher than that of benign lesions (P < .001), and the MD of benign lesions was higher than that of malignant lesions (P < .05). The ADC of benign lesions was higher than that of malignant lesions (P < .05). For MK, the area under the curve of the 2 testers was 0.855/0.869, respectively. When the best cutoff value of MK for tester 1 was 0.515, the sensitivity and specificity of MK for diagnosing malignant tumors were 83.3%/87.0%, respectively. For the 2 testers MD, and ADC, the area under the curve was < 0.5, and the diagnostic value was low. The MK value obtained by DKI has a specific value in the differential diagnosis of benign and malignant breast lesions. DKI is helpful in the identification of benign and malignant breast tumors. The diagnostic value is outstanding, and its importance to the changes in the microstructure of the organization needs to be further explored.
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Affiliation(s)
- Yufei Gao
- Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yong Wang
- Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hui Zhang
- Department of Radiology, Hebei General Hospital, Shijiazhuang, China
| | - Xiaolei Li
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Lina Han
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
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Savitz J, Goeckner BD, Ford BN, Kent Teague T, Zheng H, Harezlak J, Mannix R, Tugan Muftuler L, Brett BL, McCrea MA, Meier TB. The effects of cytomegalovirus on brain structure following sport-related concussion. Brain 2023; 146:4262-4273. [PMID: 37070698 PMCID: PMC10545519 DOI: 10.1093/brain/awad126] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 03/06/2023] [Accepted: 03/27/2023] [Indexed: 04/19/2023] Open
Abstract
The neurotrophic herpes virus cytomegalovirus is a known cause of neuropathology in utero and in immunocompromised populations. Cytomegalovirus is reactivated by stress and inflammation, possibly explaining the emerging evidence linking it to subtle brain changes in the context of more minor disturbances of immune function. Even mild forms of traumatic brain injury, including sport-related concussion, are major physiological stressors that produce neuroinflammation. In theory, concussion could predispose to the reactivation of cytomegalovirus and amplify the effects of physical injury on brain structure. However, to our knowledge this hypothesis remains untested. This study evaluated the effect of cytomegalovirus serostatus on white and grey matter structure in a prospective study of athletes with concussion and matched contact-sport controls. Athletes who sustained concussion (n = 88) completed MRI at 1, 8, 15 and 45 days post-injury; matched uninjured athletes (n = 73) completed similar visits. Cytomegalovirus serostatus was determined by measuring serum IgG antibodies (n = 30 concussed athletes and n = 21 controls were seropositive). Inverse probability of treatment weighting was used to adjust for confounding factors between athletes with and without cytomegalovirus. White matter microstructure was assessed using diffusion kurtosis imaging metrics in regions previously shown to be sensitive to concussion. T1-weighted images were used to quantify mean cortical thickness and total surface area. Concussion-related symptoms, psychological distress, and serum concentration of C-reactive protein at 1 day post-injury were included as exploratory outcomes. Planned contrasts compared the effects of cytomegalovirus seropositivity in athletes with concussion and controls, separately. There was a significant effect of cytomegalovirus on axial and radial kurtosis in athletes with concussion but not controls. Cytomegalovirus positive athletes with concussion showed greater axial (P = 0.007, d = 0.44) and radial (P = 0.010, d = 0.41) kurtosis than cytomegalovirus negative athletes with concussion. Similarly, there was a significant association of cytomegalovirus with cortical thickness in athletes with concussion but not controls. Cytomegalovirus positive athletes with concussion had reduced mean cortical thickness of the right hemisphere (P = 0.009, d = 0.42) compared with cytomegalovirus negative athletes with concussion and showed a similar trend for the left hemisphere (P = 0.036, d = 0.33). There was no significant effect of cytomegalovirus on kurtosis fractional anisotropy, surface area, symptoms and C-reactive protein. The results raise the possibility that cytomegalovirus infection contributes to structural brain abnormalities in the aftermath of concussion perhaps via an amplification of concussion-associated neuroinflammation. More work is needed to identify the biological pathways underlying this process and to clarify the clinical relevance of this putative viral effect.
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Affiliation(s)
- Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK 74119, USA
| | - Bryna D Goeckner
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Bart N Ford
- Department of Pharmacology and Physiology, Oklahoma State University Center for Health Sciences, Tulsa, OK 74107, USA
| | - T Kent Teague
- Department of Psychiatry, The University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA
- Department of Surgery, The University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA
- Department of Pharmaceutical Sciences, University of Oklahoma College of Pharmacy, Tulsa, OK 74135, USA
| | - Haixia Zheng
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
| | - Jaroslaw Harezlak
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405, USA
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - L Tugan Muftuler
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Benjamin L Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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Xu W, Sun X, Jiang H, Wang X, Wang B, Niu Q, Meng H, Du J, Yang G, Liu B, Zhang H, Tan Y. Diffusion Kurtosis Imaging in Evaluating the Mild Cognitive Impairment of Occupational Aluminum Workers. Acad Radiol 2023; 30:2225-2233. [PMID: 36690563 DOI: 10.1016/j.acra.2022.12.003] [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: 08/28/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 01/23/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate whether diffusion kurtosis imaging (DKI) can distinguish mild cognitive impairment (MCI) from normal controls (NC) in aluminum (Al)-exposed workers, and to explore the association of DKI with cognitive performance and plasma Al concentration. MATERIALS AND METHODS 28 patients with MCI and 25 NC at Al factory were enrolled in this study. All subjects underwent conventional MRI and DKI scans. The mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), mean diffusivity (MD) and fractional anisotropy (FA) parameters of the hippocampus, substantia nigra, red nucleus, thalamus, anterior cingulate gyrus, genu and crus of the corpus callosum, frontal, parietal and temporal lobe were measured. To compare the parameters between the two groups, the Mann-Whitney rank sum test was used. The correlation of parameter values with cognitive performance and plasma Al concentration was analyzed using Spearman correlation analysis. The receiver operating characteristic (ROC) curve and the Z-scores were used to evaluate the diagnostic efficacy of each parameter. RESULTS Compared with the NC group, the MK, Ka, Kr, and FA values in the MCI group were significantly decreased, and the MD values were significantly increased (p<0.05). For the diagnosis of MCI, MK in the right hippocampus showed the largest AUC (0.924). The MK, Kr, MD and FA values were correlated with the Montreal Cognitive Assessment (MoCA) scores, and MK values in the right hippocampus showed the greatest correlation with MoCA scores (r=0.744, p <0.001). Plasma Al in the MCI group was higher than that in the NC group, although there was no significant difference in plasma Al between the two groups (p=0.057). There was no correlation between DKI parameters and plasma Al. CONCLUSION The DKI method might be a sensitive imaging biomarker to discriminate MCI from NC, and could preliminarily assess the severity of cognitive impairment in Al-exposed workers. MK in the right hippocampus appeared to be the best independent predictor. The mechanism of cognitive decline is an important content of aluminum exposure research. This study indicates that the DKI technique could provide valuable information for the diagnosis of MCI.
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Affiliation(s)
- Wenji Xu
- College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Xiangru Sun
- College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Haoru Jiang
- College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Xiaochun Wang
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Bin Wang
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Qiao Niu
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Huaxing Meng
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Jiangfeng Du
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Guoqiang Yang
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Bo Liu
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Hui Zhang
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Yan Tan
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China..
