scholarly journals Diffusion Is Directional: Innovative Diffusion Tensor Imaging to Improve Prostate Cancer Detection

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 563
Author(s):  
Chen Shenhar ◽  
Hadassa Degani ◽  
Yaara Ber ◽  
Jack Baniel ◽  
Shlomit Tamir ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diffusion Tensor Imaging ◽  
Predictive Value ◽  
Breast Imaging ◽  
Normal Tissue ◽  
Diffusion Tensor ◽  
Peripheral Zone ◽  
Predictive Values ◽  
Directional Diffusion ◽  
Central Gland

In the prostate, water diffusion is faster when moving parallel to duct and gland walls than when moving perpendicular to them, but these data are not currently utilized in multiparametric magnetic resonance imaging (mpMRI) for prostate cancer (PCa) detection. Diffusion tensor imaging (DTI) can quantify the directional diffusion of water in tissue and is applied in brain and breast imaging. Our aim was to determine whether DTI may improve PCa detection. We scanned patients undergoing mpMRI for suspected PCa with a DTI sequence. We calculated diffusion metrics from DTI and diffusion weighted imaging (DWI) for suspected lesions and normal-appearing prostate tissue, using specialized software for DTI analysis, and compared predictive values for PCa in targeted biopsies, performed when clinically indicated. DTI scans were performed on 78 patients, 42 underwent biopsy and 16 were diagnosed with PCa. The median age was 62 (IQR 54.4–68.4), and PSA 4.8 (IQR 1.3–10.7) ng/mL. DTI metrics distinguished PCa lesions from normal tissue. The prime diffusion coefficient (λ1) was lower in both peripheral-zone (p < 0.0001) and central-gland (p < 0.0001) cancers, compared to normal tissue. DTI had higher negative and positive predictive values than mpMRI to predict PCa (positive predictive value (PPV) 77.8% (58.6–97.0%), negative predictive value (NPV) 91.7% (80.6–100%) vs. PPV 46.7% (28.8–64.5%), NPV 83.3% (62.3–100%)). We conclude from this pilot study that DTI combined with T2-weighted imaging may have the potential to improve PCa detection without requiring contrast injection.

scholarly journals Evaluation of Peripheral Zone Prostate Cancer Aggressiveness Using the Ratio of Diffusion Tensor Imaging Measures

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Aslihan Onay ◽  
Gokhan Ertas ◽  
Metin Vural ◽  
Omer Acar ◽  
Yesim Saglican ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diffusion Tensor Imaging ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Peripheral Zone ◽  
Strong Correlations ◽  
Noncancerous Tissue ◽  
Statistical Measures ◽  
Cancer Aggressiveness ◽  
Better Than

Purpose. To evaluate the aggressiveness of peripheral zone prostate cancer by correlating the Gleason score (GS) with the ratio of the diffusion tensor imaging (DTI) measures. Materials and Methods. Forty-two peripheral zone prostate tumors were imaged using DTI. Regions of interest focusing on the center of tumor foci and noncancerous tissue were used to extract statistical measures of mean diffusivity (MD) and fractional anisotroy (FA). Measure ratio was calculated by dividing tumor measure by noncancerous tissue measure. Results. Strong correlations are observable between GS and MD measures while weak correlations are present between GS and FA measures. Minimum tumor MD (MDmin) and the ratio of minimum MD (rMDmin) show the same highest correlation with GS (both ρ=-0.73). Between GS ≤ 7 (3 + 4) and GS ≥ 7 (4 + 3), differences are significant for all MD measures but for some FA measures. MD measures perform better than FA measures in discriminating GS ≥ 7 (4 + 3). Conclusion. Ratios of MD measures can be used in evaluation of peripheral zone prostate cancer aggressiveness; however tumor MD measures alone perform similarly.

