|
1
|
Liu R, Li J, Jiang Y, Wu Z, Ji J, Li A, Wang X, Li R. The utility of diffusion-weighted imaging and ADC values in the characterization of mumps orchitis and seminoma. Acta Radiol 2022; 63:416-423. [PMID: 33557577 DOI: 10.1177/0284185121991980] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) can quantitatively reflect the diffusion characteristics of tissues, providing a theoretical basis for qualitative diagnosis and quantitative analysis of a disease. PURPOSE To characterize testicular lesions that present as a hypointense signal on magnetic resonance imaging (MRI) T2-weighted images using DWI. MATERIAL AND METHODS Study participants were divided into three groups. Group A were healthy controls (n = 35), group B included patients with mumps orchitis (n = 20), and group C included patients with seminoma (n = 15). DWI sequences used b-values of 0, 1000, and 2000 s/mm2. Apparent diffusion coefficient (ADC) values between 1000 and 2000 s/mm2 were calculated by MRI postprocessing software. The Kruskal-Wallis test and receiver operating characteristic analysis were performed to evaluate how well ADC values distinguished between mumps orchitis and seminoma. RESULTS Normal testicular tissue showed a hyperintense signal on DWI and hypointensity on the ADC map: mean ADC value was 0.77 (0.69-0.85) ± 0.08 ×10-3 mm2/s. Mumps orchitis and seminoma showed slight hyperintensity on DWI: mean ADC values were 0.85 (0.71-0.99) ± 0.15 ×10-3 mm2/s and 0.43 (0.39-0.47) ± 0.04 × 10-3 mm2/s, respectively. There were statistically significant differences in mean ADC values between normal testicular tissue and seminoma and between mumps orchitis and seminoma. The cutoff ADC value for differentiating seminoma from mumps orchitis was 0.54 × 10-3 mm2/s. The sensitivity, specificity, and Youden Index for diagnosing seminoma were 99%, 31%, and 30%, respectively. CONCLUSION High b-value DWI has potential utility for differentiating mumps orchitis from seminoma in the clinical setting.
Collapse
Affiliation(s)
- Renwei Liu
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Jianhua Li
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Yixiang Jiang
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Zhiqing Wu
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Jiayin Ji
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Aibo Li
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Xiaoping Wang
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| | - Ruifeng Li
- Department of Radiology, People’s Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China
| |
Collapse
|
|
2
|
Wang W, Sun Z, Chen Y, Zhao F, Yu H, Guo X, Shi K. Testicular tumors: discriminative value of conventional MRI and diffusion weighted imaging. Medicine (Baltimore) 2021; 100:e27799. [PMID: 35049179 PMCID: PMC9191385 DOI: 10.1097/md.0000000000027799] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 10/28/2021] [Indexed: 01/08/2023] Open
Abstract
To explore the feasibility of using conventional MRI features combined with apparent diffusion coefficient (ADC) values for the differential diagnosis of testicular tumors.A total of 63 patients with pathologically confirmed testicular tumors were enrolled in this study. In particular, there were 46 cases of malignant lesions and 17 cases of benign lesions. All patients underwent conventional magnetic resonance imaging (MRI) and diffusion weighted imaging. Multivariate logistic regression models and receiver operating characteristic curves were constructed to assess diagnostic accuracies.T2-homogeneity, intratumoral septa, and peritumoral infiltration were more common in the malignant group, and capsule sign was more common in the benign group (P < .05 for all). The mean ADC value of the malignant group was lower than that of the benign group (P < .05). When the ADC value ≤ 0.90 × 10-3 mm2/s, the diagnosis tended to be malignancy. The conventional MRI model could achieve better diagnostic accuracy than ADC values alone (P < .05). Compared with the conventional MRI model, the specificity and accuracy of the full model (ADC and conventional MRI model) increased by 9.8% and 3.2%, respectively. T2-homogeneity and T2-hypointensity were more common in seminoma and lymphoma, cystic changes were more common in nonseminomatous germ cell tumor (NSGCT), and intratumoral septa was more common in seminoma (P < .05 for all). The ADC value of NSGCT was larger than seminoma, and lymphoma was the smallest (P < .05 for all). Cystic changes, T2-hypointensity, intratumoral septa, and ADC value were independent factors for differentiating the seminoma, NSGCT, and lymphoma subgroups.A combination of conventional MRI features and ADC values can improve the diagnostic efficiency for differentiating benign and malignant testicular tumors, and can additionally distinguish different subtypes of malignant testicular tumors.
Collapse
|
|
3
|
Liu R, Li J, Jiang Y, Wu Z, Chen Y, Li R. Apparent diffusion coefficient values of cryptorchid testes and malignant transformation of cryptorchidism (MTC) (seminoma) in postpubertal patients. Br J Radiol 2021; 94:20200624. [PMID: 33411594 DOI: 10.1259/bjr.20200624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Diffusion-weighted imaging signal contrast can be quantified by apparent diffusion coefficient (ADC) maps, which reflect the diffusion properties of the examined tissue and are helpful for identifying pathology. To determine ADC values of cryptorchid testes in post-pubertal patients and assess performance for characterizing cryptorchid testes. METHODS The medical records from 35 patients with unilateral scrotal vacuity were retrospectively reviewed. Data were analyzed in three groups: Group A, normal testes (i.e. the contralateral testes of the patients with cryptorchidism or MTC); Group B, cryptorchid testes; and Group C, malignant transformation of cryptorchidism (MTC) (seminoma). DWI used b-values of 0 and 800 s/mm2. Mean ADC values were compared using the independent samples t-test. The ability of ADC values was assessed using receiver operating characteristic curve analysis. The sensitivity, specificity, and accuracy were calculated. RESULTS Mean ADC values for normal testes, cryptorchid testes, and MTC were 1.18 ± 0.18×10-3 mm2/s, 1.82 ± 0.40×10-3 mm2/s, and 0.80 ± 0.06×10-3 mm2/s, respectively. There were statistically significant differences in mean ADC values between normal testes and cryptorchid testes or MTC (p < 0.001). The cut-off ADC value for differentiating normal testes from cryptorchid testes was 1.47 × 10-3 mm2/s. The sensitivity, specificity, and accuracy were 88%, 91%, and 90%, respectively. The cut-off ADC value for differentiating normal testes from MTC was 1.22 × 10-3 mm2/s. The sensitivity, specificity, and accuracy were 100%, 31%, and 43%, respectively. CONCLUSION ADC values of cryptorchid testes may be used to inform clinical decision-making and also monitor testicular function in patients who retain undescended testicles or post-operatively. ADVANCES IN KNOWLEDGE Mean ADC values of cryptorchidism and MTC (seminoma) were used to reflect their pathological features.
Collapse
Affiliation(s)
- Renwei Liu
- Department of Radiology, The People's Hospital of Longhua, The Affiliated Hospital of Southern Medical University, Shenzhen 518109, China
| | - Jianhua Li
- Department of Radiology, The People's Hospital of Longhua, The Affiliated Hospital of Southern Medical University, Shenzhen 518109, China
| | - Yixiang Jiang
- Department of Radiology, The People's Hospital of Longhua, The Affiliated Hospital of Southern Medical University, Shenzhen 518109, China
| | - Zhiqing Wu
- Department of Radiology, The People's Hospital of Longhua, The Affiliated Hospital of Southern Medical University, Shenzhen 518109, China
| | - Yanzi Chen
- Department of Radiology, The People's Hospital of Longhua, The Affiliated Hospital of Southern Medical University, Shenzhen 518109, China
| | - Ruifeng Li
- Department of Radiology, The People's Hospital of Longhua, The Affiliated Hospital of Southern Medical University, Shenzhen 518109, China
| |
Collapse
|
|
4
|
Krishna S, Schieda N, Pedrosa I, Hindman N, Baroni RH, Silverman SG, Davenport MS. Update on MRI of Cystic Renal Masses Including Bosniak Version 2019. J Magn Reson Imaging 2020; 54:341-356. [PMID: 33009722 DOI: 10.1002/jmri.27364] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/15/2022] Open
Abstract
Incidental cystic renal masses are common, usually benign, and almost always indolent. Since 1986, the Bosniak classification has been used to express the risk of malignancy in a cystic renal mass detected at imaging. Historically, magnetic resonance imaging (MRI) was not included in that classification. The proposed Bosniak v.2019 update has formally incorporated MRI, included definitions of imaging terms designed to improve interobserver agreement and specificity for malignancy, and incorporated a variety of masses that were incompletely defined or not included in the original classification. For example, at unenhanced MRI, homogeneous masses markedly hyperintense at T2 -weighted imaging (similar to cerebrospinal fluid) and homogeneous masses markedly hyperintense at fat suppressed T1 -weighted imaging (approximately ≥2.5 times more intense than adjacent renal parenchyma) are classified as Bosniak II and may be safely ignored, even when they have not been imaged with a complete renal mass MRI protocol. MRI has specific advantages and is recommended to evaluate masses that at computed tomography (CT) 1) have abundant thick or nodular calcifications; 2) are homogeneous, hyperattenuating, ≥3 cm, and nonenhancing; or 3) are heterogeneous and nonenhancing. Although MRI is generally excellent for characterizing cystic renal masses, there are unique weaknesses of MRI that bear consideration. These details and others related to MRI of cystic renal masses are described in this review, with an emphasis on Bosniak v.2019. A website (https://bosniak-calculator.herokuapp.com/) and mobile phone apps named "Bosniak Calculator" have been developed for ease of assignment of Bosniak classes. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 3.
