scholarly journals Multiparametric MRI with diffusion-weighted imaging in predicting response to chemotherapy in cases of osteosarcoma and Ewing’s sarcoma

2020 ◽  
Vol 93 (1115) ◽  
pp. 20200257
Author(s):  
Mahmoud Mohamed Saleh ◽  
Tamer Moustafa Abdelrahman ◽  
Youusef Madney ◽  
Ghada Mohamed ◽  
Ahmed Mohammed Shokry ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Tumor Volume ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Multiparametric Mri ◽  
Dce Mri ◽  
Recist 1.1 ◽  
Progressive Group ◽  
Adc Values ◽  
Modified Recist

Objective: To evaluate the multiparametric MRI in predicting chemotherapy response in pathologically proven cases of osteosarcoma and Ewing’s sarcoma. Correlation between the tumor size changes and internal breakdown using RECIST 1.1, modified RECIST, quantitative apparent diffusion coefficient (ADC) and tumor volume as well as dynamic contrast-enhanced MRI (DCE-MRI). Methods: The study included 104 patients pathologically proved osteosarcoma (53) and Ewing`s sarcoma (51) underwent MRI examinations; before and after chemotherapy. All patients were assessed using the RECIST 1.1 criteria, m-RECIST, quantitative ADC, and tumor volume evaluation. 21 patients underwent DCE-MRI curve type with quantitative parameters. Correlation between the different evaluations was carried out. Results were correlated with the post-operative pathology in 42 patients who underwent surgery and for statistical evaluation, Those patients were classified into responders (≥90% necrosis) and non-responders (<90% necrosis). Results: The initial mean ADC of 104 patients of osteosarcoma and Ewing’s sarcoma (0.90 ± 0.29) and (0.71 ± 0.16) respectively, differed significantly from that after treatment (1.62 ± 0.46) and (1.6 ± 0.39) respectively with (p<0.001). ADC variations (ADC%) in the non-progressive group were higher than those of the progressive group (128.3 ± 63.49 vs 36.34 ± 78.7) % with (p<0.001). ADC values and ADC variations were inversely correlated with morphologic changes, regardless of the effectiveness of chemotherapy expressed as changes in tumor size based on (RECIST 1.1, RECIST, and 3D volume). Linear regression analysis revealed a Pearson correlation coefficient of r=-0.427, -0.498 and -0.408, respectively with (p<0.001). An increase in the ADC value was not always associated with a reduction in tumor volume. The disease control rate (defined as the percentage of CR+PR+SD patients) was 89.4% and 93.9% according to RECIST 1.1 and m-RECIST respectively. 42 out of the 104 patients had postsurgical histological evaluation as regards the chemotherapeutic response divided into two groups. ADC values showed a statistically significant difference between Group A and Group B being more evident with minimum ADC% (p<0.001). Conclusion: Quantitative diffusion-weighted imaging with ADC mapping and ADC % after chemotherapy allows a detailed analysis of the treatment response in osteosarcoma and Ewing’s sarcoma. The therapeutic response can be underestimated using RECIST 1.1, so the modified RECIST should be also considered. Advances in knowledge: Quantitative ADC especially ADC% provided an accurate non-invasive tool in the assessment of post-therapeutic cases of osteosarcoma and Ewing's sarcoma

scholarly journals Diffusion-weighted MR imaging diagnostic merits in the post-therapeutic assessment of musculoskeletal soft tissue sarcoma

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Amr Farouk Ibrahim Moustafa ◽  
Shaimaa Shokry Mohammed Al Shahat El Said ◽  
Maged Abdelrahman Moustafa ◽  
Marwa Mahmoud Hussein ◽  
Ahmed Mohamed Shokry
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Tumor Volume ◽  
Neoadjuvant Treatment ◽  
Evaluation Criteria ◽  
Response Evaluation ◽  
Recist 1.1 ◽  
Progressive Group ◽  
Adc Values ◽  
Response Evaluation Criteria