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Bao J, Zhang X, Zhao X. MR imaging and outcome in neonatal HIBD models are correlated with sex: the value of diffusion tensor MR imaging and diffusion kurtosis MR imaging. Front Neurosci 2023; 17:1234049. [PMID: 37790588 PMCID: PMC10543095 DOI: 10.3389/fnins.2023.1234049] [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: 06/12/2023] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
Objective Hypoxic-ischemic encephalopathy can lead to lifelong morbidity and premature death in full-term newborns. Here, we aimed to determine the efficacy of diffusion kurtosis (DK) [mean kurtosis (MK)] and diffusion tensor (DT) [fractional anisotropy (FA), mean diffusion (MD), axial diffusion (AD), and radial diffusion (RD)] parameters for the early diagnosis of early brain histopathological changes and the prediction of neurodegenerative events in a full-term neonatal hypoxic-ischemic brain injury (HIBD) rat model. Methods The HIBD model was generated in postnatal day 7 Sprague-Dawley rats to assess the changes in DK and DT parameters in 10 specific brain structural regions involving the gray matter, white matter, and limbic system during acute (12 h) and subacute (3 d and 5 d) phases after hypoxic ischemia (HI), which were validated against histology. Sensory and cognitive parameters were assessed by the open field, novel object recognition, elevated plus maze, and CatWalk tests. Results Repeated-measures ANOVA revealed that specific brain structures showed similar trends to the lesion, and the temporal pattern of MK was substantially more varied than DT parameters, particularly in the deep gray matter. The change rate of MK in the acute phase (12 h) was significantly higher than that of DT parameters. We noted a delayed pseudo-normalization for MK. Additionally, MD, AD, and RD showed more pronounced differences between males and females after HI compared to MK, which was confirmed in behavioral tests. HI females exhibited anxiolytic hyperactivity-like baseline behavior, while the memory ability of HI males was affected in the novel object recognition test. CatWalk assessments revealed chronic deficits in limb gait parameters, particularly the left front paw and right hind paw, as well as poorer performance in HI males than HI females. Conclusions Our results suggested that DK and DT parameters were complementary in the immature brain and provided great value in assessing early tissue microstructural changes and predicting long-term neurobehavioral deficits, highlighting their ability to detect both acute and long-term changes. Thus, the various diffusion coefficient parameters estimated by the DKI model are powerful tools for early HIBD diagnosis and prognosis assessment, thus providing an experimental and theoretical basis for clinical treatment.
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Affiliation(s)
- Jieaoxue Bao
- Department of Imaging, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan International Joint Laboratory of Neuroimaging, Zhengzhou, China
| | - Xiaoan Zhang
- Department of Imaging, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan International Joint Laboratory of Neuroimaging, Zhengzhou, China
| | - Xin Zhao
- Department of Imaging, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan International Joint Laboratory of Neuroimaging, Zhengzhou, China
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Pan T, Su CQ, Tang WT, Lin J, Lu SS, Hong XN. Combined texture analysis of dynamic contrast-enhanced MRI with histogram analysis of diffusion kurtosis imaging for predicting IDH mutational status in gliomas. Acta Radiol 2023; 64:2552-2560. [PMID: 37331987 DOI: 10.1177/02841851231180291] [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] [Indexed: 06/20/2023]
Abstract
BACKGROUND Non-invasive detection of isocitrate dehydrogenase (IDH) mutational status in gliomas is clinically meaningful for molecular stratification of glioma; however, it remains challenging. PURPOSE To investigate the usefulness of texture analysis (TA) of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and histogram analysis of diffusion kurtosis imaging (DKI) maps for evaluating IDH mutational status in gliomas. MATERIAL AND METHODS This retrospective study enrolled 84 patients with histologically confirmed gliomas, comprising IDH-mutant (n = 34) and IDH-wildtype (n = 50). TA was performed for the quantitative parameters derived by DCE-MRI. Histogram analysis was performed for the quantitative parameters derived by DKI. Unpaired Student's t-test was used to identify IDH-mutant and IDH-wildtype gliomas. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to compare the diagnostic performance of each parameter and their combination for predicting the IDH mutational status in gliomas. RESULTS Significant statistical differences in the TA of DCE-MRI and histogram analysis of DKI were observed between IDH-mutant and IDH-wildtype gliomas (all P < 0.05). Using multivariable logistic regression, the entropy of Ktrans, skewness of Ve, and Kapp-90th had higher prediction potential for IDH mutations with areas under the ROC curve (AUC) of 0.915, 0.735, and 0.830, respectively. A combination of these analyses for the identification of IDH mutation improved the AUC to 0.978, with a sensitivity and specificity of 94.1% and 96.0%, respectively, which was higher than the single analysis (P < 0.05). CONCLUSION Integrating the TA of DCE-MRI and histogram analysis of DKI may help to predict the IDH mutational status.
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Affiliation(s)
- Ting Pan
- Department of Radiology, Northern Jiangsu People's Hospital, Clinical Medical School of Yangzhou University, Yangzhou, PR China
| | - Chun-Qiu Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Wen-Tian Tang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Jie Lin
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Shan-Shan Lu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xun-Ning Hong
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Hu R, Tan F, Chen W, Wu Y, Jiang Y, Du W, Zuo Y, Gao B, Song Q, Miao Y. Microstructure abnormalities of the diffusion quantities in children with attention-deficit/hyperactivity disorder: an AFQ and TBSS study. Front Psychiatry 2023; 14:1237113. [PMID: 37674550 PMCID: PMC10477457 DOI: 10.3389/fpsyt.2023.1237113] [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: 06/08/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023] Open
Abstract
Objective To explore the specific alterations of white matter microstructure in children with attention-deficit/hyperactivity disorder (ADHD) by automated fiber quantification (AFQ) and tract-based spatial statistics (TBSS), and to analyze the correlation between white matter abnormality and impairment of executive function. Methods In this prospective study, a total of twenty-seven patients diagnosed with ADHD (20 males, 7 females; mean age of 8.89 ± 1.67 years) and twenty-two healthy control (HC) individuals (11 males, 11 females, mean age of 9.82 ± 2.13 years) were included. All participants were scanned with diffusion kurtosis imaging (DKI) and assessed for executive functions. AFQ and TBSS analysis methods were used to investigate the white matter fiber impairment of ADHD patients, respectively. Axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD) and fractional anisotropy (FA) of 17 fiber properties were calculated using the AFQ. The mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), mean diffusivity (MDDKI), axial diffusivity (ADDKI), radial diffusivity (RDDKI) and fractional anisotropy (FADKI) of DKI and AD, RD, MD, and FA of diffusion tensor imaging (DTI) assessed the integrity of the white matter based on TBSS. Partial correlation analyses were conducted to evaluate the correlation between white matter abnormalities and clinical test scores in ADHD while taking age, gender, and education years into account. The analyses were all family-wise error rate (FWE) corrected. Results ADHD patients performed worse on the Behavior Rating Inventory of Executive Function (BRIEF) test (p < 0.05). Minor variances existed in gender and age between ADHD and HC, but these variances did not yield statistically significant distinctions. There were no significant differences in TBSS for DKI and DTI parameters (p > 0.05, TFCE-corrected). Compared to HC volunteers, the mean AD value of right cingulum bundle (CB_R) fiber tract showed a significantly higher level in ADHD patients following the correction of FWE. As a result of the point-wise comparison between groups, significant alterations (FWE correction, p < 0.05) were mainly located in AD (nodes 36-38, nodes 83-97) and MD (nodes 92-95) of CB_R. There was no significant correlation between white matter diffusion parameters and clinical test scores in ADHD while taking age, gender, and education years into account. Conclusion The AFQ method can detect ADHD white matter abnormalities in a specific location with greater sensitivity, and the CB_R played a critical role. Our findings may be helpful in further studying the relationship between focal white matter abnormalities and ADHD.
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Affiliation(s)
- Rui Hu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Fan Tan
- Department of Nuclear Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Wen Chen
- Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yong Wu
- Department of Paediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yuhan Jiang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Wei Du
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yuchen Zuo
- Department of Paediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Bingbing Gao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qingwei Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yanwei Miao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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Genç B, Aslan K, Özçağlayan A, İncesu L. Microstructural Abnormalities in the Contralateral Normal-appearing White Matter of Glioblastoma Patients Evaluated with Advanced Diffusion Imaging. Magn Reson Med Sci 2023:mp.2023-0054. [PMID: 37532585 DOI: 10.2463/mrms.mp.2023-0054] [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] [Indexed: 08/04/2023] Open
Abstract
PURPOSE Glioblastoma patients develop recurrence in the opposite hemisphere far from the primary tumor site even after complete resection. This is one of the main reasons for short disease survival. Our aim in this study is to detect microstructural changes in the contralateral hemisphere of glioblastoma patients using different diffusion models with the fully automated tract-based spatial statistics (TBSS) method. METHODS Fourteen right-sided and eleven left-sided glioblastoma patients without any treatment and eighteen age- and gender-matched controls were included in the study. Multi-shell diffusion weighted images were created with a 3T MRI device. After various preprocessing steps, images of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), axial kurtosis (AK), mean kurtosis (MK), radial kurtosis (RK), intracellular volume fraction (ICVF), orientation dispersion index (ODI), and isotropic water fraction (ISO) were obtained. TBSS was used to compare diffusion tensor imaging, diffusion kurtosis imaging, and neurite orientation dispersion and density imaging parameters of right- and left-sided glioblastoma patients with the control group for the contralateral hemisphere. RESULTS Both right-sided and left-sided glioblastoma patients have shown an increase in MD and ODI in the contralateral hemisphere. While right-sided glioblastoma patients showed an increase in RD, AD, and ISO in a more limited area in the contralateral hemisphere, left-sided glioblastoma patients showed an increase in MK and AK. FA, ICVF, and RK did not show any difference in both groups. CONCLUSION There are microstructural changes in the contralateral hemisphere in glioblastoma patients, and these changes differ between right-sided and left-sided glioblastoma patients.
