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Mono, bi- and tri-exponential diffusion MRI modelling for renal solid masses and comparison with histopathological findings.

ABSTRACT: PURPOSE:To compare diffusion tensor imaging (DTI), intravoxel incoherent motion (IVIM), and tri-exponential models of the diffusion magnetic resonance imaging (MRI) signal for the characterization of renal lesions in relationship to histopathological findings. METHODS:Sixteen patients planned to undergo nephrectomy for kidney tumour were scanned before surgery at 3?T magnetic resonance imaging (MRI), with T2-weighted imaging, DTI and diffusion weighted imaging (DWI) using ten b-values. DTI parameters (mean diffusivity [MD] and fractional anisotropy [FA]) were obtained by iterative weighted linear least squared fitting of the DTI data and bi-, and tri-exponential fit parameters (Dbi, fstar,and Dtri, ffast,finterm) using a nonlinear fit of the multiple b-value DWI data. Average parameters were calculated for regions of interest, selecting the lesions and healthy kidney tissue. Tumour type and specificities were determined after surgery by histological examination. Mean parameter values of healthy tissue and solid lesions were compared using a Wilcoxon-signed ranked test and MANOVA. RESULTS:Thirteen solid lesions (nine clear cell carcinomas, two papillary renal cell carcinoma, one haemangioma and one oncocytoma) and four cysts were included. The mean MD of solid lesions are significantly (p?

SUBMITTER: van Baalen S

PROVIDER: S-EPMC6260899 | biostudies-other | 2018 Nov

REPOSITORIES: biostudies-other

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Mono, bi- and tri-exponential diffusion MRI modelling for renal solid masses and comparison with histopathological findings.

van Baalen Sophie S Froeling Martijn M Asselman Marino M Klazen Caroline C Jeltes Claire C van Dijk Lotte L Vroling Bart B Dik Pieter P Ten Haken Bennie B

Cancer imaging : the official publication of the International Cancer Imaging Society 20181126 1

<h4>Purpose</h4>To compare diffusion tensor imaging (DTI), intravoxel incoherent motion (IVIM), and tri-exponential models of the diffusion magnetic resonance imaging (MRI) signal for the characterization of renal lesions in relationship to histopathological findings.<h4>Methods</h4>Sixteen patients planned to undergo nephrectomy for kidney tumour were scanned before surgery at 3 T magnetic resonance imaging (MRI), with T<sub>2</sub>-weighted imaging, DTI and diffusion weighted imaging (DWI) usi ...[more]

PMID: 30477587

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Project description:PURPOSE:Diffusion-weighted imaging (DWI) plays an important role in the preoperative assessment of gliomas; however, the diagnostic performance of histogram-derived parameters from mono-, bi-, and stretched-exponential DWI models in the grading of gliomas has not been fully investigated. Therefore, we compared these models' ability to differentiate between high-grade and low-grade gliomas. METHODS:This retrospective study included 22 patients with diffuse gliomas (age, 23-74 years; 12 males; 11 high-grade and 11 low-grade gliomas) who underwent preoperative 3 T-magnetic resonance imaging from October 2014 to August 2019. The apparent diffusion coefficient was calculated from the mono-exponential model. Using 13 b-values, the true-diffusion coefficient, pseudo-diffusion coefficient, and perfusion fraction were obtained from the bi-exponential model, and the distributed-diffusion coefficient and heterogeneity index were obtained from the stretched-exponential model. Region-of-interests were drawn on each imaging parameter map for subsequent histogram analyses. RESULTS:The skewness of the apparent diffusion, true-diffusion, and distributed-diffusion coefficients was significantly higher in high-grade than in low-grade gliomas (0.67?±?0.67 vs. -?0.18?±?0.63, 0.68?±?0.74 vs. -?0.08?±?0.66, 0.63?±?0.72 vs. -?0.15?±?0.73; P?=?0.0066, 0.0192, and 0.0128, respectively). The 10th percentile of the heterogeneity index was significantly lower (0.77?±?0.08 vs. 0.88?±?0.04; P?=?0.0004), and the 90th percentile of the perfusion fraction was significantly higher (12.64?±?3.44 vs. 7.14?±?1.70%: P?<?0.0001), in high-grade than in low-grade gliomas. The combination of the 10th percentile of the true-diffusion coefficient and 90th percentile of the perfusion fraction showed the best area under the receiver operating characteristic curve (0.96). CONCLUSION:The bi-exponential model exhibited the best diagnostic performance for differentiating high-grade from low-grade gliomas.

Project description:PurposeTo investigate the clinical utility of mono-exponential model diffusion weighted imaging (DWI) using two b-values compared to the bi- or stretched exponential model to differentiate biliary atresia (BA) from non-BA in pediatric liver magnetic resonance imaging (MRI).MethodsPatients who underwent liver MRI with DWI for suspected BA from November 2017 to September 2018 were retrospectively included and divided into BA and non-BA groups. Laboratory results including γ-glutamyl transferase (γGT) were compared between the two groups using the Mann-Whitney U test and Fisher's exact test. The hepatic apparent diffusion coefficient (ADC) 10 using ten b-values and ADC 2 using two b-values were obtained from the mono-exponential model. The slow diffusion coefficient (D), fast diffusion coefficient (D*), and perfusion fraction (f) were obtained from the bi-exponential model. The distributed diffusion coefficient (DDC) and heterogeneity index (α) were measured from the stretched exponential model. Parameters were compared between the two groups using a linear mixed model and diagnostic performance was assessed using the area under the curve (AUC) analysis.ResultsFor 12 patients in the BA and five patients in the non-BA group, the ADC 10 (median 0.985 ×10-3 mm2/s vs. 1.332 ×10-3 mm2/s, p = 0.008), ADC 2 (median 0.987 ×10-3 mm2/s vs. 1.335 ×10-3 mm2/s, p = 0.017), D* (median 33.2 ×10-3 mm2/s vs. 55.3 ×10-3 mm2/s, p = 0.021), f (median 13.4%, vs. 22.1%, p = 0.009), and DDC (median 0.889 ×10-3 mm2/s vs. 1.323 ×10-3 mm2/s, p = 0.009) values were lower and the γGT (median 368.0 IU/L vs. 93.5 IU/L, p = 0.02) and α (median 0.699 vs. 0.556, p = 0.023) values were higher in the BA group. The AUC values for γGT (AUC 0.867 95% confidence interval [CI] 0.616-0.984), ADC 10 (AUC 0.963, 95% CI 0.834-0.998), ADC 2 (AUC 0.925, 95% CI 0.781-0.987), f (AUC 0.850, 95% CI 0.686-0.949), and DDC (AUC 0.925, 95% CI 0.781-0.987) were not significantly different, except for the D* and α values.ConclusionPatients with BA had lower ADC 10, ADC 2, D*, f, and DDC values and higher γGT and α values than those in the non-BA group. The diagnostic performance of ADC 2 using only two b-values showed excellent diagnostic performance and was not significantly different from that of γGT, ADC 10, f, and DDC for diagnosing BA.

Dataset Information

Mono, bi- and tri-exponential diffusion MRI modelling for renal solid masses and comparison with histopathological findings.

Publications

Mono, bi- and tri-exponential diffusion MRI modelling for renal solid masses and comparison with histopathological findings.

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