scholarly journals Application of Diffusion Kurtosis Imaging and Histogram Analysis for Assessing Preoperative Stages of Rectal Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Hui Xie ◽  
Guangyao Wu
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Rectal Adenocarcinoma ◽  
Area Under The Curve ◽  
Histogram Analysis ◽  
Diffusion Kurtosis Imaging ◽  
Diagnostic Efficiency ◽  
Significant Difference ◽  
Adc Values ◽  
Diffusion Kurtosis

Objective. To explore the value of diffusion kurtosis imaging (DKI) and histogram analysis for assessing preoperative stages and heterogeneity in rectal cancer. Methods. Fifty patients with pathologically confirmed rectal adenocarcinoma were enrolled. The value of DKI parameters and histogram metrics for assessing the preoperative stages and heterogeneity in rectal cancer was analyzed retrospectively. Results. (1) ADC-10th percentile and ADC-25th percentile were significantly higher in T1-2 than in the T3-4 rectal cancer (the ADC values were 0.65 ± 0.08 × 10−3 mm2/s versus 0.58 ± 0.11 × 10−3 mm2/s and 0.73 ± 0.11 × 10−3 mm2/s versus 0.65 ± 0.11 × 10−3 mm2/s; p values were 0.035 and 0.024, resp.). (2) D-10th percentile and D-25th percentile were also significantly higher in T1-2 than in T3-4 rectal cancer (the D values were 0.96 ± 0.19 × 10−3 mm2/s versus 0.84 ± 0.16 × 10−3 mm2/s and 1.15 ± 0.27 × 10−3 mm2/s versus 0.99 ± 0.18 × 10−3 mm2/s; p values were 0.017 and 0.044, resp.). (3) K value and its histogram metrics showed no statistically significant difference between T1-2 and T3-4. (4) D-10th had the largest area under the curve (AUC 0.799) among all the parameters; the sensitivity and specificity were 84.2 and 61.3%, respectively. (5) DKI combined with traditional MRI had an accuracy of 68% while assessing the lymph node of rectal cancer. Conclusion. DKI parameters and histogram metrics are rather valuable in assessing the preoperative stages of rectal cancer; D-10th percentile exhibits the highest diagnostic efficiency.

Histogram analysis in prostate cancer: a comparison of diffusion kurtosis imaging model versus monoexponential model

2020 ◽  
Vol 61 (10) ◽  
pp. 1431-1440
Author(s):  
Yuwei Jiang ◽  
Chunmei Li ◽  
Ying Liu ◽  
Kaining Shi ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Histogram Analysis ◽  
Diffusion Kurtosis Imaging ◽  
Single Shot ◽  
Diagnostic Efficiency ◽  
Planar Imaging ◽  
Significant Difference ◽  
Monoexponential Model ◽  
The Mean ◽  
Diffusion Kurtosis

Background There is still little research about histogram analysis of diffusion kurtosis imaging (DKI) using in prostate cancer at present. Purpose To verify the utility of histogram analysis of DKI model in detection and assessment of aggressiveness of prostate cancer, compared with monoexponential model (MEM). Material and Methods Twenty-three patients were enrolled in this study. For DKI model and MEM, the Dapp, Kapp, and apparent diffusion coefficient (ADC) were obtained by using single-shot echo-planar imaging sequence. The pathologies were confirmed by in-bore magnetic resonance (MR)-guided biopsy. Regions of interest (ROI) were drawn manually in the position where biopsy needle was put. The mean values and histogram parameters in cancer and noncancerous foci were compared using independent-samples T test. Receiver operating characteristic curves were used to investigate the diagnostic efficiency. Spearman’s test was used to evaluate the correlation of parameters and Gleason scores. Results The mean, 10th, 25th, 50th, 75th, and 90th percentiles of ADC and Dapp were significantly lower in prostate cancer than non-cancerous foci ( P < 0.001). The mean, 50th, 75th, and 90th percentiles of Kapp were significantly higher in prostate cancer ( P < 0.05). There was no significant difference between the AUCs of two models (0.971 vs. 0.963, P > 0.05). With the increasing Gleason scores, the 10th ADC decreased ( ρ = −0.583, P = 0.018), but the 90th Kapp increased ( ρ = 0.642, P = 0.007). Conclusion Histogram analysis of DKI model is feasible for diagnosing and grading prostate cancer, but it has no significant advantage over MEM.

