Combined dynamic DCE-MRI and diffusion-weighted imaging to evaluate the effect of neoadjuvant chemotherapy in cervical cancer

2019 ◽  
Vol 106 (2) ◽  
pp. 155-164 ◽  
Author(s):  
Yusen Feng ◽  
Hui Liu ◽  
Yingying Ding ◽  
Ya Zhang ◽  
Chengde Liao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Diffusion Weighted Imaging ◽  
Area Under The Curve ◽  
Dce Mri ◽  
Quantitative Parameters ◽  
Diffusion Weighted ◽  
Before And After ◽  
Adc Values ◽  
The Mean

Purpose: To prospectively investigate changes in quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and the apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) in patients with cervical cancer before and after neoadjuvant chemotherapy (NACT). Methods: Thirty-eight patients with cervical cancer underwent DCE-MRI and DWI 1 week before and 4 weeks after NACT. The patients were classified into 2 groups: significant reaction (sCR) group and the non-sCR group. DCE-MRI parameters and ADC values were measured and compared between the 2 groups. Results: Before NACT, the mean Ktrans value was higher, but the mean Ve was lower, in the sCR group compared with the non-sCR group; these differences were statistically significant ( p<0.05). After NACT, the mean Ktrans value and the delta (i.e., changed) value of Ktrans were significantly lower in the sCR group compared with the non-sCR group ( p<0.05). However, the mean ADC and the delta value of the mean ADC between the 2 groups were slightly higher in the sCR group compared with the non-sCR group ( p<0.05). The area under the curve of pre-mean Ktrans, DKtrans, and pre-mean Ktrans combined with post-mean ADC values were 0.801, 0.955, and 0.878, respectively ( p<0.05). The optimal cutoff values for distinguishing sCR from non-sCR were pretreatment Ktrans (0.7020 min−1) and DKtrans (0.0437 min−1). Conclusions: Quantitative parameters (pre-mean Ktrans, DKtrans, and pre-mean Ktrans) combined with post-mean ADC could predict treatment efficacy more precisely. However, quantitative DCE-MRI combined with DWI could not significantly improve prognostic efficacy.

scholarly journals High resolution diffusion weighted imaging for neoadjuvant chemotherapy assessment of nasopharyngeal carcinoma

2020 ◽  
Author(s):  
Tiebo Meng ◽  
Feixiang Wang ◽  
Jia Liu ◽  
Wei Dai ◽  
Lanlan Zhi ◽  
...  
Keyword(s):  
High Resolution ◽  
Neoadjuvant Chemotherapy ◽  
Diffusion Weighted Imaging ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Imaging Biomarker ◽  
Diagnostic Efficacy ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Adc Values

Abstract Background To evaluate the feasibility of high resolution diffusion weighted imaging (DWI) for the prediction about the response of neoadjuvant chemotherapy (NAC) in patients. Methods 119 NPC patients who underwent magnetic resonance imaging (MRI) including readout-segmented diffusion weighted imaging (RESOLVE-DWI) before treatment enrolled in this study from September 2017 to December 2019, and all patients underwent follow-up MRI at 3 month after two cycles of NAC. Patients were classified into stable disease (SD), partial response (PR) or completed response (CR) based on Response Evaluation Criteria in Solid Tumors (RECIST). Apparent diffusion coefficient (ADC) values were measured from RESOLVE-DWI in the first MRI examination. The ADC values were compared between responders (CR and PR) and non-responders (SD) using Independent samples t-test, and the receiver operating characteristic curve (ROC) was calculated to assess the diagnostic efficacy. Results The ADC value of responders was significantly higher than that of non-responders (719.73 ± 100.44 × 10− 3 mm2/s and 583.28 ± 53.15 × 10− 3 mm2/s, p < 0.001, respectively). The area under the curve (AUC) was 0.879 with a sensitivity at 82.8%, and specificity at 84.6%. Conclusions The ADC value obtained by RESOLVE-DWI, with a high diagnostic accuracy for NAC assessment, could be used as a pretreatment imaging biomarker to predict the early response to NAC in NPC patients.

