Non-Gaussian diffusion imaging for malignant and benign pulmonary nodule differentiation: a preliminary study

2016 ◽  
Vol 58 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Sushant Kumar Das ◽  
Dong Jun Yang ◽  
Jin Liang Wang ◽  
Chuan Zhang ◽  
Han Feng Yang
Keyword(s):  
Diagnostic Accuracy ◽  
Pulmonary Nodule ◽  
Diffusion Imaging ◽  
Pulmonary Nodules ◽  
Diagnostic Value ◽  
Observer Agreement ◽  
Diffusion Kurtosis Imaging ◽  
Human Lungs ◽  
Apparent Diffusion ◽  
Non Gaussian

Background Diffusion-weighted imaging (DWI) derived apparent diffusion coefficient (ADC) has demonstrated inconsistent results in pulmonary nodule differentiation. Diffusion kurtosis imaging (DKI), which quantifies non-Gaussian diffusion, is believed to better characterize tissue micro-structure than conventional DWI. Purpose To assess the feasibility of DKI in human lungs and to compare its diagnostic value with standard DWI in differentiating malignancies from benign pulmonary nodules. Material and Methods Thirty-five pulmonary nodules in 32 consecutive patients were evaluated by DKI by using 3b-values of 0, 500, and 1000 s/mm2 and conventional DWI with b values of 0 and 800 s/mm2. Two observers independently evaluated and compared diagnostic accuracy of mean kurtosis (MK) and ADC values in differentiating malignancies from benign pulmonary nodules. The intra- and inter-observer repeatability (intra-class correlation coefficient [ICC]) were also assessed for each derived measures. Results The diagnostic accuracy, and the area under curve (AUC) in differentiating malignancies from benign pulmonary nodule, were not significantly higher for MK (Obs. 1a: 85.70%, 0.87; Obs. 1b: 80.00%, 0.80; and Obs. 2: 82.80%, 0.91) as compared to ADC (Obs. 1a: 77.14%, 0.81; Obs. 1b: 80.00%, 0.85; and Obs. 2: 77.14%, 0.85 respectively). The intra- and inter-observer agreement (ICC) for malignant and benign lesions was substantial for each reading. Conclusion The initial results of this study indicate the feasibility of DKI in human lungs. However, there was no significant benefit of DKI derived MK values over ADC for malignant and benign pulmonary nodule differentiation.

scholarly journals White matter microstructural integrity across the adult lifespan: Combined perspective of diffusion tensor and kurtosis imaging

2021 ◽  
Author(s):  
Hiba Taha ◽  
Jordan A Chad ◽  
J. Jean Chen
Keyword(s):  
White Matter ◽  
Brain Aging ◽  
Diffusion Tensor ◽  
Diffusion Imaging ◽  
General Pattern ◽  
B Value ◽  
Diffusion Kurtosis Imaging ◽  
Adult Lifespan ◽  
Non Gaussian ◽  
Diffusion Kurtosis

Studies of healthy brain aging have reported diffusivity patterns associated with white matter degeneration using diffusion tensor imaging (DTI), which assumes that diffusion measured at the typical b-value (approximately 1000 s/mm2) is Gaussian. Diffusion kurtosis imaging (DKI) is an extension of DTI that measures non-Gaussian diffusion (kurtosis) to better capture microenvironmental changes by incorporating additional data at a higher b-value. In this study, using UK Biobank data (b values of 1000 and 2000 s/mm2), we investigate (1) the extent of novel information gained from adding diffusional kurtosis to diffusivity observations in aging, and (2) how conventional DTI metrics in aging compare with diffusivity metrics derived from DKI, which are corrected for kurtosis. We find a general pattern of lower kurtosis alongside higher diffusivity among older adults. We also find differences between diffusivity metrics derived from DTI and DKI, emphasizing the importance of accounting for non-Gaussian diffusion. This work highlights the utility of measuring diffusional kurtosis as a simple addition to conventional diffusion imaging of aging.

scholarly journals Diffusion Kurtosis Imaging Versus DWI in the Clinical Assessment of Rectal Carcinoma: A Retrospective Study

2021 ◽  
Author(s):  
Mi Zhou ◽  
Longlin Yin ◽  
Li Lai ◽  
Ju Zeng ◽  
Shaoyu Wang
Keyword(s):  
Rectal Carcinoma ◽  
Mean Diffusivity ◽  
Diagnostic Value ◽  
Diffusion Kurtosis Imaging ◽  
Control Group ◽  
Diagnostic Efficiency ◽  
Imaging Data ◽  
Apparent Diffusion ◽  
Diagnostic Values ◽  
Diffusion Kurtosis

