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Shrestha B, Stern NB, Zhou A, Dunn A, Porter T. Current trends in the characterization and monitoring of vascular response to cancer therapy. Cancer Imaging 2024; 24:143. [PMID: 39438891 PMCID: PMC11515715 DOI: 10.1186/s40644-024-00767-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 08/26/2024] [Indexed: 10/25/2024] Open
Abstract
Tumor vascular physiology is an important determinant of disease progression as well as the therapeutic outcome of cancer treatment. Angiogenesis or the lack of it provides crucial information about the tumor's blood supply and therefore can be used as an index for cancer growth and progression. While standalone anti-angiogenic therapy demonstrated limited therapeutic benefits, its combination with chemotherapeutic agents improved the overall survival of cancer patients. This could be attributed to the effect of vascular normalization, a dynamic process that temporarily reverts abnormal vasculature to the normal phenotype maximizing the delivery and intratumor distribution of chemotherapeutic agents. Longitudinal monitoring of vascular changes following antiangiogenic therapy can indicate an optimal window for drug administration and estimate the potential outcome of treatment. This review primarily focuses on the status of various imaging modalities used for the longitudinal characterization of vascular changes before and after anti-angiogenic therapies and their clinical prospects.
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Affiliation(s)
- Binita Shrestha
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA.
| | - Noah B Stern
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Annie Zhou
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Andrew Dunn
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Tyrone Porter
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
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2
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Liu F, Yao Y, Zhu B, Yu Y, Ren R, Hu Y. The novel imaging methods in diagnosis and assessment of cerebrovascular diseases: an overview. Front Med (Lausanne) 2024; 11:1269742. [PMID: 38660416 PMCID: PMC11039813 DOI: 10.3389/fmed.2024.1269742] [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: 07/30/2023] [Accepted: 03/27/2024] [Indexed: 04/26/2024] Open
Abstract
Cerebrovascular diseases, including ischemic strokes, hemorrhagic strokes, and vascular malformations, are major causes of morbidity and mortality worldwide. The advancements in neuroimaging techniques have revolutionized the field of cerebrovascular disease diagnosis and assessment. This comprehensive review aims to provide a detailed analysis of the novel imaging methods used in the diagnosis and assessment of cerebrovascular diseases. We discuss the applications of various imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and angiography, highlighting their strengths and limitations. Furthermore, we delve into the emerging imaging techniques, including perfusion imaging, diffusion tensor imaging (DTI), and molecular imaging, exploring their potential contributions to the field. Understanding these novel imaging methods is necessary for accurate diagnosis, effective treatment planning, and monitoring the progression of cerebrovascular diseases.
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Affiliation(s)
- Fei Liu
- Neuroscience Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ying Yao
- Neuroscience Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Bingcheng Zhu
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yue Yu
- Neuroscience Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Reng Ren
- Neuroscience Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yinghong Hu
- Neuroscience Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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3
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Zhang H, Zhang XY, Wang Y. Value of magnetic resonance diffusion combined with perfusion imaging techniques for diagnosing potentially malignant breast lesions. World J Clin Cases 2022; 10:6021-6031. [PMID: 35949832 PMCID: PMC9254209 DOI: 10.12998/wjcc.v10.i18.6021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/23/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Lesions of breast imaging reporting and data system (BI-RADS) 4 at mammography vary from benign to malignant, leading to difficulties for clinicians to distinguish between them. The specificity of magnetic resonance imaging (MRI) in detecting breast is relatively low, leading to many false-positive results and high rates of re-examination or biopsy. Diffusion-weighted imaging (DWI), combined with perfusion-weighted imaging (PWI), might help to distinguish between benign and malignant BI-RADS 4 breast lesions at mammography.
AIM To evaluate the value of DWI and PWI in diagnosing BI-RADS 4 breast lesions.
