Quantitative Dynamic Contrast-enhanced Magnetic Resonance Imaging Parameters Research Articles

Differential diagnosis of thyroid nodules by DCE-MRI based on compressed sensing volumetric interpolated breath-hold examination: A feasibility study

ObjectivesTo explore the potential and performance of quantitative and semi-quantitative parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) based on compressed sensing volumetric interpolated breath-hold (CS-VIBE) examination in the differential diagnosis of thyroid nodules. Materials and methodsA total of 208 patients with 259 thyroid nodules scheduled for surgery operation were prospectively recruited. All participants underwent routine and DCE-MRI. DCE-MRI quantitative parameters [Ktrans, Kep, Ve], semi-quantitative parameters [wash-in, wash-out, time to peak (TTP), arrival time (AT), peak enhancement intensity (PEI), and initial area under curve in 60 s (iAUC)] and time-intensity curve (TIC) types were analyzed. Differential diagnostic performances were assessed using area under the receiver operating characteristic curve (AUC) and compared with the Delong test. ResultsKtrans, Kep, Ve, wash-in, wash-out, PEI and iAUC were statistically significantly different between malignant and benign nodules (P < 0.001). Among these parameters, ROC analysis revealed that Ktrans showed the highest diagnostic performance in the differentiation of benign and malignant nodules, followed by wash-in. ROC analysis also revealed that Ktrans achieved the best diagnostic performance for distinguishing papillary thyroid carcinoma (PTC) from non-PTC, follicular adenoma (FA) from non-FA, nodular goiter (NG) from non-NG, with AUC values of 0.854, 0.895 and 0.609, respectively. Type III curve is frequently observed in benign thyroid nodules, accounting for 77.4% (82/106). While malignant nodules are more common in type II, accounting for 57.5% (88/153). ConclusionThyroid examination using CS-VIBE based DCE-MRI is a feasible, non-invasive method to identify benign and malignant thyroid nodules and pathological types.

Dynamic contrast-enhanced magnetic resonance imaging in cervical cancer: correlation between quantitative parameters and molecular markers hypoxia-inducible factors-1-alpha, vascular endothelial growth factor, and Ki-67

To investigate whether dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has the potential to non-invasively detect microenvironmental condition by quantitatively measuring blood perfusion, vessel wall permeability, and vascularity, and to elucidate the possible correlations between DCE-MRI quantitative parameters and the expression level of hypoxia, vascularity, and cell proliferation related molecular biomarkers. In this prospective single center clinical study, 58 patients diagnosed with cervical cancer underwent DCE-MRI before anticancer treatment were enrolled. Ktrans, Kep, Ve, and Vp were generated from Extended Toft's model. Then patients conducted colposcopy biopsy within 1 week after DCE-MRI. Pretreatment expression levels of HIF-1α, VEGF and Ki-67 were assessed and scored by immunohistochemistry on colposcopy obtained tumor specimens. In HIF-1α low-expression group, Ktrans (p=0.031) and Kep (p=0.012) values were significantly higher than the high-expression group. In VEGF high-expression group, Ktrans (p=0.044) and Ve values (p=0.021) were significantly higher than the low-expression group. In Ki-67 high-expression group, Ktrans (p=0.026) and Kep (p=0.033) were significantly higher than the low-expression group. Multiple linear regression analyses and Pearson correlation revealed that Ktrans independently negatively correlated with HIF-1α expression, Ve independently positively correlated with VEGF, and Kep independently positively correlated with Ki-67. The area under the ROC curves of Ktrans for HIF-1α, Ve for VEGF, and Kep for Ki-67 were 0.728, 0.743, 0.730, respectively. Our results suggest that DCE-MRI quantitative parameters could be potentially used as imaging markers for non-invasively detecting microenvironmental hypoxia, vascularity and proliferation in cervical cancer patients.

Microvessel barrier dysfunction in sinonasal inverted papilloma-associated squamous cell carcinoma and its manifestation in dynamic contrast-enhanced MRI.

To date, an effective means to preoperatively predict the malignant transformation of sinonasal inverted papilloma (SIP) remains lacking due to similarities in clinical appearance. This study aimed to retrospectively evaluate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters and microvessel structure in tumors with histologically confirmed SIP and inverted papilloma-associated squamous cell carcinoma (IP-SCC), as well as correlate DCE-MRI findings with angiogenesis biomarkers. Absolute quantitative DCE-MRI parameters (Ktrans , Kep , Ve ) based on the Tofts model and model-free semi-quantitative indices (Tpeak , WR, MaxSlope) of SIP (n=22) and IP-SCC (n=20) were investigated. Regions of interest (ROIs) were oriented according to the tumor subsites in the surgical records. Micro-vessel density (MVD) counts and tight junction protein (claudin-5) expression were evaluated in tumor specimens obtained during surgery. Differences in the above data were compared between the two groups. Correlations between DCE-MRI parameters and angiogenic biomarkers were analyzed. Compared with SIP specimens, IP-SCC specimens were characterized by a significantly higher MVD and a leakier microvessel barrier. The values of Tpeak and Ve were significantly higher for SIP than those for IP-SCC, whereas WR, MaxSlope, and Kep were significantly lower, indicating early enhancement and a faster dispersion model in IP-SCC. MVD was positively correlated with WR and Kep and negatively correlated with Tpeak . Tpeak was slightly positively correlated to claudin-5 expression. DCE-MRI can serve as a noninvasive biomarker of angiogenesis in the malignant transformation from SIP to IP-SCC. DCE-MRI may assist in the differentiation of malignancies and treatment selection.

