Difference in Diffusion-Weighted Magnetic Resonance Imaging and Diffusion Tensor Imaging Parameters Between Endometrioid Endometrial Adenocarcinoma and Uterine Serous Adenocarcinoma
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Objective
This study aimed to elucidate the difference in diffusion-weighted magnetic resonance imaging (DWI) and diffusion tensor imaging (DTI) parameters between endometrioid endometrial adenocarcinoma (EEA) and uterine serous adenocarcinoma (SA).Methods
Data of patients with pathologically confirmed EEA or SA who underwent DWI and DTI scanning between May 2013 and July 2016 were retrospectively analyzed. Apparent diffusion coefficient (ADC) value from DWI and ADC from DTI (ADCT) map and fractional anisotropy (FA) values from DTI were analyzed and compared statistically. The correlation between ADC and ADCT was analyzed by Pearson correlation analysis. Apparent diffusion coefficient, ADCT, and FA between the 2 groups were compared using independent t test. The effect of ADC, ADCT, and FA in distinguishing EEA and SA was evaluated by receiver operator characteristic curve.Result
Thirty-three patients were enrolled into the study, including 13 cases of SA and 20 cases of EEA. Pearson correlation analysis suggested that the value of ADC was highly related with ADCT in both the SA group (r = 0.812, P = 0.001) and the EEA group (r = 0.858, P < 0.001). The value of ADC and ADCT in the SA group was significantly lower than that in the EEA group; FA was significantly higher than that in the EEA group. Receiver operator characteristic curve analysis showed that ADC and ADCT have high sensitivity and specificity; FA has low sensitivity and high specificity.Conclusions
We suggest that both DWI and DTI could be used in distinguishing EEA from SA. Apparent diffusion coefficient and ADCT possess potential diagnostic value with high sensitivity and specificity.The choice of surgical treatment for meningiomas is affected by the subtype and clinical characteristics. Therefore, an accurate preoperative diagnosis is essential. Current magnetic resonance imaging (MRI) technology is unable to distinguish between meningioma subtypes. In the present study, we compared and evaluated the utility of conventional MRI, magnetic resonance fingerprinting (MRF), and diffusion-weighted imaging (DWI) in differentiating World Health Organization grade I transitional and fibrous meningiomas from meningothelial meningiomas.Forty-six patients with pathologically confirmed meningiomas (15 meningothelial, 18 transitional, and 13 fibrous) were enrolled in the present study. All patients underwent conventional MRI, MRF, and DWI scans before surgery using a 3T scanner. The Jonckheere-Terpstra test was used to analyze differences in the signal and enhancement characteristics of the three groups from T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI). To investigate the difference in quantitative T1 and T2 values derived from MRF and apparent diffusion coefficient (ADC) values between the three groups using the Kruskal-Wallis test, regions of interest (ROIs) were manually drawn on the parenchymal portion of the tumors; P<0.017 was considered statistically significant after Bonferroni correction for multiple comparison. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performances of the different parameters.Meningothelial meningiomas had significantly higher T1 and T2 values than transitional and fibrous meningiomas (all P<0.017). ROC analysis results revealed that the combination of T1 and T2 values had the largest area under the curve (AUC). The AUC for the combination of T1 and T2 values was 0.826 between meningothelial and transitional meningiomas, and the AUC for the combination of T1 and T2 values between meningothelial and fibrous meningiomas was 0.903. No significant differences were found in the T1 and T2 values between transitional and fibrous meningiomas. There were also no statistically significant differences in the conventional MRI (including T1WI, T2WI, and contrast-enhanced T1WI) and ADC values between the three meningioma subtypes (all P>0.05).MRF may provide more quantitative information than either conventional MRI or DWI for differentiating transitional and fibrous meningiomas from meningothelial meningiomas. T1 and T2 values derived from MRF may distinguish transitional and fibrous meningiomas from meningothelial meningiomas, and the combination of T1 and T2 values provides the highest diagnostic efficacy.
