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Bonanno L, Mammone N, De Salvo S, Bramanti A, Rifici C, Sessa E, Bramanti P, Marino S, Ciurleo R. Multiple Sclerosis lesions detection by a hybrid Watershed-Clustering algorithm. Clin Imaging 2020; 72:162-167. [PMID: 33278790 DOI: 10.1016/j.clinimag.2020.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 09/21/2020] [Accepted: 11/02/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Computer Aided Diagnosis (CAD) systems have been developing in the last years with the aim of helping the diagnosis and monitoring of several diseases. We present a novel CAD system based on a hybrid Watershed-Clustering algorithm for the detection of lesions in Multiple Sclerosis. METHODS Magnetic Resonance Imaging scans (FLAIR sequences without gadolinium) of 20 patients affected by Multiple Sclerosis with hyperintense lesions were studied. The CAD system consisted of the following automated processing steps: images recording, automated segmentation based on the Watershed algorithm, detection of lesions, extraction of both dynamic and morphological features, and classification of lesions by Cluster Analysis. RESULTS The investigation was performed on 316 suspect regions including 255 lesion and 61 non-lesion cases. The Receiver Operating Characteristic analysis revealed a highly significant difference between lesions and non-lesions; the diagnostic accuracy was 87% (95% CI: 0.83-0.90), with an appropriate cut-off of 192.8; the sensitivity was 77% and the specificity was 87%. CONCLUSIONS In conclusion, we developed a CAD system by using a modified algorithm for automated image segmentation which may discriminate MS lesions from non-lesions. The proposed method generates a detection out-put that may be support the clinical evaluation.
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Affiliation(s)
- Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | - Nadia Mammone
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | | | | | - Edoardo Sessa
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
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Dietzel M, Kaiser C, Pinker K, Wenkel E, Hammon M, Uder M, Bennani Baiti B, Clauser P, Schulz-Wendtland R, Baltzer P. Automated Semi-Quantitative Analysis of Breast MRI: Potential Imaging Biomarker for the Prediction of Tissue Response to Neoadjuvant Chemotherapy. Breast Care (Basel) 2017; 12:231-236. [PMID: 29070986 PMCID: PMC5649261 DOI: 10.1159/000480226] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We aimed to investigate an automated semi-quantitative software as an imaging biomarker for the prediction of tissue response (TR) after completion of neoadjuvant chemotherapy (NAC). METHODS Breast magnetic resonance imaging (MRI) (1.5T, protocol according to international recommendations) of 67 patients with biopsy-proven invasive breast cancer were examined before and after NAC. After completion of NAC, histopathologic assessments of TR were classified according to the Chevallier grading system (CG1/4: full/non-responder; CG2/C3: partial responder). A commercially available fully automatic software (CADstream) extracted MRI parameters of tumor extension (tumor diameter/volume: TD/TV). Pre- versus post-NAC values were compared (ΔTV and ΔTD). Additionally, the software performed volumetric analyses of vascularization (VAV) after NAC. Accuracy of MRI parameters to predict TR were identified (cross-tabs, ROC, AUC, Kruskal-Wallis). RESULTS There were 37 (34.3%) CG1, 7 (6.5%) CG2, 53 (49.1%) CG3, and 11 (10.2%) CG4 lesions. The software reached area under the curve levels of 79.5% (CG1/complete response: ΔTD), 68.6% (CG2, CG3/partial response: VAV), and 88.8% to predict TR (CG4/non-response: ΔTV). CONCLUSION Semi-quantitative automated analysis of breast MRI data enabled the prediction of tissue response to NAC.
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Affiliation(s)
- Matthias Dietzel
- Department of Radiology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Clemens Kaiser
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany
| | - Katja Pinker
- Department of Radiology, Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Vienna, Austria
| | - Evelyn Wenkel
- Department of Radiology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Hammon
- Department of Radiology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Barbara Bennani Baiti
- Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Vienna, Austria
| | - Paola Clauser
- Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Vienna, Austria
| | | | - Pascal Baltzer
- Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Division of Molecular and Gender Imaging, Vienna, Austria
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Dietzel M, Hopp T, Ruiter NV, Kaiser CG, Kaiser WA, Baltzer PA. 4D co-registration of X-ray and MR-mammograms: initial clinical results and potential incremental diagnostic value. Clin Imaging 2014; 39:225-30. [PMID: 25537430 DOI: 10.1016/j.clinimag.2014.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 10/08/2014] [Accepted: 11/10/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE 4D co-registration of X-ray- and MR-mammograms (XM and MM) is a new method of image fusion. The present study aims to evaluate its clinical feasibility, radiological accuracy, and potential clinical value. METHODS XM and MM of 25 patients were co-registered. Results were evaluated by a blinded reader. RESULTS Precision of the 4D co-registration was "very good" (mean-score [ms]=7), and lesions were "easier to delineate" (ms=5). In 88.8%, "relevant additional diagnostic information" was present, accounting for a more "confident diagnosis" in 76% (ms=5). CONCLUSION 4D co-registration is feasible, accurate, and of potential clinical value.