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Affiliation(s)
- Barış Genç
- Department of Radiology, Samsun Education and Research Hospital
| | - Kerim Aslan
- Department of Radiology, Ondokuz Mayis University, Faculty of Medicine
| | - Ali Özçağlayan
- Department of Radiology, Ondokuz Mayis University, Faculty of Medicine
| | - Lütfi İncesu
- Department of Radiology, Ondokuz Mayis University, Faculty of Medicine
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Bian B, Zhou B, Shao Z, Zhu X, Jie Y, Li D. Feasibility of diffusion kurtosis imaging in evaluating cervical spinal cord injury in multiple sclerosis. Medicine (Baltimore) 2023; 102:e34205. [PMID: 37478237 PMCID: PMC10662919 DOI: 10.1097/md.0000000000034205] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/14/2023] [Indexed: 07/23/2023] Open
Abstract
This research aimed to assess gray matter (GM), white matter (WM), lesions of multiple sclerosis (MS) and the therapeutic effect using diffusion kurtosis imaging (DKI). From January 2018 to October 2019, 78 subjects (48 of MS and 30 of health) perform routine MR scan and DKI of cervical spinal cord. The MS patients were divided into 2 groups according to the presence or absence of T2 hyperintensity. DKI-metrics were measured in the lesions, normal-appearing GM and WM. Significant differences were detected in DKI metrics between MS and healthy (P < .05) and between patients with cervical spinal cord T2-hyperintense and without T2-hyperintense (P < .001). Compared to healthy, GM-mean kurtosis (MK), GM-radial kurtosis, and WM-fractional anisotropy, WM-axial diffusion were statistically reduced in patients without T2-hyperintense (P < .05). Significant differences were observed in DKI metrics between patients with T2-hyperintense after therapy (P < .05), as well as GM-MK and WM-fractional anisotropy, WM-axial diffusion in patients without T2-hyperintense (P < .05); Expanded Disability Status Scale was correlated with MK values, as well as Expanded Disability Status Scale scores and MK values after therapy. Our results indicate that DKI-metrics can detect and quantitatively evaluate the changes in cervical spinal cord micropathological structure.
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Affiliation(s)
- BingYang Bian
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - BoXu Zhou
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - ZhiQing Shao
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - XiaoNa Zhu
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - YiGe Jie
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
| | - Dan Li
- Department of Radiology, The First Hospital of Jilin University, Changchun, China
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Wang H, Wen H, Li J, Chen Q, Li S, Wang Z. Disrupted topological organization of white matter structural networks in high myopia patients revealed by diffusion kurtosis imaging and tractography. Front Neurosci 2023; 17:1158928. [PMID: 37425009 PMCID: PMC10324656 DOI: 10.3389/fnins.2023.1158928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction High myopia (HM) is a public health issue that can lead to severe visual impairment. Previous studies have exhibited widespread white matter (WM) integrity damage in HM patients. However, how these WM damages are topologically related, and the network-level structural disruptions underlying HM has not been fully defined. We aimed to assess the alterations of brain WM structural networks in HM patients using diffusion kurtosis imaging (DKI) and tractography in the present study. Methods Individual whole-brain and ROI-level WM networks were constructed using DKI tractography in 30 HM patients and 33 healthy controls. Graph theory analysis was then applied to explore the altered global and regional network topological properties. Pearson correlations between regional properties and disease duration in the HM group were also assessed. Results For global topology, although both groups showed a small-world network organization, HM patients exhibited significant decreased local efficiency and clustering coefficient compared with controls. For regional topology, HM patients and controls showed highly similar hub distributions, except for three additional hub regions in HM patients including left insula, anterior cingulate and paracingulate gyri (ACG), and median cingulate and paracingulate gyri (DCG). In addition, HM patients showed significantly altered nodal betweenness centrality (BC) mainly in the bilateral inferior occipital gyrus (IOG), left superior occipital gyrus (SOG), caudate nucleus, rolandic operculum and right putamen, pallidum, and gyrus rectus compared with controls. Intriguingly, the nodal BC of left IOG was negatively correlated with disease duration in HM patients. Discussion Our findings suggest that HM exhibited alterations in WM structural networks as indicated by decreased local specialization. This study may advance the current understanding of the pathophysiological mechanisms underlying HM.
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Affiliation(s)
- Huihui Wang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hongwei Wen
- Key Laboratory of Cognition and Personality (Ministry of Education), Faculty of Psychology, Southwest University, Chongqing, China
| | - Jing Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shanshan Li
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Meng X, Li S, He K, Hu H, Feng C, Li Z, Wang Y. Evaluation of Whole-Tumor Texture Analysis Based on MRI Diffusion Kurtosis and Biparametric VI-RADS Model for Staging and Grading Bladder Cancer. Bioengineering (Basel) 2023; 10:745. [PMID: 37508772 PMCID: PMC10376391 DOI: 10.3390/bioengineering10070745] [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: 05/18/2023] [Revised: 06/16/2023] [Accepted: 06/18/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND to evaluate the feasibility of texture analysis (TA) based on diffusion kurtosis imaging (DKI) in staging and grading bladder cancer (BC) and to compare it with apparent diffusion coefficient (ADC) and biparametric vesical imaging reporting and data system (VI-RADS). MATERIALS AND METHODS In this retrospective study, 101 patients with pathologically confirmed BC underwent MRI with multiple-b values ranging from 0 to 2000 s/mm2. ADC- and DKI-derived parameters, including mean kurtosis (MK) and mean diffusivity (MD), were obtained. First-order texture histogram parameters of MK and MD, including the mean; 5th, 25th, 50th, 75th, and 90th percentiles; inhomogeneity; skewness: kurtosis; and entropy; were extracted. The VI-RADS score was evaluated based on the T2WI and DWI. The Mann-Whitney U-test was used to compare the texture parameters and ADC values between non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC), as well as between low and high grades. Receiver operating characteristic analysis was used to evaluate the diagnostic performance of each significant parameter and their combinations. RESULTS The NMIBC and low-grade group had higher MDmean, MD5th, MD25th, MD50th, MD75th, MD90th, and ADC values than those of the MIBC and the high-grade group. The NMIBC and low-grade group yielded lower MKmean, MK25th, MK50th, MK75th, and MK90th than the MIBC and high-grade group. Among all histogram parameters, MD75th and MD90th yielded the highest AUC in differentiating MIBC from NMIBC (both AUCs were 0.87), while the AUC for ADC was 0.86. The MK75th and MK90th had the highest AUC (both 0.79) in differentiating low- from high-grade BC, while ADC had an AUC of 0.68. The AUC (0.92) of the combination of DKI histogram parameters (MD75th, MD90th, and MK90th) with biparametric VI-RADS in staging BC was higher than that of the biparametric VI-RADS (0.89). CONCLUSIONS Texture-analysis-derived DKI is useful in evaluating both the staging and grading of bladder cancer; in addition, the histogram parameters of the DKI (MD75th, MD90th, and MK90th) can provide additional value to VI-RADS.
