Cargando…

Diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced MRI for assessment of anal fistula activity

OBJECTIVE: To evaluate intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) sequences for quantitative characterization of anal fistula activity. METHODS: This retrospective study was approved by the institutional r...

Descripción completa

Detalles Bibliográficos
Autores principales: Lefrançois, Philippe, Zummo-Soucy, Mathieu, Olivié, Damien, Billiard, Jean-Sébastien, Gilbert, Guillaume, Garel, Juliette, Visée, Emmanuel, Manchec, Perrine, Tang, An
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784995/
https://www.ncbi.nlm.nih.gov/pubmed/29370278
http://dx.doi.org/10.1371/journal.pone.0191822
_version_ 1783295552487686144
author Lefrançois, Philippe
Zummo-Soucy, Mathieu
Olivié, Damien
Billiard, Jean-Sébastien
Gilbert, Guillaume
Garel, Juliette
Visée, Emmanuel
Manchec, Perrine
Tang, An
author_facet Lefrançois, Philippe
Zummo-Soucy, Mathieu
Olivié, Damien
Billiard, Jean-Sébastien
Gilbert, Guillaume
Garel, Juliette
Visée, Emmanuel
Manchec, Perrine
Tang, An
author_sort Lefrançois, Philippe
collection PubMed
description OBJECTIVE: To evaluate intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) sequences for quantitative characterization of anal fistula activity. METHODS: This retrospective study was approved by the institutional review board. One hundred and two patients underwent MRI for clinical suspicion of anal fistula. Forty-three patients with demonstrable anal fistulas met the inclusion criteria. Quantitative analysis included measurement of DCE and IVIM parameters. The reference standard was clinical activity based on medical records. Statistical analyses included Bayesian analysis with Markov Chain Monte Carlo, multivariable logistic regression, and receiver operating characteristic analyses. RESULTS: Brevity of enhancement, defined as the time difference between the wash-in and wash-out, was longer in active than inactive fistulas (p = 0.02). Regression coefficients of multivariable logistic regression analysis revealed that brevity of enhancement increased and normalized perfusion area under curve decreased with presence of active fistulas (p = 0.03 and p = 0.04, respectively). By cross-validation, a logistic regression model that included quantitative perfusion parameters (DCE and IVIM) performed significantly better than IVIM only (p < 0.001). Area under the curves for distinguishing patients with active from those with inactive fistulas were 0.669 (95% confidence interval [CI]: 0.500, 0.838) for a model with IVIM only, 0.860 (95% CI: 0.742, 0.977) for a model with IVIM and brevity of enhancement, and 0.921 (95% CI: 0.846, 0.997) for a model with IVIM and all DCE parameters. CONCLUSION: The inclusion of brevity of enhancement measured by DCE-MRI improved assessment of anal fistula activity over IVIM-DWI only.
format Online
Article
Text
id pubmed-5784995
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-57849952018-02-09 Diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced MRI for assessment of anal fistula activity Lefrançois, Philippe Zummo-Soucy, Mathieu Olivié, Damien Billiard, Jean-Sébastien Gilbert, Guillaume Garel, Juliette Visée, Emmanuel Manchec, Perrine Tang, An PLoS One Research Article OBJECTIVE: To evaluate intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) sequences for quantitative characterization of anal fistula activity. METHODS: This retrospective study was approved by the institutional review board. One hundred and two patients underwent MRI for clinical suspicion of anal fistula. Forty-three patients with demonstrable anal fistulas met the inclusion criteria. Quantitative analysis included measurement of DCE and IVIM parameters. The reference standard was clinical activity based on medical records. Statistical analyses included Bayesian analysis with Markov Chain Monte Carlo, multivariable logistic regression, and receiver operating characteristic analyses. RESULTS: Brevity of enhancement, defined as the time difference between the wash-in and wash-out, was longer in active than inactive fistulas (p = 0.02). Regression coefficients of multivariable logistic regression analysis revealed that brevity of enhancement increased and normalized perfusion area under curve decreased with presence of active fistulas (p = 0.03 and p = 0.04, respectively). By cross-validation, a logistic regression model that included quantitative perfusion parameters (DCE and IVIM) performed significantly better than IVIM only (p < 0.001). Area under the curves for distinguishing patients with active from those with inactive fistulas were 0.669 (95% confidence interval [CI]: 0.500, 0.838) for a model with IVIM only, 0.860 (95% CI: 0.742, 0.977) for a model with IVIM and brevity of enhancement, and 0.921 (95% CI: 0.846, 0.997) for a model with IVIM and all DCE parameters. CONCLUSION: The inclusion of brevity of enhancement measured by DCE-MRI improved assessment of anal fistula activity over IVIM-DWI only. Public Library of Science 2018-01-25 /pmc/articles/PMC5784995/ /pubmed/29370278 http://dx.doi.org/10.1371/journal.pone.0191822 Text en © 2018 Lefrançois et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Lefrançois, Philippe
Zummo-Soucy, Mathieu
Olivié, Damien
Billiard, Jean-Sébastien
Gilbert, Guillaume
Garel, Juliette
Visée, Emmanuel
Manchec, Perrine
Tang, An
Diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced MRI for assessment of anal fistula activity
title Diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced MRI for assessment of anal fistula activity
title_full Diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced MRI for assessment of anal fistula activity
title_fullStr Diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced MRI for assessment of anal fistula activity
title_full_unstemmed Diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced MRI for assessment of anal fistula activity
title_short Diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced MRI for assessment of anal fistula activity
title_sort diagnostic performance of intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced mri for assessment of anal fistula activity
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784995/
https://www.ncbi.nlm.nih.gov/pubmed/29370278
http://dx.doi.org/10.1371/journal.pone.0191822
work_keys_str_mv AT lefrancoisphilippe diagnosticperformanceofintravoxelincoherentmotiondiffusionweightedimaginganddynamiccontrastenhancedmriforassessmentofanalfistulaactivity
AT zummosoucymathieu diagnosticperformanceofintravoxelincoherentmotiondiffusionweightedimaginganddynamiccontrastenhancedmriforassessmentofanalfistulaactivity
AT oliviedamien diagnosticperformanceofintravoxelincoherentmotiondiffusionweightedimaginganddynamiccontrastenhancedmriforassessmentofanalfistulaactivity
AT billiardjeansebastien diagnosticperformanceofintravoxelincoherentmotiondiffusionweightedimaginganddynamiccontrastenhancedmriforassessmentofanalfistulaactivity
AT gilbertguillaume diagnosticperformanceofintravoxelincoherentmotiondiffusionweightedimaginganddynamiccontrastenhancedmriforassessmentofanalfistulaactivity
AT gareljuliette diagnosticperformanceofintravoxelincoherentmotiondiffusionweightedimaginganddynamiccontrastenhancedmriforassessmentofanalfistulaactivity
AT viseeemmanuel diagnosticperformanceofintravoxelincoherentmotiondiffusionweightedimaginganddynamiccontrastenhancedmriforassessmentofanalfistulaactivity
AT manchecperrine diagnosticperformanceofintravoxelincoherentmotiondiffusionweightedimaginganddynamiccontrastenhancedmriforassessmentofanalfistulaactivity
AT tangan diagnosticperformanceofintravoxelincoherentmotiondiffusionweightedimaginganddynamiccontrastenhancedmriforassessmentofanalfistulaactivity