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Objective:To investigate the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) parameters combined with T 2WI texture analysis of primary lesions of rectal adenocarcinoma in preoperative prediction of lymph node metastasis with short diameter ≤9 mm. Methods:Retrospective analysis was performed on 115 cases of rectal adenocarcinoma confirmed by surgical pathology in Affiliated Provincial Hospital of Anhui Medical University from June 2015 to October 2020. All patients underwent total mesorectal resection and received conventional rectal MRI and IVIM-DWI scan before surgery. According to the pathological results of lymph node, the patients were divided into lymph node metastatic group ( n=44) and non-metastatic group ( n=71). IVIM-DWI parameters of primary rectal adenocarcinoma were measured including apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo diffusion coefficient (D *) and perfusion fraction (f). The region of interest (ROI) of the whole lesion of rectal adenocarcinoma was delineated on axial T 2WI; then the ROIs were imported into GE Analysis Kit software to extract 3D texture feature. The differences of IVIM-DWI parameters and texture feature parameters were compared between two groups using independent sample t test or Mann-Whitney U test. The optimal texture feature parameters with independent predictive function were screened by multivariate logistic regression. Then the texture feature model and combined model based IVIM-DWI and texture feature parameters were established. The receiver operating characteristic (ROC) curves were used to evaluate the performances of IVIM-DWI, texture feature parameters, texture feature model and combined model in predicting lymph node metastasis in patients with rectal adenocarcinoma. The area under the ROC curve (AUC) were compared with DeLong test. Results:Among all the IVIM-DWI parameters, the D * and f values of primary rectal adenocarcinoma were significantly different between the lymph node metastasis group and the non-lymph node metastasis group ( Z=3.39, P=0.001, Z=-3.06, P=0.002); no statistical significance was found in the ADC and D values between two groups (both P>0.05). A total of 828 texture feature parameters were obtained based on T 2WI of primary lesion of rectal adenocarcinoma, among which 3 optimal texture feature parameters were selected, including firstorder_Skewness, shape_Sphericity and glcm_Idn. The ROC curve results showed that the AUC of D * and f were 0.689 and 0.670, respectively. The AUC of 3 texture feature parameters were 0.651, 0.628, 0.631, respectively. The AUC of texture feature model and the combined model were 0.775 and 0.803. The AUC of combined model was larger than D *, f and the three texture feature parameters (all P<0.05). Conclusion:IVIM-DWI parameters combined with T 2WI texture feature parameters in primary lesion of rectal adenocarcinoma show good diagnostic efficacy in preoperative prediction of lymph node metastasis with short diameter≤9 mm.
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Objective:To investigate the value of intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) and texture analysis for predicting BRAF gene mutation in rectal cancer.Methods:The clinical diagnositic trial was conducted. The clinicopathological data of 36 rectal cancer patients who were admitted to the First People's Hospital of Shangqiu from January 2016 to June 2021 were collected. There were 28 males and 8 females, aged (50±4)years. All the 36 patients were confirmed by pathological examination. After genetic testing, 12 patients with BRAF mutant type of BRAF V600E mutation were allocated into the mutation group, and 24 patients with BRAF wild type were allocated into the non-mutation group. All patients underwent MRI scan before surgery, and IVIM related post-processing images were received by Function Tool post-processing software. Observation indicators: (1) consistency test between observers of IVIM para-meters and texture parameters; (2) comparison of IVIM parameters on MRI between the two groups; (3) comparison of texture parameters on MRI between the two groups; (4) diagnostic efficacy of IVIM and texture parameters. The intraclass correlation coefficient (ICC) was used to evaluate the consistency between observers, with ICC >0.80 as good consistency. The average values of para-meters with ICC >0.80 were included for further analysis. Measurement data with normal distribu-tion were represented as Mean± SD, and comparison between groups was analyzed by the indepen-dent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed by the chi-square test. Comparison of ordinal data was analyzed by the non-parameter rank sum test. The texture parameters were combined using the Logistic regression model. Receiver operating charac-teristic curve was used to analyze the predictive performance and calculate the sensitivity and specificity. Results:(1) Consistency test between observers of IVIM parameters and texture parameters: the ICCs between two observers of IVIM parameters including apparent diffusion coefficient, diffusion related coefficient, perfusion-related diffusion coefficient and perfusion-related parameter were 0.91, 0.90, 0.91, 0.89, respectively. The ICCs of texture parameters including the minimum value, the maximum value, the 10th percentile and the 25th percentile between two observers were <0.80 while the ICCs of texture parameters including mean value, the 50th percentile, the 75th percentile, the 90th percentile, energy, entropy, skewness and kurtosis between two observers were >0.80. (2) Comparison of IVIM parameters on MRI between the two groups: IVIM parameters of diffusion related coefficient and perfusion-related parameter on MRI were (0.70±0.13)×10 -3 mm 2/s and 0.39±0.30 for the mutation group, versus (0.79±0.12)×10 -3 mm 2/s and 0.17±0.10 for the non-mutation group, showing significant differences between the two groups ( t=-2.17, 2.46, P<0.05). (3) Comparison of texture parameters on MRI between the two groups: the texture parameters of mean value and energy on diffusion related coefficient image were 0.54±0.23 and 0.00(0.00,0.01) for the mutation group, versus 0.77±0.34 and 0.01(0.00,0.01) for the non-mutation group, showing significant differences between the two groups ( t=-2.12, Z=-1.35, P<0.05). (4) Diagnostic efficacy of IVIM and texture parameters: the areas under the curve (AUCs) of diffusion related coefficient, perfusion-related parameter, IVIM parameters combination, mean value of diffu-sion related coefficient image, energy value of diffusion related coefficient image, texture parameters combination were 0.69[95% confidence interval ( CI) as 0.52-0.84], 0.76(95% CI as 0.59-0.88), 0.79(95% CI as 0.62-0.91), 0.71(95% CI as 0.52-0.85), 0.79(95% CI as 0.62-0.91), 0.84(95% CI as 0.68-0.94), which were all lower than the AUC of IVIM and texture parameters combination as 0.92(95% CI as 0.79-0.99). Conclusions:IVIM parameters and texture parameters of MRI can non-invasively predict the mutation status of BRAF gene in rectal cancer. The combination of IVIM and texture parameters has a better predictive efficacy.