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Affiliation(s)
- Xiaoyan Meng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Shichao Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Kangwen He
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Henglong Hu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Cui Feng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yanchun Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Anand T, Ishaque A, Ta D, Khan MU, Bharti K, Wu A, Krebs D, Beaulieu C, Seres P, Kalra S. Characterization of white matter alterations using diffusion kurtosis imaging in patients with amyotrophic lateral sclerosis. Brain Behav 2023:e3102. [PMID: 37279166 DOI: 10.1002/brb3.3102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/30/2023] [Accepted: 05/18/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND To evaluate the degeneration of the corticospinal tract (CST) and corpus callosum (CC) in patients with motor neuron disease and upper motor neuron (UMN) dysfunction using diffusion kurtosis imaging (DKI). METHODS Twenty-seven patients and 33 healthy controls underwent magnetic resonance imaging along with clinical and neuropsychological testing. Tractography of diffusion tensor images was performed to extract tracts of the bilateral CST and CC. Group mean differences both across the entire averaged tract and along each tract were assessed, including correlations between diffusion metrics and clinical measures. Tract-based spatial statistics (TBSS) was performed to evaluate the spatial distribution of whole-brain microstructural abnormalities in patients. RESULTS In comparison to controls, patients had significantly higher mean and radial diffusivity and lower fractional anisotropy (FA), kurtosis anisotropy, mean kurtosis (MK), and radial kurtosis (RK) in the CST and CC (p < .017). Along-the-tract analysis revealed changes concentrated in the posterior limb of the internal capsule, corona radiata, and primary motor cortex (false-discovery rate p < .05). FA of the left CST correlated with disease progression rate, whereas MK of the bilateral CST correlated with UMN burden (p < .01). TBSS results corroborated along-tract analysis findings and additionally revealed reduced RK and MK in the fornix, where diffusion tensor imaging (DTI) changes were absent. CONCLUSION DKI abnormalities in the CST and CC are present in patients with UMN dysfunction, potentially revealing complementary information to DTI regarding the pathology and microstructural alterations occurring in such patients. DKI shows promise as a potential in vivo biomarker for cerebral degeneration in amyotrophic lateral sclerosis.
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Affiliation(s)
- Tanushka Anand
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Abdullah Ishaque
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Daniel Ta
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Muhammad Umer Khan
- Department of Computing Sciences, University of Alberta, Edmonton, Canada
| | - Komal Bharti
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Andrew Wu
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Dennell Krebs
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Christian Beaulieu
- Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
| | - Peter Seres
- Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
| | - Sanjay Kalra
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
- Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
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Zhong Y, Guan J, Ma Y, Xu M, Cheng Y, Xu L, Lin Y, Zhang X, Wu R. Role of Imaging Modalities and N-Acetylcysteine Treatment in Sepsis-Associated Encephalopathy. ACS Chem Neurosci 2023. [PMID: 37216423 DOI: 10.1021/acschemneuro.3c00180] [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] [Indexed: 05/24/2023] Open
Abstract
Sepsis-associated encephalopathy is a severe systemic infection complication. Although early stages involve pathophysiological changes, detection using conventional imaging is challenging. Glutamate chemical exchange saturation transfer and diffusion kurtosis imaging can noninvasively investigate cellular and molecular events in early disease stages using magnetic resonance imaging (MRI). N-Acetylcysteine, an antioxidant and precursor of glutathione, regulates neurotransmitter glutamate metabolism and participates in neuroinflammation. We investigated the protective role of n-acetylcysteine in sepsis-associated encephalopathy using a rat model and monitored changes in brain using magnetic resonance (MR) molecular imaging. Bacterial lipopolysaccharide was injected intraperitoneally to induce a sepsis-associated encephalopathy model. Behavioral performance was assessed using the open-field test. Tumor necrosis factor α and glutathione levels were detected biochemically. Imaging was performed using a 7.0-T MRI scanner. Protein expression, cellular damage, and changes in blood-brain barrier permeability were assessed using western blotting, pathological staining, and Evans blue staining, respectively. Lipopolysaccharide-induced rats showed reduced anxiety and depression after treatment with n-acetylcysteine. MR molecular imaging can identify pathological processes at different disease stages. Furthermore, rats treated with n-acetylcysteine showed increased glutathione levels and decreased tumor necrosis factor α, suggesting enhanced antioxidant capacity and inhibition of inflammatory processes, respectively. Western blot analysis showed reduced expression of nuclear factor kappa B (p50) protein after treatment, suggesting that n-acetylcysteine inhibits inflammation via this signaling pathway. Finally, n-acetylcysteine-treated rats showed reduced cellular damage by pathology and reduced extravasation of their blood-brain barrier by Evans Blue staining. Thus, n-acetylcysteine might be a therapeutic option for sepsis-associated encephalopathy and other neuroinflammatory diseases. Furthermore, noninvasive "dynamic visual monitoring" of physiological and pathological changes related to sepsis-associated encephalopathy was achieved using MR molecular imaging for the first time, providing a more sensitive imaging basis for early diagnosis, identification, and prognosis.
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Affiliation(s)
- Yazhi Zhong
- Department of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041 Guangdong, China
- Department of Radiology, Huizhou Central People's Hospital, Huizhou 516001 Guangdong, China
| | - Jitian Guan
- Department of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041 Guangdong, China
| | - Yunfeng Ma
- Department of Emergency, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041 Guangdong, China
| | - Meiling Xu
- Department of Emergency, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041 Guangdong, China
| | - Yan Cheng
- Department of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041 Guangdong, China
- Department of Radiology, The Second Hospital of Shandong University, Jinan 250033 Shandong, China
| | - Liang Xu
- Department of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041 Guangdong, China
- Department of Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518100 Guangdong, China
| | - Yan Lin
- Department of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041 Guangdong, China
| | - Xiaolei Zhang
- Department of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041 Guangdong, China
| | - Renhua Wu
- Department of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041 Guangdong, China
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Genç B, Aslan K, Özçağlayan A, İncesu L. The role of MR diffusion kurtosis and neurite orientation dispersion and density imaging in evaluating gliomas. J Neuroimaging 2023. [PMID: 37170070 DOI: 10.1111/jon.13113] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND AND PURPOSE Conventional MRI sequences in neuro-oncology are insufficient for glioma grading. However, newly developed diffusion-weighted imaging techniques have been shown to have a great potential for glioma grading. This study examined the diagnostic performance of diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI), neurite orientation dispersion and density imaging (NODDI), and their combinations in glioma grading. METHODS Multishell diffusion tensor images were obtained with 3T MRI in 38 glioma patients (22 high-grade glioma [HGG], 16 low-grade glioma [LGG]). DTI (fractional anisotropy [FA], mean diffusivity [MD], axial diffusivity [AD], radial diffusivity [RD]), DKI (Axial kurtosis [AK], mean kurtosis [MK], radial kurtosis [RK]), and NODDI (intracellular volume fraction [ICVF], orientation distribution index, isotropic water fraction [ISO]) images were obtained after preprocessing. The average value of these parameters was calculated in the solid components of the tumors. The receiver operating characteristic curve analyses were performed to investigate the diagnostic performance and the curves were compared with the Delong test. RESULTS FA shows an increase in HGG, while MD, RD, and AD exhibit a decrease. AK, MK, and RK were higher in HGG than LGG. ICVF increased in HGG, while ISO decreased. AK demonstrated the best diagnostic performance among all parameters, and kurtosis outperformed NODDI but not DTI. Combining these parameters did not yield a statistically significant improvement in diagnostic performance. CONCLUSION DTI, DKI, and NODDI approaches can differentiate between HGG and LGG; however, kurtosis parameters perform better and adding NODDI parameters does not improve diagnostic performance. Using multishell b-value has not led to an increase in diagnostic performance.
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Affiliation(s)
- Barış Genç
- Department of Radiology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Kerim Aslan
- Department of Neuroradiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ali Özçağlayan
- Department of Radiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Lütfi İncesu
- Department of Neuroradiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
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Yuan L, Lin X, Zhao P, Ma H, Duan S, Sun S. Correlations between DKI and DWI with Ki-67 in gastric adenocarcinoma. Acta Radiol 2023; 64:1792-1798. [PMID: 36740857 DOI: 10.1177/02841851231153035] [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] [Indexed: 02/07/2023]
Abstract
BACKGROUND Diffusion kurtosis imaging (DKI) has been applied for gastric adenocarcinoma. Correlations between its parameters and Ki-67 are unclear. PURPOSE To investigate the correlation between DKI and diffusion-weighted imaging (DWI) parameters with the Ki-67 index in gastric adenocarcinoma. MATERIAL AND METHODS A total of 54 patients with gastric adenocarcinoma were enrolled in the study and underwent DWI and DKI at 3.0-T MRI before surgery. Based on the settings of the regions of interest, the DWI and DKI parameters (including apparent diffusion coefficient [ADC], diffusion kurtosis [K], and diffusion coefficient [DK]) of each patient's gastric adenocarcinoma were measured and calculated. The participants were divided into two groups (low Ki-67 group and high Ki-67 groups). The intraclass correlation coefficient (ICC) and independent-sample t-test were used to compare differences in each parameter between two groups. Spearman's correlation coefficient was calculated to determine the correlation between Ki-67 and the parameters. Each parameter was compared using the area under the receiver operating characteristic curve. All parameters were included in the multivariate logistic regression analysis to explore the relationship between each parameter and high Ki-67 index. RESULTS ADC and DK were negatively relevant with Ki-67 and K was positively relevant with Ki-67 in gastric adenocarcinoma. ADC, DK, and K had diagnostic efficiency in differentiating the low Ki-67 group from the high Ki-67 group. A higher K value independently predicted a high Ki-67 status. CONCLUSION DWI and DKI reflected the proliferative characteristics of gastric adenocarcinoma. K was the strongest independent factor for predicting high Ki-67 status.
