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Liu K, Sun H, Wang X, Wen X, Yang J, Zhang X, Chen C, Zeng M. Feasibility of the application of deep learning-reconstructed ultra-fast respiratory-triggered T2-weighted imaging at 3 T in liver imaging. Magn Reson Imaging 2024; 109:27-33. [PMID: 38438094 DOI: 10.1016/j.mri.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/25/2024] [Accepted: 03/01/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE The evaluate the feasibility of a novel deep learning-reconstructed ultra-fast respiratory-triggered T2WI sequence (DL-RT-T2WI) In liver imaging, compared with respiratory-triggered Arms-T2WI (Arms-RT-T2WI) and respiratory-triggered FSE-T2WI (FSE-RT-T2WI) sequences. METHODS 71 patients with liver lesions underwent 3-T MRI and were prospectively enrolled. Two readers independently analyzed images acquired with DL-RT-T2WI, Arms-RT-T2WI, and FSE-RT-T2WI. The qualitative evaluation indicators, including overall image quality (OIQ), sharpness, noise, artifacts, lesion detectability (LC), lesion characterization (LD), cardiacmotion-related signal loss (CSL), and diagnostic confidence (DC), were evaluated in two readers, and further statistically compared using paired Wilcoxon rank-sum test among three sequences. RESULTS 176 lesions were detected in DL-RT-T2W and Arms-RT-T2WI, and 175 were detected in FSE-RT-T2WI. The acquisition time of DL-RT-T2WI was improved by 4.8-7.9 folds compared to the other two sequences. The OIQ was scored highest for DL-RT-T2WI (R1, 4.61 ± 0.52 and R2, 4.62 ± 0.49), was significantly superior to Arms-RT-T2WI (R1, 4.30 ± 0.66 and R2, 4.34 ± 0.69) and FSE-RT-T2WI (R1, 3.65 ± 1.08 and R2, 3.75 ± 1.01). Artifacts and sharpness scored highest for DL-RT-T2WI, followed by Arms-RT-T2WI, and were lowest for FSE-RT-T2WI in both two readers. Noise and CSL for DL-RT-T2WI scored similar to Arms-RT-T2WI (P > 0.05) and were significantly superior to FSE-RT-T2WI (P < 0.001). Both LD and LC for DL-RT-T2WI were significantly superior to Arms-RT-T2WI and FSE-RT-T2WI in two readers (P < 0.001). DC for DL-RT-T2WI scored best, significantly superior to Arms-RT-T2WI (P < 0.010) and FSE-RT-T2WI (P < 0.001). CONCLUSIONS The novel ultra-fast DL-RT-T2WI is feasible for liver imaging and lesion characterization and diagnosis, not only offers a significant improvement in acquisition time but also outperforms Arms-RT-T2WI and FSE-RT-T2WI concerning image quality and DC.
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Affiliation(s)
- Kai Liu
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China
| | - Haitao Sun
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China
| | - Xingxing Wang
- Department of Pathology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China
| | - Xixi Wen
- Shanghai United Imaging Healthcare Co., Ltd., Shanghai 201807, China
| | - Jun Yang
- Shanghai United Imaging Healthcare Co., Ltd., Shanghai 201807, China
| | - Xingjian Zhang
- Shanghai United Imaging Healthcare Co., Ltd., Shanghai 201807, China
| | - Caizhong Chen
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China.
