AIM: To assess intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for monitoring early efficacy of chemotherapy in a human gastric cancer mouse model.METHODS: IVIM-DWI was performed with 12 b-values (0...AIM: To assess intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for monitoring early efficacy of chemotherapy in a human gastric cancer mouse model.METHODS: IVIM-DWI was performed with 12 b-values (0-800 s/mm<sup>2</sup>) in 25 human gastric cancer-bearing nude mice at baseline (day 0), and then they were randomly divided into control and 1-, 3-, 5- and 7-d treatment groups (n = 5 per group). The control group underwent longitudinal MRI scans at days 1, 3, 5 and 7, and the treatment groups underwent subsequent MRI scans after a specified 5-fluorouracil/calcium folinate treatment. Together with tumor volumes (TV), the apparent diffusion coefficient (ADC) and IVIM parameters [true water molecular diffusion coefficient (D), perfusion fraction (f) and pseudo-related diffusion coefficient (D<sup>*</sup>)] were measured. The differences in those parameters from baseline to each measurement (ΔTV%, ΔADC%, ΔD%, Δf% and ΔD<sup>*</sup>%) were calculated. After image acquisition, tumor necrosis, microvessel density (MVD) and cellular apoptosis were evaluated by hematoxylin-eosin (HE), CD31 and terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) staining respectively, to confirm the imaging findings. Mann-Whitney test and Spearman’s correlation coefficient analysis were performed.RESULTS: The observed relative volume increase (ΔTV%) in the treatment group were significantly smaller than those in the control group at day 5 (ΔTV<sub>treatment</sub>% = 19.63% ± 3.01% and ΔTV<sub>control</sub>% = 83.60% ± 14.87%, P = 0.008) and day 7 (ΔTV<sub>treatment</sub>% = 29.07% ± 10.01% and ΔTV<sub>control</sub>% = 177.06% ± 63.00%, P = 0.008). The difference in ΔTV% between the treatment and the control groups was not significant at days 1 and 3 after a short duration of treatment. Increases in ADC in the treatment group (ΔADC%<sub>treatment</sub>, median, 30.10% ± 18.32%, 36.11% ± 21.82%, 45.22% ± 24.36%) were significantly higher compared with the control group (ΔADC%<sub>control</sub>, median, 4.98% ± 3.39%, 6.26% ± 3.08%, 9.24% ± 6.33%) at days 3, 5 and 7 (P = 0.008, P = 0.016, P = 0.008, respectively). Increases in D in the treatment group (ΔD%<sub>treatment</sub>, median 17.12% ± 8.20%, 24.16% ± 16.87%, 38.54% ± 19.36%) were higher than those in the control group (ΔD%<sub>control</sub>, median -0.13% ± 4.23%, 5.89% ± 4.56%, 5.54% ± 4.44%) at days 1, 3, and 5 (P = 0.032, P = 0.008, P = 0.016, respectively). Relative changes in f were significantly lower in the treatment group compared with the control group at days 1, 3, 5 and 7 follow-up (median, -34.13% ± 16.61% vs 1.68% ± 3.40%, P = 0.016; -50.64% ± 6.82% vs 3.01% ± 6.50%, P = 0.008; -49.93% ± 6.05% vs 0.97% ± 4.38%, P = 0.008, and -46.22% ± 7.75% vs 8.14% ± 6.75%, P = 0.008, respectively). D* in the treatment group decreased significantly compared to those in the control group at all time points (median, -32.10% ± 12.22% vs 1.85% ± 5.54%, P = 0.008; -44.14% ± 14.83% vs 2.29% ± 10.38%, P = 0.008; -59.06% ± 19.10% vs 3.86% ± 5.10%, P = 0.008 and -47.20% ± 20.48% vs 7.13% ± 9.88%, P = 0.016, respectively). Furthermore, histopathologic findings showed positive correlations with ADC and D and tumor necrosis (r<sub>s</sub> = 0.720, P < 0.001; r<sub>s</sub> = 0.522, P = 0.007, respectively). The cellular apoptosis of the tumor also showed positive correlations with ADC and D (r<sub>s</sub> = 0.626, P = 0.001; r<sub>s</sub> = 0.542, P = 0.005, respectively). Perfusion-related parameters (f and D<sup>*</sup>) were positively correlated to MVD (r<sub>s</sub> = 0.618, P = 0.001; r<sub>s</sub> = 0.538, P = 0.006, respectively), and negatively correlated to cellular apoptosis of the tumor (r<sub>s</sub> = -0.550, P = 0.004; r<sub>s</sub> = -0.692, P < 0.001, respectively).CONCLUSION: IVIM-DWI is potentially useful for predicting the early efficacy of chemotherapy in a human gastric cancer mouse model.展开更多