Intravoxel Incoherent Motion and Dynamic Contrast-Enhanced Magnetic Resonance Imaging Can Differentiate Between Atypical Cartilaginous Tumors and High-Grade Chondrosarcoma: Correlation With Histological Vessel Characteristics.

To differentiate between atypical cartilaginous tumors and high-grade chondrosarcoma of the major long bones using intravoxel incoherent motion (IVIM) and Dynamic Contrast-Enhanced magnetic resonance imaging (DCE-MRI), and explore the correlation of quantitative parameters with hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) and microvessel density (MVD). Between September 2016 and March 2022, 35 patients (17 atypical cartilaginous tumors, 18 high-grade chondrosarcoma) underwent MRI examination and pathological confirmation at our hospital. First, IVIM-derived parameters ( D , D* , and f ), and DCE-MRI parameters ( Ktrans , Kep , and V e ) were measured, and intraclass correlation efficient (ICC) and Mann-Whitney U test were performed. Second, receiver-operating characteristic curve analysis was performed to evaluate the diagnostic performance. Finally, Spearman's correlation analysis was performed between the quantitative parameters of IVIM-DWI and DCE-MRI and the immunohistochemical factors HIF-1α, VEGF, and MVD in chondrosarcoma tissue. D in atypical cartilaginous tumors was significantly higher than that in high-grade chondrosarcoma ( P = 0.003), whereas D* , Ktrans , and K ep in atypical cartilaginous tumors were significantly lower than those in high-grade chondrosarcoma (all P < 0.001). Ktrans demonstrated the highest area under the curve (AUC) of 0.979. The D* , Ktrans , and K ep were positively correlated with HIF-1α, VEGF, and MVD (all P < 0.001), whereas D had no correlation with HIF-1α, VEGF, and MVD ( P = 0.113, 0.077, 0.058, respectively). The IVIM-DWI quantitative parameters ( D , D* ) and DCE-MRI quantitative parameters ( Ktrans , Kep ) are helpful to differentiate between atypical cartilaginous tumors and high-grade chondrosarcoma and could be imaging biomarkers to reflect the expressions of HIF-1α, VEGF, and angiogenesis of chondrosarcoma.

Dynamic Contrast-Enhanced MRI Assessing Antifibrotic Therapeutic Effects of Pancreatic Fibrosis with Curcumin – An Experimental Study at 11.7 T

Pancreatic fibrosis is the hallmark of chronic pancreatitis (CP), which is associated with microcirculatory disturbance. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can assess the perfusion and permeability of the pancreas by providing information about microcirculation. We hypothesize that DCE-MRI parameters can be utilized to assess pancreatic fibrosis and may furthermore provide an opportunity to evaluate response to antifibrotic treatment with curcumin. Our study was to evaluate the feasibility of quantitative DCE-MRI in assessing pancreatic fibrosis and the antifibrotic effect of curcumin in a rat model of CP. Pancreatic fibrosis was induced by injecting dibutyltin dichloride (DBTC). Seventy rats were randomized to five groups: the control group (n=10); DBTC for 2 weeks (n=15); DBTC for 4 weeks (n=15); DBTC+curcumin for 2 weeks (n=15); DBTC+curcumin for 4 weeks (n=15). DCE-MRI was performed at an 11.7T MR scanner. DCE-MRI quantitative parameters (Ktrans, Ve, and Vp) were derived from an extended Tofts model. Fibrosis content and DCE-MRI parameters were compared among the above groups (one-way analysis of variance). The correlations between DCE-MRI parameters and pancreatic fibrosis content as well as the expression of α-SMA were computed by Spearman correlation coefficients. Fifty-three rats survived and underwent MR imaging. Ktrans in rats 4 weeks after DBTC injection was significantly lower than DBTC 2 weeks rats and control rats (0.30±0.06min vs 0.49±0.09 vs 0.62±0.09, respectively). Vp in DBTC 4 weeks rats was also significantly lower than control rats (0.048±0.010min-1 vs 0.065±0.011min-1, respectively). Ktrans and Vp significantly correlated with fibrosis content of pancreas (r=-0.619 and -0.450, all P<0.001), and the expression of α-SMA (r=-0.688 and -0.402, all P<0.01). Ktrans and Vp in rats with daily curcumin treatment for 4 weeks were significantly higher than DBTC 4 weeks rats (Ktrans, 0.51±0.09 vs 0.30±0.06; Vp, 0.064±0.015 vs 0.048±0.010). DCE-MRI parameters (Ktrans and Vp) have the potential to noninvasively assess pancreatic fibrosis and the antifibrotic treatment response of curcumin.

