Esophageal carcinoma: Intravoxel incoherent motion diffusion‐weighted MRI parameters and histopathological correlations

Zhu, Shuchai; Yi, Wei; Gao, Feifei; Li, Linlin; Liu, Yuehua; Huang, Zixing; Tang, Hehan; Zheng, Dandan; Wei, Xiaocheng; Sun, Tingyi; Song, Bin

doi:10.1002/jmri.26172

Cited by 16 publications

(24 citation statements)

References 35 publications

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“…The finding of ADC and D in this study is in concordance with the previous study in differentiating the intermediate from malignant solid soft‐tissue tumors . An esophageal study demonstrated that D had a significantly higher performance than ADC in grading of malignant tumors . In addition, Ki‐67, as a reflection of the tumor cell proliferation, was moderately negatively correlated with D of OETs.…”

Section: Discussionsupporting

confidence: 91%

“…However, D* was not a significant parameter for the discrimination of borderline from malignant OETs. Our findings were similar to other studies in the differential diagnosis of solid soft‐tissue tumors, and grading of esophageal carcinoma . The high uncertainty and lower diagnostic performance of D* might be because of the low signal‐to‐noise ratio and the varying vascularity among different histological types of tumors.…”

Section: Discussionsupporting

confidence: 89%

“…The numerical values of D were lower than ADC in this study. That may imply that D maintained the true diffusion by eliminating the interference of perfusion . Furthermore, D was shown to have the highest AUC in discriminating BOETs from MOETs.…”

Section: Discussionmentioning

confidence: 93%

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Intravoxel Incoherent Motion Imaging in Differentiation Borderline From Malignant Ovarian Epithelial Tumors: Correlation With Histological Cell Proliferation and Vessel Characteristics

Song

Wang

Ren

et al. 2019

Magnetic Resonance Imaging

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Background The differentiation of borderline from malignant ovarian epithelial tumors (OETs) is difficult based on morphologic characteristics. Diffusion and perfusion information from intravoxel incoherent motion (IVIM) diffusion‐weighted imaging (DWI) might be useful for this distinction. Purpose To investigate the potential of IVIM‐DWI in discriminating borderline from malignant OETs by correlating with cell proliferation and microvessel density (MVD). Study Type Prospective. Subjects Sixty‐six patients with OETs (22 borderline, BOETs; 44 malignant, MOETs) underwent IVIM‐DWI before surgery. Field Strength 3.0T IVIM‐DWI sequence with 12 b‐values (0–1000 sec/mm2). Assessment Apparent diffusion coefficient (ADC) and IVIM‐DWI parameters (diffusion coefficient [D], microvascular volume fraction [f], and pseudodiffusion coefficient [D*]) were measured. Cell proliferation and MVD was determined by immunohistochemical staining of Ki‐67 and CD‐31, respectively. Statistical Tests Mann–Whitney U‐test; two‐sample t‐test; intraclass correlation coefficient; Bland–Altman analysis; receiver operating characteristics (ROC) curves; and Spearman correlation. Results ADC and D in BOETs was significantly higher than those in MOETs (P < 0.001), while f in BOETs was significantly lower than those in MOETs (P < 0.001). No significant difference was found in D* between borderline and malignancies (P = 0.324). In the differential diagnosis of borderline from malignant OETs; D demonstrated the highest area under the curve (AUC) of 0.951, while ADC and f had a lower AUC of 0.921 and 0.847, respectively. The ADC and D was negatively correlated with cell proliferation (r = –0.682, r = –0.694, respectively, P < 0.001), while f was positively correlated with MVD of the OETs (r = 0.558, P < 0.001). Data Conclusion IVIM‐DWI may be a useful tool for differentiating BOETs from MOETs. D and f could be image biomarkers to reflect histopathological characteristics of cell proliferation and MVD in OETs. Level of Evidence: 1 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:928–935.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

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Intravoxel Incoherent Motion Imaging in Differentiation Borderline From Malignant Ovarian Epithelial Tumors: Correlation With Histological Cell Proliferation and Vessel Characteristics

Song

Wang

Ren

et al. 2019

Magnetic Resonance Imaging

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“…At present, the IVIM-DWI has been used to evaluate the pathological or blood perfusion status in the brain (5,6) and abdominal organs (7)(8)(9)(10)(11). However, few studies (12)(13)(14) have been performed regarding the diagnosis and pathological grade of esophageal carcinoma with MRI, because conventional MRI is limited in its ability to resolve the early esophageal cancer. As the constant progress achieved in this field, IVIM-DWI demonstrated the potential value for the diagnosis and pathological grade of esophageal carcinoma (12,14,15).…”

Section: Introductionmentioning

confidence: 99%

Intravoxel Incoherent Motion Model in Differentiating the Pathological Grades of Esophageal Carcinoma: Comparison of Mono-Exponential and Bi-Exponential Fit Model