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Objective:To investigate the application value of intravoxel incoherent motion (IVIM) imaging in preoperative evaluating perineural invasion (PNI) of esophageal squamous cell carcinoma (ESCC).Methods:The prospective study was conducted. The clinicopathological data of 63 ESCC patients who underwent IVIM imaging before surgery in the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital from January 2016 to April 2019 were selected. Patients underwent routine magnetic resonance imaging scan and IVIM sequence examination. The apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*) and pseudodiffusion fraction (f) values were measured. Observation indicators: (1) situations of enrolled patients; (2) IVIM examination of PNI of ESCC and its diagnostic efficiency. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and comparison between groups was analyzed using the Wilcoxon rank sum test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. The interclass correlation coefficient (ICC) was used to evaluate cosistency of results. The receiver operating characrteristic curve was used to evaluate diagnostic efficiency. Results:(1) Situations of enrolled patients. A total of 63 patients were selected for eligibility. There were 41 males and 22 females, aged 60(range, 43?74)years. Of the 63 ESCC patients, 17 cases had PNI and 46 cases had no PNI. Cases with well differentiated tumor, moderate differentiated tumor or low differentiated tumor, cases in stage T1, T2, T3, T4 of infiltra-tion depth, cases with or without lymph node metastasis were 0, 6, 11, 0, 3, 13, 1, 15, 2 in patients with PNI, versus 6, 24, 16, 1, 22, 23, 0, 12, 34 in patients without PNI, showing significant differences between them ( Z=?2.32, ?2.49, χ2=19.58, P<0.05). (2) IVIM examination of PNI of ESCC and its diagnostic efficiency. The ADC, D, D*, f values were (2.21±0.33)×10 ?3 mm 2/s, (1.46±0.31)×10 ?3 mm 2/s, 32.50 (15.55,46.75)×10 ?3 mm 2/s, (0.34±0.09)×10 ?3 mm 2/s in patients with PNI, versus (2.45±0.45)×10 ?3 mm 2/s, (1.72±0.38)×10 ?3 mm 2/s, 34.85(23.43,51.20)×10 ?3 mm 2/s, (0.42±0.13)×10 ?3 mm 2/s in patients without PNI, showing significant differences in the ADC, D and f values between them ( t=?2.03, ?2.52, ?2.34, P<0.05) and no significant difference in the D* value between them ( Z=?0.84, P>0.05). The cosistency of ADC, D, D* and f values in the 63 ESCC patients measured by 2 radiologists was good, with the ICC as 0.96, 0.92, 0.89 and 0.95. The receiver operating characrteristic curve demons-trated the best cut-off value of ADC, D and f values were 2.50×10 ?3 mm 2/s, 1.68×10 ?3 mm 2/s and 0.41, with the areas under the curve as 0.67 (95% confidence interval as 0.54?0.79), 0.70 (95% confidence interval as 0.58?0.81) and 0.69 (95% confidence interval as 0.57?0.80), respectively. The combina-tion of D and f value for diagnosing PNI of ESCC had the area under the curve as 0.74 (95% confidence interval as 0.62?0.84), with the cut-off value as 0.20, sensitivity and specificity as 94.1% and 56.5%. Conclusions:IVIM parameters D and f values can evaluate and predict the PNI of ESCC preopera-tively. The combination of D and f values can further improve the diagnostic efficiency.
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Magnetic resonance imaging (MRI) is a very important imaging method for diagnosis and treatment of prostate cancer (PCa) in clinical practice. As functional MRI is growing and maturing, its quantitative parameters are expected to enhance the clinical value of MRI furtherly. Intravoxel incoherent motion diffusion imaging, diffusion tensor imaging, and diffusion kurtosis imaging, which were derived from diffusion weighted imaging, have provided richer and more accurate parameters. The newly-developed magnetic resonance elastography can complement the mechanical characteristics of PCa.