Histogram analysis of dynamic contrast-enhanced magnetic resonance imaging to predict extramural venous invasion in rectal cancer

BackgroundTo explore the potential of histogram analysis (HA) of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the identification of extramural venous invasion (EMVI) in rectal cancer patients.MethodsThis retrospective study included preoperative images of 194 rectal cancer patients at our hospital between May 2019 and April 2022. The postoperative histopathological examination served as the reference standard. The mean values of DCE-MRI quantitative perfusion parameters (Ktrans, Kep and Ve) and other HA features calculated from these parameters were compared between the pathological EMVI-positive and EMVI-negative groups. Multivariate logistic regression analysis was performed to establish the prediction model for pathological EMVI-positive status. Diagnostic performance was assessed and compared using the receiver operating characteristic (ROC) curve. The clinical usefulness of the best prediction model was further measured with patients with indeterminate MRI-defined EMVI (mrEMVI) score 2(possibly negative) and score 3 (probably positive).ResultsThe mean values of Ktrans and Ve in the EMVI-positive group were significantly higher than those in the EMVI-negative group (P = 0.013 and 0.025, respectively). Significant differences in Ktrans skewness, Ktrans entropy, Ktrans kurtosis, and Ve maximum were observed between the two groups (P = 0.001,0.002, 0.000, and 0.033, respectively). The Ktrans kurtosis and Ktrans entropy were identified as independent predictors for pathological EMVI. The combined prediction model had the highest area under the curve (AUC) at 0.926 for predicting pathological EMVI status and further reached the AUC of 0.867 in subpopulations with indeterminate mrEMVI scores.ConclusionsHistogram Analysis of DCE-MRI Ktrans maps may be useful in preoperative identification of EMVI in rectal cancer, particularly in patients with indeterminate mrEMVI scores.

Multiple parameters from ultrafast dynamic contrast-enhanced magnetic resonance imaging to discriminate between benign and malignant breast lesions: Comparison with apparent diffusion coefficient

PurposeThe purpose of this study was first to assess the diagnostic performance of ultrafast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters compared to apparent diffusion coefficient (ADC) for distinguishing benign from malignant breast lesions and second to investigate the complementarity of ultrafast DCE-MRI with DWI in that task. Materials and methodsA total of 142 women (mean age, 48.42 ± 11.03 [SD]) years; range: 14–78 years) with 150 breast lesions who underwent breast ultrafast DCE-MRI were prospectively recruited. Ultrafast DCE-MRI semi-quantitative parameters (maximum slope [MS], time to peak [TTP], time to enhancement [TTE], and initial area under curve in 60 s [iAUC]), ultrafast DCE-MRI quantitative parameters (Kep, Ktrans, and Ve), and the ADC were estimated and compared between benign and malignant breast lesions. Classification performances were assessed using area under the receiver operating characteristic curve (AUC) and compared using Delong test. ResultsThe ultrafast DCE-MRI semi-quantitative multiparameters (AUC, 0.913; 95% CI: 0.856–0.953) showed better classification performance than the quantitative multiparameters (AUC, 0.818; 95% CI: 0.747–0.876) (P = 0.022). No differences in AUC were found between ultrafast DCE-MRI semi-quantitative multiparameters and ADC (AUC, 0.912; 95% CI: 0.855–0.952) (P = 0.990). The combination of ultrafast DCE-MRI semi-quantitative multiparameters and ADC (AUC, 0.960; 95% CI: 0.915–0.985) showed better classification performance than the ultrafast DCE-MRI semi-quantitative multiparameters (P = 0.014) and quantitative multiparameters (P < 0.001). ConclusionUltrafast DCE-MRI can be used as an accurate method for discriminating benign from malignant breast lesions. The combination of ultrafast DCE-MRI and DWI significantly increases the diagnostic value of ultrafast DCE-MRI.

Dynamic contrast-enhanced MRI parameters and apparent diffusion coefficient as treatment response markers of skull base osteomyelitis: a preliminary study.