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Affiliation(s)
- Matthias Dietzel
- Department of Neuroradiology, University of Erlangen-Nürnberg, Schwabachanlage 6, D-91054, Germany; Institute of Diagnostic and Interventional Radiology I, Friedrich-Schiller-University Jena, Erlanger Allee 101, D-07740 Jena, Germany.
| | - Torsten Hopp
- Karlsruhe Institute of Technology (KIT), Institute for Data Processing and Electronics, Postfach 3640, D-76021 Karlsruhe, Germany
| | - Nicole V Ruiter
- Karlsruhe Institute of Technology (KIT), Institute for Data Processing and Electronics, Postfach 3640, D-76021 Karlsruhe, Germany
| | - Clemens G Kaiser
- Institute of Diagnostic and Interventional Radiology I, Friedrich-Schiller-University Jena, Erlanger Allee 101, D-07740 Jena, Germany; Karlsruhe Institute of Technology (KIT), Institute for Data Processing and Electronics, Postfach 3640, D-76021 Karlsruhe, Germany
| | - Werner A Kaiser
- Institute of Diagnostic and Interventional Radiology I, Friedrich-Schiller-University Jena, Erlanger Allee 101, D-07740 Jena, Germany
| | - Pascal A Baltzer
- Institute of Diagnostic and Interventional Radiology I, Friedrich-Schiller-University Jena, Erlanger Allee 101, D-07740 Jena, Germany; Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim-University of Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim Jena, Germany; Department of Biomedical Imaging and Image-guided therapy, Vienna
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Hopp T, Dietzel M, Baltzer P, Kreisel P, Kaiser W, Gemmeke H, Ruiter N. Automatic multimodal 2D/3D breast image registration using biomechanical FEM models and intensity-based optimization. Med Image Anal 2013; 17:209-18. [DOI: 10.1016/j.media.2012.10.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 10/30/2012] [Accepted: 10/31/2012] [Indexed: 10/27/2022]
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Dietzel M, Zoubi R, Vag T, Gajda M, Runnebaum IB, Kaiser WA, Baltzer PA. Association between survival in patients with primary invasive breast cancer and computer aided MRI. J Magn Reson Imaging 2012; 37:146-55. [PMID: 23011784 DOI: 10.1002/jmri.23812] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 08/08/2012] [Indexed: 11/07/2022] Open
Affiliation(s)
- Matthias Dietzel
- Institute of Diagnostic and Interventional Radiology I, Friedrich-Schiller-University Jena, Germany
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Renz DM, Böttcher J, Diekmann F, Poellinger A, Maurer MH, Pfeil A, Streitparth F, Collettini F, Bick U, Hamm B, Fallenberg EM. Detection and classification of contrast-enhancing masses by a fully automatic computer-assisted diagnosis system for breast MRI. J Magn Reson Imaging 2012; 35:1077-88. [DOI: 10.1002/jmri.23516] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 10/26/2011] [Indexed: 12/27/2022] Open
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2D/3D image fusion of X-ray mammograms with breast MRI: visualizing dynamic contrast enhancement in mammograms. Int J Comput Assist Radiol Surg 2011; 7:339-48. [DOI: 10.1007/s11548-011-0623-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Accepted: 05/13/2011] [Indexed: 10/18/2022]
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Dietzel M, Baltzer PAT, Vag T, Herzog A, Gajda M, Camara O, Kaiser WA. The necrosis sign in magnetic resonance-mammography: diagnostic accuracy in 1,084 histologically verified breast lesions. Breast J 2011; 16:603-8. [PMID: 21070437 DOI: 10.1111/j.1524-4741.2010.00982.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Necrosis sign (NS) is a new descriptor for differential diagnosis of breast lesions in magnetic resonance (MR)-mammography (MRM). This study was designed: (a) to analyze diagnostic accuracy of NS in 1,084 histologically verified breast lesions, (b) to assess performance of NS in subgroups. This study was approved by the local ethical committee. All histologically verified lesions having undergone MR-mammography at our institution over 12 years were evaluated by experienced radiologists (> 500 MRM) according to standard protocols and study design (T1w; 0.1 mmol/kg bw gadolinium diethylenetriamine penta-acetic acid; T2-turbo spin echo (TSE)). Patients with history of breast biopsy (surgically, minimal-invasive), radiation- or chemotherapy ≤ 1 year before MRM were excluded. NS was assessed on T2w-TSE sequences and was rated positive if a hyperintense center in a hypointense lesion could be visualized (chi-squared test). One thousand and eighty-four lesions were available for statistical analysis (648: malignant, 436: benign). NS was significantly associated with malignancy (p < 0.001), providing specificity and positive predictive value (PPV) of 96.1% and 78.8%. Malignant lesions > 20 mm presented significantly more often NS (p < 0.001) than neoplasias ≤ 20 mm. There was no difference regarding prevalence of NS in small versus advanced benign lesions (n.s.), leading to better performance of NS in lesions > 20 mm (PPV: 87.8%). Correlation between NS and Grading of invasive carcinomas was significant. In this study of 1,084 lesions necrosis sign was a specific and highly predictive feature for differential diagnosis in MRM (Specificity: 96.1%; PPV: 78.8%). This particularly counts for advanced lesions (PPV 87.8%). As this new descriptor correlates with Grading, it could be used as an initial estimate of patient's prognosis.
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Affiliation(s)
- Matthias Dietzel
- Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Germany.
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