METHODS This is a retrospective study which included patients who underwent breast MRI between May 2017 and May 2019 in the hospital. The lesions were divided into benign and malignant groups according to the classification of histopathological results. The diagnostic efficacy of DWI and PWI were analyzed respectively and combinedly. The 95 lesions were divided according to histopathological diagnosis, with 46 benign and 49 malignant. The main statistical methods used included the Student t-test, the Mann-Whitney U-test, the chi-square test or Fisher’s exact test.
RESULTS The mean apparent diffusion coefficient (ADC) values in the parenchyma and lesion area of the normal mammary gland were 1.82 ± 0.22 × 10-3 mm2/s and 1.24 ± 0.16 × 10-3 mm2/s, respectively (P = 0.021). The mean ADC value of the malignant group was 1.09 ± 0.23 × 10-3 mm2/s, which was lower than that of the benign group (1.42 ± 0.68 × 10-3 mm2/s) (P = 0.016). The volume transfer constant (Ktrans) and rate constant (Kep) values were higher in malignant lesions than in benign ones (all P < 0.001), but there were no significant statistical differences regarding volume fraction (Ve) (P = 0.866). The sensitivity and specificity of PWI combined with DWI (91.7% and 89.3%, respectively) were higher than that of PWI or DWI alone. The accuracy of PWI combined with DWI in predicting pathological results was significantly higher than that predicted by PWI or DWI alone.
CONCLUSION DWI, combined with PWI, might possibly distinguish between benign and malignant BI-RADS 4 breast lesions at mammography.
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Affiliation(s)
- Hui Zhang
- Department of Radiology, Hebei General Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Xin-Yi Zhang
- Department of Radiology, the First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Yong Wang
- Department of Radiology, the First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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4
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Scola E, Desideri I, Bianchi A, Gadda D, Busto G, Fiorenza A, Amadori T, Mancini S, Miele V, Fainardi E. Assessment of brain tumors by magnetic resonance dynamic susceptibility contrast perfusion-weighted imaging and computed tomography perfusion: a comparison study. LA RADIOLOGIA MEDICA 2022; 127:664-672. [PMID: 35441970 DOI: 10.1007/s11547-022-01470-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/11/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To investigate the association and agreement between magnetic resonance dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) and computed tomography perfusion (CTP) in determining vascularity and permeability of primary and secondary brain tumors. MATERIAL AND METHODS DSC-PWI and CTP studies from 97 patients with high-grade glioma, low-grade glioma and solitary brain metastasis were retrospectively reviewed. Normalized cerebral blood flow (nCBF), cerebral blood volume (nCBV), capillary transfer constant (nK2) and permeability surface area product (nPS) values were obtained. Variables among groups were compared, and correlation and agreement between DSC-PWI and CTP were tested. RESULTS All DSC-PWI and CTP parameters were higher in high-grade than in low-grade gliomas (p < 0.01 and p < 0.001). Metastases had greater DSC-PWI nCBV (p < 0.05), nCTP-CBF (p < 0.05), nCTP-CBV (p < 0.01) and nCTP-PS (p < 0.0001) than low-grade gliomas and more elevated nCTP-PS (p < 0.01) than high-grade gliomas. The correlation was strong between DSC-PWI nCBF and CTP nCBF (r = 0.79; p < 0.00001) and between DSC-PWI nCBV and CTP nCBV (r = 0.83; p < 0.00001), weaker between DSC-PWI nK2 and CTP nPS (r = 0.29; p < 0.01). Bland-Altman plots indicated that the agreement was strong between DSC-PWI nCBF and CTP nCBF, good between DSC-PWI nCBV and CTP nCBV and poorer between DSC-PWI nK2 and CTP nPS. CONCLUSION DSC-PWI and CTP CBF and CBV maps were comparable and interchangeable in the assessment of tumor vascularity, unlike DSC-PWI K2 and CTP PS maps that were more discordant in the analysis of tumor permeability. CTP could be an alternative method to quantify tumor neoangiogenesis when MRI is not available or when the patient does not tolerate it.
