The value of diffusion kurtosis imaging and dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of parotid gland tumors
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SUBMITTER: Liu Z
PROVIDER: S-EPMC11336784 | biostudies-literature | 2024 Jul
REPOSITORIES: biostudies-literature
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Project description:ObjectiveTo assess the usefulness of combined diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced MRI (DCE-MRI) in the differentiation of parotid gland tumors.MethodsSeventy patients with 80 parotid gland tumors who underwent DKI and DCE-MRI were retrospectively enrolled and divided into four groups: pleomorphic adenomas (PAs), Warthin tumors (WTs), other benign tumors (OBTs), and malignant tumors (MTs). DCE-MRI and DKI quantitative parameters were measured. The Kruskal-Wallis H test and post hoc test with Bonferroni correction and ROC curve were used for statistical analysis.ResultsWTs demonstrated the highest Kep value (median 1.89, interquartile range [1.46-2.31] min-1) but lowest Ve value (0.20, [0.15-0.25]) compared with PAs (Kep, 0.34 [0.21-0.55] min-1; Ve, 0.36 [0.24-0.43]), OBTs (Kep, 1.22 [0.27-1.67] min-1; Ve, 0.28 [0.25-0.41]), and MTs (Kep, 0.71 [0.50-1.23] min-1; Ve, 0.35 [0.26-0.45]) (all p < .05). MTs had the lower D value (1.10, [0.88-1.29] × 10-3 mm2/s) compared with PAs (1.81, [1.60-2.20] × 10-3 mm2/s) and OBTs (1.57, [1.32-1.89] × 10-3 mm2/s) (both p < .05). PAs had the lower Ktrans value (0.12, [0.07-0.18] min-1) compared with OBTs (0.28, [0.11-0.50] min-1) (p < .05). The cutoff values of combined Kep and Ve, D, and Ktrans to distinguish WTs, MTs, and PAs sequentially were 1.06 min-1, 0.28, 1.46 × 10-3 mm2/s, and 0.21 min-1, respectively (accuracy, 89% [71/80], 91% [73/80], 78% [62/80], respectively).ConclusionThe combined use of DKI and DCE-MRI may help differentiate parotid gland tumors.Key points• The combined use of DKI and DCE-MRI could facilitate the understanding of the pathophysiological characteristics of parotid gland tumors. • A stepwise diagnostic diagram based on the combined use of DCE-MRI parameters and the diffusion coefficient is helpful for accurate preoperative diagnosis in parotid gland tumors and may further facilitate the clinical management of patients.
| S-EPMC8921043 | biostudies-literature
Project description:Background and objectiveIn recent years, magnetic resonance imaging (MRI) has shown excellent results in the study of the prostate gland. MRI has indeed shown to be advantageous in the prostate cancer (PCa) detection, as in guiding targeting biopsy, improving its diagnostic yield. Although current acquisition protocols provide for multiparametric acquisition, recent evidence has shown that biparametric protocols can be non-inferior in PCa detection. Diffusion-weighted imaging (DWI) sequence, in particular, plays a key role, particularly in the peripheral zone which accounts for the larger part of the prostate. High b-values are generally recommended, although with the possibility of obtaining non-Gaussian diffusion effects, which requires a more sophisticated model for the analysis, namely through the diffusion kurtosis imaging (DKI). Purpose of this narrative review was to analyze the current applications and clinical evidence regarding the use of DKI with a main focus on PCa detection, also in comparison with DWI.MethodsThis narrative review synthesized the findings of literature retrieved from main researches, narrative and systematic reviews, and meta-analyses obtained from PubMed.Key content and findingsDKI analyses the non-Gaussian water diffusivity and describe the effect of signal intensity decay related to high b-value through two main metrics (Dapp and Kapp). Differently from DWI-apparent diffusion coefficient (DWI-ADC) which reflects only water restriction outside of cells, DKI metrics are supposed to represent also the direct interaction of water molecules with cell membranes and intracellular compounds. This review describes current evidence on ADC and DKI metrics in clinical imaging, and finally collect the results derived from the main articles focused on DWI and DKI models in detecting PCa.ConclusionsDKI advantages, compared to conventional ADC analysis, still remain controversial. Wider application and greater technical knowledge of DKI, however, may help in proving its intrinsic validity in the field of oncology and therefore in the study of clinically significant PCa. Finally, a deep understanding of DKI is important for radiologists to better understand what Kapp and Dapp mean in the context of different cancer and how these metrics may vary specifically in PCa imaging.