Collapse
Affiliation(s)
- Satheesh Krishna
- Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Nicola Schieda
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Ivan Pedrosa
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Nicole Hindman
- Department of Radiology, New York University Langone Medical Center, New York, New York, USA
| | - Ronaldo H Baroni
- Department of Radiology and Diagnostic Imaging, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Stuart G Silverman
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Matthew S Davenport
- Departments of Radiology and Urology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
|
5
|
Contrast-Enhanced Ultrasound (CEUS) for Follow-Up of Bosniak 2F Complex Renal Cystic Lesions-A 12-Year Retrospective Study in a Specialized European Center. Cancers (Basel) 2020; 12:cancers12082170. [PMID: 32759819 PMCID: PMC7465614 DOI: 10.3390/cancers12082170] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 02/07/2023] Open
Abstract
Bosniak 2F renal cystic lesions feature morphologic characteristics between Bosniak I and III categories, the majority of which remain benign. However, a minor part of Bosniak 2F lesions may progress to malignancy. The purpose of this study was to assess Bosniak 2F cystic lesions during follow-up examinations by CEUS. One-hundred-and-twelve out of 364 patients with Bosniak 2F lesions underwent follow-up CEUS examinations between February 2008 and February 2020. Twelve out of 364 patients underwent renal surgery without follow-up CEUS. The progression rate of Bosniak 2F renal lesions detected by CEUS accounted for 7.1% (8/112 patients) after a mean of 12.9 months. The first follow-up CEUS revealed 75% of progressions (6/8), the remaining 25% (2/8) of progressions were detected during second follow-up CEUS. Underlying clear-cell renal cell carcinoma was histopathologically validated in 5/8 progressive complex cystic renal lesions. Stable sonomorphologic features were observed in 92.1% (104/112 patients). CEUS depicts a promising diagnostic imaging modality in the diagnostic work-up and follow-up of complex renal cystic lesions at higher spatial and temporal resolutions than CT or MRI. Its excellent safety profile, its easy and repeatable accessibility, and low financial costs render CEUS an attractive and powerful alternative imaging tool for monitoring complex renal cystic lesions.
Collapse
|
|
6
|
The usefulness of diffusion-weighted MRI in the differentiation between focal uterine endometrial soft tissue lesions. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2019. [DOI: 10.1186/s43055-019-0076-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Several endometrial conditions may be challenging for radiologists due to the overlap of imaging features and variable endometrial pathologies. MRI with DWI is the most commonly used imaging technique for the diagnosis and characterization of endometrial focal lesions.
Results
The 50 studied lesions were classified according to their histopathological results into the benign group (28 lesions, 56%) and the malignant group (22 lesions, 44%). Conventional MRI could correctly diagnose 39 of the 50 lesions (22/28 benign and 17/22 malignant lesions), achieving a sensitivity of 77.27%, specificity of 78.56%, accuracy of 78%, predictive positive value (PPV) of 73.91%, and negative positive value (NPV) of 81.48%. By combining DWI and apparent diffusion coefficient (ADC) value mapping at a high b value (b = 1000) in MRI, we could correctly diagnose 47 of the 50 lesions (26/28 benign and 21/22 malignant lesions), with increased sensitivity (95.45%), specificity (92.86%), accuracy (94%), PPV (91.3%), and NPV (96%).
Conclusion
Combining DWI with ADC mapping at a high b value in pelvic MRI examination is valuable in differentiating endometrial focal lesions with increased diagnostic sensitivity, specificity, and accuracy.
Aim of the work
This study aimed to evaluate the role of DWI in the diagnosis and differential diagnosis of benign and malignant focal endometrial masses.
Collapse
|
|
7
|
Relationship of renal apparent diffusion coefficient and functional MR urography in children with pelvicalyceal dilation. Pediatr Radiol 2019; 49:1032-1041. [PMID: 31001665 DOI: 10.1007/s00247-019-04395-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 02/25/2019] [Accepted: 03/26/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aim is to evaluate the age-related changes and relationship of renal apparent diffusion coefficient (ADC) against the morphological and functional changes detected by functional magnetic resonance urography (fMRU) in children with pelvicalyceal dilation, with suspected or known ureteropelvic junction obstruction. MATERIALS AND METHODS We retrospectively analyzed fMRUs with diffusion-weighted imaging (DWI) of the kidney in 35 subjects (25 males; median age: 7.1 years, range: 0.3-22.7 years) with 70 kidneys (40 with pelvicalyceal dilation and 30 with no pelvicalyceal dilation). Inclusion criteria were pelvicalyceal dilation, the absence of duplex kidneys and no ureteric dilation. DWI was performed with 3 diffusion gradient directions (b values = 0, 200, 500, 800 and 1,000 s/mm2). Metrics for fMRU included calyceal and renal transit times (CTT, RTT), time-to-peak (TTP), differential renal function based on volume (vDRF), Patlak number (pDRF) and combined volume and Patlak number (vpDRF). The grades of pelvicalyceal dilation, cortical thinning and corticomedullary differentiation were evaluated. The relationship between ADC values and the fMRU parameters was analyzed. RESULTS ADC increases with age in kidneys without pelvicalyceal dilation (R2=0.37, P<0.001). Renal ADC does not correlate with any of the morphological or fMRU parameters (P>0.07). The median ADC of kidneys without pelvicalyceal dilation was 3.73×10-3 mm2/s (range: 2.78-5.37×0-3 mm2/s) and the median ADC of kidneys with pelvicalyceal dilation was 3.82×10-3 mm2/s (range: 2.70-5.70×10-3 mm2/s). There was no correlation between ADC and the absolute differences of vDRF or pDRF (P>0.33). CONCLUSION Renal ADC does not correlate with morphological and functional results of fMRU changes in children with pelvicalyceal dilation due to suspected or known ureteropelvic junction obstruction.
Collapse
|
|
8
|
Heywood S, Tang V, Mare A, Tamhane R. Renal infarction with diffusion restriction changes on MRI. JOURNAL OF CLINICAL UROLOGY 2018. [DOI: 10.1177/2051415818802967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
| | | | | | - Rohit Tamhane
- Canberra Imaging Group, Brindabella Specialist Centre, Australia
| |
Collapse
|
|
9
|
Caglic I, Barrett T. Diffusion-weighted imaging (DWI) in lymph node staging for prostate cancer. Transl Androl Urol 2018; 7:814-823. [PMID: 30456184 PMCID: PMC6212625 DOI: 10.21037/tau.2018.08.04] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
In patients with prostate cancer, the presence of lymph node (LN) metastases is a critical prognostic factor and is essential for treatment planning. Conventional cross-sectional imaging performs poorly for nodal staging as both computed tomography (CT) and magnetic resonance imaging (MRI) are mainly dependent on size and basic morphological criteria. Therefore, extended pelvic LN dissection (ePLND) remains the gold standard for LN staging, however, it is an invasive procedure with its own drawbacks, thus creating a need for accurate preoperative imaging test. Incorporating functional MRI by using diffusion-weighted MRI has proven superior to conventional MRI protocol by means of both qualitative and quantitative assessment. Currently, the increased diagnostic performance remains insufficient to replace ePLND and the future role of DWI may be through combination with MR lymphangiography or with novel positron emission tomography (PET) tracers. In this article, the current state of data supporting DWI in LN staging of patients with prostate cancer is discussed.