Subject(s)
Humans , Male , Diffusion Magnetic Resonance Imaging , Diffusion Tensor Imaging , Magnetic Resonance Imaging , Motion , Prostatic Neoplasms/diagnostic imagingABSTRACT
Objective:To explore the value of intravoxel incoherent motion (IVIM) DWI in preoperative prediction of angiolymphatic invasion in esophageal squamous cell carcinoma (ESCC).Methods:From April 2016 to April 2019, 63 ESCC patients who planned to undergo resection of esophageal cancer were prospectively collected at Henan Cancer Hospital.According to the postoperative pathological results, 63 patients were divided into angiolymphatic invasion group (30 cases) and no angiolymphatic invasion group (33 cases). All patients underwent IVIM sequence and routine MRI examination before operation. The ADC, true diffusion coefficient (D), pseudodiffusion coefficient (D *) and pseudodiffusion fraction (f) were measured. The differences of parameter values between ESCC with and without angiolymphatic invasion were analyzed using Student′s t test or Wilcoxon rank sum test.The logistic regression was used to analyze the significance of various parameters. For the parameters with statistical significance, the ROC curves were performed to evaluatethe diagnostic performance of parameters for identifying angiolymphatic invasion.The Z test was used to compare the area under the ROC curves(AUC) of parameters. Results:The difference of ADC, D and f values between angiolymphatic invasion group and no angiolymphatic invasion group were statistically signi?cant ( t=4.476, 5.033 and 5.712 respectively, all P<0.001). The D * values showed no statistically signi?cant di?erence ( Z=0.184, P=0.854). The logistic regression analysis showed that D (OR=9.042) and f (OR=26.221) were in correlation with angiolymphatic invasion. The ROC analyses demonstrated that the AUCs of ADC, D and f values in predicting angiolymphatic invasion of ESCC were 0.787, 0.822 and 0.853, respectively. D combined with f had highest AUC (0.917) in predicting the angiolymphatic invasion of ESCC, sensitivity and specificity were 93.3% and 75.8%. D combined with f showed better diagnostic performance than the D and the f value, and the difference were statistically significant ( Z=2.403, 2.289, P=0.016, 0.022). Conclusions:IVIM can be used as an effective functional imaging modality for preoperative evaluation and prediction of the angiolymphatic invasion of ESCC. D value combined with f value can further improve prediction performance of angiolymphatic invasion.
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Objective:To evaluate the efficacy of T 2* mapping and zoomed imaging with parallel transmission technique (ZOOMit) intravoxel incoherent motion (IVIM) DWI in differentiating benign and malignant thyroid nodules. Methods:The data of 67 patients with thyroid nodules confirmed by surgery and pathology in Ma′anshan People′s Hospital from July 2019 to March 2020 were retrospectively collected. There were a total of 80 nodules, of which 39 were benign nodules and 41 were malignant nodules. All patients underwent MRI including T 2WI, T 2* mapping, and ZOOMit IVIM sequence scans before surgery to measure the T 2*, D, D *, and f values of the nodules. The comparison of the parameters between benign and malignant nodules was evaluated by independent sample t test or Wilcoxon rank sum test. A combined parameter model was established through two-class logistic regression and the predicted probability value was calculated. The ROC curve was used to evaluate the diagnostic efficacy of each parameter and the combined parameter model in differentiating between benign and malignant thyroid nodules. Results:The T 2*, D, f values of benign thyroid nodule group were higher than that in malignant group, and the difference was statistically significant ( P<0.05). The difference of D * value between two groups was not statistically significant ( Z=1.258, P= 0.215). The area under ROC curve (AUC) of T 2*, D, and f values for identifying benign and malignant nodules was 0.703, 0.892, and 0.743, the diagnostic sensitivity was 80.2%, 84.1%, and 80.0%, and the specificity was 65.6%, 81.3%, and 75.0%, respectively. The AUC of T 2*combined with D, T 2*with D * and T 2* with f was 0.925, 0.709, and 0.743, the diagnostic sensitivity was 96.2%, 80.4%, and 80.0%, and the specificity was 81.2%, 65.6%, and 75.0%, respectively. Conclusion:D, f and T 2* derived from ZOOMit IVIM have good value in differentiating between benign and malignant thyroid nodules, and the combination of T 2* and D parameters has the higher diagnostic efficacy.
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Background: Conventional magnetic resonance imaging (MRI) does not accurately evaluate lymph node (LN) status, which is essential for the treatment and prognosis assessment in patients with rectal cancer. Objective: The aim of this study is to evaluate the diagnostic value of intravoxel incoherent motion (IVIM) MRI in differentiating metastatic and nonmetastatic mesorectal LNs with different short-axis diameters in rectal cancer patients. Materials and Methods: Forty patients (154 LNs) were divided into three groups based on short-axis diameter: 3 mm ≤ × ≤5 mm, 5 mm < × ≤7 mm, and × >7 mm. MRI characteristics and IVIM parameters were compared between the metastatic and nonmetastatic LNs to determine the diagnostic value for discriminating them. Results: In the 3 mm ≤ × ≤ 5 mm group, mean D values were significantly lower in metastatic than in the nonmetastatic LNs (P < 0.001). In the 5 mm < × ≤7 mm group, mean f values were significantly lower in metastatic than nonmetastatic LNs (P < 0.05). In the × >7 mm group, only the short-axis diameter of metastatic LNs was significantly greater than that of nonmetastatic LNs (P < 0.05). The area under the curve, sensitivity, specificity, and cutoff values were used for differentiating the metastatic from the nonmetastatic LNs. Conclusion: IVIM parameters can differentiate metastatic from nonmetastatic LNs with smaller short-axis diameters (× ≤7 mm) in rectal cancer, and the short-axis diameter is a significant factor in identifying metastatic and nonmetastatic LNs in larger short-axis diameter groups (× >7 mm).
