RESUMO
BACKGROUND: 1p/19q co-deletion in low-grade gliomas (LGG, World Health Organization grade II and III) is of great significance in clinical decision making. We aim to use radiomics analysis to predict 1p/19q co-deletion in LGG based on amide proton transfer weighted (APTw), diffusion weighted imaging (DWI), and conventional MRI. METHODS: This retrospective study included 90 patients histopathologically diagnosed with LGG. We performed a radiomics analysis by extracting 8454 MRI-based features form APTw, DWI and conventional MR images and applied a least absolute shrinkage and selection operator (LASSO) algorithm to select radiomics signature. A radiomics score (Rad-score) was generated using a linear combination of the values of the selected features weighted for each of the patients. Three neuroradiologists, including one experienced neuroradiologist and two resident physicians, independently evaluated the MR features of LGG and provided predictions on whether the tumor had 1p/19q co-deletion or 1p/19q intact status. A clinical model was then constructed based on the significant variables identified in this analysis. A combined model incorporating both the Rad-score and clinical factors was also constructed. The predictive performance was validated by receiver operating characteristic curve analysis, DeLong analysis and decision curve analysis. P < 0.05 was statistically significant. RESULTS: The radiomics model and the combined model both exhibited excellent performance on both the training and test sets, achieving areas under the curve (AUCs) of 0.948 and 0.966, as well as 0.909 and 0.896, respectively. These results surpassed the performance of the clinical model, which achieved AUCs of 0.760 and 0.766 on the training and test sets, respectively. After performing Delong analysis, the clinical model did not significantly differ in predictive performance from three neuroradiologists. In the training set, both the radiomic and combined models performed better than all neuroradiologists. In the test set, the models exhibited higher AUCs than the neuroradiologists, with the radiomics model significantly outperforming resident physicians B and C, but not differing significantly from experienced neuroradiologist. CONCLUSIONS: Our results suggest that our algorithm can noninvasively predict the 1p/19q co-deletion status of LGG. The predictive performance of radiomics model was comparable to that of experienced neuroradiologist, significantly outperforming the diagnostic accuracy of resident physicians, thereby offering the potential to facilitate non-invasive 1p/19q co-deletion prediction of LGG.
Assuntos
Neoplasias Encefálicas , Glioma , Humanos , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patologia , Prótons , Estudos Retrospectivos , Radiômica , Glioma/diagnóstico por imagem , Glioma/genética , Glioma/patologia , Algoritmos , Imageamento por Ressonância Magnética/métodosRESUMO
Chemical exchange saturation transfer (CEST) imaging is an important molecular magnetic resonance imaging technique that can image numerous low-concentration biomolecules with water-exchangeable protons (such as cellular proteins) and tissue pH. CEST, or more specially amide proton transfer-weighted imaging, has been widely used for the detection, diagnosis, and response assessment of brain tumors, and its feasibility in identifying molecular markers in gliomas has also been explored in recent years. In this paper, after briefing on the basic principles and quantification methods of CEST imaging, we review its early applications in identifying isocitrate dehydrogenase mutation status, MGMT methylation status, 1p/19q deletion status, and H3K27M mutation status in gliomas. Finally, we discuss the limitations or weaknesses in these studies.
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Neoplasias Encefálicas , Glioma , Humanos , Marcadores Genéticos , Imageamento por Ressonância Magnética/métodos , Glioma/diagnóstico por imagem , Glioma/genética , Glioma/química , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/química , Prótons , Isocitrato Desidrogenase/genéticaRESUMO
BACKGROUND: Stiffness of meningioma is an important factor affecting the surgical resection and the prognosis of patients. PURPOSE: To examine the feasibility of APTw-magnetic resonance imaging (MRI) in evaluating meningioma stiffness. STUDY TYPE: Retrospective. POPULATION: Seventy-one patient with meningiomas, 39 were male and 32 were female; the mean age was 51 ± 10 years. FIELD STRENGTH/SEQUENCE: 3.0T; Turbo-spin-echo T1 -weighted and Gd-T1 -weighted sequence; Turbo-spin-echo T2 -weighted sequence; 2D fat-suppressed, turbo-spin-echo APTw pulse sequence. ASSESSMENT: The T1 WI signal intensity score, T2 WI signal intensity score, APTwmin , APTwmax , and APTwmean values were compared between soft, medium stiff and stiff meningiomas or non-stiff meningiomas and stiff meningiomas group. STATISTICAL TESTS: Chi-square test, one-way ANOVA analysis, independent-samples t-test, intra-class correlation coefficient, rank-sum test, receiver operating characteristic curve analysis. P < 0.05 was considered statistically significant in all tests. RESULTS: APTwmin and APTwmean in the stiff group were significantly lower than that in the non-stiff group (2.79% ± 0.42% vs. 1.90% ± 0.60% and 3.20% ± 0.31% vs. 2.55% ± 0.61%). APTwmin and APTwmean in the stiff group were significantly lower than that in the medium stiff and soft groups (1.90% ± 0.60% vs. 2.69% ± 0.40% and 3.12% ± 0.32%, 2.55% ± 0.61% vs. 3.17% ± 0.33% and 3.39% ± 0.18%), APTwmin in the medium stiff group was significantly lower than in the soft group, there was no significant difference in APTwmean between the medium stiff and soft groups (P = 0.190). APTwmin showed the best diagnostic performance for evaluating meningioma stiffness with an area under the curve of 0.913, when the APTwmin was lower than 2.4%, the meningioma was defined as a stiff tumor, the sensitivity, specificity, and accuracy were 87.1%, 87.5%, and 85.9%, respectively. DATA CONCLUSION: APTw-MRI could be used to evaluate meningioma stiffness, with APTwmin having the best evaluative efficiency. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 1.
