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Wang YF, Ren Y, Zhu CF, Qian L, Yang Q, Deng WM, Zou LY, Liu Z, Luo DH. Optimising diffusion-weighted imaging of the thyroid gland using dedicated surface coil. Clin Radiol 2022; 77:e791-e798. [PMID: 36096939 DOI: 10.1016/j.crad.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/03/2022]
Abstract
AIM To assess the feasibility of applying field-of-view (FOV) optimised and constrained undistorted single-shot (FOCUS) diffusion-weighted imaging (DWI) in the thyroid gland by comparing its image quality with conventional DWI (C-DWI) qualitatively and quantitatively using a dedicated surface coil exclusively designed for the thyroid gland at 3 T magnetic resonance imaging (MRI). MATERIALS AND METHODS In this prospective study, 32 healthy volunteers who had undergone 3 T the thyroid gland MRI with FOCUS-DWI and C-DWI were enrolled. Two independent reviewers assessed the overall image quality, artefacts, sharpness, and geometric distortion based on a five-point Likert scale. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) were quantified for both sequences. Interobserver agreement, qualitative scores, and quantitative parameters were compared between two sequences. RESULTS Agreement between the two readers was good for FOCUS-DWI (κ = 0.714-0.778) and moderate to good for C-DWI (κ = 0.525-0.672) in qualitative image quality assessment. Qualitatively, image quality (overall image quality, artefacts, sharpness, and geometric distortion) was significantly better in FOCUS-DWI than that in the C-DWI (all p<0.05); however, quantitatively, FOCUS-DWI had significantly lower SNRs (p<0.001) and CNRs (p=0.012) compared with C-DWI. The ADC value on FOCUS-DWI was significantly higher than that on C-DWI (p<0.001). CONCLUSION FOCUS-DWI depicted the thyroid gland with significantly better image quality qualitatively and less ghost artefacts, but had significantly lower SNR and CNR quantitatively, compared with C-DWI, suggesting that both DWI sequences have advantages and could be chosen for different purposes.
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Affiliation(s)
- Y F Wang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - Y Ren
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - C F Zhu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - L Qian
- MR Research, GE Healthcare, Beijing, China
| | - Q Yang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - W M Deng
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - L Y Zou
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - Z Liu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China.
| | - D H Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China; Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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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: 17] [Impact Index Per Article: 4.3] [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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Touska P, Connor SEJ. Recent advances in MRI of the head and neck, skull base and cranial nerves: new and evolving sequences, analyses and clinical applications. Br J Radiol 2019; 92:20190513. [PMID: 31529977 PMCID: PMC6913354 DOI: 10.1259/bjr.20190513] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 12/14/2022] Open
Abstract
MRI is an invaluable diagnostic tool in the investigation and management of patients with pathology of the head and neck. However, numerous technical challenges exist, owing to a combination of fine anatomical detail, complex geometry (that is subject to frequent motion) and susceptibility effects from both endogenous structures and exogenous implants. Over recent years, there have been rapid developments in several aspects of head and neck imaging including higher resolution, isotropic 3D sequences, diffusion-weighted and diffusion-tensor imaging as well as permeability and perfusion imaging. These have led to improvements in anatomic, dynamic and functional imaging. Further developments using contrast-enhanced 3D FLAIR for the delineation of endolymphatic structures and black bone imaging for osseous structures are opening new diagnostic avenues. Furthermore, technical advances in compressed sensing and metal artefact reduction have the capacity to improve imaging speed and quality, respectively. This review explores novel and evolving MRI sequences that can be employed to evaluate diseases of the head and neck, including the skull base.