Diffusion-weighted magnetic resonance imaging(DWMRI) is considered part of the standard imaging protocol for the evaluation of patients with prostate cancer.It has been proven valuable as a functional tool for qualita...Diffusion-weighted magnetic resonance imaging(DWMRI) is considered part of the standard imaging protocol for the evaluation of patients with prostate cancer.It has been proven valuable as a functional tool for qualitative and quantitative analysis of prostate cancer beyond anatomical MRI sequences such as T2-weighted imaging. This review discusses ongoing controversies in DW-MRI acquisition, including the optimal number of b-values to be used for prostate DWI, and summarizes the current literature on the use of advanced DWMRI techniques. These include intravoxel incoherent motion imaging, which better accounts for the nonmono-exponential behavior of the apparent diffusion coefficient as a function of b-value and the influence of perfusion at low b-values. Another technique is diffusion kurtosis imaging(DKI). Metrics from DKI reflect excess kurtosis of tissues, representing its deviation from Gaussian diffusion behavior. Preliminary results suggest that DKI findings may have more value than findings from conventional DW-MRI for the assessment of prostate cancer.展开更多
Background: Intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) can not only observe the diffusion of tissue water molecules but also reflect the blood perfusion information of tissue microcirculation. ...Background: Intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) can not only observe the diffusion of tissue water molecules but also reflect the blood perfusion information of tissue microcirculation. IVIM-DWI has been applied in many clinical areas. However, few studies have addressed the use of IVIM-DWI for the evaluation of transarterial chemoembolization (TACE) response in hepatocellular carcinoma (HCC) patients. Objectives: The purpose of the present study was to explore the role of IVIM-DWI for the therapeutic response of TACE for HCC. Materials and Methods: Twenty patients underwent IVIM-DWI scan on a 3.0T magnetic resonance imaging instrument 1 - 3 days before and 30 to 40 days after TACE. The values of IVIM-DWI parameters, including standard apparent diffusion coefficient (ADC), pure diffusion coefficient (Dslow), pseudo-diffusion coefficient (Dfast) and perfusion fraction (f) were measured. The values of IVIM-DWI parameters before and after TACE were compared using paired t tests. The values between responsive and non-responsive groups were compared using independent-samples t test. P 0.05 indicated statistical significance. Results: After TACE, the ADC and Dslow values in the tumors increased significantly, and the values of Dfast decreased significantly, while the values of f value did not change obviously. The ADC values in responsive group were remarkably higher than those in non-responsive group, the Dfast values in responsive group were significantly lower than those in non-responsive group, but the values of Dslow and f between the two groups were not different significantly. Conclusions: IVIM-DWI parameters can be used as potential markers for the therapeutic response of TACE for HCC.展开更多
Objective The aim of this study was to investigate the ability of intravoxel incoherent motion(IVIM) diffusion-weighted magnetic resonance imaging(MRI) to diagnose cervical cancer and to evaluate the response of uteri...Objective The aim of this study was to investigate the ability of intravoxel incoherent motion(IVIM) diffusion-weighted magnetic resonance imaging(MRI) to diagnose cervical cancer and to evaluate the response of uterine cervical cancer to radiochemotherapy(CRT).Methods This prospective study was approved by the institutional review board, and informed consent was obtained from all patients. A total of 23 patients with primary cervical cancer who were undergoing CRT and 16 age-matched healthy subjects were prospectively recruited for IVIM(b = 0–800 s/mm2) and standard pelvic MRI. Bi-exponential analysis was performed to derive f(perfusion fraction), D*(pseudo-diffusion coefficient), and D(true molecular diffusion coefficient) in cervical cancer(n = 23) and the normal cervix(n = 16). The apparent diffusion coefficient(standard ADC) was calculated. The independent-samples t-test and paired-samples