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Le Bihan D. From Brownian motion to virtual biopsy: a historical perspective from 40 years of diffusion MRI. Jpn J Radiol 2024; 42:1357-1371. [PMID: 39289243 PMCID: PMC11588775 DOI: 10.1007/s11604-024-01642-z] [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: 07/15/2024] [Accepted: 08/07/2024] [Indexed: 09/19/2024]
Abstract
Diffusion MRI was introduced in 1985, showing how the diffusive motion of molecules, especially water, could be spatially encoded with MRI to produce images revealing the underlying structure of biologic tissues at a microscopic scale. Diffusion is one of several Intravoxel Incoherent Motions (IVIM) accessible to MRI together with blood microcirculation. Diffusion imaging first revolutionized the management of acute cerebral ischemia by allowing diagnosis at an acute stage when therapies can still work, saving the outcomes of many patients. Since then, the field of diffusion imaging has expanded to the whole body, with broad applications in both clinical and research settings, providing insights into tissue integrity, structural and functional abnormalities from the hindered diffusive movement of water molecules in tissues. Diffusion imaging is particularly used to manage many neurologic disorders and in oncology for detecting and classifying cancer lesions, as well as monitoring treatment response at an early stage. The second major impact of diffusion imaging concerns the wiring of the brain (Diffusion Tensor Imaging, DTI), allowing to obtain from the anisotropic movement of water molecules in the brain white-matter images in 3 dimensions of the brain connections making up the Connectome. DTI has opened up new avenues of clinical diagnosis and research to investigate brain diseases, neurogenesis and aging, with a rapidly extending field of application in psychiatry, revealing how mental illnesses could be seen as Connectome spacetime disorders. Adding that water diffusion is closely associated to neuronal activity, as shown from diffusion fMRI, one may consider that diffusion MRI is ideally suited to investigate both brain structure and function. This article retraces the early days and milestones of diffusion MRI which spawned over 40 years, showing how diffusion MRI emerged and expanded in the research and clinical fields, up to become a pillar of modern clinical imaging.
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Affiliation(s)
- Denis Le Bihan
- NeuroSpin, CEA, Paris-Saclay University, Bât 145, CEA-Saclay Center, 91191, Gif-sur-Yvette, France.
- Human Brain Research Center, Kyoto University, Kyoto, Japan.
- Department of System Neuroscience, National Institutes for Physiological Sciences, Okazaki, Japan.
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Ma M, Cheng J, Li X, Fan Z, Wang C, Reeder SB, Hernando D. Prediction of MRI R 2 * $$ {\mathrm{R}}_2^{\ast } $$ relaxometry in the presence of hepatic steatosis by Monte Carlo simulations. NMR IN BIOMEDICINE 2024:e5274. [PMID: 39394902 DOI: 10.1002/nbm.5274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 09/14/2024] [Accepted: 09/30/2024] [Indexed: 10/14/2024]
Abstract
To develop Monte Carlo simulations to predict the relationship ofR 2 * $$ {\mathrm{R}}_2^{\ast } $$ with liver fat content at 1.5 T and 3.0 T. For various fat fractions (FFs) from 1% to 25%, four types of virtual liver models were developed by incorporating the size and spatial distribution of fat droplets. Magnetic fields were then generated under different fat susceptibilities at 1.5 T and 3.0 T, and proton movement was simulated for phase accrual and MRI signal synthesis. The synthesized signal was fit to single-peak and multi-peak fat signal models forR 2 * $$ {\mathrm{R}}_2^{\ast } $$ and proton density fat fraction (PDFF) predictions. In addition, the relationships betweenR 2 * $$ {\mathrm{R}}_2^{\ast } $$ and PDFF predictions were compared with in vivo calibrations and Bland-Altman analysis was performed to quantitatively evaluate the effects of these components (type of virtual liver model, fat susceptibility, and fat signal model) onR 2 * $$ {\mathrm{R}}_2^{\ast } $$ predictions. A virtual liver model with realistic morphology of fat droplets was demonstrated, andR 2 * $$ {\mathrm{R}}_2^{\ast } $$ and PDFF values were predicted by Monte Carlo simulations at 1.5 T and 3.0 T.R 2 * $$ {\mathrm{R}}_2^{\ast } $$ predictions were linearly correlated with PDFF, while the slope was unaffected by the type of virtual liver model and increased as fat susceptibility increased. Compared with in vivo calibrations, the multi-peak fat signal model showed superior performance to the single-peak fat signal model, which yielded an underestimation of liver fat. TheR 2 * $$ {\mathrm{R}}_2^{\ast } $$ -PDFF relationships by simulations with fat susceptibility of 0.6 ppm and the multi-peak fat signal model wereR 2 * = 0.490 × PDFF + 28.0 $$ {\mathrm{R}}_2^{\ast }=0.490\times \mathrm{PDFF}+28.0 $$ (R 2 = 0.967 $$ {R}^2=0.967 $$ ,p < 0.01 $$ p<0.01 $$ ) at 1.5 T andR 2 * = 0.928 × PDFF + 39.4 $$ {\mathrm{R}}_2^{\ast }=0.928\times \mathrm{PDFF}+39.4 $$ (R 2 = 0.972 $$ {R}^2=0.972 $$ ,p < 0.01 $$ p<0.01 $$ ) at 3.0 T. Monte Carlo simulations provide a new means forR 2 * $$ {\mathrm{R}}_2^{\ast } $$ -PDFF prediction, which is primarily determined by fat susceptibility, fat signal model, and magnetic field strength. AccurateR 2 * $$ {\mathrm{R}}_2^{\ast } $$ -PDFF calibration has the potential to correct the effect of fat onR 2 * $$ {\mathrm{R}}_2^{\ast } $$ quantification, and may be helpful for accurateR 2 * $$ {\mathrm{R}}_2^{\ast } $$ measurements in liver iron overload. In this study, a Monte Carlo simulation of hepatic steatosis was developed to predict the relationship betweenR 2 * $$ {\mathrm{R}}_2^{\ast } $$ and PDFF. Furthermore, the effects of fat droplet morphology, fat susceptibility, fat signal model, and magnetic field strength were evaluated for theR 2 * $$ {\mathrm{R}}_2^{\ast } $$ -PDFF calibration. Our results suggest that Monte Carlo simulations provide a new means forR 2 * $$ {\mathrm{R}}_2^{\ast } $$ -PDFF prediction and this means can be easily generated for various regimes, such as simulations with higher fields and different echo times, as well as correction of magnetic susceptibility measurements for liver iron quantification.
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Affiliation(s)
- Mengyuan Ma
- School of Biomedical Engineering, Anhui Medical University, Hefei, China
| | - Junying Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoben Li
- School of Biomedical Engineering, Anhui Medical University, Hefei, China
| | - Zhuangzhuang Fan
- School of Biomedical Engineering, Anhui Medical University, Hefei, China
| | - Changqing Wang
- School of Biomedical Engineering, Anhui Medical University, Hefei, China
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Scott B Reeder
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
- Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
- Department of Emergency Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Diego Hernando
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
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Van AT, McTavish S, Peeters JM, Weiss K, Makowski MR, Braren RF, Karampinos DC. Motion-induced phase-corrected homodyne reconstruction for partial Fourier single-shot diffusion-weighted echo planar imaging of the liver. NMR IN BIOMEDICINE 2024; 37:e5147. [PMID: 38561247 DOI: 10.1002/nbm.5147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 04/04/2024]
Abstract
Partial Fourier encoding is popular in single-shot (ss) diffusion-weighted (DW) echo planar imaging (EPI) because it enables a shorter echo time (TE) and, hence, improves the signal-to-noise-ratio. Motion during diffusion encoding causes k-space shifting and dispersion, which compromises the quality of the homodyne reconstruction. This work provides a comprehensive understanding of the artifacts in homodyne reconstruction of partial Fourier ss-DW-EPI data in the presence of motion-induced phase and proposes the motion-induced phase-corrected homodyne (mpc-hdyne) reconstruction method to ameliorate these artifacts. Simulations with different types of motion-induced phase were performed to provide an understanding of the potential artifacts that occur in the homodyne reconstruction of partial Fourier ss-DW-EPI data. To correct for the artifacts, the mpc-hdyne reconstruction is proposed. The algorithm recenters k-space, updates the partial Fourier factor according to detected global k-space shifts, and removes low-resolution nonlinear phase before the conventional homodyne reconstruction. The mpc-hdyne reconstruction is tested on both simulation and in vivo data. Motion-induced phase can cause signal overestimation, worm artifacts, and signal loss in partial Fourier ss-DW-EPI data with the conventional homodyne reconstruction. Simulation and in vivo data showed that the proposed mpc-hdyne reconstruction ameliorated artifacts, yielding higher quality DW images compared with conventional homodyne reconstruction. Based on the understanding of the artifacts in homodyne reconstruction of partial Fourier ss-DW-EPI data, the mpc-hdyne reconstruction was proposed and showed superior performance compared with the conventional homodyne reconstruction on both simulation and in vivo data.
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Affiliation(s)
- Anh T Van
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Sean McTavish
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | | | | | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Rickmer F Braren
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
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Wang Q, Yu G, Qiu J, Lu W. Application of Intravoxel Incoherent Motion in Clinical Liver Imaging: A Literature Review. J Magn Reson Imaging 2024; 60:417-440. [PMID: 37908165 DOI: 10.1002/jmri.29086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 11/02/2023] Open
Abstract
Intravoxel incoherent motion (IVIM) modeling is a widely used double-exponential model for describing diffusion-weighted imaging (DWI) signal, with a slow component related to pure molecular diffusion and a fast component associated with microcirculatory perfusion, which compensates for the limitations of traditional DWI. IVIM is a noninvasive technique for obtaining liver pathological information and characterizing liver lesions, and has potential applications in the initial diagnosis and treatment monitoring of liver diseases. Recent studies have demonstrated that IVIM-derived parameters are useful for evaluating liver lesions, including nonalcoholic fatty liver disease (NAFLD), liver fibrosis and liver tumors. However, the results are not stable. Therefore, it is necessary to summarize the current applications of IVIM in liver disease research, identify existing shortcomings, and point out the future development direction. In this review, we searched for studies related to hepatic IVIM-DWI applications over the past two decades in the PubMed database. We first introduce the fundamental principles and influential factors of IVIM, and then discuss its application in NAFLD, liver fibrosis, and focal hepatic lesions. It has been found that IVIM is still unstable in ensuring the robustness and reproducibility of measurements in the assessment of liver fibrosis grade and liver tumors differentiation, due to inconsistent and substantial overlap in the range of IVIM-derived parameters for different fibrotic stages. In the end, the future direction of IVIM-DWI in the assessment of liver diseases is discussed, emphasizing the need for further research on the stability of IVIM-derived parameters, particularly perfusion-related parameters, in order to promote the clinical practice of IVIM-DWI. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Qi Wang
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Guanghui Yu
- Department of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Weizhao Lu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
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Shrestha U, Esparza JP, Satapathy SK, Vanatta JM, Abramson ZR, Tipirneni-Sajja A. Hepatic steatosis modeling and MRI signal simulations for comparison of single- and dual-R2* models and estimation of fat fraction at 1.5T and 3T. Comput Biol Med 2024; 174:108448. [PMID: 38626508 DOI: 10.1016/j.compbiomed.2024.108448] [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: 12/07/2023] [Revised: 03/06/2024] [Accepted: 04/07/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND AND OBJECTIVE Magnetic resonance imaging (MRI) has emerged as a noninvasive clinical tool for assessment of hepatic steatosis. Multi-spectral fat-water MRI models, incorporating single or dual transverse relaxation decay rate(s) (R2*) have been proposed for accurate fat fraction (FF) estimation. However, it is still unclear whether single- or dual-R2* model accurately mimics in vivo signal decay for precise FF estimation and the impact of signal-to-noise ratio (SNR) on each model performance. Hence, this study aims to construct virtual steatosis models and synthesize MRI signals with different SNRs to systematically evaluate the accuracy of single- and dual-R2* models for FF and R2* estimations at 1.5T and 3.0T. METHODS Realistic hepatic steatosis models encompassing clinical FF range (0-60 %) were created using morphological features of fat droplets (FDs) extracted from human liver biopsy samples. MRI signals were synthesized using Monte Carlo simulations for noise-free (SNRideal) and varying SNR conditions (5-100). Fat-water phantoms were scanned with different SNRs to validate simulation results. Fat water toolbox was used to calculate R2* and FF for both single- and dual-R2* models. The model accuracies in R2* and FF estimates were analyzed using linear regression, bias plot and heatmap analysis. RESULTS The virtual steatosis model closely mimicked in vivo fat morphology and Monte Carlo simulation produced realistic MRI signals. For SNRideal and moderate-high SNRs, water R2* (R2*W) by dual-R2* and common R2* (R2*com) by single-R2* model showed an excellent agreement with slope close to unity (0.95-1.01) and R2 > 0.98 at both 1.5T and 3.0T. In simulations, the R2*com-FF and R2*W-FF relationships exhibited slopes similar to in vivo calibrations, confirming the accuracy of our virtual models. For SNRideal, fat R2* (R2*F) was similar to R2*W and dual-R2* model showed slightly higher accuracy in FF estimation. However, in the presence of noise, dual-R2* produced higher FF bias with decreasing SNR, while leading to only marginal improvement for high SNRs and in regions dominated by fat and water. In contrast, single-R2* model was robust and produced accurate FF estimations in simulations and phantom scans with clinical SNRs. CONCLUSION Our study demonstrates the feasibility of creating virtual steatosis models and generating MRI signals that mimic in vivo morphology and signal behavior. The single-R2* model consistently produced lower FF bias for clinical SNRs across entire FF range compared to dual-R2* model, hence signifying that single-R2* model is optimal for assessing hepatic steatosis.
