1
|
Nguyen TB, Cron GO, Bezzina K, Perdrizet K, Torres CH, Chakraborty S, Woulfe J, Jansen GH, Thornhill RE, Zanette B, Cameron IG. Correlation of Tumor Immunohistochemistry with Dynamic Contrast-Enhanced and DSC-MRI Parameters in Patients with Gliomas. AJNR Am J Neuroradiol 2016; 37:2217-2223. [PMID: 27585700 DOI: 10.3174/ajnr.a4908] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 07/01/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Tumor CBV is a prognostic and predictive marker for patients with gliomas. Tumor CBV can be measured noninvasively with different MR imaging techniques; however, it is not clear which of these techniques most closely reflects histologically-measured tumor CBV. Our aim was to investigate the correlations between dynamic contrast-enhanced and DSC-MR imaging parameters and immunohistochemistry in patients with gliomas. MATERIALS AND METHODS Forty-three patients with a new diagnosis of glioma underwent a preoperative MR imaging examination with dynamic contrast-enhanced and DSC sequences. Unnormalized and normalized cerebral blood volume was obtained from DSC MR imaging. Two sets of plasma volume and volume transfer constant maps were obtained from dynamic contrast-enhanced MR imaging. Plasma volume obtained from the phase-derived vascular input function and bookend T1 mapping (Vp_Φ) and volume transfer constant obtained from phase-derived vascular input function and bookend T1 mapping (Ktrans_Φ) were determined. Plasma volume obtained from magnitude-derived vascular input function (Vp_SI) and volume transfer constant obtained from magnitude-derived vascular input function (Ktrans_SI) were acquired, without T1 mapping. Using CD34 staining, we measured microvessel density and microvessel area within 3 representative areas of the resected tumor specimen. The Mann-Whitney U test was used to test for differences according to grade and degree of enhancement. The Spearman correlation was performed to determine the relationship between dynamic contrast-enhanced and DSC parameters and histopathologic measurements. RESULTS Microvessel area, microvessel density, dynamic contrast-enhanced, and DSC-MR imaging parameters varied according to the grade and degree of enhancement (P < .05). A strong correlation was found between microvessel area and Vp_Φ and between microvessel area and unnormalized blood volume (rs ≥ 0.61). A moderate correlation was found between microvessel area and normalized blood volume, microvessel area and Vp_SI, microvessel area and Ktrans_Φ, microvessel area and Ktrans_SI, microvessel density and Vp_Φ, microvessel density and unnormalized blood volume, and microvessel density and normalized blood volume (0.44 ≤ rs ≤ 0.57). A weaker correlation was found between microvessel density and Ktrans_Φ and between microvessel density and Ktrans_SI (rs ≤ 0.41). CONCLUSIONS With dynamic contrast-enhanced MR imaging, use of a phase-derived vascular input function and bookend T1 mapping improves the correlation between immunohistochemistry and plasma volume, but not between immunohistochemistry and the volume transfer constant. With DSC-MR imaging, normalization of tumor CBV could decrease the correlation with microvessel area.
Collapse
Affiliation(s)
- T B Nguyen
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | - G O Cron
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | - K Bezzina
- Psychiatry (K.B.), The Ottawa Hospital, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | - C H Torres
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | - S Chakraborty
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | | | | | - R E Thornhill
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | - B Zanette
- Department of Medical Biophysics (B.Z.), University of Toronto, Toronto, Ontario, Canada
| | - I G Cameron
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.).,Medical Physics (I.G.C.)
| |
Collapse
|
2
|
Nguyen TB, Cron GO, Perdrizet K, Bezzina K, Torres CH, Chakraborty S, Woulfe J, Jansen GH, Sinclair J, Thornhill RE, Foottit C, Zanette B, Cameron IG. Comparison of the Diagnostic Accuracy of DSC- and Dynamic Contrast-Enhanced MRI in the Preoperative Grading of Astrocytomas. AJNR Am J Neuroradiol 2015; 36:2017-22. [PMID: 26228886 DOI: 10.3174/ajnr.a4398] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 03/24/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Dynamic contrast-enhanced MR imaging parameters can be biased by poor measurement of the vascular input function. We have compared the diagnostic accuracy of dynamic contrast-enhanced MR imaging by using a phase-derived vascular input function and "bookend" T1 measurements with DSC MR imaging for preoperative grading of astrocytomas. MATERIALS AND METHODS This prospective study included 48 patients with a new pathologic diagnosis of an astrocytoma. Preoperative MR imaging was performed at 3T, which included 2 injections of 5-mL gadobutrol for dynamic contrast-enhanced and DSC MR imaging. During dynamic contrast-enhanced MR imaging, both magnitude and phase images were acquired to estimate plasma volume obtained from phase-derived vascular input function (Vp_Φ) and volume transfer constant obtained from phase-derived vascular input function (K(trans)_Φ) as well as plasma volume obtained from magnitude-derived vascular input function (Vp_SI) and volume transfer constant obtained from magnitude-derived vascular input function (K(trans)_SI). From DSC MR imaging, corrected relative CBV was computed. Four ROIs were placed over the solid part of the tumor, and the highest value among the ROIs was recorded. A Mann-Whitney U test was used to test for difference between grades. Diagnostic accuracy was assessed by using receiver operating characteristic analysis. RESULTS Vp_ Φ and K(trans)_Φ values were lower for grade II compared with grade III astrocytomas (P < .05). Vp_SI and K(trans)_SI were not significantly different between grade II and grade III astrocytomas (P = .08-0.15). Relative CBV and dynamic contrast-enhanced MR imaging parameters except for K(trans)_SI were lower for grade III compared with grade IV (P ≤ .05). In differentiating low- and high-grade astrocytomas, we found no statistically significant difference in diagnostic accuracy between relative CBV and dynamic contrast-enhanced MR imaging parameters. CONCLUSIONS In the preoperative grading of astrocytomas, the diagnostic accuracy of dynamic contrast-enhanced MR imaging parameters is similar to that of relative CBV.
