Apparent Diffusion Coefficient Values In Patients Research Articles

Survival prediction using apparent diffusion coefficient values in recurrent glioblastoma under bevacizumab treatment: an updated systematic review and meta-analysis

Bevacizumab is a common strategy for the treatment of recurrent glioblastoma. Survival status is a crucial issue for patients with recurrent glioblastoma, and the apparent diffusion coefficient (ADC) values of the lower Gaussian curve have been reported to have the potential to predict prognosis in recurrent glioblastoma. In the present study, we aimed to clarify the survival prediction of ADC values in patients with recurrent glioblastoma receiving bevacizumab treatment through a systematic review and meta-analysis of randomized clinical trials, comparing ADC values higher than the cut-off values with those lower than the cut-off values to determine which type of ADC values can be associated with significant survival benefits. Different survival indicators were analyzed, including overall survival (OS) and progression-free survival (PFS). Ten studies with a total of 782 patients with recurrent glioblastoma were included. The focused outcomes were OS and PFS. Our results showed that ADC values lower than the cut-off values were associated with significant benefits for OS status compared with ADC values higher than the cut-off values. Similar significant benefits were observed for PFS. The meta-analysis results suggest that ADC values lower than the cut-off values might be associated with significant benefits for OS and PFS when compared with ADC values higher than the cut-off values. However, bias in relation to the different stages of recurrent glioblastoma and different types, doses, and regimens of bevacizumab should not be ignored.

Accelerating acquisition of readout-segmented echo planar imaging (rs-EPI) with a simultaneous multislice (SMS) technique for diffusion-weighted (DW) breast MRI: Evaluation of image quality factors

PurposeThis study aims to compare the image quality, apparent diffusion coefficient (ADC), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) values, and scan time between readout-segmented echo planar imaging (rs-EPI) and simultaneous multislice (SMS) rs-EPI sequences. MethodsA total of 80 consecutive women who underwent breast diffusion-weighted imaging (DWI) were included, and two rs-EPI DWI sequences with and without SMS were acquired and compared. Qualitative analysis involved three radiologists independently scoring image quality and radiologist preference. For quantitative comparison, the radiologists independently measured the ADC values in patients, while SNR, CNR, and ADC values were measured on a phantom. ResultsThe acquisition time was 5:47 min for rs-EPI and 3:20 min for SMS rs-EPI. In terms of image quality, scores were similar between rs-EPI and SMS rs-EPI sequences in the pooled data set, with the exception of skin-line distinction (p = 0.001) and background noise (p < 0.001). All radiologists considered SMS rs-EPI as equal or superior to rs-EPI in more than 70 % of cases. SMS rs-EPI demonstrated significantly higher ADC values than rs-EPI by all radiologists (p ≤ 0.002). For the phantom measurement, ADC (SMS: 1.26 ± 0.68 and RS: 1.26 ± 0.68, p = 0.198), SNR (SMS: 540.6 ± 342.1 and RS: 558.8 ± 523.2, p = 0.927), and CNR (SMS: 235.5 ± 38.9 and RS: 252.8 ± 108.0, p = 0.784) values did not significantly differ between the two sequences. ConclusionSMS rs-EPI exhibited comparable image quality and similar ADC, SNR, and CNR values to rs-EPI while reducing the scan time by 42%.

The value of multimodal magnetic resonance imaging in breast cancer and its correlation with pathological features and prognosis.

