Feasibility of diffusion-weighted magnetic resonance imaging in evaluation of early therapeutic response after CT-guided microwave ablation of inoperable lung neoplasms

Abstract Objective To determine the early treatment response after microwave ablation (MWA) of inoperable lung neoplasms using the apparent diffusion coefficient (ADC) value calculated 24 h after the ablation. Materials and methods This retrospective study included 47 patients with 68 lung lesions, who underwent percutaneous MWA from January 2008 to December 2017. Evaluation of the lesions was done using MRI including DWI sequence with ADC value calculation pre-ablation and 24 h post-ablation. DWI-MR was performed with b values (50, 400, 800 mm2/s). The post-ablation follow-up was performed using chest CT and/or MRI within 24 h following the procedure; after 3, 6, 9, and 12 months; and every 6 months onwards to determine the local tumor response. The post-ablation ADC value changes were compared to the end response of the lesions. Results Forty-seven patients (mean age: 63.8 ± 14.2 years, 25 women) with 68 lesions having a mean tumor size of 1.5 ± 0.9 cm (range: 0.7–5 cm) were evaluated. Sixty-one lesions (89.7%) showed a complete treatment response, and the remaining 7 lesions (10.3%) showed a local progression (residual activity). There was a statistically significant difference regarding the ADC value measured 24 h after the ablation between the responding (1.7 ± 0.3 × 10−3 mm2/s) and non-responding groups (1.4 ± 0.3 × 10−3 mm2/s) with significantly higher values in the responding group (p = 0.001). A suggested ADC cut-off value of 1.42 could be used as a reference point for the post-ablation response prediction (sensitivity: 66.67%, specificity: 84.21%, PPV: 66.7%, and NPV: 84.2%). No significant difference was reported regarding the ADC value performed before the ablation as a factor for the prognosis of treatment response (p = 0.86). Conclusion ADC value assessment following ablation may allow the early prediction of treatment efficacy after MWA of inoperable lung neoplasms. Key Points • ADC value calculated 24 h post-treatment may allow the early prediction of MWA efficacy as a treatment of pulmonary tumors and can be used in the early immediate post-ablation imaging follow-up. • The pre-treatment ADC value of lung neoplasms is not different between the responding and non-responding tumors.

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Clinical Application of CT-Guided Percutaneous Microwave Ablation for the Treatment of Lung Metastasis from Colorectal Cancer

Gastroenterology Research and Practice ◽

10.1155/2017/9621585 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9

Author(s):

Lin Li ◽

Ketong Wu ◽

Haiyang Lai ◽

Bo Zhang

Keyword(s):

Colorectal Cancer ◽

Lung Metastasis ◽

Microwave Ablation ◽

Progression Free Survival ◽

Ct Guided ◽

Metastatic Lesions ◽

Local Progression ◽

Invasive Method ◽

Percutaneous Microwave Ablation

Objective. The aim of our research is to explore the clinical efficacy and safety of CT-guided percutaneous microwave ablation (MWA) for the treatment of lung metastasis from colorectal cancer. Materials and Methods. CT-guided percutaneous MWA was performed in 22 patients (male 14, female 8, mean age: 56.05 ± 12.32 years) with a total of 36 lung metastatic lesions from colorectal cancer between February 2014 and May 2017. Clinical data were retrospectively analyzed with respect to the efficacy, safety, and outcome. Results. Of the 36 lesions, 34 lesions (94.4%) reduced obviously with small cavitations or fibrous stripes formed and had no evidence of recurrence during follow-up. The volume of the other 2 lesions demonstrated local progression after 6 months by follow-up CT. The primary complications included pneumothorax (28%), chest pain (21%), and fever (5%). These symptoms and signs were obviously relieved or disappeared after several-day conservative treatment. The mean follow-up of the patients was 25.54 ± 12.58 months (range 2–41 months). The estimated progression-free survival rate was 94.4%. Conclusion. Our results demonstrate that CT-guided percutaneous MWA appears to be an effective, reliable, and minimally invasive method for the treatment of lung metastasis from colorectal cancer. This trial is registered with ChiCTR-ORC-17012904.