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Intrahepatic Cholangiocarcinoma
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Neuroimaging findings in 1,2-dichloroethane (1,2-DCE) encephalopathy have seldom been reported. We present the comprehensive neuroimaging findings, conventional magnetic resonance imaging (MRI) combined with diffusion tensor imaging (DTI) and 1 H-magnetic resonance spectroscopy ( 1 H-MRS), in a case of 1,2-DCE encephalopathy. On day-4 the signal intensity of the lesions on diffusion-weighted imaging (DWI) was higher than that with T2-weighted imaging (T2WI); mean apparent diffusion coefficient (ADC) values for lesions were lower than control values. On day-20, the mean ADC value was increased gradually, whereas the mean fractional anisotropy (FA) of the lesions was significantly reduced. 1 H-MRS showed reduced ratios of N-acetyl aspartate to creatinine (NAA/Cr) and NAA to choline (NAA/Cho) on day-20 as compared with the control values. Combining conventional MRI with DTI and MRS is valuable in the early diagnosis and prognosis of 1,2-DCE-induced encephalopathy.
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Objective
This study aimed to elucidate the difference in diffusion-weighted magnetic resonance imaging (DWI) and diffusion tensor imaging (DTI) parameters between endometrioid endometrial adenocarcinoma (EEA) and uterine serous adenocarcinoma (SA).Methods
Data of patients with pathologically confirmed EEA or SA who underwent DWI and DTI scanning between May 2013 and July 2016 were retrospectively analyzed. Apparent diffusion coefficient (ADC) value from DWI and ADC from DTI (ADCT) map and fractional anisotropy (FA) values from DTI were analyzed and compared statistically. The correlation between ADC and ADCT was analyzed by Pearson correlation analysis. Apparent diffusion coefficient, ADCT, and FA between the 2 groups were compared using independent t test. The effect of ADC, ADCT, and FA in distinguishing EEA and SA was evaluated by receiver operator characteristic curve.Result
Thirty-three patients were enrolled into the study, including 13 cases of SA and 20 cases of EEA. Pearson correlation analysis suggested that the value of ADC was highly related with ADCT in both the SA group (r = 0.812, P = 0.001) and the EEA group (r = 0.858, P < 0.001). The value of ADC and ADCT in the SA group was significantly lower than that in the EEA group; FA was significantly higher than that in the EEA group. Receiver operator characteristic curve analysis showed that ADC and ADCT have high sensitivity and specificity; FA has low sensitivity and high specificity.Conclusions
We suggest that both DWI and DTI could be used in distinguishing EEA from SA. Apparent diffusion coefficient and ADCT possess potential diagnostic value with high sensitivity and specificity.Cite
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Creatine
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Infiltration (HVAC)
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BACKGROUND AND PURPOSE: Treatment with chemotherapy and radiation therapy for brain tumors can cause white matter (WM) injury. Conventional MR imaging, however, cannot always depict treatment-induced transient WM abnormalities. We investigated the ability of diffusion-tensor (DT) MR imaging and proton MR spectroscopy to detect the treatment-induced transient changes within normal-appearing WM. METHODS: DT MR imaging and proton MR spectroscopy were performed in 8 patients treated with a combination of surgery, chemotherapy, and radiation therapy for brain tumors (17 examinations) and 11 age-matched controls. Apparent diffusion coefficient (ADC) value, fractional anisotropy (FA) value, and N-acetylaspartate (NAA)/creatine (Cr) ratio were obtained from 27 hemispheres with normal-appearing WM in the patients. We divided the datasets of isotropic ADC, FA, and NAA/Cr, on the basis of the time period after completion of radiation therapy, into 4 groups: group 1 (0–2 months; n = 10), group 2 (3–5 months; n = 5), group 3 (6–9 months; n = 7), and group 4 (10–12 months; n = 5). We compared averages of mean isotropic ADC, mean FA, and NAA/Cr of each patient group with those of the control group by using a t test. RESULTS: In the group 2, averages of mean FA and NAA/Cr decreased and average of mean isotopic ADC increased in comparison with those of the control group (P = .004, .04, and .0085, respectively). There were no significant differences in the averages between the control group and patient groups 1, 3, and 4. CONCLUSION: DT MR imaging and proton MR spectroscopy can provide quantitative indices that may reflect treatment-induced transient derangement of normal-appearing WM.