Currently, there is no definitive consensus on the optimal imaging modality for determining the treatment response in patients with skull base osteomyelitis (SBO). This study aimed to investigate the utility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters and apparent diffusion coefficient (ADC) as treatment response markers of SBO. This study included 6 patients with SBO, who underwent both pre- and post-treatment DCE-MRI and diffusion-weighted imaging (DWI). Quantitative DCE-MRI parameters and ADC of the region-of-interest were analysed. These normalized parameters were calculated by dividing the region-of-interest by the reference region. The Wilcoxon signed rank test was used to compare these parameters between pre- and post-treatment periods. The normalized fraction of the extravascular extracellular space (Ve) and ADC of the post-treatment status of SBO was significantly lower than those of pre-treatment measures (p = 0.03). The normalized fraction of blood plasma (Vp), normalized rate of transfer from the blood plasma into the extravascular extracellular space (Ktrans), and normalized backflow leakage of material from the extravascular extracellular space into the blood plasma (Kep) demonstrated no significant differences between pre- and post-treatment. DCE-MRI parameters Ve and ADC demonstrated a significant reduction when comparing measures across the pre- and post-treatment periods. These parameters may potentially serve as a valuable surrogate treatment response marker for SBO activity.

Quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging to predict lymphovascular invasion and survival outcome in breast cancer

BackgroundLymphovascular invasion (LVI) predicts a poor outcome of breast cancer (BC), but LVI can only be postoperatively diagnosed by histopathology. We aimed to determine whether quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can preoperatively predict LVI and clinical outcome of BC patients.MethodsA total of 189 consecutive BC patients who underwent multiparametric MRI scans were retrospectively evaluated. Quantitative (Ktrans, Ve, Kep) and semiquantitative DCE-MRI parameters (W− in, W− out, TTP), and clinicopathological features were compared between LVI-positive and LVI-negative groups. All variables were calculated by using univariate logistic regression analysis to determine the predictors for LVI. Multivariate logistic regression was used to build a combined-predicted model for LVI-positive status. Receiver operating characteristic (ROC) curves evaluated the diagnostic efficiency of the model and Kaplan-Meier curves showed the relationships with the clinical outcomes. Multivariate analyses with a Cox proportional hazard model were used to analyze the hazard ratio (HR) for recurrence-free survival (RFS) and overall survival (OS).ResultsLVI-positive patients had a higher Kep value than LVI-negative patients (0.92 ± 0.30 vs. 0.81 ± 0.23, P = 0.012). N2 stage [odds ratio (OR) = 3.75, P = 0.018], N3 stage (OR = 4.28, P = 0.044), and Kep value (OR = 5.52, P = 0.016) were associated with LVI positivity. The combined-predicted LVI model that incorporated the N stage and Kep yielded an accuracy of 0.735 and a specificity of 0.801. The median RFS was significantly different between the LVI-positive and LVI-negative groups (31.5 vs. 34.0 months, P = 0.010) and between the combined-predicted LVI-positive and LVI-negative groups (31.8 vs. 32.0 months, P = 0.007). The median OS was not significantly different between the LVI-positive and LVI-negative groups (41.5 vs. 44.0 months, P = 0.270) and between the combined-predicted LVI-positive and LVI-negative groups (42.8 vs. 43.5 months, P = 0.970). LVI status (HR = 2.40), N2 (HR = 3.35), and the combined-predicted LVI model (HR = 1.61) were independently associated with disease recurrence.ConclusionThe quantitative parameter of Kep could predict LVI. LVI status, N stage, and the combined-predicted LVI model were predictors of a poor RFS but not OS.

Preoperative prediction of extramural venous invasion in rectal cancer by dynamic contrast-enhanced and diffusion weighted MRI: a preliminary study

BackgroundTo explore the value of the quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) parameters in assessing preoperative extramural venous invasion (EMVI) in rectal cancer.MethodsEighty-two rectal adenocarcinoma patients who had underwent MRI preoperatively were enrolled in this study. The differences in quantitative DCE-MRI and DWI parameters including Krans, Kep and ADC values were analyzed between MR-detected EMVI (mrEMVI)-positive and -negative groups. Multivariate logistic regression analysis was performed to build the combined prediction model for pathologic EMVI (pEMVI) with statistically significant quantitative parameters. The performance of the model for predicting pEMVI was evaluated using receiver operating characteristic (ROC) curve.ResultsOf the 82 patients, 24 were mrEMVI-positive and 58 were -negative. In the mrEMVI positive group, the Ktrans and Kep values were significantly higher than those in the mrEMVI negative group (P < 0.01), but the ADC values were significantly lower (P < 0.01). A negative correlation was observed between the Ktrans vs ADC values and Kep vs ADC values in patients with rectal cancer. Among the four quantitative parameters, Ktrans and ADC value were independently associated with mrEMVI by multivariate logistic regression analysis. ROC analysis showed that combined prediction model based on quantitative DCE parameters and ADC values had a good prediction efficiency for pEMVI in rectal cancer.ConclusionThe quantitative DCE-MRI parameters, Krans, Kep and ADC values play important role in predicting EMVI of rectal cancer, with Ktrans and ADC value being independent predictors of EMVI in rectal cancer.