Assuntos
Neoplasias Meníngeas , Meningioma , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Meningioma/patologia , Prótons , Estudos de Viabilidade , Amidas , Estudos Retrospectivos , Imageamento por Ressonância Magnética/métodosRESUMO
Amide proton transfer-weighted (APTw) MR imaging shows promise as a biomarker of brain tumor status. Currently used APTw MRI pulse sequences and protocols vary substantially among different institutes, and there are no agreed-on standards in the imaging community. Therefore, the results acquired from different research centers are difficult to compare, which hampers uniform clinical application and interpretation. This paper reviews current clinical APTw imaging approaches and provides a rationale for optimized APTw brain tumor imaging at 3 T, including specific recommendations for pulse sequences, acquisition protocols, and data processing methods. We expect that these consensus recommendations will become the first broadly accepted guidelines for APTw imaging of brain tumors on 3 T MRI systems from different vendors. This will allow more medical centers to use the same or comparable APTw MRI techniques for the detection, characterization, and monitoring of brain tumors, enabling multi-center trials in larger patient cohorts and, ultimately, routine clinical use.
Assuntos
Neoplasias Encefálicas , Amidas , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Consenso , Dimaprit/análogos & derivados , Humanos , Imageamento por Ressonância Magnética/métodos , PrótonsRESUMO
Natural and synthetic sugars have great potential for developing highly biocompatible and translatable chemical exchange saturation transfer (CEST) MRI contrast agents. In this study, we aimed to develop the smallest clinically available form of dextran, Dex1 (molecular weight, MW ~ 1 kDa), as a new CEST agent. We first characterized the CEST properties of Dex1 in vitro at 11.7 T and showed that the Dex1 had a detectable CEST signal at ~1.2 ppm, attributed to hydroxyl protons. In vivo CEST MRI studies were then carried out on C57BL6 mice bearing orthotopic GL261 brain tumors (n = 5) using a Bruker BioSpec 11.7 T MRI scanner. Both steady-state full Z-spectral images and single offset (1.2 ppm) dynamic dextran-enhanced (DDE) images were acquired before and after the intravenous injection of Dex1 (2 g/kg). The steady-state Z-spectral analysis showed a significantly higher CEST contrast enhancement in the tumor than in contralateral brain (∆MTRasym1.2 ppm = 0.010 ± 0.006 versus 0.002 ± 0.008, P = 0.0069) at 20 min after the injection of Dex1. Pharmacokinetic analyses of DDE were performed using the area under the curve (AUC) in the first 10 min after Dex1 injection, revealing a significantly higher uptake of Dex1 in the tumor than in brain tissue for tumor-bearing mice (AUC[0-10 min] = 21.9 ± 4.2 versus 5.3 ± 6.4%·min, P = 0.0294). In contrast, no Dex1 uptake was foundling in the brains of non-tumor-bearing mice (AUC[0-10 min] = -1.59 ± 2.43%·min). Importantly, the CEST MRI findings were consistent with the measurements obtained using DCE MRI and fluorescence microscopy, demonstrating the potential of Dex1 as a highly translatable CEST MRI contrast agent for assessing tumor hemodynamics.
