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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 2024:10.1038/s41571-024-00891-1. [PMID: 38641651 DOI: 10.1038/s41571-024-00891-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [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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Qiu Y, Dai K, Zhong S, Chen S, Wang C, Chen H, Frydman L, Zhang Z. Spatiotemporal encoding MRI in a portable low-field system. Magn Reson Med 2024. [PMID: 38623991 DOI: 10.1002/mrm.30104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Demonstrate the potential of spatiotemporal encoding (SPEN) MRI to deliver largely undistorted 2D, 3D, and diffusion weighted images on a 110 mT portable system. METHODS SPEN's quadratic phase modulation was used to subsample the low-bandwidth dimension of echo planar acquisitions, delivering alias-free images with an enhanced immunity to image distortions in a laboratory-built, low-field, portable MRI system lacking multiple receivers. RESULTS Healthy brain images with different SPEN time-bandwidth products and subsampling factors were collected. These compared favorably to EPI acquisitions including topup corrections. Robust 3D and diffusion weighted SPEN images of diagnostic value were demonstrated, with 2.5 mm isotropic resolutions achieved in 3 min scans. This performance took advantage of the low specific absorption rate and relative long TEs associated with low-field MRI. CONCLUSION SPEN MRI provides a robust and advantageous fast acquisition approach to obtain faithful 3D images and DWI data in low-cost, portable, low-field systems without parallel acceleration.
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Affiliation(s)
- Yueqi Qiu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Ke Dai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Sijie Zhong
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Suen Chen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Changyue Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Hao Chen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Lucio Frydman
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel
| | - Zhiyong Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Lee PK, Zhou X, Hargreaves BA. Robust multishot diffusion-weighted imaging of the abdomen with region-based shot rejection. Magn Reson Med 2024. [PMID: 38623901 DOI: 10.1002/mrm.30102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/18/2024] [Accepted: 03/18/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Diffusion-weighted (DW) imaging provides a useful clinical contrast, but is susceptible to motion-induced dephasing caused by the application of strong diffusion gradients. Phase navigators are commonly used to resolve shot-to-shot motion-induced phase in multishot reconstructions, but poor phase estimates result in signal dropout and Apparent Diffusion Coefficient (ADC) overestimation. These artifacts are prominent in the abdomen, a region prone to involuntary cardiac and respiratory motion. To improve the robustness of DW imaging in the abdomen, region-based shot rejection schemes that selectively weight regions where the shot-to-shot phase is poorly estimated were evaluated. METHODS Spatially varying weights for each shot, reflecting both the accuracy of the estimated phase and the degree of subvoxel dephasing, were estimated from the phase navigator magnitude images. The weighting was integrated into a multishot reconstruction using different formulations and phase navigator resolutions and tested with different phase navigator resolutions in multishot DW-echo Planar Imaging acquisitions of the liver and pancreas, using conventional monopolar and velocity-compensated diffusion encoding. Reconstructed images and ADC estimates were compared qualitatively. RESULTS The proposed region-based shot rejection reduces banding and signal dropout artifacts caused by physiological motion in the liver and pancreas. Shot rejection allows conventional monopolar diffusion encoding to achieve median ADCs in the pancreas comparable to motion-compensated diffusion encoding, albeit with a greater spread of ADCs. CONCLUSION Region-based shot rejection is a linear reconstruction that improves the motion robustness of multi-shot DWI and requires no sequence modifications.
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Affiliation(s)
- Philip K Lee
- Radiology, Stanford University, Stanford, California, USA
| | - Xuetong Zhou
- Radiology, Stanford University, Stanford, California, USA
- Bioengineering, Stanford University, Stanford, California, USA
| | - Brian A Hargreaves
- Radiology, Stanford University, Stanford, California, USA
- Bioengineering, Stanford University, Stanford, California, USA
- Electrical Engineering, Stanford University, Stanford, California, USA
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Veiga-Canuto D, Cerdá Alberich L, Fernández-Patón M, Jiménez Pastor A, Lozano-Montoya J, Miguel Blanco A, Martínez de Las Heras B, Sangüesa Nebot C, Martí-Bonmatí L. Imaging biomarkers and radiomics in pediatric oncology: a view from the PRIMAGE (PRedictive In silico Multiscale Analytics to support cancer personalized diaGnosis and prognosis, Empowered by imaging biomarkers) project. Pediatr Radiol 2024; 54:562-570. [PMID: 37747582 DOI: 10.1007/s00247-023-05770-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/01/2023] [Accepted: 09/03/2023] [Indexed: 09/26/2023]
Abstract
This review paper presents the practical development of imaging biomarkers in the scope of the PRIMAGE (PRedictive In silico Multiscale Analytics to support cancer personalized diaGnosis and prognosis, Empowered by imaging biomarkers) project, as a noninvasive and reliable way to improve the diagnosis and prognosis in pediatric oncology. The PRIMAGE project is a European multi-center research initiative that focuses on developing medical imaging-derived artificial intelligence (AI) solutions designed to enhance overall management and decision-making for two types of pediatric cancer: neuroblastoma and diffuse intrinsic pontine glioma. To allow this, the PRIMAGE project has created an open-cloud platform that combines imaging, clinical, and molecular data together with AI models developed from this data, creating a comprehensive decision support environment for clinicians managing patients with these two cancers. In order to achieve this, a standardized data processing and analysis workflow was implemented to generate robust and reliable predictions for different clinical endpoints. Magnetic resonance (MR) image harmonization and registration was performed as part of the workflow. Subsequently, an automated tool for the detection and segmentation of tumors was trained and internally validated. The Dice similarity coefficient obtained for the independent validation dataset was 0.997, indicating compatibility with the manual segmentation variability. Following this, radiomics and deep features were extracted and correlated with clinical endpoints. Finally, reproducible and relevant imaging quantitative features were integrated with clinical and molecular data to enrich both the predictive models and a set of visual analytics tools, making the PRIMAGE platform a complete clinical decision aid system. In order to ensure the advancement of research in this field and to foster engagement with the wider research community, the PRIMAGE data repository and platform are currently being integrated into the European Federation for Cancer Images (EUCAIM), which is the largest European cancer imaging research infrastructure created to date.
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Affiliation(s)
- Diana Veiga-Canuto
- Grupo de Investigación Biomédica en Imagen, Instituto de Investigación Sanitaria La Fe, Avenida Fernando Abril Martorell, 106 Torre A planta 7, 46026, Valencia, Spain.
- Área Clínica de Imagen Médica, Área Clínica de Imagen Médica, Hospital Universitari i Politècnic La Fe, Avinguda Fernando Abril Martorell, 106 Torre E planta 0, 46026, València, Spain.
| | - Leonor Cerdá Alberich
- Grupo de Investigación Biomédica en Imagen, Instituto de Investigación Sanitaria La Fe, Avenida Fernando Abril Martorell, 106 Torre A planta 7, 46026, Valencia, Spain
| | - Matías Fernández-Patón
- Grupo de Investigación Biomédica en Imagen, Instituto de Investigación Sanitaria La Fe, Avenida Fernando Abril Martorell, 106 Torre A planta 7, 46026, Valencia, Spain
| | | | | | - Ana Miguel Blanco
- Grupo de Investigación Biomédica en Imagen, Instituto de Investigación Sanitaria La Fe, Avenida Fernando Abril Martorell, 106 Torre A planta 7, 46026, Valencia, Spain
| | - Blanca Martínez de Las Heras
- Pediatric Oncology Department, Hospital Universitario y Politécnico La Fe, Avenida Fernando Abril Martorell, 106 Torre G planta 2, 46026, Valencia, Spain
| | - Cinta Sangüesa Nebot
- Área Clínica de Imagen Médica, Área Clínica de Imagen Médica, Hospital Universitari i Politècnic La Fe, Avinguda Fernando Abril Martorell, 106 Torre E planta 0, 46026, València, Spain
| | - Luis Martí-Bonmatí
- Grupo de Investigación Biomédica en Imagen, Instituto de Investigación Sanitaria La Fe, Avenida Fernando Abril Martorell, 106 Torre A planta 7, 46026, Valencia, Spain
- Área Clínica de Imagen Médica, Área Clínica de Imagen Médica, Hospital Universitari i Politècnic La Fe, Avinguda Fernando Abril Martorell, 106 Torre E planta 0, 46026, València, Spain
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Oshiro H, Hata J, Nakashima D, Hayashi N, Haga Y, Hagiya K, Yoshimaru D, Okano H. Influence of Diffusion Time and Temperature on Restricted Diffusion Signal: A Phantom Study. Magn Reson Med Sci 2024; 23:136-145. [PMID: 36754420 PMCID: PMC11024708 DOI: 10.2463/mrms.mp.2022-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/17/2022] [Indexed: 02/10/2023] Open
Abstract
PURPOSE Diffusion MRI is a physical measurement method that quantitatively indicates the displacement of water molecules diffusing in voxels. However, there are insufficient data to characterize the diffusion process physically in a uniform structure such as a phantom. This study investigated the transitional relationship between structure scale, temperature, and diffusion time for simple restricted diffusion using a capillary phantom. METHODS We performed diffusion-weighted pulsed-gradient stimulated-echo acquisition mode (STEAM) MRI with a 9.4 Tesla MRI system (Bruker BioSpin, Ettlingen, Germany) and a quadrature coil with an inner diameter of 86 mm (Bruker BioSpin). We measured the diffusion coefficients (radial diffusivity [RD]) of capillary plates (pore sizes 6, 12, 25, 50, and 100 μm) with uniformly restricted structures at various temperatures (10ºC, 20ºC, 30ºC, and 40ºC) and multiple diffusion times (12-800 ms). We evaluated the characteristics of scale, temperature, and diffusion time for restricted diffusion. RESULTS The RD decayed and became constant depending on the structural scale. Diffusion coefficient fluctuations with temperature occurred mostly under conditions of a large structural scale and short diffusion time. We obtained data suggesting that temperature-dependent changes in the diffusion coefficients follow physical laws. CONCLUSION No water molecules were observed outside the glass tubes in the capillary plates, and the capillary plates only reflected a restricted diffusion process within the structure.We experimentally evaluated the characteristics of simple restricted diffusion to reveal the transitional relationship of the diffusion coefficient with diffusion time, structure scale, and temperature through composite measurement.
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Affiliation(s)
- Hinako Oshiro
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
- Center for Brain Science, RIKEN, Wako, Saitama, Japan
| | - Junichi Hata
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
- Center for Brain Science, RIKEN, Wako, Saitama, Japan
- School of Medicine, Keio University, Tokyo, Japan
- Division of Regenerative Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Naoya Hayashi
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
- Center for Brain Science, RIKEN, Wako, Saitama, Japan
| | - Yawara Haga
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
- Center for Brain Science, RIKEN, Wako, Saitama, Japan
| | - Kei Hagiya
- Center for Brain Science, RIKEN, Wako, Saitama, Japan
| | - Daisuke Yoshimaru
- Center for Brain Science, RIKEN, Wako, Saitama, Japan
- School of Medicine, Keio University, Tokyo, Japan
- Division of Regenerative Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideyuki Okano
- Center for Brain Science, RIKEN, Wako, Saitama, Japan
- School of Medicine, Keio University, Tokyo, Japan
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Parsaei M, Hasehmi SM, Seyedmirzaei H, Cattarinussi G, Sambataro F, Brambilla P, Delvecchio G. Microstructural white matter alterations associated with social anxiety disorders: A systematic review. J Affect Disord 2024; 350:78-88. [PMID: 38220105 DOI: 10.1016/j.jad.2024.01.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/04/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Social anxiety disorder (SAD) is a psychiatric condition characterized by impaired social functioning that negatively impacts individuals' quality of life. Previous neuroimaging studies have revealed morphological and functional changes in various brain regions associated with SAD. Recent advances in diffusion tensor imaging (DTI) and diffusion-weighted imaging (DWI) have enabled the investigation of microstructural white matter (WM) alterations in SAD. This study aims to provide an overview of DTI/DWI studies exploring WM microstructure changes in SAD. METHODS A systematic search on PubMed, Scopus, Web of Science, and PsycINFO was conducted for relevant records on July 8, 2023. An exploratory meta-analysis was also performed. RESULTS Eight studies were reviewed. Consistent findings indicated reduced fractional anisotropy and increased diffusivity measures in different WM tracts in SAD patients compared to healthy controls. These alterations were mostly observed within regions of the fronto-limbic network, like uncinate fasciculus (UF) and superior and inferior longitudinal fasciculi (SLF and ILF). Finally, our exploratory meta-analysis on four studies utilizing a voxel-wise analytic approach yielded no significant differences between SAD patients and controls. LIMITATIONS Limited number of studies, small sample sizes, and heterogeneity in analysis methods. CONCLUSIONS Patients with SAD exhibited altered WM integrity, particularly in the UF, SLF, and ILF, compared to healthy controls. However, due to the limited number of included studies, our meta-analysis yielded no significant differences between SAD patients and controls. Therefore, future research is crucial to unravel the link between altered WM structure and the involvement of other limbic and cortical structures in SAD pathogenesis.
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Affiliation(s)
- Mohammadamin Parsaei
- Maternal, Fetal & Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Homa Seyedmirzaei
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Interdisciplinary Neuroscience Research Program Tehran University of Medical Sciences, Tehran, Iran
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Buchalska B, Kamińska K, Owe-Larsson M, Cudnoch-Jędrzejewska A. Cannabinoids in the treatment of glioblastoma. Pharmacol Rep 2024; 76:223-234. [PMID: 38457018 DOI: 10.1007/s43440-024-00580-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/16/2024] [Accepted: 02/22/2024] [Indexed: 03/09/2024]
Abstract
Glioblastoma (GBM) is the most prevalent primary malignant tumor of the nervous system. While the treatment of other neoplasms is increasingly more efficacious the median survival rate of GBM patients remains low and equals about 14 months. Due to this fact, there are intensive efforts to find drugs that would help combat GBM. Nowadays cannabinoids are becoming more and more important in the field of cancer and not only because of their properties of antiemetic drugs during chemotherapy. These compounds may have a direct cytotoxic effect on cancer cells. Studies indicate GBM has disturbances in the endocannabinoid system-changes in cannabinoid metabolism as well as in the cannabinoid receptor expression. The GBM cells show expression of cannabinoid receptors 1 and 2 (CB1R and CB2R), which mediate various actions of cannabinoids. Through these receptors, cannabinoids inhibit the proliferation and invasion of GBM cells, along with changing their morphology. Cannabinoids also induce an intrinsic pathway of apoptosis in the tumor. Hence the use of cannabinoids in the treatment of GBM may be beneficial to the patients. So far, studies focusing on using cannabinoids in GBM therapy are mainly preclinical and involve cell lines and mice. The results are promising and show cannabinoids inhibit GBM growth. Several clinical studies are also being carried out. The preliminary results show good tolerance of cannabinoids and prolonged survival after administration of these drugs. In this review, we describe the impact of cannabinoids on GBM and glioma cells in vitro and in animal studies. We also provide overview of clinical trials on using cannabinoids in the treatment of GBM.
