Comparison between diffusion‐weighted imaging, T2‐weighted, and postcontrast T1‐weighted imaging after MR‐guided, high intensity, focused ultrasound treatment of uterine leiomyomata: Preliminary results
Purpose : To investigate the comparison between diffusion‐weighted imaging (DWI),T2‐weighted imaging, (T2WI) and contrast T1‐weighted imaging (cT1WI) in uterine leiomyoma following treatment by magnetic resonance imaging‐guided, high intensity focused ultrasound surgery (MRg‐HIFUS). Methods : Twenty...
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| Veröffentlicht in: | Medical physics (Lancaster) 2010-09, Vol.37 (9), p.4768-4776 |
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| creator | Jacobs, Michael A. Gultekin, David H. Kim, Hyun S. |
| description | Purpose
: To investigate the comparison between diffusion‐weighted imaging (DWI),T2‐weighted imaging, (T2WI) and contrast T1‐weighted imaging (cT1WI) in uterine leiomyoma following treatment by magnetic resonance imaging‐guided, high intensity focused ultrasound surgery (MRg‐HIFUS).
Methods
: Twenty one patients(45±5yrs) with clinical symptoms of uterine leiomyoma (fibroids) were treated by MRg‐HIFUS using an integrated 1.5T MRI‐HIFUS system. MRI parameters consisted of DWI, T2WI, and T1‐weighted fast spoiled gradient echo before and after contrast. The post‐MRg‐HIFUS treatment volume in the fibroid was assessed by cT1WI and DWI. Trace apparent diffusion coefficient maps were constructed for quantitative analysis. The regions of the treated uterine tissue were defined by a semisupervised segmentation method called the “eigenimage filter,” using both cT1WI and DWI. Signal‐to‐noise ratios were determined for the T2WI pretreatment images. Segmented regions were tested by a similarity index for congruence. Descriptive, regression, and Bland–Altman statistics were calculated.
Results
: All the patients exhibited heterogeneously increased DWI signal intensity localized in the treated fibroid regions and were colocalized with thecT1WI defined area. The mean pretreatment T2WI signal intensity ratios were T2WI/muscle=1.8±0.7 and T2WI/myometrium=0.7±0.4. The congruence between the regions was significant, with a similarity of 84% and a difference of 8% between the regions. Regression analyses of the cT1WI and DWI segmented treatment volumes were found to be significantly correlated (r2=0.94,p |
| doi_str_mv | 10.1118/1.3475940 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2937052</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>759877778</sourcerecordid><originalsourceid>FETCH-LOGICAL-p1830-f48652c9b12819d6eb4f82194cc994119f9fff623a1eb30d07c7bc81daa720783</originalsourceid><addsrcrecordid>eNptkk2O1DAQhS0EYpqBBRdA3rHpDLbj_JgF0qjFnzQjRqhZW05SThsldrAdWtlxBM7GETgJjqYZDRLelORX73uyqxB6TskFpbR-RS9yXhWCkwdow3iVZ5wR8RBtCBE8Y5wUZ-hJCF8JIWVekMfoLMklp6LcoF87N07Km-AsbiAeASzujNZzMM7-_vHzCKY_ROiwGVVvbL_Fe3bveouV7fDkQmydjV6FiPf0PzasdASPrz8nrZ9NtzoPqQUbG8EGE5ct1q6dQ7LMwwpycwJHDyqOYCN2Gs-JYCzgAYwbFzeqqF7jGw-DGY1VfsEeQvKGp-iRVkOAZ6d6jr68e7vffciuPr3_uLu8yiZa5yTTvC4L1oqGspqKroSG65pRwdtWCE6p0EJrXbJcUWhy0pGqrZq2pp1SFSNVnZ-jN7fcaW5G6FpYP2CQk09v9ot0ysh_FWsOsnffJRN5RQqWAC9PAO--zRCiHE1oYRiUBTcHmUZaV-msUS_uR91l_J1jashuG45mgOVOp0SuCyKpPC2IvL5ZS_4H_rK3Cg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>759877778</pqid></control><display><type>article</type><title>Comparison between diffusion‐weighted imaging, T2‐weighted, and postcontrast T1‐weighted imaging after MR‐guided, high intensity, focused ultrasound treatment of uterine leiomyomata: Preliminary results</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><source>Alma/SFX Local Collection</source><creator>Jacobs, Michael A. ; Gultekin, David H. ; Kim, Hyun S.</creator><creatorcontrib>Jacobs, Michael A. ; Gultekin, David H. ; Kim, Hyun S.</creatorcontrib><description>Purpose
: To investigate the comparison between diffusion‐weighted imaging (DWI),T2‐weighted imaging, (T2WI) and contrast T1‐weighted imaging (cT1WI) in uterine leiomyoma following treatment by magnetic resonance imaging‐guided, high intensity focused ultrasound surgery (MRg‐HIFUS).