Assuntos
Meios de Contraste , Aumento da Imagem , Imageamento por Ressonância Magnética/métodos , Animais , Neoplasias Encefálicas/diagnóstico por imagem , Dextranos , Feminino , Camundongos , Camundongos Endogâmicos C57BL , Microscopia de FluorescênciaRESUMO
OBJECTIVES: To evaluate the performance of velocity-selective (VS) ASL among patients with untreated gliomas by comparing with both pseudo-continuous (PC) ASL and dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI). METHODS: Forty-four consecutive patients with newly diagnosed glioma who underwent preoperative perfusion MRI including VSASL, PCASL, and DSC-PWI between 2017 and 2019 were retrospectively evaluated. Visual inspection was performed to evaluate the tumor signal intensity relative to gray matter based on 1-5 score criteria and weighted kappa was used to evaluate the pair-wise concordance between VSASL or PCASL and DSC-PWI. The relative tumor blood flow (rTBF) was measured from sampling intra-tumoral areas of hot-spot on the blood flow map and normalized against the contralateral normal gray matter blood flow. Linear regression and Bland-Altman analyses were performed to evaluate the correlation and agreement of rTBF measurements between ASL methods and DSC-PWI. The ROC analysis was constructed to determine the diagnostic performance of three perfusion methods for grading gliomas. RESULTS: TBF maps derived from VSASL were more comparable with DSC-PWI than PCASL on visual inspection (weighted kappa of 0.90 vs 0.68). In quantitative analysis, VSASL-rTBF yielded higher correlation with the values from DSC-PWI than PCASL-rTBF (R2 = 80% vs 47%, p < 0.001 for both). Both ASL and DSC-derived rTBF showed good distinction between low-grade and high-grade gliomas (p < 0.001). Compared to PCASL, VSASL yielded superior diagnostic sensitivity, specificity, and accuracy in glioma grading. CONCLUSIONS: VSASL showed great promise for accurate quantification of TBF and could potentially improve the diagnostic performance of ASL in preoperative grading of gliomas. KEY POINTS: ⢠VSASL demonstrated a greater agreement with DSC-PWI than with PCASL on visual inspection and perfusion quantification. ⢠VSASL showed a higher diagnostic sensitivity, negative predictive value, and accuracy than PCASL for glioma grading. ⢠With the advantages of insensitivity to transit delay and no need of prescribing a labeling plane, VSASL could potentially improve the diagnostic performance of ASL for a more accurate, noninvasive quantification of TBF in patients with glioma.
Assuntos
Neoplasias Encefálicas , Glioma , Encéfalo/patologia , Neoplasias Encefálicas/patologia , Circulação Cerebrovascular/fisiologia , Meios de Contraste/farmacologia , Glioma/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Perfusão , Estudos Retrospectivos , Marcadores de SpinRESUMO
BACKGROUND: Concerns over gadolinium (Gd) retention encourage the use of lower Gd doses. However, lower Gd doses may compromise imaging performance. Higher relaxivity gadobenate may be suited to reduced dose protocols. PURPOSE: To compare 0.05 mmol/kg and 0.1 mmol/kg gadobenate in patients undergoing enhanced MRI of the central nervous system (CNS). STUDY TYPE: Retrospective, multicenter. POPULATION: Three hundred and fifty-two patients receiving 0.05 (n = 181) or 0.1 (n = 171) mmol/kg gadobenate. FIELD STRENGTH/SEQUENCES: 1.5 T and 3.0 T/precontrast and postcontrast T1-weighted spin echo/fast spin echo (SE/FSE) and/or gradient echo/fast field echo (GRE/FFE); precontrast T2-weighted FSE and T2-FLAIR. ASSESSMENT: Images of patients with extra-axial lesions at 1.5 T or any CNS lesion at 3.0 T were reviewed by three blinded, independent neuroradiologists for qualitative (lesion border delineation, internal morphology visualization, contrast enhancement; scores from 1 = poor to 4 = excellent) and quantitative (lesion-to-brain ratio [LBR], contrast-to-noise ratio [CNR]; SI measurements at regions-of-interest on lesion and normal parenchyma) enhancement measures. Noninferiority of 0.05 mmol/kg gadobenate was determined for each qualitative endpoint if the lower limit of the 95% confidence interval (CI) for the difference in precontrast + postcontrast means was above a noninferiority margin of -0.4. STATISTICAL TESTS: Student's t-test for comparison of mean qualitative endpoint scores, Wilcoxon signed rank test for comparison of LBR and CNR values; Wilcoxon rank sum test for comparison of SI changes. Tests were significant for P < 0.05. RESULTS: The mean change from precontrast to precontrast + postcontrast was significant for all endpoints. Readers 1, 2, and 3 evaluated 304, 225, and 249 lesions for 0.05 mmol/kg gadobenate, and 382, 309, and 298 lesions for 0.1 mmol/kg gadobenate. The lower limit of the 95% CI was above -0.4 for all comparisons. Significantly, higher LBR and CNR was observed with the higher dose. DATA CONCLUSION: 0.05 mmol/kg gadobenate was noninferior to 0.1 mmol/kg gadobenate for lesion visualization. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 3.