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Affiliation(s)
- Letian Yuan
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, PR China
| | - Xiangtao Lin
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, PR China
| | - Peng Zhao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, PR China
| | - Hui Ma
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, PR China
| | - Shuai Duan
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, PR China
| | - Shanshan Sun
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, PR China
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Li C, Fieremans E, Novikov DS, Ge Y, Zhang J. Measuring water exchange on a preclinical MRI system using filter exchange and diffusion time dependent kurtosis imaging. Magn Reson Med 2023; 89:1441-1455. [PMID: 36404493 PMCID: PMC9892228 DOI: 10.1002/mrm.29536] [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: 12/19/2021] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE Filter exchange imaging (FEXI) and diffusion time (t)-dependent diffusion kurtosis imaging (DKI(t)) are both sensitive to water exchange between tissue compartments. The restrictive effects of tissue microstructure, however, introduce bias to the exchange rate obtained by these two methods, as their interpretation conventionally rely on the Kärger model of barrier limited exchange between Gaussian compartments. Here, we investigated whether FEXI and DKI(t) can provide comparable exchange rates in ex vivo mouse brains. THEORY AND METHODS FEXI and DKI(t) data were acquired from ex vivo mouse brains on a preclinical MRI system. Phase cycling and negative slice prewinder gradients were used to minimize the interferences from imaging gradients. RESULTS In the corpus callosum, apparent exchange rate (AXR) from FEXI correlated with the exchange rate (the inverse of exchange time, 1/τex ) from DKI(t) along the radial direction. In comparison, discrepancies between FEXI and DKI(t) were found in the cortex due to low filter efficiency and confounding effects from tissue microstructure. CONCLUSION The results suggest that FEXI and DKI(t) are sensitive to the same exchange processes in white matter when separated from restrictive effects of microstructure. The complex microstructure in gray matter, with potential exchange among multiple compartments and confounding effects of microstructure, still pose a challenge for FEXI and DKI(t).
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Affiliation(s)
- Chenyang Li
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, USA
- Vilcek Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, New York, NY, USA
| | - Els Fieremans
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, USA
| | - Dmitry S. Novikov
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, USA
| | - Yulin Ge
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, USA
| | - Jiangyang Zhang
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, USA
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Maralakunte M, Gupta V, Grover S, Ahuja CK, Sahoo S, Kishore K, Vyas S, Garg G, Singh P, Govind V. Cross-sectional analysis of whole-brain microstructural changes in adult patients with bipolar and unipolar depression by diffusion kurtosis imaging. Neuroradiol J 2023; 36:176-181. [PMID: 35817080 PMCID: PMC10034704 DOI: 10.1177/19714009221114446] [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] [Indexed: 11/16/2022] Open
Abstract
RATIONALE AND OBJECTIVES More than half of the bipolar depression (BD) subjects are misdiagnosed as unipolar depression (UD) due to lack of objective diagnostic criteria. We aimed to identify microstructural neuronal changes differentiating BD from UD groups using diffusion kurtosis imaging (DKI). The objective of the study is to identify an objective neuro-imaging marker to differentiate BD from UD. MATERIALS AND METHODS A prospective, cross-sectional study included total of 62 subjects with diagnosis of bipolar depression (n = 21), unipolar depression (n = 21), and healthy controls (n = 20). All subjects underwent diffusion-weighted imaging (b = 0,1000,2000) of the whole brain on 3-Tesla MR scanner. DKI data was analyzed using 189 region whole-brain atlas. Eight diffusion and kurtosis metrics including mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), fractional anisotropy (FA), mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), and kurtosis fractional anisotropy (FKA) were measured against these 189 regions. Principle component analysis (PCA) was utilized to identify the most significant regions of the brain. ANOVA with post hoc tests was used for analyzing these regions. RESULTS BD group showed increased MD, RD, decreased AK at the left amygdala and decreased MK and RK at the right hemi-cerebellum. UD group showed increased MK and RK at the right external capsule; and increased AK, MK, and RK at the right amygdala. CONCLUSION The right and left amygdala, right external capsule, and right hemi-cerebellum showed microstructural abnormalities capable of differentiating BD and UD groups. Diffusion imaging especially DKI can aid in management of depression patients.
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Affiliation(s)
| | - Vivek Gupta
- Interventional Neuroradiology, Fortis Hospital, India
| | | | | | | | | | - Sameer Vyas
- Department of Radiodiagnosis and
Imaging, PGIMER, India
| | - Gaurav Garg
- Department of Radiodiagnosis and
Imaging, PGIMER, India
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Li Y, Wen H, Li H, Peng Y, Tai J, Bai J, Mei L, Ji T, Li X, Liu Y, Ni X. Characterisation of brain microstructural alterations in children with obstructive sleep apnea syndrome using diffusion kurtosis imaging. J Sleep Res 2023; 32:e13710. [PMID: 36377256 DOI: 10.1111/jsr.13710] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/10/2022] [Accepted: 07/20/2022] [Indexed: 11/16/2022]
Abstract
Obstructive sleep apnea (OSA) is a common chronic sleep-related breathing disorder in children. Previous studies showed widespread alterations in white matter (WM) in children with OSA mainly by using diffusion tensor imaging (DTI), while diffusional kurtosis imaging (DKI) extended DTI and exhibited improved sensitivity in detecting developmental and pathological changes in neural tissues. Therefore, we conducted whole-brain DTI and DKI analyses and compared the differences in kurtosis and diffusion parameters within the skeleton between 41 children with OSA and 32 healthy children. Between-group differences were evaluated by tract-based spatial statistics (TBSS) analysis (p < 0.05, TFCE corrected), and partial correlations between DKI metrics and sleep parameters were assessed considering age and gender as covariates. Compared with the controls, children with OSA showed significantly decreased kurtosis fractional anisotropy (KFA) mainly in white matter regions with a complex fibre arrangement including the posterior corona radiate (PCR), superior longitudinal fasciculus (SLF), and inferior fronto-occipital fasciculus (IFOF), while decreased FA in white matter regions with a coherent fibre arrangement including the posterior limb of internal capsule (PLIC), anterior thalamic radiation (ATR), and corpus callosum (CC). Notably, the receiver operating characteristic (ROC) curve analysis demonstrated the KFA value in complex tissue regions significantly (p < 0.001) differentiated children with OSA from the controls. In addition, the KFA value in the left PCR, SLF, and IFOF showed significant partial correlations to the sleep parameters for children with OSA. Combining DKI derived kurtosis and diffusion parameters can provide complementary neuroimaging biomarkers for assessing white matter alterations, and reveal pathological changes and monitor disease progression in paediatric OSA.