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Affiliation(s)
- Barbara Buchalska
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, Warsaw, 02097, Poland
| | - Katarzyna Kamińska
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, Warsaw, 02097, Poland.
| | - Maja Owe-Larsson
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, Warsaw, 02097, Poland
| | - Agnieszka Cudnoch-Jędrzejewska
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, Warsaw, 02097, Poland
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Reiss AB, Jacob B, Zubair A, Srivastava A, Johnson M, De Leon J. Fibrosis in Chronic Kidney Disease: Pathophysiology and Therapeutic Targets. J Clin Med 2024; 13:1881. [PMID: 38610646 PMCID: PMC11012936 DOI: 10.3390/jcm13071881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
Chronic kidney disease (CKD) is a slowly progressive condition characterized by decreased kidney function, tubular injury, oxidative stress, and inflammation. CKD is a leading global health burden that is asymptomatic in early stages but can ultimately cause kidney failure. Its etiology is complex and involves dysregulated signaling pathways that lead to fibrosis. Transforming growth factor (TGF)-β is a central mediator in promoting transdifferentiation of polarized renal tubular epithelial cells into mesenchymal cells, resulting in irreversible kidney injury. While current therapies are limited, the search for more effective diagnostic and treatment modalities is intensive. Although biopsy with histology is the most accurate method of diagnosis and staging, imaging techniques such as diffusion-weighted magnetic resonance imaging and shear wave elastography ultrasound are less invasive ways to stage fibrosis. Current therapies such as renin-angiotensin blockers, mineralocorticoid receptor antagonists, and sodium/glucose cotransporter 2 inhibitors aim to delay progression. Newer antifibrotic agents that suppress the downstream inflammatory mediators involved in the fibrotic process are in clinical trials, and potential therapeutic targets that interfere with TGF-β signaling are being explored. Small interfering RNAs and stem cell-based therapeutics are also being evaluated. Further research and clinical studies are necessary in order to avoid dialysis and kidney transplantation.
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Affiliation(s)
- Allison B. Reiss
- Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA; (B.J.); (A.Z.); (A.S.); (M.J.); (J.D.L.)
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Altmann S, Grauhan NF, Mercado MAA, Steinmetz S, Kronfeld A, Paul R, Benkert T, Uphaus T, Groppa S, Winter Y, Brockmann MA, Othman AE. Deep Learning Accelerated Brain Diffusion-Weighted MRI with Super Resolution Processing. Acad Radiol 2024:S1076-6332(24)00139-9. [PMID: 38521612 DOI: 10.1016/j.acra.2024.02.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVES To investigate the clinical feasibility and image quality of accelerated brain diffusion-weighted imaging (DWI) with deep learning image reconstruction and super resolution. METHODS 85 consecutive patients with clinically indicated MRI at a 3 T scanner were prospectively included. Conventional diffusion-weighted data (c-DWI) with four averages were obtained. Reconstructions of one and two averages, as well as deep learning diffusion-weighted imaging (DL-DWI), were accomplished. Three experienced readers evaluated the acquired data using a 5-point Likert scale regarding overall image quality, overall contrast, diagnostic confidence, occurrence of artefacts and evaluation of the central region, basal ganglia, brainstem, and cerebellum. To assess interrater agreement, Fleiss' kappa (ϰ) was determined. Signal intensity (SI) levels for basal ganglia and the central region were estimated via automated segmentation, and SI values of detected pathologies were measured. RESULTS Intracranial pathologies were identified in 35 patients. DL-DWI was significantly superior for all defined parameters, independently from applied averages (p-value <0.001). Optimum image quality was achieved with DL-DWI by utilizing a single average (p-value <0.001), demonstrating very good (80.9%) to excellent image quality (14.5%) in nearly all cases, compared to 12.5% with very good and 0% with excellent image quality for c-MRI (p-value <0.001). Comparable results could be shown for diagnostic confidence. Inter-rater Fleiss' Kappa demonstrated moderate to substantial agreement for virtually all defined parameters, with good accordance, particularly for the assessment of pathologies (p = 0.74). Regarding SI values, no significant difference was found. CONCLUSION Ultra-fast diffusion-weighted imaging with super resolution is feasible, resulting in highly accelerated brain imaging while increasing diagnostic image quality.
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Affiliation(s)
- Sebastian Altmann
- Department of Neuroradiology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany.
| | - Nils F Grauhan
- Department of Neuroradiology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Mario Alberto Abello Mercado
- Department of Neuroradiology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Sebastian Steinmetz
- Department of Neuroradiology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Andrea Kronfeld
- Department of Neuroradiology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Roman Paul
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Johannes Gutenberg University, Rhabanusstr. 3/Tower A, 55118 Mainz, Germany
| | | | - Timo Uphaus
- Department of Neurology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Sergiu Groppa
- Department of Neurology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Yaroslav Winter
- Department of Neurology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany; Department of Neurology, Philipps-University Marburg, Baldingerstr, 35043 Marburg, Germany
| | - Marc A Brockmann
- Department of Neuroradiology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Ahmed E Othman
- Department of Neuroradiology, University Medical Center Mainz, Johannes Gutenberg University, Langenbeckstr. 1, 55131 Mainz, Germany
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Mohammadi S, Ghaderi S. Advanced magnetic resonance neuroimaging techniques: feasibility and applications in long or post-COVID-19 syndrome - a review. Ann Med Surg (Lond) 2024; 86:1584-1589. [PMID: 38463042 PMCID: PMC10923379 DOI: 10.1097/ms9.0000000000001808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/29/2024] [Indexed: 03/12/2024] Open
Abstract
Long-term or post-COVID-19 syndrome (PCS) is a condition that affects people infected with SARS‑CoV‑2, the virus that causes COVID-19. PCS is characterized by a wide range of persistent or new symptoms that last months after the initial infection, such as fatigue, shortness of breath, cognitive dysfunction, and pain. Advanced magnetic resonance (MR) neuroimaging techniques can provide valuable information on the structural and functional changes in the brain associated with PCS as well as potential biomarkers for diagnosis and prognosis. In this review, we discuss the feasibility and applications of various advanced MR neuroimaging techniques in PCS, including perfusion-weighted imaging (PWI), diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), functional MR imaging (fMRI), diffusion tensor imaging (DTI), and tractography. We summarize the current evidence on neuroimaging findings in PCS, the challenges and limitations of these techniques, and the future directions for research and clinical practice. Although still uncertain, advanced MRI techniques show promise for gaining insight into the pathophysiology and guiding the management of COVID-19 syndrome, pending larger validation studies.
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Affiliation(s)
- Sana Mohammadi
- Department of Medical Sciences, School of Medicine, Iran University of Medical Sciences
| | - Sadegh Ghaderi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Caznok Silveira AC, Antunes ASLM, Athié MCP, da Silva BF, Ribeiro dos Santos JV, Canateli C, Fontoura MA, Pinto A, Pimentel-Silva LR, Avansini SH, de Carvalho M. Between neurons and networks: investigating mesoscale brain connectivity in neurological and psychiatric disorders. Front Neurosci 2024; 18:1340345. [PMID: 38445254 PMCID: PMC10912403 DOI: 10.3389/fnins.2024.1340345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/29/2024] [Indexed: 03/07/2024] Open
Abstract
The study of brain connectivity has been a cornerstone in understanding the complexities of neurological and psychiatric disorders. It has provided invaluable insights into the functional architecture of the brain and how it is perturbed in disorders. However, a persistent challenge has been achieving the proper spatial resolution, and developing computational algorithms to address biological questions at the multi-cellular level, a scale often referred to as the mesoscale. Historically, neuroimaging studies of brain connectivity have predominantly focused on the macroscale, providing insights into inter-regional brain connections but often falling short of resolving the intricacies of neural circuitry at the cellular or mesoscale level. This limitation has hindered our ability to fully comprehend the underlying mechanisms of neurological and psychiatric disorders and to develop targeted interventions. In light of this issue, our review manuscript seeks to bridge this critical gap by delving into the domain of mesoscale neuroimaging. We aim to provide a comprehensive overview of conditions affected by aberrant neural connections, image acquisition techniques, feature extraction, and data analysis methods that are specifically tailored to the mesoscale. We further delineate the potential of brain connectivity research to elucidate complex biological questions, with a particular focus on schizophrenia and epilepsy. This review encompasses topics such as dendritic spine quantification, single neuron morphology, and brain region connectivity. We aim to showcase the applicability and significance of mesoscale neuroimaging techniques in the field of neuroscience, highlighting their potential for gaining insights into the complexities of neurological and psychiatric disorders.
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Affiliation(s)
- Ana Clara Caznok Silveira
- National Laboratory of Biosciences, Brazilian Center for Research in Energy and Materials, Campinas, Brazil
- School of Electrical and Computer Engineering, University of Campinas, Campinas, Brazil
| | | | - Maria Carolina Pedro Athié
- National Laboratory of Biosciences, Brazilian Center for Research in Energy and Materials, Campinas, Brazil
| | - Bárbara Filomena da Silva
- National Laboratory of Biosciences, Brazilian Center for Research in Energy and Materials, Campinas, Brazil
| | | | - Camila Canateli
- National Laboratory of Biosciences, Brazilian Center for Research in Energy and Materials, Campinas, Brazil
| | - Marina Alves Fontoura
- National Laboratory of Biosciences, Brazilian Center for Research in Energy and Materials, Campinas, Brazil
| | - Allan Pinto
- Brazilian Synchrotron Light Laboratory, Brazilian Center for Research in Energy and Materials, Campinas, Brazil
| | | | - Simoni Helena Avansini
- National Laboratory of Biosciences, Brazilian Center for Research in Energy and Materials, Campinas, Brazil
| | - Murilo de Carvalho
- National Laboratory of Biosciences, Brazilian Center for Research in Energy and Materials, Campinas, Brazil
- Brazilian Synchrotron Light Laboratory, Brazilian Center for Research in Energy and Materials, Campinas, Brazil
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Bušić M, Rumboldt Z, Čerina D, Bušić Ž, Dolić K. Prognostic Value of Apparent Diffusion Coefficient (ADC) in Patients with Diffuse Gliomas. Cancers (Basel) 2024; 16:681. [PMID: 38398073 PMCID: PMC10886867 DOI: 10.3390/cancers16040681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
This study aimed to evaluate potential posttreatment changes in ADC values within the tissue surrounding the enhancing lesion, particularly in areas not exhibiting MRI characteristics of involvement. Additionally, the objective was to investigate the correlations among ADC values, treatment response, and survival outcomes in individuals diagnosed with gliomas. This retrospective study included a total of 49 patients that underwent either stereotactic biopsy or maximal surgical resection. Histologically confirmed as Grade III or IV gliomas, all cases adhered to the 2016 and 2021 WHO classifications, with subsequent radio-chemotherapy administered post-surgery. Patients were divided into two groups: short and long survival groups. Baseline and follow-up MRI scans were obtained on a 1.5 T MRI scanner. Two ROI circles were positioned near the enhancing area, one ROI in the NAWM ipsilateral to the neoplasm and another symmetrically in the contralateral hemisphere on ADC maps. At follow-up there was a significant difference in both ipsilateral and contralateral NAWM between the two groups, -0.0857 (p = 0.004) and -0.0607 (p = 0.037), respectively. There was a weak negative correlation between survival and ADC values in ipsilateral and contralateral NAWM at the baseline with the correlation coefficient -0.328 (p = 0.02) and -0.302 (p = 0.04), respectively. The correlation was stronger at the follow-up. The findings indicate that ADC values in normal-appearing white matter (NAWM) may function as a prognostic biomarker in patients with diffuse gliomas.
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Affiliation(s)
- Marija Bušić
- Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia; (M.B.); (Ž.B.)
| | - Zoran Rumboldt
- School of Medicine, University of Rijeka, Ulica Braće Branchetta 20/1, 51000 Rijeka, Croatia;
| | - Dora Čerina
- Department of Oncology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia;
| | - Željko Bušić
- Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia; (M.B.); (Ž.B.)
| | - Krešimir Dolić
- Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia; (M.B.); (Ž.B.)
- School of Medicine, University of Split, Šoltanska 1, 21000 Split, Croatia
- University Department of Health Studies, University of Split, Ulica Ruđera Boškovića 35, 21000 Split, Croatia
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Tazza F, Schiavi S, Leveraro E, Cellerino M, Boffa G, Ballerini S, Dighero M, Uccelli A, Sbragia E, Aluan K, Inglese M, Lapucci C. Clinical and radiological correlates of apathy in multiple sclerosis. Mult Scler 2024; 30:247-256. [PMID: 38095151 DOI: 10.1177/13524585231217918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND Although apathy has been associated with fronto-striatal dysfunction in several neurological disorders, its clinical and magnetic resonance imaging (MRI) correlates have been poorly investigated in people with multiple sclerosis (PwMS). OBJECTIVES To evaluate clinical variables and investigate microstructural integrity of fronto-striatal grey matter (GM) and white matter (WM) structures using diffusion tensor imaging (DTI). METHODS A total of 123 PwMS (age: 40.25 ± 11.5; female: 60.9%; relapsing-remitting multiple sclerosis: 75.6%) were prospectively enrolled and underwent neurological and neuropsychological evaluation, including Expanded Disability Status Scale (EDSS), Apathy Evaluation Scale (AES-S), Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS) and brain 3T-MRI volumes of whole brain, frontal/prefrontal cortex (PFC) and subcortical regions were calculated. DTI-derived metrics were evaluated in the same GM regions and in connecting WM tracts. RESULTS Apathetic PwMS (32.5%) showed lower education levels, higher HADS, MFIS scores and WM lesions volume than nonapathetic PwMS. Significant differences in DTI metrics were found in middle frontal, anterior cingulate and superior frontal PFC subregions and in caudate nuclei. Significant alterations were found in the right cingulum and left striatal-frontorbital tracts. CONCLUSIONS Apathy in PwMS is associated with higher levels of physical disability, depression, anxiety and fatigue together with lower educational backgrounds. Microstructural damage within frontal cortex, caudate and fronto-striatal WM bundles is a significant pathological substrate of apathy in multiple sclerosis (MS).
