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Zhong S, Ai C, Ding Y, Tan J, Jin Y, Wang H, Zhang H, Li M, Zhu R, Gu S, Zhang Y. Combining multimodal diffusion-weighted imaging and morphological parameters for detecting lymph node metastasis in cervical cancer. Abdom Radiol (NY) 2024; 49:4574-4583. [PMID: 38990301 DOI: 10.1007/s00261-024-04494-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/05/2024] [Accepted: 07/06/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Accurate detection of lymph node metastasis (LNM) is crucial for determining the tumor stage, selecting optimal treatment, and estimating the prognosis for cervical cancer. This study aimed to assess the diagnostic efficacy of multimodal diffusion-weighted imaging (DWI) and morphological parameters alone or in combination, for detecting LNM in cervical cancer. METHODS In this prospective study, we enrolled consecutive cervical cancer patients who received multimodal DWI (conventional DWI, intravoxel incoherent motion DWI, and diffusion kurtosis imaging) before treatment from June 2022 to June 2023. The largest lymph node (LN) observed on each side on imaging was matched with that detected on pathology to improve the accuracy of LN matching. Comparison of the diffusion and morphological parameters of LNs and the primary tumor between the positive and negative LN groups. A combined diagnostic model was constructed using multivariate logistic regression, and the diagnostic performance was evaluated using receiver operating characteristic curves. RESULTS A total of 93 cervical cancer patients were enrolled: 35 with LNM (48 positive LNs were collected), and 58 without LNM (116 negative LNs were collected). The area under the curve (AUC) values for the apparent diffusion coefficient, diffusion coefficient, mean diffusivity, mean kurtosis, long-axis diameter, short-axis diameter of LNs, and the largest primary tumor diameter were 0.716, 0.720, 0.716, 0.723, 0.726, 0.798, and 0.744, respectively. Independent risk factors included the diffusion coefficient, mean kurtosis, short-axis diameter of LNs, and the largest primary tumor diameter. The AUC value of the combined model based on the independent risk factors was 0.920, superior to the AUC values of all the parameters mentioned above. CONCLUSION Combining multimodal DWI and morphological parameters improved the diagnostic efficacy for detecting cervical cancer LNM than using either alone.
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Affiliation(s)
- Suixing Zhong
- Department of Radiology, Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Xishan District, Kunming, 650118, China
| | - Conghui Ai
- Department of Radiology, Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Xishan District, Kunming, 650118, China
| | - Yingying Ding
- Department of Radiology, Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Xishan District, Kunming, 650118, China
| | - Jing Tan
- Department of Radiology, Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Xishan District, Kunming, 650118, China
| | - Yan Jin
- Department of Radiology, Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Xishan District, Kunming, 650118, China
| | - Hongbo Wang
- Department of Radiology, Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Xishan District, Kunming, 650118, China
| | - Huimei Zhang
- Department of Radiology, Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Xishan District, Kunming, 650118, China
| | - Miaomiao Li
- Department of Radiology, Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Xishan District, Kunming, 650118, China
| | - Rong Zhu
- Department of Radiology, Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Xishan District, Kunming, 650118, China
| | - Shangwei Gu
- Department of Radiology, Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Xishan District, Kunming, 650118, China
| | - Ya Zhang
- Department of Radiology, Yunnan Cancer Hospital, Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Xishan District, Kunming, 650118, China.
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Shen M, Lin X, Yang C, Zhou Z, Chen S, Yin Y, Long L, Huang L, Yang Z, Wang R, Kang M. Potential predictive value of IVIM MR for xerostomia in nasopharyngeal carcinoma. Radiother Oncol 2024; 197:110323. [PMID: 38734144 DOI: 10.1016/j.radonc.2024.110323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 04/24/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND AND PURPOSE Xerostomia, caused by radiation-induced parotid damage, is the most commonly reported radiotherapy (RT) complication for nasopharyngeal carcinoma (NPC). The purpose of this study was to evaluate the value of intravoxel incoherent motion (IVIM) MR in monitoring radiation-induced parotid gland damage and predicting the risk of xerostomia. METHODS Fifty-four NPC patients were enrolled and underwent at least three IVIM MR scans: before (pre-RT), after 5 fractions of (5th-RT), halfway through (mid-RT), and after RT (post-RT). The degree of xerostomia patients was assessed before each MR examination. Furthermore, the time when patients first reported xerostomia symptoms was recorded. The changes in IVIM parameters throughout RT, as well as the relationships between IVIM parameters and xerostomia, were analysed. RESULT All IVIM parameters increased significantly from pre-RT to post-RT (p < 0.001). The rates of D, D* and f increase increased significantly from pre-RT to mid-RT (p < 0.001), indicating that cell necrosis mainly occurs in the first half of RT. In multivariate analysis, N3 (p = 0.014), pre-D (p = 0.007) and pre-D* (p = 0.003) were independent factors influencing xerostomia. D and f were significantly higher at 5th-RT than at pre-RT (both p < 0.05). IVIM detected parotid gland injury at 5th-RT at an average scanning time of 6.18 ± 1.07 days, earlier than the 11.94 ± 2.61 days when the patient first complained of xerostomia according to the RTOG scale (p < 0.001). CONCLUSIONS IVIM MR can dynamically monitor radiation-induced parotid gland damage and assess it earlier and more objectively than RTOG toxicity. Moreover, IVIM can screen people at risk of more severe xerostomia early.
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Affiliation(s)
- Mingjun Shen
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, Guangxi, China; Guangxi Medical University, Nanning, 530021, Guangxi, China; Department of Radiation Oncology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China
| | - Xiangying Lin
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Department of Radiation Oncology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, 570311,Hainan, China
| | - Chaolin Yang
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, Guangxi, China; Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Ziyan Zhou
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, Guangxi, China; Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Sixia Chen
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, Guangxi, China; Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Yuanxiu Yin
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, Guangxi, China; Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Liling Long
- Guangxi Medical University, Nanning, 530021, Guangxi, China; Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Lixuan Huang
- Guangxi Medical University, Nanning, 530021, Guangxi, China; Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Zongxiang Yang
- Guangxi Medical University, Nanning, 530021, Guangxi, China; Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Rensheng Wang
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, Guangxi, China; Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Min Kang
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, Guangxi, China; Guangxi Medical University, Nanning, 530021, Guangxi, China.
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Cheng J, Su W, Wang Y, Zhan Y, Wang Y, Yan S, Yuan Y, Chen L, Wei Z, Zhang S, Gao X, Tang Z. Magnetic resonance imaging based on radiomics for differentiating T1-category nasopharyngeal carcinoma from nasopharyngeal lymphoid hyperplasia: a multicenter study. Jpn J Radiol 2024; 42:709-719. [PMID: 38409300 DOI: 10.1007/s11604-024-01544-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/29/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE To investigate the role of magnetic resonance imaging (MRI) based on radiomics using T2-weighted imaging fat suppression (T2WI-FS) and contrast enhanced T1-weighted imaging (CE-T1WI) sequences in differentiating T1-category nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPH). MATERIALS AND METHODS This study enrolled 614 patients (training dataset: n = 390, internal validation dataset: n = 98, and external validation dataset: n = 126) of T1-category NPC and NPH. Three feature selection methods were used, including analysis of variance, recursive feature elimination, and relief. The logistic regression classifier was performed to construct the radiomics signatures of T2WI-FS, CE-T1WI, and T2WI-FS + CE-T1WI to differentiate T1-category NPC from NPH. The performance of the optimal radiomics signature (T2WI-FS + CE-T1WI) was compared with those of three radiologists in the internal and external validation datasets. RESULTS Twelve, 15, and 15 radiomics features were selected from T2WI-FS, CE-T1WI, and T2WI-FS + CE-T1WI to develop the three radiomics signatures, respectively. The area under the curve (AUC) values for radiomics signatures of T2WI-FS + CE-T1WI and CE-T1WI were significantly higher than that of T2WI-FS (AUCs = 0.940, 0.935, and 0.905, respectively) for distinguishing T1-category NPC and NPH in the training dataset (Ps all < 0.05). In the internal and external validation datasets, the radiomics signatures based on T2WI-FS + CE-T1WI and CE-T1WI outperformed T2WI-FS with no significant difference (AUCs = 0.938, 0.925, and 0.874 for internal validation dataset and 0.932, 0.918, and 0.882 for external validation dataset; Ps > 0.05). The radiomics signature of T2WI-FS + CE-T1WI significantly performed better than three radiologists in the internal and external validation datasets. CONCLUSION The MRI-based radiomics signature is meaningful in differentiating T1-category NPC from NPH and potentially helps clinicians select suitable therapy strategies.
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Affiliation(s)
- Jingfeng Cheng
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Wenzhe Su
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Yuzhe Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yang Zhan
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yin Wang
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Shuyu Yan
- Fudan University, Shanghai, 200032, China
| | - Yuan Yuan
- Fudan University, Shanghai, 200032, China
| | | | - Zixun Wei
- Fudan University, Shanghai, 200032, China
| | - Shengjian Zhang
- Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Xin Gao
- Shanghai Universal Medical Imaging Diagnostic Center, Shanghai, 200233, China.
| | - Zuohua Tang
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
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Xia C, Zhao J, Huang Y, Miao H, Zhao F. Angiogenesis in nasopharyngeal carcinoma: insights, imaging, and therapeutic strategies. Front Oncol 2024; 14:1331064. [PMID: 38863627 PMCID: PMC11165036 DOI: 10.3389/fonc.2024.1331064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/09/2024] [Indexed: 06/13/2024] Open
Abstract
Nasopharyngeal carcinoma (NPC) is a highly prevalent head and neck malignancy in southern China frequently diagnosed at advanced stages owing to subtle early symptoms and associated metastasis. Angiogenesis emerges as a pivotal factor in NPC progression, with numerous angiogenesis-related factors showing aberrant expression and contributing to increased neovascularization within NPC tumors. These abnormal vessels not only nourish tumor growth but also facilitate metastasis, culminating in unfavorable patient outcomes. Multiple studies have demonstrated the applicability of various imaging techniques for assessing angiogenesis in NPC tumors, thus serving as a foundation for personalized treatment strategies and prognostic assessments. Anti-angiogenic therapies have exhibited significant potential for inhibiting NPC angiogenesis and exerting anti-tumor effects. To enhance efficacy, anti-angiogenic drugs are frequently combined with other treatment modalities to synergistically enhance anti-tumor effects while mitigating the side effects associated with single-agent therapies, consequently improving patient prognosis. Identifying the potential mechanisms and key targets underlying NPC angiogenesis and exploring more effective detection and treatment approaches holds promise for shaping the future of NPC diagnosis, treatment, and prognosis, thereby offering new avenues and perspectives for research and clinical practice.
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Affiliation(s)
- Chenxi Xia
- Department of Otolaryngology-Head and Neck Surgery, the Affiliated Hospital of Southwest Medical University, Southwest Medical University, Luzhou, Sichuan, China
| | - Jia Zhao
- Department of Otolaryngology-Head and Neck Surgery, the Affiliated Hospital of Southwest Medical University, Southwest Medical University, Luzhou, Sichuan, China
| | - Yu Huang
- Department of Otolaryngology-Head and Neck Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan, China
| | - Hongbin Miao
- Department of Otolaryngology-Head and Neck Surgery, Bishan hospital of Chongqing Medical University, Bishan Hospital of Chongqing, Bishan, Chongqing, China
| | - Feipeng Zhao
- Department of Otolaryngology-Head and Neck Surgery, the Affiliated Hospital of Southwest Medical University, Southwest Medical University, Luzhou, Sichuan, China
- Department of Otolaryngology-Head and Neck Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan, China
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Chen R, Ye H, Wu Z, Zhou Y, Lin H, Xu Y, He L, Liang C, Liu Z, Wang G. Using the non-distortion IVIM to reduce the need for contrast agents in nasopharyngeal MRI. Magn Reson Imaging 2023; 104:115-120. [PMID: 37844785 DOI: 10.1016/j.mri.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/04/2023] [Accepted: 10/12/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Patients with nasopharyngeal carcinoma (NPC) who undergo longitudinal follow-up contrast-enhanced MRI are at risk of developing gadolinium deposition in their neural tissue, which may potentially harm them. Therefore, for these patients, a non-contrast-enhanced method is potentially beneficial as an alternative approach to predict enhancement in T1-weighted imaging (CE-T1WI). The traditional intravoxel incoherent motion (IVIM) is one of the non-contrast-enhanced methods; however, the severe distortion and signal loss limit its application in patients with NPC. The present study aimed to investigate whether non-distortion IVIM could reduce the need of CE-T1WI in the follow-up of patients with NPC. METHODS The patients with NPC underwent Turbo Spin-echo MVXD diffusion-weighted imaging-based IVIM (non-distortion IVIM) from November 2021 to May 2022. Firstly, thirty patients with NPC were underwent both non-distortion IVIM and traditional IVIM. The distortion rate (DR) of the non-distortion IVIM was compared with the traditional IVIM. Then, twenty-one NPC patients with tumors (areas >50mm2) were included and correlation coefficient analysis was used to assess the relationship between their non-distortion IVIM and CE-T1WI. Linear regression analysis was performed to determine whether non-distortion IVIM predictors could predict CE-T1WI. RESULTS The correlation was observed between the parameter f of the non-distortion IVIM and the enhancement ratio of CE-T1WI (r = 0.543, P = 0.011). Moreover, the linear regression analysis revealed that f was an independent IVIM predictor of CE-T1WI in patients with NPC (P = 0.011). The DR of the non-distortion IVIM was significantly smaller than that of the traditional IVIM (0.12 ± 0.05 vs 0.48 ± 0.16, P < 0.001). CONCLUSIONS In patients with NPC, non-distortion IVIM showed potential clinical benefits to reduce the need for contrast agents, and it can independently predict the enhancement ratio.
