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Heskamp L, Birkbeck MG, Hall J, Schofield IS, Bashford J, Williams TL, De Oliveira HM, Whittaker RG, Blamire AM. Whole-body fasciculation detection in amyotrophic lateral sclerosis using motor unit MRI. Clin Neurophysiol 2024; 161:246-255. [PMID: 38448302 DOI: 10.1016/j.clinph.2024.02.016] [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: 09/15/2023] [Revised: 01/19/2024] [Accepted: 02/07/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Compare fasciculation rates between amyotrophic lateral sclerosis (ALS) patients and healthy controls in body regions relevant for diagnosing ALS using motor unit MRI (MUMRI) at baseline and 6 months follow-up, and relate this to single-channel surface EMG (SEMG). METHODS Tongue, biceps brachii, paraspinals and lower legs were assessed with MUMRI and biceps brachii and soleus with SEMG in 10 healthy controls and 10 patients (9 typical ALS, 1 primary lateral sclerosis [PLS]). RESULTS MUMRI-detected fasciculation rates in typical ALS patients were higher compared to healthy controls for biceps brachii (2.40 ± 1.90 cm-3min-1vs. 0.04 ± 0.10 cm-3min-1, p = 0.004), paraspinals (1.14 ± 1.61 cm-3min-1vs. 0.02 ± 0.02 cm-3min-1, p = 0.016) and lower legs (1.42 ± 1.27 cm-3min-1vs. 0.13 ± 0.10 cm-3min-1, p = 0.004), but not tongue (1.41 ± 1.94 cm-3min-1vs. 0.18 ± 0.18 cm-3min-1, p = 0.556). The PLS patient showed no fasciculation. At baseline, 6/9 ALS patients had increased fasciculation rates compared to healthy controls in at least 2 body regions. At follow-up every patient had increased fasciculation rates in at least 2 body regions. The MUMRI-detected fasciculation rate correlated with SEMG-detected fasciculation rates (τ = 0.475, p = 0.006). CONCLUSION MUMRI can non-invasively image fasciculation in multiple body regions and appears sensitive to disease progression in individual patients. SIGNIFICANCE MUMRI has potential as diagnostic tool for ALS.
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Affiliation(s)
- Linda Heskamp
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, United Kingdom.
| | - Matthew G Birkbeck
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle Biomedical Research Centre (BRC), Newcastle University, Newcastle Upon Tyne, United Kingdom; Northern Medical Physics and Clinical Engineering, Freeman Hospital, Newcastle Upon Tyne NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom.
| | - Julie Hall
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, United Kingdom; Department of Neuroradiology, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom.
| | - Ian S Schofield
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, United Kingdom.
| | - James Bashford
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Timothy L Williams
- Directorate of Clinical Neurosciences, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom.
| | - Hugo M De Oliveira
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, United Kingdom; Directorate of Clinical Neurosciences, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom.
| | - Roger G Whittaker
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, United Kingdom; Directorate of Clinical Neurosciences, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom.
| | - Andrew M Blamire
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, United Kingdom.
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Kazerouni AS, Peterson LM, Jenkins I, Novakova-Jiresova A, Linden HM, Gralow JR, Hockenbery DM, Mankoff DA, Porter PL, Partridge SC, Specht JM. Multimodal prediction of neoadjuvant treatment outcome by serial FDG PET and MRI in women with locally advanced breast cancer. Breast Cancer Res 2023; 25:138. [PMID: 37946201 PMCID: PMC10636950 DOI: 10.1186/s13058-023-01722-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/26/2023] [Indexed: 11/12/2023] Open
Abstract
PURPOSE To investigate combined MRI and 18F-FDG PET for assessing breast tumor metabolism/perfusion mismatch and predicting pathological response and recurrence-free survival (RFS) in women treated for breast cancer. METHODS Patients undergoing neoadjuvant chemotherapy (NAC) for locally-advanced breast cancer were imaged at three timepoints (pre, mid, and post-NAC), prior to surgery. Imaging included diffusion-weighted and dynamic contrast-enhanced (DCE-) MRI and quantitative 18F-FDG PET. Tumor imaging measures included apparent diffusion coefficient, peak percent enhancement (PE), peak signal enhancement ratio (SER), functional tumor volume, and washout volume on MRI and standardized uptake value (SUVmax), glucose delivery (K1) and FDG metabolic rate (MRFDG) on PET, with percentage changes from baseline calculated at mid- and post-NAC. Associations of imaging measures with pathological response (residual cancer burden [RCB] 0/I vs. II/III) and RFS were evaluated. RESULTS Thirty-five patients with stage II/III invasive breast cancer were enrolled in the prospective study (median age: 43, range: 31-66 years, RCB 0/I: N = 11/35, 31%). Baseline imaging metrics were not significantly associated with pathologic response or RFS (p > 0.05). Greater mid-treatment decreases in peak PE, along with greater post-treatment decreases in several DCE-MRI and 18F-FDG PET measures were associated with RCB 0/I after NAC (p < 0.05). Additionally, greater mid- and post-treatment decreases in DCE-MRI (peak SER, washout volume) and 18F-FDG PET (K1) were predictive of prolonged RFS. Mid-treatment decreases in metabolism/perfusion ratios (MRFDG/peak PE, MRFDG/peak SER) were associated with improved RFS. CONCLUSION Mid-treatment changes in both PET and MRI measures were predictive of RCB status and RFS following NAC. Specifically, our results indicate a complementary relationship between DCE-MRI and 18F-FDG PET metrics and potential value of metabolism/perfusion mismatch as a marker of patient outcome.
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Affiliation(s)
- Anum S Kazerouni
- Department of Radiology, University of Washington/Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Lanell M Peterson
- Division of Hematology and Oncology, University of Washington/Fred Hutchinson Cancer Center, 1144 Eastlake (Mail Stop LG-500), Seattle, WA, 98109-1023, USA
| | | | | | - Hannah M Linden
- Division of Hematology and Oncology, University of Washington/Fred Hutchinson Cancer Center, 1144 Eastlake (Mail Stop LG-500), Seattle, WA, 98109-1023, USA
| | - Julie R Gralow
- American Society of Clinical Oncology, Alexandria, VA, USA
| | | | - David A Mankoff
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Savannah C Partridge
- Department of Radiology, University of Washington/Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Jennifer M Specht
- Division of Hematology and Oncology, University of Washington/Fred Hutchinson Cancer Center, 1144 Eastlake (Mail Stop LG-500), Seattle, WA, 98109-1023, USA.
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Crimì F, Angelone R, Corso A, Bao QR, Cabrelle G, Vernuccio F, Spolverato G, Pucciarelli S, Quaia E. Diagnostic accuracy of state-of-the-art rectal MRI sequences for the diagnosis of extramural vascular invasion in locally advanced rectal cancer after preoperative chemoradiotherapy: dos or maybes? Eur Radiol 2023; 33:6852-6860. [PMID: 37115215 DOI: 10.1007/s00330-023-09655-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/12/2023] [Accepted: 03/26/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVES The aim of this study was to determine the accuracy of three state-of-the-art MRI sequences for the detection of extramural venous invasion (EMVI) in locally advanced rectal cancer (LARC) patients after preoperative chemoradiotherapy (pCRT). METHODS This retrospective study included 103 patients (median age 66 years old [43-84]) surgically treated with pCRT for LARC and submitted to preoperative contrast-enhanced pelvic MRI after pCRT. T2-weighted, DWI, and contrast-enhanced sequences were evaluated by two radiologists with expertise in abdominal imaging, blinded to clinical and histopathological data. Patients were scored according to the probability of EMVI presence on each sequence using a grading score ranging from 0 (no evidence of EMVI) to 4 (strong evidence of EMVI). Results from 0 to 2 were ranked as EMVI negative and from 3 to 4 as EMVI positive. ROC curves were drawn for each technique, using histopathological results as reference standard. RESULTS T2-weighted, DWI, and contrast-enhanced sequences demonstrated an area under the ROC curve (AUC) respectively of 0.610 (95% CI: 0.509-0.704), 0.729 (95% CI: 0.633-0.812), and 0.624 (95% CI: 0.523-0.718). The AUC of DWI sequence was significantly higher than that of T2-weighted (p = 0.0494) and contrast-enhanced (p = 0.0315) sequences. CONCLUSIONS DWI is more accurate than T2-weighted and contrast-enhanced sequences for the identification of EMVI following pCRT in LARC patients. CLINICAL RELEVANCE STATEMENT MRI protocol for restaging locally advanced rectal cancer after preoperative chemoradiotherapy should routinely include DWI due to its higher accuracy for the diagnosis of extramural venous invasion compared to high-resolution T2-weighted and contrast-enhanced T1-weighted sequences. KEY POINTS • MRI has a moderately high accuracy for the diagnosis of extramural venous invasion in locally advanced rectal cancer after preoperative chemoradiotherapy. • DWI is more accurate than T2-weighted and contrast-enhanced T1-weighted sequences in the detection of extramural venous invasion after preoperative chemoradiotherapy of locally advanced rectal cancer. • DWI should be routinely included in the MRI protocol for restaging locally advanced rectal cancer after preoperative chemoradiotherapy.
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Affiliation(s)
- Filippo Crimì
- Institute of Radiology, Department of Medicine-DIMED, University of Padova, Via Niccolò Giustiniani N.2, 35128, Padua, Italy
| | - Raimondo Angelone
- Institute of Radiology, Department of Medicine-DIMED, University of Padova, Via Niccolò Giustiniani N.2, 35128, Padua, Italy
| | - Antonio Corso
- Institute of Radiology, Department of Medicine-DIMED, University of Padova, Via Niccolò Giustiniani N.2, 35128, Padua, Italy
| | - Quoc Riccardo Bao
- General Surgery 3, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, 35128, Padua, Italy
| | - Giulio Cabrelle
- Department of Radiology, University Hospital of Padova, 35128, Padova, Italy
| | - Federica Vernuccio
- Department of Radiology, University Hospital of Padova, 35128, Padova, Italy.
| | - Gaya Spolverato
- General Surgery 3, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, 35128, Padua, Italy
| | - Salvatore Pucciarelli
- General Surgery 3, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, 35128, Padua, Italy
| | - Emilio Quaia
- Institute of Radiology, Department of Medicine-DIMED, University of Padova, Via Niccolò Giustiniani N.2, 35128, Padua, Italy
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Klingebiel M, Weiland E, Boschheidgen M, Ullrich T, Arsov C, Radtke JP, Benkert T, Nickel M, Strecker R, Wittsack HJ, Albers P, Antoch G, Schimmöller L. Improved diffusion-weighted imaging of the prostate: Comparison of readout-segmented and zoomed single-shot imaging. Magn Reson Imaging 2023; 98:55-61. [PMID: 36649807 DOI: 10.1016/j.mri.2023.01.010] [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: 09/24/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Diffusion weighted imaging (DWI) is the most important sequence for detection and grading prostate cancer (PCa), but it is considerably prone to artifacts. New approaches like zoomed single-shot imaging (z-EPI) with advanced image processing or multi-shot readout segmentation (rs-EPI) try to improve DWI quality. This study evaluates objective and subjective image quality (IQ) of rs-EPI and z-EPI with and without advanced processing. MATERIALS AND METHODS Fifty-six consecutive patients (67 ± 8 years; median PSA 8.3 ng/ml) with mp-MRI performed at 3 Tesla between February and October 2019 and subsequently verified PCa by targeted plus systematic MRI/US-fusion biopsy were included in this retrospective single center cohort study. Rs-EPI and z-EPI were prospectively acquired in every patient. Signal intensities (SI) of PCa and benign tissue in ADC, b1000, and calculated high b-value images were analyzed. Endpoints were signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), PCa contrast intensity (CI), and subjective IQ on a 5-point scale evaluated by three blinded readers. Wilcoxon signed rank test, Friedman test and Cohen's kappa coefficient was calculated. RESULTS SNR, CNR, and PCa CI of z-EPI with and without advanced processing was superior to rs-EPI (p < 0.01), whereas no significant differences were observed between z-EPI with and without advanced processing. Subjective IQ was significantly higher for z-EPI with advanced processing compared rs-EPI for ADC, b1000, and calculated high b-values (p < 0.01). Compared to z-EPI without advanced processing, z-EPI with advanced processing was superior for ADC and calculated high b-values (p < 0.01), but no significant differences were shown for b1000 images. CONCLUSIONS Z-EPI with and without advanced processing was superior to rs-EPI regarding objective imaging parameters and z-EPI with advanced processing was superior to rs-EPI regarding subjective imaging parameters for the detection of PCa.