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Humans , Adenocarcinoma , Carcinoma, Squamous Cell , Magnetic Resonance Imaging , Reference Values , Retrospective Studies , Uterine Cervical NeoplasmsABSTRACT
Objective: To explore the impact of non-ionic dimeric isotonic iodine contrast agent on rabbit kidneys using intravoxel incoherent motion (IVIM)-DWI and blood oxygen level-dependent (BOLD) imaging. Methods: Totally 25 male New Zealand rabbits were randomly equally divided into 5 groups (each n=5). IVIM-DWI and BOLD scanning and blood collection were performed in four experimental groups (1, 24, 48, 72 h group) 1, 24, 48,72 h after injection of iodixanol, respectively, also in base-line group after injection of equal amount of saline. The rabbits were killed immediately after MRI,and the kidneys were taken for histopathological analysis. Results: Compared with base-line group, both cortex and medulla of kidneys showed decreased ADC, D and f values and the lowest D* value, as well as increased R2* in 1 h group. The lowest ADC, D and f values, the highest R2* and increased D* value of both cortex and medulla were observed in 24 h group. In 72 h group, R2* value of both cortex and medulla were still lower than baseline (all P<0.05), and D* value basically returned to baseline, while f and D values of medulla were still statistically different with respect to baseline (all P<0.05). Meanwhile, different degrees of glomerular and tubular damage were observed in the pathological sections. The serum creatinine and blood urea nitrogen in 48 h group and 72 h group were higher than those in base-line group (all P<0.05). The expression of hypoxia inducible factor-1α and heme oxygenase-1 increased in 1 h group and up to peak in 24 h group. Conclusion: Combining IVIM-DWI with BOLD can effectively evaluate rabbit renal pathophysiologic changes associated with contrast-induced acute kidney injury.
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Objective: To quantitatively evaluate the changes of diffusional and perfusion of degenerative water molecules in lumbar inervertebral disc by multiple b-value voxel incoherent motion imaging. Methods: We selected 60 patients (34 males and 26 females) with low back pain or sciatica from The First Affiliated Hospital of Xi'an Jiaotong University. The subjects underwent lumbar MRI sagittal T2WI and median sagittal multiple b-value weighted imaging. We graded the L1-S1 disc according to the Pfirrmann grading standards, and measured the ADCslow, ADCfast, f values of the nucleus pulla, and the anterior and posterior edges of the annulus fibrosus. We compared the mean values of ADCslow, ADCfast, f at the anterior and posterior edges of nucleus pulposus and annulus fibrosus and analyzed the correlation analysis between them and the grade of degeneration. Single factor analysis of variance combined with SNK test was used in the statistics. Results: A total of 300 discs were measured and the statistical results showed that: ① The mean value of the ADC of the nucleus pulposus of each grade of the lumbar disc decreased with the increase of the grade. Although there was no significant difference between grade and grade Ⅱ, grade and grade , there were statistically significant differences between the other grades (P0.05). Conclusion: The quantitative measurement of nucleus pulposus ADCslow based on IVIM is a potential and more sensitive quantitative magnetic resonance method for evaluating early degeneration of lumbar disc.
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PURPOSE: Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI)was evaluated regarding its ability to preliminarily predict the short-term treatment response of nasopharyngeal carcinoma (NPC) following intensity-modulated radiation therapy. MATERIALS AND METHODS: IVIM-DWI with 14 b-factors (0-1,000 sec/mm2) was performed with a 3T MR system on 47 consecutive NPCs before, during (end of the 5th, 10th, 15th, 20th, and 25th fractions), and after fractional radiotherapy. IVIM parametrics (D, f, and D*) were calculated and compared to the baseline and xth fraction. Patients were categorized into responders and non-responders after radiotherapy. IVIM parametrics were also compared between subgroups. RESULTS: After fractional radiations, the D (except D5 and D at the end of the 5th fraction) after radiations were larger than the baseline D0 (p < 0.05), and the post-radiation D* (except D*5 and D*10) were smaller than D*0 (p < 0.05). f0 was smaller than f5 and f10 (p < 0.001) but larger than fend (p < 0.05). Furthermore, greater D5, D10, D15, and f10 coupled with smaller f0, D*20, and D*25 were observed in responders than non-responders (all p < 0.01). Responders also presented larger ΔD10, Δf10, ΔD*20, and δD*20 than non-responders (p < 0.05). Receiver operating characteristic curve analysis indicated that the D5, D*20, and f10 could better differentiate responders from non-responders. CONCLUSION: IVIM-DWI could efficiently assess tumor treatment response to fractional radiotherapy and predict the radio-sensitivity for NPCs.