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Affiliation(s)
- Rui Chen
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China
| | - Huifen Ye
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China
| | - Zhigang Wu
- MSC Clinical & Technical Solutions, Philips Healthcare, China
| | - Yifen Zhou
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China
| | - Hui Lin
- Department of Radiation Oncology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yongzhou Xu
- MSC Clinical & Technical Solutions, Philips Healthcare, China
| | - Lan He
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China
| | - Changhong Liang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China
| | - Zaiyi Liu
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China.
| | - Guangyi Wang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou 510080, China.
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Tao J, Yin Z, Li X, Zhang Y, Zhang K, Yang Y, Fang S, Wang S. Correlation between IVIM parameters and microvessel architecture: direct comparison of MRI images and pathological slices in an orthotopic murine model of rhabdomyosarcoma. Eur Radiol 2023; 33:8576-8584. [PMID: 37368112 DOI: 10.1007/s00330-023-09835-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 03/20/2023] [Accepted: 04/14/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE This study aimed to explore the correlation between intravoxel incoherent motion (IVIM) parameters and microvessel architecture (microvessel density (MVD), vasculogenic mimicry (VM), and pericyte coverage index (PCI)) in an orthotopic murine model of rhabdomyosarcoma. METHODS The murine model was established by injecting rhabdomyosarcoma-derived (RD) cells into the muscle. Nude mice underwent routine magnetic resonance imaging (MRI) and IVIM examinations with ten b values (0, 50, 100, 150, 200, 400, 600, 800, 1000, and 2000 s/mm2). D, D*, and f values were calculated with the ADW4.7 workstation. MRI images and pathological slices were directly compared to ensure that radiology parameters accurately reflect pathology. MVD, VM, PCI, and cellularity were obtained by histological analysis. The correlations were assessed between IVIM parameters (D, D*, f, and fD* values) and pathological markers (MVD, VM, PCI, and cellularity). RESULTS The average of D, D*, f, and fD* values were 0.55 ± 0.07 × 10-3 mm2/s, 5.25 ± 0.73 × 10-3 mm2/s, 13.39 ± 7.68%, and 0.73 ± 0.49 × 10-3 mm2/s, respectively. The average of MVD, VM, PCI, and cellularity were 41.91 ± 10.98, 1.16 ± 0.83, 0.49 ± 0.18, and 39.15 ± 9.00%. D*, f, and fD* values showed a positive correlation with MVD separately, while the D value did not correlate with MVD. D value negatively correlated to VM moderately, and other parameters did not associate with VM. D* and fD* values were positively correlated with PCI, but no correlation was observed between other parameters and PCI. CONCLUSIONS IVIM may evaluate the tumor microvessel architecture. D*, f, and fD* may reflect the endothelial lining blood vessel; D could indirectly reflect the VM; D* and fD* could reflect PCI(the normal degree of the tumor blood vessel). CLINICAL RELEVANCE STATEMENT An intravoxel incoherent motion may be useful in assessing rhabdomyosarcoma microvessel structure to predict the target and effectiveness of anti-angiogenic therapy. KEY POINTS • IVIM may be used to evaluate the tumor microvessel architecture in the mouse rhabdomyosarcoma model. • The MRI-pathology control method achieves correspondence between MRI slices and pathology slices, which ensures the consistency of the ROI of MRI and the pathology observation region.
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Affiliation(s)
- Juan Tao
- Department of Pathology, The Second Hospital, Dalian Medical University, 467 Zhongshan Road, Dalian, China
| | - Zhenzhen Yin
- Department of Radiology, The Second Hospital, Dalian Medical University, 467 Zhongshan Road, Dalian, 116027, China
| | - Xiangwen Li
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China
| | - Yu Zhang
- Department of Radiology, The Second Hospital, Dalian Medical University, 467 Zhongshan Road, Dalian, 116027, China
| | - Kai Zhang
- Department of Radiology, The Second Hospital, Dalian Medical University, 467 Zhongshan Road, Dalian, 116027, China
| | - Yanyu Yang
- Department of Radiology, The Second Hospital, Dalian Medical University, 467 Zhongshan Road, Dalian, 116027, China
| | - Shaobo Fang
- Department of Radiology, The Second Hospital, Dalian Medical University, 467 Zhongshan Road, Dalian, 116027, China
| | - Shaowu Wang
- Department of Radiology, The Second Hospital, Dalian Medical University, 467 Zhongshan Road, Dalian, 116027, China.
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Li X, Li Z, Liu L, Pu Y, Ji Y, Tang W, Chen T, Liang Q, Zhang X. Early assessment of acute kidney injury in severe acute pancreatitis with multimodal DWI: an animal model. Eur Radiol 2023; 33:7744-7755. [PMID: 37368106 DOI: 10.1007/s00330-023-09782-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/16/2023] [Accepted: 03/26/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES To evaluate the feasibility of multimodal diffusion-weighted imaging (DWI) for detecting the occurrence and severity of acute kidney injury (AKI) caused by severe acute pancreatitis (SAP) in rats. METHODS SAP was induced in thirty rats by the retrograde injection of 5.0% sodium taurocholate through the biliopancreatic duct. Six rats underwent MRI of the kidneys 24 h before and 2, 4, 6, and 8 h after this AKI model was generated. Conventional and functional MRI sequences were used, including intravoxel incoherent motion imaging (IVIM), diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DTI). The main DWI parameters and histological results were analyzed. RESULTS The fast apparent diffusion coefficient (ADC) of the renal cortex was significantly reduced at 2 h, as was the fractional anisotropy (FA) value of the renal cortex on DTI. The mean kurtosis (MK) values for the renal cortex and medulla gradually increased after model generation. The renal histopathological score was negatively correlated with the medullary slow ADC, fast ADC, and perfusion scores for both the renal cortex and medulla, as were the ADC and FA values of the renal medulla in DTI, whereas the MK values of the cortex and medulla were positively correlated (r = 0.733, 0.812). Thus, the cortical fast ADC, medullary MK, FADTI, and slow ADC were optimal parameters for diagnosing AKI. Of these parameters, cortical fast ADC had the highest diagnostic efficacy (AUC = 0.950). CONCLUSIONS The fast ADC of the renal cortex is the core indicator of early AKI, and the medullary MK value might serve as a sensitive biomarker for grading renal injury in SAP rats. CLINICAL RELEVANCE STATEMENT The multimodal parameters of renal IVIM, DTI, and DKI are potential beneficial for the early diagnosis and severity grading of renal injury in SAP patients. KEY POINTS • The multimodal parameters of renal DWI, including IVIM, DTI, and DKI, may be valuable for the noninvasive detection of early AKI and the severity grading of renal injury in SAP rats. • Cortical fast ADC, medullary MK, FA, and slow ADC are optimal parameters for early diagnosis of AKI, and cortical fast ADC has the highest diagnostic efficacy. • Medullary fast ADC, MK, and FA as well as cortical MK are useful for predicting the severity grade of AKI, and the renal medullary MK value exhibits the strongest correlation with pathological scores.
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Affiliation(s)
- Xinghui Li
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 1 South Maoyuan Street, Nanchong, 637001, China
| | - Zenghui Li
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 1 South Maoyuan Street, Nanchong, 637001, China
| | - Lu Liu
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 1 South Maoyuan Street, Nanchong, 637001, China
| | - Yu Pu
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 1 South Maoyuan Street, Nanchong, 637001, China
| | - Yifan Ji
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 1 South Maoyuan Street, Nanchong, 637001, China
| | - Wei Tang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 1 South Maoyuan Street, Nanchong, 637001, China
| | - Tianwu Chen
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 1 South Maoyuan Street, Nanchong, 637001, China
| | - Qi Liang
- Department of Clinical Laboratory, Affiliated Hospital of North Sichuan Medical College, 1 South Maoyuan Street, Nanchong, 637001, Sichuan Province, China.
| | - Xiaoming Zhang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 1 South Maoyuan Street, Nanchong, 637001, China.
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Wu W, Xia J, Li B, Liu W, Ge Z, Tan Z, Bu Q, Chen W, Li Y. Feasibility evaluation of intravoxel incoherent motion diffusion-weighted imaging in the diagnosis of skull-base invasion in nasopharyngeal carcinoma. J Cancer 2023; 14:290-298. [PMID: 36741262 PMCID: PMC9891879 DOI: 10.7150/jca.80679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/25/2022] [Indexed: 01/12/2023] Open
Abstract
Objective: This study aimed to evaluate the feasibility of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in the diagnosis of skull-base invasion (SBI) in nasopharyngeal carcinoma (NPC). Materials and methods: A total of 50 patients pathologically diagnosed with NPC and a group of 40 controls comprised of those with either normal nasopharynx or patients with nasopharyngitis underwent conventional MRI and IVIM-DWI scans with 3 different groups of b values. Among the 50 patients, 36 patients diagnosed with SBI in NPC were included in the case group according to SBI criteria. All subjects (including those in the control group and case group) were divided into the b1, b2, and b3 groups based on their b values. The pure diffusion coefficient (D), perfusion-related incoherent microcirculation (D*), and microvascular volume fraction (f) values obtained in each measurement area of each group were tested for variance. Next,2 groups of b-value parameters with statistically significant data in the 3 groups were randomly selected for use in both the control group and the case group. A t-test was performed on the D, D*, and f values obtained by measuring each area of the skull base, and the area under the curve (AUC) of the receiver operating characteristic (ROC) was used to evaluate the diagnostic efficacy of the D, D*, and f values. Results: There was no statistical significance among the D, D*, and f values of the b1 and b3 groups (P>0.05), and the differences in parameters between the b1 and b2 groups were statistically significant(P < 0.05),and the differences in parameters between the b3 and b2 groups were also statistically significant(P < 0.05).The f value of the case group, which was obtained using the b1 and b2 parameters in each area of the skull base, was lower than that of the control group (P <0.05).The D, D*, and f values of the case group obtained by the b1 and b2 parameters in the pars petrosa of the temporal bone (including the foramen lacerum) were lower than those of the control group (P<0.05).When the parameters of the b1 group were used in the corpus of sphenoid bone (including the foramen ovale), the D, D*, and f values of the control group and the case group were compared, yielding a statistically significant difference (P<0.05).When the parameters of the b1 group were used, the diagnostic efficacy of the f value in each area of the skull base was the highest (AUC=0.908-0.991), followed by the D* value (AUC=0.624-0.692). Conclusion: When the number of b values <200 s/mm2 in IVIM-DWI accounts for more than half of the selected b values, IVIM-DWI is highly stable for the diagnosis of SBI in NPC. The D, D*, and f values of the bone and muscle areas of the skull base in patients with SBI of NPC showed a downward trend, and the f value had the best diagnostic performance, followed by the D* value, while the D value had the worst. Thus, IVIM-DWI can be used as a noninvasive method in the diagnosis of SBI in NPC.
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Affiliation(s)
- Weiquan Wu
- Clinical Research Experiment Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Jun Xia
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Bin Li
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Wenci Liu
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Zhan Ge
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Zhi Tan
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Qiujin Bu
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Wubiao Chen
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.,✉ Corresponding authors: Yuange Li, Department of Radiology, Affiliated Hospital of Guangdong Medical University, 57 South Renmin Rd., Xiashan District, Zhanjiang, Guangdong Province, 524001, China. Tel: +86-13692380351; E-mail: . Wubiao Chen, Department of Radiology, Affiliated Hospital of Guangdong Medical University, 57 South Renmin Rd., Xiashan District, Zhanjiang, Guangdong Province, 524001, China. Tel: +86-13509931577; E-mail:
| | - Yuange Li
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.,✉ Corresponding authors: Yuange Li, Department of Radiology, Affiliated Hospital of Guangdong Medical University, 57 South Renmin Rd., Xiashan District, Zhanjiang, Guangdong Province, 524001, China. Tel: +86-13692380351; E-mail: . Wubiao Chen, Department of Radiology, Affiliated Hospital of Guangdong Medical University, 57 South Renmin Rd., Xiashan District, Zhanjiang, Guangdong Province, 524001, China. Tel: +86-13509931577; E-mail:
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9
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Zhu X, Wang J, Wang YC, Zhu ZF, Tang J, Wen XW, Fang Y, Han J. Quantitative differentiation of malignant and benign thyroid nodules with multi-parameter diffusion-weighted imaging. World J Clin Cases 2022; 10:8587-8598. [PMID: 36157818 PMCID: PMC9453341 DOI: 10.12998/wjcc.v10.i24.8587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/25/2022] [Accepted: 07/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The value of conventional magnetic resonance imaging in the differential diagnosis of thyroid nodules is limited; however, the value of multi-parameter diffusion-weighted imaging (DWI) in the quantitative evaluation of thyroid nodules has not been well determined.
AIM To determine the utility of multi-parametric DWI including mono-exponential, bi-exponential, stretched exponential, and kurtosis models for the differentiation of thyroid lesions.
METHODS Seventy-nine patients (62 with benign and 17 with malignant nodules) underwent multi-b value diffusion-weighted imaging of the thyroid. Multiple DWI parameters were obtained for statistical analysis.
