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Tan HY. Comprehensive imaging diagnosis of ovarian metastatic tumors: A bibliometric analysis. Asian J Surg 2024:S1015-9584(24)01127-8. [PMID: 38834473 DOI: 10.1016/j.asjsur.2024.05.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 05/24/2024] [Indexed: 06/06/2024] Open
Affiliation(s)
- Hua-Yun Tan
- Obstetrics Department of Weifang People's Hospital, Weifang City, Shandong Province, 261041, China.
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Hoffmann E, Masthoff M, Kunz WG, Seidensticker M, Bobe S, Gerwing M, Berdel WE, Schliemann C, Faber C, Wildgruber M. Multiparametric MRI for characterization of the tumour microenvironment. Nat Rev Clin Oncol 2024; 21:428-448. [PMID: 38641651 DOI: 10.1038/s41571-024-00891-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 04/21/2024]
Abstract
Our understanding of tumour biology has evolved over the past decades and cancer is now viewed as a complex ecosystem with interactions between various cellular and non-cellular components within the tumour microenvironment (TME) at multiple scales. However, morphological imaging remains the mainstay of tumour staging and assessment of response to therapy, and the characterization of the TME with non-invasive imaging has not yet entered routine clinical practice. By combining multiple MRI sequences, each providing different but complementary information about the TME, multiparametric MRI (mpMRI) enables non-invasive assessment of molecular and cellular features within the TME, including their spatial and temporal heterogeneity. With an increasing number of advanced MRI techniques bridging the gap between preclinical and clinical applications, mpMRI could ultimately guide the selection of treatment approaches, precisely tailored to each individual patient, tumour and therapeutic modality. In this Review, we describe the evolving role of mpMRI in the non-invasive characterization of the TME, outline its applications for cancer detection, staging and assessment of response to therapy, and discuss considerations and challenges for its use in future medical applications, including personalized integrated diagnostics.
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Affiliation(s)
- Emily Hoffmann
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Max Masthoff
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Wolfgang G Kunz
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Max Seidensticker
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Stefanie Bobe
- Gerhard Domagk Institute of Pathology, University Hospital Münster, Münster, Germany
| | - Mirjam Gerwing
- Clinic of Radiology, University of Münster, Münster, Germany
| | | | | | - Cornelius Faber
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Moritz Wildgruber
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany.
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Jackson A, Pathak R, deSouza NM, Liu Y, Jacobs BKM, Litiere S, Urbanowicz-Nijaki M, Julie C, Chiti A, Theysohn J, Ayuso JR, Stroobants S, Waterton JC. MRI Apparent Diffusion Coefficient (ADC) as a Biomarker of Tumour Response: Imaging-Pathology Correlation in Patients with Hepatic Metastases from Colorectal Cancer (EORTC 1423). Cancers (Basel) 2023; 15:3580. [PMID: 37509240 PMCID: PMC10377224 DOI: 10.3390/cancers15143580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Background: Tumour apparent diffusion coefficient (ADC) from diffusion-weighted magnetic resonance imaging (MRI) is a putative pharmacodynamic/response biomarker but the relationship between drug-induced effects on the ADC and on the underlying pathology has not been adequately defined. Hypothesis: Changes in ADC during early chemotherapy reflect underlying histological markers of tumour response as measured by tumour regression grade (TRG). Methods: Twenty-six patients were enrolled in the study. Baseline, 14 days, and pre-surgery MRI were performed per study protocol. Surgical resection was performed in 23 of the enrolled patients; imaging-pathological correlation was obtained from 39 lesions from 21 patients. Results: There was no evidence of correlation between TRG and ADC changes at day 14 (study primary endpoint), and no significant correlation with other ADC metrics. In scans acquired one week prior to surgery, there was no significant correlation between ADC metrics and percentage of viable tumour, percentage necrosis, percentage fibrosis, or Ki67 index. Conclusions: Our hypothesis was not supported by the data. The lack of meaningful correlation between change in ADC and TRG is a robust finding which is not explained by variability or small sample size. Change in ADC is not a proxy for TRG in metastatic colorectal cancer.
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Affiliation(s)
- Alan Jackson
- Centre for Imaging Sciences, University of Manchester, Manchester M20 4GJ, UK
| | - Ryan Pathak
- Centre for Imaging Sciences, University of Manchester, Manchester M20 4GJ, UK
| | - Nandita M deSouza
- CRUK Cancer Imaging Centre, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, London SW7 3RP, UK
| | - Yan Liu
- European Organisation for Research and Treatment of Cancer, 1200 Brussels, Belgium
| | - Bart K M Jacobs
- European Organisation for Research and Treatment of Cancer, 1200 Brussels, Belgium
| | - Saskia Litiere
- European Organisation for Research and Treatment of Cancer, 1200 Brussels, Belgium
| | | | - Catherine Julie
- EA 4340 BECCOH, UVSQ, Universite Paris-Saclay, 92104 Boulogne-Billancourt, France
- Department of Pathology, APHP-Hopital Ambroise Pare, 92100 Boulogne-Billancourt, France
| | - Arturo Chiti
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Bio-Medical Sciences, Humanitas University, 20072 Milan, Italy
| | - Jens Theysohn
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - Juan R Ayuso
- Radiology Department-CDI, Hospital Clinic Universitari de Barcelona, 08036 Barcelona, Spain
| | - Sigrid Stroobants
- Molecular Imaging and Radiology, University of Antwerp, 2000 Antwerp, Belgium
| | - John C Waterton
- Centre for Imaging Sciences, University of Manchester, Manchester M20 4GJ, UK
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Li S, Liu J, Zhang W, Lu H, Wang W, Lin L, Zhang Y, Cheng J. T1 mapping and multimodel diffusion-weighted imaging in the assessment of cervical cancer: a preliminary study. Br J Radiol 2023:20220952. [PMID: 37183908 PMCID: PMC10392640 DOI: 10.1259/bjr.20220952] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVE To evaluate the clinical feasibility of T1 mapping and multimodel diffusion-weighted imaging (DWI) for assessing the histological type, grade, and lymphovascular space invasion (LVSI) of cervical cancer. METHODS Eighty patients with cervical cancer and 43 patients with a normal cervix underwent T1 mapping and DWI with 11 b-values (0-2000 s/mm2). Monoexponential, biexponential, and kurtosis models were fitted to calculate the apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion (D*), perfusion fraction (f), mean diffusivity (MD), and mean kurtosis (MK). Native T1 and DWI-derived parameters (ADCmean, ADCmin, Dmean, Dmin, D*, f, MDmean, MDmin, MKmean, and MKmax) were compared based on histological type, grade, and LVSI status. RESULTS Native T1 and DWI-derived parameters differed significantly between cervical cancer and normal cervix (all p < 0.05), except D* (p = 0.637). Native T1 and MKmean varied significantly between squamous cell carcinoma (SCC) and adenocarcinoma (both p < 0.05). ADCmin, Dmin, and MDmin were significantly lower while MKmax was significantly higher in the high-grade SCC group than in the low-grade SCC group (all p < 0.05). LVSI-positive SCC had a significantly higher MKmean than LVSI-negative SCC (p < 0.05). CONCLUSION Both T1 mapping and multimodel DWI can effectively differentiate cervical cancer from a normal cervix and cervical adenocarcinoma from SCC. Furthermore, multimodel DWI may provide quantitative metrics for non-invasively predicting histological grade and LVSI status in SCC patients. ADVANCES IN KNOWLEDGE Combined use of T1 mapping and multimodel DWI may provide more comprehensive information for non-invasive pre-operative evaluation of cervical cancer.
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Affiliation(s)
- Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Liu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenhua Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huifang Lu
- Department of Gynecology and Obstetrics, Huaihe Hospital of Henan University, Kaifeng, China
| | - Weijian Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liangjie Lin
- Advanced Technical Support, Philips Healthcare, Beijing, China
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Hafeez S, Koh M, Jones K, Ghzal AE, D’Arcy J, Kumar P, Khoo V, Lalondrelle S, McDonald F, Thompson A, Scurr E, Sohaib A, Huddart RA. Diffusion-weighted MRI to determine response and long-term clinical outcomes in muscle-invasive bladder cancer following neoadjuvant chemotherapy. Front Oncol 2022; 12:961393. [PMID: 36452501 PMCID: PMC9702046 DOI: 10.3389/fonc.2022.961393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/29/2022] [Indexed: 09/05/2023] Open
Abstract
Objective This study aims to determine local treatment response and long-term survival outcomes in patients with localised muscle-invasive bladder cancer (MIBC) patients receiving neoadjuvant chemotherapy (NAC) using diffusion-weighted MRI (DWI) and apparent diffusion coefficient (ADC) analysis. Methods Patients with T2-T4aN0-3M0 bladder cancer suitable for NAC were recruited prospectively. DWI was performed prior to NAC and was repeated following NAC completion. Conventional response assessment was performed with cystoscopy and tumour site biopsy. Response was dichotomised into response ( Results Forty-eight patients (96 DWI) were evaluated. NAC response was associated with significant increase in mean ΔADC and %ΔADC compared to poor response (ΔADCall 0.32×10-3 versus 0.11×10-3 mm2/s; p=0.009, and %ΔADCall 21.70% versus 8.23%; p=0.013). Highest specificity predicting response was seen at 75th percentile ADC (AUC, 0.8; p=0.01). Sensitivity, specificity, positive predictive power, and negative predictive power of %ΔADCb100 75th percentile was 73.7%, 90.0%, 96.6%, and 52.9%, respectively. %ΔADCb100 75th percentile >15.5% was associated with significant improvement in OS (HR, 0.40; 95% CI, 0.19-0.86; p=0.0179), bCSS (HR, 0.26; 95% CI, 0.08-0.82; p=0.0214), PFS (HR, 0.16; 95% CI, 0.05-0.48; p=0.0012), and time to cystectomy (HR, 0.19; 95% CI, 0.07-0.47; p=0.0004). Conclusions Quantitative ADC analysis can successfully identify NAC response and improved long-term clinical outcomes. Multi-centre validation to assess reproducibility and repeatability is required before testing within clinical trials to inform MIBC treatment decision making. Advances in knowledge We successfully demonstrated that measured change in DWI can successfully identify NAC response and improved long-term survival outcomes.
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Affiliation(s)
- Shaista Hafeez
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Urology Unit, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
- Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Mu Koh
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Diagnostic Radiology, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Kelly Jones
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Urology Unit, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Amir El Ghzal
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Urology Unit, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - James D’Arcy
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Pardeep Kumar
- Urology Unit, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Vincent Khoo
- Urology Unit, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
- Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Susan Lalondrelle
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Fiona McDonald
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Alan Thompson
- Urology Unit, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Erica Scurr
- Department of Diagnostic Radiology, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Aslam Sohaib
- Department of Diagnostic Radiology, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Robert Anthony Huddart
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Urology Unit, The Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
- Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, London, United Kingdom
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Zhang J, Xing X, Wang Q, Chen Y, Yuan H, Lang N. Preliminary study of monoexponential, biexponential, and stretched-exponential models of diffusion-weighted MRI and diffusion kurtosis imaging on differential diagnosis of spinal metastases and chordoma. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:3130-3138. [PMID: 35648206 DOI: 10.1007/s00586-022-07269-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/03/2022] [Accepted: 05/15/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Quantitative comparison of diffusion parameters from various models of diffusion-weighted (DWI) and diffusion kurtosis (DKI) imaging for distinguishing spinal metastases and chordomas. METHODS DWI and DKI examinations were performed in 31 and 13 cases of spinal metastases and chordomas, respectively. DWI derived apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), water molecular distributed diffusion coefficient (DDC), and intravoxel water diffusion heterogeneity (α). DKI derived mean diffusivity (MD) and mean kurtosis (MK). Independent sample t-testing compared statistical differences among parameters. Sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve were determined. Pearson correlation analysis evaluated the parameters' correlations. RESULTS ADC, D, f, DDC, α, and MD were significantly lower in spinal metastases than chordomas (all P < 0.05). MK was significantly higher in spinal metastases than chordomas (P < 0.05). D had the highest area under the ROC curve (AUC) of 0.886, greater than MD (AUC = 0.706) or DDC (AUC = 0.742) in differentiating the two tumors (both P < 0.05). Combining D with f and α statistically significantly increased the AUC for diagnosis (to 0.995) relative to D alone (P < 0.05). There was a certain correlation among DDC, ADC, and D (all P < 0.05). CONCLUSIONS Monoexponential, biexponential, and stretched-exponential models of DWI and DKI can potentially differentiate spinal metastases and chordomas. D combined with f and α performed best.
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Affiliation(s)
- Jiahui Zhang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Xiaoying Xing
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Qizheng Wang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Yongye Chen
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Ning Lang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.
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Song J, Lu Y, Wang X, Peng W, Lin W, Hou Z, Yan Z. A comparative study of four diffusion-weighted imaging models in the diagnosis of cervical cancer. Acta Radiol 2022; 63:536-544. [PMID: 33745294 DOI: 10.1177/02841851211002017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Most commonly used diffusion-weighted imaging (DWI) models include intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), stretched exponential model (SEM), and mono-exponential model (MEM). Previous studies of the four models were inconsistent on which model was more effective in distinguishing cervical cancer from normal cervical tissue. PURPOSE To assess the performance of four DWI models in characterizing cervical cancer and normal cervical tissue. MATERIAL AND METHODS Forty-seven women with suspected cervical carcinoma underwent DWI using eight b-values before treatment. Imaging parameters, calculated using IVIM, SEM, DKI, and MEM, were compared between cervical cancer and normal cervical tissue. The diagnostic performance of the models was evaluated using independent t-test, Mann-Whitney U test, receiver operating characteristic (ROC) curve analysis, and multivariate logistic regression analysis. RESULTS All parameters except pseudo-diffusion coefficient (D*) differed significantly between cervical cancer and normal cervical tissue (P < 0.001). Through logistic regression analysis, all combined models showed a significant improvement in area under the ROC curve (AUC) compared to individual DWI parameters. The model with combined IVIM parameters had a larger AUC value compared to those of other combined models (P < 0.05). CONCLUSION All four DWI models are useful for differentiating cervical cancer from normal cervical tissue and IVIM may be the optimal model.
