Assessment of Cervical Cancer with a Parameter-Free Intravoxel Incoherent Motion Imaging Algorithm

Abstract

ObjectiveTo evaluate the feasibility of a parameter-free intravoxel incoherent motion (IVIM) approach in cervical cancer, to assess the optimal b-value threshold, and to preliminarily examine differences in the derived perfusion and diffusion parameters for different histological cancer types.Materials and MethodsAfter Institutional Review Board approval, 19 female patients (mean age, 54 years; age range, 37–78 years) gave consent and were enrolled in this prospective magnetic resonance imaging study. Clinical staging and biopsy results were obtained. Echo-planar diffusion weighted sequences at 13 b-values were acquired at 3 tesla field strength. Single-sliced region-of-interest IVIM analysis with adaptive b-value thresholds was applied to each tumor, yielding the optimal fit and the optimal parameters for pseudodiffusion (D*), perfusion fraction (Fp) and diffusion coefficient (D). Monoexponential apparent diffusion coefficient (ADC) was calculated for comparison with D.ResultsBiopsy revealed squamous cell carcinoma in 10 patients and adenocarcinoma in 9. The b-value threshold (median [interquartile range]) depended on the histological type and was 35 (22.5–50) s/mm2 in squamous cell carcinoma and 150 (100–150) s/mm2 in adenocarcinoma (p < 0.05). Comparing squamous cell vs. adenocarcinoma, D* (45.1 [25.1–60.4] × 10−3 mm2/s vs. 12.4 [10.5–21.2] × 10−3 mm2/s) and Fp (7.5% [7.0–9.0%] vs. 9.9% [9.0–11.4%]) differed significantly between the subtypes (p < 0.02), whereas D did not (0.89 [0.75–0.94] × 10−3 mm2/s vs. 0.90 [0.82–0.97] × 10−3 mm2/s, p = 0.27). The residuals did not differ (0.74 [0.60–0.92] vs. 0.94 [0.67–1.01], p = 0.32). The ADC systematically underestimated the magnitude of diffusion restriction compared to D (p < 0.001).ConclusionThe parameter-free IVIM approach is feasible in cervical cancer. The b-value threshold and perfusion-related parameters depend on the tumor histology type.

Age of Data in Contemporary Research Articles Published in Representative General Radiology Journals

“…In total, 50 KJR (9101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354565758), 492 ER, and 254 Radiology articles reported original research studies analyzing patient data. Of these, 44 (88%; 95% CI: 75.8–94.8%) (910121314151617181920212324262728293031323435363738394041424344474849505152535455565758), 359 (73%; 95% CI: 68.9–76.7%), and 211 (83.1%; 95% CI: 78–87.2%) articles, respectively, revealed the start and end of data collection to the level of calendar month.…”

“…Of these, 44 (88%; 95% CI: 75.8–94.8%) (910121314151617181920212324262728293031323435363738394041424344474849505152535455565758), 359 (73%; 95% CI: 68.9–76.7%), and 211 (83.1%; 95% CI: 78–87.2%) articles, respectively, revealed the start and end of data collection to the level of calendar month. The point estimate value of this proportion was slightly larger in KJR than in ER and Radiology, although the difference was not statistically significant.…”

Combinative evaluation of primary tumor and lymph nodes to predict pelvic lymphatic metastasis in cervical cancer: an integrated PET-IVIM MRI study

“…In the IVIM model, D and f value are indicators to reflect the true diffusion coefficient and perfusion information of the molecule, respectively. IVIM modalities have also been used in other cervical cancer studies [21,22]. However, the current IVIM technology still has shortcomings and has not been applied on a large scale in the clinic setting.…”

A Glimpse on Trends and Characteristics of Recent Articles Published in the Korean Journal of Radiology

“…KJR started to publish articles on deep learning or artificial intelligence as many other journals are interested in them (1234567891011121314). KJR also welcomes articles on radiomics (1151617), other advanced imaging techniques, and new imaging systems (181920212223242526272829303132333435363738394041424344454647484950). KJR increasingly publishes meta-analyses (251525354555657585960), and guidelines (193161626364656667686970717273747576777879), and KJR also publishes consensus statements and recommendations (67808182) in collaboration with Korean Society of Radiology or other societies (68788384).…”

“…KJR increasingly publishes meta-analyses (251525354555657585960), and guidelines (193161626364656667686970717273747576777879), and KJR also publishes consensus statements and recommendations (67808182) in collaboration with Korean Society of Radiology or other societies (68788384). Trends show increasing number of published articles with a prospective design and/or multicenter involvement in the studies (220214950858687888990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127). The numbers of articles with guidelines or consensus statements/recommendations were one in 2016, three in 2017, four in 2018, and 12 in 2019.…”