Diffusion Kurtosis at 3.0T as an in vivo Imaging Marker for Breast Cancer Characterization: Correlation With Prognostic Factors

Huang, Yao; Lin, Yan; Hu, Wei; Ma, Changchun; Lin, Weixun; Wang, Zhening; Liang, Jiahao; Ye, Wei; Jin, Zhao; Wu, Renhua

doi:10.1002/jmri.26249

Cited by 52 publications

(66 citation statements)

References 41 publications

(82 reference statements)

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“…D-value reflects the diffusion dynamics of water molecule, which may be limited in the crowded tumor cellularity with a high proliferative activity. Increased Ki-67 expression suggested higher cellularity and active vascular hyperplasia (25). In this study, D-value revealed negative and moderate correlations with tumor volume (r = −0.662) and Ki-67 (r = −0.781), indicating D-value can be used to predict treatment efficacy.…”

Section: Discussionmentioning

confidence: 54%

Application of IVIM-DWI in Detecting the Tumor Vasculogenic Mimicry Under Antiangiogenesis Combined With Oxaliplatin Treatment

Liang

et al. 2020

Front. Oncol.

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Objectives: This study aimed to detect the time window of vascular normalization during anti-vascular treatment using intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI). Simultaneously, we evaluated the tumor invasiveness and vasculogenic mimicry and performed synthetic assessment of treatment efficacy of angiogenesis inhibitor combined with conventional chemotherapy using IVIM-DWI. Materials and Methods: HCT116 cells were subcutaneously administered into the right flank of BALB/C nude mice to build a colon cancer xenograft model. Thirty-two tumor-bearing mice were randomly divided into four groups and intraperitoneally administered with normal saline (Group A or control group), bevacizumab (Group B), oxaliplatin monotherapy (Group C), and oxaliplatin combined with bevacizumab (Group D). The IVIM-DWI was performed on days 0, 3, 6, 9, 12, and 15 after the treatments. Another 51 tumor-bearing mice were included in the pathological examinations. α-Smooth muscle actin (SMA) and CD31 double-staining, periodic acid-Schiff (PAS) and CD31 double-staining, hematoxylin and eosin (HE), Ki-67, and E-cadherin staining were performed. The tumor growth and dynamic change of each parameter were noted. Results: The mice in Group D manifested the smallest tumor volume and highest tumor inhibition rate. Microvessel density was significantly decreased but accompanied by increased vasculogenic mimicry after antiangiogenic treatment. The trend was reversed by oxaliplatin treatment. Treated with bevacizumab, the vessel maturity index shared a similar trend with D * and f-values during days 3-12, which slowly increased from days 0 to 9 and then decreased briefly. D-value significantly correlated with vasculogenic mimicry and Ki-67, while D * and f-values showed positive correlations with microvessel density and E-cadherin, an indicator of epithelial-mesenchymal transition. Liang et al. IVIM-DWI Used in Vasculogenic Mimicry Conclusion: Oxaliplatin performed an inhibited effect on vasculogenic mimicry. Bevacizumab can enhance the tumor chemotherapy through vascular normalization within a transient time period, which can be detected by IVIM-DWI. D * and f-values are able to predict the tumor invasiveness while D is superior in reflecting vasculogenic mimicry and Ki-67 expression during antitumor treatment.

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Section: Discussionmentioning

confidence: 54%

Application of IVIM-DWI in Detecting the Tumor Vasculogenic Mimicry Under Antiangiogenesis Combined With Oxaliplatin Treatment

Liang

et al. 2020

Front. Oncol.

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“…Jensen et al (11) first introduced the DKI model in 2005 and developed new fields in brain, liver, and prostate imaging afterward (12)(13)(14). The investigation of breast tumors using the DKI model reached a peak in 2019 and became an important research area thereafter (8,(15)(16)(17)(18)(19)(20). The model provides microscopic information regarding the deviation of water diffusion from Gaussian distribution with the mean kurtosis (MK) and mean diffusivity (MD), a kurtosiscorrected diffusion coefficient.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Performance of Diffusion Kurtosis Imaging in the Characterization of Breast Tumors: A Meta-Analysis

Peng

et al. 2020

Front. Oncol.

