Value of quantitative dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging in predicting extramural venous invasion in locally advanced gastric cancer and prognostic significance

Zhu, Yongjian; Zhou, Yue; Zhang, Wen; Xue, Liyan; Li, Ying; Jiang, Jun; Zhong, Yi; Wang, Sicong; Jiang, Liming

doi:10.21037/qims-20-246

Cited by 24 publications

(23 citation statements)

References 36 publications

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“…This was consistent with most studies in nasopharyngeal carcinoma, GC, oesophageal carcinoma, rectal cancer and cervical carcinoma. 7 , 8 , 13 , 17 , 18 The V e value of T3 and T4 stage was higher than that of T1+2 stage, indicating that as the degree of malignancy increased, EES volume fraction also increased, so more intravascular fluid entered the EES to ensure adequate nutrition and oxygen supply for the tumor. 8 In addition, this study found that V e is the best parameter for identifying T staging (accuracy is 0.788), which is better than CT and ultrasound (accuracies are 0.715, 0.678, respectively).…”

Section: Discussionmentioning

confidence: 96%

Predicting T and N Staging of Resectable Gastric Cancer According to Whole Tumor Histogram Analysis About a Non-Cartesian k-Space Acquisition DCE-MRI: A Feasibility Study

Yan¹,

Qu²,

Li³

et al. 2021

CMAR

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Objective: To explore the feasibility of the whole tumor histogram analysis parameters derived from dynamic contrast-enhanced MRI (DCE-MRI) based on stack-of stars (StarVIBE) to predict T and N staging of resectable gastric cancer (GC). Methods: Eighty-seven patients confirmed as GC by histopathology were enrolled in this prospective study. DCE-MRI were performed before surgery, and quantitative DCE parameters (K trans , K ep , V e ) and histogram metrics (Skewness, Kurtosis and Entropy) were measured by Omni-Kinetics software. Intraclass correlation coefficient (ICC) testing was used to determine the consistency of K trans , K ep and V e values and histogram metrics values between two radiologists using Bland-Altman analysis. The quantitative DCE parameters or histogram metrics values between T stage or N stage were compared using ANOVA or Kruskal-Wallis testing. Receiver operating characteristic (ROC) analyses was performed to find out the best parameters for identifying T and N staging. Results: There was statistical difference in K trans , K ep , V e and entropy to identify T staging (P=0.015, 0.033, <0.001, and 0.007, respectively), and in pairwise comparisons of V e values showed statistically difference between T1+2 and T3 group (P<0.001), T1+2 and T4 group (P<0.001). There were statistical differences in V e to identify N staging (P=0.041). In ROC analysis, V e was the best parameter for identifying T staging (AUC: 0.788, the sensitivity and specificity was 0.929 and 0.578, respectively) and N staging (AUC: 0.590, the sensitivity and specificity was 0.714 and 0.899, respectively). Conclusion:The whole tumor histogram analysis parameters derived from StarVIBE DCE-MRI may be able to quantitatively evaluate T and N staging of GC, so as to help clinical treatment decision optimization.

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Section: Discussionmentioning

confidence: 96%

Predicting T and N Staging of Resectable Gastric Cancer According to Whole Tumor Histogram Analysis About a Non-Cartesian k-Space Acquisition DCE-MRI: A Feasibility Study

Yan¹,

Qu²,

Li³

et al. 2021

CMAR

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“…Previously, DCE-MRI has been proven useful in predicting the histological type and Lauren classification of the tumor and estimating tumor angiogenesis in GC [ 7 ]. It can also predict extramural venous invasion preoperatively in local AGC [ 10 ]. Unlike the abovementioned studies, which used conventional imaging analysis, we used a histogram analysis based on DCE-MRI in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Different quantitative parameters such as volume transfer constant (Ktrans), reverse reflux rate constant (Kep), extracellular extravascular volume fraction (Ve), and plasma volume fraction (Vp) can be obtained in DCE-MRI [ 8 ]. At present, DCE-MRI has proven to be reliable in predicting extramural venous invasion and patient prognosis and monitoring antiangiogenic therapies [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Association Between DCE-MRI Perfusion Histogram Parameters and EGFR and VEGF Expressions in Different Lauren Classifications of Advanced Gastric Cancer

Zhao

Wang

et al. 2022

Pathol. Oncol. Res.

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Objective: To investigate the correlations between dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) perfusion histogram parameters and vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) expressions in advanced gastric cancer (AGC).Methods: This retrospective study included 80 pathologically confirmed patients with AGC who underwent DCE-MRI before surgery from February 2017 to May 2021. The DCE-MRI perfusion histogram parameters were calculated by Omni Kinetics software in four quantitative parameter maps. Immunohistochemical methods were used to detect VEGF and EGFR expressions and calculate the immunohistochemical score.Results: VEGF expression was relatively lower in patients with intestinal-type AGC than those with diffuse-type AGC (p < 0.05). For VEGF, Receiver operating characteristics (ROC) curve analysis revealed that Quantile 90 of Ktrans, Meanvalue of Kep and Quantile 50 of Ve provided the perfect combination of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for distinguishing high and low VEGF expression, For EGFR, Skewness of Ktrans, Energy of Kep and Entropy of Vp provided the perfect combination of sensitivity, specificity, PPV and NPV for distinguishing high and low EGFR expression. Ktrans (Quantile 90, Entropy) showed the strongest correlation with VEGF and EGFR in patients with intestinal-type AGC (r = 0.854 and r = 0.627, respectively); Ktrans (Mean value, Entropy) had the strongest correlation with VEGF and EGFR in patients with diffuse-type AGC (r = 0.635 and 0.656, respectively).Conclusion: DCE-MRI perfusion histogram parameters can serve as imaging biomarkers to reflect VEGF and EGFR expressions and estimate their difference in different Lauren classifications of AGC.

