Whole-lesion ADC histogram and texture analysis in predicting recurrence of cervical cancer treated with CCRT

Meng, Jie; Zhu, Lijing; Zhu, Li; Xie, Li; Wang, Huanhuan; Liu, Song; Yan, Jing; Liu, Baorui; Guan, Yue; He, Jian; Ge, Yun; Zhou, Zhengyang; Yang, Xiaofeng

doi:10.18632/oncotarget.21374

Cited by 27 publications

(13 citation statements)

References 25 publications

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“…When repeating our analysis for the center tube only, the % RDC was 3.1% which is close to the reproducibility they reported for using torso coils. Some previously reported differences in ADC values between responders and non-responders [28,29] were smaller than the %RDC of 18% we found in this study, but larger differences have also been reported [30].…”

Section: Discussioncontrasting

confidence: 67%

Phantom-based quality assurance for multicenter quantitative MRI in locally advanced cervical cancer

Houdt

Kallehauge

Tanderup

et al. 2020

Radiotherapy and Oncology

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Background and purpose: A wide variation of MRI systems is a challenge in multicenter imaging biomarker studies as it adds variation in quantitative MRI values. The aim of this study was to design and test a quality assurance (QA) framework based on phantom measurements, for the quantitative MRI protocols of a multicenter imaging biomarker trial of locally advanced cervical cancer. Materials and methods: Fifteen institutes participated (five 1.5 T and ten 3 T scanners). Each institute optimized protocols for T2, diffusion-weighted imaging, T1, and dynamic contrast-enhanced (DCE-)MRI according to system possibilities, institutional preferences and study-specific constraints. Calibration phantoms with known values were used for validation. Benchmark protocols, similar on all systems, were used to investigate whether differences resulted from variations in institutional protocols or from system variations. Bias, repeatability (%RC), and reproducibility (%RDC) were determined. Ratios were used for T2 and T1 values. Results: The institutional protocols showed a range in bias of 0.88-0.98 for T2 (median %RC = 1%; % RDC = 12%), À0.007 to 0.029 Â 10 À3 mm 2 /s for the apparent diffusion coefficient (median %RC = 3%; % RDC = 18%), and 0.39-1.29 for T1 (median %RC = 1%; %RDC = 33%). For DCE a nonlinear vendor-specific relation was observed between measured and true concentrations with magnitude data, whereas the relation was linear when phase data was used. Conclusion: We designed a QA framework for quantitative MRI protocols and demonstrated for a multicenter trial for cervical cancer that measurement of consistent T2 and apparent diffusion coefficient values is feasible despite protocol differences. For DCE-MRI and T1 mapping with the variable flip angle method, this was more challenging.

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Section: Discussioncontrasting

confidence: 67%

Phantom-based quality assurance for multicenter quantitative MRI in locally advanced cervical cancer

Houdt

Kallehauge

Tanderup

et al. 2020

Radiotherapy and Oncology

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“…In our patients, baseline lymph node ADC values are below that threshold and rise to 1.13 × 10 −3 mm 2 /s during treatment, well above the suggested cut off value. Rising ADC values of primary tumour during treatment is confirmed by others [27,28]. Makino et al found in 25 patients a rise from 0.89 to 1.25 × 10 −3 mm 2 /s respectively at baseline to 27-47 days after start of the treatment [28].…”

Section: Tablementioning

confidence: 65%

Cervical cancer apparent diffusion coefficient values during external beam radiotherapy

Boer

Mandija

Werensteijn-Honingh

et al. 2019

Physics and Imaging in Radiation Oncology

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Background and purpose: Apparent diffusion coefficient (ADC) reflects micro-enviromental changes and therefore might be useful in predicting recurrence prior to brachytherapy. The purpose of this study is to evaluate change in ADC of the primary tumour and pathologic lymph nodes during treatment and to correlate this with clinical outcome. Material and methods: Twenty patients were included who received chemoradiation for locally advanced cervical cancer between July 2016 and November 2017. All patients underwent magnetic resonance imaging (MRI) prior to treatment, and three MRIs in weeks 1/2, 3 and 4 of treatment, including T2 and diffusion weighted imaging (b-values 0, 200, 800 s/mm 2) for determining an ADC-map. Primary tumour was delineated on T2 and ADC-map and pathologic lymph nodes were delineated only on ADC-map. Results: At time of analysis median follow-up was 15 (range 7-22) months. From MRI one to four, primary tumour on ADC-map showed a significant signal increase of 0.94 (range 0.74-1.46) × 10 −3 mm 2 /s to 1.13 (0.98-1.49) × 10 −3 mm 2 /s (p < 0.001). When tumour was delineated on T2, ADC-value signal increase (in tumour according to T2) was similar. All 46 delineated pathologic lymph nodes showed an ADC-value increase on average from 0.79 (range 0.33-1.12) × 10 −3 mm 2 /s to 1.14 (0.59-1.75) × 10 −3 mm 2 /s (p < 0.001). The mean tumour/suspected lymph node volumes decreased respectively 51/40%. Four patients developed relapse (one local and three nodal), without clear relation with ΔADC. However, the median volume decrease of the primary tumour was substantially lower in the failing patients compared to the group without relapse (19 vs. 57%). Conclusions: ADC values can be acquired using T2-based tumour delineations unless there are substantial shifts between ADC-mapping and T2 acquisition. It remains plausible that ΔADC is a predictor for response to EBRT. However, the correlation in this study was not statistically significant.