Abstract Background: To perform an analysis of mean diffusivity(MD)、mean kurtosis(MK) demonstrating the diagnostic value of diffusion kurtosis imaging (DKI) and diffusion weighted imaging (DWI) with respect to rectal carcinoma. Methods: A total of thirty-nine rectal carcinoma cases and thirty-nine healthy subjects (Normal control group) were enrolled in our study. All the subjects underwent multi-parameter (DWI, DKI )magnetic resonance examination. The acquired images were individually analysed by two readers. The obtained images were input into the corresponding software, then an analysis of the subjects’ apparent diffusion coefficient(ADC), MD and MK values was performed. A receiver-operating charasterictic (ROC) analysis was used to assess the diagnostic efficiency of the MK, MD and ADC parameters. The Mann-Whitney U test was used to contrast the parameters in both groups. Spearman correlation analysis was used to analyse the correlation between ADC and MD, MK. The Kappa consistency test was used to evaluate the consistency between each reader’s evaluation. Results: Reflecting their diagnostic values with respect to rectal carcinoma, the AUC for MK, MD, and ADC were 0.911, 0.888, and 0.827 (all P <0.05), respectively. Using 0.59, 2.15×10 －3 mm 2 /s, 1.35×10 －3 mm 2 /s as thresholds, the sensitivities of MK, MD, ADC were 89.50%, 78.90%, and 76.30%, respectively; meanwhile their respective specificities were 84.20%, 73.70%, and 73.70%.The ADC was directly proportional to MD ( r =0.994, P <0.05) and inversely proportional to MK ( r =－0.460, P <0.05). Analysis of the imaging data revealed consistent results from both readers,Kappa=0.737. Conclusion: The ADC、MK and MD parameters were effective in diagnosing rectal carcinoma. Moreover, the MK and MD parameters were found to provide even more valid information regarding the microenvironment with a higher diagnostic performance.

Study the value of lung low dose computed tomography in early detection the malignant pulmonary nodule

2020 ◽  
pp. 7-15
Author(s):  
Ha Hoang ◽  
Tien Doan Dung ◽  
Khoan Le Trong
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Early Detection ◽  
Pulmonary Nodule ◽  
Pulmonary Nodules ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Solitary Pulmonary Nodules ◽  
Cross Sectional ◽  
The Right

Background: Early diagnosis of the malignant pulmonary nodules plays an important role in decreasing the mortality, increasing the lifetime and considering as early detection of lung cancer. Objectives: To describe the characteristics and diagnostic value of the malignant suspected signs of pulmonary nodule. Materials and methods: A descriptive cross-sectional study on 33 patients with localized pulmonary nodule which has indications of biopsy or surgery at Hospital of Hue University of Medicine and Pharmacy from 05/2017 to 08/2018. Results: A majority of pulmonary nodules were found in the right upper lobe with 42.4%; solitary pulmonary nodules made up the majority of 75.8%. (Nodules > 21.5 mm: 57.6%; nodules ≤ 21.5 mm: 42.4%; solid nodules: 97% and mixed nodules: 3%, round shape: 42.4% and polygons: 57.6%; irregular margin: 78.8%; regular margin: 21.2%; eccentric and stippled calcification: 18.2%; non-calcification: 81.8%; air-bronchogram in nodules: 39.4%; air-bronchogram (-): 60.6%; fat containing pulmonary nodules: 6.1%, malignant and benign confirmed by biopsy: 39.3% and 60.7% respectively. The sensitivity and specificity of features included size > 21.5 mm; air-bronchogram in nodules, polygons for malignant nodules diagnosis are 81.6%; 92.3%; 76.9% and 60%, 65%, 85% respectively. Conclusions: Three features of nodules: Size ≥ 21.5 mm; air-bronchogram and polygons are suggestive malignant characteristics. The combination of two or more characteristics have the sensitive 92.3% and specific 80% Keywords: pulmonary nodule, thoracic computed tomography, lung cancer.

scholarly journals Diffusion Kurtosis Imaging of the neonatal Spinal Cord: design and application of the first processing pipeline implemented in Spinal Cord Toolbox

