scholarly journals Evaluation of a multiparametric MRI radiomic-based approach for stratification of equivocal PI-RADS 3 and upgraded PI-RADS 4 prostatic lesions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Valentina Brancato ◽  
Marco Aiello ◽  
Luca Basso ◽  
Serena Monti ◽  
Luigi Palumbo ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Multiparametric Mri ◽  
Order Model ◽  
Diagnostic Efficacy ◽  
Dce Mri ◽  
Contrast Enhanced ◽  
Before And After ◽  
Apparent Diffusion ◽  
Adc Map

AbstractDespite the key-role of the Prostate Imaging and Reporting and Data System (PI-RADS) in the diagnosis and characterization of prostate cancer (PCa), this system remains to be affected by several limitations, primarily associated with the interpretation of equivocal PI-RADS 3 lesions and with the debated role of Dynamic Contrast Enhanced-Magnetic Resonance Imaging (DCE-MRI), which is only used to upgrade peripheral PI-RADS category 3 lesions to PI-RADS category 4 if enhancement is focal. We aimed at investigating the usefulness of radiomics for detection of PCa lesions (Gleason Score ≥ 6) in PI-RADS 3 lesions and in peripheral PI-RADS 3 upgraded to PI-RADS 4 lesions (upPI-RADS 4). Multiparametric MRI (mpMRI) data of patients who underwent prostatic mpMRI between April 2013 and September 2018 were retrospectively evaluated. Biopsy results were used as gold standard. PI-RADS 3 and PI-RADS 4 lesions were re-scored according to the PI-RADS v2.1 before and after DCE-MRI evaluation. Radiomic features were extracted from T2-weighted MRI (T2), Apparent diffusion Coefficient (ADC) map and DCE-MRI subtracted images using PyRadiomics. Feature selection was performed using Wilcoxon-ranksum test and Minimum Redundancy Maximum Relevance (mRMR). Predictive models were constructed for PCa detection in PI-RADS 3 and upPI-RADS 4 lesions using at each step an imbalance-adjusted bootstrap resampling (IABR) on 1000 samples. 41 PI-RADS 3 and 32 upPI-RADS 4 lesions were analyzed. Among 293 radiomic features, the top selected features derived from T2 and ADC. For PI-RADS 3 stratification, second order model showed higher performances (Area Under the Receiver Operating Characteristic Curve—AUC— = 80%), while for upPI-RADS 4 stratification, first order model showed higher performances respect to superior order models (AUC = 89%). Our results support the significant role of T2 and ADC radiomic features for PCa detection in lesions scored as PI-RADS 3 and upPI-RADS 4. Radiomics models showed high diagnostic efficacy in classify PI-RADS 3 and upPI-RADS 4 lesions, outperforming PI-RADS v2.1 performance.

scholarly journals Levels of serum transferrin receptor and its response to Fe-supplement in Fe-deficient children

2006 ◽  
Vol 96 (6) ◽  
pp. 1134-1139 ◽  
Author(s):  
Xiao-Ming Lin ◽  
Cheng-Ye Ji ◽  
Wen-Jing Liu ◽  
Zhu Long ◽  
Xiao-Yi Shen
Keyword(s):  
Transferrin Receptor ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Fe Deficiency ◽  
Serum Transferrin ◽  
Diagnostic Efficacy ◽  
Republic Of China ◽  
Serum Transferrin Receptor ◽  
Before And After

The object of the present study was to investigate the levels of serum transferrin receptor (sTfR) and its response to Fe supplementation in Fe-deficient children and the role of sTfR in detecting Fe deficiency and assessing the efficacy of Fe supplementation. According to the diagnostic standard, 1006 children, aged 6–14 years in Fangshan district, Beijing, Peoples Republic of China, were divided into four groups: normal; Fe store depletion (IDs); Fe deficiency erythropoiesis (IDE); Fe deficiency anaemia (IDA). sTfR was determined and transferrin receptor-ferritin (TfR-F) index was calculated in 238 children, sixty-four normal and 174 Fe deficient. Children were administered a NaFeEDTA capsule containing 60 mg Fe once per week for the IDs and IDE groups and three times per week for the IDA group for nine consecutive weeks. The parameters reflecting Fe status and sTfR were determined before and after Fe supplementation. The levels of sTfR and TfR-F index in Fe-deficient children were significantly higher than those in the normal group. The receiver operating characteristic curve showed that sTfR has proper diagnostic efficacy for functional Fe deficiency. After Fe supplementation, the level of sTfR was significantly decreased in children with IDs, but not in children with IDE and IDA, while TfR-F index was significantly decreased in Fe-deficient children. sTfR is a reliable indicator for detecting functional Fe deficiency, and TfR-F index is a sensitive parameter for assessing the efficacy of Fe supplementation.

