Role of DWI in evaluation of HCC after radiofrequency ablation compared to dynamic MRI using MRI (3 T)

Abstract Background The purpose of this study was to investigate the diagnostic performance of diffusion weight imaging (DWI), apparent diffusion coefficient (ADC) map, normalized ADC liver, and normalized ADC spleen compared to the dynamic contrast-enhanced MRI (DCE-MRI) in the evaluation of residual hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) using 3 T (T) magnetic resonance imaging (MRI). Results A prospective study was performed on 40 patients with radiofrequency-ablated HCC, and 15 (37.5%) patients had viable lesion post-RFA, while 25 (62.5%) had non-viable lesions. DCE-MRI had a sensitivity, specificity, and accuracy of 100%, 100%, and 100%, respectively, compared to DWI which had a sensitivity, specificity, and accuracy of 80%, 88%, and 85%, respectively, for identifying post-RFA viable HCC. The sensitivity, specificity, and accuracy of ADC at a cutoff value of 1.01 × 10−3 mm2/s were 80%, 100%, and 97.1%, respectively. The optimal cutoff value of normalized ADC liver was 0.81 with a sensitivity of 73.3%, specificity of 96%, and accuracy of 92.8%. The sensitivity, specificity, and accuracy of normalized ADC spleen at a cutoff value of 1.22 were 80%, 92%, and 91.1%, respectively. Conclusions DWI-MRI is a reliable technique for assessing HCC after radiofrequency ablation. DWI-MRI with ADC may be used as an alternate sequence for assessing radiofrequency-ablated lesions in individuals who have a contraindication to the contrast media, and the normalized ADC value may be of additional benefit.

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The Role of Dynamic Magnetic Resonance Imaging in the Detection of Lesions of the Ulnocarpal Complex

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(05)80191-3 ◽

1996 ◽

Vol 21 (3) ◽

pp. 311-314 ◽

Cited By ~ 11

Author(s):

M. Gabl ◽

M. Lener ◽

S. Pechlaner ◽

W. Judmaier

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Dynamic Mri ◽

Dynamic Magnetic Resonance Imaging ◽

Resonance Imaging ◽

Non Invasive ◽

Dynamic Magnetic Resonance ◽

Magnetic Resonance Imaging Mri ◽

The Stability ◽

A Prospective Study

A prospective study of 32 patients was carried out to investigate the significance of dynamic magnetic resonance imaging (MRI) in diagnosis of triangular fibrocartilage (TFC) lesions. Tears of the TFC can be diagnosed well by means of static MRI and arthroscopy. Dynamic MRI examination has an advantage in evaluating the stability of the TFC and ulnocarpal impingement. By means of dynamic MRI it was possible to make a preoperative diagnosis of an ulnocarpal impingement in five patients, a diagnosis which was confirmed through arthroscopy in all cases. In three further patients, dynamic MRI showed ulnocarpal impingement caused by instability of the ulnar attachment of the TFC. This kind of impingement could not be ascertained arthroscopically. Dynamic MRI extends the possibilities of evaluating obscure ulnar wrist pain. Its significance lies in the non-invasive examination of ulnocarpal impingement as well as the evaluation of TFC stability.

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

Frontiers in Veterinary Science ◽

10.3389/fvets.2020.598792 ◽

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.

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Benign and malignant skull-involved lesions: discriminative value of conventional CT and MRI combined with diffusion-weighted MRI

Acta Radiologica ◽

10.1177/0284185118773541 ◽

2018 ◽

Vol 60 (7) ◽

pp. 880-886 ◽

Cited By ~ 1

Author(s):

Zhanhai Tu ◽

Zebin Xiao ◽

Yingyan Zheng ◽

Hongjie Huang ◽

Libin Yang ◽

...