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Neoplasias Encefálicas , Compostos Organometálicos , Encéfalo/diagnóstico por imagem , Meios de Contraste , Gadolínio DTPA , Humanos , Imageamento por Ressonância Magnética , Meglumina/análogos & derivados , Estudos RetrospectivosRESUMO
OBJECTIVES: To investigate age-related changes on passive muscle stiffness in healthy individuals and measure the shear modulus in different age groups. METHODS: Shear wave elastography (SWE) movies of gastrocnemius medialis (GM) were collected during passive stretching induced by ankle rotation from plantarflexion (PF) to dorsiflexion (DF). A series of SWE images at ankle angles of PF 40°, PF 30°, PF 20°, PF 10°, 0°, DF 10°, DF 20°, and DF 30° were collected and shear moduli measured accordingly for analyses. RESULTS: Eighty-six healthy volunteers (27 children, 31 middle-aged adults, and 28 older people) were recruited. No significant difference was observed in the shear modulus between the three groups at ankle angles of PF 40°, PF 30°, PF 20°, PF 10°, and 0° (p > 0.05). The difference in the shear modulus among the three groups became significant as DF increased. At ankle angles of DF 10°, DF 20°, and DF 30°, the shear modulus was the greatest in the older group, followed by the middle-aged group and then the children group (p = 0.007, 0.000, and 0.000, respectively). CONCLUSIONS: Passive muscle stiffness increases with age, and the difference between age groups was pronounced only after reaching a certain degree of stretching. KEY POINTS: ⢠The influence of age on passive muscle stiffness becomes pronounced only after reaching a certain degree of stretching. ⢠Age should be considered when evaluating passive muscle stiffness in muscular disorders.
Assuntos
Técnicas de Imagem por Elasticidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Tornozelo , Articulação do Tornozelo/diagnóstico por imagem , Criança , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Amplitude de Movimento ArticularRESUMO
INTRODUCTION: Accurately assessing axillary lymph node (ALN) status in breast cancer is vital for clinical decision making and prognosis. The purpose of this study was to evaluate the predictive value of sentinel lymph node (SLN) mapped by multidetector-row computed tomography lymphography (MDCT-LG) for ALN metastasis in breast cancer patients. METHODS: 112 patients with breast cancer who underwent preoperative MDCT-LG examination were included in the study. Long-axis diameter, short-axis diameter, ratio of long-/short-axis and cortical thickness were measured. Logistic regression analysis was performed to evaluate independent predictors associated with ALN metastasis. The prediction of ALN metastasis was determined with related variables of SLN using receiver operating characteristic (ROC) curve analysis. RESULTS: Among the 112 cases, 35 (30.8%) cases had ALN metastasis. The cortical thickness in metastatic ALN group was significantly thicker than that in non-metastatic ALN group (4.0 ± 1.2 mm vs. 2.4 ± 0.7 mm, P < 0.001). Multi-logistic regression analysis indicated that cortical thickness of > 3.3 mm (OR 24.53, 95% CI 6.58-91.48, P < 0.001) had higher risk for ALN metastasis. The best sensitivity, specificity, negative predictive value(NPV) and AUC of MDCT-LG for ALN metastasis prediction based on the single variable of cortical thickness were 76.2%, 88.5%, 90.2% and 0.872 (95% CI 0.773-0.939, P < 0.001), respectively. CONCLUSION: ALN status can be predicted using the imaging features of SLN which was mapped on MDCT-LG in breast cancer patients. Besides, it may be helpful to select true negative lymph nodes in patients with early breast cancer, and SLN biopsy can be avoided in clinically and radiographically negative axilla.
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Axila/patologia , Neoplasias da Mama/patologia , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Tomografia Computadorizada Multidetectores , Linfonodo Sentinela/diagnóstico por imagem , Linfonodo Sentinela/patologia , Adulto , Idoso , Meios de Contraste , Feminino , Humanos , Imageamento Tridimensional , Iopamidol , Linfografia/métodos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
PURPOSE: Velocity-selective saturation (VSS) pulse trains provide a viable alternative to the spatially selective methods for measuring cerebral blood volume (CBV) by reducing the sensitivity to arterial transit time. This study is to compare the Fourier-transform-based velocity-selective saturation (FT-VSS) pulse trains with the conventional flow-dephasing VSS techniques for CBV quantification. METHODS: The proposed FT-VSS label and control modules were compared with VSS pulse trains utilizing double refocused hyperbolic tangent (DRHT) and 8-segment B1-insensitive rotation (BIR-8). This was done using both numerical simulations and phantom studies to evaluate their sensitivities to gradient imperfections such as eddy currents. DRHT, BIR-8, and FT-VSS prepared CBV mapping was further compared for velocity-encoding gradients along 3 orthogonal directions in healthy subjects at 3T. RESULTS: The phantom studies exhibited more consistent immunity to gradient imperfections for the utilized FT-VSS pulse trains. Compared to DRHT and BIR-8, FT-VSS delivered more robust CBV results across the 3 VS encoding directions with significantly reduced artifacts along the superior-inferior direction and improved temporal signal-to-noise ratio (SNR) values. Average CBV values obtained from FT-VSS based sequences were 5.3 mL/100 g for gray matter and 2.3 mL/100 g for white matter, comparable to literature expectations. CONCLUSION: Absolute CBV quantification utilizing advanced FT-VSS pulse trains had several advantages over the existing approaches using flow-dephasing VSS modules. A greater immunity to gradient imperfections and the concurrent tissue background suppression of FT-VSS pulse trains enabled more robust CBV measurements and higher SNR than the conventional VSS pulse trains.