Collapse
Affiliation(s)
- Iztok Caglic
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, UK
| | - Tristan Barrett
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.,CamPARI Clinic, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| |
Collapse
|
|
10
|
Goyal A, Sharma R, Bhalla AS, Gamanagatti S, Seth A. Comparison of MDCT, MRI and MRI with diffusion-weighted imaging in evaluation of focal renal lesions: The defender, challenger, and winner! Indian J Radiol Imaging 2018; 28:27-36. [PMID: 29692523 PMCID: PMC5894314 DOI: 10.4103/ijri.ijri_40_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To compare the diagnostic performance of multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), and MRI with diffusion-weighted imaging (DWI) in the characterization of focal renal lesions. We also compared MDCT and MRI in the staging of renal cell carcinoma (RCC). MATERIALS AND METHODS One hundred and twenty adult patients underwent MDCT (40-row and 128-row scanners), MRI (at 1.5 T), and DWI (at b-values of 0 and 500 s/mm2) for characterization of 225 renal lesions. There were 65 malignant neoplasms (44 RCCs), 25 benign neoplasms, 25 abscesses, 45 pseudotumors, 15 hemorrhagic cysts, and 50 benign cysts. A composite gold standard including histology, typical imaging criteria, and follow-up imaging was employed. To determine the diagnostic performance of imaging modalities, area-under-curve (AUC) was calculated by receiver-operating-characteristic analysis and compared. Fisher's exact test was used to compare the diagnostic accuracies and confidence levels with MDCT, MRI, and MRI + DWI. Cross-tabulation was used to assess the precision of MDCT and MRI in RCC staging. RESULTS AUC for MDCT (0.834) and MRI (0.841) in the classification of benign and malignant lesions were within corresponding 95% confidence interval (CI) (P = 0.88) whereas MRI + DWI had significantly better performance (AUC 0.968, P = 0.0002 and 0.0004, respectively). Both CT and MRI had low specificity (66.9% and 68.8%, respectively), which increased substantially with DWI (93.8%) owing to correct diagnosis of pseudotumors. MRI was superior to CT in diagnosing necrotic RCC and hemorrhagic cysts. MRI + DWI had the highest accuracy (94.2%) in assigning the definitive diagnosis and 97.6% lesions were diagnosed with very high confidence, significantly better than CT and MRI. Both CT and MRI had the same accuracy (86.1%) in RCC staging and evaluation of intravascular thrombi. CONCLUSIONS Characterization of renal lesions was most accurate with MRI + DWI. The latter is also the most suitable modality in diagnosing pseudotumors and evaluating patients with renal dysfunction. CT and MRI were equivalent in RCC staging.
Collapse
Affiliation(s)
- Ankur Goyal
- Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India
| | - Raju Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India
| | - Ashu S Bhalla
- Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India
| | - Shivanand Gamanagatti
- Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India
| | - Amlesh Seth
- Department of Urology, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India
| |
Collapse
|
|
11
|
Mohanan K. Presidential address. Indian J Radiol Imaging 2018; 28:3-5. [PMID: 29692517 PMCID: PMC5894315 DOI: 10.4103/ijri.ijri_114_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- K. Mohanan
- Professor and HOD Radiodiagnosis, MES Medical College, Perinthalmanna, Kerala - 680 020, India
| |
Collapse
|
|
12
|
Conventional and ZOOMit DWI for Evaluation of Testis in Patients With Ipsilateral Varicocele. AJR Am J Roentgenol 2017; 208:1045-1050. [DOI: 10.2214/ajr.16.17292] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
|
13
|
Zhang H, Gan Q, Wu Y, Liu R, Liu X, Huang Z, Yuan F, Kuang M, Song B. Diagnostic performance of diffusion-weighted magnetic resonance imaging in differentiating human renal lesions (benignity or malignancy): a meta-analysis. Abdom Radiol (NY) 2016; 41:1997-2010. [PMID: 27271218 DOI: 10.1007/s00261-016-0790-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE This study aims to quantitatively evaluate the potential of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiating malignant and benign human renal lesions. MATERIALS AND METHODS A systematic literature was performed to identify previous research related to the diagnostic performance of DW-MRI for determining whether human renal lesions were benign or malignant. ADC values were extracted from normal renal tissue and different lesion types. Data were extracted to assess the diagnostic performance of DW-MRI for differentiating malignant and benign human renal lesions, as well as running threshold effect and heterogeneity. RESULTS Nine publications with 11 subsets were eligible for data extraction and diagnostic performance calculation. A total of 988 apparent diffusion coefficient (ADC) measurements were included. The differences in ADC values between benign lesions (2.47 ± 0.81 × 10(-3) mm(2)/s) and malignant lesions (1.81 ± 0.41 × 10(-3) mm(2)/s) were statistically significant (P < 0.001). The diagnostic odds ratio, the overall positive, negative likelihood ratios, pooled weighted sensitivity and specificity with 95% CI were 20.05 (95% CI 12.56-32.02), 3.32 (95% CI 2.13-5.18), 0.20 (95% CI 0.15-0.27), 88% (95% CI 0.84-0.91) and 72% (95% CI 0.67-0.76), respectively. The area under the curve of the summary receiver operating characteristic was 0.90. CONCLUSIONS This meta-analysis indicated that DW-MRI had a relatively good diagnostic accuracy in differentiating malignant and benign human renal lesions. We preliminarily recommend that DW-MRI is performed with a maximum b value ranging from 800 to 1000 s/mm(2) at 3.0 T for imaging protocol, and that DW-MRI should be used with caution when the study population includes children.
Collapse
Affiliation(s)
- Hanmei Zhang
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Qi Gan
- Department of Neurosurgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yinghua Wu
- Department of Radiology, The Second Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, No. 15, Section 4 Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Rongbo Liu
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Xijiao Liu
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Zixing Huang
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Fang Yuan
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Min Kuang
- Department of Radiology, The Second Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, No. 15, Section 4 Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
|
14
|
Kovač JD, Terzić M, Mirković M, Banko B, Đikić-Rom A, Maksimović R. Endometrioid adenocarcinoma of the ovary: MRI findings with emphasis on diffusion-weighted imaging for the differentiation of ovarian tumors. Acta Radiol 2016; 57:758-66. [PMID: 26307063 DOI: 10.1177/0284185115599805] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 07/15/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Preoperative differentiation of ovarian malignant tumors still remains a challenge. Diffusion-weighted imaging (DWI) provides information about cellularity of the lesion and might facilitate discrimination between different malignant ovarian lesions. PURPOSE To evaluate magnetic resonance imaging (MRI) findings of endometrioid adenocarcinoma of the ovary and to determine the value of DWI in the differential diagnosis of malignant and benign adnexal tumors. MATERIAL AND METHODS The following MRI findings were reviewed in 162 patients (21 endometrioid adenocarcinoma, 103 other malignant tumors, 38 benign tumors): lesion size, morphological appearance, T2-weighted (T2W) signal intensity, T1-weighted (T1W) signal intensity, contrast-enhancement pattern, DWI signals with apparent diffusion coefficient (ADC) calculated for b = 800 s/mm(2) in solid tumor components. RESULTS The most common morphological appearance was predominantly cystic lesion, found in 90.3% of patients with endometriod adenocarcinoma. The solid parts were slightly hyperintense on T2W images in 19 patients with marked enhancement after contrast administration. No significant difference (P = 0.13) in conventional MRI features was found between endometrioid adenocarcinoma and other malignant ovarian tumors. Hyperintensity on DWI was more frequently observed in malignant tumors than in benign lesions (P < 0.001). ADC values were significantly lower in endometrioid adenocarcinoma than other malignant tumors (0.79 ± 0.21 vs. 0.90 ± 0.19; P = 0.04) and in all malignant lesions compared with benign tumors (0.88 ± 0.31 vs. 1.33 ± 0.17; P < 0.001). CONCLUSION DWI with ADC measurement could indicate the presence of endometrioid adenocarcinomas due to a slightly but significantly lower ADC values compared to other malignant ovarian lesions. Thus, DWI is beneficial and should be part of a standard protocol for the evaluation of indeterminate adnexal lesions.