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Affiliation(s)
- Jiao Song
- Department of Radiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
| | - Yi Lu
- Department of Radiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
| | - Xue Wang
- Department of Radiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
| | - Wenwen Peng
- Department of Radiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
| | - Wenxiao Lin
- Department of Radiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
| | - Zujun Hou
- Department of Medical Imaging, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, PR China
| | - Zhihan Yan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
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Gagliardi T, Adejolu M, deSouza NM. Diffusion-Weighted Magnetic Resonance Imaging in Ovarian Cancer: Exploiting Strengths and Understanding Limitations. J Clin Med 2022; 11:1524. [PMID: 35329850 PMCID: PMC8949455 DOI: 10.3390/jcm11061524] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/05/2022] [Accepted: 03/08/2022] [Indexed: 02/06/2023] Open
Abstract
Detection, characterization, staging, and response assessment are key steps in the imaging pathway of ovarian cancer. The most common type, high grade serous ovarian cancer, often presents late, so that accurate disease staging and response assessment are required through imaging in order to improve patient management. Currently, computerized tomography (CT) is the most common method for these tasks, but due to its poor soft-tissue contrast, it is unable to quantify early response within lesions before shrinkage is observed by size criteria. Therefore, quantifiable techniques, such as diffusion-weighted magnetic resonance imaging (DW-MRI), which generates high contrast between tumor and healthy tissue, are increasingly being explored. This article discusses the basis of diffusion-weighted contrast and the technical issues that must be addressed in order to achieve optimal implementation and robust quantifiable diffusion-weighted metrics in the abdomen and pelvis. The role of DW-MRI in characterizing adnexal masses in order to distinguish benign from malignant disease, and to differentiate borderline from frankly invasive malignancy is discussed, emphasizing the importance of morphological imaging over diffusion-weighted metrics in this regard. Its key role in disease staging and predicting resectability in comparison to CT is addressed, including its valuable use as a biomarker for following response within individual lesions, where early changes in the apparent diffusion coefficient in peritoneal metastases may be detected. Finally, the task of implementing DW-MRI into clinical trials in order to validate this biomarker for clinical use are discussed, along with the trials that include it within their protocols.
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Affiliation(s)
- Tanja Gagliardi
- Department of Imaging, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (T.G.); (M.A.)
| | - Margaret Adejolu
- Department of Imaging, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (T.G.); (M.A.)
| | - Nandita M. deSouza
- Department of Imaging, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (T.G.); (M.A.)
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London SW7 3RP, UK
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Eriksson S, Bengtsson J, Torén W, Lätt J, Andersson R, Sturesson C. Changes in apparent diffusion coefficient and pathological response in colorectal liver metastases after preoperative chemotherapy. Acta Radiol 2022; 64:51-57. [PMID: 35084232 DOI: 10.1177/02841851221074496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The pathological response to preoperative chemotherapy of colorectal liver metastases (CRLMs) is predictive of long-term prognosis after liver resection. Accurate preoperative assessment of chemotherapy response could enable treatment optimization. PURPOSE To investigate whether changes in lesion-apparent diffusion coefficient (ADC) measured with diffusion-weighted magnetic resonance imaging (MRI) can be used to assess pathological treatment response in patients with CRLMs undergoing preoperative chemotherapy. MATERIAL AND METHODS Patients who underwent liver resection for CRLMs after preoperative chemotherapy between January 2011 and December 2019 were retrospectively included if they had undergone MRI before and after preoperative chemotherapy on the same 1.5-T MRI scanner with diffusion-weighted imaging with b-values 50, 400, and 800 s/mm2. The pathological chemotherapy response was assessed using the tumor regression grade (TRG) by AJCC/CAP. Lesions were divided into two groups: pathological responding (TRG 0-2) and non-responding (TRG 3). The change in lesion ADC after preoperative chemotherapy was compared between responding and non-responding lesions. RESULTS A total of 27 patients with 49 CRLMs were included, and 24/49 lesions showed a pathological chemotherapy response. After chemotherapy, ADC increased in both pathological responding (pretreatment ADC: 1.26 [95% confidence interval (CI)=1.06-1.37] vs. post-treatment ADC: 1.33 [95% CI=1.13-1.56] × 10-3 mm2/s; P = 0.026) and non-responding lesions (1.12 [95% CI=0.980-1.21] vs. 1.20 [95% CI=1.09-1.43] × 10-3 mm2/s; P = 0.018). There was no difference in median relative difference in ADC after chemotherapy between pathological responding and non-responding lesions (15.8 [95% CI=1.42-26.3] vs. 7.17 [95% CI=-4.31 to 31.2]%; P = 0.795). CONCLUSION Changes in CRLM ADCs did not differ between pathological responding and non-responding lesions.
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Affiliation(s)
- Sam Eriksson
- Surgery, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
- Center for Medical Imaging and Physiology, Skane University Hospital, Lund, Sweden
| | - Johan Bengtsson
- Center for Medical Imaging and Physiology, Skane University Hospital, Lund, Sweden
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
| | - William Torén
- Surgery, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
| | - Jimmy Lätt
- Center for Medical Imaging and Physiology, Skane University Hospital, Lund, Sweden
| | - Roland Andersson
- Surgery, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
| | - Christian Sturesson
- Surgery, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
- Division of Surgery, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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Feng W, Gao Y, Lu XR, Xu YS, Guo ZZ, Lei JQ. Correlation between molecular prognostic factors and magnetic resonance imaging intravoxel incoherent motion histogram parameters in breast cancer. Magn Reson Imaging 2021; 85:262-270. [PMID: 34740800 DOI: 10.1016/j.mri.2021.10.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 07/26/2021] [Accepted: 10/17/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To explore the efficacy of the quantitative parameter histogram analysis of intravoxel incoherent motion (IVIM) for different molecular prognostic factors of breast cancer. MATERIALS AND METHODS A total of 72 patients with breast cancer who were confirmed by surgical pathology and underwent preoperative magnetic resonance imaging (MRI) were analyzed retrospectively. A region of interest (ROI) was drawn in each slice of the IVIM images. Whole-tumor histogram parameters were obtained with Firevoxel's software by accumulating all ROIs. Next, Kolmogorov-Smirnov test, Student's t-test, Mann-Whitney U test, receiver operating characteristic curve analysis and spearman rank correlation analysis were used to assess the relationship between histogram parameters and molecular prognostic factors of breast cancer. RESULTS Among estrogen receptor (ER)-negative ROCs, the apparent diffusion coefficient (ADC) 10th percentile had the highest ROC of 0.792, with a cut-off value of 0.788 × 10-3 mm2/s, and sensitivity and specificity of 0.714 and 0.867, respectively. The negative correlation between lymph node metastasis status and ADC standard deviation was significant (ρ = -0.44, the correlation coefficients was represented by ρ). Positive correlations were observed between hormonal expression of ER and progesterone receptor (PR) with heterogeneity metrics of ADC or perfusion fraction (f), such as ADC inhomogeneity (ρ = 0.37, ρ = 0.29) and f skewness (ρ = 0.32, ρ = 0.28). Negative correlations were observed with numerical metrics, such as the ADC median (ρ = -0.31, ρ = -0.34) and f 45th percentile (ρ = -0.35, ρ = -0.28). The positive correlations between human epidermal receptor factor-2 (HER2) and pseudo-diffusivity (Dp) numerical metrics, Ki-67 expression, and heterogeneity metrics of Dp were high. CONCLUSIONS The ADC 10th percentile had the largest area under the curve in the ER-negative ROC analysis, and the ADC standard deviation was the most valuable in the correlation analysis of lymph node metastasis. Whole-lesion quantitative histogram parameters of IVIM could, therefore, provide a scientific basis for radiomics to further guide clinical practice in the prognosis of breast cancer.
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Affiliation(s)
- Wen Feng
- The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu, China; Department of Radiology, the First hospital of Lanzhou University, Lanzhou 730000, Gansu, China
| | - Ya Gao
- Department of Radiology, the First hospital of Lanzhou University, Lanzhou 730000, Gansu, China
| | - Xing-Ru Lu
- Department of Radiology, the First hospital of Lanzhou University, Lanzhou 730000, Gansu, China
| | - Yong-Sheng Xu
- Department of Radiology, the First hospital of Lanzhou University, Lanzhou 730000, Gansu, China
| | - Zhuan-Zhuan Guo
- Department of Radiology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shanxi, China
| | - Jun-Qiang Lei
- Department of Radiology, the First hospital of Lanzhou University, Lanzhou 730000, Gansu, China.
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11
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Radiomics of diffusion-weighted MRI compared to conventional measurement of apparent diffusion-coefficient for differentiation between benign and malignant soft tissue tumors. Sci Rep 2021; 11:15276. [PMID: 34315971 PMCID: PMC8316538 DOI: 10.1038/s41598-021-94826-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Diffusion-weighted imaging (DWI) is proven useful to differentiate benign and malignant soft tissue tumors (STTs). Radiomics utilizing a vast array of extracted imaging features has a potential to uncover disease characteristics. We aim to assess radiomics using DWI can outperform the conventional DWI for STT differentiation. In 151 patients with 80 benign and 71 malignant tumors, ADCmean and ADCmin were measured on solid portion within the mass by two different readers. For radiomics approach, tumors were segmented and 100 original radiomic features were extracted on ADC map. Eight radiomics models were built with training set (n = 105), using combinations of 2 different algorithms—multivariate logistic regression (MLR) and random forest (RF)—and 4 different inputs: radiomics features (R), R + ADCmin (I), R + ADCmean (E), R + ADCmin and ADCmean (A). All models were validated with test set (n = 46), and AUCs of ADCmean, ADCmin, MLR-R, RF-R, MLR-I, RF-I, MLR-E, RF-E, MLR-A and RF-A models were 0.729, 0.753 0.698, 0.700, 0.773, 0.807, 0.762, 0.744, 0.773 and 0.807, respectively, without statistically significant difference. In conclusion, radiomics approach did not add diagnostic value to conventional ADC measurement for differentiating benign and malignant STTs.
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Development of MRI-Based Radiomics Model to Predict the Risk of Recurrence in Patients With Advanced High-Grade Serous Ovarian Carcinoma. AJR Am J Roentgenol 2021; 217:664-675. [PMID: 34259544 DOI: 10.2214/ajr.20.23195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE. The purpose of our study was to develop a radiomics model based on preoperative MRI and clinical information for predicting recurrence-free survival (RFS) in patients with advanced high-grade serous ovarian carcinoma (HGSOC). MATERIALS AND METHODS. This retrospective study enrolled 117 patients with HGSOC, including 90 patients with recurrence and 27 without recurrence; 1046 radiomics features were extracted from T2-weighted images and contrast-enhanced T1-weighted images using a manual segmentation method. L1 regularization-based least absolute shrinkage and selection operator (LASSO) regression was performed to select features, and the synthetic minority oversampling technique (SMOTE) was used to balance our dataset. A support vector machine (SVM) classifier was used to build the classification model. To validate the performance of the proposed models, we applied a leave-one-out cross-validation method to train and test the classifier. Cox proportional hazards regression, Harrell concordance index (C-index), and Kaplan-Meier plots analysis were used to evaluate the associations between radiomics signatures and RFS. RESULTS. The fusion radiomics-based model yielded a significantly higher AUC value of 0.85 in evaluating RFS than the model using contrast-enhanced T1-weighted imaging features alone or T2-weighted imaging features alone (AUC = 0.79 and 0.74 and p = .02 and .01, respectively). Kaplan-Meier survival curves showed significant differences between high and low recurrence risk in patients with HGSOC by different models. The fusion model combining radiomics features and clinical information showed higher performance than the clinical model (C-index = 0.62 and 0.60, respectively). CONCLUSION. The proposed MRI-based radiomics signatures may provide a potential way to develop a prediction model and can help identify patients with advanced HGSOC who have a high risk of recurrence.
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Crombé A, Gauquelin L, Nougaret S, Chicart M, Pulido M, Floquet A, Guyon F, Croce S, Kind M, Cazeau AL. Diffusion-weighted MRI and PET/CT reproducibility in epithelial ovarian cancers during neoadjuvant chemotherapy. Diagn Interv Imaging 2021; 102:629-639. [PMID: 34112625 DOI: 10.1016/j.diii.2021.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 01/12/2023]
Abstract
PURPOSE To investigate the reproducibility of diffusion-weighted (DW) MRI and 18F-Fluorodeoxyglucose (18F-FDG)-Positron emission tomography/CT (PET/CT) in monitoring response to neoadjuvant chemotherapy in epithelial ovarian cancer. MATERIALS AND METHODS Ten women (median age, 67 years; range: 41.8-77.3 years) with stage IIIC-IV epithelial ovarian cancers were included in this prospective trial (NCT02792959) between 2014 and 2016. All underwent initial laparoscopic staging, four cycles of carboplatine-paclitaxel-based chemotherapy and interval debulking surgery. PET/CT and DW-MRI were performed at baseline (C0), after one cycle (C1) and before surgery (C4). Two nuclear physicians and two radiologists assessed five anatomic sites for the presence of ≥1 lesion. Target lesions in each site were defined and their apparent diffusion coefficient (ADC), maximal standardized uptake value (SUV-max), SUV-mean, SUL-peak, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were monitored (i.e., 10 patients ×5 sites ×3 time-points). Their relative early and late changes were calculated. Intra/inter-observer reproducibilities of qualitative and quantitative analysis were estimated with Kappa and intra-class correlation coefficients (ICCs). RESULTS For both modalities, inter- and intra-observer agreement percentages were excellent for initial staging but declined later for DW-MRI, leading to lower Kappa values for inter- and intra-observer variability (0.949 and 1 at C0, vs. 0.633 and 0.643 at C4, respectively) while Kappa values remained>0.8 for PET/CT. Inter- and intra-observer ICCs were>0.75 for SUV-max, SUL-peak, SUV-mean and their change regardless the time-point. ADC showed lower ICCs (range: 0.013-0.811). ANOVA found significant influences of the evaluation time, the measurement used (ADC, SUV-max, SUV-mean, SUV-max, SUL-peak, MTV or TLG) and their interaction on ICC values (P=0.0023, P<0.0001 and P =0.0028, respectively). CONCLUSION While both modalities demonstrated high reproducibility at baseline, only SUV-max, SUL-peak, SUV-mean and their changes maintained high reproducibility during chemotherapy.