Combining tumor size and diffusion-weighted imaging to diagnose normal-sized metastatic pelvic lymph nodes in cervical cancers

2018 ◽  
Vol 60 (3) ◽  
pp. 388-395 ◽  
Author(s):  
Jiacheng Song ◽  
Qiming Hu ◽  
Junwen Huang ◽  
Zhanlong Ma ◽  
Ting Chen
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tumor Size ◽  
Diffusion Weighted Imaging ◽  
Area Under The Curve ◽  
Adc Value ◽  
Cervical Cancers ◽  
Pelvic Lymph Nodes ◽  
Diffusion Weighted

Background Detecting normal-sized metastatic pelvic lymph nodes (LNs) in cervical cancers, although difficult, is of vital importance. Purpose To investigate the value of diffusion-weighted-imaging (DWI), tumor size, and LN shape in predicting metastases in normal-sized pelvic LNs in cervical cancers. Material and Methods Pathology confirmed cervical cancer patients with complete magnetic resonance imaging (MRI) were documented from 2011 to 2016. A total of 121 cervical cancer patients showed small pelvic LNs (<5 mm) and 92 showed normal-sized (5–10 mm) pelvic LNs (39 patients with 55 nodes that were histologically metastatic, 53 patients with 71 nodes that were histologically benign). Preoperative clinical and MRI variables were analyzed and compared between the metastatic and benign groups. Results LN apparent diffusion coefficient (ADC) values and short-to-long axis ratios were not significantly different between metastatic and benign normal-sized LNs (0.98 ± 0.15 × 10−3 vs. 1.00 ± 0.18 × 10−3 mm2/s, P = 0.45; 0.65 ± 0.16 vs. 0.64 ± 0.16, P = 0.60, respectively). Tumor ADC value of the metastatic LNs was significantly lower than the benign LNs (0.98 ± 0.12 × 10−3 vs. 1.07 ± 0.21 × 10−3 mm2/s, P = 0.01). Tumor size (height) was significantly higher in the metastatic LN group (27.59 ± 9.18 mm vs. 21.36 ± 10.40 mm, P < 0.00). Spiculated border rate was higher in the metastatic LN group (9 [16.4%] vs. 3 [4.2%], P = 0.03). Tumor (height) combined with tumor ADC value showed the highest area under the curve of 0.702 ( P < 0.00) in detecting metastatic pelvic nodes, with a sensitivity of 59.1% and specificity of 78.8%. Conclusions Tumor DWI combined with tumor height were superior to LN DWI and shape in predicting the metastatic state of normal-sized pelvic LNs in cervical cancer patients.

Predicting axillary response to neoadjuvant chemotherapy: the role of diffusion weighted imaging

2021 ◽  
Author(s):  
Lucia Graña-López ◽  
Tania Pérez-Ramos ◽  
Fiz Andrés Maciñeira ◽  
Ángeles Villares ◽  
Manuel Vázquez-Caruncho
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Diffusion Weighted Imaging ◽  
Primary Tumour ◽  
Pathologic Complete Response ◽  
Tumour Response ◽  
Complete Response ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Adc Values ◽  
Response To Neoadjuvant Chemotherapy

Objective: The aim of this study is to investigate whether the primary tumour response to neoadjuvant chemotherapy (NAC), based on the increase in the ADC-values (apparent diffusion coefficient) within the breast lesion, could help to predict axillary complete response. Methods: We retrospectively included 74 patients who were treated with NAC followed by surgery at Lucus Augusti Hospital between January 2015 and September 2020. Simple logistic regression was used to evaluate the factors associated with axillary pathological complete response, including the changes in breast tumour ADC-values due to the treatment. Results: Axillary complete response was correlated with negative oestrogen receptor status, Her2 positivity and response of primary tumour. It was achieved in 31% of the patients. In addition, the increase in the tumour ADC-values with NAC was higher for responders. Among the tumours that demonstrated an increase in ADC-value >0.92 ×10−3 mm2/s, 42.8% (15/35) showed axillary complete response. Eight (20.5%) breast cancers with an increase in ADC below the cut-off value were found to have no metastatic nodes after treatment (p = 0.038). Conclusion: Our results suggest that the performance of models predicting axillary response to NAC can be improved by adding the tumour response determined also using diffusion-weighted imaging. Advances in knowledge: For the fist time, we investigate the relation between tumour response to NAC, assessed using diffusion-weighted imaging, and axillary pathologic complete response.