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Affiliation(s)
- Elisa Scola
- Struttura Organizzativa Dipartimentale di Neuroradiologia, Dipartimento di Radiologia, Ospedale Universitario Careggi, Largo Brambilla 3, 50134, Florence, Italy.
| | - Ilaria Desideri
- Struttura Organizzativa Dipartimentale di Neuroradiologia, Dipartimento di Radiologia, Ospedale Universitario Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Andrea Bianchi
- Struttura Organizzativa Dipartimentale di Neuroradiologia, Dipartimento di Radiologia, Ospedale Universitario Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Davide Gadda
- Struttura Organizzativa Dipartimentale di Neuroradiologia, Dipartimento di Radiologia, Ospedale Universitario Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Giorgio Busto
- Struttura Organizzativa Dipartimentale di Neuroradiologia, Dipartimento di Radiologia, Ospedale Universitario Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | - Alessandro Fiorenza
- Radiodiagnostic Unit N. 2, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Tommaso Amadori
- Radiodiagnostic Unit N. 2, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Sara Mancini
- Radiodiagnostic Unit N. 2, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
| | - Enrico Fainardi
- Struttura Organizzativa Dipartimentale di Neuroradiologia, Dipartimento di Radiologia, Ospedale Universitario Careggi, Largo Brambilla 3, 50134, Florence, Italy.,Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
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Li L, Zhong L, Tang C, Gan L, Mo T, Na J, He J, Huang Y. CD105: tumor diagnosis, prognostic marker and future tumor therapeutic target. Clin Transl Oncol 2022; 24:1447-1458. [PMID: 35165838 DOI: 10.1007/s12094-022-02792-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/21/2022] [Indexed: 02/06/2023]
Abstract
Cancer is one of the diseases with the highest morbidity and mortality rates worldwide, and its therapeutic options are inadequate. The endothelial glycoprotein, also known as CD105, is a type I transmembrane glycoprotein located on the surface of the cell membranes and it is one of the transforming growth factor-β (TGF-β) receptor complexes. It regulates the responses associated with binding to transforming growth factor β1 egg (Activin-A), bone morphogenetic protein 2 (BMP-2), and bone morphogenetic protein 7 (BMP-7). Additionally, it is involved in the regulation of angiogenesis. This glycoprotein is indispensable in the treatment of tumor angiogenesis, and it also plays a leading role in tumor angiogenesis therapy. Therefore, CD105 is considered to be a novel therapeutic target. In this study, we explored the significance of CD105 in the diagnosis, treatment and prognosis of various tumors, and provided evidence for the effect and mechanism of CD105 on tumors.
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Affiliation(s)
- Lan Li
- National Center for International Research of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-Targeting Theranostics, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Liping Zhong
- National Center for International Research of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-Targeting Theranostics, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Chao Tang
- National Center for International Research of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-Targeting Theranostics, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Lu Gan
- National Center for International Research of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-Targeting Theranostics, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Tong Mo
- National Center for International Research of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-Targeting Theranostics, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Jintong Na
- National Center for International Research of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-Targeting Theranostics, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Jian He
- National Center for International Research of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-Targeting Theranostics, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Yong Huang
- National Center for International Research of Bio-Targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-Targeting Theranostics, Guangxi Medical University, Nanning, 530021, Guangxi, China.
- Guangxi Medical University, Nanning, 530021, Guangxi, China.