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Role of Diffusion Weighted Imaging in Differentiating Benign from Pathological Vertebral Compression

QJM ◽

10.1093/qjmed/hcab106.010 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Faten Mohammed Mahmoud Kamel ◽

Hazem Ibrahim Abdel Rahman ◽

Amany Sayed Khaleel Ahmed Elkhayat

Keyword(s):

Vertebral Fractures ◽

Diffusion Weighted Imaging ◽

Laboratory Evaluation ◽

Vertebral Collapse ◽

Adc Value ◽

Conventional Mri ◽

Diffusion Weighted ◽

Significant Difference

Abstract Background Vertebral collapse is a common problem due to benign conditions (trauma, infection, osteoporosis) or malignant process. And although the spine is the most common site of bone metastases (39% of bony metastases in patients with primary neoplasms) benign vertebral fractures due to osteopenia occur in one third of cancer patients, making it essential to determine whether the cause of vertebral collapse is benign or malignant. Aim of the Work To establish the role of DWI in differentiating benign from pathologic vertebral fractures using ADC values in comparison with histopathology report /laboratory evaluation and clinical follow-up. Patients and Methods A cross sectional study is approved by the ethics review board of Ain Shams University Hospital (Al Demerdash). All patients provided informed consent for the MR imaging examinations and for inclusion of their data in this analysis. From April 2020 to october 2020, 25 cases with previous imaging with vertebral compression underwent conventional MRI study on the affected region. Diffusion weighted imaging and ADC was added. Results We performed DWI using maximum b-values 600, and quantitative analysis, named apparent diffusion coefficient (ADC). We correlated the ADC number to histopathology, laboratory finding and clinical follow up. In our study there was significant difference (p < 0.04) between DWI of the benign and malignant groups. Also the ADC value showed significant difference <0.001. The mean ADCs of benign VCFs were higher significantly than those of pathological fractures. Conclusion DWI with ADC value was helpful when added to conventional MRI to differentiate benign from pathological (malignant) vertebral compression. It should be a routine sequence in patients with vertebral compression fractures for accurate diagnosis and successful management also can decrease no of biopsies.

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CT-Guided Percutaneous Microwave Ablation of Sclerosing Hepatic Carcinoma

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2020/8881978 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Hongshen Song ◽

Huaiyin Ding ◽

Chuandong Zhu

Keyword(s):

Microwave Ablation ◽

Tracking System ◽

Control Group ◽

Multiple Site ◽

Hepatic Carcinoma ◽

Adequate Treatment ◽

Ct Guided ◽

Significant Difference ◽

High Thermal Resistance ◽

Histological Characteristics

Sclerosing http://mts.hindawi.com/update/) in our Manuscript Tracking System and after you have logged in click on the ORCID link at the top of the page. This link will take you to the ORCID website where you will be able to create an account for yourself. Once you have done so, your new ORCID will be saved in our Manuscript Tracking System automatically."?>hepatic carcinoma (SHC) is a rare subtype of hepatic carcinoma that can be caused by various pathogeneses. The histological characteristics of SHC demonstrate its high resistance to chemoembolization and thermal ablation; thus, surgical resection represents the primary option for the majority of patients. However, a small proportion of patients who cannot withstand surgery or who have inoperable tumors may not receive adequate treatment, causing the progression of cancer and related high mortality. To overcome the high puncture resistance, high thermal resistance, and poor thermal conductivity of microwave ablation, we developed percutaneous no-touch multiple-site microwave ablation (NTMSWA) to ablate SHC lesions. In this retrospective study, 96 and 41 patients underwent NTMSWA and surgery, respectively. In the NTMSWA group, tumor size and histological classification were determined by medical imaging and tissue biopsy before ablation, and then a personalized ablation regimen was performed. Complete ablation was achieved in a single session in 81 out of 96 (84.4%) patients. The median survival (MS) of the 90 patients who underwent NTMSWA was 51 months, and the overall survival (OS) rate at 5 years was 49.1%. In contrast, the MS in the control group was 57 months, and the OS rate at 5 years was 56.3%. There was no significant difference between the two groups, indicating that SHC <50 mm in size can be effectively ablated with NTMSWA. By adopting no-touch, multiple-site, low-power, intermittent ablation, SHC less than 50 mm in size can be completely ablated.

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Head tremor in patients with cervical dystonia: different outcome?