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Affiliation(s)
- Utsav Shrestha
- Department of Biomedical Engineering, The University of Memphis, Memphis, TN, USA; Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Juan P Esparza
- Department of Biomedical Engineering, The University of Memphis, Memphis, TN, USA
| | - Sanjaya K Satapathy
- Department of Medicine, Division of Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra, Hempstead, NY, USA; Northwell Health Center for Liver Diseases & Transplantation, North Shore University Hospital, Manhasset, NY, USA
| | - Jason M Vanatta
- Department of Surgery, University of Tennessee Health and Science Center, Memphis, TN, USA
| | - Zachary R Abramson
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Aaryani Tipirneni-Sajja
- Department of Biomedical Engineering, The University of Memphis, Memphis, TN, USA; Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA.
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Maruyama M, Yoshizako T, Aso H, Maruyama M, Araki H, Yoshida R, Ando S, Nakamura M, Kaji Y. Evaluation of Local Vascular Perfusion in the Lower Extremities on Intravoxel Incoherent Motion Imaging before and after Endovascular Therapy. Cardiovasc Intervent Radiol 2024; 47:494-502. [PMID: 38446209 DOI: 10.1007/s00270-024-03672-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/23/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE To evaluate improvement in local vascular perfusion of the lower limbs on intravoxel incoherent motion (IVIM) imaging after endovascular therapy (EVT). MATERIALS AND METHODS IVIM imaging was performed on 20 lower limbs of 16 patients with lower extremity arterial diseases before and after EVT. To estimate IVIM, diffusion-weighted lower-limb axial images (number of slices = 25 and slice thickness = 3.5 mm) were acquired using different b values (0, 300, and 1000 s/mm2). IVIM imaging with the simplified IVIM techniques was performed. The perfusion-related coefficient (D* [10-3 mm2/s]), perfusion fraction (f [%]), and D*f product (10-3 mm2/s %) were calculated before and 2-3 days after EVT. The ankle brachial index (ABI), mean D* (10-3 mm2/s), mean f (%), and mean D*f product (10-3 mm2/s %) before and after EVT were compared. RESULTS Successful revascularization was achieved in all cases. After EVT, the mean ABI significantly increased from 0.59 ± 0.19 to 0.87 ± 0.15 (p < 0.001, paired t test). The mean D* (10-3 mm2/s) (22.08 ± 3.26 versus 24.87 ± 2.65, p = 0.005, paired t test), and D*f product (10-3 mm2/s%) (551.03 ± 79.02 versus 634.55 ± 76.96, p = 0.002, paired t-test) of the lower limbs significantly increased after EVT, whereas f (%) (25.00 ± 1.28 versus 25.52 ± 1.61, p = 0.261, paired t-test) did not significantly increased after EVT. CONCLUSION D* (10-3 mm2/s) and D*f product (10-3 mm2/s %) on IVIM imaging could evaluate improvement in local vascular perfusion of the lower limbs after EVT. LEVEL OF EVIDENCE Level 4, Case Series.
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Affiliation(s)
- Mitsunari Maruyama
- Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya Cho, P.O. Box 00693-8501, Izumo, Japan.
| | - Takeshi Yoshizako
- Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya Cho, P.O. Box 00693-8501, Izumo, Japan
| | - Hiroya Aso
- Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya Cho, P.O. Box 00693-8501, Izumo, Japan
| | - Minako Maruyama
- Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya Cho, P.O. Box 00693-8501, Izumo, Japan
| | - Hisatoshi Araki
- Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya Cho, P.O. Box 00693-8501, Izumo, Japan
| | - Rika Yoshida
- Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya Cho, P.O. Box 00693-8501, Izumo, Japan
| | - Shinji Ando
- Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya Cho, P.O. Box 00693-8501, Izumo, Japan
| | - Megumi Nakamura
- Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya Cho, P.O. Box 00693-8501, Izumo, Japan
| | - Yasushi Kaji
- Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya Cho, P.O. Box 00693-8501, Izumo, Japan
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Tunlayadechanont P, Panyaping T, Chansakul T, Hirunpat P, Kampaengtip A. Intravoxel incoherent motion for differentiating residual/recurrent tumor from post-treatment change in patients with high-grade glioma. Neuroradiol J 2023; 36:657-664. [PMID: 37105183 PMCID: PMC10649527 DOI: 10.1177/19714009231173108] [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] [Indexed: 04/29/2023] Open
Abstract
PURPOSE To investigate the diagnostic value of f derived from IVIM technique and to correlate it with rCBV derived from DSC for the differentiation of residual/recurrent tumor from post-treatment change in patients with high-grade glioma. MATERIALS AND METHODS Patients who underwent MR imaging with IVIM and DSC studies for evaluation of high-grade glioma after standard treatment were enrolled in this retrospective study. For qualitative analysis, the f and rCBV maps were interpreted as hypoperfused or hyperperfused in each parameter. Quantitative analysis was performed using ROI analysis in f and rCBV parameters. The lesions were divided into residual/recurrent tumor and post-treatment change groups. RESULTS Nineteen patients with high-grade glioma were included. In qualitative analysis, the f-map shows higher sensitivity (100.0%) than rCBV map (92.3%), while the rCBV map shows higher specificity (100.0%) than the f-map (83.3%). In quantitative analysis, the optimal cutoff values of 1.19 for f and 1.06 for rCBV are shown to provide high diagnostic value with high sensitivity (91.7%) for both parameters but slightly higher specificity of rCBV (85.7%) than f (71.4%). The correlation between f and rCBV was good with ICC of 0.810. CONCLUSION The f value measured by IVIM technique, non-contrast perfusion technique, has high diagnostic performance and potential to be an alternative method to CBV measured by DSC for differentiation between residual/recurrent tumor and post-treatment change in patients with high-grade glioma.
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Affiliation(s)
- Padcha Tunlayadechanont
- Division of Neurological Radiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Theeraphol Panyaping
- Division of Neurological Radiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Thanissara Chansakul
- Division of Neurological Radiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pornrujee Hirunpat
- Division of Neurological Radiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Adun Kampaengtip
- Division of Neurological Radiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Zhang S, Guo Q, Yang Y, Feng H, Zhao Y, Guo P, Li D, Du X, Song Q. Feasibility Study of 3D FACT and IVIM Sequences in the Evaluation of Female Osteoporosis. Bioengineering (Basel) 2023; 10:710. [PMID: 37370641 DOI: 10.3390/bioengineering10060710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The aim of this study is to search for the predictive value of 3D fat analysis and calculation technique (FACT) and intravoxel incoherent motion (IVIM) parameters in identifying osteoporosis in women. METHODS We enrolled 48 female subjects who underwent 3.0 T MRI, including 3D FACT and IVIM sequences. Bone mineral density (BMD) values and Fracture Risk Assessment (FRAX) scores were obtained. Proton density fat fraction (PDFF) in the bone marrow and the real diffusion (D) value of intervertebral discs were measured on 3D FACT and IVIM images, respectively. Accuracy and bias were assessed by linear regression analysis and Bland-Altman plots. Intraclass correlation coefficients were used to assess the measurements' reproducibility. Spearman's rank correlation was applied to explore the correlation. MRI-based parameters were tested for significant differences among the three groups using ANOVA analyses. A receiver operating characteristic (ROC) analysis was performed. RESULTS The PDFF of the vertebral body showed a negative correlation with BMD (R = -0.393, p = 0.005) and a positive correlation with the FRAX score (R = 0.706, p < 0.001). The D value of intervertebral discs showed a positive correlation with BMD (R = 0.321, p = 0.024) and a negative correlation with the FRAX score (R = -0.334, p = 0.019). The area under the curve values from the ROC analysis showed that the 3D FACT and IVIM sequences could accurately differentiate between normal and osteoporosis (AUC = 0.88 using the PDFF; AUC = 0.77 using the D value). The PDFF value demonstrated a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 78.6%, 89.5%, 84.6%, and 85.0%, respectively, in its ability to predict osteoporosis. The D value had a sensitivity, specificity, PPV, and NPV of 63.16%, 92.9%, 65.0%, and 77.8%, respectively, for predicting osteoporosis. CONCLUSIONS The 3D FACT- and IVIM-measured PDFF and D values are promising biomarkers in the assessment of bone quality and fracture risk.
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Affiliation(s)
- Shuo Zhang
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Qianrui Guo
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Yang Yang
- Beijing United Imaging Research Institute of Intelligent Imaging, Beijing 100094, China
| | - Hongbo Feng
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Yan Zhao
- Department of Information Center, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Peng Guo
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Di Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Xuemei Du
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Qingwei Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
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Fowler KJ. Gastrointestinal Imaging: What Has Shaped and What Will Shape Our Field Going Forward. Radiology 2023; 307:e223251. [PMID: 36916893 DOI: 10.1148/radiol.223251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Affiliation(s)
- Kathryn J Fowler
- From the Department of Diagnostic Radiology, Division of Body Imaging, University of California-San Diego, 6206 Lakewood St, San Diego, CA 92122
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10
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Maruyama M, Aso H, Araki H, Yoshida R, Ando S, Nakamura M, Yoshizako T. Improvement in local vascular perfusion of the lower extremities on intravoxel incoherent motion imaging: A case report. Radiol Case Rep 2022; 17:4319-4322. [PMID: 36132059 PMCID: PMC9483734 DOI: 10.1016/j.radcr.2022.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/06/2022] [Accepted: 08/10/2022] [Indexed: 11/07/2022] Open
Abstract
Intravoxel incoherent motion imaging has its improvement-evaluating ability in lower limb perfusion after endovascular therapy in individuals with lower extremity arterial disease. Here, we present a 70-year-old man with intermittent claudication of the left lower limb, whose microperfusion on intravoxel incoherent motion imaging improved after endovascular therapy. The patient underwent intravoxel incoherent motion imaging of the lower extremities pre- and postendovascular therapy. After endovascular therapy, the left ankle brachial index increased from 0.46 to 1.06. The mean perfusion-related coefficient (10−3 mm2/s) of the left lower limb increased from 19.70 ± 3.17 to 24.81 ± 3.41, and mean perfusion fraction (%) of the left lower limb slightly increased from 24.41 ± 0.96% to 25.20 ± 1.89% after endovascular therapy. Therefore, successful revascularization can improve microperfusion on intravoxel incoherent motion imaging in a patient with lower extremity arterial disease.
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Zhou Y, Zheng J, Yang C, Peng J, Liu N, Yang L, Zhang XM. Application of intravoxel incoherent motion diffusion-weighted imaging in hepatocellular carcinoma. World J Gastroenterol 2022; 28:3334-3345. [PMID: 36158259 PMCID: PMC9346463 DOI: 10.3748/wjg.v28.i27.3334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/26/2022] [Accepted: 06/26/2022] [Indexed: 02/06/2023] Open
Abstract
The morbidity and mortality of hepatocellular carcinoma (HCC) rank 6th and 4th, respectively, among malignant tumors worldwide. Traditional diffusion-weighted imaging (DWI) uses the apparent diffusion coefficient (ADC) obtained by applying the monoexponential model to reflect water molecule diffusion in active tissue; however, the value of ADC is affected by microcirculation perfusion. Using a biexponential model, intravoxel incoherent motion (IVIM)-DWI quantitatively measures information related to pure water molecule diffusion and microcirculation perfusion, thus compensating for the shortcomings of DWI. The number of studies examining the application of IVIM-DWI in patients with HCC has gradually increased over the last few years, and many results show that IVIM-DWI has vital value for HCC differentiation, pathological grading, and predicting and evaluating the treatment response. The present study principally reviews the principle of IVIM-DWI and its research progress in HCC differentiation, pathological grading, predicting and evaluating the treatment response, predicting postoperative recurrence and predicting gene expression prediction.