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6
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Wang J, Hu Y, Zhou X, Bao S, Chen Y, Ge M, Jia Z. A radiomics model based on DCE-MRI and DWI may improve the prediction of estimating IDH1 mutation and angiogenesis in gliomas. Eur J Radiol 2022; 147:110141. [PMID: 34995947 DOI: 10.1016/j.ejrad.2021.110141] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/30/2021] [Accepted: 12/28/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE To investigate the value of a radiomics model based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted imaging (DWI) in estimating isocitrate dehydrogenase 1 (IDH1) mutation and angiogenesis in gliomas. METHOD One hundred glioma patients with DCE-MRI and DWI were enrolled in this study (training and validation groups with a ratio of 7:3). The IDH1 genotypes and expression of vascular endothelial growth factor (VEGF) in gliomas were assessed by immunohistochemistry. Radiomics features were extracted by an open source software (3DSlicer) and reduced using Least absolute shrinkage and selection operator (Lasso). The support vector machine (SVM) model was developed based on the most useful predictive radiomics features. The conventional model was built by the selected clinical and morphological features. Finally, a combined model including radiomics signature, age and enhancement degree was established. Receiver operator characteristic (ROC) curve was implemented to assess the diagnostic performance of the three models. RESULTS For IDH1 mutation, the combined model achieved the highest area under curve (AUC) in comparison with the SVM and conventional models (training group, AUC = 0.967, 0.939 and 0.906; validation group, AUC = 0.909, 0.880 and 0.842). Furthermore, the SVM model showed good diagnostic performance in estimating gliomas VEGF expression (validation group, AUC = 0.919). CONCLUSIONS The radiomics model based on DCE-MRI and DWI can have a considerable effect on the evaluation of IDH1 mutation and angiogenesis in gliomas.
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Affiliation(s)
- Jie Wang
- Department of Medical Imaging, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Yue Hu
- Department of Medical Imaging, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xuejun Zhou
- Department of Medical Imaging, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Shanlei Bao
- Department of Medical Imaging, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
| | - Yue Chen
- Department of Medical Imaging, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Min Ge
- Department of Medical Imaging, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Zhongzheng Jia
- Department of Medical Imaging, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
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Liang H, Hu C, Lu J, Zhang T, Jiang J, Ding D, Du S, Duan S. Correlation of radiomic features on dynamic contrast-enhanced magnetic resonance with microvessel density in hepatocellular carcinoma based on different models. J Int Med Res 2021; 49:300060521997586. [PMID: 33682491 PMCID: PMC7944531 DOI: 10.1177/0300060521997586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective To explore the correlations of radiomic features of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with microvessel density (MVD) in patients with hepatocellular carcinoma (HCC), based on single-input and dual-input two-compartment extended Tofts (SITET and DITET) models. Methods We compared the quantitative parameters of SITET and DITET models for DCE-MRI in 30 patients with HCC using paired sample t-tests. The correlations of SITET and DITET model parameters with CD31-MVD and CD34-MVD were analyzed using Pearson’s correlation analysis. A diagnostic model of CD34-MVD was established and the diagnostic abilities of models for MVD were analyzed using receiver operating characteristic curve (ROC) analysis. Results There were significant differences between the quantitative parameters in the two kinds of models. Compared with SITET, DITET parameters showed better correlations with CD31-MVD and CD34-MVD. The Ktrans and Ve radiomics features of the DITET model showed high efficiency for predicting the level of CD34-MVD according to ROC analysis, with areas under curves of 0.83 and 0.94, respectively. Conclusion Compared with SITET, the DITET model provides a better indication of the microcirculation of HCC and is thus more suitable for examining patients with HCC.
