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Jiang L, Chen J, Huang H, Wu J, Zhang J, Lan X, Liu D, Zhang J. Comparison of the Differential Diagnostic Performance of Intravoxel Incoherent Motion Imaging and Diffusion Kurtosis Imaging in Malignant and Benign Thyroid Nodules. Front Oncol 2022; 12:895972. [PMID: 35936691 PMCID: PMC9354485 DOI: 10.3389/fonc.2022.895972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022] Open
Abstract
Objective This study aimed to compare the diagnostic capacity between IVIM and DKI in differentiating malignant from benign thyroid nodules. Material and Methods This study is based on magnetic resonance imaging data of the thyroid with histopathology as the reference standard. Spearman analysis was used to assess the relationship of IVIM-derived parameters D, f, D* and the DKI-derived parameters Dapp and Kapp. The parameters of IVIM and DKI were compared between the malignant and benign groups. Binary logistic regression analysis was performed to establish the diagnostic model, and receiver operating characteristic (ROC) curve analysis was subsequently performed. The DeLong test was used to compare the diagnostic effectiveness of different prediction models. Spearman analysis was used to assess the relationship of Ki-67 expression and parameters of IVIM and DKI. Results Among the 93 nodules, 46 nodules were malignant, and 47 nodules were benign. The Dapp of DKI-derived parameter was related to the D (P < 0.001, r = 0.863) of IVIM-derived parameter. The Kapp of DKI-derived parameter was related to the D (P < 0.001, r = -0.831) of IVIM-derived parameters. The malignant group had a significantly lower D value (P < 0.001) and f value (P = 0.013) than the benign group. The malignant group had significantly higher Kapp and lower Dapp values (all P < 0.001). The D+f had an area under the curve (AUC) of 0.951. The Dapp+Kapp had an AUC of 0.943. The D+f+Dapp+Kapp had an AUC of 0.954. The DeLong test showed no statistical significance among there prediction models. The D (P = 0.007) of IVIM-derived parameters and Dapp (P = 0.045) of DKI-derived parameter were correlated to the Ki-67 expression. Conclusions IVIM and DKI were alternative for each other in in differentiating malignant from benign thyroid nodules.
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Affiliation(s)
- Liling Jiang
- Department of Radiology, Cancer Hospital, Chongqing University, Chongqing, China
| | - Jiao Chen
- Department of Radiology, Cancer Hospital, Chongqing University, Chongqing, China
| | - Haiping Huang
- Department of Pathology, Cancer Hospital, Chongqing University, Chongqing, China
| | - Jian Wu
- Head and Neck Cancer Center, Cancer Hospital, Chongqing University, Chongqing, China
| | - Junbin Zhang
- Head and Neck Cancer Center, Cancer Hospital, Chongqing University, Chongqing, China
| | - Xiaosong Lan
- Department of Radiology, Cancer Hospital, Chongqing University, Chongqing, China
| | - Daihong Liu
- Department of Radiology, Cancer Hospital, Chongqing University, Chongqing, China
| | - Jiuquan Zhang
- Department of Radiology, Cancer Hospital, Chongqing University, Chongqing, China
- *Correspondence: Jiuquan Zhang,
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Englund EK, Reiter DA, Shahidi B, Sigmund EE. Intravoxel Incoherent Motion Magnetic Resonance Imaging in Skeletal Muscle: Review and Future Directions. J Magn Reson Imaging 2021; 55:988-1012. [PMID: 34390617 DOI: 10.1002/jmri.27875] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 12/29/2022] Open
Abstract
Throughout the body, muscle structure and function can be interrogated using a variety of noninvasive magnetic resonance imaging (MRI) methods. Recently, intravoxel incoherent motion (IVIM) MRI has gained momentum as a method to evaluate components of blood flow and tissue diffusion simultaneously. Much of the prior research has focused on highly vascularized organs, including the brain, kidney, and liver. Unique aspects of skeletal muscle, including the relatively low perfusion at rest and large dynamic range of perfusion between resting and maximal hyperemic states, may influence the acquisition, postprocessing, and interpretation of IVIM data. Here, we introduce several of those unique features of skeletal muscle; review existing studies of IVIM in skeletal muscle at rest, in response to exercise, and in disease states; and consider possible confounds that should be addressed for muscle-specific evaluations. Most studies used segmented nonlinear least squares fitting with a b-value threshold of 200 sec/mm2 to obtain IVIM parameters of perfusion fraction (f), pseudo-diffusion coefficient (D*), and diffusion coefficient (D). In healthy individuals, across all muscles, the average ± standard deviation of D was 1.46 ± 0.30 × 10-3 mm2 /sec, D* was 29.7 ± 38.1 × 10-3 mm2 /sec, and f was 11.1 ± 6.7%. Comparisons of reported IVIM parameters in muscles of the back, thigh, and leg of healthy individuals showed no significant difference between anatomic locations. Throughout the body, exercise elicited a positive change of all IVIM parameters. Future directions including advanced postprocessing models and potential sequence modifications are discussed. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Erin K Englund
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - David A Reiter
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA.,Department of Orthopedics, Emory University, Atlanta, Georgia, USA
| | - Bahar Shahidi
- Department of Orthopaedic Surgery, UC San Diego, San Diego, California, USA
| | - Eric E Sigmund
- Department of Radiology, New York University Grossman School of Medicine, NYU Langone Health, New York, New York, USA.,Center for Advanced Imaging and Innovation (CAI2R), Bernard and Irene Schwarz Center for Biomedical Imaging (CBI), NYU Langone Health, New York, New York, USA