Clinical suspicion of spondylodiscitis with equivocal MRI findings: does diffusion-weighted imaging prove helpful here?

2020 ◽  
pp. 028418512092790
Author(s):  
Jeanette Henkelmann ◽  
Kristina Bremicker ◽  
Timm Denecke ◽  
Karl-Titus Hoffmann ◽  
Ralf Henkelmann ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Region Of Interest ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Mri Findings ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Adc Values

Background Despite the high sensitivity of magnetic resonance imaging (MRI), early detection of spondylodiscitis (SpD) remains challenging due to its low specificity. Purpose To assess the diagnostic value of diffusion-weighted imaging (DWI) in suspected cases of SpD with ambiguous early MRI findings in the differentiation of degenerative disorders (DD). Material and Methods In this prospective study, 52 patients suspected of having SpD underwent a whole-spine 3-T MRI scan comprising sagittal DWI. Of 58 conspicuous, T2-weighted, signal increased discs, 39 were successfully evaluated using DWI. Apparent diffusion coefficient (ADC) values and ADC maps were blindly analyzed using the region of interest of the conspicuous disc and a normal adjacent reference disc. Intraindividual ratios (conspicuous disc: reference disc) were calculated. Results All conspicuous discs showed increased absolute ADC values, which did not differ significantly between SpD (n = 22) and DD (n = 17). However, ADC ratio was significantly higher in SpD vs. DD ( P < 0.05). In receiver operating characteristic curve analysis, an ADC ratio threshold of 1.6 resulted in 45% sensitivity and 88% specificity (area under the curve = 0.69) for SpD diagnosis. Conclusion The absolute ADC value does not provide a reliable diagnosis of SpD. Increased diffusivity can be an indication of infection but should always be discussed in the context of existing disc degeneration.

scholarly journals The Influence of Bowel Preparation on ADC Measurements: Comparison between Conventional DWI and DWIBS Sequences

Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 394
Author(s):  
Ilze Apine ◽  
Monta Baduna ◽  
Reinis Pitura ◽  
Juris Pokrotnieks ◽  
Gaida Krumina
Keyword(s):  
Bowel Preparation ◽  
Diffusion Weighted Imaging ◽  
Mr Enterography ◽  
High Signal ◽  
Diffusion Weighted ◽  
Signal Suppression ◽  
Significant Difference ◽  
Before And After ◽  
Apparent Diffusion ◽  
Adc Values