Abstract Background The purpose of the study is assessing the diagnostic merits of diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping in evaluating tumor response to chemo-radiotherapy. The study included 36 patients with soft tissue sarcoma, who received chemo/radiotherapy. Tumor longest dimension according to response evaluation criteria in solid tumors 1.1 (RECIST 1.1), the longest dimension of the contrast-enhanced portion of the tumor according to modified response evaluation criteria in solid tumors: (mRECIST), the tumor volume (VOL) (cm3), and DWI with ADC values were recorded. Results ADC values in the non-progressive group were higher than those of the progressive group after neoadjuvant treatment (1.63 ± 0.42 vs. 1.24 ± 0.35) with (p < 0.005). ADC variations in the non-progressive group were higher than those of the progressive group (27.09 ± 48.09 vs. − 3.08 ± 23.5)% with (p < 0.05). ADC values after neoadjuvant treatment were negatively related to tumor volume variations (VOL%) after neoadjuvant treatment. ADC variations (ADC%) were inversely correlated with morphologic changes, regardless of the effectiveness of anticancer therapy expressed as changes in tumor size based on (RECIST, mRECIST, and three-dimensional volumetric assessment). An increase in the ADC value was not always associated with a reduction of tumor volume. Conclusion Quantitative DW imaging after neoadjuvant therapy provides added value in determining treatment response in soft tissue sarcomas. Therapeutic response to neoadjuvant therapy can be underestimated using RECIST 1.1; therefore, the mRECIST should also be considered.

scholarly journals Diagnostic value of diffusion-weighted imaging with synthetic b-values in breast tumors: comparison with dynamic contrast-enhanced and multiparametric MRI

2020 ◽  
Vol 31 (1) ◽  
pp. 356-367
Author(s):  
Isaac Daimiel Naranjo ◽  
Roberto Lo Gullo ◽  
Carolina Saccarelli ◽  
Sunitha B. Thakur ◽  
Almir Bitencourt ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Image Quality ◽  
Cancer Detection ◽  
Multiparametric Mri ◽  
Breast Cancer Detection ◽  
Dense Breast ◽  
B Values ◽  
Dce Mri ◽  
Adc Values ◽  
Lesion Conspicuity

Abstract Objectives To assess DWI for tumor visibility and breast cancer detection by the addition of different synthetic b-values. Methods Eighty-four consecutive women who underwent a breast-multiparametric-MRI (mpMRI) with enhancing lesions on DCE-MRI (BI-RADS 2–5) were included in this IRB-approved retrospective study from September 2018 to March 2019. Three readers evaluated DW acquired b-800 and synthetic b-1000, b-1200, b-1500, and b-1800 s/mm2 images for lesion visibility and preferred b-value based on lesion conspicuity. Image quality (1–3 scores) and breast composition (BI-RADS) were also recorded. Diagnostic parameters for DWI were determined using a 1–5 malignancy score based on qualitative imaging parameters (acquired + preferred synthetic b-values) and ADC values. BI-RADS classification was used for DCE-MRI and quantitative ADC values + BI-RADS were used for mpMRI. Results Sixty-four malignant (average = 23 mm) and 39 benign (average = 8 mm) lesions were found in 80 women. Although b-800 achieved the best image quality score, synthetic b-values 1200–1500 s/mm2 were preferred for lesion conspicuity, especially in dense breast. b-800 and synthetic b-1000/b-1200 s/mm2 values allowed the visualization of 84–90% of cancers visible with DCE-MRI performing better than b-1500/b-1800 s/mm2. DWI was more specific (86.3% vs 65.7%, p < 0.001) but less sensitive (62.8% vs 90%, p < 0.001) and accurate (71% vs 80.7%, p = 0.003) than DCE-MRI for breast cancer detection, where mpMRI was the most accurate modality accounting for less false positive cases. Conclusion The addition of synthetic b-values enhances tumor conspicuity and could potentially improve tumor visualization particularly in dense breast. However, its supportive role for DWI breast cancer detection is still not definite. Key Points • The addition of synthetic b-values (1200–1500 s/mm2) to acquired DWI afforded a better lesion conspicuity without increasing acquisition time and was particularly useful in dense breasts. • Despite the use of synthetic b-values, DWI was less sensitive and accurate than DCE-MRI for breast cancer detection. • A multiparametric MRI modality still remains the best approach having the highest accuracy for breast cancer detection and thus reducing the number of unnecessary biopsies.

scholarly journals Feasibility and possible value of quantitative semi-automated diffusion weighted imaging volumetry of neuroblastic tumors

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sebastian Gassenmaier ◽  
Ilias Tsiflikas ◽  
Jörg Fuchs ◽  
Robert Grimm ◽  
Cristian Urla ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Tumor Volume ◽  
Integrated Analysis ◽  
Volume Comparison ◽  
Total Tumor Volume ◽  
Diffusion Weighted ◽  
Parametric Data ◽  
Significant Difference ◽  
Neuroblastic Tumors ◽  
Adc Values