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Kurokawa M, Tsuneda M, Abe K, Ikeda Y, Kanazawa A, Saito M, Kodate A, Harada R, Yokota H, Watanabe M, Uno T. A pilot study on interobserver variability in organ-at-risk contours in magnetic resonance imaging-guided online adaptive radiotherapy for pancreatic cancer. Front Oncol 2024; 14:1335623. [PMID: 38800394 PMCID: PMC11116709 DOI: 10.3389/fonc.2024.1335623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/15/2024] [Indexed: 05/29/2024] Open
Abstract
Purpose Differences in the contours created during magnetic resonance imaging-guided online adaptive radiotherapy (MRgOART) affect dose distribution. This study evaluated the interobserver error in delineating the organs at risk (OARs) in patients with pancreatic cancer treated with MRgOART. Moreover, we explored the effectiveness of drugs that could suppress peristalsis in restraining intra-fractional motion by evaluating OAR visualization in multiple patients. Methods This study enrolled three patients who underwent MRgOART for pancreatic cancer. The study cohort was classified into three conditions based on the MRI sequence and butylscopolamine administration (Buscopan): 1, T2 imaging without butylscopolamine administration; 2, T2 imaging with butylscopolamine administration; and 3, multi-contrast imaging with butylscopolamine administration. Four blinded observers visualized the OARs (stomach, duodenum, small intestine, and large intestine) on MR images acquired during the initial and final MRgOART sessions. The contour was delineated on a slice area of ±2 cm surrounding the planning target volume. The dice similarity coefficient (DSC) was used to evaluate the contour. Moreover, the OARs were visualized on both MR images acquired before and after the contour delineation process during MRgOART to evaluate whether peristalsis could be suppressed. The DSC was calculated for each OAR. Results Interobserver errors in the OARs (stomach, duodenum, small intestine, large intestine) for the three conditions were 0.636, 0.418, 0.676, and 0.806; 0.725, 0.635, 0.762, and 0.821; and 0.841, 0.677, 0.762, and 0.807, respectively. The DSC was higher in all conditions with butylscopolamine administration compared with those without it, except for the stomach in condition 2, as observed in the last session of MR image. The DSCs for OARs (stomach, duodenum, small intestine, large intestine) extracted before and after contouring were 0.86, 0.78, 0.88, and 0.87; 0.97, 0.94, 0.90, and 0.94; and 0.94, 0.86, 0.89, and 0.91 for conditions 1, 2, and 3, respectively. Conclusion Butylscopolamine effectively reduced interobserver error and intra-fractional motion during the MRgOART treatment.
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Affiliation(s)
- Marie Kurokawa
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Masato Tsuneda
- Department of Radiation Oncology, MR Linac ART Division, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Kota Abe
- Department of Radiation Oncology, MR Linac ART Division, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Yohei Ikeda
- Department of Radiology, Chiba University Hospital, Chuo-ku, Chiba, Japan
| | - Aki Kanazawa
- Department of Radiology, Chiba University Hospital, Chuo-ku, Chiba, Japan
| | - Makoto Saito
- Department of Radiology, Chiba University Hospital, Chuo-ku, Chiba, Japan
| | - Asuka Kodate
- Department of Radiology, Chiba University Hospital, Chuo-ku, Chiba, Japan
| | - Rintaro Harada
- Department of Radiology, Chiba University Hospital, Chuo-ku, Chiba, Japan
| | - Hajime Yokota
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Miho Watanabe
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Takashi Uno
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
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Ogawa A, Nakamura M, Iramina H, Yoshimura M, Mizowaki T. Potential utility of cone-beam CT-guided adaptive radiotherapy under end-exhalation breath-hold conditions for pancreatic cancer. J Appl Clin Med Phys 2022; 24:e13827. [PMID: 36316795 PMCID: PMC9924116 DOI: 10.1002/acm2.13827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/15/2022] [Accepted: 10/07/2022] [Indexed: 02/14/2023] Open
Abstract
PURPOSE The purpose of this study was to demonstrate the potential utility of cone-beam computed tomography (CBCT)-guided online adaptive radiotherapy (ART) under end-exhalation breath-hold (EE-BH) conditions for pancreatic cancer (PC). METHODS Eleven PC patients who underwent 15-fraction volumetric-modulated arc therapy under EE-BH conditions were included. Planning CT images and daily 165 CBCT images were imported into a dedicated treatment planning system. The prescription dose was set to 48 Gy in 15 fractions. The reference plan was automatically generated along with predefined clinical goals. After segmentation was completed on CBCT images, two different plans were generated: One was an adapted (ADP) plan in which re-optimization was performed on the anatomy of the day, and the other was a scheduled (SCH) plan, which was the same as the reference plan. The dose distributions calculated using the synthetic CT created from both planning CT and CBCT were compared between the two plans. Independent calculation-based quality assurance was also performed for the ADP plans, with a gamma passing rate of 3%/3 mm. RESULTS All clinical goals were successfully achieved during the reference plan generation. Of the 165 sessions, gross tumor volume D98% and clinical target volume D98% were higher in 100 (60.1%) and 122 (74.0%) ADP fractions. In each fraction, the V3 Gy < 1 cm3 of the stomach and duodenum was violated in 47 (28.5%) and 48 (29.1%), respectively, of the SCH fractions, whereas no violations were observed in the ADP fractions. There were statistically significant differences in the dose-volume indices between the SCH and ADP fractions (p < 0.05). The gamma passing rates were above 95% in all ADP fractions. CONCLUSIONS The CBCT-guided online ART under EE-BH conditions successfully reduced the dose to the stomach and duodenum while maintaining target coverage.