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Affiliation(s)
- Amandine Crombé
- Department of Oncologic Imaging, Institut Bergonié, Comprehensive Cancer Center of Nouvelle-Aquitaine, 33000 Bordeaux, France; Bordeaux University, 33000 Bordeaux, France; Modelisation in Oncology (MOnc) Team, INRIA Bordeaux-Sud-Ouest, CNRS UMR 5251, 33405, Talence, France.
| | - Lisa Gauquelin
- Department of Biostatistics, Institut Bergonié, Comprehensive Cancer Center of Nouvelle-Aquitaine, 33000 Bordeaux, France
| | - Stéphanie Nougaret
- Department of Radiology, Montpellier Cancer Institute, University of Montpellier, 34090 Montpellier, France
| | - Marine Chicart
- Department of nuclear medicine, Institut Bergonié, Comprehensive Cancer Center of Nouvelle-Aquitaine, 33000 Bordeaux, France
| | - Marina Pulido
- Department of Biostatistics, Institut Bergonié, Comprehensive Cancer Center of Nouvelle-Aquitaine, 33000 Bordeaux, France
| | - Anne Floquet
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center of Nouvelle-Aquitaine, 33000 Bordeaux, France
| | - Frédéric Guyon
- Department of Oncological Surgery, Institut Bergonié, Comprehensive Cancer Center of Nouvelle-Aquitaine, 33000 Bordeaux, France
| | - Sabrina Croce
- Department of Pathology, Institut Bergonié, Comprehensive Cancer Center of Nouvelle-Aquitaine, 33000 Bordeaux, France
| | - Michèle Kind
- Department of Oncologic Imaging, Institut Bergonié, Comprehensive Cancer Center of Nouvelle-Aquitaine, 33000 Bordeaux, France
| | - Anne-Laure Cazeau
- Department of nuclear medicine, Institut Bergonié, Comprehensive Cancer Center of Nouvelle-Aquitaine, 33000 Bordeaux, France
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Noninvasive DW-MRI metrics for staging hepatic fibrosis and grading inflammatory activity in patients with chronic hepatitis B. Abdom Radiol (NY) 2021; 46:1864-1875. [PMID: 33074424 DOI: 10.1007/s00261-020-02801-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/21/2020] [Accepted: 09/29/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE To assess the value of various diffusion parameters obtained from monoexponential, biexponential, and stretched-exponential diffusion-weighted imaging (DWI) models for staging hepatic fibrosis (HF) and grading inflammatory activity in patients with chronic hepatitis B (CHB). METHODS 82 patients with CHB and 30 healthy volunteers underwent DWI with 13 b-values on a 3T MRI unit. The standard apparent diffusion coefficient (ADCst) was calculated using a monoexponential model. The true diffusion coefficient (Dt), pseudo-diffusion coefficient (Dp), and perfusion fraction (f) were calculated using a biexponential model. The distributed diffusion coefficient (DDC) and water-molecule diffusion heterogeneity index (α) were calculated using a stretched-exponential model. Receiver operating characteristic (ROC) curves were performed for diffusion parameters to compare the diagnosis performance. RESULTS The distributions of hepatic fibrosis stages and the inflammatory activity grades (METAVIR scoring system) were as follows: F0, n = 1; F1, n = 16; F2, n = 31; F3, n = 19; and F4, n = 15. A0, n = 1; A1, n = 14; A2, n = 46; and A3, n = 21. ADCst, Dt and DDC values showed negative correlation with the fibrosis stage (r = - 0.418, - 0.717 and - 0.630, all P < 0.001) and the inflammatory activity grade (r = - 0.514, - 0.626 and - 0.550, all P < 0.001). The area under the ROC curve (AUC) of Dt (AUC = 0.854, 0.881) and DDC (AUC = 0.794, 0.834) were significantly higher than that of ADCst (AUC = 0.637, 0.717) in discriminating significant fibrosis (≥ F2) and advanced fibrosis (≥ F3) (all P < 0.05). Although Dt (AUC = 0.867, 0.836) and DDC (AUC = 0.810, 0.808) showed higher AUCs than ADCst (AUC = 0.767, 0.803), there was no significant difference in their ability in detecting inflammatory activity grade ≥ A2/A3 (P > 0.05). CONCLUSIONS Dt and DDC are promising indicators and outperform ADCst for staging HF. While both Dt and DDC have similar diagnostic performance compared with ADCst for grading inflammatory activity.
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Association between IVIM parameters and treatment response in locally advanced squamous cell cervical cancer treated by chemoradiotherapy. Eur Radiol 2021; 31:7845-7854. [PMID: 33786654 DOI: 10.1007/s00330-021-07817-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/07/2021] [Accepted: 02/19/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine the associations of intravoxel incoherent motion (IVIM) parameters with treatment response in cervical cancer following concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS Forty-five patients, median age of 58 years (range: 28-82), with pre-CCRT and post-CCRT MRI, were retrospectively analysed. The IVIM parameters pure diffusion coefficient (D) and perfusion fraction (f) were estimated using the full b-value distribution (BVD) as well as an optimised subsample BVD. Dice similarity coefficient (DSC) and intraclass correlation coefficient (ICC) were used to measure observer repeatability in tumour delineation at both time points. Treatment response was determined by the response evaluation criteria in solid tumour (RECIST) 1.1 between MRI examinations. Mann-Whitney U tests were used to test for significant differences in IVIM parameters between treatment response groups. RESULTS Pre-CCRT tumour delineation repeatability was good (DSC = 0.81) while post-CCRT delineation repeatability was moderate (DSC = 0.67). Values of D and f had good repeatability at both time points (ICC > 0.80). Pre-CCRT f estimated using the full BVD and optimised subsample BVD were found to be significantly higher in patients with partial response compared to those with stable disease or disease progression (p = 0.01 and 95% CI = -0.02-0.00 for both cases). CONCLUSION Pre-CCRT f was associated with treatment response in cervical cancer with good observer repeatability. Similar discriminative ability was also observed in estimated pre-CCRT f from an optimised subsample BVD. KEY POINTS • Pre-treatment tumour delineation and IVIM parameters had good observer repeatability. • Post-treatment tumour delineation was worse than at pre-treatment, but IVIM parameters retained good ICC. • Pre-treatment perfusion fraction estimated from all b-values and an optimised subsample of b-values were associated with treatment response.
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16
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Rogers HJ, Verhagen MV, Clark CA, Hales PW. Comparison of models of diffusion in Wilms' tumours and normal contralateral renal tissue. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:261-271. [PMID: 32617696 PMCID: PMC8018931 DOI: 10.1007/s10334-020-00862-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/08/2020] [Accepted: 06/23/2020] [Indexed: 11/28/2022]
Abstract
Objective ADC (Apparent Diffusion Coefficient) derived from Diffusion-Weighted Imaging (DWI) has shown promise as a non-invasive quantitative imaging biomarker in Wilms’ tumours. However, many non-Gaussian models could be applied to DWI. This study aimed to compare the suitability of four diffusion models (mono exponential, IVIM [Intravoxel Incoherent Motion], stretched exponential, and kurtosis) in Wilms’ tumours and the unaffected contralateral kidneys. Materials and methods DWI data were retrospectively reviewed (110 Wilms’ tumours and 75 normal kidney datasets). The goodness of fit for each model was measured voxel-wise using Akaike Information Criteria (AIC). Mean AIC was calculated for each tumour volume (or contralateral normal kidney tissue). One-way ANOVAs with Greenhouse–Geisser correction and post hoc tests using the Bonferroni correction evaluated significant differences between AIC values; the lowest AIC indicating the optimum model. Results IVIM and stretched exponential provided the best fits to the Wilms’ tumour DWI data. IVIM provided the best fit for the normal kidney data. Mono exponential was the least appropriate fitting method for both Wilms’ tumour and normal kidney data. Discussion The diffusion weighted signal in Wilms’ tumours and normal kidney tissue does not exhibit a mono-exponential decay and is better described by non-Gaussian models of diffusion.
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Affiliation(s)
- Harriet J Rogers
- Great Ormond Street Institute of Child Health, University College London, 30 Guilford St, Holborn, London, WC1N 1EH, UK. .,Centre of Medical Imaging, Division of Medicine, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK.
| | | | - Chris A Clark
- Great Ormond Street Institute of Child Health, University College London, 30 Guilford St, Holborn, London, WC1N 1EH, UK
| | - Patrick W Hales
- Great Ormond Street Institute of Child Health, University College London, 30 Guilford St, Holborn, London, WC1N 1EH, UK
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Iima M. Perfusion-driven Intravoxel Incoherent Motion (IVIM) MRI in Oncology: Applications, Challenges, and Future Trends. Magn Reson Med Sci 2020; 20:125-138. [PMID: 32536681 PMCID: PMC8203481 DOI: 10.2463/mrms.rev.2019-0124] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Recent developments in MR hardware and software have allowed a surge of interest in intravoxel incoherent motion (IVIM) MRI in oncology. Beyond diffusion-weighted imaging (and the standard apparent diffusion coefficient mapping most commonly used clinically), IVIM provides information on tissue microcirculation without the need for contrast agents. In oncology, perfusion-driven IVIM MRI has already shown its potential for the differential diagnosis of malignant and benign tumors, as well as for detecting prognostic biomarkers and treatment monitoring. Current developments in IVIM data processing, and its use as a method of scanning patients who cannot receive contrast agents, are expected to increase further utilization. This paper reviews the current applications, challenges, and future trends of perfusion-driven IVIM in oncology.
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Affiliation(s)
- Mami Iima
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine.,Department of Clinical Innovative Medicine, Institute for Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital
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18
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Xing X, Zhang J, Chen Y, Zhao Q, Lang N, Yuan H. Application of monoexponential, biexponential, and stretched-exponential models of diffusion-weighted magnetic resonance imaging in the differential diagnosis of metastases and myeloma in the spine-Univariate and multivariate analysis of related parameters. Br J Radiol 2020; 93:20190891. [PMID: 32462885 DOI: 10.1259/bjr.20190891] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To explore the value of related parameters in monoexponential, biexponential, and stretched-exponential models of diffusion-weighted imaging (DWI) in differentiating metastases and myeloma in the spine. METHODS 53 metastases and 16 myeloma patients underwent MRI with 10 b-values (0-1500 s/mm2). Parameters of apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), the distribution diffusion coefficient (DDC), and intravoxel water diffusion heterogeneity (α) from DWI were calculated. The independent sample t test and the Mann-Whiney U test were used to compare the statistical difference of the parameter values between the two. Receiver operating characteristics (ROC) curve analysis was used to identify the diagnostic efficacy. Then substituted each parameter into the decision tree model and logistic regression model, identified meaningful parameters, and evaluated their joint diagnostic performance. RESULTS The ADC, D, and α values of metastases were higher than those of myeloma, whereas the D* value was lower than that of myeloma, and the difference was significant (p < 0.05); the area under the ROC curve for the above parameters was 0.661, 0.710, 0.781, and 0.743, respectively. There was no significant difference in the f and DDC values (p > 0.05). D and α were found to conform to the decision tree model, and the accuracy of model diagnosis was 84.1%. ADC and α were found to conform to the logistic regression model, and the accuracy was 87.0%. CONCLUSION The 3 models of DWI have certain values indifferentiating metastases and myeloma in spine, and the diagnostic performance of ADC, D, α and D*was better. Combining ADC with α may markedly aid in the differential diagnosis of the two. ADVANCES IN KNOWLEDGE Monoexponential, biexponential, and stretched-exponential models can offer additional information in the differential diagnosis of metastases and myeloma in the spine. Decision tree model and logistic regression model are effective methods to help further distinguish the two.
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Affiliation(s)
- Xiaoying Xing
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
| | - Jiahui Zhang
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
| | - Yongye Chen
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
| | - Qiang Zhao
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
| | - Ning Lang
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
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Goodburn RJ, Barrett T, Patterson I, Gallagher FA, Lawrence EM, Gnanapragasam VJ, Kastner C, Priest AN. Removing rician bias in diffusional kurtosis of the prostate using real-data reconstruction. Magn Reson Med 2020; 83:2243-2252. [PMID: 31737935 PMCID: PMC7065237 DOI: 10.1002/mrm.28080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE To compare prostate diffusional kurtosis imaging (DKI) metrics generated using phase-corrected real data with those generated using magnitude data with and without noise compensation (NC). METHODS Diffusion-weighted images were acquired at 3T in 16 prostate cancer patients, measuring 6 b-values (0-1500 s/mm2 ), each acquired with 6 signal averages along 3 diffusion directions, with noise-only images acquired to allow NC. In addition to conventional magnitude averaging, phase-corrected real data were averaged in an attempt to reduce rician noise-bias, with a range of phase-correction low-pass filter (LPF) sizes (8-128 pixels) tested. Each method was also tested using simulations. Pixelwise maps of apparent diffusion (D) and apparent kurtosis (K) were calculated for magnitude data with and without NC and phase-corrected real data. Average values were compared in tumor, normal transition zone (NTZ), and normal peripheral zone (NPZ). RESULTS Simulations indicated LPF size can strongly affect K metrics, where 64-pixel LPFs produced accurate metrics. Relative to metrics estimated from magnitude data without NC, median NC K were lower (P < 0.0001) by 6/11/8% in tumor/NPZ/NTZ, 64-LPF real-data K were lower (P < 0.0001) by 4/10/7%, respectively. CONCLUSION Compared with magnitude data with NC, phase-corrected real data can produce similar K, although the choice of phase-correction LPF should be chosen carefully.