Subject(s)
Humans , Diffusion , Radiation Tolerance , Radiotherapy , Radiotherapy, Intensity-Modulated , ROC CurveABSTRACT
Objective To assess the myocardial microcirculation of patients with hypertension using intravoxel incoherent motion (IVIM) diffusion-weighted imaging, and to analyze the differences compared with normal volunteers. Methods Thirty normal volunteers and 18 hypertensive patients, who underwent cardiac magnetic resonance cine and IVIM scans in our hospital from May 2015 to Sep. 2018, were enrolled. The IVIM scan was performed on middle view of left ventricular short-axis with 8 b values (20, 50, 80, 100, 120, 200, 300 and 500 s/mm2). The structural and functional parameters were measured on left ventricular short-axis, and the IVIM parameters (fast apparent diffusion coefficient [ADCfast], slow apparent diffusion coefficient, fraction of ADCfast) were measured using biexponential model. The differences of all parameters were analyzed between the normal volunteers and hypertensive patients. Results The left ventricular ejection fraction, cardiac output and myocardial mass of the hypertensive patients were higher than those of the normal volunteers ([68.39±7.51]% vs [63.20±5.22]%, [6.84±2.03] L vs [5.41±1.08] L, and [122.54±33.63] g vs [85.97±25.42] g), and the differences were significant (t=-2.75, -2.64 and -4.15; all P0.05). The ADCfast of the hypertensive patients was significantly lower than that of the normal volunteers (0.12 [0.03-0.17] mm2/s vs 0.14 [0.10-0.21] mm2/s, Z=-2.83, P<0.01). Conclusion The application of IVIM can contribute to evaluating myocardial microcirculation of the hypertensive patients.
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Objective To explore the value of 3.0 T cardiac magnetic resonance (CMR) intravoxel incoherent motion (IVIM) for evaluating microvascular dysfunction in hypertrophic cardiomyopathy (HCM) patients. Methods Twenty-six HCM patients and 12 healthy controls, who received CMR examination in the First Hospital of Lanzhou University from Apr. 2016 to Oct. 2017, were enrolled. All volunteers underwent short-axis cardiac cine and IVIM scans, and HCM patients underwent late gadolinium enhancement (LGE) scan. The fraction of fast apparent diffusion coefficient (f), fast apparent diffusion coefficient (ADCfast) and slow apparent diffusion coefficient (ADCslow) were measured using MITK-Diffusion post-processing software. End-diastolic thickness (EDTH) was measured on short-axis cine image. HCM patients were grouped according to the severity of the left ventricular hypertrophy and whether having LGE or not. The differences of f value, ADCfast and ADCslow were compared between HCM patients and healthy controls, non-hypertrophic segments and hypertrophic segments of HCM patients, LGE segments and non-LGE segments of HCM patients, and different hypertrophic subgroups in hypertrophic segment group. Spearman correlation analysis was performed to explore the correlation between IVIM parameters (f value, ADCfast and ADCslow) and EDTH in each segment. Results The ADCslow and ADCfast of the HCM patients were lower than those of the healthy controls (ADCslow: 0.003 [0.002, 0.005] mm2/s vs 0.004 [0.002, 0.007] mm2/s, ADCfast: 0.046 [0.025, 0.074] mm2/s vs 0.069 [0.052, 0.086] mm2/s), and the differences were significant (Z=-2.434 and -7.268, both P0.05). The ADCfast values of the non-hypertrophic segment group and the hypertrophic segment group in the HCM patients were 0.051 (0.029, 0.077) mm2/s and 0.027 (0.019, 0.052) mm2/s, respectively, which were both significantly lower than that of the healthy controls (Z=-5.505 and -8.144, both P0.05). The f value and ADCfast of the segmental myocardia with LGE were significantly lower than those without LGE (Z=-2.704 and -2.143, P=0.007 and 0.032). Spearman correlation analysis showed that EDTH was significantly negatively correlated with f value and ADCfast (r=-0.195 and -0.282, both P<0.01). Conclusion CMR IVIM technology can non-invasively and quantitatively reflect cardiac microvascular dysfunction in HCM patients. The severity of microvascular dysfunction is related to the severity of myocardial hypertrophy. Microvascular dysfunction is also present in non-hypertrophic and non-LGE myocardia.