Keyword(s):

Roc Curve ◽

Mri Findings ◽

Adc Value ◽

Diffusion Weighted ◽

Apparent Diffusion ◽

Discriminative Value ◽

Magnetic Resonance Imaging Mri ◽

Mri Characteristics ◽

Conventional Ct ◽

Ct And Mri

Background Little is known about the value of computed tomography (CT) and magnetic resonance imaging (MRI) combined with diffusion-weighted imaging (DWI) in distinguishing malignant from benign skull-involved lesions. Purpose To evaluate the discriminative value of DWI combined with conventional CT and MRI for differentiating between benign and malignant skull-involved lesions. Material and Methods CT and MRI findings of 58 patients with pathologically proven skull-involved lesions (43 benign and 15 malignant) were retrospectively reviewed. Conventional CT and MRI characteristics and apparent diffusion coefficient (ADC) value of the two groups were evaluated and compared. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the differential performance of each parameter separately and together. Results The presence of cortical defects or break-through and ill-defined margins were associated with malignant skull-involved lesions (both P < 0.05). Malignant skull-involved lesions demonstrated a significantly lower ADC ( P = 0.016) than benign lesions. ROC curve analyses indicated that a combination of CT, MRI, and DWI with an ADC ≤ 0.703 × 10–3 mm2/s showed optimal sensitivity, while DWI along showed optimal specificity of 88.4% in differentiating between benign and malignant skull-involved lesions. Conclusion The combination of CT, MRI, and DWI can help to differentiate malignant from benign skull-involved lesions. CT + MRI + DWI offers optimal sensitivity, while DWI offers optimal specificity.

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Imaging Hallmarks of the Tumor Microenvironment in Glioblastoma Progression

Frontiers in Oncology ◽

10.3389/fonc.2021.692650 ◽

2021 ◽

Vol 11 ◽

Author(s):

John J. Walsh ◽

Maxime Parent ◽

Adil Akif ◽

Lucas C. Adam ◽

Samuel Maritim ◽

...

Keyword(s):

Tumor Microenvironment ◽

Tumor Growth ◽

Aerobic Glycolysis ◽

Dce Mri ◽

Cancer Hallmarks ◽

Longitudinal Measurements ◽

Tumor Periphery ◽

Contrast Enhanced ◽

Apparent Diffusion ◽

Magnetic Resonance Imaging Mri

Glioblastoma progression involves multifaceted changes in vascularity, cellularity, and metabolism. Capturing such complexities of the tumor niche, from the tumor core to the periphery, by magnetic resonance imaging (MRI) and spectroscopic imaging (MRSI) methods has translational impact. In human-derived glioblastoma models (U87, U251) we made simultaneous and longitudinal measurements of tumor perfusion (Fp), permeability (Ktrans), and volume fractions of extracellular (ve) and blood (vp) spaces from dynamic contrast enhanced (DCE) MRI, cellularity from apparent diffusion coefficient (ADC) MRI, and extracellular pH (pHe) from an MRSI method called Biosensor Imaging of Redundant Deviation in Shifts (BIRDS). Spatiotemporal patterns of these parameters during tumorigenesis were unique for each tumor. While U87 tumors grew faster, Fp, Ktrans, and vp increased with tumor growth in both tumors but these trends were more pronounced for U251 tumors. Perfused regions between tumor periphery and core with U87 tumors exhibited higher Fp, but Ktrans of U251 tumors remained lowest at the tumor margin, suggesting primitive vascularization. Tumor growth was uncorrelated with ve, ADC, and pHe. U87 tumors showed correlated regions of reduced ve and lower ADC (higher cellularity), suggesting ongoing proliferation. U251 tumors revealed that the tumor core had higher ve and elevated ADC (lower cellularity), suggesting necrosis development. The entire tumor was uniformly acidic (pHe 6.1-6.8) early and throughout progression, but U251 tumors were more acidic, suggesting lower aerobic glycolysis in U87 tumors. Characterizing these cancer hallmarks with DCE-MRI, ADC-MRI, and BIRDS-MRSI will be useful for exploring tumorigenesis as well as timely therapies targeted to specific vascular and metabolic aspects of the tumor microenvironment.