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Affiliation(s)
- Philip Touska
- Department of Radiology, Guy’s and St. Thomas’ NHS Foundation Trust, Guy’s Hospital, Great Maze Pond, London, SE1 9RT, United Kingdom
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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: 7] [Impact Index Per Article: 1.4] [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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Chen X, Zhang Y, Cao Y, Sun R, Huang P, Xu Y, Wang W, Feng Q, Xiao J, Yi J, Li Y, Dai J. A feasible study on using multiplexed sensitivity-encoding to reduce geometric distortion in diffusion-weighted echo planar imaging. Magn Reson Imaging 2018; 54:153-159. [DOI: 10.1016/j.mri.2018.08.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/29/2018] [Accepted: 08/29/2018] [Indexed: 10/28/2022]
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Liu J, Liu M, Chen Z, Jia Y, Wang G. Magnetic resonance T1-mapping evaluates the degree of thyroid destruction in patients with autoimmune thyroiditis. Endocr Connect 2018; 7:1315-1321. [PMID: 30120203 PMCID: PMC6240139 DOI: 10.1530/ec-18-0175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 08/13/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Autoimmune thyroiditis (AIT) is the most common autoimmune thyroid disease. Longitudinal relaxation time mapping (T1-mapping) measured by MRI is a new technique for assessing interstitial fibrosis of some organs, such as heart and liver. This study aimed to evaluate the relationship between T1-mapping value and thyroid function and determine the usefulness of T1-mapping in identifying thyroid destruction in AIT patients. METHODS This case-control study recruited 57 drug-naïve AIT patients and 17 healthy controls. All participants were given thyroid MRI, and T1-mapping values were measured using a modified look-locker inversion-recovery sequence. RESULTS AIT patients had significantly higher thyroid T1-mapping values than the healthy controls (1.077 ± 177 vs 778 ± 82.9 ms; P < 0.01). A significant increase in thyroid T1-mapping values was presented along with the increased severity of thyroid dysfunction (P < 0.01). Correlation analyses showed that increased thyroid T1-mapping values were associated with higher TSH and lower FT3 and FT4 levels (TSH: r = 0.75; FT3: r = -0.47; FT4: r = -0.72; all P < 0.01). Receiver-operating characteristic curve analysis revealed a high diagnostic value of T1-mapping values for the degree of thyroid destruction (area under the curve was 0.95, 95% CI: 0.90-0.99, P < 0.01). CONCLUSIONS AIT patients have higher thyroid T1-mapping values than the healthy controls, and the T1-mapping values increased with the progression of thyroid dysfunction. Thyroid T1-mapping value might be a new index to quantitatively evaluate the degree of thyroid destruction in AIT patients.
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Affiliation(s)
- Jia Liu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Min Liu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Zhe Chen
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yumei Jia
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guang Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Correspondence should be addressed to G Wang:
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Diffusion-weighted MRI in the evaluation of the thyroid nodule: Comparison between integrated-shimming EPI and conventional 3D-shimming EPI techniques. Oncotarget 2018; 9:26209-26216. [PMID: 29899853 PMCID: PMC5995232 DOI: 10.18632/oncotarget.25279] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 04/07/2018] [Indexed: 12/22/2022] Open
Abstract
This study aimed to evaluate whether a prototype echo planar imaging sequence with integrated-shimming (iShim-EPI) can improve image quality in the thyroid gland in comparison to 3D-volume shimming echo planar imaging (3D-Shim-EPI), and to compare ADC values derived from iShim-EPI with those of 3D-Shim-EPI. Twenty-one patients with thyroid disease were enrolled and underwent axial DWIs with iShim-EPI and 3D-Shim-EPI using a 3 Tesla magnetic resonance scanner in this prospective study. Both sets of DWI images were evaluated by two independent observers who identified susceptibility and ghost artifacts and evaluated the images' capacity to detect thyroid nodules using quantitative scores. The ADC values of the thyroid nodules and the normal thyroid gland were measured two times within a 4-week period. The reproducibility was evaluated using the intraclass correlation coefficient (ICC) and Bland-Altman plots. There were significant differences in the image quality scores for susceptibility (2.81 ± 0.37 vs. 1.93 ± 0.29, p < 0.001), ghost artifacts (2.95 ± 0.15 vs. 1.93 ± 0.29, p < 0.001) and the detectability of thyroid nodules (3.00 ± 0.00 vs. 2.55 ± 0.75, p = 0.008) between the iShim-EPI and 3D-Shim-EPI techniques, except for the ADC values of the thyroid nodules (1.607 ± 0.466×10−3 mm2/s vs. 1.561 ± 0.483 × 10−3 mm2/s, p = 0.184) and contralateral normal thyroid gland (1.295 ± 0.340 × 10−3 mm2/s vs.1.279 ± 0.411 × 10−3 mm2/s, p = 0.777). Both techniques demonstrated excellent agreement between the ADC values using the ICC (range, 0.963 to 0.999) and Bland-Altman plots. The iShim-EPI technique demonstrated significantly higher image quality compared with the conventional 3D-Shim-EPI technique, with no significant differences in the ADC values.