t-test were used for comparisons.Results Pre-treatment cervical cancer had the lowest standard ADC(1.15 ± 0.13 × 10-3 mm2/s) and D(0.89 ± 0.10 × 10-3 mm2/s) values, and these were significantly different from the normal cervix and posttreatment cervical cancer(P = 0.00). The f(16.67 ± 5.85%) was lowest in pre-treatment cervical cancer and was significantly different from the normal cervix and post-treatment cervical cancer(p = 0.012 and 0.00, respectively). No difference was observed in D*.Conclusion IVIM is potentially promising for differentiating between the normal cervix and cervical cancer because pre-treated cervical cancer has low perfusion and diffusion IVIM characteristics. Further, the standard ADC, D, and f of cervical cancer showed a tendency to normalize after CRT; thus, IVIM may be useful for monitoring the response to CRT in cervical cancer.展开更多
Hepatocellular carcinoma(HCC) is one of the major causes of morbidity and mortality in patients with chronic liver disease. Transarterial chemoembolization(TACE) can significantly improve the survival rate of patients...Hepatocellular carcinoma(HCC) is one of the major causes of morbidity and mortality in patients with chronic liver disease. Transarterial chemoembolization(TACE) can significantly improve the survival rate of patients with HCC and is the first treatment choice for patients who are not suitable for surgical resections. The evaluation of the response to TACE treatment affects not only the assessment of the therapy efficacy but also the development of the next step in the treatment plan. The use of imaging to examine changes in tumor volume to assess the response of solid tumors to treatment has been controversial. In recent years, the emergence of new imaging technology has made it possible to observe the response of tumors to treatment prior to any morphological changes. In this article, the advances in studies reporting the use of computed tomography perfusion imaging, diffusionweighted magnetic resonance imaging(MRI), intravoxel incoherent motion, diffusion kurtosis imaging, magnetic resonance spectroscopy, magnetic resonance perfusionweighted imaging, blood oxygen level-dependent MRI, positron emission tomography(PET)/computed tomography and PET/MRI to assess the TACE treatment response are reviewed.展开更多
To investigate the evaluation value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)on the early efficacy of magnetic resonance-guided high-intensity focused ultrasound(MRgFUS)ablation for uterine ...To investigate the evaluation value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)on the early efficacy of magnetic resonance-guided high-intensity focused ultrasound(MRgFUS)ablation for uterine adenomyoma.The clinical and magnetic resonance imaging(MRI)data of 36 patients with uterine adenomyoma before and after MRgFUS treatment in our hospital from January 2018 to December 2018 were retrospectively analyzed.All the 36 patients underwent MRI examination one day before operation and immediately after operation using GE Discovery MR7503.0T MRI,including conventional sequences(T1WI,T2WI,and T2 fat suppression sequences)plain scan,IVIM-DWI sequences with 9 b values,and contrast enhanced-MRI sequences.The IVIM-DWI quantitative parameters(true diffusion coefficient D,perfusion related diffusion coefficient D*,and perfusion fraction f)of double-exponential model were obtained by using GE ADW 4.7 functool,a postprocessor.SPSS 24.0 software was used to analyze the difference in parameter between the ablation and non-ablation areas of uterine adenomyoma.DWI signal in the ablation area of uterine adenomyoma was increased,and manifested as heterogeneous diffuse high signal,with low central signal and high edge signal.Values of D,D*and f in the ablation area of uterine adenomyoma were significantly lower than those in the non-ablation area,and there was statistical difference between the two(P<0.05).The areas under receiver operating characteristic(ROC)curve of D,D*and f values in the ablation area of uterine adenomyoma were 0.854,0.898 and 0.924,respectively;the optimal thresholds for the diagnosis of ablation area of uterine adenomyoma were 0.81×10−3 mm2/s,4.99×10−3 mm2/s and 0.24,respectively;the diagnostic sensitivity was 80.6%,72.2%and 94.4%,respectively;and the specificity was 91.7%,97.2%and 94.4%,respectively.IVIM-DWI has a certain clinical value in the evaluation on early efficacy of MRgFUS ablation of uterine adenomyosis.展开更多
