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12 pages, 1144 KiB

Open AccessArticle

Association between Dynamic Contrast-Enhanced MRI Parameters and Prognostic Factors in Patients with Primary Rectal Cancer

by Hye Ri Kim, Seung Ho Kim and Kyung Han Nam

Curr. Oncol. 2023, 30(2), 2543-2554; https://doi.org/10.3390/curroncol30020194 - 20 Feb 2023

Cited by 1 | Viewed by 1967

Abstract

Background: To evaluate the association between perfusion parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with prognostic factors in primary rectal cancer patients. Methods: A sample of 51 patients with pathologically proven rectal adenocarcinoma through surgery were retrospectively enrolled. All the patients [...] Read more.

Background: To evaluate the association between perfusion parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with prognostic factors in primary rectal cancer patients. Methods: A sample of 51 patients with pathologically proven rectal adenocarcinoma through surgery were retrospectively enrolled. All the patients underwent preoperative DCE-MRI including 3D-spoiled gradient echo. Two radiologists determined the tumor border after radiologic–pathologic correlation and drew regions of interest. The perfusion parameters, including the volume transfer constant (K^trans), were calculated under the extended Toft model. The prognostic factors included TN stage, circumferential resection margin, extramural venous invasion, Kirsten-ras mutation, tumor size, carcinoembryonic antigen, and tumor differentiation. The association was assessed via correlation or t-test. For significant prognostic factors, receiver operating characteristic (ROC) curve analyses were performed to estimate the diagnostic predictive values. Results: K^trans only showed a significant difference according to tumor differentiation, between the well-differentiated (n = 6) and moderately differentiated (n = 45) groups (0.127 ± 0.032, 0.084 ± 0.036, p = 0.036). The AUC was 0.838 (95% CI, 0.702–0.929), and the estimated accuracy, sensitivity, and specificity were 87%, 90%, and 60%, respectively. Conclusions: K^trans showed a significant difference based on tumor differentiation, which may be conducive to prediction of prognosis in primary rectal cancer. Full article

(This article belongs to the Special Issue Gastrointestinal Cancer Imaging)

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14 pages, 3024 KiB

Open AccessArticle

Spectral Computed Tomography-Derived Iodine Content and Tumor Response in the Follow-Up of Neuroendocrine Tumors—A Single-Center Experience

by Winna Lim, Elisa Birgit Sodemann, Laura Büttner, Martin Jonczyk, Willie Magnus Lüdemann, Johannes Kahn, Dominik Geisel, Henning Jann, Annette Aigner and Georg Böning

Curr. Oncol. 2023, 30(2), 1502-1515; https://doi.org/10.3390/curroncol30020115 - 23 Jan 2023

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Abstract

Spectral computed tomography (SCT) allows iodine content (IC) calculation for characterization of hypervascularized neoplasms and thus might help in the staging of neuroendocrine tumors (NETs). This single-center prospective study analyzed the association between SCT-derived IC and tumor response in the follow-up of metastasized [...] Read more.

Spectral computed tomography (SCT) allows iodine content (IC) calculation for characterization of hypervascularized neoplasms and thus might help in the staging of neuroendocrine tumors (NETs). This single-center prospective study analyzed the association between SCT-derived IC and tumor response in the follow-up of metastasized NETs. Twenty-six patients with a median age of 70 years (range 51–85) with histologically proven NETs and a total of 78 lesions underwent SCT for staging. Because NETS are rare, no primary NET types were excluded. Lesions and intralesional hotspots were measured in virtual images and iodine maps. Tumor response was classified as progressive or nonprogressive at study endpoint. Generalized estimating equations served to estimate associations between IC and tumor response, additionally stratified by lesion location. Most commonly affected sites were the lymph nodes, liver, pancreas, and bones. Median time between SCT and endpoint was 64 weeks (range 5–260). Despite statistical imprecision in the estimate, patients with higher IC in lymphonodular metastases had lower odds for disease progression (adjusted OR = 0.21, 95% CI: 0.02–2.02). Opposite tendencies were observed in hepatic and pancreatic metastases in unadjusted analyses, which vanished after adjusting for therapy and primary tumor grade. Full article

(This article belongs to the Special Issue Gastrointestinal Cancer Imaging)

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12 pages, 5042 KiB

Open AccessArticle

Application of Intravoxel Incoherent Motion in the Evaluation of Hepatocellular Carcinoma after Transarterial Chemoembolization

by Xiaofei Yue, Yuting Lu, Qiqi Jiang, Xiangjun Dong, Xuefeng Kan, Jiawei Wu, Xiangchuang Kong, Ping Han, Jie Yu and Qian Li

Curr. Oncol. 2022, 29(12), 9855-9866; https://doi.org/10.3390/curroncol29120774 - 14 Dec 2022

Cited by 1 | Viewed by 1856

Abstract

(1) Background: To assess the efficacy of the quantitative parameters of intravoxel incoherent motion (IVIM) diffusion-weighted imaging for hepatocellular carcinoma (HCC) diagnosis after transarterial chemoembolization (TACE). (2) Methods: Fifty HCC patients after TACE were included and underwent MRI. All of the patients were [...] Read more.