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Affiliation(s)
- M Klingebiel
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - E Weiland
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany.
| | - M Boschheidgen
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - T Ullrich
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - C Arsov
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany.
| | - J P Radtke
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany.
| | - T Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany.
| | - M Nickel
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany.
| | - R Strecker
- Siemens Healthcare GmbH, Europe, Middle East & Africa, Karlheinz-Kaske-Str. 2, 91052 Erlangen, Germany.
| | - H J Wittsack
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - P Albers
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany.
| | - G Antoch
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - L Schimmöller
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
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Granger SJ, Colon-Perez L, Larson MS, Bennett IJ, Phelan M, Keator DB, Janecek JT, Sathishkumar MT, Smith AP, McMillan L, Greenia D, Corrada MM, Kawas CH, Yassa MA. Reduced structural connectivity of the medial temporal lobe including the perforant path is associated with aging and verbal memory impairment. Neurobiol Aging 2023; 121:119-128. [PMID: 36434930 DOI: 10.1016/j.neurobiolaging.2022.10.012] [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: 01/17/2022] [Revised: 10/20/2022] [Accepted: 10/22/2022] [Indexed: 11/11/2022]
Abstract
The perforant path, the white matter bundle connecting the entorhinal cortex (ERC) with the hippocampal formation deteriorates with age-related cognitive decline. Previous investigations using diffusion-weighted MRI to quantify perforant path integrity in-vivo have been limited due to image resolution or have quantified the perforant path using methods susceptible to partial volume effects such as the tensor model and without consideration of its 3-dimensional morphology. In this investigation, we use quantitative-anisotropy informed tractography derived from ultra-high resolution diffusion imaging (ZOOMit) to investigate structural connectivity of the perforant path and other medial temporal lobe (MTL) pathways in older adults (63 to 98 years old, n = 51). We show that graph density within the MTL declines with age and is associated with lower delayed recall performance. We also show that older age and poorer delayed recall are associated with reduced streamlines connecting the ERC and dentate gyrus of the hippocampus (the putative perforant path). This work suggest that intra-MTL connectivity may new candidate biomarkers for age-related cognitive decline.
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Affiliation(s)
- Steven J Granger
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA; Department of Neurobiology and Behavior, University of California, Irvine, CA
| | - Luis Colon-Perez
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA; Department of Neurobiology and Behavior, University of California, Irvine, CA
| | - Myra Saraí Larson
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA; Department of Neurobiology and Behavior, University of California, Irvine, CA
| | - Ilana J Bennett
- Department of Psychology, University of California, Riverside, CA
| | - Michael Phelan
- Department of Statistics, University of California, Irvine, CA
| | - David B Keator
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA
| | - John T Janecek
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA; Department of Neurobiology and Behavior, University of California, Irvine, CA
| | - Mithra T Sathishkumar
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA; Department of Neurobiology and Behavior, University of California, Irvine, CA
| | - Anna P Smith
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA; Department of Neurobiology and Behavior, University of California, Irvine, CA
| | - Liv McMillan
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA; Department of Neurobiology and Behavior, University of California, Irvine, CA
| | - Dana Greenia
- Department of Neurology, University of California, Irvine, CA
| | - Maria M Corrada
- Department of Neurology, University of California, Irvine, CA
| | - Claudia H Kawas
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA; Department of Neurobiology and Behavior, University of California, Irvine, CA; Department of Neurology, University of California, Irvine, CA
| | - Michael A Yassa
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA; Department of Neurobiology and Behavior, University of California, Irvine, CA; Department of Psychiatry and Human Behavior, University of California, Irvine, CA; Department of Neurology, University of California, Irvine, CA.
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Hansen CB, Schilling KG, Rheault F, Resnick S, Shafer AT, Beason-Held LL, Landman BA. Contrastive semi-supervised harmonization of single-shell to multi-shell diffusion MRI. Magn Reson Imaging 2022; 93:73-86. [PMID: 35716922 PMCID: PMC9901230 DOI: 10.1016/j.mri.2022.06.004] [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: 03/11/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 02/08/2023]
Abstract
Diffusion weighted MRI (DW-MRI) harmonization is necessary for multi-site or multi-acquisition studies. Current statistical methods address the need to harmonize from one site to another, but do not simultaneously consider the use of multiple datasets which are comprised of multiple sites, acquisitions protocols, and age demographics. This work explores deep learning methods which can generalize across these variations through semi-supervised and unsupervised learning while also learning to estimate multi-shell data from single-shell data using the Multi-shell Diffusion MRI Harmonization Challenge (MUSHAC) and Baltimore Longitudinal Study on Aging (BLSA) datasets. We compare disentanglement harmonization models, which seek to encode anatomy and acquisition in separate latent spaces, and a CycleGAN harmonization model, which uses generative adversarial networks (GAN) to perform style transfer between sites, to the baseline preprocessing and to SHORE interpolation. We find that the disentanglement models achieve superior performance in harmonizing all data while at the same transforming the input data to a single target space across several diffusion metrics (fractional anisotropy, mean diffusivity, mean kurtosis, primary eigenvector).
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Affiliation(s)
- Colin B Hansen
- Computer Science, Vanderbilt University, Nashville, TN, USA.
| | - Kurt G Schilling
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | | | - Bennett A Landman
- Computer Science, Vanderbilt University, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Electrical Engineering, Vanderbilt University, Nashville, TN, USA
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Raja R, Na X, Glasier C, Badger T, Akmyradov C, Ou X. Track-weighted imaging analysis of white matter microstructures in healthy children: Sex and hemispheric differences. Proc SPIE Int Soc Opt Eng 2022; 12036:120361Y. [PMID: 35685405 PMCID: PMC9173648 DOI: 10.1117/12.2607490] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Structural substrates of sex differences in human function and behavior have been elucidated in previous studies. Diffusion weighted magnetic resonance imaging (DW-MRI) is a widely used non-invasive imaging technique in studying human brain white matter structural organization. While many DW-MRI studies reporting sex differences in WM structure are based on diffusion tensor imaging (DTI) measures, tract specific microstructural differences require further investigation. In this study, we aim to investigate sex differences and sex-specific hemispheric differences in white matter microstructural development in healthy 8-year-old children based on novel track weighted imaging (TWI) analysis. Average pathlength map (APM) is a TWI contrast in which the average length of fibers passing through a voxel is utilized. In this study, we employed tract specific APM measures to evaluate sex differences in WM microstructural development. A total of 37 WM tracts were analyzed including 7 commissural tracts, 9 bilateral association tracts and 6 bilateral projection tracts. APM maps were generated for each tract. Tract-wise group tests were done using the mean values of APM maps. Sex differences were tested using general linear model based group comparisons. Age and total brain volume were included as covariates in the group analysis. Sex specific hemispheric differences were performed for the 15 bilateral tracts. One sample t-tests were done independently for left>right and right>left cases and the APM measures were controlled for age and total cerebral hemispheric volume. P-values<0.05 were considered significant after correcting for multiple comparisons accounting for the total number of tracts. Significant sex differences were revealed in APM measures between boys and girls in 11 WM tracts including rostral body of corpus callosum (CC), left inferior fronto-occipital fasciculus (IFOF), right cingulum, bilateral first and second segments of superior longitudinal fasciculus (SLF), right middle longitudinal fasciculus (MLF), bilateral fronto-pontine (FPT) and right parieto-occipital pontine tracts (POPT). The sex differences showed higher APM values for these 11 tracts in boys as compared to that of girls. In hemispheric differences analysis for both boys and girls, 2 tracts, arcuate fasciculus and optic radiation showed higher APM in left tracts as compared right; 5 tracts, IFOF, MLF, third segment of SLF, FPT and superior thalamic radiation showed higher APM in right tracts as compared to left. This indicates that boys and girls possess similar lateral asymmetries in these 7 tracts. Additionally, anterior thalamic radiation (ATR) showed higher APM in left tract and 4 tracts, first segment of SLF, POPT, inferior longitudinal fasciculus and cortico-spinal tract showed higher APM in right for boys. In girls, second segment of SLF and uncinate fasciculus showed higher APM in right hemisphere. These results indicate different lateral asymmetries between boys and girls for 7 tracts. Overall, boys showed higher average fiber length in most of the tracts, even after controlling for total brain volume.
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Affiliation(s)
- Rajikha Raja
- Department of Radiology, University of Arkansas for Medical Sciences
| | - Xiaoxu Na
- Department of Radiology, University of Arkansas for Medical Sciences
| | - Charles Glasier
- Department of Radiology, University of Arkansas for Medical Sciences
- Department of Pediatrics, University of Arkansas for Medical Sciences
| | - Thomas Badger
- Department of Pediatrics, University of Arkansas for Medical Sciences
- Arkansas Children’s Nutrition Center
| | - Chary Akmyradov
- Arkansas Children’s Research Institute, 1 Children’s Way, Little Rock, AR USA 72202
| | - Xiawei Ou
- Department of Radiology, University of Arkansas for Medical Sciences
- Department of Pediatrics, University of Arkansas for Medical Sciences
- Arkansas Children’s Nutrition Center
- Arkansas Children’s Research Institute, 1 Children’s Way, Little Rock, AR USA 72202
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van Oostenbrugge TJ, Spenkelink IM, Bokacheva L, Rusinek H, van Amerongen MJ, Langenhuijsen JF, Mulders PFA, Fütterer JJ. Kidney tumor diffusion-weighted magnetic resonance imaging derived ADC histogram parameters combined with patient characteristics and tumor volume to discriminate oncocytoma from renal cell carcinoma. Eur J Radiol 2021; 145:110013. [PMID: 34768055 DOI: 10.1016/j.ejrad.2021.110013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/20/2021] [Revised: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE To assess the ability to discriminate oncocytoma from RCC based on a model using whole tumor ADC histogram parameters with additional use of tumor volume and patient characteristics. METHOD In this prospective study, 39 patients (mean age 65 years, range 28-79; 9/39 (23%) female) with 39 renal tumors (32/39 (82%) RCC and 7/39 (18%) oncocytoma) underwent multiparametric MRI between November 2014 and June 2018. Two regions of interest (ROIs) were drawn to cover both the entire tumor volume and a part of healthy renal cortex. ROI ADC maps were calculated using a mono-exponential model and ADC histogram distribution parameters were calculated. A logistic regression model was created using ADC histogram parameters, radiographic and patient characteristics that were significantly different between oncocytoma and RCC. A ROC curve of the model was constructed and the AUC, sensitivity and specificity were calculated. Furthermore, differences in intra-patient ADC histogram parameters between renal tumor and healthy cortex were calculated. A separate ROC curve was constructed to differentiate oncocytoma from RCC using statistically significant intra-patient parameter differences. RESULTS ADC standard deviation (p = 0.008), entropy (p = 0.010), tumor volume (p = 0.012), and patient sex (p = 0.018) were significantly different between RCC and oncocytoma. The regression model of these parameters combined had an ROC-AUC of 0.91 with a sensitivity of 86% and specificity of 84%. Intra-patient difference in ADC 25th percentile (p < 0.01) and entropy (p = 0.030) combined had a ROC-AUC of 0.86 with a sensitivity and specificity of 86%, and 81%, respectively. CONCLUSION A model combining ADC standard deviation and entropy with tumor volume and patient sex has the highest diagnostic value for discrimination of oncocytoma. Although less accurate, intra-patient difference in ADC 25th percentile and entropy between renal tumor and healthy cortex can also be used. Although the results of this preliminary study do not yet justify clinical use of the model, it does stimulate further research using whole tumor ADC histogram parameters.
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Affiliation(s)
| | - Ilse M Spenkelink
- Department of Radiology and Nuclear Medicine Radboud University Medical Center, Nijmegen, the Netherlands
| | - Louisa Bokacheva
- Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Henry Rusinek
- Center for Advanced Imaging Innovation and Research (CAI2R) and Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Martin J van Amerongen
- Department of Radiology and Nuclear Medicine Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Peter F A Mulders
- Department of Urology Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jurgen J Fütterer
- Department of Radiology and Nuclear Medicine Radboud University Medical Center, Nijmegen, the Netherlands
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9
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Ozturk M, Polat AV, Selcuk MB. Whole-lesion ADC histogram analysis versus single-slice ADC measurement for the differentiation of benign and malignant soft tissue tumors. Eur J Radiol 2021; 143:109934. [PMID: 34500411 DOI: 10.1016/j.ejrad.2021.109934] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/25/2021] [Accepted: 08/23/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate and compare the diagnostic performances of whole-lesion apparent diffusion coefficient (ADC) histogram analysis and single-slice ADC measurement in the differentiation of benign and malignant soft tissue tumors. METHODS Fifty-three patients (mean age: 48.5 ± 21.4) with soft tissue tumors (27 benign and 26 malignant) were evaluated with diffusion-weighted MRI. Whole-lesion ADC histogram parameters (mean, median, 10th percentile, 90th percentile, minimum, maximum, range, mean absolute deviation, interquartile range, kurtosis, skewness, root mean squared, variance and inhomogeneity) of the lesions were measured using the whole solid tumor volume region of interest (ROI). In other sessions, five ROIs were manually drawn on the tumor slices, and mean ADC and minimum ADC of the measurements were calculated. Diagnostic accuracies of the two methods were assessed and compared. RESULTS Mean, median, minimum, 10th percentile, 90th percentile, range, root mean squared and inhomogeneity of ADC histogram analysis, and mean ADC and minimum ADC of single-slice ADC measurement were significantly different between malignant and benign lesions (p < 0.001 - p = 0.002). Among the ADC histogram parameters, 10th percentile had the highest diagnostic performance (AUC = 0.825) followed by mean (AUC = 0.792) and median (AUC = 0.789). For the single-slice ADC measurement, the AUC of mean ADC and minimum ADC were 0.842 and 0.786, respectively. Mean ADC of single-slice measurement had a similar diagnostic performance with the 10th percentile, mean, and median of ADC histogram analysis (p = 0.070-1.000). CONCLUSIONS Both whole-lesion ADC histogram analysis and single-slice ADC measurement can differentiate benign and malignant soft tissue tumors with similar diagnostic performances.
