1
|
Yang Y, Fang S, Tao J, Liu Y, Wang C, Yin Z, Chen B, Duan Z, Liu W, Wang S. Correlation of Apparent Diffusion Coefficient With Proliferation and Apoptotic Indexes in a Murine Model of Fibrosarcoma: Comparison of Four Methods for MRI Region of Interest Positioning. J Magn Reson Imaging 2022; 57:1406-1413. [PMID: 35864603 DOI: 10.1002/jmri.28371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) has demonstrated great potential in predicting the expression of tumor cell proliferation and apoptosis indexes. PURPOSE To evaluate the impact of four region of interest (ROI) methods on interobserver variability and apparent diffusion coefficient (ADC) values and to examine the correlation of ADC values with Ki-67, Bcl-2, and P53 labeling indexes (LIs) in a murine model of fibrosarcoma. STUDY TYPE Prospective, animal model. ANIMAL MODEL A total of 22 female BALB/c mice bearing intramuscular fibrosarcoma xenografts. FIELD STRENGTH/SEQUENCE A 3.0 T/T1-weighted fast spin-echo (FSE), T2-weighted fast relaxation fast spin-echo, and DWI PROPELLER FSE sequences. ASSESSMENT Four radiologists measured ADC values using four ROI methods (oval, freehand, small-sample, and whole-volume). Immunohistochemical assessment of Ki-67, Bcl-2, and P53 LIs was performed. STATISTICAL TESTS Interclass correlation coefficient (ICC), one-way analysis of variance followed by LSD-t post hoc analysis, and Pearson correlation test were performed. The statistical threshold was defined as a P-value of <0.05. RESULTS All ROI methods for ADC measurements showed excellent interobserver agreement (ICC range, 0.832-0.986). The ADC values demonstrated significant differences among the four ROI methods. The ADC values for oval, freehand, small-sample, and whole-volume ROI methods showed a moderately negative correlation with Ki-67 (r = -0.623; r = -0.629; r = -0.642, and r = -0.431) and Bcl-2 (r = -0.590; r = -0.597; r = -0.659, and r = -0.425) LIs, but no correlation with P53 LI (r = 0.364, P = 0.104; r = 0.350, P = 0.120; r = 0.379, P = 0.091; r = 0.390, P = 0.080). DATA CONCLUSION The ADC value can be used to evaluate cell proliferation and apoptosis indexes in a murine model of fibrosarcoma, employing the small-sample ROI as a reliable method. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 3.
Collapse
Affiliation(s)
- Yanyu Yang
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Shaobo Fang
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Juan Tao
- Department of Pathology, The Second Hospital, Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Yajie Liu
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Chunjie Wang
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Zhenzhen Yin
- Department of Radiology, Suzhou Hospital of Anhui Medical University, Suzhou, Anhui, People's Republic of China
| | - Bo Chen
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Zhiqing Duan
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Wenyu Liu
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Shaowu Wang
- Department of Radiology, The Second Hospital, Dalian Medical University, Dalian, Liaoning, People's Republic of China
| |
Collapse
|
2
|
Volpi F, D’Amore CA, Colligiani L, Milazzo A, Cavaliere S, De Liperi A, Neri E, Romei C. The Use of Chest Magnetic Resonance Imaging in Malignant Pleural Mesothelioma Diagnosis. Diagnostics (Basel) 2022; 12:diagnostics12030750. [PMID: 35328305 PMCID: PMC8946868 DOI: 10.3390/diagnostics12030750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/10/2022] Open
Abstract
In recent years, many articles have demonstrated that magnetic resonance imaging (MRI) may be performed successfully in the study of the chest. The aim of this study was to evaluate the potential role of MRI in the differentiation of benign from malignant pleural disease with a special focus on malignant pleural mesothelioma and on MRI protocols. A systematic literature search was performed to find original articles about chest MRI in patients with either benign or malignant pleural disease. We retrieved 1246 papers and 17 studies were finally identified as being in accordance with our purpose. For a morphologic assessment, T1-weighted and T2-weighted sequences were usually performed, eventually associated with T1 post-contrast sequences for better detection of pleural lesions. Functional sequences such as Diffusion Weighting Imaging (DWI), associated with the evaluation of Apparent Diffusion Coefficient (ADC) maps, were lately and gradually introduced in chest MRI protocols and their potentiality in differentiating benign from malignant disease has been investigated by many authors. Many progresses have been performed to improve quality images and diagnostic performances of MRI. A better and early identification of pleural disease may be obtained, providing MRI as a possible tool that can differentiate malignant from benign pleural disease without using invasive procedures.