基金Supported by National Research Foundation of South Korea,No.NRF-2013R1A1A2013878 and No.2015R1A2A2A01007827
文摘AIM: To assess intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for monitoring early efficacy of chemotherapy in a human gastric cancer mouse model.METHODS: IVIM-DWI was performed with 12 b-values (0-800 s/mm<sup>2</sup>) in 25 human gastric cancer-bearing nude mice at baseline (day 0), and then they were randomly divided into control and 1-, 3-, 5- and 7-d treatment groups (n = 5 per group). The control group underwent longitudinal MRI scans at days 1, 3, 5 and 7, and the treatment groups underwent subsequent MRI scans after a specified 5-fluorouracil/calcium folinate treatment. Together with tumor volumes (TV), the apparent diffusion coefficient (ADC) and IVIM parameters [true water molecular diffusion coefficient (D), perfusion fraction (f) and pseudo-related diffusion coefficient (D<sup>*</sup>)] were measured. The differences in those parameters from baseline to each measurement (ΔTV%, ΔADC%, ΔD%, Δf% and ΔD<sup>*</sup>%) were calculated. After image acquisition, tumor necrosis, microvessel density (MVD) and cellular apoptosis were evaluated by hematoxylin-eosin (HE), CD31 and terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) staining respectively, to confirm the imaging findings. Mann-Whitney test and Spearman’s correlation coefficient analysis were performed.RESULTS: The observed relative volume increase (ΔTV%) in the treatment group were significantly smaller than those in the control group at day 5 (ΔTV<sub>treatment</sub>% = 19.63% ± 3.01% and ΔTV<sub>control</sub>% = 83.60% ± 14.87%, P = 0.008) and day 7 (ΔTV<sub>treatment</sub>% = 29.07% ± 10.01% and ΔTV<sub>control</sub>% = 177.06% ± 63.00%, P = 0.008). The difference in ΔTV% between the treatment and the control groups was not significant at days 1 and 3 after a short duration of treatment. Increases in ADC in the treatment group (ΔADC%<sub>treatment</sub>, median, 30.10% ± 18.32%, 36.11% ± 21.82%, 45.22% ± 24.36%) were significantly higher compared with the control group (ΔADC%<sub>control</sub>, median, 4.98% ± 3.39%, 6.26% ± 3.08%, 9.24% ± 6.33%) at days 3, 5 and 7 (P = 0.008, P = 0.016, P = 0.008, respectively). Increases in D in the treatment group (ΔD%<sub>treatment</sub>, median 17.12% ± 8.20%, 24.16% ± 16.87%, 38.54% ± 19.36%) were higher than those in the control group (ΔD%<sub>control</sub>, median -0.13% ± 4.23%, 5.89% ± 4.56%, 5.54% ± 4.44%) at days 1, 3, and 5 (P = 0.032, P = 0.008, P = 0.016, respectively). Relative changes in f were significantly lower in the treatment group compared with the control group at days 1, 3, 5 and 7 follow-up (median, -34.13% ± 16.61% vs 1.68% ± 3.40%, P = 0.016; -50.64% ± 6.82% vs 3.01% ± 6.50%, P = 0.008; -49.93% ± 6.05% vs 0.97% ± 4.38%, P = 0.008, and -46.22% ± 7.75% vs 8.14% ± 6.75%, P = 0.008, respectively). D* in the treatment group decreased significantly compared to those in the control group at all time points (median, -32.10% ± 12.22% vs 1.85% ± 5.54%, P = 0.008; -44.14% ± 14.83% vs 2.29% ± 10.38%, P = 0.008; -59.06% ± 19.10% vs 3.86% ± 5.10%, P = 0.008 and -47.20% ± 20.48% vs 7.13% ± 9.88%, P = 0.016, respectively). Furthermore, histopathologic findings showed positive correlations with ADC and D and tumor necrosis (r<sub>s</sub> = 0.720, P < 0.001; r<sub>s</sub> = 0.522, P = 0.007, respectively). The cellular apoptosis of the tumor also showed positive correlations with ADC and D (r<sub>s</sub> = 0.626, P = 0.001; r<sub>s</sub> = 0.542, P = 0.005, respectively). Perfusion-related parameters (f and D<sup>*</sup>) were positively correlated to MVD (r<sub>s</sub> = 0.618, P = 0.001; r<sub>s</sub> = 0.538, P = 0.006, respectively), and negatively correlated to cellular apoptosis of the tumor (r<sub>s</sub> = -0.550, P = 0.004; r<sub>s</sub> = -0.692, P < 0.001, respectively).CONCLUSION: IVIM-DWI is potentially useful for predicting the early efficacy of chemotherapy in a human gastric cancer mouse model.