Neuroradiology
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Prospective longitudinal study.To verify the feasibility of performing in vivo quantitative magnetic resonance imaging evaluation of moderate traumatic spinal cord injury (SCI) in rats using a clinical 3T scanner.Animal models of human diseases are essential for translational medicine. Potential treatments of SCI are evaluated in 2 ways: anatomical and functional. Advanced magnetic resonance sequences allow a noninvasive assessment of the spinal cord depicting both. This study describes and validates a very reproducible, feasible, affordable, and reliable method, designed to be applied in commercial 3T equipment, using a novel stereotactic device for spinal cord, leading to a readily available assessment of the progression of damage generated after traumatic SCI in rats.Four Long-Evans female rats were injured with a New York University weight-drop device to produce the SCI by contusion at thoracic level 10. All animals were placed in a fixation system, using a commercial wrist antenna to obtain magnetic resonance imaging data of the relaxometry time, apparent diffusion coefficient, and fractional anisotropy. Three sets of data obtained before SCI and 1 and 4 weeks after injury were compared.The data showed a progressive decline in fractional anisotropy measurements after SCI comparing baseline versus the 1-week period (P < 0.001) and baseline versus the 4-week period (P < 0.019), with a significant progressive increase in apparent diffusion coefficient values and T2 after SCI only in the baseline versus the 4-week period (P < 0.045 and P < 0.024, respectively).Our results helped us to validate a novel method to acquire highly reproducible and reliable quantitative biomarkers of traumatic SCI in vivo by using a 3T clinical MR scanner coupled with a novel stereotactic device for rats.N/A.
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The purpose of this study was to examine whether the combined use of MR diffusion tensor imaging (DTI) parameters [DTI-apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD)] could provide a more accurate diagnosis in differentiating between low-grade and atypical/anaplastic (high-grade) meningioma.Pathologically proven 45 meningioma patients [32 low-grade, 13 high-grade (11 atypical and 2 anaplastic)] who had received DTI before surgery were assessed retrospectively by 2 independent observers. For each lesion, MR DTI parameters (ADCmin, ADCmax, ADCmean, FA, AD, and RD) and ratios (rADCmin, rADCmax, rADCmean, rFA, rAD, and rRD) were calculated. When differentiating between low- and high-grade meningioma, the optimum cutoff values of all MR DTI parameters were determined by using receiver operating characteristic (ROC) analysis. Area under the curve (AUC) was measured with combined ROC analysis for different combinations of MR DTI parameters in order to identify the model combination with the best diagnostic accuracy in differentiation between low and high-grade meningioma.Although the ADCmin, ADCmax, ADCmean, AD, RD, rADCmin, rADCmax, rADCmean, rAD, and rRD values of high-grade meningioma were significantly low (p = 0.007, p = 0.045, p = 0.035, p = 0.045, p = 0.003, p = 0.02, p = 0.03, p = 0.03, p = 0.045, and p = 0.01, respectively), when compared with low-grade meningioma, their FA and rFA values were significantly high (p = 0.007 and p = 0.01, respectively). For all MR DTI parameters, the highest individual distinctive power was RD with AUC of 0.778. The best diagnostic accuracy in differentiating between low- and high-grade meningioma was obtained by combining the ADCmin, RD, and FA parameters with 0.962 AUC.This study shows that combined MR DTI parameters consisting of ADCmin, RD, and FA can differentiate high-grade from low-grade meningioma with a diagnostic accuracy of 96.2%. Advances in knowledge: To the best of our knowledge, this is the first study reporting that a combined use of all MR DTI parameters provides higher diagnostic accuracy for the differentiation of low- from high-grade meningioma. Our study shows that any of the model combinations was superior to use of any individual MR DTI parameters for differentiation between low and high-grade meningioma. A combination of ADCmin, RD, and FA was found to be the best model for differentiating low-grade from high-grade meningioma and sensitivity, specificity, and AUC values were found to be 92.3%, 100%, and 0.96, respectively. Thus, a combination of MR DTI parameters can provide more accurate diagnostic information when differentiation between low and high-grade meningioma.
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