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Schakel T, Hoogduin JM, Terhaard CHJ, Philippens MEP. Technical Note: Diffusion-weighted MRI with minimal distortion in head-and-neck radiotherapy using a turbo spin echo acquisition method. Med Phys 2017; 44:4188-4193. [PMID: 28543364 DOI: 10.1002/mp.12363] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 05/18/2017] [Accepted: 05/18/2017] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Diffusion-weighted (DW) MRI, showing high contrast between tumor and background tissue, is a promising technique in radiotherapy for tumor delineation. However, its use for head-and-neck patients is hampered by poor geometric accuracy in conventional echo planar imaging (EPI) DW-MRI. An alternative turbo spin echo sequence, DW-SPLICE, is implemented and demonstrated in patients. METHODS The DW-SPLICE sequence was implemented on a 3.0 T system and evaluated in 10 patients. The patients were scanned in treatment position, using a customized head support and immobilization mask. Image distortions were quantified at the gross tumor volume (GTV) using field map analysis. The apparent diffusion coefficient (ADC) was evaluated using an ice water phantom. RESULTS The DW images acquired by DW-SPLICE showed no image distortions. Field map analysis at the gross tumor volumes resulted in a median distortion of 0.2 mm for DW-SPLICE, whereas for the conventional method this was 7.2 mm. ADC values, measured using an ice water phantom were in accordance with literature values. CONCLUSIONS The implementation of DW-SPLICE allows for diffusion-weighted imaging of patients in treatment position with excellent geometrical accuracy. The images can be used to facilitate target volume delineation in RT treatment planning.
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Affiliation(s)
- Tim Schakel
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Johannes M Hoogduin
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Chris H J Terhaard
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Marielle E P Philippens
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Preliminary study of diffusion kurtosis imaging in thyroid nodules and its histopathologic correlation. Eur Radiol 2017; 27:4710-4720. [DOI: 10.1007/s00330-017-4874-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/09/2017] [Accepted: 05/02/2017] [Indexed: 12/14/2022]
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Hao Y, Pan C, Chen W, Li T, Zhu W, Qi J. Differentiation between malignant and benign thyroid nodules and stratification of papillary thyroid cancer with aggressive histological features: Whole-lesion diffusion-weighted imaging histogram analysis. J Magn Reson Imaging 2016; 44:1546-1555. [PMID: 27093648 DOI: 10.1002/jmri.25290] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 04/04/2016] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To explore the usefulness of whole-lesion histogram analysis of apparent diffusion coefficient (ADC) derived from reduced field-of-view (r-FOV) diffusion-weighted imaging (DWI) in differentiating malignant and benign thyroid nodules and stratifying papillary thyroid cancer (PTC) with aggressive histological features. MATERIALS AND METHODS This Institutional Review Board-approved, retrospective study included 93 patients with 101 pathologically proven thyroid nodules. All patients underwent preoperative r-FOV DWI at 3T. The whole-lesion ADC assessments were performed for each patient. Histogram-derived ADC parameters between different subgroups (pathologic type, extrathyroidal extension, lymph node metastasis) were compared. Receiver operating characteristic curve analysis was used to determine optimal histogram parameters in differentiating benign and malignant nodules and predicting aggressiveness of PTC. RESULTS Mean ADC, median ADC, 5th percentile ADC, 25th percentile ADC, 75th percentile ADC, 95th percentile ADC (all P < 0.001), and kurtosis (P = 0.001) were significantly lower in malignant thyroid nodules, and mean ADC achieved the highest AUC (0.919) with a cutoff value of 1842.78 × 10-6 mm2 /s in differentiating malignant and benign nodules. Compared to the PTCs without extrathyroidal extension, PTCs with extrathyroidal extension showed significantly lower median ADC, 5th percentile ADC, and 25th percentile ADC. The 5th percentile ADC achieved the highest AUC (0.757) with cutoff value of 911.5 × 10-6 mm2 /s for differentiating between PTCs with and without extrathyroidal extension. CONCLUSION Whole-lesion ADC histogram analysis might help to differentiate malignant nodules from benign ones and show the PTCs with extrathyroidal extension. J. Magn. Reson. Imaging 2016;44:1546-1555.