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Objective@#To evaluate the feasibility of intravoxel incoherent motion diffusion-weighted magnetic resonance imaging (IVIM-DWI MRI) in the evaluation of tumor vascular normalization in a mouse model of colorectal cancer induced by recombinant human endostatin (rhES).@*Methods@#The CT26 colorectal cancer xenograft model of BALB/c mice were established and divided into rhES group and control group, with 20 mice in each group. The mice of rhES group were intravenously injected with rhES 5 mg·kg-1·d-1 once daily for 12 days, while the mice of the control group were intravenously injected with the same volume of 0.9% saline. 5 mice of rhES group and control group were randomly selected to perform IVIM-DWI MRI as following times: before treatment and four, eight, twelve days after treatment. The parameters of IVIM-DWI were recorded, including true diffusion coefficient(D), pseudo-diffusion coefficient (D*) and perfusion fraction (f). Meanwhile, microvessel density (MVD), pericyte coverage and tumor perfusion in tumor tissues were detected by immunofluorescence, respectively.@*Results@#The tumor volumes of control group and rhES group before treatment were (154.42±24.65) mm3 and (174.24±28.27)mm3, respectively, without statistically significant difference (P=0.440). From day 2 to day 12 after treatment, the tumor volume of rhES group was significantly smaller than that of control group (all P<0.05). There were no statistical significances of D value between the rhES group and control group before and after treatment (all P>0.05). The D* values of the rhES group were (10.940±2.834)×10-3mm2/s and (12.940±2.801)×10-3mm2/s in day 4 and 8 after treatment respectively, significantly higher than (6.980±1.554)×10-3mm2/s and (7.898±1.603)×10-3mm2/s of control group (P<0.05). Moreover, compared with control group, the D* value of rhES group was significantly lower in day 12 (6.848±1.460)×10-3mm2/s vs (9.950±2.596)×10-3mm2/s, (P<0.05). The f value of rhES group in day 8 was (0.226±0.021)%, significantly higher than (0.178±0.016)% of control group (P<0.01). The MVD of rhES group was significantly lower than that of control group (P<0.05), while the pericyte coverage and tumor perfusion of rhES group were significantly higher than those of control group in day 4 and 8 after treatment (all P<0.05). In addition, we found D* value of IVIM-DWI in rhES group was significantly related with MVD, pericyte coverage and tumor perfusion (r=-0.354, r=0.555, r=0.559, all P<0.05). Meanwhile, the f value in rhES group was also significantly related with MVD, pericyte coverage and tumor perfusion (r=-0.391, r=0.538, r=0.315, all P<0.05).@*Conclusions@#IVIM-DWI MRI can effectively evaluate the vascular normalization in rhES-induced CT26 colorectal tumor.The parameters D* and f are closely related to intratumorally microvessel density, pericyte coverage and perfusion, which can effectively monitor the occurrence of tumor vascular normalization time.
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Objective@#To explore the values of metrics on intravoxel incoherent motion (IVIM) and gadoxetic acid enhanced T1ρ imaging for staging of non-alcoholic fatty liver disease activity scores (NAS) and inflammation in nonalcoholic steatohepatitis (NASH) rabbits model.@*Methods@#NASH rabbits model was established by feeding with a varied duration (4, 8, 12 weeks) of high-fat, high-cholesterol diet. IVIM and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced T1ρ images were performed by a 3.0 T MR scanner. The inter-class correlation coefficients (ICC) and Bland-Altman analysis were applied to evaluate the reproducibility of the IVIM and Gd-EOB-DTPA enhanced T1ρ mapping measurers. Spearman correlation analysis were used to assess the correlation between MR metrics, including ADC, D, D*, f, T1ρ, T1ρ (hepatobiliary phase, HBP), and NAS score and inflammation grades respectively with reference to histopathology. ROC curve analysis was used to evaluate the diagnostic performance of T1ρ and IVIM parameters for NASH, inflammation grade, and hepatic fibrosis. Multiple linear regression equations were used to analyze the independent influence factors of T1ρ (HBP).@*Results@#The f value was negatively correlated with the NAS score (r=-0.530, P<0.01). The f value of the fibrosis S1-2 was significantly lower than that of the S0 (P<0.01). There was no statistical difference in D, D*, ADC among NASH score, inflammation, and fibrosis stage. T1ρ and T1ρ (HBP) values were positively correlated with NAS scores and inflammation grades. The area under curve (AUC) for the diagnosis of NASH for T1ρ, T1ρ(HBP), ADC, D, D*, and f values were 0.849, 0.949, 0.728, 0.596, 0.522, and 0.871, respectively. The AUCs of T1ρ (HBP)+f in the diagnosis of NASH, G2-3 inflammation, and F1-2 fibrosis were 0.971, 0.935, and 0.903, respectively. Fibrosis (R2=0.624, P=0.002) and inflammation (R2=0.746, P=0.002) were major independent factors of T1ρ (HBP).@*Conclusion@#Gd-EOB-DTPA enhanced T1ρ imaging can reflect the severity of NASH and degree of inflammation. IVIM measurements are not accurate enough to stage liver inflammatory activity of NASH. T1ρ (HBP)+f might be a superior noninvasive imaging biomarker than either non-enhanced T1ρ or IVIM for NASH activity and inflammation assessments.
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Objective@#To evaluate the diagnostic value of intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) parameters in diagnosing prostate cancer(PCa) in transition zone (TZ) and stratifying pathologic Gleason grade of prostate cancer.@*Methods@#A total of 55 patients who were undergoing preoperative muti-parameters MRI of T2WI, DWI, IVIM and DKI model for the exploration of prostate cancer (January 2015 to June 2017) with pathologically confirmed by MRI-transrectal ultrasound (TRUS) targeted fusion biopsy were retrospectively included. Parameters were postprocessed by IVIM models including quantitation of perfusion fraction (f), diffusivity (D) and pseudo-diffusivity (D*) and DKI models including the mean diffusivity (MD), mean kurtosis (MK) and fractional anisotropy (FA) by outlining the 3D VOI. Independent sample t-test was used to compare the differences in lesion parameters between prostate cancer and BPH, low-risk (BPH+Gleason score 6 points) and medium-high-risk lesions (Gleason score ≥7 points). Correlation between ADC values, IVIM and DKI parameters and Gleason scores were assessed with Spearman analysis. Receiver operating characteristic curve analysis was used to evaluate the efficacy of various parameters in the differential diagnosis of prostate cancer and BPH with low-risk or high-risk.@*Results@#27 (36 focus) cases of PCa and 28 (40 focus) cases of benign prostatic hyperplasia (BPH) in PZ were included, meanwhile, the cases of GS ≥7 and and BPH+(GS=6) were 33,43,respectively. There were significant differences in ADC, D, MD, MK, and FA between patients in PCa-BHP group and high-low risk group in TZ (P<0.05), D* and f had no significant differences (P>0.05). ADC and MD showed relatively higher negativity correlations (r were -0.585 and -0.489, P<0.05) with GS of PCa in TZ. ADC exhibited a higher area under the curve (AUC 0.864) compared with D with area under the curve (AUC 0.853), however, the difference is not significant (P>0.05). Of model DKI in diagnose of PCa and BPH, the highest classification accuracy was MD(AUC 0.796). The AUC derived from multiple model parameters in different combination of ADC+D value, ADC+MD value, and ADC+MD+D value were 0.892, 0.884, and 0.897, respectively. ADC and D of IVIM model showed a significance difference between GS ≥7 and BPH+(GS=6) with a higher AUC of 0.826 and 0.743. The AUC was 0.851 of the combination of mean ADC and D, 0.846 of combination of mean ADC and MD, the AUC (0.856) of the combination of ADC, D and MD significant higher than any two combined parameters (P>0.05).@*Conclusions@#IVIM and DKI models may help to discriminate prostate cancer from BPH, and predict mid-higher GS PCa in TZ. But there is no significant advantage compared with ADC values. It is feasible to stratify the pathological grade of prostate cancer in TZ by mean ADC and MD.
