Magnetic resonance (MR) imaging has been increasingly used in the evaluation of prostate cancer. As studies have suggested that the majority of cancers arise from the peripheral zone (PZ), MR imaging has focused on th...Magnetic resonance (MR) imaging has been increasingly used in the evaluation of prostate cancer. As studies have suggested that the majority of cancers arise from the peripheral zone (PZ), MR imaging has focused on the PZ of the prostate gland thus far. However, a considerable number of cancers (up to 30%) originate in the transition zone (TZ), substantially contributing to morbidity and mortality. Therefore, research is needed on the TZ of the prostate gland. Recently, MR imaging and advanced MR techniques have been gaining acceptance in evaluation of the TZ. In this article, the MR imaging features of TZ prostate cancers, the role of MR imaging in TZ cancer detection and staging, and recent advanced MR techniques will be discussed in light of the literature.展开更多
Colorectal cancer (CRC) represents one of the leading causes of tumor-related deaths worldwide. Among the various tools at physicians’ disposal for the diagnostic management of the disease, tomographic imaging (e.g.,...Colorectal cancer (CRC) represents one of the leading causes of tumor-related deaths worldwide. Among the various tools at physicians’ disposal for the diagnostic management of the disease, tomographic imaging (e.g., CT, MRI, and hybrid PET imaging) is considered essential. The qualitative and subjective evaluation of tomographic images is the main approach used to obtain valuable clinical information, although this strategy suffers from both intrinsic and operator-dependent limitations. More recently, advanced imaging techniques have been developed with the aim of overcoming these issues. Such techniques, such as diffusion-weighted MRI and perfusion imaging, were designed for the “in vivo” evaluation of specific biological tissue features in order to describe them in terms of quantitative parameters, which could answer questions difficult to address with conventional imaging alone (e.g., questions related to tissue characterization and prognosis). Furthermore, it has been observed that a large amount of numerical and statistical information is buried inside tomographic images, resulting in their invisibility during conventional assessment. This information can be extracted and represented in terms of quantitative parameters through different processes (e.g., texture analysis). Numerous researchers have focused their work on the significance of these quantitative imaging parameters for the management of CRC patients. In this review, we aimed to focus on evidence reported in the academic literature regarding the application of parametric imaging to the diagnosis, staging and prognosis of CRC while discussing future perspectives and present limitations. While the transition from purely anatomical to quantitative tomographic imaging appears achievable for CRC diagnostics, some essential milestones, such as scanning and analysis standardization and the definition of robust cut-off values, must be achieved before quantitative tomographic imaging can be incorporated into daily clinical practice.展开更多
In patients with colorectal liver metastasis(CRLMs)unsuitable for surgery,oncological treatments,such as chemotherapy and targeted agents,can be performed.Cross-sectional imaging[computed tomography(CT),magnetic reson...In patients with colorectal liver metastasis(CRLMs)unsuitable for surgery,oncological treatments,such as chemotherapy and targeted agents,can be performed.Cross-sectional imaging[computed tomography(CT),magnetic resonance imaging(MRI),18-fluorodexoyglucose positron emission tomography with CT/MRI]evaluates the response of CRLMs to therapy,using post-treatment lesion shrinkage as a qualitative imaging parameter.This point is critical because the risk of toxicity induced by oncological treatments is not always balanced by an effective response to them.Consequently,there is a pressing need to define biomarkers that can predict treatment responses and estimate the likelihood of drug resistance in individual patients.Advanced quantitative imaging(diffusionweighted imaging,perfusion imaging,molecular imaging)allows the in vivo evaluation of specific biological tissue features described as quantitative parameters.Furthermore,radiomics can represent large amounts of numerical and statistical information buried inside cross-sectional images as quantitative parameters.As a result,parametric analysis(PA)translates the numerical data contained in the voxels of each image into quantitative parameters representative of peculiar neoplastic features such as perfusion,structural heterogeneity,cellularity,oxygenation,and glucose consumption.PA could be a potentially useful imaging marker for predicting CRLMs treatment response.This review describes the role of PA applied to cross-sectional imaging in predicting the response to oncological therapies in patients with CRLMs.展开更多