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Affiliation(s)
- Yi Zhou
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Medical Research Center, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
- Department of Radiology, People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China
| | - Jing Zheng
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Medical Research Center, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Cui Yang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Medical Research Center, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
- Department of Radiology, Panzhihua Central Hospital, Panzhihua 617000, Sichuan Province, China
| | - Juan Peng
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Medical Research Center, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
- Department of Radiology, Sichuan Provincial People's Hospital Jinniu Hospital, Chengdu Jinniu District People's Hospital, Chengdu 610007, Sichuan Province, China
| | - Ning Liu
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Medical Research Center, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Lin Yang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Medical Research Center, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xiao-Ming Zhang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Medical Research Center, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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Value of Intravoxel Incoherent Motion (IVIM) Imaging for Differentiation between Intrahepatic Cholangiocarcinoma and Hepatocellular Carcinoma. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:1504463. [PMID: 35615729 PMCID: PMC9113914 DOI: 10.1155/2022/1504463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/21/2022] [Accepted: 04/22/2022] [Indexed: 12/19/2022]
Abstract
Efficient noninvasive imaging techniques in the differentiation of intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) are very important because of their different management and prognosis. Our purpose was to evaluate the difference of parameters extracted from intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) between the two groups and their performance for the differentiation, as well as the significance of perfusion information. IVIM studies (9 b-values) in 41 patients with either ICC or HCC were reviewed retrospectively by two observers. Diffusion coefficient (D), pseudodiffusion coefficient (D∗), perfusion fraction (f), ADC, and the mean percentage of parenchymal enhancement (MPPE) at 30 s after contrast-enhancement were calculated and compared between ICC and HCC. The relationship between D∗, f values, and MPPE was evaluated by Spearman's correlation test. The diagnostic efficacy of all parameters was analyzed by the receiver operating characteristic (ROC) curve. Interobserver and intraobserver agreements were analyzed. The parameters (D and ADC) of ICC were distinctly higher than those of HCC; whereas the parameters (f and MPPE of arterial phase) were distinctly lower (all false discovery rate [FDR]-corrected P < 0.05). The metric D∗ value of ICC was slightly higher than that of HCC (71.44 vs 69.41) with FDR-corrected P > 0.05. Moreover, the value of parameter D was significantly lower than that of ADC (FDR-corrected P < 0.05). The parameters (D and f values) extracted from IVIM showed excellent diagnostic efficiency in the identification, and the diagnostic efficiency of D value was significantly higher than that of the ADC. There were positive correlations between perfusion-related parameters (D∗, f values) and MPPE. Interobserver and intraobserver agreements were excellent or perfect in measurements of all parameters. Parameters derived from IVIM were valuable for distinguishing ICC and HCC. Moreover, the D value showed better diagnostic efficiency for the differential diagnosis than monoexponential fitting-derived ADC value. Meanwhile, the significant correlation between perfusion-related parameters and MPPE demonstrates that specific IVIM metrics may serve as a noninvasive indicator for the vascular perfusion information of ICC and HCC.
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Lewis S, Dawson L, Barry A, Stanescu T, Mohamad I, Hosni A. Stereotactic body radiation therapy for hepatocellular carcinoma: from infancy to ongoing maturity. JHEP Rep 2022; 4:100498. [PMID: 35860434 PMCID: PMC9289870 DOI: 10.1016/j.jhepr.2022.100498] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 12/16/2022] Open
Affiliation(s)
- Shirley Lewis
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Canada
| | - Laura Dawson
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Canada
| | - Aisling Barry
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Canada
| | - Teodor Stanescu
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Canada
| | - Issa Mohamad
- Department of Radiation Oncology, King Hussein Cancer Centre, Jordan
| | - Ali Hosni
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Canada
- Corresponding author. Address: Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada.
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Englund EK, Reiter DA, Shahidi B, Sigmund EE. Intravoxel Incoherent Motion Magnetic Resonance Imaging in Skeletal Muscle: Review and Future Directions. J Magn Reson Imaging 2022; 55:988-1012. [PMID: 34390617 PMCID: PMC8841570 DOI: 10.1002/jmri.27875] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 12/29/2022] Open
Abstract
Throughout the body, muscle structure and function can be interrogated using a variety of noninvasive magnetic resonance imaging (MRI) methods. Recently, intravoxel incoherent motion (IVIM) MRI has gained momentum as a method to evaluate components of blood flow and tissue diffusion simultaneously. Much of the prior research has focused on highly vascularized organs, including the brain, kidney, and liver. Unique aspects of skeletal muscle, including the relatively low perfusion at rest and large dynamic range of perfusion between resting and maximal hyperemic states, may influence the acquisition, postprocessing, and interpretation of IVIM data. Here, we introduce several of those unique features of skeletal muscle; review existing studies of IVIM in skeletal muscle at rest, in response to exercise, and in disease states; and consider possible confounds that should be addressed for muscle-specific evaluations. Most studies used segmented nonlinear least squares fitting with a b-value threshold of 200 sec/mm2 to obtain IVIM parameters of perfusion fraction (f), pseudo-diffusion coefficient (D*), and diffusion coefficient (D). In healthy individuals, across all muscles, the average ± standard deviation of D was 1.46 ± 0.30 × 10-3 mm2 /sec, D* was 29.7 ± 38.1 × 10-3 mm2 /sec, and f was 11.1 ± 6.7%. Comparisons of reported IVIM parameters in muscles of the back, thigh, and leg of healthy individuals showed no significant difference between anatomic locations. Throughout the body, exercise elicited a positive change of all IVIM parameters. Future directions including advanced postprocessing models and potential sequence modifications are discussed. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Erin K. Englund
- Department of Radiology, University of Colorado Anschutz Medical Campus
| | | | | | - Eric E. Sigmund
- Department of Radiology, New York University Grossman School of Medicine, NYU Langone Health
- Center for Advanced Imaging and Innovation (CAIR), Bernard and Irene Schwarz Center for Biomedical Imaging (CBI), NYU Langone Health
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Calistri L, Maraghelli D, Nardi C, Vidali S, Rastrelli V, Crocetti L, Grazioli L, Colagrande S. Magnetic resonance imaging of inflammatory pseudotumor of the liver: a 2021 systematic literature update and series presentation. Abdom Radiol (NY) 2022; 47:2795-2810. [PMID: 35648207 PMCID: PMC9300573 DOI: 10.1007/s00261-022-03555-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE Inflammatory pseudotumors of the liver (IPTL) are not exceptional benign lesions with various etiologies, histology, and imaging appearances. The incomplete knowledge of this pathology and the wide polymorphism sometimes resembling malignancy often induce long and expensive diagnostic flow, biopsy and occasionally unnecessary surgery. We propose a systematic revision of MRI literature data (2000-2021) with some narrative inserts and 10 new complete MRI cases, with the aim of organizing the data about IPTL and identifying some typical features able to improve its diagnosis from imaging. METHODS We performed a systematic revision of literature from 2000 to 2021 to obtain MRI features, epidemiological, and clinical data of IPTL. The basic online search algorithm on the PubMed database was "(pseudotumor) AND (liver) AND (imaging)." Quality assessment was performed using both scales by Moola for case report studies and by Munn for cross-sectional studies reporting prevalence data. A case-based retrospective study by collecting patients diagnosed with IPTL from three different university hospitals from 2015 to 2021 was done as well. Only cases with MR examinations complete with T1/T2/contrast-enhanced T1/Diffusion-Weighted (W) images and pathology-proven IPTL were selected. RESULTS After screening/selection 38 articles were included for a total of 114 patients. In our experience we selected 10 cases for a total of 16 IPTLs; 8 out of 10 patients underwent at least 1 MRI follow-up. Some reproducible and rather typical imaging findings for IPTL were found. The targetoid aspect of IPTL is very frequent in our experience (75% on T1W, 44% on T2W, 81% on contrast-enhanced T1W (at least one phase), 100% on Diffusion-W images) but is also recurrent in the literature (6% on T1W, 31% on T2W, 51% on CE-T1W (at least one phase), 18% on Diffusion-W images, and 67% on hepatobiliary phase). In our experience, Apparent Diffusion Coefficient map values were always equal to or higher than those of the surrounding parenchyma, and at MRI follow-up, nodule/s disappeared at first/second control, in six patients, while in the remaining 2, lesions persisted with tendency to dehydration. CONCLUSION A targetoid-like aspect of a focal liver lesion must raise diagnostic suspicion, especially if IgG4-positive plasma is detected. MRI follow-up mainly shows the disappearance of the lesion or its reduction with dehydration.
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Affiliation(s)
- Linda Calistri
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence - Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Davide Maraghelli
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence - Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Cosimo Nardi
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence - Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Sofia Vidali
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence - Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Vieri Rastrelli
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence - Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Laura Crocetti
- Clinical and Translational Science Research Department - Division of Interventional Radiology, Cisanello University Hospital, Bldg 30, Via Paradisa 2, 56124 Pisa, Italy
| | - Luigi Grazioli
- Department of Radiology, University of Brescia “Spedali Civili”, P. le Spedali Civili 1, Brescia, Italy
| | - Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence - Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy
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Rata M, Khan K, Collins DJ, Koh DM, Tunariu N, Bali MA, d'Arcy J, Winfield JM, Picchia S, Valeri N, Chau I, Cunningham D, Fassan M, Leach MO, Orton MR. DCE-MRI is more sensitive than IVIM-DWI for assessing anti-angiogenic treatment-induced changes in colorectal liver metastases. Cancer Imaging 2021; 21:67. [PMID: 34924031 PMCID: PMC8684660 DOI: 10.1186/s40644-021-00436-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/24/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Diffusion weighted imaging (DWI) with intravoxel incoherent motion (IVIM) modelling can inform on tissue perfusion without exogenous contrast administration. Dynamic-contrast-enhanced (DCE) MRI can also characterise tissue perfusion, but requires a bolus injection of a Gadolinium-based contrast agent. This study compares the use of DCE-MRI and IVIM-DWI methods in assessing response to anti-angiogenic treatment in patients with colorectal liver metastases in a cohort with confirmed treatment response. METHODS This prospective imaging study enrolled 25 participants with colorectal liver metastases to receive Regorafenib treatment. A target metastasis > 2 cm in each patient was imaged before and at 15 days after treatment on a 1.5T MR scanner using slice-matched IVIM-DWI and DCE-MRI protocols. MRI data were motion-corrected and tumour volumes of interest drawn on b=900 s/mm2 diffusion-weighted images were transferred to DCE-MRI data for further analysis. The median value of four IVIM-DWI parameters [diffusion coefficient D (10-3 mm2/s), perfusion fraction f (ml/ml), pseudodiffusion coefficient D* (10-3 mm2/s), and their product fD* (mm2/s)] and three DCE-MRI parameters [volume transfer constant Ktrans (min-1), enhancement fraction EF (%), and their product KEF (min-1)] were recorded at each visit, before and after treatment. Changes in pre- and post-treatment measurements of all MR parameters were assessed using Wilcoxon signed-rank tests (P<0.05 was considered significant). DCE-MRI and IVIM-DWI parameter correlations were evaluated with Spearman rank tests. Functional MR parameters were also compared against Response Evaluation Criteria In Solid Tumours v.1.1 (RECIST) evaluations. RESULTS Significant treatment-induced reductions of DCE-MRI parameters across the cohort were observed for EF (91.2 to 50.8%, P<0.001), KEF (0.095 to 0.045 min-1, P<0.001) and Ktrans (0.109 to 0.078 min-1, P=0.002). For IVIM-DWI, only D (a non-perfusion parameter) increased significantly post treatment (0.83 to 0.97 × 10-3 mm2/s, P<0.001), while perfusion-related parameters showed no change. No strong correlations were found between DCE-MRI and IVIM-DWI parameters. A moderate correlation was found, after treatment, between Ktrans and D* (r=0.60; P=0.002) and fD* (r=0.67; P<0.001). When compared to RECIST v.1.1 evaluations, KEF and D correctly identified most clinical responders, whilst non-responders were incorrectly identified. CONCLUSION IVIM-DWI perfusion-related parameters showed limited sensitivity to the anti-angiogenic effects of Regorafenib treatment in colorectal liver metastases and showed low correlation with DCE-MRI parameters, despite profound and significant post-treatment reductions in DCE-MRI measurements. TRIAL REGISTRATION NCT03010722 clinicaltrials.gov; registration date 6th January 2015.
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Affiliation(s)
- Mihaela Rata
- Department of Radiology, MRI Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom.
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom.
- Royal Marsden NHS Foundation Trust & Institute of Cancer Research, Downs Road, SM2 5PT, Sutton, London, UK.
| | - Khurum Khan
- Department of Medicine, GI and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - David J Collins
- Department of Radiology, MRI Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Dow-Mu Koh
- Department of Radiology, MRI Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Nina Tunariu
- Department of Radiology, MRI Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Maria Antonietta Bali
- Department of Radiology, MRI Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - James d'Arcy
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
- Cancer Research UK National Cancer Imaging Translational Accelerator (NCITA), London, United Kingdom
| | - Jessica M Winfield
- Department of Radiology, MRI Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Simona Picchia
- Department of Radiology, MRI Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Nicola Valeri
- Department of Medicine, GI and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
- Centre for Evolution and Cancer, The Institute of Cancer Research, London and Sutton, United Kingdom
- Division of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Ian Chau
- Department of Medicine, GI and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - David Cunningham
- Department of Medicine, GI and Lymphoma Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Matteo Fassan
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Martin O Leach
- Department of Radiology, MRI Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Matthew R Orton
- Department of Radiology, MRI Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
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Nuessle NC, Behling F, Tabatabai G, Castaneda Vega S, Schittenhelm J, Ernemann U, Klose U, Hempel JM. ADC-Based Stratification of Molecular Glioma Subtypes Using High b-Value Diffusion-Weighted Imaging. J Clin Med 2021; 10:3451. [PMID: 34441747 PMCID: PMC8397197 DOI: 10.3390/jcm10163451] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To investigate the diagnostic performance of in vivo ADC-based stratification of integrated molecular glioma grades. MATERIALS AND METHODS Ninety-seven patients with histopathologically confirmed glioma were evaluated retrospectively. All patients underwent pre-interventional MRI-examination including diffusion-weighted imaging (DWI) with implemented b-values of 500, 1000, 1500, 2000, and 2500 s/mm2. Apparent Diffusion Coefficient (ADC), Mean Kurtosis (MK), and Mean Diffusivity (MD) maps were generated. The average values were compared among the molecular glioma subgroups of IDH-mutant and IDH-wildtype astrocytoma, and 1p/19q-codeleted oligodendroglioma. One-way ANOVA with post-hoc Games-Howell correction compared average ADC, MD, and MK values between molecular glioma groups. A Receiver Operating Characteristic (ROC) analysis determined the area under the curve (AUC). RESULTS Two b-value-dependent ADC-based evaluations presented statistically significant differences between the three molecular glioma sub-groups (p < 0.001, respectively). CONCLUSIONS High-b-value ADC from preoperative DWI may be used to stratify integrated molecular glioma subgroups and save time compared to diffusion kurtosis imaging. Higher b-values of up to 2500 s/mm2 may present an important step towards increasing diagnostic accuracy compared to standard DWI protocol.