ABSTRACT
Objective To evaluate the diagnostic value of intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) parameters in diagnosing prostate cancer(PCa) in transition zone (TZ) and stratifying pathologic Gleason grade of prostate cancer. Methods A total of 55 patients who were undergoing preoperative muti?parameters MRI of T2WI, DWI, IVIM and DKI model for the exploration of prostate cancer (January 2015 to June 2017) with pathologically confirmed by MRI?transrectal ultrasound (TRUS) targeted fusion biopsy were retrospectively included. Parameters were postprocessed by IVIM models including quantitation of perfusion fraction (f), diffusivity (D) and pseudo?diffusivity (D*) and DKI models including the mean diffusivity (MD), mean kurtosis (MK) and fractional anisotropy (FA) by outlining the 3D VOI. Independent sample t?test was used to compare the differences in lesion parameters between prostate cancer and BPH, low?risk (BPH+Gleason score 6 points) and medium?high?risk lesions (Gleason score ≥7 points). Correlation between ADC values, IVIM and DKI parameters and Gleason scores were assessed with Spearman analysis.Receiver operating characteristic curve analysis was used to evaluate the efficacy of various parameters in the differential diagnosis of prostate cancer and BPH with low?risk or high?risk. Results 27 (36 focus) cases of PCa and 28 (40 focus) cases of benign prostatic hyperplasia(BPH) in PZ were included, meanwhile, the cases of GS≥7 and and BPH+(GS=6) were 33,43,respectively. There were significant differences in ADC, D, MD, MK, and FA between patients in PCa?BHP group and high?low risk group in TZ (P<0.05), D*and f had no significant differences (P>0.05). ADC and MD showed relatively higher negativity correlations (r were－0.585 and－0.489, P<0.05) with GS of PCa in TZ. ADC exhibited a higher area under the curve (AUC 0.864) compared with D with area under the curve (AUC 0.853), however, the difference is not significant (P>0.05). Of model DKI in diagnose of PCa and BPH, the highest classification accuracy was MD(AUC 0.796). The AUC derived from multiple model parameters in different combination of ADC+D value, ADC+MD value, and ADC+MD+D value were 0.892, 0.884, and 0.897, respectively. ADC and D of IVIM model showed a significance difference between GS≥7 and BPH+(GS=6) with a higher AUC of 0.826 and 0.743. The AUC was 0.851 of the combination of mean ADC and D, 0.846 of combination of mean ADC and MD, the AUC (0.856) of the combination of ADC, D and MD significant higher than any two combined parameters (P>0.05). Conclusions IVIM and DKI models may help to discriminate prostate cancer from BPH, and predict mid?higher GS PCa in TZ. But there is no significant advantage compared with ADC values. It is feasible to stratify the pathological grade of prostate cancer in TZ by mean ADC and MD.