scholarly journals Preoperatively Grading Rectal Cancer with the Combination of Intravoxel Incoherent Motions Imaging and Diffusion Kurtosis Imaging

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Zhijun Geng ◽  
Yunfei Zhang ◽  
Shaohan Yin ◽  
Shanshan Lian ◽  
Haoqiang He ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Diagnostic Performance ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Diffusion Kurtosis Imaging ◽  
Low Grade ◽  
Characteristic Analysis ◽  
Microstructural Heterogeneity ◽  
Diffusion Kurtosis ◽  
And Diffusion

Purpose. To combine Intravoxel Incoherent Motions (IVIM) imaging and diffusion kurtosis imaging (DKI) which can aid in the quantification of different biological inspirations including cellularity, vascularity, and microstructural heterogeneity to preoperatively grade rectal cancer. Methods. A total of 58 rectal patients were included into this prospective study. MRI was performed with a 3T scanner. Different combinations of IVIM-derived and DKI-derived parameters were performed to grade rectal cancer. Pearson correlation coefficients were applied to evaluate the correlations. Binary logistic regression models were established via integrating different DWI parameters for screening the most sensitive parameter. Receiver operating characteristic analysis was performed for evaluating the diagnostic performance. Results. For individual DWI-derived parameters, all parameters except the pseudodiffusion coefficient displayed the capability of grading rectal cancer ( p < 0.05 ). The better discrimination between high- and low-grade rectal cancer was achieved with the combination of different DWI-derived parameters. Similarly, ROC analysis suggested the combination of D (true diffusion coefficient), f (perfusion fraction), and Kapp (apparent kurtosis coefficient) yielded the best diagnostic performance (AUC = 0.953, p < 0.001 ). According to the result of binary logistic analysis, cellularity-related D was the most sensitive predictor (odds ratio: 9.350 ± 2.239) for grading rectal cancer. Conclusion. The combination of IVIM and DKI holds great potential in accurately grading rectal cancer as IVIM and DKI can provide the quantification of different biological inspirations including cellularity, vascularity, and microstructural heterogeneity.

Differentiation of soft-tissue lymphoma from undifferentiated sarcoma: apparent diffusion coefficient histogram analysis

2020 ◽  
pp. 028418512095195
Author(s):  
Ji Hyun Hong ◽  
Won-Hee Jee ◽  
Sunyoung Whang ◽  
Chan-Kwon Jung ◽  
Yang-Guk Chung ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Soft Tissue ◽  
Apparent Diffusion Coefficient ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Histogram Analysis ◽  
Undifferentiated Sarcoma ◽  
Single Slice ◽  
Significant Difference ◽  
Apparent Diffusion

Background Making the preoperative diagnosis of soft-tissue lymphoma is important because the treatments for lymphoma and sarcoma are different. Purpose To determine the reliability and accuracy of single-slice and whole-tumor apparent diffusion coefficient (ADC) histogram analysis when differentiating soft-tissue lymphoma from undifferentiated sarcoma. Material and Methods Patients with confirmed soft-tissue lymphoma or undifferentiated sarcoma who underwent 3-T magnetic resonance imaging (MRI), including diffusion-weighted imaging, were included. Single-slice and whole-tumor ADC histogram analyses were performed using software. Mean, standard deviation (SD), 5th and 95th percentiles, skewness, and kurtosis were compared between groups, and a receiver operating characteristic curve with area under the curve (AUC) was obtained. Results Thirteen patients with soft-tissue lymphoma and 12 patients with undifferentiated sarcoma were included. ADC histogram analysis of single-slice and whole-tumor, mean, SD, and 5th and 95th percentiles was significantly lower in lymphoma than in undifferentiated sarcoma. Whole-tumor analysis kurtosis was significantly higher in lymphoma than in undifferentiated sarcoma. All AUCs were high in single-slice and whole-tumor analysis: 0.987 vs. 1.000 in mean; 0.821 vs. 0.782 in SD; 0.949 vs. 0.949 in 5th percentile; and 1.000 vs. 1.000 in 95th percentile without significant difference. AUC of kurtosis in whole-tumor ADC histogram analysis was 0.750. Conclusion Single-slice and whole-tumor ADC histogram analysis seems to be reliable and accurate for differentiating soft-tissue lymphoma from undifferentiated sarcoma.