Collapse
Affiliation(s)
- Jelena Djokić Kovač
- Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Terzić
- Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Mirković
- Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Bojan Banko
- Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Đikić-Rom
- Pathology Department, First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - Ružica Maksimović
- Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| |
Collapse
|
|
15
|
Manoharan D, Das CJ, Aggarwal A, Gupta AK. Diffusion weighted imaging in gynecological malignancies - present and future. World J Radiol 2016; 8:288-297. [PMID: 27027614 PMCID: PMC4807338 DOI: 10.4329/wjr.v8.i3.288] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 10/07/2015] [Accepted: 12/04/2015] [Indexed: 02/06/2023] Open
Abstract
The management of gynaecological malignancies has undergone a significant change in recent years with our improved understanding of cancer biogenetics, development of new treatment regimens and enhanced screening. Due to the rapid blooming of newer methods and techniques in gynaecology, surgery and oncology the scope and the role of imaging has also widened. Functional imaging in the form of diffusion weighted imaging (DWI) has been recently found to be very useful in assessing various tumours. Its ability to identify changes in the molecular level has dramatically changed the diagnostic approach of radiologists which was solely based on morphological criteria. It can improve the diagnostic accuracy of conventional magnetic resonance imaging, lend a hand in assessing tumour response to treatment regimens and detect tumour recurrence with better spatial resolution, negative radiation and diagnostic accuracy compared to positron emission tomography scan. The ability to quantify the diffusion has also lead to potential prediction of tumour aggressiveness and grade which directly correlate with the patient prognosis and management. Hence, it has become imperative for a radiologist to understand the concepts of DWI and its present and evolving role. In this article we present a brief description of the basics of DWI followed by its role in evaluation of female gynaecological malignancies.
Collapse
|
|
16
|
Foti PV, Ognibene N, Spadola S, Caltabiano R, Farina R, Palmucci S, Milone P, Ettorre GC. Non-neoplastic diseases of the fallopian tube: MR imaging with emphasis on diffusion-weighted imaging. Insights Imaging 2016; 7:311-27. [PMID: 26992404 PMCID: PMC4877350 DOI: 10.1007/s13244-016-0484-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/26/2016] [Accepted: 03/03/2016] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE We illustrate the magnetic resonance imaging (MRI) features of non-neoplastic tubaric conditions. BACKGROUND A variety of pathologic non-neoplastic conditions may affect the fallopian tubes. Knowledge of their imaging appearance is important for correct diagnosis. With recent advances in MRI, along with conventional MR sequences, diffusion-weighted imaging (DWI) sequences are available and may improve lesion characterization by discriminating the nature of the content of the dilated tube. Tubal fluid with low signal intensity on T1-weighted images, high signal intensity on T2-weighted images and no restricted diffusion on DWI is indicative of hydrosalpinx. Content with high signal intensity on T1-weighted images and restricted diffusion on DWI is suggestive of hematosalpinx associated with endometriosis or tubal pregnancy. A dilated tube with variable or heterogeneous signal intensity content on conventional MR sequences and restricted diffusion on DWI may suggest a pyosalpinx or tubo-ovarian abscess. We describe morphological characteristics, MR signal intensity features, enhancement behaviour and possible differential diagnosis of each lesion. CONCLUSION MRI is the method of choice to study adnexal pelvic masses. Qualitative and quantitative functional imaging with DWI can be of help in characterization of tubaric diseases, provided that findings are interpreted in conjunction with those obtained with conventional MRI sequences. TEACHING POINTS • Nondilated fallopian tubes are not usually seen on MR images. • MRI is the method of choice to characterize and localize utero-adnexal masses. • MRI allows characterization of lesions through evaluation of the fluid content's signal intensity. • DWI in conjunction with conventional MRI sequences may improve tissue characterization. • Pelvic inflammatory disease is the most common tubal pathology.
Collapse
Affiliation(s)
- Pietro Valerio Foti
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy.
| | - Noemi Ognibene
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Saveria Spadola
- Department G.F. Ingrassia - Institute of Pathology, University of Catania, Catania, Italy
| | - Rosario Caltabiano
- Department G.F. Ingrassia - Institute of Pathology, University of Catania, Catania, Italy
| | - Renato Farina
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Stefano Palmucci
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Pietro Milone
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| | - Giovanni Carlo Ettorre
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy
| |
Collapse
|
|
17
|
Wu LM, Zhou B, Lu Q, Suo ST, Liu Q, Hu J, Haccke EM, Chen XX, Xu JR. T2* relaxation time in the detection and assessment of aggressiveness of peripheral zone cancer in comparison with diffusion-weighted imaging. Clin Radiol 2016; 71:356-62. [PMID: 26823021 DOI: 10.1016/j.crad.2015.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/09/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
Abstract
AIM To investigate the feasibility of T2* relaxation time for distinguishing benign from malignant regions, as well as tumour aggressiveness, within the peripheral zone (PZ) of the prostate in comparison with diffusion-weighted imaging (DWI). MATERIALS AND METHODS Fifty-eight patients with prostate cancer underwent 3 T magnetic resonance imaging using multi-echo T2* and DWI (maximum b-value, 2000 s/mm(2)). Parametric maps were obtained for apparent diffusion coefficient (ADC) and T2* values. Two radiologists reviewed these maps and measured ADC and T2* values in sextants positive for cancer at biopsy. Data were analysed using mixed-model analysis of variance and receiver operating characteristic curves. RESULTS Ninety-three sextants exhibited a Gleason score of 6; 59 exhibited a Gleason score of 7 or 8. The T2* value was significantly lower in cancerous sextants than in the benign PZ (48.69+0.60 versus 74.14+0.56, p<0.001), as well as in cancerous sextants with higher rather than lower Gleason scores (43.18+0.89 versus 52.18+0.55, p<0.001). The T2* value showed significantly greater specificity for differentiating cancerous sextants from benign PZ than ADC (93.1% versus 89.7%, p<0.001), with equal sensitivity (82.8% versus 81%, p>0.05). The T2* value exhibited significantly greater sensitivity and specificity for differentiating sextants with low- and high-grade cancer than ADC (79.6% versus 64.5% and 81.4% versus 72.9%, respectively; p<0.05). The T2* value had a significantly greater area under the receiver operating characteristic curve for differentiating sextants with low- and high-grade cancer than ADC (0.77 versus 0.71, p<0.01). CONCLUSION Preliminary findings suggest that the T2* relaxation time has increased diagnostic value compared with DWI in prostate PZ cancer assessment.
Collapse
Affiliation(s)
- L-M Wu
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - B Zhou
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Q Lu
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - S-T Suo
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Q Liu
- Department of Pathology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J Hu
- Department of Radiology, Wayne State University, Detroit, MI 48201, USA
| | - E M Haccke
- Department of Radiology, Wayne State University, Detroit, MI 48201, USA
| | - X-X Chen
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J-R Xu
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
| |
Collapse
|
|
18
|
Algebally AM, Tantawy HI, Yousef RRH, Szmigielski W, Darweesh A. Advantage of Adding Diffusion Weighted Imaging to Routine MRI Examinations in the Diagnostics of Scrotal Lesions. Pol J Radiol 2015; 80:442-9. [PMID: 26491491 PMCID: PMC4588671 DOI: 10.12659/pjr.894399] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 06/26/2015] [Indexed: 01/29/2023] Open
Abstract
Background The purpose of the study is to identify the diagnostic value of adding diffusion weighted images (DWI) to routine MRI examinations of the scrotum. Material/Methods The study included 100 testes of 50 patients with a unilateral testicular disease. Fifty normal contralateral testes were used as a control group. All patients underwent conventional MRI and DWI examinations of the scrotum. The results of MRI and DWI of the group of patients treated surgically were correlated with histopathological findings. The MRI and DWI results of non-surgical cases were correlated with the results of clinical, laboratory and other imaging studies. Comparison of the ADC value of normal and pathological tissues was carried out followed by a statistical analysis. Results There was a significant difference between ADC values of malignant testicular lesions and normal testicular tissues as well as benign testicular lesions (P=0.000). At a cut-off ADC value of ≤0.99, it had a sensitivity of 93.3%, specificity of 90%, positive predictive value of 87.5%, and negative predictive value of 94.7% in the characterization of intratesticular masses. Conclusions Inclusion of DWI to routine MRI has a substantial value in improving diagnosis in patients with scrotal lesions and consequently can reduce unnecessary radical surgical procedures in these patients.