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Objective To investigate the value of intravoxel incoherent motion (IVIM)and three-dimensional arterial spin labeling (3D-ASL)technique in preoperative grading diffuse gliomas.Methods Thirty-one patients with diffuse gliomas proved by pathology were enrolled,including 12 cases with low grade gliomas and 19 cases with high grade gliomas.All patients underwent 3D-ASL and IVIM examination before operation.Original dates were disposed in particular software,then the images of cerebral blood flow (CBF), D? and D were obtained,and ROI were selected and relevant parameter values were calculated.The parameter values were analyzed in SPSS,and unpaired two-tailed student t test were performed to compare parameter values between two groups.P＜0.05 was regarded as statistically significant. ROC analysis curves were performed to acquire optimum threshold value,sensibility and specificity of each parameter.Finally,the sensibility and specificity of the associating screening of 3D-ASL and IVIM were obtained.Results The CBF and relative CBF(rCBF) values of high grade gliomas group [(103.89±27.00)mL/min?100 g and (4.28±0.63)mL/min?100 g]were significantly higher than those of low grade gliomas group [(63.96±22.17)mL/min?100 g and (2.72±0.84)mL/min?100 g];The D? and relative D?(rD?) values of high grade gliomas group [(3.82 ± 0.60 )mm2/s and 1.9 5 ± 0.30 ]were significantly higher than those of low grade gliomas group [(2.54±0.50)mm2/s and 1.28±0.14],the D and relative D (rD)values of high grade gliomas group [(0.58±0.12)mm2/s and 2.40±0.49]were significantly lower than those of low grade gliomas group [(0.75±0.12)mm2/s and 3.1 1±0.42](P＜0.05). Statistical analysis in ROC demonstrated AUC value of 0.879 and 0.917 for CBF and rCBF,optimum threshold value of 79.24 mL/min?100 g and 2.85,sensibility of 84.2% and 100%,specificity of 83.3%and 83.3%;AUC value of 0.925,0.846,0.956 and 0.882 for D?,D ,rD? and rD ,optimum threshold value of 2.95 mm2/s, 0.63 mm2/s,1.40 and 2.95,sensibility of 94.7%,91.7%,94.7%and 75%,specificity of 83.3%,73.3%,91.7% and 94.7%.The sensibility and specificity of the associating screening of 3D-ASL and IVIM were 100% and 9 1.7%.Conclusion IVIM and 3D-ASL can be used to grade diffuse gliomas,and the values of rCBF,rD? and rD are optimal indicator.Combination of IVIM and 3D-ASL can improve the sensibility and specificity of grading diffuse gliomas.
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Objective To explore the values of metrics on intravoxel incoherent motion (IVIM) and gadoxetic acid enhanced T1ρ imaging for staging of non?alcoholic fatty liver disease activity scores (NAS) and inflammation in nonalcoholic steatohepatitis (NASH) rabbits model. Methods NASH rabbits model was established by feeding with a varied duration (4, 8, 12 weeks) of high?fat, high?cholesterol diet. IVIM and gadolinium?ethoxybenzyl?diethylenetriamine pentaacetic acid (Gd?EOB?DTPA) enhanced T1ρ images were performed by a 3.0 T MR scanner. The inter?class correlation coefficients (ICC) and Bland?Altman analysis were applied to evaluate the reproducibility of the IVIM and Gd?EOB?DTPA enhanced T1ρ mapping measurers. Spearman correlation analysis were used to assess the correlation between MR metrics, including ADC, D, D*, f, T1ρ, T1ρ (hepatobiliary phase, HBP), and NAS score and inflammation grades respectively with reference to histopathology. ROC curve analysis was used to evaluate the diagnostic performance of T1ρ and IVIM parameters for NASH, inflammation grade, and hepatic fibrosis. Multiple linear regression equations were used to analyze the independent influence factors of T1ρ (HBP). Results The f value was negatively correlated with the NAS score (r=-0.530, P<0.01). The f value of the fibrosis S1?2 was significantly lower than that of the S0 (P<0.01). There was no statistical difference in D, D*, ADC among NASH score, inflammation, and fibrosis stage. T1ρ and T1ρ (HBP) values were positively correlated with NAS scores and inflammation grades. The area under curve (AUC) for the diagnosis of NASH for T1ρ, T1ρ(HBP), ADC, D, D*, and f values were 0.849, 0.949, 0.728, 0.596, 0.522, and 0.871, respectively. The AUCs of T1ρ (HBP)+f in the diagnosis of NASH, G2?3 inflammation, and F1?2 fibrosis were 0.971, 0.935, and 0.903, respectively. Fibrosis (R2=0.624, P=0.002) and inflammation (R2=0.746, P=0.002) were major independent factors of T1ρ (HBP). Conclusion Gd?EOB?DTPA enhanced T1ρ imaging can reflect the severity of NASH and degree of inflammation. IVIM measurements are not accurate enough to stage liver inflammatory activity of NASH. T1ρ (HBP)+f might be a superior noninvasive imaging biomarker than either non?enhanced T1ρ or IVIM for NASH activity and inflammation assessments.
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Objective To compare the value of diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) in evaluation of histological classification and grading of cervical squamous cell carcinoma and cervical adenocarcinoma. Methods DKI and IVIM data of 60 patients with cervical cancer were retrospectively analyzed, and MK, MD, D, D* and f values were measured. The differences of the parameters between cervical squamous cell carcinoma group (n=38) and cervical adenocarcinoma group (n=22) were analyzed, as well as among different graded subgroups. The diagnostic efficiency of each parameter was evaluated with ROC curve, the correlations between the parameters and pathological grades were analyzed using Spearman method. Results MK of cervical squamous cell carcinoma group was higher than that of cervical adenocarcinoma group, while MD, D, D* and f were lower than those of cervical adenocarcinoma group (all P<0.05). In both groups, the differences of MK, MD and D were statistically significant among different subgroups (all P<0.05), while in cervical adenocarcinoma group, the differences of f were also statistically significant among different subgroups (all P<0.05). MK had the highest AUC in diagnosing cervical squamous cell carcinoma and adenocarcinoma.Except for D*, there was correlation between other parameters and pathological grade (all P<0.05). Conclusion Compared with IVIM, DKI can more effectively evaluate cervical squamous cell carcinoma and cervical adenocarcinoma and their pathological grading.