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Affiliation(s)
- Yanhua Li
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Hongwei Wen
- Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality (Ministry of Education), Chongqing, China
| | - Hongbin Li
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Yun Peng
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Jun Tai
- Department of Otolaryngology, Head and Neck Surgery, Capital Institute of Pediatrics, Beijing, China
| | - Jie Bai
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Lin Mei
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Tingting Ji
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Xiaodan Li
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Yue Liu
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Xin Ni
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
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Deng X, Duan Z, Fang S, Wang S. Advances in The Application and Research of Magnetic Resonance Diffusion Kurtosis Imaging in The Musculoskeletal System. J Magn Reson Imaging 2023; 57:670-689. [PMID: 36200754 DOI: 10.1002/jmri.28463] [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: 06/22/2022] [Revised: 09/22/2022] [Accepted: 09/22/2022] [Indexed: 11/11/2022] Open
Abstract
Magnetic resonance diffusion kurtosis imaging (DKI) is an emerging magnetic resonance imaging (MRI) technique that can reflect microstructural changes in tissue through non-Gaussian diffusion of water molecules. Compared to traditional diffusion weighted imaging (DWI), the DKI model has shown greater sensitivity for diagnosis of musculoskeletal diseases and can help formulate more reasonable treatment plans. Moreover, DKI is an important auxiliary examination for evaluation of the motor function of the musculoskeletal system. This article briefly introduces the basic principles of DKI and reviews the application and research of DKI in the evaluation of disorders of the musculoskeletal system (including bone tumors, soft tissue tumors, spinal lesions, chronic musculoskeletal diseases, musculoskeletal trauma, and developmental disorders) as well as the normal musculoskeletal tissues. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: 1.
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Affiliation(s)
- Xiyang Deng
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, China
| | - Zhiqing Duan
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, China
| | - Shaobo Fang
- Department of Medical Imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, Henan, China.,Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Shaowu Wang
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, China
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Zhou Z, Chen Y, Zhao F, Sun Z, Zhu L, Yu H, Wang W. Predictive value of intravoxel incoherent motion combined with diffusion kurtosis imaging for breast cancer axillary lymph node metastasis: a retrospective study. Acta Radiol 2023; 64:951-961. [PMID: 35765225 DOI: 10.1177/02841851221107626] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Non-invasive imaging technologies for assessing axillary lymph node (ALN) metastasis of breast cancer are needed in clinical practice. PURPOSE To explore the clinical value of intravoxel incoherent motion (IVIM) and diffusional kurtosis imaging (DKI) for predicting ALN metastasis of breast cancer. MATERIAL AND METHODS A total of 194 patients with pathologically confirmed breast cancer who underwent IVIM and DKI examination were reviewed retrospectively. The IVIM derived parameters of D, D*, and f and DKI-derived parameters of MD and MK were measured. The independent samples t-test was used to compare the parameters between the ALN metastasis and non-ALN metastasis groups. Receiver operating characteristic (ROC) curve analysis was also performed. RESULTS The D and MD in the ALN metastasis group were significantly lower than those in the non-ALN metastasis group (P < 0.001, P < 0.001). The D*, f, and MK were higher in the ALN metastasis group than in the non-ALN metastasis group (P = 0.015, P = 0.014, and P = 0.001, respectively). The area under the ROC curve (AUC) of D (0.768) was highest. In addition, the diagnostic efficiency of both IVIM and DKI were higher than that of the conventional MRI (P = 0.002, P = 0.048). The diagnostic efficiency of IVIM + DKI were higher than that of the IVIM or DKI alone (P = 0.021, P = 0.004). CONCLUSION IVIM and DKI can be used for predicting breast cancer ALN metastasis with D as the most meaningful parameter.
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Affiliation(s)
- Zhe Zhou
- Department of Medical Imaging, 562122The Affiliated Hospital of Jining Medical University, Jining, PR China
| | - Yueqin Chen
- Department of Medical Imaging, 562122The Affiliated Hospital of Jining Medical University, Jining, PR China
| | - Fan Zhao
- Department of Medical Imaging, 562122The Affiliated Hospital of Jining Medical University, Jining, PR China
| | - Zhanguo Sun
- Department of Medical Imaging, 562122The Affiliated Hospital of Jining Medical University, Jining, PR China
| | - Laimin Zhu
- Department of Medical Imaging, 562122The Affiliated Hospital of Jining Medical University, Jining, PR China
| | - Hao Yu
- Department of Medical Imaging, 562122The Affiliated Hospital of Jining Medical University, Jining, PR China
| | - Weiwei Wang
- Department of Medical Imaging, 562122The Affiliated Hospital of Jining Medical University, Jining, PR China
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Christiaanse E, Wyss PO, Scheel‐Sailer A, Frotzler A, Lehnick D, Verma RK, Berger MF, Leemans A, De Luca A. Mean kurtosis-Curve (MK-Curve) correction improves the test-retest reproducibility of diffusion kurtosis imaging at 3 T. NMR Biomed 2023; 36:e4856. [PMID: 36285630 PMCID: PMC10078439 DOI: 10.1002/nbm.4856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/25/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Diffusion kurtosis imaging (DKI) is applied to gain insights into the microstructural organization of brain tissues. However, the reproducibility of DKI outside brain white matter, particularly in combination with advanced estimation to remedy its noise sensitivity, remains poorly characterized. Therefore, in this study, we investigated the variability and reliability of DKI metrics while correcting implausible values with a fit method called mean kurtosis (MK)-Curve. A total of 10 volunteers (four women; age: 41.4 ± 9.6 years) were included and underwent two MRI examinations of the brain. The images were acquired on a clinical 3-T scanner and included a T1-weighted image and a diffusion sequence with multiple diffusion weightings suitable for DKI. Region of interest analysis of common kurtosis and tensor metrics derived with the MK-Curve DKI fit was performed, including intraclass correlation (ICC) and Bland-Altman (BA) plot statistics. A p value of less than 0.05 was considered statistically significant. The analyses showed good to excellent agreement of both kurtosis tensor- and diffusion tensor-derived MK-Curve-corrected metrics (ICC values: 0.77-0.98 and 0.87-0.98, respectively), with the exception of two DKI-derived metrics (axial kurtosis in the cortex: ICC = 0.68, and radial kurtosis in deep gray matter: ICC = 0.544). Non-MK-Curve-corrected kurtosis tensor-derived metrics ranged from 0.01 to 0.52 and diffusion tensor-derived metrics from 0.06 to 0.66, indicating poor to moderate reliability. No structural bias was observed in the BA plots for any of the diffusion metrics. In conclusion, MK-Curve-corrected DKI metrics of the human brain can be reliably acquired in white and gray matter at 3 T and DKI metrics have good to excellent agreement in a test-retest setting.
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Affiliation(s)
- Ernst Christiaanse
- Department of RadiologySwiss Paraplegic CentreNottwilSwitzerland
- Image Sciences Institute, Division Imaging & OncologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Patrik O. Wyss
- Department of RadiologySwiss Paraplegic CentreNottwilSwitzerland
| | - Anke Scheel‐Sailer
- Rehabilitation and Quality ManagementSwiss Paraplegic CentreNottwilSwitzerland
- Department of Health Sciences and MedicineUniversity of LucerneLucerneSwitzerland
| | - Angela Frotzler
- Clinical Trial UnitSwiss Paraplegic CentreNottwilSwitzerland
| | - Dirk Lehnick
- Department of Health Sciences and Medicine, Biostatistics and MethodologyUniversity LucerneLucerneSwitzerland
| | - Rajeev K. Verma
- Department of RadiologySwiss Paraplegic CentreNottwilSwitzerland
| | - Markus F. Berger
- Department of RadiologySwiss Paraplegic CentreNottwilSwitzerland
| | - Alexander Leemans
- Image Sciences Institute, Division Imaging & OncologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Alberto De Luca
- Image Sciences Institute, Division Imaging & OncologyUniversity Medical Center UtrechtUtrechtthe Netherlands
- Neurology Department, UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtthe Netherlands
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Sun H, Wu Y, Liu N, Long M, Liu G, Sun PZ, Yin J. Tissue perfusion of the kurtosis/diffusion mismatch differs from the central core and peripheral regions in acute cerebral infarction patients. Acta Radiol 2023; 64:1155-1165. [PMID: 35765208 DOI: 10.1177/02841851221109678] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite its wide adoption in stroke imaging, the diffusion-weighted imaging (DWI) lesion is heterogeneous. The emerging diffusion kurtosis imaging (DKI) has been postulated to resolve the graded DWI lesion. PURPOSE To determine the perfusion characteristics of the central infarction core, kurtosis/diffusion mismatch, and peripheral regions. MATERIAL AND METHODS Patients with acute ischemic stroke underwent DWI, DKI, and perfusion-weighted imaging (PWI) scans. The patients were divided into mean kurtosis (MK)/mean diffusivity (MD) match and mismatch groups. Perfusion parameters were measured in the MK/MD lesion and peripheral areas in the MK/MD match group. We also analyzed perfusion status in the MK/MD lesion mismatch area for the mismatch group. RESULTS A total of 40 eligible patients (24 MK/MD match and 16 MK/MD mismatch) were enrolled in the final data analysis. The MTT and TTP progressively decreased, while the cerebral blood flow (CBF) and cerebral blood volume (CBV) increased from the central to peripheral areas. In addition, CBF in the MK/MD mismatch region was significantly higher than that in the central region (P < 0.05), but similar to the peripheral region. Furthermore, CBV in the MK/MD mismatch region did not differ significantly from that of the central region, but both were significantly lower than that of the peripheral area (P < 0.05). CONCLUSION The MK/MD mismatch region had blood flow similar to the peripheral region but with a reduced blood volume, indicating that it was less ischemic from the infarction core, albeit insufficient collateral circulation.
