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Feasibility and possible value of quantitative semi-automated diffusion weighted imaging volumetry of neuroblastic tumors

BACKGROUND: To assess the feasibility and possible value of semi-automated diffusion weighted imaging (DWI) volumetry of whole neuroblastic tumors with apparent diffusion coefficient (ADC) map evaluation after neoadjuvant chemotherapy. METHODS: Pediatric patients who underwent surgical resection of...

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Autores principales: Gassenmaier, Sebastian, Tsiflikas, Ilias, Fuchs, Jörg, Grimm, Robert, Urla, Cristian, Esser, Michael, Maennlin, Simon, Ebinger, Martin, Warmann, Steven W., Schäfer, Jürgen F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745476/
https://www.ncbi.nlm.nih.gov/pubmed/33334369
http://dx.doi.org/10.1186/s40644-020-00366-3
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author Gassenmaier, Sebastian
Tsiflikas, Ilias
Fuchs, Jörg
Grimm, Robert
Urla, Cristian
Esser, Michael
Maennlin, Simon
Ebinger, Martin
Warmann, Steven W.
Schäfer, Jürgen F.
author_facet Gassenmaier, Sebastian
Tsiflikas, Ilias
Fuchs, Jörg
Grimm, Robert
Urla, Cristian
Esser, Michael
Maennlin, Simon
Ebinger, Martin
Warmann, Steven W.
Schäfer, Jürgen F.
author_sort Gassenmaier, Sebastian
collection PubMed
description BACKGROUND: To assess the feasibility and possible value of semi-automated diffusion weighted imaging (DWI) volumetry of whole neuroblastic tumors with apparent diffusion coefficient (ADC) map evaluation after neoadjuvant chemotherapy. METHODS: Pediatric patients who underwent surgical resection of neuroblastic tumors at our institution from 2013 to 2019 and who received a preoperative MRI scan with DWI after chemotherapy were included. Tumor volume was assessed with a semi-automated approach in DWI using a dedicated software prototype. Quantitative ADC values were calculated automatically of the total tumor volume after manual exclusion of necrosis. Manual segmentation in T1 weighted and T2 weighted sequences was used as reference standard for tumor volume comparison. The Student’s t test was used for parametric data while the Wilcoxon rank sum test and the Kruskal-Wallis test were applied for non-parametric data. RESULTS: Twenty seven patients with 28 lesions (neuroblastoma (NB): n = 19, ganglioneuroblastoma (GNB): n = 7, ganglioneuroma (GN): n = 2) could be evaluated. Mean patient age was 4.5 ± 3.2 years. Median volume of standard volumetry (T1w or T2w) was 50.2 ml (interquartile range (IQR): 91.9 ml) vs. 45.1 ml (IQR: 98.4 ml) of DWI (p = 0.145). Mean ADC values (× 10(− 6) mm(2)/s) of the total tumor volume (without necrosis) were 1187 ± 301 in NB vs. 1552 ± 114 in GNB/GN (p = 0.037). The 5th percentile of ADC values of NB (614 ± 275) and GNB/GN (1053 ± 362) provided the most significant difference (p = 0.007) with an area under the curve of 0.848 (p < 0.001). CONCLUSIONS: Quantitative semi-automated DWI volumetry is feasible in neuroblastic tumors with integrated analysis of tissue characteristics by providing automatically calculated ADC values of the whole tumor as well as an ADC heatmap. The 5th percentile of the ADC values of the whole tumor volume proved to be the most significant parameter for differentiation of the histopathological subtypes in our patient cohort and further investigation seems to be worthwhile. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40644-020-00366-3.
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spelling pubmed-77454762020-12-18 Feasibility and possible value of quantitative semi-automated diffusion weighted imaging volumetry of neuroblastic tumors Gassenmaier, Sebastian Tsiflikas, Ilias Fuchs, Jörg Grimm, Robert Urla, Cristian Esser, Michael Maennlin, Simon Ebinger, Martin Warmann, Steven W. Schäfer, Jürgen F. Cancer Imaging Research Article BACKGROUND: To assess the feasibility and possible value of semi-automated diffusion weighted imaging (DWI) volumetry of whole neuroblastic tumors with apparent diffusion coefficient (ADC) map evaluation after neoadjuvant chemotherapy. METHODS: Pediatric patients who underwent surgical resection of neuroblastic tumors at our institution from 2013 to 2019 and who received a preoperative MRI scan with DWI after chemotherapy were included. Tumor volume was assessed with a semi-automated approach in DWI using a dedicated software prototype. Quantitative ADC values were calculated automatically of the total tumor volume after manual exclusion of necrosis. Manual segmentation in T1 weighted and T2 weighted sequences was used as reference standard for tumor volume comparison. The Student’s t test was used for parametric data while the Wilcoxon rank sum test and the Kruskal-Wallis test were applied for non-parametric data. RESULTS: Twenty seven patients with 28 lesions (neuroblastoma (NB): n = 19, ganglioneuroblastoma (GNB): n = 7, ganglioneuroma (GN): n = 2) could be evaluated. Mean patient age was 4.5 ± 3.2 years. Median volume of standard volumetry (T1w or T2w) was 50.2 ml (interquartile range (IQR): 91.9 ml) vs. 45.1 ml (IQR: 98.4 ml) of DWI (p = 0.145). Mean ADC values (× 10(− 6) mm(2)/s) of the total tumor volume (without necrosis) were 1187 ± 301 in NB vs. 1552 ± 114 in GNB/GN (p = 0.037). The 5th percentile of ADC values of NB (614 ± 275) and GNB/GN (1053 ± 362) provided the most significant difference (p = 0.007) with an area under the curve of 0.848 (p < 0.001). CONCLUSIONS: Quantitative semi-automated DWI volumetry is feasible in neuroblastic tumors with integrated analysis of tissue characteristics by providing automatically calculated ADC values of the whole tumor as well as an ADC heatmap. The 5th percentile of the ADC values of the whole tumor volume proved to be the most significant parameter for differentiation of the histopathological subtypes in our patient cohort and further investigation seems to be worthwhile. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40644-020-00366-3. BioMed Central 2020-12-17 /pmc/articles/PMC7745476/ /pubmed/33334369 http://dx.doi.org/10.1186/s40644-020-00366-3 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Gassenmaier, Sebastian
Tsiflikas, Ilias
Fuchs, Jörg
Grimm, Robert
Urla, Cristian
Esser, Michael
Maennlin, Simon
Ebinger, Martin
Warmann, Steven W.
Schäfer, Jürgen F.
Feasibility and possible value of quantitative semi-automated diffusion weighted imaging volumetry of neuroblastic tumors
title Feasibility and possible value of quantitative semi-automated diffusion weighted imaging volumetry of neuroblastic tumors
title_full Feasibility and possible value of quantitative semi-automated diffusion weighted imaging volumetry of neuroblastic tumors
title_fullStr Feasibility and possible value of quantitative semi-automated diffusion weighted imaging volumetry of neuroblastic tumors
title_full_unstemmed Feasibility and possible value of quantitative semi-automated diffusion weighted imaging volumetry of neuroblastic tumors
title_short Feasibility and possible value of quantitative semi-automated diffusion weighted imaging volumetry of neuroblastic tumors
title_sort feasibility and possible value of quantitative semi-automated diffusion weighted imaging volumetry of neuroblastic tumors
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745476/
https://www.ncbi.nlm.nih.gov/pubmed/33334369
http://dx.doi.org/10.1186/s40644-020-00366-3
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