Repeatability analysis of ADC histogram metrics of the uterus

2018 ◽  
Vol 60 (4) ◽  
pp. 526-534 ◽  
Author(s):  
Koichi Onodera ◽  
Masamitsu Hatakenaka ◽  
Naoya Yama ◽  
Maki Onodera ◽  
Tsuyoshi Saito ◽  
...  
Keyword(s):  
Resonance Imaging ◽  
Altman Plot ◽  
Adc Value ◽  
Pelvic Mri ◽  
Bland Altman Plot ◽  
Clinical Magnetic Resonance Imaging ◽  
Apparent Diffusion ◽  
Magnetic Resonance Imaging Mri ◽  
High Repeatability ◽  
Skewness And Kurtosis

Background Recently, histogram analysis based on voxel-wise apparent diffusion coefficient (ADC) value distribution has been increasingly performed. However, few studies have been reported regarding its repeatability. Purpose To evaluate the repeatability of ADC histogram metrics of the uterus in clinical magnetic resonance imaging (MRI). Material and Methods Thirty-three female patients who underwent pelvic MRI including diffusion-weighted imaging (DWI) were prospectively included after providing informed consent. Two sequential DWI acquisitions with identical parameters and position were obtained. Regions of interest (ROIs) for histologically confirmed uterine lesions (five cervical and three endometrial cancers, and one endometrial hyperplasia) and normal appearing tissues (21 endometrium and 33 myometrium) were assigned on the first DWI dataset and then pasted onto the second DWI dataset. ADC histogram metrics within the ROIs were calculated and repeatability was evaluated by calculating within-subject coefficient of variance (%) (wCV (%)) and Bland–Altman plot (%). Results ADC 10%, 25%, median, 75%, 90%, maximum, mean, and entropy showed high repeatability (wCV (%) < 7, 95% limit of agreement in Bland–Altman plot (%) < ±20), followed by ADC minimum (wCV (%) = 8.12, 95% limit of agreement in Bland–Altman plot (%) < ±30). However, ADC skewness and kurtosis showed very low repeatability in all evaluations. Conclusion ADC histogram metrics like ADC 10%, 25%, median, 75%, 90%, maximum, mean, and entropy are robust biomarkers and could be applicable to clinical use. However, ADC skewness and kurtosis lack robustness. Radiologists should keep these characteristics and limitations in mind when interpreting quantitative DWI.

scholarly journals Diffusion-weighted magnetic resonance imaging in cystic renal masses

2017 ◽  
Vol 11 (1-2) ◽  
pp. 8 ◽  
Author(s):  
Fikret Balyemez ◽  
Ahmet Aslan ◽  
Ibrahim Inan ◽  
Ercan Ayaz ◽  
Vildan Karagöz ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Renal Cysts ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Renal Masses ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Magnetic Resonance Imaging Mri

Introduction: We aimed to introduce the diagnostic value of diffusion-weighted (DWI) magnetic resonance imaging (MRI) for distinguishing benign and malignant renal cystic masses.Methods: Abdominal DWI-MRIs of patients with Bosniak categories 2F, 3, and 4 cystic renal masses were evaluated retrospectively. Cystic masses were assigned as benign or malignant according to histopathological or followup MRI findings and compared with apparent diffusion coefficient (ADC) values.Results: There were 30 patients (18 males and 12 females, mean age was 59.23 ± 12.08 years [range 38‒83 years]) with cystic renal masses (eight Bosniak category 2F, 12 Bosniak category 3, 10 Bosniak category 4). Among them, 14 cysts were diagnosed as benign and 16 as malignant by followup imaging or histopathological findings. For the malignant lesions, the mean ADC values were lower than for benign lesions (p=0.001). An ADC value of ≤2.28 x10-6 mm2/s or less had a sensitivity of 75% and a specificity of 92.86% for detecting malignancy.Conclusions: ADC can improve the diagnostic performance of MRI in the evaluation of complex renal cysts when used together with conventional MRI sequences.

scholarly journals False diagnosis of and needless therapy for presumed gestational trophoblastic disease in women with an unusual site of residual pregnancy

2018 ◽  
Vol 47 (2) ◽  
pp. 673-681 ◽  
Author(s):  
Tong Gao ◽  
Mingming Sun ◽  
Liangqing Yao ◽  
Wei Jiang
Keyword(s):  
Clinical Manifestations ◽  
Diagnostic Value ◽  
Gestational Trophoblastic Disease ◽  
High Serum ◽  
Resonance Imaging ◽  
Unusual Site ◽  
Pelvic Mri ◽  
Trophoblastic Disease ◽  
False Diagnosis ◽  
Magnetic Resonance Imaging Mri

