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  • 1
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    Differentiation of brain infection from necrotic glioblastoma using combined analysis of diffusion and perfusion MRI
    Wiley ; 2019
    In:  Journal of Magnetic Resonance Imaging Vol. 49, No. 1 ( 2019-01), p. 184-194
    Details
    In: Journal of Magnetic Resonance Imaging, Wiley, Vol. 49, No. 1 ( 2019-01), p. 184-194
    Abstract: Accurate differentiation of brain infections from necrotic glioblastomas (GBMs) may not always be possible on morphologic MRI or on diffusion tensor imaging (DTI) and dynamic susceptibility contrast perfusion‐weighted imaging (DSC‐PWI) if these techniques are used independently. Purpose To investigate the combined analysis of DTI and DSC‐PWI in distinguishing brain injections from necrotic GBMs. Study Type Retrospective. Population Fourteen patients with brain infections and 21 patients with necrotic GBMs. Field Strength/Sequence 3T MRI, DTI, and DSC‐PWI. Assessment Parametric maps of mean diffusivity (MD), fractional anisotropy (FA), coefficient of linear (CL), and planar anisotropy (CP) and leakage corrected cerebral blood volume (CBV) were computed and coregistered with postcontrast T 1 ‐weighted and FLAIR images. All lesions were segmented into the central core and enhancing region. For each region, median values of MD, FA, CL, CP, relative CBV (rCBV), and top 90 th percentile of rCBV (rCBV max ) were measured. Statistical Tests All parameters from both regions were compared between brain infections and necrotic GBMs using Mann–Whitney tests. Logistic regression analyses were performed to obtain the best model in distinguishing these two conditions. Results From the central core, significantly lower MD (0.90 × 10 −3  ± 0.44 × 10 −3 mm 2 /s vs. 1.66 × 10 −3  ± 0.62 × 10 −3 mm 2 /s, P  = 0.001), significantly higher FA (0.15 ± 0.06 vs. 0.09 ± 0.03, P   〈  0.001), and CP (0.07 ± 0.03 vs. 0.04 ± 0.02, P  = 0.009) were observed in brain infections compared to those in necrotic GBMs. Additionally, from the contrast‐enhancing region, significantly lower rCBV (1.91 ± 0.95 vs. 2.76 ± 1.24, P  = 0.031) and rCBV max (3.46 ± 1.41 vs. 5.89 ± 2.06, P  = 0.001) were observed from infective lesions compared to necrotic GBMs. FA from the central core and rCBV max from enhancing region provided the best classification model in distinguishing brain infections from necrotic GBMs, with a sensitivity of 91% and a specificity of 93%. Data Conclusion Combined analysis of DTI and DSC‐PWI may provide better performance in differentiating brain infections from necrotic GBMs. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:184–194.
    Type of Medium: Online Resource
    ISSN: 1053-1807 , 1522-2586
    URL: Issue
    URL: Article
    DOI: 10.1002/jmri.v49.1
    DOI: 10.1002/jmri.26053
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 1497154-9
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  • 2
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    Dynamic contrast‐enhanced MRI and Doppler sonography in patients with squamous cell carcinoma of head and neck treated with induction chemotherapy
    Wiley ; 2022
    In:  Journal of Clinical Ultrasound Vol. 50, No. 9 ( 2022-11), p. 1353-1359
    Details
    In: Journal of Clinical Ultrasound, Wiley, Vol. 50, No. 9 ( 2022-11), p. 1353-1359
    Abstract: In view of the inherent limitations associated with performing dynamic contrast enhanced‐magnetic resonance imaging (DCE‐MRI) in clinical settings, current study was designed to provide a proof of principle that Doppler sonography and DCE‐MRI derived perfusion parameters yield similar hemodynamic information from metastatic lymph nodes in squamous cell carcinomas of head and neck (HNSCCs). Strong positive correlations between volume fraction of plasma space in tissues ( V p ) and blood volume ( r  = 0.72, p  = 0.02) and between V p and %area perfused ( r  = 0.65, p  = 0.04) were observed. Additionally, a moderate positive correlation trending towards significance was obtained between volume transfer constant ( K trans ) and %area perfused ( r  = 0.49, p  = 0.09).
    Type of Medium: Online Resource
    ISSN: 0091-2751 , 1097-0096
    URL: Issue
    URL: Article
    DOI: 10.1002/jcu.v50.9
    DOI: 10.1002/jcu.23361
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 1492376-2
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  • 3
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    Histopathology‐validated machine learning radiographic biomarker for noninvasive discrimination between true progression and pseudo‐progression in glioblastoma
    Wiley ; 2020
    In:  Cancer Vol. 126, No. 11 ( 2020-06), p. 2625-2636
    Details
    In: Cancer, Wiley, Vol. 126, No. 11 ( 2020-06), p. 2625-2636
    Abstract: Artificial intelligence methods can accurately predict pseudo‐progression in glioblastoma. The histopathologic characteristics of glioblastoma progression correlate with radiomic features.