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Affiliation(s)
- Hongwei Liang
- Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Medical Imaging, Soochow University, Suzhou, China.,Department of Radiology, Nantong Third People's Hospital, Nantong, China
| | - Chunhong Hu
- Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Medical Imaging, Soochow University, Suzhou, China
| | - Jian Lu
- Department of Radiology, Nantong Third People's Hospital, Nantong, China
| | - Tao Zhang
- Department of Radiology, Nantong Third People's Hospital, Nantong, China
| | - Jifeng Jiang
- Department of Radiology, Nantong Third People's Hospital, Nantong, China
| | - Ding Ding
- Department of Radiology, Nantong Third People's Hospital, Nantong, China
| | - Sheng Du
- Department of Radiology, Nantong Third People's Hospital, Nantong, China
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van Amerongen MJ, Vos AM, van der Woude W, Nagtegaal ID, de Wilt JHW, Fütterer JJ, Hermans JJ. Does perfusion computed tomography correlate to pathology in colorectal liver metastases? PLoS One 2021; 16:e0245764. [PMID: 33497385 PMCID: PMC7837475 DOI: 10.1371/journal.pone.0245764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/08/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Targeted therapy against tumor angiogenesis is widely used in clinical practice for patients with colorectal liver metastases (CRLM). Possible predictive biomarkers for tumor angiogenesis, such as, microvessel density (MVD), hypoxia and cell proliferation, can be determined using immunohistochemical staining. However, patients ineligible for surgical treatment need to undergo invasive diagnostic interventions in order to determine these biomarkers. CT perfusion (CTP) is an emerging functional imaging technique, which can non-invasively determine vascular properties of solid tumors. The purpose of this study was to evaluate CTP with histological biomarkers in CRLM. Material and methods Patients with CRLM underwent CTP one day before liver surgery. CTP analysis was performed on the entire volume of the largest metastases in each patient. Dual-input maximum slope analysis was used and data concerning arterial flow (AF), portal flow (PF) and perfusion index (PI) were recorded. Immunohistochemical staining with CD34, M75/CA-IX and MIB-1 was performed on the rim in the midsection of the tumor to determine respectively MVD, hypoxia and cell proliferation. Results Twenty CRLM in 20 patients were studied. Mean size of the largest CRLM was 37 mm (95% CI 21–54 mm). Mean AF and PF were respectively 64 ml/min/100ml (95% CI 48–79) and 30 ml/min/100ml (95% CI 22–38). Mean PI was 68% (95% CI 62–73). No significant correlation was found between tumor growth patterns and CTP (p = 0.95). MVD did not significantly correlate to AF (r = 0.05; p = 0.84), PF (r = 0.17; p = 0.47) and PI (r = -0.12; p = 0.63). Cell proliferation also did not significantly correlate to AF (r = 0.07; p = 0.78), PF (r = -0.01; p = 0.95) and PI (r = 0.15; p = 0.52). Hypoxia did not significantly correlate to AF (r = -0.05; p = 0.83), however, significantly to PF (r = 0.51; p = 0.02) and a trend to negative correlation with PF (r = -0.43; p = 0.06). However, after controlling the false discovery rate, no significant correlation between CTP and used immunohistochemical biomarkers was found. Conclusion In conclusion, this feasibility study found a trend to negative correlation between PI and hypoxia, CTP might therefore possibly evaluate this prognostic marker in CRLM non-invasively. However, CTP is not an appropriate technique for the assessment of microvessels or cell proliferation in CRLM.
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Affiliation(s)
- M. J. van Amerongen
- Department of Radiology and Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- * E-mail:
| | - A. M. Vos
- Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - W. van der Woude
- Department of Radiology and Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - I. D. Nagtegaal
- Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - J. H. W. de Wilt
- Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - J. J. Fütterer
- Department of Radiology and Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - J. J. Hermans
- Department of Radiology and Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Hu Y, Zhang N, Yu MH, Zhou XJ, Ge M, Shen DD, Hua Y, Shi JL, Jia ZZ. Volume-based histogram analysis of dynamic contrast-enhanced MRI for estimation of gliomas IDH1 mutation status. Eur J Radiol 2020; 131:109247. [PMID: 32891974 DOI: 10.1016/j.ejrad.2020.109247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/17/2020] [Accepted: 08/16/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The study aimed to investigate whether isocitrate dehydrogenase 1 (IDH1) mutation status in gliomas can be estimated by volume-based histogram analysis of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). MATERIALS AND METHODS Preoperative DCE-MRI data of 85 pathologically confirmed glioma patients including 33 carrying IDH1 mutant type (IDH1mut) and 52 with IDH1 wildtype (IDH1wt) were reviewed in a retrospective approach. Regions of interest (ROI) covering entire tumor volume were manually delineated using O.K. software (OmniKinetics, GE Healthcare, China). Histogram parameters of volume transfer constant (Ktrans) and volume of extravascular /extracellular space per unit volume of tissue (Ve) derived from DCE-MRI were obtained. Mann-Whitney U tests were made to compare the differences in histogram parameters of Ktrans and Ve between IDH1mut and IDH1wt in all gliomas and high-grade gliomas (HGGs, grade III and IV). Receiver operator characteristic (ROC) analysis were implemented to assess the diagnostic performance. RESULTS In histogram parameters of Ktrans and Ve, pairwise comparisons demonstrated statistically significant differences in mean, standard deviation (SD), 90th and 95th percentiles (90%, 95%) values between IDH1mut and IDH1wt in all cases of gliomas and HGGs (P < 0.05, respectively). The ROC analysis revealed that the cut-off values of 95% value of Ktrans (0.097 min-1) and mean value of Ve (0.099) provided the best combination of sensitivity and specificity to distinguish all gliomas with IDH1mut from IDH1wt. In HGGs, the cut-off values of mean value of Ktrans and Ve (0.044 min-1, 0.099) played similar role. CONCLUSION Volume-based histogram analysis of DCE-MRI performs well in identification of IDH1mut gliomas.