| S-EPMC10788566 | biostudies-literature
Project description:BackgroundThe aim of this study was to investigate the value of unenhanced magnetic resonance imaging (MRI) with diffusion kurtosis imaging (DKI) in diagnosing papillary thyroid carcinoma (PTC).MethodsIn all, 77 consecutive patients comprising a total of 77 thyroid nodules were enrolled in this study. Of these nodules, 41 were histopathologically confirmed PTCs and 36 were benign nodules. All patients underwent thyroid MRI including T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and DKI. All the images were assessed by 2 radiologists. The signal intensity ratio (SIR) of these nodules on T1WI and T2WI, the apparent diffusion coefficient (ADC) from DWI, and mean diffusivity (MD) and mean kurtosis (MK) from DKI were measured. Morphological features on these images were also evaluated. Univariate and multivariate logistic regression analyses were used to evaluate the value of these parameters as potential predictors of PTC.ResultsIn the univariate analyses, the features that significantly indicated PTC were decreased ADC value (P<0.001), decreased MD value (P<0.001), increased MK value (P<0.001), younger age (P=0.001), female tendency (P=0.049), smaller tumor diameter (P<0.001), solid component (P<0.001), and irregular margin (P<0.001). In the multivariate analysis, decreased MD value (odds ratio =25.321; P=0.001), smaller diameter (odds ratio =13.751; P=0.006), and irregular margin (odds ratio =16.003; P=0.003) were independent risk factors for PTC. The combined predictor of MD, diameter, and margin showed an area under the receiver operating characteristic (ROC) curve of 0.996 in diagnosing PTC, with an optimal cutoff value of 0.69 (95.1% sensitivity, 100.0% specificity).ConclusionsLower MD value from DKI, smaller diameter, and irregular margin are useful predictive biomarkers for PTC.
| S-EPMC10102801 | biostudies-literature
Project description:ObjectiveTo investigate the diagnostic value of diffusion kurtosis imaging (DKI) histogram analysis in hepatic fibrosis staging.Materials and methodsThirty-six rats were divided into carbon tetrachloride-induced fibrosis groups (6 rats per group for 2, 4, 6, and 8 weeks) and a control group (n = 12). MRI was performed using a 3T scanner. Histograms of DKI were obtained for corrected apparent diffusion (D), kurtosis (K) and apparent diffusion coefficient (ADC). Mean, median, skewness, kurtosis and 25th and 75th percentiles were generated and compared according to the fibrosis stage and inflammatory activity.ResultsA total of 35 rats were included, and 12, 5, 5, 6, and 7 rats were diagnosed as F0-F4. The mean, median, 25th and 75th percentiles, kurtosis of D map, median, 25th percentile, skewness of K map, and 75th percentile of ADC map demonstrated significant correlation with fibrosis stage (r = -0.767 to 0.339, p < 0.001 to p = 0.039). The fibrosis score was the independent variable associated with histogram parameters compared with inflammatory activity grade (p < 0.001 to p = 0.041), except the median of K map (p = 0.185). Areas under the receiver operating characteristic curve of D were larger than K and ADC maps in fibrosis staging, although no significant differences existed in pairwise comparisons (p = 0.0512 to p = 0.847).ConclusionCorrected apparent diffusion of DKI histogram analysis provides added value and better diagnostic performance to detect various liver fibrosis stages compared with ADC.
| S-EPMC6082766 | biostudies-literature
Project description:BackgroundTo systematically evaluate the qualitative diagnostic value of multimodal magnetic resonance imaging (MRI) for parotid gland tumors. However, there is still a lot of controversy in this area, and the results of different studies are not consistent. Therefore, it is necessary to use meta method to analyze the significance of multimodal MRI in the diagnosis of parotid gland tumors.MethodsThis study aimed to assess the diagnostic performance of multimodal MRI for parotid gland malignancies. We performed a search in the databases of the Cochrane Library, PubMed, Web of Science, Embase, Chinese BioMedical Literature (CBM). Quality evaluation and data extraction were performed for the included articles, and meta-analysis was performed on the included studies using Stata 15.0 software.ResultsAfter screening, a total of 5 relevant documents met the standards and were included. The results of analysis showed that the MRI with diffusion-weighted imaging (MRI-DWI) combined sensitivity and specificity were 0.54 (0.22-0.83) and 0.93 (0.79-0.98). The MRI with dynamic contrast-enhanced (MRI-DCE) combined sensitivity and specificity were 0.81 (0.48-0.95) and 0.95 (0.92-0.97). The pooled area under the curve (AUC) of the MRI-DWI was 0.89 (95% CI: 0.86-0.91) and the pooled area under the curve (AUC) of the MRI-DCE was 0.96 (95% CI: 0.94-0.97).DiscussionThe results of meta-analysis showed that multimodal MRI had good sensitivity, specificity and high sensitivity in the diagnosis of parotid gland carcinoma. However, there is high heterogeneity, which needs to be verified by a large number of clinical studies.