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Measurement of Apparent Diffusion Coefficient (ADC) Values of Ependymoma and Medulloblastoma Tumors: a Patient-based Study

Journal of Biomedical Physics and Engineering ◽

10.31661/jbpe.v0i0.889 ◽

2019 ◽

Author(s):

H Taheri ◽

M B Tavakoli

Keyword(s):

Diffusion Coefficient ◽

Apparent Diffusion Coefficient ◽

Pediatric Patients ◽

Clinical Images ◽

Adc Value ◽

Conventional Mri ◽

Apparent Diffusion ◽

Adc Values ◽

The Mean ◽

Magnetic Resonance Imaging Mri

Background: aimed to compare the apparent diffusion coefficient (ADC) of two different cerebellar pediatric tumors, including ependymoma and medulloblastoma which have shown similar clinical images in conventional magnetic resonance imaging (MRI) methods.Material and Methods: Thirty six pediatric patients who were suspected to have the mentioned tumors according to their CT image findings were included in this study. The patients were subjected to conventional MRI protocols followed by diffusion weighted imaging (DWI) and ADC values of the tumors were calculated automatically using MRI scanner software.Results: The mean (± SD) ADC value for ependymoma (1.2± 0.06 ×10-3 mm2/s) was significantly higher than medulloblastoma (0.87 ± 0.02 ×10-3 mm2/s) (p = 0.041). Moreover, the maximum ADC value of ependymoma was considerably different in comparison with medulloblastoma (1.4 ×10-3 mm2/s and 0.96×10-3 mm2/s, respectively; p = 0.035) Furthermore, the minimum ADC value of ependymoma was higher compared to medulloblastoma (1.0 ×10-3 mm2/s and 0.61×10-3 mm2/s, respectively), but it was not significant (p = 0.067).Conclusion: Evaluation of ADC values for ependymoma and medulloblastoma is a reliable method to differentiate these two malignancies. This is due to different ADC values reflected during the evaluation.

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The Diagnostic Accuracy of Dynamic MRI in diagnosis of complex adnexal masses

10.53350/pjmhs211571646 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1646-1649

Author(s):

Anum Awais ◽

Saulat Sarfraz ◽

Fatima Saleem ◽

Sidra Sajjad ◽

Tuba Tariq ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Adnexal Mass ◽

Dynamic Mri ◽

Cross Sectional Study ◽

Cross Sectional ◽

Adnexal Masses ◽

Mri Scans ◽

The Mean ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

Background: When ultrasonographic data are restricted, magnetic resonance imaging (MRI) scans can assist identify adnexal mass features. Two European centers have done pioneering work on Dynamic MRI with varied accuracy in diagnosis of complex adnexal lesions. Aim: To evaluate diagnostic accuracy of Dynamic MRI in diagnosing complex adnexal masses, Methods: The Department of Radiology conducted a cross-sectional study. Sheikh Zayed hospital, Lahore for 6 months (September 2017-March 2018). Procedure was done for MRI and histopathology for detecting the adnexal masses. Results of MRI were compared with histopathology results, which are taken as gold standard. Reporting was done by researcher herself under supervision of consultant radiologist. SPSS version 20 was used to enter and evaluate the data. Results: The mean age of patients was 41.57±11.69 years. Dynamic MRI has a 95% sensitivity, specificity, and diagnostic accuracy. 94.37% and 94.7% respectively. Conclusion: Dynamic MRI is reliable and useful tool with high values of responsiveness, for detecting complicated indeterminate adnexal masseson Doppler considering histopathology as gold standard.Specificity and diagnostic accuracy are important. Keywords: Dynamic MRI, Histopathology, Complex Adnexal Mass

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Role of MRI in osteosarcoma for chemotherapy response evaluation and prediction: Correlation with histological necrosis

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.10540 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 10540-10540

Author(s):

J. Bajpai ◽

S. Gamnagatti ◽

V. Sreenivas ◽

R. Phulia ◽

M. Sharma ◽

...