Collapse
Affiliation(s)
| | | | | | - Wojciech Szmigielski
- Department of Clinical Imaging, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Adham Darweesh
- Department of Clinical Imaging, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
|
19
|
Seo N, Kim JH, Byun JH, Lee SS, Kim HJ, Lee MG. Immunoglobulin G4-Related Kidney Disease: A Comprehensive Pictorial Review of the Imaging Spectrum, Mimickers, and Clinicopathological Characteristics. Korean J Radiol 2015; 16:1056-67. [PMID: 26357500 PMCID: PMC4559777 DOI: 10.3348/kjr.2015.16.5.1056] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/20/2015] [Indexed: 12/12/2022] Open
Abstract
Immunoglobulin G4 (IgG4)-related kidney disease (IgG4-KD) has recently been demonstrated to be an important part of IgG4-related sclerosing disease (IgG4-SD). However, since IgG4-KD is still relatively unfamiliar to radiologists and physicians as compared to IgG4-SD involving other organs, it could, therefore, be easily missed. In this article, we present a comprehensive pictorial review of IgG4-KD with regards to the imaging spectrum, mimickers, and clinicopathologic characteristics, based on our clinical experience with 48 patients during the past 13 years, as well as a literature review. Awareness of the broad imaging spectrum of IgG4-KD and differential diagnosis from its mimickers will thus facilitate its early diagnosis and treatment.
Collapse
Affiliation(s)
- Nieun Seo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Jin Hee Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Jae Ho Byun
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Seung Soo Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Hyoung Jung Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Moon-Gyu Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| |
Collapse
|
|
20
|
Ciszak T, Mittal PK, Sullivan P, Cardona K, Hanley KZ, Khanna N, Moreno CC. Case report: MR imaging features of disseminated uterine leiomyosarcoma presenting after hysterectomy with morcellation. ACTA ACUST UNITED AC 2015; 40:2600-5. [DOI: 10.1007/s00261-015-0486-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
|
21
|
Tsili AC, Giannakis D, Sylakos A, Ntorkou A, Astrakas LG, Sofikitis N, Argyropoulou MI. Apparent diffusion coefficient values of normal testis and variations with age. Asian J Androl 2014; 16:493-7. [PMID: 24556745 PMCID: PMC4023385 DOI: 10.4103/1008-682x.122865] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The usefulness of diffusion-weighted magnetic resonance imaging (DWI) in the evaluation of scrotal pathology has recently been reported. A standard reference of normal testicular apparent diffusion coefficient (ADC) values and their variations with age is necessary when interpreting normal testicular anatomy and pathology. We evaluated 147 normal testes using DWI, including 71 testes from 53 men aged 20-39 years (group 1), 67 testes from 42 men aged 40-69 years (group 2) and nine testes from six men older than 70 years (group 3). DWI was performed along the axial plane, using a single shot, multislice spin-echo planar diffusion pulse sequence and b-values of 0 and 900 s mm-2 . The mean and standard deviation of the ADC values of normal testicular parenchyma were calculated for each age group separately. Analysis of variance (ANOVA) followed by post hoc analysis (Dunnett T3) was used for statistical purposes. The ADC values (× 10-3 mm 2 s-1 ) of normal testicular tissue were different among age groups (group 1: 1.08 ± 0.13; group 2: 1.15 ± 0.15 and group 3: 1.31 ± 0.22). ANOVA revealed differences in mean ADC among age groups (F = 11.391, P < 0.001). Post hoc analysis showed differences between groups 1 and 2 (P = 0.008) and between groups 1 and 3 (P = 0.043), but not between groups 2 and 3 (P = 0.197). Our findings suggest that ADC values of normal testicular tissue increase with advancing age.
Collapse
Affiliation(s)
- Athina C Tsili
- Department of Clinical Radiology, University of Ioannina, Ioannina, Greece
| | | | | | | | | | | | | |
Collapse
|
|
22
|
Dhanda S, Thakur M, Kerkar R, Jagmohan P. Diffusion-weighted Imaging of Gynecologic Tumors: Diagnostic Pearls and Potential Pitfalls. Radiographics 2014; 34:1393-416. [DOI: 10.1148/rg.345130131] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
|
23
|
Algebally AM, Tantawy HI, Yousef RRH. Value of diffusion weighted magnetic resonance imaging in diagnosis and characterization of scrotal abnormalities. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
|
|
24
|
Iannuccilli JD, Grand DJ, Dupuy DE, Mayo-Smith WW. Percutaneous ablation for small renal masses-imaging follow-up. Semin Intervent Radiol 2014; 31:50-63. [PMID: 24596440 DOI: 10.1055/s-0033-1363843] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Image-guided percutaneous thermal ablation is a safe and effective nephron-sparing alternative to surgical resection for the treatment of small renal tumors. Assessment of treatment efficacy relies heavily on interval follow-up imaging after treatment. Contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) both play a pivotal role in evaluating the treatment zone, identifying residual tumor, and detecting early and delayed procedure-related complications. This article discusses a surveillance imaging protocol for patients who undergo percutaneous thermal ablation of renal tumors, and also illustrates the typical appearances of both successfully treated tumors and residual disease on contrast-enhanced CT or MRI. In addition, it discusses the imaging appearance of potential early and delayed treatment-related complications to facilitate their prompt detection and management.
Collapse
Affiliation(s)
- Jason D Iannuccilli
- Department of Diagnostic Imaging, Rhode Island Hospital, Alpert Medical School, Brown University, Providence, Rhode Island
| | - David J Grand
- Department of Diagnostic Imaging, Rhode Island Hospital, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Damian E Dupuy
- Department of Diagnostic Imaging, Rhode Island Hospital, Alpert Medical School, Brown University, Providence, Rhode Island
| | - William W Mayo-Smith
- Department of Diagnostic Imaging, Rhode Island Hospital, Alpert Medical School, Brown University, Providence, Rhode Island
| |
Collapse
|
|
25
|
Kim B, Kim JH, Byun JH, Kim HJ, Lee SS, Kim SY, Lee MG. IgG4-related kidney disease: MRI findings with emphasis on the usefulness of diffusion-weighted imaging. Eur J Radiol 2014; 83:1057-1062. [PMID: 24768583 DOI: 10.1016/j.ejrad.2014.03.033] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 03/25/2014] [Accepted: 03/27/2014] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate the imaging findings of immunoglobulin G4 (IgG4)-related kidney disease (IgG4-KD) on magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) and to evaluate the usefulness of DWI in lesion detection. METHODS This retrospective cohort study included 31 patients with IgG4-KD who underwent MRI covering both kidneys. Two radiologists reviewed in consensus the MR images to determine the distribution pattern (location, laterality, and multiplicity) and the visually assessed signal intensity (hypointense, isointense or hyperintense) of the renal lesions compared to the normal renal parenchyma on each sequence. Per-patient sensitivity for detecting IgG4-KD and the number of detectable lesions were compared in T2-weighted images, DWI, and dynamic contrast-enhanced images. RESULTS IgG4-KD typically manifested as bilateral (83.9%), multiple (93.5%), and renal parenchymal (87.1%) nodules appearing isointense (93.5%) on T1-weighted images, hypointense (77.4%) on T2-weighted images, hyperintense (100%) on DWI (b=1000), and hypointense (83.3%) in the arterial phase and with a progressive enhancement pattern on dynamic contrast-enhanced images. The sensitivity of DWI for detecting IgG4-KD was significantly higher than that of T2-weighted images (100% vs. 77.4%, P=0.034). The median number of detectable lesions was significantly greater in DWI (n=9) than in T2-weighted images (n=2) and dynamic contrast-enhanced images (n=5) (P≤0.008). CONCLUSIONS The characteristic MRI findings of IgG4-KD were bilateral, multiple, renal parenchymal nodules with T2 hypointensity, diffusion restriction, and a progressive enhancement pattern. As DWI was useful in the detection of IgG4-KD, adding DWI to conventional MRI for patients suspected of having IgG4-KD may enhance the diagnosis.