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Affiliation(s)
- Mesut Ozturk
- Radiology Clinic, Samsun Gazi State Hospital, Samsun, Turkey; Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey.
| | - Ahmet Veysel Polat
- Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey
| | - Mustafa Bekir Selcuk
- Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey
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10
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Chen K, She HL, Wu T, Hu F, Li T, Luo LP. Comparison of percentage changes in quantitative diffusion parameters for assessing pathological complete response to neoadjuvant therapy in locally advanced rectal cancer: a meta-analysis. Abdom Radiol (NY) 2021; 46:894-908. [PMID: 32975646 DOI: 10.1007/s00261-020-02770-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 02/01/2023]
Abstract
PURPOSE To evaluate and compare the diagnostic performance of percentage changes in apparent diffusion coefficient (∆ADC%) and slow diffusion coefficient (∆D%) for assessing pathological complete response (pCR) to neoadjuvant therapy in patients with locally advanced rectal cancer (LARC). METHODS A systematic search in PubMed, EMBASE, the Web of Science, and the Cochrane Library was performed to retrieve related original studies. For each parameter (∆ADC% and ∆D%), we pooled the sensitivity, specificity and calculated the area under summary receiver operating characteristic curve (AUROC) values. Meta-regression and subgroup analyses were performed to explore heterogeneity among the studies on ∆ADC%. RESULTS 15 original studies (804 patients with 805 lesions, 15 studies on ∆ADC%, 4 of the studies both on ∆ADC% and ∆D%) were included. pCR was observed in 213 lesions (26.46%). For the assessment of pCR, the pooled sensitivity, specificity and AUROC of ∆ADC% were 0.83 (95% confidence intervals [CI] 0.76, 0.89), 0.74 (95% CI 0.66, 0.81), 0.87 (95% CI 0.83, 0.89), and ∆D% were 0.70 (95% CI 0.52, 0.84), 0.81 (95% CI 0.65, 0.90), 0.81 (95% CI 0.77, 0.84), respectively. In the four studies on the both metrics, ∆ADC% yielded an equivalent diagnostic performance (AUROC 0.80 [95% CI 0.76, 0.83]) to ∆D%, but lower than in the studies (n = 11) only on ∆ADC% (AUROC 0.88 [95% CI 0.85, 0.91]). Meta-regression and subgroup analyses showed no significant factors affecting heterogeneity. CONCLUSIONS Our meta-analysis confirms that ∆ADC% could reliably evaluate pCR in patients with LARC after neoadjuvant therapy. ∆D% may not be superior to ∆ADC%, which deserves further investigation.
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Affiliation(s)
- Kai Chen
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, 613 Huangpu Street, Guangzhou, 510630, China
- Department of Radiology, Affiliated Hospital of Xiangnan University (Clinical College), 25 Renmin West Road, Chenzhou, 423000, China
| | - Hua-Long She
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, 613 Huangpu Street, Guangzhou, 510630, China
- Department of Radiology, Affiliated Hospital of Xiangnan University (Clinical College), 25 Renmin West Road, Chenzhou, 423000, China
| | - Tao Wu
- Department of Radiology, Affiliated Hospital of Xiangnan University (Clinical College), 25 Renmin West Road, Chenzhou, 423000, China
| | - Fang Hu
- College of Medical Imaging and Medical Examination, Xiangnan University, 25 Renmin West Road, Chenzhou, 423000, China
| | - Tao Li
- College of Medical Imaging and Medical Examination, Xiangnan University, 25 Renmin West Road, Chenzhou, 423000, China.
| | - Liang-Ping Luo
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, 613 Huangpu Street, Guangzhou, 510630, China.
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11
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Kul S, Metin Y, Bekircavusoglu S, Kul M. Qualitative characterization of breast tumors with diffusion-weighted imaging has comparable accuracy to quantitative analysis. Clin Imaging 2021; 77:17-24. [PMID: 33639496 DOI: 10.1016/j.clinimag.2021.02.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/22/2021] [Accepted: 02/10/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the applicability and accuracy of a new qualitative diffusion-weighted imaging (DWI) assessment method in the characterization of breast tumors compared to quantitative ADC measurement and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). MATERIALS AND METHODS After review board approval, MRIs of 216 consecutive women with final diagnoses (131 malignant, 85 benign) were retrospectively analyzed. Two radiologists independently scored DWI and dynamic contrast-enhanced MRI (DCE-MRI) according to malignancy probability. Qualitative assessments were performed by combined analysis of tumor morphology and diffusion signal. Quantitative data was obtained from apparent diffusion coefficient (ADC) measurements. Lastly, descriptive DWI features were evaluated and recorded. Cohen's kappa, receiver operating characteristic and multivariate analyzes were applied. RESULTS Of malignant tumors, 97% were visible on DWI. Qualitative and quantitative DWI assessments provided comparable sensitivities of 89-94% and 88-92% and specificities of 51-61% and 59-67%, respectively. There was no statistical difference between the accuracies of qualitative and quantitative DWI (p ≥ 0.105). Best diagnostic values were obtained with DCE-MRI (sensitivity, 99-100%; specificity, 69-71%). Inter-reader agreement was moderate (kappa = 0.597) for qualitative DWI and substantial (kappa = 0.689) for DCE-MRI (p < 0.001). Agreement between qualitative DWI and DCE-MRI scores was moderate (kappa = 0.536 and 0.442). Visual diffusion signal, mass margin and shape were the most predictive features of malignancy on multivariate analysis of qualitative assessment. CONCLUSION Qualitative characterization of breast tumors on DWI has comparable accuracy to quantitative ADC analysis. This method might be used to make DWI more widely available with eliminating the need to a predetermined ADC threshold in tumor characterization. However, lower accuracy and inter-reader agreement of it compared to DCE-MRI should be considered.
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12
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Malattia C, Tolend M, Mazzoni M, Panwar J, Zlotnik M, Otobo T, Vidarsson L, Doria AS. Current status of MR imaging of juvenile idiopathic arthritis. Best Pract Res Clin Rheumatol 2020; 34:101629. [PMID: 33281052 DOI: 10.1016/j.berh.2020.101629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common chronic arthropathy in the pediatric population. Although the diagnosis is essentially clinical for many affected joints, MR imaging has become an important tool for the assessment of joints that are difficult to evaluate clinically, such as temporomandibular and sacroiliac joints, and for screening of inflammatory changes in the entire body by whole body MRI (WBMRI) assessment. The utilization of MR imaging is challenging in the pediatric population given the need for discrimination between pathological and physiological changes in the growing skeleton. Several multicentric multidisciplinary organizations have made major efforts over the past decades to standardize, quantify, and validate scoring systems to measure joint changes both cross-sectionally and longitudinally according to rigorous methodological standards. In this paper, we (1) discuss current trends for the diagnosis and management of JIA, (2) review challenges for detecting real pathological changes in growing joints, (3) summarize the current status of standardization of MRI protocols for data acquisition and the quantification of joint pathology in JIA by means of scoring systems, and (4) outline novel MR imaging techniques for the evaluation of anatomy and function of joints in JIA. Optimizing the role of MRI as a robust biomarker and outcome measure remains a priority of future research in this field.
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Affiliation(s)
- Clara Malattia
- Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Italy
| | - Mirkamal Tolend
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Marta Mazzoni
- Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Italy
| | - Jyoti Panwar
- Department of Radiology, Christian Medical College, Vellore, India
| | - Margalit Zlotnik
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Tarimobo Otobo
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Logi Vidarsson
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Andrea S Doria
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
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13
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Perl RM, Gronbach F, Fritz J, Horger MS, Hepp T. Longitudinal monitoring of apparent diffusion coefficient (ADC) in myeloma patients with lower M-gradient levels undergoing systemic treatment and whole-body MRI monitoring. Eur J Radiol 2020; 132:109306. [PMID: 33038578 DOI: 10.1016/j.ejrad.2020.109306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/19/2020] [Accepted: 09/20/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Longitudinal assessment of changes in apparent diffusion coefficient (ADC)-values in multiple myeloma (MM) patients and their potential role for classifying disease activity. METHODS Retrospective analysis of whole-body-MRI data in 73 stage III MM patients undergoing systemic treatment. Bone marrow involvement was evaluated using a standardized unenhanced 4-sequences whole-body-MRI protocol. We measured ADC-values in focal lesions (FL) and diffusely involved bone marrow (DIBM) areas. Response to treatment was based on the course of hematologic parameters. The time points of MRI-examinations were baseline, 1st (mean, 3 months), 2nd (mean, 10 months), and 3rd (mean, 18 months) follow up (FU). RESULTS Mean IgG and IgA serum values at baseline were 2.1 mg/dl and 1.8 mg/dl, respectively. Patients were classified into responders (n = 59) and non-responders (n = 34). Some patients were re-enrolled for new treatment regimens as they became therapy-refractory. Patterns of medullary involvement were focal (n = 44), diffuse (n = 61) and mixed (n = 30). In FL, a subgroup of myeloma patients undergoing short-term 1st FU experienced a significant increase in ADC in responders (p = 0.001), but not in non-responders (p = 0.9). In the further course of the study, ADC levels decreased continuously in responders (p = 0.02) and increased slightly in non-responders (p = 0.8). In patients with DIBM, ADC values decreased in the responders (p < 0.001) and in the non-responders (p = 0.78). An ADC cut-off value of 0.5-0.6 × 10-3 mm2/s for diagnosing inactive disease at follow-up proved unreliable. CONCLUSIONS In myeloma-patients with lower tumor burden, the longitudinal course of ADC-values is predictable only for FL whereas for DIBM ADC-changes considerably overlap between responders and non-responders and are not indicative for assessment of the disease activity.
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Affiliation(s)
- Regine Mariette Perl
- Department of Diagnostic and Interventional Radiology University-Hospital of Tuebingen, Germany.
| | - Felix Gronbach
- Department of Diagnostic and Interventional Radiology University-Hospital of Tuebingen, Germany
| | - Jan Fritz
- New York University Langone HealthGrossman School of Medicine, Department of Radiology, New York, USA
| | - Marius Stefan Horger
- Department of Diagnostic and Interventional Radiology University-Hospital of Tuebingen, Germany
| | - Tobias Hepp
- Department of Diagnostic and Interventional Radiology University-Hospital of Tuebingen, Germany; Max Planck Institute for Intelligent Systems, Tuebingen, Germany
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14
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Donners R, Obmann MM, Boll D, Gutzeit A, Harder D. Dixon or DWI - Comparing the utility of fat fraction and apparent diffusion coefficient to distinguish between malignant and acute osteoporotic vertebral fractures. Eur J Radiol 2020; 132:109342. [PMID: 33068837 DOI: 10.1016/j.ejrad.2020.109342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/16/2020] [Revised: 09/02/2020] [Accepted: 10/05/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE To compare fat fraction (FF) and apparent diffusion coefficient (ADC) as discriminators distinguishing malignant from acute/subacute osteoporotic vertebral fractures. METHOD 1.5 T MRIs of 42 malignant and 27 acute/subacute osteoporotic vertebral fractures (38 patients) were retrospectively reviewed. Two readers independently classified fractures as malignant or osteoporotic based on conventional imaging morphology. Diagnostic reader confidence was rated as confident or not confident. FF was derived from axial T1 gradient-echo 2-point Dixon MRI. ADC maps were calculated from axial b50 and b900 images. Both readers independently performed ROI measurements of mean FF and ADC of the same fractured vertebrae. FF and ADC values, corresponding ROC curves and optimized cut-off value performance were compared. Inter-reader agreement was analysed by calculation of intraclass correlation coefficients (ICCs). A p-value < 0.05 was deemed significant. RESULTS Mean FF and ADC were significantly lower in malignant (9.5 % and 1.05 × 10-3 mm²/s) compared to osteoporotic fractures (32 % and 1.34 × 10-3 mm²/s, all p < 0.001). The optimal cut-off FF was 11.5 %, detecting malignant fractures with 86 %/89 % sensitivity/specificity. The optimal ADC cut-off of 1.04 × 10-3 mm/s² yielded 62 %/96 % sensitivity/specificity. FF AUC (0.93) was significantly larger than ADC AUC (0.82, p = 0.03). In the subgroup of nine cases reported with low expert reader confidence, the optimized cut-off specificities of FF (83 %) and ADC (83 %) exceeded reader specificity (50 %). There was excellent inter-reader agreement for mean FF (ICC = 0.99) and good agreement for mean ADC (ICC = 0.86) measurements. CONCLUSION FF and ADC can improve reader specificity to distinguish between malignant and acute or subacute osteoporotic vertebral fractures. As single discriminator, FF was superior to ADC.