(1) Background: To assess the efficacy of the quantitative parameters of intravoxel incoherent motion (IVIM) diffusion-weighted imaging for hepatocellular carcinoma (HCC) diagnosis after transarterial chemoembolization (TACE). (2) Methods: Fifty HCC patients after TACE were included and underwent MRI. All of the patients were scanned with the IVIM-DWI sequence and underwent TACE retreatment within 1 week. Referring to digital subtraction angiography (DSA) and MR enhanced images, two readers measured the f, D, and D* values of the tumor active area (TAA), tumor necrotic area (TNA), and adjacent normal hepatic parenchyma (ANHP). Then, the distinctions of the TAA, TNA, and ANHP were compared and we analyzed the differential diagnosis of the parameters in three tissues. (3) Results: For values of f and D, there were significant differences between any of the TAA, TNA, and ANHP (p < 0.05). The values of f and D were the best indicators for identifying the TAA and TNA, with AUC values of 0.959 and 0.955, respectively. The values of f and D performed well for distinguishing TAA from ANHP, with AUC values of 0.835 and 0.753, respectively. (4) Conclusions: Quantitative IVIM-DWI was effective for evaluating tumor viability in HCC patients treated with TACE and may be helpful for non-invasive monitoring of the tumor viability. Full article

(This article belongs to the Special Issue Gastrointestinal Cancer Imaging)

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11 pages, 783 KiB

Open AccessArticle

Magnetic Resonance Imaging of Peritoneal Carcinomatosis: Evaluation of High b-Value Computed Diffusion-Weighted Imaging

by Maxime Ablefoni, Jakob Leonhardi, Constantin Ehrengut, Matthias Mehdorn, Robert Sucher, Ines Gockel, Timm Denecke and Hans-Jonas Meyer

Curr. Oncol. 2022, 29(7), 4593-4603; https://doi.org/10.3390/curroncol29070364 - 29 Jun 2022

Cited by 2 | Viewed by 2018

Abstract

Over the last few years, diffusion-weighted imaging (DWI) has become increasingly relevant in the diagnostic assessment of peritoneal carcinomatosis. The aim of this study was to investigate the benefits of high-b DWI (c-DWI) compared to standard DWI in patients with peritoneal carcinomatosis. A [...] Read more.

Over the last few years, diffusion-weighted imaging (DWI) has become increasingly relevant in the diagnostic assessment of peritoneal carcinomatosis. The aim of this study was to investigate the benefits of high-b DWI (c-DWI) compared to standard DWI in patients with peritoneal carcinomatosis. A cohort of 40 patients with peritoneal carcinomatosis were included in this retrospective study. DWI was performed with b-values of 50, 400, and 800 or 1000 s/mm² on a 1.5-T magnetic resonance imaging (MRI) scanner. C-DWI was calculated using a mono-exponential model with high b-values of 1000, 2000, 3000, 4000, and 5000 s/mm². All c-DWI images with high b-values were compared in terms of volume, detectability of peritoneal lesions, and image quality with the DWI sequence acquired with a b-value of 800 or 1000 s/mm² by two readers. In the group with a b-value of 800 s/mm², there was no statistically significant difference in terms of lesion volume. In the second group with a b-value of 1000 s/mm², peritoneal carcinomatosis lesions were statistically significantly larger than in the c-DWI with a- high b-value of 2000 s/mm² (median 7 cm³, range 1–26 cm³vs. median 6 cm³, range 1–83 cm³, p < 0.05). In both groups, there was a marked decrease in the detectability of peritoneal lesions starting at b = 2000 s/mm². In addition, image quality decreased noticeably from c-DWI at b = 3000 s/mm². In both groups, all images with high b-values at b = 4000 s/mm² and 5000 s/mm² were not diagnostically valuable due to poor image quality. The c-DWI technique offers good diagnostic performance without additional scanning time. High c-DWI b-values up to b = 1000 s/mm² provide comparable detectability of peritoneal carcinomatosis compared to standard DWI. Higher b-values over 1500 s/mm² result in lower image quality, which might lead to misdiagnosis. Full article