This study aimed to explore the diagnostic value of multimodal magnetic resonance imaging (MRI) in breast cancer (BC) and its correlation with pathological features of the disease. Clinical data of 85 BC patients (malignant group) and 85 patients with benign breast diseases (benign group), admitted to 3201 Hospital of Xi'an Jiaotong University Health Science Center from May 2020 to May 2022, were retrospectively collected. Both groups underwent multimodal MRI examinations. We compared the differences in multimodal MRI examination parameters between the groups, as well as between patients with different pathological characteristics and prognoses in the malignant group. The correlation between multimodal MRI examination parameters and pathological features of BC was analyzed. The apparent diffusion coefficient (ADC) of the malignant group was lower than that of the benign group, while the extravascular extracellular volume fraction (Ve), reaction rate constant (Kep), and volume transfer constant (Ktrans) of the malignant group were higher compared to the benign group (p<0.05). In the malignant group, patients with stage III+IV disease, lymph node metastases, and low differentiation had lower ADC values, and higher Ve, Ktrans, and Kep compared to patients with stage I+II disease, no lymph node metastasis, and medium to high differentiation (p<0.05). ADC value negatively correlated with the stage of the disease, lymph node metastases but positively correlated with the degree of differentiation (p<0.05). Ve, Ktrans, and Kep positively correlated with the stage of the disease and lymph node metastasis, and negatively correlated with the degree of differentiation (p<0.05). ADC value of patients with poor prognosis was lower, while Ve, Ktrans, and Kep were higher compared to patients with good prognosis (p<0.05). The Receiver operating characteristic (ROC) analysis showed that ADC, Ve, Ktrans, and Kep have certain predictive values for the poor prognosis of BC patients (p<0.05). Multimodal MRI examination detected obvious differences in the examination parameters of BC patients, and the increase or decrease in these parameters is closely correlated with the pathological characteristics and prognosis of the disease. Multimodal MRI examination can be used for pathological evaluation and prognosis prediction in BC patients.

The usefulness of the apparent diffusion coefficient value in diagnosing acute spinal cord ischemia.

The purpose of our study was to assess the usefulness of the apparent diffusion coefficient (ADC) value in differentiating between a normal spinal cord and a spinal cord with acute ischemia. Control group of 113 and 8 acute spinal cord ischemia patients were enrolled in this study. The ADC values were measured when diffusion-weighted imaging was first performed after the onset of acute spinal cord ischemia. The mean ADC value each of the control group and acute spinal cord ischemia patients was 0.99 ± 0.19 × 10-3 mm2/s and 0.70 ± 0.15 × 10-3 mm2/s. The mean ADC value in patients with acute spinal cord ischemia was significantly lower than that in patients with a normal spinal cord (P < 0.01). We found the cutoff ADC value (0.86 × 10-3 mm2/s) to be a useful indicator of acute spinal cord ischemia (sensitivity = 100.0%, specificity = 71.7%, AUC = 0.92). In conclusions, it is suggested that the ADC value may be useful in the diagnosis of acute spinal cord ischemia.

Correlation of magnetic resonance imaging quantitative parameters and apparent diffusion coefficient value with pathological breast cancer.

BACKGROUNDChina ranks 120th worldwide for the incidence of breast cancer and 163rd for mortality. Early screening, diagnosis, and timely determination of the optimal treatment plan can help ensure clinical efficacy and prognosis.AIMTo investigate the relationship between quantitative magnetic resonance imaging parameters, apparent diffusion coefficient value, pathological immunohistochemical status, and patient prognosis.METHODSA total of 108 patients with breast cancer (breast cancer group) and 110 patients with benign breast tumors (benign group) confirmed by pathological examination at our Hospital from September 2013 to August 2016 were selected. All patients had undergone preoperative magnetic resonance imaging (MRI) examinations, and the quantitative parameters of MRI and apparent diffusion coefficient (ADC) values for the two groups were compared. The MRI quantitative parameters and ADC values of patients with different estrogen receptor (ER), progesterone receptor, and human epidermal growth factor receptor-2 expression were statistically analyzed. The relationship between the quantitative parameters of MRI and ADC values and patient recurrence was analyzed using receiver operating curves.RESULTSThe measured values of the quantitative parameters of MRI- Ktrans, Kep, and Ve in the breast cancer group were higher than those in the benign group; the ADC value in the breast cancer group was lower than that in the benign group, and the difference was statistically significant (P < 0.05). The Ktrans, Ve, and ADC values in patients with ER-positive breast cancer were significantly lower than those in patients with negative ER expression (P < 0.05). After 5 years of follow-up, 22 patients with breast cancer experienced postoperative recurrence. The Kep, Ve, and ADC values of the recurrence group were significantly lower than those of the non-recurrence group, and the difference was statistically significant (P < 0.05). CONCLUSIONMRI quantitative parameters and ADC are related to the expression of breast cancer-related immunological receptor factors and have certain clinical value in assessing postoperative recurrence in patients.