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Affiliation(s)
- Nils C. Nuessle
- Department of Neuroradiology, University Hospital Tübingen, Eberhard Karls University, 72076 Tübingen, Germany; (U.E.); (U.K.); (J.-M.H.)
| | - Felix Behling
- Department of Neurosurgery, University Hospital Tübingen, Eberhard Karls University, 72076 Tübingen, Germany;
- Departments of Neurology and Interdisciplinary Neuro-Oncology, University Hospital Tübingen, Hertie Institute for Clinical Brain Research, Eberhard Karls University, 72076 Tübingen, Germany;
| | - Ghazaleh Tabatabai
- Departments of Neurology and Interdisciplinary Neuro-Oncology, University Hospital Tübingen, Hertie Institute for Clinical Brain Research, Eberhard Karls University, 72076 Tübingen, Germany;
| | - Salvador Castaneda Vega
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, University Hospital Tübingen, Eberhard Karls University, 72076 Tübingen, Germany;
| | - Jens Schittenhelm
- Department of Pathology and Neuropathology, University Hospital Tübingen, Institute of Neuropathology, Eberhard Karls University, 72076 Tübingen, Germany;
| | - Ulrike Ernemann
- Department of Neuroradiology, University Hospital Tübingen, Eberhard Karls University, 72076 Tübingen, Germany; (U.E.); (U.K.); (J.-M.H.)
| | - Uwe Klose
- Department of Neuroradiology, University Hospital Tübingen, Eberhard Karls University, 72076 Tübingen, Germany; (U.E.); (U.K.); (J.-M.H.)
| | - Johann-Martin Hempel
- Department of Neuroradiology, University Hospital Tübingen, Eberhard Karls University, 72076 Tübingen, Germany; (U.E.); (U.K.); (J.-M.H.)
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18
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Meng F, Zou B, Yang R, Duan Q, Qian T. The diagnostic efficiency of the perfusion-related parameters in assessing the vascular disrupting agent (CA4P) response in a rabbit VX2 liver tumor model. Acta Radiol 2021; 63:1147-1156. [PMID: 34279135 DOI: 10.1177/02841851211032450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There are inconsistencies when concomitantly using dynamic contrast enhancement (DCE) and intravoxel incoherent motion (IVIM) to evaluate diagnostic efficiency. PURPOSE To evaluate the diagnostic efficiency of perfusion-related parameters in assessing the effect of Combretastatin-A4-phosphate (CA4P) in a rabbit VX2 liver tumor model using DCE and IVIM. MATERIAL AND METHODS Twenty rabbits implanted with VX2 tumors were included in the study. The perfusion-parameters of DCE (Ktrans and iAUC60) and IVIM (f and D*) were measured at baseline and 4 h after administration of CA4P. Subsequently, the rabbits were euthanized. Pre- and post-treatment perfusion parameters were analyzed using paired t-test. Correlation between the various perfusion parameters and correlation of perfusion parameters with microvascular density (MVD) were assessed using Pearson correlation analysis. The diagnostic efficiency was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS All perfusion parameters (Ktrans, iAUC60, f and D*) showed significant decrease after 4 h of CA4P administration (all P < 0.001). Post-treatment perfusion parameters showed a moderate correlation with MVD (r = 0.663, r = 0.567, r = 0.685, r = 0.618, respectively; all P < 0.05). At baseline and after treatment, Ktrans values and iAUC60 showed correlation with f and D* (all P < 0.05). Concomitant use of perfusion parameters of DCE and IVIM showed the best diagnostic performance, which was slightly greater than that observed with individual application of DCE or IVIM (AUC = 0.915, 0.880, and 0.895, respectively). CONCLUSION Although concomitant application of DCE and IVIM can slightly improve the diagnostic value in assessing the effect of CA4P, the values were relatively small.
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Affiliation(s)
- Fanhua Meng
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, PR China
| | - Biao Zou
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, PR China
| | - Rong Yang
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, PR China
| | - Qingqing Duan
- Department of Radiology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, PR China
| | - Ting Qian
- Department of Radiology, International Peace Maternity and Child Health Hospital, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
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Spinner GR, Federau C, Kozerke S. Bayesian inference using hierarchical and spatial priors for intravoxel incoherent motion MR imaging in the brain: Analysis of cancer and acute stroke. Med Image Anal 2021; 73:102144. [PMID: 34261009 DOI: 10.1016/j.media.2021.102144] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 06/12/2021] [Accepted: 06/21/2021] [Indexed: 12/24/2022]
Abstract
The intravoxel incoherent motion (IVIM) model allows to map diffusion (D) and perfusion-related parameters (F and D*). Parameter estimation is, however, error-prone due to the non-linearity of the signal model, the limited signal-to-noise ratio (SNR) and the small volume fraction of perfusion in the in-vivo brain. In the present work, the performance of Bayesian inference was examined in the presence of brain pathologies characterized by hypo- and hyperperfusion. In particular, a hierarchical and a spatial prior were combined. Performance was compared relative to conventional segmented least squares regression, hierarchical prior only (non-segmented and segmented data likelihoods) and a deep learning approach. Realistic numerical brain IVIM simulations were conducted to assess errors relative to ground truth. In-vivo, data of 11 central nervous system cancer patients and 9 patients with acute stroke were acquired. The proposed method yielded reduced error in simulations for both the cancer and acute stroke scenarios compared to other methods across the whole investigated SNR range. The contrast-to-noise ratio of the proposed method was better or on par compared to the other techniques in-vivo. The proposed Bayesian approach hence improves IVIM parameter estimation in brain cancer and acute stroke.
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Affiliation(s)
- Georg Ralph Spinner
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, Zurich 8092, Switzerland
| | - Christian Federau
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, Zurich 8092, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, Zurich 8092, Switzerland.
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Noninvasive assessment of endometrial fibrosis in patients with intravoxel incoherent motion MR imaging. Sci Rep 2021; 11:12887. [PMID: 34145361 PMCID: PMC8213850 DOI: 10.1038/s41598-021-92383-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/07/2021] [Indexed: 11/08/2022] Open
Abstract
Recently, few noninvasive methods have been reported to evaluate endometrial fibrosis. Our study was to investigate the feasibility of intravoxel incoherent motion (IVIM) MR imaging in the detection of endometrial fibrosis in patients with intrauterine injury. 30 patients with hysteroscopy-confirmed endometrial fibrosis and 28 healthy women were enrolled to undergo MR examination including the IVIM sequence. Endometrial thickness (ET); apparent diffusion coefficient (ADC); and IVIM parameters, including pure diffusion coefficient (D), pseudodiffusion coefficient (D*) and vascular fraction (f) were evaluated. A multivariable model combing ADC, D, and f values using binary logistic regression analysis was built to diagnose endometrial fibrosis. Endometrial fibrosis patients demonstrated lower endometrial ADC, D, f values and ET (all p < 0.05). The multivariable model, ADC, D, f values and ET performed well in diagnosing endometrial fibrosis with AUC of 0.979, 0.965, 0.920, 0.901 and 0.833, respectively. The multivariable model revealed a better diagnostic accuracy than D, f and ET (all p < 0.05). Although ADC achieved a better diagnostic value than ET (z = 2.082, p < 0.05), no difference in AUC was shown among ADC, D, and f (all p > 0.05); between ET and D (p > 0.05); and between ET and f (p > 0.05). The reproducibility of ADC, D, f and D* values in patients with endometrial fibrosis and healthy women were good to excellent (ICC: 0.614-0.951). IVIM parameters exhibit promising potential to serve as imaging biomarkers in the noninvasive assessment of endometrial fibrosis.
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Półtorak-Szymczak G, Budlewski T, Furmanek MI, Wierzba W, Sklinda K, Walecki J, Mruk B. Radiological Imaging of Gastro-Entero-Pancreatic Neuroendocrine Tumors. The Review of Current Literature Emphasizing the Diagnostic Value of Chosen Imaging Methods. Front Oncol 2021; 11:670233. [PMID: 34211845 PMCID: PMC8239281 DOI: 10.3389/fonc.2021.670233] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/14/2021] [Indexed: 02/03/2023] Open
Abstract
Despite development of radiologic imaging, detection and follow-up of neuroendocrine neoplasms (NENs) still pose a diagnostic challenge, due to the heterogeneity of NEN, their relatively long-term growth, and small size of primary tumor. A set of information obtained by using different radiological imaging tools simplifies a choice of the most appropriate treatment method. Moreover, radiological imaging plays an important role in the assessment of metastatic lesions, especially in the liver, as well as, tumor response to treatment. This article reviews the current, broadly in use imaging modalities which are applied to the diagnosis of GEP-NETs, (the most common type of NENs) and put emphasis on the strengths and limitations of each modality.
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Affiliation(s)
- Gabriela Półtorak-Szymczak
- Department of Radiology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
| | - Tadeusz Budlewski
- Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland.,Department of Nuclear Medicine, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
| | - Mariusz Ireneusz Furmanek
- Department of Radiology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
| | - Waldemar Wierzba
- Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland.,University of Humanities and Economics, Lodz, Poland
| | - Katarzyna Sklinda
- Department of Radiology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
| | - Jerzy Walecki
- Department of Radiology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
| | - Bartosz Mruk
- Department of Radiology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
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Song Q, Guo Y, Yao X, Rao S, Qian C, Ye D, Zeng M. Comparative study of evaluating the microcirculatory function status of primary small HCC between the CE (DCE-MRI) and Non-CE (IVIM-DWI) MR Perfusion Imaging. Abdom Radiol (NY) 2021; 46:2575-2583. [PMID: 33483778 DOI: 10.1007/s00261-020-02945-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/20/2020] [Accepted: 12/31/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE To compare the difference of evaluating the microcirculatory function status of primary small HCC between DCE-MRI with two-compartmental pharmacokinetic model and IVIM-DWI. METHODS 27 patients (22 men, 5 women; mean age, 49 years; range 36-65 years) with primary single sHCC who underwent IVIM-DWI and DCE-MRI before the operation were included in this retrospective study. The MR perfusion parameters are Ktrans, Ve, Kep, D, D* and f. Pathological results include pathological grade (low grade ≤ II, high grade > II) and MVD. The perfusion parameters and pathological results of sHCC were analyzed and compared in their relevance, sensitivity and specificity. Statistical methods included Spearman and ROC curve analysis. RESULTS The perfusion parameters (Ktrans, Kep, D*, f) were significantly positive correlated (r = 0.892, 0.808, 0.589 and 0.543, P = 0.000, 0.000, 0.001 and 0.003 with MVD of sHCC. The parameter Ve and D values were negatively correlated (r = - 0.454 and - 0.399, P = 0.017 and 0.039, respectively) with the pathological grade. Regarding the evaluation MVD of sHCC, the evaluation of the sensitivity and specificity performance was present in descending order: Ktrans > Kep > PF > D*. In the evaluation pathological grade of sHCC, the sensitivity and specificity were better by parameters D than Ve. CONCLUSION DCE-MRI is better than IVIM-DWI for evaluation microcirculation functional status of sHCC. But for evaluating the pathological grade, IVIM-DWI is better than DCE-MRI. Combination of the two imaging techniques may provide more comprehensive evaluation in microcirculation functional status of the sHCC.