Methods
: Twenty one patients(45±5yrs) with clinical symptoms of uterine leiomyoma (fibroids) were treated by MRg‐HIFUS using an integrated 1.5T MRI‐HIFUS system. MRI parameters consisted of DWI, T2WI, and T1‐weighted fast spoiled gradient echo before and after contrast. The post‐MRg‐HIFUS treatment volume in the fibroid was assessed by cT1WI and DWI. Trace apparent diffusion coefficient maps were constructed for quantitative analysis. The regions of the treated uterine tissue were defined by a semisupervised segmentation method called the “eigenimage filter,” using both cT1WI and DWI. Signal‐to‐noise ratios were determined for the T2WI pretreatment images. Segmented regions were tested by a similarity index for congruence. Descriptive, regression, and Bland–Altman statistics were calculated.
Results
: All the patients exhibited heterogeneously increased DWI signal intensity localized in the treated fibroid regions and were colocalized with thecT1WI defined area. The mean pretreatment T2WI signal intensity ratios were T2WI/muscle=1.8±0.7 and T2WI/myometrium=0.7±0.4. The congruence between the regions was significant, with a similarity of 84% and a difference of 8% between the regions. Regression analyses of the cT1WI and DWI segmented treatment volumes were found to be significantly correlated (r2=0.94,p<0.05) with the linear equation, (cT1WI)=1.1(DWI)−0.66. There is good agreement between the regions defined by cT1WI and DWI in most of the cases as shown from the Bland–Altman plots.
Conclusions
: Diffusion‐weighted imaging exhibited excellent agreement, congruence, and correlation with thecT1WI‐defined region of treatment in uterine fibroid. Therefore, DWI could be useful as an adjunct for assessing treatment of uterine fibroids by MRg‐HIFUS.</description><identifier>ISSN: 0094-2405</identifier><identifier>EISSN: 2473-4209</identifier><identifier>EISSN: 0094-2405</identifier><identifier>DOI: 10.1118/1.3475940</identifier><identifier>PMID: 20964196</identifier><language>eng</language><publisher>United States: American Association of Physicists in Medicine</publisher><subject>ADC map ; Adult ; biomedical MRI ; biomedical ultrasonics ; Computed tomography ; Diffusion ; diffusion‐weighted imaging ; gynaecology ; high intensity focused ultrasound surgery ; Humans ; image segmentation ; Intracellular signaling ; leiomyoma ; Leiomyoma - diagnosis ; Leiomyoma - therapy ; leiomyomata ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Magnetic Resonance Physics ; Medical imaging ; Middle Aged ; muscle ; Muscles ; regression analysis ; surgery ; thermotherapy ; Tissue ablation ; Tissue characterization ; Tissues ; tumours ; Ultrasonic Therapy - methods ; Ultrasonography ; uterine fibroids</subject><ispartof>Medical physics (Lancaster), 2010-09, Vol.37 (9), p.4768-4776</ispartof><rights>2010 American Association of Physicists in Medicine</rights><rights>Copyright © 2010 American Association of Physicists in Medicine 2010 American Association of Physicists in Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1118%2F1.3475940$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1118%2F1.3475940$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20964196$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jacobs, Michael A.</creatorcontrib><creatorcontrib>Gultekin, David H.</creatorcontrib><creatorcontrib>Kim, Hyun S.</creatorcontrib><title>Comparison between diffusion‐weighted imaging, T2‐weighted, and postcontrast T1‐weighted imaging after MR‐guided, high intensity, focused ultrasound treatment of uterine leiomyomata: Preliminary results</title><title>Medical physics (Lancaster)</title><addtitle>Med Phys</addtitle><description>Purpose
: To investigate the comparison between diffusion‐weighted imaging (DWI),T2‐weighted imaging, (T2WI) and contrast T1‐weighted imaging (cT1WI) in uterine leiomyoma following treatment by magnetic resonance imaging‐guided, high intensity focused ultrasound surgery (MRg‐HIFUS).
Methods
: Twenty one patients(45±5yrs) with clinical symptoms of uterine leiomyoma (fibroids) were treated by MRg‐HIFUS using an integrated 1.5T MRI‐HIFUS system. MRI parameters consisted of DWI, T2WI, and T1‐weighted fast spoiled gradient echo before and after contrast. The post‐MRg‐HIFUS treatment volume in the fibroid was assessed by cT1WI and DWI. Trace apparent diffusion coefficient maps were constructed for quantitative analysis. The regions of the treated uterine tissue were defined by a semisupervised segmentation method called the “eigenimage filter,” using both cT1WI and DWI. Signal‐to‐noise ratios were determined for the T2WI pretreatment images. Segmented regions were tested by a similarity index for congruence. Descriptive, regression, and Bland–Altman statistics were calculated.
