Automatic Prediction and Assessment of Treatment Response in Patients with Hodgkin’s Lymphoma Using a Whole-Body DW-MRI Based Approach

Abstract

The lack of validation and standardization represents the main drawback for a clear role of whole-body diffusion weighted imaging (WB-DWI) for prediction and assessment of treatment response in Hodgkin’s lymphoma (HL). We explored the reliability of an automatic approach based on the WB-DWI technique for prediction and assessment of response to treatment in patients with HL. The study included 20 HL patients, who had whole-body positron emission tomography (PET)/ magnetic resonance Imaging (MRI) performed before, during and after chemotherapy. Using the syngo.via MR Total Tumor Load tool, we automatically extracted values of diffusion volume (DV) and its associated histogram features by WB-DWI images, and evaluated their utility in predicting and assessing interim and end-of-treatment (EOT) response. The Mann–Whitney test followed by receiver operator characteristic (ROC) analysis was performed between features and their inter-time point percentage differences for patients having a complete or partial treatment response, revealing that several WB-DWI associated features allowed for prediction of interim response and both prediction and assessment of EOT response. Our proposed method offers huge advantages in terms of saving time and work, enabling clinicians to draw conclusions relating to HL treatment response in a fully automatic way, and encloses, also, all DWI advantages compared to PET/ computed tomography (CT).

Evaluation of a multiparametric MRI radiomic-based approach for stratification of equivocal PI-RADS 3 and upgraded PI-RADS 4 prostatic lesions

“…These results suggest that the inclusion of radiomic features derived from DCE-MRI does not provide a clear added value for PCa detection of PI-RADS 3 lesions. On one hand, this would justify the choice to exclude DCE-MRI from dominant sequences for PI-RADSv2 and PI-RADS v2.1 score assessment 17 , 24 , 45 . Similar considerations also apply to upPI-RADS 4 classification task, for which DCE-MRI features did not even survive in the univariate analysis preceding the mRMR step.…”

“…mpMRI images and histopathology records were collected at H.S. Maria delle Grazie, Italy and informed consent was given before Magnetic Resonance (MR) examination 24 . The study was conducted in accordance with the Declaration of Helsinki, and the study protocol was approved by the Ethics Committee of the Istituto Nazionale Tumouri “Fondazione G. Pascale (protocol number 1/20).…”

“…Patients were injected with contrast agent Gadoteridol (Gd-HP-DO3A; Pro Hance, Bracco Diagnostics, Princeton, NJ, USA) with a dose of 0.1 mL/kg before DCE-MRI acquisition. All patients were imaged using MAGNETOM-Avanto scanner (Siemens Healthcare, Erlangen, Germany) at 1.5 T with both endorectal coil and phase-array pelvic coil 24 . More details on the technical parameters of the MRI sequences are shown in Supplementary Table S1 .…”

“…They independently reviewed MR images blinded to the results of biopsy and any clinical information. Evaluation of MR images was performed in two reading-sessions, following a similar procedure performed in our previous study 24 : the first reading-session was performed considering a biparametric MRI (bpMRI) protocol consisting of axial, sagittal and coronal T2 images and axial DWI images with their corresponding ADC maps and a b-computed image with b = 1400 s/mm 2 ; the second reading-session was performed after 2 weeks considering the entire mpMRI protocol, and rearranging patient IDs in a different order, to reduce memory bias. Discrepancies were resolved by consensus.…”

“…The number of randomly-taken samples could vary depending on dimensions of prostate gland, as well as number of target samples could do depending on dimension of each lesion. Target sampling was performed with an MRI/TRUS fusion, using alternately the cognitive technique or dedicated software, coupled with ultrasound platforms from various companies 24 . The gross description included number and core lengths of needle biopsies.…”