scholarly journals The Role of Advanced MRI in the Development of Treat-to-Target Therapeutic Strategies, Patient Stratification and Phenotyping in Rheumatoid Arthritis

2019 ◽  
Author(s):  
Ali Mobasheri ◽  
Mark Hinton ◽  
Olga Kubassova
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Marrow Edema ◽  
Objective Assessment ◽  
Treat To Target ◽  
Resonance Imaging ◽  
Advanced Imaging ◽  
Dce Mri ◽  
Contrast Enhanced ◽  
Magnetic Resonance Imaging Mri

Abstract In this commentary we discuss the potential of advanced imaging, particularly Dynamic Contrast Enhanced (DCE) magnetic resonance imaging (MRI) for the objective assessment of disease progression in rheumatoid arthritis (RA). We emphasise the potential DCE-MRI in advancing the field and exploring new areas of research and development in RA. We believe that different grades of bone marrow edema (BME) and synovitis in RA can be examined and monitored in a more sensitive manner with DCE-MRI. Future treatments for RA will be significantly improved by enhanced imaging of BMEs and synovitis. DCE-MRI will also facilitate enhanced stratification and phenotyping of patients enrolled in clinical trials.

scholarly journals Use of Radiomics to Improve Diagnostic Performance of PI-RADS v2.1 in Prostate Cancer

2021 ◽  
Vol 10 ◽  
Author(s):  
Mou Li ◽  
Ling Yang ◽  
Yufeng Yue ◽  
Jingxu Xu ◽  
Chencui Huang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Performance ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Training Set ◽  
Combined Model ◽  
Contrast Enhanced ◽  
Apparent Diffusion ◽  
Validation Set

ObjectiveTo investigate whether a radiomics model can help to improve the performance of PI-RADS v2.1 in prostate cancer (PCa).MethodsThis was a retrospective analysis of 203 patients with pathologically confirmed PCa or non-PCa between March 2015 and December 2016. Patients were divided into a training set (n = 141) and a validation set (n = 62). The radiomics model (Rad-score) was developed based on multi-parametric MRI including T2 weighted imaging (T2WI), diffusion weighted imaging (DWI), apparent diffusion coefficient (ADC) imaging, and dynamic contrast enhanced (DCE) imaging. The combined model involving Rad-score and PI-RADS was compared with PI-RADS for the diagnosis of PCa by using the receiver operating characteristic curve (ROC) analysis.ResultsA total of 112 (55.2%) patients had PCa, and 91 (44.8%) patients had benign lesions. For PCa versus non-PCa, the Rad-score had a significantly higher area under the ROC curve (AUC) [0.979 (95% CI, 0.940–0.996)] than PI-RADS [0.905 (0.844–0.948), P = 0.002] in the training set. However, the AUC between them was insignificant in the validation set [0.861 (0.749–0.936) vs. 0.845 (0.731–0.924), P = 0.825]. When Rad-score was added to PI-RADS, the performance of the PI-RADS was significantly improved for the PCa diagnosis (AUC = 0.989, P < 0.001 for the training set and AUC = 0.931, P = 0.038 for the validation set).ConclusionsThe radiomics based on multi-parametric MRI can help to improve the diagnostic performance of PI-RADS v2.1 in PCa.

scholarly journals Συμβολή νεότερων τεχνικών μαγνητικού συντονισμού στη διάγνωση και παρακολούθηση του θεραπευτικού αποτελέσματος στον καρκίνο του προστάτη

2014 ◽  
Author(s):  
Αναστάσιος Γυφτόπουλος
Keyword(s):  
Multiparametric Mri ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced