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Affiliation(s)
- Francesco Tazza
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simona Schiavi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elisa Leveraro
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maria Cellerino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giacomo Boffa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Stefania Ballerini
- Department of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mara Dighero
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Uccelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elvira Sbragia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Kenda Aluan
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Caterina Lapucci
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Dhabalia R, Kashikar SV, Parihar PS, Mishra GV. Unveiling the Intricacies: A Comprehensive Review of Magnetic Resonance Imaging (MRI) Assessment of T2-Weighted Hyperintensities in the Neuroimaging Landscape. Cureus 2024; 16:e54808. [PMID: 38529430 PMCID: PMC10961652 DOI: 10.7759/cureus.54808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/24/2024] [Indexed: 03/27/2024] Open
Abstract
T2-weighted hyperintensities in neuroimaging represent areas of heightened signal intensity on magnetic resonance imaging (MRI) scans, holding crucial importance in neuroimaging. This comprehensive review explores the T2-weighted hyperintensities, providing insights into their definition, characteristics, clinical relevance, and underlying causes. It highlights the significance of these hyperintensities as sensitive markers for neurological disorders, including multiple sclerosis, vascular dementia, and brain tumors. The review also delves into advanced neuroimaging techniques, such as susceptibility-weighted and diffusion tensor imaging, and the application of artificial intelligence and machine learning in hyperintensities analysis. Furthermore, it outlines the challenges and pitfalls associated with their assessment and emphasizes the importance of standardized protocols and a multidisciplinary approach. The review discusses future directions for research and clinical practice, including the development of biomarkers, personalized medicine, and enhanced imaging techniques. Ultimately, the review underscores the profound impact of T2-weighted hyperintensities in shaping the landscape of neurological diagnosis, prognosis, and treatment, contributing to a deeper understanding of complex neurological conditions and guiding more informed and effective patient care.
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Affiliation(s)
- Rishabh Dhabalia
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Shivali V Kashikar
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pratap S Parihar
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Gaurav V Mishra
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Heskamp L, Birkbeck MG, Baxter-Beard D, Hall J, Schofield IS, Elameer M, Whittaker RG, Blamire AM. Motor Unit Magnetic Resonance Imaging (MUMRI) In Skeletal Muscle. J Magn Reson Imaging 2024. [PMID: 38216545 DOI: 10.1002/jmri.29218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/14/2024] Open
Abstract
Magnetic resonance imaging (MRI) is routinely used in the musculoskeletal system to measure skeletal muscle structure and pathology in health and disease. Recently, it has been shown that MRI also has promise for detecting the functional changes, which occur in muscles, commonly associated with a range of neuromuscular disorders. This review focuses on novel adaptations of MRI, which can detect the activity of the functional sub-units of skeletal muscle, the motor units, referred to as "motor unit MRI (MUMRI)." MUMRI utilizes pulsed gradient spin echo, pulsed gradient stimulated echo and phase contrast MRI sequences and has, so far, been used to investigate spontaneous motor unit activity (fasciculation) and used in combination with electrical nerve stimulation to study motor unit morphology and muscle twitch dynamics. Through detection of disease driven changes in motor unit activity, MUMRI shows promise as a tool to aid in both earlier diagnosis of neuromuscular disorders and to help in furthering our understanding of the underlying mechanisms, which proceed gross structural and anatomical changes within diseased muscle. Here, we summarize evidence for the use of MUMRI in neuromuscular disorders and discuss what future research is required to translate MUMRI toward clinical practice. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Linda Heskamp
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, UK
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Matthew G Birkbeck
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, UK
- Newcastle Biomedical Research Centre (BRC), Newcastle University, Newcastle upon Tyne, UK
- Northern Medical Physics and Clinical Engineering, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Daniel Baxter-Beard
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, UK
| | - Julie Hall
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, UK
- Department of Neuroradiology, Royal Victoria Infirmary, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ian S Schofield
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, UK
| | - Mathew Elameer
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, UK
- Department of Neuroradiology, Royal Victoria Infirmary, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Roger G Whittaker
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, UK
- Directorate of Clinical Neurosciences, Royal Victoria Infirmary, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Andrew M Blamire
- Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle Upon Tyne, UK
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Rastogi A, Yalavarthy PK. Greybox: A hybrid algorithm for direct estimation of tracer kinetic parameters from undersampled DCE-MRI data. Med Phys 2024. [PMID: 38214325 DOI: 10.1002/mp.16935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 11/28/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND A variety of deep learning-based and iterative approaches are available to predict Tracer Kinetic (TK) parameters from fully sampled or undersampled dynamic contrast-enhanced (DCE) MRI data. However, both the methods offer distinct benefits and drawbacks. PURPOSE To propose a hybrid algorithm (named as 'Greybox'), using both model- as well as DL-based, for solving a multi-parametric non-linear inverse problem of directly estimating TK parameters from undersampled DCE MRI data, which is invariant to undersampling rate. METHODS The proposed algorithm was inspired by plug-and-play algorithms used for solving linear inverse imaging problems. This technique was tested for its effectiveness in solving the nonlinear ill-posed inverse problem of generating 3D TK parameter maps from four-dimensional (4D; Spatial + Temporal) retrospectively undersampled k-space data. The algorithm learns a deep learning-based prior using UNET to estimate theK trans $\mathbf {K_{trans}}$ andV p $\mathbf {V_{p}}$ parameters based on the Patlak pharmacokinetic model, and this trained prior was utilized to estimate the TK parameter maps using an iterative gradient-based optimization scheme. Unlike the existing DL models, this network is invariant to the undersampling rate of the input data. The proposed method was compared with the total variation-based direct reconstruction technique on brain, breast, and prostate DCE-MRI datasets for various undersampling rates using the Radial Golden Angle (RGA) scheme. For the breast dataset, an indirect estimation using the Fast Composite Splitting algorithm was utilized for comparison. Undersampling rates of 8× , 12× and 20× were used for the experiments, and the results were compared using the PSNR and SSIM as metrics. For the breast dataset of 10 patients, data from four patients were utilized for training (1032 samples), two for validation (752 samples), and the entire volume of four patients for testing. Similarly, for the prostate dataset of 18 patients, 10 patients were utilized for training (720 samples), five for validation (216 samples), and the whole volume of three patients for testing. For the brain dataset of nineteen patients, ten patients were used for training (3152 samples), five for validation (1168 samples), and the whole volume of four patients for testing. Statistical tests were also conducted to assess the significance of the improvement in performance. RESULTS The experiments showed that the proposed Greybox performs significantly better than other direct reconstruction methods. The proposed algorithm improved the estimatedK trans $\mathbf {K_{trans}}$ andV p $\mathbf {V_{p}}$ in terms of the peak signal-to-noise ratio by up to 3 dB compared to other standard reconstruction methods. CONCLUSION The proposed hybrid reconstruction algorithm, Greybox, can provide state-of-the-art performance in solving the nonlinear inverse problem of DCE-MRI. This is also the first of its kind to utilize convolutional neural network-based encodings as part of the plug-and-play priors to improve the performance of the reconstruction algorithm.
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Affiliation(s)
- Aditya Rastogi
- Department of Computational and Data Sciences, Indian Institute of Science, Bangalore, India
- University Hospital Heidelberg, Heidelberg, Germany
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Fatima K, Naik S, Jain M, Bhoi SK, Padhi S, Bag ND, Panigrahi A, Mohakud S. Diffusion-Weighted Imaging and Chemical Shift Imaging to Differentiate Benign and Malignant Vertebral Lesion: A Hospital-Based Cross-Sectional Study. Indian J Radiol Imaging 2024; 34:76-84. [PMID: 38106853 PMCID: PMC10723945 DOI: 10.1055/s-0043-1772848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Objective The aim of this study was to evaluate the role of diffusion-weighted imaging (DWI) and chemical shift imaging (CSI) for the differentiation of benign and malignant vertebral lesions. Methods Patients with vertebral lesions underwent routine magnetic resonance imaging (MRI) along with DWI and CSI. Qualitative analysis of the morphological features was done by routine MRI. Quantitative analysis of apparent diffusion coefficient (ADC) from DWI and fat fraction (FF) from CSI was done and compared between benign and malignant vertebral lesions. Results Seventy-two patients were included. No significant difference was noted in signal intensities of benign and malignant lesions on conventional MRI sequences. Posterior element involvement, paravertebral soft-tissue lesion, and posterior vertebral bulge were common in malignant lesion, whereas epidural/paravertebral collection, absence of posterior vertebral bulge, and multiple compression fractures were common in benign vertebral lesion ( p < 0.001). The mean ADC value was 1.25 ± 0.27 mm 2 /s for benign lesions and 0.9 ± 0.19 mm 2 /s for malignant vertebral lesions ( p ≤ 0.001). The mean value of FF was 12.7 ± 7.49 for the benign group and 4.04 ± 2.6 for the malignant group ( p < 0.001). A receiver operating characteristic (ROC) curve analysis showed that an ADC cutoff of 1.05 × 10 -3 mm 2 /s and an FF cutoff of 6.9 can differentiate benign from malignant vertebral lesions, with the former having 86% sensitivity and 82.8% specificity and the latter having 93% sensitivity and 96.6% specificity. Conclusion The addition of DWI and CSI to routine MRI protocol in patients with vertebral lesions promises to be very helpful in differentiating benign from malignant vertebral lesions when difficulty in qualitative interpretation of conventional MR images arises.
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Affiliation(s)
- Kaneez Fatima
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mantu Jain
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Somnath Padhi
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari Deep Bag
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ashutosh Panigrahi
- Department of Haematology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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van den Elshout R, Ariëns B, Blaauboer J, Meijer FJA, van der Kolk AG, Esmaeili M, Scheenen TWJ, Henssen DJHA. Quantification of perineural satellitosis in pretreatment glioblastoma with structural MRI and a diffusion tensor imaging template. Neurooncol Adv 2024; 6:vdad168. [PMID: 38196738 PMCID: PMC10776201 DOI: 10.1093/noajnl/vdad168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
Background Survival outcomes for glioblastoma (GBM) patients remain unfavorable, and tumor recurrence is often observed. Understanding the radiological growth patterns of GBM could aid in improving outcomes. This study aimed to examine the relationship between contrast-enhancing tumor growth direction and white matter, using an image registration and deformation strategy. Methods In GBM patients 2 pretreatment scans (diagnostic and neuronavigation) were gathered retrospectively, and coregistered to a template and diffusion tensor imaging (DTI) atlas. The GBM lesions were segmented and coregistered to the same space. Growth vectors were derived and divided into vector populations parallel (Φ = 0-20°) and perpendicular (Φ = 70-90°) to white matter. To test for statistical significance between parallel and perpendicular groups, a paired samples Student's t-test was performed. O6-methylguanine-DNA methyltransferase (MGMT) methylation status and its correlation to growth rate were also tested using a one-way ANOVA test. Results For 78 GBM patients (mean age 61 years ± 13 SD, 32 men), the included GBM lesions showed a predominant preference for perineural satellitosis (P < .001), with a mean percentile growth of 30.8% (95% CI: 29.6-32.0%) parallel (0° < |Φ| < 20°) to white matter. Perpendicular tumor growth with respect to white matter microstructure (70° < |Φ| < 90°) showed to be 22.7% (95% CI: 21.3-24.1%) of total tumor growth direction. Conclusions The presented strategy showed that tumor growth direction in pretreatment GBM patients correlated with white matter architecture. Future studies with patient-specific DTI data are required to verify the accuracy of this method prospectively to identify its usefulness as a clinical metric in pre and posttreatment settings.
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Affiliation(s)
- Rik van den Elshout
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Benthe Ariëns
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joost Blaauboer
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frederick J A Meijer
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anja G van der Kolk
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Morteza Esmaeili
- Department of Diagnostic Imaging, Akershus University Hospital, Lørenskog, Norway
- Department of Electrical Engineering and Computer Science, University of Stavanger, Stavanger, Norway
| | - Tom W J Scheenen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dylan J H A Henssen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
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Woo S, Vargas HA. Editorial for "Efficiency and Accuracy Evaluation of Multiple Diffusion-Weighted MRI Techniques Across Different Scanners". J Magn Reson Imaging 2024; 59:323-324. [PMID: 37367223 DOI: 10.1002/jmri.28873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/03/2023] [Indexed: 06/28/2023] Open
Affiliation(s)
- Sungmin Woo
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Hebert A Vargas
- Department of Radiology, NYU Langone Health, New York, New York, USA
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Genç B, Delibalta S, Aslan K, Ceyhan Bilgici MN. Paediatric supratentorial tumours do not cause microstructural alterations in contralateral white matter: a preliminary study. Childs Nerv Syst 2024; 40:41-46. [PMID: 37470834 DOI: 10.1007/s00381-023-06083-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/15/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND AND PURPOSE Intracranial tumours in children can exhibit different characteristics compared to those in adults. Understanding the microstructural changes in the contralateral normal-appearing white matter (NAWM) in children with primary intracranial masses is essential for optimizing treatment strategies. This study aimed to investigate the apparent diffusion coefficient (ADC) changes in contralateral NAWM using fully automated methods and deep learning algorithms. METHODS We included 22 paediatric patients with primary supratentorial intracranial masses (23% high-grade) in the study. ADC values of the contralateral NAWM in the patient group were compared to those of a control group. Deep learning algorithms were utilized to analyse diffusion changes in NAWM. RESULTS The mean ADC values of contralateral NAWM in the patient group were 0.80 ± 0.03 × 10-3 mm2/s, while the control group had a mean ADC value of 0.81 ± 0.03 × 10-3 mm2/s. There was no statistically significant difference between the groups (p = 0.39). Our findings indicate that there are no significant diffusion changes in the contralateral white matter of children with supratentorial intracranial masses. CONCLUSION Primary supratentorial intracranial masses in children do not cause microstructural changes in contralateral normal-appearing white matter. This could be attributed to the less infiltrative nature and different biochemical profile of these tumour groups in the paediatric population. Further studies using advanced imaging techniques could provide additional insights into the distinct characteristics of paediatric intracranial tumours and improve patient management.