Correlation of gleason scores with magnetic resonance diffusion tensor imaging in peripheral zone prostate cancer

2014 ◽  
Vol 42 (2) ◽  
pp. 460-467 ◽  
Author(s):  
Liang Li ◽  
Daniel J.A. Margolis ◽  
Ming Deng ◽  
Jie Cai ◽  
Ling Yuan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diffusion Tensor Imaging ◽  
Magnetic Resonance ◽  
Diffusion Tensor ◽  
Peripheral Zone

Diffusion tensor imaging in children following prenatal myelomeningocele repair and its predictive value for the need and timing of subsequent CSF diversion surgery for hydrocephalus

2021 ◽  
Vol 27 (4) ◽  
pp. 391-399
Author(s):  
Weihong Yuan ◽  
Charles B. Stevenson ◽  
Mekibib Altaye ◽  
Blaise V. Jones ◽  
James Leach ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Diffusion Tensor Imaging ◽  
Logistic Regression Analysis ◽  
Predictive Value ◽  
Diffusion Tensor ◽  
Linear Regression Analysis ◽  
Model Performance ◽  
Time Interval ◽  
Csf Diversion

OBJECTIVE The aim of this study was to investigate diffusion tensor imaging (DTI), an objective and noninvasive neuroimaging technique, for its potential as an imaging biomarker to predict the need and timing of CSF diversion surgery in patients after prenatal myelomeningocele (MMC) repair. METHODS This was a retrospective analysis of data based on 35 pediatric patients after prenatal MMC repair (gestational age at birth 32.68 ± 3.42 weeks, range 24–38 weeks; 15 females and 20 males). A logistic regression analysis was used to classify patients to determine the need for CSF diversion surgery. The model performance was compared between using the frontooccipital horn ratio (FOHR) alone and using the FOHR combined with DTI values (the genu of the corpus callosum [gCC] and the posterior limb of the internal capsule [PLIC]). For patients who needed to be treated surgically, timing of the procedure was used as the clinical outcome to test the predictive value of DTI acquired prior to surgery based on a linear regression analysis. RESULTS Significantly lower fractional anisotropy (FA) values in the gCC (p = 0.014) and PLIC (p = 0.037) and higher mean diffusivity (MD) values in the gCC (p = 0.013) were found in patients who required CSF diversion surgery compared with those who did not require surgery (all p values adjusted for age). Based on the logistic regression analysis, the FOHR alone showed an accuracy of performance of 0.69 and area under the receiver operating characteristic curve (AUC) of 0.60. The performance of the model was higher when DTI measures were used in the logistic regression model (accuracy = 0.77, AUC = 0.84 for using DTI values in gCC; accuracy = 0.75, AUC = 0.84 for using DTI values in PLIC). Combining the DTI values of the gCC or PLIC and FOHR did not improve the model performance when compared with using the DTI values alone. In patients who needed CSF diversion surgery, significant correlation was found between DTI values in the gCC and the time interval between imaging and surgery (FA: ρ = 0.625, p = 0.022; MD: ρ = −0.6830, p = 0.010; both adjusted for age and FOHR). CONCLUSIONS The authors’ data demonstrated that DTI could potentially serve as an objective biomarker differentiating patients after prenatal MMC repair regarding those who may require surgery for MMC-associated hydrocephalus. The predictive value for the need and timing of CSF diversion surgery is highly clinically relevant for improving and optimizing decision-making for the treatment of hydrocephalus in this patient population.

Does the increased motion probing gradient directional diffusion tensor imaging of lumbar nerves using multi-band SENSE improve the visualization and accuracy of FA values?

2020 ◽  
Vol 29 (7) ◽  
pp. 1693-1701
Author(s):  
Masaki Norimoto ◽  
Yawara Eguchi ◽  
Atsuya Watanabe ◽  
Takayuki Sakai ◽  
Daichi Murayama ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Diffusion Tensor ◽  
Directional Diffusion ◽  
Multi Band

Diffusion-Tensor MRI at 3 T: Differentiation of Central Gland Prostate Cancer From Benign Prostatic Hyperplasia

2014 ◽  
Vol 202 (3) ◽  
pp. W254-W262 ◽  
Author(s):  
Sung Yoon Park ◽  
Chan Kyo Kim ◽  
Byung Kwan Park ◽  
Sang Yun Ha ◽  
Ghee Young Kwon ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Benign Prostatic Hyperplasia ◽  
Diffusion Tensor ◽  
Prostatic Hyperplasia ◽  
Diffusion Tensor Mri ◽  
Central Gland

Predictive value of flexion and extension diffusion tensor imaging in the early stage of cervical myelopathy