ΣΚΟΠΟΣ : Σκοπός της παρούσας διδακτορικής διατριβής ήταν η μελέτη ασθενών με διαγνωσμένο καρκίνο του προστάτη με νεότερες τεχνικές απεικόνισης (διάχυση (DWI), αιματική διήθηση), η συσχέτιση των απεικονιστικών με τα παθολογοανατομικά ευρήματα καθώς και η λειτουργική μελέτη του αδένα κατά τη διάρκεια της θεραπείας με σκοπό την εκτίμηση της ανταπόκρισης σε αυτή. Επιπρόσθετα η σύγκριση των παραμέτρων της πολυπαραμετρικής μαγνητικής τομογραφίας δηλαδή των ακολουθιών Τ2 προσανατολισμού, των ακολουθιών διάχυσης, της δυναμικής εξέτασης ή του συνδυασμού τους για την καλύτερη διάγνωση της κακοήθειας στον προστάτη.Σαν ελάχιστες προυποθέσεις για την πραγματοποίηση πολυπαραμετρικής Μαγνητικής Τομογραφίας είναι ο συνδυασμός ακολουθιών Τ1 και Τ2 προσανατολισμού με ακολουθίες διάχυσης (DWΙ) ή δυναμική εξέταση μετά χορήγηση παραμαγνητικής (dynamic contrast-enhanced MRΙ). ΥΛΙΚΟ-ΜΕΣΑ : Κατά τη διάρκεια των τελευταίων ετών της παρούσας μελέτης εξετάστηκαν στο Β’ Εργαστήριο Ακτινολογίας ασθενείς με υψηλά επίπεδα ειδικού προστατικού αντιγόνου (PSA) ορού αίματος στους οποίους είχε τεθεί η διάγνωση του καρκίνου του προστάτη με διορθική βιοψία. Τα παρακευάσματα των χειρουργηθέντων ασθενών τέμνονταν απο τον παθολογοανατόμο με εγκάρσιες τομές , σε αντιστοιχία με τα δεδομένα της εγκάρσιας ανατομίας όπως απεικονίζεται με την μαγνητική τομογραφία. Ορισμένοι ασθενείς υπεβλήθησαν σε ακτινοθεραπεία πραγματοποίησαν εξετάσεις πριν και μετά το πέρας της θεραπείας. ΑΠΟΤΕΛΕΣΜΑΤΑ: Η πολυπαραμετρική μελέτη είχε αυξημένη ευαισθησία ειδικότητα, μεγαλύτερη απο κάθε τεχνική ή συνδυασμό τους . Η αρνητική προγνωστική αξία του συνδυασμού των απεικονιστικών τεχνικών για την ανίχνευση του όγκου ήταν 88.3% . Η δυναμική εξέταση ( DCE ) είχε την υψηλότερη ευαισθησία στην μελέτη μας.Στη μελέτη μας φάνηκε οτι η ακτινοθεραπεία προκαλεί ελάττωση των τιμών στους χάρτες ADC απο τους πρώτους κύκλους θεραπείας. Το γεγονός αυτό συσχετίζεται με ανταπόκριση στη θεραπεία. Τα αποτελέσματα της ποσοτικής προσέγγισης αναδεικνύουν χαμηλότερες τιμές Τ2, ADC και υψηλότερες τιμές Ktrans στις περιοχές κακοήθειας με στατιστικά σημαντική διαφορά όσο αφορά τις δυο τελευταίες παραμέτρους. ΣΥΜΠΕΡΑΣΜΑ : Η πολυπαραμετρική Μαγνητική Τομογραφία (Multiparametric MRI) έχει την δυνατότητα να αλλάξει την συνηθισμένη διαγνωστική και θεραπευτική προσέγγιση της νόσου. Η προσθήκη τεχνικών όπως οι ακολουθίες διάχυσης (DWI), και η δυναμική μελέτη μετά την ενδοφλέβια χορήγηση παραμαγνητικής ουσίας (DCE-MRI) παρέχουν ανατομικές και λειτουργικές πληροφορίες και βοηθούν στον διαχωρισμό του φυσιολογικού απο τον παθολογικό ιστό. H πολυπαραμετρική μαγνητική τομογραφία είναι ένα εξαιρετικό εργαλείο για την διάγνωση ,τον καθορισμό της θεραπείας , την μελέτη του αποτελέσματός της καθώς και την παρακολούθηση των ασθενών με καρκίνο του προστάτη αδένα.

scholarly journals APACHE IV system helps to determine role of cholecystostomy in elderly patients with acute cholecystitis

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110592
Author(s):  
Hua Jiang ◽  
Guo Guo ◽  
Zhimin Yao ◽  
Yuehua Wang
Keyword(s):  
High Risk ◽  
Acute Cholecystitis ◽  
Scoring System ◽  
Characteristic Curve ◽  
Chi Square ◽  
High Risk Patients ◽  
Before And After ◽  
Risk Patients ◽  
Apache Iv

Objective Cholecystostomy is a palliative treatment for patients unfit to undergo immediate cholecystectomy. Nevertheless, the role of cholecystostomy in the clinical management of such patients remains unclear. The Acute Physiology and Chronic Health Evaluation IV (APACHE IV) scoring system is useful for estimating the hospital mortality of high-risk patients. We evaluated the therapeutic effect of cholecystostomy by the APACHE IV scoring system in patients aged >65 years with acute cholecystitis. Methods In total, 597 patients aged >65 years with acute cholecystitis were retrospectively analyzed using APACHE IV scores. Results The fitness of the APACHE IV score prediction was good, with an area under the receiver operating characteristic curve of 0.894. The chi square independence test indicated that compared with conservative treatment, cholecystostomy may have different effects on mortality for patients whose estimated mortality rate was >10%. Comparison of the estimated mortality of patients before and after cholecystostomy indicated that the estimated mortality was significantly lower after than before puncture, both in the whole patient group and in the group with an estimated mortality of >10%. Conclusion The APACHE IV scoring system showed that cholecystostomy is a safe and effective treatment for elderly high-risk patients with acute cholecystitis.