The Assessment of Prostate Cancer Aggressiveness Using a Combination of Quantitative Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced Magnetic Resonance Imaging.

ObjectiveTo explore the value of combining dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters with apparent diffusion coefficient (ADC) values in the diagnosis of prostate cancer.MethodsThe clinical data of 146 patients with prostate lesions, including 87 patients with prostate cancer (PCa) and 59 with benign prostatic hyperplasia (BPH), were collected. After DCE-MRI and diffusion-weighted imaging (DWI) prostate scans, the magnitude of the DCE-MRI transfer constant (Ktrans), rate constant (kep), the volume of the extravascular extracellular space (ve), and the ADC between the groups were compared, and the correlations between the DCE-MRI parameters and Gleason scores were analyzed. The diagnostic efficacy of these quantitative parameters was assessed by the area under the receiver operating characteristic (ROC) curve.ResultsThe DCE-MRI parameters Ktrans and kep were significantly greater in the PCa group than in the BPH group (p < 0.05). The ROC curve showed the area under the Ktrans, kep, and ADC curves to be 0.665, 0.658, and 0.782, respectively. When all three quantitative indicators were combined, the area under the ROC curve was 0.904, with sensitivity and specificity rates of 83.6% and 93.7%, respectively. The Gleason scores were positively correlated with the Ktrans, kep, and ve (r = 0.39, 0.572, 0.30, respectively; p < 0.05) and negatively correlated with the ADC (r = –0.525; p < 0.05).ConclusionThe DCE-MRI quantitative parameters Ktrans and kep, as well as the ADC value, provided effective references for the differential diagnosis of PCa and BPH, as well as more precise and reliable quantitative parameters for grading the aggressiveness of PCa.

Value of quantitative dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging in predicting extramural venous invasion in locally advanced gastric cancer and prognostic significance.

Extramural venous invasion (EMVI) has been found to be related to poor prognosis in gastric cancer. Preoperative diagnosis of EMVI is challenging, as it can only be detected by surgical pathology. The present study aimed to investigate the value of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) in predicting EMVI preoperatively, and to determine the relationship between prediction results and prognosis in patients with locally advanced gastric cancer (LAGC). Between January, 2015, and June, 2017, 79 LAGC patients underwent MRI preoperatively were enrolled in this study. Pathological EMVI (pEMVI) was used as the gold standard for diagnosis. The differences in quantitative DCE-MRI and DWI parameters between groups with different pEMVI status were analyzed. Multivariate logistic regression was used to build the combined prediction model for pEMVI with statistically significant quantitative parameters. The performance of the model for predicting pEMVI was evaluated using receiver operating characteristic (ROC) analysis. Patients were grouped based on MRI-predicted EMVI (mrEMVI). Kaplan-Meier analysis was used to investigate the relationship between mrEMVI and 2-year recurrence-free survival (RFS). Of the 79 LAGC patients who underwent MRI, 29 were pEMVI positive and 50 were pEMVI negative. Among the patients' clinical and pathological characteristics, only postoperative staging showed a significant difference between the 2 groups (P=0.015). The pEMVI-positive group had higher volume transfer constant (Ktrans) and rate constant (kep), and lower apparent diffusion coefficient (ADC) values than the negative group (0.189 vs. 0.082 min-1, 0.687 vs. 0.475 min-1, and 1.230×10-3 vs. 1.463×10-3 mm2/s, respectively; P<0.05). Quantitative parameters, Ktrans and kep, and ADC values, were independently associated with pEMVI which odds ratio values were 3.66, 2.65, and 0.30 (P<0.05), respectively, using multivariate logistic regression. ROC analysis showed that the area under the curve, sensitivity, specificity, positive predictive value, and negative predictive value in predicting pEMVI using combined Ktrans, kep, and ADC values were 0.879, 72.4%, 96%, 91.3%, and 85.7%, respectively. A total of 23 cases were considered to be mrEMVI positive, and 56 cases were considered to be mrEMVI negative, according to the predictive results. The median RFS of the mrEMVI-positive group was significant lower than the negative group (21.7 vs. 31.2 months), and the 2-year RFS rate in the mrEMVI-positive group was significantly lower than that of the negative group (43.6% vs. 72.5%, P=0.010). The quantitative DCE-MRI parameters, Ktrans and kep, and DWI parameter, ADC, are independent predictors of pEMVI in LAGC; mrEMVI was confirmed to be a poor prognostic predictor for RFS.

DCE-MRI Quantitative Parameters as Predictors of Treatment Response in Patients With Locally Advanced Cervical Squamous Cell Carcinoma Underwent CCRT.