Abstract Background To assess the feasibility and possible value of semi-automated diffusion weighted imaging (DWI) volumetry of whole neuroblastic tumors with apparent diffusion coefficient (ADC) map evaluation after neoadjuvant chemotherapy. Methods Pediatric patients who underwent surgical resection of neuroblastic tumors at our institution from 2013 to 2019 and who received a preoperative MRI scan with DWI after chemotherapy were included. Tumor volume was assessed with a semi-automated approach in DWI using a dedicated software prototype. Quantitative ADC values were calculated automatically of the total tumor volume after manual exclusion of necrosis. Manual segmentation in T1 weighted and T2 weighted sequences was used as reference standard for tumor volume comparison. The Student’s t test was used for parametric data while the Wilcoxon rank sum test and the Kruskal-Wallis test were applied for non-parametric data. Results Twenty seven patients with 28 lesions (neuroblastoma (NB): n = 19, ganglioneuroblastoma (GNB): n = 7, ganglioneuroma (GN): n = 2) could be evaluated. Mean patient age was 4.5 ± 3.2 years. Median volume of standard volumetry (T1w or T2w) was 50.2 ml (interquartile range (IQR): 91.9 ml) vs. 45.1 ml (IQR: 98.4 ml) of DWI (p = 0.145). Mean ADC values (× 10− 6 mm2/s) of the total tumor volume (without necrosis) were 1187 ± 301 in NB vs. 1552 ± 114 in GNB/GN (p = 0.037). The 5th percentile of ADC values of NB (614 ± 275) and GNB/GN (1053 ± 362) provided the most significant difference (p = 0.007) with an area under the curve of 0.848 (p < 0.001). Conclusions Quantitative semi-automated DWI volumetry is feasible in neuroblastic tumors with integrated analysis of tissue characteristics by providing automatically calculated ADC values of the whole tumor as well as an ADC heatmap. The 5th percentile of the ADC values of the whole tumor volume proved to be the most significant parameter for differentiation of the histopathological subtypes in our patient cohort and further investigation seems to be worthwhile.

Prognostic significance of tumor volume in localized Ewing's sarcoma of bone in children and adolescents

1987 ◽  
Vol 113 (2) ◽  
pp. 187-191 ◽  
Author(s):  
V. G�bel ◽  
H. J�rgens ◽  
G. Etsp�ler ◽  
H. Kemperdick ◽  
R. M. Jungblut ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Tumor Volume ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Prognostic Significance

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.

Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging for Differentiation between Parotid Neoplasms

2019 ◽  
Vol 70 (3) ◽  
pp. 264-272 ◽  
Author(s):  
Ali H. Elmokadem ◽  
Ahmed M. Abdel Khalek ◽  
Rihame M. Abdel Wahab ◽  
Nehal Tharwat ◽  
Ghada M. Gaballa ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Multiparametric Mri ◽  
Resonance Imaging ◽  
Roc Curve Analysis ◽  
Dce Mri ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Significant Difference ◽  
Adc Values ◽  
Malignant Lesions ◽  
Parotid Tumours

Purpose This study was designed to evaluate the role of multiparametric magnetic resonance imaging (MRI) for differentiation of parotid gland neoplasms. Methods Prospective study was conducted upon 52 consecutive patients (30 men, 22 women; aged 24–78 years; mean, 51 years) with parotid tumours that underwent multiparametric MRI using combined static MRI, dynamic contrast enhanced (DCE) MRI, and diffusion-weighted imaging (DWI). The static MRI parameter, time signal intensity curves (TIC) derived from DCE-MRI, and apparent diffusion coefficient (ADC) values of parotid tumours were correlated with histopathological findings. Results Static MRI revealed a significant difference between both benign and malignant lesions in regards to margin definition ( P < .001) and T2 hypointensity ( P < .013), with a diagnostic accuracy 95% and 78.33% respectively. Study of the TIC type on DCE-MRI revealed statistically significant difference between benign and malignant lesions ( P < .001) and diagnostic accuracy 96.55%. There was no statistically significant difference ( P = .181) between the ADC values of benign and malignant lesions. ROC curve analysis revealed that by using ADC cut-off value of 1 × 10−3 mm2/s had accuracy of 84.62% respectively for differentiating Warthin from malignant tumours that could be modified to higher value (94.28%) by excluding lymphoma from malignant lesions. By using cutoff value of 1.3 × 10−3 mm2/s to differentiate pleomorphic adenoma from malignancy, ROC curve analysis had high accuracy of 97.06%. Conclusion Multiparametric MRI can be used for differentiation of malignant from benign parotid tumours and characterization of some benign parotid tumours.