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Affiliation(s)
- Yue Hu
- Department of Medical Imaging, Affiliated Hospital of Nantong University, NO. 20 Xisi Road Nantong 226001, Jiangsu, People's Republic of China.
| | - Ni Zhang
- Department of Medical Imaging, Affiliated Hospital of Nantong University, NO. 20 Xisi Road Nantong 226001, Jiangsu, People's Republic of China.
| | - Min Hao Yu
- Department of Medical Imaging, Affiliated Hospital of Nantong University, NO. 20 Xisi Road Nantong 226001, Jiangsu, People's Republic of China.
| | - Xue Jun Zhou
- Department of Medical Imaging, Affiliated Hospital of Nantong University, NO. 20 Xisi Road Nantong 226001, Jiangsu, People's Republic of China.
| | - Min Ge
- Department of Medical Imaging, Affiliated Hospital of Nantong University, NO. 20 Xisi Road Nantong 226001, Jiangsu, People's Republic of China.
| | - Dan Dan Shen
- Department of Medical Imaging, Affiliated Hospital of Nantong University, NO. 20 Xisi Road Nantong 226001, Jiangsu, People's Republic of China.
| | - Ye Hua
- Department of Medical Imaging, Affiliated Hospital of Nantong University, NO. 20 Xisi Road Nantong 226001, Jiangsu, People's Republic of China.
| | - Jin Long Shi
- Department of Neurosurgery, Affiliated Hospital of Nantong University, NO. 20 Xisi Road, Nantong 226001, Jiangsu, People's Republic of China.
| | - Zhong Zheng Jia
- Department of Medical Imaging, Affiliated Hospital of Nantong University, NO. 20 Xisi Road Nantong 226001, Jiangsu, People's Republic of China.
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Wang H, Hu Y, Li H, Xie Y, Wang X, Wan W. Preliminary study on identification of estrogen receptor-positive breast cancer subtypes based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) texture analysis. Gland Surg 2020; 9:622-628. [PMID: 32775251 DOI: 10.21037/gs.2020.04.01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Currently, breast cancer is divided into Luminal A, Luminal B, HER-2 overexpression (HER-2) and basal cell at genetic level. However, the differential diagnosis of estrogen receptor (ER)-positive breast cancer subtypes is rare. Therefore, we aimed to investigate the feasibility of identifying the ER-positive breast cancer subtypes based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) texture analysis. Methods A retrospective analysis was performed for clinical data of 51 patients with ER-positive breast invasive ductal carcinoma confirmed by surgery and pathology from January 20 to October 2018. FireVoxel texture analysis software was used to delineate the tumor boundary layer by layer. The differences in the above characteristics between Luminal A and Luminal B breast cancer were compared, and the diagnostic efficacy of statistically significant texture parameters for ER-positive breast cancer subtypes was analyzed. Results There were no significant differences in mean, standard deviation (SD), skewness and tumor size between Luminal A and Luminal B groups (P>0.05). The kurtosis, inhomogeneity and entropy could effectively distinguish between the two groups with statistically significant difference (P=0.001, P=0.000, and P=0.000). The area under the receiver operating characteristic (ROC) curve (AUC) of kurtosis, inhomogeneity and entropy diagnosed with malignant mass were 0.832, 0.859 and 0.891, respectively (P<0.01). In addition, the entropy was the best among the three indicators. When the entropy was ≤4.22, the sensitivity of the diagnosis Luminal B was 90.62% and the specificity was 78.95%. Conclusions The texture analysis features based on DCE-MRI can help to identify ER-positive breast cancer subtypes. Entropy can be the best single texture indicator.