PurposeTo evaluate the predictive value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters in treatment response to concurrent chemoradiotherapy (CCRT) for locally advanced cervical squamous cell carcinoma (LACSC).Methods and materialsLACSC patients underwent CCRT had DCE-MRI before (e0) and after 3 days of treatment (e3). Extended Tofts Linear model with a user arterial input function was adopted to generate quantitative measurements. Endothelial transfer constant (Ktrans), reflux rate (Kep), fractional extravascular extracellular space volume (Ve), and fractional plasma volume (Vp) were calculated, and percentage changes ΔKtrans, ΔKep, ΔVe, and ΔVp were computed. The correlations of these measurements with the tumor regression rate were analyzed. The predictive value of these parameters on treatment outcome was generated by the receiver operating characteristic (ROC) curve. Univariate and multivariate logistic regression analyses were conducted to find the independent variables.ResultsKtrans-e0, Kep -e0, ΔKtrans, and ΔVe were positively correlated with the tumor regression rate. Mean values of Ktrans-e0, Ktrans-e3, ΔKtrans, and ΔVe were higher in the non-residual tumor group than residual tumor group and were independent prognostic factors for predicting residual tumor occurrence. Ktrans-e3 showed the highest area under the curve (AUC) for treatment response prediction.ConclusionsQuantitative parameters at e0 and e3 from DCE-MRI could be used as potential indicators for predicting treatment response of LACSC.

Quantitative dynamic contrast-enhanced MR imaging can be used to predict the pathologic stages of oral tongue squamous cell carcinoma

BackgroundTo investigate whether quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) pharmacokinetic parameters can be used to predict the pathologic stages of oral tongue squamous cell carcinoma (OTSCC).MethodsFor this prospective study, DCE-MRI was performed in participants with OTSCC from May 2016 to June 2017. The pharmacokinetic parameters, including Ktrans, Kep, Ve, and Vp, were derived from DCE-MRI by utilizing a two-compartment extended Tofts model and a three-dimensional volume of interest. The postoperative pathologic stage was determined in each patient based on the 8th AJCC cancer staging manual. The quantitative DCE-MRI parameters were compared between stage I–II and stage III–IV lesions. Logistic regression analysis was used to determine independent predictors of tumor stages, followed by receiver operating characteristic (ROC) analysis to evaluate the predictive performance.ResultsThe mean Ktrans, Kep and Vp values were significantly lower in stage III–IV lesions compared with stage I–II lesions (p = 0.013, 0.005 and 0.011, respectively). Kep was an independent predictor for the advanced stages as determined by univariate and multivariate logistic analysis. ROC analysis showed that Kep had the highest predictive capability, with a sensitivity of 64.3%, a specificity of 82.6%, a positive predictive value of 81.8%, a negative predictive value of 65.5%, and an accuracy of 72.5%.ConclusionThe quantitative DCE-MRI parameter Kep can be used as a biomarker for predicting pathologic stages of OTSCC.

Brain Glioma Localization Diagnosis Based on Magnetic Resonance Imaging

We used dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) technology and its perfusion parameters to diagnose central glioma high-grade glioma (HGG), primary central nervous system glioma low-grade glioma (LGG), brain metastases, and meningioma and make differential diagnoses. Forty-one cases of brain tumors (8 cases of LGG, 17 cases of HGG, 5 cases of "primary central nervous system lymphoma" [PCNSL], 6 cases of brain metastases, and 5 cases of meningiomas) were subjected to routine and DCE-MRI scans. The DCE-MRI quantitative parameters of the tumor parenchymal area and peripheral enema area of each tumor were measured and recorded as t-Ktrans value, t-Ve value, t-Vp value, t-Kep value and p-Ktrans value, p-Ve value, p-Vp value, and p-Kep value. Compared with other tumor types, LGG showed lower t-Ktrans value (P < 0.01, sensitivity= 89%, specificity= 99%) and low t-Ve value (P < 0.01, sensitivity= 94%, specificity= 100%); PCNSL showed a high t-Ve value (P < 0.01, sensitivity= 100%, specificity= 88%), but other perfusion parameters overlap more obviously with other tumors. Compared with LGG, the difference between t-Ktrans value, t-Ve value, and t-Kep value is statistically significant. Among them, t-Ktrans value distinguishes the highest sensitivity and specificity (when t-Ktrans value= when 0.154 is the cutoff value, the area under the curve is 1.000, P= 0.000, specificity= 100%, sensitivity= 94.1%); compared with PCNSL, the difference of t-Ve value between HGG and PCNSL is statistically significant, t-Ve of PCNSL. The value is slightly higher, and its specificity and sensitivity are not high. DCE-MRI can distinguish HGG and LGG more accurately, of which t-Ktrans value has higher specificity and sensitivity, although the difference of t-Ve value between PCNSL and HGG is statistically significant but the sensitivity and specificity are not high; the p-Ktrans value and p-Kep value of metastatic tumors are lower than HGG and have higher specificity, but meningiomas and HGG and PCNSL, meningiomas and metastases are not accurate identification.

