Diffusion kurtosis imaging for differentiating borderline from malignant epithelial ovarian tumors: A correlation with Ki‐67 expression

Li, Hai Ming; Zhao, Siwen; Qiang, Jin Wei; Zhang, Guo Fu; Feng, Feng; Feng, Hua; Li, Yong Ai; Gu, Wei Yong

doi:10.1002/jmri.25696

Cited by 40 publications

(35 citation statements)

References 26 publications

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“…Recent studies and meta‐analyses have shown a strong correlation between ADC and cellularity and a good association between ADC and cell proliferation (in terms of KI67 nuclear protein) in ovarian cancer, mainly of the serous subtype . In agreement with studies on other tumor types, our results show that response to treatment is clearly identified using mono‐exponential fitting with b values higher than 100 s/mm 2 .…”

Section: Discussionsupporting

confidence: 89%

Integration of MRI and MRS approaches to monitor molecular imaging and metabolomic effects of trabectedin on a preclinical ovarian cancer model

et al. 2018

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Although several drugs are available to treat recurrences of human epithelial ovarian cancer (EOC), clinical responses often remain short lived and lead to only marginal improvements in patients' survival. One of the new drugs proposed for recurrent platinum-resistant EOC patients is trabectedin (Trab), a marine-derived antitumor agent initially isolated from the tunicate Ecteinascidia turbinata and currently produced synthetically. Predictive biomarkers of therapy response to this drug and the potential use of non-invasive functional MRI and MRS approaches for an early assessment of Trab efficacy have not yet been evaluated, although they might be relevant for improving the clinical management of EOC patients. In the present work we combined functional and spectroscopic magnetic resonance technologies, such as in vivo diffusion-weighted MRI and 1 H MRS, with ex vivo high resolution MRS (HR-MRS) metabolomic analyses, with the aim of identifying new pharmacodynamic markers of Trab effectiveness on well characterized, highly aggressive human SKOV3.ip (a HER2-enriched cell variant derived from SKOV3 cells) EOC xenografts. In vivo treatment with Trab (three consecutive weekly 0.2 mg/kg i.v. injections) resulted in the following: (1) a significant reduction of in vivo tumor growth, along with the formation in cancer lesions of diffuse hyper-intense areas detected by T 2 -weighted MRI and attributed to necrosis, in agreement with histopathology findings; (2) significant increases in the apparent diffusion coefficient mean and median values versus saline-treated control tumors; and (3) a significant reduction in the cholinecontaining metabolites' signal detected by quantitative in vivo MRS. Multivariate and quantitative HR-MRS analyses on ex vivo tissue samples revealed Trab-induced alterations in phospholipid and glucose metabolism identified as a decrease in phosphocholine and an increase in lactate. Collectively, these data identify Trab-

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Section: Discussionsupporting

confidence: 89%

Integration of MRI and MRS approaches to monitor molecular imaging and metabolomic effects of trabectedin on a preclinical ovarian cancer model

et al. 2018

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“…Functional MRI scans (dynamic contrast-enhanced MRI, diffusion-weighted imaging(DWI), MR spectroscopy(MRS), etc.) showed a higher ability to distinguish a BOT from ovarian epithelial cancer than conventional MRI, such as T1-weighted imaging (T1WI) and T2WI, as shown in recently published studies (11,12). However, given that functional MRI acquisition is not routinely used in clinical scenarios, the scanning parameters are not presently standardized universally and may change across MRI machines or institutions.…”

Section: Introductionmentioning

confidence: 99%

The Two-dimensional and Three-dimensional T2 Weighted Imaging-based Radiomic Signatures for the Preoperative Discrimination of Ovarian Borderline Tumors and Epithelial Cancer.