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Affiliation(s)
- Qiong Song
- Department of Radiology, Zhongshan Hospital of Fudan University, Fudan University, Shanghai Institute of Medical Imaging, No 130, Dongan Rd, Xuhui District, Shanghai, 200032, People's Republic of China
- Radiology Department, Xuzhou Mining Group General Hospital, Xuzhou, 221000, Jiangsu, People's Republic of China
- Shanghai Aitrox Technology Corporation Limited, Shanghai, 200032, People's Republic of China
| | - Yixian Guo
- Department of Radiology, Zhongshan Hospital of Fudan University, Fudan University, Shanghai Institute of Medical Imaging, No 130, Dongan Rd, Xuhui District, Shanghai, 200032, People's Republic of China
| | - Xiuzhong Yao
- Department of Radiology, Zhongshan Hospital of Fudan University, Fudan University, Shanghai Institute of Medical Imaging, No 130, Dongan Rd, Xuhui District, Shanghai, 200032, People's Republic of China
| | - Shengxiang Rao
- Department of Radiology, Zhongshan Hospital of Fudan University, Fudan University, Shanghai Institute of Medical Imaging, No 130, Dongan Rd, Xuhui District, Shanghai, 200032, People's Republic of China
| | - Chengyao Qian
- Shanghai Aitrox Technology Corporation Limited, Shanghai, 200032, People's Republic of China
| | - Dexian Ye
- Shanghai Aitrox Technology Corporation Limited, Shanghai, 200032, People's Republic of China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital of Fudan University, Fudan University, Shanghai Institute of Medical Imaging, No 130, Dongan Rd, Xuhui District, Shanghai, 200032, People's Republic of China.
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Shrestha U, van der Merwe M, Kumar N, Jacobs E, Satapathy SK, Morin C, Tipirneni-Sajja A. Morphological characterization of hepatic steatosis and Monte Carlo modeling of MRI signal for accurate quantification of fat fraction and relaxivity. NMR IN BIOMEDICINE 2021; 34:e4489. [PMID: 33586261 DOI: 10.1002/nbm.4489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/16/2020] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
Chemical-shift-based fat-water MRI signal models with single- or dual-R2 * correction have been proposed for quantification of fat fraction (FF) and assessment of hepatic steatosis. However, there is a void in our understanding of which model truly mimics the underlying biophysical mechanism of steatosis on MRI signal relaxation. The purpose of this study is to morphologically characterize and build realistic steatosis models from histology and synthesize MRI signal using Monte Carlo simulations to investigate the accuracy of single- and dual-R2 * models in quantifying FF and R2 *. Fat morphology was characterized by performing automatic segmentation on 16 mouse liver histology images and extracting the radius, nearest neighbor (NN) distance, and regional anisotropy of fat droplets. A gamma distribution function (GDF) was used to generalize extracted features, and regression analysis was performed to derive relationships between FF and GDF parameters. Virtual steatosis models were created based on derived morphological and statistical descriptors, and the MRI signal was synthesized at 1.5 T and 3 T. R2 * and FF values were calculated using single- and dual-R2 * models and compared with in vivo R2 *-FF calibrations and simulated FFs. The steatosis models generated with regional anisotropy and NN distribution closely mimicked the true in vivo fat morphology. For both R2 * models, predicted R2 * values showed positive correlation with FFs, with slopes similar to those of the in vivo calibrations (P > 0.05), and predicted FFs showed excellent agreement with true FFs (R2 > 0.99), with slopes close to unity. Our study, hence, demonstrates the proof of concept for generating steatosis models from histologic data and synthesizing MRI signal to show the expected signal relaxation under conditions of steatosis. Our results suggest that a single R2 * is sufficient to accurately estimate R2 * and FF values for lower FFs, which agrees with in vivo studies. Future work involves characterizing and building steatosis models at higher FFs and testing single- and dual-R2 * models for accurate assessment of steatosis.
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Affiliation(s)
- Utsav Shrestha
- Department of Biomedical Engineering, The University of Memphis, Memphis, Tennessee, USA
- Department of Computer Science, The University of Memphis, Memphis, Tennessee, USA
| | - Marie van der Merwe
- College of Health Sciences, The University of Memphis, Memphis, Tennessee, USA
| | - Nirman Kumar
- Department of Computer Science, The University of Memphis, Memphis, Tennessee, USA
| | - Eddie Jacobs
- Department of Electrical & Computer Engineering, The University of Memphis, Memphis, Tennessee, USA
| | - Sanjaya K Satapathy
- Department of Medicine, North Shore University Hospital/Northwell Health, Manhasset, New York, USA
| | - Cara Morin
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Aaryani Tipirneni-Sajja
- Department of Biomedical Engineering, The University of Memphis, Memphis, Tennessee, USA
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Zhou Y, Yang G, Gong XQ, Tao YY, Wang R, Zheng J, Yang C, Peng J, Yang L, Li JD, Zhang XM. A study of the correlations between IVIM-DWI parameters and the histologic differentiation of hepatocellular carcinoma. Sci Rep 2021; 11:10392. [PMID: 34001962 PMCID: PMC8129092 DOI: 10.1038/s41598-021-89784-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/30/2021] [Indexed: 02/07/2023] Open
Abstract
The present study aimed to investigate the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in the preoperative prediction of the histologic differentiation of hepatocellular carcinoma (HCC). Seventy HCC patients were scanned with a 3.0 T magnetic resonance scanner. The values of apparent diffusion coefficient (ADC), slow apparent diffusion coefficient (D), fast apparent diffusion coefficient (D*), and the fraction of the fast apparent diffusion coefficient (f) were measured. Analysis of variance was used to compare the differences in parameters between groups with different degrees of histologic differentiation. p < 0.05 was considered statistically significant. Receiver operating characteristic (ROC) curves were used to analyse the efficacy of IVIM-DWI parameters for predicting the histologic differentiation of HCC. The ADC and D values for well, moderately and poorly differentiated HCC were 1.35 ± 0.17 × 10-3 mm2/s, 1.16 ± 0.17 × 10-3 mm2/s, 0.98 ± 0.21 × 10-3 mm2/s, and 1.06 ± 0.15 × 10-3 mm2/s, 0.88 ± 0.16 × 10-3 mm2/s, 0.76 ± 0.18 × 10-3 mm2/s, respectively, and all differences were significant. The D* and f values of the three groups were 32.87 ± 14.70 × 10-3 mm2/s, 41.68 ± 17.90 × 10-3 mm2/s, 34.54 ± 18.60 × 10-3 mm2/s and 0.22 ± 0.07, 0.23 ± 0.08, 0.18 ± 0.07, respectively, with no significant difference. When the cut-off values of ADC and D were 1.25 × 10-3 mm2/s and 0.97 × 10-3 mm2/s, respectively, their diagnostic sensitivities and specificities for distinguishing well differentiated HCC from moderately differentiated and poorly differentiated HCC were 73.3%, 85.5%, 86.7%, and 78.2%, and their areas under the ROC curve were 0.821 and 0.841, respectively. ADC and D values can be used preoperatively to predict the degree of histologic differentiation in HCC, and the D value has better diagnostic value.
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Affiliation(s)
- Yi Zhou
- Medical Imaging Key Laboratory of Sichuan Province, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China
- Department of Radiology, People's Hospital of Deyang City, Deyang, 618000, Sichuan, People's Republic of China
| | - Gang Yang
- Institute of Hepato-Biliary-Intestinal Disease, Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China
| | - Xue-Qin Gong
- Medical Imaging Key Laboratory of Sichuan Province, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China
| | - Yun-Yun Tao
- Medical Imaging Key Laboratory of Sichuan Province, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China
| | - Ran Wang
- Medical Imaging Key Laboratory of Sichuan Province, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China
| | - Jing Zheng
- Medical Imaging Key Laboratory of Sichuan Province, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China
| | - Cui Yang
- Medical Imaging Key Laboratory of Sichuan Province, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China
| | - Juan Peng
- Medical Imaging Key Laboratory of Sichuan Province, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China
| | - Lin Yang
- Medical Imaging Key Laboratory of Sichuan Province, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China.
| | - Jing-Dong Li
- Institute of Hepato-Biliary-Intestinal Disease, Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China
| | - Xiao-Ming Zhang
- Medical Imaging Key Laboratory of Sichuan Province, Medical Research Center, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, People's Republic of China
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Charatcharoenwitthaya P, Sukonrut K, Korpraphong P, Pongpaibul A, Saiviroonporn P. Diffusion-weighted magnetic resonance imaging for the assessment of liver fibrosis in chronic viral hepatitis. PLoS One 2021; 16:e0248024. [PMID: 33662022 PMCID: PMC7932524 DOI: 10.1371/journal.pone.0248024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/14/2021] [Indexed: 12/16/2022] Open
Abstract
Background Accurate noninvasive methods for the assessment of liver fibrosis are urgently needed. This prospective study evaluated the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DWI) for the staging of liver fibrosis and proposed a diagnostic algorithm using DWI to identify cirrhosis in patients with chronic viral hepatitis. Methods One hundred twenty-one treatment-naïve patients with chronic hepatitis B or C were evaluated with DWI followed by liver biopsy on the same day. Breath-hold single-shot echo-planar DWI was performed to measure the apparent diffusion coefficient (ADC) of the liver and spleen. Normalized liver ADC was calculated as the ratio of liver ADC to spleen ADC. Results There was an inverse correlation between fibrosis stage and normalized liver ADC (p<0.05). For the prediction of fibrosis stage ≥2, stage ≥3, and cirrhosis, the area under the receiver-operating curve of normalized liver ADC was 0.603, 0.704, and 0.847, respectively. The normalized liver ADC value ≤1.02×10−3 mm2/s had 88% sensitivity, 81% specificity, 25% positive predictive value (PPV), and 99% negative predictive value (NPV) for the diagnosis of cirrhosis. Using a sequential approach with the Fibrosis-4 index followed by DWI, normalized liver ADC ≤1.02×10−3 mm2/s in patients with Fibrosis-4 >3.25 yielded an 80% PPV for cirrhosis, and a 100% NPV to exclude cirrhosis in patients with Fibrosis-4 between 1.45 and 3.25. Only 15.7% of patients would require a liver biopsy. This sequential strategy can reduce DWI examinations by 53.7%. Conclusion Normalized liver ADC measurement on DWI is an accurate and noninvasive tool for the diagnosis of cirrhosis in patients with chronic viral hepatitis.
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Affiliation(s)
- Phunchai Charatcharoenwitthaya
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- * E-mail:
| | - Kamonthip Sukonrut
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pornpim Korpraphong
- Radiology Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ananya Pongpaibul
- Pathology Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pairash Saiviroonporn
- Radiology Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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26
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Lee W, Kim B, Park H. Quantification of intravoxel incoherent motion with optimized b-values using deep neural network. Magn Reson Med 2021; 86:230-244. [PMID: 33594783 DOI: 10.1002/mrm.28708] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE To develop a framework for quantifying intravoxel incoherent motion (IVIM) parameters, where a neural network for quantification and b-values for diffusion-weighted imaging are simultaneously optimized. METHOD A deep neural network (DNN) method is proposed for accurate quantification of IVIM parameters from multiple diffusion-weighted images. In addition, optimal b-values are selected to acquire the multiple diffusion-weighted images. The proposed framework consists of an MRI signal generation part and an IVIM parameter quantification part. Monte-Carlo (MC) simulations were performed to evaluate the accuracy of the IVIM parameter quantification and the efficacy of b-value optimization. In order to analyze the effect of noise on the optimized b-values, simulations were performed with five different noise levels. For in vivo data, diffusion images were acquired with the b-values from four b-values selection methods for five healthy volunteers at 3T MRI system. RESULTS Experiment results showed that both the optimization of b-values and the training of DNN were simultaneously performed to quantify IVIM parameters. We found that the accuracies of the perfusion coefficient (Dp ) and perfusion fraction (f) were more sensitive to b-values than the diffusion coefficient (D) was. Furthermore, when the noise level changed, the optimized b-values also changed. Therefore, noise level has to be considered when optimizing b-values for IVIM quantification. CONCLUSION The proposed scheme can simultaneously optimize b-values and train DNN to minimize quantification errors of IVIM parameters. The trained DNN can quantify IVIM parameters from the diffusion-weighted images obtained with the optimized b-values.
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Affiliation(s)
- Wonil Lee
- Department of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Byungjai Kim
- Department of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - HyunWook Park
- Department of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
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27
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Stabinska J, Ljimani A, Zöllner HJ, Wilken E, Benkert T, Limberg J, Esposito I, Antoch G, Wittsack HJ. Spectral diffusion analysis of kidney intravoxel incoherent motion MRI in healthy volunteers and patients with renal pathologies. Magn Reson Med 2021; 85:3085-3095. [PMID: 33462838 DOI: 10.1002/mrm.28631] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/22/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To assess the feasibility of measuring tubular and vascular signal fractions in the human kidney using nonnegative least-square (NNLS) analysis of intravoxel incoherent motion data collected in healthy volunteers and patients with renal pathologies. METHODS MR imaging was performed at 3 Tesla in 12 healthy subjects and 3 patients with various kidney pathologies (fibrotic kidney disease, failed renal graft, and renal masses). Relative signal fractions f and mean diffusivities of the diffusion components in the cortex, medulla, and renal lesions were obtained using the regularized NNLS fitting of the intravoxel incoherent motion data. Test-retest repeatability of the NNLS approach was tested in 5 volunteers scanned twice. RESULTS In the healthy kidneys, the NNLS method yielded diffusion spectra with 3 distinguishable components that may be linked to the slow tissue water diffusion, intermediate tubular and vascular flow, and fast blood flow in larger vessels with the relative signal fractions, fslow , finterm and ffast , respectively. In the pathological kidneys, the diffusion spectra varied substantially from those acquired in the healthy kidneys. Overall, the renal cyst showed substantially higher finterm and lower fslow , whereas the fibrotic kidney, failed renal graft, and renal cell carcinoma demonstrated the opposite trend. CONCLUSION NNLS-based intravoxel incoherent motion could potentially become a valuable tool in assessing changes in tubular and vascular volume fractions under pathophysiological conditions.
