Purpose:To compare the apparent diffusion coefficient (ADC) values of prostate cancer in both the peripheral zone (PZ) and the transition zone (TZ) with those of benign tissue in the same zone using echo-planar diffusion weighted imaging with a parallel imaging technique.
Materials and Methods:A total of 29 consecutive male patients (mean age 61.3 years, age range 53-88 years) with suspected prostate cancer were referred for MR imaging. All patients underwent transrectal ultrasound (TRUS)-guided biopsy of the prostate after MR imaging at 1.5 T, including ADC. For each patient, seven to 10 specimens were obtained from the prostate, and regions of interest (ROIs) were drawn on the ADC map by referring to the urologist's illustration of TRUSguided biopsy sites. ADC values of cancerous tissue in both the PZ and TZ were compared to those of noncancerous tissue in the same zone.
Results:Out of 29 patients, 23 had cancer tissue. In the 23 patients with cancer, the mean ADC value of all cancer ROIs and that of all noncancer ROIs, respectively, were 1.11 Ϯ 0.41 ϫ 10 -3 and 1.68 Ϯ 0.40 ϫ 10 -3 mm 2 /second (values are mean Ϯ SD) (P Ͻ 0.01). The mean ADC value of TZ cancer ROIs and that of TZ noncancer ROIs, respectively, were 1.13 Ϯ 0.42 ϫ 10 -3 and 1.58 Ϯ 0.37 ϫ 10 -3 mm 2 /second (P Ͻ 0.01).Conclusions: ADC measurement with a parallel imaging technique showed that ADC values of prostate cancer in both the PZ and TZ were significantly lower than those of benign tissue in the PZ and TZ, respectively.
A relation between apparent diffusion coefficient (ADC) values and tumor cellular density has been reported. The purpose of this study was to measure the ADC values of cervical cancers in the uterus and compare them with those of normal cervical tissues, and to test whether ADC could differentiate between normal and malignant cervical tissues in the uterus. Twelve consecutive female patients with cervical cancer of the uterus and ten female patients with other pelvic abnormalities were included in this study. ADC was measured at 1.5 T with b-factors of 0, 300 and 600 s/mm2 using single-shot echo-planar diffusion-weighted imaging and a parallel imaging technique. The mean ADC value of cervical cancer lesions was 1.09+/-0.20 x 10(-3) mm2/s, and that of normal cervix tissue was 1.79+/-0.24 x 10(-3) mm2/s (P<0.0001). In nine patients treated by chemotherapy and/or radiation therapy, the mean ADC value of the cervical cancer lesion increased significantly after therapy (P<0.001). The present study showed, with a small number of patients, that ADC measurement has a potential ability to differentiate between normal and cancerous tissue in the uterine cervix. Further study is necessary to determine the accuracy of ADC measurement in monitoring the treatment response.
DiŠusion-weighted imaging (DWI) has recently been attempted in the abdominal region. We review diŠusion-weighted images of the liver, especially from the technical point of view. We discuss selection of pulse sequence parameters, eŠects of anti-breathing motion technique, tips for measuring apparent diŠusion coe‹cient (ADC), and utility of superparamagnetic iron oxide (SPIO), showing clinical cases, including those at 3T. Our current trial of new pulse sequencing, such as SPIO-mediated breath-holding black-blood ‰uid-attenuated inversion recovery (BH-BB-FLAIR), imaging is shown. Some prospects for the future in DWI of the liver are also stated.
It has been reported that 3D-FLAIR can reduce the flow artifact resulting from cerebrospinal fluid (CSF) at 1.5 T compared to 2D-FLAIR. Flow-related artifacts tend to be worse at 3 T than at 1.5 T. The purpose of this study was to compare the CSF flow artifacts of 2D-FLAIR and 3D-FLAIR sequences at 3 T in eight healthy volunteers. The grade of CSF-related artifacts were scored through observing the perimedullary cistern, cerebellopontine angle cisterns, fourth ventricule, prepontine cistern, suprasellar cistern, ambient cisterns, sylvian fissures, third ventricle and lateral ventricles. Grading was performed on either axial or sagittal images. The CSF in-flow artifact scores were significantly higher on axial 2D-FLAIR than on axial 3D-FLAIR MPR images in all areas except the bilateral sylvian fissures, and higher on sagittal 2D-FLAIR than on sagittal 3D-FLAIR MPR images in perimedullary, bilateral CP angle and suprasellar cisterns. The CSF-related flow artifacts were significantly reduced by 3D-FLAIR, while structures in the cistern were depicted more clearly, even at 3 T. Further study is necessary to compare the clinical efficacy between 2D-FLAIR and 3D-FLAIR in depicting subtle abnormalities.
In animals, the enhancement of perilymph in the cochlea has been reported using 1.25 mmol/kg of Gd-DTPA, allowing the separate visualisation of perilymph and endolymph for the diagnosis of Meniere's disease. The purpose of this study was three-fold: (1) to determine the optimal timing for detecting cochlear fluid enhancement using 3D-FLAIR (fluid-attenuated inversion recovery) after intravenous administration of 0.1 mmol/kg of Gd-DTPA in healthy human subjects; (2) to examine the reliability of enhancement in multiple healthy subjects; and (3) to investigate whether endolymph and perilymph space can be visually discriminated. In two healthy subjects, 3D-FLAIR images were obtained before, immediately after and 2 h, 4 h and 6 h after the injection. Three more healthy subjects were scanned before and 4 h after the injection. In all four ears of the initial two subjects, cochlear fluid was found to be most intensely enhanced 4 h after the injection. In all of the additional three subjects, the cochlear fluid signal had increased after 4 h from injection. However, visual differentiation of endolymph and perilymph fluid could not be achieved. Using 3D-FLAIR and Gd-DTPA, cochlear fluid enhancement can be observed in healthy human ears, even with a single dose of contrast-medium injection.
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