Background and objectives: The aim of the study was to assess whether there were differences between apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) and diffusion-weighted imaging with background body signal suppression (DWIBS) sequences in non-prepared and prepared bowels before and after preparation with an enteric hyperosmolar agent, to assess whether ADC measurements have the potential to avoid bowel preparation and whether ADC-DWIBS has advantages over ADC-DWI. Materials and Methods: 106 adult patients without evidence of inflammatory bowel disease (IBD) underwent magnetic resonance (MR) enterography before and after bowel preparation. ADC-DWI and ADC-DWIBS values were measured in the intestinal and colonic walls demonstrating high signal intensity (SI) at DWI tracking images of b = 800 s/mm2 before and after preparation. Results: There were significant difference (p < 0.0001) in both ADC-DWI and ADC-DWIBS results between non-prepared and prepared jejunum for DWI being 1.09 × 10−3 mm2/s and 1.76 × 10−3 mm2/s, respectively, and for DWIBS being 0.91 × 10−3 mm2/s and 1.75 × 10−3 mm2/s, respectively. Both ADC-DWI and DWIBS also showed significant difference between non-prepared and prepared colon (p < 0.0001), with DWI values 1.41 × 10−3 mm2/s and 2.13 × 10−3 mm2/s, and DWIBS—1.01 × 10−3 mm2/s and 2.04 × 10−3 mm2/s, respectively. No significant difference between ADC-DWI and ADC-DWIBS was found in prepared jejunum (p = 0.84) and prepared colon (p = 0.58), whereas a significant difference was found in non-prepared jejunum and non-prepared colon (p = 0.0001 in both samples). Conclusions: ADC between DWI and DWIBS does not differ in prepared bowel walls but demonstrates a difference in non-prepared bowel. ADC in non-prepared bowel is lower than in prepared bowel and possible overlap with the ADC range of IBD is possible in non-prepared bowel. ADC-DWIBS has no advantage over ADC-DWI in regard to IBD assessment.

scholarly journals Addition of Diffusion-Weighted Imaging to Dynamic Contrast Enhanced MRI: can it help differentiate benign from malignant jaw lesions?

2020 ◽  
Author(s):  
Xue Zhao
Keyword(s):  
Diffusion Weighted Imaging ◽  
Adc Value ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced Mri ◽  
Dynamic Contrast Enhanced ◽  
Enhanced Mri ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
Adc Values ◽  
Contrast Enhanced Mri

Abstract Objective: To explore the diagnosis value of adding diffusion-weighted imaging (DWI) to dynamic contrast enhanced MRI (DCE-MRI) in distinguishing benign from malignant jaw lesions.Materials and Methods: This retrospective study was involved 53 patients (23 benign, 30 malignant) with jaw lesions confirmed by pathology were analyzed. DWI and DCE-MRI were performed in all patients. The Apparent Diffusion Coefficient (ADC) value as well as the DCE-MRI parameters [time to peak (Tpeak), wash in rate (WIR), wash out rate (WOR), relative enhancement, and maximum enhancement] were measured for each patient. The optimal cut-off value of ADC values and DCE-MRI parameters were determined by using a receiver operating characteristics (ROCs), and the area under ROC curve (AUC) was evaluated. P < 0.05 was considered to indicate a significant difference. Results: Among the five parameters of DCE-MRI, the WOR displayed the most significantly difference with a threshold value of 4.90 l/s between benign and malignant group (P<0.05). When only WOR was used as the basis for diagnosis, the sensitivity, specificity, and AUC were 77.20%, 78.00%, and 0.800, respectively (Fig.3, 4). However, sensitivity (77.20% vs 83.30%), specificity (78.00% vs 87.20%) and accuracy (0.80 vs 0.85) significantly improved with the addition of ADC values in the evaluation of jaw lesions, which manifested better than that by using WOR alone.Conclusion: The high WOR of DCE-MRI may have a malignant tendency, but in the evaluation of jaw disease, the addition of ADC value can improve the diagnostic value.

scholarly journals The role of diffusion-weighted MRI in assessment of response to chemotherapy in osteosarcoma

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Tarek Ahmed Raafat ◽  
Randa Osama Kaddah ◽  
Lobna Mohamed Bokhary ◽  
Hend Ali Sayed ◽  
Ahmed Sayed Awad
Keyword(s):  
Tumor Necrosis ◽  
Therapeutic Response ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Before And After ◽  
Adc Values ◽  
The Mean ◽  
Value Measurement ◽  
Post Therapy