A valuable MRI examination method for prostate cancer screening.

To investigate the value of the 1.5T magnetic resonance imaging (MRI) apparent diffusion coefficient (ADC) and the prostate imaging reporting and data system (PI-RADS) score in prostate cancer (PCa) screening.Forty PCa patients diagnosed by pathology from December 2014 to September 2018 were recruited as the PCa group; 60 patients with benign prostatic hyperplasia (BPH) were recruited as the benign group. Patients from both groups underwent 1.5T MRI scanning. The prostate ADC values, exponential apparent diffusion coefficient (eADC) values, and PI-RADS scores of patients from the 2 groups were compared. The different methods for PCa diagnosis were compared.The ADC values of patients in the PCa group were significantly lower than those in the benign group, whereas the eADC values of patients were significantly higher than those in the benign group, with statistically significant differences (P < .05). The differences in the PI-RADS scores of patients from the 2 groups were statistically significant (P < .05). Receiver Operating Characteristic (ROC) curve results showed that the ADC value combined with the PI-RADS score was superior to the ADC value or the PI-RADS score alone in sensitivity, specificity, and Youden index for PCa diagnosis. By comparing the area under the curve (AUC) of each ROC curve from the different diagnostic methods, the combination of ADC value and PI-RADS score showed the largest area.The ADC value from 1.5T MRI combined with the PI-RADS score could be used as the standard for PCa screening, which would effectively improve screening for PCa and be valuable for clinical applications.

BIOM-37. INITIAL RADIOGRAPHIC ASSESSMENT OF ADC VALUES IN PEDIATRIC PATIENTS TREATED WITH DAY101 FOR RECURRENT OR PROGRESSIVE LOW-GRADE GLIOMAS (LGGs) HARBORING MEK/ERK PATHWAY ALTERATIONS

Abstract BACKGROUND Calculated from a diffusion-weight image (DWI), the apparent diffusion coefficient (ADC) is a quantitative measure that reflects observed net movement of water and correlates to tumor cellularity. We examine the changes in ADC values in patients with LGG treated with dimeric, pan-RAF inhibitor DAY101 (formerly TAK-580/MLN2480). METHODS Focusing on ADC change with treatment, we reviewed historical, baseline, and on-treatment brain MRIs for 9 patients enrolled on our institutional, IRB-approved phase 1 trial of DAY101 in children and young adults with radiographically recurrent or progressive LGG harboring MEK/ERK pathway alterations. De-identified DICOM MRI files were independently reviewed. Time points selected included baseline, first follow-up and best response. The pmod molecular image software package was utilized for data processing of ADC estimates. ADC changes were displayed as a histogram with mean values. Results were based upon a single read paradigm. RESULTS A shift to lower ADC values for solid components of these tumors was observed, reflecting cellularity and organization; while necrosis correlated with a shift toward higher ADC values. DWI results show reduced ADCs in responding patients, with greater percent change in ADC from baseline associated with deeper responses among treated patients. DWI for treated patients with resultant stable disease showed no significant change in ADC values from baseline while a shift toward higher ADC values was evident in treated, progressing tumors. CONCLUSION Preliminary DWI analysis reveals that a reduction in ADC values may correlate with treatment response and a shift toward more normal cellularity in tumors treated with DAY101. This method will be applied to a larger cohort of patients in an ongoing phase 1 trial (NCT03429803) and a planned phase 2 trial.

