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Dynamic contrast-enhanced MRI of the prostate: An intraindividual assessment of the effect of temporal resolution on qualitative detection and quantitative analysis of histopathologically proven prostate cancer

Ream, Justin M; Doshi, Ankur M; Dunst, Diane; Parikh, Nainesh; Kong, Max X; Babb, James S; Taneja, Samir S; Rosenkrantz, Andrew B
PURPOSE: To assess the effects of temporal resolution (RT ) in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) on qualitative tumor detection and quantitative pharmacokinetic parameters in prostate cancer. MATERIALS AND METHODS: This retrospective Institutional Review Board (IRB)-approved study included 58 men (64 +/- 7 years). They underwent 3T prostate MRI showing dominant peripheral zone (PZ) tumors (24 with Gleason >/= 4 + 3), prior to prostatectomy. Continuously acquired DCE utilizing GRASP (Golden-angle RAdial Sparse Parallel) was retrospectively reconstructed at RT of 1.4 sec, 3.7 sec, 6.0 sec, 9.7 sec, and 14.9 sec. A reader placed volumes-of-interest on dominant tumors and benign PZ, generating quantitative pharmacokinetic parameters (ktrans , ve ) at each RT . Two blinded readers assessed each RT for lesion presence, location, conspicuity, and reader confidence on a 5-point scale. Data were assessed by mixed-model analysis of variance (ANOVA), generalized estimating equation (GEE), and receiver operating characteristic (ROC) analysis. RESULTS: RT did not affect sensitivity (R1all : 69.0%-72.4%, all Padj = 1.000; R1GS>/=4 + 3 : 83.3-91.7%, all Padj = 1.000; R2all : 60.3-69.0%, all Padj = 1.000; R2GS>/=4 + 3 : 58.3%-79.2%, all Padj = 1.000). R1 reported greater conspicuity of GS >/= 4 + 3 tumors at RT of 1.4 sec vs. 14.9 sec (4.29 +/- 1.23 vs. 3.46 +/- 1.44; Padj = 0.029). No other tumor conspicuity pairwise comparison reached significance (R1all : 2.98-3.43, all Padj >/= 0.205; R2all : 2.57-3.19, all Padj >/= 0.059; R1GS>/=4 + 3 : 3.46-4.29, all other Padj >/= 0.156; R2GS>/=4 + 3 : 2.92-3.71, all Padj >/= 0.439). There was no effect of RT on reader confidence (R1all : 3.17-3.34, all Padj = 1.000; R2all : 2.83-3.19, all Padj >/= 0.801; R1GS>/=4 + 3 : 3.79-4.21, all Padj = 1.000; R2GS>/=4 + 3 : 3.13-3.79, all Padj = 1.000). ktrans and ve of tumor and benign tissue did not differ across RT (all adjusted P values [Padj ] = 1.000). RT did not significantly affect area under the curve (AUC) of Ktrans or ve for differentiating tumor from benign (all Padj = 1.000). CONCLUSION: Current PI-RADS recommendations for RT of 10 seconds may be sufficient, with further reduction to the stated PI-RADS preference of RT
PMID: 27649481
ISSN: 1522-2586
CID: 2254782

Retrospective Assessment of Histogram-Based Diffusion Metrics for Differentiating Benign and Malignant Endometrial Lesions

Kierans, Andrea S; Doshi, Ankur M; Dunst, Diane; Popiolek, Dorota; Blank, Stephanie V; Rosenkrantz, Andrew B
OBJECTIVE: Our study aimed to retrospectively evaluate the utility of volumetric histogram-based diffusion metrics in differentiating benign from malignant endometrial abnormalities. METHODS: A total of 54 patients underwent pelvic magnetic resonance imaging with diffusion-weighted imaging before endometrial tissue diagnosis. Two radiologists placed volumes of interest on the apparent diffusion coefficient (ADC) map encompassing the entire endometrium and focal endometrial lesions. The mean ADC, percentile ADC values, kurtosis, skewness, and entropy of ADC were compared between benign and malignant abnormalities. RESULTS: In premenopausal patients, significant independent predictors of malignancy were whole-endometrium analysis for R1, 10th to 25th ADC percentile (P = 0.012); whole-endometrium analysis for R2, mean ADC (P = 0.001) and skewness (P = 0.004); focal lesion analysis for R1, skewness (P = 0.045); focal lesion analysis for R2, 10th to 25th ADC percentile (P
PMID: 27224233
ISSN: 1532-3145
CID: 2115002

Utility of diffusion-weighted MRI for differentiating acute from chronic cholecystitis

Wang, Annie; Shanbhogue, Alampady K; Dunst, Diane; Hajdu, Cristina H; Rosenkrantz, Andrew B
PURPOSE: To assess the use of diffusion-weighted imaging (DWI) for differentiating acute from chronic cholecystitis, in comparison with conventional magnetic resonance imaging (MRI) features. MATERIALS AND METHODS: Liver MRI including DWI (b-values 0/500/1000s/mm2 ) was performed at 1.5T
PMID: 26691912
ISSN: 1522-2586
CID: 1884122

Comparison of MRI features of pathologically proven hepatocellular carcinoma between patients with hepatitis B and hepatitis C infection

Dunst, Diane; Ream, Justin M; Khalef, Victoria; Hajdu, Cristina H; Rosenkrantz, Andrew B
PURPOSE: To compare MRI features of pathologically-proven hepatocellular carcinoma (HCC) between patients with hepatitis B (HBV) and hepatitis C (HCV) infection. METHODS: Two radiologists assessed 51 confirmed HCCs on MRI in HBV (n=18) or HCV (n=33) patients; a third, more experienced, radiologist resolved discrepancies. RESULTS: Arterial hyperenhancement occurred more frequently in HCV (90.9% vs. 66.7%; P=.032), DWI/T2WI hyperintensity more frequently in HBV [(DWI: 78.6% vs. 45.8%, T2WI: 77.8% vs. 48.5%; P=.073-0.088)]. Tumors were larger in HBV (P
PMID: 27133666
ISSN: 1873-4499
CID: 2100762