2018 ◽  
Vol 60 (11) ◽  
pp. 1181-1191 ◽  
Author(s):  
Tomasz Tykocki ◽  
Philip English ◽  
David Minks ◽  
Arunkumar Krishnakumar ◽  
Guy Wynne-Jones
Keyword(s):  
Diffusion Tensor Imaging ◽  
Predictive Value ◽  
Cervical Myelopathy ◽  
Diffusion Tensor ◽  
Early Stage ◽  
Flexion And Extension

Early radiation response between GnRH agonist versus antagonist combined with radiotherapy in high-risk prostate cancer.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 97-97 ◽  
Author(s):  
Gilles Crehange ◽  
Alexandre Cochet ◽  
Adele Cueff ◽  
Etienne Martin ◽  
Philippe Maingon ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Gnrh Agonist ◽  
Peripheral Zone ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer ◽  
Central Gland ◽  
The Mean ◽  
Early Radiation ◽  
Pathway Inhibition

97 Background: Degarelix, a GnRH antagonist, provides a very rapid and sustained testosterone suppression alongside with the VEGF pathway inhibition through the FSH receptors. This raises the question as to whether high risk localized prostate cancer (HRPCa) could respond differently to radiotherapy (RT) + Degarelix when compared with RT + GnRH agonist. Methods: 30 HRPCa patients were treated with exclusive RT combined with a GnRH agonist (n= 19) or Degarelix (n= 11). MRSI was performed before the start of hormones and 3 months after the end of RT. Choline (tumor metabolism) and citrate (healthy prostate metabolism) were quantified with MR spectroscopy and the slopes of gadolinium wash-in (SWI) and wash-out (SWO) were assessed in the peripheral zone (PZ), the central gland (CG) and the tumor with DCE-MRI. Results: At baseline, 14 patients had a T3 (46.7%) and 9 patients (30%) had a GS≥8. The median PSA values were 12.7 ng/mL [3.0-153.7] for agonists and 14.0 ng/mL [6.8-23.6] for Degarelix (p=ns). The mean prostate volumes (Pvol) were 32.0±15.5 mL for agonist and 33.0±10.0 mL for Degarelix (p=ns). The median dose of RT was 78Gy in each group, [72.0-80.0] with agonist and [70.2-80.0] with Degarelix. There were no significant differences in choline, citrate, SWI and SWO in the PZ, the CG and the tumor. At 3 months, Pvol were 20.8±8.0 mL for agonist and 21.4±6.2 mL for Degarelix (p=0.71) and the mean and median PSA values for agonist vs Degarelix were 0.5±0.8 ng/mL vs 0.1±0.1 ng/mL and 0.1 ng/mL [0.02-2.8] vs 0.1 ng/mL [0.005-0.3], respectively. Citrate was significantly decreased with Degarelix in the PZ (4.3±4.4 vs 1.1±0.8, p=0.0142), in the CG (4.0±4.0 vs 1.1±1.0, p=0.009) but not in the tumor (2.5±2.6 vs 1.7±1.9, p=0.23). Choline concentrations were similar between both groups in the PZ, the CG and the tumor. There was a trend towards a lower contrast uptake in the tumor with Degarelix (mean SWI and SWO: 134.6±56.2 s-1 vs 104.1±36.3 s-1, p=0.13 and 259.6±103.1 s-1 vs 306.1±70.4 s-1, p=0.15). Conclusions: Degarelix combined with RT offers a significant early, more profound metabolic atrophy in the prostate, but not in the tumor. There is a trend towards a lower tumor vascularization with Degarelix compared with GnRH agonists.

scholarly journals Does Diffusion Tensor Imaging-Based Tractography at 3 Months of Age Contribute to the Prediction of Motor Outcome After Perinatal Arterial Ischemic Stroke?

