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Decker JA, Fischer AM, Schoepf UJ, Xiong F, Todoran TM, Aldinger J, Ellis L, Edelman RR, Koktzoglou I, Emrich T, Varga-Szemes A. Quiescent-Interval Slice-Selective MRA Accurately Estimates Intravascular Stent Dimensions Prior to Intervention in Patients With Peripheral Artery Disease. J Magn Reson Imaging 2021; 55:246-254. [PMID: 34323329 DOI: 10.1002/jmri.27864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Quiescent-interval slice-selective (QISS) magnetic resonance angiography (MRA) is a non-contrast alternative for the pre-procedural assessment of patients with peripheral artery disease (PAD). However, the feasibility of pre-procedural stent size estimation using QISS MRA would merit investigation. PURPOSE To evaluate the feasibility of QISS MRA for pre-procedural stent size estimation in PAD patients compared to computed tomography angiography (CTA). STUDY TYPE Retrospective. SUBJECTS Thirty-three PAD patients (68 ± 9 years, 18 men, 15 women). FIELD STRENGTH/SEQUENCE Two-dimensional balanced steady-state free precession QISS MRA at 1.5 T and 3 T. ASSESSMENT All patients received QISS MRA and CTA of the lower extremity run-off followed by interventional digital subtraction angiography (DSA). Stenotic lesion length and diameter were quantified (AMF and AVS with 3 and 13 years of experience in cardiovascular imaging, respectively) to estimate the dimensions of the stent necessary to restore blood flow in the treated arteries. Measured dimensions were adjusted to the closest stent size available. STATISTICAL TESTS The Friedman test with subsequent pairwise Wilcoxon signed-rank test was used to compare the estimated stent dimensions between QISS MRA, CTA, and the physical stent size used for intervention. Intra-class correlation (ICC) analysis was performed to assess inter-reader agreement. Significant differences were considered at P < 0.05. RESULTS No significant difference was observed between estimated stent diameter by QISS MRA or CTA compared to physical stent diameter (8.9 ± 2.9 mm, 8.8 ± 3.0 mm, and 8.8 ± 3.8 mm, respectively; χ2 = 1.45, P = 0.483). There was a significant underestimation of stent length for both QISS MRA and CTA, compared to physical stent length (45.8 ± 27.8 mm, 46.4 ± 29.3 mm, and 50.4 ± 34.0 mm, respectively; χ2 = 11.96) which could be corrected when measurements were adjusted to the next available stent length (χ2 = 2.38, P = 0.303). Inter-reader assessment showed good to excellent agreement between the readers (all ICC ≥0.81). DATA CONCLUSION QISS MRA represents a reliable method for pre-procedural lesion assessment and stent diameter and length estimation in PAD patients. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Josua A Decker
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA.,Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany
| | - Andreas M Fischer
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
| | - U Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Fei Xiong
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA.,Cardiovascular MR R&D, Siemens Medical Solutions USA Inc., Charleston, South Carolina, USA
| | - Thomas M Todoran
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jonathan Aldinger
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Lauren Ellis
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Robert R Edelman
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Department of Radiology, Northshore University HealthSystem, Evanston, Illinois, USA
| | - Ioannis Koktzoglou
- Department of Radiology, Northshore University HealthSystem, Evanston, Illinois, USA.,Department of Radiology, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | - Tilman Emrich
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA.,Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
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Grimaldi V, Schiano C, Casamassimi A, Zullo A, Soricelli A, Mancini FP, Napoli C. Imaging techniques to evaluate cell therapy in peripheral artery disease: state of the art and clinical trials. Clin Physiol Funct Imaging 2014; 36:165-78. [PMID: 25385089 DOI: 10.1111/cpf.12210] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 10/10/2014] [Indexed: 12/13/2022]
Abstract
Cell-based therapies, as potential approach to cure peripheral artery disease (PAD), have been clinically investigated after promising results in preclinical models. The so far published studies are very heterogeneous, as different cell sources, cell types, amounts of administered cells and delivering strategies have been used. Overall, cell therapies for PAD bring about a general improvement of patient's clinical condition, even though conclusions cannot be established due to the small size and non-randomized design of these trials. In this context, non-invasive imaging techniques, aimed to monitor angiogenesis and neovascularization after cell therapy, will help the follow-up of clinical studies. However, still much work is needed to establish advanced imaging procedure to overcome the limitation of the current techniques and to accumulate more data in large populations of patients. Here, we report the main imaging techniques employed to evaluate the outcome of the different cell-based therapies in PAD. Moreover, we focus on both published and ongoing clinical trials utilizing cell therapy in PAD.
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Affiliation(s)
- Vincenzo Grimaldi
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Naples, Italy
| | - Concetta Schiano
- Institute of Diagnostic and Nuclear Development (SDN) IRCCS, Naples, Italy
| | - Amelia Casamassimi
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy
| | - Alberto Zullo
- Department of Sciences and Technologies, University of Sannio, Benevento, Italy.,CEINGE, Advanced Biotechnologies, Naples, Italy
| | - Andrea Soricelli
- Institute of Diagnostic and Nuclear Development (SDN) IRCCS, Naples, Italy
| | | | - Claudio Napoli
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Naples, Italy.,Institute of Diagnostic and Nuclear Development (SDN) IRCCS, Naples, Italy
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Bueno A, Acín F, Cañibano C, Fernandez-Casado JL, Castillo E. Diagnostic accuracy of contrast-enhanced magnetic resonance angiography and duplex ultrasound in patients with peripheral vascular disease. Vasc Endovascular Surg 2010; 44:576-85. [PMID: 20675318 DOI: 10.1177/1538574410377018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Noninvasive techniques such as duplex ultrasound (DU) and contrast-enhanced magnetic resonance angiography (CE-MRA) are valid alternatives in the preoperative evaluation of such patients. Our aim is to assess the diagnostic accuracy of CE-MRA and DU in patients with peripheral arterial disease (PAD). METHODS Forty consecutive patients underwent DU, hybrid CE-MRA, and digital subtraction angiography (DSA). Magnetic resonance angiography and DSA images were evaluated independently and in a blinded fashion. Every segment was graded as normal, stenosed less than 50%, stenosed more than 50%, or occluded. RESULTS There were 1720 segments for analysis. Duplex ultrasound depicting stenosis >50% demonstrated a sensitivity (S) 81.4%, specificity (E) 99%, positive predictive value (PPV) 96.2%, and negative predictive value (NPV) 94.8%. Occlusions showed S 90%, E 97%, PPV 98.1%, and NPV 88.4%. Magnetic resonance angiography depicting stenosis >50% demonstrated a S 91%, E 99%, PPV 96.7%, and NPV 97.6%. Occlusions showed S 95.4%, E 98%, PPV 98.4%, and NPV 94.7%. CONCLUSION Combined CE-MRA and DU is the first diagnostic approach in the preoperative assessment of PAD, leading to the use of DSA for selected cases.
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Affiliation(s)
- Alicia Bueno
- Vascular Surgery Department, Hospital Universitario de Getafe, Madrid, Spain.
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