scholarly journals Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

Diagnostics ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 164 ◽  
Author(s):  
Valentina Brancato ◽  
Giuseppe Di Costanzo ◽  
Luca Basso ◽  
Liberatore Tramontano ◽  
Marta Puglia ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Multiparametric Mri ◽  
Added Value ◽  
Operating Characteristics ◽  
Dce Mri ◽  
Contrast Enhanced ◽  
Mri Protocol ◽  
Controversial Topic ◽  
Clinically Significant ◽  
Method Agreement

The role of dynamic contrast-enhanced-MRI (DCE-MRI) for Prostate Imaging-Reporting and Data System (PI-RADS) scoring is a controversial topic. In this retrospective study, we aimed to measure the added value of DCE-MRI in combination with T2-weighted (T2W) and diffusion-weighted imaging (DWI) using PI-RADS v2.1, in terms of reproducibility and diagnostic accuracy, for detection of prostate cancer (PCa) and clinically significant PCa (CS-PCa, for Gleason Score ≥ 7). 117 lesions in 111 patients were identified as suspicion by multiparametric MRI (mpMRI) and addressed for biopsy. Three experienced readers independently assessed PI-RADS score, first using biparametric MRI (bpMRI, including DWI and T2W), and then multiparametric MRI (also including DCE). The inter-rater and inter-method agreement (bpMRI- vs. mpMRI-based scores) were assessed by Cohen’s kappa (κ). Receiver operating characteristics (ROC) analysis was performed to evaluate the diagnostic accuracy for PCa and CS-PCa detection among the two scores. Inter-rater agreement was excellent for the three pairs of readers (κ ≥ 0.83), while the inter-method agreement was good (κ ≥ 0.73). Areas under the ROC curve (AUC) showed similar high-values (0.8 ≤ AUC ≤ 0.85). The reproducibility of PI-RADS v2.1 scoring was comparable and high among readers, without relevant differences, depending on the MRI protocol used. The inclusion of DCE did not influence the diagnostic accuracy.

Differential diagnosis of central lymphoma and high-grade glioma: dynamic contrast-enhanced histogram

2020 ◽  
Vol 61 (9) ◽  
pp. 1221-1227
Author(s):  
Han-wen Zhang ◽  
Gui-wen Lyu ◽  
Wen-jie He ◽  
Yi Lei ◽  
Fan Lin ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Histogram Analysis ◽  
High Grade ◽  
Diagnostic Efficiency ◽  
Roc Curve Analysis ◽  
Diagnostic Efficacy ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Significant Difference

Background In clinical diagnosis, some central nervous system lymphomas (CNSL) are difficult to distinguish from high-grade gliomas (HGG). Purpose To evaluate the diagnostic efficacy of the histogram analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in the identification of CNSL and HGG. Material and Methods In all, 43 patients diagnosed with HGG (n = 28) and CNSL (n = 15) by histopathology underwent DCE-MRI scanning. Differences in histogram parameters based on DCE-MRI between HGG and CNSL were analyzed by Mann–Whitney U test. In addition, receiver operating characteristic (ROC) analysis was performed. Short-term follow-up of patients was performed using Kaplan–Meier analysis to explore the survival rates of HGG and CNSL. Results For the ROC curve analysis, we demonstrate that the 10th percentile of Ktrans (area under the curve [AUC] = 0.912, sensitivity = 86.7%, specificity = 92.9%), Kep (AUC = 0.940, sensitivity = 93.3%, specificity = 79.6%), Ve (AUC = 0.907, sensitivity = 86.7%, specificity = 89.3%), and AUC (AUC = 0.904, sensitivity = 86.7%, specificity = 92.9%) were significantly different between the CNSL and HGG groups ( P < 0.001), with high diagnostic efficiency. Table 2 shows that the histogram features based on AUC maps (10th, 25th, median, 75th, 90th, and mean) were always significantly higher in the CNSL group than in the HGG group ( P < 0.001). There was no significant difference in Vp or in the 75th, 90th and mean of Ktrans, Kep, and Ve between the CNSL and HGG groups ( P > 0.05). Conclusion A histogram analysis of DCE-MRI identified significant differences between HGG and CNSL, and this will help in the clinical differential diagnosis of these conditions.

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