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Affiliation(s)
- Julia Stabinska
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Dusseldorf, Düsseldorf, Germany
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Dusseldorf, Düsseldorf, Germany
| | - Helge Jörn Zöllner
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Dusseldorf, Düsseldorf, Germany.,Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Enrica Wilken
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Dusseldorf, Düsseldorf, Germany
| | - Thomas Benkert
- MR Application Development, Siemens Healthcare GmbH, Erlangen, Germany
| | - Juliane Limberg
- Institute of Pathology, Medical Faculty, Heinrich Heine University Dusseldorf, Düsseldorf, Germany
| | - Irene Esposito
- Institute of Pathology, Medical Faculty, Heinrich Heine University Dusseldorf, Düsseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Dusseldorf, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Dusseldorf, Düsseldorf, Germany
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Zheng J, Gong XQ, Tao YY, Wang R, Yang G, Li JD, Ren T, Li ZM, Yang C, Wang WC, Yang L, Zhang XM. A Correlative Study Between IVIM-DWI Parameters and the Expression Levels of Ang-2 and TKT in Hepatocellular Carcinoma. Front Oncol 2021; 10:594366. [PMID: 33520706 PMCID: PMC7845759 DOI: 10.3389/fonc.2020.594366] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/23/2020] [Indexed: 02/05/2023] Open
Abstract
Background Noninvasive evaluation of the expression of angiopoietin-2 (Ang-2) and transketolase (TKT) in hepatocellular carcinoma (HCC) is of great significance for the clinical development of individualized treatment plans. However, the correlation between intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and the expression of Ang-2 and TKT has not been reported. We sought to investigate the correlations between IVIM-DWI parameters and Ang-2 and TKT expression levels in HCCs. Methods Conventional non-enhanced magnetic resonance imaging (MRI) and IVIM-DWI and dynamic contrast MRI were performed for 61 patients with HCC before surgical treatment. Various IVIM-DWI parameters, such as apparent diffusion coefficient (ADC), slow apparent diffusion coefficient (D), fast apparent diffusion coefficient (D*) and fraction of fast apparent diffusion coefficient (f), were calculated using Function-MADC software. Expression levels of Ang-2 and TKT in HCC were detected via immunohistochemical staining and classified into two grades. Independent sample t tests were used to compare differences in parameters between the two groups. The Spearman rank correlation test was used to analyze the correlations between IVIM-DWI parameters and Ang-2 and TKT expression levels in HCCs. Results The D* and f values were significantly higher in the high Ang-2 group than in the low Ang-2 group; there were no obvious between-group differences in ADC and D. Ang-2 expression was positively correlated with D* and f but not with ADC and D. The ADC and D values were significantly lower in the high TKT group than in the low TKT group, whereas the between-group differences for D* and f were not significant. TKT expression was negatively correlated with ADC and D but not with D* and f. Conclusions IVIM-DWI can be used to evaluate Ang-2 and TKT expression in HCC.
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Affiliation(s)
- Jing Zheng
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xue Qin Gong
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yun Yun Tao
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ran Wang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Gang Yang
- Institute of Hepato-Biliary-Intestinal Disease, Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jing Dong Li
- Institute of Hepato-Biliary-Intestinal Disease, Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Tian Ren
- Department of Medical Record Statistics, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Zu Mao Li
- Department of Pathology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Cui Yang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Wei Cheng Wang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Lin Yang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xiao Ming Zhang
- Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Alwalid O, Wang Y, Fan W, Han P. Value of gadoxetic acid-enhanced MR imaging and DWI in classification, characterization and confidence in diagnosis of solid focal liver lesions. Scand J Gastroenterol 2021; 56:72-80. [PMID: 33232614 DOI: 10.1080/00365521.2020.1847314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To assess gadoxetic acid (Gd-EOB-DTPA) and diffusion-weighted imaging (DWI) value in classification (benign vs. malignant) and characterization of solid focal liver lesions (SFLLs) and impact on confidence in diagnosis. METHODS A total of 195 lesions (46 hepatocellular carcinomas [HCCs], 45 metastases, 32 adenomas, 37 focal nodular hyperplasias [FNHs] and 35 hemangiomas) were retrospectively evaluated in 93 patients. Three imaging datasets were compared: DWI/ apparent diffusion coefficient (ADC) (set A), Gd-EOB-DTPA (set B) and combination of both (set C). Two radiologists (R) independently classified (on a five-point ordinal scale) and characterized each lesion. The accuracy in classification and characterization was compared, and the diagnostic confidence was assessed. RESULTS The classification accuracy on set A, B and C was 86.2%, 91.3% and 91.8% (R1), and 84.6%, 91.8% and 93.3% (R2); and characterization accuracy was 67.2%, 88.2% and 87.7% (R1), and 60.5%, 88.2% and 85.6% (R2). Classification by reader 1 showed no significant difference between set A and B (p=.09). For both readers, there was a significant difference between set A and C in both classification and characterization (all p < .05), but no significant difference between set B and C in neither classification nor characterization. No significant difference between the three datasets in classification and characterization of hemangiomas (all p > .05). The diagnostic confidence of the readers has increased progressively from set A to Set C (all p < .01). CONCLUSIONS DWI may suggest benignity or malignancy of solid liver lesions, while Gd-EOB-DTPA-enhanced imaging remains superior in lesions characterization and the combination of both increases the diagnostic confidence. DWI is very helpful in the diagnosis of hepatic hemangiomas.
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Affiliation(s)
- Osamah Alwalid
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yuhui Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Ping Han
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
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Intravoxel incoherent motion magnetic resonance imaging: basic principles and clinical applications. Pol J Radiol 2020; 85:e624-e635. [PMID: 33376564 PMCID: PMC7757509 DOI: 10.5114/pjr.2020.101476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 06/03/2020] [Indexed: 12/26/2022] Open
Abstract
The purpose of this article was to show basic principles, acquisition, advantages, disadvantages, and clinical applications of intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI). IVIM MRI as a method was introduced in the late 1980s, but recently it started attracting more interest thanks to its applications in many fields, particularly in oncology and neuroradiology. This imaging technique has been developed with the objective of obtaining not only a functional analysis of different organs but also different types of lesions. Among many accessible tools in diagnostic imaging, IVIM MRI aroused the interest of many researchers in terms of studying its applicability in the evaluation of abdominal organs and diseases. The major conclusion of this article is that IVIM MRI seems to be a very auspicious method to investigate the human body, and that nowadays the most promising clinical application for IVIM perfusion MRI is oncology. However, due to lack of standardisation of image acquisition and analysis, further studies are needed to validate this method in clinical practice.
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Ohno N, Miyati T, Fujihara S, Gabata T, Kobayashi S. Biexponential analysis of intravoxel incoherent motion in calf muscle before and after exercise: Comparisons with arterial spin labeling perfusion and T2. Magn Reson Imaging 2020; 72:42-48. [DOI: 10.1016/j.mri.2020.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/18/2020] [Accepted: 06/09/2020] [Indexed: 12/26/2022]
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Ozaki K, Ikeno H, Koneri K, Higuchi S, Hosono N, Kosaka N, Goi T, Gabata T, Kimura H. Primary hepatic diffuse large B-cell lymphoma presenting unusual imaging features. Clin J Gastroenterol 2020; 13:1265-1272. [PMID: 32794156 DOI: 10.1007/s12328-020-01203-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/21/2020] [Indexed: 11/24/2022]
Abstract
Primary hepatic lymphomas are frequently misdiagnosed, due to their rarity and non-specific clinical manifestations. As these tumors can be successfully treated with chemotherapy and/or radiotherapy, early recognition on imaging is essential to avoid unnecessary surgery. We report a case of primary hepatic lymphoma in a 73-year-old woman presenting with a 1-week history of persistent fever and elevated hepatobiliary enzymes. Ultrasound showed a hypoechoic hepatic mass in the anterior segment. Dynamic contrast-enhanced computed tomography (CT) revealed an ill-defined solitary mass showing peripherally dominant slight-to-moderate enhancement contrasting with a hypovascular central area. On magnetic resonance imaging, the mass showed moderate hyperintensity on T2-weighted imaging, hypointensity on T1-weighted imaging, doughnut-like hyperintensity on diffusion-weighted imaging, and an obviously low apparent diffusion coefficient (ADC). The pattern of enhancement resembled that of CT. Neither calcification nor any fat component was observed. Doughnut-like accumulation was seen on 18F-fluorodeoxyglucose (FDG)-positron emission tomography/CT without other FDG-avid lesions. Imaging findings suggested the possibility of cholangiocellular carcinoma, but the low ADC and extremely high FDG accumulation were suggestive of malignant lymphoma, and diffuse large B-cell lymphoma was pathologically confirmed from percutaneous biopsy. The mass disappeared after radiochemotherapy, and no recurrence has been observed for 3 years.
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Affiliation(s)
- Kumi Ozaki
- Departments of Radiology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan.
| | - Hiroshi Ikeno
- Department of Radiology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Kenji Koneri
- Departments of Surgery, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shohei Higuchi
- Departments of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Nahoko Hosono
- Departments of Pathology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Nobuyuki Kosaka
- Departments of Radiology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan
| | - Takanori Goi
- Departments of Surgery, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Hirohiko Kimura
- Departments of Radiology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan
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Tao YY, Zhou Y, Wang R, Gong XQ, Zheng J, Yang C, Yang L, Zhang XM. Progress of intravoxel incoherent motion diffusion-weighted imaging in liver diseases. World J Clin Cases 2020; 8:3164-3176. [PMID: 32874971 PMCID: PMC7441263 DOI: 10.12998/wjcc.v8.i15.3164] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/11/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
Traditional magnetic resonance (MR) diffusion-weighted imaging (DWI) uses a single exponential model to obtain the apparent diffusion coefficient to quantitatively reflect the diffusion motion of water molecules in living tissues, but it is affected by blood perfusion. Intravoxel incoherent motion (IVIM)-DWI utilizes a double-exponential model to obtain information on pure water molecule diffusion and microcirculatory perfusion-related diffusion, which compensates for the insufficiency of traditional DWI. In recent years, research on the application of IVIM-DWI in the diagnosis and treatment of hepatic diseases has gradually increased and has achieved considerable progress. This study mainly reviews the basic principles of IVIM-DWI and related research progress in the diagnosis and treatment of hepatic diseases.
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Affiliation(s)
- Yun-Yun Tao
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Yi Zhou
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Ran Wang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xue-Qin Gong
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Jing Zheng
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Cui Yang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Lin Yang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xiao-Ming Zhang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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Gulbay M, Ciliz DS, Celikbas AK, Ocalan DT, Sayin B, Ozbay BO, Alp E. Intravoxel incoherent motion parameters in the evaluation of chronic hepatitis B virus-induced hepatic injury: fibrosis and capillarity changes. Abdom Radiol (NY) 2020; 45:2345-2357. [PMID: 32162021 DOI: 10.1007/s00261-020-02430-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the diagnostic efficacy of intravoxel incoherent motion (IVIM) parameters in hepatitis B virus (HBV)-induced hepatic fibrosis using different calculation methods and to investigate histopathologic origins. MATERIALS AND METHODS Liver biopsies from 37 prospectively recruited chronic hepatitis B patients were obtained. Twelve b-value (0-1000 s/mm2) diffusion-weighted imaging (DWI) was performed with a 1.5 T scanner and was followed by blinded percutaneous liver biopsy. All biopsy specimens were evaluated with Ishak staging, and the microvascular density (MVD) was calculated. Patients were classified as having no/mild (F0-1), moderate (F2-3), or marked (F4-5) fibrosis. Pseudodiffusion (D*), the perfusion fraction (f), and the apparent diffusion coefficient (ADC) were calculated using all b-values, while true diffusion (D) was calculated using all b-values [D0-1000] and b-values greater than 200 s/mm2 [D200-1000]. Three concentric regions of interest (ROIs) (5, 10, and 20 mm) centered on the biopsy site were used. RESULTS D* was correlated with the MVD (p = 0.015, Pearson's r = 0.415), but f was not (p = 0.119). D0-1000 was inversely correlated with Ishak stage (p = 0.000, Spearman's rs = - 0.685) and was significantly decreased in all the fibrosis groups; however, only the no/mild and marked fibrosis groups had significantly different D200-1000 values. A pairwise comparison of receiver operating characteristic (ROC) curves of D0-1000 and D200-1000 showed significant differences (p = 0.039). D* was the best at discriminating early fibrosis (AUC = 0.861), while the ADC best discriminated advanced fibrosis (AUC = 0.964). CONCLUSION D* was correlated with the MVD and is a powerful parameter to discriminate early hepatic fibrosis. D significantly decreased with advanced fibrosis stage when using b-values less than 200 s/mm2 in calculations.
