Whole solid tumour volume histogram analysis of the apparent diffusion coefficient for differentiating high-grade from low-grade serous ovarian carcinoma: correlation with Ki-67 proliferation status

2019 ◽  
Vol 74 (12) ◽  
pp. 918-925 ◽  
Author(s):  
H.M. Li ◽  
R. Zhang ◽  
W.Y. Gu ◽  
S.H. Zhao ◽  
N. Lu ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Ovarian Carcinoma ◽  
Solid Tumour ◽  
Tumour Volume ◽  
Low Grade ◽  
High Grade ◽  
Ki 67 ◽  
Serous Ovarian Carcinoma ◽  
Apparent Diffusion

Is the standard deviation of the apparent diffusion coefficient a potential tool for the preoperative prediction of tumor grade in endometrial cancer?

2020 ◽  
Vol 61 (12) ◽  
pp. 1724-1732
Author(s):  
Bin Yan ◽  
Xiufen Liang ◽  
Tingting Zhao ◽  
Caixia Ding ◽  
Ming Zhang
Keyword(s):  
Diffusion Coefficient ◽  
Endometrial Cancer ◽  
Standard Deviation ◽  
Apparent Diffusion Coefficient ◽  
Tumor Grade ◽  
Low Grade ◽  
High Grade ◽  
Ki 67 ◽  
Preoperative Prediction ◽  
Apparent Diffusion

Background The tumor histological grade is closely related to the prognosis of endometrial cancer (EC). The use of the apparent diffusion coefficient (ADC), tumor volume, and MRI-based texture analysis has allowed exciting advances in predicting EC grade before surgery. However, whether this constitutes a simple, convenient, and powerful diagnostic method remains unknown. Purpose To explore the utility of standard deviation (SD) of the ADC (ADCSD) for predicting the tumor grade in patients with EC. Material and Methods We retrospectively evaluated 138 patients with EC. All patients underwent unenhanced MRI and diffusion-weighted imaging (DWI). The mean ADC value (ADCmean) and SD were obtained using a freehand region of interest traced on the ADC map. Spearman’s linear correlation coefficients were calculated to analyze the correlations between the indexes (including ADCSD and the ADCmean) and the Ki-67 index. The Kruskal–Wallis and Mann–Whitney U tests were used to compare differences in the index results among tumor grades. Results A significant difference in ADCSD was observed among the tumor grades ( P=0.000), and the ADCSD value was significantly higher for high-grade EC than for low-grade tumors (289.7 vs. 216.3×10−6mm2 /s, P=0.000). A statistically significant positive correlation was observed between ADCSD and the Ki-67 index (r=0.364, P=0.000). According to the receiver operating characteristic curve, ADCSD ≥240.2×10−6mm2 /s predicted high-grade EC with a sensitivity, specificity, and accuracy of 73.1%, 80.2%, and 77.5%, respectively. Conclusion Based on the intratumor heterogeneity of EC, ADCSD represents a potential method for the preoperative prediction of high-grade EC, although further studies are needed.

Can the apparent diffusion coefficient differentiate the grade of endometrioid adenocarcinoma and the histological subtype of endometrial cancer?

2017 ◽  
Vol 59 (3) ◽  
pp. 363-370 ◽  
Author(s):  
Bin Yan ◽  
Tingting Zhao ◽  
Xiufen Liang ◽  
Chen Niu ◽  
Caixia Ding
Keyword(s):  
Diffusion Coefficient ◽  
Endometrial Cancer ◽  
Apparent Diffusion Coefficient ◽  
Low Grade ◽  
Endometrioid Adenocarcinoma ◽  
High Grade ◽  
Squamous Differentiation ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Endometrial Cancers