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Affiliation(s)
- Rosie J. Goodburn
- Department of Medical PhysicsCambridge University Hospitals NHS Foundation TrustCambridgeUnited Kingdom
- Division of Radiotherapy and ImagingThe Institute of Cancer ResearchLondon
| | - Tristan Barrett
- Department of RadiologySchool of Clinical MedicineUniversity of CambridgeCambridgeUnited Kingdom
| | - Ilse Patterson
- Department of RadiologyCambridge University Hospitals NHS Foundation TrustCambridgeUnited Kingdom
| | - Ferdia A. Gallagher
- Department of RadiologySchool of Clinical MedicineUniversity of CambridgeCambridgeUnited Kingdom
| | - Edward M. Lawrence
- Department of RadiologySchool of Clinical MedicineUniversity of CambridgeCambridgeUnited Kingdom
| | | | - Christof Kastner
- Department of UrologyCambridge University Hospitals NHS Foundation TrustCambridgeUnited Kingdom
| | - Andrew N. Priest
- Department of RadiologySchool of Clinical MedicineUniversity of CambridgeCambridgeUnited Kingdom
- Department of RadiologyCambridge University Hospitals NHS Foundation TrustCambridgeUnited Kingdom
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Zhang J, Suo S, Liu G, Zhang S, Zhao Z, Xu J, Wu G. Comparison of Monoexponential, Biexponential, Stretched-Exponential, and Kurtosis Models of Diffusion-Weighted Imaging in Differentiation of Renal Solid Masses. Korean J Radiol 2020; 20:791-800. [PMID: 30993930 PMCID: PMC6470087 DOI: 10.3348/kjr.2018.0474] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 01/09/2019] [Indexed: 12/13/2022] Open
Abstract
Objective To compare various models of diffusion-weighted imaging including monoexponential apparent diffusion coefficient (ADC), biexponential (fast diffusion coefficient [Df], slow diffusion coefficient [Ds], and fraction of fast diffusion), stretched-exponential (distributed diffusion coefficient and anomalous exponent term [α]), and kurtosis (mean diffusivity and mean kurtosis [MK]) models in the differentiation of renal solid masses. Materials and Methods A total of 81 patients (56 men and 25 women; mean age, 57 years; age range, 30–69 years) with 18 benign and 63 malignant lesions were imaged using 3T diffusion-weighted MRI. Diffusion model selection was investigated in each lesion using the Akaike information criteria. Mann-Whitney U test and receiver operating characteristic (ROC) analysis were used for statistical evaluations. Results Goodness-of-fit analysis showed that the stretched-exponential model had the highest voxel percentages in benign and malignant lesions (90.7% and 51.4%, respectively). ADC, Ds, and MK showed significant differences between benign and malignant lesions (p < 0.05) and between low- and high-grade clear cell renal cell carcinoma (ccRCC) (p < 0.05). α was significantly lower in the benign group than in the malignant group (p < 0.05). All diffusion measures showed significant differences between ccRCC and non-ccRCC (p < 0.05) except Df and α (p = 0.143 and 0.112, respectively). α showed the highest diagnostic accuracy in differentiating benign and malignant lesions with an area under the ROC curve of 0.923, but none of the parameters from these advanced models revealed significantly better performance over ADC in discriminating subtypes or grades of renal cell carcinoma (RCC) (p > 0.05). Conclusion Compared with conventional diffusion parameters, α may provide additional information for differentiating benign and malignant renal masses, while ADC remains the most valuable parameter for differentiation of RCC subtypes and for ccRCC grading.
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Affiliation(s)
- Jianjian Zhang
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shiteng Suo
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Guiqin Liu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shan Zhang
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Zizhou Zhao
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Jianrong Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Guangyu Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
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Kim E, Kim CK, Kim HS, Jang DP, Kim IY, Hwang J. Histogram analysis from stretched exponential model on diffusion-weighted imaging: evaluation of clinically significant prostate cancer. Br J Radiol 2020; 93:20190757. [PMID: 31899654 DOI: 10.1259/bjr.20190757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To evaluate the usefulness of histogram analysis of stretched exponential model (SEM) on diffusion-weighted imaging in evaluating clinically significant prostate cancer (CSC). METHODS A total of 85 patients with prostate cancer underwent 3 T multiparametric MRI, followed by radical prostatectomy. Histogram parameters of the tumor from the SEM [distributed diffusion coefficient (DDC) and α] and the monoexponential model [MEM; apparent diffusion coefficient (ADC)] were evaluated. The associations between parameters and Gleason score or Prostate Imaging Reporting and Data System v. 2 were evaluated. The area under the receiver operating characteristics curve was calculated to evaluate diagnostic performance of parameters in predicting CSC. RESULTS The values of histogram parameters of DDC and ADC were significantly lower in patients with CSC than in patients without CSC (p < 0.05), except for skewness and kurtosis. The value of the 25th percentile of α was significantly lower in patients with CSC than in patients without CSC (p = 0.014). Histogram parameters of ADC and DDC had significant weak to moderate negative associations with Gleason score or Prostate Imaging Reporting and Data System v. 2 (p < 0.001), except for skewness and kurtosis. For predicting CSC, the area under the curves of mean ADC (0.856), 50th percentile DDC (0.852), and 25th percentile α (0.707) yielded the highest values compared to other histogram parameters from each group. CONCLUSION Histogram analysis of the SEM on diffusion-weighted imaging may be a useful quantitative tool for evaluating CSC. However, the SEM did not outperform the MEM. ADVANCES IN KNOWLEDGE Histogram parameters of SEM may be useful for evaluating CSC.
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Affiliation(s)
- EunJu Kim
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea.,Philips Healthcare, Seoul, Republic of Korea
| | - Chan Kyo Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Medical Device Management and Research, SAIHST Sungkyunkwan University, Seoul, Republic of Korea.,Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hyun Soo Kim
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Dong Pyo Jang
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - In Young Kim
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
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Diffusion-weighted magnetic resonance imaging in peritoneal carcinomatosis from suspected ovarian cancer: Diagnostic performance in correlation with surgical findings. Eur J Radiol 2019; 121:108696. [PMID: 31683251 DOI: 10.1016/j.ejrad.2019.108696] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 09/13/2019] [Accepted: 09/26/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE Ovarian cancer (OC) is the commonest cause of death by gynaecological cancer in developed countries. Peritoneal carcinomatosis (PC) complete debulking without residual disease of >1 cm is the best prognostic predictor in advanced OC. PC is assessed with Computed tomography (CT). CT accuracy and cytoreduction success predictive ability are limited. PET/CT is not an imaging standard for PC. PC shows high signal foci in Diffusion-weighted magnetic resonance imaging (DWI MRI). We assessed the diagnostic performance (DP) and tumour burden correlation of Whole body DWI with background suppression MRI (WB-DWIBS/MRI) in PC of suspected OC using the Peritoneal Cancer Index (PCI), referring to cytoreduction surgery as the standard reference. METHOD Fifty patients with suspicion of disseminated OC underwent cytoreduction and WB-DWIBS/MRI. The PCI scores tumour burden (0-3) in 13 anatomical regions (global range of 0-39). Two radiologists (Rad1/Rad2) assessed the PCI preoperatively and with surgical findings. We evaluated regional and global DP, the interobserver agreement (Cohen´s kappa coefficient), statistical differences (McNemar test) and tumour burden (Pearson's test). RESULTS 72% (36/50) were epithelial OC and 78% (39/50) achieved complete cytoreduction. Global-PCI correlation was 0.762 (Rad1) with DP: Sensitivity 0.84, specificity 0.89, accuracy 0.89, and kappa 0.41. Average global-PCI was 7. The pelvis and right hypochondrium showed the highest positive rate and DP, while the intestinal regions presented the lowest. Previous studies reported higher sensitivity than CT or PET/CT, although only a few used the PCI. CONCLUSIONS WB-DWIBS/MRI is reliable to depict, quantify and to predict complete cytoreductive surgery in OC PC.
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Lin L, Xue Y, Duan Q, Chen X, Chen H, Jiang R, Zhong T, Xu G, Geng D, Zhang J. Grading meningiomas using mono-exponential, bi-exponential and stretched exponential model-based diffusion-weighted MR imaging. Clin Radiol 2019; 74:651.e15-651.e23. [DOI: 10.1016/j.crad.2019.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 04/03/2019] [Indexed: 02/07/2023]
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Song XL, Wang L, Ren H, Wei R, Ren JL, Niu J. Intravoxel Incoherent Motion Imaging in Differentiation Borderline From Malignant Ovarian Epithelial Tumors: Correlation With Histological Cell Proliferation and Vessel Characteristics. J Magn Reson Imaging 2019; 51:928-935. [PMID: 31373117 DOI: 10.1002/jmri.26885] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/16/2019] [Accepted: 07/16/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The differentiation of borderline from malignant ovarian epithelial tumors (OETs) is difficult based on morphologic characteristics. Diffusion and perfusion information from intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) might be useful for this distinction. PURPOSE To investigate the potential of IVIM-DWI in discriminating borderline from malignant OETs by correlating with cell proliferation and microvessel density (MVD). STUDY TYPE Prospective. SUBJECTS Sixty-six patients with OETs (22 borderline, BOETs; 44 malignant, MOETs) underwent IVIM-DWI before surgery. FIELD STRENGTH 3.0T IVIM-DWI sequence with 12 b-values (0-1000 sec/mm2 ). ASSESSMENT Apparent diffusion coefficient (ADC) and IVIM-DWI parameters (diffusion coefficient [D], microvascular volume fraction [f], and pseudodiffusion coefficient [D*]) were measured. Cell proliferation and MVD was determined by immunohistochemical staining of Ki-67 and CD-31, respectively. STATISTICAL TESTS Mann-Whitney U-test; two-sample t-test; intraclass correlation coefficient; Bland-Altman analysis; receiver operating characteristics (ROC) curves; and Spearman correlation. RESULTS ADC and D in BOETs was significantly higher than those in MOETs (P < 0.001), while f in BOETs was significantly lower than those in MOETs (P < 0.001). No significant difference was found in D* between borderline and malignancies (P = 0.324). In the differential diagnosis of borderline from malignant OETs; D demonstrated the highest area under the curve (AUC) of 0.951, while ADC and f had a lower AUC of 0.921 and 0.847, respectively. The ADC and D was negatively correlated with cell proliferation (r = -0.682, r = -0.694, respectively, P < 0.001), while f was positively correlated with MVD of the OETs (r = 0.558, P < 0.001). DATA CONCLUSION IVIM-DWI may be a useful tool for differentiating BOETs from MOETs. D and f could be image biomarkers to reflect histopathological characteristics of cell proliferation and MVD in OETs. LEVEL OF EVIDENCE 1 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:928-935.
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Affiliation(s)
- Xiao-Li Song
- The Radiology Department, Shanxi Medical University Second Affiliated Hospital, Taiyuan, Shanxi, China
| | - Lifang Wang
- The Radiology Department, Shanxi Medical University Second Affiliated Hospital, Taiyuan, Shanxi, China
| | - Honghong Ren
- The Radiology Department, Shanxi Medical University Second Affiliated Hospital, Taiyuan, Shanxi, China
| | - Rong Wei
- Pathology Department, Shanxi Medical University Second Affiliated Hospital, Taiyuan, Shanxi, China
| | | | - Jinliang Niu
- The Radiology Department, Shanxi Medical University Second Affiliated Hospital, Taiyuan, Shanxi, China
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Extended abdominopelvic MRI versus CT at the time of adnexal mass characterization for assessing radiologic peritoneal cancer index (PCI) prior to cytoreductive surgery. Abdom Radiol (NY) 2019; 44:2254-2261. [PMID: 30788559 DOI: 10.1007/s00261-019-01939-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate whether extending the MRI scan to include the abdomen at the time of adnexal mass characterization could replace additional CT for peritoneal cancer index (PCI) assessment. METHODS After institutional review board approval for this prospective study, 36 consecutive females with ovarian and FT malignancies were included. All patients signed an informed consent. Patients underwent preoperative CT (32 patients) and MRI (36 patients). Images were interpreted by 2 independent observers. Surgical data were available in 27 patients. Region-by-region analysis was performed for detection rates of peritoneal carcinomatosis (PC). Inter-observer agreement for each region was evaluated by kappa statistics. Radiologic PCI was calculated by CT and MRI independently and inter-observer agreement for CT and MRI as well as agreement between radiologic and surgical PCI were evaluated by weighted-kappa statistics. RESULTS On region-by-region analysis, the highest detection rates of PC were noted at the central abdomen and pelvis. Detection rates were higher by MRI than CT, mainly in bowel serosal surface, pelvis, and right upper abdomen regions. Inter-observer agreement of MRI was higher than CT in most regions. The median PCI by CT was 5 and 4 for the first and second observers (range 0-21 for both observers), respectively. The median PCI by MRI was 6 (range 0-23 for both observers). The inter-observer agreement of PCI was excellent by both CT and MRI (k = 0.876 and k = 0.912, respectively). The agreement between CT and surgical PCI was 0.660 and 0.590 for the first and second observers, respectively. The agreement between MRI and surgical PCI was 0.797 and 0.798 for the first and second observers, respectively. CONCLUSIONS Extending MRI scan to include the abdomen at the time of adnexal mass characterization allows accurate estimation of PC, with better results than CT, obviating the need for dedicated CT scan of abdomen and pelvis for imaging of PC.
