Differentiation of benign and malignant solid pancreatic masses using magnetic resonance elastography with spin-echo echo planar imaging and three-dimensional inversion reconstruction: a prospective study

Shi, Yu; Gao, Feng; Li, Yue; Tao, Shengzhen; Yu, Bing; Liu, Zaiyi; Liu, Yanqing; Glaser, Kevin J.; Ehman, Richard L.; Guo, Qiyong

doi:10.1007/s00330-017-5062-y

Cited by 39 publications

(36 citation statements)

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“…Second, MR elastography has lower resolution than does standard MR imaging pulse sequences. The recently proposed spinecho echo-planar imaging MR elastography with threedimensional processing can improve resolution and provide robust estimation of pancreatic stiffness (12,15,17). Third, most of our patients (86 of 112 patients) had a body mass index less than 25 kg/m 2 , so our results should be confirmed in larger samples that include more overweight or obese patients.…”

Section: Discussionmentioning

confidence: 73%

“…The total acquisition time was approximately 15-20 minutes. MR elastography was performed by using 40-Hz vibrations and a 32-section spin-echo echo-planar imaging pulse sequence that covered the entire pancreas to obtain volumetric vector displacement for imaging the propagating shear waves (12,15,17,18). See Appendix E1 (online) and Figure E1 (online) for details of MR elastographic acquisitions, failures, and verification of wave propagation.…”

Section: Image Acquisitionmentioning

confidence: 99%

“…Following the development of a three-dimensional wave field inversion algorithm based on acquisition of spin-echo echo-planar images, MR elastography has been successfully applied in organs with complex geometry, including the brain, lung, and pancreas (12)(13)(14)(15)(16). Moreover, 40-Hz vibration with a pancreas-tailored soft driver provided robust estimates of tissue shear stiffness in both healthy and diseased pancreas and provided a better wave pattern and higher amplitude of motion than did imaging at 60 Hz (12,15,17). In our study, we hypothesized that the morphologic and mechanical qualities of the pancreatic stump measured with preoperative MR imaging could serve as accurate markers for predicting POPF.…”

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confidence: 99%

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Pancreatic Stiffness Quantified with MR Elastography: Relationship to Postoperative Pancreatic Fistula after Pancreaticoenteric Anastomosis

et al. 2018

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Purpose To describe the relationship between conventional magnetic resonance (MR) imaging parameters and MR elastography of the pancreas in association with pancreatic histologic features and occurrence of postoperative pancreatic fistula (POPF). Materials and Methods Patients who underwent preoperative MR imaging (MR elastography and diffusion-, T1-, and T2-weighted imaging) followed by pancreatectomy with pancreaticoenteric anastomosis were included. The relationships between preoperative MR imaging parameters, demographic data, and intraoperative factors with POPF risk were analyzed with logistic regression analyses. The correlation of MR imaging parameters with histologic characteristics was evaluated with multivariate regression analysis. Results A total of 112 patients (64 men, 48 women; median age, 58 years) were evaluated. Forty-two patients (37.5%) developed POPF and 20 (17.9%) developed high-grade POPF (grades B and C). Lower pancreatic stiffness (≤1.43 kPa; odds ratio [OR], 9.196; 95% confidence interval [CI]: 1.92, 43.98), nondilated main pancreatic duct (MPD) diameter (<3 mm; OR, 7.298; 95% CI: 1.51, 35.34), and larger stump area (≥211 mm; OR, 9.210; 95% CI: 1.53, 55.26) were risk factors for POPF. Lower pancreatic stiffness (≤1.27 kPa; OR, 8.389; 95% CI: 1.88, 37.41) was the only independent predictor of high-grade POPF. Log-transformed pancreatic stiffness was independently associated with fibrosis (β = 0.060; 95% CI: 0.052, 0.068), acinar atrophy (β = 0.015; 95% CI: 0.003, 0.028), and lipomatosis (β = -0.016; 95% CI: -0.026, -0.006). Conclusion Preoperative MR assessment of pancreatic stiffness, MPD diameter, and stump area are important predictors of POPF.