膀胱癌是泌尿系统发病率最高的恶性肿瘤,因对其进行准确的分类及分期较为困难,使膀胱癌患者的诊治面临着诸多问题。随着现代医疗技术的不断发展和完善,2018年,基于多参数磁共振成像(multi-parametric magnetic resonance imaging, mpMRI...膀胱癌是泌尿系统发病率最高的恶性肿瘤,因对其进行准确的分类及分期较为困难,使膀胱癌患者的诊治面临着诸多问题。随着现代医疗技术的不断发展和完善,2018年,基于多参数磁共振成像(multi-parametric magnetic resonance imaging, mpMRI)技术所提出的膀胱影像报告和数据系统(Vesical Imaging-Reporting and Data System, VI-RADS)得到了日本腹部放射学会、欧洲泌尿外科协会及欧洲泌尿外科影像学会的共同认可。VI-RADS评分可对膀胱癌进行较为准确的分类,为临床医生对膀胱癌患者的治疗提供指导。本文就VI-RADS在膀胱癌中的诊断效能、VI-RADS参数及诊断膀胱癌时最佳临界值的选择、VI-RADS与影像组学的联合等研究现状及进展进行综述,并对肿瘤大小和肿瘤所在部位对VI-RADS的影响等未来研究方向进行展望,旨在为该领域研究提供参考。展开更多
目的:探究表观弥散系数(apparent diffusion coefficient,ADC)及指数化ADC(exponential ADC,eADC)在双参数磁共振成像(bi-parametric magnetic resonance imaging,bpMRI)诊断临床显著性前列腺癌中的应用价值。方法:回顾并分析2014年1月...目的:探究表观弥散系数(apparent diffusion coefficient,ADC)及指数化ADC(exponential ADC,eADC)在双参数磁共振成像(bi-parametric magnetic resonance imaging,bpMRI)诊断临床显著性前列腺癌中的应用价值。方法:回顾并分析2014年1月—2021年12月在首都医科大学电力教学医院就诊的101例临床怀疑为前列腺癌患者的临床、影像学及病理学资料。依据穿刺活检结果分为组1(临床显著性前列腺癌组)和组2(非临床显著性前列腺癌+非前列腺癌),由2名阅片者依据前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System,PI-RADS)指南评分标准分别按照bpMRI诊断方案和多参数MRI(multi-parametric MRI,mpMRI)诊断方案进行评分(记为bpMRI评分和mpMRI评分),并且测量病灶最大层面的ADC值和eADC值,将bpMRI评分和mpMRI评分分别与ADC值及eADC值联合构建logistic回归模型,绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价ADC值、eADC值、bpMRI诊断方案、mpMRI诊断方案以及两者分别联合ADC值及eADC值对临床显著性前列腺癌的诊断价值,运用Z检验对比各方案的曲线下面积(area under curve,AUC)有无差异。结果:109例可疑病灶中,组1病灶共计50例,组2病灶共计59例。ADC值、eADC值、bpMRI评分及mpMRI评分是诊断临床显著性前列腺癌的有效指标(P<0.001),ADC值及eADC值的AUC值分别为0.888和0.931,差异无统计学意义(Z=1.512,P=0.1306)。BpMRI评分分别联合ADC值及eADC值的AUC值分别为0.973、0.978,高于单独运用bpMRI评分的AUC值(AUC=0.954),差异有统计学意义(Z=2.391,P=0.0168;Z=2.125,P=0.0336)。mpMRI评分分别联合ADC值及eADC值的AUC值分别为0.985、0.985,高于单独运用mpMRI评分的AUC值(AUC=0.974),但差异无统计学意义(Z=1.295,P=0.1953;Z=1.354,P=0.1757)。结论:ADC值和eADC值都是诊断临床显著性前列腺癌有价值的MRI定量指标,两者联合bpMRI评分可以显著地提高bpMRI的诊断效能与临床应用价值。展开更多
文摘Magnetic resonance (MR) imaging has been increasingly used in the evaluation of prostate cancer. As studies have suggested that the majority of cancers arise from the peripheral zone (PZ), MR imaging has focused on the PZ of the prostate gland thus far. However, a considerable number of cancers (up to 30%) originate in the transition zone (TZ), substantially contributing to morbidity and mortality. Therefore, research is needed on the TZ of the prostate gland. Recently, MR imaging and advanced MR techniques have been gaining acceptance in evaluation of the TZ. In this article, the MR imaging features of TZ prostate cancers, the role of MR imaging in TZ cancer detection and staging, and recent advanced MR techniques will be discussed in light of the literature.
文摘Colorectal cancer (CRC) represents one of the leading causes of tumor-related deaths worldwide. Among the various tools at physicians’ disposal for the diagnostic management of the disease, tomographic imaging (e.g., CT, MRI, and hybrid PET imaging) is considered essential. The qualitative and subjective evaluation of tomographic images is the main approach used to obtain valuable clinical information, although this strategy suffers from both intrinsic and operator-dependent limitations. More recently, advanced imaging techniques have been developed with the aim of overcoming these issues. Such techniques, such as diffusion-weighted MRI and perfusion imaging, were designed for the “in vivo” evaluation of specific biological tissue features in order to describe them in terms of quantitative parameters, which could answer questions difficult to address with conventional imaging alone (e.g., questions related to tissue characterization and prognosis). Furthermore, it has been observed that a large amount of numerical and statistical information is buried inside tomographic images, resulting in their invisibility during conventional assessment. This information can be extracted and represented in terms of quantitative parameters through different processes (e.g., texture analysis). Numerous researchers have focused their work on the significance of these quantitative imaging parameters for the management of CRC patients. In this review, we aimed to focus on evidence reported in the academic literature regarding the application of parametric imaging to the diagnosis, staging and prognosis of CRC while discussing future perspectives and present limitations. While the transition from purely anatomical to quantitative tomographic imaging appears achievable for CRC diagnostics, some essential milestones, such as scanning and analysis standardization and the definition of robust cut-off values, must be achieved before quantitative tomographic imaging can be incorporated into daily clinical practice.