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Affiliation(s)
- Ricardo Donners
- Department of Radiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
| | - Markus M Obmann
- Department of Radiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
| | - Daniel Boll
- Department of Radiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
| | - Andreas Gutzeit
- Institute of Radiology and Nuclear Medicine and Breast Center St. Anna, Hirslanden Klinik St. Anna, St. Anna-Strasse 32, 6006, Lucerne, Switzerland; Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zurich, Vladimir-Prelog-Weg 1-5 / 10, 8093, Zurich, Switzerland; Department of Radiology, Paracelsus Medical University, Salzburg, Austria.
| | - Dorothee Harder
- Department of Radiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
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15
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Attenberger UI, Tavakoli A, Stocker D, Stieb S, Riesterer O, Turina M, Schoenberg SO, Pilz L, Reiner CS. Reduced and standard field-of-view diffusion weighted imaging in patients with rectal cancer at 3 T-Comparison of image quality and apparent diffusion coefficient measurements. Eur J Radiol 2020; 131:109257. [PMID: 32947092 DOI: 10.1016/j.ejrad.2020.109257] [Citation(s) in RCA: 4] [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: 03/17/2020] [Revised: 06/30/2020] [Accepted: 08/24/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE To compare a zoomed EPI-DWI (z-EPI) with a standard EPI-DWI (s-EPI) in the primary diagnostics of rectal cancer and assess its potential of reduced image artifacts. METHOD 22 therapy-naïve patients with rectal cancer underwent rectal MRI at a 3 T-system. The protocols consisted of a z-EPI DWI and s-EPI DWI sequence. Images were assessed by two independent and experienced readers regarding overall image quality and artifacts on a 5-point Likert scale, as well as overall sequence preference. In a lesion-based analysis, tumor and lymph node detection were rated on a 4-point Likert scale. Apparent diffusion coefficient (ADC) measurements were performed. RESULTS Overall Image quality score for z-EPI and s-EPI showed no statistically significant differences (p = 0.80/0.54, reader 1/2) with a median score of 4 ("good" image quality) for both sequences. The image quality preference rank for z-EPI and s-EPI was given the category 'no preference' in 64 % (reader 1) and 50 % (reader 2). Most artifact-related scores (susceptibility, motion and distortion) did not show reproducible significant differences between z-EPI and s-EPI. The two sequences exhibited comparable, mostly good and excellent quality scores for tumor and lymph node detection (p = 0.19-0.99). ADC values were significantly lower for z-EPI than for s-EPI (p = 0.001/0.002, reader 1/2) with good agreement of ADC measurements between both readers. CONCLUSION Our data showed comparable image quality and lesion detection for the z-EPI and the s-EPI sequence in MRI of rectal cancer, whereas the mean ADC of the tumor was significantly lower in z-EPI compared to s-EPI.
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Affiliation(s)
- U I Attenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany.
| | - A Tavakoli
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Germany.
| | - D Stocker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
| | - S Stieb
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland
| | - O Riesterer
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland.
| | - M Turina
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
| | - S O Schoenberg
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany.
| | - L Pilz
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - C S Reiner
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
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16
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Viher PV, Abdulkadir A, Savadijev P, Stegmayer K, Kubicki M, Makris N, Karmacharya S, Federspiel A, Bohlhalter S, Vanbellingen T, Müri R, Wiest R, Strik W, Walther S. Structural organization of the praxis network predicts gesture production: Evidence from healthy subjects and patients with schizophrenia. Cortex 2020; 132:322-333. [PMID: 33011518 DOI: 10.1016/j.cortex.2020.05.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 09/13/2019] [Revised: 04/11/2020] [Accepted: 05/19/2020] [Indexed: 01/09/2023]
Abstract
Hand gestures are an integral part of social interactions and communication. Several imaging studies in healthy subjects and lesion studies in patients with apraxia suggest the praxis network for gesture production, involving mainly left inferior frontal, posterior parietal and temporal regions. However, little is known about the structural connectivity underlying gesture production. We recruited 41 healthy participants and 39 patients with schizophrenia. All participants performed a gesture production test, the Test of Upper Limb Apraxia, and underwent diffusion tensor imaging. We hypothesized that gesture production is associated with structural network connectivity as well as with tract integrity. We defined the praxis network as an undirected graph comprised of 13 bilateral regions of interest and derived measures of local and global structural connectivity and tract integrity from Finsler geometry. We found an association of gesture deficit with reduced global and local efficiency of the praxis network. Furthermore, reduced tract integrity, for example in the superior longitudinal fascicle, arcuate fascicle or corpus callosum were related to gesture deficits. Our findings contribute to the understanding of structural correlates of gesture production as they first present diffusion tensor imaging data in a combined sample of healthy subjects and a patient cohort with gestural deficits.
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Affiliation(s)
- Petra V Viher
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
| | - Ahmed Abdulkadir
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Peter Savadijev
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Diagnostic Radiology, McGill University, Montreal, Canada
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Nikos Makris
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Departments of Psychiatry, Neurology and Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Sarina Karmacharya
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stephan Bohlhalter
- Department of Clinical Research, University Hospital, Inselspital, Bern, Switzerland; Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Tim Vanbellingen
- Department of Clinical Research, University Hospital, Inselspital, Bern, Switzerland; Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland; Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
| | - René Müri
- Department of Clinical Research, University Hospital, Inselspital, Bern, Switzerland; Department of Neurology, University Hospital Inselspital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging, Institute of Neuroradiology, University of Bern, Bern, Switzerland
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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17
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Fliedner FP, Engel TB, El-Ali HH, Hansen AE, Kjaer A. Diffusion weighted magnetic resonance imaging (DW-MRI) as a non-invasive, tissue cellularity marker to monitor cancer treatment response. BMC Cancer 2020; 20:134. [PMID: 32075610 PMCID: PMC7031987 DOI: 10.1186/s12885-020-6617-x] [Citation(s) in RCA: 21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 02/11/2020] [Indexed: 01/21/2023] Open
Abstract
Background Diffusion weighted magnetic resonance imaging (DW-MRI) holds great potential for monitoring treatment response in cancer patients shortly after initiation of radiotherapy. It is hypothesized that a decrease in cellular density of irradiated cancerous tissue will lead to an increase in quantitative apparent diffusion coefficient (ADC) values. DW-MRI can therefore serve as a non-invasive marker of cell death and apoptosis in response to treatment. In the present study, we aimed to investigate the applicability of DW-MRI in preclinical models to monitor radiation-induced treatment response. In addition, we compared DW-MRI with ex vivo measures of cell density, cell death and apoptosis. Methods DW-MRI was tested in two different syngeneic mouse models, a colorectal cancer (CT26) and a breast cancer (4 T1). ADC values were compared with quantitative determinations of apoptosis and cell death by flow cytometry. Furthermore, ADC-values were also compared to histological measurement of cell density on tumor sections. Results We found a significant correlation between ADC-values and apoptotic state in the CT26 model (P = 0.0031). A strong correlation between the two measurements of ADC-value and apoptotic state was found in both models, which were also present when comparing ADC-values to cell densities. Conclusions Our findings demonstrate that DW-MRI can be used for non-invasive monitoring of radiation-induced changes in cell state during cancer therapy. ADC values reflect ex vivo cell density and correlates well with apoptotic state, and can hereby be described as a marker for the cell state after therapy and used as a non-invasive response marker.
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Affiliation(s)
- Frederikke Petrine Fliedner
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.,Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Trine Bjørnbo Engel
- Colloids and Biological Interface Group, Department of Micro- and Nanotechnology, Technical University of Denmark, Lyngby, Denmark
| | - Henrik H El-Ali
- Section of Cellular and Metabolic Research, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anders Elias Hansen
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.,Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.,Colloids and Biological Interface Group, Department of Micro- and Nanotechnology, Technical University of Denmark, Lyngby, Denmark
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark. .,Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
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18
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Sharma SD, Hall A, Bartley AC, Bassett P, Singh A, Lingam RK. Surgical mapping of middle ear cholesteatoma with fusion of computed tomography and diffusion-weighted magnetic resonance images: Diagnostic performance and interobserver agreement. Int J Pediatr Otorhinolaryngol 2020; 129:109788. [PMID: 31775116 DOI: 10.1016/j.ijporl.2019.109788] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/16/2019] [Accepted: 11/16/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the diagnostic performance in detecting primary cholesteatoma at various anatomical subsites using Computed Tomography (CT), Diffusion-weighted Magnetic Resonance Imaging (DWMRI) and Fusion of CT and DWMRI (Fusion CT-MRI) images. STUDY DESIGN A retrospective study of 22 children identified from a prospective database of surgically treated cholesteatoma cases over a five year period. All cases underwent pre-operative CT, non-echo planar DWMRI and Fusion CT-DWMRI, and with clearly documented surgical findings. For each imaging modality, two radiologists scored for the presence or absence of cholesteatoma with confidence levels at different anatomical subsites. The radiologists were blinded to the surgical findings to which their findings were compared. SETTING Large Teaching Hospital in London. PATIENTS 22 children with cholesteatoma confirmed surgically. INTERVENTION CT, DWMRI imaging and fusion CT-MRI. MAIN OUTCOME MEASURE Diagnostic performance of subsite localisation of cholesteatoma by CT, DWMRI and fusion CT-MRI imaging with intra-operative findings. RESULTS Twenty-two patients were included (12 women and 10 men). The median age of patients was 11 years. When considering all subsites combined, the result for all imaging methods suggested 'good' agreement between both observers. When all subsites were examined together, all methods had relatively high sensitivity values (87% for CT vs 84% for DWMRI vs 85% for fusion CT-DWMRI). Specificity was highest with fusion CT-DWMRI (46% for CT vs 76% for DWMRI vs 97% for fusion CT-DWMRI), as was accuracy (66% for CT vs 80% for DWMRI vs 91% for fusion). CONCLUSIONS Our study has demonstrated that fusion CT-DWMRI is superior to DWMRI or CT separately in localizing cholesteatoma at various middle ear cleft subsites and bony relations, making it a valuable tool for surgical planning.
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Affiliation(s)
- Sunil Dutt Sharma
- Department of Radiology & Otolaryngology, Northwick Park Hospital, Watford Road, Harrow, HA1 3UJ, London, United Kingdom.
| | - Andrew Hall
- Department of Radiology & Otolaryngology, Northwick Park Hospital, Watford Road, Harrow, HA1 3UJ, London, United Kingdom.
| | - Anthony C Bartley
- Department of Radiology & Otolaryngology, Northwick Park Hospital, Watford Road, Harrow, HA1 3UJ, London, United Kingdom.
| | - Paul Bassett
- Department of Radiology & Otolaryngology, Northwick Park Hospital, Watford Road, Harrow, HA1 3UJ, London, United Kingdom.
| | - Arvind Singh
- Department of Radiology & Otolaryngology, Northwick Park Hospital, Watford Road, Harrow, HA1 3UJ, London, United Kingdom.
| | - Ravi K Lingam
- Department of Radiology & Otolaryngology, Northwick Park Hospital, Watford Road, Harrow, HA1 3UJ, London, United Kingdom.
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Mahmood F, Hjorth Johannesen H, Geertsen P, Hansen RH. Diffusion MRI outlined viable tumour volume beats GTV in intra-treatment stratification of outcome. Radiother Oncol 2019; 144:121-126. [PMID: 31805516 DOI: 10.1016/j.radonc.2019.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 05/21/2019] [Revised: 11/09/2019] [Accepted: 11/12/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE In radiotherapy, treatment response is generally evaluated many weeks after end of the treatment course. If the treatment outcome could be predicted during radiotherapy better tumour control could be achieved through timely adaptation of the treatment strategy. In this study intra-treatment change based on the diffusion MRI outlined viable tumour volume (VTV) was assessed and compared to the standard GTV to study their outcome prediction capacity. MATERIALS AND METHODS Thirty-eight brain metastases from twenty-one cancer patients were analysed in this prospective trial. Diffusion and structural MRI was acquired on a 1 T machine before, during, and at follow-up 2-3 months after radiotherapy. The VTV was defined as a region with high cellularity using high b-value diffusion MRI scans. Further, the diffusivity of the VTV was derived as the apparent diffusion coefficient (ADC). Treatment outcome was determined using RECIST defined bounds in the T1W MRI follow-up scan. Longitudinal statistical analysis was performed using a linear mixed effect model. RESULTS The GTV declined in both responding and non-responding (significantly) tumours with inseparable rates during radiotherapy. The VTV volume fraction reduced significantly in the responding tumours only. The ADC of the VTV increased significantly in responding metastases whereas it decreased in non-responding metastases. Furthermore, no association between baseline tumour size or primary disease and outcome was observed. CONCLUSION GTV size change during radiotherapy is not a reliable predictor of outcome in brain metastases. On the other hand, change in the volume fraction of VTV and diffusivity of VTV shows ability to stratify treatment outcome.