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Affiliation(s)
- Barış Genç
- Department of Radiology, Samsun Education and Research Hospital, İlkadım, Samsun, 55060, Turkey.
| | - Semra Delibalta
- Department of Radiology, Amasya Sabuncuoğlu Şerefeddin Education and Research Hospital, Amasya, Turkey
| | - Kerim Aslan
- Department of Radiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
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21
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Ristow I, Kaul MG, Stark M, Zapf A, Riedel C, Lenz A, Mautner VF, Farschtschi S, Apostolova I, Adam G, Bannas P, Salamon J, Well L. Discrimination of benign, atypical, and malignant peripheral nerve sheath tumors in neurofibromatosis type 1 using diffusion-weighted MRI. Neurooncol Adv 2024; 6:vdae021. [PMID: 38468867 PMCID: PMC10926940 DOI: 10.1093/noajnl/vdae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Background Neurofibromatosis type 1 (NF1) is associated with the development of benign (BPNST) and malignant (MPNST) peripheral nerve sheath tumors. Recently described atypical neurofibromas (ANF) are considered pre-malignant precursor lesions to MPNSTs. Previous studies indicate that diffusion-weighted magnetic resonance imaging (DW-MRI) can reliably discriminate MPNSTs from BPNSTs. We therefore investigated the diagnostic accuracy of DW-MRI for the discrimination of benign, atypical, and malignant peripheral nerve sheath tumors. Methods In this prospective explorative single-center phase II diagnostic study, 44 NF1 patients (23 male; 30.1 ± 11.8 years) underwent DW-MRI (b-values 0-800 s/mm²) at 3T. Two radiologists independently assessed mean and minimum apparent diffusion coefficients (ADCmean/min) in areas of largest tumor diameters and ADCdark in areas of lowest signal intensity by manual contouring of the tumor margins of 60 BPNSTs, 13 ANFs, and 21 MPNSTs. Follow-up of ≥ 24 months (BPNSTs) or histopathological evaluation (ANFs + MPNSTs) served as diagnostic reference standard. Diagnostic ADC-based cut-off values for discrimination of the three tumor groups were chosen to yield the highest possible specificity while maintaining a clinically acceptable sensitivity. Results ADC values of pre-malignant ANFs clustered between BPNSTs and MPNSTs. Best BPNST vs. ANF + MPNST discrimination was obtained using ADCdark at a cut-off value of 1.6 × 10-3 mm2/s (85.3% sensitivity, 93.3% specificity), corresponding to an AUC of 94.3% (95% confidence interval: 85.2-98.0). Regarding BPNST + ANF vs. MPNST, best discrimination was obtained using an ADCdark cut-off value of 1.4 × 10-3 mm2/s (83.3% sensitivity, 94.5% specificity). Conclusions DW-MRI using ADCdark allows specific and noninvasive discrimination of benign, atypical, and malignant nerve sheath tumors in NF1.
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Affiliation(s)
- Inka Ristow
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael G Kaul
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maria Stark
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Antonia Zapf
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Riedel
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Lenz
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Victor F Mautner
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Said Farschtschi
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ivayla Apostolova
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Bannas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes Salamon
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Diagnostic and Interventional Radiology, Medical Care Center Beste Trave, Bad Oldesloe, Germany
| | - Lennart Well
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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22
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Paltoglou G, Stefanaki C, Chrousos GP. Functional MRI Techniques Suggesting that the Stress System Interacts with Three Large Scale Core Brain Networks to Help Coordinate the Adaptive Response: A Systematic Review. Curr Neuropharmacol 2024; 22:976-989. [PMID: 37533249 PMCID: PMC10845086 DOI: 10.2174/1570159x21666230801151718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/16/2023] [Accepted: 04/06/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVE Synthesis of functional MRI (fMRI) and functional connectivity (FC) analysis data on human stress system (SS) function, as it relates to the dynamic function of the Salience (SN), Default Mode (DMN) and Central Executive (CEN) networks. METHODS Systematic search of Medline, Scopus, Clinical Trials.gov, and Google Scholar databases of studies published prior to September 2022 resulted in 28 full-text articles included for qualitative synthesis. RESULTS Acute stress changes the states of intra-/inter- neural network FCs and activities from those of resting, low arousal state in the SN, DMN and CEN, during which intra- and inter-network FCs and activities of all three networks are low. SS activation is positively linked to the activity of the SN and negatively to that of the DMN, while, in parallel, it is associated with an initial decrease and a subsequent increase of the intra- network FC and activity of the CEN. The FC between the DMN and the CEN increases, while those between the SN and the CEN decrease, allowing time for frontal lobe strategy input and "proper" CEN activity and task decision. SN activation is linked to sensory hypersensitivity, "impaired" memory, and a switch from serial to parallel processing, while trait mindfulness is associated with FC changes promoting CEN activity and producing a "task-ready state". CONCLUSION SS activation is tightly connected to that of the SN, with stress hormones likely potentiating the intra-network FC of the latter, attenuating that of the DMN, and causing a biphasic suppression- to-activation response of the CEN, all adaptive changes favoring proper decisions and survival.
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Affiliation(s)
- George Paltoglou
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children's Hospital, Athens 11527, Greece
- Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “A. & P. Kyriakou” Children's Hospital, Athens 11527, Greece
- UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Charikleia Stefanaki
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children's Hospital, Athens 11527, Greece
- UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - George P. Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children's Hospital, Athens 11527, Greece
- UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
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Mavroidis P, Giankou E, Papaioannou M, Roka V, Tsikrika A, Kostopoulos S, Glotsos D, Sakkas GK, Dardiotis E, Chaniotis D, Kapsalaki E, Lavdas E. Comparison Between EPI DWI and PROPELLER DWI in Brain MR Imaging. Curr Probl Diagn Radiol 2024; 53:73-80. [PMID: 37735000 DOI: 10.1067/j.cpradiol.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/17/2023] [Accepted: 08/23/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE EPI DWI is a routinely used sequence in brain imaging but it has limitations when it comes to SNR and artifact reduction. PROPELLER DWI has the benefit of improving image quality compared to EPI DWI. The aim of this study is to compare the EPI DWI sequence in brain MR imaging with the PROPELLER DWI sequence. The objective is to identify which sequence is more beneficial in brain imaging by evaluating image quality and the depiction of pathologies. MATERIALS AND METHODS A total of 101 patients (55 females and 46 males, mean age 56 years) underwent brain MRI examination on a 1.5 T scanner. EPI DWI and PROPELLER DWI sequences were acquired in every exam and were reviewed by 2 radiologists. The images were evaluated by performing a quantitative analysis based on Relative Contrast and a qualitative analysis (overall image quality, conspicuousness of lesions, artifact reduction, etc.). RESULTS In both the qualitative and quantitative analysis PROPELLER DWI achieved better results than EPI DWI. PROPELLER DWI showed statistical significance in the overall image quality (P < 0.001), the elimination of susceptibility (P < 0.001) and flow pulsation artifacts (P < 0.001), as well as in the contrast between CSF with white (P < 0.001) and grey matter (P < 0.001). Also, PROPELLER DWI presented better delineation of pathologies like ischemic strokes, metastasis, tumors and vasogenic edemas than conventional EPI DWI. CONCLUSION PROPELLER DWI was the preferred sequence during the image evaluation. Compared to EPI DWI, PROPELLER DWI managed to reduce susceptibility and flow pulsation whilst achieving higher image quality and lesion delineation and earlier depiction of ischemic strokes than the conventional EPI DWI. PROPELLER DWI may be incorporated in brain MR imaging replacing EPI DWI.
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Affiliation(s)
- Panayiotis Mavroidis
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC.
| | | | - Maria Papaioannou
- Department of Medical Imaging, Animus Kyanous Stavros Larissa, Larissa, Greece
| | - Violeta Roka
- Department of General Medicine, Health Center of Farkadona, Trikala, Greece
| | | | - Spiros Kostopoulos
- Department of Biomedical Engineering, University of West Attica, Athens, Greece
| | - Dimitrios Glotsos
- Department of Biomedical Engineering, University of West Attica, Athens, Greece
| | - Giorgos K Sakkas
- Department of Sport and Health Sciences, University of Thessaly, Trikala, Greece
| | | | - Dimitrios Chaniotis
- Department of Biomedical Sciences, University of West Attica, Athens, Greece
| | | | - Eleftherios Lavdas
- Department of Medical Imaging, Animus Kyanous Stavros Larissa, Larissa, Greece; Department of Biomedical Sciences, University of West Attica, Athens, Greece
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Kim DK, Lee SY, Lee J, Huh YJ, Lee S, Lee S, Jung JY, Lee HS, Benkert T, Park SH. Deep learning-based k-space-to-image reconstruction and super resolution for diffusion-weighted imaging in whole-spine MRI. Magn Reson Imaging 2024; 105:82-91. [PMID: 37939970 DOI: 10.1016/j.mri.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/30/2023] [Accepted: 11/04/2023] [Indexed: 11/10/2023]
Abstract
PURPOSE To assess the feasibility of deep learning (DL)-based k-space-to-image reconstruction and super resolution for whole-spine diffusion-weighted imaging (DWI). METHOD This retrospective study included 97 consecutive patients with hematologic and/or oncologic diseases who underwent DL-processed whole-spine MRI from July 2022 to March 2023. For each patient, conventional (CONV) axial single-shot echo-planar DWI (b = 50, 800 s/mm2) was performed, followed by DL reconstruction and super resolution processing. The presence of malignant lesions and qualitative (overall image quality and diagnostic confidence) and quantitative (nonuniformity [NU], lesion contrast, signal-to-noise ratio [SNR], contrast-to-noise ratio [CNR], and ADC values) parameters were assessed for DL and CONV DWI. RESULTS Ultimately, 67 patients (mean age, 63.0 years; 35 females) were analyzed. The proportions of vertebrae with malignant lesions for both protocols were not significantly different (P: [0.55-0.99]). The overall image quality and diagnostic confidence scores were higher for DL DWI (all P ≤ 0.002) than CONV DWI. The NU, lesion contrast, SNR, and CNR of each vertebral segment (P ≤ 0.04) but not the NU of the sacral segment (P = 0.51) showed significant differences between protocols. For DL DWI, the NU was lower, and lesion contrast, SNR, and CNR were higher than those of CONV DWI (median values of all segments; 19.8 vs. 22.2, 5.4 vs. 4.3, 7.3 vs. 5.5, and 0.8 vs. 0.7). Mean ADC values of the lesions did not significantly differ between the protocols (P: [0.16-0.89]). CONCLUSIONS DL reconstruction can improve the image quality of whole-spine diffusion imaging.
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Affiliation(s)
- Dong Kyun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - So-Yeon Lee
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Jinyoung Lee
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeon Jong Huh
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seungeun Lee
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sungwon Lee
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joon-Yong Jung
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun-Soo Lee
- MR research Collaboration, Siemens Healthineers Ltd, Seoul, Republic of Korea
| | - Thomas Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Sung-Hong Park
- Department of Bio and Brain Engineering, KAIST, Daejeon, Republic of Korea
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25
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Otto PO, Loft MK, Rafaelsen SR, Pedersen MRV. Diffusion-Weighted MRI as a Quantitative Imaging Biomarker in Colon Tumors. Cancers (Basel) 2023; 16:144. [PMID: 38201571 PMCID: PMC10778248 DOI: 10.3390/cancers16010144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE To assess the use of quantitative diffusion-weighted MRI (DW-MRI) as a diagnostic imaging biomarker in differentiating between benign colon adenoma, early, and advanced cancer of the colon, as well as predicting lymph node involvement, and finally comparing mucinous-producing colon cancer with adenomas and non-mucinous colon cancer. METHOD Patients with a confirmed tumor on colonoscopy were eligible for inclusion in this study. Using a 3.0 Tesla MRI machine, the main tumor mean apparent diffusion coefficient (mADC) was obtained. Surgically resected tumor specimens served as an endpoint, except in mucinous colon cancers, which were classified based on T2 images. RESULTS A total of 152 patients were included in the study population. The mean age was 71 years. A statistically significant mADC mean difference of -282 × 10-6 mm2/s [-419--144 95% CI, p < 0.001] was found between colon adenomas and early colon cancer, with an AUC of 0.80 [0.68-0.93 95% CI] and an optimal cut off value of 1018 × 10-6 mm2/s. Only a small statistically significant difference (p = 0.039) in mADC was found between benign tumors and mucinous colon cancer. We found no statistical difference in mADC mean values between early and advanced colon cancer, and between colon cancer with and without lymph node involvement. CONCLUSION Quantitative DW-MRI is potentially useful for determining whether a colonic tumor is benign or malignant. Mucinous colon cancer shows less diffusion restriction when compared to non-mucinous colon cancer, a potential pitfall.
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Affiliation(s)
- Peter Obel Otto
- Department of Radiology, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark
| | - Martina Kastrup Loft
- Department of Radiology, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark
- Danish Colorectal Cancer Center South, Vejle Hospital, 7100 Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
| | - Søren Rafael Rafaelsen
- Department of Radiology, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark
- Danish Colorectal Cancer Center South, Vejle Hospital, 7100 Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
| | - Malene Roland Vils Pedersen
- Department of Radiology, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark
- Danish Colorectal Cancer Center South, Vejle Hospital, 7100 Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
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Cheung SM, Wu WS, Senn N, Sharma R, McGoldrick T, Gagliardi T, Husain E, Masannat Y, He J. Towards detection of early response in neoadjuvant chemotherapy of breast cancer using Bayesian intravoxel incoherent motion. Front Oncol 2023; 13:1277556. [PMID: 38125950 PMCID: PMC10731248 DOI: 10.3389/fonc.2023.1277556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction The early identification of good responders to neoadjuvant chemotherapy (NACT) holds a significant potential in the optimal treatment of breast cancer. A recent Bayesian approach has been postulated to improve the accuracy of the intravoxel incoherent motion (IVIM) model for clinical translation. This study examined the prediction and early sensitivity of Bayesian IVIM to NACT response. Materials and methods Seventeen female patients with breast cancer were scanned at baseline and 16 patients were scanned after Cycle 1. Tissue diffusion and perfusion from Bayesian IVIM were calculated at baseline with percentage change at Cycle 1 computed with reference to baseline. Cellular proliferative activity marker Ki-67 was obtained semi-quantitatively with percentage change at excision computed with reference to core biopsy. Results The perfusion fraction showed a significant difference (p = 0.042) in percentage change between responder groups at Cycle 1, with a decrease in good responders [-7.98% (-19.47-1.73), n = 7] and an increase in poor responders [10.04% (5.09-28.93), n = 9]. There was a significant correlation between percentage change in perfusion fraction and percentage change in Ki-67 (p = 0.042). Tissue diffusion and pseudodiffusion showed no significant difference in percentage change between groups at Cycle 1, nor was there a significant correlation against percentage change in Ki-67. Perfusion fraction, tissue diffusion, and pseudodiffusion showed no significant difference between groups at baseline, nor was there a significant correlation against Ki-67 from core biopsy. Conclusion The alteration in tumour perfusion fraction from the Bayesian IVIM model, in association with cellular proliferation, showed early sensitivity to good responders in NACT. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT03501394, identifier NCT03501394.