Results
: All the patients exhibited heterogeneously increased DWI signal intensity localized in the treated fibroid regions and were colocalized with thecT1WI defined area. The mean pretreatment T2WI signal intensity ratios were T2WI/muscle=1.8±0.7 and T2WI/myometrium=0.7±0.4. The congruence between the regions was significant, with a similarity of 84% and a difference of 8% between the regions. Regression analyses of the cT1WI and DWI segmented treatment volumes were found to be significantly correlated (r2=0.94,p<0.05) with the linear equation, (cT1WI)=1.1(DWI)−0.66. There is good agreement between the regions defined by cT1WI and DWI in most of the cases as shown from the Bland–Altman plots.
Conclusions
: Diffusion‐weighted imaging exhibited excellent agreement, congruence, and correlation with thecT1WI‐defined region of treatment in uterine fibroid. Therefore, DWI could be useful as an adjunct for assessing treatment of uterine fibroids by MRg‐HIFUS.</description><subject>ADC map</subject><subject>Adult</subject><subject>biomedical MRI</subject><subject>biomedical ultrasonics</subject><subject>Computed tomography</subject><subject>Diffusion</subject><subject>diffusion‐weighted imaging</subject><subject>gynaecology</subject><subject>high intensity focused ultrasound surgery</subject><subject>Humans</subject><subject>image segmentation</subject><subject>Intracellular signaling</subject><subject>leiomyoma</subject><subject>Leiomyoma - diagnosis</subject><subject>Leiomyoma - therapy</subject><subject>leiomyomata</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Magnetic Resonance Physics</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>muscle</subject><subject>Muscles</subject><subject>regression analysis</subject><subject>surgery</subject><subject>thermotherapy</subject><subject>Tissue ablation</subject><subject>Tissue characterization</subject><subject>Tissues</subject><subject>tumours</subject><subject>Ultrasonic Therapy - methods</subject><subject>Ultrasonography</subject><subject>uterine fibroids</subject><issn>0094-2405</issn><issn>2473-4209</issn><issn>0094-2405</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkk2O1DAQhS0EYpqBBRdA3rHpDLbj_JgF0qjFnzQjRqhZW05SThsldrAdWtlxBM7GETgJjqYZDRLelORX73uyqxB6TskFpbR-RS9yXhWCkwdow3iVZ5wR8RBtCBE8Y5wUZ-hJCF8JIWVekMfoLMklp6LcoF87N07Km-AsbiAeASzujNZzMM7-_vHzCKY_ROiwGVVvbL_Fe3bveouV7fDkQmydjV6FiPf0PzasdASPrz8nrZ9NtzoPqQUbG8EGE5ct1q6dQ7LMwwpycwJHDyqOYCN2Gs-JYCzgAYwbFzeqqF7jGw-DGY1VfsEeQvKGp-iRVkOAZ6d6jr68e7vffciuPr3_uLu8yiZa5yTTvC4L1oqGspqKroSG65pRwdtWCE6p0EJrXbJcUWhy0pGqrZq2pp1SFSNVnZ-jN7fcaW5G6FpYP2CQk09v9ot0ysh_FWsOsnffJRN5RQqWAC9PAO--zRCiHE1oYRiUBTcHmUZaV-msUS_uR91l_J1jashuG45mgOVOp0SuCyKpPC2IvL5ZS_4H_rK3Cg</recordid><startdate>201009</startdate><enddate>201009</enddate><creator>Jacobs, Michael A.</creator><creator>Gultekin, David H.</creator><creator>Kim, Hyun S.</creator><general>American Association of Physicists in Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201009</creationdate><title>Comparison between diffusion‐weighted imaging, T2‐weighted, and postcontrast T1‐weighted imaging after MR‐guided, high intensity, focused ultrasound treatment of uterine leiomyomata: Preliminary results</title><author>Jacobs, Michael A. ; Gultekin, David H. ; Kim, Hyun S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p1830-f48652c9b12819d6eb4f82194cc994119f9fff623a1eb30d07c7bc81daa720783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>ADC map</topic><topic>Adult</topic><topic>biomedical MRI</topic><topic>biomedical ultrasonics</topic><topic>Computed tomography</topic><topic>Diffusion</topic><topic>diffusion‐weighted imaging</topic><topic>gynaecology</topic><topic>high intensity focused ultrasound surgery</topic><topic>Humans</topic><topic>image segmentation</topic><topic>Intracellular signaling</topic><topic>leiomyoma</topic><topic>Leiomyoma - diagnosis</topic><topic>Leiomyoma - therapy</topic><topic>leiomyomata</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Magnetic Resonance Physics</topic><topic>Medical imaging</topic><topic>Middle Aged</topic><topic>muscle</topic><topic>Muscles</topic><topic>regression analysis</topic><topic>surgery</topic><topic>thermotherapy</topic><topic>Tissue ablation</topic><topic>Tissue characterization</topic><topic>Tissues</topic><topic>tumours</topic><topic>Ultrasonic Therapy - methods</topic><topic>Ultrasonography</topic><topic>uterine fibroids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jacobs, Michael A.