Long-term apparent diffusion coefficient value changes in patients undergoing radiosurgical treatment of meningiomas

A noninvasive method to predict the progress or treatment response of meningiomas is desirable to improve the tumor management. Studies showed that apparent diffusion coefficient (ADC) pretreatment values can predict treatment response in brain tumors. The aim of this study was to analyze changes of intratumoral ADC values in patients with meningiomas undergoing conservative or radiosurgery. MR images of 51 patients with diagnose of meningiomas were retrospectively reviewed. Twenty-five patients undergoing conservative or radiosurgery treatment, respectively, were included in the study. The follow-up data ranged between 1 and 10 years. Based on ROI analysis, the mean ADC values, ADC10%min, and ADC90%max were evaluated at different time points during follow-up. Baseline ADC values in between both groups were similar. The ADCmean values, ADC10%min, and ADC90%max within the different groups did not show any significant changes during the follow-up times in the untreated (ADCmean over 10 years period: 0.87 ± 0.05 × 10-3 mm2/s) and radiosurgically treated (ADCmean over 4 years period: 1.02 ± 0.12 × 10-3 mm2/s) group. However, statistically significant difference was observed when comparing the ADCmean and ADC90%max values of untreated with radiosurgically treated (p < 0.0001) meningiomas. Also, ADC10%min revealed statistically significant difference between the untreated and the radiosurgery group (p < 0.05). ADC values in conservatively managed meningiomas remain stable during the follow-up. However, meningiomas undergoing radiosurgery reveal significant change of the mean ADC values over time, suggesting that ADC may reflect a change in the biological behavior of the tumor. These observations might suggest the value of ADC changes as an indicator of treatment response.

Detection of water-molecular-motion configuration in patients with lupus nephritis: a primary study using diffusion-weighted imaging

BackgroundLupus nephritis (LN) is one of most common types of secondary glomerulonephritis, which is characterized by longitudinal pathological changes. Microstructural lesions of LN will impact the motion of water molecules, which can be detected by diffusion-weighted imaging (DWI). There are few reported measurements of water diffusion in patients with LN, and the nature of water diffusion across the entire depth of the renal parenchyma remains largely unknown.MethodsTwenty adult patients with LN and 11 healthy volunteers underwent DWI inspection. Renal biopsy samples were characterized based on the revised ISN/RPS 2003 classification. The apparent-diffusion coefficient (ADC) was calculated via fitting into a mono-exponential model. To compare the ADC level across the entire renal parenchyma between the two groups, repeated-measures analysis of variance (RM-ANOVA) was performed. ADC data derived from DWI pictures were transformed into tridimensional maps by MATLAB software.ResultsCompared with data from healthy volunteers, lower average ADC values with major undulatory magnitudes were found in patients with LN, especially in the cortical zone. Tridimensional maps of patients with LN displayed geographic terrain-like canyons and/or valleys that were different from the corresponding terrain-like flatlands and/or plateaus in healthy volunteers. A heterogeneity of ADC values was found in bilateral kidneys. Left kidneys predominated higher ADC values in patients with LN. The ADC values across the entire renal parenchyma exhibited statistically significant differences among the three identified pathological subclasses (P < 0.001).ConclusionsAnalysis of the motion of water molecules across the entire renal parenchyma may be helpful for better understanding the pathological conditions of LN, for which microstructural and functional heterogeneity may be detected and visualized via DWI.

Correlation Between Apparent Diffusion Coefficient Values of the Renal Parenchyma and Estimated Glomerular Filtration Rates on 3-T Diffusion-Weighted Echo-Planar Magnetic Resonance Imaging.

