Diagnostic accuracy of high b-value diffusion weighted imaging for patients with prostate cancer: a diagnostic comprehensive analysis.
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ABSTRACT:
SUBMITTER: Li C
PROVIDER: S-EPMC8266335 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:PURPOSE:This study aims to investigate the role of diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI) in combination for the detection of prostate cancer, specifically assessing the role of high b-values (> 1000 s/mm2), with a systematic review and meta-analysis of the existing published data. METHODS:The electronic databases MEDLINE, EMBASE, and OpenSIGLE were searched between inception and September 1, 2017. Eligible studies were those that reported the sensitivity and specificity of DWI and T2WI for the diagnosis of prostate cancer by visual assessment using a histopathologic reference standard. The QUADAS-2 critical appraisal tool was used to assess the quality of included studies. A meta-analysis with pooling of sensitivity, specificity, likelihood, and diagnostic odds ratios was undertaken, and a summary receiver-operating characteristics (sROC) curve was constructed. Predetermined subgroup analysis was also performed. RESULTS:Thirty-three studies were included in the final analysis, evaluating 2949 patients. The pooled sensitivity and specificity were 0.69 (95% CI 0.68-0.69) and 0.84 (95% CI 0.83-0.85), respectively, and the sROC AUC was 0.84 (95% CI 0.81-0.87). Subgroup analysis showed significantly better sensitivity with high b-values (> 1000 s/mm2). There was high statistical heterogeneity between studies. CONCLUSION:The diagnostic accuracy of combined DWI and T2WI is good with high b-values (> 1000 s/mm2) seeming to improve overall sensitivity while maintaining specificity. However, further large-scale studies specifically looking at b-value choice are required before a categorical recommendation can be made.
| S-EPMC6061488 | biostudies-literature
Project description:ObjectivesAn ill-defined hyperintense edge and hypointense core on diffusion-weighted imaging (DWI) is typical of progressive multifocal leukoencephalopathy (PML). We aimed to investigate whether a b-value of 3,000 s/mm2 (b3000) can improve visualisation of PML, or provide different structural information compared to 1,000 s/mm2 (b1000).MethodsWe retrospectively identified HIV-positive patients with confirmed PML studied under a clinical protocol including both b1000 and b3000 DWI. The rim and core of each PML lesion and normal-appearing white matter (NAWM) were outlined on trace-weighted DWI. Signal intensities, apparent diffusion coefficient (ADC) values and volumes were measured and compared between b1000 and b3000.ResultsNine lesions from seven patients were analysed. The rim and core were better visualised on b3000, with higher signal of the rim and lower signal of the core compared to NAWM. The hyperintense rim had non-restricted average ADCs, but included foci of low ADC on both b3000 and b1000. Despite similar total lesion volumes, b3000 displayed significantly larger core and smaller rim volumes than b1000.Conclusionb3000 improves visualisation of this important PML hallmark. Moreover, b3000 partly reclassifies tissue from rim into core, and might provide potentially more accurate biomarkers of PML activity and prognosis.Key points• B3000 improves contrast resolution between lesion rim, core and normal-appearing white matter. • B3000 improves identification of the typical rim-and-core pattern of PML lesions. • B3000 and b1000 similarly identify lesions, but b3000 results in smaller rims and larger cores. • B3000 excludes some high diffusion components from rim, reclassifying them into core. • B3000 DWI may provide more precise PML biomarkers of disease activity and tissue damage.