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Affiliation(s)
- Faisal Mahmood
- Laboratory of Radiation Physics, Department of Oncology, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Odense C, Denmark; Section of Radiotherapy, Department of Oncology, Herlev Hospital, Denmark.
| | | | - Poul Geertsen
- Section of Radiotherapy, Department of Oncology, Herlev Hospital, Denmark.
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20
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Roknsharifi S, Fishman MDC, Agarwal MD, Brook A, Kharbanda V, Dialani V. The role of diffusion weighted imaging as supplement to dynamic contrast enhanced breast MRI: Can it help predict malignancy, histologic grade and recurrence? Acad Radiol 2019; 26:923-929. [PMID: 30293819 DOI: 10.1016/j.acra.2018.09.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 08/05/2018] [Revised: 08/29/2018] [Accepted: 09/06/2018] [Indexed: 12/18/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate the value of adding Diffusion Weighted Imaging (DWI) with Apparent Diffusion Coefficient (ADC) mapping to dynamic contrast enhanced (DCE-MRI) to distinguish benign from malignant pathology subtypes and tumor recurrence. METHOD AND MATERIALS In this retrospective IRB approved study, 956 consecutive patients underwent bilateral breast MRI between 1/2015 and 12/2015, with 156 BIRADS 4, 5, or 6 lesions detected in 111 patients. DWI imaging at B0, B100, B600, B1000 was performed with DCE-MRI. Values for diffusion and ADC images were recorded by two fellowship-trained breast radiologists. Mean ADC and signal intensity (SI) values were correlated with histology, tumor grade, hormone receptors (ER, PR, and HER-2)and Oncotype DX scores, when available. p ≤ 0.05 was considered significant. RESULTS Of 156 lesions, there were 59 (38%) benign lesions, 24 (15%) Ductal Carcinoma In-Situ, 47 (30%) Invasive Ductal Carcinoma (IDC), 15 (10%) Invasive Lobular Carcinoma (ILC) and 2 (2%) Mucinous carcinoma (MC), five (5%) mixed IDC and ILC, and four (4%) other, including tubular and rare types of malignancy. Mean ADC values for malignancy were significantly lower than for benign lesions (1085 ± 343 × 10-6 vs 1481 ± 276 × 10-6 mm2/s), which is highly predictive (area under curve = 0.82). In addition, tumors with PR negativity and Oncotype score ≥18 (intermediate to high risk for recurrence) demonstrated significantly lower ADC values. SI at B100 and B600 was helpful in distinguishing benign versus IDC. There was no significant correlation between ADC values and tumor grade or ER/HER2 status. CONCLUSION ADC value is important factor in distinguishing malignancy, differentiating tumors with higher Oncotype score, and PR negativity. Therefore, it can be used as an important tool to assist appropriate treatment selection.
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MESH Headings
- Adenocarcinoma, Mucinous/diagnostic imaging
- Adenocarcinoma, Mucinous/pathology
- Adult
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Lobular/diagnostic imaging
- Carcinoma, Lobular/pathology
- Contrast Media
- Diffusion Magnetic Resonance Imaging/methods
- Female
- Humans
- Magnetic Resonance Imaging/methods
- Middle Aged
- Neoplasm Grading
- Neoplasm Recurrence, Local/diagnostic imaging
- Neoplasms, Complex and Mixed/diagnostic imaging
- Neoplasms, Complex and Mixed/pathology
- Predictive Value of Tests
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Retrospective Studies
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Affiliation(s)
- Shima Roknsharifi
- Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Ave, Shapiro 4, Breast Imaging, Boston, MA 02215
| | - Michael D C Fishman
- Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Ave, Shapiro 4, Breast Imaging, Boston, MA 02215
| | - Monica D Agarwal
- Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Ave, Shapiro 4, Breast Imaging, Boston, MA 02215
| | - Alexander Brook
- Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Ave, Shapiro 4, Breast Imaging, Boston, MA 02215
| | - Vritti Kharbanda
- Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Ave, Shapiro 4, Breast Imaging, Boston, MA 02215
| | - Vandana Dialani
- Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Ave, Shapiro 4, Breast Imaging, Boston, MA 02215
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21
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Santamaría G, Bargalló X, Ganau S, Alonso I, Muñoz M, Mollà M, Fernández PL, Prat A. Multiparametric MR imaging to assess response following neoadjuvant systemic treatment in various breast cancer subtypes: Comparison between different definitions of pathologic complete response. Eur J Radiol 2019; 117:132-139. [PMID: 31307638 DOI: 10.1016/j.ejrad.2019.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 05/10/2019] [Accepted: 06/11/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To validate the performance of multiparametric magnetic resonance (MR) imaging to assess pathologic response to neoadjuvant systemic therapy (NST) in various breast cancer subtypes considering two definitions of pCR: absence of any residual invasive cancer or DCIS (ypT0) and absence of invasive tumour cells (ypT0/is). METHODS Institutional review board-approved retrospective study, with waiver of the need to obtain informed consent. From January 2015 to June 2017, 81 women with 82 breast cancers undergoing NST were included. Eighteen lesions (22%) were immunohistochemically HER2-positive, 12 (15%) triple negative (TN), 42 (51%) luminal B-like and 10 (12%) luminal B-like/HER2-positive. Breast MR imaging was performed before and after NST. A comparative analysis considering pCR as ypT0 and ypT0/is was carried out. Performance of univariate and multivariate models to potentially predict pathologic response were evaluated. RESULTS ypT0 was attained in 23% (19/82) of cases and ypT0/is in 33% (27/82) of cases. In both scenarios, HER2-positive subtype achieved the best response, 53% and 48%, respectively. A significant relationship was found between late enhancement and pathologic response (p < 0.001) regardless of pCR definition. In the ypT0 scenario, mean ADC ratio in the pCR subgroup was significantly higher than that in the non-pCR subgroup (p = 0.021) but no significant relationship was noted in ypT0/is. A multivariate model including MR late enhancement, ADC ratio and tumor subtype identified pathologic response with 86% and 84% accuracy when ypT0 and ypT0/is were considered, respectively. CONCLUSION MR imaging late enhancement and ADC ratio along with breast cancer IHC subtype identify pathologic response following NST with high accuracy, achieving the highest NPV in TN and HER2-positive tumors and the highest PPV in luminal B-like subtypes, regardless of the definition of pCR as ypT0 or ypT0/is. In light of these findings and given that residual DCIS does not have an impact on survival rates, ypT0/is seems to be the preferable definition of pCR.
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Affiliation(s)
- G Santamaría
- Department of Radiology, Institution of Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
| | - X Bargalló
- Department of Radiology, Institution of Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - S Ganau
- Department of Radiology, Institution of Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - I Alonso
- Department of Gynecology and Obstetrics, Institution of Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - M Muñoz
- Department of Medical Oncology, Institution of Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - M Mollà
- Department of Radiation Oncology, Institution of Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - P L Fernández
- Department of Pathology, Institution of Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - A Prat
- Department of Medical Oncology, Institution of Hospital Clinic de Barcelona, Villarroel 170, 08036, Barcelona, Spain
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Kohannim O, Huang JC, Hathout GM. Detection of subthreshold atrophy in crossed cerebellar degeneration via two-compartment mathematical modeling of cell density in DWI: A proof of concept study. Med Hypotheses 2018; 120:96-100. [PMID: 30220350 DOI: 10.1016/j.mehy.2018.08.025] [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: 06/26/2018] [Accepted: 08/28/2018] [Indexed: 11/26/2022]
Abstract
Crossed cerebellar diaschisis (CCD) refers to transneuronal degeneration of the corticopontocerebellar pathway, resulting in atrophy of cerebellum contralateral to supratentorial pathology. CCD is traditionally diagnosed on nuclear medicine studies. Our aim is to apply a biexponential diffusion model, composed of intracellular and extracellular compartments, to the detection of subthreshold CCD on DWI, with the calculated fraction of the intracellular compartment as a proposed measure of cell density. At a voxel-by-voxel basis, we solve for intracellular and extracellular coefficients in each side of the cerebellum and compare the distribution of coefficients between each hemisphere. We demonstrate, in all six CCD cases, a significantly lower contribution of the intracellular compartment to the cerebellar hemisphere contralateral to supratentorial pathology (p < 0.01). In a separate, proof-of-concept case of pontine stroke, we also demonstrate reduced intracellular coefficients in bilateral cerebellar hemispheres, excluding middle cerebellar peduncles (p < 0.01). Our findings are consistent with a decreased intracellular fraction, presumably a surrogate for reduced cellular density in corticopontocerebellar degeneration, despite normal-appearing scans. Our approach allows detection of subthreshold structural changes and offers the additional advantage of applicability to most clinical cases, where only three DWI beta values are available.
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Affiliation(s)
- Omid Kohannim
- Department of Radiology, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, United States.
| | - Jimmy C Huang
- Department of Radiology, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, United States; Department of Radiology, Department of Veteran Affairs, Los Angeles, CA 90073, United States; Department of Radiology, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States
| | - Gasser M Hathout
- Department of Radiology, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, United States; Department of Radiology, Department of Veteran Affairs, Los Angeles, CA 90073, United States; Department of Radiology, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States
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23
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Vandecasteele K, Tummers P, Van Bockstal M, De Visschere P, Vercauteren T, De Gersem W, Denys H, Naert E, Makar A, De Neve W. EXclusion of non-Involved uterus from the Target Volume (EXIT-trial): an individualized treatment for locally advanced cervical cancer using modern radiotherapy and imaging techniques. BMC Cancer 2018; 18:898. [PMID: 30223802 PMCID: PMC6142314 DOI: 10.1186/s12885-018-4800-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background Definitive chemoradiotherapy is standard of care in locally advanced cervical cancer (LACC). Both toxicity and local relapse remain major concerns in this treatment. We hypothesize that a magnetic resonance imaging (MRI) based redefining of the radiotherapeutic target volume will lead to a reduction of acute and late toxicity. In our center, chemoradiotherapy followed by hysterectomy was implemented successfully in the past. This enables us to assess the safety of reducing the target volume but also to explore the biological effects of chemoradiation on the resected hysterectomy specimen. Methods The EXIT-trial is a phase II, single arm study aimed at LACC patients. This study evaluates whether a MRI-based exclusion of the non-tumor-bearing parts of the uterus out of the target volume results in absence of tumor in the non-high doses irradiated part of the uterus in the hysterectomy specimen. Secondary endpoints include a dosimetric comparison of dose on normal tissue when comparing study treatment plans compared to treatment of the whole uterus at high doses; acute and chronic toxicity, overall survival, local relapse- and progression-free survival. In the translational part of the study, we will evaluate the hypothesis that the baseline apparent diffusion coefficient (ADC) values of diffusion weighted MRI and its evolution 2 weeks after start of CRT, for the whole tumor as well as for intra-tumoral regions, is prognostic for residual tumor on the hysterectomy specimen. Discussion Although MRI is already used to guide target delineation in brachytherapy, the EXIT-trial is the first to use this information to guide target delineation in external beam radiotherapy. Early therapy resistance prediction using DW-MRI opens a window for early treatment adaptation or further dose-escalation on tumors/intratumoral regions at risk for treatment failure. Trial registration Belgian Registration: B670201526181 (prospectively registered, 26/11/2015); ClinicalTrials.gov Identifier: NCT03542942 (retrospectively registered, 17/5/2018).