Collapse
Affiliation(s)
- Bohyun Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-Gu, Seoul 138-736, Republic of Korea
| | - Jin Hee Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-Gu, Seoul 138-736, Republic of Korea.
| | - Jae Ho Byun
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-Gu, Seoul 138-736, Republic of Korea
| | - Hyoung Jung Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-Gu, Seoul 138-736, Republic of Korea
| | - Seung Soo Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-Gu, Seoul 138-736, Republic of Korea
| | - So Yeon Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-Gu, Seoul 138-736, Republic of Korea
| | - Moon-Gyu Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-Gu, Seoul 138-736, Republic of Korea
| |
Collapse
|
|
26
|
Goyal A, Sharma R, Bhalla A, Gamanagatti S. Diffusion-weighted MRI in detection of renal metastases. BMJ Case Rep 2014; 2014:bcr2013201555. [PMID: 24408929 PMCID: PMC3902368 DOI: 10.1136/bcr-2013-201555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ankur Goyal
- Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India
| | | | | | | |
Collapse
|
|
27
|
Lee NK, Kim S, Kim TU, Kim DU, Seo HI, Jeon TY. Diffusion-weighted MRI for differentiation of benign from malignant lesions in the gallbladder. Clin Radiol 2013; 69:e78-85. [PMID: 24290779 DOI: 10.1016/j.crad.2013.09.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 09/13/2013] [Accepted: 09/20/2013] [Indexed: 02/07/2023]
Abstract
AIM To investigate the value of diffusion-weighted imaging (DWI) for differentiating benign from malignant gallbladder lesions. MATERIALS AND METHODS One hundred and twenty-six patients who had undergone magnetic resonance imaging (MRI) with DWI, in whom the histopathological diagnosis of their gallbladder lesions was confirmed by biopsy or surgery were retrospectively analysed. Thirty-six malignant and 90 benign lesions were included. Two radiologists categorized gallbladder lesions into seven types on two imaging sets [T2-weighted imaging (WI) alone and combined T2WI and DWI (b = 800 s/mm(2))] according to the presence of wall thickening, layered patterns, morphology of the mass, and diffusion restriction. Disagreements were resolved in consensus. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each imaging set for diagnosing gallbladder carcinoma were calculated. The diagnostic performance of each imaging set was calculated using receiver operating characteristic (ROC) curve analysis. Additionally, ADC values of malignant and benign gallbladder lesions were compared separately for 1.5 and 3 T MRI. RESULTS The sensitivity, specificity, PPV, and NPV of diagnosis at T2WI were 97.2%, 86.7%, 74.5%, and 98.7%, respectively. The sensitivity, specificity, PPV, and NPV using combined T2WI and DWI were 97.2%, 92.2%, 83.3%, and 98.8%, respectively. Diagnostic accuracy for gallbladder carcinoma slightly improved after adding DWI, from 0.92 to 0.95 (p < 0.05). ADC values for gallbladder carcinoma were significantly lower than those for benign lesions. Mean ADC values of malignant and benign lesions were 0.97 ± 0.25 × 10(-3) and 1.72 ± 0.56 × 10(-3) mm(2)/s, respectively, at 1.5 T (p < 0.001), and 1.04 ± 0.38 × 10(-3) and 2.2 ± 0.72 × 10(-3) mm(2)/s, respectively, at 3 T (p < 0.001). CONCLUSION DWI can improve diagnostic accuracy for differentiating benign from malignant gallbladder lesions.
Collapse
Affiliation(s)
- N K Lee
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
| | - S Kim
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.
| | - T U Kim
- Department of Radiology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - D U Kim
- Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
| | - H I Seo
- Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
| | - T Y Jeon
- Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
| |
Collapse
|
|
28
|
Riffel P, Rao RK, Haneder S, Meyer M, Schoenberg SO, Michaely HJ. Impact of field strength and RF excitation on abdominal diffusion-weighted magnetic resonance imaging. World J Radiol 2013; 5:334-344. [PMID: 24198912 PMCID: PMC3817292 DOI: 10.4329/wjr.v5.i9.334] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 08/06/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To retrospectively and prospectively compare diffusion-weighted (DW) images in the abdomen in a 1.5T system and 3.0T systems with and without two-channel functionality for B1 shimming.
METHODS: DW images of the abdomen were obtained on 1.5T and 3.0T (with and without two-channel functionality for B1 shimming) scanners on 150 patients (retrospective study population) and 10 volunteers (prospective study population). Eight regions were selected for clinical significance or artifact susceptibility (at higher field strengths). Objective grading quantified signal-to-noise ratio (SNR), and subjective evaluation qualified image quality, ghosting artifacts, and diagnostic value. Statistical significance was calculated using χ2 tests (categorical variables) and independent two-sided t tests or Mann-Whitney U tests (continuous variables).
RESULTS: The 3.0T using dual-source parallel transmit (dpTX 3.0T) provided the significantly highest SNRs in nearly all regions. In regions susceptible to artifacts at higher field strengths (left lobe of liver, head of pancreas), the SNR was better or similar to the 1.5T system. Subjectively, both dpTX 3.0T and 1.5T systems provided higher image quality, diagnostic value, and less ghosting artifact (P < 0.01, most values) compared to the 3.0T system without dual-source parallel transmit (non-dpTX 3.0T).
CONCLUSION: The dpTX 3.0T scanner provided the highest SNR. Its image quality, lack of ghosting, and diagnostic value were equal to or outperformed most currently used systems.
Collapse
|
|
29
|
Goyal A, Sharma R, Bhalla AS, Gamanagatti S, Seth A. Diffusion-weighted MRI in inflammatory renal lesions: all that glitters is not RCC! Eur Radiol 2013; 23:272-279. [PMID: 22797980 DOI: 10.1007/s00330-012-2577-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 06/09/2012] [Accepted: 06/12/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To evaluate the diffusion characteristics of inflammatory renal lesions and assess whether apparent diffusion coefficient (ADC) values can distinguish them from renal-cell carcinomas (RCCs). METHODS Eighty-eight patients underwent multidetector computed tomography (MDCT), magnetic resonance imaging (MRI) and diffusion-weighted (DW) MRI (at b values of 0 and 500 s/mm(2)) for characterisation of focal renal lesions. On retrospective evaluation, 15 patients had 20 inflammatory lesions and 33 patients had 36 RCCs. DW images were compared and receiver operating characteristic (ROC) curves were drawn to establish cut-off ADC values. RESULTS All inflammatory lesions and 91.7% of RCCs showed restricted diffusion. DW images showed markedly restricted diffusion in fluid intensity areas of abscesses, whereas RCCs showed free diffusion in their cystic portions. Quantitatively, both abscesses and RCCs showed ADC values significantly lower than normal renal parenchyma [1.12 and 1.56 respectively vs 2.34 (× 10(-3) mm(2)/s) for normal kidney] (P < 0.0001 for both) and significantly different from each other (P < 0.0001). ROC analysis in differentiating inflammatory lesions and RCC revealed high sensitivity (100%) and specificity (78.1%) for cut-off ADC value of 1.41 (× 10(-3) mm(2)/s). CONCLUSIONS Both abscess and RCC showed restricted diffusion, the former did so to a greater extent, distinctly in fluid components. Thus, ADC values provide an additional paradigm for characterisation of indeterminate renal lesions.