| S-EPMC5544784 | biostudies-literature
Project description:To evaluate the incremental value of diffusion-weighted (DW) imaging and apparent diffusion coefficient (ADC) mapping in relation to conventional breast magnetic resonance (MR) imaging in the characterization of benign versus malignant breast lesions at 3.0 T.This retrospective HIPAA-compliant study was approved by the institutional review board, with the requirement for informed patient consent waived. Of 550 consecutive patients who underwent bilateral breast MR imaging over a 10-month period, 93 women with 101 lesions met the following study inclusion criteria: They had undergone three-dimensional (3D) high-spatial-resolution T1-weighted contrast material-enhanced MR imaging, dynamic contrast-enhanced MR imaging, and DW imaging examinations at 3.0 T and either had received a pathologic analysis-proven diagnosis (96 lesions) or had lesion stability confirmed at more than 2 years of follow-up (five lesions). DW images were acquired with b values of 0 and 600 sec/mm(2). Regions of interest were drawn on ADC maps of breast lesions and normal glandular tissue. Morphologic features (margin, enhancement pattern), dynamic contrast-enhanced MR results (semiquantitative kinetic curve data), absolute ADCs, and glandular tissue-normalized ADCs were included in multivariate models to predict a diagnosis of benign versus malignant lesion.Forty-one (44%) of the 93 patients were premenopausal, and 52 (56%) were postmenopausal. Thirty-three (32.7%) of the 101 lesions were benign, and 68 (67.3%) were malignant. Normalized ADCs were significantly different between the benign (mean ADC, 1.1 x 10(-3) mm(2)/sec +/- 0.4 [standard deviation]) and malignant (mean ADC, 0.55 x 10(-3) mm(2)/sec +/- 0.16) lesions (P < .001). Adding normalized ADCs to the 3D T1-weighted and dynamic contrast-enhanced MR data improved the diagnostic performance of MR imaging: The area under the receiver operating characteristic curve improved from 0.89 to 0.98, and the false-positive rate decreased from 36% (nine of 25 lesions) to 24% (six of 25 lesions).DW imaging with glandular tissue-normalized ADC assessment improves the characterization of breast lesions beyond the characterization achieved with conventional 3D T1-weighted and dynamic contrast-enhanced MR imaging at 3.0 T.
| S-EPMC2897691 | biostudies-other
Project description:PurposeSupratentorial pilocytic astrocytoma (PA) may mimic pleomorphic xanthoastrocytoma (PXA) on conventional MR imaging, and a differentiation is clinically important because of distinct recurrence rate and anaplastic transformation rate. The purpose of this study was to investigate the diagnostic potential of diffusion-weighted imaging (DWI) in differentiating supratentorial PA from PXA.MethodsWe retrospectively reviewed DWI and conventional MR imaging of 16 patients with supratentorial PA and 8 patients with PXA. Variables of mean ADC values (ADCmean) and minimum ADC values (ADCmin) were calculated from the ROIs containing the contrast-enhancing lesion on DWI. ADCmean values and ADCmin values were compared among all supratentorial PA and PXA as well as between the subgroup of lobar PA and PXA by using an unpaired Student's t test. The optimum threshold, sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve (AUC) were determined.ResultsBoth ADCmean values (1542 ± 186 vs 1084 ± 201 × 10-6 mm2/s; P < 0.001) and ADCmin values (1355 ± 183 vs 988 ± 180 × 10-6 mm2/s; P < 0.001) were significantly higher in supratentorial PA compared with PXA. The ADCmean values and ADCmin values were also significantly higher in lobar PA than those in PXA. The ADCmean values were useful for differentiating supratentorial PA from PXA, with a threshold value of > 1189.8 × 10-6 mm2/s (sensitivity, 93.8%; specificity, 100%). The optimal threshold values of > 1189.8 × 10-6 mm2/s for ADCmean values provide sensitivity and specificity of 85.7 and 100%, respectively, for discriminating lobar PA from PXA. The optimum threshold value for ADCmin was > 1063.5 × 10-6 mm2/s.ConclusionDWI is helpful in characterization and differentiation of supratentorial PA from PXA.
| S-EPMC5996010 | biostudies-literature
Project description:ObjectivesThe purpose of this study was to analyze the diagnostic performance and clinical application of diffusion-weighted imaging (DWI) in patients with suspected pleural malignancy (PM).MethodsA retrospective review of patients with suspected PM was performed from March 2014 to August 2018 (NCT02320617). All patients underwent chest DWI and computed tomography (CT) with cytological or histopathological findings as reference standards. The diagnostic performance of DWI and CT was analyzed and compared. A DWI diagnostic algorithm with three sequential steps was established.ResultsSeventy patients (61.6 ± 13.6 years; 47 males and 23 females) were included. The sensitivity of DWI (94.2%, 49/52) for the diagnosis of PM was significantly higher compared with CT (67.3%, 35/52), with similar specificity (72.2% vs. 72.2%, respectively). The apparent diffusion coefficient of malignant lesions (1.15 ± 0.32 × 10-3 mm2/s) was lower compared with benign lesions (1.46 ± 0.68 × 10-3 mm2/s), but the cutoff value was difficult to define for overlap between groups. Approximately 62.5% (5/8) of invasive procedures were avoided when using the DWI diagnostic algorithm in patients with suspected PM without N3 lymph node or extra-thoracic metastasis.ConclusionIncluding DWI into the diagnostic algorithm of suspected PM can effectively identify malignancy and avoid unnecessary invasive procedures, which may have some potential in clinical application.Key points• Diffusion-weighted imaging can identify pleural malignancy much more efficiently than CT. • A diffusion-weighted imaging diagnostic algorithm helped to avoid unnecessary invasive procedures in patients without N3 lymph node or extra-thoracic lesions. • A hyperintense signal on DWI at a high b value (800 s/mm2) but not at a low b value (50 s/mm2) was a reliable signature of PM.