Assuntos
Encéfalo , Volume Sanguíneo Cerebral/fisiologia , Análise de Fourier , Processamento de Imagem Assistida por Computador/métodos , Angiografia por Ressonância Magnética/métodos , Adulto , Encéfalo/irrigação sanguínea , Encéfalo/diagnóstico por imagem , Simulação por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagens de Fantasmas , Razão Sinal-Ruído , Marcadores de SpinRESUMO
BACKGROUND: Psychological investigations and functional imaging technology have been used to describe neural correlations of different types of memory with various stimuli. Memory with limited storage capacity and a short retention time can be classified as short-term memory (STM) while long-term memory (LTM) can be life-long without defined capacity. METHODS: To identify brain activation pattern associated with different modes of memory for numerical figures, we detected brain activities from twenty-two healthy subjects when performing three types of memory tasks for numbers, namely STM, LTM and working memory (WM), by using functional magnetic resonance imaging (fMRI) technique. RESULTS: The result revealed variable patterns of activation in different brain regions responding to different types of memory tasks. The activation regions with primary processing and transient maintenance of STM for numerical figures are located in the visual cortex and mainly encoded by visual representations, while LTM was encoded by semantics and mainly recruiting left frontal cortex. We also found that subcortical structures, such as the caudate nucleus and the marginal division of the striatum, plays important roles in working memory. CONCLUSIONS: Activation of different brain regions in these three kinds of memories, indicating that different kinds of memories rely on different neural correlates and mental processes.
Assuntos
Encéfalo/fisiologia , Imageamento por Ressonância Magnética , Memória de Longo Prazo/fisiologia , Memória de Curto Prazo/fisiologia , Mapeamento Encefálico , Feminino , Humanos , Masculino , Adulto JovemRESUMO
OBJECTIVES: To determine the utility of the amide proton transfer-weighted MR imaging in differentiating the WHO grade and predict proliferative activity of meningioma. METHODS: Fifty-three patients with WHO grade I meningiomas and 26 patients with WHO grade II meningiomas underwent conventional and APT-weighted sequences on a 3.0 Tesla MR before clinical intervention. The APT-weighted (APTw) parameters in the solid tumor region were obtained and compared between two grades using the t test; the receiver operating characteristic (ROC) curve was used to assess the best parameter for predicting the grade of meningiomas. Pearson's correlation coefficient was calculated between the APTwmax and Ki-67 labeling index in meningiomas. RESULTS: The APTwmax and APTwmean values were not significantly different between WHO grade I and grade II meningiomas (p = 0.103 and p = 0.318). The APTwmin value was higher and the APTwmax-min value was lower in WHO grade II meningiomas than in WHO grade I tumors (p = 0.027 and p = 0.019). But the APTwmin was higher and the APTwmax-min was lower in microcystic meningiomas than in WHO grade II meningiomas (p = 0.001 and p = 0.006). The APTwmin combined with APTwmax-min showed the best diagnostic performance in predicting the grade of meningiomas with an AUC of 0.772. The APTwmax value was positively correlated with Ki-67 labeling index (r = 0.817, p < 0.001) in meningiomas; the regression equation for the Ki-67 labeling index (%) (Y) and APTwmax (%) (X) was Y = 4.9 × X - 12.4 (R2 = 0.667, p < 0.001). CONCLUSION: As a noninvasive imaging method, the ability of APTw-MR imaging in differentiating the grade of meningiomas is limited, but the technology can be used to predict the proliferative activity of meningioma. KEY POINTS: ⢠The APTw min value was higher and the APTw max-min value was lower in WHO grade II meningioma than in grade I tumors. ⢠The APTw min value was higher and the APTw max-min value was lower in microcystic meningiomas than in WHO grade II meningiomas. ⢠The APTw max value was positively correlated with meningioma proliferation index.
Assuntos
Amidas , Neoplasias Meníngeas/patologia , Meningioma/patologia , Prótons , Adulto , Idoso , Proliferação de Células/fisiologia , Feminino , Humanos , Antígeno Ki-67/metabolismo , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Curva ROCRESUMO
The purpose of this work was to investigate the diagnostic performance of amide proton transfer-weighted (APTW) and intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in the preoperative grading of gliomas. Fifty-one patients with suspected gliomas were recruited and underwent a preoperative MRI examination that included APTW and IVIM sequences. All cases were confirmed by postsurgical histopathology. APTW signal intensity, true diffusion coefficient (D), perfusion fraction (f) and pseudo-diffusion coefficient (D*) were applied to assess the solid tumor component and contralateral normal-appearing white matter. The relative APTW signal intensity (rAPTW) was also used. Independent-sample and paired-sample t-tests were used to compare differences in MRI parameters between low-grade glioma (LGG) and high-grade glioma (HGG) groups. The diagnostic performance was assessed with the receiver operating characteristic curve. Twenty-six patients were pathologically diagnosed with LGG and 25 were diagnosed with HGG. APTW, rAPTW and f values were significantly higher (all p < 0.001), whereas D values were significantly lower (p < 0.001) in the HGG group than in the LGG group. There was no significant difference between D* values for the two groups. rAPTW had an area under the curve (AUC) of 0.957, with a sensitivity of 100% and a specificity of 84.6%, followed by APTW, f, D and D*. The combined use of APTW and IVIM showed the best diagnostic performance, with an AUC of 0.986. In conclusion, APTW and IVIM, as two promising supplementary sequences for routine MRI, could be valuable in differentiating LGGs from HGGs.