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Section: Discussionmentioning

confidence: 73%

Section: Image Acquisitionmentioning

confidence: 99%

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confidence: 99%

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Pancreatic Stiffness Quantified with MR Elastography: Relationship to Postoperative Pancreatic Fistula after Pancreaticoenteric Anastomosis

et al. 2018

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“…Clinical applications of MRE measurements of tumor mechanical stiffness have shown significant potential for clinical cancer staging and treatment response assessment . In a recent study by Gordic et al, MRE was used to assess tumor stiffness following locoregional therapy for hepatocellular carcinoma .…”

Section: Quantitatively Interrogating Biologymentioning

confidence: 99%

“…61,62 Clinical applications of MRE measurements of tumor mechanical stiffness have shown significant potential for clinical cancer staging and treatment response assessment. 63,64 In a recent study by Gordic et al, MRE was used to assess tumor stiffness following locoregional therapy for hepatocellular carcinoma. 65 Tumor stiffness was found to be significantly reduced in treated tumors, with significant correlations of reduced stiffness to tumor necrosis.…”

Section: Mechanical Propertiesmentioning

confidence: 99%

Translating preclinical MRI methods to clinical oncology

Hormuth

Sorace

Virostko

et al. 2019

Magnetic Resonance Imaging

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The complexity of modern in vivo magnetic resonance imaging (MRI) methods in oncology has dramatically changed in the last 10 years. The field has long since moved passed its (unparalleled) ability to form images with exquisite soft‐tissue contrast and morphology, allowing for the enhanced identification of primary tumors and metastatic disease. Currently, it is not uncommon to acquire images related to blood flow, cellularity, and macromolecular content in the clinical setting. The acquisition of images related to metabolism, hypoxia, pH, and tissue stiffness are also becoming common. All of these techniques have had some component of their invention, development, refinement, validation, and initial applications in the preclinical setting using in vivo animal models of cancer. In this review, we discuss the genesis of quantitative MRI methods that have been successfully translated from preclinical research and developed into clinical applications. These include methods that interrogate perfusion, diffusion, pH, hypoxia, macromolecular content, and tissue mechanical properties for improving detection, staging, and response monitoring of cancer. For each of these techniques, we summarize the 1) underlying biological mechanism(s); 2) preclinical applications; 3) available repeatability and reproducibility data; 4) clinical applications; and 5) limitations of the technique. We conclude with a discussion of lessons learned from translating MRI methods from the preclinical to clinical setting, and a presentation of four fundamental problems in cancer imaging that, if solved, would result in a profound improvement in the lives of oncology patients. Level of Evidence: 5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:1377–1392.

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Design, Construction, and Implementation of a Magnetic Resonance Elastography Actuator for Research Purposes

et al. 2022

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Magnetic resonance elastography (MRE) is a technique for determining the mechanical response of soft materials using applied harmonic deformation of the material and a motion‐sensitive magnetic resonance imaging sequence. This technique can elucidate significant information about the health and development of human tissue such as liver and brain, and has been used on phantom models (e.g., agar, silicone) to determine their suitability for use as a mechanical surrogate for human tissues in experimental models. The applied harmonic deformation used in MRE is generated by an actuator, transmitted in bursts of a specified duration, and synchronized with the magnetic resonance signal excitation. These actuators are most often a pneumatic design (common for human tissues or phantoms) or a piezoelectric design (common for small animal tissues or phantoms). Here, we describe how to design and assemble both a pneumatic and a piezoelectric MRE actuator for research purposes. For each of these actuator types, we discuss displacement requirements, end‐effector options and challenges, electronics and electronic‐driving requirements and considerations, and full MRE implementation. We also discuss how to choose the actuator type, size, and power based on the intended material and use. © 2022 Wiley Periodicals LLC. Basic Protocol 1: Design, construction, and implementation of a convertible pneumatic MRE actuator for use with tissues and phantom models Basic Protocol 2: Design, construction, and implementation of a piezoelectric MRE actuator for localized excitation in phantom models

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Differentiation of benign and malignant solid pancreatic masses using magnetic resonance elastography with spin-echo echo planar imaging and three-dimensional inversion reconstruction: a prospective study

Abstract: • 3D MRE is useful for calculating stiffness of solid pancreatic tumours. • Stiffness ratio outperformed stiffness and CA19-9 for differentiating PDAC from MFP. • Incorporation of 3D MRE into a standard MRI protocol is recommended.

Cited by 39 publications

References 35 publications

Pancreatic Stiffness Quantified with MR Elastography: Relationship to Postoperative Pancreatic Fistula after Pancreaticoenteric Anastomosis

Pancreatic Stiffness Quantified with MR Elastography: Relationship to Postoperative Pancreatic Fistula after Pancreaticoenteric Anastomosis

Translating preclinical MRI methods to clinical oncology

Design, Construction, and Implementation of a Magnetic Resonance Elastography Actuator for Research Purposes

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