| S-EPMC8589770 | biostudies-literature
Project description:BackgroundRoutine screening of prostate specific antigen (PSA) is no longer recommended because of a high rate of over-diagnosis of prostate cancer (PCa).ObjectiveTo evaluate the efficacy of diffusion-weighted magnetic resonance imaging (DW-MRI) for PCa detection, and to explore the clinical utility of ultrahigh b-value DW-MRI in predicting prostate biopsy outcomes.Methodology73 male patients were selected for the study. They underwent 3T MRI using T2WI conventional DW-MRI with b-value 1000 s/mm2, and ultrahigh b-value DW-MRI with b-values of 2000 s/mm2 and 3000 s/mm2. Two radiologists evaluated individual prostate gland images on a 5-point rating scale using PI-RADS, for the purpose of region-specific comparisons among modalities. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios (LR) were investigated for each MRI modality. The area under the receiver operating characteristic (ROC) curve (AUC) was also calculated.ResultsResults showed the improved diagnostic value of ultrahigh b-value DWI-MRI for detection of PCa when compared to other b values and conventional MRI protocols. Sensitivity values for 3000 s/mm2 in both peripheral zone (PZ) and transition zone (TZ) were significantly higher than those observed with conventional DW-MRI-Specificity values for 3000 s/mm2 in the TZ were significantly higher than other b-value images, whereas specificity values using 3000 s/mm2 in the PZ were not significantly higher than 2000 s/mm2 images. PPV and NPV between 3000 s/mm2 and the other three modalities were significantly higher for both PZ and TZ images. The PLRs and NLRs of b-value 3000 s/mm2 DW-MRI in the PZ and TZ were also recorded. ROC analysis showed greater AUCs for the b value 3000 s/mm2 DWI than for the other three modalities.ConclusionsDW-MRI with a b-value of 3000 s/mm2 was found to be the most accurate and reliable MRI modality for PCa tumor detection and localization, particularly for TZ lesion discrimination. It may be stated that the b-value of 3000 s/mm2 is a novel, improved diagnostic biomarker with greater predictive accuracy for PCa prior to biopsy.
| S-EPMC4786278 | biostudies-literature
Project description:BACKGROUND:To investigate the ability of amide proton transfer (APT) weighted magnetic resonance imaging (MRI), arterial spin labeling (ASL), diffusion weighted imaging (DWI) and the combination for differentiating high-grade gliomas (HGGs) from low-grade gliomas (LGGs). METHODS:Twenty-seven patients including nine LGGs and eighteen HGGs underwent conventional, APT, ASL and DWI MRI with a 3.0-T MR scanner. Histogram analyses was performed and quantitative parameters including mean apparent diffusion coefficient (ADC mean), 20th-percentile ADC (ADC 20th), mean APT (APT mean), 90th-percentile APT (APT 90th), relative mean cerebral blood flow (rCBF mean) and relative 90th-percentile CBF (rCBF 90th) were compared between HGGs and LGGs. The diagnostic performance was evaluated with receiver operating characteristic (ROC) analysis of each parameter and their combination. Correlations were analyzed among the MRI parameters and Ki-67. RESULTS:The APT values were significantly higher in the HGGs compared to the LGGs (p?<? 0.005), whereas ADC values were significantly lower in HGGs than LGGs (P?<? 0.0001). The ADC 20th and APT mean had higher discrimination abilities compared with other single parameters, with the area under the ROC curve (AUC) of 0.877 and 0.840. Adding ADC parameter, the discrimination ability of APT and rCBF significantly improved. The ADC was negatively correlated with the APT and rCBF value, respectively, while APT value was positively correlated with rCBF value. Significant correlations between ADC values and Ki-67 were also observed. CONCLUSIONS:APT and DWI are valuable in differentiating HGGs from LGGs. The combination of APT, DWI and ASL imaging could improve the ability for discriminating HGGs from LGGs.