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Affiliation(s)
- Sai Man Cheung
- Institute of Medical Sciences, School of Medicine, University of Aberdeen, Aberdeen, United Kingdom
| | - Wing-Shan Wu
- Institute of Medical Sciences, School of Medicine, University of Aberdeen, Aberdeen, United Kingdom
| | - Nicholas Senn
- Institute of Medical Sciences, School of Medicine, University of Aberdeen, Aberdeen, United Kingdom
| | - Ravi Sharma
- Department of Oncology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - Trevor McGoldrick
- Department of Oncology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - Tanja Gagliardi
- Institute of Medical Sciences, School of Medicine, University of Aberdeen, Aberdeen, United Kingdom
- Department of Radiology, Royal Marsden Hospital, London, United Kingdom
| | - Ehab Husain
- Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - Yazan Masannat
- Breast Unit, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - Jiabao He
- Institute of Medical Sciences, School of Medicine, University of Aberdeen, Aberdeen, United Kingdom
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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Abstract
In advancing our understanding of tinnitus, some of the more impactful contributions in the past two decades have come from human brain imaging studies, specifically the idea of both auditory and extra-auditory neural networks that mediate tinnitus. These networks subserve both the perception of tinnitus and the psychological reaction to chronic, continuous tinnitus. In this article, we review particular studies that report on the nodes and links of such neural networks and their inter-network connections. Innovative neuroimaging tools have contributed significantly to the increased understanding of anatomical and functional connections of attention, emotion-processing, and default mode networks in adults with tinnitus. We differentiate between the neural correlates of tinnitus and those of comorbid hearing loss; surprisingly, tinnitus and hearing loss when they co-occur are not necessarily additive in their impact and, in rare cases, additional tinnitus may act to mitigate the consequences of hearing loss alone on the brain. The scale of tinnitus severity also appears to have an impact on brain networks, with some of the alterations typically attributed to tinnitus reaching significance only in the case of bothersome tinnitus. As we learn more about comorbid conditions of tinnitus, such as depression, anxiety, hyperacusis, or even aging, their contributions to the network-level changes observed in tinnitus will need to be parsed out in a manner similar to what is currently being done for hearing loss or severity. Together, such studies advance our understanding of the heterogeneity of tinnitus and will lead to individualized treatment plans.
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Affiliation(s)
- Fatima T Husain
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, 901 S. Sixth Street, Champaign, IL, 61820, USA.
- Neuroscience Program, University of Illinois Urbana-Champaign, 2355/57 Beckman Institute, 405 North Mathews Avenue, Urbana, IL, 61801, USA.
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, 61801, USA.
| | - Rafay A Khan
- Neuroscience Program, University of Illinois Urbana-Champaign, 2355/57 Beckman Institute, 405 North Mathews Avenue, Urbana, IL, 61801, USA
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, 61801, USA
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28
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Schillmaier M, Kaika A, Topping GJ, Braren R, Schilling F. Repeatability and reproducibility of apparent exchange rate measurements in yeast cell phantoms using filter-exchange imaging. MAGMA 2023; 36:957-974. [PMID: 37436611 PMCID: PMC10667135 DOI: 10.1007/s10334-023-01107-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVES Development of a protocol for validation and quality assurance of filter-exchange imaging (FEXI) pulse sequences with well-defined and reproducible phantoms. MATERIALS AND METHODS A FEXI pulse sequence was implemented on a 7 T preclinical MRI scanner. Six experiments in three different test categories were established for sequence validation, demonstration of the reproducibility of phantoms and the measurement of induced changes in the apparent exchange rate (AXR). First, an ice-water phantom was used to investigate the consistency of apparent diffusion coefficient (ADC) measurements with different diffusion filters. Second, yeast cell phantoms were utilized to validate the determination of the AXR in terms of repeatability (same phantom and session), reproducibility (separate but comparable phantoms in different sessions) and directionality of diffusion encodings. Third, the yeast cell phantoms were, furthermore, used to assess potential AXR bias because of altered cell density and temperature. In addition, a treatment experiment with aquaporin inhibitors was performed to evaluate the influence of these compounds on the cell membrane permeability in yeast cells. RESULTS FEXI-based ADC measurements of an ice-water phantom were performed for three different filter strengths, showed good agreement with the literature value of 1.099 × 10-3 mm2/s and had a maximum coefficient of variation (CV) of 0.55% within the individual filter strengths. AXR estimation in a single yeast cell phantom and imaging session with five repetitions resulted in an overall mean value of (1.49 ± 0.05) s-1 and a CV of 3.4% between the chosen regions of interest. For three separately prepared phantoms, AXR measurements resulted in a mean value of (1.50 ± 0.04) s-1 and a CV of 2.7% across the three phantoms, demonstrating high reproducibility. Across three orthogonal diffusion directions, a mean value of (1.57 ± 0.03) s-1 with a CV of 1.9% was detected, consistent with isotropy of AXR in yeast cells. Temperature and AXR were linearly correlated (R2 = 0.99) and an activation energy EA of 37.7 kJ/mol was determined by Arrhenius plot. Furthermore, a negative correlation was found between cell density (as determined by the reference ADC/fe) and AXR (R2 = 0.95). The treatment experiment resulted in significantly decreased AXR values at different temperatures in the treated sample compared to the untreated control indicating an inhibiting effect. CONCLUSIONS Using ice-water and yeast cell-based phantoms, a protocol for the validation of FEXI pulse sequences was established for the assessment of stability, repeatability, reproducibility and directionality. In addition, a strong dependence of AXR on cell density and temperature was shown. As AXR is an emerging novel imaging biomarker, the suggested protocol will be useful for quality assurance of AXR measurements within a study and potentially across multiple sites.
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Affiliation(s)
- Mathias Schillmaier
- Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
- Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Athanasia Kaika
- Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Geoffrey J Topping
- Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Rickmer Braren
- Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany.
- German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Franz Schilling
- Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany.
- German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Madamesila J, Tchistiakova E, Faruqi S, Das S, Ploquin N. Can machine learning models improve early detection of brain metastases using diffusion weighted imaging-based radiomics? Quant Imaging Med Surg 2023; 13:7706-7718. [PMID: 38106308 PMCID: PMC10722027 DOI: 10.21037/qims-23-441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/15/2023] [Indexed: 12/19/2023]
Abstract
Background Metastatic complications are a major cause of cancer-related morbidity, with up to 40% of cancer patients experiencing at least one brain metastasis. Earlier detection may significantly improve patient outcomes and overall survival. We investigated machine learning (ML) models for early detection of brain metastases based on diffusion weighted imaging (DWI) radiomics. Methods Longitudinal diffusion imaging from 116 patients previously treated with stereotactic radiosurgery (SRS) for brain metastases were retrospectively analyzed. Clinical contours from 600 metastases were extracted from radiosurgery planning computed tomography, and rigidly registered to corresponding contrast enhanced-T1 and apparent diffusion coefficient (ADC) maps. Contralateral contours located in healthy brain tissue were used as control. The dataset consisted of (I) radiomic features using ADC maps, (II) radiomic feature change calculated using timepoints before the metastasis manifested on contrast enhanced-T1, (III) primary cancer, and (IV) anatomical location. The dataset was divided into training and internal validation sets using an 80/20 split with stratification. Four classification algorithms [Linear Support Vector Machine (SVM), Random Forest (RF), AdaBoost, and XGBoost] underwent supervised classification training, with contours labeled either 'control' or 'metastasis'. Hyperparameters were optimized towards balanced accuracy. Various model metrics (receiver operating characteristic curve area scores, accuracy, recall, and precision) were calculated to gauge performance. Results The radiomic and clinical data set, feature engineering, and ML models developed were able to identify metastases with an accuracy of up to 87.7% on the training set, and 85.8% on an unseen test set. XGBoost and RF showed superior accuracy (XGBoost: 0.877±0.021 and 0.833±0.47, RF: 0.823±0.024 and 0.858±0.045) for training and validation sets, respectively. XGBoost and RF also showed strong area under the receiver operating characteristic curve (AUC) performance on the validation set (0.910±0.037 and 0.922±0.034, respectively). AdaBoost performed slightly lower in all metrics. SVM model generalized poorly with the internal validation set. Important features involved changes in radiomics months before manifesting on contrast enhanced-T1. Conclusions The proposed models using diffusion-based radiomics showed encouraging results in differentiating healthy brain tissue from metastases using clinical imaging data. These findings suggest that longitudinal diffusion imaging and ML may help improve patient care through earlier diagnosis and increased patient monitoring/follow-up. Future work aims to improve model classification metrics, robustness, user-interface, and clinical applicability.
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Affiliation(s)
- Joseph Madamesila
- Department of Physics and Astronomy, University of Calgary, Calgary, Canada
- Department of Medical Physics, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Canada
| | - Ekaterina Tchistiakova
- Department of Physics and Astronomy, University of Calgary, Calgary, Canada
- Department of Medical Physics, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Salman Faruqi
- Department of Radiation Oncology, Tom Baker Cancer Center, Alberta Health Services, Calgary, Canada
| | - Subhadip Das
- Division of Radiation Oncology and Developmental Radiotherapeutics, BC Cancer Agency-Victoria, University of British Columbia, Victoria, Canada
| | - Nicolas Ploquin
- Department of Physics and Astronomy, University of Calgary, Calgary, Canada
- Department of Medical Physics, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Nakharutai N, Chitapanarux I, Traisathit P, Srikummoon P, Pojchamarnwiputh S, Inmutto N, Na Chiangmai W. Prediction of survival and analysis of prognostic factors for hepatocellular carcinoma: a 20-year of imaging diagnosis in Upper Northern Thailand. BMC Cancer 2023; 23:1063. [PMID: 37923991 PMCID: PMC10625219 DOI: 10.1186/s12885-023-11429-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/21/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND To evaluate survival rates of hepatocellular carcinoma (HCC), the Chiang Mai Cancer Registry provided characteristics data of 6276 HCC patients diagnosed between 1998-2020 based on evolution of imaging diagnosis. Evolution can be separated into four cohorts, namely, cohort 1 (1990-2005) when we had ultrasound (US) and single-phase computed tomography (CT), cohort 2 (2006-2009) when one multi-phase CT and one magnetic resonance imaging (MRI) were added, cohort 3 (2010-2015) when MRI with LI-RADS was added, and finally, cohort 4 (2016-2020) when two upgraded MRIs with LI-RADS were added. METHODS Cox proportional hazard models were used to determine the relation between death and risk factors including methods of imagining diagnosis, gender, age of diagnosis, tumor stages, history of smoking and alcohol-use, while Kaplan-Meier curves were used to calculate survival rates. RESULTS The median age of diagnosis was 57.0 years (IQR: 50.0-65.0) and the median survival time was 5.8 months (IQR: 1.9-26.8) during the follow-up period. In the univariable analysis, all factors were all associated with a higher risk of death in HCC patients except age of diagnosis. In a multivariable analysis, elderly age at diagnosis, regional and metastatic stages and advanced methods of imagining diagnosis during cohorts 2 and 3 were independently associated with the risk of death in HCC patients. The survival rate of patients diagnosed during cohort 4 was significantly higher than the other cohorts. CONCLUSION As a significantly increasing survival rate of HCC patients in cohort 4, advanced methods of diagnostic imaging can be a part of the recommendation to diagnose HCC.
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Affiliation(s)
- Nawapon Nakharutai
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Imjai Chitapanarux
- Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Pimwarat Srikummoon
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | | | - Nakarin Inmutto
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wittanee Na Chiangmai
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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31
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Ingenerf M, Schmid-Tannwald C. Diffusion-weighted imaging in Crohn's disease. Radiologie (Heidelb) 2023; 63:27-33. [PMID: 37603068 DOI: 10.1007/s00117-023-01191-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Diffusion-weighted MRI (DWI) is routinely used in abdominal imaging. In addition to neoplastic diseases, inflammatory changes can be delineated and diagnosed based on diffusion restriction in DWI. DWI is also increasingly used in the context of MRI of the small and large intestine. OBJECTIVE This article focuses on the technical aspects of DWI and its role in the diagnosis of Crohn's disease (CD) as well as in the grading of disease severity and in treatment monitoring. MATERIALS AND METHODS Guidelines, basic research papers, and review articles were analyzed. RESULTS Diffusion-weighted MRI is a specialized MRI technique that visualizes the diffusion of water molecules in biological tissues. In the context of MRI of the small and large intestine, DWI facilitates the diagnosis of inflammatory bowel disease and assessment of treatment response. DWI enables detection of not only intra- and transmural changes, but also extramural pathologies and complications. However, DWI also has its limitations and challenges. CONCLUSION This article provides a comprehensive overview of the use of DWI for diagnostic evaluation of bowel wall changes and extramural complications in the setting of CD. It also summarizes the relevant evidence available in the literature.
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Affiliation(s)
- Maria Ingenerf
- Department of Radiology, University Hospital, LMU Munich, Ziemssenstr. 5, 80336, Munich, Germany
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32
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Shakur A, Lee JYJ, Freeman S. An Update on the Role of MRI in Treatment Stratification of Patients with Cervical Cancer. Cancers (Basel) 2023; 15:5105. [PMID: 37894476 PMCID: PMC10605640 DOI: 10.3390/cancers15205105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Cervical cancer is the fourth most common cancer in women worldwide and the most common gynaecological malignancy. The FIGO staging system is the most commonly utilised classification system for cervical cancer worldwide. Prior to the most recent update in the FIGO staging in 2018, the staging was dependent upon clinical assessment alone. Concordance between the surgical and clinical FIGO staging decreases rapidly as the tumour becomes more advanced. MRI now plays a central role in patients diagnosed with cervical cancer and enables accurate staging, which is essential to determining the most appropriate treatment. MRI is the best imaging option for the assessment of tumour size, location, and parametrial and sidewall invasion. Notably, the presence of parametrial invasion precludes surgical options, and the patient will be triaged to chemoradiotherapy. As imaging is intrinsic to the new 2018 FIGO staging system, nodal metastases have been included within the classification as stage IIIC disease. The presence of lymph node metastases within the pelvis or abdomen is associated with a poorer prognosis, which previously could not be included in the staging classification as these could not be reliably detected on clinical examination. MRI findings corresponding to the 2018 revised FIGO staging of cervical cancers and their impact on treatment selection will be described.