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Affiliation(s)
- Katrien Vandecasteele
- Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Philippe Tummers
- Gynaecologic Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Mieke Van Bockstal
- Pathology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.,Pathology, Erasmus Medical Center, s-Gravendijkwal 230, 3015, Rotterdam, The Netherlands
| | - Pieter De Visschere
- Radiology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Tom Vercauteren
- Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Werner De Gersem
- Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Hannelore Denys
- Medical Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Eline Naert
- Medical Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Amin Makar
- Gynaecologic Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Wilfried De Neve
- Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
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Peltenburg B, Driessen JP, Philippens MEP, Pameijer FA, Castelijns J, Dankbaar JW, Dorgelo B, Lange CAH, Meijer FJA, Palm WM, Roosendaal SD, Steens SCA, Verbist BM, Stegeman I, Janssen LM, de Bree R, Terhaard CHJ. The interobserver agreement in the detection of recurrent HNSCC using MRI including diffusion weighted MRI. Eur J Radiol 2018; 105:134-40. [PMID: 30017269 DOI: 10.1016/j.ejrad.2018.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 05/24/2018] [Accepted: 05/29/2018] [Indexed: 11/23/2022]
Abstract
INTRODUCTION For the detection of local recurrences of head and neck squamous cell carcinomas (HNSCC) after (chemo)radiation, diagnostic imaging is generally performed. Diffusion weighted magnetic resonance imaging (DW-MRI) has been proven to be able to adequately diagnose the presence of cancer. However evaluation of DW-MR images for recurrences is difficult and could be subject to individual interpretation. AIM To determine the interobserver agreement, intraobserver agreement and influence of experience of radiologists in the assessment of DW-MRI in patients clinically suspected of local recurrent HNSCC after (chemo)radiation. METHODS Ten experienced head and neck radiologists assessed follow-up MRI including DW-MRI series of 10 patients for the existence of local recurrence on a two point decision scale (local recurrence or local control). Patients were clinically suspected for a recurrence of laryngeal (n = 3), hypopharyngeal (n = 3) or oropharyngeal (n = 4) cancer after (chemo)radiation with curative intent. Fleiss' and Cohen's Kappa were used to determine interobserver agreement and intraobserver agreement, respectively. RESULTS Interobserver agreement was κ = 0.55. Intraobserver agreement was κ = 0.80. Prior experience within the field of radiology and with DW-MRI had no significant influence on the scoring. CONCLUSION For the assessment of HNSCC recurrence after (chemo)radiation by DW-MRI, moderate interobserver agreement and substantial intraobserver agreement was found.
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Gyebnár G, Szabó Á, Sirály E, Fodor Z, Sákovics A, Salacz P, Hidasi Z, Csibri É, Rudas G, Kozák LR, Csukly G. What can DTI tell about early cognitive impairment? - Differentiation between MCI subtypes and healthy controls by diffusion tensor imaging. Psychiatry Res Neuroimaging 2018; 272:46-57. [PMID: 29126669 DOI: 10.1016/j.pscychresns.2017.10.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 05/03/2017] [Revised: 10/17/2017] [Accepted: 10/21/2017] [Indexed: 01/10/2023]
Abstract
Mild cognitive impairment (MCI) gained a lot of interest recently, especially that the conversion rate to Alzheimer Disease (AD) in the amnestic subtype (aMCI) is higher than in the non-amnestic subtype (naMCI). We aimed to determine whether and how diffusion-weighted MRI (DWI) using the diffusion tensor model (DTI) can differentiate MCI subtypes from healthy subjects. High resolution 3D T1W and DWI images of patients (aMCI, n = 18; naMCI, n = 20; according to Petersen criteria) and controls (n = 27) were acquired at 3T and processed using ExploreDTI and SPM. Voxel-wise and region of interest (ROI) analyses of fractional anisotropy (FA) and mean diffusivity (MD) were performed with ANCOVA; MD was higher in aMCI compared to controls or naMCI in several grey and white matter (GM, WM) regions (especially in the temporal pole and the inferior temporal lobes), while FA was lower in WM ROI-s (e.g. left Cingulum). Moreover, significant correlations were identified between verbal fluency, visual and verbal memory performance and DTI metrics. Logistic regression showed that measuring FA of the crus of fornix along GM volumetry improves the discrimination of aMCI from naMCI. Additional information from DWI/DTI aids preclinical detection of AD and may help detecting early non-Alzheimer type dementia, too.
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Affiliation(s)
- Gyula Gyebnár
- Magnetic Resonance Research Centre, Semmelweis University, Budapest, Hungary.
| | - Ádám Szabó
- Magnetic Resonance Research Centre, Semmelweis University, Budapest, Hungary
| | - Enikő Sirály
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Fodor
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Anna Sákovics
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Pál Salacz
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; Department of Neurology, Péterfy Hospital and Trauma Centre, Budapest, Hungary
| | - Zoltán Hidasi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Éva Csibri
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Gábor Rudas
- Magnetic Resonance Research Centre, Semmelweis University, Budapest, Hungary
| | - Lajos R Kozák
- Magnetic Resonance Research Centre, Semmelweis University, Budapest, Hungary
| | - Gábor Csukly
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
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Chen BB, Tien YW, Chang MC, Cheng MF, Chang YT, Yang SH, Wu CH, Kuo TC, Shih IL, Yen RF, Shih TTF. Multiparametric PET/MR imaging biomarkers are associated with overall survival in patients with pancreatic cancer. Eur J Nucl Med Mol Imaging 2018; 45:1205-1217. [PMID: 29476229 DOI: 10.1007/s00259-018-3960-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/22/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE To correlate the overall survival (OS) with the imaging biomarkers of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), diffusion-weighted imaging (DWI), magnetic resonance spectroscopy, and glucose metabolic activity derived from integrated fluorine 18 fluorodeoxyglucose positron emission tomography (18F-FDG PET)/MRI in patients with pancreatic cancer. METHODS This prospective study was approved by the institutional review board and informed consent was obtained from all participants. Sixty-three consecutive patients (mean age, 62.7 ± 12 y; men/women, 40/23) with pancreatic cancer underwent PET/MRI before treatment. The imaging biomarkers were comprised of DCE-MRI parameters (peak, IAUC 60 , K trans , k ep , v e ), the minimum apparent diffusion coefficient (ADCmin), choline level, standardized uptake values, metabolic tumor volume, and total lesion glycolysis (TLG) of the tumors. The relationships between these imaging biomarkers with OS were evaluated with the Kaplan-Meier and Cox proportional hazard models. RESULTS Seventeen (27%) patients received curative surgery, with the median follow-up duration being 638 days. Univariate analysis showed that patients at a low TNM stage (≦3, P = 0.041), high peak (P = 0.006), high ADCmin (P = 0.002) and low TLG (P = 0.01) had better OS. Moreover, high TLG/peak ratio was associated with poor OS (P = 0.016). Multivariate analysis indicated that ADCmin (P = 0.011) and TLG/peak ratio (P = 0.006) were independent predictors of OS after adjustment for age, gender, tumor size, and TNM stage. The TLG/peak ratio was an independent predictor of OS in a subgroup of patients who did not receive curative surgery (P = 0.013). CONCLUSION The flow-metabolism mismatch reflected by the TLG/peak ratio may better predict OS than other imaging biomarkers from PET/MRI in pancreatic cancer patients.
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Affiliation(s)
- Bang-Bin Chen
- Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan
| | - Yu-Wen Tien
- Department of Surgery, National Taiwan University College of Medicine and Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan
| | - Ming-Chu Chang
- Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan
| | - Mei-Fang Cheng
- Department of Nuclear Medicine and Radiology, National Taiwan University College of Medicine and Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan
| | - Yu-Ting Chang
- Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan
| | - Shih-Hung Yang
- Department of Oncology, National Taiwan University College of Medicine and Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan
| | - Chih-Horng Wu
- Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan
| | - Ting-Chun Kuo
- Department of Surgery, National Taiwan University College of Medicine and Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan
| | - I-Lun Shih
- Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan
| | - Ruoh-Fang Yen
- Department of Nuclear Medicine and Radiology, National Taiwan University College of Medicine and Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan
| | - Tiffany Ting-Fang Shih
- Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, No 7, Chung-Shan South Rd, Taipei, 10016, Taiwan.
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Cho GY, Gennaro L, Sutton EJ, Zabor EC, Zhang Z, Giri D, Moy L, Sodickson DK, Morris EA, Sigmund EE, Thakur SB. Intravoxel incoherent motion (IVIM) histogram biomarkers for prediction of neoadjuvant treatment response in breast cancer patients. Eur J Radiol Open 2017; 4:101-107. [PMID: 28856177 PMCID: PMC5565789 DOI: 10.1016/j.ejro.2017.07.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 07/16/2017] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To examine the prognostic capabilities of intravoxel incoherent motion (IVIM) metrics and their ability to predict response to neoadjuvant treatment (NAT). Additionally, to observe changes in IVIM metrics between pre- and post-treatment MRI. METHODS This IRB-approved, HIPAA-compliant retrospective study observed 31 breast cancer patients (32 lesions). Patients underwent standard bilateral breast MRI along with diffusion-weighted imaging before and after NAT. Six patients underwent an additional IVIM-MRI scan 12-14 weeks after initial scan and 2 cycles of treatment. In addition to apparent diffusion coefficients (ADC) from monoexponential decay, IVIM mean values (tissue diffusivity Dt, perfusion fraction fp, and pseudodiffusivity Dp) and histogram metrics were derived using a biexponential model. An additional filter identified voxels of highly vascular tumor tissue (VTT), excluding necrotic or normal tissue. Clinical data include histology of biopsy and clinical response to treatment through RECIST assessment. Comparisons of treatment response were made using Wilcoxon rank-sum tests. RESULTS Average, kurtosis, and skewness of pseudodiffusion Dp significantly differentiated RECIST responders from nonresponders. ADC and Dt values generally increased (∼70%) and VTT% values generally decreased (∼20%) post-treatment. CONCLUSION Dp metrics showed prognostic capabilities; slow and heterogeneous pseudodiffusion offer poor prognosis. Baseline ADC/Dt parameters were not significant predictors of response. This work suggests that IVIM mean values and heterogeneity metrics may have prognostic value in the setting of breast cancer NAT.
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Affiliation(s)
- Gene Y Cho
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York School of Medicine, New York, NY, 10016, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), New York University Langone Medical Center, New York, NY, 10016, USA
| | - Lucas Gennaro
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Elizabeth J Sutton
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Emily C Zabor
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA
| | - Zhigang Zhang
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA
| | - Dilip Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Linda Moy
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York School of Medicine, New York, NY, 10016, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), New York University Langone Medical Center, New York, NY, 10016, USA
| | - Daniel K Sodickson
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York School of Medicine, New York, NY, 10016, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), New York University Langone Medical Center, New York, NY, 10016, USA
| | - Elizabeth A Morris
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Eric E Sigmund
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York School of Medicine, New York, NY, 10016, USA.,Center for Advanced Imaging Innovation and Research (CAI2R), New York University Langone Medical Center, New York, NY, 10016, USA
| | - Sunitha B Thakur
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.,Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
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Pecheva D, Yushkevich P, Batalle D, Hughes E, Aljabar P, Wurie J, Hajnal JV, Edwards AD, Alexander DC, Counsell SJ, Zhang H. A tract-specific approach to assessing white matter in preterm infants. Neuroimage 2017; 157:675-694. [PMID: 28457976 PMCID: PMC5607355 DOI: 10.1016/j.neuroimage.2017.04.057] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 03/03/2017] [Revised: 04/12/2017] [Accepted: 04/25/2017] [Indexed: 11/23/2022] Open
Abstract
Diffusion-weighted imaging (DWI) is becoming an increasingly important tool for studying brain development. DWI analyses relying on manually-drawn regions of interest and tractography using manually-placed waypoints are considered to provide the most accurate characterisation of the underlying brain structure. However, these methods are labour-intensive and become impractical for studies with large cohorts and numerous white matter (WM) tracts. Tract-specific analysis (TSA) is an alternative WM analysis method applicable to large-scale studies that offers potential benefits. TSA produces a skeleton representation of WM tracts and projects the group's diffusion data onto the skeleton for statistical analysis. In this work we evaluate the performance of TSA in analysing preterm infant data against results obtained from native space tractography and tract-based spatial statistics. We evaluate TSA's registration accuracy of WM tracts and assess the agreement between native space data and template space data projected onto WM skeletons, in 12 tracts across 48 preterm neonates. We show that TSA registration provides better WM tract alignment than a previous protocol optimised for neonatal spatial normalisation, and that TSA projects FA values that match well with values derived from native space tractography. We apply TSA for the first time to a preterm neonatal population to study the effects of age at scan on WM tracts around term equivalent age. We demonstrate the effects of age at scan on DTI metrics in commissural, projection and association fibres. We demonstrate the potential of TSA for WM analysis and its suitability for infant studies involving multiple tracts. Evaluation of tract-specific analysis (TSA) for white matter studies in infants. TSA improves white matter tract alignment over scalar-based registration. TSA closely approximates native space tractography DTI values. The first application of TSA to a neonatal population.