文摘Diffusion-weighted magnetic resonance imaging(DWMRI) is considered part of the standard imaging protocol for the evaluation of patients with prostate cancer.It has been proven valuable as a functional tool for qualitative and quantitative analysis of prostate cancer beyond anatomical MRI sequences such as T2-weighted imaging. This review discusses ongoing controversies in DW-MRI acquisition, including the optimal number of b-values to be used for prostate DWI, and summarizes the current literature on the use of advanced DWMRI techniques. These include intravoxel incoherent motion imaging, which better accounts for the nonmono-exponential behavior of the apparent diffusion coefficient as a function of b-value and the influence of perfusion at low b-values. Another technique is diffusion kurtosis imaging(DKI). Metrics from DKI reflect excess kurtosis of tissues, representing its deviation from Gaussian diffusion behavior. Preliminary results suggest that DKI findings may have more value than findings from conventional DW-MRI for the assessment of prostate cancer.
文摘Background: Intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) can not only observe the diffusion of tissue water molecules but also reflect the blood perfusion information of tissue microcirculation. IVIM-DWI has been applied in many clinical areas. However, few studies have addressed the use of IVIM-DWI for the evaluation of transarterial chemoembolization (TACE) response in hepatocellular carcinoma (HCC) patients. Objectives: The purpose of the present study was to explore the role of IVIM-DWI for the therapeutic response of TACE for HCC. Materials and Methods: Twenty patients underwent IVIM-DWI scan on a 3.0T magnetic resonance imaging instrument 1 - 3 days before and 30 to 40 days after TACE. The values of IVIM-DWI parameters, including standard apparent diffusion coefficient (ADC), pure diffusion coefficient (Dslow), pseudo-diffusion coefficient (Dfast) and perfusion fraction (f) were measured. The values of IVIM-DWI parameters before and after TACE were compared using paired t tests. The values between responsive and non-responsive groups were compared using independent-samples t test. P 0.05 indicated statistical significance. Results: After TACE, the ADC and Dslow values in the tumors increased significantly, and the values of Dfast decreased significantly, while the values of f value did not change obviously. The ADC values in responsive group were remarkably higher than those in non-responsive group, the Dfast values in responsive group were significantly lower than those in non-responsive group, but the values of Dslow and f between the two groups were not different significantly. Conclusions: IVIM-DWI parameters can be used as potential markers for the therapeutic response of TACE for HCC.