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Affiliation(s)
- Yonghong Hao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chu Pan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - WeiWei Chen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Li
- Department of Radiology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - WenZhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - JianPin Qi
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Brown AM, Nagala S, McLean MA, Lu Y, Scoffings D, Apte A, Gonen M, Stambuk HE, Shaha AR, Tuttle RM, Deasy JO, Priest AN, Jani P, Shukla‐Dave A, Griffiths J. Multi-institutional validation of a novel textural analysis tool for preoperative stratification of suspected thyroid tumors on diffusion-weighted MRI. Magn Reson Med 2016; 75:1708-16. [PMID: 25995019 PMCID: PMC4654719 DOI: 10.1002/mrm.25743] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/05/2015] [Accepted: 04/02/2015] [Indexed: 12/20/2022]
Abstract
PURPOSE Ultrasound-guided fine needle aspirate cytology fails to diagnose many malignant thyroid nodules; consequently, patients may undergo diagnostic lobectomy. This study assessed whether textural analysis (TA) could noninvasively stratify thyroid nodules accurately using diffusion-weighted MRI (DW-MRI). METHODS This multi-institutional study examined 3T DW-MRI images obtained with spin echo echo planar imaging sequences. The training data set included 26 patients from Cambridge, United Kingdom, and the test data set included 18 thyroid cancer patients from Memorial Sloan Kettering Cancer Center (New York, New York, USA). Apparent diffusion coefficients (ADCs) were compared over regions of interest (ROIs) defined on thyroid nodules. TA, linear discriminant analysis (LDA), and feature reduction were performed using the 21 MaZda-generated texture parameters that best distinguished benign and malignant ROIs. RESULTS Training data set mean ADC values were significantly different for benign and malignant nodules (P = 0.02) with a sensitivity and specificity of 70% and 63%, respectively, and a receiver operator characteristic (ROC) area under the curve (AUC) of 0.73. The LDA model of the top 21 textural features correctly classified 89/94 DW-MRI ROIs with 92% sensitivity, 96% specificity, and an AUC of 0.97. This algorithm correctly classified 16/18 (89%) patients in the independently obtained test set of thyroid DW-MRI scans. CONCLUSION TA classifies thyroid nodules with high sensitivity and specificity on multi-institutional DW-MRI data sets. This method requires further validation in a larger prospective study. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance.
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Affiliation(s)
- Anna M. Brown
- Cancer Research UK Cambridge Institute, University of CambridgeLi Ka Shing CentreRobinson WayCambridgeUnited Kingdom
- Duke University School of MedicineDurhamNorth CarolinaUSA
| | - Sidhartha Nagala
- Addenbrooke's Hospital Department of OtolaryngologyCambridgeUnited Kingdom
| | - Mary A. McLean
- Cancer Research UK Cambridge Institute, University of CambridgeLi Ka Shing CentreRobinson WayCambridgeUnited Kingdom
| | - Yonggang Lu
- Department of Medical PhysicsMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Daniel Scoffings
- Addenbrooke's Hospital Department of RadiologyCambridgeUnited Kingdom
| | - Aditya Apte
- Department of Medical PhysicsMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Mithat Gonen
- Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Hilda E. Stambuk
- Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Ashok R. Shaha
- Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - R. Michael Tuttle
- Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Joseph O. Deasy
- Department of Medical PhysicsMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Andrew N. Priest
- Addenbrooke's Hospital Department of RadiologyCambridgeUnited Kingdom
| | - Piyush Jani
- Cambridge Teaching Hospitals ENT DepartmentCambridgeUnited Kingdom