</creatorcontrib><creatorcontrib>Gultekin, David H.</creatorcontrib><creatorcontrib>Kim, Hyun S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medical physics (Lancaster)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jacobs, Michael A.</au><au>Gultekin, David H.</au><au>Kim, Hyun S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison between diffusion‐weighted imaging, T2‐weighted, and postcontrast T1‐weighted imaging after MR‐guided, high intensity, focused ultrasound treatment of uterine leiomyomata: Preliminary results</atitle><jtitle>Medical physics (Lancaster)</jtitle><addtitle>Med Phys</addtitle><date>2010-09</date><risdate>2010</risdate><volume>37</volume><issue>9</issue><spage>4768</spage><epage>4776</epage><pages>4768-4776</pages><issn>0094-2405</issn><eissn>2473-4209</eissn><eissn>0094-2405</eissn><abstract>Purpose
: To investigate the comparison between diffusion‐weighted imaging (DWI),T2‐weighted imaging, (T2WI) and contrast T1‐weighted imaging (cT1WI) in uterine leiomyoma following treatment by magnetic resonance imaging‐guided, high intensity focused ultrasound surgery (MRg‐HIFUS).
Methods
: Twenty one patients(45±5yrs) with clinical symptoms of uterine leiomyoma (fibroids) were treated by MRg‐HIFUS using an integrated 1.5T MRI‐HIFUS system. MRI parameters consisted of DWI, T2WI, and T1‐weighted fast spoiled gradient echo before and after contrast. The post‐MRg‐HIFUS treatment volume in the fibroid was assessed by cT1WI and DWI. Trace apparent diffusion coefficient maps were constructed for quantitative analysis. The regions of the treated uterine tissue were defined by a semisupervised segmentation method called the “eigenimage filter,” using both cT1WI and DWI. Signal‐to‐noise ratios were determined for the T2WI pretreatment images. Segmented regions were tested by a similarity index for congruence. Descriptive, regression, and Bland–Altman statistics were calculated.
Results
: All the patients exhibited heterogeneously increased DWI signal intensity localized in the treated fibroid regions and were colocalized with thecT1WI defined area. The mean pretreatment T2WI signal intensity ratios were T2WI/muscle=1.8±0.7 and T2WI/myometrium=0.7±0.4. The congruence between the regions was significant, with a similarity of 84% and a difference of 8% between the regions. Regression analyses of the cT1WI and DWI segmented treatment volumes were found to be significantly correlated (r2=0.94,p<0.05) with the linear equation, (cT1WI)=1.1(DWI)−0.66. There is good agreement between the regions defined by cT1WI and DWI in most of the cases as shown from the Bland–Altman plots.
Conclusions
: Diffusion‐weighted imaging exhibited excellent agreement, congruence, and correlation with thecT1WI‐defined region of treatment in uterine fibroid. Therefore, DWI could be useful as an adjunct for assessing treatment of uterine fibroids by MRg‐HIFUS.</abstract><cop>United States</cop><pub>American Association of Physicists in Medicine</pub><pmid>20964196</pmid><doi>10.1118/1.3475940</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | ADC map Adult biomedical MRI biomedical ultrasonics Computed tomography Diffusion diffusion‐weighted imaging gynaecology high intensity focused ultrasound surgery Humans image segmentation Intracellular signaling leiomyoma Leiomyoma - diagnosis Leiomyoma - therapy leiomyomata Magnetic resonance imaging Magnetic Resonance Imaging - methods Magnetic Resonance Physics Medical imaging Middle Aged muscle Muscles regression analysis surgery thermotherapy Tissue ablation Tissue characterization Tissues tumours Ultrasonic Therapy - methods Ultrasonography uterine fibroids |
| title | Comparison between diffusion‐weighted imaging, T2‐weighted, and postcontrast T1‐weighted imaging after MR‐guided, high intensity, focused ultrasound treatment of uterine leiomyomata: Preliminary results |
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