1
|
Chan SW, Hu WH, Ouyang YC, Su HC, Lin CY, Chang YC, Hsu CC, Chen KW, Liu CC, Chien SH. Quantitative Measurement of Breast Tumors Using Intravoxel Incoherent Motion (IVIM) MR Images. J Pers Med 2021; 11:656. [PMID: 34357123 DOI: 10.3390/jpm11070656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/07/2021] [Accepted: 07/10/2021] [Indexed: 12/13/2022] Open
Abstract
Breast magnetic resonance imaging (MRI) is currently a widely used clinical examination tool. Recently, MR diffusion-related technologies, such as intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI), have been extensively studied by breast cancer researchers and gradually adopted in clinical practice. In this study, we explored automatic tumor detection by IVIM-DWI. We considered the acquired IVIM-DWI data as a hyperspectral image cube and used a well-known hyperspectral subpixel target detection technique: constrained energy minimization (CEM). Two extended CEM methods—kernel CEM (K-CEM) and iterative CEM (I-CEM)—were employed to detect breast tumors. The K-means and fuzzy C-means clustering algorithms were also evaluated. The quantitative measurement results were compared to dynamic contrast-enhanced T1-MR imaging as ground truth. All four methods were successful in detecting tumors for all the patients studied. The clustering methods were found to be faster, but the CEM methods demonstrated better performance according to both the Dice and Jaccard metrics. These unsupervised tumor detection methods have the advantage of potentially eliminating operator variability. The quantitative results can be measured by using ADC, signal attenuation slope, D*, D, and PF parameters to classify tumors of mass, non-mass, cyst, and fibroadenoma types.
Collapse
|
2
|
He M, Ruan H, Ma M, Zhang Z. Application of Diffusion Weighted Imaging Techniques for Differentiating Benign and Malignant Breast Lesions. Front Oncol 2021; 11:694634. [PMID: 34235084 PMCID: PMC8255916 DOI: 10.3389/fonc.2021.694634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/07/2021] [Indexed: 12/25/2022] Open
Abstract
To explore the value of apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM), and diffusional kurtosis imaging (DKI) based on diffusion weighted magnetic resonance imaging (DW-MRI) in differentiating benign and malignant breast lesions. A total of 215 patients with breast lesions were prospectively collected for breast MR examination. Single exponential, IVIM, and DKI models were calculated using a series of b values. Parameters including ADC, perfusion fraction (f), tissue diffusion coefficient (D), perfusion-related incoherent microcirculation (D*), average kurtosis (MK), and average diffusivity (MD) were compared between benign and malignant lesions. ROC curves were used to analyze the optimal diagnostic threshold of each parameter, and to evaluate the diagnostic efficacy of single and combined parameters. ADC, D, MK, and MD values were significantly different between benign and malignant breast lesions (P<0.001). Among the single parameters, ADC had the highest diagnostic efficiency (sensitivity 91.45%, specificity 82.54%, accuracy 88.84%, AUC 0.915) and the best diagnostic threshold (0.983 μm2/ms). The combination of ADC and MK offered high diagnostic performance (sensitivity 90.79%, specificity 85.71%, accuracy 89.30%, AUC 0.923), but no statistically significant difference in diagnostic performance as compared with single-parameter ADC (P=0.268). The ADC, D, MK, and MD parameters have high diagnostic value in differentiating benign and malignant breast lesions, and of these individual parameters the ADC has the best diagnostic performance. Therefore, our study revealed that the use of ADC alone should be useful for differentiating between benign and malignant breast lesions, whereas the combination of MK and ADC might improve the diagnostic performance to some extent.