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Affiliation(s)
| | | | - Sue Freeman
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.S.); (J.Y.J.L.)
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Maino C, Vernuccio F, Cannella R, Cortese F, Franco PN, Gaetani C, Giannini V, Inchingolo R, Ippolito D, Defeudis A, Pilato G, Tore D, Faletti R, Gatti M. Liver metastases: The role of magnetic resonance imaging. World J Gastroenterol 2023; 29:5180-5197. [PMID: 37901445 PMCID: PMC10600959 DOI: 10.3748/wjg.v29.i36.5180] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/28/2023] [Accepted: 09/11/2023] [Indexed: 09/20/2023] Open
Abstract
The liver is one of the organs most commonly involved in metastatic disease, especially due to its unique vascularization. It's well known that liver metastases represent the most common hepatic malignant tumors. From a practical point of view, it's of utmost importance to evaluate the presence of liver metastases when staging oncologic patients, to select the best treatment possible, and finally to predict the overall prognosis. In the past few years, imaging techniques have gained a central role in identifying liver metastases, thanks to ultrasonography, contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI). All these techniques, especially CT and MRI, can be considered the non-invasive reference standard techniques for the assessment of liver involvement by metastases. On the other hand, the liver can be affected by different focal lesions, sometimes benign, and sometimes malignant. On these bases, radiologists should face the differential diagnosis between benign and secondary lesions to correctly allocate patients to the best management. Considering the above-mentioned principles, it's extremely important to underline and refresh the broad spectrum of liver metastases features that can occur in everyday clinical practice. This review aims to summarize the most common imaging features of liver metastases, with a special focus on typical and atypical appearance, by using MRI.
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Affiliation(s)
- Cesare Maino
- Department of Radiology, Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy
| | - Federica Vernuccio
- University Hospital of Padova, Institute of Radiology, Padova 35128, Italy
| | - Roberto Cannella
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo 90127, Italy
| | - Francesco Cortese
- Unit of Interventional Radiology, F Miulli Hospital, Acquaviva delle Fonti 70021, Italy
| | - Paolo Niccolò Franco
- Department of Radiology, Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy
| | - Clara Gaetani
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Valentina Giannini
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Riccardo Inchingolo
- Unit of Interventional Radiology, F Miulli Hospital, Acquaviva delle Fonti 70021, Italy
| | - Davide Ippolito
- Department of Radiology, Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy
- School of Medicine, University of Milano Bicocca, Milano 20100, Italy
| | - Arianna Defeudis
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Giulia Pilato
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo 90127, Italy
| | - Davide Tore
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Riccardo Faletti
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Marco Gatti
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
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Tang Z, Chen S, D’Souza A, Liu D, Calamante F, Barnett M, Cai W, Wang C, Cabezas M. High angular diffusion tensor imaging estimation from minimal evenly distributed diffusion gradient directions. Front Radiol 2023; 3:1238566. [PMID: 37766937 PMCID: PMC10520249 DOI: 10.3389/fradi.2023.1238566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023]
Abstract
Diffusion-weighted Imaging (DWI) is a non-invasive imaging technique based on Magnetic Resonance Imaging (MRI) principles to measure water diffusivity and reveal details of the underlying brain micro-structure. By fitting a tensor model to quantify the directionality of water diffusion a Diffusion Tensor Image (DTI) can be derived and scalar measures, such as fractional anisotropy (FA), can then be estimated from the DTI to summarise quantitative microstructural information for clinical studies. In particular, FA has been shown to be a useful research metric to identify tissue abnormalities in neurological disease (e.g. decreased anisotropy as a proxy for tissue damage). However, time constraints in clinical practice lead to low angular resolution diffusion imaging (LARDI) acquisitions that can cause inaccurate FA value estimates when compared to those generated from high angular resolution diffusion imaging (HARDI) acquisitions. In this work, we propose High Angular DTI Estimation Network (HADTI-Net) to estimate an enhanced DTI model from LARDI with a set of minimal and evenly distributed diffusion gradient directions. Extensive experiments have been conducted to show the reliability and generalisation of HADTI-Net to generate high angular DTI estimation from any minimal evenly distributed diffusion gradient directions and to explore the feasibility of applying a data-driven method for this task. The code repository of this work and other related works can be found at https://mri-synthesis.github.io/.
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Affiliation(s)
- Zihao Tang
- School of Computer Science, The University of Sydney, Sydney, NSW, Australia
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Sheng Chen
- School of Computer Science, The University of Sydney, Sydney, NSW, Australia
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Arkiev D’Souza
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Dongnan Liu
- School of Computer Science, The University of Sydney, Sydney, NSW, Australia
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Fernando Calamante
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
- School of Biomedical Engineering, The University of Sydney, Sydney, NSW, Australia
- Sydney Imaging, The University of Sydney, Sydney, NSW, Australia
| | - Michael Barnett
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
- Sydney Neuroimaging Analysis Centre, Sydney, NSW, Australia
| | - Weidong Cai
- School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Chenyu Wang
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
- Sydney Neuroimaging Analysis Centre, Sydney, NSW, Australia
| | - Mariano Cabezas
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
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35
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Wu CQ, Cowan FM, Jary S, Thoresen M, Chakkarapani E, Spencer APC. Cerebellar growth, volume and diffusivity in children cooled for neonatal encephalopathy without cerebral palsy. Sci Rep 2023; 13:14869. [PMID: 37684324 PMCID: PMC10491605 DOI: 10.1038/s41598-023-41838-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Children cooled for HIE and who did not develop cerebral palsy (CP) still underperform at early school age in motor and cognitive domains and have altered supra-tentorial brain volumes and white matter connectivity. We obtained T1-weighted and diffusion-weighted MRI, motor (MABC-2) and cognitive (WISC-IV) scores from children aged 6-8 years who were cooled for HIE secondary to perinatal asphyxia without CP (cases), and controls matched for age, sex, and socioeconomic status. In 35 case children, we measured cerebellar growth from infancy (age 4-15 days after birth) to childhood. In childhood, cerebellar volumes were measured in 26 cases and 23 controls. Diffusion properties (mean diffusivity, MD and fractional anisotropy, FA) were calculated in 24 cases and 19 controls, in 9 cerebellar regions. Cases with FSIQ ≤ 85 had reduced growth of cerebellar width compared to those with FSIQ > 85 (p = 0.0005). Regional cerebellar volumes were smaller in cases compared to controls (p < 0.05); these differences were not significant when normalised to total brain volume. There were no case-control differences in MD or FA. Interposed nucleus volume was more strongly associated with IQ in cases than in controls (p = 0.0196). Other associations with developmental outcome did not differ between cases and controls.
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Affiliation(s)
- Chelsea Q Wu
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Frances M Cowan
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Department of Paediatrics, Imperial College London, London, UK
| | - Sally Jary
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marianne Thoresen
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ela Chakkarapani
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
- Neonatal Intensive Care Unit, St Michael's Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS2 8EG, UK.
| | - Arthur P C Spencer
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Guirguis M, Pezeshk P, Ashikyan O, Gowda P, Archer H, Hoang D, Xi Y, Chhabra A. Incremental value of diffusion weighted imaging over conventional MRI for the diagnosis of osteomyelitis of extremities. Skeletal Radiol 2023; 52:1669-1682. [PMID: 37004525 DOI: 10.1007/s00256-023-04331-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 04/04/2023]
Abstract
OBJECTIVE To determine the incremental value of diffusion weighted imaging (DWI) over conventional MR imaging in diagnosing extremity osteomyelitis (OM). MATERIALS AND METHODS In this cross-sectional study, three experienced musculoskeletal radiologists evaluated clinically suspected cases of extremity OM in two rounds-first on conventional MR imaging, and then conventional MR imaging combined with DWI 4-6 weeks later. The readers recorded a result of the presence or absence of OM and their diagnostic confidence on a 1-5 scale. Mean and minimum apparent diffusion coefficient (ADC) were measured. Pathology diagnosis served as the reference standard. Statistical analysis utilized intraclass correlation (ICC) and Conger's kappa. RESULTS A total of 213 scans of suspected OM were reviewed by three musculoskeletal radiologists with no significant changes in sensitivity (0.97, 0.97), specificity (0.97, 0.94), positive predictive value (0.91, 0.87), or negative predictive value (0.98, 0.98) between conventional MR imaging and MR imaging combined with DWI, respectively. Reader confidence did not significantly change with the addition of DWI (4.55 and 4.70, respectively). A high inter-reader agreement was observed for the diagnosis of OM, soft tissue abscess, and intraosseous abscess in both rounds. A higher mean (1.46+/-0.43 × 10-3 mm2/s > 0.64+/-0.47 × 10-3mm2/s) and minimum (1.18+/-0.45 × 10-3mm2/s > 0.37+/-0.44 × 10-3mm2/s) ADC value was associated with OM (p-value < 0.0001) with odds ratios of 1.34 and 1.31, respectively, for mean and minimum ADC of the involved bone. CONCLUSION DWI-derived ADC increase is associated with OM. The use of DWI slightly increases reader confidence in the diagnosis of OM; however, no significant incremental value over conventional MR imaging is seen for the final diagnosis of OM.
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Affiliation(s)
| | | | | | | | | | | | - Yin Xi
- Radiology, UT Southwestern, Dallas, TX, USA
| | - Avneesh Chhabra
- Radiology, UT Southwestern, Dallas, TX, USA.
- Orthopedic Surgery, UT Southwestern, Dallas, TX, 75390-9178, USA.
- Johns Hopkins University, Baltimore, MD, USA.
- University of Dallas, Richardson, TX, USA.
- Walton Centre for Neuroscience, Liverpool, UK.
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Abu-Leil S, Weisman A, Peled N, Kasem H, Dar G, Masharawi Y. Lumbosacral zone features in individuals with nonspecific chronic low back pain are unique compared to controls and correlate with pain and dysfunction. Eur Radiol 2023; 33:6392-6401. [PMID: 37060447 DOI: 10.1007/s00330-023-09626-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVES To compare the lumbosacral nerve distances (LNDs) and sacroiliac joint (SIJ) morphology in individuals with nonspecific chronic low back pain (NSCLBP) and control and examine their correlations with pain and dysfunction in the former. MATERIALS AND METHODS The sample includes 200 adult patients (ranging from 20 to 50 years old) referred for computerized abdominal tomography (CT): 100 individuals with NSCLBP (50 males and 50 females) and 100 individuals without NSCLBP (50 males and 50 females). CT scans were assessed for LNDs, degenerative sacroiliac changes, and joint bridging. Those factors were correlated to the outcomes of three self-reported questionnaires about pain and function (Oswestry, Fear-Avoidance, and Numerical Pain Rating Scale) in the NSCLBP group. RESULTS Individuals with NSCLBP tend to have reduced LNDs from the sacral part of the SIJ compared to controls (males: right Δ = 5.8 mm, left Δ = 6.03 mm; females: right Δ = 7.9 mm, left Δ = 7.73 mm, two-way ANOVA, p < 0.01), with moderate significant negative correlations with all three questionnaires (-0.38 < Pearson's r < - 0.57, p < 0.02, i.e., reduced LNDs with greater disability and pain). The NSCLBP group had more significant SIJ degeneration severity that moderately correlated with two questionnaires (0.39 < Pearson's r < 0.66, p < 0.04, i.e., greater SIJ degeneration with greater disability and pain). In males, the existence of SIJ bridging strongly correlated with all three questionnaires (0.38 < Pearson's r < 0.78, p < 0.03), and in females, only the Fear-Avoidance Questionnaire and Numerical Pain Scale (0.29 < Pearson's r < 0.41, p < 0.04). CONCLUSION Compared to controls, individuals with NSCLBP have reduced LNDs and worse SIJ degenerative changes that correlate with function and pain. KEY POINTS • Individuals with nonspecific low back pain tend to have reduced lumbosacral nerve distances than healthy controls. This may be due to entrapments or inflammation of the nerves or surrounding tissues. • Individuals with nonspecific low back pain tend to have more severe degeneration of their sacroiliac joint than healthy controls. • The above findings significantly correlated with the scores of three self-reported questionnaires about pain and function, implicating that they may be of clinical significance.
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Affiliation(s)
- Saher Abu-Leil
- Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Klatchkin 35, Tel-Aviv, Israel
- Department of Physical Therapy, Zefat Academic College, Zefat, Israel
| | - Asaf Weisman
- Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Klatchkin 35, Tel-Aviv, Israel
| | - Natan Peled
- Department of Radiology, Carmel Medical Center, Haifa, Israel
| | - Haytam Kasem
- Department of Mechanical Engineering, Azrieli College of Engineering, Jerusalem, Israel
| | - Gali Dar
- Department of Physical Therapy, The University of Haifa, Haifa, Israel
| | - Youssef Masharawi
- Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Klatchkin 35, Tel-Aviv, Israel.
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Saidian A, Bagrodia A. Imaging Techniques to Differentiate Benign Testicular Masses from Germ Cell Tumors. Curr Urol Rep 2023; 24:451-454. [PMID: 37368095 PMCID: PMC10449965 DOI: 10.1007/s11934-023-01172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE OF REVIEW To discuss role of different diagnostic imaging modalities in differentiation of benign testicular masses from seminomatous germ cell tumors (SGCTs) and non-seminomatous GCTs (NSGCTs). RECENT FINDINGS New modalities of ultrasonography, including contrast enhancement and shear wave elastography, may help differentiate between benign and malignant intratesticular lesions. Ultrasonography remains the recommended imaging modality for initial evaluation of testicular masses. However, MRI can be used to better define equivocal testicular lesions on US.
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Affiliation(s)
- Ava Saidian
- Department of Urology, University of California San Diego Health, 9400 Campus Point Drive #7897, 92093-7897, La Jolla, CA, USA.
| | - Aditya Bagrodia
- Department of Urology, University of California San Diego Health, 9400 Campus Point Drive #7897, 92093-7897, La Jolla, CA, USA
- Moores Cancer Center, San Diego, CA, USA
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Takanashi JI, Uetani H. Neuroimaging in acute infection-triggered encephalopathy syndromes. Front Neurosci 2023; 17:1235364. [PMID: 37638320 PMCID: PMC10447893 DOI: 10.3389/fnins.2023.1235364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023] Open
Abstract
Acute encephalopathy associated with infectious diseases occurs frequently in Japanese children (400-700 children/year) and is the most common in infants aged 0-3 years. Acute encephalopathy is classified into several clinicoradiological syndromes; acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is the most common subtype, followed by clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) and acute necrotizing encephalopathy (ANE). Neuroimaging, especially magnetic resonance imaging (MRI), is useful for the diagnosis, assessment of treatment efficacy, and evaluation of the pathophysiology of encephalopathy syndromes. MRI findings essential for diagnosis include delayed subcortical reduced diffusion (bright tree appearance) for AESD, reversible splenial lesions with homogeneously reduced diffusion for MERS, and symmetric hemorrhagic thalamic lesions for ANE. We reviewed several MRI techniques that have been applied in recent years, including diffusion-weighted imaging for the characterization of cerebral edema, arterial spin labeling for evaluating cerebral perfusion, and magnetic resonance spectroscopy for evaluating metabolic abnormality.