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“…Quantitative DCE-MRI was performed by using multiphase axial 3D spoiled-gradient recalled-echo sequences for liver acquisition with volume acceleration-extended volume (LAVA-XV) sequence with breath-hold. According to our previous study ( 19 ), pre-contrast T1 mapping with four different flip angles (3°, 6°, 9°, and 12°) was acquired before dynamic scanning for the determination of pre-contrast T1 values. Then a dynamic scan with 42 consecutive phases was performed, which shared the scanning parameters and range as T1 mapping, with a flip angle of 15° and temporal resolution of 6 s/phase.…”

Section: Methodsmentioning

confidence: 99%

“…The signal intensity on MRI was converted into an equivalent concentration of contrast material using the variable flip angles method. The pharmacokinetic parameters including volume transfer constant (K trans ), reverse reflux rate constant (k ep ), extracellular extravascular volume fraction (v e ), and plasma volume fraction (v p ), which were derived from DCE-MRI, were calculated using the two-compartment extended Tofts model as described in our previous study and report ( 19 , 20 ).…”

Section: Methodsmentioning

confidence: 99%

Quantitative Dynamic-Enhanced MRI and Intravoxel Incoherent Motion Diffusion−Weighted Imaging for Prediction of the Pathological Response to Neoadjuvant Chemotherapy and the Prognosis in Locally Advanced Gastric Cancer

et al. 2022

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BackgroundThis study aimed to explore the predictive value of quantitative dynamic contrast-enhanced MRI (DCE-MRI) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) quantitative parameters for the response to neoadjuvant chemotherapy (NCT) in locally advanced gastric cancer (LAGC) patients, and the relationship between the prediction results and patients’ prognosis, so as to provide a basis for clinical individualized precision treatment.MethodsOne hundred twenty-nine newly diagnosed LAGC patients who underwent IVIM-DWI and DCE-MRI pretreatment were enrolled in this study. Pathological tumor regression grade (TRG) served as the reference standard of NCT response evaluation. The differences in DCE-MRI and IVIM-DWI parameters between pathological responders (pR) and pathological non-responders (pNR) groups were analyzed. Univariate and multivariate logistic regressions were used to identify independent predictive parameters for NCT response. Prediction models were built with statistically significant quantitative parameters and their combinations. The performance of these quantitative parameters and models was evaluated using receiver operating characteristic (ROC) analysis. Clinicopathological variables, DCE-MRI and IVIM-DWI derived parameters, as well as the prediction model were analyzed in relation to 2-year recurrence-free survival (RFS) by using Cox proportional hazards model. RFS was compared using the Kaplan–Meier method and the log-rank test.ResultsSixty-nine patients were classified as pR and 60 were pNR. Ktrans, kep, and ve values in the pR group were significantly higher, while ADCstandard and D values were significantly lower than those in the pNR group. Multivariate logistic regression analysis demonstrated that Ktrans, kep, ve, and D values were independent predictors for NCT response. The combined predictive model, which consisted of DCE-MRI and IVIM-DWI, showed the best prediction performance with an area under the curve (AUC) of 0.922. Multivariate Cox regression analysis showed that ypStage III and NCT response predicted by the IVIM-DWI model were independent predictors of poor RFS. The IVIM-DWI model could significantly stratify median RFS (52 vs. 15 months) and 2-year RFS rate (72.3% vs. 21.8%) of LAGC.ConclusionPretreatment DCE-MRI quantitative parameters Ktrans, kep, ve, and IVIM-DWI parameter D value were independent predictors of NCT response for LAGC patients. The regression model based on baseline DCE-MRI, IVIM-DWI, and their combination could help RFS stratification of LAGC patients.

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Value of quantitative dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging in predicting extramural venous invasion in locally advanced gastric cancer and prognostic significance

Cited by 24 publications

References 36 publications

Predicting T and N Staging of Resectable Gastric Cancer According to Whole Tumor Histogram Analysis About a Non-Cartesian k-Space Acquisition DCE-MRI: A Feasibility Study

Predicting T and N Staging of Resectable Gastric Cancer According to Whole Tumor Histogram Analysis About a Non-Cartesian k-Space Acquisition DCE-MRI: A Feasibility Study

Association Between DCE-MRI Perfusion Histogram Parameters and EGFR and VEGF Expressions in Different Lauren Classifications of Advanced Gastric Cancer

Quantitative Dynamic-Enhanced MRI and Intravoxel Incoherent Motion Diffusion−Weighted Imaging for Prediction of the Pathological Response to Neoadjuvant Chemotherapy and the Prognosis in Locally Advanced Gastric Cancer

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