    Type of Medium: Online Resource
    ISSN: 0008-543X , 1097-0142
    URL: Article
    DOI: 10.1002/cncr.32790
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 1479932-7
    detail.hit.zdb_id: 2599218-1
    detail.hit.zdb_id: 2594979-2
    detail.hit.zdb_id: 1429-1
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  • 4
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    Wallerian Degeneration Beyond the Corticospinal Tracts: Conventional and Advanced MRI Findings
    Wiley ; 2017
    In:  Journal of Neuroimaging Vol. 27, No. 3 ( 2017-05), p. 272-280
    Details
    In: Journal of Neuroimaging, Wiley, Vol. 27, No. 3 ( 2017-05), p. 272-280
    Abstract: Wallerian degeneration (WD) is defined as progressive anterograde disintegration of axons and accompanying demyelination after an injury to the proximal axon or cell body. Since the 1980s and 1990s, conventional magnetic resonance imaging (MRI) sequences have been shown to be sensitive to changes of WD in the subacute to chronic phases. More recently, advanced MRI techniques, such as diffusion‐weighted imaging (DWI) and diffusion tensor imaging (DTI), have demonstrated some of earliest changes attributed to acute WD, typically on the order of days. In addition, there is increasing evidence on the value of advanced MRI techniques in providing important prognostic information related to WD. This article reviews the utility of conventional and advanced MRI techniques for assessing WD, by focusing not only on the corticospinal tract but also other neural tracts less commonly thought of, including corticopontocerebellar tract, dentate‐rubro‐olivary pathway, posterior column of the spinal cord, corpus callosum, limbic circuit, and optic pathway. The basic anatomy of these neural pathways will be discussed, followed by a comprehensive review of existing literature supported by instructive clinical examples. The goal of this review is for readers to become more familiar with both conventional and advanced MRI findings of WD involving important neural pathways, as well as to illustrate increasing utility of advanced MRI techniques in providing important prognostic information for various pathologies.
    Type of Medium: Online Resource
    ISSN: 1051-2284 , 1552-6569
    URL: Issue
    URL: Article
    DOI: 10.1111/jon.2017.27.issue-3
    DOI: 10.1111/jon.12404
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2035400-9
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  • 5
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    Neuroimaging of Dilated Perivascular Spaces: From Benign and Pathologic Causes to Mimics
    Wiley ; 2018
    In:  Journal of Neuroimaging Vol. 28, No. 2 ( 2018-03), p. 139-149
    Details
    In: Journal of Neuroimaging, Wiley, Vol. 28, No. 2 ( 2018-03), p. 139-149
    Abstract: Perivascular spaces (PVSs), also known as Virchow‐Robin spaces, are pial‐lined, fluid‐filled structures found in characteristic locations throughout the brain. They can become abnormally enlarged or dilated and in rare cases can cause hydrocephalus. Dilated PVSs can pose a diagnostic dilemma for radiologists because of their varied appearance, sometimes mimicking more serious entities such as cystic neoplasms, including dysembryoplastic neuroepithelial tumor and multinodular and vacuolating neuronal tumor, or cystic infections including toxoplasmosis and neurocysticercosis. In addition, various pathologic processes, including cryptococcosis and chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids, can spread into the brain via PVSs, resulting in characteristic magnetic resonance imaging appearances. This review aims to describe the key imaging characteristics of normal and dilated PVSs, as well as cystic mimics and pathologic processes that directly involve PVSs.
    Type of Medium: Online Resource
    ISSN: 1051-2284 , 1552-6569
    URL: Issue
    URL: Article
    DOI: 10.1111/jon.2018.28.issue-2
    DOI: 10.1111/jon.12493
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2035400-9
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  • 6
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    Metabolic and physiologic magnetic resonance imaging in distinguishing true progression from pseudoprogression in patients with glioblastoma
    Wiley ; 2022
    In:  NMR in Biomedicine Vol. 35, No. 7 ( 2022-07)
    Details
    In: NMR in Biomedicine, Wiley, Vol. 35, No. 7 ( 2022-07)
    Abstract: Pseudoprogression (PsP) refers to treatment‐related clinico‐radiologic changes mimicking true progression (TP) that occurs in patients with glioblastoma (GBM), predominantly within the first 6 months after the completion of surgery and concurrent chemoradiation therapy (CCRT) with temozolomide. Accurate differentiation of TP from PsP is essential for making informed decisions on appropriate therapeutic intervention as well as for prognostication of these patients. Conventional neuroimaging findings are often equivocal in distinguishing between TP and PsP and present a considerable diagnostic dilemma to oncologists and radiologists. These challenges have emphasized the need for developing alternative imaging techniques that may aid in the accurate diagnosis of TP and PsP. In this review, we encapsulate the current state of knowledge in the clinical applications of commonly used metabolic and physiologic magnetic resonance (MR) imaging techniques such as diffusion and perfusion imaging and proton spectroscopy in distinguishing TP from PsP. We also showcase the potential of promising imaging techniques, such as amide proton transfer and amino acid‐based positron emission tomography, in providing useful information about the treatment response. Additionally, we highlight the role of “radiomics”, which is an emerging field of radiology that has the potential to change the way in which advanced MR techniques are utilized in assessing treatment response in GBM patients. Finally, we present our institutional experiences and discuss future perspectives on the role of multiparametric MR imaging in identifying PsP in GBM patients treated with “standard‐of‐care” CCRT as well as novel/targeted therapies.