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Affiliation(s)
- Haizhen Sun
- Department of Radiology, Tianjin Medical University Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin, PR China
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin, PR China
| | - Yalin Wu
- The First Central Clinical College of Tianjin Medical University, Tianjin, PR China
| | - Na Liu
- The First Central Clinical College of Tianjin Medical University, Tianjin, PR China
| | - Miaomiao Long
- Department of Radiology, 66571Tianjin First Central Hospital, Tianjin Medical Imaging Institution, Tianjin, PR China
| | - Guoping Liu
- Department of Neurology, 66571Tianjin First Central Hospital, Tianjin, PR China
| | - Phillip Zhe Sun
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Department of Radiology and Imaging Sciences, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Jianzhong Yin
- Department of Radiology, 66571Tianjin First Central Hospital, Tianjin Medical Imaging Institution, Tianjin, PR China
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Stenberg J, Skandsen T, Gøran Moen K, Vik A, Eikenes L, Håberg AK. Diffusion Tensor and Kurtosis Imaging Findings the First Year following Mild Traumatic Brain Injury. J Neurotrauma 2023; 40:457-471. [PMID: 36305387 PMCID: PMC9986024 DOI: 10.1089/neu.2022.0206] [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] [Indexed: 11/12/2022] Open
Abstract
Despite enormous research interest in diffusion tensor imaging and diffusion kurtosis imaging (DTI; DKI) following mild traumatic brain injury (MTBI), it remains unknown how diffusion in white matter evolves post-injury and relates to acute MTBI characteristics. This prospective cohort study aimed to characterize diffusion changes in white matter the first year after MTBI. Patients with MTBI (n = 193) and matched controls (n = 83) underwent 3T magnetic resonance imaging (MRI) within 72 h and 3- and 12-months post-injury. Diffusion data were analyzed in three steps: 1) voxel-wise comparisons between the MTBI and control group were performed with tract-based spatial statistics at each time-point; 2) clusters of significant voxels identified in step 1 above were evaluated longitudinally with mixed-effect models; 3) the MTBI group was divided into: (A) complicated (with macrostructural findings on MRI) and uncomplicated MTBI; (B) long (1-24 h) and short (< 1 h) post-traumatic amnesia (PTA); and (C) other and no other concurrent injuries to investigate if findings in step 1 were driven mainly by aberrant diffusion in patients with a more severe injury. At 72 h, voxel-wise comparisons revealed significantly lower fractional anisotropy (FA) in one tract and significantly lower mean kurtosis (Kmean) in 11 tracts in the MTBI compared with control group. At 3 months, the MTBI group had significantly higher mean diffusivity in eight tracts compared with controls. At 12 months, FA was significantly lower in four tracts and Kmean in 10 tracts in patients with MTBI compared with controls. There was considerable overlap in affected tracts across time, including the corpus callosum, corona radiata, internal and external capsule, and cerebellar peduncles. Longitudinal analyses revealed that the diffusion metrics remained relatively stable throughout the first year after MTBI. The significant group*time interactions identified were driven by changes in the control rather than the MTBI group. Further, differences identified in step 1 did not result from greater diffusion abnormalities in patients with complicated MTBI, long PTA, or other concurrent injuries, as standardized mean differences in diffusion metrics between the groups were small (0.07 ± 0.11) and non-significant. However, follow-up voxel-wise analyses revealed that other concurrent injuries had effects on diffusion metrics, but predominantly in other metrics and at other time-points than the effects observed in the MTBI versus control group analysis. In conclusion, patients with MTBI differed from controls in white matter integrity already 72 h after injury. Diffusion metrics remained relatively stable throughout the first year after MTBI and were not driven by deviating diffusion in patients with a more severe MTBI.
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Affiliation(s)
- Jonas Stenberg
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Toril Skandsen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kent Gøran Moen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Radiology, Vestre Viken Hospital Trust, Drammen Hospital, Drammen, Norway.,Department of Radiology, Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Norway
| | - Anne Vik
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Live Eikenes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Asta K Håberg
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Zhou KP, Huang HB, Bu C, Luo ZX, Huang WS, Xie LZ, Liu QY, Bian J. Sub-differentiation of PI-RADS 3 lesions in TZ by advanced diffusion-weighted imaging to aid the biopsy decision process. Front Oncol 2023; 13:1092073. [PMID: 36845749 PMCID: PMC9950630 DOI: 10.3389/fonc.2023.1092073] [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: 11/07/2022] [Accepted: 01/26/2023] [Indexed: 02/12/2023] Open
Abstract
Background Performing biopsy for intermediate lesions with PI-RADS 3 has always been controversial. Moreover, it is difficult to differentiate prostate cancer (PCa) and benign prostatic hyperplasia (BPH) nodules in PI-RADS 3 lesions by conventional scans, especially for transition zone (TZ) lesions. The purpose of this study is sub-differentiation of transition zone (TZ) PI-RADS 3 lesions using intravoxel incoherent motion (IVIM), stretched exponential model, and diffusion kurtosis imaging (DKI) to aid the biopsy decision process. Methods A total of 198 TZ PI-RADS 3 lesions were included. 149 lesions were BPH, while 49 lesions were PCa, including 37 non-clinical significant PCa (non-csPCa) lesions and 12 clinical significant PCa (csPCa) lesions. Binary logistic regression analysis was used to examine which parameters could predict PCa in TZ PI-RADS 3 lesions. The ROC curve was used to test diagnostic efficiency in distinguishing PCa from TZ PI-RADS 3 lesions, while one-way ANOVA analysis was used to examine which parameters were statistically significant among BPH, non-csPCa and csPCa. Results The logistic model was statistically significant (χ2 = 181.410, p<0.001) and could correctly classify 89.39% of the subjects. Parameters of fractional anisotropy (FA) (p=0.004), mean diffusion (MD) (p=0.005), mean kurtosis (MK) (p=0.015), diffusion coefficient (D) (p=0.001), and distribute diffusion coefficient (DDC) (p=0.038) were statistically significant in the model. ROC analysis showed that AUC was 0.9197 (CI 95%: 0.8736-0.9659). Sensitivity, specificity, positive predictive value and negative predictive value were 92.1%, 80.4%, 93.9% and 75.5%, respectively. FA and MK of csPCa were higher than those of non-csPCa (all p<0.05), while MD, ADC, D, and DDC of csPCa were lower than those of non-csPCa (all p<0.05). Conclusion FA, MD, MK, D, and DDC can predict PCa in TZ PI-RADS 3 lesions and inform the decision-making process of whether or not to perform a biopsy. Moreover, FA, MD, MK, D, DDC, and ADC may have ability to identify csPCa and non-csPCa in TZ PI-RADS 3 lesions.