To evaluate the relationship between the apparent diffusion coefficient (ADC) values of renal parenchyma and estimated glomerular filtration rates (eGFR). Data on 216 patients examined by 3-T magnetic resonance imaging for various reasons were retrospectively collected. There was a significant linear correlation between the ADC values and eGFRs (r = 0.254, P < 0.001). The ADC values in patients with an eGFR of less than 60 mL/min per 1.73 m were significantly lower than those with an eGFR of 60 mL/min per 1.73 m or greater. The mean ADC value of patients with grouped stage 2 disease was significantly higher than those with grouped stage 3 of chronic kidney disease (P < 0.01). The ADC value of renal parenchyma may be a promising marker for the determination of patients with normal to mild reduction in renal function (eGFR ≥60 mL/min per 1.73 m) versus those with a moderate to severe reduction in renal function (eGFR <60 mL/min per 1.73 m).

Changes in diffusion tensor imaging indices of the lumbosacral enlargement correlate with cervical spinal cord changes and clinical assessment in patients with cervical spondylotic myelopathy

ObjectivesWe examined whether changes in diffusion tensor imaging (DTI) indices of the lumbosacral enlargement are similar to those at the cervical level, and correlate with clinical assessments in patients with cervical spondylotic myelopathy (CSM). Patients and methodsPatients with CSM and healthy volunteers (40–42/group) received DTI scans at both lumbosacral enlargement and cervical spinal cord. Modified Japanese Orthopedic Association (mJOA) score was also recorded for those with CSM. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values of DTI in the two groups were compared. We also examined the correlation between DTI indices (ADC and FA) of the lumbosacral enlargement and those of the cervical spinal cord, and between DTI indices and mJOA in the CSM group. ResultsCompared with the values of healthy subjects, the ADC values of patients with CSM were significantly increased, and FA values were significantly decreased at both cervical spinal cord and lumbosacral enlargement. Changes in FA value of the cervical cord showed a positive correlation to those of the lumbosacral enlargement in the CSM group. Importantly, a linear correlation was detected between mJOA score and DTI indices (ADC and FA) of the cervical cord, as well as FA value of the lumbosacral enlargement in the CSM group. ConclusionDTI indices, especially FA, of the lumbosacral enlargement correlate with clinical assessments of patients with CSM, and hence may be useful for evaluating the severity of cervical cord injury.

Correlation Between Semen Analysis Parameters and Diffusion-Weighted Magnetic Resonance Imaging of the Testicles in Patients With Varicocele: A Pilot Study.

The aims of this study were to evaluate using testicle apparent diffusion coefficient (ADC) values in patients with varicocele and compare them with those of healthy individuals, to identify an optimal ADC threshold level to predict abnormal semen analysis using diffusion-weighted imaging. Thirty-one patients with the diagnosis of varicocele and 20 healthy controls were enrolled in the study. All subjects underwent testicle diffusion-weighted imaging at b values of 0, 400, and 800 s/mm and semen analysis. Student t tests were used to compare continuous variables between 2 groups. Testicle ADC values were correlated with semen analysis parameters. The relationship between ADC values and impaired semen analysis parameters was evaluated using Pearson correlation coefficient analysis. Receiver operating characteristic curves were formed. Cut-off values for ADC, sensitivity, and specificity values were measured. There was a negative correlation between mean ADC values and plexus pampiniformis vein diameter (r = -0.467, P < 0.001) and a positive correlation between mean ADC values and sperm count (r = 0.838, P < 0.001) as well as sperm morphology (r = 0.548, P < 0.05). Sensitivity values of 94.3% and 86.6% and specificity values of 87.5% and 43.8% were determined for the best cut-off ADC values in diagnosing the sperm count and morphology, respectively (area under the curve, 0.961 and 0.781). Decreased testicular ADC values in patients with varicocele are significantly correlated with semen parameters. This method may be used to determine the degree of testicular parenchymal destruction. In addition, testicular ADC cut-off values might be useful in dyspermia patients for the management of patients with varicocele.

Apparent diffusion coefficient (ADC) does not correlate with different serological parameters in myositis and myopathy.