    Type of Medium: Online Resource
    ISSN: 0952-3480 , 1099-1492
    URL: Issue
    URL: Article
    DOI: 10.1002/nbm.v35.7
    DOI: 10.1002/nbm.4719
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2002003-X
    detail.hit.zdb_id: 1000976-0
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  • 7
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    Emerging MRI Techniques to Redefine Treatment Response in Patients With Glioblastoma
    Wiley ; 2020
    In:  Journal of Magnetic Resonance Imaging Vol. 52, No. 4 ( 2020-10), p. 978-997
    Details
    In: Journal of Magnetic Resonance Imaging, Wiley, Vol. 52, No. 4 ( 2020-10), p. 978-997
    Abstract: Glioblastoma is the most common and most malignant primary brain tumor. Despite aggressive multimodal treatment, its prognosis remains poor. Even with continuous developments in MRI, which has provided us with newer insights into the diagnosis and understanding of tumor biology, response assessment in the posttherapy setting remains challenging. We believe that the integration of additional information from advanced neuroimaging techniques can further improve the diagnostic accuracy of conventional MRI. In this article, we review the utility of advanced neuroimaging techniques such as diffusion‐weighted imaging, diffusion tensor imaging, perfusion‐weighted imaging, proton magnetic resonance spectroscopy, and chemical exchange saturation transfer in characterizing and evaluating treatment response in patients with glioblastoma. We will also discuss the existing challenges and limitations of using these techniques in clinical settings and possible solutions to avoiding pitfalls in study design, data acquisition, and analysis for future studies. Level of Evidence 2 Technical Efficacy Stage 3 J. Magn. Reson. Imaging 2020;52:978–997.
    Type of Medium: Online Resource
    ISSN: 1053-1807 , 1522-2586
    URL: Issue
    URL: Article
    DOI: 10.1002/jmri.v52.4
    DOI: 10.1002/jmri.27105
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 1497154-9
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  • 8
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    Hyaluronic acid induced foreign body reaction mimicking neoplastic parotid cytology
    Wiley ; 2019
    In:  Diagnostic Cytopathology Vol. 47, No. 9 ( 2019-09), p. 904-906
    Details
    In: Diagnostic Cytopathology, Wiley, Vol. 47, No. 9 ( 2019-09), p. 904-906
    Abstract: Masses near the angle of the mandible containing extracellular matrix or mucin on cytology raise concern for various benign and malignant parotid gland neoplasms. Here a 76‐year‐old female with a history of cosmetic hyaluronic acid (HA) filler injections presented with a painless 6 mm left sided facial mass. Injection of hyaluronidase into the mass had failed to cause regression, raising concern for a neoplastic process. Fine‐needle aspiration (FNA) showed amorphous, mucinous/extracellular matrix‐like material in a background of numerous histiocytes and occasional multinucleated giant cells, consistent with a foreign body giant cell reaction to HA. This uncommon reaction to HA filler creates previously unrecognized diagnostic pitfalls because of its resemblance on FNA to the extracellular matrix or mucin found in many salivary neoplasms.