Stroke ◽  
2011 ◽  
Vol 42 (12) ◽  
pp. 3410-3414 ◽  
Author(s):  
Niek E. van der Aa ◽  
Alexander Leemans ◽  
Frances J. Northington ◽  
Henrica L. van Straaten ◽  
Ingrid C. van Haastert ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Diffusion Tensor Imaging ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Neonatal Period ◽  
Motor Behavior ◽  
Diffusion Tensor ◽  
Motor Deficits ◽  
Arterial Ischemic Stroke ◽  
Perinatal Arterial Ischemic Stroke

Background and Purpose— After perinatal arterial ischemic stroke, diffusion-weighted imaging (DWI) and early evaluation of spontaneous motor behavior can be used to predict the development of unilateral motor deficits. The aim of this study was to investigate whether diffusion tensor imaging-based tractography at 3 months of age contributes to this prediction. Methods— Twenty-two infants with unilateral perinatal arterial ischemic stroke were included and scanned during the neonatal period. DWI was used to assess restricted diffusion in the cerebral peduncle. At the age of 3 months, diffusion tensor imaging-based tractography of the corticospinal tracts was performed along with assessment of the movement repertoire. The role of DWI, diffusion tensor imaging, and motor assessment in predicting unilateral motor deficits were compared by calculating the positive and negative predictive values for each assessment. Results— Eleven infants (50%) showed abnormal motor behavior at 3 months with subsequent development of unilateral motor deficits in 8 as determined at follow-up (9–48 months, positive predictive value 73%). Diffusion tensor imaging-based tractography correctly predicted the development of unilateral motor deficits in all 8 infants (positive predictive value 100%). A diagnostic neonatal DWI was available in 20 of 22 (91%) infants. Seven infants showed an abnormal DWI, resulting in unilateral motor deficits in 6 infants (positive predictive value 86%). All assessments had a negative predictive value of 100%. Conclusions— Diffusion tensor imaging-based tractography at 3 months can be used to predict neurodevelopmental outcome after perinatal arterial ischemic stroke. It has a similar predictive value as DWI in the neonatal period and can especially be of additional value in case of an indecisive neonatal DWI or unexpected abnormal early motor development.

scholarly journals Diagnostic accuracy of the Novel 29 MHz micro-ultrasound “ExactVuTM” for the detection of clinically significant prostate cancer: A prospective single institutional study. A step forward in the diagnosis of prostate cancer

2021 ◽  
Vol 93 (2) ◽  
pp. 132-138
Author(s):  
Francesco Chessa ◽  
Riccardo Schiavina ◽  
Amelio Ercolino ◽  
Caterina Gaudiano ◽  
Davide Giusti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Predictive Value ◽  
Transrectal Ultrasound ◽  
Peripheral Zone ◽  
Risk Identification ◽  
The Novel ◽  
Fusion Biopsy ◽  
Ultrasound System ◽  
Clinically Significant ◽  
Sensitivity Specificity

Introduction and Objective: ExactVuTM is a real-time micro-ultrasound system which provides, according to the Prostate Risk Identification Using Micro-Ultrasound protocol (PRI-MUS), a 300% higher resolution compared to conventional transrectal ultrasound. To evaluate the performance of ExactVuTM in the detection of Clinically significant Prostate Cancer (CsPCa). Materials and methods: Patients with Prostate Cancer diagnosed at fusion biopsy were imaged with ExactVuTM. CsPCa was defined as any Gleason Score ≥ 3+4. ExactVuTM examination was considered as positive when PRI-MUS score was ≥ 3. PRI-MUS scoring system was considered as correct when the fusion biopsy was positive for CsPCa. A transrectal fusion biopsy- proven CsPCa was considered as a gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operator characteristic (ROC) curve (AUC) were calculated. Results: 57 patients out of 68 (84%) had a csPCa. PRI-MUS score was correctly assessed in 68% of cases. Regarding the detection of CsPCa, ExactVuTM ’s sensitivity, specificity, PPV, and NPV was 68%, 73%, 93%, and 31%, respectively and the AUC was 0.7 (95% CI 0.5-0-8). For detecting CsPCa in the transition/ anterior zone the sensitivity, specificity, PPV, and NPV was 45%, 66%, 83% and 25% respectively ant the AUC was 0.5 (95% CI 0.2-0.9). Accounting only the CsPCa located in the peripheral zone, sensitivity, specificity, PPV, and NPV raised up to 74%, 75%, 94%, 33%, respectively with AUC 0.75 (95% CI 0.5-0-9). Conclusions: ExactVuTM provides high resolution of the prostatic peripheral zone and could represent a step forward in the detection of CsPCa as a triage tool. Further studies are needed to confirm these promising results.

Sign in / Sign up

Export Citation Format

Share Document