Combining Tumor-Selective Bacterial Therapy with Salmonella typhimurium A1-R and Cancer Metabolism Targeting with Oral Recombinant Methioninase Regressed an Ewing’s Sarcoma in a Patient-Derived Orthotopic Xenograft Model

Chemotherapy ◽  
2018 ◽  
Vol 63 (5) ◽  
pp. 278-283 ◽  
Author(s):  
Kentaro Miyake ◽  
Tasuku Kiyuna ◽  
Shukuan Li ◽  
Qinghong Han ◽  
Yuying Tan ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Salmonella Typhimurium ◽  
Cancer Metabolism ◽  
Tumor Volume ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Xenograft Model ◽  
Orthotopic Xenograft ◽  
Orthotopic Xenograft Model ◽  
Tumor Selective

Background: Ewing’s sarcoma (ES) is a recalcitrant disease in need of transformative therapeutics. Objectives: The aim of this study was to investigate the efficacy of tumor-selective Salmonella typhimurium A1-R combined with tumor metabolism targeting with oral administration of recombinant methioninase (o-rMETase), on an ES patient-derived orthotopic xenograft (PDOX) model. Methods: The ES PDOX models were previously established in the right chest wall. The ES PDOX models were randomized into 5 groups when the tumor volume reached 80 mm3: G1: untreated control; G2: doxorubicin; G3: S. typhimurium A1-R; G4: o-rMETase; G5: S. typhimurium A1-R combined with o-rMETase. All mice were sacrificed on day 15. Body weight and tumor volume were assessed twice a week. Results: S. typhimurium A1-R and o-rMETase respectively suppressed tumor growth as monotherapies (p = 0.050 and p = 0.032). S. typhimurium A1-R combined with o-rMETase regressed tumor growth significantly compared to untreated group on day 15 (p < 0.032). S. typhimurium A1-R combined with o-rMETase group was significantly more effective than S. typhimurium A1-R or o-rMETase monotherapy (p = 0.032, p = 0.032). Conclusions: The present results suggest that the combination of S. typhimurium A1-R and o-rMETase has promise to be a transformative therapy for ES.

scholarly journals Treatment Effect of a Vascular-Disrupting Agent Dynamically Monitored by DWI: An Animal Experimental Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Danping Huang ◽  
Ruimeng Yang ◽  
Yong Zou ◽  
Hongmei Lin ◽  
Xiangdong Xu ◽  
...  
Keyword(s):  
Treatment Effect ◽  
Diffusion Weighted Imaging ◽  
Tumor Volume ◽  
Control Group ◽  
Vascular Disrupting Agent ◽  
Time Points ◽  
Vx2 Tumor ◽  
Adc Values ◽  
Vascular Disrupting ◽  
Time Point

Objective. To investigate the treatment effect of a vascular-disrupting agent, M410, using diffusion-weighted imaging in a rabbit model of hepatic VX2 tumor. Methods. 28 New Zealand white rabbit models with VX2 liver tumors were established and were randomly divided into M410 (intravenous injection of M410 at a dose of 25 mg/kg every three days) and control (intravenous injection of saline every three days) groups. Conventional and diffusion-weighted imaging (DWI) were acquired on a 3.0 T MR unit at baseline, 4 h, d 1, d 4, d 7, and d 14 posttreatment. B-value with 700 (s/mm2) was chosen during DWI examinations. Tumor volume and apparent diffusion coefficient (ADC) values of the entire tumor and solid component of the tumor at every time point were measured. Two randomly chosen rabbits from each group were sacrificed for H&E staining and CD34 immunohistochemical assessments at each time point. An independent sample t-test was used to assess differences in tumor sizes and ADC values of the entire tumor and solid component of tumors between two groups, with P < 0.05 considered statistically significant. Result. There was no significant difference in tumor volume between the two groups at baseline, 4 h, and d 1. With time, the tumors in the control group grew significantly faster than those in the M410 group, and the average ADC values of the M410 group were lower than those of the control group at d 1 and higher than those of the control group at d 4; as such, there were statistical differences between the two groups at these two time points but not at the other four time points. The following pathological results reflected the underlying morphological changes and vascular alterations. Conclusions. M410 performed well in inhibiting the growth of the hepatic VX2 tumor which could be noninvasively monitored by DWI metrics.

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.

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