Collapse
Affiliation(s)
- Federica Volpi
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy; (F.V.); (C.A.D.); (L.C.); (A.M.); (E.N.)
| | - Caterina A. D’Amore
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy; (F.V.); (C.A.D.); (L.C.); (A.M.); (E.N.)
| | - Leonardo Colligiani
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy; (F.V.); (C.A.D.); (L.C.); (A.M.); (E.N.)
| | - Alessio Milazzo
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy; (F.V.); (C.A.D.); (L.C.); (A.M.); (E.N.)
| | - Silvia Cavaliere
- Department of Diagnostic Imaging, Diagnostic Radiology 2, Pisa University Hospital, 56124 Pisa, Italy; (S.C.); (A.D.L.)
| | - Annalisa De Liperi
- Department of Diagnostic Imaging, Diagnostic Radiology 2, Pisa University Hospital, 56124 Pisa, Italy; (S.C.); (A.D.L.)
| | - Emanuele Neri
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Pisa, Italy; (F.V.); (C.A.D.); (L.C.); (A.M.); (E.N.)
| | - Chiara Romei
- Department of Diagnostic Imaging, Diagnostic Radiology 2, Pisa University Hospital, 56124 Pisa, Italy; (S.C.); (A.D.L.)
- Correspondence:
| |
Collapse
|
3
|
Li H, Liu L, Ding L, Zhang Z, Zhang M. Quantitative Assessment of Bladder Cancer Reflects Grade and Recurrence: Comparing of Three Methods of Positioning Region of Interest for ADC Measurements at Diffusion-weighted MR Imaging. Acad Radiol 2019; 26:1148-1153. [PMID: 30503834 DOI: 10.1016/j.acra.2018.10.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/14/2018] [Accepted: 10/14/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE To determine the impact of three different regions of interests (ROIs) positioning methods for apparent diffusion coefficient (ADC) measurements on the assessment of the grade and recurrence and to examine the correlation between ADC value and histopathological grade/ Ki-67 labeling index (LI) in patients with bladder cancer. MATERIALS AND METHODS Sixty-one patients with bladder cancer were retrospectively evaluated. Two observers measured mean ADC values using whole-volume-ROIs, single-section-ROI and three-ROIs methods. Interclass correlation coefficient was analyzed to assess interobserver variability. The grade and recurrence in patients with bladder cancer were assessed by calculating the areas under the receiver operating characteristic curves with Az values. Spearman's correlation was used to analyze the correlations of ADC value with grade and Ki-67 LI. RESULTS For the mean ADC value, the interclass correlation coefficient were excellent with the whole-volume and the single-section method (0.90 [95% CI: 0.84, 0.94] and 0.89 [95% CI: 0.81, 0.93]) and was good with the three-ROIs method (0.72 [95% CI: 0.53, 0.83]). The Az value for determining histological grade and recurrence of bladder cancer were not significantly different from each positioning method (all p > 0.05). There's significant correlation between histological grade and ADC measuring by whole-volume-ROIs and single-section-ROI methods (r = 0.31, p = 0.02; r = 0.37, p < 0.05). The ADC measured by whole-volume-ROIs, single-section-ROI, and three-ROIs methods were significantly and inversely correlated with the Ki-67 LI (r = -0.3; r = -0.49; r = -0.40, all p < 0.05). CONCLUSION There's no significant difference among any of the ROI positioning methods in evaluation of tumor grade and recurrence. There's significant correlation between histological grade and ADC measuring by whole-volume-ROIs and single-section-ROI methods. The ADC value obtained by either of three methods was significantly and inversely correlated with the Ki-67 LI.