Assuntos
Amidas/química , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/patologia , Glioma/diagnóstico , Glioma/patologia , Imageamento por Ressonância Magnética , Movimento (Física) , Prótons , Adolescente , Adulto , Demografia , Feminino , Glioma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Reprodutibilidade dos Testes , Adulto JovemRESUMO
OBJECTIVES: To explore the feasibility of using amide proton transfer-weighted (APTw) MRI metrics as surrogate biomarkers to identify the O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status in glioblastoma (GBM). METHODS: Eighteen newly diagnosed GBM patients, who were previously scanned at 3T and had a confirmed MGMT methylation status, were retrospectively analysed. For each case, a histogram analysis in the tumour mass was performed to evaluate several quantitative APTw MRI metrics. The Mann-Whitney test was used to evaluate the difference in APTw parameters between MGMT methylated and unmethylated GBMs, and the receiver-operator-characteristic analysis was further used to assess diagnostic performance. RESULTS: Ten GBMs were found to harbour a methylated MGMT promoter, and eight GBMs were unmethylated. The mean, variance, 50th percentile, 90th percentile and Width10-90 APTw values were significantly higher in the MGMT unmethylated GBMs than in the MGMT methylated GBMs, with areas under the receiver-operator-characteristic curves of 0.825, 0.837, 0.850, 0856 and 0.763, respectively, for the discrimination of MGMT promoter methylation status. CONCLUSIONS: APTw signal metrics have the potential to serve as valuable imaging biomarkers for identifying MGMT methylation status in the GBM population. KEY POINTS: ⢠APTw-MRI is applied to predict MGMT promoter methylation status in GBMs. ⢠GBMs with unmethylated MGMT promoter present higher APTw-MRI than methylated GBMs. ⢠Multiple APTw histogram metrics can identify MGMT methylation status. ⢠Mean APTw values showed the highest diagnostic accuracy (AUC = 0.825).
Assuntos
Amidas/química , Neoplasias Encefálicas/diagnóstico , Encéfalo/diagnóstico por imagem , Metilases de Modificação do DNA/genética , Enzimas Reparadoras do DNA/genética , Glioblastoma/diagnóstico , Imageamento por Ressonância Magnética/métodos , Proteínas Supressoras de Tumor/genética , Adulto , Idoso , Biomarcadores/metabolismo , Encéfalo/metabolismo , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/metabolismo , Metilação de DNA , Metilases de Modificação do DNA/metabolismo , Enzimas Reparadoras do DNA/metabolismo , Feminino , Glioblastoma/genética , Glioblastoma/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Regiões Promotoras Genéticas , Prótons , Curva ROC , Estudos Retrospectivos , Proteínas Supressoras de Tumor/metabolismo , Adulto JovemRESUMO
PURPOSE: To assess the amide proton transfer-weighted (APTw) MRI features of isocitrate dehydrogenase (IDH)-wildtype and IDH-mutant grade II gliomas and to test the hypothesis that the APTw signal is a surrogate imaging marker for identifying IDH mutation status preoperatively. METHODS: Twenty-seven patients with pathologically confirmed low-grade glioma, who were previously scanned at 3T, were retrospectively analyzed. The Mann-Whitney test was used to evaluate relationships between APTw intensities for IDH-mutant and IDH-wildtype groups, and receiver operator characteristic (ROC) analysis was used to assess the diagnostic performance of APTw. RESULTS: Based on histopathology and molecular analysis, seven cases were diagnosed as IDH-wildtype grade II gliomas and 20 cases as IDH-mutant grade II gliomas. The maximum and minimum APTw values, based on multiple regions of interest, as well as the whole-tumor histogram-based mean and 50th percentile APTw values, were significantly higher in the IDH-wildtype gliomas than in the IDH-mutant groups. This corresponded to the areas under the ROC curves of 0.89, 0.76, 0.75, and 0.75, respectively, for the prediction of the IDH mutation status. CONCLUSION: IDH-wildtype lesions typically were associated with relatively high APTw signal intensities as compared with IDH-mutant lesions. The APTw signal could be a valuable imaging biomarker by which to identify IDH1 mutation status in grade II gliomas. Magn Reson Med 78:1100-1109, 2017. © 2017 International Society for Magnetic Resonance in Medicine.