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Winfield JM, Miah AB, Strauss D, Thway K, Collins DJ, deSouza NM, Leach MO, Morgan VA, Giles SL, Moskovic E, Hayes A, Smith M, Zaidi SH, Henderson D, Messiou C. Utility of Multi-Parametric Quantitative Magnetic Resonance Imaging for Characterization and Radiotherapy Response Assessment in Soft-Tissue Sarcomas and Correlation With Histopathology. Front Oncol 2019; 9:280. [PMID: 31106141 PMCID: PMC6494941 DOI: 10.3389/fonc.2019.00280] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 03/27/2019] [Indexed: 02/05/2023] Open
Abstract
Purpose: To evaluate repeatability of quantitative multi-parametric MRI in retroperitoneal sarcomas, assess parameter changes with radiotherapy, and correlate pre-operative values with histopathological findings in the surgical specimens. Materials and Methods: Thirty patients with retroperitoneal sarcoma were imaged at baseline, of whom 27 also underwent a second baseline examination for repeatability assessment. 14/30 patients were treated with pre-operative radiotherapy and were imaged again after completing radiotherapy (50.4 Gy in 28 daily fractions, over 5.5 weeks). The following parameter estimates were assessed in the whole tumor volume at baseline and following radiotherapy: apparent diffusion coefficient (ADC), parameters of the intra-voxel incoherent motion model of diffusion-weighted MRI (D, f, D*), transverse relaxation rate, fat fraction, and enhancing fraction after gadolinium-based contrast injection. Correlation was evaluated between pre-operative quantitative parameters and histopathological assessments of cellularity and fat fraction in post-surgical specimens (ClinicalTrials.gov, registration number NCT01902667). Results: Upper and lower 95% limits of agreement were 7.1 and -6.6%, respectively for median ADC at baseline. Median ADC increased significantly post-radiotherapy. Pre-operative ADC and D were negatively correlated with cellularity (r = -0.42, p = 0.01, 95% confidence interval (CI) -0.22 to -0.59 for ADC; r = -0.45, p = 0.005, 95% CI -0.25 to -0.62 for D), and fat fraction from Dixon MRI showed strong correlation with histopathological assessment of fat fraction (r = 0.79, p = 10-7, 95% CI 0.69-0.86). Conclusion: Fat fraction on MRI corresponded to fat content on histology and therefore contributes to lesion characterization. Measurement repeatability was excellent for ADC; this parameter increased significantly post-radiotherapy even in disease categorized as stable by size criteria, and corresponded to cellularity on histology. ADC can be utilized for characterizing and assessing response in heterogeneous retroperitoneal sarcomas.
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Affiliation(s)
- Jessica M. Winfield
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Radiology, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Aisha B. Miah
- Sarcoma Unit, Department of Radiotherapy and Physics, The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Dirk Strauss
- Department of Surgery, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Khin Thway
- Sarcoma Unit, Department of Radiotherapy and Physics, The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Department of Histopathology, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - David J. Collins
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Radiology, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Nandita M. deSouza
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Radiology, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Martin O. Leach
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Veronica A. Morgan
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Radiology, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Sharon L. Giles
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Radiology, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Eleanor Moskovic
- Department of Radiology, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Andrew Hayes
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Surgery, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Myles Smith
- Department of Surgery, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Shane H. Zaidi
- Sarcoma Unit, Department of Radiotherapy and Physics, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Daniel Henderson
- Sarcoma Unit, Department of Radiotherapy and Physics, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Christina Messiou
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Department of Radiology, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
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Jin YN, Zhang Y, Cheng JL, Zheng DD, Hu Y. Monoexponential, Biexponential, and stretched-exponential models using diffusion-weighted imaging: A quantitative differentiation of breast lesions at 3.0T. J Magn Reson Imaging 2019; 50:1461-1467. [PMID: 30919518 DOI: 10.1002/jmri.26729] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) plays an important role in the differentiation of malignant and benign breast lesions. PURPOSE To investigate the utility of various diffusion parameters obtained from monoexponential, biexponential, and stretched-exponential DWI models in the differential diagnosis of breast lesions. STUDY TYPE Prospective. POPULATION Sixty-one patients (age range: 25-68 years old; mean age: 46 years old) with 31 malignant lesions, 42 benign lesions, and 28 normal breast tissues diagnosed initially by clinical palpation, ultrasonography, or conventional mammography were enrolled in the study from January to September 2016. FIELD STRENGTH 3.0T MR scanner, T1 WI, T2 WI, DWI (conventional and multi-b values), dynamic contrast-enhanced. ASSESSMENT The apparent diffusion coefficient (ADC) was calculated by monoexponential analysis. The diffusion coefficient (ADCslow ), pseudodiffusion coefficient (ADCfast ), and perfusion fraction (f) were calculated using the biexponential model. The distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) were obtained using a stretched-exponential model. All parameters were compared for malignant tumors, benign tumors, and normal breast tissues. A receiver operating characteristic curve was used to compare the ability of these parameters, in order to differentiate benign and malignant breast lesions. STATISTICAL TESTS All statistical analyses were performed using statistical software (SPSS). RESULTS ADC, ADCslow , f, DDC, and α values were significantly lower in malignant tumors when compared with normal breast tissues and benign tumors (P < 0.05). However, ADC and f had higher area under the receiver operating characteristic curve (AUC) values (0.889 and 0.919, respectively). DATA CONCLUSION The parameters derived from the biexponential and stretched-exponential DWI could provide additional information for differentiating between benign and malignant breast tumors when compared with conventional diffusion parameters. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2019;50:1461-1467.
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Affiliation(s)
- Ya-Nan Jin
- Department of Magnetic Resonance Imaging, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Zhang
- Department of Magnetic Resonance Imaging, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing-Liang Cheng
- Department of Magnetic Resonance Imaging, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Ying Hu
- Department of Magnetic Resonance Imaging, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Peerlings J, Woodruff HC, Winfield JM, Ibrahim A, Van Beers BE, Heerschap A, Jackson A, Wildberger JE, Mottaghy FM, DeSouza NM, Lambin P. Stability of radiomics features in apparent diffusion coefficient maps from a multi-centre test-retest trial. Sci Rep 2019; 9:4800. [PMID: 30886309 PMCID: PMC6423042 DOI: 10.1038/s41598-019-41344-5] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 03/05/2019] [Indexed: 12/16/2022] Open
Abstract
Quantitative radiomics features, extracted from medical images, characterize tumour-phenotypes and have been shown to provide prognostic value in predicting clinical outcomes. Stability of radiomics features extracted from apparent diffusion coefficient (ADC)-maps is essential for reliable correlation with the underlying pathology and its clinical applications. Within a multicentre, multi-vendor trial we established a method to analyse radiomics features from ADC-maps of ovarian (n = 12), lung (n = 19), and colorectal liver metastasis (n = 30) cancer patients who underwent repeated (<7 days) diffusion-weighted imaging at 1.5 T and 3 T. From these ADC-maps, 1322 features describing tumour shape, texture and intensity were retrospectively extracted and stable features were selected using the concordance correlation coefficient (CCC > 0.85). Although some features were tissue- and/or respiratory motion-specific, 122 features were stable for all tumour-entities. A large proportion of features were stable across different vendors and field strengths. By extracting stable phenotypic features, fitting-dimensionality is reduced and reliable prognostic models can be created, paving the way for clinical implementation of ADC-based radiomics.
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Affiliation(s)
- Jurgen Peerlings
- The D-Lab, Department of Precision Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Henry C Woodruff
- The D-Lab, Department of Precision Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
- Department of Radiology and Nuclear Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
| | - Jessica M Winfield
- Cancer Research UK Cancer Imaging Centre, The Institute of Cancer Research and Royal Marsden Hospital, Sutton, UK
| | - Abdalla Ibrahim
- The D-Lab, Department of Precision Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Bernard E Van Beers
- Laboratory of Imaging Biomarkers, UMR 1149 Inserm - University Paris Diderot, Paris; Department of Radiology, Beaujon University Hospital Paris Nord, Clichy, France
| | - Arend Heerschap
- Department of Radiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Alan Jackson
- Wolfson Imaging Centre, Wolfson Molecular Imaging Centre, University of Manchester, 23 Palatine Rd, Withington, Greater Manchester, UK
| | - Joachim E Wildberger
- Department of Radiology and Nuclear Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Nuclear Medicine, University Hospital RWTH Aachen University, Aachen, Germany
| | - Nandita M DeSouza
- Cancer Research UK Cancer Imaging Centre, The Institute of Cancer Research and Royal Marsden Hospital, Sutton, UK
| | - Philippe Lambin
- The D-Lab, Department of Precision Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Wang Y, Hu D, Yu H, Shen Y, Tang H, Kamel IR, Li Z. Comparison of the Diagnostic Value of Monoexponential, Biexponential, and Stretched Exponential Diffusion-weighted MRI in Differentiating Tumor Stage and Histological Grade of Bladder Cancer. Acad Radiol 2019; 26:239-246. [PMID: 29753491 DOI: 10.1016/j.acra.2018.04.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 04/01/2018] [Accepted: 04/04/2018] [Indexed: 01/13/2023]
Abstract
RATIONALE AND OBJECTIVES We aimed to determine the utility of various diffusion parameters obtained from monoexponential, biexponential, and stretched exponential diffusion-weighted imaging (DWI) models in differentiating tumor stage and grade of bladder cancer. MATERIALS AND METHODS Forty-five patients with pathologically confirmed bladder cancer underwent multi-b-value DWI. An apparent diffusion coefficient (ADC) was calculated from DWI by using a monoexponential model. A true diffusion coefficient (D), perfusion-related pseudo-diffusion coefficient (D*), and perfusion fraction (f) were calculated from DWI by using a biexponential model. A water molecular diffusion heterogeneity index (α) and distributed diffusion coefficient (DDC) were calculated from DWI by using a stretched exponential model. All parameters were compared between different stages and grades by using the Mann-Whitney U test. Receiver operating characteristic and intrareader correlation coefficient analysis were used for statistical evaluations. RESULTS ADC, D, f, and DDC values were significantly higher in the non-muscle-invasive vs muscle-invasive bladder cancers (P = .000, .000, .002, and .000, respectively) and in low-grade vs high-grade ones (P = .000, .000, .018, and .000, respectively). D* value was significantly lower in the low-grade bladder cancers compared to high-grade ones (P = .012). The areas under the receiver operating characteristic curve of ADC, D, and DDC values were 0.945, 0.912, and 0.946 in staging bladder cancers; 0.866, 0.862, and 0.856 in grading bladder cancers, respectively. CONCLUSION Biexponential and stretched exponential DWI models may provide more parameters in staging and grading bladder cancers and show a slight difference between DDC and ADC values in staging bladder cancers. These two DWI models, as well as the monoexponential models, were very helpful in staging and grading bladder cancers.
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Schmeel FC. Variability in quantitative diffusion-weighted MR imaging (DWI) across different scanners and imaging sites: is there a potential consensus that can help reducing the limits of expected bias? Eur Radiol 2018; 29:2243-2245. [PMID: 30488105 DOI: 10.1007/s00330-018-5866-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 10/25/2018] [Indexed: 12/16/2022]
Abstract
KEY POINTS • Variability of ADC measurements may be substantial across different MRI scanners and imaging sites. • DWI protocol standardization and increased awareness of frequent sources of error can help reducing the limits of expected bias. • Focusing on ADC change and normalized ADC values rather than on absolute measurements can facilitate consistent use of ADC in multi-center studies.
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Affiliation(s)
- Frederic Carsten Schmeel
- Department of Radiology, University Hospital Bonn, Rheinische-Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Germany.
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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.
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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
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Fan H, Wang TT, Ren G, Fu HL, Wu XR, Chu CT, Li WH. Characterization of tubo-ovarian abscess mimicking adnexal masses: Comparison between contrast-enhanced CT, 18F-FDG PET/CT and MRI. Taiwan J Obstet Gynecol 2018; 57:40-46. [PMID: 29458901 DOI: 10.1016/j.tjog.2017.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2017] [Indexed: 02/08/2023] Open
Abstract
0BJECTIVE: We compared the diagnostic accuracy of contrast-enhanced computed tomography (CT), fluorine 18-labeled-fludeoxyglucose (18F-FDG) positron emission tomography (PET)/CT and conventional magnetic resonance imaging (MRI) without and with diffusion-weighted imaging (DWI) for characterization of tubo-ovarian abscesses (TOAs) that mimic adnexal tumors. MATERIALS AND METHODS We evaluated (retrospectively) 43 patients who underwent contrast-enhanced CT, PET/CT, conventional MRI without and with DWI, and who were found to have TOAs and complex adnexal tumors. All images were evaluated independently by four radiologists using a two-point grading system. Results of contrast-enhanced CT, PET/CT, MRI without DWI, and MRI with DWI were compared for each patient using receiver operating characteristic curves. Sensitivity, specificity, and positive predictive value (PPV) were calculated and compared using the chi-square test. RESULTS Sensitivity of MRI with DWI (95%) was significantly higher than that of contrast-enhanced CT (78.6%), PET/CT (86.7%) and MRI without DWI (87.5%). Specificities of these modalities were not significantly different. The PPV of MRI with DWI (100%) was significantly higher than that of the other three modalities (CT, 72.4%; PET/CT 78.5%; MRI without DWI, 81.5%). Overall accuracy of MRI with DWI was significantly higher than that of the other three modalities (CT, 74.4%; PET/CT, 81.4%; MRI without DWI, 83.7%). CONCLUSION MRI with DWI shows high accuracy for characterization of complex ovarian lesions, and is the most useful method for differentiation of TOAs from ovarian tumors.
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Affiliation(s)
- Hua Fan
- Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
| | - Ting-Ting Wang
- Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
| | - Gang Ren
- Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
| | - Hong-Liang Fu
- Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
| | - Xiang-Ru Wu
- Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
| | - Cai-Ting Chu
- Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China
| | - Wen-Hua Li
- Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China.
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deSouza NM, Winfield JM, Waterton JC, Weller A, Papoutsaki MV, Doran SJ, Collins DJ, Fournier L, Sullivan D, Chenevert T, Jackson A, Boss M, Trattnig S, Liu Y. Implementing diffusion-weighted MRI for body imaging in prospective multicentre trials: current considerations and future perspectives. Eur Radiol 2018; 28:1118-1131. [PMID: 28956113 PMCID: PMC5811587 DOI: 10.1007/s00330-017-4972-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 05/24/2017] [Accepted: 06/28/2017] [Indexed: 12/18/2022]
Abstract
For body imaging, diffusion-weighted MRI may be used for tumour detection, staging, prognostic information, assessing response and follow-up. Disease detection and staging involve qualitative, subjective assessment of images, whereas for prognosis, progression or response, quantitative evaluation of the apparent diffusion coefficient (ADC) is required. Validation and qualification of ADC in multicentre trials involves examination of i) technical performance to determine biomarker bias and reproducibility and ii) biological performance to interrogate a specific aspect of biology or to forecast outcome. Unfortunately, the variety of acquisition and analysis methodologies employed at different centres make ADC values non-comparable between them. This invalidates implementation in multicentre trials and limits utility of ADC as a biomarker. This article reviews the factors contributing to ADC variability in terms of data acquisition and analysis. Hardware and software considerations are discussed when implementing standardised protocols across multi-vendor platforms together with methods for quality assurance and quality control. Processes of data collection, archiving, curation, analysis, central reading and handling incidental findings are considered in the conduct of multicentre trials. Data protection and good clinical practice are essential prerequisites. Developing international consensus of procedures is critical to successful validation if ADC is to become a useful biomarker in oncology. KEY POINTS • Standardised acquisition/analysis allows quantification of imaging biomarkers in multicentre trials. • Establishing "precision" of the measurement in the multicentre context is essential. • A repository with traceable data of known provenance promotes further research.