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Affiliation(s)
- Kun-Peng Zhou
- Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Hua-Bin Huang
- Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Chao Bu
- Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Zhong-Xing Luo
- Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Wen-Sheng Huang
- Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | | | - Qing-Yu Liu
- Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Jie Bian
- Radiology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China,*Correspondence: Jie Bian,
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Li X, Liang Q, Ouchi E, Bautista M, Hu J, Zhang X. Using Multi-model Diffusion Weighted Imaging to Study Acute Kidney
Injury in Patients with Acute Pancreatitis. Curr Med Imaging 2023:CMIR-EPUB-129157. [PMID: 36717989 DOI: 10.2174/1573405619666230130123138] [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: 05/25/2022] [Revised: 10/29/2022] [Accepted: 11/23/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To explore the diagnostic value and severity of acute kidney injury (AKI) in patients with acute pancreatitis (AP) using intravoxel incoherent motion imaging (IVIM), diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DKI). METHODS 224 AP patients, categorized into either the AKI group or the non-AKI group, were retrospectively analyzed in this study. MRI sequences included routine abdominal, IVIM, DTI, and DKI scans, and the main MRI parameters of kidney imaging and clinical characteristics were measured. The diagnostic performance of AKI was compared, and the relationships among these indices, glomerular filtration rate (eGFR), and AKI staging were analyzed. Finally, all parameters were analyzed by single and multi-parameter regression. RESULTS Compared with the non-AKI group, the fast apparent diffusion coefficient (ADC) value and
perfusion fraction (Ff ADC) value of the renal medulla in the AKI group were significantly lower than
those in the non-AKI group. The fractional anisotropy (FA) value in the renal cortex was significantly
lower than that in the medulla and significantly lower than in the non-AKI group. Lastly, the renal
medulla mean kurtosis (MK) value was also significantly lower in the AKI group compared to the non-
AKI group and exhibited the best diagnostic value for AKI in AP patients. The renal medulla MK value
positively correlated with AKI staging and negatively correlated with eGFR. The MK value was an
independent risk factor for AKI, as evidenced by multi-parameter logistic regression analysis. CONCLUSION The measurement of renal DKI parameters is practical for diagnosing and predicting the severity of acute kidney injury in AP patients.
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Affiliation(s)
- Xinghui Li
- Medical Imaging Key Laboratory of Sichuan Province; Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Qi Liang
- Department of Clinical Laboratory, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province 637000, China
| | - Erika Ouchi
- Department of Radiology, Wayne State University, Detroit, 48201, Michigan, United States of America
| | - Matthew Bautista
- Department of Radiology, Wayne State University, Detroit, 48201, Michigan, United States of America
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, 48201, Michigan, United States of America
| | - XiaoMing Zhang
- Medical Imaging Key Laboratory of Sichuan Province; Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
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Li J, Wu B, Huang Z, Zhao Y, Zhao S, Guo S, Xu S, Wang X, Tian T, Wang Z, Zhou J. Whole-lesion histogram analysis of multiple diffusion metrics for differentiating lung cancer from inflammatory lesions. Front Oncol 2023; 12:1082454. [PMID: 36741699 PMCID: PMC9890049 DOI: 10.3389/fonc.2022.1082454] [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: 10/28/2022] [Accepted: 12/21/2022] [Indexed: 01/19/2023] Open
Abstract
Background Whole-lesion histogram analysis can provide comprehensive assessment of tissues by calculating additional quantitative metrics such as skewness and kurtosis; however, few studies have evaluated its value in the differential diagnosis of lung lesions. Purpose To compare the diagnostic performance of conventional diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) and diffusion kurtosis imaging (DKI) in differentiating lung cancer from focal inflammatory lesions, based on whole-lesion volume histogram analysis. Methods Fifty-nine patients with solitary pulmonary lesions underwent multiple b-values DWIs, which were then postprocessed using mono-exponential, bi-exponential and DKI models. Histogram parameters of the apparent diffusion coefficient (ADC), true diffusivity (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f), apparent diffusional kurtosis (Kapp) and kurtosis-corrected diffusion coefficient (Dapp) were calculated and compared between the lung cancer and inflammatory lesion groups. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic performance. Results The ADCmean, ADCmedian, D mean and D median values of lung cancer were significantly lower than those of inflammatory lesions, while the ADCskewness, Kapp mean, Kapp median, Kapp SD, Kapp kurtosis and Dapp skewness values of lung cancer were significantly higher than those of inflammatory lesions (all p < 0.05). ADCskewness (p = 0.019) and D median (p = 0.031) were identified as independent predictors of lung cancer. D median showed the best performance for differentiating lung cancer from inflammatory lesions, with an area under the ROC curve of 0.777. Using a D median of 1.091 × 10-3 mm2/s as the optimal cut-off value, the sensitivity, specificity, positive predictive value and negative predictive value were 69.23%, 85.00%, 90.00% and 58.62%, respectively. Conclusions Whole-lesion histogram analysis of DWI, IVIM and DKI parameters is a promising approach for differentiating lung cancer from inflammatory lesions, and D median shows the best performance in the differential diagnosis of solitary pulmonary lesions.
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Affiliation(s)
- Jiaxin Li
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Baolin Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Zhun Huang
- Department of Radiology, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yixiang Zhao
- Department of Critical Care Medicine, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Sen Zhao
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Shuaikang Guo
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Shufei Xu
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Xiaolei Wang
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Tiantian Tian
- Department of Radiology, Huaihe Hospital of Henan University, Kaifeng, China
| | - Zhixue Wang
- Department of Radiology, The First Affiliated Hospital of Henan University, Kaifeng, China,*Correspondence: Zhixue Wang, ; Jun Zhou,
| | - Jun Zhou
- Interventional Diagnostic and Therapeutic Center, Zhongnan Hospital of Wuhan University, Wuhan, China,*Correspondence: Zhixue Wang, ; Jun Zhou,
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He X, Zhao X, Sun Y, Geng P, Zhang X. Application of TBSS-based machine learning models in the diagnosis of pediatric autism. Front Neurol 2023; 13:1078147. [PMID: 36742048 PMCID: PMC9889873 DOI: 10.3389/fneur.2022.1078147] [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: 10/24/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
Objective To explore the microstructural changes of white matter in children with pediatric autism by using diffusion kurtosis imaging (DKI), and evaluate whether the combination of tract-based spatial statistics (TBSS) and back-propagation neural network (BPNN)/support vector machine (SVM)/logistic regression (LR) was feasible for the classification of pediatric autism. Methods DKI data were retrospectively collected from 32 children with autism and 27 healthy controls (HCs). Kurtosis fractional anisotropy (FAK), mean kurtosis (MK), axial kurtosis (KA), radial kurtosis (RK), fractional anisotropy (FA), axial diffusivity (DA), mean diffusivity (MD) and Radial diffusivity (DR) were generated by iQuant workstation. TBSS was used to detect the regions of parameters values abnormalities and for the comparison between these two groups. In addition, we also introduced the lateralization indices (LI) to study brain lateralization in children with pediatric autism, using TBSS for additional analysis. The parameters values of the differentiated regions from TBSS were then calculated for each participant and used as the features in SVM/BPNN/LR. All models were trained and tested with leave-one-out cross validation (LOOCV). Results Compared to the HCs group, the FAK, DA, and KA values of multi-fibers [such as the bilateral superior longitudinal fasciculus (SLF), corticospinal tract (CST) and anterior thalamic radiation (ATR)] were lower in pediatric autism group (p < 0.05, TFCE corrected). And we also found DA lateralization abnormality in Superior longitudinal fasciculus (SLF) (the LI in HCs group was higher than that in pediatric autism group). However, there were no significant differences in FA, MD, MK, DR, and KR values between HCs and pediatric autism group (P > 0.05, TFCE corrected). After performing LOOCV to train and test three model (SVM/BPNN/LR), we found the accuracy of BPNN (accuracy = 86.44%) was higher than that of LR (accuracy = 76.27%), but no different from SVM (RBF, accuracy = 81.36%; linear, accuracy = 84.75%). Conclusion Our proposed method combining TBSS findings with machine learning (LR/SVM/BPNN), was applicable in the classification of pediatric autism with high accuracy. Furthermore, the FAK, DA, and KA values and Lateralization index (LI) value could be used as neuroimaging biomarkers to discriminate the children with pediatric autism or not.
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Affiliation(s)
- Xiongpeng He
- Department of Imaging, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Henan International Joint Laboratory of Neuroimaging, Zhengzhou, China
| | - Xin Zhao
- Department of Imaging, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Henan International Joint Laboratory of Neuroimaging, Zhengzhou, China
| | - Yongbing Sun
- Department of Imaging, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Pengfei Geng
- Department of Imaging, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Henan International Joint Laboratory of Neuroimaging, Zhengzhou, China
| | - Xiaoan Zhang
- Department of Imaging, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China,Henan International Joint Laboratory of Neuroimaging, Zhengzhou, China,*Correspondence: Xiaoan Zhang ✉
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