Background Magnetic resonance imaging (MRI) is widely used in several muscle disorders. Diffusion-weighted imaging (DWI) is an imaging modality, which can reflect microstructural tissue composition. The apparent diffusion coefficient (ADC) is used to quantify the random motion of water molecules in tissue. Purpose To investigate ADC values in patients with myositis and non-inflammatory myopathy and to analyze possible associations between ADC and laboratory parameters in these patients. Material and Methods Overall, 17 patients with several myositis entities, eight patients with non-inflammatory myopathies, and nine patients without muscle disorder as a control group were included in the study (mean age = 55.3 ± 14.3 years). The diagnosis was confirmed by histopathology in every case. DWI was obtained in a 1.5-T scanner using two b-values: 0 and 1000 s/mm2. In all patients, the blood sample was acquired within three days to the MRI. The following serological parameters were estimated: C-reactive protein, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, creatine kinase, and myoglobine. Results The estimated mean ADC value for the myositis group was 1.89 ± 0.37 × 10-3 mm2/s and for the non-inflammatory myopathy group was 1.79 ± 0.33 × 10-3 mm2/s, respectively. The mean ADC values (1.15 ± 0.37 × 10-3 mm2/s) were significantly higher to unaffected muscles (vs. myositis P = 0.0002 and vs. myopathy P = 0.0021). There were no significant correlations between serological parameters and ADC values. Conclusion Affected muscles showed statistically significantly higher ADC values than normal muscles. No linear correlations between ADC and serological parameters were identified.

Predictive value of pre-treatment apparent diffusion coefficient (ADC) in radio-chemiotherapy treated head and neck squamous cell carcinoma.

This study aimed at evaluating the role of "baseline" apparent diffusion coefficent (ADC), in patients affected by head and neck cancer treated with radio-chemotherapy, as a potential marker of response to therapy. Fifty-seven patients underwent pretreatment ADC maps. Minimum, maximum, and medium ADC were computed. Age, dose, treatment time, and ADC values were compared between the two groups (Group 1: local control; Group 2: relapse/persistence of disease) using the Student t test two-tailed unpaired. Two-tailed Fischer exact test was used to compare T stage, N stage, grading and type of treatment between two groups. We have analyzed the receiver operating characteristic (ROC) of statistically significant variables. In patients with local control, values of pre-treatment medium and minimum ADC were lower than ADC values of patients with persistent or recurrent disease, with values, respectively, of 0.83±0.02×10-3mm2/s and 0.59±0.02×10-3mm2/s (vs 0.94±0.05×10-3mm2/s and 0.70±0.05×10-3mm2/s). ROC curve analysis displayed statistical significance as regarding the medium ADC value, showing a sensitivity of 50% and a specificity of 84.8%. ROC analysis of the values minimum ADC showed a sensitivity of 42.9% and specificity of 87.9%. The value of the ADC pre-treatment of patients with local control of the disease is lower than that of patients with persistent disease or recurrence.

Can Diffusion-Weighted Imaging and Related Apparent Diffusion Coefficient be a Prognostic Value in Women With Breast Cancer?

ABSTRACTPurpose: To analyze diffusion-weighted imaging (DWI) and the related apparent diffusion coefficient (ADC) in women with breast cancer, correlating these values with the presence at 3 years of distant metastases, and to demonstrate that DWI-Magnetic Resonance Imaging (MRI) and related ADC values may represent a prognostic value in the study of women with breast cancer. Materials and methods: Sixty women (aged 45–73 years) affected with breast cancer with a follow-up in 3 years were enrolled. On DWI, we obtained the ADC values, and these were correlated with the clinical condition of patients at 3 years. Moreover, tumour size, lymph node status, and molecular markers, including estrogens receptor, progesterone receptor, Ki-67 index, and human growth factor receptor 2 protein, were correlated with ADC values. This study was approved by the Scientific Committee of our institution. Results: We considered patients with metastasis at 3 years (12 patients – 20%) and without metastasis (48 patients – 80%). The mean ADC value in patients with no metastases at 3 years was 1.06 ± 0.38, while for patients with metastases it was 0.74 ± 0.34 (p = .011). The receiver–operator curve analysis identified a value of 0.75 (<0.75 with risk to develop metastasis) as the best predictive cutoff for ADC values, with the highest sensitivity (81.25%) and higher specificity (66.67%). After regression analysis, ADC value, positivity to estrogen–progestin receptors, and presence of lymph nodes were the only prognostic factors found to be statistically significant. Conclusions: DWI-MRI and related ADC values may represent a prognostic value in women with breast cancer.