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Affiliation(s)
- Jun-ichi Takanashi
- Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Hiroyuki Uetani
- Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Li T, Wang J, Yang Y, Glide-Hurst CK, Wen N, Cai J. Multi-parametric MRI for radiotherapy simulation. Med Phys 2023; 50:5273-5293. [PMID: 36710376 PMCID: PMC10382603 DOI: 10.1002/mp.16256] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 09/10/2022] [Accepted: 12/06/2022] [Indexed: 01/31/2023] Open
Abstract
Magnetic resonance imaging (MRI) has become an important imaging modality in the field of radiotherapy (RT) in the past decade, especially with the development of various novel MRI and image-guidance techniques. In this review article, we will describe recent developments and discuss the applications of multi-parametric MRI (mpMRI) in RT simulation. In this review, mpMRI refers to a general and loose definition which includes various multi-contrast MRI techniques. Specifically, we will focus on the implementation, challenges, and future directions of mpMRI techniques for RT simulation.
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Affiliation(s)
- Tian Li
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jihong Wang
- Department of Radiation Physics, Division of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Yingli Yang
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong Univeristy School of Medicine, Shanghai, China
- SJTU-Ruijing-UIH Institute for Medical Imaging Technology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Carri K Glide-Hurst
- Department of Radiation Oncology, University of Wisconsin, Madison, Wisconsin, USA
| | - Ning Wen
- Department of Radiology, Ruijin Hospital, Shanghai Jiaotong Univeristy School of Medicine, Shanghai, China
- SJTU-Ruijing-UIH Institute for Medical Imaging Technology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- The Global Institute of Future Technology, Shanghai Jiaotong University, Shanghai, China
| | - Jing Cai
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China
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Choi SW, Duclos S, Camelo-Piragua S, Chaudhary N, Sukovich J, Hall T, Pandey A, Xu Z. Histotripsy Treatment of Murine Brain and Glioma: Temporal Profile of Magnetic Resonance Imaging and Histological Characteristics Post-treatment. Ultrasound Med Biol 2023; 49:1882-1891. [PMID: 37277304 DOI: 10.1016/j.ultrasmedbio.2023.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Currently, there is a knowledge gap in our understanding of the magnetic resonance imaging (MRI) characteristics of brain tumors treated with histotripsy to evaluate treatment response as well as treatment-related injuries. Our aim was to bridge this gap by investigating and correlating MRI with histological analysis after histotripsy treatment of mouse brain with and without brain tumors and evaluating the evolution of the histotripsy ablation zone on MRI over time. METHODS An eight-element, 1 MHz histotripsy transducer with a focal distance of 32.5 mm was used to treat orthotopic glioma-bearing mice and normal mice. The tumor burden at the time of treatment was ∼5 mm3. T2, T2*, T1 and T1-gadolinium (Gd) MR images and histology of the brain were acquired on days 0, 2 and 7 for tumor-bearing mice and days 0, 2, 7, 14, 21 and 28 post-histotripsy for normal mice. RESULTS T2 and T2* sequences most accurately correlated with histotripsy treatment zone. The treatment-induced blood products, T1 along with T2, revealed blood product evolution from oxygenated, de-oxygenated blood and methemoglobin to hemosiderin. And T1-Gd revealed the state of the blood-brain barrier arising from the tumor or histotripsy ablation. Histotripsy leads to minor localized bleeding, which resolves within the first 7 d as evident on hematoxylin and eosin staining. By day 14, the ablation zone could be distinguished only by the macrophage-laden hemosiderin, which resides around the ablation zone, rendering the treated zone hypo-intense on all MR sequences. CONCLUSION These results provide a library of radiological features on MRI sequences correlated to histology, thus allowing for non-invasive evaluation of histotripsy treatment effects in in vivo experiments.
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Affiliation(s)
- Sang Won Choi
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
| | - Sarah Duclos
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | | | - Neeraj Chaudhary
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Jonathan Sukovich
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Timothy Hall
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Aditya Pandey
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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Abstract
PURPOSE OF REVIEW Imaging is used in the diagnosis of peripheral and axial disease in juvenile spondyloarthritis (JSpA). Imaging of the joints and entheses in children and adolescents can be challenging for those unfamiliar with the appearance of the maturing skeleton. These differences are key for rheumatologists and radiologists to be aware of. RECENT FINDINGS In youth, skeletal variation during maturation makes the identification of arthritis, enthesitis, and sacroiliitis difficult. A great effort has been put forward to define imaging characteristics seen in healthy children in order to more accurately identify disease. Additionally, there are novel imaging modalities on the horizon that are promising to further differentiate normal physiologic changes versus disease. SUMMARY This review describes the current state of imaging, limitations, and future imaging modalities in youth, with key attention to differences in imaging interpretation of the peripheral joints, entheses, and sacroiliac joint in youth and adults.
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Affiliation(s)
- Hallie A Carol
- Division of Rheumatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Pamela F Weiss
- Division of Rheumatology, Department of Pediatrics, Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Gaughan C, Nasa A, Roman E, Cullinane D, Kelly L, Riaz S, Brady C, Browne C, Sooknarine V, Mosley O, Almulla A, Alsehli A, Kelliher A, Murphy C, O'Hanlon E, Cannon M, Roddy DW. A Pilot Study of Adolescents with Psychotic Experiences: Potential Cerebellar Circuitry Disruption Early Along the Psychosis Spectrum. Cerebellum 2023:10.1007/s12311-023-01579-5. [PMID: 37351730 DOI: 10.1007/s12311-023-01579-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Abstract
A berrant connectivity in the cerebellum has been found in psychotic conditions such as schizophrenia corresponding with cognitive and motor deficits found in these conditions. Diffusion differences in the superior cerebellar peduncles, the white matter connecting the cerebellar circuitry to the rest of the brain, have also been found in schizophrenia and high-risk states. However, white matter diffusivity in the peduncles in individuals with sub-threshold psychotic experiences (PEs) but not reaching the threshold for a definitive diagnosis remains unstudied. This study investigates the cerebellar peduncles in adolescents with PEs but no formal psychiatric diagnosis.Sixteen adolescents with PEs and 17 age-matched controls recruited from schools underwent High-Angular-Resolution-Diffusion neuroimaging. Following constrained spherical deconvolution whole-brain tractography, the superior, inferior and middle peduncles were isolated and virtually dissected out using ExploreDTI. Differences for macroscopic and microscopic tract metrics were calculated using one-way between-group analyses of covariance controlling for age, sex and estimated Total Intracranial Volume (eTIV). Multiple comparisons were corrected using Bonferroni correction.A decrease in fractional anisotropy was identified in the right (p = 0.045) and left (p = 0.058) superior cerebellar peduncle; however, this did not survive strict Bonferroni multiple comparison correction. There were no differences in volumes or other diffusion metrics in either the middle or inferior peduncles.Our trend level changes in the superior cerebellar peduncle in a non-clinical sample exhibiting psychotic experiences complement similar but more profound changes previously found in ultra-high-risk individuals and those with psychotic disorders. This suggests that superior cerebellar peduncle circuitry perturbations may occur early along in the psychosis spectrum.
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Affiliation(s)
- Caoimhe Gaughan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Anurag Nasa
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Elena Roman
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Dearbhla Cullinane
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Linda Kelly
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Sahar Riaz
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Conan Brady
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Ciaran Browne
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Vitallia Sooknarine
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Olivia Mosley
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Ahmad Almulla
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Assael Alsehli
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Allison Kelliher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Cian Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Erik O'Hanlon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Darren William Roddy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland.
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Mohamed ASR, Abusaif A, He R, Wahid KA, Salama V, Youssef S, McDonald BA, Naser M, Ding Y, Salzillo TC, AboBakr MA, Wang J, Lai SY, Fuller CD. Prospective validation of diffusion-weighted MRI as a biomarker of tumor response and oncologic outcomes in head and neck cancer: Results from an observational biomarker pre-qualification study. Radiother Oncol 2023; 183:109641. [PMID: 36990394 PMCID: PMC10848569 DOI: 10.1016/j.radonc.2023.109641] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE To determine DWI parameters associated with tumor response and oncologic outcomes in head and neck (HNC) patients treated with radiotherapy (RT). METHODS HNC patients in a prospective study were included. Patients had MRIs pre-, mid-, and post-RT completion. We used T2-weighted sequences for tumor segmentation which were co-registered to respective DWIs for extraction of apparent diffusion coefficient (ADC) measurements. Treatment response was assessed at mid- and post-RT and was defined as: complete response (CR) vs. non-complete response (non-CR). The Mann-Whitney U test was used to compare ADC between CR and non-CR. Recursive partitioning analysis (RPA) was performed to identify ADC threshold associated with relapse. Cox proportional hazards models were done for clinical vs. clinical and imaging parameters and internal validation was done using bootstrapping technique. RESULTS Eighty-one patients were included. Median follow-up was 31 months. For patients with post-RT CR, there was a significant increase in mean ADC at mid-RT compared to baseline ((1.8 ± 0.29) × 10-3 mm2/s vs. (1.37 ± 0.22) × 10-3 mm2/s, p < 0.0001), while patients with non-CR had no significant increase (p > 0.05). RPA identified GTV-P delta (Δ)ADCmean < 7% at mid-RT as the most significant parameter associated with worse LC and RFS (p = 0.01). Uni- and multi-variable analysis showed that GTV-P ΔADCmean at mid-RT ≥ 7% was significantly associated with better LC and RFS. The addition of ΔADCmean significantly improved the c-indices of LC and RFS models compared with standard clinical variables (0.85 vs. 0.77 and 0.74 vs. 0.68 for LC and RFS, respectively, p < 0.0001 for both). CONCLUSION ΔADCmean at mid-RT is a strong predictor of oncologic outcomes in HNC. Patients with no significant increase of primary tumor ADC at mid-RT are at high risk of disease relapse.
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Affiliation(s)
- Abdallah S R Mohamed
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA; The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
| | - Abdelrahman Abusaif
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Renjie He
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Kareem A Wahid
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA; The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Vivian Salama
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA; The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Sara Youssef
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Brigid A McDonald
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA; The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Mohamed Naser
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Yao Ding
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Travis C Salzillo
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Moamen A AboBakr
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Jihong Wang
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen Y Lai
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA; Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA; The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA; The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
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Rashidi A, Baratto L, Jayapal P, Theruvath AJ, Greene EB, Lu R, Spunt SL, Daldrup-Link HE. Detection of bone marrow metastases in children and young adults with solid cancers with diffusion-weighted MRI. Skeletal Radiol 2023; 52:1179-1192. [PMID: 36441237 PMCID: PMC10757820 DOI: 10.1007/s00256-022-04240-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the diagnostic accuracy of diffusion-weighted (DW)-MRI with b-values of 50 s/mm2 and 800 s/mm2 for the detection of bone marrow metastases in children and young adults with solid malignancies. METHODS In an institutional review board-approved prospective study, we performed 51 whole-body DW-MRI scans in 19 children and young adults (14 males, 5 females; age range: 1-25 years) with metastasized cancers before (n = 19 scans) and after (n = 32 scans) chemotherapy. Two readers determined the presence of focal bone marrow lesions in 10 anatomical areas. A third reader measured ADC and SNR of focal lesions and normal marrow. Simultaneously acquired 18F-FDG-PET scans served as the standard of reference. Data of b = 50 s/mm2 and 800 s/mm2 images were compared with the Wilcoxon signed-rank test. Inter-reader agreement was evaluated with weighted kappa statistics. RESULTS The SNR of bone marrow metastases was significantly higher compared to normal bone marrow on b = 50 s/mm2 (mean ± SD: 978.436 ± 1239.436 vs. 108.881 ± 109.813, p < 0.001) and b = 800 s/mm2 DW-MRI (499.638 ± 612.721 vs. 86.280 ± 89.120; p < 0.001). On 30 out of 32 post-treatment DW-MRI scans, reconverted marrow demonstrated low signal with low ADC values (0.385 × 10-3 ± 0.168 × 10-3mm2/s). The same number of metastases (556/588; 94.6%; p > 0.99) was detected on b = 50 s/mm2 and 800 s/mm2 images. However, both normal marrow and metastases exhibited low signals on ADC maps, limiting the ability to delineate metastases. The inter-reader agreement was substantial, with a weighted kappa of 0.783 and 0.778, respectively. CONCLUSION Bone marrow metastases in children and young adults can be equally well detected on b = 50 s/mm2 and 800 s/mm2 images, but ADC values can be misleading.
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Affiliation(s)
- Ali Rashidi
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, CA, USA
| | - Lucia Baratto
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, CA, USA
| | - Praveen Jayapal
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, CA, USA
| | - Ashok Joseph Theruvath
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, CA, USA
| | - Elton Benjamin Greene
- Department of Radiology, Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, CA, USA
| | - Rong Lu
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, CA, USA
| | - Sheri L Spunt
- Department of Pediatrics, Hematology/Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Heike E Daldrup-Link
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, CA, USA.
- Department of Pediatrics, Hematology/Oncology, Stanford University School of Medicine, Stanford, CA, USA.
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, 725 Welch Rd, Stanford, CA, 94305-5654, USA.