RESULTS Good agreement was found for diffusion parameters of thyroid nodules. Malignant lesions displayed lower diffusion parameters including apparent diffusion coefficient (ADC), the true diffusion coefficient (D), the perfusion fraction (f), the distributed diffusion coefficient (DDC), the intravoxel water diffusion heterogeneity (α) and kurtosis model-derived ADC (Dapp), and higher apparent diffusional kurtosis (Kapp) than benign entities (all P < 0.01), except for the pseudodiffusion coefficient (D*) (P > 0.05). The area under the ROC curve (AUC) of the ADC(0 and 1000) was not significantly different from that of the ADC(0 and 2000), ADC(0 to 2000), ADC(0 to 1000), D, DDC, Dapp and Kapp (all P > 0.05), but was significantly higher than the AUC of D*, f and α (all P < 0.05) for differentiating benign from malignant lesions.
CONCLUSION Multiple DWI parameters including ADC, D, f, DDC, α, Dapp and Kapp could discriminate benign and malignant thyroid nodules. The metrics including D, DDC, Dapp and Kapp provide additional information with similar diagnostic performance of ADC, combination of these metrics may contribute to differentiate benign and malignant thyroid nodules. The ADC calculated with higher b values may not lead to improved diagnostic performance.
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Affiliation(s)
- Xiang Zhu
- Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Jia Wang
- Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Yan-Chun Wang
- Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Ze-Feng Zhu
- Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Jian Tang
- Department of Head and Neck Surgery, the First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Xiao-Wei Wen
- Department of Pathology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Ying Fang
- Department of Pathology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Jun Han
- Department of Radiology, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
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10
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Borgheresi A, De Muzio F, Agostini A, Ottaviani L, Bruno A, Granata V, Fusco R, Danti G, Flammia F, Grassi R, Grassi F, Bruno F, Palumbo P, Barile A, Miele V, Giovagnoni A. Lymph Nodes Evaluation in Rectal Cancer: Where Do We Stand and Future Perspective. J Clin Med 2022; 11:2599. [PMID: 35566723 PMCID: PMC9104021 DOI: 10.3390/jcm11092599] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/25/2022] [Accepted: 05/03/2022] [Indexed: 12/12/2022] Open
Abstract
The assessment of nodal involvement in patients with rectal cancer (RC) is fundamental in disease management. Magnetic Resonance Imaging (MRI) is routinely used for local and nodal staging of RC by using morphological criteria. The actual dimensional and morphological criteria for nodal assessment present several limitations in terms of sensitivity and specificity. For these reasons, several different techniques, such as Diffusion Weighted Imaging (DWI), Intravoxel Incoherent Motion (IVIM), Diffusion Kurtosis Imaging (DKI), and Dynamic Contrast Enhancement (DCE) in MRI have been introduced but still not fully validated. Positron Emission Tomography (PET)/CT plays a pivotal role in the assessment of LNs; more recently PET/MRI has been introduced. The advantages and limitations of these imaging modalities will be provided in this narrative review. The second part of the review includes experimental techniques, such as iron-oxide particles (SPIO), and dual-energy CT (DECT). Radiomics analysis is an active field of research, and the evidence about LNs in RC will be discussed. The review also discusses the different recommendations between the European and North American guidelines for the evaluation of LNs in RC, from anatomical considerations to structured reporting.
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Affiliation(s)
- Alessandra Borgheresi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
| | - Federica De Muzio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Andrea Agostini
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
- Department of Radiological Sciences, University Hospital Ospedali Riuniti, 60126 Ancona, Italy;
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
| | - Letizia Ottaviani
- Department of Radiological Sciences, University Hospital Ospedali Riuniti, 60126 Ancona, Italy;
| | - Alessandra Bruno
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale IRCCS di Napoli, 80131 Naples, Italy;
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Napoli, Italy
| | - Ginevra Danti
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy;
| | - Federica Flammia
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy;
| | - Roberta Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80128 Naples, Italy
| | - Francesca Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80128 Naples, Italy
| | - Federico Bruno
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Pierpaolo Palumbo
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Abruzzo Health Unit 1, Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, 67100 L’Aquila, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy;
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
- Department of Radiological Sciences, University Hospital Ospedali Riuniti, 60126 Ancona, Italy;
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Li S, Mou A, Li X, Guo Y, Song Q, Liu A, Li Z. Myocardium microcirculation study in a healthy Chinese population using 3.0-T cardiac magnetic resonance intravoxel incoherent motion imaging. Acta Radiol 2022; 63:596-605. [PMID: 33887964 DOI: 10.1177/02841851211006311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Intravoxel incoherent motion imaging (IVIM) can non-invasively evaluate diffusion and microvascular perfusion. PURPOSE To explore the myocardium microcirculation of a healthy Chinese population by using cardiac magnetic resonance (CMR) IVIM. MATERIAL AND METHODS A total of 80 healthy volunteers (44 men, 36 women) who underwent 3.0-T CMR examination were enrolled. All participants had cardiac cine imaging and short-axis CMR-IVIM of the left ventricle (LV) using multiple b-values. The consistency of the IVIM parameters was assessed by intraclass correlation coefficient (ICC) and the Bland-Altman test. Spearman correlation analysis was performed between IVIM parameters and age, and body mass index (BMI). The differences of IVIM parameters were analyzed between gender and different ages. RESULTS LV end-diastolic volume (EDV), end-systolic volume (ESV), LVmass, cardiac output (CO), and BMI in the male group were higher than those in the female group (P<0.05). IVIM parameters had good intra-observer and inter-observer consistency (≥0.75). Bland-Altman analysis also showed good intra-observer and inter-observer consistency. ADCfast decreased with increasing female age (rs = -0.37; P = 0.01), while IVIM parameters had no correlation with BMI regardless of sex. ADCfast in the female group had a statistical difference between different age groups. The ADCslow and f in the male group were lower than those in the female group (P<0.05); however, there was no statistical difference in ADCfast between genders. CONCLUSION IVIM parameters in healthy Chinese volunteers provided good consistency. There was a negative correlation between ADCfast and age in the female group.
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Affiliation(s)
- Shilan Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China
| | - Anna Mou
- Department of Radiology, Affiliated Hospital of Medical School, University of Electronic Science and Technology of China, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, PR China
| | - Xin Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China
| | - Yan Guo
- GE Healthcare, Shenyang City, Liaoning Province, PR China
| | - Qingwei Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China
| | - Ailian Liu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China
| | - Zhiyong Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China
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12
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Zhou QQ, Zhang W, Yu YS, Li HY, Wei L, Li XS, He ZZ, Zhang H. Comparative Study between ZOOMit and Conventional Intravoxel Incoherent Motion MRI for Assessing Parotid Gland Abnormalities in Patients with Early- or Mid-Stage Sjögren’s Syndrome. Korean J Radiol 2022; 23:455-465. [PMID: 35289149 PMCID: PMC8961020 DOI: 10.3348/kjr.2021.0695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/11/2021] [Accepted: 12/27/2021] [Indexed: 11/25/2022] Open
Abstract
Objective To compare the reproducibility and performance of quantitative metrics between ZOOMit and conventional intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in the diagnosis of early- and mid-stage Sjögren’s syndrome (SS). Materials and Methods Twenty-two patients (mean age ± standard deviation, 52.0 ± 10.8 years; male:female, 2:20) with early- or mid-stage SS and 20 healthy controls (46.9 ± 14.6 years; male:female, 7:13) were prospectively enrolled in our study. ZOOMit IVIM and conventional IVIM MRI were performed simultaneously in all individuals using a 3T scanner. Quantitative IVIM parameters - including tissue diffusivity (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) - inter- and intra-observer reproducibility in measuring these parameters, and their ability to distinguish patients with SS from healthy individuals were assessed and compared between ZOOMit IVIM and conventional IVIM methods, appropriately. MR gland nodular grade (MRG) was also examined. Results Inter- and intra-observer reproducibility was better with ZOOMit imaging than with conventional IVIM imaging (ZOOMit vs. conventional, intraclass correlation coefficient of 0.897–0.941 vs. 0.667–0.782 for inter-observer reproducibility and 0.891–0.968 vs. 0.814–0.853 for intra-observer reproducibility). Significant differences in ZOOMit f, ZOOMit D*, conventional D*, and MRG between patients with SS and healthy individuals (all p < 0.05) were observed. ZOOMit D* outperformed conventional D* in diagnosing early- and mid-stage SS (area under receiver operating curve, 0.867 and 0.658, respectively; p = 0.002). The combination of ZOOMit D*, MRG, and ZOOMit f as a new diagnostic index for SS, increased diagnostic area under the curve to 0.961, which was higher than that of any single parameter (all p < 0.01). Conclusion Considering its better reproducibility and performance, ZOOMit IVIM may be preferred over conventional IVIM MRI, and may subsequently improve the ability to diagnose early- and mid-stage SS.
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Affiliation(s)
- Qing-Qing Zhou
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Zhang
- Department of Immunology and Rheumatology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Yu-Sheng Yu
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Hong-Yan Li
- Department of Immunology and Rheumatology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Liang Wei
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Xue-Song Li
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Zhen-Zhen He
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
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Boucher F, Liao E, Srinivasan A. Diffusion-Weighted Imaging of the Head and Neck (Including Temporal Bone). Magn Reson Imaging Clin N Am 2021; 29:205-232. [PMID: 33902904 DOI: 10.1016/j.mric.2021.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Diffusion techniques provide valuable information when performing head and neck imaging. This information can be used to detect the presence or absence of pathology, refine differential diagnosis, determine the location for biopsy, assess response to treatment, and prognosticate outcomes. For example, when certain technical factors are taken into consideration, diffusion techniques prove indispensable in assessing for residual cholesteatoma following middle ear surgery. In other scenarios, pretreatment apparent diffusion coefficient values may assist in prognosticating outcomes in laryngeal cancer and likelihood of response to radiation therapy. As diffusion techniques continue to advance, so too will its clinical utility.
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Affiliation(s)
- Felix Boucher
- Neuroradiology Division, Radiology, Michigan Medicine, 1500 East Medical Center Drive, B1D502, Ann Arbor 48109-5030, USA
| | - Eric Liao
- Neuroradiology Division, Radiology, Michigan Medicine, 1500 East Medical Center Drive, Taubman Center B1-132, Ann Arbor 48109-5030, USA
| | - Ashok Srinivasan
- Neuroradiology Division, Radiology, Michigan Medicine, 1500 East Medical Center Drive, B2A209, Ann Arbor 48109-5030, USA.
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Xiao B, Wang P, Zhao Y, Liu Y, Ye Z. Using arterial spin labeling blood flow and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma from lymphoid hyperplasia. Medicine (Baltimore) 2021; 100:e24955. [PMID: 33663135 PMCID: PMC7909173 DOI: 10.1097/md.0000000000024955] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/09/2020] [Accepted: 02/04/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT To investigate the feasibility of arterial spin labeling (ASL) blood flow (BF) and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPLH).Sixty-three stage T1 NPC patients and benign NPLH patients underwent ASL on a 3.0-T magnetic resonance imaging system. BF histogram parameters were derived automatically, including the mean, median, maximum, minimum, kurtosis, skewness, and variance. Absolute values were obtained for skewness and kurtosis (absolute value of skewness [AVS] and absolute value of kurtosis [AVK], respectively). The Mann-Whitney U test, receiver operating characteristic curve, and multiple logistic regression models were used for statistical analysis.The mean, maximum, and variance of ASL BF values were significantly higher in early-stage NPC than in NPLH (all P < 0.0001), while the median and AVK values of early-stage NPC were also significantly higher than those of NPLH (all P < 0.001). No significant difference was found between the minimum and AVS values in early-stage NPC compared with NPLH (P = 0.125 and P = 0.084, respectively). The area under the curve (AUC) of the maximum was significantly higher than those of the mean and median (P < 0.05). The AUC of variance was significantly higher than those of the other parameters (all P < 0.05). Multivariate analysis showed that variance was the only independent predictor of outcome (P < 0.05).ASL BF and its histogram analysis could distinguish early-stage NPC from NPLH, and the variance value was a unique independent predictor.
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Affiliation(s)
| | - Peiguo Wang
- Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
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Pace L, Nicolai E, Cavaliere C, Basso L, Garbino N, Spinato G, Salvatore M. Prognostic value of 18F-FDG PET/MRI in patients with advanced oropharyngeal and hypopharyngeal squamous cell carcinoma. Ann Nucl Med 2021; 35:479-484. [PMID: 33575927 PMCID: PMC7981313 DOI: 10.1007/s12149-021-01590-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/12/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the prognostic value of combined positron emission tomography (PET)/magnetic resonance imaging (MRI) parameters provided by simultaneous 18F-fluorodeoxyglucose (FDG) PET/MRI in patients with locally advanced oropharyngeal and hypopharyngeal squamous cell carcinomas (OHSCC). METHODS Forty-five patients with locally advanced OHSCC who underwent simultaneous FDG PET/MRI before (chemo)radiotherapy were retrospectively enrolled. Peak standardized uptake value (SULpeak), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of the primary lesion were obtained on PET data. On MRI scans, primary tumor size, diffusion and perfusion parameters were assessed using pre-contrast and high-resolution post-contrast images. Ratios between metabolic/metabolo-volumetric parameters and ADC were calculated. Comparisons between groups were performed by Student's t test. Survival analysis was performed by univariate Cox proportional hazard regression analysis. Overall survival curves were obtained by the Kaplan-Meier method and compared with the log-rank test. Survivors were censored at the time of the last clinical control. p < 0.05 was considered statistically significant RESULTS: During follow-up (mean 31.4 ± 21 months), there were 15 deaths. Univariate analysis shows that SULpeak and SULpeak/ADCmean were significant predictors of overall survival (OS). At multivariate analysis, only SULpeak remained a significant predictor of OS. Kaplan-Meier survival analyses showed that patients with higher SULpeak had poorer outcome compared to those with lower values (HR: 3.7, p = 0.007). CONCLUSION Pre-therapy SULpeak of the primary site was predictive of overall survival in patients with oropharyngeal or hypopharyngeal cancer treated with (chemo)radiotherapy.