scholarly journals Evaluation of cerebral glioma using 3T diffusion kurtosis tensor imaging and the relationship between diffusion kurtosis metrics and tumor cellularity

2017 ◽  
Vol 45 (4) ◽  
pp. 1347-1358 ◽  
Author(s):  
Chong Qi ◽  
Song Yang ◽  
Lanxi Meng ◽  
Huiyuan Chen ◽  
Zhenlan Li ◽  
...  
Keyword(s):  
Mean Diffusivity ◽  
Area Under The Curve ◽  
Tumor Grade ◽  
Superior Performance ◽  
Cerebral Glioma ◽  
Operating Characteristics ◽  
Significant Difference ◽  
Characteristics Analysis ◽  
Sensitivity Specificity ◽  
Diffusion Kurtosis

Purpose To evaluate the clinical utility of diffusion kurtosis tensor imaging in the characterization of cerebral glioma and investigate correlations between diffusion and kurtosis metrics with tumor cellularity. Materials and Methods A group of 163 patients (age: 40.5 ± 11.5 years) diagnosed with cerebral glioma underwent diffusion kurtosis tensor imaging with a 3 T scanner. Diffusion and kurtosis metrics were measured in the solid part of tumors, and their abilities to distinguish between tumor grades was evaluated. In addition, we analyzed correlations between the metrics and tumor cellularity. Results Mean kurtosis (MK) revealed a significant difference between each pair of tumor grades ( P < 0.05) and produced the best performance in a receiver operating characteristics analysis (area under the curve [AUC] = 0.89, sensitivity/specificity = 83.3/90). In contrast, mean diffusivity (MD) revealed a significant difference only for tumor grade II versus IV ( P < 0.05). No significant differences between grades were detected with fractional anisotropy (FA; P > 0.05). Thus, kurtosis metrics exhibited a positive and strong correlation with tumor cellularity, while MD exhibited a negative or weak correlation with tumor cellularity. Conclusion Diffusion kurtosis metrics, particularly MK, demonstrated superior performance in distinguishing cerebral glioma of different grades compared with conventional diffusion metrics, and were closely associated with tumor cellularity.

Chemoradiation-induced alteration of programmed death-ligand 1 and CD8+ tumor-infiltrating lymphocytes in rectal cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 570-570
Author(s):  
Marina Baretti ◽  
Wei Fu ◽  
Hao Wang ◽  
Robert A Anders ◽  
Nilofer Saba Azad ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Checkpoint Inhibitors ◽  
Rectal Adenocarcinoma ◽  
Neoadjuvant Chemoradiotherapy ◽  
Tumor Infiltrating Lymphocytes ◽  
Tumor Stroma ◽  
Immune Checkpoints ◽  
Mucin Expression ◽  
Significant Difference ◽  
Potential Applicability