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Affiliation(s)
- Diliana Pecheva
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK; Department of Computer Science and Centre for Medical Image Computing, University College London, UK
| | - Paul Yushkevich
- Penn Image Computing and Science Laboratory (PISCL), Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Dafnis Batalle
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - Emer Hughes
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - Paul Aljabar
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - Julia Wurie
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - Joseph V Hajnal
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - A David Edwards
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK
| | - Daniel C Alexander
- Department of Computer Science and Centre for Medical Image Computing, University College London, UK
| | - Serena J Counsell
- Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, UK.
| | - Hui Zhang
- Department of Computer Science and Centre for Medical Image Computing, University College London, UK
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Monnot C, Zhang X, Nikkhou-Aski S, Damberg P, Svenningsson P. Asymmetric dopaminergic degeneration and levodopa alter functional corticostriatal connectivity bilaterally in experimental parkinsonism. Exp Neurol 2017; 292:11-20. [PMID: 28223037 PMCID: PMC5405850 DOI: 10.1016/j.expneurol.2017.02.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 10/17/2016] [Revised: 01/02/2017] [Accepted: 02/17/2017] [Indexed: 12/11/2022]
Abstract
Asymmetric dopamine loss is commonly found in early Parkinson's disease (PD), but its effects on functional networks have been difficult to delineate in PD patients because of variations in age, disease duration and therapy. Here we used unilateral 6-hydroxydopamine-lesioned (6-OHDA) rats and controls and treated them with a single intraperitoneal injection of levodopa (L-DOPA) before performing diffusion weighted MRI and resting state functional MRI (rs-fMRI). In accordance with a neurodegeneration of the nigrostriatal dopaminergic pathway, diffusion tensor imaging showed increased radial diffusivity and decreased fractional anisotropy in the lesioned substantia nigra. Likewise a deterministic connectometry approach showed increase of isotropic diffusion values in the medial forebrain bundle. rs-fMRI showed reduced interhemispheric functional connectivity (FC) between the intact and the 6-OHDA lesioned caudate-putamen. Unexpectedly, there was an increased FC between the 6-OHDA lesioned caudate-putamen and sensorimotor cortices of both hemispheres. L-DOPA reversed the FC changes between the dopamine denervated caudate-putamen and the sensorimotor cortices, but not the reduced interhemispheric FC between caudate-putamina. Similarly, L-DOPA induced c-fos expression in both sensorimotor cortices, but only in the dopamine-depleted caudate-putamen. Taken together, these data suggest that asymmetric degeneration of the nigrostriatal dopamine pathway results in functional asynchrony between the intact and 6-OHDA-lesioned caudate-putamen and increased interhemispheric synchrony between sensorimotor cortices. The results also indicate that the initial effect of L-DOPA is to restore functional corticostriatal connectivity rather than synchronize caudate-putamina. Rats unilaterally lesioned with 6-hydroxydopamine (6-OHDA) are examined using MRI. Diffusion MRI revealed loss of fractional anisotropy in a lesioned substantia nigra. rs-fMRI showed lower functional connectivity (FC) btw intact and lesioned striata. FC increased between the lesioned striatum and both sensorimotor cortices. Levodopa normalized FC between sensorimotor cortices and lesioned striatum.
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Affiliation(s)
- Cyril Monnot
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden.
| | - Xiaoqun Zhang
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden
| | - Sahar Nikkhou-Aski
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Karolinska Experimental Research and Imaging Center, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Peter Damberg
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Karolinska Experimental Research and Imaging Center, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Per Svenningsson
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden.
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Alzahrani M, Alhazmi R, Bélair M, Saliba I. Postoperative diffusion weighted MRI and preoperative CT scan fusion for residual cholesteatoma localization. Int J Pediatr Otorhinolaryngol 2016; 90:259-263. [PMID: 27729145 DOI: 10.1016/j.ijporl.2016.09.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 06/08/2016] [Revised: 08/17/2016] [Accepted: 09/25/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate the ability of preoperative mastoid high resolution Computerized tomography (CT Scan) fusion with the postoperative diffusion weighted magnetic resonance imaging (Non-EPI DWI) to accurately localize the residual cholesteatoma thus sparing an unnecessary postoperative CT scan radiation. PATIENTS AND METHODS this is a prospective study performed in our tertiary care center. We followed up prospectively a consecutive group of patients presenting with middle ear cholesteatoma using preoperative mastoid CT scans, postoperative mastoid CT scan and mastoid diffusion weighted MRI (DWI) between 2012 and 2013. Postoperative DWI were fused to both: the preoperative and postoperative mastoid CT scans. Fused images were evaluated for their ability to detect accurately the location of residual cholesteatoma if any. Results were correlated to the surgical findings. RESULTS Twenty-eight patients were included in this study. Ten patients showed middle ear opacity on the postoperative CT scans; the remaining negatively patients were excluded. DWI detected residual cholesteatoma in 3 out of the ten patients. Both CT scans; the pre and postoperative were able to precisely localize the residual cholesteatoma when fused to the postoperative DWI. Intra-operatively, three patients had a residual cholesteatoma that corresponded to the fused radiological images while a fourth patient presenting low signal intensity on the Non-EPI DWI had no cholesteatoma. CONCLUSION Diffusion weighted MRI/CT scan fusion combines the advantages of residual cholesteatoma detection and precise localization. Preoperative CT scans performed before the first surgery can be used for the fusion with the Non-EPI DWI in order to spare the patient an unnecessary another CT scan and thus decreasing radiation exposure.
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Affiliation(s)
- Musaed Alzahrani
- Department of Surgery, Division of Otolaryngology, King Fahad Specialist Hospital-Dammam, Saudi Arabia
| | - Rami Alhazmi
- Department of Medical Imaging, King Fahad Specialist Hospital-Dammam, Saudi Arabia
| | - Manon Bélair
- Department of Neuroradiology, Montreal University Hospital Center (CHUM), Quebec, Canada
| | - Issam Saliba
- Department of Surgery, Division of Otorhinolaryngology, Montreal University Hospital Center (CHUM), Quebec, Canada.
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Ahn JH, Yu JS, Cho ES, Chung JJ, Kim JH, Kim KW. Diffusion-Weighted MRI of Malignant versus Benign Portal Vein Thrombosis. Korean J Radiol 2016; 17:533-40. [PMID: 27390544 PMCID: PMC4936175 DOI: 10.3348/kjr.2016.17.4.533] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 09/22/2015] [Accepted: 04/19/2016] [Indexed: 12/20/2022] Open
Abstract
Objective To validate the diffusion-weighted MRI (DWI) for differentiation of benign from malignant portal vein thrombosis. Materials and Methods The Institutional Review Board approved this retrospective study and waived informed consent. A total of 59 consecutive patients (52 men and 7 women, aged 40–85 years) with grossly defined portal vein thrombus (PVT) on hepatic MRI were retrospectively analyzed. Among them, liver cirrhosis was found in 45 patients, and hepatocellular carcinoma in 47 patients. DWI was performed using b values of 50 and 800 sec/mm2 at 1.5-T unit. A thrombus was considered malignant if it enhanced on dynamic CT or MRI; otherwise, it was considered bland. There were 18 bland thrombi and 49 malignant thrombi in 59 patients, including 8 patients with simultaneous benign and malignant PVT. Mean apparent diffusion coefficients (ADCs) of benign and malignant PVTs were compared by using Mann-Whitney U test. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis. Results The mean ADC ± standard deviation of bland and malignant PVT were 1.00 ± 0.39 × 10-3 mm2/sec and 0.92 ± 0.25 × 10-3 mm2/sec, respectively; without significant difference (p = 0.799). The area under ROC curve for ADC was 0.520. An ADC value of > 1.35 × 10-3 mm2/sec predicted bland PVT with a specificity of 94.6% (95% confidence interval [CI]: 84.9–98.9%) and a sensitivity of 22.2% (95% CI: 6.4–47.6%), respectively. Conclusion Due to the wide range and considerable overlap of the ADCs, DWI cannot differentiate the benign from malignant thrombi efficiently.
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Affiliation(s)
- Jhii-Hyun Ahn
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Korea
| | - Jeong-Sik Yu
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Korea
| | - Eun-Suk Cho
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Korea
| | - Jae-Joon Chung
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Korea
| | - Joo Hee Kim
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Korea
| | - Ki Whang Kim
- Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Korea
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Grosu S, Schäfer AO, Baumann T, Manegold P, Langer M, Gerstmair A. Differentiating locally recurrent rectal cancer from scar tissue: Value of diffusion-weighted MRI. Eur J Radiol 2016; 85:1265-70. [PMID: 27235873 DOI: 10.1016/j.ejrad.2016.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 03/30/2016] [Accepted: 04/13/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine a cut-off apparent diffusion coefficient (ADC) value distinguishing local recurrence from scar tissue in patients with rectal cancer treated with complete surgical tumour removal. METHODS 72 patients were retrospectively included. Patients underwent 1.5T MRI including multiplanar T2-weighted turbo-spin-echo sequences (TSE) and axial single-shot epi-diffusion-weighted sequences (EPSE). Two independent observers measured mean tumour and scar tissue ADCs by manually drawing regions of interest (ROIs). The t-test and ROC analysis were used for comparison and determining an optimal discrimination threshold. As reference standard histopathological results were used in 23 patients (32%) and clinical follow-up in 49 patients (68%). RESULTS Recurrent rectal cancer was found in 30 patients (4 female, 26 male, median age 63.13 years) and treatment related changes such as scar tissue in 42 patients (11 female, 31 male, median age 63.67 years). The mean ADC value of tumour recurrence was 1.02×10(-3)mm(2)/s (0.63-1.44×10(-3)mm(2)/s) and of scar tissue 1.77×10(-3)mm(2)/s (1.11-2.41×10(-3)mm(2)/s) showing a statistically significant difference (p<0.001). The cut-off ADC value was 1.34×10(-3)mm(2)/s with a sensitivity, specificity, and accuracy of 93%, 91%, and 92% respectively. CONCLUSIONS Diffusion weighted MRI allows for the differentiation of tumour recurrence from scar tissue after surgical resection of rectal cancer.
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Nash R, Wong PY, Kalan A, Lingam RK, Singh A. Comparing diffusion weighted MRI in the detection of post-operative middle ear cholesteatoma in children and adults. Int J Pediatr Otorhinolaryngol 2015; 79:2281-5. [PMID: 26547234 DOI: 10.1016/j.ijporl.2015.10.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/17/2015] [Accepted: 10/21/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION There is a limited evidence base for the use of diffusion weighted MRI (DWMRI) in the assessment of post-operative cholesteatoma in children. This is important to address as this technique is particularly relevant in a paediatric setting. METHODS We searched a prospectively collected database of patients undergoing DWMRI for the assessment of residual and recurrent cholesteatoma. Imaging findings were correlated with findings at revision surgery. 320 investigations were divided into paediatric and adult groups (90 in children, 230 in adults) and compared. RESULTS Operative findings were available for 158 cases, of which 54 were children. The accuracy of DWMRI in children was 96.3%, and in adults was 88.5%. There were no statistically significant differences in the sensitivity, specificity, positive or negative predictive values between adults and children. DISCUSSION An increasing number of patients are not undergoing confirmatory surgery after negative DWMRI scans. False negative results are commonly secondary to small foci of disease; false positives have several possible causes. Performing MRI on children can be challenging, but sedation may be helpful in younger children. CONCLUSION The performance of diffusion weighted MRI is similar in paediatric and adult settings. This study suggests that DWMRI may be used in clinical practice in a similar way in children and adults.
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Affiliation(s)
- Robert Nash
- Department of Otolaryngology, Head and Neck Surgery, Northwick Park Hospital & Central Middlesex Hospital, London Northwest Healthcare NHS Trust, Harrow, London HA1 3UJ, United Kingdom
| | - Phui Yee Wong
- Department of Otolaryngology, Head and Neck Surgery, Northwick Park Hospital & Central Middlesex Hospital, London Northwest Healthcare NHS Trust, Harrow, London HA1 3UJ, United Kingdom
| | - Ali Kalan
- Department of Otolaryngology, Head and Neck Surgery, Northwick Park Hospital & Central Middlesex Hospital, London Northwest Healthcare NHS Trust, Harrow, London HA1 3UJ, United Kingdom
| | - Ravi K Lingam
- Department of Radiology, Northwick Park Hospital & Central Middlesex Hospital, London Northwest Healthcare NHS Trust, Harrow, London HA1 3UJ, United Kingdom.
| | - Arvind Singh
- Department of Otolaryngology, Head and Neck Surgery, Northwick Park Hospital & Central Middlesex Hospital, London Northwest Healthcare NHS Trust, Harrow, London HA1 3UJ, United Kingdom
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Palmucci S, Cappello G, Attinà G, Foti PV, Siverino ROA, Roccasalva F, Piccoli M, Sinagra N, Milone P, Veroux M, Ettorre GC. Diffusion weighted imaging and diffusion tensor imaging in the evaluation of transplanted kidneys. Eur J Radiol Open 2015; 2:71-80. [PMID: 26937439 PMCID: PMC4750625 DOI: 10.1016/j.ejro.2015.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 03/12/2015] [Accepted: 05/04/2015] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The aim of this study is to investigate the relation between renal indexes and functional MRI in a population of kidney transplant recipients who underwent MR with diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) of the transplanted graft. METHOD Study population included 40 patients with single kidney transplant. The patients were divided into 3 groups, on the basis of creatinine clearance (CrCl) values calculated using Cockcroft-Gault formula: group A, including patients with normal renal function (CrCl ≥ 60 mL/min); group B, which refers to patients with moderate renal impairment (CrCl > 30 but <60 mL/min); and, finally, group C, which means severe renal deterioration (CrCl ≤ 30 mL/min). All patients were investigated with a 1.5 Tesla MRI scanner, acquiring DWI and DTI sequences. A Mann-Whitney U test was adopted to compare apparent diffusion coefficients (ADCs) and fractional anisotropy (FA) measurements between groups. Receiver operating characteristic (ROC) curves were created for prediction of normal renal function (group A) and renal failure (group C). Pearson correlation was performed between renal clearance and functional imaging parameter (ADC and FA), obtained for cortical and medullar regions. RESULTS Mann-Whitney U test revealed a highly significant difference (p < 0.01) between patients with low CrCl (group C) and normal CrCl (group A) considering both medullar ADC and FA and cortical ADC. Regarding contiguous groups, the difference between group B and C was highly significant (p < 0.01) for medullar ADC and significant (p < 0.05) for cortical ADC and medullar FA. No difference between these groups was found considering cortical FA. Analyzing groups A and B, we found a significant difference (p < 0.05) for medullar both ADC and FA, while no difference was found for cortical ADC and FA. Strongest Pearson correlation was found between CrCl and medullar ADC (r = 0.65). For predicting normal renal function or severe renal impairment, highest values of AUC were observed using medullar ADC cut-off values (respectively 0.885 and 0.871); medullar FA showed also high accuracy (respectively 0.831 and 0.853). CONCLUSIONS DWI and DTI are promising tools for non-invasive monitoring of renal function; medullar ADC proved to be the best parameter for renal function assessment.