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Affiliation(s)
- Leonardo Pace
- Dipartimento di Medicina Chirurgia e Odontoiatria "Scuola Medica Salernitana", Università degli Studi di Salerno, via M. de Vito Piscicelli 44, 80128, Naples, Italy.
| | | | | | | | | | - Giacomo Spinato
- Dipartimento di Neuroscienze Sezione di Otorinolaringoiatria e Centro Regionale Tumori Testa Collo, Università degli Studi di Padova, Treviso, Italy
- Dipartimento di ChirurgiaOncologia e GastroenterologiaSezione di Oncologia ed Immunologia, Università degli Studi di Padova, Padua, Italy
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Investigation of the feasibility of synthetic MRI in the differential diagnosis of non-keratinising nasopharyngeal carcinoma and benign hyperplasia using different contoured methods for delineation of the region of interest. Clin Radiol 2020; 76:238.e9-238.e15. [PMID: 33213835 DOI: 10.1016/j.crad.2020.10.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 10/21/2020] [Indexed: 12/16/2022]
Abstract
AIM To assess the feasibility and preliminary diagnostic performances of relaxation times derived from synthetic magnetic resonance imaging (syMRI) for differentiating nasopharyngeal carcinoma from nasopharyngeal benign lymphoid hyperplasia, and to assess the influence of tissue segmentation method on relaxation estimates. MATERIALS AND METHODS Fifty participants with nasopharyngeal carcinoma (NPC) and 40 participants with benign hyperplasia (NPH) who underwent syMRI examination were enrolled prospectively. T1, T2, and proton density (PD) values were obtained from four different regions of interest (ROIs), namely, partial-section, single-section, three-sections, and whole-lesion. The metrics between NPC and NPH or among different ROIs were compared using Student's t-test or one-way ANOVA. The area under curve (AUC) was calculated to assess the performance of metrics obtained from different ROIs to differentiate NPC and NPH. RESULTS The T1, T2, and PD values for NPH were significantly higher than those for NPC, regardless of the type of ROI used, except for the PD value obtained from the whole-lesion ROI. The T2 values obtained from the single-section ROI showed the highest diagnostic accuracy in distinguishing NPC from NPH, with an AUC of 0.894, sensitivity of 0.900, and specificity of 0.800. Additionally, the T1, T2, and PD values for nasopharyngeal lesions showed no statistical difference among different kinds of ROI, except for the difference in T1 value between partial-section and other methods. CONCLUSION Quantitative analysis of syMRI has the potential to distinguish NPC from NPH. Moreover, different types of ROI showed limited influence on the relaxation time estimation for nasopharyngeal lesions.
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Li Y, Li X, Yu X, Lin M, Ouyang H, Xie L, Shang Y. Investigating the value of arterial spin labeling and intravoxel incoherent motion imaging on diagnosing nasopharyngeal carcinoma in T1 stage. Cancer Imaging 2020; 20:62. [PMID: 32859273 PMCID: PMC7456064 DOI: 10.1186/s40644-020-00339-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/17/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND To investigate the diagnostic value of arterial spin labeling (ASL) and intravoxel incoherent motion (IVIM) imaging in distinguishing nasopharyngeal carcinoma (NPC) in T1 stage from healthy controls (HC). METHODS Forty-five newly diagnosed NPC patients in the T1 stage and thirty-one healthy volunteers who underwent MR examinations for both 3D pseudo-continuous ASL (pCASL) and IVIM were enrolled in this study. The Mann-Whitney test was used to compare the mean values of blood flow (BF) derived from pCASL and IVIM derived parameters, including apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f) between NPC tumor and benign nasopharyngeal mucosa of HC. Receiver Operating Characteristic (ROC) was performed to determine diagnostic cutoff and efficiency. The correlation coefficients among parameters were investigated using Spearman's test. RESULTS The NPC in the T1 stage showed higher mean BF, lower ADC, D, and f compared to benign nasopharyngeal mucosa (P < 0.001) with the area under curve of ROC of 0.742-0.996 (highest by BF). BF cutoff was set at > 36 mL/100 g/min; the corresponding sensitivity, specificity, and accuracy in differentiating NPC stage T1 from benign nasopharyngeal mucosa were 95.56% (43/45), 100% (31/31) and 97.37% (74/76), respectively. BF demonstrated moderate negative correlation with D* on HC (ρ [Spearman correlation coefficients] = - 0.426, P = 0.017). CONCLUSIONS ASL and IVIM could reflect the difference in perfusion and diffusion between tumor and benign nasopharyngeal mucosa, indicating a potential for accessing early diagnosis of NPC. Notably, BF, with a specificity of 100%, demonstrated better performance compared to IVIM in distinguishing malignant lesions from healthy tissue.
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Affiliation(s)
- Yujie Li
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No17, Panjiayuannanli, Chaoyang District, Beijing, P.R. China, 100021
| | - Xiaolu Li
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No17, Panjiayuannanli, Chaoyang District, Beijing, P.R. China, 100021
| | - Xiaoduo Yu
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No17, Panjiayuannanli, Chaoyang District, Beijing, P.R. China, 100021
| | - Meng Lin
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No17, Panjiayuannanli, Chaoyang District, Beijing, P.R. China, 100021.
| | - Han Ouyang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No17, Panjiayuannanli, Chaoyang District, Beijing, P.R. China, 100021
| | - Lizhi Xie
- MR Research China, GE Healthcare, Beijing, Beijing, P.R. China, 100176
| | - Yuqing Shang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, CT06510, USA
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Intravoxel incoherent motion diffusion-weighted imaging for discrimination of benign and malignant retropharyngeal nodes. Neuroradiology 2020; 62:1667-1676. [PMID: 32676831 DOI: 10.1007/s00234-020-02494-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/08/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Anatomical imaging criteria for the diagnosis of malignant head and neck nodes may not always be reliable. This study aimed to evaluate the diagnostic value of conventional diffusion-weighted imaging (DWI) and intravoxel incoherent motion (IVIM) DWI in discriminating benign and malignant metastatic retropharyngeal nodes (RPNs). METHODS IVIM DWI using 14 b-values was performed on RPNs of 30 patients with newly diagnosed metastatic nasopharyngeal carcinoma (NPC) and 30 patients with elevated plasma Epstein-Barr virus (EBV)-DNA without NPC who were part of an EBV-based NPC screening program. Histogram measurements of the two groups were compared for pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion volume fraction (f) and apparent diffusion coefficient (ADC) using the Mann-Whitney U test. Area under the curves (AUCs) of significant measurements were calculated from receiver-operating characteristics analysis and compared using the DeLong test. RESULTS Compared with metastatic RPNs, benign RPNs had lower ADCmean (0.73 vs 0.82 × 10-3 mm2/s) and Dmean (0.60 vs 0.71 × 10-3 mm2/s) and a higher D*mean (35.21 vs 28.66 × 10-3 mm2/s) (all p < 0.05). There was no difference in the f measurements between the two groups (p = 0.204 to 0.301). Dmean achieved the highest AUC of 0.800, but this was not statistically better than the AUCs of the other parameters (p = 0.148 to 0.991). CONCLUSION Benign RPNs in patients with EBV-DNA showed greater restriction of diffusion compared with malignant metastatic RPNs from NPC. IVIM did not show a significant advantage over conventional DWI in discriminating benign and malignant nodes.
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Ai QY, King AD, So TY, Lam WKJ, Mo FKF, Tse IOL, Woo JKS, Chan KCA. MRI of benign hyperplasia in the nasopharynx: is there an association with Epstein-Barr virus? Clin Radiol 2020; 75:711.e13-711.e18. [PMID: 32571521 DOI: 10.1016/j.crad.2020.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 05/07/2020] [Indexed: 10/24/2022]
Abstract
AIM To evaluate whether there is an association between persistently positive plasma Epstein-Barr virus (EBV) DNA and the presence and the change in benign hyperplasia. MATERIALS AND METHODS One hundred and seventeen participants with positive-plasma EBV-DNA, but without NPC from previous nasopharyngeal carcinoma (NPC) screening, underwent follow-up magnetic resonance imaging (MRI) and plasma EBV-DNA after 2 years. Logistic regression was used to analyse associations between MRI (benign hyperplasia on the follow-up MRI and change from 2 years earlier), and plasma EBV-DNA, smoking, and age. RESULTS At follow-up, EBV-DNA positivity and smoking were independent parameters for the presence of benign hyperplasia (p=0.027 and 0.023 respectively). Compared with participants in whom EBV-DNA became negative (n=44/117 37.6%), those in whom EBV-DNA remained positive (n=73/117 62.4%) had a greater risk of benign hyperplasia developing (previous MRI normal), being stable or processing (52/73 71.2% versus 18/44 40.9%; p=0.001). CONCLUSION These results suggest a potential link between benign hyperplasia on MRI and the EBV. As EBV contributes to NPC oncogenesis, future MRI research is warranted to determine if persistent benign hyperplasia is a risk marker for development of NPC.
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Affiliation(s)
- Q-Y Ai
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - A D King
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China.
| | - T Y So
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - W K J Lam
- Department of Chemical Pathology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - F K F Mo
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China; Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - I O L Tse
- Department of Chemical Pathology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - J K S Woo
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - K C A Chan
- Department of Chemical Pathology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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Xing X, Zhang J, Chen Y, Zhao Q, Lang N, Yuan H. Application of monoexponential, biexponential, and stretched-exponential models of diffusion-weighted magnetic resonance imaging in the differential diagnosis of metastases and myeloma in the spine-Univariate and multivariate analysis of related parameters. Br J Radiol 2020; 93:20190891. [PMID: 32462885 DOI: 10.1259/bjr.20190891] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To explore the value of related parameters in monoexponential, biexponential, and stretched-exponential models of diffusion-weighted imaging (DWI) in differentiating metastases and myeloma in the spine. METHODS 53 metastases and 16 myeloma patients underwent MRI with 10 b-values (0-1500 s/mm2). Parameters of apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), the distribution diffusion coefficient (DDC), and intravoxel water diffusion heterogeneity (α) from DWI were calculated. The independent sample t test and the Mann-Whiney U test were used to compare the statistical difference of the parameter values between the two. Receiver operating characteristics (ROC) curve analysis was used to identify the diagnostic efficacy. Then substituted each parameter into the decision tree model and logistic regression model, identified meaningful parameters, and evaluated their joint diagnostic performance. RESULTS The ADC, D, and α values of metastases were higher than those of myeloma, whereas the D* value was lower than that of myeloma, and the difference was significant (p < 0.05); the area under the ROC curve for the above parameters was 0.661, 0.710, 0.781, and 0.743, respectively. There was no significant difference in the f and DDC values (p > 0.05). D and α were found to conform to the decision tree model, and the accuracy of model diagnosis was 84.1%. ADC and α were found to conform to the logistic regression model, and the accuracy was 87.0%. CONCLUSION The 3 models of DWI have certain values indifferentiating metastases and myeloma in spine, and the diagnostic performance of ADC, D, α and D*was better. Combining ADC with α may markedly aid in the differential diagnosis of the two. ADVANCES IN KNOWLEDGE Monoexponential, biexponential, and stretched-exponential models can offer additional information in the differential diagnosis of metastases and myeloma in the spine. Decision tree model and logistic regression model are effective methods to help further distinguish the two.
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Affiliation(s)
- Xiaoying Xing
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
| | - Jiahui Zhang
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
| | - Yongye Chen
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
| | - Qiang Zhao
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
| | - Ning Lang
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
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Cheng Y, Bai L, Shang J, Tang Y, Ling X, Guo B, Gong J, Wang L, Xu H. Preliminary clinical results for PET/MR compared with PET/CT in patients with nasopharyngeal carcinoma. Oncol Rep 2019; 43:177-187. [PMID: 31746412 PMCID: PMC6908933 DOI: 10.3892/or.2019.7392] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 09/09/2019] [Indexed: 12/23/2022] Open
Abstract
The present study aimed to assess the performance of positron emission tomography-magnetic resonance imaging (PET/MR) for the visualization and characterization of lesions. In addition, the present study investigated whether the apparent diffusion coefficient (ADC) and intravoxel incoherent motion parameters exhibited any significant correlation with standardized uptake values (SUV) in patients with nasopharyngeal carcinoma (NPC). A total of 35 patients with NPC underwent whole body PET-computed tomography (CT) and head and neck MR imaging (MRI) scans using the PET/CT-MRI system. Image quality, lesion conspicuity and the diagnostic confidence of PET/CT, T1 weighted (T1w) PET/MR and T2w PET/MR imaging were assessed. The true diffusion coefficient (D), the pseudo-diffusion coefficient or diffusion within the microcirculation (D*), and the perfusion fraction or the contribution of water moving in the capillaries (f), and ADC, were calculated. The correlation between the ADC, D*, D and f values and the SUV were analyzed using Pearson's correlation analysis. Similar image quality was obtained using PET/CT, T1w PET/MR and T2w PET/MR imaging. However, the T1w PET/MR and T2w PET/MR imaging were more effective than PET/CT in analyzing the lesion conspicuity of the primary tumors and lymph nodes. In addition, T2w PET/MR imaging was more efficient than T1w PET/MR imaging in analyzing primary tumors and lymph nodes. Pearson's correlation analysis showed no significant correlation between the SUV and ADC, and D*, D and f values in NPC. The present results suggested that the application of PET/MR is feasible and could serve as a reliable alternative to PET/CT, while SUV and ADC, D*, D and f values were identified as independent biomarkers in NPC.