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Affiliation(s)
- Mutlu Gulbay
- Department of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
- Ankara Sehir Hastanesi Radyoloji Klinigi, 06800, Universiteler Mah Bilkent Blv No:1, Ankara, Turkey.
| | - Deniz Sozmen Ciliz
- Department of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Aysel Kocagul Celikbas
- Department of Clinical Microbiology and Infectious Diseases, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Devrim Tuba Ocalan
- Department of Pathology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Bige Sayin
- Department of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Bahadır Orkun Ozbay
- Department of Clinical Microbiology and Infectious Diseases, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Emre Alp
- Department of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
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Peng J, Zheng J, Yang C, Wang R, Zhou Y, Tao YY, Gong XQ, Wang WC, Zhang XM, Yang L. Intravoxel incoherent motion diffusion-weighted imaging to differentiate hepatocellular carcinoma from intrahepatic cholangiocarcinoma. Sci Rep 2020. [DOI: doi.org/10.1038/s41598-020-64804-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
AbstractThe present study aimed to explore the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in differentiating hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC). This study included 65 patients with malignant hepatic nodules (55 with HCC, 10 with ICC), and 17 control patients with normal livers. All patients underwent IVIM-DWI scans on a 3.0 T magnetic resonance imaging (MRI) scanner. The standard apparent diffusion coefficient (ADC), pure diffusion coefficient (Dslow), pseudo-diffusion coefficient (Dfast), and perfusion fraction (f) were obtained. Differences in the parameters among the groups were analysed using one-way ANOVA, with p < 0.05 indicating statistical significance. Receiver operating characteristic (ROC) curve analysis was used to compare the efficacy of each parameter in differentiating HCC from ICC. ADC, Dslow, Dfast, f significantly differed among the three groups. ADC and Dslow were significantly lower in the HCC group than in the ICC group, while Dfast was significantly higher in the HCC group than in the ICC group; f did not significantly differ between the HCC and ICC groups. When the cut-off values of ADC, Dslow, and Dfast were 1.27 × 10−3 mm2/s, 0.81 × 10−3 mm2/s, and 26.04 × 10−3 mm2/s, respectively, their diagnostic sensitivities for differentiating HCC from ICC were 98.18%, 58.18%, and 94.55%, their diagnostic specificities were 50.00%, 80.00%, and 80.00%, and their areas under the ROC curve (AUCs) were 0.687, 0.721, and 0.896, respectively. Dfast displayed the largest AUC value. IVIM-DWI can be used to differentiate HCC from ICC.
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Peng J, Zheng J, Yang C, Wang R, Zhou Y, Tao YY, Gong XQ, Wang WC, Zhang XM, Yang L. Intravoxel incoherent motion diffusion-weighted imaging to differentiate hepatocellular carcinoma from intrahepatic cholangiocarcinoma. Sci Rep 2020; 10:7717. [PMID: 32382050 PMCID: PMC7206040 DOI: 10.1038/s41598-020-64804-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 04/20/2020] [Indexed: 02/08/2023] Open
Abstract
The present study aimed to explore the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in differentiating hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC). This study included 65 patients with malignant hepatic nodules (55 with HCC, 10 with ICC), and 17 control patients with normal livers. All patients underwent IVIM-DWI scans on a 3.0 T magnetic resonance imaging (MRI) scanner. The standard apparent diffusion coefficient (ADC), pure diffusion coefficient (Dslow), pseudo-diffusion coefficient (Dfast), and perfusion fraction (f) were obtained. Differences in the parameters among the groups were analysed using one-way ANOVA, with p < 0.05 indicating statistical significance. Receiver operating characteristic (ROC) curve analysis was used to compare the efficacy of each parameter in differentiating HCC from ICC. ADC, Dslow, Dfast, f significantly differed among the three groups. ADC and Dslow were significantly lower in the HCC group than in the ICC group, while Dfast was significantly higher in the HCC group than in the ICC group; f did not significantly differ between the HCC and ICC groups. When the cut-off values of ADC, Dslow, and Dfast were 1.27 × 10-3 mm2/s, 0.81 × 10-3 mm2/s, and 26.04 × 10-3 mm2/s, respectively, their diagnostic sensitivities for differentiating HCC from ICC were 98.18%, 58.18%, and 94.55%, their diagnostic specificities were 50.00%, 80.00%, and 80.00%, and their areas under the ROC curve (AUCs) were 0.687, 0.721, and 0.896, respectively. Dfast displayed the largest AUC value. IVIM-DWI can be used to differentiate HCC from ICC.
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Affiliation(s)
- Juan Peng
- Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, P. R. China
- Department of Radiology, Sichuan Provincial People's Hospital Jinniu Hospital,Chengdu Jinniu District People's Hospital, Chengdu, Sichuan, 610007, P. R. China
| | - Jing Zheng
- Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, P. R. China
| | - Cui Yang
- Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, P. R. China
| | - Ran Wang
- Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, P. R. China
| | - Yi Zhou
- Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, P. R. China
| | - Yun-Yun Tao
- Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, P. R. China
| | - Xue-Qin Gong
- Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, P. R. China
| | - Wei-Cheng Wang
- Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, P. R. China
| | - Xiao-Ming Zhang
- Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, P. R. China
| | - Lin Yang
- Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, P. R. China.
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Tosun M, Onal T, Uslu H, Alparslan B, Çetin Akhan S. Intravoxel incoherent motion imaging for diagnosing and staging the liver fibrosis and inflammation. Abdom Radiol (NY) 2020; 45:15-23. [PMID: 31705248 DOI: 10.1007/s00261-019-02300-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To evaluate the diagnostic accuracy of intravoxel incoherent motion (IVIM) model parameters for the diagnosis and staging of liver fibrosis and inflammation in patients with chronic hepatitis B. METHODS Fifty-four patients with chronic hepatitis B and 42 healthy volunteers were included in the study. All subjects were examined by 3 T magnetic resonance imaging. Diffusion-weighted imaging was undertaken with sixteen b values. IVIM parameters [D (true diffusion coefficient), D* (pseudo-diffusion coefficient), f (perfusion fraction)] were calculated. Histological evaluation of biopsy samples was considered the reference standard for the staging of liver fibrosis and inflammation. Differences in IVIM parameters between patient and control groups were analyzed. In the patient group, fibrosis stage and inflammation grade groups were analyzed with respect to IVIM parameters. The correlation was assessed between IVIM parameters and Ishak-modified scale of fibrosis stages and inflammation grades. RESULTS The D was significantly lower in the patient group than the control group, p = 0.038 with Cohen's d effect size of 0.452. D was significantly different between fibrosis stage levels. D values decreased in fibrosis stages from the minimal to moderate to marked fibrosis. Fibrosis grades significantly negatively correlated with D and D* values, p = 0.001, and 0.021, respectively. In addition, inflammation grades negatively correlated with f values, p = 0.047. CONCLUSION D values measured with IVIM imaging may help to diagnose liver fibrosis. IVIM imaging could be an alternative to liver biopsy for the staging of liver fibrosis.
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Affiliation(s)
- Mesude Tosun
- Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey.
| | | | - Hande Uslu
- Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Burcu Alparslan
- Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Sıla Çetin Akhan
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University School of Medicine, Kocaeli, Turkey
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Intravoxel incoherent motion MRI for the initial characterization of non-fatty non-vascular soft tissue tumors. Diagn Interv Imaging 2019; 101:245-255. [PMID: 31837951 DOI: 10.1016/j.diii.2019.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE To compare the capabilities of intravoxel incoherent motion (IVIM) to those of monoexponential diffusion-weighted imaging for differentiating benign from malignant non-vascular, non-fatty soft tissue tumors (NVSFSTT). MATERIAL AND METHODS A total of 64 patients with 64 histologically confirmed soft-tissue tumors were retrospectively included. There were 23 men and 41 women with a mean age of 52±17 (SD) (range: 18-92 years). IVIM parameters, including molecular diffusion restriction coefficient (ADCtrue), perfusion fraction, and tissue perfusion related coefficient were compared to mean monoexponential ADC (ADCstd) values. Two readers calculated all parameters, which were compared to histopathological findings that were used as standard of reference. RESULTS The overall performance of ADCtrue and ADCstd was similar for the benign-malignant differentiation of NFNVSTT with accuracies ranging from 73% to 75% for both readers (P=0.3). Interobserver reproducibility was considered excellent for both ADCstd and all IVIM parameters (ICC=0.81-0.96). When myxoid tumors were excluded from morphological analysis, an increase in sensitivity of 16-21% of ADCtrue was observed, with no changes in specificity values. The use of perfusion related IVIM parameters in association with ADCtrue did not improve tumor characterization. CONCLUSION The use of IVIM parameters does not improve the characterization of NVNFSTT by comparison with conventional monoexponential ADC calculation.
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Kamata Y, Shinohara Y, Kuya K, Tsubouchi Y, Saito Y, Maegaki Y, Fujii S, Ogawa T. Computed diffusion-weighted imaging for acute pediatric encephalitis/encephalopathy. Acta Radiol 2019; 60:1341-1347. [PMID: 30674215 DOI: 10.1177/0284185118823335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Yuji Kamata
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yuki Shinohara
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Keita Kuya
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshiko Tsubouchi
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshiaki Saito
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshihiro Maegaki
- Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Shinya Fujii
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Toshihide Ogawa
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
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Lin Y, Luo X, Yu L, Zhang Y, Zhou J, Jiang Y, Zhang C, Zhang J, Li C, Chen M. Amide proton transfer-weighted MRI for predicting histological grade of hepatocellular carcinoma: comparison with diffusion-weighted imaging. Quant Imaging Med Surg 2019; 9:1641-1651. [PMID: 31728308 DOI: 10.21037/qims.2019.08.07] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver, preoperative grading of HCC is of great clinical significance. Amide proton transfer-weighted (APTw) imaging, as a novel contrast mechanism in the field of molecular imaging, provided new diagnostic ideas for the grading of HCC. Methods Between May 2017 and April 2018, 32 consecutive patients with pathologically confirmed HCC were enrolled, including 19 high-grade HCCs and 13 low-grade HCCs. DWI and APTw scanning was performed on a 3T MRI scanner. Two observers drew regions of interest independently by referring to the axial T2-weighted imaging, and APTw and apparent diffusion coefficient (ADC) values were obtained. Inter- and intra-observer agreements were assessed with the intraclass correlation coefficients (ICCs). The independent sample t test was used to compare the APTw and ADC values between the high- and low-grade HCC tumor parenchyma. The receiver operating characteristic curve was used to analyze the diagnostic efficacy of high- from low-grade HCC tumors. Spearman correlation analysis was used to assess the relationship between APTw and ADC values and HCC histological grades. Results There were significant differences between the APTw or ADC values for the high- and low-grade HCCs (P=0.034 and 0.010). Both APTw and DWI had good diagnostic performance in differentiating the high- from the low-grade HCCs, with areas under the curves of 0.814 and 0.745, respectively. Moderate correlations existed between APTw values and histological grades (r=0.534; P=0.002), as well as ADC values and histological grades (r=-0.417; P=0.018). Conclusions The APTw imaging is a useful imaging biomarker that complements DWI for the more accurate and comprehensive HCC characterization.
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Affiliation(s)
- Yue Lin
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China.,Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Xiaojie Luo
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Lu Yu
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China.,Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Yi Zhang
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou 310058, China
| | - Jinyuan Zhou
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Yuwei Jiang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Chen Zhang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Jintao Zhang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Chunmei Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China.,Graduate School of Peking Union Medical College, Beijing 100730, China
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Effect of intravoxel incoherent motion on diffusion parameters in normal brain. Neuroimage 2019; 204:116228. [PMID: 31580945 DOI: 10.1016/j.neuroimage.2019.116228] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/15/2019] [Accepted: 09/25/2019] [Indexed: 02/07/2023] Open
Abstract
At very low diffusion weighting the diffusion MRI signal is affected by intravoxel incoherent motion (IVIM) caused by dephasing of magnetization due to incoherent blood flow in capillaries or other sources of microcirculation. While IVIM measurements at low diffusion weightings have been frequently used to investigate perfusion in the body as well as in malignant tissue, the effect and origin of IVIM in normal brain tissue is not completely established. We investigated the IVIM effect on the brain diffusion MRI signal in a cohort of 137 radiologically-normal patients (62 male; mean age = 50.2 ± 17.8, range = 18 to 94). We compared the diffusion tensor parameters estimated from a mono-exponential fit at b = 0 and 1000 s/mm2 versus at b = 250 and 1000 s/mm2. The asymptotic fitting method allowed for quantitative assessment of the IVIM signal fraction f* in specific brain tissue and regions. Our results show a mean (median) percent difference in the mean diffusivity of about 4.5 (4.9)% in white matter (WM), about 7.8 (8.7)% in cortical gray matter (GM), and 4.3 (4.2)% in thalamus. Corresponding perfusion fraction f* was estimated to be 0.033 (0.032) in WM, 0.066 (0.065) in cortical GM, and 0.033 (0.030) in the thalamus. The effect of f* with respect to age was found to be significant in cortical GM (Pearson correlation ρ = 0.35, p = 3*10-5) and the thalamus (Pearson correlation ρ = 0.20, p = 0.022) with an average increase in f* of 5.17*10-4/year and 3.61*10-4/year, respectively. Significant correlations between f* and age were not observed for WM, and corollary analysis revealed no effect of gender on f*. Possible origins of the IVIM effect in normal brain tissue are discussed.