Collapse
Affiliation(s)
- Ankur Goyal
- Department of Radiodiagnosis, All India Institute of Medical Sciences (A.I.I.M.S.), Ansari Nagar, New Delhi, 110029, India.
| | | | | | | | | |
Collapse
|
|
30
|
Lee NK, Kim S, Kim GH, Kim DU, Seo HI, Kim TU, Kang DH, Jang HJ. Diffusion-weighted imaging of biliopancreatic disorders: correlation with conventional magnetic resonance imaging. World J Gastroenterol 2012; 18:4102-4117. [PMID: 22919242 PMCID: PMC3422790 DOI: 10.3748/wjg.v18.i31.4102] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 04/26/2012] [Accepted: 05/06/2012] [Indexed: 02/06/2023] Open
Abstract
Diffusion-weighted magnetic resonance imaging (DWI) is a well established method for the evaluation of intracranial diseases, such as acute stroke. DWI for extracranial application is more difficult due to physiological motion artifacts and the heterogeneous composition of the organs. However, thanks to the newer technical development of DWI, DWI has become increasingly used over the past few years in extracranial organs including the abdomen and pelvis. Most previous studies of DWI have been limited to the evaluation of diffuse parenchymal abnormalities and focal lesions in abdominal organs, whereas there are few studies about DWI for the evaluation of the biliopancreatic tract. Although further studies are needed to determine its performance in evaluating bile duct, gallbladder and pancreas diseases, DWI has potential in the assessment of the functional information on the biliopancreatic tract concerning the status of tissue cellularity, because increased cellularity is associated with impeded diffusion, as indicated by a reduction in the apparent diffusion coefficient. The detection of malignant lesions and their differentiation from benign tumor-like lesions in the biliopancreatic tract could be improved using DWI in conjunction with findings obtained with conventional magnetic resonance cholagiopancreatography. Additionally, DWI can be useful for the assessment of the biliopancreatic tract in patients with renal impairment because contrast-enhanced computed tomography or magnetic resonance scans should be avoided in these patients.
Collapse
|
|
31
|
Thoeny HC, Forstner R, De Keyzer F. Genitourinary Applications of Diffusion-weighted MR Imaging in the Pelvis. Radiology 2012; 263:326-42. [DOI: 10.1148/radiol.12110446] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
|
32
|
Rao RK, Riffel P, Meyer M, Kettnaker PJ, Lemke A, Haneder S, Schoenberg SO, Michaely HJ. Implementation of dual-source RF excitation in 3 T MR-scanners allows for nearly identical ADC values compared to 1.5 T MR scanners in the abdomen. PLoS One 2012; 7:e32613. [PMID: 22393422 PMCID: PMC3290586 DOI: 10.1371/journal.pone.0032613] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 02/01/2012] [Indexed: 12/27/2022] Open
Abstract
Background To retrospectively and prospectively compare abdominal apparent diffusion coefficient (ADC) values obtained within in a 1.5 T system and 3 T systems with and without dual-source parallel RF excitation techniques. Methodology/Principal Findings After IRB approval, diffusion-weighted (DW) images of the abdomen were obtained on three different MR systems (1.5 T, a first generation 3 T, and a second generation 3 T which incorporates dual-source parallel RF excitation) on 150 patients retrospectively and 19 volunteers (57 examinations total) prospectively. Seven regions of interest (ROI) were throughout the abdomen were selected to measure the ADC. Statistical analysis included independent two-sided t-tests, Mann-Whitney U tests and correlation analysis. In the DW images of the abdomen, mean ADC values were nearly identical with nonsignificant differences when comparing the 1.5 T and second generation 3 T systems in all seven anatomical regions in the patient population and six of the seven in the volunteer population (p>0.05 in all distributions). The strength of correlation measured in the volunteer population between the two scanners in the kidneys ranged from r = 0.64–0.88 and in the remaining regions (besides the spleen), r>0.85. In the patient population the first generation 3 T scanner had different mean ADC values with significant differences (p<0.05) compared to the other two scanners in each of the seven distributions. In the volunteer population, the kidneys shared similar ADC mean values in comparison to the other two scanners with nonsignificant differences. Conclusions/Significance A second generation 3 T scanner with dual-source parallel RF excitation provides nearly identical ADC values compared with the 1.5 T imaging system in abdominal imaging.
Collapse
Affiliation(s)
- Raghuram K. Rao
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- Department of Radiology, The University of Texas, Medical Branch, Galveston, Texas, United States of America
| | - Philipp Riffel
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Mathias Meyer
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Paul J. Kettnaker
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Andreas Lemke
- Department of Computer Assisted Clinical Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Stefan Haneder
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Stefan O. Schoenberg
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Henrik J. Michaely
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- * E-mail:
| |
Collapse
|
|
33
|
Tsili AC, Argyropoulou MI, Giannakis D, Tsampalas S, Sofikitis N, Tsampoulas K. Diffusion-weighted MR imaging of normal and abnormal scrotum: preliminary results. Asian J Androl 2012; 14:649-54. [PMID: 22367182 DOI: 10.1038/aja.2011.172] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Magnetic resonance (MR) imaging of the scrotum represents an important supplemental diagnostic tool in the evaluation of scrotal diseases. Diffusion-weighted (DW) MR imaging is a developing technique, proved to improve tissue characterization. We evaluated the feasibility and diagnostic performance of DW MR imaging in the detection and characterization of scrotal lesions. We retrospectively evaluated 31 scrotal lesions (23 intratesticular and 8 extratesticular) in 26 men. All MR examinations were performed on a 1.5-T unit, using a pelvic-phased array coil. DW sequences were obtained using a single shot, multislice spin echo planar diffusion pulse sequence and a b factor of 0 and 900 s mm(-2). The DW MR characteristics and the apparent diffusion coefficient (ADC) values of normal scrotal contents and scrotal diseases were evaluated. Comparison between the ADC values of normal scrotum, benign lesions and scrotal malignancies was performed. The accuracy of conventional sequences, DW images alone and DW imaging combined with conventional images in differentiating benign from malignant scrotal lesions was calculated. The ADC values of testicular malignancies were different from those of normal testis and benign intratesticular lesions, and the ADC values of benign extratesticular lesions from those of normal epididymis (P<0.05). The overall accuracy of conventional imaging, DW imaging alone and DW MR combined with conventional sequences in the characterization of intratesticular lesions was 91%, 87% and 100%, respectively. Our findings suggest that DW MR imaging and ADC values may provide valuable information in the diagnosis and characterization of scrotal diseases.
Collapse
Affiliation(s)
- Athina C Tsili
- Department of Clinical Radiology, University Hospital of Ioannina, Ioannina 45500, Greece.
| | | | | | | | | | | |
Collapse
|
|
34
|
Papalia R, Simone G, Grasso R, Augelli R, Faiella E, Guaglianone S, Cazzato R, Del Vescovo R, Ferriero M, Zobel B, Gallucci M. Diffusion-weighted magnetic resonance imaging in patients selected for radical cystectomy: detection rate of pelvic lymph node metastases. BJU Int 2011; 109:1031-6. [PMID: 21883835 DOI: 10.1111/j.1464-410x.2011.10446.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate whether DW-MRI improves the detection of pelvic lymph nodes metastates in patients with bladder cancer undergoing radical cystectomy. PATIENTS AND METHODS 36 patients with CT scan negative for nodal metastates underwent DW-MRI before surgery. Diagnostic accuracy of DW-MRI was compared with histopathological findings. RESULTS Mean ADC value was 0.85 × 10(-3) mm(3)/s in the nodal metastatic group and 1 × 10(-3) mm(3)/s in the nodal non-metastatic group (P = 0.02). The ADC cut-off value, obtained by the ROC curve was 0.86 × 10(-3) mm(3)/s. Patient-based sensitivity, specificity and positive and negative predictive values were 76.4%, 89.4%, 26.6%, and 71.4%, respectively. CONCLUSION DW-MRI may be used to differentiate metastatic from non-metastatic lymph nodes in patients with high-grade bladder cancer.