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Affiliation(s)
- Hui Wang
- Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yunting Hu
- Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Hui Li
- Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yuanliang Xie
- Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiang Wang
- Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Weijia Wan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Meyer HJ, Hamerla G, Leifels L, Höhn AK, Surov A. Histogram analysis parameters derived from DCE-MRI in head and neck squamous cell cancer – Associations with microvessel density. Eur J Radiol 2019; 120:108669. [DOI: 10.1016/j.ejrad.2019.108669] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 09/04/2019] [Accepted: 09/10/2019] [Indexed: 01/21/2023]
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Macrovascular Networks on Contrast-Enhanced Magnetic Resonance Imaging Improves Survival Prediction in Newly Diagnosed Glioblastoma. Cancers (Basel) 2019; 11:cancers11010084. [PMID: 30646519 PMCID: PMC6356693 DOI: 10.3390/cancers11010084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 12/17/2018] [Accepted: 12/20/2018] [Indexed: 12/30/2022] Open
Abstract
A higher degree of angiogenesis is associated with shortened survival in glioblastoma. Feasible morphometric parameters for analyzing vascular networks in brain tumors in clinical practice are lacking. We investigated whether the macrovascular network classified by the number of vessel-like structures (nVS) visible on three-dimensional T1-weighted contrast–enhanced (3D-T1CE) magnetic resonance imaging (MRI) could improve survival prediction models for newly diagnosed glioblastoma based on clinical and other imaging features. Ninety-seven consecutive patients (62 men; mean age, 58 ± 15 years) with histologically proven glioblastoma underwent 1.5T-MRI, including anatomical, diffusion-weighted, dynamic susceptibility contrast perfusion, and 3D-T1CE sequences after 0.1 mmol/kg gadobutrol. We assessed nVS related to the tumor on 1-mm isovoxel 3D-T1CE images, and relative cerebral blood volume, relative cerebral flow volume (rCBF), delay mean time, and apparent diffusion coefficient in volumes of interest for contrast-enhancing lesion (CEL), non-CEL, and contralateral normal-appearing white matter. We also assessed Visually Accessible Rembrandt Images scoring system features. We used ROC curves to determine the cutoff for nVS and univariate and multivariate cox proportional hazards regression for overall survival. Prognostic factors were evaluated by Kaplan-Meier survival and ROC analyses. Lesions with nVS > 5 were classified as having highly developed macrovascular network; 58 (60.4%) tumors had highly developed macrovascular network. Patients with highly developed macrovascular network were older, had higher volumeCEL, increased rCBFCEL, and poor survival; nVS correlated negatively with survival (r = −0.286; p = 0.008). On multivariate analysis, standard treatment, age at diagnosis, and macrovascular network best predicted survival at 1 year (AUC 0.901, 83.3% sensitivity, 93.3% specificity, 96.2% PPV, 73.7% NPV). Contrast-enhanced MRI macrovascular network improves survival prediction in newly diagnosed glioblastoma.