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Affiliation(s)
- Yong Cheng
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Le Bai
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Jingjie Shang
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Yongjin Tang
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Xueying Ling
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Bin Guo
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Jian Gong
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Lu Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
| | - Hao Xu
- Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China
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Huang TX, Lu N, Lian SS, Li H, Yin SH, Geng ZJ, Xie CM. The primary lesion apparent diffusion coefficient is a prognostic factor for locoregionally advanced nasopharyngeal carcinoma: a retrospective study. BMC Cancer 2019; 19:470. [PMID: 31101029 PMCID: PMC6525458 DOI: 10.1186/s12885-019-5684-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 05/08/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND To explore prognostic value of the pre-treatment primary lesion apparent diffusion coefficient (ADC) in locoregionally advanced nasopharyngeal carcinoma (LA-NPC). METHODS A total of 843 patients with newly diagnosed LA-NPC were enrolled from January 2011 to April 2014 and divided into two groups based on ADC values: the low-ADC group and high-ADC group. The 3-year local relapse-free survival (LRFS), distant metastasis free survival (DMFS), disease-free survival (DFS) and overall survival (OS) rates between two groups were compared using Kaplan-Meier curve, and Cox regression analyses were performed to test prognostic value of the pretreatment ADC in LA-NPC. RESULTS The cut-off value of the pretreatment ADC for predicting local relapse was 784.5 × 10- 6 mm2/s (AUC [area under curve] = 0.604; sensitivity = 0.640; specificity = 0.574), thus patients were divided into low-ADC (< 784.5 × 10- 6; n = 473) group and high-ADC (≥784.5 × 10- 6; n = 370) group. The low-ADC group had significantly higher 3-year LRFS rate and DFS rate than the high-ADC group (LRFS: 96.2% vs. 91.4%, P = 0.003; DFS: 81.4% vs. 73.0%, P = 0.0056). Multivariate analysis showed that the pretreatment ADC is an independent prognostic factor for LRFS (HR, 2.04; 95% CI, 1.13-3.66; P = 0.017) and DFS (HR, 1.41; 95% CI, 1.04-1.89; P = 0.024). CONCLUSIONS The pretreatment ADC of the primary lesion is an independent prognostic factor for LRFS and DFS in LA-NPC patients.
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Affiliation(s)
- Tao-Xiang Huang
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China.,Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University (SYSU), No 600, Tianhe Road, Guangzhou, Guangdong, 510630,, People's Republic of China
| | - Nian Lu
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China
| | - Shan-Shan Lian
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China
| | - Hui Li
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China
| | - Shao-Han Yin
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China
| | - Zhi-Jun Geng
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China
| | - Chuan-Miao Xie
- Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in Southern China, No. 651 Dongfeng Road East, 510060, Guangzhou, People's Republic of China.
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Ai QY, King AD, Chan JSM, Chen W, Chan KCA, Woo JKS, Zee BCY, Chan ATC, Poon DMC, Ma BBY, Hui EP, Ahuja AT, Vlantis AC, Yuan J. Distinguishing early-stage nasopharyngeal carcinoma from benign hyperplasia using intravoxel incoherent motion diffusion-weighted MRI. Eur Radiol 2019; 29:5627-5634. [DOI: 10.1007/s00330-019-06133-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/14/2019] [Accepted: 03/06/2019] [Indexed: 11/29/2022]
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Tan H, Chen J, Zhao YL, Liu JH, Zhang L, Liu CS, Huang D. Feasibility of Intravoxel Incoherent Motion for Differentiating Benign and Malignant Thyroid Nodules. Acad Radiol 2019; 26:147-153. [PMID: 29908978 DOI: 10.1016/j.acra.2018.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/29/2018] [Accepted: 05/02/2018] [Indexed: 12/29/2022]
Abstract
RATIONALE AND OBJECTIVES This study aimed to preliminarily investigate the feasibility of intravoxel incoherent motion (IVIM) theory in the differential diagnosis of benign and malignant thyroid nodules. MATERIALS AND METHODS Forty-five patients with 56 confirmed thyroid nodules underwent preoperative routine magnetic resonance imaging and IVIM diffusion-weighted imaging. The histopathologic diagnosis was confirmed by surgery. Apparent diffusion coefficient (ADC), perfusion fraction f, diffusivity D, and pseudo-diffusivity D* were quantified. Independent samples t test of IVIM-derived metrics were conducted between benign and malignant nodules. Receiver-operating characteristic analyses were performed to determine the optimal thresholds as well as the sensitivity and specificity for differentiating. RESULTS Significant intergroup difference was observed in ADC, D, D*, and f (p < 0.001). Malignant tumors featured significantly lower ADC, D and D* values and a higher f value than that of benign nodules. The ADC, D, and D* could distinguish the benign from malignant thyroid nodules, and parameter f differentiate the malignant tumors from benign nodules. The values of the area under the curve for parameter ADC, D, and D* were 0.784 (p = 0.001), 0.795 (p = 0.001), and 0.850 (p < 0.001), separately, of which the area under the curve of f value was the maximum for identifying the malignant from benign nodules, which was 0.841 (p < 0.001). CONCLUSION This study suggested that ADC and IVIM-derived metrics, including D, D*, and f, could potentially serve as noninvasive predictors for the preoperative differentiating of thyroid nodules, and f value performed best in identifying the malignant from benign nodules among these parameters.
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Affiliation(s)
- Hui Tan
- Department of Radiology, Renmin Hospital of Wuhan University, No. 99, Zhang Zhidong Road, Wuhan 430060, Hubei, China.
| | - Jun Chen
- Department of Radiology, Renmin Hospital of Wuhan University, No. 99, Zhang Zhidong Road, Wuhan 430060, Hubei, China.
| | - Yi Ling Zhao
- Department of Radiology, Renmin Hospital of Wuhan University, No. 99, Zhang Zhidong Road, Wuhan 430060, Hubei, China
| | - Jin Huan Liu
- Department of Radiology, Renmin Hospital of Wuhan University, No. 99, Zhang Zhidong Road, Wuhan 430060, Hubei, China
| | - Liang Zhang
- Department of Radiology, Renmin Hospital of Wuhan University, No. 99, Zhang Zhidong Road, Wuhan 430060, Hubei, China
| | - Chang Sheng Liu
- Department of Radiology, Renmin Hospital of Wuhan University, No. 99, Zhang Zhidong Road, Wuhan 430060, Hubei, China
| | - Dongjie Huang
- Department of Radiology, Renmin Hospital of Wuhan University, No. 99, Zhang Zhidong Road, Wuhan 430060, Hubei, China
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Payabvash S. Quantitative diffusion magnetic resonance imaging in head and neck tumors. Quant Imaging Med Surg 2018; 8:1052-1065. [PMID: 30598882 DOI: 10.21037/qims.2018.10.14] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In patients with head and neck cancer, conventional anatomical magnetic resonance imaging (MRI) scans are commonly used for identification of primary lesion, assessment of structural distortion, and presence of metastatic lymph nodes. However, quantitative analysis of diffusion MRI can provide added value to structural and anatomical evaluation of head and neck tumors (HNT), by differentiation of primary malignant process, prognostic prediction, and treatment monitoring. In this article, we will review the applications of quantitative diffusion MRI in identification of primary malignant tissue, differentiation of tumor pathology, prediction of molecular phenotype, monitoring of treatment response, and evaluation of posttreatment changes in patient with HNT.
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Affiliation(s)
- Seyedmehdi Payabvash
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
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Li F, Wang H, Hou J, Tang J, Lu Q, Wang L, Yu X. Utility of intravoxel incoherent motion diffusion-weighted imaging in predicting early response to concurrent chemoradiotherapy in oesophageal squamous cell carcinoma. Clin Radiol 2018; 73:756.e17-756.e26. [DOI: 10.1016/j.crad.2018.03.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 03/28/2018] [Indexed: 02/07/2023]
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Does intravoxel incoherent motion reliably stage hepatic fibrosis, steatosis, and inflammation? Abdom Radiol (NY) 2018; 43:600-606. [PMID: 28828711 DOI: 10.1007/s00261-017-1263-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To investigate the usefulness of intravoxel incoherent motion (IVIM) in determining the severity of hepatic fibrosis, steatosis, and inflammation in patients with chronic liver disease. METHODS Forty-nine patients who had liver MRI with IVIM sequence and liver biopsy within three months of MRI were enrolled. A reviewer, blinded to histology, placed regions of interest of 1-2 cm2 in the right liver lobe. In addition, the first twenty patients were assessed with a second reviewer. Perfusion fraction (f), pseudodiffusion coefficient (D fast), true diffusion coefficient (D slow), and apparent diffusion coefficient (ADC) were calculated from normalized signal intensities that were fitted into a biexponential model. Errors in the model were minimized with global stochastic optimization using Simulated Annealing. ANOVA with post hoc Tukey-Kramer test and multivariate generalized linear model analysis were performed, using histological findings as the gold standard. RESULTS The most common etiologies for liver disease were hepatitis C and alcohol, accounting together for 76% (37/49) of patients. Low-grade fibrosis (F0, F1), hepatic steatosis, and inflammation were seen in 24% (12/49), 31% (15/49), and 29% (14/49) of patients, respectively. The interobserver correlation was poor for D fast and D slow (0.105, 0.173) and moderate for f and ADC (0.461, 0.418). ANOVA showed a strong inverse association between D fast and liver fibrosis grade (p = 0.001). A weak inverse association was seen between ADC and hepatic steatosis (p = 0.059). Multivariate general linear model revealed that the only significant association between IVIM parameters and pathological features was between D fast and fibrosis. On ROC curve analysis, D fast < 23.4 × 10-3 mm2/s had a sensitivity of 82.8% and a specificity of 64.3% in predicting high-grade fibrosis. CONCLUSION D fast has the strongest association with hepatic fibrosis but has weak interobserver correlation. IVIM parameters were not significantly associated with hepatic inflammation or steatosis.
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Zhang B, Dong Y, Guo B, Chen W, Ouyang F, Lian Z, Liu J, Zhang S. Application of noninvasive functional imaging to monitor the progressive changes in kidney diffusion and perfusion in contrast-induced acute kidney injury rats at 3.0 T. Abdom Radiol (NY) 2018; 43:655-662. [PMID: 28677006 DOI: 10.1007/s00261-017-1247-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Contrast-induced acute kidney injury is a prevalent cause of renal failure, and the noninvasive tools to monitor its progress are lacking. We applied intravoxel incoherent motion (IVIM) DWI to measure the progressive changes in kidney diffusion and perfusion of CI-AKI. METHODS Twenty-four rats received Iopromide (370 mg/ml, 1600 mg iodine/kg) to induce CI-AKI. IVIM DWI was performed on rats (n = 6) at 24 h prior to and 12, 24, 48, 72, and 96 h after the injection using a 3.0 T MRI scanner. The progressive changes in the diffusion (D) and perfusion parameters (D* and f) were studied in the cortex (CO), outer medulla (OM), and inner medulla (IM). For the histology group (n = 18), three rats were sacrificed at each time point. RESULTS In the CO, D reduced progressively from 24 to 48 h (P < 0.001) and increased starting from 72 h (P < 0.001). However, D decreased until to 72 h in the medulla (P < 0.001) and increased starting from 96 h (P < 0.001). D* decreased to the bottom at 24 h in the cortex and medulla (P = 0.037) and started to recover at 48 h (P = 0.007). f decreased in the cortex and medulla in an early stage (12 h) (P = 0.035) of CI-AKI and then ascended in the later stage (72 h) (P = 0.017). The H & E staining showed different degrees of serial pathological change including cloudy swelling, atrophy, even necrosis, and interstitial vasodilation of tubule epithelial cells and glomerulus cells. CONCLUSION Our study demonstrates the feasibility of using IVIM DWI to monitor the progress of CI-AKI, implying that IVIM DWI is a useful biomarker in the staging of CI-AKI.
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Luo M, Zhang L, Jiang XH, Zhang WD. Intravoxel incoherent motion: application in differentiation of hepatocellular carcinoma and focal nodular hyperplasia. Diagn Interv Radiol 2018; 23:263-271. [PMID: 28703102 DOI: 10.5152/dir.2017.16595] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE We aimed to explore whether intravoxel incoherent motion (IVIM)-related parameters of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH) demonstrate differences that could be used to differentiate and improve diagnostic efficiency. METHODS A total of 27 patients, including 22 with HCC and 5 with FNH, underwent liver 3.0 T magnetic resonance imaging for routine sequences. They were concurrently examined by IVIM diffusion-weighted imaging (DWI) scanning with 11 different b values (0-800 s/mm2). IVIM-derived parameters, such as pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADCtotal), were quantified automatically by post-processing software and compared between HCC and FNH groups. A receiver operating characteristic (ROC) curve was then created to predict their diagnostic value. RESULTS D* was weak in terms of reproducibility among the other parameters. ADCtotal, D, and D* were significantly lower in the HCC group than in the FNH group, while f did not show a significant difference. ADCtotal and D had the largest area under the curve values (AUC; 0.915 and 0.897, respectively) and similarly high efficacy to differentiate the two conditions. CONCLUSION IVIM provides a new modality to differentiate the HCC and FNH. ADCtotal and D demonstrated outstanding and comparable diagnosing utility.