Background Diffusion-weighted imaging (DWI) provides useful information for the identification of benign and malignant uterine lesions. However, the use of the apparent diffusion coefficient (ADC) for histopathological grading of endometrial cancer is controversial. Purpose To explore the use of ADC values in differentiating the preoperative tumor grading of endometrioid adenocarcinomas and investigate the relationship between the ADC values of endometrial cancer and the histological tumor subtype. Material and Methods We retrospectively evaluated 98 patients with endometrial cancers, including both endometrioid adenocarcinomas (n = 80) and non-endometrioid adenocarcinomas (n = 18). All patients underwent DWI procedures and ADC values were calculated. The Kruskal–Wallis test and the independent samples Mann–Whitney U test were used to compare differences in the ADC values between different tumor grades and different histological subtypes. Results The mean ADC values (ADCmean) for high-grade endometrioid adenocarcinomas were significantly lower than the values for low-grade tumors (0.800 versus 0.962 × 10–3 mm2/s) ( P = 0.002). However, no significant differences in ADCmean and minimum ADC values (ADCmin) were found between tumor grades (G1, G2, and G3) of endometrial cancer. Compared with endometrioid adenocarcinomas, the adenocarcinoma with squamous differentiation showed lower ADC values (mean/minimum = 0.863/0.636 versus 0.962/0.689 × 10–3 mm2/s), but the differences were not significant ( Pmean = 0.074, Pmin = 0.441). Moreover, ADCmean for carcinosarcomas was significantly higher than the value for G3 non-carcinosarcoma endometrial cancers (1.047 versus 0.823 × 10–3 mm2/s) ( P = 0.001). Conclusion The ADCmean was useful for identifying high-grade and low-grade endometrioid adenocarcinomas. Additionally, squamous differentiation may decrease ADCmean and ADCmin of endometrioid adenocarcinoma, and carcinosarcomas showed relatively high ADCmean.

Diagnostic role of apparent diffusion coefficient combined with intratumoral susceptibility signals in differentiating high-grade gliomas from brain metastases

2020 ◽  
pp. 197140092098016
Author(s):  
Mustafa Bozdağ ◽  
Ali Er ◽  
Akın Çinkooğlu ◽  
Sümeyye Ekmekçi
Keyword(s):  
Diffusion Coefficient ◽  
Brain Metastases ◽  
Apparent Diffusion Coefficient ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Proliferation Index ◽  
High Grade ◽  
Ki 67 ◽  
Apparent Diffusion ◽  
High Grade Gliomas

Objective The aim of this study was to assess whether tumoral and peritumoral apparent diffusion coefficient values and intratumoral susceptibility signals on susceptibility-weighted imaging could distinguish between high-grade gliomas and brain metastases, and to investigate their associations with the Ki-67 proliferation index. Materials and methods Fifty-seven patients with pathologically confirmed diagnoses of either high-grade glioma or brain metastasis were enrolled in this study (23 with high-grade gliomas and 34 with brain metastases). The minimum and mean apparent diffusion coefficients in the enhancing tumoral region (ADCmin and ADCmean) and the minimum apparent diffusion coefficient in the peritumoral region (ADCedema) were measured from apparent diffusion coefficient maps, and intratumoral susceptibility signal grades acquired by susceptibility-weighted imaging were calculated. Ki-67 proliferation index values were obtained from the hospital database. These parameters were evaluated using the Mann-Whitney U test, independent-sample t-test, Spearman correlation analysis, receiver operating characteristic curve, and logistic regression analyses. Results ADCmean, ADCmin values, and intratumoral susceptibility signal grades in brain metastases were significantly lower than those in high-grade gliomas (all p < 0.05). Ki-67 proliferation index values showed significant correlations with ADCmean, ADCmin, and intratumoral susceptibility signal grade in brain metastases (all p < 0.05), but no correlation was found in high-grade gliomas (all p > 0.05). According to receiver operating characteristic curve analysis, ADCmean achieved the highest diagnostic performance for discriminating high-grade gliomas from brain metastases. Furthermore, the combination of tumoral apparent diffusion coefficient parameters with intratumoral susceptibility signal grade provided a higher area under the curve than univariate parameters. Conclusion The combination of tumoral apparent diffusion coefficient with intratumoral susceptibility signal grade can offer better diagnostic performances for differential diagnosis. Apparent diffusion coefficient and intratumoral susceptibility signal may reflect cellular proliferative activity in brain metastases, but not in high-grade gliomas.

Association of apparent diffusion coefficient with Ki-67 proliferation index, progesterone-receptor status and various histopathological parameters, and its utility in predicting the high grade in meningiomas

2020 ◽  
pp. 028418512092214
Author(s):  
Mustafa Bozdağ ◽  
Ali Er ◽  
Sümeyye Ekmekçi
Keyword(s):  
Diffusion Coefficient ◽  
Progesterone Receptor ◽  
Histological Grade ◽  
Proliferation Index ◽  
Proliferative Potential ◽  
Low Grade ◽  
High Grade ◽  
Ki 67 ◽  
Apparent Diffusion ◽  
Adc Values