Collapse
Affiliation(s)
- Muzhen He
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Huiping Ruan
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Mingping Ma
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Radiology, Fujian Provincial Hospital, Fuzhou, China
| | | |
Collapse
|
3
|
Guo B, Ouyang F, Ouyang L, Huang X, Guo T, Lin S, Liu Z, Zhang R, Yang SM, Chen H, Hu QG. Intravoxel Incoherent Motion Magnetic Resonance Imaging for Prediction of Induction Chemotherapy Response in Locally Advanced Hypopharyngeal Carcinoma: Comparison With Model-Free Dynamic Contrast-Enhanced Magnetic Resonance Imaging. J Magn Reson Imaging 2021; 54:91-100. [PMID: 33576125 DOI: 10.1002/jmri.27537] [Citation(s) in RCA: 3] [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] [Received: 09/20/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Multiparametric intravoxel incoherent motion (IVIM) provides diffusion and perfusion information for the treatment prediction of cancer. However, the superiority of IVIM over dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in locally advanced hypopharyngeal carcinoma (LAHC) remains unclear. PURPOSE To compare the diagnostic performance of IVIM and model-free DCE in assessing induction chemotherapy (IC) response in patients with LAHC. STUDY TYPE Prospective. POPULATION Forty-two patients with LAHC. FIELD STRENGTH/SEQUENCE 3.0 T MRI, including IVIM (12 b values, 0-800 seconds/mm2 ) with a single-shot echo planar imaging sequence and DCE-MRI with a volumetric interpolated breath-hold examination sequence. IVIM MRI is a commercially available sequence and software for calculation and analysis from vendor. ASSESSMENT The IVIM-derived parameters (diffusion coefficient [D], pseudodiffusion coefficient [D*], and perfusion fraction [f]) and DCE-derived model-free parameters (Wash-in, time to maximum enhancement [Tmax], maximum enhancement [Emax], area under enhancement curve [AUC] over 60 seconds [AUC60 ], and whole area under enhancement curve [AUCw ]) were measured. At the end of IC, patients with complete or partial response were classified as responders according to the Response Evaluation Criteria in Solid Tumors. STATISTICAL TESTS The differences of parameters between responders and nonresponders were assessed using Mann-Whitney U tests. The performance of parameters for predicting IC response was evaluated by the receiver operating characteristic curves. RESULTS Twenty-three (54.8%) patients were classified as responders. Compared with nonresponders, the perfusion parameters D*, f, f × D*, and AUCw were significantly higher whereas Wash-in was lower in responders (all P-values <0.05). The f × D* outperformed other parameters, with an AUC of 0.84 (95% confidence interval [CI]: 0.69-0.93), sensitivity of 79.0% (95% CI: 54.4-93.9), and specificity of 82.6% (95% CI: 61.2-95.0). DATA CONCLUSION The IVIM MRI technique may noninvasively help predict the IC response before treatment in patients with LAHC. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
Collapse
Affiliation(s)
- Baoliang Guo
- Department of Radiology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
| | - Fusheng Ouyang
- Department of Radiology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
| | - Lizhu Ouyang
- Department of Ultrasound, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
| | - Xiyi Huang
- Department of Clinical Laboratory, The Affiliated Shunde Hospital of Guangzhou, Medical University, Foshan, China
| | - Tiandi Guo
- Department of Radiology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
| | - Shaojia Lin
- Department of Radiology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
| | - Ziwei Liu
- Department of Radiology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
| | - Rong Zhang
- Department of Radiology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
| | - Shao-Min Yang
- Department of Radiology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
| | - Haixiong Chen
- Department of Radiology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
| | - Qiu-Gen Hu
- Department of Radiology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
| |
Collapse
|
4
|
Abstract
Renal perfusion can be quantitatively assessed by multiple magnetic resonance imaging (MRI) methods, including dynamic contrast enhanced (DCE), arterial spin labeling (ASL), and diffusion-weighted imaging with intravoxel incoherent motion (IVIM) analysis. In this review we summarize the advances in the field of renal-perfusion MRI over the past 5 years. The review starts with a brief introduction of relevant MRI methods, followed by a discussion of recent technical developments. In the main section of the review, we examine the clinical and preclinical applications for three disease populations: chronic kidney disease, renal transplant, and renal tumors. The DCE method has been routinely used for assessing renal tumors but not other renal diseases. As a noncontrast alternative, ASL was extensively explored in both preclinical and clinical applications and showed much promise. Protocol standardization for the methods is desperately needed, and then large-scale clinical trials for the methods can be initiated prior to their broad clinical use. Level of Evidence: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019. J. Magn. Reson. Imaging 2020;52:369-379.