Assuntos
Biomarcadores Tumorais/genética , Neoplasias Encefálicas/diagnóstico por imagem , Glioma/diagnóstico por imagem , Isocitrato Desidrogenase/genética , Imageamento por Ressonância Magnética/métodos , Imagem Molecular/métodos , Adulto , Neoplasias Encefálicas/química , Neoplasias Encefálicas/genética , Feminino , Glioma/química , Glioma/genética , Humanos , Masculino , Pessoa de Meia-Idade , Mutação/genética , Prótons , Estudos RetrospectivosRESUMO
OBJECTIVES: To determine the utility of amide proton transfer-weighted (APTw) MR imaging in distinguishing solitary brain metastases (SBMs) from glioblastomas (GBMs). METHODS: Forty-five patients with SBMs and 43 patients with GBMs underwent conventional and APT-weighted sequences before clinical intervention. The APTw parameters and relative APTw (rAPTw) parameters in the tumour core and the peritumoral brain zone (PBZ) were obtained and compared between SBMs and GBMs. The receiver-operating characteristic (ROC) curve was used to assess the best parameter for distinguishing between the two groups. RESULTS: The APTwmax, APTwmin, APTwmean, rAPTwmax, rAPTwmin or rAPTwmean values in the tumour core were not significantly different between the SBM and GBM groups (P = 0.141, 0.361, 0.221, 0.305, 0.578 and 0.448, respectively). However, the APTwmax, APTwmin, APTwmean, rAPTwmax, rAPTwmin or rAPTwmean values in the PBZ were significantly lower in the SBM group than in the GBM group (P < 0.001). The APTwmin values had the highest area under the ROC curve 0.905 and accuracy 85.2% in discriminating between the two neoplasms. CONCLUSION: As a noninvasive imaging method, APT-weighted MR imaging can be used to distinguish SBMs from GBMs. KEY POINTS: ⢠APTw values in the tumour core were not different between SBMs and GBMs. ⢠APTw values in peritumoral brain zone were lower in SBMs than in GBMs. ⢠The APTw min was the best parameter to distinguish SBMs from GBMs.
Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Glioblastoma/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador , Imageamento por Ressonância Magnética/métodos , Adolescente , Adulto , Idoso , Amidas , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Neoplasias Encefálicas/patologia , Diagnóstico Diferencial , Feminino , Glioblastoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prótons , Curva ROC , Adulto JovemRESUMO
OBJECTIVES: To show the ability of using the amide proton transfer-weighted (APTW) MRI signals as imaging biomarkers to differentiate primary central nervous system lymphomas (PCNSLs) from high-grade gliomas (HGGs). METHODS: Eleven patients with lymphomas and 21 patients with HGGs were examined. Magnetization-transfer (MT) spectra over an offset range of ± 6 ppm and the conventional MT ratio (MTR) at 15.6 ppm were acquired. The APTW signals, total chemical-exchange-saturation-transfer signal (integral between 0 and 5 ppm, CEST total), and MTR signal were obtained and compared between PCNSLs and HGGs. The diagnostic performance was assessed with the receiver operating characteristic (ROC) curve analysis. RESULTS: The PCNSLs usually showed more homogeneous APTW hyperintensity (spatially compared to normal brain tissue) than the HGGs. The APTW max, APTW max-min and CEST total signal intensities were significantly lower (P < 0.05, 0.001 and 0.05, respectively), while the APTW min and MTR were significantly higher (both P < 0.01) in PCNSL lesions than in HGG lesions. The APTW values in peritumoral oedema were significantly lower for PCNSLs than for HGGs (P < 0.01). APTW max-min had the highest area under the ROC curve (0.963) and accuracy (94.1 %) in differentiating PCNSLs from HGGs. CONCLUSIONS: The protein-based APTW signal would be a valuable MRI biomarker by which to identify PCNSLs and HGGs presurgically. KEY POINTS: PCNSLs overall showed more homogeneous APTW hyperintensity than HGGs. Maximum APTW signals were lower in PCNSL lesions than in HGG lesions. MTR signals were higher in PCNSLs than in HGGs. APTW heterogeneity had the highest accuracy in differentiating PCNSLs from HGGs.