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Affiliation(s)
- Ayaka Ogawa
- Department of Radiation Oncology and Image‐Applied TherapyGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Mitsuhiro Nakamura
- Department of Radiation Oncology and Image‐Applied TherapyGraduate School of MedicineKyoto UniversityKyotoJapan,Division of Medical PhysicsDepartment of Information Technology and Medical EngineeringHuman Health SciencesGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Hiraku Iramina
- Department of Radiation Oncology and Image‐Applied TherapyGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Michio Yoshimura
- Department of Radiation Oncology and Image‐Applied TherapyGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image‐Applied TherapyGraduate School of MedicineKyoto UniversityKyotoJapan
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Ciggaar IA, Henneman OD, Oei SA, J.S.M.L. Vanhooymissen I, Blikkendaal MD, Bipat S. Bowel preparation in MRI for detection of endometriosis: comparison of the effect of an enema, no additional medication and intravenous butylscopolamine on image quality. Eur J Radiol 2022; 149:110222. [DOI: 10.1016/j.ejrad.2022.110222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/08/2022] [Accepted: 02/12/2022] [Indexed: 11/27/2022]
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Assessing Lymphatic Uptake of Lipids Using Magnetic Resonance Imaging: A Feasibility Study in Healthy Human Volunteers with Potential Application for Tracking Lymph Node Delivery of Drugs and Formulation Excipients. Pharmaceutics 2021; 13:pharmaceutics13091343. [PMID: 34575420 PMCID: PMC8470042 DOI: 10.3390/pharmaceutics13091343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/17/2021] [Accepted: 08/25/2021] [Indexed: 11/18/2022] Open
Abstract
Dietary lipids and some pharmaceutical lipid excipients can facilitate the targeted delivery of drugs to the intestinal lymphatics. Here, the feasibility of magnetic resonance imaging (MRI) for imaging lipid uptake into the intestinal lymphatics was assessed, shedding light on which lymph nodes can be targeted using this approach. Three healthy male volunteers were scanned at 3.0 T at baseline, 120, 180, 240, and 300 min post high-fat meal. A sagittal multi-slice image was acquired using a diffusion-weighted whole-body imaging sequence with background suppression (DWIBS) (pre inversion TI = 260 ms). Changes in area, major, and minor axis length were compared at each time point. Apparent diffusion coefficient (ADC) was calculated (b = 0 and 600 s/mm2) across eight slices. An average of 22 nodes could be visualised across all time points. ADC increased at 120 and 180 min compared to the baseline in all three participants by an average of 9.2% and 6.8%, respectively. In two participants, mean node area and major axis lengths increased at 120 and 180 min relative to the baseline. In conclusion, the method described shows potential for repeated lymph node measurements and the tracking of lipid uptake into the lymphatics. Further studies should focus on methodology optimisation in a larger cohort.