Collapse
|
4
|
Yu H, Shen YQ, Tan FQ, Zhou ZL, Li Z, Hu DY, Morelli JN. Quantitative diffusion-weighted magnetic resonance enterography in ileal Crohn's disease: A systematic analysis of intra and interobserver reproducibility. World J Gastroenterol 2019; 25:3619-3633. [PMID: 31367161 PMCID: PMC6658399 DOI: 10.3748/wjg.v25.i27.3619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/20/2019] [Accepted: 06/08/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Magnetic resonance enterography (MRE) is increasingly attractive as a noninvasive and radiation-free tool for assessing Crohn’s disease (CD). Diffusion-weighted imaging (DWI) is recommended as an optional MRE sequence for CD by the European Society of Gastrointestinal and Abdominal Radiology, and has shown a superb potential as a quantitative modality for bowel inflammation evaluation. However, the measurement reproducibility of quantitative DWI analysis in MRE has not been ascertained so far. To facilitate the application of quantitative diffusion-weighted MRE in the clinical routine, systematic investigations of the intra and interobserver reproducibility of DWI quantitative parameters should be performed.
AIM To evaluate the intra and interobserver reproducibility of quantitative analysis for diffusion-weighted MRE (DW-MRE) in ileal CD.
METHODS Forty-four subjects (21 with CD and 23 control subjects) who underwent ileocolonoscopy and DW-MRE (b = 800 s/mm2) within one week were included. Two radiologists independently measured apparent diffusion coefficients (ADC) of the terminal ileum and signal intensity ratio (SR) of the terminal ileum to ipsilateral psoas muscle on DWI images (b = 800 s/mm2). Between- and within-reader agreements were assessed using intraclass correlation coefficients (ICC), coefficients of variation (CoV), and 95% limits of agreement of Bland-Altman plots (BA-LA LoA). Diagnostic performances of ADC and SR for identifying inflamed terminal ileum from the normal were evaluated by receiver operating characteristic (ROC) curve analysis.
RESULTS There were no significant differences in ADC or SR values between the two sessions or between the two radiologists either in the CD or control group (paired t-test, P > 0.05). The intra and interobserver reproducibility of ADC (ICC: 0.952-0.984; CoV: 3.73-6.28%; BA-LA LoA: ±11.27% to ±15.88%) and SR (ICC: 0.969-0.989; CoV: 3.51%-4.64%; BA-LA LoA: ±10.62% to ±15.45%) was excellent for CD. Agreement of ADC measurements was slightly less in control subjects (ICC: 0.641-0.736; CoV: 10.47%-11.43%; BA-LA LoA: ± 26.59% to ± 30.83%). SR of normal terminal ileum demonstrated high intra and interobserver reproducibility (ICC: 0.944-0.974; CoV: 3.73%-6.28%; BA-LA LoA: ± 18.58% to ± 24.43%). ADC and SR of two readers had outstanding diagnostic efficiencies (area under the ROC curve: 0.923-0.988).
CONCLUSION Quantitative parameters derived from DW-MRE have good to excellent intra and interobserver agreements with high diagnostic accuracy, and can serve as robust and efficient quantitative biomarkers for CD evaluation.
Collapse
Affiliation(s)
- Hao Yu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Ya-Qi Shen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Fang-Qin Tan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Zi-Ling Zhou
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Dao-Yu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - John N Morelli
- St. John’s Medical Center, Tulsa, OK 74133, United States
| |
Collapse
|
5
|