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Affiliation(s)
- Ma Luo
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
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Lin X, Lin D, Ge X, Qiu S, Feng S, Chen R. Noninvasive detection of nasopharyngeal carcinoma based on saliva proteins using surface-enhanced Raman spectroscopy. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-6. [PMID: 29030944 DOI: 10.1117/1.jbo.22.10.105004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/21/2017] [Indexed: 05/20/2023]
Abstract
The present study evaluated the capability of saliva analysis combining membrane protein purification with surface-enhanced Raman spectroscopy (SERS) for noninvasive detection of nasopharyngeal carcinoma (NPC). A rapid and convenient protein purification method based on cellulose acetate membrane was developed. A total of 659 high-quality SERS spectra were acquired from purified proteins extracted from the saliva samples of 170 patients with pathologically confirmed NPC and 71 healthy volunteers. Spectral analysis of those saliva protein SERS spectra revealed specific changes in some biochemical compositions, which were possibly associated with NPC transformation. Furthermore, principal component analysis combined with linear discriminant analysis (PCA-LDA) was utilized to analyze and classify the saliva protein SERS spectra from NPC and healthy subjects. Diagnostic sensitivity of 70.7%, specificity of 70.3%, and diagnostic accuracy of 70.5% could be achieved by PCA-LDA for NPC identification. These results show that this assay based on saliva protein SERS analysis holds promising potential for developing a rapid, noninvasive, and convenient clinical tool for NPC screening.
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Affiliation(s)
- Xueliang Lin
- Fujian Normal University, Ministry of Education, Key Laboratory of Optoelectronic Science and Techno, China
| | - Duo Lin
- Fujian Normal University, Ministry of Education, Key Laboratory of Optoelectronic Science and Techno, China
- Fujian University of Traditional Chinese Medicine, College of Integrated Traditional Chinese and Wes, China
| | - Xiaosong Ge
- Fujian Normal University, Ministry of Education, Key Laboratory of Optoelectronic Science and Techno, China
| | - Sufang Qiu
- Fujian Medical University Cancer Hospital, Fujian Provincial Key Laboratory of Translational Cancer, China
| | - Shangyuan Feng
- Fujian Normal University, Ministry of Education, Key Laboratory of Optoelectronic Science and Techno, China
| | - Rong Chen
- Fujian Normal University, Ministry of Education, Key Laboratory of Optoelectronic Science and Techno, China
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Chen WB, Zhang B, Liang L, Dong YH, Cai GH, Liang CH, Lan BW, Zhang SX. To predict the radiosensitivity of nasopharyngeal carcinoma using intravoxel incoherent motion MRI at 3.0 T. Oncotarget 2017; 8:53740-53750. [PMID: 28881847 PMCID: PMC5581146 DOI: 10.18632/oncotarget.17367] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 04/11/2017] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To investigate intravoxel incoherent motion (IVIM) MRI for evaluating the sensitivity of radiotherapy on nasopharyngeal carcinoma (NPC). RESULTS The reproducibility between intra-observer and inter-observer was relatively good. D (0.72×10-3 mm2/s±0.14 vs. 0.54×10-3 mm2/s±0.23; P < 0.001) and D* (157.92×10-3 mm2/s±15.21 vs. 120.36×10-3 mm2/s±10.22; P < 0.0001) were significantly higher in effective group than poor-effective group, whereas the difference of f (18.79%±2.51 vs. 16.47%±1.51) and ADC (1.21×10-3 mm2/s±0.11 vs. 1.33×10-3 mm2/s±0.23) could not reach statistical significant between the 2 groups (P > 0.05). CONCLUSIONS IVIM may be potentially useful in assessing the radiosensitivity of NPC. The higher D value combining with higher D* value might indicate the more radiosensitive of NPC, and increased D* might reflect increased blood vessel generation and parenchymal perfusion in NPC. MATERIALS AND METHODS Sixty consecutive patients (20 female, range, 27-83 years, mean age, 52 years) newly diagnosed NPC in the stage of T3 or T4 were enrolled. Forty-two of them were divided into effective group clinically after a standard radiotherapy according to the RECIST criteria. IVIM with 13 b-values (range, 0-800 s/mm2) and general MRI were performed at 3.0T MR scanner before and after radiotherapy. The parameters of IVIM including perfusion fraction (f), perfusion-related diffusion (D*), pure molecular diffusion (D) and apparent diffusion coefficient (ADC) were calculated. Two radiologists major in MRI diagnose analyzed all images independently and placed regions of interest (ROIs). Intra-class correlation coefficient (ICC) was used to evaluate intra-observer and inter-observer agreement. And Mann-Whitney test was used to assess the differences between the two groups.
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Affiliation(s)
- Wen Bo Chen
- Department of Radiology, HuiZhou Municipal Central Hospital, Huizhou, Guangdong, P.R. China
| | - Bin Zhang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong, P.R. China
- Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Long Liang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong, P.R. China
| | - Yu Hao Dong
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong, P.R. China
- Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Guan Hui Cai
- Department of Radiology, HuiZhou Municipal Central Hospital, Huizhou, Guangdong, P.R. China
| | - Chang Hong Liang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong, P.R. China
| | - Bo Wen Lan
- Department of Radiology, HuiZhou Municipal Central Hospital, Huizhou, Guangdong, P.R. China
| | - Shui Xing Zhang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong, P.R. China
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Lymph node metastasis in head and neck squamous carcinoma: Efficacy of intravoxel incoherent motion magnetic resonance imaging for the differential diagnosis. Eur J Radiol 2017; 90:159-165. [DOI: 10.1016/j.ejrad.2017.02.039] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/17/2017] [Accepted: 02/23/2017] [Indexed: 01/13/2023]
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Noij DP, Martens RM, Marcus JT, de Bree R, Leemans CR, Castelijns JA, de Jong MC, de Graaf P. Intravoxel incoherent motion magnetic resonance imaging in head and neck cancer: A systematic review of the diagnostic and prognostic value. Oral Oncol 2017; 68:81-91. [DOI: 10.1016/j.oraloncology.2017.03.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/12/2017] [Accepted: 03/25/2017] [Indexed: 12/20/2022]
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Park S, Kwack KS, Chung NS, Hwang J, Lee HY, Kim JH. Intravoxel incoherent motion diffusion-weighted magnetic resonance imaging of focal vertebral bone marrow lesions: initial experience of the differentiation of nodular hyperplastic hematopoietic bone marrow from malignant lesions. Skeletal Radiol 2017; 46:675-683. [PMID: 28265697 DOI: 10.1007/s00256-017-2603-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 01/13/2017] [Accepted: 02/09/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the ability of intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) parameters to differentiate nodular hyperplastic hematopoietic bone marrow (HHBM) from malignant vertebral bone marrow lesions (VBMLs). MATERIALS AND METHODS A total of 33 patients with 58 VBMLs, including 9 nodular HHBM lesions, 39 bone metastases, and 10 myelomas, were retrospectively assessed. All diagnoses were confirmed either pathologically or via image assessment. IVIM diffusion-weighted MRI with 11 b values (from 0 to 800 s/mm2) were obtained using a 3.0-T MR imager. The apparent diffusion coefficient (ADC), pure diffusion coefficient (D), perfusion fraction (f), and pseudodiffusion coefficient (D*) were calculated. ADC and IVIM parameters were compared using the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performances of ADC, D, f, and D* in terms of VBML characterization. The diagnostic performance of morphological MR sequences was also assessed for comparison. RESULTS The ADC and D values of nodular HHBM were significantly lower than those of malignant VBML (both p values < 0.001), whereas the f value was significantly higher (p < 0.001). However, there were no significant differences in D* between the two groups (p = 0.688). On ROC analysis, the area under the curve (AUC) for D was 1.000, which was significantly larger than that for ADC (AUC = 0.902). CONCLUSION Intravoxel incoherent motion diffusion-weighted MRI can be used to differentiate between nodular HHBM and malignant VBML. The D value was significantly lower for nodular HHBM, and afforded a better diagnostic performance than the ADC, f, and D* values in terms of such differentiation.
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Affiliation(s)
- Sunghoon Park
- Division of Musculoskeletal Radiology, Department of Radiology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, South Korea, 16499.,Musculoskeletal Imaging Laboratory, Ajou University Medical Center, Suwon, South Korea
| | - Kyu-Sung Kwack
- Division of Musculoskeletal Radiology, Department of Radiology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, South Korea, 16499. .,Musculoskeletal Imaging Laboratory, Ajou University Medical Center, Suwon, South Korea.
| | - Nam-Su Chung
- Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, South Korea
| | - Jinwoo Hwang
- Department of Clinical Science, Philips Healthcare, Seoul, South Korea
| | - Hyun Young Lee
- Regional Clinical Trial Center, Ajou University Medical Center, Suwon, South Korea.,Department of Biostatistics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Ho Kim
- Division of Musculoskeletal Radiology, Department of Radiology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, South Korea, 16499.,Musculoskeletal Imaging Laboratory, Ajou University Medical Center, Suwon, South Korea
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Wang F, Wang Y, Zhou Y, Liu C, Xie L, Zhou Z, Liang D, Shen Y, Yao Z, Liu J. Comparison between types I and II epithelial ovarian cancer using histogram analysis of monoexponential, biexponential, and stretched-exponential diffusion models. J Magn Reson Imaging 2017; 46:1797-1809. [PMID: 28379611 DOI: 10.1002/jmri.25722] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 03/14/2017] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To evaluate the utility of histogram analysis of monoexponential, biexponential, and stretched-exponential models to a dualistic model of epithelial ovarian cancer (EOC). MATERIALS AND METHODS Fifty-two patients with histopathologically proven EOC underwent preoperative magnetic resonance imaging (MRI) (including diffusion-weighted imaging [DWI] with 11 b-values) using a 3.0T system and were divided into two groups: types I and II. Apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), distributed diffusion coefficient (DDC), and intravoxel water diffusion heterogeneity (α) histograms were obtained based on solid components of the entire tumor. The following metrics of each histogram were compared between two types: 1) mean; 2) median; 3) 10th percentile and 90th percentile. Conventional MRI morphological features were also recorded. RESULTS Significant morphological features for predicting EOC type were maximum diameter (P = 0.007), texture of lesion (P = 0.001), and peritoneal implants (P = 0.001). For ADC, D, f, DDC, and α, all metrics were significantly lower in type II than type I (P < 0.05). Mean, median, 10th, and 90th percentile of D* were not significantly different (P = 0.336, 0.154, 0.779, and 0.203, respectively). Most histogram metrics of ADC, D, and DDC had significantly higher area under the receiver operating characteristic curve values than those of f and α (P < 0.05) CONCLUSION: It is feasible to grade EOC by morphological features and three models with histogram analysis. ADC, D, and DDC have better performance than f and α; f and α may provide additional information. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1797-1809.
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Affiliation(s)
- Feng Wang
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, P.R. China
| | - Yuxiang Wang
- Department of Pathology, School of Basic Medical Science, Peking University Third Hospital, Peking University Health Science Center, Beijing, P.R. China
| | - Yan Zhou
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, P.R. China
| | - Congrong Liu
- Department of Pathology, School of Basic Medical Science, Peking University Third Hospital, Peking University Health Science Center, Beijing, P.R. China
| | - Lizhi Xie
- GE Healthcare, MR Research China, Beijing, P.R. China
| | - Zhenyu Zhou
- GE Healthcare, MR Research China, Beijing, P.R. China
| | - Dong Liang
- Siemens Ltd., China, Chaoyang District, Beijing, P.R. China
| | - Yang Shen
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, P.R. China
| | - Zhihang Yao
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, P.R. China
| | - Jianyu Liu
- Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, P.R. China
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Ye X, Chen S, Tian Y, You B, Zhang W, Zhao Y, Jiang T, Hu B, Li H. A preliminary exploration of the intravoxel incoherent motion applied in the preoperative evaluation of mediastinal lymph node metastasis of lung cancer. J Thorac Dis 2017; 9:1073-1080. [PMID: 28523162 DOI: 10.21037/jtd.2017.03.110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND The aim of this study was to investigate the diagnostic value of the intravoxel incoherent motion (IVIM) for distinguishing non-metastatic from metastatic mediastinal lymph nodes in lung cancer. METHODS IVIM-diffusion weighted imaging (DWI) exams were performed preoperatively on 66 patients with lung cancer from October 2015 to June 2016 in Beijing Chao-Yang Hospital, Capital Medical University. Fifty patients underwent enhanced chest computed tomography (CT) in our hospital, while the other 16 patients already had enhanced chest CT images when they were admitted. The patients' complete preoperative examination included chest magnetic resonance imaging (MRI), enhanced chest CT, head MRI, bone scanning and cardiopulmonary function testing. None of the patients were receiving any treatment for their cancer prior to their evaluation and surgery, including neoadjuvant chemotherapy, radiation therapy, immunotherapy or gene targeted therapy. The following IVIM parameters of the mediastinal lymph nodes were measured: the short axis diameter, apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f). All of the patients underwent lobectomy and lymph node dissection. We compared the CT and MRI results and analysed the IVIM parameters of the pathologically determined non-metastatic and metastatic mediastinal lymph nodes in our 50 patients to generate the ROC curves and determine the best cut-off value for diagnosis. The remaining 16 patients' IVIM parameters were used to verify the diagnostic cut-off value. This study was approved by the institutional research ethics committee of Beijing Chao-Yang Hospital (2014-S-166), and all the patients signed the MRI informed consent. RESULTS In this study, MRI was used to measure 140 groups of mediastinal lymph nodes in 50 cases, and the results showed that 19 groups of mediastinal lymph nodes were metastatic, while 121 groups of mediastinal lymph nodes were non-metastatic. The pathological analysis showed that 20 groups of mediastinal lymph nodes were metastatic and 120 groups of mediastinal lymph nodes were non-metastatic. CT was used to measure 273 groups of mediastinal lymph nodes, and the result showed that 34 groups of mediastinal lymph nodes were metastatic, while 239 groups of mediastinal lymph nodes were non-metastatic. The pathological analysis showed that 20 groups of mediastinal lymph nodes were metastatic and 253 groups of mediastinal lymph nodes were non-metastatic. The ADC, D, D*, f values and the short axis diameters of the non-metastatic lymph nodes (n=121) were 2.9370±0.743×10-3, 0.533±0.175×10-3, 0.384±0.121×10-3 mm2/s, 0.426±0.120, 6.903±1.831 mm, respectively, and 1.863±0.691×10-3, 0.454±0.204×10-3, 0.358±0.106×10-3 mm2/s, 0.413±0.085, 7.705±2.213 mm, respectively, for the metastatic lymph nodes (n=19). The ADC and D values of the non-metastatic lymph nodes were significantly higher than the values for the metastatic lymph nodes (P<0.01); the other parameters (D*, f, and short axis diameter) did not show significantly different results between the two groups. The optimal cut-off values [area under the curve (AUC), sensitivity, and specificity] for distinguishing metastatic from non-metastatic lymph nodes were as follows: ADC =1.890×10-3 mm2/s (0.897, 93.3%, 80.0%), Youden index 0.733; and D =0.344×10-3 mm2/s (0.651, 90.8%, 50.0%), Youden index 0.651. When these cut-off values were applied as the diagnostic criteria in the remaining cases and compared with the pathology results, the diagnostic performance was good. CONCLUSIONS IVIM is useful to distinguish metastatic from non-metastatic lymph nodes in lung cancer. The ADC and the D values are significantly lower in metastatic lymph nodes, making these parameters more sensitive than the other parameters (D*, f, and short axis diameter). As a result, IVIM can be used in the N-stage diagnosis of lung cancer.