Collapse
Affiliation(s)
- Jeff L Zhang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Vivian S Lee
- Verily Life Sciences, Cambridge, Massachusetts, USA
| |
Collapse
|
5
|
Chen W, Zhang J, Long D, Wang Z, Zhu JM. Optimization of intra-voxel incoherent motion measurement in diffusion-weighted imaging of breast cancer. J Appl Clin Med Phys 2017; 18:191-199. [PMID: 28349630 PMCID: PMC5689860 DOI: 10.1002/acm2.12065] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/04/2017] [Accepted: 02/10/2017] [Indexed: 01/17/2023] Open
Abstract
Purpose The purpose of this study was to optimize intra‐voxel incoherent motion (IVIM) measurement in diffusion‐weighted imaging (DWI) of breast cancer by separating perfusion and diffusion effects through the determination of an optimal threshold b‐value, thus benign and cancerous breast tissues can be accurately differentiated using IVIM‐derived diffusion and perfusion parameters. Materials and Methods Twenty‐eight patients, with biopsy‐confirmed breast cancers, were studied with a 3T MRI scanner, using T1‐weighted dynamic contrast‐enhanced MRI images, and diffusion‐weighted images with nine b‐values, ranging from 0 to 1000 s/mm². IVIM‐derived parameter maps for tissue diffusion coefficients D, perfusion fraction f, and pseudo‐diffusion coefficients D* were computed using the segmented fitting method with optimized threshold b‐value, and the sum of squared residuals (SSR) were calculated for IVIM‐derived parameters in different breast lesions. Results The IVIM analysis method developed in this work can separate perfusion and diffusion effects with the optimal threshold b‐value of 300 s/mm², and the results of diffusion and perfusion parameters from IVIM analysis can be used to differentiate pathological changes in breast tissues. It was found that the averages and standard deviations of the diffusion and perfusion parameters, D, f, D*, are the following, for malignant, benign and normal breast tissues respectively: D (0.813 ± 0.225 × 10−3 mm2/s, 1.437 ± 0.538 × 10−3 mm2/s, 1.838 ± 0.213 × 10−3 mm2/s), f (10.73 ± 3.44%, 7.86 ± 3.70%, 8.92 ± 3.72%), D* (15.23 ± 12.17×10−3 mm²/s, 12.02 ± 3.19 × 10−3 mm2/s, 12.03 ± 7.21 × 10−3 mm2/s). Conclusion IVIM‐derived diffusion and perfusion parameter maps depend highly on the choice of threshold b‐value. Using the methodology developed in this work, and with the optimized threshold b‐value, the diffusion and perfusion parameters of breast tissues can be accurately assessed, making IVIM MRI a technique of choice for differential diagnosis of breast cancer.
Collapse
Affiliation(s)
- Wenjing Chen
- Institute for Biomedical Engineering, China Jiliang University, Hangzhou, Zhejiang, China
| | - Juan Zhang
- Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
| | - Dan Long
- Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
| | - Zhenchang Wang
- Department of Radiology and Center for Medical Imaging Research, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jian-Ming Zhu
- Institute for Biomedical Engineering, China Jiliang University, Hangzhou, Zhejiang, China.,Department of Radiology and Center for Medical Imaging Research, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Park HJ, Sung YS, Lee SS, Lee Y, Cheong H, Kim YJ, Lee MG. Intravoxel incoherent motion diffusion-weighted MRI of the abdomen: The effect of fitting algorithms on the accuracy and reliability of the parameters. J Magn Reson Imaging 2016; 45:1637-1647. [PMID: 27865032 DOI: 10.1002/jmri.25535] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [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: 08/03/2016] [Accepted: 10/13/2016] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To evaluate the influence of fitting methods on the accuracy and reliability of intravoxel incoherent motion (IVIM) parameters, with a particular emphasis on the constraint function. MATERIALS AND METHODS Diffusion-weighted (DW) imaging data were analyzed using IVIM-based full-fitting (simultaneous fit of all parameters) and segmented-fitting (step-by-step fit of each parameter), each with and without the constraint function, to estimate the molecular diffusion coefficient (Dslow ), perfusion fraction (f), and flow-related diffusion coefficient (Dfast ). Computational simulations were performed at variable signal-to-noise ratios to evaluate the relative error (RE) and coefficient of variation (CV) of the estimated IVIM parameters. DW imaging of the abdomen was performed twice at 1.5 Tesla using nine b-values (0-900 s/mm2 ) in 12 health volunteers (6 men and 6 women; mean age: 30 years). The measurement repeatability of IVIM parameters in the liver and the pancreas was evaluated using the within-subject coefficient of variation (w CV). RESULTS In simulations, full-fitting without the constraint function yielded the largest RE (P < 0.001 for Dslow and f; P ≤ 0.044 for Dfast ) and CV (P ≤ 0.033 for Dslow and f; P ≤ 0.473 for Dfast ) for IVIM parameters among all four algorithms. In volunteer imaging, full-fitting without the constraint function also resulted in the poorest repeatability for Dslow (w CV, 17.12%-65.45%) and f (w CV, 19.35%-42.84%) in the liver and pancreas, while the other algorithms had similar repeatability values (w CV, 4.05%-11.99% for Dslow and 9.65%-18.66% for f). Measurement repeatability of Dfast (w CV, 29.52%-85.01%) was the poorest among the IVIM parameters. CONCLUSION For accurate and reliable measurement of IVIM parameters, segmented fitting or full-fitting with the constraint function should be used for IVIM-based analysis of DW imaging. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1637-1647.