Abstract Background The most effective treatment for osteosarcoma is neoadjuvant chemotherapy along with surgical resection of the tumor. The prognosis significantly correlates with the degree of tumor necrosis following preoperative chemotherapy. The tumor necrosis will result in loss of the cell membrane integrity and expansion of the extracellular diffusion space which can be detected as an increase in the mean ADC value. The aim of our work is to evaluate the use of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) value measurement for monitoring the therapeutic response after chemotherapy in osteosarcoma. Results This study included 25 cases of osteosarcoma: 15 males and 10 females. The age of the patients ranged from 7 to 46 years with mean age 22 years. All were assessed by magnetic resonance imaging (MRI) including DWI and the mean and minimum ADC values were calculated before and after chemotherapy. Follow-up DWI post-therapy revealed a rise in mean ADC value in 17 patients who considered having good response. The ADC value had been raised from 1.05 ± 0.4 × 10−3 mm2/s to 1.82 ± 0.45 × 10−3 mm2/s (P < 0.027) that is statistically moderately significant. In 8 patients, the post-therapy ADC value was similar to that of pre- or with a little change and they were considered having poor response. It showed changes from 1.29 ± 0.35 × 10−3 mm2/s to 1.32 ± 0.36 × 10−3 mm2/s (P > 0.05) that means no significant difference. Conclusion DWI and ADC value measurement play an important role in monitoring the therapeutic response after chemotherapy in osteosarcoma patients by comparing the mean ADC values before and after treatment.

scholarly journals Integrated slice-specific dynamic shimming diffusion weighted imaging (DWI) for rectal Cancer detection and characterization

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jianxing Qiu ◽  
Jing Liu ◽  
Zhongxu Bi ◽  
Xiaowei Sun ◽  
Xin Wang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Image Quality ◽  
Diffusion Weighted Imaging ◽  
Rectal Tumor ◽  
B Values ◽  
Primary Rectal Cancer ◽  
Diffusion Weighted ◽  
Adc Values ◽  
Group 2 ◽  
Group 1

Abstract Purpose To compare integrated slice-specific dynamic shimming (iShim) diffusion weighted imaging (DWI) and single-shot echo-planar imaging (SS-EPI) DWI in image quality and pathological characterization of rectal cancer. Materials and methods A total of 193 consecutive rectal tumor patients were enrolled for retrospective analysis. Among them, 101 patients underwent iShim-DWI (b = 0, 800, and 1600 s/mm2) and 92 patients underwent SS-EPI-DWI (b = 0, and 1000 s/mm2). Qualitative analyses of both DWI techniques was performed by two independent readers; including adequate fat suppression, the presence of artifacts and image quality. Quantitative analysis was performed by calculating standard deviation (SD) of the gluteus maximus, signal intensity (SI) of lesion and residual normal rectal wall, apparent diffusion coefficient (ADC) values (generated by b values of 0, 800 and 1600 s/mm2 for iShim-DWI, and by b values of 0 and 1000 s/mm2 for SS-EPI-DWI) and image quality parameters, such as signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of primary rectal tumor. For the primary rectal cancer, two pathological groups were divided according to pathological results: Group 1 (well-differentiated) and Group 2 (poorly differentiated). Statistical analyses were performed with p < 0.05 as significant difference. Results Compared with SS-EPI-DWI, significantly higher scores of image quality were obtained in iShim-DWI cases (P < 0.001). The SDbackground was significantly reduced on b = 1600 s/mm2 images and ADC maps of iShim-DWI. Both SNR and CNR of b = 800 s/mm2 and b = 1600 s/mm2 images in iShim-DWI were higher than those of b = 1000 s/mm2 images in SS-EPI-DWI. In primary rectal cancer of iShim-DWI cohort, SIlesion was significantly higher than SIrectum in both b = 800 and 1600 s/mm2 images. ADC values were significantly lower in Group 2 (0.732 ± 0.08) × 10− 3 mm2/s) than those in Group 1 ((0.912 ± 0.21) × 10− 3 mm2/s). ROC analyses showed significance of ADC values and SIlesion between the two groups. Conclusion iShim-DWI with b values of 0, 800 and 1600 s/mm2 is a promising technique of high image quality in rectal tumor imaging, and has potential ability to differentiate rectal cancer from normal wall and predicting pathological characterization.

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