Background Accurate preoperative determination of the histological grade and cellular proliferative potential of meningioma by non-invasive imaging is of paramount importance. Purpose To evaluate the utility of apparent diffusion coefficient (ADC) in determining the histological grade of meningioma, and to investigate the correlation of ADC with Ki-67 proliferation index (PI), progesterone receptor (PR) status, and a number of other histopathological parameters. Material and Methods Histopathologically confirmed 94 meningioma patients (72 low-grade, 22 high-grade) who had undergone preoperative diffusion-weighted imaging were retrospectively evaluated. ADC values were obtained by manually drawing the regions of interest (ROIs) within the solid components of the tumor. The relationship between ADC and Ki-67 values, PR status, and multiple histopathological parameters were investigated, and the ADC values of high-grade and low-grade meningiomas were compared. Independent sample t-test, Mann–Whitney U test, receiver operating characteristic, Pearson correlation, and multiple logistic regression analysis were used for statistical assessment. Results All ADC and rADC values were significantly lower in high-grade meningiomas than in low-grade meningiomas (all P < 0.05). ADC values showed significantly negative correlations with Ki-67 and mitotic index ( P < 0.001 for each). Numerous ADC parameters were significantly lower in meningiomas demonstrating hypercellularity and necrosis features ( P < 0.05). ADC values did not show a significant correlation with PR score (all P > 0.05). Conclusion ADC can be utilized as a reliable imaging biomarker for predicting the proliferative potential and histological grade in meningiomas.

scholarly journals Diffusion weighted imaging in high-grade gliomas: A histogram-based analysis of apparent diffusion coefficient profile

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249878
Author(s):  
Georg Gihr ◽  
Diana Horvath-Rizea ◽  
Elena Hekeler ◽  
Oliver Ganslandt ◽  
Hans Henkes ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Standard Deviation ◽  
Apparent Diffusion Coefficient ◽  
Anaplastic Astrocytoma ◽  
Methylation Status ◽  
Proliferation Index ◽  
High Grade ◽  
Ki 67 ◽  
Significant Difference ◽  
Apparent Diffusion

Purpose Glioblastoma and anaplastic astrocytoma represent the most commonly encountered high-grade-glioma (HGG) in adults. Although both neoplasms are very distinct entities in context of epidemiology, clinical course and prognosis, their appearance in conventional magnetic resonance imaging (MRI) is very similar. In search for additional information aiding the distinction of potentially confusable neoplasms, histogram analysis of apparent diffusion coefficient (ADC) maps recently proved to be auxiliary in a number of entities. Therefore, our present exploratory retrospective study investigated whether ADC histogram profile parameters differ significantly between anaplastic astrocytoma and glioblastoma, reflect the proliferation index Ki-67, or are associated with the prognostic relevant MGMT (methylguanine-DNA methyl-transferase) promotor methylation status. Methods Pre-surgical ADC volumes of 56 HGG patients were analyzed by histogram-profiling. Association between extracted histogram parameters and neuropathology including WHO-grade, Ki-67 expression and MGMT promotor methylation status was investigated due to comparative and correlative statistics. Results Grade IV gliomas were more heterogeneous than grade III tumors. More specifically, ADCmin and the lowest percentile ADCp10 were significantly lower, whereas ADCmax, ADC standard deviation and Skewness were significantly higher in the glioblastoma group. ADCmin, ADCmax, ADC standard deviation, Kurtosis and Entropy of ADC histogram were significantly correlated with Ki-67 expression. No significant difference could be revealed by comparison of ADC histogram parameters between MGMT promotor methylated and unmethylated HGG. Conclusions ADC histogram parameters differ significantly between glioblastoma and anaplastic astrocytoma and show distinct associations with the proliferative activity in both HGG. Our results suggest ADC histogram profiling as promising biomarker for differentiation of both, however, further studies with prospective multicenter design are wanted to confirm and further elaborate this hypothesis.

Apparent diffusion coefficient values and non-homogeneity of diffusion in brain tumors in diffusion-weighted MRI

2019 ◽  
Vol 61 (2) ◽  
pp. 244-252
Author(s):  
Sedigheh Basirjafari ◽  
Masoud Poureisa ◽  
Babak Shahhoseini ◽  
Mohammad Zarei ◽  
Saeideh Aghayari Sheikh Neshin ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Standard Deviation ◽  
Brain Tumors ◽  
Region Of Interest ◽  
Low Grade ◽  
High Grade ◽  
Ki 67 ◽  
Apparent Diffusion ◽  
Adc Values ◽  
The Mean