| S-EPMC7227252 | biostudies-literature
Project description:Diffusion-weighted magnetic resonance imaging (DWI/MRI) has been described in recent literature as a highly sensitive and specific modality for the detection of peritoneal metastases PM. It has been demonstrated to be superior to CT for patients with known peritoneal disease from colorectal and gynaecological malignancies as a staging tool for cytoreductive surgery. It was also demonstrated to be superior for the detection of PM for gastric cancer patients otherwise considered with a resectable tumor. However, the literature is scarce on the role of DWI/MRI in the detection of peritoneal recurrence for patients with high-risk features, either colorectal cancer (CRC) or appendiceal neoplasms (AN).
The aim of this study is to prospectively assess the added value of whole-body DWI/MRI (WB-DWI/MRI) to CT and diagnostic laparoscopy for detection of PM in the follow-up of patients presenting with CRC or AN and high-risk features for peritoneal recurrence and evaluate how it correlates with intraoperative findings.
| 461 | ecrin-mdr-crc
Project description:BackgroundMagnetic resonance imaging (MRI) is essential in the detection and staging of prostate cancer. However, improved tools to distinguish between low-risk and high-risk cancer are needed in order to select the appropriate treatment.PurposeTo investigate the diagnostic potential of signal fractions estimated from a two-component model using combined T2- and diffusion-weighted imaging (T2-DWI).Material and methods62 patients with prostate cancer and 14 patients with benign prostatic hyperplasia (BPH) underwent combined T2-DWI (TE = 55 and 73 ms, b-values = 50 and 700 s/mm2) following clinical suspicion of cancer, providing a set of 4 measurements per voxel. Cancer was confirmed in post-MRI biopsy, and regions of interest (ROIs) were delineated based on radiology reporting. Signal fractions of the slow component (SFslow) of the proposed two-component model were calculated from a model fit with 2 free parameters, and compared to conventional bi- and mono-exponential apparent diffusion coefficient (ADC) models.ResultsAll three models showed a significant difference (p<0.0001) between peripheral zone (PZ) tumor and normal tissue ROIs, but not between non-PZ tumor and BPH ROIs. The area under the receiver operating characteristics curve distinguishing tumor from prostate voxels was 0.956, 0.949 and 0.949 for the two-component, bi-exponential and mono-exponential models, respectively. The corresponding Spearman correlation coefficients between tumor values and Gleason Grade Group were fair (0.370, 0.499 and -0.490), but not significant.ConclusionSignal fraction estimates from a two-component model based on combined T2-DWI can differentiate between tumor and normal prostate tissue and show potential for prostate cancer diagnosis. The model performed similarly to conventional diffusion models.
| S-EPMC8158951 | biostudies-literature
Project description:BackgroundPrevious meta-analyses examined either multiple tools for the diagnosis of peritoneal metastases (PMs), but not diffusion-weighted imaging (DWI), or included only 1 tumor type. This study aimed to determine the summary diagnostic value of DWI/magnetic resonance imaging in determining PMs originating from various tumors.MethodsPubMed, Embase, and Cochrane library were searched for available papers up to 2019/12. Pooled estimates for sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and accuracy were calculated using random-effects models.ResultsTen studies were included and could be used to calculate the pooled sensitivity and specificity. The pooled sensitivity of DWI for PMs was 89% (95% confidence interval [CI]: 83%-93%). The pooled specificity was 86% (95% CI: 79%-91%). When considering only the retrospective studies, the pooled sensitivity of DWI for PMs was 85% (95% CI: 81%-89%). The pooled specificity was 84% (95% CI: 72%-92%). When considering only the studies about gastrointestinal tumors, the pooled sensitivity of DWI for PMs was 97% (95% CI: 68%-100%). The pooled specificity was 86% (95% CI: 69%-95%). No publication bias was observed (P = dd.27).ConclusionDWI magnetic resonance imaging is highly sensitive and specific for the detection of PMs from various abdominal cancers.
| S-EPMC7870229 | biostudies-literature