(This article belongs to the Special Issue Gastrointestinal Cancer Imaging)

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11 pages, 1383 KiB

Open AccessArticle

CT and 3 Tesla MRI in the TN Staging of Colon Cancer: A Prospective, Blind Study

by Søren R. Rafaelsen, Claus Dam, Chris Vagn-Hansen, Jakob Møller, Hans B. Rahr, Mikkel Sjöström, Jan Lindebjerg, Torben Frøstrup Hansen and Malene Roland Vils Pedersen

Curr. Oncol. 2022, 29(2), 1069-1079; https://doi.org/10.3390/curroncol29020091 - 13 Feb 2022

Cited by 13 | Viewed by 3619

Abstract

(1) Background: Computer tomography (CT) scanning is currently the standard method for staging of colon cancer; however, the CT based preoperative local staging is far from optimal. The purpose of this study was to investigate the sensitivity and specificity of magnetic resonance imaging [...] Read more.

(1) Background: Computer tomography (CT) scanning is currently the standard method for staging of colon cancer; however, the CT based preoperative local staging is far from optimal. The purpose of this study was to investigate the sensitivity and specificity of magnetic resonance imaging (MRI) compared to CT in the T- and N-staging of colon cancer. (2) Methods: Patients underwent a standard contrast-enhanced CT examination. For the abdominal MRI scan, a 3 Tesla unit was used, including diffusion weighted imaging (DWI). Experienced radiologists reported the CT and MRI scans blinded to each other and the endpoint of the pathological report. (3) Results: From 2018 to 2021, 134 patients received CT and MRI scans. CT identified 118 of the 134 tumors, whereas MRI identified all tumors. For discriminating between stage T3ab and T3cd, the sensitivity of CT was 51.1% and of MRI 80.0% (p = 0.02). CT and MRI showed a sensitivity of 21.4% and 46.4% in detecting pT4 tumors and a specificity of 79.0% and 85.0%, respectively. (4) Conclusion: Compared to CT, the sensitivity of MRI was statistically significantly higher in staging advanced T3cd and T4 tumors. MRI has the potential to be used in the treatment planning of colon cancer. Full article

(This article belongs to the Special Issue Gastrointestinal Cancer Imaging)

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13 pages, 1611 KiB

Open AccessArticle

Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort

by Max Seidensticker, Ingo G. Steffen, Irene Bargellini, Thomas Berg, Alberto Benito, Bernhard Gebauer, Roberto Iezzi, Christian Loewe, Musturay Karçaaltincaba, Maciej Pech, Christian Sengel, Otto van Delden, Vincent Vandecaveye, Christoph J. Zech and Jens Ricke

Curr. Oncol. 2022, 29(2), 565-577; https://doi.org/10.3390/curroncol29020051 - 27 Jan 2022

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Abstract

The value of gadoxetic acid in the diagnosis of hepatocellular carcinoma (HCC), based on perfusion criteria, is under dispute. This post-hoc analysis of the prospective, phase II, randomized, controlled SORAMIC study compared the accuracy of gadoxetic acid-enhanced dynamic magnetic resonance imaging (MRI) (arterial, [...] Read more.

The value of gadoxetic acid in the diagnosis of hepatocellular carcinoma (HCC), based on perfusion criteria, is under dispute. This post-hoc analysis of the prospective, phase II, randomized, controlled SORAMIC study compared the accuracy of gadoxetic acid-enhanced dynamic magnetic resonance imaging (MRI) (arterial, portovenous, and venous phase only) versus contrast-enhanced computed tomography (CT) for stratifying patients with HCC to curative ablation or palliative treatment. Two reader groups (radiologists, R1 and R2) performed blind reads of CT and gadoxetic acid-enhanced MRI (contrast dynamics only). A truth panel, with access to clinical and imaging follow-up data, served as reference. Primary endpoint was non-inferiority (margin: 5% points) of MRI vs. CT (lower 95% confidence interval [CI] > 0.75) in a first step and superiority (complete 95% CI > 1) in a second step. The intent-to-treat population comprised 538 patients. Accuracy of treatment decisions was 73.4% and 70.8% for CT (R1 and R2, respectively) and 75.1% and 70.3% for gadoxetic acid-enhanced dynamic MRI. Non-inferiority but not superiority of gadoxetic acid-enhanced dynamic MRI versus CT was demonstrated (odds ratio 1.01; CI 0.97–1.05). Despite a theoretical disadvantage in wash-out depiction, gadoxetic acid-enhanced dynamic MRI is non-inferior to CT in accuracy of treatment decisions for curative ablation versus palliative strategies. This outcome was not subject to the use of additional MR standard sequences. Full article