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Rationale and Objectives: Diffusion kurtosis imaging (DKI) is a promising imaging technique, but the results regarding the diagnostic performance of DKI in the characterization and classification of breast tumors are inconsistent among published studies. This study aimed to pool all published results to provide more robust evidence of the differential diagnosis between malignant and benign breast tumors using DKI. Methods: Studies on the differential diagnosis of breast tumors using DKI-derived parameters were systemically retrieved from PubMed, Embase, and Web of Science without a time limit. Review Manager 5.3 was used to calculate the standardized mean differences (SMDs) and 95% confidence intervals of the mean kurtosis (MK), mean diffusivity (MD), and apparent diffusion coefficient (ADC). Stata 12.0 was used to pool the sensitivity, specificity, and diagnostic odds ratio (DOR) as well as the publication bias and heterogeneity of each parameter. Fagan's nomograms were plotted to predict the post-test probabilities. Results: Thirteen studies including 867 malignant and 460 benign breast lesions were analyzed. Most of the included studies showed a low to unclear risk of bias and low concerns regarding applicability. Breast cancer showed a higher MK (SMD = 1.23, P < 0.001) but a lower MD (SMD = −1.29, P < 0.001) and ADC (SMD = −1.21, P < 0.001) than benign tumors. The MK (SMD = −1.36, P = 0.006) rather than the MD (SMD = 0.29, P = 0.20) or ADC (SMD = 0.26, P = 0.24) can further differentiate invasive ductal carcinoma from ductal carcinoma in situ. The DKI-derived MK (sensitivity = 90%, specificity = 88%, DOR = 66) and MD (sensitivity = 86% and specificity = 88%, DOR = 46) demonstrated superior diagnostic performance and post-test probability (65, 64, and 56% for MK, MD, and ADC) in differentiating malignant from benign breast lesions, with a higher sensitivity and specificity than the DWI-derived ADC (sensitivity = 85% and specificity = 83%, DOR = 29). Li et al. Characterizing Breast Tumor With DKI Conclusion: The DKI-derived MK and MD demonstrate a comparable diagnostic performance in the discrimination of breast tumors based on their microstructures and non-Gaussian characteristics. The MK can further differentiate invasive ductal carcinoma from ductal carcinoma in situ.

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“…DKI and DWI data were analyzed using an in-house program written in MATLAB (version R2013b, MathWorks, MA, USA). The DKI parameter was fitted according to the following equation [10][11][12][13]:…”

Section: Imaging Analysismentioning

confidence: 99%

“…The ADC is the mean value obtained using all b values that were fitted with a conventional mono-exponential model according to the following equation [11,12]:…”

Section: Imaging Analysismentioning

confidence: 99%

“…Diffusion kurtosis imaging is an advanced DWI model that quantifies non-Gaussian behavior of diffusion, yielding additional parameters, apparent kurtosis coefficient (K app ), reflecting the deviation degree from the ideal Gaussian curve, and the corrected ADC value, which quantifies the non-Gaussian behavior of water molecular diffusion [10]. Recent years, DKI has been widely applied to the preoperative diagnosis, grading and postoperative surveillance of cancer [11][12][13]. Nevertheless, few studies applied DKI to evaluate the activity of autoimmune inflammation diseases, especially in the inflammatory bowel disease.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the inflammatory activity in Crohn’s disease using magnetic resonance diffusion kurtosis imaging

et al. 2019

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Objectives To explore the feasibility of diffusion kurtosis imaging (DKI) for evaluating inflammatory activity in Crohn's disease (CD). Materials and methods In all, 51 CD patients were included, who were performed with consecutive enteroscopy, MR and DKI (b values = 0-2000 mm 2 /s). The lesions of bowel segments were graded as inactive (0-2), mild (3-6), and moderatesevere group (> 6) based on simplified endoscopic activity score for Crohn's disease (SES-CD), The abilities of the parameters of DKI and DWI in grading different activity lesions were compared. Results One hundred and twenty-seven bowel segments including inactive (15), mild (45) and moderate-severe (67) were analyzed. ADC (r = − 0.627, p < 0.001), D app (r = − 0.381, p < 0.001) and K app (r = 0.641, p < 0.001) were correlated with SES-CD. These parameters were significantly different among the three groups (all p < 0.001). ROC analysis found ADC had the highest accuracy (AUC = 0.884, p < 0.001) to differentiate inactive from active group with the threshold at 0.865 × 10 −3 mm 2 /s, which was slightly higher than K app (AUC = 0.867, p < 0.001) with the threshold at 0.645, and was obviously higher than D app (AUC = 0.726, p = 0.005). Similarly, ADC also had the highest accuracy (AUC = 0.846, p < 0.001) to differentiate inactive-mild from moderate-severe group with the threshold at 0.825 × 10 −3 mm 2 /s, and minimally higher than K app (AUC = 0.843, p < 0.001) with the threshold at 0.695, and obviously higher than D app (AUC = 0.690, p < 0.001). Conclusion DKI is feasible and comparable to conventional DWI for the evaluation of inflammatory activity in CD.

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Diffusion Kurtosis at 3.0T as an in vivo Imaging Marker for Breast Cancer Characterization: Correlation With Prognostic Factors

Abstract: 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2018.

Cited by 52 publications

References 41 publications

Application of IVIM-DWI in Detecting the Tumor Vasculogenic Mimicry Under Antiangiogenesis Combined With Oxaliplatin Treatment

Application of IVIM-DWI in Detecting the Tumor Vasculogenic Mimicry Under Antiangiogenesis Combined With Oxaliplatin Treatment

The Diagnostic Performance of Diffusion Kurtosis Imaging in the Characterization of Breast Tumors: A Meta-Analysis

Evaluating the inflammatory activity in Crohn’s disease using magnetic resonance diffusion kurtosis imaging

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