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Affiliation(s)
- N. M. deSouza
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - J. M. Winfield
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - J. C. Waterton
- Manchester Academic Health Sciences Institute, University of Manchester, Manchester, UK
| | - A. Weller
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - M.-V. Papoutsaki
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - S. J. Doran
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - D. J. Collins
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT UK
| | - L. Fournier
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Radiology Department, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - D. Sullivan
- Duke Comprehensive Cancer Institute, Durham, NC USA
| | - T. Chenevert
- Department of Radiology, University of Michigan Health System, Ann Arbor, MI USA
| | - A. Jackson
- Manchester Academic Health Sciences Institute, University of Manchester, Manchester, UK
| | - M. Boss
- Applied Physics Division, National Institute of Standards and Technology (NIST), Boulder, CO USA
| | - S. Trattnig
- Department of Biomedical Imaging and Image guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
| | - Y. Liu
- European Organisation for Research and Treatment of Cancer, Headquarters, Brussels, Belgium
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Wang Q, Guo C, Zhang L, Zhang R, Wang Z, Xu Y, Xiao W. BOLD MRI to evaluate early development of renal injury in a rat model of diabetes. J Int Med Res 2018; 46:1391-1403. [PMID: 29446322 PMCID: PMC6091826 DOI: 10.1177/0300060517743826] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To investigate changes in renal oxygenation levels by blood-oxygenation-level dependent (BOLD)-magnetic resonance imaging (MRI), and to evaluate BOLD-MRI for detecting early diabetic renal injury. Methods Seventy-five rats, with unilateral nephrectomy, were randomly divided into streptozotocin-induced diabetes mellitus (DM, n = 65) and normal control (NC, n = 10) groups. BOLD-MRI scans were performed at baseline (both groups) and at 3, 7, 14, 21, 28, 35, 42, 49, 56, 63 and 70 days (DM only). Renal cortical (C) and medullary (M) R2* signals were measured and R2* medulla/cortex ratio (MCR) was calculated. Results DM-group CR2* and MR2* values were significantly higher than NC values following diabetes induction. R2* values increased gradually and peaked at day 35 (CR2*, 33.95 ± 0.34 s–1; MR2*, 43.79 ± 1.46 s–1), then dropped gradually (CR2*, 33.17 ± 0.69 s–1; MR2*, 41.61 ± 0.95 s–1 at day 70). DM-group MCR rose gradually from 1.12 to 1.32 at day 42, then decreased to 1.25 by day 70. Conclusions BOLD-MRI can be used to non-invasively evaluate renal hypoxia and early diabetic renal injury in diabetic rats. MCR may be adopted to reflect dynamic changes in renal hypoxia.
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Affiliation(s)
- Qidong Wang
- 1 Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,*These authors contributed equally to this work
| | - Chuangen Guo
- 1 Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,*These authors contributed equally to this work
| | - Lan Zhang
- 2 Department of Radiology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, China
| | - Rui Zhang
- 1 Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhaoming Wang
- 3 Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Xu
- 4 Department of Nephrology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wenbo Xiao
- 1 Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,2 Department of Radiology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, China
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Barnes A, Alonzi R, Blackledge M, Charles-Edwards G, Collins DJ, Cook G, Coutts G, Goh V, Graves M, Kelly C, Koh DM, McCallum H, Miquel ME, O’Connor J, Padhani A, Pearson R, Priest A, Rockall A, Stirling J, Taylor S, Tunariu N, van der Meulen J, Walls D, Winfield J, Punwani S. UK quantitative WB-DWI technical workgroup: consensus meeting recommendations on optimisation, quality control, processing and analysis of quantitative whole-body diffusion-weighted imaging for cancer. Br J Radiol 2018; 91:20170577. [PMID: 29076749 PMCID: PMC5966219 DOI: 10.1259/bjr.20170577] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/09/2017] [Accepted: 10/11/2017] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Application of whole body diffusion-weighted MRI (WB-DWI) for oncology are rapidly increasing within both research and routine clinical domains. However, WB-DWI as a quantitative imaging biomarker (QIB) has significantly slower adoption. To date, challenges relating to accuracy and reproducibility, essential criteria for a good QIB, have limited widespread clinical translation. In recognition, a UK workgroup was established in 2016 to provide technical consensus guidelines (to maximise accuracy and reproducibility of WB-MRI QIBs) and accelerate the clinical translation of quantitative WB-DWI applications for oncology. METHODS A panel of experts convened from cancer centres around the UK with subspecialty expertise in quantitative imaging and/or the use of WB-MRI with DWI. A formal consensus method was used to obtain consensus agreement regarding best practice. Questions were asked about the appropriateness or otherwise on scanner hardware and software, sequence optimisation, acquisition protocols, reporting, and ongoing quality control programs to monitor precision and accuracy and agreement on quality control. RESULTS The consensus panel was able to reach consensus on 73% (255/351) items and based on consensus areas made recommendations to maximise accuracy and reproducibly of quantitative WB-DWI studies performed at 1.5T. The panel were unable to reach consensus on the majority of items related to quantitative WB-DWI performed at 3T. CONCLUSION This UK Quantitative WB-DWI Technical Workgroup consensus provides guidance on maximising accuracy and reproducibly of quantitative WB-DWI for oncology. The consensus guidance can be used by researchers and clinicians to harmonise WB-DWI protocols which will accelerate clinical translation of WB-DWI-derived QIBs.
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Affiliation(s)
- Anna Barnes
- Centre for Medical Imaging, University College London,University College London, London, UK
| | - Roberto Alonzi
- Clinical Oncology, Mount Vernon Cancer Centre, Northwood, UK
| | - Matthew Blackledge
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, Institute of Cancer Research,Institute of Cancer Research, Sutton, UK
| | | | | | | | - Glynn Coutts
- MR Physics, The Christie NHS Foundation Trust, The Christie NHS Foundation Trust, Manchester, UK
| | | | - Martin Graves
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust,Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Charles Kelly
- Department of Radiology, Northern Centre for CancerCare, Newcastle upon Tyne Hospitals, NHS Foundations Trust,Northern Centre for CancerCare, Newcastle upon Tyne Hospitals, NHS Foundations Trust, Newcastle upon Tyne, UK
| | | | - Hazel McCallum
- Department of Radiology, Northern Centre for CancerCare, Newcastle upon Tyne Hospitals, NHS Foundations Trust,Northern Centre for CancerCare, Newcastle upon Tyne Hospitals, NHS Foundations Trust, Newcastle upon Tyne, UK
| | | | | | - Anwar Padhani
- Paul Strickland Cancer Centre, Mount Vernon Cancer Centre, Northwood, UK
| | | | - Andrew Priest
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust,Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Andrea Rockall
- Department of Radiology, The Royal Marsden Hospital Foundation Trust,The Royal Marsden Hospital Foundation Trust, Surrey, UK
| | | | | | | | - Jan van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine,London School of Hygiene and Tropical Medicine, London, UK
| | - Darren Walls
- Institute Nuclear Medicine, University College London, London, UK
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Liu C, Wang K, Li X, Zhang J, Ding J, Spuhler K, Duong T, Liang C, Huang C. Breast lesion characterization using whole-lesion histogram analysis with stretched-exponential diffusion model. J Magn Reson Imaging 2017; 47:1701-1710. [PMID: 29165847 DOI: 10.1002/jmri.25904] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/06/2017] [Indexed: 01/13/2023] Open
Affiliation(s)
- Chunling Liu
- Department of Radiology; Guangdong General Hospital affiliated to South China University of Technology/Guangdong Academy of Medical Sciences; P.R. China
| | - Kun Wang
- Department of Breast Center, Cancer Center; Guangdong General Hospital affiliated to South China University of Technology/Guangdong Academy of Medical Sciences; P.R. China
| | - Xiaodan Li
- Department of Radiology; Guangdong General Hospital affiliated to South China University of Technology/Guangdong Academy of Medical Sciences; P.R. China
| | - Jine Zhang
- Department of Radiology; Guangdong General Hospital affiliated to South China University of Technology/Guangdong Academy of Medical Sciences; P.R. China
| | - Jie Ding
- Department of Biomedical Engineering; Stony Brook University; Stony Brook New York USA
| | - Karl Spuhler
- Department of Biomedical Engineering; Stony Brook University; Stony Brook New York USA
| | - Timothy Duong
- Department of Radiology; Stony Brook Medicine; Stony Brook New York USA
| | - Changhong Liang
- Department of Radiology; Guangdong General Hospital affiliated to South China University of Technology/Guangdong Academy of Medical Sciences; P.R. China
| | - Chuan Huang
- Department of Radiology; Stony Brook Medicine; Stony Brook New York USA
- Department of Psychiatry; Stony Brook Medicine; Stony Brook New York USA
- Department of Biomedical Engineering; Stony Brook University; Stony Brook New York USA
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Pathak R, Ragheb H, Thacker NA, Morris DM, Amiri H, Kuijer J, deSouza NM, Heerschap A, Jackson A. A data-driven statistical model that estimates measurement uncertainty improves interpretation of ADC reproducibility: a multi-site study of liver metastases. Sci Rep 2017; 7:14084. [PMID: 29075009 PMCID: PMC5658431 DOI: 10.1038/s41598-017-14625-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 10/09/2017] [Indexed: 02/06/2023] Open
Abstract
Apparent Diffusion Coefficient (ADC) is a potential quantitative imaging biomarker for tumour cell density and is widely used to detect early treatment changes in cancer therapy. We propose a strategy to improve confidence in the interpretation of measured changes in ADC using a data-driven model that describes sources of measurement error. Observed ADC is then standardised against this estimation of uncertainty for any given measurement. 20 patients were recruited prospectively and equitably across 4 sites, and scanned twice (test-retest) within 7 days. Repeatability measurements of defined regions (ROIs) of tumour and normal tissue were quantified as percentage change in mean ADC (test vs. re-test) and then standardised against an estimation of uncertainty. Multi-site reproducibility, (quantified as width of the 95% confidence bound between the lower confidence interval and higher confidence interval for all repeatability measurements), was compared before and after standardisation to the model. The 95% confidence interval width used to determine a statistically significant change reduced from 21.1 to 2.7% after standardisation. Small tumour volumes and respiratory motion were found to be important contributors to poor reproducibility. A look up chart has been provided for investigators who would like to estimate uncertainty from statistical error on individual ADC measurements.
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Affiliation(s)
- Ryan Pathak
- University of Manchester, Wolfson Molecular Imaging Centre, Manchester, UK.
| | - Hossein Ragheb
- University of Manchester, Wolfson Molecular Imaging Centre, Manchester, UK
| | - Neil A Thacker
- University of Manchester, Wolfson Molecular Imaging Centre, Manchester, UK
| | - David M Morris
- University of Manchester, Wolfson Molecular Imaging Centre, Manchester, UK
| | - Houshang Amiri
- Radboudumc, Radiology and Nuclear Medicine, Nijmegen, Gelderland, NL, Netherlands
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Joost Kuijer
- VU University Medical Center, Physics & Medical Technology, PO Box 7057, Amsterdam, NL, 1007MB, Netherlands
| | - Nandita M deSouza
- Institute of Cancer Research, MRI Unit, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - Arend Heerschap
- Radboudumc, Radiology and Nuclear Medicine, Nijmegen, Gelderland, NL, Netherlands
| | - Alan Jackson
- University of Manchester, Wolfson Molecular Imaging Centre, Manchester, UK
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Morgan VA, Parker C, MacDonald A, Thomas K, deSouza NM. Monitoring Tumor Volume in Patients With Prostate Cancer Undergoing Active Surveillance: Is MRI Apparent Diffusion Coefficient Indicative of Tumor Growth? AJR Am J Roentgenol 2017; 209:620-628. [PMID: 28609110 DOI: 10.2214/ajr.17.17790] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The purpose of this study was to measure longitudinal change in tumor volume of the dominant intraprostatic lesion and determine whether baseline apparent diffusion coefficient (ADC) and change in ADC are indicative of tumor growth in patients with prostate cancer undergoing active surveillance. SUBJECTS AND METHODS The study group included 151 men (mean age, 68.1 ± 7.4 [SD] years; range, 50-83 years) undergoing active surveillance with 3D whole prostate, zonal, and tumor volumetric findings documented at endorectal MRI examinations performed at two time points (median interval, 1.9 years). Tumor (location confirmed at transrectal ultrasound or template biopsy) ADC was measured on the slice with the largest lesion. Twenty randomly selected patients had the measurements repeated by the same observer after a greater than 4-month interval, and the limits of agreement of measurements were calculated. Tumor volume increases greater than the upper limit of agreement were designated measurable growth, and their baseline ADCs and change in ADC were compared with those of tumors without measurable growth (independent-samples t test). RESULTS Fifty-two (34.4%) tumors increased measurably in volume. Baseline ADC and tumor volume were negatively correlated (r = -0.42, p = 0.001). Baseline ADC values did not differ between those with and those without measurable growth (p = 0.06), but change in ADC was significantly different (-6.8% ± 12.3% for those with measurable growth vs 0.23% ± 10.1% for those without, p = 0.0005). Percentage change in tumor volume and percentage change in ADC were negatively correlated (r = -0.31, p = 0.0001). A 5.8% reduction in ADC indicated a measurable increase in tumor volume with 54.9% sensitivity and 77.0% specificity (AUC, 0.67). CONCLUSION Tumor volume increased measurably in 34.4% of men after 2 years of active surveillance. Change in ADC may be used to identify tumors with measurable growth.