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2008000600005 ◽

2008 ◽

Vol 66 (4) ◽

pp. 805-808 ◽

Cited By ~ 8

Author(s):

Clecio Godeiro-Junior ◽

Andre C. Felicio ◽

Patricia C. Aguiar ◽

Vanderci Borges ◽

Sonia M.A. Silva ◽

...

Keyword(s):

Clinical Outcome ◽

Treatment Response ◽

Cervical Dystonia ◽

Age At Onset ◽

Demographic Parameters ◽

Hand Tremor ◽

Head Tremor ◽

Significant Difference ◽

Pre Treatment

OBJECTIVE: The association of cervical dystonia (CD) with other movement disorders have been already described, but data on clinical outcome regarding these patients are scant. The aim of this paper was to investigate whether patients with CD and head tremor (HT) would have a different outcome regarding to botulinum toxin type-A (BTX-A) treatment response and clinical and demographic parameters. METHOD: We retrospectively evaluated 118 medical charts of patients with CD and divided them into two groups: with (HT+) and without (HT-) head tremor. We compared the following clinical and demographic parameters: age at onset, disease duration, progression of symptoms, etiology, familial history, presence of hand tremor. We also analyzed the response to BTX-A according to Tsui score in both groups. RESULTS: The occurrence of head tremor in our sample was of 38.2%. The occurrence of postural hand tremor in the patients from the HT+ group was higher than in the HT- one (p=0.015) and if we compare BTX-A response in each group, we observe that patients with HT present a better outcome in a setting of longer follow-up. In HT+ group, Tsui score pre treatment was 10 (6-12.5) and after follow-up was 8 (5.5-10.5); p<0.001. In HT- group there was no significant difference 9 (7-12) in pre treatment and after follow-up; p=0.07. CONCLUSION: According to our data it seems that head tremor may influence the clinical outcome or treatment response with BTX-A in patients with CD.

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Gut microbial biomarkers for the treatment response in first-episode, drug-naïve schizophrenia: a 24-week follow-up study

Translational Psychiatry ◽

10.1038/s41398-021-01531-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Xiuxia Yuan ◽

Yunpeng Wang ◽

Xue Li ◽

Jiajun Jiang ◽

Yulin Kang ◽

...

Keyword(s):

Treatment Response ◽

First Episode ◽

Antipsychotic Treatment ◽

Follow Up Study ◽

Α Diversity ◽

Microbial Biomarkers ◽

Significant Difference ◽

Drug Naïve ◽

Risperidone Treatment

AbstractPreclinical studies have shown that the gut microbiota can play a role in schizophrenia (SCH) pathogenesis via the gut-brain axis. However, its role in the antipsychotic treatment response is unclear. Here, we present a 24-week follow-up study to identify gut microbial biomarkers for SCH diagnosis and treatment response, using a sample of 107 first-episode, drug-naïve SCH patients, and 107 healthy controls (HCs). We collected biological samples at baseline (all participants) and follow-up time points after risperidone treatment (SCH patients). Treatment response was assessed using the Positive and Negative Symptoms Scale total (PANSS-T) score. False discovery rate was used to correct for multiple testing. We found that SCH patients showed lower α-diversity (the Shannon and Simpson’s indices) compared to HCs at baseline (p = 1.21 × 10−9, 1.23 × 10−8, respectively). We also found a significant difference in β-diversity between SCH patients and HCs (p = 0.001). At baseline, using microbes that showed different abundance between patients and controls as predictors, a prediction model can distinguish patients from HCs with an area under the curve (AUC) of 0.867. In SCH patients, after 24 weeks of risperidone treatment, we observed an increase of α-diversity toward the basal level of HCs. At the genus level, we observed decreased abundance of Lachnoclostridium (p = 0.019) and increased abundance Romboutsia (p = 0.067). Moreover, the treatment response in SCH patients was significantly associated with the basal levels of Lachnoclostridium and Romboutsia (p = 0.005 and 0.006, respectively). Our results suggest that SCH patients may present characteristic microbiota, and certain microbiota biomarkers may predict treatment response in this patient population.