Collapse
Affiliation(s)
- T B Nguyen
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | - G O Cron
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | | | - K Bezzina
- Faculty of Medicine (K.B.), Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - C H Torres
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | - S Chakraborty
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | | | | | - J Sinclair
- Surgery, Division of Neurosurgery (J.S.)
| | - R E Thornhill
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.)
| | | | - B Zanette
- Department of Medical Biophysics (B.Z.), University of Toronto, Toronto, Ontario, Canada
| | - I G Cameron
- From the Departments of Radiology (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C.) Medical Physics (C.F., I.G.C.)
| |
Collapse
|
3
|
Nguyen TB, Cron GO, Mercier JF, Foottit C, Torres CH, Chakraborty S, Woulfe J, Jansen GH, Caudrelier JM, Sinclair J, Hogan MJ, Thornhill RE, Cameron IG. Preoperative prognostic value of dynamic contrast-enhanced MRI-derived contrast transfer coefficient and plasma volume in patients with cerebral gliomas. AJNR Am J Neuroradiol 2015; 36:63-9. [PMID: 24948500 DOI: 10.3174/ajnr.a4006] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The prognostic value of dynamic contrast-enhanced MR imaging-derived plasma volume obtained in tumor and the contrast transfer coefficient has not been well-established in patients with gliomas. We determined whether plasma volume and contrast transfer coefficient in tumor correlated with survival in patients with gliomas in addition to other factors such as age, type of surgery, preoperative Karnofsky score, contrast enhancement, and histopathologic grade. MATERIALS AND METHODS This prospective study included 46 patients with a new pathologically confirmed diagnosis of glioma. The contrast transfer coefficient and plasma volume obtained in tumor maps were calculated directly from the signal-intensity curve without T1 measurements, and values were obtained from multiple small ROIs placed within tumors. Survival curve analysis was performed by dichotomizing patients into groups of high and low contrast transfer coefficient and plasma volume. Univariate analysis was performed by using dynamic contrast-enhanced parameters and clinical factors. Factors that were significant on univariate analysis were entered into multivariate analysis. RESULTS For all patients with gliomas, survival was worse for groups of patients with high contrast transfer coefficient and plasma volume obtained in tumor (P < .05). In subgroups of high- and low-grade gliomas, survival was worse for groups of patients with high contrast transfer coefficient and plasma volume obtained in tumor (P < .05). Univariate analysis showed that factors associated with lower survival were age older than 50 years, low Karnofsky score, biopsy-only versus resection, marked contrast enhancement versus no/mild enhancement, high contrast transfer coefficient, and high plasma volume obtained in tumor (P < .05). In multivariate analysis, a low Karnofsky score, biopsy versus resection in combination with marked contrast enhancement, and a high contrast transfer coefficient were associated with lower survival rates (P < .05). CONCLUSIONS In patients with glioma, those with a high contrast transfer coefficient have lower survival than those with low parameters.
Collapse
Affiliation(s)
- T B Nguyen
- From the Departments of Diagnostic Imaging (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
| | - G O Cron
- From the Departments of Diagnostic Imaging (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
| | - J F Mercier
- Department of Radiology (J.F.M.), Hôpital de Hull, Gatineau, Québec, Canada
| | | | - C H Torres
- From the Departments of Diagnostic Imaging (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
| | - S Chakraborty
- From the Departments of Diagnostic Imaging (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
| | | | | | - J M Caudrelier
- From the Departments of Diagnostic Imaging (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
| | - J Sinclair
- Surgery, Division of Neurosurgery (J.S.)
| | - M J Hogan
- Medicine, Division of Neurology (M.J.H.), The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - R E Thornhill
- From the Departments of Diagnostic Imaging (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
| | - I G Cameron
- From the Departments of Diagnostic Imaging (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C., J.M.C.) Medical Physics (C.F., I.G.C.)