Objective This study aimed to determine the diagnostic value of magnetic resonance imaging (MRI), hysteroscopy, and laparoscopy to avoid unnecessary treatment when patients present with clinical manifestations that are close to those of gestational trophoblastic neoplasia (GTN). Methods Three patients who were falsely diagnosed with presumed GTN and received needless chemotherapy in our hospital from July 2011 to March 2012 were studied. We also reviewed data of patients with similar clinical features who were diagnosed as having residual pregnancy in recent years. Clinical manifestations were evaluated. Results All three patients had persistently high serum β-human chorionic gonadotrophin levels and a mass with abundant blood supply in the uterus after termination of pregnancy. The patients were diagnosed with GTN and underwent chemotherapy. They responded poorly to chemotherapy and underwent surgery. The pathological diagnosis in all patients was residual pregnancy. In recent years, no patients were misdiagnosed because pelvic MRI, hysteroscopy, or laparoscopy was used when residual pregnancy could not be excluded. Conclusion Gynecologists should diagnose carefully when patients present with clinical manifestations that are close to those of GTN to avoid unnecessary treatment. MRI, hysteroscopy, and laparoscopy could be important examinations for excluding residual pregnancy.

scholarly journals Diffusion-weighted magnetic resonance imaging: biomarker for treatment response in oncology

2013 ◽  
Vol 46 (3) ◽  
pp. 178-180 ◽  
Author(s):  
Maria Luiza Testa ◽  
Rubens Chojniak ◽  
Letícia Silva Sene ◽  
Aline Santos Damascena
Keyword(s):  
Magnetic Resonance Imaging ◽  
Diffusion Coefficient ◽  
Quantitative Assessment ◽  
Therapeutic Response ◽  
Imaging Biomarker ◽  
Resonance Imaging ◽  
Adc Value ◽  
Early Increase ◽  
Apparent Diffusion ◽  
Weighted Magnetic Resonance Imaging

The authors report a case where a quantitative assessment of the apparent diffusion coefficient (ADC) of liver metastasis in a patient undergoing chemotherapy has shown to be an effective early marker for predicting therapeutic response, anticipating changes in tumor size. A lesion with lower initial ADC value and early increase in such value in the course of the treatment tends to present a better therapeutic response.

scholarly journals The Value of Diffusion-Weighted Magnetic Resonance Imaging in Predicting the Efficacy of Radiation and Chemotherapy in Cervical Cancer

2018 ◽  
Vol 13 (1) ◽  
pp. 305-311 ◽  
Author(s):  
Jingjing Chen ◽  
Hui Hua ◽  
Jing Pang ◽  
Xianglong Shi ◽  
Weiqun Bi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Cancer ◽  
Diffusion Coefficient ◽  
Magnetic Resonance ◽  
Tumor Diameter ◽  
Resonance Imaging ◽  
Adc Value ◽  
Apparent Diffusion ◽  
Maximum Tumor Diameter ◽  
Weighted Magnetic Resonance Imaging

AbstractBackgroundTo analyze the application value of apparent diffusion coefficient (ADC) and exponent apparent diffusion coefficient (EADC) in evaluating the efficacy of radiation and chemotherapy in cervical cancer using pre- and posttreatment diffusion-weighted magnetic resonance imaging (DW-MRI) scans.Methods52 patients with cervical cancer were administered radiation and chemotherapy. Both MRI and DW-MRI were obtained at different stages. The ADC and EADC values, as well as the maximum tumor diameter, were measured and analyzed.ResultsWe found that the ADC value increased after treatment, and the EADC value decreased. Changes in the calculated ADC occurred earlier than the morphologic changes of the tumors. A negative correlation was detected between reduced rates in the maximum tumor diameter two months after treatment and pretreatment ADC value (r = –0.658, P < 0.05). An ROC curve and nonlinear regression analysis showed that the formula, y = (1525500.122x2 – 4689.962x + 3.482) × 100%, can be used to calculate the percentage of complete remission after treatment according to the pretreatment ADC value.ConclusionOur data suggest that pretreatment ADC and EADC values are predictive of the efficacy of radiation and chemotherapy. Both ADC and EADC values during treatment were instrumental in early monitoring and dynamic observation.

scholarly journals The Capabilities and Limitations of Clinical Magnetic Resonance Imaging for Detecting Kidney Stones: A Retrospective Study

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
El-Sayed H. Ibrahim ◽  
Joseph G. Cernigliaro ◽  
Mellena D. Bridges ◽  
Robert A. Pooley ◽  
William E. Haley
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Resonance Imaging ◽  
Case Scenario ◽  
Stone Size ◽  
Clinical Magnetic Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Ct And Mri

The purpose of this work was to investigate the performance of currently available magnetic resonance imaging (MRI) for detecting kidney stones, compared to computed tomography (CT) results, and to determine the characteristics of successfully detected stones. Patients who had undergone both abdominal/pelvic CT and MRI exams within 30 days were studied. The images were reviewed by two expert radiologists blinded to the patients’ respective radiological diagnoses. The study consisted of four steps: (1) reviewing the MRI images and determining whether any kidney stone(s) are identified; (2) reviewing the corresponding CT images and confirming whether kidney stones are identified; (3) reviewing the MRI images a second time, armed with the information from the corresponding CT, noting whether any kidney stones are positively identified that were previously missed; (4) for all stones MRI-confirmed on previous steps, the radiologist experts being asked to answer whether in retrospect, with knowledge of size and location on corresponding CT, these stones would be affirmed as confidently identified on MRI or not. In this best-case scenario involving knowledge of stones and their locations on concurrent CT, radiologist experts detected 19% of kidney stones on MRI, with stone size being a major factor for stone identification.