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Andrews L, Keller SS, Osman-Farah J, Macerollo A. A structural magnetic resonance imaging review of clinical motor outcomes from deep brain stimulation in movement disorders. Brain Commun 2023; 5:fcad171. [PMID: 37304793 PMCID: PMC10257440 DOI: 10.1093/braincomms/fcad171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 04/05/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023] Open
Abstract
Patients with movement disorders treated by deep brain stimulation do not always achieve successful therapeutic alleviation of motor symptoms, even in cases where surgery is without complications. Magnetic resonance imaging (MRI) offers methods to investigate structural brain-related factors that may be predictive of clinical motor outcomes. This review aimed to identify features which have been associated with variability in clinical post-operative motor outcomes in patients with Parkinson's disease, dystonia, and essential tremor from structural MRI modalities. We performed a literature search for articles published between 1 January 2000 and 1 April 2022 and identified 5197 articles. Following screening through our inclusion criteria, we identified 60 total studies (39 = Parkinson's disease, 11 = dystonia syndromes and 10 = essential tremor). The review captured a range of structural MRI methods and analysis techniques used to identify factors related to clinical post-operative motor outcomes from deep brain stimulation. Morphometric markers, including volume and cortical thickness were commonly identified in studies focused on patients with Parkinson's disease and dystonia syndromes. Reduced metrics in basal ganglia, sensorimotor and frontal regions showed frequent associations with reduced motor outcomes. Increased structural connectivity to subcortical nuclei, sensorimotor and frontal regions was also associated with greater motor outcomes. In patients with tremor, increased structural connectivity to the cerebellum and cortical motor regions showed high prevalence across studies for greater clinical motor outcomes. In addition, we highlight conceptual issues for studies assessing clinical response with structural MRI and discuss future approaches towards optimizing individualized therapeutic benefits. Although quantitative MRI markers are in their infancy for clinical purposes in movement disorder treatments, structural features obtained from MRI offer the powerful potential to identify candidates who are more likely to benefit from deep brain stimulation and provide insight into the complexity of disorder pathophysiology.
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Affiliation(s)
- Luke Andrews
- Correspondence to: Luke Andrews The BRAIN Lab, University of Liverpool Cancer Research Centre 200 London Rd, Liverpool L3 9TA, United Kingdom E-mail:
| | - Simon S Keller
- The Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L3 9TA, UK
| | - Jibril Osman-Farah
- Department of Neurology and Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool L97LJ, UK
| | - Antonella Macerollo
- Correspondence may also be sent to: Antonella Macerollo. The Walton Centre NHS Trust, Lower Lane Liverpool L9 7LJ, United Kingdom E-mail:
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Alghamdi AJ. The Value of Various Post-Processing Modalities of Diffusion Weighted Imaging in the Detection of Multiple Sclerosis. Brain Sci 2023; 13:brainsci13040622. [PMID: 37190587 DOI: 10.3390/brainsci13040622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
Diffusion tensor imaging (DTI) showed its adequacy in evaluating the normal-appearing white matter (NAWM) and lesions in the brain that are difficult to evaluate with routine clinical magnetic resonance imaging (MRI) in multiple sclerosis (MS). Recently, MRI systems have been developed with regard to software and hardware, leading to different proposed diffusion analysis methods such as diffusion tensor imaging, q-space imaging, diffusional kurtosis imaging, neurite orientation dispersion and density imaging, and axonal diameter measurement. These methods have the ability to better detect in vivo microstructural changes in the brain than DTI. These different analysis modalities could provide supplementary inputs for MS disease characterization and help in monitoring the disease’s progression as well as treatment efficacy. This paper reviews some of the recent diffusion MRI methods used for the assessment of MS in vivo.
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Affiliation(s)
- Ahmad Joman Alghamdi
- Radiological Sciences Department, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
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Peer S, Gopinath R, Saini J, Kumar P, Srinivas D, Nagaraj C. Evaluation of the Diagnostic Performance of F18-Fluorodeoxyglucose-Positron Emission Tomography, Dynamic Susceptibility Contrast Perfusion, and Apparent Diffusion Coefficient in Differentiation between Recurrence of a High-grade Glioma and Radiation Necrosis. Indian J Nucl Med 2023; 38:115-124. [PMID: 37456178 PMCID: PMC10348492 DOI: 10.4103/ijnm.ijnm_73_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/20/2022] [Accepted: 09/06/2022] [Indexed: 07/18/2023] Open
Abstract
Background Differentiation between recurrence of brain tumor and radiation necrosis remains a challenge in current neuro-oncology practice despite recent advances in both radiological and nuclear medicine techniques. Purpose The purpose of this study was to compare the diagnostic performance of dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging (MRI), apparent diffusion coefficient (ADC) derived from diffusion-weighted imaging, and F18-fluorodeoxyglucose-positron emission tomography (F18-FDG-PET) in the differentiation between the recurrence of a high-grade glioma and radiation necrosis. Materials and Methods Patients with a diagnosis of high-grade glioma (WHO Grades III and IV) who had undergone surgical resection of the tumor followed by radiotherapy with or without chemotherapy were included in the study. DSC perfusion, diffusion-weighted MRI, and PET scan were acquired on a hybrid PET/MRI scanner. For each lesion, early and delayed tumor-to-brain ratio (TBR), early and delayed maximum standardized uptake value (SUVmax), normalized ADC ratio, and normalized relative cerebral blood volume (rCBV) ratio were calculated and the pattern of lesional enhancement was noted. The diagnosis was finalized with either histopathological examination or the characteristics on follow-up imaging. The statistical analysis using the receiver operator characteristic curves was done to determine the diagnostic performance of DSC perfusion, 18-F FDG-PET, and ADC in differentiation between tumor recurrence and radiation necrosis. Results Fifty patients were included in the final analysis, 32 of them being men (64%). A cutoff value of early TBR >0.8 (sensitivity of 100% and specificity of 80%), delayed TBR >0.93 (sensitivity of 92.3% and specificity of 80%), early SUVmax >10.2 (sensitivity of 76.9% and specificity of 80%), delayed SUVmax >13.2 (sensitivity of 61.54% and specificity of 100%), normalized rCBV ratio >1.21 (sensitivity of 100% and specificity of 60%), normalized ADC ratio >1.66 (sensitivity of 38.5% and specificity of 80%), and Grade 3 enhancement (sensitivity of 100% and specificity of 60%) were found to differentiate recurrence from radiation necrosis. Early TBR had the highest accuracy (94.44%), while ADC ratio had the lowest accuracy (50%). A combination of early TBR (cutoff value of 0.8), late TBR (cutoff value of 0.93), and rCBV ratio (cutoff value of 1.21) showed a sensitivity of 100%, specificity of 92.3%, positive predictive value of 88.9%, negative predictive value of 93.7%, and an accuracy of 96.6% in discrimination between radiation necrosis and recurrence of tumor. Conclusion F18-FDG-PET and DSC perfusion can reliably differentiate tumor recurrence from radiation necrosis, with early TBR showing the highest accuracy. ADC demonstrates a low sensitivity, specificity, and accuracy in differentiating radiation necrosis from recurrence. A combination of early TBR, delayed TBR, and rCBV may be more useful in discrimination between radiation necrosis and recurrence of glioma, with this combination showing a better diagnostic performance than individual parameters or any other combination of parameters.
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Affiliation(s)
- Sameer Peer
- Department of Radiodiagnosis, AIIMS, Bathinda, Punjab, India
| | - R. Gopinath
- Department of Neuro Imaging and Interventional Radiology, Bengaluru, Karnataka, India
| | - Jitender Saini
- Department of Neuro Imaging and Interventional Radiology, Bengaluru, Karnataka, India
| | - Pardeep Kumar
- Department of Neuro Imaging and Interventional Radiology, Bengaluru, Karnataka, India
| | | | - Chandana Nagaraj
- Department of Nuclear Medicine, St. Johns National Academy of Health Sciences, Bengaluru, Karnataka, India
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49
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Warner W, Palombo M, Cruz R, Callaghan R, Shemesh N, Jones DK, Dell'Acqua F, Ianus A, Drobnjak I. Temporal Diffusion Ratio (TDR) for imaging restricted diffusion: Optimisation and pre-clinical demonstration. Neuroimage 2023; 269:119930. [PMID: 36750150 PMCID: PMC7615244 DOI: 10.1016/j.neuroimage.2023.119930] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 01/12/2023] [Accepted: 02/02/2023] [Indexed: 02/07/2023] Open
Abstract
Temporal Diffusion Ratio (TDR) is a recently proposed dMRI technique (Dell'Acqua et al., proc. ISMRM 2019) which provides contrast between areas with restricted diffusion and areas either without restricted diffusion or with length scales too small for characterisation. Hence, it has a potential for informing on pore sizes, in particular the presence of large axon diameters or other cellular structures. TDR employs the signal from two dMRI acquisitions obtained with the same, large, b-value but with different diffusion gradient waveforms. TDR is advantageous as it employs standard acquisition sequences, does not make any assumptions on the underlying tissue structure and does not require any model fitting, avoiding issues related to model degeneracy. This work for the first time introduces and optimises the TDR method in simulation for a range of different tissues and scanner constraints and validates it in a pre-clinical demonstration. We consider both substrates containing cylinders and spherical structures, representing cell soma in tissue. Our results show that contrasting an acquisition with short gradient duration, short diffusion time and high gradient strength with an acquisition with long gradient duration, long diffusion time and low gradient strength, maximises the TDR contrast for a wide range of pore configurations. Additionally, in the presence of Rician noise, computing TDR from a subset (50% or fewer) of the acquired diffusion gradients rather than the entire shell as proposed originally further improves the contrast. In the last part of the work the results are demonstrated experimentally on rat spinal cord. In line with simulations, the experimental data shows that optimised TDR improves the contrast compared to non-optimised TDR. Furthermore, we find a strong correlation between TDR and histology measurements of axon diameter. In conclusion, we find that TDR has great potential and is a very promising alternative (or potentially complement) to model-based approaches for informing on pore sizes and restricted diffusion in general.
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Affiliation(s)
- William Warner
- Centre for Medical Image Computing (CMIC), Computer Science Department, University College London, United Kingdom
| | - Marco Palombo
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom; School of Computer Science and Informatics, Cardiff University, Cardiff, United Kingdom
| | - Renata Cruz
- Champalimaud Research, Champalimaud Foundation, Lisbon, Portugal
| | | | - Noam Shemesh
- Champalimaud Research, Champalimaud Foundation, Lisbon, Portugal
| | - Derek K Jones
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Flavio Dell'Acqua
- NatBrainLab, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Andrada Ianus
- Champalimaud Research, Champalimaud Foundation, Lisbon, Portugal.
| | - Ivana Drobnjak
- Centre for Medical Image Computing (CMIC), Computer Science Department, University College London, United Kingdom.
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50
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Abele N, Langner S, Felbor U, Lode H, Hosten N. Quantitative Diffusion-Weighted MRI of Neuroblastoma. Cancers (Basel) 2023; 15:cancers15071940. [PMID: 37046600 PMCID: PMC10092990 DOI: 10.3390/cancers15071940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 04/14/2023] Open
Abstract
Neuroblastoma is the most common extracranial, malignant, solid tumor found in children. In more than one-third of cases, the tumor is in an advanced stage, with limited resectability. The treatment options include resection, with or without (neo-/) adjuvant therapy, and conservative therapy, the latter even with curative intent. Contrast-enhanced MRI is used for staging and therapy monitoring. Diffusion-weighted imaging (DWI) is often included. DWI allows for a calculation of the apparent diffusion coefficient (ADC) for quantitative assessment. Histological tumor characteristics can be derived from ADC maps. Monitoring the response to treatment is possible using ADC maps, with an increase in ADC values in cases of a response to therapy. Changes in the ADC value precede volume reduction. The usual criteria for determining the response to therapy can therefore be supplemented by ADC values. While these changes have been observed in neuroblastoma, early changes in the ADC value in response to therapy are less well described. In this study, we evaluated whether there is an early change in the ADC values in neuroblastoma under therapy; if this change depends on the form of therapy; and whether this change may serve as a prognostic marker. We retrospectively evaluated neuroblastoma cases treated in our institution between June 2007 and August 2014. The examinations were grouped as 'prestaging'; 'intermediate staging'; 'final staging'; and 'follow-up'. A classification of "progress", "stable disease", or "regress" was made. For the determination of ADC values, regions of interest were drawn along the borders of all tumor manifestations. To calculate ADC changes (∆ADC), the respective MRI of the prestaging was used as a reference point or, in the case of therapies that took place directly after previous therapies, the associated previous staging. In the follow-up examinations, the previous examination was used as a reference point. The ∆ADC were grouped into ∆ADCregress for regressive disease, ∆ADCstable for stable disease, and ∆ADC for progressive disease. In addition, examinations at 60 to 120 days from the baseline were grouped as er∆ADCregress, er∆ADCstable, and er∆ADCprogress. Any differences were tested for significance using the Mann-Whitney test (level of significance: p < 0.05). In total, 34 patients with 40 evaluable tumor manifestations and 121 diffusion-weighted MRI examinations were finally included. Twenty-seven patients had INSS stage IV neuroblastoma, and seven had INSS stage III neuroblastoma. A positive N-Myc expression was found in 11 tumor diseases, and 17 patients tested negative for N-Myc (with six cases having no information). 26 patients were assigned to the high-risk group according to INRG and eight patients to the intermediate-risk group. There was a significant difference in mean ADC values from the high-risk group compared to those from the intermediate-risk group, according to INRG. The differences between the mean ∆ADC values (absolute and percentage) according to the course of the disease were significant: between ∆ADCregress and ∆ADCstable, between ∆ADCprogress and ∆ADCstable, as well as between ∆ADCregress and ∆ADCprogress. The differences between the mean er∆ADC values (absolute and percentage) according to the course of the disease were significant: between er∆ADCregress and er∆ADCstable, as well as between er∆ADCregress and er∆ADCprogress. Forms of therapy, N-Myc status, and risk groups showed no further significant differences in mean ADC values and ∆ADC/er∆ADC. A clear connection between the ADC changes and the response to therapy could be demonstrated. This held true even within the first 120 days after the start of therapy: an increase in the ADC value corresponds to a probable response to therapy, while a decrease predicts progression. Minimal or no changes were seen in cases of stable disease.
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Affiliation(s)
- Niklas Abele
- Department of Radiology, Germany University of Greifswald, 17475 Greifswald, Germany
- Institute of Pathology, University of Erlangen, 91054 Erlangen, Germany
| | - Soenke Langner
- Department of Radiology, Germany University of Greifswald, 17475 Greifswald, Germany
- Department of Radiology, University of Rostock, 18057 Rostock, Germany
| | - Ute Felbor
- Department of Human Genetics, University of Greifswald, 17475 Greifswald, Germany
- Interfaculty Institute of Genetics and Functional Genetics, University of Greifswald, 17475 Greifswald, Germany
| | - Holger Lode
- Department of Pediatric Hematology and Oncology, University of Greifswald, 17475 Greifswald, Germany
| | - Norbert Hosten
- Department of Radiology, Germany University of Greifswald, 17475 Greifswald, Germany
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