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OBJECTIVE: To determine the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and DCE ultrasound (DCE-US) for predicting response to neoadjuvant chemotherapy (NAC) in breast cancer patients. MATERIALS AND METHODS: This Institutional Review Board-approved prospective study was performed between 2014 and 2016. Thirty-nine women with breast cancer underwent DCE-US and DCE-MRI before the NAC, follow-up DCE-US after the first cycle of NAC, and follow-up DCE-MRI after the second cycle of NAC. DCE-MRI parameters (transfer constant [Ktrans], reverse constant [kep], and leakage space [Ve]) were assessed with histograms. From DCE-US, peak-enhancement, the area under the curve, wash-in rate, wash-out rate, time to peak, and rise time (RT) were obtained. After surgery, all the imaging parameters and their changes were compared with histopathologic response using the Miller-Payne Grading (MPG) system. Data from minor and good responders were compared using Wilcoxon rank sum test, chi-square test, or Fisher's exact test. Receiver operating characteristic curve analysis was used for assessing diagnostic performance to predict good response. RESULTS: Twelve patients (30.8%) showed a good response (MPG 4 or 5) and 27 (69.2%) showed a minor response (MPG 1–3). The mean, 25th, 50th, and 75th percentiles of Ktrans and Kep of post-NAC DCE-MRI differed between the two groups. These parameters showed fair to good diagnostic performance for the prediction of response to NAC (AUC 0.76–0.81, p ≤ 0.007). Among DCE-US parameters, the percentage change in RT showed fair prediction (AUC 0.71, p = 0.023). CONCLUSION: Quantitative analysis of DCE-MRI and DCE-US was helpful for early prediction of response to NAC.
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Female , Humans , Breast Neoplasms , Breast , Drug Therapy , Follow-Up Studies , Magnetic Resonance Imaging , Prospective Studies , ROC Curve , UltrasonographyABSTRACT
Objective To study the feasibility of DCE-MRI application in the orthotopic transplantation model of gastric cancer in nude mice.Methods Orthotopic transplantation model of gastric cancer in nude mice was established, and 15 models underwent DCE-MRI using the contrast agent of gadopentetate.Subsequently, the tumor was dissected in order to detect the MVD.The MVD was compared between orthotopic transplantation tumor model of gastric cancer and normal gastric mucosa.Results Fifteen nude mice with orthotopic transplantation of gastric cancer successfully underwent DCE-MRI examination.As for the cancer, the values of Ktrans, Kep and Ve were (2.11±0.44) min-1, (4.59±0.93) min-1, and 0.46±0.06, respectively.The MVD in gastric cancer tissues was significantly higher than that in normal gastric mucosa (χ2=16.205, P<0.001).Conclusion DCE-MRI can be used for noninvasively quantitative evaluation of vascular parameters of gastric carcinoma.
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PURPOSE: To investigate whether quantitative parameters derived from Diffusion-weighted magnetic resonance imaging (DW-MRI) correlate with those of Dynamic contrast-enhanced MRI (DCE-MRI). MATERIALS AND METHODS: Thirteen patients with pathologically or clinically proven bony metastasis who had undergone MRI prior to treatment were included. The voxel size was 1.367 x 1.367 x 5 mm. A dominant tumor was selected and the apparent diffusion coefficient (ADC) value and DCE-MRI parameters were obtained by matching voxels. DCE-MRI data were analyzed yielding estimates of K(trans) (volume transfer constant) and ve. (extravascular extracellular volume fraction). Statistical analysis of ADC, K(trans), and ve value was conducted using Pearson correlation analyses. RESULTS: Fifteen lesions in pelvic bones were evaluated. Of these, 11 showed a statistically significant correlation (P < 0.05) between ADC and K(trans). The ADC and K(trans) were inversely related in 7 lesions and positively related in 4 lesions. This did not depend on the primary cancer or site of metastasis. The ADC and ve of 9 lesions correlated significantly. Of these, 4 lesions were inversely related and 5 lesions were positively related. CONCLUSION: Unlike our theoretic hypothesis, there was no consistent correlation between ADC values and K(trans) or between ADC values and ve in metastatic bone tumors.
Subject(s)
Humans , Diffusion , Magnetic Resonance Imaging , Neoplasm Metastasis , Pelvic BonesABSTRACT
Objective To determine whether volume transfer coefficient (Ktrans )can be used to differentiate high-grade glioma (HGG)and metastasis.Methods Thirty-nine patients with brain tumors (12 HGG,27 metastases)underwent dynamic contrast en-hanced MR imaging before surgical resection or stereotactic biopsy.Images were acquired with a three-dimensional (3D)fast gradi-ent echo sequence.Gadolinium-based contrast agent was injected intravenously with dosage of 0.1 mmol/kg bodyweight at a rate of 3.0 mL/s.Ktrans and Ve were calculated from the DCE MRI data.The results of Ktrans and Ve were compared between the 2 types of tumors.Receiver operating characteristic curve analysis was performed for each of the variables in differentiation cerebral metastasis from HGG.Results The Ktrans values in the parenchyma of HGG and metastases were 0.10 (0.11,0.71)min-1 and 0.21 (0.05, 0.77)min-1 ,respectively.The difference was not statistically significant (P>0.05).The Ktrans values in the peritumoral region of the HGG and brain metastasis were 0.04 (0.01,0.10)min-1 and 0.01 (0.00,0.06)min-1 ,respectively.There was a significant difference between the Ktrans values in the peritumoral edema of HGG and cerebral metastases (P<0.05).The optimal cutoff value of Ktrans for differentiating HGG from cerebral metastases was 0.03,with sensitivity of 75% and specificity of 70%.Conclusion Ktrans values in the peritumoral edema may be useful in the differentiating cerebral metastases between HGG.
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OBJECTIVE: To investigate the correlation between quantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) parameters and microvascular density (MVD) in a human-colon-cancer xenograft mouse model using 3 Tesla MRI. MATERIALS AND METHODS: A human-colon-cancer xenograft model was produced by subcutaneously inoculating 1 x 106 DLD-1 human-colon-cancer cells into the right hind limbs of 10 mice. The tumors were allowed to grow for two weeks and then assessed using MRI. DCE-MRI was performed by tail vein injection of 0.3 mmol/kg of gadolinium. A region of interest (ROI) was drawn at the midpoints along the z-axes of the tumors, and a Tofts model analysis was performed. The quantitative parameters (Ktrans, Kep and Ve) from the whole transverse ROI and the hotspot ROI of the tumor were calculated. Immunohistochemical microvessel staining was performed and analyzed according to Weidner's criteria at the corresponding MRI sections. Additional Hematoxylin and Eosin staining was performed to evaluate tumor necrosis. The Mann-Whitney test and Spearman's rho correlation analysis were performed to prove the existence of a correlation between the quantitative parameters, necrosis, and MVD. RESULTS: Whole transverse ROI of the tumor showed no significant relationship between the MVD values and quantitative DCE-MRI parameters. In the hotspot ROI, there was a difference in MVD between low and high group of Ktrans and Kep that had marginally statistical significance (ps = 0.06 and 0.07, respectively). Also, Ktrans and Kep were found to have an inverse relationship with MVD (r = -0.61, p = 0.06 in Ktrans; r = -0.60, p = 0.07 in Kep). CONCLUSION: Quantitative analysis of T1-weighted DCE-MRI using hotspot ROI may provide a better histologic match than whole transverse section ROI. Within the hotspots, Ktrans and Kep tend to have a reverse correlation with MVD in this colon cancer mouse model.