570 Background: DNA damage and subsequent neoantigen formation has been hypothesized as a mechanismfor radiotherapy and PD-1/PD-L1 pathway inhibition to synergize in an antitumor immune response. We investigated neoadjuvant chemoradiotherapy (nCRT)-induced changes in CD8+ tumor infiltrating lymphocyte, PD-L1 and mucin expression in rectal cancer patients as compared to patients who did not receive nCRT. Methods: Tumor samples were collected from rectal adenocarcinoma patients who had undergone resection between 2008-2014 with (n = 62) or without (n = 17) nCRT treatment. Tissue sections were stained with CD8 and PD-L1 antibodies for immunohistochemistry. Whole slides images were acquired at 20x magnification. The prevalence of positive CD8 stained cells was recorded in tumor, interface tumor side, interface background rectal side. Image analysis (HALO Indica Labs) was used to determine the density (# of cells/surface area analyzed) of CD8 expressing lymphocytes. The percentage of PD-L1 membranous expression was manually counted in tumor cells (TC), tumor stroma (TS) and invasive front (IF). Mucin expression was determined as the percentage of the mucin area in the whole tumor mass area. Results: PD-L1 expression on TCs was identified in 7.7 % (6/78) of specimens. All 6 cases had received nCRT (p = 0.33). 80% and 75.5% of the nCRT cases showed PD-L1 expression on TS and IF respectively, versus 20% (p = 0.55) and 24.5% (p = 0.56) in non-nCRT cases. The median densities of CD8+ infiltrating T lymphocytes in tumor, interface tumor side, interface background rectal side did not differ significantly between the two groups (p = 0.79, p = 0.47, p = 0.22). No nCRT-changes in mucin expression observed in the 28 evaluable cases (p = 0.25). Conclusions: nCRT exposure was associated with a non-significant difference in PD-L1 expression on TS and IF cells in patients with rectal adenocarcinoma as compared to non-nCRT case, possibly due to sample size limitations. Further mechanistic investigations and comprehensive analysis of other immune checkpoints are needed to understand nCRT-induced immunologic shift in rectal cancer and to expand the potential applicability of checkpoint inhibitors in this setting.

Whole-tumour diffusion kurtosis MR imaging histogram analysis of rectal adenocarcinoma: Correlation with clinical pathologic prognostic factors

2017 ◽  
Vol 28 (4) ◽  
pp. 1485-1494 ◽  
Author(s):  
Yanfen Cui ◽  
Xiaotang Yang ◽  
Xiaosong Du ◽  
Zhizheng Zhuo ◽  
Lei Xin ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Mr Imaging ◽  
Rectal Adenocarcinoma ◽  
Histogram Analysis ◽  
Diffusion Kurtosis

scholarly journals Amide Proton Transfer Weighted and Intravoxel Incoherent Motion Imaging in Evaluation of Prognostic Factors for Rectal Adenocarcinoma

2022 ◽  
Vol 11 ◽  
Author(s):  
Juan Li ◽  
Liangjie Lin ◽  
Xuemei Gao ◽  
Shenglei Li ◽  
Jingliang Cheng
Keyword(s):  
Diffusion Coefficient ◽  
Prognostic Factors ◽  
Proton Transfer ◽  
Rectal Adenocarcinoma ◽  
Roc Curves ◽  
Amide Proton ◽  
High Grade ◽  
Significant Difference ◽  
Adc Values ◽  
D Values

ObjectivesTo analyze the value of amide proton transfer (APT) weighted and intravoxel incoherent motion (IVIM) imaging in evaluation of prognostic factors for rectal adenocarcinoma, compared with diffusion weighted imaging (DWI).Materials and MethodsPreoperative pelvic MRI data of 110 patients with surgical pathologically confirmed diagnosis of rectal adenocarcinoma were retrospectively evaluated. All patients underwent high-resolution T2-weighted imaging (T2WI), APT, IVIM, and DWI. Parameters including APT signal intensity (APT SI), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADC) were measured in different histopathologic types, grades, stages, and structure invasion statuses. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy, and the corresponding area under the curves (AUCs) were calculated.ResultsAPT SI, D and ADC values of rectal mucinous adenocarcinoma (MC) were significantly higher than those of rectal common adenocarcinoma (AC) ([3.192 ± 0.661%] vs. [2.333 ± 0.471%], [1.153 ± 0.238×10-3 mm2/s] vs. [0.792 ± 0.173×10-3 mm2/s], and [1.535 ± 0.203×10-3 mm2/s] vs. [0.986 ± 0.124×10-3 mm2/s], respectively; all P&lt;0.001). In AC group, the APT SI and D values showed significant differences between low- and high-grade tumors ([2.226 ± 0.347%] vs. [2.668 ± 0.638%], and [0.842 ± 0.148×10-3 mm2/s] vs. [0.777 ± 0.178×10-3 mm2/s], respectively, both P&lt;0.05). The D value had significant difference between positive and negative extramural vascular invasion (EMVI) tumors ([0.771 ± 0.175×10-3 mm2/s] vs. [0.858 ± 0.151×10-3 mm2/s], P&lt;0.05). No significant difference of APT SI, D, D*, f or ADC was observed in different T stages, N stages, perineural and lymphovascular invasions (all P&gt;0.05). The ROC curves showed that the AUCs of APT SI, D and ADC values for distinguishing MC from AC were 0.921, 0.893 and 0.995, respectively. The AUCs of APT SI and D values in distinguishing low- from high-grade AC were 0.737 and 0.663, respectively. The AUC of the D value for evaluating EMVI involvement was 0.646.ConclusionAPT and IVIM were helpful to assess the prognostic factors related to rectal adenocarcinoma, including histopathological type, tumor grade and the EMVI status.