Preoperative Prediction of Extramural Venous Invasion in Rectal Cancer: Comparison of the Diagnostic Efficacy of Radiomics Models and Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging.

Background: To compare the diagnostic performance of radiomics models with that of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) perfusion parameters for the preoperative prediction of extramural venous invasion (EMVI) in rectal cancer patients and to develop a preoperative nomogram for predicting the EMVI status.Methods: In total, 106 rectal cancer patients were enrolled in our study. All patients under went preoperative rectal high-resolution MRI and DCE-MRI. We built five models based on the perfusion parameters of DCE-MRI (quantitative model), the radiomics of T2-weighted (T2W) CUBE imaging (R1 model), DCE-MRI (R2 model), clinical features (clinical model), and clinical-radiomics features. The predictive efficacy of the radiomics signature was assessed and internally verified. The area under the receiver operating curve (AUC) was used to compare the diagnostic performance of different radiomics models and DCE-MRI quantitative parameters. The radiomics score and clinical-pathologic risk factors were incorporated into an easy-to-use nomogram.Results: The quantitative parameters Ktrans and Ve were significantly higher in the EMVI-positive group than in the EMVI-negative group (both P =0.02). Ktrans combined with Ve showed a fair degree of accuracy (AUC 0.680 in the training cohort and AUC 0.715 in the validation cohort) compared with Ktrans or Ve alone. The AUCs of the R1 and R2 models were 0.826, 0.715 and 0.872, 0.812 in the training and validation cohorts, respectively. In addition, the R2-C model yielded an AUC of 0.904 in the training cohort and 0.812 in the validation cohort. The nomogram was presented based on the clinical-radiomics model. The calibration curves showed good agreement.Conclusion: The radiomics nomogram that incorporates the radiomics score, histopathological grade and T stage demonstrated better diagnostic accuracy than the DCE-MRI quantitative parameters and may have significant clinical implications for the preoperative individualized prediction of EMVI in rectal cancer patients.

Quantitative Analysis of DCE-MRI and RESOLVE-DWI for Differentiating Nasopharyngeal Carcinoma from Nasopharyngeal Lymphoid Hyperplasia.

To explore the ability of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) analysis and readout segmentation of long variable echo-trains diffusion weighted imaging (RESOLVE-DWI) to distinguish nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPLH). Twenty-five patients with NPC and 30 patients with NPLH were evaluated. Three quantitative DCE-MRI parameters (Ktrans, Kep and Ve) and the apparent diffusion coeffcient (ADC) of lesions were calculated. The two independent samples t test or Mann-Whitney U test was used to compare the parameters between NPC and NPLH group. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic ability for distinguishing NPC from NPLH. A P value less than 0.05 was considered statistically significant. The difference in Ktrans value between the NPC group and the NPLH group was statistically significant, and the value of the NPC group was larger than that of the NPLH group. There was no statistical difference in Kep and Ve between the two groups. The ADC value of NPC group was smaller than that of NPLH group, and the difference was statistically significant. ROC curve analysis showed that both Ktrans and ADC were effective in diagnosing NPC and the area under the curve (AUC) was 0.773 and 0.704, respectively. In addition, the combination of Ktrans and ADC demonstrated the obviously improved AUC of 0.884. DCE-MRI and RESOLVE-DWI are effective in differentiating NPC from NPLH, especially the combination of the two models.

[Predictive value of quantitative dynamic contrast-enhanced magnetic resonance imaging for the efficacy of neoadjuvant chemotherapy in locally advanced gastric cancer].

Objective: To investigate the predictive value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters for the efficacy of neoadjuvant chemotherapy in locally advanced gastric cancer. Methods: Sixty-five patients with locally advanced gastric cancer (LAGC) confirmed by gastroscopy and received neoadjuvant chemotherapy (NCT) were enrolled in this study. Quantitative DCE-MRI was performed before NCT, and the quantitative parameters were measured, including volume transfer constant (K(trans)), rate constant (K(ep)), volume fraction of extravascular extracellular space (V(e)) and volume fraction of plasma (V(p)). After NCT, all patients received radical gastrectomy. According to postoperative pathological tumor regression grade, patients were divided into response group and non-response group, and the differences of DCE quantitative parameters between the two groups were compared. ROC curve was utilized to analyze the predictive efficacy of DCE quantitative parameters for NCT response of LAGC, and multivariate logistic regression analysis was performed to analyze the predictive efficacy of combined parameters. Results: Thirty-seven patients were in response group and 28 patients were in non-response group. The pretreatment K(trans) in the response group were [0.216 min(-1) (0.130 min(-1), 0.252 min(-1))], significantly higher than [0.091 min(-1) (0.069 min(-1), 0.146 min(-1))] of non-response group (P<0.001), and V(e) in the response group were [0.354(0.228, 0.463)], significantly higher than [0.200(0.177, 0.253)]of non-response group (P<0.001). ROC analysis showed the AUCS of K(trans) and V(e) in predicting NCT efficacy were 0.881 and 0.756, respectively. Multiple logistic regression analysis showed that the combination of the two parameters could improve the AUC to 0.921, with the sensitivity and specificity of 86.5% and 89.3%, respectively. Conclusion: DCE-MRI quantitative parameters could help to predict the NCT response of LAGC, and the combination of parameters could improve the predictive efficacy.