scholarly journals Diffusion-Weighted Imaging Findings of Ischemic Spinal Injury in a Chondrodystrophic Dog With Fibrocartilaginous Embolism

2020 ◽  
Vol 7 ◽  
Author(s):  
Taesik Yun ◽  
Kang-Il Lee ◽  
Yoonhoi Koo ◽  
Hakhyun Kim ◽  
Dongwoo Chang ◽  
...  
Keyword(s):  
Spinal Injury ◽  
Mri Findings ◽  
Intact Male ◽  
Post Contrast ◽  
Adc Value ◽  
Fluid Analysis ◽  
Fibrocartilaginous Embolism ◽  
Apparent Diffusion ◽  
Fluid Attenuated Inversion Recovery ◽  
Magnetic Resonance Imaging Mri

A 9-year-old, intact male Shih Tzu dog presented with systemic weakness and peracute onset of tetraplegia. Tetraplegia with lower motor neuron signs was noted upon neurological examination. Diseases that cause acute flaccid tetraparesis, such as acute fulminating myasthenia gravis, polyradiculoneuritis, tick paralysis, and botulism, were ruled out based on the medical history, normal electrophysiological tests, and non-response to the neostigmine challenging test. Initial 0.3-Tesla (T) magnetic resonance imaging (MRI) findings included sharply demarcated intramedullary lesions at the C3-C6 level, mainly involving gray matter, which appeared hypo- to iso- intense on T1-weighted images (WIs), and hyperintense on T2-WIs and fluid-attenuated inversion recovery images. There was no enhancement on post-contrast T1-WIs. Neutrophilic pleocytosis was observed in the cerebrospinal fluid analysis. No clinical responses were observed for the treatment of non-infectious myelitis with an immunosuppressive dosage of prednisolone. A follow-up 3-T MRI 6 days later demonstrated hyperintensity on diffusion-WI (DWI) and a decreased apparent diffusion coefficient (ADC) value (0.54 × 10−3 mm2/s) of the spinal lesions. Through histological examination, a fibrocartilaginous embolism was definitively confirmed. This is the first report to describe an ischemic spinal injury visualized by DWI and ADC mapping with high-field MRI in a chondrodystrophic dog diagnosed with a fibrocartilaginous embolism.

Clinical Application of Diffusion-Weighted Magnetic Resonance Imaging in Uterine Cervical Cancer

2015 ◽  
Vol 25 (6) ◽  
pp. 1073-1078 ◽  
Author(s):  
Ying Liu ◽  
Zhaoxiang Ye ◽  
Haoran Sun ◽  
Renju Bai
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Cancer ◽  
Uterine Cervical Cancer ◽  
Pathological Grade ◽  
Resonance Imaging ◽  
Adc Value ◽  
Cellular Density ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Weighted Magnetic Resonance Imaging

ObjectiveThis study aimed to investigate the application value of apparent diffusion coefficient (ADC) values in evaluating histological type as well as pathologic grade of uterine cervical cancer; and to investigate whether ADC values could reflect tumor cellular density.MethodsNinety-eight patients with histopathologically proven uterine cervical cancer were included in this study. Mean ADC value and minimum ADC value of the tumor were measured. Tumor cellular density was counted using colored multifunction imaging analyzing system.ResultsBoth mean ADC value and minimum ADC value of squamous cell carcinoma were significantly lower than that of adenocarcinoma (P= 0.001;P= 0.000). Using mean ADC criteria (≤0.965 × 10−3mm2/s) and minimum ADC criteria (≤0.844 × 10−3mm2/s), the sensitivity and specificity for differentiating squamous cell carcinoma from adenocarcinoma were 83.5% and 76.9%, and 77.6% and 92.3%, respectively. Receiver operating characteristic analysis revealed that there was no statistically significant difference in the Az values between them (P= 0.990). Tumor cellular density, mean ADC value, and minimum ADC value of different pathological grade varied significantly (P= 0.000,P= 0.000,P= 0.000). There was a significant positive linear correlation between tumor cellular density and pathological grade of tumor (P= 0.000). Both mean ADC value and minimum ADC value correlated negatively with cellular density (P= 0.000,P= 0.000) and the pathological grade of tumor (P= 0.000,P= 0.000). Comparisons of correlation coefficients showed no significant differences (P= 0.656,P= 0.631).ConclusionsDiffusion-weighted magnetic resonance imaging has a potential ability to indicate the histologic type of uterine cervical cancer. Apparent diffusion coefficient measurements of uterine cervical cancer can represent tumor cellular density, thus providing a new method for evaluating the pathological grade of tumor.

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