scholarly journals Analysis of clinical and pathological factors in patients undergoing surgery for rectal cancer: a single-centre experience with 692 patients in China

2020 ◽  
Author(s):  
Liping Xu ◽  
Chi Zhang ◽  
Zhaoyue Zhang ◽  
Xinyu Tang ◽  
Qin Qin ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Perineural Invasion ◽  
Radical Surgery ◽  
Node Metastasis ◽  
T Stage ◽  
Significant Difference ◽  
Tumour Location ◽  
Poorly Differentiated

Abstract Background: The management of rectal carcinoma has substantially evolved over the past two decades, so as AJCC staging and NCCN guidelines. The inherent relationships of pathologic factors warrant further study. The present study aimed to assess the associations of clinical and pathological factors in rectal cancer patients undergoing radical surgery.Methods: From October 2015 to February 2019, all rectal cancer patients treated with radical surgery without neoadjuvant therapy were identified. The analysis was performed with data obtained from the prospectively collected database. Predictive factors for lymph node metastasis were analysed.Results: In total, 692 patients with a median age of 61.64 years (range: 22-89) were included. There was no significant difference in onset age between male and female patients (61.75±11.10 vs 61.43±11.92, P=0.723).Tumour location (P=0.004), perineural invasion (PNI) (P=0.000), lymphovascular invasion (LVI) (P=0.000), tumour deposit (TD) (P=0.000), and differentiation grade (P=0.000) were significantly related to pathologic T stage in univariate analysis, while sex was not (p=0.192).Compared to patients with T1 disease, there was a significantly higher proportion of positive LVI in patients with stage T3 disease (P=0.011, OR=3.404, 95% CI: 1.319-8.787) but not in those with T2 (P=0.686, OR=0.804, 95% CI: 0.280-2.310) and T4 (P=0.063, OR=3.200, 95% CI: 0.941-10.886) disease. Compared to patients with T2 disease, there was a significantly higher proportion of perineural invasion in patients with stage T3 (P=0.000, OR=6.2376, 95% CI: 3.371-11.685) but not T4 (P=0.172, OR=2.309, 95% CI: 0.694-7.676) disease. Compared to patients with T1 disease, a significantly higher proportion of TDs occurred in patients with stage T3 (P=0.013, OR=6.106, 95% CI: 1.455-25.631) and stage T4 (P=0.019, OR=7.146, 95% CI: 1.378-37.044) but not stage T2 (P=0.435, OR=0.503, 95% CI: 0.089-2.824) disease. The overall incidence of lymph node metastasis was 44.9% (19.6% for T1, 23.6% for T2, 56.7% for T3, and 67.8% for T4). Patient age, sex, and tumour location did not significantly affect lymph node metastasis (LNM). The presence of LVI (OR=3.882, 95% CI=2.338-6.440, P=0.000), TD (OR=27.645, 95% CI=9.805-77.947, P=0.000), higher T stage (OR=1.969, 95% CI=1.471-2.635, P=0.000), and poorly differentiated histology (OR=2.255, 95% CI=1.544-3.293, P=0.000) were associated with a higher incidence of LNM on multivariate analysis. Perineural invasion (P=0.000) significantly affected LNM in univariate but not multivariate analysis (OR=1.213, 95% CI=0.734-2.003, P=0.452).Conclusion: There was no significant difference between male and female patients in onset age. Tumour location, PNI, LVI, TD, and differentiation grade were significantly related to pathologic T stage. Patients with the presence of LVI and TD, higher T stage, and poorly differentiated histology have a significantly higher chance of LNM.

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