Diffusion kurtosis imaging to assess correlations with clinicopathologic factors for bladder cancer: a comparison between the multi-b value method and the tensor method. Eur Radiol 2019; 29:4447-4455. [PMID: 30666451 DOI: 10.1007/s00330-018-5977-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 12/06/2018] [Accepted: 12/17/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To assess the efficacy of diffusion kurtosis imaging (DKI) in differentiating low-grade from high-grade tumors and evaluating the aggressiveness of bladder cancer. METHODS From January 2017 to July 2017, 35 patients (28 males, 7 females; mean age 63 ± 9 years) diagnosed with bladder cancer underwent diffusion-weighted imaging (DWI) with two types of DKI protocols: (1) multi-b value ranging from 0 to 2000 s/mm2 to obtain mean diffusivity/kurtosis (MDb/MKb) and (2) the tensor method with 32 directions with 3 b values (0, 1000, and 2000s/mm2) to obtain mean/axial/radial diffusivity (MDt/Da/Dr), mean/axial/radial kurtosis (MKt/Ka/Kr), and fractional anisotropy (FA) before radical cystectomy. Comparisons between the low- and high-grade groups, non-muscle-invasive bladder cancer (NMIBC), and muscle-invasive bladder cancer (MIBC) were performed with the areas under the receiver operating characteristic curves (AUCs). RESULTS The MKt and Kr values were significantly (p = 0.017 and p = 0.048) higher in patients with high-grade bladder tumors than in those with low-grade tumors. The MKt, Kr, and MKb values were significantly (p = 0.022, p = 0.000, and p = 0.044, respectively) higher in patients with MIBC than in those with NMIBC, while no significant differences (p > 0.05) were found in other values. The AUC of Kr (0.883) was the largest and was significantly higher than those of other metrics (all p < 0.05) for differentiating MIBC from NMIBC, with a sensitivity and specificity of 81.8% and 91.7%, respectively. CONCLUSIONS Kurtosis metrics performed better than diffusion metrics in differentiating MIBC from NMIBC, and directional kurtosis and Kr metrics may also have great potential in providing additional information regarding bladder cancer invasiveness. KEY POINTS • Kurtosis metrics performed better than diffusion metrics in differentiating muscle-invasive bladder cancer (MIBC) from non-muscle-invasive bladder cancer (NMIBC). • Directional kurtosis can provide additional directional microstructural information regarding bladder cancer invasiveness.
Collapse
|
6
|
Tang L, Zhou XJ. Diffusion MRI of cancer: From low to high b-values. J Magn Reson Imaging 2018; 49:23-40. [PMID: 30311988 DOI: 10.1002/jmri.26293] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 12/14/2022] Open
Abstract
Following its success in early detection of cerebral ischemia, diffusion-weighted imaging (DWI) has been increasingly used in cancer diagnosis and treatment evaluation. These applications are propelled by the rapid development of novel diffusion models to extract biologically valuable information from diffusion-weighted MR signals, and significant advances in MR hardware that has enabled image acquisition with high b-values. This article reviews recent technical developments and clinical applications in cancer imaging using DWI, with a special emphasis on high b-value diffusion models. The article is organized in four sections. First, we provide an overview of diffusion models that are relevant to cancer imaging. The model parameters are discussed in relation to three tissue properties-cellularity, vascularity, and microstructures. An emphasis is placed on characterization of microstructural heterogeneity, given its novelty and close relevance to cancer. Second, we illustrate diffusion MR clinical applications in each of the following three categories: 1) cancer detection and diagnosis; 2) cancer grading, staging, and classification; and 3) cancer treatment response prediction and evaluation. Third, we discuss several practical issues, including selection of image acquisition parameters, reproducibility and reliability, motion management, image distortion, etc., that are commonly encountered when applying DWI to cancer in clinical settings. Lastly, we highlight a few ongoing challenges and provide some possible future directions, particularly in the area of establishing standards via well-organized multicenter clinical trials to accelerate clinical translation of advanced DWI techniques to improving cancer care on a large scale. Level of Evidence: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:23-40.