Collapse
Affiliation(s)
- Hyo Jung Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| | - Yu Sub Sung
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| | - Seung Soo Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| | - Yedaun Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Hyunhee Cheong
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| | - Yeong Jae Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| | - Moon-Gyu Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| |
Collapse
|
7
|
Huang HM, Shih YY, Lin C. Formation of parametric images using mixed-effects models: a feasibility study. NMR Biomed 2016; 29:239-247. [PMID: 26915793 DOI: 10.1002/nbm.3453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/18/2015] [Accepted: 11/08/2015] [Indexed: 06/05/2023]
Abstract
Mixed-effects models have been widely used in the analysis of longitudinal data. By presenting the parameters as a combination of fixed effects and random effects, mixed-effects models incorporating both within- and between-subject variations are capable of improving parameter estimation. In this work, we demonstrate the feasibility of using a non-linear mixed-effects (NLME) approach for generating parametric images from medical imaging data of a single study. By assuming that all voxels in the image are independent, we used simulation and animal data to evaluate whether NLME can improve the voxel-wise parameter estimation. For testing purposes, intravoxel incoherent motion (IVIM) diffusion parameters including perfusion fraction, pseudo-diffusion coefficient and true diffusion coefficient were estimated using diffusion-weighted MR images and NLME through fitting the IVIM model. The conventional method of non-linear least squares (NLLS) was used as the standard approach for comparison of the resulted parametric images. In the simulated data, NLME provides more accurate and precise estimates of diffusion parameters compared with NLLS. Similarly, we found that NLME has the ability to improve the signal-to-noise ratio of parametric images obtained from rat brain data. These data have shown that it is feasible to apply NLME in parametric image generation, and the parametric image quality can be accordingly improved with the use of NLME. With the flexibility to be adapted to other models or modalities, NLME may become a useful tool to improve the parametric image quality in the future. Copyright © 2015 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Husan-Ming Huang
- Medical Physics Research Center, Institute of Radiological Research, Chang Gung University and Chang Gung Memorial Hospital, Taoyuan City, Taiwan (ROC)
| | - Yi-Yu Shih
- Siemens Shenzhen Magnetic Resonance Ltd., Siemens MR Center, Shenzhen, People's Republic of China
| | - Chieh Lin
- Department of Nuclear Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan (ROC)
| |
Collapse
|
8
|
Chiaradia M, Baranes L, Van Nhieu JT, Vignaud A, Laurent A, Decaens T, Charles-Nelson A, Brugières P, Katsahian S, Djabbari M, Deux JF, Sobhani I, Karoui M, Rahmouni A, Luciani A. Intravoxel incoherent motion (IVIM) MR imaging of colorectal liver metastases: are we only looking at tumor necrosis? J Magn Reson Imaging 2013; 39:317-25. [PMID: 23723012 DOI: 10.1002/jmri.24172] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [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: 07/09/2012] [Accepted: 03/15/2013] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To determine if intra-voxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters, including free molecular-based (D) and perfusion-related (D*, f) diffusion parameters, correlate with the degree of tumor necrosis and viable tumor in colo-rectal cancer (CRC) metastasis. MATERIALS AND METHODS Fifteen patients referred for resection of liver metastases from CRC were retrospectively included in this Institutional Review Board approved study. An IVIM-DWI sequence was performed on a 1.5 Tesla MR imaging system, with 10 b factors (0, 10, 20, 30, 50, 80, 100, 200, 400 and 800 s/mm(2) ). Mean D, D*, f and apparent diffusion coefficient (ADC) values were determined in metastases with a longest diameter above 10 mm. Correlations between the diffusion parameters and the degree of liver tumor necrosis and viable tissue were determined (Spearman). RESULTS Correlation between diffusion parameters and histopathological findings was performed in 35 hepatic metastases with a diameter of more than 10 mm (mean size of 17.9 mm; range, 1-68 mm). Both D (r = 0.36; P = 0.035) and ADC (r = 0.4; P = 0.02) correlated with the degree of tumor necrosis but not with viable tumor. CONCLUSION ADC variation observed in CRC metastases following systemic chemotherapy reflects a specific increase in free-molecular diffusion (D), in itself correlated to the degree of metastasis necrosis.
Collapse
Affiliation(s)
- Melanie Chiaradia
- AP-HP, Groupe Henri Mondor Albert Chenevier, Imagerie Medicale, Creteil, France; Universite Paris Est Creteil, Creteil, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|