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Slevin F, Beasley M, Zhong J, Hudson E, Speight R, Lilley J, Murray LJ, Henry AM. A feasibility study of hyoscine butylbromide (buscopan) to improve image quality of cone beam computed tomography during abdominal/pelvic Stereotactic Ablative Radiotherapy. BJR Open 2021; 3:20210045. [PMID: 34381954 PMCID: PMC8328082 DOI: 10.1259/bjro.20210045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Cone beam computed tomography (CBCT) is used for image guidance of stereotactic ablative radiotherapy (SABR), but it is susceptible to bowel motion artefacts. This trial evaluated the impact of hyoscine butylbromide (buscopan) on CBCT image quality and its feasibility within a radiotherapy workflow. METHODS A single-centre feasibility trial (ISRCTN24362767) was performed in patients treated with SABR for abdominal/pelvic oligorecurrence. Buscopan was administered to separate cohorts by intramuscular (IM) or intravenous (i.v.) injection on alternate fractions, providing within-patient control data. 4-point Likert scales were used to assess overall image quality (ranging from excellent to impossible to use) and bowel motion artefact (ranging from none to severe). Feasibility was determined by patient/radiographer questionnaires and toxicity assessment. Descriptive statistics are presented. RESULTS 16 patients were treated (8 by IM and 8 by i.v. buscopan). The percentage of images of excellent quality with/without buscopan was 47 vs 29% for IM buscopan and 65 vs 40% for i.v. buscopan. The percentage of images with no bowel motion artefact with/without buscopan was 24.6 vs 8.9% for IM buscopan and 25.8 vs 7% for i.v. buscopan. Four patients (25%) reported dry mouth. 14 patients (93%) would accept buscopan as routine. 11 radiographers (92%) reported no delay in treatments. CONCLUSIONS A trend towards improved image quality/reduced bowel motion artefact was observed with IM/i.v. buscopan. Buscopan was well tolerated with limited impact on workflow. ADVANCES IN KNOWLEDGE This is the first trial of buscopan within a radiotherapy workflow. It demonstrated a trend to improved image quality and feasibility of use.
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Affiliation(s)
| | - Matthew Beasley
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, UK
| | | | - Eleanor Hudson
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Richard Speight
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, UK
| | - John Lilley
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, UK
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Sneag DB, Mendapara P, Zhu JC, Lee SC, Lin B, Curlin J, Bogner EA, Fung M. Prospective respiratory triggering improves high‐resolution brachial plexus MRI quality. J Magn Reson Imaging 2018; 49:1723-1729. [DOI: 10.1002/jmri.26559] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Darryl B. Sneag
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Parrykumar Mendapara
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Jacqui C. Zhu
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Susan C. Lee
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Bin Lin
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Jahnavi Curlin
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
| | - Eric A. Bogner
- Department of Radiology and Imaging Hospital for Special Surgery New York New York USA
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Saito K, Tajima Y, Harada TL. Diffusion-weighted imaging of the liver: Current applications. World J Radiol 2016; 8:857-867. [PMID: 27928467 PMCID: PMC5120245 DOI: 10.4329/wjr.v8.i11.857] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/10/2016] [Accepted: 10/24/2016] [Indexed: 02/06/2023] Open
Abstract
Diffusion-weighted imaging (DWI) of the liver can be performed using most commercially available machines and is currently accepted in routine sequence. This sequence has some potential as an imaging biomarker for fibrosis, tumor detection/characterization, and following/predicting therapy. To improve reliability including accuracy and reproducibility, researchers have validated this new technique in terms of image acquisition, data sampling, and analysis. The added value of DWI in contrast-enhanced magnetic resonance imaging was established in the detection of malignant liver lesions. However, some limitations remain in terms of lesion characterization and fibrosis detection. Furthermore, the methodologies of image acquisition and data analysis have been inconsistent. Therefore, researchers should make every effort to not only improve accuracy and reproducibility but also standardize imaging parameters.