Collapse
Affiliation(s)
- Lei Tang
- Department of Radiology, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research, Beijing, China
| | - Xiaohong Joe Zhou
- Center for MR Research and Departments of Radiology, Neurosurgery, and Bioengineering, University of Illinois at Chicago, Chicago, Illinois, USA
| |
Collapse
|
7
|
Measurement and scan reproducibility of parameters of intravoxel incoherent motion in renal tumor and normal renal parenchyma: a preliminary research at 3.0 T MR. Abdom Radiol (NY) 2018; 43:1739-1748. [PMID: 29071436 DOI: 10.1007/s00261-017-1361-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To prospectively estimate measurement and scan reproducibility of parameters of intravoxel incoherent motion (IVIM) in renal tumors, normal renal cortex, and medulla. METHODS Twenty-four consecutive patients (twelve males and twelve females; median age 56.7 years, range 32-71 years) with 25 renal tumors (20 renal cell carcinomas, one urothelium carcinoma, three angiomyolipomas, and one oncocytoma) were examined twice using IVIM1 and IVIM2 with 9 and 16 b values, respectively, at 3.0 T. All the patients were re-scanned in 24-48 h. Regions of interest (ROIs) were placed in solid part of tumor, normal cortex, and medulla to derive IVIM parameters D (true diffusion coefficient), D* (pseudodiffusion coefficient), and f (perfusion fraction of pseudodiffusion). Differences in parameters between two IVIM sets and intra-observer, inter-observer, and scan-rescan differences were assessed using paired t tests. Intra-observer, inter-observer, and scan-rescan reproducibility were assessed by measuring coefficient of variation and Bland-Altman limits of agreements. RESULTS Intra-observer reproducibility of renal tumors, normal renal cortex, and medulla was excellent for apparent diffusion coefficient (ADC; CV: 3.45%-5.34%, BA-LA: -14% to 18%) and D (CV: 3.65% to 6.04%, BA-LA: -18% to 19%), good for f (CV: 11.96%-16.08%, BA-LA: -76.4% to 92.1% except f of medulla with CV of 32.59% and BA-LA of -76.4% to 92.1% in IVIM1), and poor for D* (CV: 25.0% to 75.4%, BA-LA: -111% to 150%). The same order was in inter-observer reproducibility analysis. Scan-rescan reproducibility was the worst of the three parameters. Renal medulla showed worse reproducibility than renal tumors and the normal cortex. The metrics of IVIM2 had better reproducibility than IVIM1. CONCLUSION Excellent reproducibility evaluation for ADC and D, good for f, and poor for D* derived from IVIM was performed in renal tumors, normal renal cortex, and medulla. D* has limited reliability and scan-rescan reproducibility should be improved.
Collapse
|
8
|
Priola AM, Priola SM, Gned D, Giraudo MT, Veltri A. Nonsuppressing normal thymus on chemical-shift MR imaging and anterior mediastinal lymphoma: differentiation with diffusion-weighted MR imaging by using the apparent diffusion coefficient. Eur Radiol 2017; 28:1427-1437. [PMID: 29143106 DOI: 10.1007/s00330-017-5142-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/14/2017] [Accepted: 10/18/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To prospectively evaluate usefulness of the apparent diffusion coefficient (ADC) in differentiating anterior mediastinal lymphoma from nonsuppressing normal thymus on chemical-shift MR, and to look at the relationship between patient age and ADC. METHODS Seventy-three young subjects (25 men, 48 women; age range, 9-29 years), who underwent chemical-shift MR and diffusion-weighted MR were divided into a normal thymus group (group A, 40 subjects), and a lymphoma group (group B, 33 patients). For group A, all subjects had normal thymus with no suppression on opposed-phase chemical-shift MR. Two readers measured the signal intensity index (SII) and ADC. Differences in SII and ADC between groups were tested using t-test. ADC was correlated with age using Pearson correlation coefficient. RESULTS Mean SII±standard deviation was 2.7±1.8% for group A and 2.2±2.4% for group B, with no significant difference between groups (P=.270). Mean ADC was 2.48±0.38x10-3mm2/s for group A and 1.24±0.23x10-3mm2/s for group B. A significant difference between groups was found (P<.001), with no overlap in range. Lastly, significant correlation was found between age and ADC (r=0.935, P<.001) in group A. CONCLUSIONS ADC of diffusion-weighted MR is a noninvasive and accurate parameter for differentiating lymphoma from nonsuppressing thymus on chemical-shift MR in young subjects. KEY POINTS • SII cannot differentiate mediastinal lymphoma from nonsuppressing normal thymus at visual assessment • ADC is useful for distinguishing nonsuppressing normal thymus from mediastinal lymphoma • ADC is more accurate than transverse-diameter and surface-area in this discrimination • ADC of normal thymus is age dependent and increases with increasing age.
Collapse
Affiliation(s)
- Adriano Massimiliano Priola
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043, Orbassano, Torino, Italy.
| | - Sandro Massimo Priola
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043, Orbassano, Torino, Italy
| | - Dario Gned
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043, Orbassano, Torino, Italy
| | - Maria Teresa Giraudo
- Department of Mathematics, "Giuseppe Peano", University of Torino, Via Carlo Alberto 10, 10123, Torino, Italy
| | - Andrea Veltri
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Regione Gonzole 10, 10043, Orbassano, Torino, Italy
| |
Collapse
|