    Type of Medium: Online Resource
    ISSN: 8755-1039 , 1097-0339
    URL: Issue
    URL: Article
    DOI: 10.1002/dc.v47.9
    DOI: 10.1002/dc.24202
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2001251-2
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  • 9
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    Three‐dimensional echo planar spectroscopic imaging for differentiation of true progression from pseudoprogression in patients with glioblastoma
    Wiley ; 2019
    In:  NMR in Biomedicine Vol. 32, No. 2 ( 2019-02)
    Details
    In: NMR in Biomedicine, Wiley, Vol. 32, No. 2 ( 2019-02)
    Abstract: Accurate differentiation of true progression (TP) from pseudoprogression (PsP) in patients with glioblastomas (GBMs) is essential for planning adequate treatment and for estimating clinical outcome measures and future prognosis. The purpose of this study was to investigate the utility of three‐dimensional echo planar spectroscopic imaging (3D‐EPSI) in distinguishing TP from PsP in GBM patients. For this institutional review board approved and HIPAA compliant retrospective study, 27 patients with GBM demonstrating enhancing lesions within six months of completion of concurrent chemo‐radiation therapy were included. Of these, 18 were subsequently classified as TP and 9 as PsP based on histological features or follow‐up MRI studies. Parametric maps of choline/creatine (Cho/Cr) and choline/N‐acetylaspartate (Cho/NAA) were computed and co‐registered with post‐contrast T 1 ‐weighted and FLAIR images. All lesions were segmented into contrast enhancing (CER), immediate peritumoral (IPR), and distal peritumoral (DPR) regions. For each region, Cho/Cr and Cho/NAA ratios were normalized to corresponding metabolite ratios from contralateral normal parenchyma and compared between TP and PsP groups. Logistic regression analyses were performed to obtain the best model to distinguish TP from PsP. Significantly higher Cho/NAA was observed from CER (2.69 ± 1.00 versus 1.56 ± 0.51, p  = 0.003), IPR (2.31 ± 0.92 versus 1.53 ± 0.56, p  = 0.030), and DPR (1.80 ± 0.68 versus 1.19 ± 0.28, p  = 0.035) regions in TP patients compared with those with PsP. Additionally, significantly elevated Cho/Cr (1.74 ± 0.44 versus 1.34 ± 0.26, p  = 0.023) from CER was observed in TP compared with PsP. When these parameters were incorporated in multivariate regression analyses, a discriminatory model with a sensitivity of 94% and a specificity of 87% was observed in distinguishing TP from PsP. These results indicate the utility of 3D‐EPSI in differentiating TP from PsP with high sensitivity and specificity.
    Type of Medium: Online Resource
    ISSN: 0952-3480 , 1099-1492
    URL: Issue
    URL: Article
    DOI: 10.1002/nbm.v32.2
    DOI: 10.1002/nbm.4042
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2002003-X
    detail.hit.zdb_id: 1000976-0
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  • 10
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    Prediction of distant metastases in patients with squamous cell carcinoma of head and neck using DWI and DCE‐MRI
    Wiley ; 2020
    In:  Head & Neck Vol. 42, No. 11 ( 2020-11), p. 3295-3306
    Details
    In: Head & Neck, Wiley, Vol. 42, No. 11 ( 2020-11), p. 3295-3306
    Abstract: The primary purpose was to evaluate the prognostic potential of diffusion imaging (DWI) and dynamic contrast enhanced magnetic resonance imaging (DCE‐MRI) in predicting distant metastases in squamous cell carcinoma of head and neck (HNSCC) patients. The secondary aim was to examine differences in DWI and DCE‐MRI‐derived parameters on the basis of human papilloma virus (HPV) status, differentiation grade, and nodal stage of HNSCC. Methods Fifty‐six patients underwent pretreatment DWI and DCE‐MRI. Patients were divided into groups who subsequently did (n = 12) or did not develop distant metastases (n = 44). Median values of apparent diffusion coefficient (ADC), volume transfer constant ( K trans ), and mean intracellular water‐lifetime ( τ i ) and volume were computed from metastatic lymph nodes and were compared between two groups. Prognostic utility of HPV status, differentiation grading, and nodal staging was also evaluated both in isolation or in combination with MRI parameters in distinguishing patients with and without distant metastases. Additionally, MRI parameters were compared between two groups based on dichotomous HPV status, differentiation grade, and nodal stage. Results Lower but not significantly different K trans (0.51 ± 0.15 minute −1 vs 0.60 ± 0.05 minute −1 ) and not significantly different τ i (0.13 ± 0.03 second vs 0.19 ± 0.02 second) were observed in patients who developed distant metastases than those who did not. Additionally, no significant differences in ADC or volume were found. τ i, was the best parameter in discriminating two groups with moderate sensitivity (67%) and specificity (61.4%). Multivariate logistic regression analyses did not improve the overall prognostic performance for combination of all variables. A trend toward higher τ i was observed in HPV‐positive patients than those with HPV‐negative patients. Also, a trend toward higher K trans was observed in poorly differentiated HNSCCs than those with moderately differentiated HNSCCs. Conclusion Pretreatment DCE‐MRI may be useful in predicting distant metastases in HNSCC.
    Type of Medium: Online Resource
    ISSN: 1043-3074 , 1097-0347
    URL: Issue
    URL: Article
    DOI: 10.1002/hed.v42.11
    DOI: 10.1002/hed.26386
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2001440-5
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