基金Supported by grants from the the National Natural Science Foundation of China(No.81371524,81271529)the Hubei Provincial Natural Science Foundation of China(No.2014CFB298)
文摘Objective The aim of this study was to investigate the ability of intravoxel incoherent motion(IVIM) diffusion-weighted magnetic resonance imaging(MRI) to diagnose cervical cancer and to evaluate the response of uterine cervical cancer to radiochemotherapy(CRT).Methods This prospective study was approved by the institutional review board, and informed consent was obtained from all patients. A total of 23 patients with primary cervical cancer who were undergoing CRT and 16 age-matched healthy subjects were prospectively recruited for IVIM(b = 0–800 s/mm2) and standard pelvic MRI. Bi-exponential analysis was performed to derive f(perfusion fraction), D*(pseudo-diffusion coefficient), and D(true molecular diffusion coefficient) in cervical cancer(n = 23) and the normal cervix(n = 16). The apparent diffusion coefficient(standard ADC) was calculated. The independent-samples t-test and paired-samples t-test were used for comparisons.Results Pre-treatment cervical cancer had the lowest standard ADC(1.15 ± 0.13 × 10-3 mm2/s) and D(0.89 ± 0.10 × 10-3 mm2/s) values, and these were significantly different from the normal cervix and posttreatment cervical cancer(P = 0.00). The f(16.67 ± 5.85%) was lowest in pre-treatment cervical cancer and was significantly different from the normal cervix and post-treatment cervical cancer(p = 0.012 and 0.00, respectively). No difference was observed in D*.Conclusion IVIM is potentially promising for differentiating between the normal cervix and cervical cancer because pre-treated cervical cancer has low perfusion and diffusion IVIM characteristics. Further, the standard ADC, D, and f of cervical cancer showed a tendency to normalize after CRT; thus, IVIM may be useful for monitoring the response to CRT in cervical cancer.
基金Supported by Projects of Department of Science and Technology of Sichuan Province,No.2016JY0105
文摘Hepatocellular carcinoma(HCC) is one of the major causes of morbidity and mortality in patients with chronic liver disease. Transarterial chemoembolization(TACE) can significantly improve the survival rate of patients with HCC and is the first treatment choice for patients who are not suitable for surgical resections. The evaluation of the response to TACE treatment affects not only the assessment of the therapy efficacy but also the development of the next step in the treatment plan. The use of imaging to examine changes in tumor volume to assess the response of solid tumors to treatment has been controversial. In recent years, the emergence of new imaging technology has made it possible to observe the response of tumors to treatment prior to any morphological changes. In this article, the advances in studies reporting the use of computed tomography perfusion imaging, diffusionweighted magnetic resonance imaging(MRI), intravoxel incoherent motion, diffusion kurtosis imaging, magnetic resonance spectroscopy, magnetic resonance perfusionweighted imaging, blood oxygen level-dependent MRI, positron emission tomography(PET)/computed tomography and PET/MRI to assess the TACE treatment response are reviewed.
文摘To investigate the evaluation value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)on the early efficacy of magnetic resonance-guided high-intensity focused ultrasound(MRgFUS)ablation for uterine adenomyoma.The clinical and magnetic resonance imaging(MRI)data of 36 patients with uterine adenomyoma before and after MRgFUS treatment in our hospital from January 2018 to December 2018 were retrospectively analyzed.All the 36 patients underwent MRI examination one day before operation and immediately after operation using GE Discovery MR7503.0T MRI,including conventional sequences(T1WI,T2WI,and T2 fat suppression sequences)plain scan,IVIM-DWI sequences with 9 b values,and contrast enhanced-MRI sequences.The IVIM-DWI quantitative parameters(true diffusion coefficient D,perfusion related diffusion coefficient D*,and perfusion fraction f)of double-exponential model were obtained by using GE ADW 4.7 functool,a postprocessor.SPSS 24.0 software was used to analyze the difference in parameter between the ablation and non-ablation areas of uterine adenomyoma.DWI signal in the ablation area of uterine adenomyoma was increased,and manifested as heterogeneous diffuse high signal,with low central signal and high edge signal.Values of D,D*and f in the ablation area of uterine adenomyoma were significantly lower than those in the non-ablation area,and there was statistical difference between the two(P<0.05).The areas under receiver operating characteristic(ROC)curve of D,D*and f values in the ablation area of uterine adenomyoma were 0.854,0.898 and 0.924,respectively;the optimal thresholds for the diagnosis of ablation area of uterine adenomyoma were 0.81×10−3 mm2/s,4.99×10−3 mm2/s and 0.24,respectively;the diagnostic sensitivity was 80.6%,72.2%and 94.4%,respectively;and the specificity was 91.7%,97.2%and 94.4%,respectively.IVIM-DWI has a certain clinical value in the evaluation on early efficacy of MRgFUS ablation of uterine adenomyosis.