Keyword(s):

Multivariable Analysis ◽

Relative Size ◽

Chemotherapy Response ◽

Response Evaluation ◽

Time Intensity Curve ◽

Dce Mri ◽

Receiver Operating Characteristic Curves ◽

Apparent Diffusion ◽

Treatment Naïve ◽

Magnetic Resonance Imaging Mri

10540 Background:Histologic necrosis (HN), the current gold standard for response evaluation in osteosarcoma (OS), is accessible only after neoadjuvant chemotherapy (NACT) and may get affected by confounding factors. Thus, it would be useful to have surrogate markers of response evaluation and prognostication using magnetic resonance imaging (MRI) to individualize therapy. Method:Thirty-one treatment naïve OS patients received 3 cycles of NACT followed by surgery during 2006–2008. All patients underwent baseline and post-NACT conventional(C), diffusion-weighted (DW) and dynamic contrast enhanced (DCE) MRI. Taking ‘Huvos grading’ (good response >/= 90% HN) as reference standard, various parameters of MRI were compared with it. Tumor considered as ellipsoidal; volume (V), average tumor plane (ATP) and relative(r)-ATP (ATP/body surface area) were calculated using standard formula for ellipse. Receiver operating characteristic curves were generated to assess the best threshold and predictability. Sensitivity and specificity were calculated along with 95% confidence limits. After deriving thresholds for each parameter in univariable analysis, multivariable analysis was carried out. Results: Both pre-and post NACT, absolute and relative size parameters were well correlated with HN, though post NACT change in parameters did not. Apparent diffusion coefficient (ADC), either pre-and post NACT measurements or change following chemotherapy were not correlating well. However, on adjusting for volume, significant correlation was found. Thus, we could derive a new parameter diffusion per unit volume (DV= ADC /V). Change in shape of time intensity curve did not show significant correlation. Conclusions: In OS, NACT response can be assessed and predicted by conventional and DW- MRI early in the disease course which correlates well with HN. DV seems to be a sensitive substitute for response evaluation. For DCE-MRI, more sophisticated models in future studies might be useful. [Table: see text] No significant financial relationships to disclose.

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Value of Diffusion Weighted MRI with Quantitative ADC Map in Diagnosis of Malignant Thyroid Disease

Diagnostics ◽

10.3390/diagnostics9040129 ◽

2019 ◽

Vol 9 (4) ◽

pp. 129

Author(s):

Le Tuan Linh ◽

Nguyen Ngoc Cuong ◽

Tran Viet Hung ◽

Nguyen Van Hieu ◽

Bui Van Lenh ◽

...

Keyword(s):

Thyroid Nodules ◽

Statistical Tests ◽

B Value ◽

University Hospital ◽

Common Disease ◽

Diffusion Weighted Mri ◽

Adc Value ◽

Diffusion Weighted ◽

Apparent Diffusion ◽

Magnetic Resonance Imaging Mri

Thyroid nodule is a common disease in clinical practice. The diagnosis of malignant thyroid tumors determines the treatment strategy. Among a number of methods have claimed to help evaluating thyroid nodules, ultrasound is a usable one in spite of several disadvantages (dependent on the physician/technician, incomparable, etc.) and magnetic resonance imaging (MRI) accompanied by quantitative apparent diffusion coefficient (ADC) is a promising diagnostic tool. This study was designed to investigate the usefulness of ADC cut-off values and the protocol of thyroid MRI derived from quantitative diffusion weighted imaging (DWI) in differentiating benign and malignant thyroid nodules. The study was conducted on 93 patients with 128 thyroid nodules, diagnosed and underwent surgery at Hanoi Medical University Hospital. All the patients took thyroid MRI with different b levels (from 200 to 800). ADC value was calculated to each b level, and the statistical tests were conducted with the Statistical Package for Social Sciences (SPSS—Windows and Mac version 20) and STATA 12. The mean ADC with all the b ranging from 200 to 800 of malignant groups was significantly higher than the group of benign lesions (p from <0.001 to 0.01). We chose b = 500 as a standard b-value in the protocol of thyroid MRI. The ADC cut-off point for distinguishing malignant from benign thyroid lesions: 1.7 × 10−3 mm2/s with high accuracy (87.1%, 95% CI: 79.59–92.07%). The study revealed that quantitative diffusion weighted MRI with ADC measurement could potentially quantitatively differentiate between benign and malignant thyroid nodules.