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Affiliation(s)
- Xin Ye
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Shuo Chen
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Yaru Tian
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Bin You
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Wenqian Zhang
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Yan Zhao
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Tao Jiang
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Bin Hu
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Marzi S, Piludu F, Forina C, Sanguineti G, Covello R, Spriano G, Vidiri A. Correlation study between intravoxel incoherent motion MRI and dynamic contrast-enhanced MRI in head and neck squamous cell carcinoma: Evaluation in primary tumors and metastatic nodes. Magn Reson Imaging 2017; 37:1-8. [DOI: 10.1016/j.mri.2016.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/07/2016] [Accepted: 10/05/2016] [Indexed: 12/12/2022]
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Mou A, Zhang C, Li M, Jin F, Song Q, Liu A, Li Z. Evaluation of myocardial microcirculation using intravoxel incoherent motion imaging. J Magn Reson Imaging 2017; 46:1818-1828. [PMID: 28306208 DOI: 10.1002/jmri.25706] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/02/2017] [Indexed: 11/07/2022] Open
Affiliation(s)
- Anna Mou
- Department of Radiology; First Affiliated Hospital of Dalian Medical University; Dalian P.R. China
| | - Chen Zhang
- Department of Radiology; First Affiliated Hospital of Dalian Medical University; Dalian P.R. China
| | - Mengying Li
- Department of Radiology; First Affiliated Hospital of Dalian Medical University; Dalian P.R. China
| | - Fengqiang Jin
- Department of Radiology; First Affiliated Hospital of Dalian Medical University; Dalian P.R. China
| | - Qingwei Song
- Department of Radiology; First Affiliated Hospital of Dalian Medical University; Dalian P.R. China
| | - Ailian Liu
- Department of Radiology; First Affiliated Hospital of Dalian Medical University; Dalian P.R. China
| | - Zhiyong Li
- Department of Radiology; First Affiliated Hospital of Dalian Medical University; Dalian P.R. China
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Zhou N, Chu C, Dou X, Li M, Liu S, Zhu L, Liu B, Guo T, Chen W, He J, Yan J, Zhou Z, Yang X, Liu T. Early evaluation of irradiated parotid glands with intravoxel incoherent motion MR imaging: correlation with dynamic contrast-enhanced MR imaging. BMC Cancer 2016; 16:865. [PMID: 27821130 PMCID: PMC5100256 DOI: 10.1186/s12885-016-2900-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/30/2016] [Indexed: 12/13/2022] Open
Abstract
Background Radiation-induced parotid damage is one of the most common complications in patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy (RT). Intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging has been reported for evaluating irradiated parotid damage. However, the changes of IVIM perfusion-related parameters in irradiated parotid glands have not been confirmed by conventional perfusion measurements obtained from dynamic contrast-enhanced (DCE) MR imaging. The purposes of this study were to monitor radiation-induced parotid damage using IVIM and DCE MR imaging and to investigate the correlations between changes of these MR parameters. Methods Eighteen NPC patients underwent bilateral parotid T1-weighted, IVIM and DCE MR imaging pre-RT (2 weeks before RT) and post-RT (4 weeks after RT). Parotid volume; IVIM MR parameters, including apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f); and DCE MR parameters, including maximum relative enhancement (MRE), time to peak (TTP), Wash in Rate, and the degree of xerostomia were recorded. Correlations of parotid MR parameters with mean radiation dose, atrophy rate and xerostomia degree, as well as the relationships between IVIM and DCE MR parameters, were investigated. Results From pre-RT to post-RT, all of the IVIM and DCE MR parameters increased significantly (p < 0.001 for ADC, D, f, MRE, Wash in Rate; p = 0.024 for D*; p = 0.037 for TTP). Change rates of ADC, f and MRE were negatively correlated with atrophy rate significantly (all p < 0.05). Significant correlations were observed between the change rates of D* and MRE (r = 0.371, p = 0.026) and between the change rates of D* and TTP (r = 0.396, p = 0.017). The intra- and interobserver reproducibility of IVIM and DCE MR parameters was good to excellent (intraclass correlation coefficient, 0.633–0.983). Conclusions Early radiation-induced changes of parotid glands could be evaluated by IVIM and DCE MR imaging. Certain IVIM and DCE MR parameters were correlated significantly.
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Affiliation(s)
- Nan Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Chen Chu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Xin Dou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Ming Li
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Song Liu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Lijing Zhu
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, 210008, China
| | - Baorui Liu
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, 210008, China
| | - Tingting Guo
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210008, China
| | - Weibo Chen
- Philips Healthcare, Shanghai, 200233, China
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Jing Yan
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, 210008, China.
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
| | - Tian Liu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
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Kang KM, Choi SH, Kim DE, Yun TJ, Kim JH, Sohn CH, Park SW. Application of Cardiac Gating to Improve the Reproducibility of Intravoxel Incoherent Motion Measurements in the Head and Neck. Magn Reson Med Sci 2016; 16:190-202. [PMID: 27818467 PMCID: PMC5600025 DOI: 10.2463/mrms.mp.2016-0051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Purpose: To prospectively evaluate whether cardiac gating can improve the reproducibility of intravoxel incoherent motion (IVIM) parameters in the head and neck, we performed IVIM diffusion-weighted imaging (DWI) using 4 b values (4b), 4 b values with cardiac gating (4b gating) and 17 b values (17b). Methods: We performed IVIM DWI twice per person on nine healthy volunteers using 4b, 4b gating and 17b and five patients with head and neck masses using 4b gating and 17b. The ADC, perfusion fraction (f), diffusion coefficient (D) and perfusion-related diffusion coefficient (D*) were calculated in the brain, masticator muscle, parotid gland, submandibular gland, tonsil and masses. Intraclass coefficient (ICC), Bland-Altman analysis (BAA) and coefficient of variation (CV) were used to assess short-term test-retest reproducibility. Kruskal-Wallis test and Mann-Whitney test were used to investigate whether 4b, 4b gating or 17b had significant influences on the parameters. Results: For normal tissues and masses, ICC was excellent for all maps except the D* map. All parameters showed the lowest CV in the 4b gating. BAA also revealed the narrowest 95% limits of agreement using 4b gating for all parameters. In the subgroup analysis, almost all parameters in brain, muscle, parotid gland and submandibular gland showed the best reproducibility using 4b gating. In the muscle, parotid gland and submandibular gland, the values of ADC, f and D were not significantly different between among the three methods. Conclusion: 4b gating was more reproducible with respect to measurements of IVIM parameters in comparison with 4b or 17b.
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Affiliation(s)
- Koung Mi Kang
- Department of Radiology, Seoul National University Hospital.,Department of Radiology, Seoul National University College of Medicine
| | - Seung Hong Choi
- Department of Radiology, Seoul National University Hospital.,School of Chemical and Biological Engineering, Seoul National University
| | | | - Tae Jin Yun
- Department of Radiology, Seoul National University Hospital.,Department of Radiology, Seoul National University College of Medicine
| | - Ji-Hoon Kim
- Department of Radiology, Seoul National University Hospital.,Department of Radiology, Seoul National University College of Medicine
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University Hospital.,Center for Nanoparticle Research, Institute for Basic Science (IBS)
| | - Sun-Won Park
- Department of Radiology, Seoul National University Boramae Hospital
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Deng Y, Li X, Lei Y, Liang C, Liu Z. Use of diffusion-weighted magnetic resonance imaging to distinguish between lung cancer and focal inflammatory lesions: a comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient. Acta Radiol 2016; 57:1310-1317. [PMID: 25972370 DOI: 10.1177/0284185115586091] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Using imaging techniques to diagnose malignant and inflammatory lesions in the lung can be challenging. Purpose To compare intravoxel incoherent motion (IVIM) and apparent diffusion coefficient (ADC) magnetic resonance imaging (MRI) analysis in their ability to discriminate lung cancer from focal inflammatory lung lesions. Material and Methods Thirty-eight patients with lung masses were included: 30 lung cancers and eight inflammatory lesions. Patients were imaged with 3.0T MRI diffusion weighted imaging (DWI) using 10 b values (range, 0-1000 s/mm2). Tissue diffusivity ( D), pseudo-diffusion coefficient ( D*), and perfusion fraction ( f) were calculated using segmented biexponential analysis. ADC (total) was calculated with monoexponential fitting of the DWI data. D, D*, f, and ADC were compared between lung cancer and inflammatory lung lesions. Receiver operating characteristic analysis was performed for all DWI parameters. Results The ADC was significantly higher for inflammatory lesions than for lung cancer ([1.21 ± 0.20] × 10-3 mm2/s vs. [0.97 ± 0.15] × 10-3 mm2/s; P = 0.004). By IVIM, f was found to be significantly higher in inflammatory lesions than lung cancer ([46.10 ± 12.92] % vs. [29.29 ± 10.89] %; P = 0.005). There was no difference in D and D* between lung cancer and inflammatory lesions ( P = 0.747 and 0.124, respectively). f showed comparable diagnostic performance with ADC in differentiating lung cancer from inflammatory lung lesions, with areas under the curve of 0.833 and 0.826, sensitivity 80.0% and 73.3%, and specificity 75.0% and 87.5%, respectively. Conclusion The IVIM parameter f value provides comparable diagnostic performance with ADC and could be used as a surrogate marker for differentiating lung cancer from inflammatory lesions.
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Affiliation(s)
- Yu Deng
- Southern Medical University, Guangzhou, PR China
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangzhou, PR China
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Xinchun Li
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Yongxia Lei
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Changhong Liang
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangzhou, PR China
| | - Zaiyi Liu
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangzhou, PR China
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Xu XQ, Choi YJ, Sung YS, Yoon RG, Jang SW, Park JE, Heo YJ, Baek JH, Lee JH. Intravoxel Incoherent Motion MR Imaging in the Head and Neck: Correlation with Dynamic Contrast-Enhanced MR Imaging and Diffusion-Weighted Imaging. Korean J Radiol 2016; 17:641-9. [PMID: 27587952 PMCID: PMC5007390 DOI: 10.3348/kjr.2016.17.5.641] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 05/17/2016] [Indexed: 12/25/2022] Open
Abstract
Objective To investigate the correlation between perfusion- and diffusion-related parameters from intravoxel incoherent motion (IVIM) and those from dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion-weighted imaging in tumors and normal muscles of the head and neck. Materials and Methods We retrospectively enrolled 20 consecutive patients with head and neck tumors with MR imaging performed using a 3T MR scanner. Tissue diffusivity (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were derived from bi-exponential fitting of IVIM data obtained with 14 different b-values in three orthogonal directions. We investigated the correlation between D, f, and D* and model-free parameters from the DCE-MRI (wash-in, Tmax, Emax, initial AUC60, whole AUC) and the apparent diffusion coefficient (ADC) value in the tumor and normal masseter muscle using a whole volume-of-interest approach. Pearson's correlation test was used for statistical analysis. Results No correlation was found between f or D* and any of the parameters from the DCE-MRI in all patients or in patients with squamous cell carcinoma (p > 0.05). The ADC was significantly correlated with D values in the tumors (p < 0.001, r = 0.980) and muscles (p = 0.013, r = 0.542), despite its significantly higher value than D. The difference between ADC and D showed significant correlation with f values in the tumors (p = 0.017, r = 0.528) and muscles (p = 0.003, r = 0.630), but no correlation with D* (p > 0.05, respectively). Conclusion Intravoxel incoherent motion shows no significant correlation with model-free perfusion parameters derived from the DCE-MRI but is feasible for the analysis of diffusivity in both tumors and normal muscles of the head and neck.