Background The values that have been received from apparent diffusion coefficient (ADC) maps of diffusion-weighted magnetic resonance imaging (DW-MRI) might play a vital role in evaluating tumors and their grading scale. Purpose To investigate the predictive role of this heterogeneity in brain tumor pathologies and its correlation with Ki-67. Material and Methods A total of 124 patients with brain tumors underwent brain MRI with gadolinium injection. ADC and standard deviation of each lesion have been obtained from manual localization of the region of interest on the ADC map. A receiver operating characteristic analysis was conducted to determine the minimum cut-off values of the mean ADC and mean standard deviation of ADC maps having the highest sensitivity and specificity to differentiate high-grade and low-grade tumors. Results Mean ADC values in the region of interest were significantly lower for malignant tumors (grade IV and metastasis) than grade I brain tumors, while a higher mean standard deviation was observed. In a more detailed comparison of tumor groups, the mean standard deviation of the ADC for glioblastoma multiform was significantly higher than meningioma grade I ( P < 0.001) and metastasis was significantly higher than grade III and IV astrocytic tumors ( P = 0.004). The analysis of Ki-67 proliferation index and mean ADC values in gliomas showed a significant inverse correlation between the parameters (r = –0.0429, P < 0.001) and direct correlation between Ki-67 and mean standard deviation of the ADC (r = 0.551, P < 0.001). As an index for the ADC to differentiate high-grade and low-grade tumors, the cut-off values of 1.40*10−3 mm2/s for mean ADC and 45*10−3 mm2/s for mean standard deviation have the highest combination of sensitivity, specificity, and area under the curve. Conclusion The mean value and standard deviation of the ADC could be considered for differentiating between low-grade and high-grade brain tumors, as two available non-invasive methods.

scholarly journals Low-Grade Gliomas: Six-month Tumor Growth Predicts Patient Outcome Better than Admission Tumor Volume, Relative Cerebral Blood Volume, and Apparent Diffusion Coefficient

Radiology ◽  
2009 ◽  
Vol 253 (2) ◽  
pp. 505-512 ◽  
Author(s):  
Gisele Brasil Caseiras ◽  
Olga Ciccarelli ◽  
Daniel R. Altmann ◽  
Christopher E. Benton ◽  
Daniel J. Tozer ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Tumor Growth ◽  
Blood Volume ◽  
Cerebral Blood Volume ◽  
Tumor Volume ◽  
Low Grade ◽  
Apparent Diffusion ◽  
Better Than

Diagnostic value of apparent diffusion coefficient in differentiating between high-grade gliomas and brain metastases

2017 ◽  
Vol 59 (5) ◽  
pp. 599-605 ◽  
Author(s):  
Ionut Caravan ◽  
Cristiana Augusta Ciortea ◽  
Alexandra Contis ◽  
Andrei Lebovici
Keyword(s):  
Diffusion Coefficient ◽  
Brain Metastases ◽  
Apparent Diffusion Coefficient ◽  
Curve Analysis ◽  
High Grade ◽  
Peritumoral Edema ◽  
Roc Curve Analysis ◽  
Apparent Diffusion ◽  
Adc Values ◽  
The Mean

Background High-grade gliomas (HGGs) and brain metastases (BMs) can display similar imaging characteristics on conventional MRI. In HGGs, the peritumoral edema may be infiltrated by the malignant cells, which was not observed in BMs. Purpose To determine whether the apparent diffusion coefficient values could differentiate HGGs from BMs. Material and Methods Fifty-seven patients underwent conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) before treatment. The minimum and mean ADC in the enhancing tumor (ADCmin, ADCmean) and the minimum ADC in the peritumoral region (ADCedema) were measured from ADC maps. To determine whether there was a statistical difference between groups, ADC values were compared. A receiver operating characteristic (ROC) curve analysis was used to determine the cutoff ADC value for distinguishing between HGGs and BMs. Results The mean ADCmin values in the intratumoral regions of HGGs were significantly higher than those in BMs. No differences were observed between groups regarding ADCmean values. The mean ADCmin values in the peritumoral edema of HGGs were significantly lower than those in BMs. According to ROC curve analysis, a cutoff value of 1.332 × 10−3 mm2/s for the ADCedema generated the best combination of sensitivity (95%) and specificity (84%) for distinguishing between HGGs and BMs. The same value showed a sensitivity of 95.6% and a specificity of 100% for distinguishing between GBMs and BMs. Conclusion ADC values from DWI were found to distinguish between HGGs and solitary BMs. The peritumoral ADC values are better than the intratumoral ADC values in predicting the tumor type.

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