2021 ◽  
Author(s):  
Rosella Trò ◽  
Monica Roascio ◽  
Domenico Tortora ◽  
Mariasavina Severino ◽  
Andrea Rossi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Diagnostic Value ◽  
Clinical Applications ◽  
Diffusion Kurtosis Imaging ◽  
Tissue Microstructure ◽  
Stage Of Development ◽  
Study Results ◽  
Non Gaussian ◽  
Diffusion Kurtosis ◽  
Age Range

AbstractDiffusion Kurtosis Imaging (DKI) has undisputed advantages over more classical diffusion Magnetic Resonance Imaging (dMRI), as witnessed by a fast-increasing number of clinical applications and software packages widely adopted in brain imaging domain. Despite its power in probing tissue microstructure compared to conventional MRI, DKI is still largely underutilized in Spinal Cord (SC) imaging because of its inherently demanding technological requirements.If state-of-the-art hardware advancements have recently allowed to make great strides in applying this emerging method to adult and child SC, the same does not apply to neonatal setting. Indeed, amplified technical issues related to SC district in this age range have made this field still unexplored. However, results arising from recent application of DKI to adult and child SC are promising enough to suggest how informative this technique would be in investigating newborns, too.Due to its extreme sensitivity to non-gaussian diffusion, DKI proves particularly suitable for detecting complex, subtle, fast microstructural changes occurring in this area at this early and critical stage of development, and not identifiable with only DTI. Given the multiplicity of congenital anomalies of the spinal canal, their crucial effect on later developmental outcome, and the close interconnection between SC region and the above brain, managing to apply such a method to neonatal cohort becomes of utmost importance.In this work, we illustrate the first semi-automated pipeline for handling with DKI data of neonatal SC, from acquisition setting to estimation of diffusion (DTI & DKI) measures, through accurate adjustment of processing algorithms customized for adult SC. Each processing step of this pipeline, built on Spinal Cord Toolbox (SCT) software, has undergone Quality Control check by supervision of an expert pediatric neuroradiologist, and the overall procedure has preliminarily been tested in a pilot clinical case study. Results of this application agree with findings achieved in a corresponding adult survey, thus confirming validity of adopted pipeline and diagnostic value of DKI in pediatrics. This novel tool hence paves the wave for extending its application also to other promising advanced dMRI models, such as Neurite Orientation Dispersion and Density Imaging (NODDI), and to a wider range of potential clinical applications concerning neonatal period.

scholarly journals Clinical application of the 2011 IFCPC colposcope terminology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bei Zhang ◽  
Shuhui Hong ◽  
Guihui Zhang ◽  
Fengnian Rong
Keyword(s):  
Diagnostic Accuracy ◽  
Precancerous Lesions ◽  
High Specificity ◽  
Diagnostic Value ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Diagnostic Significance ◽  
Cervical Precancerous Lesions ◽  
Intraepithelial Lesion ◽  
Common Sign

Abstract Background Colposcopy offers an accurate way to the diagnose of cervical precancerous lesions. However, the diagnostic accuracy of colposcopy is unsatisfied. This study was to evaluate colposcopic accuracy according to the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) terminology. Methods A retrospective cohort study was performed in 1,838 patients who underwent colposcopy in Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University from October 2013 to April 2018. Using conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated, and correlations between variables were analyzed. Results As an authoritative and widely used terminology for colposcopy diagnosis, the 2011 IFCPC terminology has certain clinical practicality and diagnostic accuracy. However, some signs such as mosaic, punctation, sharp border, inner border sign and ridge sign had high specificity but unsatisfactory sensitivity, which limited the diagnostic value. Therefore, we discussed the Lugol’s staining, a very common sign in colposcopy, and analyzed the diagnostic significance of bright yellow staining in low-grade squamous intraepithelial lesion (LSIL) and mustard yellow staining in high-grade squamous intraepithelial lesion (HSIL). The results showed that mustard yellow may be a valuable indicator in the diagnosis of HSIL. Conclusion The 2011 IFCPC colposcope terminology has standardized interpretations of the colposcopic findings and improved the accuracy of colposcopy diagnosis. The aceto-white epithelium still has important diagnostic value; however, the value of a few signs is needed to be discussed and new signs are expected to be discovered. Although the significance of Lugol’s staining was diminishing, mustard yellow might be a valuable indicator for the diagnosis of HSIL.