| |
Collapse
|
4
|
Nguyen TB, Cron GO, Mercier JF, Foottit C, Torres CH, Chakraborty S, Woulfe J, Jansen GH, Caudrelier JM, Sinclair J, Hogan MJ, Thornhill RE, Cameron IG. Diagnostic accuracy of dynamic contrast-enhanced MR imaging using a phase-derived vascular input function in the preoperative grading of gliomas. AJNR Am J Neuroradiol 2012; 33:1539-45. [PMID: 22442046 DOI: 10.3174/ajnr.a3012] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The accuracy of tumor plasma volume and K(trans) estimates obtained with DCE MR imaging may have inaccuracies introduced by a poor estimation of the VIF. In this study, we evaluated the diagnostic accuracy of a novel technique by using a phase-derived VIF and "bookend" T1 measurements in the preoperative grading of patients with suspected gliomas. MATERIALS AND METHODS This prospective study included 46 patients with a new pathologically confirmed diagnosis of glioma. Both magnitude and phase images were acquired during DCE MR imaging for estimates of K(trans)_φ and V(p_)φ (calculated from a phase-derived VIF and bookend T1 measurements) as well as K(trans)_SI and V(p_)SI (calculated from a magnitude-derived VIF without T1 measurements). RESULTS Median K(trans)_φ values were 0.0041 minutes(-1) (95 CI, 0.00062-0.033), 0.031 minutes(-1) (0.011-0.150), and 0.088 minutes(-1) (0.069-0.110) for grade II, III, and IV gliomas, respectively (P ≤ .05 for each). Median V(p_)φ values were 0.64 mL/100 g (0.06-1.40), 0.98 mL/100 g (0.34-2.20), and 2.16 mL/100 g (1.8-3.1) with P = .15 between grade II and III gliomas and P = .015 between grade III and IV gliomas. In differentiating low-grade from high-grade gliomas, AUCs for K(trans)_φ, V(p_φ), K(trans)_SI, and V(p_)SI were 0.87 (0.73-1), 0.84 (0.69-0.98), 0.81 (0.59-1), and 0.84 (0.66-0.91). The differences between the AUCs were not statistically significant. CONCLUSIONS K(trans)_φ and V(p_)φ are parameters that can help in differentiating low-grade from high-grade gliomas.
Collapse
Affiliation(s)
- T B Nguyen
- Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Yoshimoto M, Cunha IW, Coudry RA, Fonseca FP, Torres CH, Soares FA, Squire JA. FISH analysis of 107 prostate cancers shows that PTEN genomic deletion is associated with poor clinical outcome. Br J Cancer 2007; 97:678-85. [PMID: 17700571 PMCID: PMC2360375 DOI: 10.1038/sj.bjc.6603924] [Citation(s) in RCA: 218] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
This study examines the clinical impact of PTEN genomic deletions using fluorescence in situ hybridisation (FISH) analysis of 107 prostate cancers, with follow-up information covering a period of up to 10 years. Tissue microarray analysis using interphase FISH indicated that hemizygous PTEN losses were present in 42/107 (39%) of prostatic adenocarcinomas, with a homozygous PTEN deletion observed in 5/107 (5%) tumours. FISH analysis using closely linked probes centromeric and telomeric to the PTEN indicated that subband microdeletions accounted for ∼70% genomic losses. Kaplan–Meier survival analysis of PTEN genomic losses (hemizygous and homozygous deletion vs not deleted) identified subgroups with different prognosis based on their time to biochemical relapse after surgery, and demonstrated significant association between PTEN deletion and an earlier onset of disease recurrence (as determined by prostate-specific antigen levels). Homozygous PTEN deletion was associated with a much earlier onset of biochemical recurrence (P=0.002). Furthermore, PTEN loss at the time of prostatectomy correlated with clinical parameters of more advanced disease, such as extraprostatic extension and seminal vesicle invasion. Collectively, our data indicates that haploinsufficiency or PTEN genomic loss is an indicator of more advanced disease at surgery, and is predictive of a shorter time to biochemical recurrence of disease.
Collapse
Affiliation(s)
- M Yoshimoto
- Division of Applied Molecular Oncology, Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Ontario, M5G 2M9, Canada
| | - I W Cunha
- Departamento de Patologia, Centro de Tratamento e Pesquisa, Hospital do Câncer, A.C. Camargo, São Paulo, 01509 010, Brazil
| | - R A Coudry
- Departamento de Patologia, Centro de Tratamento e Pesquisa, Hospital do Câncer, A.C. Camargo, São Paulo, 01509 010, Brazil
| | - F P Fonseca
- Serviço de Urologia, Departamento de Cirurgia Pélvica, Hospital do Câncer, A.C. Camargo, São Paulo, 01509 010, Brazil
| | - C H Torres
- Instituto de Matemática e Estatística, Universidade de São Paulo, São Paulo, 01509 010, Brazil
| | - F A Soares
- Departamento de Patologia, Centro de Tratamento e Pesquisa, Hospital do Câncer, A.C. Camargo, São Paulo, 01509 010, Brazil
| | - J A Squire
- Division of Applied Molecular Oncology, Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Ontario, M5G 2M9, Canada
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, M5G 2M9, Canada
- Division of Applied Molecular Oncology, Ontario Cancer Institute, Princess Margaret Hospital. 610 University Avenue, Room 9-721, Toronto, Ontario, M5G 2M9, Canada. E-mail:
| |
Collapse
|