文摘In patients with colorectal liver metastasis(CRLMs)unsuitable for surgery,oncological treatments,such as chemotherapy and targeted agents,can be performed.Cross-sectional imaging[computed tomography(CT),magnetic resonance imaging(MRI),18-fluorodexoyglucose positron emission tomography with CT/MRI]evaluates the response of CRLMs to therapy,using post-treatment lesion shrinkage as a qualitative imaging parameter.This point is critical because the risk of toxicity induced by oncological treatments is not always balanced by an effective response to them.Consequently,there is a pressing need to define biomarkers that can predict treatment responses and estimate the likelihood of drug resistance in individual patients.Advanced quantitative imaging(diffusionweighted imaging,perfusion imaging,molecular imaging)allows the in vivo evaluation of specific biological tissue features described as quantitative parameters.Furthermore,radiomics can represent large amounts of numerical and statistical information buried inside cross-sectional images as quantitative parameters.As a result,parametric analysis(PA)translates the numerical data contained in the voxels of each image into quantitative parameters representative of peculiar neoplastic features such as perfusion,structural heterogeneity,cellularity,oxygenation,and glucose consumption.PA could be a potentially useful imaging marker for predicting CRLMs treatment response.This review describes the role of PA applied to cross-sectional imaging in predicting the response to oncological therapies in patients with CRLMs.
文摘膀胱癌是泌尿系统发病率最高的恶性肿瘤,因对其进行准确的分类及分期较为困难,使膀胱癌患者的诊治面临着诸多问题。随着现代医疗技术的不断发展和完善,2018年,基于多参数磁共振成像(multi-parametric magnetic resonance imaging, mpMRI)技术所提出的膀胱影像报告和数据系统(Vesical Imaging-Reporting and Data System, VI-RADS)得到了日本腹部放射学会、欧洲泌尿外科协会及欧洲泌尿外科影像学会的共同认可。VI-RADS评分可对膀胱癌进行较为准确的分类,为临床医生对膀胱癌患者的治疗提供指导。本文就VI-RADS在膀胱癌中的诊断效能、VI-RADS参数及诊断膀胱癌时最佳临界值的选择、VI-RADS与影像组学的联合等研究现状及进展进行综述,并对肿瘤大小和肿瘤所在部位对VI-RADS的影响等未来研究方向进行展望,旨在为该领域研究提供参考。
文摘目的:探究表观弥散系数(apparent diffusion coefficient,ADC)及指数化ADC(exponential ADC,eADC)在双参数磁共振成像(bi-parametric magnetic resonance imaging,bpMRI)诊断临床显著性前列腺癌中的应用价值。方法:回顾并分析2014年1月—2021年12月在首都医科大学电力教学医院就诊的101例临床怀疑为前列腺癌患者的临床、影像学及病理学资料。依据穿刺活检结果分为组1(临床显著性前列腺癌组)和组2(非临床显著性前列腺癌+非前列腺癌),由2名阅片者依据前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System,PI-RADS)指南评分标准分别按照bpMRI诊断方案和多参数MRI(multi-parametric MRI,mpMRI)诊断方案进行评分(记为bpMRI评分和mpMRI评分),并且测量病灶最大层面的ADC值和eADC值,将bpMRI评分和mpMRI评分分别与ADC值及eADC值联合构建logistic回归模型,绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价ADC值、eADC值、bpMRI诊断方案、mpMRI诊断方案以及两者分别联合ADC值及eADC值对临床显著性前列腺癌的诊断价值,运用Z检验对比各方案的曲线下面积(area under curve,AUC)有无差异。结果:109例可疑病灶中,组1病灶共计50例,组2病灶共计59例。ADC值、eADC值、bpMRI评分及mpMRI评分是诊断临床显著性前列腺癌的有效指标(P<0.001),ADC值及eADC值的AUC值分别为0.888和0.931,差异无统计学意义(Z=1.512,P=0.1306)。BpMRI评分分别联合ADC值及eADC值的AUC值分别为0.973、0.978,高于单独运用bpMRI评分的AUC值(AUC=0.954),差异有统计学意义(Z=2.391,P=0.0168;Z=2.125,P=0.0336)。mpMRI评分分别联合ADC值及eADC值的AUC值分别为0.985、0.985,高于单独运用mpMRI评分的AUC值(AUC=0.974),但差异无统计学意义(Z=1.295,P=0.1953;Z=1.354,P=0.1757)。结论:ADC值和eADC值都是诊断临床显著性前列腺癌有价值的MRI定量指标,两者联合bpMRI评分可以显著地提高bpMRI的诊断效能与临床应用价值。