scholarly journals Effect of a pulmonary nodule fact sheet on patient anxiety and knowledge: a quality improvement initiative

2018 ◽  
Vol 7 (3) ◽  
pp. e000437 ◽  
Author(s):  
Matthew T Koroscil ◽  
Mitchell H Bowman ◽  
Michael J Morris ◽  
Andrew J Skabelund ◽  
Andrew M Hersh
Keyword(s):  
Lung Cancer ◽  
Quality Improvement ◽  
Pulmonary Nodule ◽  
Early Stage ◽  
Pulmonary Nodules ◽  
Low Risk ◽  
Quality Improvement Initiative ◽  
Patient Anxiety ◽  
Patient Understanding ◽  
Fact Sheet

IntroductionThe utilisation of chest CT for the evaluation of pulmonary disorders, including low-dose CT for lung cancer screening, is increasing in the USA. As a result, the discovery of both screening-detected and incidental pulmonary nodules has become more frequent. Despite an overall low risk of malignancy, pulmonary nodules are a common cause of emotional distress among adult patients.MethodsWe conducted a multi-institutional quality improvement (QI) initiative involving 101 participants to determine the effect of a pulmonary nodule fact sheet on patient knowledge and anxiety. Males and females aged 35 years or older, who had a history of either screening-detected or incidental solid pulmonary nodule(s) sized 3–8 mm, were included. Prior to an internal medicine or pulmonary medicine clinic visit, participants were given a packet containing a pre-fact sheet survey, a pulmonary nodule fact sheet and a post-fact sheet survey.ResultsOf 101 patients, 61 (60.4%) worried about their pulmonary nodule at least once per month with 18 (17.8%) worrying daily. The majority 67/101 (66.3%) selected chemotherapy, chemotherapy and radiation, or radiation as the best method to cure early-stage lung cancer. Despite ongoing radiographic surveillance, 16/101 (15.8%) stated they would not be interested in an intervention if lung cancer was diagnosed. Following review of the pulmonary nodule fact sheet, 84/101 (83.2%) reported improved anxiety and 96/101 (95.0%) reported an improved understanding of their health situation. Patient understanding significantly improved from 4.2/10.0 to 8.1/10.0 (p<0.01).ConclusionThe incorporation of a standardised fact sheet for subcentimeter solid pulmonary nodules improves patient understanding and alleviates anxiety. We plan to implement pulmonary nodule fact sheets into the care of our patients with low-risk subcentimeter pulmonary nodules.

Is diagnostic accuracy for detecting pulmonary nodules in chest CT reduced after a long day of reading?

2012 ◽  
Author(s):  
Elizabeth A. Krupinski ◽  
Kevin S. Berbaum ◽  
Robert Caldwell ◽  
Kevin M. Schartz
Keyword(s):  
Diagnostic Accuracy ◽  
Pulmonary Nodules ◽  
Chest Ct ◽  
Long Day

scholarly journals Malignant melanoma without primary, presenting as solitary pulmonary nodule: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
George Tsaknis ◽  
Muhammad Naeem ◽  
Advitya Singh ◽  
Siddharth Vijayakumar
Keyword(s):  
Lung Cancer ◽  
Malignant Melanoma ◽  
Pulmonary Nodule ◽  
Solitary Pulmonary Nodule ◽  
Past History ◽  
White Male ◽  
Pulmonary Nodules ◽  
Metastatic Malignant Melanoma ◽  
Unknown Primary ◽  
Solitary Pulmonary Nodules

Abstract Background Solitary pulmonary nodules are the most common incidental finding on chest imaging. Their management is very well defined by several guidelines, with risk calculators for lung cancer being the gold standard. Solitary intramuscular metastasis combined with a solitary pulmonary nodule from malignant melanoma without a primary site is rare. Case presentation A 57-year-old white male was referred to our lung cancer service with solitary pulmonary nodule. After positron-emission tomography, we performed an ultrasound-guided core needle biopsy of an intramuscular solitary lesion, not identified on computed tomography scan, and diagnosed metastatic malignant melanoma. The solitary pulmonary nodule was resected and also confirmed metastatic melanoma. There was no primary skin lesion. The patient received oral targeted therapy and is disease-free 5 years later. Conclusions Clinicians dealing with solitary pulmonary nodules must remain vigilant for other extrathoracic malignancies even in the absence of obvious past history. Lung metastasectomy may have a role in metastatic malignant melanoma with unknown primary.

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