[Correlation between DCE-MRI quantitative perfusion histogram parameters, apparent diffusion coefficient and Ki-67 in different pathological types of lung cancer].

Objective: To explore the efficacy of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) histogram molecular imaging index, apparent diffusion coefficient (ADC) in different types of lung cancer and explore their correlation with Ki-67. Methods: A total of 33 cases of lung cancer patients confirmed by pathology in Shaoxing People's Hospital from March 2017 to March 2018 were collected, 28 males and 5 females aged 50-85 years old, including 15 cases of squamous cell carcinoma, 12 cases of adenocarcinoma, and 6 cases of small cell carcinoma. All patients performed DCE-MRI and DWI imaging within one week before surgery or puncture. ADC values, DCE-MRI quantitative perfusion parameters by histogram metrics analysis (mean value, skewness, kurtosis, uniformity, entropy, energy, quantile) of K(trans), K(ep), V(e), and V(p) were then collected. Ki-67 expression in lung cancer tissue was detected by immunohistochemical method. One-way analysis of variance and least significant difference were used to compare the differences among the parameters of the three groups which were normal distribution and equal variances, while Kruskal-Walls test and Mann-Whitney U test were used to compare the parameters that did not conform to normal distribution or variance. Pearson correlation analysis was used to compare the correlations between quantitative perfusion histogram parameters, ADC values and immunohistochemical scores of Ki-67. Results: The Ki-67 count in small cell lung cancer(458±82, P=0.011) and squamous cell carcinoma(355±277, P=0.034)were significantly higher than that in adenocarcinoma (168±164). The correlation analysis showed that there was a significant negative correlation between ADC values and Ki-67 (P=0.018, r=-0.416). And V(e) (Q5, Q10) was negatively related to Ki-67 (P=0.017, r=-0.420; P=0.040, r=-0.366). In squamous cell carcinoma patients, V(e) (homogeneity) was significantly negatively correlated with the expression of Ki-67 (P=0.033, r=-0.570). K(trans)(homogeneity) and V(e) (homogeneity, Q5, Q10, Q25) were significantly positively correlated with ADC values (P value from 0.001 to 0.035, r value from 0.545 to 0.765). Conclusion: DCE-MRI quantitative perfusion histogram parameters, ADC value can evaluate the lung cancer cell proliferation activity in different pathological types.

Correlation Between Intravoxel Incoherent Motion and Dynamic Contrast-Enhanced Magnetic Resonance Imaging Parameters in Rectal Cancer

This study aimed to determine the correlation between intravoxel incoherent motion (IVIM) and multiphase dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters in patients with rectal cancer. Ninety-seven patients with rectal cancer were included in this study. All pelvic MRI examinations were performed in a 3.0 T MR unit, including diffusion-weighted imaging with 16 b values, DCE-MRI with two different flip angles (5° and 10°, respectively), and T1-fast field echo sequences as the reference. The IVIM perfusion-related parameters (f, perfusion fraction; D*, pseudo-diffusion coefficient; f·D*, the multiplication of the two parameters) were calculated by biexponential analysis. Quantitative DCE-MRI parameters were transfer constant (Ktrans) between blood plasma and extravascular extracellular space), Kep (rate between extravascular extracellular space and blood plasma), Ve (extravascular volume fraction), Vp (plasma volume fraction), and area under the gadolinium concentration curve. Interobserver agreements were evaluated using the intraclass correlation coefficient and Bland-Altman analysis. A p value <0.05 indicated a statistically significant difference. The study included 75 males and 22 females with a median age of 58.8 years (range, 26-85years). Interobserver reproducibility for IVIM perfusion-related parameters and DCE-MRI quantitative parameters was good to excellent (intraclass correlation coefficient = 0.8618-0.9181, intraclass correlation coefficient = 0.7826-0.9088, respectively). Moderate correlations were found between f·D* and Ktrans (r = 0.533; p < 0.001), and relatively weak correlations between D* and Ktrans (r = 0.389; p < 0.001), D* and Vp (r = 0.442; p < 0.001), f·D* and Vp (r = 0.466; p < 0.001), and f and Vp (r = -0.234; p = 0.021). IVIM perfusion-related parameters, especially f·D*, demonstrated moderate correlations with DCE-MRI quantitative parameters in rectal cancer.