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The effect of spatial resolution on the reproducibility of diffusion imaging when controlled signal to noise ratio. Biomed J 2019; 42:268-276. [PMID: 31627869 PMCID: PMC6818162 DOI: 10.1016/j.bj.2019.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 02/26/2019] [Accepted: 03/11/2019] [Indexed: 12/28/2022] Open
Abstract
Background The purpose of the study is to evaluate the reproducibility and repeatability of the compartmental diffusion measurement. Methods Two identical whipping cream phantoms and two healthy Sprague–Dawley rats were scanned on a 7T MR scanner, each repeated for three times. Diffusion weighted images were acquired along 30 non-collinear gradient directions, each with four b-values of 750, 1500, 2250 and 3000 s/mm2. Slice thickness and field of view were used to create different combinations of voxel sizes, varied between 1.210 and 2.366 mm3 in phantom and 0.200–0.303 mm3 in rat brains. Multiple averages were used to achieve a controlled signal to noise ratio. Results Diffusion imaging showed good stability throughout the range of voxel sizes acquired from either the cream phantom or the rat, when the signal to noise ratio is controlled. The reproducibility analysis showed the within-subject coefficient of variation varied between 0.88% and 6.99% for phantom and 0.69%–6.19% for rat. Diffusion imaging is stable among different voxel sizes in 3 aspects: A. from both compartments in phantom and in the rat; B. in measurement of diffusivity and kurtosis and C. along axial, radial and averaged in all directions. Conclusion Diffusion imaging in a heterogeneous but isotropic phantom and in vivo is consistent within the range of spatial resolution in preclinical use and when the signal to noise ratio is fixed. The result is reproducible for repeated measurements.
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Spinner GR, Stoeck CT, Mathez L, von Deuster C, Federau C, Kozerke S. On probing intravoxel incoherent motion in the heart‐spin‐echo versus stimulated‐echo DWI. Magn Reson Med 2019; 82:1150-1163. [DOI: 10.1002/mrm.27777] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/06/2019] [Accepted: 03/27/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Georg R. Spinner
- Institute for Biomedical Engineering University and ETH Zurich Zurich Switzerland
| | - Christian T. Stoeck
- Institute for Biomedical Engineering University and ETH Zurich Zurich Switzerland
| | - Linda Mathez
- Institute for Biomedical Engineering University and ETH Zurich Zurich Switzerland
| | | | - Christian Federau
- Institute for Biomedical Engineering University and ETH Zurich Zurich Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering University and ETH Zurich Zurich Switzerland
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Mürtz P, Pieper CC, Reick M, Sprinkart AM, Schild HH, Willinek WA, Kukuk GM. Is liver lesion characterisation by simplified IVIM DWI also feasible at 3.0 T? Eur Radiol 2019; 29:5889-5900. [DOI: 10.1007/s00330-019-06192-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/25/2019] [Accepted: 03/20/2019] [Indexed: 12/21/2022]
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Wu L, Li J, Fu C, Kühn B, Wang X. Chemotherapy response of pancreatic cancer by diffusion-weighted imaging (DWI) and intravoxel incoherent motion DWI (IVIM-DWI) in an orthotopic mouse model. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2019; 32:501-509. [DOI: 10.1007/s10334-019-00745-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 01/19/2019] [Accepted: 02/17/2019] [Indexed: 12/14/2022]
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Wáng YXJ. Living tissue intravoxel incoherent motion (IVIM) diffusion MR analysis without b=0 image: an example for liver fibrosis evaluation. Quant Imaging Med Surg 2019; 9:127-133. [PMID: 30976535 PMCID: PMC6414775 DOI: 10.21037/qims.2019.01.07] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 01/25/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
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Wáng YXJ, Li YT, Chevallier O, Huang H, Leung JCS, Chen W, Lu PX. Dependence of intravoxel incoherent motion diffusion MR threshold b-value selection for separating perfusion and diffusion compartments and liver fibrosis diagnostic performance. Acta Radiol 2019; 60:3-12. [PMID: 29742916 DOI: 10.1177/0284185118774913] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Intravoxel incoherent motion (IVIM) tissue parameters depend on the threshold b-value. PURPOSE To explore how threshold b-value impacts PF ( f), Dslow ( D), and Dfast ( D*) values and their performance for liver fibrosis detection. MATERIAL AND METHODS Fifteen healthy volunteers and 33 hepatitis B patients were included. With a 1.5-T magnetic resonance (MR) scanner and respiration gating, IVIM data were acquired with ten b-values of 10, 20, 40, 60, 80, 100, 150, 200, 400, and 800 s/mm2. Signal measurement was performed on the right liver. Segmented-unconstrained analysis was used to compute IVIM parameters and six threshold b-values in the range of 40-200 s/mm2 were compared. PF, Dslow, and Dfast values were placed along the x-axis, y-axis, and z-axis, and a plane was defined to separate volunteers from patients. RESULTS Higher threshold b-values were associated with higher PF measurement; while lower threshold b-values led to higher Dslow and Dfast measurements. The dependence of PF, Dslow, and Dfast on threshold b-value differed between healthy livers and fibrotic livers; with the healthy livers showing a higher dependence. Threshold b-value = 60 s/mm2 showed the largest mean distance between healthy liver datapoints vs. fibrotic liver datapoints, and a classification and regression tree showed that a combination of PF (PF < 9.5%), Dslow (Dslow < 1.239 × 10-3 mm2/s), and Dfast (Dfast < 20.85 × 10-3 mm2/s) differentiated healthy individuals and all individual fibrotic livers with an area under the curve of logistic regression (AUC) of 1. CONCLUSION For segmented-unconstrained analysis, the selection of threshold b-value = 60 s/mm2 improves IVIM differentiation between healthy livers and fibrotic livers.
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Affiliation(s)
- Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
| | - Yáo T Li
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
| | - Olivier Chevallier
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
- Department of Vascular and Interventional Radiology, University of Bourgogne/Franche-Comté, François-Mitterrand Teaching Hospital, Dijon Cedex, France
| | - Hua Huang
- Department of Radiology, The Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, PR China
| | - Jason Chi Shun Leung
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR
| | - Weitian Chen
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR
| | - Pu-Xuan Lu
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong Province, PR China
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Clinical efficacy of simplified intravoxel incoherent motion imaging using three b-values for differentiating high- and low-grade gliomas. PLoS One 2018; 13:e0209796. [PMID: 30589912 PMCID: PMC6307720 DOI: 10.1371/journal.pone.0209796] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 12/11/2018] [Indexed: 11/27/2022] Open
Abstract
In this study, we evaluated the efficacy of intravoxel incoherent motion (IVIM)-derived parameters calculated with three b-values in differentiating high-grade gliomas (HGGs) from low-grade gliomas (LGGs) by comparing those calculated with multiple b-values. Ten patients with LGG (ages 35.1±12.1 yrs; 4 males, 6 females) and 21 patients with HGG (ages 60.6±19.1 yrs; 10 males, 11 females) who underwent subsequent surgical resections were examined with both IVIM imaging and histopathological analysis. The IVIM diffusion-weighted imaging was conducted using a single-shot echo planar sequence with 13 b-factors (0, 10, 20, 30, 50, 80, 100, 200, 300, 400, 600, 800, and 1000 sec/mm2) at 3T. In the conventional IVIM analysis, the perfusion fraction (f) and true diffusion coefficient (D) were calculated by biexponential fitting model with 13 b-values. In the simplified method with the selected three b-values (0, 300, and 1000 sec/mm2), D simply corresponds to the slope of a straight line passing through two logarithmic signal intensities (SIs) at the b-values of 300 and 1000 s/mm2, and f corresponds to the difference between the intercept of this line and SI at the b-value of 0 sec/mm2. The maximum f (f-max) and minimum D (D-min) was measured in each tumor. The f-max values calculated with three b-values (12.8±5.9%) were significantly lower than those with 13 b-values (17.3±7.5%, p<0.0001), but a good correlation and agreement were observed between these sets of f-max values (r = 0.79, ICC = 0.87). In the IVIM imaging with both three and 13 b-values, the HGGs showed significantly higher f-max values compared to the LGGs (p<0.001, respectively). The D-min values calculated with three b-values (1.06±0.31 ×10−3 mm2/sec) was not different from those with 13 b-values (1.07±0.33 ×10−3 mm2/sec), and an excellent correlation and agreement were found between them (r = 0.99, ICC = 0.99). The simplified IVIM imaging using three b-values can efficiently differentiate HGGs and LGGs.
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Spinner GR, Schmidt JFM, von Deuster C, Federau C, Stoeck CT, Kozerke S. Enhancing intravoxel incoherent motion parameter mapping in the brain using k-b PCA. NMR IN BIOMEDICINE 2018; 31:e4008. [PMID: 30264445 DOI: 10.1002/nbm.4008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/11/2018] [Accepted: 07/30/2018] [Indexed: 06/08/2023]
Abstract
Intravoxel incoherent motion (IVIM) imaging of diffusion and perfusion parameters in the brain using parallel imaging suffers from local noise amplification. To address the issue, signal correlations in space and along the diffusion encoding dimension are exploited jointly using a constrained image reconstruction approach. IVIM imaging was performed on a clinical 3 T MR system with diffusion weighting along six gradient directions and 16 b-values encoded per direction across a range of 0-900 s/mm2 . Data were collected in 11 subjects, retrospectively undersampled in k-space with net factors ranging from 2 to 6 and reconstructed using CG-SENSE and the proposed k-b PCA approach. Results of k-b PCA and CG-SENSE from retrospectively undersampled data were compared with those from the fully sampled reference. In addition, prospective single-shot k-b undersampling was implemented and data were acquired in five additional volunteers. IVIM parameter maps were derived using a segmented least-squares method. The proposed k-b PCA method outperformed CG-SENSE in terms of reconstruction errors for effective undersampling factors of 3 and beyond. Undersampling artifacts were effectively removed with k-b PCA up to sixfold undersampling. At net sixfold undersampling, relative errors (compared with the fully sampled reference) of image magnitude and IVIM parameters (D, f and D* ) were (median ± interquartile range): 3.5 ± 3.7 versus 25.3 ± 25.8%, 2.7 ± 3.6 versus 14.2 ± 20.4%, 15.1 ± 26.1 versus 96.6 ± 67.4% and 14.8 ± 26.6 versus 100 ± 195.1% for k-b PCA versus CG-SENSE, respectively. Acquisition with sixfold prospective undersampling yielded average IVIM parameters in the brain of 0.79 ± 0.18 × 10-3 mm2 /s for D, 7.35 ± 7.27% for f and 7.11 ± 2.39 × 10-3 mm2 /s for D* . Constrained reconstruction using k-b PCA improves IVIM parameter mapping from undersampled data when compared with CG-SENSE reconstruction. Prospectively undersampled single-shot echo planar imaging acquisition was successfully employed using k-b PCA, demonstrating a reduction of image artifacts and noise relative to parallel imaging.
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Affiliation(s)
- Georg R Spinner
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Johannes F M Schmidt
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | | | - Christian Federau
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Christian T Stoeck
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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Miyoshi F, Shinohara Y, Kambe A, Kuya K, Murakami A, Kurosaki M, Ogawa T. Utility of intravoxel incoherent motion magnetic resonance imaging and arterial spin labeling for recurrent glioma after bevacizumab treatment. Acta Radiol 2018; 59:1372-1379. [PMID: 29471670 DOI: 10.1177/0284185118759707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Detecting recurrence of glioma on magnetic resonance imaging (MRI) is getting more and more important, especially after administration of new anti-tumor agent. However, it is still hard to identify. Purpose To examine the utility of intravoxel incoherent motion (IVIM) MRI and arterial spin labeling-cerebral blood flow (ASL-CBF) for recurrent glioma after initiation of bevacizumab (BEV) treatment. Material and Methods Thirteen patients (7 men, 6 women; age range = 41-82 years) with glioma (high grade, n = 11; low grade, n = 2) were enrolled in the study. IVIM parameters including apparent diffusion coefficient (ADC), true diffusion coefficient (D), and perfusion fraction (f) were obtained with 14 different b-values. We identified tumor progression during BEV therapy by MRI monitoring consisting of diffusion-weighted imaging (DWI), fluid-attenuated inversion recovery (FLAIR) imaging, and contrast-enhanced T1-weighted (CE-T1W) imaging by measuring tumor area. We also measured each parameter of IVIM and ASL-CBF, and calculated relative ADC (rADC), relative D (rD), relative f (rf), and relative CBF (rCBF) by obtaining the ratio between each area and the contralateral cerebral white matter. We calculated the rate of change (Δ) by subtracting values from those from the preceding MRI study, and obtained Spearman's rank correlation coefficient (rs). Results Tumor progression was identified in nine patients (high grade, n = 7; low grade, n = 2). Negative correlations were identified between ΔrD and ΔDWI area (rs = -0.583), and between ΔrD and ΔCE-T1W imaging area (rs = -0.605). Conclusion Tumor progression after BEV treatment can be identified by decreasing rD.
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Affiliation(s)
- Fuminori Miyoshi
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yuki Shinohara
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Atsushi Kambe
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Keita Kuya
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Atsushi Murakami
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Masamichi Kurosaki
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Toshihide Ogawa
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Yonago, Japan
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