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CT Guided Microwave Ablation of Osteoid Osteoma – Efficacy in Alleviation of Symptoms

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/379 ◽

2021 ◽

Vol 10 (24) ◽

pp. 1835-1839

Author(s):

Naufal. P. ◽

Rinu Susan Thomas ◽

Lin Varghese

Keyword(s):

Osteoid Osteoma ◽

Microwave Ablation ◽

Bone Tumour ◽

Pain Scale ◽

Sleep Loss ◽

Ct Guided ◽

Pain Disability ◽

Key Words Osteoid Osteoma

BACKGROUND Osteoid osteoma is a benign bone tumour which eventually undergoes spontaneous resolution but causes distress due to severe inflammatory pain and sleep loss. Major goal of ablative procedure is alleviation of symptoms. Long term follow up studies on pain remission and complications are less commonly available for microwave ablation. We wanted to assess alleviation of symptoms and long term complications in CT guided microwave ablation of osteoid osteoma. METHODS CT (Computed tomography) guided microwave ablation was performed on 10 patients referred with clinicoradiological diagnosis of osteoid osteoma and their preoperative and 6 month postoperative numerical pain scale, frequency of pain, disability and analgesic uses were compared. Subjects were between 13 and 30 years of age. RESULTS Pain scale dropped to 0 in 9 out of 10 patients. The single remaining patient had partial remission at 6 month follow up. The only complication encountered was wound site infection. All patients were free of analgesic use, disability due to pain, and sleep loss, on follow up. CONCLUSIONS Microwave ablation as an ablative procedure offers many potential benefits and appears to have good treatment response rate with minimal complications. KEY WORDS Osteoid Osteoma, Microwave Ablation, Bone, Interventional Radiology

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Microwave ablation as an efficient therapy for primary hyperparathyroidism: Efficacy and predictors of treatment success

10.22541/au.161515058.88177467/v1 ◽

2021 ◽

Author(s):

Mehmet Sercan Ertürk ◽

Bulent Cekic ◽

Isilay Sarı ◽

Baris Pamuk

Keyword(s):

Logistic Regression ◽

Primary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Microwave Ablation ◽

Treatment Success ◽

Significant Difference ◽

Alkaline Phosphate ◽

The Difference ◽

Response Group

Background:Microwave ablation has a great potential to treat primary hyperparathyroidism; but its predictors and the therapeutic efficiency are not clear enough and so the more investigations are required. Aim:The purpose of this study was to explore safety and predictors of the MWA efficacy in patients with primary hyperparathyroidism (PHPT) induced by parathyroid adenoma. Methods: Patients with PHPT treated with MWA were included in this study. Depending on the treatment efficacy, patients divided into two groups as response and no response group. Possible predictors as age, gender, Parathyroid adenoma volume, baseline levels of calcium (Ca), phosphorous (P), alkaline phosphate (ALP), vitamin D and location of parathyroid adenoma and the instrumental parameters which are microwave ablation time and power were compared between two groups. The resulting possible predictors the MWA efficacy exhibiting statistically significant difference was investigated by using logistic regression. Results: Thirty-two patients participated into predictor analysis for MWA efficacy. Comparison of the values of response and no response groups in terms possible predictors revealed only the baseline Ca level as the potential predictor of the efficacy of MWA (P <0.05). Further logistic regression results showed the baseline Ca level as insignificant to construct a mathematical model to predict the efficacy of MWA (P = 0.071). Furthermore, a significant difference in time differences was observed after 1 day of the MWA treatments in the levels of Ca, P, and PHT except than ALP, those of which was 30 days later (P <0.001). Later on, the difference stayed steady until the end of follow up. Conclusions:MWA is an effective and safe therapy for in patients with PHPT caused by parathyroid adenoma. Baseline Ca level has been found as potential but detailed investigations revealed none of the explored factors as predictive for the assessed patients. Keywords:Primary hyperparathyroidism, microwave ablation, predictor, efficacy

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Early therapy response assessment by apparent diffusion coefficient (ADC) quantification following glass-based yttrium-90 radioembolization for unresectable hepatocellular carcinoma (HCC).

