Browsing by Author "Pornphan Wibulpolprasert"

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    Clinical applications of diffusion-weighted-MRI in prostate cancer
    (2013-08-01) Pornphan Wibulpolprasert; Sith Phongkitkarun; Panas Chalermsanyakorn; Mahidol University
    Objective: To determine the relationship between the apparent diffusion coefficient (ADC) values calculated from diffusionweighted (DW) MR imaging in different b values and tumor grading by Gleason scores of the peripheral zone prostate cancer. Material and Method: Thirty-nine patients with prostate cancer who underwent pre-operative endorectal Diffusion-Weighted (DW) magnetic resonance (MR) imaging between March 2006 and March 2010 were included. Regions of interest (ROIs) were drawn on ADC maps at sites of visible tumor on DW images and ADC maps comparison to histopathology. Differentiation between ADC values of tumor and non-tumor areas were analyzed by using paired t-test and sign-test and between tumors grading were analyzed by using Wilcoxon rank-sum (Mann-Whitney) test and Kruskal-Wallis equality-of population rank test. Results: The mean ADC of tumor is lower than non-tumor areas at all b-values. There is negative correlation between ADC value and tumor grading with statistical significance at b = 1,000 sec/mm2, between tumor grade I (1.95x10-3 mm2/sec, SD = 0.33) and tumor grade II (1.16x10-3 mm2/sec, SD = 0.27) (p = 0.03) and between tumor grade I and tumor grade III (1.10x10-3 mm2/sec, SD = 0.36) (p = 0.002) and at b = 2,000 sec/mm2, between tumor grade I (2.21x10-3 mm2/sec, SD = 0.08) and tumor grade II (1.22x10-3 mm2/sec, SD = 0.38) (p = 0.01), and between tumor grade I and tumor grade III (1.32x10-3 mm2/sec, SD = 0.49) (p = 0.04). There is no statistical significance difference between tumor grade II and grade III. Conclusion: Tumor shows restricted diffusion with ADC value lower than non-tumor areas. There is a significant negative correlation between ADCs and tumor grading between low and intermediate grades and between low and high grades tumor at the b = 1,000 and 2,000 sec/mm2. ADC maps may be a useful tool for non-invasive assessment of the aggressiveness of prostate cancers that are visible on MR images.
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    The correlation between kidney volume and measured glomerular filtration rate in an Asian ADPKD population: a prospective cohort study
    (2021-12-01) Bunyong Phakdeekitcharoen; Watcharapong Treesinchai; Pornphan Wibulpolprasert; Sarinya Boongird; Pinkael Klytrayong; Ramathibodi Hospital
    Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disorder that leads to end stage renal disease (ESRD). Cyst expansion in ADPKD is strongly associated with the decline in renal function. However, the correlation between total kidney volume (TKV) and glomerular filtration rate (GFR) at an early stage has not been well demonstrated. There is growing evidence that utilization of estimated GFR (eGFR) may induce misleading information in a population with near normal renal function. Therefore, a more accurate method is essential. Methods: A prospective cohort of ADPKD patients was conducted with clinical data and laboratory collection. Measured GFR (mGFR) was assessed by iohexol plasma clearance method using ultra performance liquid chromatography. eGFR was calculated using the CKD-EPI equation. Kidney volumes were evaluated using MRI imaging protocol. Results: Thirty two patients completed the study. The mean age was 56 years old. The mean initial mGFR was 83.8 mL/min/1.73m2. The mean change in mGFR per year was –2.99 mL/min/1.73m2/year. The mean initial height-adjusted TKV (htTKV) was 681.0 mL/m. The mean percentage change in htTKV per year (%ΔhtTKV/y) was 4.77 %/year. mGFR had a better association with clinical parameters than eGFR. Initial mGFR was significantly and inversely correlated with initial htTKV and age. The percentage change in mGFR per year was significantly and inversely correlated with the %ΔhtTKV/y and 24-hr urine albumin. The %ΔhtTKV/y was significantly correlated with initial htTKV. Conclusions: Our studies demonstrated that mGFR using iohexol is a more reliable and accurate method than eGFR for evaluating GFR changes in the early stages of ADPKD patients. There is a strong inverse correlation between kidney volume and mGFR in an Asian ADPKD population. The initial htTKV is a good predictor of kidney volume progression. The %ΔhtTKV/y is a good early surrogate marker for the decline in renal function. 24-hr urine albumin is also a good indicator for renal progression.