Assuntos
Neoplasias Encefálicas/patologia , Glioma/patologia , Linfoma não Hodgkin/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Amidas , Encéfalo/patologia , Diagnóstico Diferencial , Feminino , Humanos , Linfoma/patologia , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Neuroimagem/métodos , Prótons , Curva ROC , Estudos RetrospectivosRESUMO
Objective: To investigate the magnetic resonance imaging ï¼MRIï¼ and computed tomography (CT) features of clonorchiasis-associated cholangiocarcinoma, and provide reference for its clinical diagnosis. Methods: The CT and MRI ï¼including magnetic resonance cholangiopancreatography, MRCPï¼ data of 60 patients diagnosed to have cholangiocarcinomaï¼26 cases with clonorchiasis-associated cholangiocarcinoma, group A; 34 cases with simple cholangiocarcinomas, group Bï¼ by surgery or biopsy in two hospitals in Guangdong Province during July 2005 and June 2015 were collected. The tumor location, pathological types, imaging features, mode of enhancement, and the bile duct expansion were analyzed. Results: Imaging results showed that the tumor tended to occur in the right liver in group Aï¼46.2%, 12/26ï¼ and in the left hepatic duct and the liver explorer in group B ï¼61.8%, 21/34ï¼ï¼P<0.05ï¼. The pathological types of tumor in both groups included the nodule/mass type (group A, 73.1%, 19/26; group B, 52.9%, 18/34), the infiltration type ï¼15.4%, 4/26; 23.5%, 8/34ï¼, and the cavity growth typeï¼11.5%, 3/26; 23.5%, 8/34ï¼ï¼P>0.05ï¼. Plain and enhanced CT and MRI results revealed no significant difference in tumor density, signal characteristics or the mode of enhancement between the two groups. MRCP results showed that the intrahepatic distal bile duct cystic dilatation, the intrahepatic bile duct cane soft tubular ectasia, the bile duct dilatation in the tumor, and the bile duct dilatation surrounding the tumor accounted for 61.5%ï¼16/26ï¼, 19.2% ï¼5/26ï¼, 50% ï¼13/26ï¼ and 7.7%ï¼2/26ï¼ in group A, and 8.8% ï¼3/34ï¼, 64.8% ï¼22/34ï¼, 20.6% ï¼7/34ï¼ and 38.2% ï¼13/34ï¼ in group B ï¼P<0.05 for each of the fourï¼ï¼ respectively. Conclusion: The clonorchiasis-associated cholangiocarcinoma has certain imaging characteristics. It is different from the simple cholangiocarcinomas in tumor location and intrahepatic bile duct dilatation.
Assuntos
Neoplasias dos Ductos Biliares , Colangiocarcinoma , Clonorquíase , Ductos Biliares Intra-Hepáticos , Biópsia , Cistos , Humanos , Hepatopatias , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: To develop a novel analysis method to evaluate quantitative amide proton transfer (qAPT) effects with reduced interference of conventional magnetization transfer effect. METHODS: A modified Z-spectrum is generated by a fitting procedure that achieves an effectively reduced magnetization transfer asymmetry. A qAPT map is then produced by subtraction of the original Z-spectrum from the modified version. This approach has been tested on both healthy volunteers and patients with brain tumors. Comparisons are made between the maps of qAPT and the commonly-used MTRasym (3.5 ppm) at different saturation powers. The negative background (NB) in MTRasym (3.5 ppm) image is recovered from the difference between the MTRasym (3.5 ppm) and qAPT maps. RESULTS: Both qAPT and MTRasym (3.5 ppm) are strongly dependent on saturation power. At a saturation power below 2 µT, the MTRasym (3.5 ppm) map is dominated by the NB rather than the APT effects for healthy brain tissue. Similar to the MTRasym (3.5 ppm) image, the qAPT image exhibits strong and robust tumor contrast. CONCLUSION: The newly-developed analysis method of qAPT is able to obtain a quantitative APT effect with less inferences from magnetization transfer asymmetry as compared to the conventional MTRasym (3.5 ppm) and can be used to evaluate human brain tumors at 3T. Magn Reson Med, 2014. © 2014 Wiley Periodicals, Inc. Magn Reson Med 74:208-216, 2015. © 2014 Wiley Periodicals, Inc.
RESUMO
Pickering foam is a type of foam stabilized by solid particles known as Pickering stabilizers. These solid stabilizers adsorb at the liquid-gas interface, providing superior stability to the foam. Because of its high stability, controllability, versatility, and minimal environmental impact, nanomaterial-stabilized Pickering foam has opened up new possibilities and development prospects for foam applications. This review provides an overview of the current state of development of Pickering foam stabilized by a wide range of nanomaterials, including cellulose nanomaterials, chitin nanomaterials, silica nanoparticles, protein nanoparticles, clay mineral, carbon nanotubes, calcium carbonate nanoparticles, MXene, and graphene oxide nanosheets. Particularly, the preparation and surface modification methods of various nanoparticles, the fundamental properties of nanomaterial-stabilized Pickering foam, and the synergistic effects between nanoparticles and surfactants, functional polymers, and other additives are systematically introduced. In addition, the latest progress in the application of nanomaterial-stabilized Pickering foam in the oil industry, food industry, porous functional material, and foam flotation field is highlighted. Finally, the future prospects of nanomaterial-stabilized Pickering foam in different fields, along with directions for further research and development directions, are outlined.