Added Value of Quantitative Apparent Diffusion Coefficient Values for Neuroprognostication After Cardiac Arrest

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011991
Author(s):  
Anke Wouters ◽  
Lauranne Scheldeman ◽  
Sam Plessers ◽  
Ronald Peeters ◽  
Sarah Cappelle ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Brain Mri ◽  
Multivariate Model ◽  
Added Value ◽  
Neurological Recovery ◽  
Adc Value ◽  
Apparent Diffusion Coefficient Values ◽  
Apparent Diffusion

ObjectiveTo test the prognostic value of brain MRI in addition to clinical and electrophysiological variables in post-cardiac arrest (CA) patients, we explored data from the randomized Neuroprotect post-CA trial (NCT02541591).MethodsIn this trial brain MRI’s were prospectively obtained. We calculated receiver operating characteristic curves for the average Apparent Diffusion Coefficient (ADC) value and percentage of brain voxels with an ADC value < 650 x 10-6 mm2/s and < 450 x 10-6 mm2/s. We constructed multivariable logistic regression models with clinical characteristics, electroencephalogram (EEG), somatosensory evoked potentials (SSEP) and ADC value as independent variables, to predict good neurological recovery.ResultsIn 79/102 patients MRI data were available and in 58/79 patients all other data were available. At 180 days post-CA, 25/58 (43%) patients had good neurological recovery. In univariable analysis of all tested MRI parameters, average ADC value in the postcentral cortex had the highest accuracy to predict good neurological recovery with an AUC of 0.78. In the most optimal multivariate model which also included corneal reflexes and EEG, this parameter remained an independent predictor of good neurological recovery (AUC = 0.96, false positive = 27%). This model provided a more accurate prediction compared to the most optimal combination of EEG, corneal reflexes and SSEP (p=0.03).ConclusionAdding information on brain MRI in a multivariate model may improve the prediction of good neurological recovery in post-CA patients.Classification of Evidence:"This study provides Class III evidence that MRI ADC features predict neurological recovery in post-cardiac arrest patients."

scholarly journals Assessment of Apparent Diffusion Coefficient Values as Predictor of Aggressiveness in Peripheral Zone Prostate Cancer: Comparison with Gleason Score

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Shayan Sirat Maheen Anwar ◽  
Zahid Anwar Khan ◽  
Rana Shoaib Hamid ◽  
Fahd Haroon ◽  
Raza Sayani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Gleason Score ◽  
Case Series ◽  
Adc Value ◽  
Apparent Diffusion Coefficient Values ◽  
Apparent Diffusion Coefficient Value ◽  
Apparent Diffusion ◽  
Adc Values

Purpose. To determine association between apparent diffusion coefficient value on diffusion-weighted imaging and Gleason score in patients with prostate cancer. Methods. This retrospective case series was conducted at Radiology Department of Aga Khan University between June 2009 and June 2011. 28 patients with biopsy-proven prostate cancer were included who underwent ultrasound guided sextant prostate biopsy and MRI. MRI images were analyzed on diagnostic console and regions of interest were drawn. Data were entered and analyzed on SPSS 20.0. ADC values were compared with Gleason score using one-way ANOVA test. Results. In 28 patients, 168 quadrants were biopsied and 106 quadrants were positive for malignancy. 89 lesions with proven malignancy showed diffusion restriction. The mean ADC value for disease with a Gleason score of 6 was 935 mm2/s (SD=248.4 mm2/s); Gleason score of 7 was 837 mm2/s (SD=208.5 mm2/s); Gleason score of 8 was 614 mm2/s (SD=108 mm2/s); and Gleason score of 9 was 571 mm2/s (SD=82 mm2/s). Inverse relationship was observed between Gleason score and mean ADC values. Conclusion. DWI and specifically quantitative ADC values may help differentiate between low-risk (Gleason score, 6), intermediate-risk (Gleason score, 7), and high-risk (Gleason score 8 and 9) prostate cancers, indirectly determining the aggressiveness of the disease.

scholarly journals Apparent diffusion coefficient values of cryptorchid testes and malignant transformation of cryptorchidism (MTC) (seminoma) in postpubertal patients