Collapse
Affiliation(s)
- Rocco Papalia
- Radiology Department, University Campus Bio Medico, Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
|
35
|
Rosenkrantz AB, Mannelli L, Kong X, Niver BE, Berkman DS, Babb JS, Melamed J, Taneja SS. Prostate cancer: utility of fusion of T2-weighted and high b-value diffusion-weighted images for peripheral zone tumor detection and localization. J Magn Reson Imaging 2011; 34:95-100. [PMID: 21698707 DOI: 10.1002/jmri.22598] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE To retrospectively assess the utility of fusion of T2-weighted images (T2WI) and high b-value diffusion-weighted images (DWI) for prostate cancer detection and localization. MATERIALS AND METHODS In this IRB-approved HIPAA-compliant study, 42 patients with prostate cancer underwent MRI including multiplanar T2WI and axial DWI before prostatectomy. Two independent radiologists first assessed multiplanar T2WI and axial DWI(b-1000) images and recorded whether tumor was present in each sextant. Axial T2WI was then fused with axial DWI(b-1000) images, and the radiologists re-evaluated each sextant for tumor. Accuracy was compared using generalized estimating equations based on a binary logistic regression model. RESULTS The accuracy, sensitivity, specificity, PPV, and NPV for tumor detection on a sextant-basis using separate and fused image sets was 65.1%, 50.8%, 78.0%, 67.8%, and 63.6% and 71.0%, 60.8%, 80.3%, 73.7%, and 69.3%, respectively, for reader 1, and 54.0%, 42.5%, 64.4%, 52.0%, and 55.2%, and 61.1%, 56.7%, 65.2%, 59.6%, and 62.3%, respectively, for reader 2. The improvements in accuracy, sensitivity, and NPV using fused images were statistically significant for both readers, as was the improvement in PPV for reader 2 (P ranging from <0.0001 to 0.041). With either separate or fused images, there was greater sensitivity for tumors of higher grade or larger size (P ranging from <0.001 to 0.099). CONCLUSION Fusion of T2WI and high b-value DWI resulted in significant improvements in sensitivity and accuracy for tumor detection on a sextant-basis, with similar specificity.
Collapse
Affiliation(s)
- Andrew B Rosenkrantz
- Department of Radiology, NYU Langone Medical Center, TCH-HW202, New York, New York 10016, USA.
| | | | | | | | | | | | | | | |
Collapse
|
|
36
|
The role of dynamic contrast-enhanced and diffusion weighted magnetic resonance imaging in the female pelvis. Eur J Radiol 2011; 76:367-85. [PMID: 20810230 DOI: 10.1016/j.ejrad.2010.01.026] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Accepted: 01/12/2010] [Indexed: 12/18/2022]
Abstract
Functional imaging by means of dynamic multiphase contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted magnetic resonance imaging (DW-MRI) is now part of the standard imaging protocols for evaluation of the female pelvis. DCE-MRI and DW-MRI are important MR imaging techniques which enable the radiologist to move from morphological to functional assessment of diseases of the female pelvis. This is mainly due to the limitations of morphologic imaging, particularly in lesion characterization, accurate lymph node staging, assessment of tumour response and inability to differentiate post-treatment changes from tumour recurrence. DCE-MRI improves the accuracy of T2WI in staging of endometrial cancer. It also helps differentiate tumour recurrence from radiation fibrosis in patients with cervical cancer. DCE-MRI improves characterization of cystic adnexal lesions and detection of small peritoneal implants in patients with ovarian cancer. DW-MRI is valuable in preoperative staging of patients with endometrial and cervical cancer, especially in detection of extra-uterine disease. It does increase reader's confidence for detection of recurrent disease in gynaecological malignancies and improves detection of small peritoneal implants in patients with ovarian cancer. In this review article we give an overview of both DCE-MRI and DW-MRI techniques, concentrating on their main clinical application in the female pelvis, and present a practical approach of the added value of these techniques according to the main pathological conditions, highlighting the pearls and pitfalls of each technique.
Collapse
|
|
37
|
Coutinho AC, Krishnaraj A, Pires CE, Bittencourt LK, Guimarães AR. Pelvic Applications of Diffusion Magnetic Resonance Images. Magn Reson Imaging Clin N Am 2011; 19:133-57. [DOI: 10.1016/j.mric.2010.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
|
|
38
|
Kim MS, Kim KA, Chang SH. Testicular Epidermoid Cyst on Diffusion-Weighted MR Imaging and ADC Map : A Case Report. ACTA ACUST UNITED AC 2011. [DOI: 10.13104/jksmrm.2011.15.2.154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Mi Sun Kim
- Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Korea
| | - Kyung Ah Kim
- Department of Radiology, Yonsei University College of Medicine, Korea
| | - Sun Hee Chang
- Department of Pathology, Ilsan Paik Hospital, Inje University College of Medicine, Korea
| |
Collapse
|
|
39
|
Prostate Cancer: Comparison of Tumor Visibility on Trace Diffusion-Weighted Images and the Apparent Diffusion Coefficient Map. AJR Am J Roentgenol 2011; 196:123-9. [DOI: 10.2214/ajr.10.4738] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
|
40
|
Diffusion-weighted magnetic resonance imaging in patients with unilateral prostate cancer on extended prostate biopsy: predictive accuracy of laterality and implications for hemi-ablative therapy. J Urol 2010; 184:1963-9. [PMID: 20851437 DOI: 10.1016/j.juro.2010.06.136] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Indexed: 11/20/2022]
Abstract
PURPOSE We evaluated the ability of extended prostate biopsy to detect unilateral prostate cancer and assessed the incremental diagnostic benefit of diffusion-weighted magnetic resonance imaging to predict unilateral prostate cancer. MATERIALS AND METHODS A total of 130 patients with prostate cancer detected by extended pattern prostate biopsy underwent magnetic resonance imaging before radical prostatectomy. Tumor laterality on extended prostate biopsy was compared with the corresponding lobe on the radical prostatectomy specimen. In patients with unilateral prostate cancer on biopsy we calculated the probability of a tumor in the contralateral lobe on magnetic resonance images and calculated area under the receiver operating characteristics curve. We compared the diagnostic accuracy of combined T2-weighted and diffusion-weighted magnetic resonance images to that of T2-weighted magnetic resonance images alone. RESULTS Of the 130 patients 88 (67.7%) had unilateral disease on extended prostate biopsy. Radical prostatectomy pathology showed that 19% of these patients had unilateral disease but 81% had bilateral disease. Area under the receiver operating characteristics curve of combined diffusion-weighted and T2-weighted magnetic resonance imaging was greater than that of T2-weighted magnetic resonance imaging alone (0.814, 95% CI 0.716-0.889 vs 0.510, 95% CI 0.401-0.618). T2-weighted plus diffusion-weighted magnetic resonance imaging had significantly higher sensitivity (84.1% vs 61.9%, p = 0.003) and specificity (72.0% vs 36.0%, p = 0.004) to predict cancer in the contralateral lobe than T2-weighted magnetic resonance alone. CONCLUSIONS Extended prostate biopsy cannot accurately determine prostate cancer unilaterality. Diffusion-weighted magnetic resonance combined with T2-weighted magnetic resonance imaging has an incremental diagnostic benefit to predict unilateral prostate cancer.
Collapse
|
|
41
|
Smets AM, de Kraker J. Malignant tumours of the kidney: imaging strategy. Pediatr Radiol 2010; 40:1010-8. [PMID: 20432020 PMCID: PMC2861760 DOI: 10.1007/s00247-010-1584-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Accepted: 01/30/2010] [Indexed: 11/25/2022]
Abstract
Primitive malignant renal tumours comprise 6% of all childhood cancers. Wilms tumour (WT) or nephroblastoma is the most frequent type accounting for more than 90%. Imaging alone cannot differentiate between these tumours with certainty but it plays an important role in screening, diagnostic workup, assessment of therapy response, preoperative evaluation and follow-up. The outcome of WT after therapy is excellent with an overall survival around 90%. In tumours such as those where the outcome is extremely good, focus can be shifted to a risk-based stratification to maintain excellent outcome in children with low risk tumours while improving quality of life and decreasing toxicity and costs. This review will discuss the imaging issues for WT from the European perspective and briefly discuss the characteristics of other malignant renal tumours occurring in children and new imaging techniques with potential in this matter.
Collapse
Affiliation(s)
- Anne M Smets
- Department of Radiology G1, Academic Medical Center, PO Box 22700, Amsterdam 1100 DE, The Netherlands.
| | | |
Collapse
|