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The usefulness of diffusion-weighted MRI in the differentiation between focal uterine endometrial soft tissue lesions

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0076-x ◽

2019 ◽

Vol 50 (1) ◽

Cited By ~ 1

Author(s):

Tarek Mohamed M. Mansour ◽

Yasser Abd Al-aal Ahmed ◽

Ghada Abd El-Razik Ahmed

Keyword(s):

Imaging Features ◽

Focal Lesions ◽

Adc Value ◽

Pelvic Mri ◽

Apparent Diffusion ◽

Malignant Group ◽

Increased Sensitivity ◽

Malignant Lesions ◽

Sensitivity Specificity ◽

Histopathological Results

Abstract Background Several endometrial conditions may be challenging for radiologists due to the overlap of imaging features and variable endometrial pathologies. MRI with DWI is the most commonly used imaging technique for the diagnosis and characterization of endometrial focal lesions. Results The 50 studied lesions were classified according to their histopathological results into the benign group (28 lesions, 56%) and the malignant group (22 lesions, 44%). Conventional MRI could correctly diagnose 39 of the 50 lesions (22/28 benign and 17/22 malignant lesions), achieving a sensitivity of 77.27%, specificity of 78.56%, accuracy of 78%, predictive positive value (PPV) of 73.91%, and negative positive value (NPV) of 81.48%. By combining DWI and apparent diffusion coefficient (ADC) value mapping at a high b value (b = 1000) in MRI, we could correctly diagnose 47 of the 50 lesions (26/28 benign and 21/22 malignant lesions), with increased sensitivity (95.45%), specificity (92.86%), accuracy (94%), PPV (91.3%), and NPV (96%). Conclusion Combining DWI with ADC mapping at a high b value in pelvic MRI examination is valuable in differentiating endometrial focal lesions with increased diagnostic sensitivity, specificity, and accuracy. Aim of the work This study aimed to evaluate the role of DWI in the diagnosis and differential diagnosis of benign and malignant focal endometrial masses.

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Use of Ultrasonography Versus Magnetic Resonance Imaging for Tendon Abnormalities Around the Ankle

Foot & Ankle International ◽

10.1177/107110079801900907 ◽

1998 ◽

Vol 19 (9) ◽

pp. 604-612 ◽

Cited By ~ 66

Author(s):

Matthew S. Rockett ◽

Gayle Waitches ◽

Gary Sudakoff ◽

Michael Brage

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Resonance Imaging ◽

Mri Findings ◽

Sensitivity Measurement ◽

Tendon Tears ◽

Magnetic Resonance Imaging Mri ◽

High Resolution Ultrasonography ◽

Sensitivity Specificity ◽

A Prospective Study

A prospective study was performed on 28 patients who underwent surgery for tendon disorders around the ankle. Preoperatively, all patients had real-time, high resolution ultrasonography performed with a 7.5 or 10 mHz transducer. Twenty of these patients also had a preoperative magnetic resonance imaging (MRI) examination of the ankle. A total of 54 tendons were inspected intraoperativey, revealing a total of 24 intrasubstance or complete tendon tears. These surgical findings were compared with the ultrasound and MRI findings, from which the sensitivity, specificity, and accuracy were calculated for both modalities. Ultrasound produced results with a sensitivity measurement of 100%, specificity of 89.9%, and accuracy of 94.4%. MRI produced results with a sensitivity measurement of 23.4%, specificity of 100%, and accuracy of 65.75%. Ultrasound results were more sensitive and accurate than MRI in the detection of ankle tendon tears in our study.

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