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Affiliation(s)
- Xiao Quan Xu
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.; Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Yu Sub Sung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Ra Gyoung Yoon
- Department of Radiology, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon 22711, Korea
| | - Seung Won Jang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Young Jin Heo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.; Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
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Bhosale P, Ramalingam P, Ma J, Iyer R, Soliman P, Frumovitz M, Kundra V. Can reduced field-of-view diffusion sequence help assess microsatellite instability in FIGO stage 1 endometrial cancer? J Magn Reson Imaging 2016; 45:1216-1224. [DOI: 10.1002/jmri.25427] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/02/2016] [Indexed: 01/22/2023] Open
Affiliation(s)
- Priya Bhosale
- Department of Diagnostic Radiology; University of Texas M. D. Anderson Cancer Center; Houston Texas USA
| | - Preetha Ramalingam
- Department of Pathology; University of Texas M. D. Anderson Cancer Center; Houston Texas USA
| | - Jingfei Ma
- Department of Physics; University of Texas M. D. Anderson Cancer Center; Houston Texas USA
| | - Revathy Iyer
- Department of Diagnostic Radiology; University of Texas M. D. Anderson Cancer Center; Houston Texas USA
| | - Pamela Soliman
- Department of Gynecologic Oncology; University of Texas M. D. Anderson Cancer Center; Houston Texas USA
| | - Micheal Frumovitz
- Department of Gynecologic Oncology; University of Texas M. D. Anderson Cancer Center; Houston Texas USA
| | - Vikas Kundra
- Department of Diagnostic Radiology; University of Texas M. D. Anderson Cancer Center; Houston Texas USA
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Hou J, Yu X, Hu Y, Li F, Xiang W, Wang L, Wang H, Lu Q, Zhang Z, Zeng W. Value of intravoxel incoherent motion and dynamic contrast-enhanced MRI for predicting the early and short-term responses to chemoradiotherapy in nasopharyngeal carcinoma. Medicine (Baltimore) 2016; 95:e4320. [PMID: 27583847 PMCID: PMC5008531 DOI: 10.1097/md.0000000000004320] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The aim of the study was to investigate the value of intravoxel incoherent motion diffusion-weighted magnetic resonance imaging (IVIM-DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting the early and short-term responses to chemoradiotherapy (CRT) in patients with nasopharyngeal carcinoma (NPC).Forty-three NPC patients underwent IVIM-DWI and DCE-MRI at baseline (pretreatment) and after the first cycle of induction chemotherapy (posttreatment). Based on whether locoregional lesions were identified, patients were divided into the residual and nonresidual groups at the end of CRT and into the good-responder and poor-responder groups 6 months after the end of CRT. The pretreatment and posttreatment IVIM-DWI parameters (ADC, D, D*, and f) and DCE-MRI parameters (K, Kep, and Ve) values and their percentage changes (Δ%) were compared between the residual and nonresidual groups and between the good-responder and poor-responder groups.None of perfusion-related parametric values derived from either DCE-MRI or IVIM-DWI showed significant differences either between the residual and nonresidual groups or between the good-responder and poor-responder groups. The nonresidual group exhibited lower pre-ADC, lower pre-D, and higher Δ%D values than did the residual group (all P <0.05). The good-responder group had lower pre-D and pre-ADC values than did the poor-responder group (both P <0.05). Based on receiver operating characteristic (ROC) curve analysis, pre-D had the highest area under the curve in predicting both the early and short-term responses to CRT for NPC patients (0.817 and 0.854, respectively).IVIM-DWI is more valuable than DCE-MRI in predicting the early and short-term response to CRT for NPC, and furthermore diffusion-related IVIM-DWI parameters (pre-ADC, pre-D, and Δ%D) are more powerful than perfusion-related parameters derived from both IVIM-DWI and DCE-MRI.
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Affiliation(s)
- Jing Hou
- School of Pharmaceutical Sciences, Central South University
- Department of Diagnostic Radiology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University
| | - Xiaoping Yu
- Department of Diagnostic Radiology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University
- Hunan Provincial Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital, Changsha, Hunan
- Correspondence: Xiaoping Yu, 283 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, People's Republic of China (e-mail: ); Wenbin Zeng, 172 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, People's Republic of China (e-mail: )
| | - Yin Hu
- Hunan Provincial Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital, Changsha, Hunan
| | - Feiping Li
- Department of Diagnostic Radiology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University
| | - Wang Xiang
- Department of Diagnostic Radiology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University
| | - Lanlan Wang
- Department of Diagnostic Radiology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University
| | - Hui Wang
- Hunan Provincial Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital, Changsha, Hunan
| | - Qiang Lu
- Department of Diagnostic Radiology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University
| | | | - Wenbin Zeng
- School of Pharmaceutical Sciences, Central South University
- Correspondence: Xiaoping Yu, 283 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, People's Republic of China (e-mail: ); Wenbin Zeng, 172 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, People's Republic of China (e-mail: )
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The Role of Intravoxel Incoherent Motion MRI in Predicting Early Treatment Response to Chemoradiation for Metastatic Lymph Nodes in Nasopharyngeal Carcinoma. Adv Ther 2016; 33:1158-68. [PMID: 27294489 DOI: 10.1007/s12325-016-0352-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Pilot studies have suggested potential clinical applications for intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in head and neck cancers. This study aimed to characterize metastatic lymph nodes using IVIM MRI, and to evaluate the role of IVIM MRI in the prediction of the early treatment response of lymph node metastasis from nasopharyngeal carcinoma (NPC). METHODS A total of 122 patients with metastatic lymph nodes from NPC underwent two MRI examinations, pre-treatment and post-treatment (at 4 weeks and at ≥2 years from the end of chemoradiotherapy). Treatment response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1. Differences in the initial IVIM parameters [pure molecular diffusion (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f)] between nodes with a partial response (PR) and a complete response (CR) were analyzed in 102 patients after the exclusion of 20. RESULTS The initial D*, D, and apparent diffusion coefficient (ADC) did not reveal a significant difference between nodes showing a PR or a CR. The mean initial f value was significantly higher in patients with a PR relative to patients with a CR (p = 0.003), and its sensitivity and specificity in predicting treatment response to chemoradiotherapy were 86.7% and 100%, respectively. CONCLUSIONS The present study indicated that the initial f value may be more accurate than the initial D*, D, and ADC in the early prediction of treatment response to chemoradiotherapy for metastatic lymph nodes in patients with NPC.
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Fujima N, Yoshida D, Sakashita T, Homma A, Tsukahara A, Shimizu Y, Tha KK, Kudo K, Shirato H. Prediction of the treatment outcome using intravoxel incoherent motion and diffusional kurtosis imaging in nasal or sinonasal squamous cell carcinoma patients. Eur Radiol 2016; 27:956-965. [DOI: 10.1007/s00330-016-4440-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 03/10/2016] [Accepted: 05/23/2016] [Indexed: 12/11/2022]
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Yang K, Zhang XM, Yang L, Xu H, Peng J. Advanced imaging techniques in the therapeutic response of transarterial chemoembolization for hepatocellular carcinoma. World J Gastroenterol 2016; 22:4835-4847. [PMID: 27239110 PMCID: PMC4873876 DOI: 10.3748/wjg.v22.i20.4835] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 03/29/2016] [Accepted: 04/20/2016] [Indexed: 02/07/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is one of the major causes of morbidity and mortality in patients with chronic liver disease. Transarterial chemoembolization (TACE) can significantly improve the survival rate of patients with HCC and is the first treatment choice for patients who are not suitable for surgical resections. The evaluation of the response to TACE treatment affects not only the assessment of the therapy efficacy but also the development of the next step in the treatment plan. The use of imaging to examine changes in tumor volume to assess the response of solid tumors to treatment has been controversial. In recent years, the emergence of new imaging technology has made it possible to observe the response of tumors to treatment prior to any morphological changes. In this article, the advances in studies reporting the use of computed tomography perfusion imaging, diffusion-weighted magnetic resonance imaging (MRI), intravoxel incoherent motion, diffusion kurtosis imaging, magnetic resonance spectroscopy, magnetic resonance perfusion-weighted imaging, blood oxygen level-dependent MRI, positron emission tomography (PET)/computed tomography and PET/MRI to assess the TACE treatment response are reviewed.
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Mao J, Shen J, Yang Q, Yu T, Duan X, Zhong J, Phuyal P, Liang B. Intravoxel incoherent motion MRI in differentiation between recurrent carcinoma and postchemoradiation fibrosis of the skull base in patients with nasopharyngeal carcinoma. J Magn Reson Imaging 2016; 44:1556-1564. [PMID: 27227674 DOI: 10.1002/jmri.25302] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/25/2016] [Indexed: 12/27/2022] Open
Affiliation(s)
- Jiaji Mao
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Jun Shen
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Qihua Yang
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Taihui Yu
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Xiaohui Duan
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Jinglian Zhong
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Prakash Phuyal
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
| | - Biling Liang
- Department of Radiology; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangdong China
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Yan C, Xu J, Xiong W, Wei Q, Feng R, Wu Y, Liu Q, Li C, Chan Q, Xu Y. Use of intravoxel incoherent motion diffusion-weighted MR imaging for assessment of treatment response to invasive fungal infection in the lung. Eur Radiol 2016; 27:212-221. [PMID: 27180185 DOI: 10.1007/s00330-016-4380-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 03/16/2016] [Accepted: 04/22/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The purpose of this study was to determine whether intravoxel incoherent motion (IVIM) -derived parameters and apparent diffusion coefficient (ADC) could act as imaging biomarkers for predicting antifungal treatment response. METHODS Forty-six consecutive patients (mean age, 33.9 ± 13.0 y) with newly diagnosed invasive fungal infection (IFI) in the lung according to EORTC/MSG criteria were prospectively enrolled. All patients underwent diffusion-weighted magnetic resonance (MR) imaging at 3.0 T using 11 b values (0-1000 sec/mm2). ADC, pseudodiffusion coffiecient D*, perfusion fraction f, and the diffusion coefficient D were compared between patients with favourable (n=32) and unfavourable response (n=14). RESULTS f values were significantly lower in the unfavourable response group (12.6%±4.4%) than in the favourable response group (30.2%±8.6%) (Z=4.989, P<0.001). However, the ADC, D, and D* were not significantly different between the two groups (P>0.05). Receiver operating characteristic curve analyses showed f to be a significant predictor for differentiation, with a sensitivity of 93.8% and a specificity of 92.9%. CONCLUSIONS IVIM-MRI is potentially useful in the prediction of antifungal treatment response to patients with IFI in the lung. Our results indicate that a low perfusion fraction f may be a noninvasive imaging biomarker for unfavourable response. KEY POINTS • Recognition of IFI indicating clinical outcome is important for treatment decision-making. • IVIM can reflect diffusion and perfusion information of IFI lesions separately. • Perfusion characteristics of IFI lesions could help differentiate treatment response. • An initial low f may predict unfavourable response in IFI.
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Affiliation(s)
- Chenggong Yan
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China
| | - Jun Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China
| | - Wei Xiong
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China
| | - Qi Wei
- Department of Hematology, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China
| | - Ru Feng
- Department of Hematology, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China
| | - Yuankui Wu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China
| | - Qifa Liu
- Department of Hematology, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China
| | - Caixia Li
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China
| | - Queenie Chan
- Philips Healthcare, Science Park East Avenue, Hong Kong Science Park, New Territories, Hong Kong
| | - Yikai Xu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China.
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Yu XP, Hou J, Li FP, Wang H, Hu PS, Bi F, Wang W. Intravoxel Incoherent Motion Diffusion Weighted Magnetic Resonance Imaging for Differentiation Between Nasopharyngeal Carcinoma and Lymphoma at the Primary Site. J Comput Assist Tomogr 2016; 40:413-8. [PMID: 26953769 PMCID: PMC4872642 DOI: 10.1097/rct.0000000000000391] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/16/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the utility of intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (DWI) for differentiating nasopharyngeal carcinoma (NPC) from lymphoma. METHODS Intravoxel incoherent motion-based parameters including the apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and fD* (the product of D* and f) were retrospectively compared between 102 patients (82 with NPC, 20 with lymphoma) who received pretreatment IVIM DWI. RESULTS Compared with lymphoma, NPC exhibited higher ADC, D, D*, fD* values (P < 0.001) and f value (P = 0.047). The optimal cutoff values (area under the curve, sensitivity, and specificity, respectively) for distinguishing the 2 tumors were as follows: ADC value of 0.761 × 10 mm/s (0.781, 93.90%, 55.00%); D, 0.66 × 10 mm/s (0.802, 54.88%, 100.00%); D*, 7.89 × 10 mm/s (0.898, 82.93%, 85.00%); f, 0.29 (0.644, 41.46%, 95.00%); and fD*, 1.99 × 10 mm/s (0.960, 85.37%, 100.00%). CONCLUSIONS Nasopharyngeal carcinoma exhibits different IVIM-based imaging features from lymphoma. Intravoxel incoherent motion DWI is useful for differentiating lymphoma from NPC.
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Affiliation(s)
- Xiao-Ping Yu
- From the *Department of Diagnostic Radiology, Hunan Cancer Hospital, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University; †Department of Radiology, the Third Xiangya Hospital, Central South University; and ‡Hunan Provincial Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital, Changsha, Hunan, PR China
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