| S-EPMC9372210 | biostudies-literature
Project description:Early diagnosis of liver fibrosis is important. The objective of this study was to explore the characteristics and to assess the accuracy of monoexponential, stretched exponential models (SEM), and diffusion kurtosis imaging (DKI) with diffusion-weighted imaging (DWI)-magnetic resonance imaging (MRI) in various stages of liver fibrosis in two standard rat models induced by carbon tetrachloride (CCl4) and biliary duct ligation (BDL). Parameters (ADC, Dapp, Kapp, DDC, ?) were measured with a 3.0T MRI. Liver fibrosis stages (F0-F4) were defined by METAVIR scoring. Parameters (ADC, Dapp, DDC) were found to be negatively associated (r: -0.675~-0.789; P<0.05) with advancement of fibrosis stage. The analysis of receiver operating characteristic (ROC) curves illustrated that the areas under the curves (AUC) for ADC, Dapp, and DDC were 0.687~0.957, 0.805~0.938 and 0.876~1.000, respectively. The study showed that (ADC, Dapp, Kapp, DDC, ?) from various diffusion models reflected pathological and physiological tissue changes. We conclude that SEM and DKI may provide more accurate information about diffusion, and non-Gaussian diffusion analysis may be a complementary tool for the assessment of liver fibrosis.
| S-EPMC5788645 | biostudies-literature
Project description:BackgroundAccording to hormone receptor (HR) status, human epidermal growth factor 2 positive (HER2+) breast carcinoma can be divided into HR- and HR+, with different treatment and prognosis. We analyzed the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) findings, apparent diffusion coefficient (ADC) value and the combination of DCE-MRI and ADC value of HER2+/HR- breast carcinoma.MethodsTotally 259 cases (96 HR-, 163 HR+) of pathologically verified HER2+ breast carcinoma were collected. Patients underwent DCE-MRI and diffusion weighted imaging (DWI). The morphological characteristics, internal enhancement characteristics, early enhancement rate (EER), and time-signal intensity curves (TIC) were recorded, and ADC values were measured. The relationship between each feature and HER2+/HR- breast cancer was analyzed. Area under the cures (AUC) was used to compare diagnostic performance of DCE-MRI, ADC value and the combination of DCE-MRI and ADC value.ResultsHER2+/HR- breast cancer presented as non-mass enhancement (NME), mass with NME, whereas HER2+/HR+ breast cancer presented as mass (P<0.001). HR- cases showed a round or oval shape with circumscribed margins, whereas HR+ cases showed an irregular mass with irregular or spiculated margins (P=0.001, P=0.028). The size of the mass, the internal enhancement characteristics, EER, and TIC did not differ significantly between the two HER2+ breast carcinomas. The ADC values for HR- and HR+ breast cancers were [1.2 (1.14, 1.33)] ×10-3 mm2/s and [1.0 (0.89, 1.11)] ×10-3 mm2/s, respectively, which were statistically significant (Z=-9.119, P<0.001). The ADC value can be used for diagnosing HER2+/HR- breast carcinoma, with the threshold value of 1.095×10-3 mm2/s [negative predictive value (NPV) of 89.8%, sensitivity of 86.5% and specificity of 70.6%]. The AUCs of ADC value, DCE-MRI, and DCE-MRI combined with ADC value were 0.839, 0.689 and 0.860, respectively. AUC of the DCE-MRI combined with ADC value was significantly higher than DCE-MRI alone (P<0.0001).ConclusionsThe diagnostic performance of the DCE-MRI combined with ADC value was good in diagnosing HER2+/HR- breast cancers. MRI is an effective tool in diagnosing HER2+/HR- breast carcinoma, which will help select the clinical treatment plan and determine the prognosis.