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Affiliation(s)
- Veronica A Morgan
- 1 Cancer Research UK Cancer Imaging Centre, MRI Unit, Royal Marsden Hospital, Downs Rd, Sutton, Surrey SM2 5PT, UK
| | - Christopher Parker
- 2 Academic Urology Unit, Royal Marsden Hospital NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey, UK
| | - Alison MacDonald
- 1 Cancer Research UK Cancer Imaging Centre, MRI Unit, Royal Marsden Hospital, Downs Rd, Sutton, Surrey SM2 5PT, UK
| | - Karen Thomas
- 3 Statistics Unit, Royal Marsden Hospital NHS Foundation Trust, Sutton, Surrey, UK
| | - Nandita M deSouza
- 1 Cancer Research UK Cancer Imaging Centre, MRI Unit, Royal Marsden Hospital, Downs Rd, Sutton, Surrey SM2 5PT, UK
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Intravoxel Incoherent Motion Diffusion-Weighted Magnetic Resonance Imaging of Cervical Cancer With Different b-Values. J Comput Assist Tomogr 2017; 41:592-598. [PMID: 27997440 DOI: 10.1097/rct.0000000000000569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aims of this study were to evaluate the dependence of diffusion parameters on the b values adopted for intravoxel incoherent motion diffusion-weighted magnetic resonance imaging and to investigate the application value of multiple diffusion parameters obtained from monoexponential and biexponential models in subjects with a normal cervix and in cervical cancer patients. METHODS A total of 120 female patients with cervical cancer and 21 female control subjects with a normal cervix underwent diffusion-weighted magnetic resonance imaging with 13 b values (0-2000 s/mm) at 3 T. The standard apparent diffusion coefficient (Dst), diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were calculated by fitting with monoexponential and biexponential models at 2 different ranges of b values: 0 to 1000 and 0 to 2000 s/mm. A univariate analysis was performed to identify factors that could distinguish cervical carcinoma from normal cervical tissue. Parameters that correlated with the pathological grade and stage of cervical cancer were also evaluated. Receiver operating characteristic curves were used to evaluate the diagnostic efficiency of every parameter. RESULTS All the tested parameters, except the D* of the 2 different ranges of b value groups, significantly differed between the patients with cervical carcinoma and control subjects (P < 0.01). D2000, Dst2000, and D1000 showed comparable diagnostic value, with an area under the curve of 0.923, 0.909, and 0.907, respectively. Dst2000, D2000, Dst1000, and D1000 differed significantly among the 3 degrees of cervical stromal infiltration depth (P < 0.05). CONCLUSIONS D2000 and Dst2000 tended to outperform D1000 in terms of diagnostic efficiency, but there was no significant difference in their ability to differentiate cervical carcinoma from normal cervix. Cervical cancers with lower Dst and D values tended to have greater infiltration depth.
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Reischauer C, Patzwahl R, Koh DM, Froehlich JM, Gutzeit A. Non-Mono-Exponential Analysis of Diffusion-Weighted Imaging for Treatment Monitoring in Prostate Cancer Bone Metastases. Sci Rep 2017; 7:5809. [PMID: 28724944 PMCID: PMC5517576 DOI: 10.1038/s41598-017-06246-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/27/2017] [Indexed: 01/14/2023] Open
Abstract
Diffusion-weighted imaging quantified using the mono-exponential model has shown great promise for monitoring treatment response in prostate cancer bone metastases. The aim of this prospective study is to evaluate whether non-mono-exponential diffusion models better describe the water diffusion properties and may improve treatment response assessment. Diffusion-weighted imaging data of 12 treatment-naïve patients with 34 metastases acquired before and at one, two, and three months after initiation of antiandrogen treatment are analysed using the mono-exponential, the intravoxel incoherent motion, the stretched exponential, and the statistical model. Repeatability of the fitted parameters and changes under therapy are quantified. Model preference is assessed and correlation coefficients across times are calculated to delineate the relationship between the prostate-specific antigen levels and the diffusion parameters as well as between the diffusion parameters within each model. There is a clear preference for non-mono-exponential diffusion models at all time points. Particularly the stretched exponential is favoured in approximately 60% of the lesions. Its parameters increase significantly in response to treatment and are highly repeatable. Thus, the stretched exponential may be utilized as a potential optimal model for monitoring treatment response. Compared with the mono-exponential model, it may provide complementary information on tissue properties and improve response assessment.
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Affiliation(s)
- Carolin Reischauer
- Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Hirslanden Hospital St. Anna, Lucerne, Switzerland.
- Institute for Biomedical Engineering, ETH and University of Zurich, Zurich, Switzerland.
| | - René Patzwahl
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Dow-Mu Koh
- Academic Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
- CR-UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, Sutton, Surrey, UK
| | - Johannes M Froehlich
- Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Hirslanden Hospital St. Anna, Lucerne, Switzerland
| | - Andreas Gutzeit
- Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Hirslanden Hospital St. Anna, Lucerne, Switzerland
- Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
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Bedair R, Priest AN, Patterson AJ, McLean MA, Graves MJ, Manavaki R, Gill AB, Abeyakoon O, Griffiths JR, Gilbert FJ. Assessment of early treatment response to neoadjuvant chemotherapy in breast cancer using non-mono-exponential diffusion models: a feasibility study comparing the baseline and mid-treatment MRI examinations. Eur Radiol 2017; 27:2726-2736. [PMID: 27798751 PMCID: PMC5486805 DOI: 10.1007/s00330-016-4630-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 09/29/2016] [Accepted: 10/03/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To assess the feasibility of the mono-exponential, bi-exponential and stretched-exponential models in evaluating response of breast tumours to neoadjuvant chemotherapy (NACT) at 3 T. METHODS Thirty-six female patients (median age 53, range 32-75 years) with invasive breast cancer undergoing NACT were enrolled for diffusion-weighted MRI (DW-MRI) prior to the start of treatment. For assessment of early response, changes in parameters were evaluated on mid-treatment MRI in 22 patients. DW-MRI was performed using eight b values (0, 30, 60, 90, 120, 300, 600, 900 s/mm2). Apparent diffusion coefficient (ADC), tissue diffusion coefficient (D t), vascular fraction (ƒ), distributed diffusion coefficient (DDC) and alpha (α) parameters were derived. Then t tests compared the baseline and changes in parameters between response groups. Repeatability was assessed at inter- and intraobserver levels. RESULTS All patients underwent baseline MRI whereas 22 lesions were available at mid-treatment. At pretreatment, mean diffusion coefficients demonstrated significant differences between groups (p < 0.05). At mid-treatment, percentage increase in ADC and DDC showed significant differences between responders (49 % and 43 %) and non-responders (21 % and 32 %) (p = 0.03, p = 0.04). Overall, stretched-exponential parameters showed excellent repeatability. CONCLUSION DW-MRI is sensitive to baseline and early treatment changes in breast cancer using non-mono-exponential models, and the stretched-exponential model can potentially monitor such changes. KEY POINTS • Baseline diffusion coefficients demonstrated significant differences between complete pathological responders and non-responders. • Increase in ADC and DDC at mid-treatment can discriminate responders and non-responders. • The ƒ fraction at mid-treatment decreased in responders whereas increased in non-responders. • The mono- and stretched-exponential models showed excellent inter- and intrarater repeatability. • Treatment effects can potentially be assessed by non-mono-exponential diffusion models.
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Affiliation(s)
- Reem Bedair
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Andrew N Priest
- Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Andrew J Patterson
- Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Mary A McLean
- Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, CB2 0RE, UK
| | - Martin J Graves
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
- Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Roido Manavaki
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Andrew B Gill
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Oshaani Abeyakoon
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - John R Griffiths
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, CB2 0RE, UK
| | - Fiona J Gilbert
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
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Wang F, Wang Y, Zhou Y, Liu C, Xie L, Zhou Z, Liang D, Shen Y, Yao Z, Liu J. Comparison between types I and II epithelial ovarian cancer using histogram analysis of monoexponential, biexponential, and stretched-exponential diffusion models. J Magn Reson Imaging 2017; 46:1797-1809. [PMID: 28379611 DOI: 10.1002/jmri.25722] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 03/14/2017] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To evaluate the utility of histogram analysis of monoexponential, biexponential, and stretched-exponential models to a dualistic model of epithelial ovarian cancer (EOC). MATERIALS AND METHODS Fifty-two patients with histopathologically proven EOC underwent preoperative magnetic resonance imaging (MRI) (including diffusion-weighted imaging [DWI] with 11 b-values) using a 3.0T system and were divided into two groups: types I and II. Apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), distributed diffusion coefficient (DDC), and intravoxel water diffusion heterogeneity (α) histograms were obtained based on solid components of the entire tumor. The following metrics of each histogram were compared between two types: 1) mean; 2) median; 3) 10th percentile and 90th percentile. Conventional MRI morphological features were also recorded. RESULTS Significant morphological features for predicting EOC type were maximum diameter (P = 0.007), texture of lesion (P = 0.001), and peritoneal implants (P = 0.001). For ADC, D, f, DDC, and α, all metrics were significantly lower in type II than type I (P < 0.05). Mean, median, 10th, and 90th percentile of D* were not significantly different (P = 0.336, 0.154, 0.779, and 0.203, respectively). Most histogram metrics of ADC, D, and DDC had significantly higher area under the receiver operating characteristic curve values than those of f and α (P < 0.05) CONCLUSION: It is feasible to grade EOC by morphological features and three models with histogram analysis. ADC, D, and DDC have better performance than f and α; f and α may provide additional information. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1797-1809.
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Affiliation(s)
- Feng Wang
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, P.R. China
| | - Yuxiang Wang
- Department of Pathology, School of Basic Medical Science, Peking University Third Hospital, Peking University Health Science Center, Beijing, P.R. China
| | - Yan Zhou
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, P.R. China
| | - Congrong Liu
- Department of Pathology, School of Basic Medical Science, Peking University Third Hospital, Peking University Health Science Center, Beijing, P.R. China
| | - Lizhi Xie
- GE Healthcare, MR Research China, Beijing, P.R. China
| | - Zhenyu Zhou
- GE Healthcare, MR Research China, Beijing, P.R. China
| | - Dong Liang
- Siemens Ltd., China, Chaoyang District, Beijing, P.R. China
| | - Yang Shen
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, P.R. China
| | - Zhihang Yao
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, P.R. China
| | - Jianyu Liu
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, P.R. China
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Lee EYP, Perucho JAU, Vardhanabhuti V, He J, Siu SWK, Ngu SF, Mayr NA, Yuh WTC, Chan Q, Khong PL. Intravoxel incoherent motion MRI assessment of chemoradiation-induced pelvic bone marrow changes in cervical cancer and correlation with hematological toxicity. J Magn Reson Imaging 2017; 46:1491-1498. [PMID: 28225579 DOI: 10.1002/jmri.25680] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 02/06/2017] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To investigate bone marrow changes after chemoradiation (CRT) using intravoxel incoherent motion magnetic resonance imaging (IVIM-MRI) and correlate imaging changes with hematological toxicity (HT) in patients with locally advanced cervical cancer. MATERIALS AND METHODS Thirty-nine patients with newly diagnosed cervical cancer were prospectively recruited for two sequential 3.0T IVIM-MRI studies: before treatment (MRI-1) and 3-4 weeks after standardized CRT (MRI-2). The irradiated pelvic bone marrow was outlined as the regions of interest to derive the true diffusion coefficient (D) and perfusion fraction (f) based on a biexponential model. The apparent coefficient diffusion (ADC) was derived using the monoexponential model. Changes in these parameters between MRI-1 and MRI-2 were calculated as ΔD, Δf, and ΔADC. HT was defined accordingly to NCI-CTCAE (v. 4.03) of grade 3 and above. Statistical analysis was performed using Mann-Whitney U-test. RESULTS The median age of patients was 54 years old (range 27-83 years old); 14 patients suffered from HT. Early bone marrow changes (3-4 weeks) of ΔD showed a significant difference between HT and non-HT groups (6.4 ± 19.7% vs. -6.4 ± 19.4%, respectively, P = 0.041). However, no significant changes were noted in Δf (3.7 ± 13.3% vs. 1.5 ± 12.5% respectively, P = 0. 592) and ΔADC (5.5 ± 26.3% vs. -3.3 ± 27.0% respectively, P = 0.303) between the HT and non-HT groups. Δf increased insignificantly for both groups. CONCLUSION ΔD was the only significant parameter to differentiate early cellular environment changes in bone marrow after CRT, suggestive that ΔD was more sensitive than Δf and ΔADC to reflect the underlying microenvironment injury. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1491-1498.