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“…For example, entropy was associated with p53 expression [ 27 ]. Moreover, Meng et al identified that ADC histogram parameters can predict tumor recurrence after radiochemotherapy with an area under the curve 0.85 [ 28 ]. In another study, it was identified that skewness and several percentiles derived from ADC maps were significantly different between squamous cell and adenocarcinomas of the uterine cervix and, therefore, ADC histogram analysis might aid in discrimination of the entities [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Cervical Cancer: Associations between Metabolic Parameters and Whole Lesion Histogram Analysis Derived from Simultaneous ¹⁸F-FDG-PET/MRI

Meyer¹,

Purz

Sabri

2018

Contrast Media & Molecular Imaging

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Multimodal imaging has been increasingly used in oncology, especially in cervical cancer. By using a simultaneous positron emission (PET) and magnetic resonance imaging (MRI, PET/MRI) approach, PET and MRI can be obtained at the same time which minimizes motion artefacts and allows an exact imaging fusion, which is especially important in anatomically complex regions like the pelvis. The associations between functional parameters from MRI and 18F-FDG-PET reflecting different tumor aspects are complex with inconclusive results in cervical cancer. The present study correlates histogram analysis and 18F-FDG-PET parameters derived from simultaneous FDG-PET/MRI in cervical cancer. Overall, 18 female patients (age range: 32–79 years) with histopathologically confirmed squamous cell cervical carcinoma were retrospectively enrolled. All 18 patients underwent a whole-body simultaneous 18F-FDG-PET/MRI, including diffusion-weighted imaging (DWI) using b-values 0 and 1000 s/mm2. Apparent diffusion coefficient (ADC) histogram parameters included several percentiles, mean, min, max, mode, median, skewness, kurtosis, and entropy. Furthermore, mean and maximum standardized uptake values (SUVmean and SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were estimated. No statistically significant correlations were observed between SUVmax or SUVmean and ADC histogram parameters. TLG correlated inversely with p25 (r=−0.486, P=0.041), p75 (r=−0.490, P=0.039), p90 (r=−0.513, P=0.029), ADC median (r=−0.497, P=0.036), and ADC mode (r=−0.546, P=0.019). MTV also showed significant correlations with several ADC parameters: mean (r=−0.546, P=0.019), p10 (r=−0.473, P=0.047), p25 (r=−0.569, P=0.014), p75 (r=−0.576, P=0.012), p90 (r=−0.585, P=0.011), ADC median (r=−0.577, P=0.012), and ADC mode (r=−0.597, P=0.009). ADC histogram analysis and volume-based metabolic 18F-FDG-PET parameters are related to each other in cervical cancer.

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Whole-lesion ADC histogram and texture analysis in predicting recurrence of cervical cancer treated with CCRT

Cited by 27 publications

References 25 publications

Phantom-based quality assurance for multicenter quantitative MRI in locally advanced cervical cancer

Phantom-based quality assurance for multicenter quantitative MRI in locally advanced cervical cancer

Cervical cancer apparent diffusion coefficient values during external beam radiotherapy

Cervical Cancer: Associations between Metabolic Parameters and Whole Lesion Histogram Analysis Derived from Simultaneous ¹⁸F-FDG-PET/MRI

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Whole-lesion ADC histogram and texture analysis in predicting recurrence of cervical cancer treated with CCRT

Cited by 27 publications

References 25 publications

Phantom-based quality assurance for multicenter quantitative MRI in locally advanced cervical cancer

Phantom-based quality assurance for multicenter quantitative MRI in locally advanced cervical cancer

Cervical cancer apparent diffusion coefficient values during external beam radiotherapy

Cervical Cancer: Associations between Metabolic Parameters and Whole Lesion Histogram Analysis Derived from Simultaneous 18F-FDG-PET/MRI

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Cervical Cancer: Associations between Metabolic Parameters and Whole Lesion Histogram Analysis Derived from Simultaneous ¹⁸F-FDG-PET/MRI