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Núñez DA, Lu Y, Paudyal R, Hatzoglou V, Moreira AL, Oh JH, Stambuk HE, Mazaheri Y, Gonen M, Ghossein RA, Shaha AR, Tuttle RM, Shukla-Dave A. Quantitative Non-Gaussian Intravoxel Incoherent Motion Diffusion-Weighted Imaging Metrics and Surgical Pathology for Stratifying Tumor Aggressiveness in Papillary Thyroid Carcinomas. ACTA ACUST UNITED AC 2020; 5:26-35. [PMID: 30854439 PMCID: PMC6403039 DOI: 10.18383/j.tom.2018.00054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We assessed a priori aggressive features using quantitative diffusion-weighted imaging metrics to preclude an active surveillance management approach in patients with papillary thyroid cancer (PTC) with tumor size 1-2 cm. This prospective study enrolled 24 patients with PTC who underwent pretreatment multi-b-value diffusion-weighted imaging on a GE 3 T magnetic resonance imaging scanner. The apparent diffusion coefficient (ADC) metric was calculated from monoexponential model, and the perfusion fraction (f), diffusion coefficient (D), pseudo-diffusion coefficient (D*), and diffusion kurtosis coefficient (K) metrics were estimated using the non-Gaussian intravoxel incoherent motion model. Neck ultrasonography examination data were used to calculate tumor size. The receiver operating characteristic curve assessed the discriminative specificity, sensitivity, and accuracy between PTCs with and without features of tumor aggressiveness. Multivariate logistic regression analysis was performed on metrics using a leave-1-out cross-validation method. Tumor aggressiveness was defined by surgical histopathology. Tumors with aggressive features had significantly lower ADC and D values than tumors without tumor-aggressive features (P < .05). The absolute relative change was 46% in K metric value between the 2 tumor types. In total, 14 patients were in the critical size range (1-2 cm) measured by ultrasonography, and the ADC and D were significantly different and able to differentiate between the 2 tumor types (P < .05). ADC and D can distinguish tumors with aggressive histological features to preclude an active surveillance management approach in patients with PTC with tumors measuring 1-2 cm.
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Affiliation(s)
- David Aramburu Núñez
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yonggang Lu
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI
| | - Ramesh Paudyal
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Andre L Moreira
- Department of Pathology, NYU Langone Medical Center, New York, NY
| | - Jung Hun Oh
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Yousef Mazaheri
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | | | - Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY.,Departments of Radiology
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Song M, Yue Y, Jin Y, Guo J, Zuo L, Peng H, Chan Q. Intravoxel incoherent motion and ADC measurements for differentiating benign from malignant thyroid nodules: utilizing the most repeatable region of interest delineation at 3.0 T. Cancer Imaging 2020; 20:9. [PMID: 31969196 PMCID: PMC6977258 DOI: 10.1186/s40644-020-0289-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 01/13/2020] [Indexed: 01/17/2023] Open
Abstract
Background There is a growing need for a reproducible and effective imaging method for the quantitative differentiation of benign from malignant thyroid nodules. This study aimed to investigate the performances of intravoxel incoherent motion (IVIM) parameters and the apparent diffusion coefficient (ADC) in differentiating malignant from benign thyroid nodules derived from the most repeatable region of interest (ROI) delineation. Methods Forty-three patients with 46 pathologically confirmed thyroid nodules underwent diffusion-weighted imaging (DWI) with 8 b values. Two observers measured the intravoxel incoherent motion (IVIM) parameters (D, f and D*) and the apparent diffusion coefficient (ADC), ADC600 and ADC990 values using whole-lesion (W-L) ROI and IVIM parameters using single-section (S-S) ROI delineation. The intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to evaluate the intra- and interobserver variability. The diagnostic performance of these parameters was evaluated by generating receiver operating characteristic (ROC) curves. Results The ICC values of all IVIM with W-L ROI delineation were higher than those with S-S ROI delineation, and excellent intra- and interobserver reproducibility was obtained. According to the Bland-Altman plots, the 95% limits of agreement of the IVIM parameters determined by the W-L ROIs revealed smaller absolute intra- and interobserver variability than those determined by S-S ROIs. The D and ADC600 values obtained from the W-L ROIs were the most powerful parameters in differentiating benign from the malignant nodules [area under the ROC curve = 0.962 and 0.970, P = 0.771]. Conclusions The W-L ROI of the thyroid was considered an effective method for obtaining IVIM measurements with excellent reproducibility for differentiating benign from malignant nodules.
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Affiliation(s)
- Minghui Song
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Tieyilu #10, Haidian District, Beijing, 100038, China
| | - Yunlong Yue
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Tieyilu #10, Haidian District, Beijing, 100038, China.
| | - Yanfang Jin
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Tieyilu #10, Haidian District, Beijing, 100038, China
| | - Jinsong Guo
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Tieyilu #10, Haidian District, Beijing, 100038, China
| | - Lili Zuo
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Tieyilu #10, Haidian District, Beijing, 100038, China
| | - Hong Peng
- Department of Otolaryngology, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Queenie Chan
- Philips Healthcare, Shatin, New Territories, Hong Kong, China
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Song MH, Jin YF, Guo JS, Zuo L, Xie H, Shi K, Yue YL. Application of whole-lesion intravoxel incoherent motion analysis using iZOOM DWI to differentiate malignant from benign thyroid nodules. Acta Radiol 2019; 60:1127-1134. [PMID: 30458628 DOI: 10.1177/0284185118813599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Ming-hui Song
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
| | - Yan-fang Jin
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
| | - Jin-song Guo
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
| | - Lili Zuo
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
| | - Hong Xie
- Department of Otolaryngology, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
| | | | - Yun-long Yue
- Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
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