| S-EPMC10423352 | biostudies-literature
Project description:BackgroundRenal disease in children may lead to a continuous decline of renal function. Multimodal functional magnetic resonance imaging (fMRI) technology can provide quantitative evaluation of renal function information. We investigated the feasibility of intravoxel incoherent motion imaging (IVIM) and diffusion kurtosis imaging (DKI) based on 3.0T MRI for the assessment of normal renal function in children and then analyzed the changes in functional parameters during development.MethodsA total of 132 children with normal function of both kidneys were grouped according to age: ≤1 year old, 1-≤2 years old, 2-≤3 years old, 3-≤10 years old, and 10-≤14 years old. All subjects received renal IVIM examinations to obtain the measured values of true diffusion coefficient (D), pseudo diffusion coefficient (Dp), perfusion fraction (f), and DKI examinations to obtain the mean diffusivity (MD) and mean kurtosis (MK) parameters of both kidneys. The differences of IVIM and DKI function indexes between the upper, middle and lower poles of the normal ipsilateral kidney, between the left and right kidneys, and between the renal cortex and medulla were compared. The correlations between the above parameters and age were analyzed.ResultsThere was no significant difference in the IVIM and DKI parameters between the upper, middle and lower poles in the ipsilateral kidney. There was no significant difference between bilateral kidneys. The D, MD, and MK values of the renal cortex and medulla at the same age were statistically different. The D and MD values of the renal cortex were higher than those of the medulla; the MK value of the renal medulla was higher than that of the cortex. The Dp and f values of the renal cortex and medulla were not statistically different. Except for Dp, all functional parameters of the remaining renal cortex and medulla were related to age.ConclusionsIVIM and DKI functional imaging of children's normal kidneys can reflect the physiological characteristics and differences in the renal cortex and medulla, and their functional parameters have particular regularity with growth and development, suggesting that this technique has potential application value in children's kidney diseases.
| S-EPMC9834948 | biostudies-literature
Project description:The diffusion-weighted magnetic resonance imaging (DWI) technique enables quantification of water mobility for probing microstructural properties of biological tissue and has become an effective tool for collecting information about the underlying pathology of cancerous tissue. Measurements using multiple b-values have indicated biexponential signal attenuation, ascribed to "fast" (high ADC) and "slow" (low ADC) diffusion components. In this empirical study, we investigate the properties of the diffusion time (Δ)-dependent components of the diffusion-weighted (DW) signal in a constant b-value experiment. A xenograft gliobastoma mouse was imaged using Δ = 11 ms, 20 ms, 40 ms, 60 ms, and b = 500-4000 s/mm(2) in intervals of 500 s/mm(2). Data were corrected for EPI distortions, and the Δ-dependence on the DW-signal was measured within three regions of interest [intermediate- and high-density tumor regions and normal-appearing brain (NAB) tissue regions]. In this study, we verify the assumption that the slow decaying component of the DW-signal is non-Gaussian and dependent on Δ, consistent with restricted diffusion of the intracellular space. As the DW-signal is a function of Δ and is specific to restricted diffusion, manipulating Δ at constant b-value (cb) provides a complementary and direct approach for separating the restricted from the hindered diffusion component. We found that Δ-dependence is specific to the tumor tissue signal. Based on an extended biexponential model, we verified the interpretation of the diffusion time-dependent contrast and successfully estimated the intracellular restricted ADC, signal volume fraction, and cell size within each ROI.
| S-EPMC4970563 | biostudies-literature
Project description:Gadolinium-based contrast agents (GBCAs) are the most widely used T1 contrast agents for magnetic resonance imaging (MRI) and have achieved remarkable success in clinical cancer diagnosis. However, GBCAs could cause severe nephrogenic systemic fibrosis to patients with renal insufficiency. Nevertheless, GBCAs are quickly excreted from the kidneys, which shortens their imaging window and prevents long-term monitoring of the disease per injection. Herein, a nephrotoxicity-free T1 MRI contrast agent is developed by coordinating ferric iron into a telodendritic, micellar nanostructure. This new nano-enabled, iron-based contrast agent (nIBCA) not only can reduce the renal accumulation and relieve the kidney burden, but also exhibit a significantly higher tumor to noise ratio (TNR) for cancer diagnosis. In comparison with Magnevist (a clinical-used GBCA), Magnevist induces obvious nephrotoxicity while nIBCA does not, indicating that such a novel contrast agent may be applicable to renally compromised patients requiring a contrast-enhanced MRI. The nIBCA could precisely image subcutaneous brain tumors in a mouse model and the effective imaging window lasted for at least 24 h. The nIBCA also precisely highlights the intracranial brain tumor with high TNR. The nIBCA presents a potential alternative to GBCAs as it has superior biocompatibility, high TNR and effective imaging window.
| S-EPMC7442595 | biostudies-literature