Evaluation of Apparent Diffusion Coefficients in the Cerebellar Tonsils and Bulbus in Chiari Type I Malformations: Comparison Before and After Surgery.

To evaluate the preoperative and postoperative 6th month mean apparent diffusion coefficient (ADC) values of the cerebellar tonsils and bulbus in patients with Chiari Malformation Type I (CMI), and to compare the results with healthy controls. We included 15 patients with CMI who underwent suboccipital decompression, upper cervical laminectomy, and duraplasty surgery, and compared them with 10 healthy individuals. Three regions of interest were placed, one each in the cerebellar tonsils and one in the bulbus. The mean ADC values were measured separately in each region. Among the patients, mean ADC values were significantly decreased after surgery compared with before surgery. The mean ADC values before surgery were significantly higher for patients than for controls; however, although mean ADC values were slightly higher after surgery for patients than for controls, the differences were not significant. Thus, after surgical intervention, ADC values in patients with CMI became close to those of normal individuals. The increased ADC values in patients with CMI before surgery implied that not only morphologic changes but also increased diffusivity may play a key role in the pathophysiology and clinical presentation of the disease. We conclude that decompression surgery can produce favorable diffusional alterations.

Role of Functional Magnetic Resonance Imaging Derived Parameters as Imaging Biomarkers and Correlation with Clinicopathological Features in Carcinoma of Uterine Cervix.

Magnetic Resonance Imaging (MRI) is emerging as a powerful tool in the evaluation and management of cervical cancer. The role of Diffusion Weighted Imaging (DWI) with Apparent Diffusion Coefficient (ADC) as a non-invasive imaging biomarker is promising in characterization of the tumour and prediction of response. The aim of this study was to evaluate the role of conventional MRI and diffusion weighted MRI in predicting clinicopathological prognostic factors. This was a retrospective study. The data of 100 cervical cancer patients who had MRI with DWI was retrieved from the database and analysed. Clinico pathological details were collected from the computerized hospital information system. SPSS version 15.0 was used for statistical analysis. The mean tumour dimensions on MRI in x, y and z axes were 43.04 mm (±13.93, range: 17-85), 37.05mm (±11.83, range: 9-80) and 39.63 mm (±14.81, range: 14 -76). The mean T2W MRI based tumour volume (TV) was 48.18 (±34.3, range: 7-206) and on DWI images was 36.68(±33.72, range: 2.5-200). The mean ADC value in patients with squamous cell carcinoma was 0.694 (±0.125, n=88), adenocarcinoma was 0.989 (±0.309, n=6), adenosquamous was 0.894 (±0.324, n=4). There was statistical significant difference in mean ADC between squamous vs. non squamous histology (p = 0.02). The mean ADC values of well differentiated, moderately differentiated, and poorly differentiated tumours were 0.841(±0.227, n= 26), 0.729 (±0.125, n=28), 0.648 (±0.099, n=46) respectively. There was significant statistical difference of mean ADC between well differentiated, moderately differentiated (p=0.020) and poorly differentiated tumours (p=0.0001). Difference between the mean ADC values between the node positive and node negative disease was statistically significant (p=0.0001). There was no correlation between the tumour volumes on T2W and DWI images and ADC values. Sixteen patients had residual/recurrent disease at a median follow up of 12 months (range: 3-59 months). The mean ADC values in this group was 0.71 (n=16) and was not significantly different from the disease free group (mean ADC =0.72, n=74). Higher ADC values are associated with favourable histology and differentiation. Adenocarcinomas have higher ADC values followed by adenosquamous followed by squamous cell carcinomas. Well differentiated tumours had higher ADC values than moderately followed by poorly differentiated tumours. DWI with ADC have a potential role as an imaging biomarker for prognostication and needs further studies for routine clinical applications.