2021 ◽  
pp. 20200624
Author(s):  
Renwei Liu ◽  
Jianhua Li ◽  
Yixiang Jiang ◽  
Zhiqing Wu ◽  
Yanzi Chen ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Malignant Transformation ◽  
Clinical Decision Making ◽  
Characteristic Curve ◽  
Adc Value ◽  
Apparent Diffusion Coefficient Values ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Sensitivity Specificity

Objectives: Diffusion-weighted imaging signal contrast can be quantified by apparent diffusion coefficient (ADC) maps, which reflect the diffusion properties of the examined tissue and are helpful for identifying pathology. To determine ADC values of cryptorchid testes in post-pubertal patients and assess performance for characterizing cryptorchid testes. Methods: The medical records from 35 patients with unilateral scrotal vacuity were retrospectively reviewed. Data were analyzed in three groups: Group A, normal testes (i.e. the contralateral testes of the patients with cryptorchidism or MTC); Group B, cryptorchid testes; and Group C, malignant transformation of cryptorchidism (MTC) (seminoma). DWI used b-values of 0 and 800 s/mm2. Mean ADC values were compared using the independent samples t-test. The ability of ADC values was assessed using receiver operating characteristic curve analysis. The sensitivity, specificity, and accuracy were calculated. Results: Mean ADC values for normal testes, cryptorchid testes, and MTC were 1.18 ± 0.18×10−3 mm2/s, 1.82 ± 0.40×10−3 mm2/s, and 0.80 ± 0.06×10−3 mm2/s, respectively. There were statistically significant differences in mean ADC values between normal testes and cryptorchid testes or MTC (p < 0.001). The cut-off ADC value for differentiating normal testes from cryptorchid testes was 1.47 × 10−3 mm2/s. The sensitivity, specificity, and accuracy were 88%, 91%, and 90%, respectively. The cut-off ADC value for differentiating normal testes from MTC was 1.22 × 10−3 mm2/s. The sensitivity, specificity, and accuracy were 100%, 31%, and 43%, respectively. Conclusion: ADC values of cryptorchid testes may be used to inform clinical decision-making and also monitor testicular function in patients who retain undescended testicles or post-operatively. Advances in knowledge: Mean ADC values of cryptorchidism and MTC (seminoma) were used to reflect their pathological features.

scholarly journals Apparent diffusion coefficient cannot discriminate metastatic and non-metastatic lymph nodes in rectal cancer: a meta-analysis

2021 ◽  
Author(s):  
Alexey Surov ◽  
Hans-Jonas Meyer ◽  
Maciej Pech ◽  
Maciej Powerski ◽  
Jasan Omari ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Lymph Nodes ◽  
Meta Analysis ◽  
Adc Value ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Apparent Diffusion ◽  
Adc Values

Abstract Background Our aim was to provide data regarding use of diffusion-weighted imaging (DWI) for distinguishing metastatic and non-metastatic lymph nodes (LN) in rectal cancer. Methods MEDLINE library, EMBASE, and SCOPUS database were screened for associations between DWI and metastatic and non-metastatic LN in rectal cancer up to February 2021. Overall, 9 studies were included into the analysis. Number, mean value, and standard deviation of DWI parameters including apparent diffusion coefficient (ADC) values of metastatic and non-metastatic LN were extracted from the literature. The methodological quality of the studies was investigated according to the QUADAS-2 assessment. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian, and Laird random-effects models with inverse-variance weights were used to account the heterogeneity between the studies. Mean DWI values including 95% confidence intervals were calculated for metastatic and non-metastatic LN. Results ADC values were reported for 1376 LN, 623 (45.3%) metastatic LN, and 754 (54.7%) non-metastatic LN. The calculated mean ADC value (× 10−3 mm2/s) of metastatic LN was 1.05, 95%CI (0.94, 1.15). The calculated mean ADC value of the non-metastatic LN was 1.17, 95%CI (1.01, 1.33). The calculated sensitivity and specificity were 0.81, 95%CI (0.74, 0.89) and 0.67, 95%CI (0.54, 0.79). Conclusion No reliable ADC threshold can be recommended for distinguishing of metastatic and non-metastatic LN in rectal cancer.

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