et al. 2021

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PurposeTo compare the diagnostic efficiency of the mono-exponential model and bi-exponential model deriving from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in differentiating the pathological grade of esophageal squamous cell carcinoma (ESCC).MethodsFifty-four patients with ESCC were divided into three groups of poorly-differentiated (PD), moderately-differentiated (MD), and well-differentiated (WD), and underwent the IVIM-DWI scan. Mono-exponential (Dmono, D*mono, and fmono) and bi-exponential fit parameters (Dbi, D*bi, and fbi) were calculated using the IVIM data for the tumors. Mean parameter values of three groups were compared using a one-way ANOVA followed by post hoc tests. The receiver operating characteristic curve was drawn for differentiating pathological grade of ESCC. Correlations between pathological grades and IVIM parameters were analyzed.ResultsThere were significant differences in fmono and fbi among the PD, MD and WD ESCC groups (all p<0.05). The fmono were 0.32 ± 0.07, 0.23 ± 0.08, and 0.16 ± 0.05, respectively, and the fbi were 0.35 ± 0.08, 0.26 ± 0.10, and 0.18 ± 0.07, respectively. There was a significant difference in the Dmono between the WD and the PD group (1.48 ± 0.51* 10-3 mm2/s versus 1.05 ± 0.44*10-3 mm2/s, p<0.05), but there was no significant difference between the WD and MD groups, MD and PD groups (all p>0.05). The D*mono, Dbi, and D*bi showed no significant difference among the three groups (all p>0.05). The area under the curve (AUC) of Dmono, fmono and fbi in differentiating WD from PD ESCC were 0.764, 0.961 and 0.932, and the sensitivity and specificity were 92.9% and 60%, 92.9% and 90%, 85.7% and 100%, respectively. The AUC of fmono and fbi in differentiating MD from PD ESCC were 0.839 and 0.757, and the sensitivity and specificity were 78.6% and 80%, 85.7% and 70%, respectively. The AUC of fmono and fbi in differentiating MD from WD ESCC were 0.746 and 0.740, and the sensitivity and specificity were 65% and 85%, 80% and 60%, respectively. The pathologically differentiated grade was correlated with all IVIM parameters (all p<0.05).ConclusionsThe mono-exponential IVIM model is superior to the bi-exponential IVIM model in differentiating pathological grades of ESCC, which may be a promising imaging method to predict pathological grades of ESCC.

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“…For example, diffusion weighted imaging (DWI) is a noninvasive approach to probe the molecular diffusion of water on the microscopic scale without contrast administration, and the apparent diffusion coefficient (ADC) value has been utilized to evaluate the treatment response to CRT in many cancers including esophageal carcinoma [8]. Nevertheless, only a few studies have evaluated the clinical significance of the capacity of DWI to predict the treatment response in patients with EC [9–11], and there is uncertainty about how to select the timing of observation post-therapy to avoid false negatives, and how to minimize the confounding factors that may interfere with the measurements [12].…”

Section: Introductionmentioning

confidence: 99%

ADC correlation with Sirtuin1 to assess early chemoradiotherapy response of locally advanced esophageal carcinoma patients

Chen

Xie

et al. 2019

Radiat Oncol

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AimsTo determine the biological correlation between apparent diffusion coefficient (ADC) values and Sirtuin1 (SIRT1) levels of tumour tissues in patients with esophageal carcinoma (EC), and to ascertain the treatment biomarker of ADC in predicting the early response of patients undergoing definitive chemoradiotherapy (CRT).MethodsA total of 66 patients were enrolled, and the specimens of tumour tissues were collected before treatment to perform immunohistochemical (IHC) examinations and quantify the levels of SIRT1. Then all patients were given two esophageal magnetic resonance imaging (MRI) examinations with diffused weighed imaging (DWI) including pretreatment and intra-treatment (1~2 weeks after the start of radiotherapy). The regions of interest (ROIs) were contoured according to the stipulated rules in advance using off-line software, and the values of the ADC in the ROIs were generated automatically. Then, the values of the ADC at baseline and intra-treatment were labeled as pre-ADC and intra-ADC respectively, and ΔADC, ADCratio were calculated. Pearson’s correlation coefficients were acquired to estimate the correlation between each of ADC values and SIRT1 levels. Spearman’s rank correlation coefficients were acquired to estimate the correlation between early response and the values of each ADC. Receptor operation characteristics (ROC) curves were constructed to estimate the accuracy of the ADC in predicting the early response of CRT.ResultsThe findings of this study showed different correlations between ADC values and the levels of SIRT1 (ΔADC: r = − 0.943, P = 0.002; ADCratio: r = − 0.911, P = 0.000; intra-ADC: r = − 0.748, P = 0.002; pre-ADC: r = 0.109, P = 0.558). There was a positive correlation between ΔADC and early response to treatment (ρ = 0.615, P = 0.023), and multivariable logistic regression revealed that ΔADC was significantly associated with short-term response of CRT in esophageal carcinoma patients.ConclusionsIn summary, early increases in ADC may facilitate the predication of early CRT response in patients with esophageal squamous cell carcinoma (ESCC), which may be attributed to the different correlation between ADC changes and SIRT1 expression.

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Esophageal carcinoma: Intravoxel incoherent motion diffusion‐weighted MRI parameters and histopathological correlations

Abstract: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.

Cited by 16 publications

References 35 publications

Intravoxel Incoherent Motion Imaging in Differentiation Borderline From Malignant Ovarian Epithelial Tumors: Correlation With Histological Cell Proliferation and Vessel Characteristics

Intravoxel Incoherent Motion Imaging in Differentiation Borderline From Malignant Ovarian Epithelial Tumors: Correlation With Histological Cell Proliferation and Vessel Characteristics

Intravoxel Incoherent Motion Model in Differentiating the Pathological Grades of Esophageal Carcinoma: Comparison of Mono-Exponential and Bi-Exponential Fit Model

ADC correlation with Sirtuin1 to assess early chemoradiotherapy response of locally advanced esophageal carcinoma patients

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