Liu

Wang

Zhang

et al. 2020

Preprint

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Background: Accurate discrimination between ovarian borderline tumors (BOTs) and malignancies with imaging play an important role in management.Methods: A total of 95 patients with pathologically proven ovarian BOTs and 101 patients with malignancies were retrospectively included in this study. We evaluated the diagnostic performance of the signatures derived from T2WI-based radiomics in their ability to differentiate between BOTs and malignancies and compared the performance differences in the 2D and 3D segmentation models. The least absolute shrinkage and selection operator method (LASSO) was used for radiomics feature selection and machine learning processing.Results: The radiomics score between BOTs and malignancies in four types of selected T2WI-based radiomics models differed significantly at the statistical level (p < 0.0001). For the classification between BOTs and malignant masses, the 2D and 3D coronal T2WI-based radiomics models yielded accuracy values of 0.79 and 0.83 in the testing group, respectively; the 2D and 3D sagittal fat-suppressed (fs) T2WI-based radiomics models yielded an accuracy of 0.78 and 0.99, respectively.Conclusion: Our results suggest that T2WI-based radiomic features were highly correlated with ovarian tumor subtype classification. 3D-sagittal MRI radiomics features may help clinicians differentiate ovarian BOTs from malignancies with high accuracy (ACC).

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“…Compared with standard DWI, it can more accurately describe the complicated water diffusivity in biological tissue and provide more information about tissue heterogeneity and cellularity with parameters of D (corrected ADC) and K (diffusion kurtosis) [ 8 ]. DKI has mainly been used for the differential diagnosis of benign and malignant tumors [ 9 , 10 ]. Until now, to the best of our knowledge, DKI has not been applied for the early evaluation and prediction of the chemotherapy response of EOC, except in a few studies concerning glioblastoma and nasopharyngeal carcinoma [ 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted imaging and diffusion kurtosis imaging for early evaluation of the response to docetaxel in rat epithelial ovarian cancer

2018

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BackgroundTo investigate diffusion-weighted magnetic imaging (DWI) and diffusion kurtosis magnetic imaging (DKI) for the early detection of the response to docetaxel (DTX) chemotherapy in rat epithelial ovarian cancer (EOC).Methods7,12-Dimethylbenz[A]anthracene was applied to induce orthotopic EOC in Sprague–Dawley rats. Rats with EOC were treated with DTX on day 0 (treatment group) or were left untreated (control group). DWI and DKI were performed on days 0, 3, 7, 14 and 21 after treatment. On day 21, the tumors were categorized into the sensitive and insensitive groups according to the size change. The cutoff values of the DWI and DKI parameters for the early response were determined. The experiment was repeated, and the treatment group was divided into the sensitive and insensitive groups according to the initially obtained cutoff values. The DWI and DKI parameters were correlated with tumor size, proliferation, apoptosis and tumor necrosis.ResultsIn the sensitive vs. insensitive or control group, significant differences were found in the Δ% of the DWI and DKI parameters (ADC, D and K) from day 3 and in tumor size from day 14. Early on day 7, the Δ% of K had an AUC of 1 and sensitivity and specificity values of 100% and 100%, respectively, to detect the response to DTX using a cutoff value of 19.03% reduction in K. From day 7, significant differences were found in the Δ% of Ki-67 and CA125 in the sensitive vs. control group and from day 14 in the sensitive vs. insensitive group. From day 14, there were significant differences in the Δ% of Bcl-2, apoptosis and tumor necrosis in the sensitive vs. control or insensitive group. The Δ% values of ADC and D were negatively correlated with the Δ% values of tumor size, Ki-67, CA125 and Bcl-2 and were positively correlated with the Δ% values of apoptosis and tumor necrosis. The Δ% of K was positively correlated with the Δ% values of tumor size, Ki-67, CA125 and Bcl-2 and was negatively correlated with the Δ% values of apoptosis and tumor necrosis.ConclusionsDWI and DKI parameters, especially K, are superior for imaging tumor size for the early detection of the response to DTX chemotherapy in induced rat EOC.

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Diffusion kurtosis imaging for differentiating borderline from malignant epithelial ovarian tumors: A correlation with Ki‐67 expression

Abstract: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1499-1506.

Cited by 40 publications

References 26 publications

Integration of MRI and MRS approaches to monitor molecular imaging and metabolomic effects of trabectedin on a preclinical ovarian cancer model

Integration of MRI and MRS approaches to monitor molecular imaging and metabolomic effects of trabectedin on a preclinical ovarian cancer model

The Two-dimensional and Three-dimensional T2 Weighted Imaging-based Radiomic Signatures for the Preoperative Discrimination of Ovarian Borderline Tumors and Epithelial Cancer.

Diffusion-weighted imaging and diffusion kurtosis imaging for early evaluation of the response to docetaxel in rat epithelial ovarian cancer

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