Use of intravoxel incoherent motion diffusion-weighted MR imaging for assessment of treatment response to invasive fungal infection in the lung.
Eur Radiol
; 27(1): 212-221, 2017 Jan.
Article
en En
| MEDLINE
| ID: mdl-27180185
ABSTRACT
OBJECTIVES:
The purpose of this study was to determine whether intravoxel incoherent motion (IVIM) -derived parameters and apparent diffusion coefficient (ADC) could act as imaging biomarkers for predicting antifungal treatment response.METHODS:
Forty-six consecutive patients (mean age, 33.9 ± 13.0 y) with newly diagnosed invasive fungal infection (IFI) in the lung according to EORTC/MSG criteria were prospectively enrolled. All patients underwent diffusion-weighted magnetic resonance (MR) imaging at 3.0 T using 11 b values (0-1000 sec/mm2). ADC, pseudodiffusion coffiecient D*, perfusion fraction f, and the diffusion coefficient D were compared between patients with favourable (n=32) and unfavourable response (n=14).RESULTS:
f values were significantly lower in the unfavourable response group (12.6%±4.4%) than in the favourable response group (30.2%±8.6%) (Z=4.989, P<0.001). However, the ADC, D, and D* were not significantly different between the two groups (P>0.05). Receiver operating characteristic curve analyses showed f to be a significant predictor for differentiation, with a sensitivity of 93.8% and a specificity of 92.9%.CONCLUSIONS:
IVIM-MRI is potentially useful in the prediction of antifungal treatment response to patients with IFI in the lung. Our results indicate that a low perfusion fraction f may be a noninvasive imaging biomarker for unfavourable response. KEY POINTS ⢠Recognition of IFI indicating clinical outcome is important for treatment decision-making. ⢠IVIM can reflect diffusion and perfusion information of IFI lesions separately. ⢠Perfusion characteristics of IFI lesions could help differentiate treatment response. ⢠An initial low f may predict unfavourable response in IFI.Palabras clave
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Infecciones Fúngicas Invasoras
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Enfermedades Pulmonares Fúngicas
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Antifúngicos
Tipo de estudio:
Diagnostic_studies
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Evaluation_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2017
Tipo del documento:
Article