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Affiliation(s)
- Elaine Yuen Phin Lee
- Department of Diagnostic Radiology, Queen Mary Hospital, University of Hong Kong, P.R. China
| | | | - Vince Vardhanabhuti
- Department of Diagnostic Radiology, Queen Mary Hospital, University of Hong Kong, P.R. China
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, P.R. China
| | | | - Siew Fei Ngu
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, P.R. China
| | - Nina A Mayr
- Department of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - William T C Yuh
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | | | - Pek-Lan Khong
- Department of Diagnostic Radiology, Queen Mary Hospital, University of Hong Kong, P.R. China
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Winfield JM, Orton MR, Collins DJ, Ind TEJ, Attygalle A, Hazell S, Morgan VA, deSouza NM. Separation of type and grade in cervical tumours using non-mono-exponential models of diffusion-weighted MRI. Eur Radiol 2017; 27:627-636. [PMID: 27221560 PMCID: PMC5209433 DOI: 10.1007/s00330-016-4417-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/15/2016] [Accepted: 05/13/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Assessment of empirical diffusion-weighted MRI (DW-MRI) models in cervical tumours to investigate whether fitted parameters distinguish between types and grades of tumours. METHODS Forty-two patients (24 squamous cell carcinomas, 14 well/moderately differentiated, 10 poorly differentiated; 15 adenocarcinomas, 13 well/moderately differentiated, two poorly differentiated; three rare types) were imaged at 3 T using nine b-values (0 to 800 s mm-2). Mono-exponential, stretched exponential, kurtosis, statistical, and bi-exponential models were fitted. Model preference was assessed using Bayesian Information Criterion analysis. Differences in fitted parameters between tumour types/grades and correlation between fitted parameters were assessed using two-way analysis of variance and Pearson's linear correlation coefficient, respectively. RESULTS Non-mono-exponential models were preferred by 83 % of tumours with bi-exponential and stretched exponential models preferred by the largest numbers of tumours. Apparent diffusion coefficient (ADC) and diffusion coefficients from non-mono-exponential models were significantly lower in poorly differentiated tumours than well/moderately differentiated tumours. α (stretched exponential), K (kurtosis), f and D* (bi-exponential) were significantly different between tumour types. Strong correlation was observed between ADC and diffusion coefficients from other models. CONCLUSIONS Non-mono-exponential models were preferred to the mono-exponential model in DW-MRI data from cervical tumours. Parameters of non-mono-exponential models showed significant differences between types and grades of tumours. KEY POINTS • Non-mono-exponential DW-MRI models are preferred in the majority of cervical tumours. • Poorly differentiated cervical tumours exhibit lower diffusion coefficients than well/moderately differentiated tumours. • Non-mono-exponential model parameters α, K, f, and D* differ between tumour types. • Micro-structural features are likely to affect parameters in non-mono-exponential models differently.
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Affiliation(s)
- Jessica M Winfield
- MRI Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK.
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK.
| | - Matthew R Orton
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
| | - David J Collins
- MRI Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
| | - Thomas E J Ind
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
| | - Ayoma Attygalle
- Department of Histopathology, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
| | - Steve Hazell
- Department of Histopathology, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
| | - Veronica A Morgan
- MRI Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
| | - Nandita M deSouza
- MRI Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
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Suo S, Cheng F, Cao M, Kang J, Wang M, Hua J, Hua X, Li L, Lu Q, Liu J, Xu J. Multiparametric diffusion-weighted imaging in breast lesions: Association with pathologic diagnosis and prognostic factors. J Magn Reson Imaging 2017; 46:740-750. [PMID: 28139036 DOI: 10.1002/jmri.25612] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 12/09/2016] [Indexed: 12/16/2022] Open
Affiliation(s)
- Shiteng Suo
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Fang Cheng
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Mengqiu Cao
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Jiwen Kang
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Mingyao Wang
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Jia Hua
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Xiaolan Hua
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Lan Li
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Qing Lu
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
| | - Jialin Liu
- School of Biomedical Engineering; Shanghai Jiao Tong University; Shanghai PR China
| | - Jianrong Xu
- Department of Radiology, Renji Hospital, School of Medicine; Shanghai Jiao Tong University; Shanghai PR China
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46
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Jerome NP, Miyazaki K, Collins DJ, Orton MR, d'Arcy JA, Wallace T, Moreno L, Pearson ADJ, Marshall LV, Carceller F, Leach MO, Zacharoulis S, Koh DM. Repeatability of derived parameters from histograms following non-Gaussian diffusion modelling of diffusion-weighted imaging in a paediatric oncological cohort. Eur Radiol 2017; 27:345-353. [PMID: 27003140 PMCID: PMC5127877 DOI: 10.1007/s00330-016-4318-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 02/29/2016] [Accepted: 03/02/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To examine repeatability of parameters derived from non-Gaussian diffusion models in data acquired in children with solid tumours. METHODS Paediatric patients (<16 years, n = 17) were scanned twice, 24 h apart, using DWI (6 b-values, 0-1000 mm-2 s) at 1.5 T in a prospective study. Tumour ROIs were drawn (3 slices) and all data fitted using IVIM, stretched exponential, and kurtosis models; percentage coefficients of variation (CV) calculated for each parameter at all ROI histogram centiles, including the medians. RESULTS The values for ADC, D, DDCα, α, and DDCK gave CV < 10 % down to the 5th centile, with sharp CV increases below 5th and above 95th centile. K, f, and D* showed increased CV (>30 %) over the histogram. ADC, D, DDCα, and DDCK were strongly correlated (ρ > 0.9), DDCα and α were not correlated (ρ = 0.083). CONCLUSION Perfusion- and kurtosis-related parameters displayed larger, more variable CV across the histogram, indicating observed clinical changes outside of D/DDC in these models should be interpreted with caution. Centiles below 5th for all parameters show high CV and are unreliable as diffusion metrics. The stretched exponential model behaved well for both DDCα and α, making it a strong candidate for modelling multiple-b-value diffusion imaging data. KEY POINTS • ADC has good repeatability as low 5th centile of the histogram distribution. • High CV was observed for all parameters at extremes of histogram. • Parameters from the stretched exponential model showed low coefficients of variation. • The median ADC, D, DDC α , and DDC K are highly correlated and repeatable. • Perfusion/kurtosis parameters showed high CV variations across their histogram distributions.
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Affiliation(s)
- Neil P Jerome
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, Cancer Research UK Cancer Imaging Centre, 123 Old Brompton Road, London, SW7 3RP, UK
| | - Keiko Miyazaki
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, Cancer Research UK Cancer Imaging Centre, 123 Old Brompton Road, London, SW7 3RP, UK
| | - David J Collins
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, Cancer Research UK Cancer Imaging Centre, 123 Old Brompton Road, London, SW7 3RP, UK
| | - Matthew R Orton
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, Cancer Research UK Cancer Imaging Centre, 123 Old Brompton Road, London, SW7 3RP, UK
| | - James A d'Arcy
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, Cancer Research UK Cancer Imaging Centre, 123 Old Brompton Road, London, SW7 3RP, UK
| | - Toni Wallace
- Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK
| | - Lucas Moreno
- Paediatric Drug Development Team, Division of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
- Hospital Niño Jesus, Av Menendez Pelayo 65, Madrid, Spain
- Paediatric Drug Development Unit, Children and Young People's Unit, Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK
| | - Andrew D J Pearson
- Paediatric Drug Development Team, Division of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
- Paediatric Drug Development Unit, Children and Young People's Unit, Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK
| | - Lynley V Marshall
- Paediatric Drug Development Team, Division of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
- Paediatric Drug Development Unit, Children and Young People's Unit, Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK
| | - Fernando Carceller
- Paediatric Drug Development Team, Division of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
- Paediatric Drug Development Unit, Children and Young People's Unit, Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK
| | - Martin O Leach
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, Cancer Research UK Cancer Imaging Centre, 123 Old Brompton Road, London, SW7 3RP, UK.
| | - Stergios Zacharoulis
- Paediatric Drug Development Team, Division of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK
- Paediatric Drug Development Unit, Children and Young People's Unit, Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK
| | - Dow-Mu Koh
- Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK
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Jerome NP, d’Arcy JA, Feiweier T, Koh DM, Leach MO, Collins DJ, Orton MR. Extended T2-IVIM model for correction of TE dependence of pseudo-diffusion volume fraction in clinical diffusion-weighted magnetic resonance imaging. Phys Med Biol 2016; 61:N667-N680. [PMID: 27893459 PMCID: PMC5952260 DOI: 10.1088/1361-6560/61/24/n667] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 10/24/2016] [Accepted: 11/01/2016] [Indexed: 01/19/2023]
Abstract
The bi-exponential intravoxel-incoherent-motion (IVIM) model for diffusion-weighted MRI (DWI) fails to account for differential T 2 s in the model compartments, resulting in overestimation of pseudodiffusion fraction f. An extended model, T2-IVIM, allows removal of the confounding echo-time (TE) dependence of f, and provides direct compartment T 2 estimates. Two consented healthy volunteer cohorts (n = 5, 6) underwent DWI comprising multiple TE/b-value combinations (Protocol 1: TE = 62-102 ms, b = 0-250 mm-2s, 30 combinations. Protocol 2: 8 b-values 0-800 mm-2s at TE = 62 ms, with 3 additional b-values 0-50 mm-2s at TE = 80, 100 ms; scanned twice). Data from liver ROIs were fitted with IVIM at individual TEs, and with the T2-IVIM model using all data. Repeat-measures coefficients of variation were assessed for Protocol 2. Conventional IVIM modelling at individual TEs (Protocol 1) demonstrated apparent f increasing with longer TE: 22.4 ± 7% (TE = 62 ms) to 30.7 ± 11% (TE = 102 ms); T2-IVIM model fitting accounted for all data variation. Fitting of Protocol 2 data using T2-IVIM yielded reduced f estimates (IVIM: 27.9 ± 6%, T2-IVIM: 18.3 ± 7%), as well as T 2 = 42.1 ± 7 ms, 77.6 ± 30 ms for true and pseudodiffusion compartments, respectively. A reduced Protocol 2 dataset yielded comparable results in a clinical time frame (11 min). The confounding dependence of IVIM f on TE can be accounted for using additional b/TE images and the extended T2-IVIM model.
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Affiliation(s)
- N P Jerome
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG, UK
| | - J A d’Arcy
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG, UK
| | | | - D-M Koh
- Department of Radiology, Royal Marsden Hospital, Sutton, Surrey, UK
| | - M O Leach
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG, UK
| | - D J Collins
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG, UK
| | - M R Orton
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG, UK
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Zhu HB, Zhang XY, Zhou XH, Li XT, Liu YL, Wang S, Sun YS. Assessment of pathological complete response to preoperative chemoradiotherapy by means of multiple mathematical models of diffusion-weighted MRI in locally advanced rectal cancer: A prospective single-center study. J Magn Reson Imaging 2016; 46:175-183. [PMID: 27981667 DOI: 10.1002/jmri.25567] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/10/2016] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To assess stretched-exponential, mono-exponential and intravoxel incoherent motion (IVIM) models of diffusion-weighted MRI(DWI) in predicting pathological complete response (pCR) to neoadjuvant chemoradiotherapy (CRT) in rectal cancer patients. MATERIALS AND METHODS This prospective study recruited 98 consecutive patients with locally advanced rectal cancer who underwent 3 Tesla MR examination before, during and after CRT. The apparent diffusion coefficient (ADC), IVIM-derived parameters (D, f, and D*), and stretched-exponential model-derived parameters (DDC and α) were measured. The parameters and their corresponding changes during and after CRT were compared between pCR and non-pCR. Receiver-operating characteristic curve analysis was performed to evaluate the diagnostic performance. Coefficient of variations and intraclass correlation coefficient were calculated to assess reliability and agreement. RESULTS Nineteen patients achieved pCR while 79 did not. The pCR group had higher ADC and α (ADC2 and α2 ), and their changes (ΔADC2 , and Δα2 ) at the endpoint than non-pCR group. α2 and ADC2 yielded similar AUCs (P = 0.339), Δα2 and ΔADC2 yielded similar AUCs (P = 0.263) ADC and α presented substantial agreement, and α presented the minimum CV (5.0-7.0%). CONCLUSION ADC and α were useful for assessing pCR after CRT. α might be more useful because it demonstrated better diagnostic performance than IVIM-derived parameters and better reliability than ADC. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:175-183.
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Affiliation(s)
- Hai-Bin Zhu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52, Beijing, China
| | - Xiao-Yan Zhang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52, Beijing, China
| | - Xiao-Hong Zhou
- Center for Magnetic Research, Medical Hospital, University of Illinois Hospital, Chicago, Illinois, USA
| | - Xiao-Ting Li
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52, Beijing, China
| | - Yu-Liang Liu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52, Beijing, China
| | - Shuai Wang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52, Beijing, China
| | - Ying-Shi Sun
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52, Beijing, China
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Contribution of mono-exponential, bi-exponential and stretched exponential model-based diffusion-weighted MR imaging in the diagnosis and differentiation of uterine cervical carcinoma. Eur Radiol 2016; 27:2400-2410. [DOI: 10.1007/s00330-016-4596-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 08/24/2016] [Accepted: 09/01/2016] [Indexed: 10/20/2022]
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50
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Taouli B, Beer AJ, Chenevert T, Collins D, Lehman C, Matos C, Padhani AR, Rosenkrantz AB, Shukla-Dave A, Sigmund E, Tanenbaum L, Thoeny H, Thomassin-Naggara I, Barbieri S, Corcuera-Solano I, Orton M, Partridge SC, Koh DM. Diffusion-weighted imaging outside the brain: Consensus statement from an ISMRM-sponsored workshop. J Magn Reson Imaging 2016; 44:521-40. [PMID: 26892827 PMCID: PMC4983499 DOI: 10.1002/jmri.25196] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/28/2016] [Accepted: 01/30/2016] [Indexed: 12/11/2022] Open
Abstract
The significant advances in magnetic resonance imaging (MRI) hardware and software, sequence design, and postprocessing methods have made diffusion-weighted imaging (DWI) an important part of body MRI protocols and have fueled extensive research on quantitative diffusion outside the brain, particularly in the oncologic setting. In this review, we summarize the most up-to-date information on DWI acquisition and clinical applications outside the brain, as discussed in an ISMRM-sponsored symposium held in April 2015. We first introduce recent advances in acquisition, processing, and quality control; then review scientific evidence in major organ systems; and finally describe future directions. J. Magn. Reson. Imaging 2016;44:521-540.
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Affiliation(s)
- Bachir Taouli
- Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ambros J. Beer
- Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany
| | - Thomas Chenevert
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - David Collins
- CR UK Cancer Imaging Centre, Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
| | - Constance Lehman
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Celso Matos
- Department of Radiology, Champalimaud Clinical Centre, Lisbon, Portugal
| | | | | | - Amita Shukla-Dave
- Departments of Medical Physics and Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Eric Sigmund
- Irene and Bernard Schwartz Center for Biomedical Imaging (CBI) and Center for Advanced Imaging and Innovation (CAIR), Department of Radiology, NYU Langone Medical Center, New York, New York, USA
| | - Lawrence Tanenbaum
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Harriet Thoeny
- Department of Diagnostic Radiology, Inselspital Bern, Bern, Switzerland
| | | | | | - Idoia Corcuera-Solano
- Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Matthew Orton
- CR UK Cancer Imaging Centre, Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
| | | | - Dow-Mu Koh
- Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
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