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e15140 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e15140-e15140

Author(s):

Nima Kokabi ◽

Juan C. Camacho ◽

Bassel F. El-Rayes ◽

John S. Kauh ◽

Hyun Sik Kim

Keyword(s):

Treatment Response ◽

Objective Response ◽

Imaging Biomarker ◽

Single Shot ◽

Adc Value ◽

Early Therapy ◽

Mean Values ◽

Significant Difference ◽

Adc Values ◽

Post Therapy

e15140 Background: Early objective imaging biomarker assessment of infiltrative HCC following Y90 radioembolization is not well understood. Early diffusion weighted imaging (DWI) of treated lesions was evaluated and correlated with anatomical treatment response using modified response evaluation criteria in solid tumors (mRECIST). Methods: In an IRB approved prospective proof of concept study, 10 consecutive patients (89% men, median age 55) with unresectable infiltrative HCC and portal vein thrombosis underwent Y90. MR imaging was obtained pre-Y90, 1 and 3 months post-Y90. DWI fat-suppressed single-shot echo-planar sequence with tri-directional diffusion gradient was performed (b=50,400,800 s/mm2). Using pixel-based ADC maps, mean values of treated lesions and surrounding tumor-free liver were measured by manually drawing a noncircular region of interest around corresponding areas on the same image slice. Treatment response was evaluated using mRECIST with complete response as non-enhancement of treated lesion. T-test was performed using SPSS Statistics v20.0 (IBM, Armonk, NY) and significance set at < 0.05. Results: On 30 day post therapy MR and based on mRECIST, 70% of patients had objective response (CR=30%, PR=40%, SD=20%, PD=10%). Mean pre and post-Y90 ADC value of cancer-free liver was 1.10 × 10−3 and 1.08 × 10−3 mm2/sec (p=0.65). Mean ADC value of all treated tumors pre and post-Y90 was 0.82 × 10−3 and 1.19 × 10−3 mm2/sec respectively (p <0.001). Correlating with mRECIST treatment response, mean post-Y90 ADC of lesions with objective and those with no objective response were 1.03 × 10−3 mm2/sec and 1.26 × 10−3 mm2/sec respectively (p=0.003). While there was a significant difference between ADC values of lesion with objective response vs. others, no significant difference was observed at baseline ADC of tumors with eventual objective response vs. others. Corresponding ADC values on 30 and 90 day followup scans were unchanged. Conclusions: Mean ADC value measured 30-days post-therapy shows promises as an objective imaging biomarker to assess treatment response following Y90 therapy for infiltrative HCC.

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A machine learning based delta-radiomics process for early prediction of treatment response of pancreatic cancer

npj Precision Oncology ◽

10.1038/s41698-019-0096-z ◽

2019 ◽

Vol 3 (1) ◽

Cited By ~ 8

Author(s):

Haidy Nasief ◽

Cheng Zheng ◽

Diane Schott ◽

William Hall ◽

Susan Tsai ◽

...

Keyword(s):

Machine Learning ◽

Pancreatic Cancer ◽

Treatment Response ◽

Prediction Models ◽

Feature Space ◽

Response Prediction ◽

Pathological Response ◽

Early Prediction ◽

Linear Regression Models ◽

Ct Guided

Abstract Changes of radiomic features over time in longitudinal images, delta radiomics, can potentially be used as a biomarker to predict treatment response. This study aims to develop a delta-radiomic process based on machine learning by (1) acquiring and registering longitudinal images, (2) segmenting and populating regions of interest (ROIs), (3) extracting radiomic features and calculating their changes (delta-radiomic features, DRFs), (4) reducing feature space and determining candidate DRFs showing treatment-induced changes, and (5) creating outcome prediction models using machine learning. This process was demonstrated by retrospectively analyzing daily non-contrast CTs acquired during routine CT-guided-chemoradiation therapy for 90 pancreatic cancer patients. A total of 2520 CT sets (28-daily-fractions-per-patient) along with their pathological response were analyzed. Over 1300 radiomic features were extracted from the segmented ROIs. Highly correlated DRFs were ruled out using Spearman correlations. Correlation between the selected DRFs and pathological response was established using linear-regression-models. T test and linear-mixed-effects-models were used to determine which DRFs changed significantly compared with first fraction. A Bayesian-regularization-neural-network was used to build a response prediction model. The model was trained using 50 patients and leave-one-out-cross-validation. Performance was judged using the area-under-ROC-curve. External independent validation was done using data from the remaining 40 patients. The results show that 13 DRFs passed the tests and demonstrated significant changes following 2–4 weeks of treatment. The best performing combination differentiating good versus bad responders (CV-AUC = 0.94) was obtained using normalized-entropy-to-standard-deviation-difference-(NESTD), kurtosis, and coarseness. With further studies using larger data sets, delta radiomics may develop into a biomarker for early prediction of treatment response.

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