(This article belongs to the Special Issue Gastrointestinal Cancer Imaging)

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Review

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17 pages, 317 KiB

Open AccessReview

PET/CT for Predicting Occult Lymph Node Metastasis in Gastric Cancer

by Danyu Ma, Ying Zhang, Xiaoliang Shao, Chen Wu and Jun Wu

Curr. Oncol. 2022, 29(9), 6523-6539; https://doi.org/10.3390/curroncol29090513 - 11 Sep 2022

Cited by 12 | Viewed by 3154

Abstract

A portion of gastric cancer patients with negative lymph node metastasis at an early stage eventually die from tumor recurrence or advanced metastasis. Occult lymph node metastasis (OLNM] is a potential risk factor for the recurrence and metastasis in these patients, and it [...] Read more.

A portion of gastric cancer patients with negative lymph node metastasis at an early stage eventually die from tumor recurrence or advanced metastasis. Occult lymph node metastasis (OLNM] is a potential risk factor for the recurrence and metastasis in these patients, and it is highly important for clinical prognosis. Positron emission tomography (PET)/computed tomography (CT) is used to assess lymph node metastasis in gastric cancer due to its advantages in anatomical and functional imaging and non-invasive nature. Among the major metabolic parameters of PET, the maximum standardized uptake value (SUVmax) is commonly used for examining lymph node status. However, SUVmax is susceptible to interference by a variety of factors. In recent years, the exploration of new PET metabolic parameters, new PET imaging agents and radiomics, has become an active research topic. This paper aims to explore the feasibility and predict the effectiveness of using PET/CT to detect OLNM. The current landscape and future trends of primary metabolic parameters and new imaging agents of PET are reviewed. For gastric cancer patients, the possibility to detect OLNM non-invasively will help guide surgeons to choose the appropriate lymph node dissection area, thereby reducing unnecessary dissections and providing more reasonable, personalized and comprehensive treatments. Full article

(This article belongs to the Special Issue Gastrointestinal Cancer Imaging)

26 pages, 14078 KiB

Open AccessReview

Imaging Spectrum of Intrahepatic Mass-Forming Cholangiocarcinoma and Its Mimickers: How to Differentiate Them Using MRI

by Jelena Djokic Kovač, Aleksandra Janković, Aleksandra Đikić-Rom, Nikica Grubor, Andrija Antić and Vladimir Dugalić

Curr. Oncol. 2022, 29(2), 698-723; https://doi.org/10.3390/curroncol29020061 - 30 Jan 2022

Cited by 14 | Viewed by 10497

Abstract

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy, with mass-forming growth pattern being the most common. The typical imaging appearance of mass-forming ICC (mICC) consists of irregular ring enhancement in the arterial phase followed by the progressive central enhancement on [...] Read more.

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy, with mass-forming growth pattern being the most common. The typical imaging appearance of mass-forming ICC (mICC) consists of irregular ring enhancement in the arterial phase followed by the progressive central enhancement on portal venous and delayed phases. However, atypical imaging presentation in the form of hypervascular mICC might also be seen, which can be attributed to distinct pathological characteristics. Ancillary imaging features such as lobular shape, capsular retraction, segmental biliary dilatation, and vascular encasement favor the diagnosis of mICC. Nevertheless, these radiological findings may also be present in certain benign conditions such as focal confluent fibrosis, sclerosing hemangioma, organizing hepatic abscess, or the pseudosolid form of hydatid disease. In addition, a few malignant lesions including primary liver lymphoma, hemangioendothelioma, solitary hypovascular liver metastases, and atypical forms of hepatocellular carcinoma (HCC), such as scirrhous HCC, infiltrative HCC, and poorly differentiated HCC, may also pose a diagnostic dilemma by simulating mICC in imaging studies. Diffusion-weighted imaging and the use of hepatobiliary contrast agents might be helpful for differential diagnosis in certain cases. The aim of this manuscript is to provide a comprehensive overview of mICC imaging features and to describe useful tips for differential diagnosis with its potential mimickers. Full article

(This article belongs to the Special Issue Gastrointestinal Cancer Imaging)

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