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    PublicationOpen Access
    Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging in Peripheral Zone Prostate Cancer Detection
    (2018) Pornphan Wibulpolprasert; Sasiprapa Rongthong; Sith Phongkitkarun; Panas Chalermsanyakorn; พรพรรณ วิบุลผลประเสริฐ; ศศิประภา รงค์ทอง; สิทธิ์ พงษ์กิจการุณ; พนัส เฉลิมแสนยากร; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Diagnostic and Therapeutic Radiology; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Pathology
    Background: Multiparametric magnetic resonance imaging (mp-MRI) has emerged as the best noninvasive imaging modality for prostate cancer detection, grading, staging, and targeted biopsy guidance. Validate performance of mp-MRI for peripheral zone prostate cancer detection is important for clinical implication. Objective: To determine the accuracy of T2-weighted (T2W) imaging, diffusion-weighted imaging (DWI), three dimensional (3D) magnetic resonance spectroscopic (MRS) and dynamic contrast-enhanced imaging (DCE) in peripheral zone prostate cancer detection. Methods: The retrospective study included 38 patients who has undergone pre-operative endorectal MRI from March 2006, to March 2010. The correlation of T2W, DWI, MRS and DCE in differentiation between tumor and non-tumor areas were analyzed by using Pearson's chi-square test or Fisher’s exact test. The receiver operating characteristic (ROC) analysis was use to evaluate the distinguishing ability of T2W, DWI, MRS, DCE, and the combinations in tumor detection. Results: In 76 lesions from 38 patients, the area under the ROC curve (AUC) for tumor detection was 0.86 (T2W), 0.86 (DWI), 0.95 (MRS), and 0.61 (DCE). Combination of T2W+DWI, T2W+MRS, T2W+DCE achieved an AUC of 0.86, 0.92, and 0.80, respectively. There is no statistically significant difference in AUC between combination of T2W+DWI (0.86), and combination of T2W+DWI+DCE (0.82), T2W+DWI+MRS (0.81), or T2W+DWI+MRS+DCE (0.78). Conclusions: DWI is the most useful complementary sequence to conventional anatomical T2W imaging for prostate cancer foci identification. The 3D-MRS and DCE images may be use as confirmation tools in peripheral zone prostate cancer detection.
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    PublicationOpen Access
    Distinguishing Infiltrative Transitional Cell Carcinoma From Other Infiltrative Lesions of the Kidneys on Multidetector Computed Tomography
    (2019) Pornphan Wibulpolprasert; Sasiwimon Jungtheerapanich; Bussanee Wibulpolprasert; พรพรรณ วิบุลผลประเสริฐ; ศศิวิมล จึงธีรพานิช; บุษณี วิบุลผลประเสริฐ; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Diagnostic and Therapeutic Radiology,
    Background: The infiltrative renal growth pattern is either characteristic of certain prototype transitional cell carcinomas (TCCs) or other mimickers. Specific computed tomography (CT) features may be used to differentiate TCCs from other overlap findings. Accurate early diagnosis is important to improve treatment outcome and prevent morbidity and mortality from delayed specific treatment. Objective: To determine the multidetector computed tomography (MDCT) features that discriminate infiltrative TCCs from other infiltrative renal lesions. Methods: A retrospective review was performed on patients with infiltrative, proven renal lesions on CT from January 2008 to July 2014. Individual CT sequences were analyzed for lesion number, location, size, and density on unenhanced and nephrographic phase scans. Final diagnoses were confirmed by histopathology or clinical or imaging follow-up after treatment. The CT findings of intrarenal TCCs and mimics were compared by using logistic regression analysis. Results: In 73 patients, there were 18 (24.6%) TCCs, 2 (2.7%) renal cell carcinomas (RCCs), 11 (15.1%) lymphomas, 15 (20.5%) renal parenchymal metastases, 17 (23.3%) infections, and 10 (13.7%) other diagnosis. Compared to non-TCCs, intrarenal TCCs were more likely to be solitary lesion, lack intralesional calcification, less avidly enhance in nephrographic phase and infiltrate pelvicalyceal and perinephric tissue (P < .05). Conclusions: Five MDCT features including solitary lesion, absence of calcification and poor absolute, relative enhancement, pelvicalyceal system involvement, and perinephric tissue invasion were significantly associated with intrarenal and infiltrative TCCs.
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    PublicationOpen Access
    Distinguishing Renal Cell Carcinoma From Other Focal Renal Lesions on Multidetector Computed Tomography
    (2020) Pornphan Wibulpolprasert; Chompoonuch Thongthong; Bussanee Wibulpolprasert; พรพรรณ วิบุลผลประเสริฐ; ชมพูนุช ธงทอง; บุษณี วิบุลผลประเสริฐ; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Diagnostic and Therapeutic Radiology
    Background: The increased use of imaging modalities has led to a greater incidence in depicting solid renal mass. These lesions comprise a wide spectrum of malignant such as renal cell carcinoma (RCC) and benign histologies. Objective: To determine the multidetector computed tomography (MDCT) features that discriminate RCC from other focal renal lesions. Methods: A retrospective review was performed on 148 patients who underwent renal CT scan followed by renal surgery or biopsy during January 2008 to July 2014. Specific predictive MDCT features of RCC were determined by logistic regression analysis. Interobserver agreement (kappa [K] values) was also calculated for each CT feature. Results: In 148 pathologic proved focal renal lesions, 91 (61.5%) were RCCs and 57 (38.5%) were non-RCCs. RCCs were more likely to be in male patients (OR, 5.39; 95% CI, 2.25 - 12.90), no internal fat component (OR, 46.50; 95% CI, 5.25 - 411.90), locate at peripheral (OR, 7.41; 95% CI, 1.63 - 33.73), and mixed central-peripheral locations (OR, 26.22; 95% CI, 4.23 - 162.58) of the kidney. There was moderate-to-excellent agreement among the readers over all these features (K = 0.43 - 0.91). Conclusions: Focal renal lesion with no internal fat component in MDCT is the most useful characteristic in differentiating RCCs from others.