Comparison of diffusion-weighed MRI findings of the testis in patients with the advanced stage unilateral testicular varicocele

The aim of this study was to compare the testicular apparent diffusion coefficient (ADC) values of the patients with unilateral advanced stage varicocele and healthy volunteers. Twenty-seven patients with unilateral advanced stage varicocele and twenty-seven healthy volunteers were included in the study. Those with a diagnosis of clinical varicocele and the healthy volunteers were examined clinical and color Doppler ultrasonography. Patients with a unilateral (left) varicocele clinically grade III, color Doppler ultrasound grade IV-V were included in the study. All the patients and healthy volunteers were obtained ADC values. Mean values were calculated and statistical comparison was performed. ADC values were analysed by using an independent t test for each participant. Pearson's correlation test was used for the comparison of left pampiniform venous diameter and both testicular parenchymal ADC values. Left testicular ADC values were observed to be significantly lower when a comparison of the testicular parenchymal with left advanced stage varicocele and healthy volunteers revealed significantly low left testicular ADC values in patients (p

Brain diffusion changes in Eisenmenger syndrome.

This preliminary study aimed to evaluate whether there are changes in the apparent diffusion coefficient (ADC) values of the brain in patients presenting with Eisenmenger syndrome (ES). This cross-sectional study included 10 consecutively recruited patients with ES and 10 healthy control subjects. In the patients and controls, eight distinct neuroanatomical locations were selected for analysis. Quantitative measurements of ADC values of the frontal white matter (FWM), occipital white matter, lentiform nucleus (LN), thalamus, frontal cortex, anterior and posterior limbs of the internal capsule and caudate nucleus were measured. Statistical analysis was performed using SPSS® (IBM Corp., New York, NY; formerly SPSS Inc., Chicago, IL) for Windows v. 20. Data were presented as mean ± standard deviation values. The Kruskal-Wallis test was used to assess differences in the ADC values of each brain location between the ES group and the control group. Statistical significance was accepted at the level of p < 0.05. The ADC values of the FWM and LN were significantly higher in the ES group than that in the control group. The mean ADC levels of other brain regions were not significantly different between the groups. Chronic hypoxia in patients with ES may lead to diffusion changes in the brain tissue. There is a need for further studies to assess the clinical significance of cerebral ADC values in patients with ES. Advances in knowledge: The ratio of extracellular volume to intracellular volume in the FWM and LN can be considered to be increased in patients with ES.

One‐month apparent diffusion coefficient correlates with response to radiofrequency ablation of hepatocellular carcinoma

To assess whether apparent diffusion coefficient (ADC) values at 1 and 3 months after radiofrequency ablation (RFA) may be associated with a favorable response to therapy for hepatocellular carcinoma (HCC) and liver metastases. Fifty-nine patients with HCC (n = 35) or liver metastases (n = 24) who underwent 1.5T diffusion-weighted magnetic resonance imaging (DWMRI) at 1 and 3 months post-RFA were included. ADC values of patients with local tumor recurrence were compared to those without local recurrence. A subgroup analysis was performed for HCC and metastases. Thirty-eight HCC and 27 metastases were evaluated. The ADC value of HCC at 1 month after RFA was lower in recurrent tumors (0.957 ± 0.229 [SD] × 10-3 mm2 ) compared to tumors with complete response (1.414 ± 0.322 [SD] × 10-3 mm2 /s, P = 0.006). At multivariate analysis, ADC at 1 month was the single independent variable associated with recurrence for HCC (area under the receiver operating characteristic curve = 0.860). No significant association was observed for liver metastases (P = 0.089). A low ADC value at 1 month after RFA is associated with an early local recurrence of HCC. This study does not confirm that such association exists for hepatic metastases. 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1648-1658.