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van Dijken BR, van Laar PJ, Smits M, Dankbaar JW, Enting RH, van der Hoorn A. Perfusion MRI in treatment evaluation of glioblastomas: Clinical relevance of current and future techniques. J Magn Reson Imaging 2019; 49:11-22. [PMID: 30561164 PMCID: PMC6590309 DOI: 10.1002/jmri.26306] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 07/30/2018] [Indexed: 12/22/2022] Open
Abstract
Treatment evaluation of patients with glioblastomas is important to aid in clinical decisions. Conventional MRI with contrast is currently the standard method, but unable to differentiate tumor progression from treatment-related effects. Pseudoprogression appears as new enhancement, and thus mimics tumor progression on conventional MRI. Contrarily, a decrease in enhancement or edema on conventional MRI during antiangiogenic treatment can be due to pseudoresponse and is not necessarily reflective of a favorable outcome. Neovascularization is a hallmark of tumor progression but not for posttherapeutic effects. Perfusion-weighted MRI provides a plethora of additional parameters that can help to identify this neovascularization. This review shows that perfusion MRI aids to identify tumor progression, pseudoprogression, and pseudoresponse. The review provides an overview of the most applicable perfusion MRI methods and their limitations. Finally, future developments and remaining challenges of perfusion MRI in treatment evaluation in neuro-oncology are discussed. Level of Evidence: 3 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2019;49:11-22.
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Affiliation(s)
- Bart R.J. van Dijken
- Department of Radiology, Medical Imaging Center (MIC)University Medical Center GroningenGroningenthe Netherlands
| | - Peter Jan van Laar
- Department of Radiology, Medical Imaging Center (MIC)University Medical Center GroningenGroningenthe Netherlands
| | - Marion Smits
- Department of Radiology and Nuclear MedicineErasmus Medical CenterRotterdamthe Netherlands
| | - Jan Willem Dankbaar
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Roelien H. Enting
- Department of NeurologyUniversity Medical Center GroningenGroningenthe Netherlands
| | - Anouk van der Hoorn
- Department of Radiology, Medical Imaging Center (MIC)University Medical Center GroningenGroningenthe Netherlands
- Brain Tumour Imaging Group, Division of Neurosurgery, Department of Clinical NeurosciencesUniversity of Cambridge and Addenbrooke's HospitalCambridgeUK
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IDH1 mutation is associated with lower expression of VEGF but not microvessel formation in glioblastoma multiforme. Oncotarget 2018; 9:16462-16476. [PMID: 29662659 PMCID: PMC5893254 DOI: 10.18632/oncotarget.24536] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 02/10/2018] [Indexed: 12/18/2022] Open
Abstract
Introduction Glioblastoma multiforme (GBM) represents the most malignant primary brain tumor characterized by pathological vascularization. Mutations in isocitrate dehydrogenases 1 and 2 (IDH1 and IDH2) were observed in GBM. We aimed to assess the intra-tumor hypoxia, angiogenesis and microvessel formation in GBM and to find their associations with IDH1 mutation status and patients prognosis. Methods 52 patients with a diagnosis of GBM were included into the study. IDH1 R132H mutation was assessed by RT-PCR from FFPE tumor samples obtained during surgery. The expression of markers of hypoxia (HIF2α), angiogenesis (VEGF), tumor microvascularity (CD31, CD34, vWF, CD105), and proliferation (Ki-67) were assessed immunohistochemically (IHC). IDH1 mutation and IHC markers were correlated with the patient survival. Results 20 from 52 GBM tumor samples comprised IDH1 R132H mutation (38.5%). The majority of mutated tumors were classified as secondary glioblastomas (89.9%). Patients with IDH1 mutated tumors experienced better progression-free survival (P = 0.037) as well as overall survival (P = 0.035) compared with wild type tumors. The significantly lower expression of VEGF was observed in GBM with IDH1 mutation than in wild type tumors (P = 0.01). No such association was found for microvascular markers. The increased expression of newly-formed microvessels (ratio CD105/CD31) in tumor samples was associated with worse patient’s progression-free survival (P = 0.026). Summary No increase in HIF/VEGF-mediated angiogenesis was observed in IDH1-mutated GBM compared with IDH1 wild type tumors. The histological assessment of the portion of newly-formed microvessels in tumor tissue can be used for the prediction of GBM patient’s prognosis.
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