| | - Amita Shukla‐Dave
- Department of Medical PhysicsMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
- Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - John Griffiths
- Cancer Research UK Cambridge Institute, University of CambridgeLi Ka Shing CentreRobinson WayCambridgeUnited Kingdom
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Wang Y, Li Z, Meng X, Hu X, Shen Y, Morelli J, Lin H, Zhang Z, Hu D. Nonmuscle-invasive and Muscle-invasive Urinary Bladder Cancer: Image Quality and Clinical Value of Reduced Field-of-view Versus Conventional Single-shot Echo-planar Imaging DWI. Medicine (Baltimore) 2016; 95:e2951. [PMID: 26962794 PMCID: PMC4998875 DOI: 10.1097/md.0000000000002951] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study compared the imaging quality, diagnostic accuracy, and apparent diffusion coefficient (ADC) values of reduced field-of-view (rFOV) diffusion-weighted imaging (DWI) and full field-of-view (fFOV) single-shot echo-planar imaging with regard to patients with nonmuscle-invasive or muscle-invasive bladder cancer.Thirty-nine patients with 60 bladder tumors underwent rFOV and fFOV DWI in this internal review board-approved study. Pathologic and histologic grades were determined for all tumors. Two observers rated DWI image quality using a 4-point scale. Two radiologists who were blinded to the pathology findings reviewed 3 image sets (T2-weighted alone, T2-weighted plus fFOV DWI, and T2-weighted plus rFOV DWI) and assigned T stages and confidence levels for tumors of stage T2 or higher. The image quality scores for the 2 DWI sequences were assessed using the Wilcoxon signed-rank test. Differences in the diagnostic accuracy, sensitivity, and specificity for each image set were evaluated using the McNemar test. Differences in performance were analyzed by comparing the areas under the receiver-operating characteristic curves (ie, the Az values). A Mann-Whitney U test was used to compare the mean ADCs and the relationship between tumor stage and histologic grade.Image quality scores were significantly higher for rFOV (mean = 3.62) than for fFOV DWI (2.98; P < 0.001). The pooled diagnostic accuracies were 57%, 70%, and 78% for the T2-weighted alone images, the T2-weighted plus fFOV DWI images, and the T2-weighted plus rFOV DWI images, respectively. The overall accuracy, specificity, and Az for diagnosing T2 or higher stages were significantly improved by adding rFOV DWI (P < 0.05). The mean ADC values of the muscle-invasive and G3 grade bladder cancers were significantly lower than those of the nonmuscle-invasive tumors and G1 grade cancers, regardless of DWI sequence (P < 0.01).rFOV DWI is superior to fFOV DWI with respect to image quality and diagnostic accuracy. ADC values might be useful for distinguishing nonmuscle-invasive from muscle-invasive cancers, and G1 from G3 grade lesions.
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Affiliation(s)
- Yanchun Wang
- From the Department of Radiology (YW, ZL, XM, XH, YS, DH), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; St John's Medical Center (JM), Tulsa, OK; and Department of GE Healthcare (HL, ZZ), China
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Koh DM, Lee JM, Bittencourt LK, Blackledge M, Collins DJ. Body Diffusion-weighted MR Imaging in Oncology: Imaging at 3 T. Magn Reson Imaging Clin N Am 2016; 24:31-44. [PMID: 26613874 DOI: 10.1016/j.mric.2015.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Advances in hardware and software enable high-quality body diffusion-weighted images to be acquired for oncologic assessment. 3.0 T affords improved signal/noise for higher spatial resolution and smaller field-of-view diffusion-weighted imaging (DWI). DWI at 3.0 T can be applied as at 1.5 T to improve tumor detection, disease characterization, and the assessment of treatment response. DWI at 3.0 T can be acquired on a hybrid PET-MR imaging system, to allow functional MR information to be combined with molecular imaging.