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Affiliation(s)
- Stefano Palmucci
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123 Catania, Italy
| | - Giuseppina Cappello
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123 Catania, Italy
| | - Giancarlo Attinà
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123 Catania, Italy
| | - Pietro Valerio Foti
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123 Catania, Italy
| | - Rita Olivia Anna Siverino
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123 Catania, Italy
| | - Federica Roccasalva
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123 Catania, Italy
| | - Marina Piccoli
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123 Catania, Italy
| | - Nunziata Sinagra
- Vascular Surgery and Organ Transplant Unit, Department of Surgery, Transplantation and Advanced Technologies, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123 Catania, Italy
| | - Pietro Milone
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123 Catania, Italy
| | - Massimiliano Veroux
- Vascular Surgery and Organ Transplant Unit, Department of Surgery, Transplantation and Advanced Technologies, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123 Catania, Italy
| | - Giovanni Carlo Ettorre
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123 Catania, Italy
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Lyness RC, Alvarez I, Sereno MI, MacSweeney M. Microstructural differences in the thalamus and thalamic radiations in the congenitally deaf. Neuroimage 2014; 100:347-57. [PMID: 24907483 PMCID: PMC4148523 DOI: 10.1016/j.neuroimage.2014.05.077] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 05/18/2014] [Accepted: 05/28/2014] [Indexed: 12/01/2022] Open
Abstract
There is evidence of both crossmodal and intermodal plasticity in the deaf brain. Here, we investigated whether sub-cortical plasticity, specifically of the thalamus, contributed to this reorganisation. We contrasted diffusion weighted magnetic resonance imaging data from 13 congenitally deaf and 13 hearing participants, all of whom had learnt British Sign Language after 10 years of age. Connectivity based segmentation of the thalamus revealed changes to mean and radial diffusivity in occipital and frontal regions, which may be linked to enhanced peripheral visual acuity, and differences in how visual attention is deployed in the deaf group. Using probabilistic tractography, tracts were traced between the thalamus and its cortical targets, and microstructural measurements were extracted from these tracts. Group differences were found in microstructural measurements of occipital, frontal, somatosensory, motor and parietal thalamo-cortical tracts. Our findings suggest that there is sub-cortical plasticity in the deaf brain, and that white matter alterations can be found throughout the deaf brain, rather than being restricted to, or focussed in the auditory cortex.
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Affiliation(s)
- Rebecca C Lyness
- Cognitive and Perceptual Brain Sciences, 26 Bedford Way, University College London, London WC1H 0AP, UK.
| | - I Alvarez
- Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Martin I Sereno
- Cognitive and Perceptual Brain Sciences, 26 Bedford Way, University College London, London WC1H 0AP, UK; Birkbeck, University of London, Malet Street, Bloomsbury, London WC1E 7HX, UK
| | - Mairéad MacSweeney
- Deafness, Cognition & Language Research Centre, 49 Gordon Square, University College London, London WC1H 0PD, UK; Institute of Cognitive Neuroscience, 17 Queen Square, University College London, London WC1H 3AR, UK
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Boutet C, Rouffiange-Leclair L, Garnier P, Quenet S, Delsart D, Varvat J, Epinat M, Schneider F, Antoine JC, Mismetti P, Barral FG. Brain magnetic resonance imaging findings in cryptogenic stroke patients under 60 years with patent foramen ovale. Eur J Radiol 2014; 83:824-8. [PMID: 24582173 DOI: 10.1016/j.ejrad.2014.01.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 07/08/2013] [Revised: 01/19/2014] [Accepted: 01/27/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To compare magnetic resonance imaging (MRI) brain feature in cryptogenic stroke patients with patent foramen ovale (PFO), cryptogenic stroke patients without PFO and patients with cardioembolic stroke. MATERIALS AND METHODS The ethics committee required neither institutional review board approval nor informed patient consent for retrospective analyses of the patients' medical records and imaging data. The patients' medical files were retrospectively reviewed in accordance with human subject research protocols. Ninety-two patients under 60 years of age were included: 15 with cardioembolic stroke, 32 with cryptogenic stroke with PFO and 45 with cryptogenic stroke without PFO. Diffusion-weighted imaging of brain MRI was performed by a radiologist blinded to clinical data. Univariate, Fischer's exact test for qualitative data and non-parametric Wilcoxon test for quantitative data were used. RESULTS There was no statistically significant difference found between MRI features of patients with PFO and those with cardioembolic stroke (p<.05). Patients without PFO present more corticosubcortical single lesions (p<.05) than patients with PFO. Patients with PFO have more often subcortical single lesions larger than 15mm, involvement of posterior cerebral arterial territory and intracranial occlusion (p<.05) than patients with cryptogenic stroke without PFO. CONCLUSION Our study suggests a cardioembolic mechanism in ischemic stroke with PFO.
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Affiliation(s)
- Claire Boutet
- Department of Radiology, University Hospital of Saint-Etienne, France; Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France.
| | | | - Pierre Garnier
- Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France; Department of Neurology, University Hospital of Saint-Etienne, France.
| | - Sara Quenet
- Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France.
| | - Daphné Delsart
- Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France; Department of Therapeutic Medicine, CHU Saint-Etienne, Hôpital Nord, Saint-Etienne, France; Inserm, CIE3, F-42055 Saint-Etienne, France.
| | - Jérôme Varvat
- Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France; Department of Neurology, University Hospital of Saint-Etienne, France.
| | - Magali Epinat
- Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France; Department of Neurology, University Hospital of Saint-Etienne, France.
| | - Fabien Schneider
- Department of Radiology, University Hospital of Saint-Etienne, France; Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France.
| | - Jean-Christophe Antoine
- Department of Neurology, University Hospital of Saint-Etienne, France; Lyon Neuroscience Research Center, INSERM U1028 - CNRS UMR5292, France; EA 4338, Jean Monnet University, Saint-Etienne, France.
| | - Patrick Mismetti
- Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France; Department of Therapeutic Medicine, CHU Saint-Etienne, Hôpital Nord, Saint-Etienne, France; Inserm, CIE3, F-42055 Saint-Etienne, France.
| | - Fabrice-Guy Barral
- Department of Radiology, University Hospital of Saint-Etienne, France; Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France.
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Lambrecht M, Van Herck H, De Keyzer F, Vandecaveye V, Slagmolen P, Suetens P, Hermans R, Nuyts S. Redefining the target early during treatment. Can we visualize regional differences within the target volume using sequential diffusion weighted MRI? Radiother Oncol 2013; 110:329-34. [PMID: 24231234 DOI: 10.1016/j.radonc.2013.09.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 09/24/2013] [Accepted: 09/25/2013] [Indexed: 01/18/2023]
Abstract
PURPOSE In head and neck cancer, diffusion weighted MRI (DWI) can predict response early during treatment. Treatment-induced changes and DWI-specific artifacts hinder an accurate registration between apparent diffusion coefficient (ADC) maps. The aim of the study was to develop a registration tool which calculates and visualizes regional changes in ADC. METHODS Twenty patients with stage IV HNC treated with primary radiotherapy received an MRI including DWI before and early during treatment. Markers were manually placed at anatomical landmarks on the different modalities at both time points. A registration method, consisting of a fully automatic rigid and nonrigid registration and two semi-automatic thin-plate spline (TPS) warps was developed and applied to the image sets. After each registration step the mean registration errors were calculated and ΔADC was compared between good and poor responders. RESULTS Adding the TPS warps significantly reduced the registration error (in mm, 6.3 ± 6.2 vs 3.2 ± 3.3 mm, p<0.001). After the marker based registration the median ΔADC in poor responders was significantly lower than in good responders (7% vs. 21%; p<0.001). CONCLUSIONS This registration method allowed for a significant reduction of the mean registration error. Furthermore the voxel-wise calculation of the ΔADC early during radiotherapy allowed for a visualization of the regional differences of ΔADC within the tumor.
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Affiliation(s)
- Maarten Lambrecht
- Department of Radiation Oncology, Leuvens Kankerinstituut, University Hospitals Leuven, Campus Gasthuisberg, Belgium.
| | - Hans Van Herck
- Department of Electrical Engineering (ESAT/PSI), KU Leuven, Belgium; iMinds - KU Leuven Future Health Department, Belgium
| | - Frederik De Keyzer
- Department of Radiology, University Hospitals Leuven, Campus Gasthuisberg, Belgium
| | - Vincent Vandecaveye
- Department of Radiology, University Hospitals Leuven, Campus Gasthuisberg, Belgium
| | - Pieter Slagmolen
- Department of Electrical Engineering (ESAT/PSI), KU Leuven, Belgium; iMinds - KU Leuven Future Health Department, Belgium
| | - Paul Suetens
- Department of Electrical Engineering (ESAT/PSI), KU Leuven, Belgium; iMinds - KU Leuven Future Health Department, Belgium
| | - Robert Hermans
- Department of Radiology, University Hospitals Leuven, Campus Gasthuisberg, Belgium
| | - Sandra Nuyts
- Department of Radiation Oncology, Leuvens Kankerinstituut, University Hospitals Leuven, Campus Gasthuisberg, Belgium
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Goyal A, Sharma R, Bhalla AS, Gamanagatti S, Seth A. Pseudotumours in chronic kidney disease: can diffusion-weighted MRI rule out malignancy. Eur J Radiol 2013; 82:1870-6. [PMID: 23932396 DOI: 10.1016/j.ejrad.2013.07.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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: 03/27/2013] [Revised: 06/03/2013] [Accepted: 07/08/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate whether diffusion-weighted MRI (DW-MRI) can distinguish pseudotumours in chronic kidney disease (CKD pseudotumours) from renal-cell-carcinomas (RCCs) (with or without CKD) and whether it offers additional benefit over conventional MRI. METHODS One-hundred patients underwent MDCT, MRI and DW-MRI (at b-values of 0 and 500s/mm(2)) for evaluation of focal renal lesions. Of these, 20 patients with 40 CKD pseudotumours and 36 patients with 40 RCCs were retrospectively analyzed. T1-weighted, T2-weighted, diffusion-weighted images were evaluated, apparent-diffusion-coefficient (ADC) values were compared and receiver-operating-characteristic (ROC) curves were drawn to establish cut-off ADC-values. RESULTS 92.5% of CKD pseudotumours remained indeterminate after conventional MRI. On DW-MRI, none of them showed restricted diffusion and thus malignancy could be ruled out in 100% of the lesions. In contrast, all the solid RCCs showed diffusion restriction. Mean ADC-value for CKD pseudotumours was significantly higher than RCCs and surrounding diseased parenchyma [2.50 vs 1.56 (×10(-3)mm(2)/s) (P<0.0001) and 2.05 (×10(-3)mm(2)/s) (P=0.0001) respectively]. ROC analysis for differentiating CKD pseudotumours and RCC yielded high sensitivity (91.7%) and specificity (100%) for cut-off ADC-value of 2.04 (×10(-3)mm(2)/s). CONCLUSIONS CKD pseudotumors usually remain indeterminate on conventional non-contrast MRI. DW-MRI can distinguish CKD pseudotumors from RCCs and offers a non-contrast non-invasive alternative for ruling out malignancy.
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Affiliation(s)
- Ankur Goyal
- Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India.
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