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Affiliation(s)
- Dow-Mu Koh
- Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
| | - Jeong-Min Lee
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
| | - Leonardo Kayat Bittencourt
- Department of Radiology, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil; CDPI and Multi-Imagem Clinics, Rio de Janeiro, Brazil
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14
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Taviani V, Alley MT, Banerjee S, Nishimura DG, Daniel BL, Vasanawala SS, Hargreaves BA. High-resolution diffusion-weighted imaging of the breast with multiband 2D radiofrequency pulses and a generalized parallel imaging reconstruction. Magn Reson Med 2016; 77:209-220. [PMID: 26778549 DOI: 10.1002/mrm.26110] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 11/20/2015] [Accepted: 12/07/2015] [Indexed: 12/25/2022]
Abstract
PURPOSE To develop a technique for high-resolution diffusion-weighted imaging (DWI) and to compare it with standard DWI methods. METHODS Multiple in-plane bands of magnetization were simultaneously excited by identically phase modulating each subpulse of a two-dimensional (2D) RF pulse. Several excitations with the same multiband pattern progressively shifted in the phase-encode direction were used to cover the prescribed field of view (FOV). The phase-encoded FOV was limited to the width of a single band to reduce off-resonance-induced distortion and blurring. Parallel imaging (PI) techniques were used to resolve aliasing from the other bands and to combine the different excitations. Following validation in phantoms and healthy volunteers, a preliminary study in breast cancer patients (N=14) was performed to compare the proposed method to conventional DWI with PI and to reduced-FOV DWI. RESULTS The proposed method gave high-resolution diffusion-weighted images with minimal artifacts at the band intersections. Compared to PI alone, higher phase-encoded FOV-reduction factors and reduced noise amplification were obtained, which translated to higher resolution images than conventional (non-multiband) DWI. The same resolution and image quality achievable over targeted regions using existing reduced-FOV methods was obtained, but the proposed method also enables complete bilateral coverage. CONCLUSION We developed an in-plane multiband technique for high-resolution DWI and compared its performance with other standard DWI methods. Magn Reson Med 77:209-220, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Valentina Taviani
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Marcus T Alley
- Department of Radiology, Stanford University, Stanford, California, USA
| | | | - Dwight G Nishimura
- Department of Electrical Engineering, Magnetic Resonance Systems Research Laboratory, Stanford University, Stanford, California, USA
| | - Bruce L Daniel
- Department of Radiology, Stanford University, Stanford, California, USA
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15
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Repeatability Investigation of Reduced Field-of-View Diffusion-Weighted Magnetic Resonance Imaging on Thyroid Glands. J Comput Assist Tomogr 2015; 39:334-9. [PMID: 25700226 DOI: 10.1097/rct.0000000000000227] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the repeatability of the quantitative magnetic resonance imaging (MRI) metric (apparent diffusion coefficient [ADC]) derived from reduced field-of-view diffusion-weighted (rFOV DWI) on thyroid glands in a clinical setting. MATERIALS AND METHODS Ten healthy human volunteers were enrolled in MRI studies performed on a 3-T MRI scanner. Each volunteer was designed to undergo 3 longitudinal examinations (2 weeks apart) with 2 repetitive sessions within each examination, which included rFOV and conventional full field-of-view (fFOV) DWI scans. Diffusion-weighted images were assessed and scored based on image characteristics. Apparent diffusion coefficient values of thyroid glands from all participants were calculated based on regions of interest. Repeatability analysis was performed based on the framework proposed by the Quantitative Imaging Biomarker Alliance, generating 4 repeatability metrics: within-participant variance ((Equation is included in full-text article.)), repeatability coefficients, intraclass correlation coefficient, and within-participant coefficient of variation. Student t test was used to compare the performance difference between rFOV and fFOV DWI. RESULTS The overall image quality from rFOV DWI was significantly higher than that from fFOV DWI (P = 0.04). The ADC values calculated from rFOV DWI were significantly lower than corresponding values from fFOV DWI (P < 0.001). There was no significant difference in ADC values across sessions and examinations in either rFOV or fFOV DWI (P > 0.05). Reduced field-of-view DWI had lower values of (Equation is included in full-text article.), repeatability coefficient, and within-participant coefficient of variation and had a higher value of intraclass correlation coefficient compared with fFOV DWI across either sessions or examinations. CONCLUSIONS This study demonstrated that rFOV DWI produced more superior-quality DWI images and more repeatable ADC measurements compared with fFOV DWI, thus providing a feasible quantitative imaging tool for investigating thyroid glands in clinical settings.
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