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Lymphatic pathway around the pancreatic head and extrahepatic bile duct: evaluation using MR imaging at 3.0-T. ACTA ACUST UNITED AC 2015; 40:1617-28. [DOI: 10.1007/s00261-014-0346-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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I.v. glucagon use in pediatric MR enterography: effect on image quality, length of examination, and patient tolerance. AJR Am J Roentgenol 2013; 201:185-9. [PMID: 23789674 DOI: 10.2214/ajr.12.9787] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of our study was to evaluate the use of i.v. glucagon in pediatric patients undergoing MR enterography. SUBJECTS AND METHODS Forty-seven patients underwent clinical MR enterography examinations consisting of identical breath-hold T1-weighted 3D gradient-recalled echo fat-saturated pulse sequences before and after i.v. glucagon administration. Images were reviewed in a blinded manner by two pediatric radiologists to determine the effect of glucagon on visualization of the small and large bowel. Image time stamps were documented separately to determine how this adjunctive medication affected examination length. A separate cohort of 50 patients was evaluated for glucagon-related symptoms, including nausea and emesis. Exact binomial testing was performed to establish whether overall visualization of the bowel and visualization of the terminal ileum were better on images with i.v. glucagon. The two-tailed Wilcoxon signed rank test was used to compare Likertlike scores for bowel visualization before and after i.v. glucagon administration. RESULTS Glucagon improved overall bowel visualization in 40 of 47 (85%) examinations for reader 1 (p < 0.0001) and 36 of 47 (77%) for reader 2 (p = 0.0001). Visualization of the terminal ileum was improved after glucagon administration in 29 of 47 (62%) examinations for both readers (p = 0.03). Glucagon improved visualization of the small bowel for reader 1 (mean score on 5-point Likertlike scale: 3.3 ± 1.0 [SD] vs 2.2 ± 0.7, respectively; p < 0.0001) and reader 2 (3.4 ± 1.1 vs 2.5 ± 0.9; p < 0.0001). Glucagon also improved large-bowel visualization for reader 1 (3.3 ± 0.9 vs 3.0 ± 0.8; p = 0.005) and reader 2 (3.4 ± 1.1 vs 3.0 ± 1.0; p = 0.002). On average, the use of glucagon added 13.7 minutes to the examination. Twenty-four of 50 (48%) patients self-reported glucagon-related nausea and four patients experienced emesis. CONCLUSION I.v. glucagon improves bowel visualization at pediatric MR enterography, increases examination length, and commonly causes nausea. Fewer than 10% of patients experience glucagon-related emesis in our practice.
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Venkatanarasimha N, Jenkins SJ, Yang N, Colak E, Kirpalani A. Impact of butylscopolamine on image quality of magnetic resonance cholangiopancreatography. Eur J Radiol 2013; 82:583-8. [DOI: 10.1016/j.ejrad.2012.11.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 10/03/2012] [Accepted: 11/20/2012] [Indexed: 10/27/2022]
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Zijta F, Nederveen A, Jensch S, Florie J, Bipat S, van der Paardt M, van Swijndregt AM, Stoker J. Feasibility of using automated insufflated carbon dioxide (CO2) for luminal distension in 3.0T MR colonography. Eur J Radiol 2012; 81:1128-33. [DOI: 10.1016/j.ejrad.2011.02.067] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 02/28/2011] [Indexed: 11/25/2022]
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Gutzeit A, Binkert CA, Koh DM, Hergan K, von Weymarn C, Graf N, Patak MA, Roos JE, Horstmann M, Kos S, Hungerbühler S, Froehlich JM. Evaluation of the anti-peristaltic effect of glucagon and hyoscine on the small bowel: comparison of intravenous and intramuscular drug administration. Eur Radiol 2012; 22:1186-94. [PMID: 22270141 DOI: 10.1007/s00330-011-2366-1] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 11/21/2011] [Accepted: 12/05/2011] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate prospectively duration and effectiveness of aperistalsis achieved by glucagon(GLU) or hyoscine N-butylbromide(HBB) following various administration routes. MATERIALS AND METHODS Six volunteers underwent Magnetic Resonance Imaging (MRI) after standardized oral preparation in random order five separate MR examinations with both spasmolytic agents (HBB intravenous(i.v.) or intramuscular(i.m.), GLU i.v. or i.m., and a combined scheme). The MR protocol included a sagittal 2D cross-section of the small bowel with a temporal resolution of 0.55 s acquired over 60 to 90 min. To quantify bowel motility, small bowel cross-sectional areas were summated over time. RESULTS The anti-peristaltic i.v. effects of HBB and glucagon started on average after 85 s/65 s and ended after 21 min/23.3 min, respectively. By comparison, the anti-peristaltic effects of i.m. HBB and glucagon started significantly later 5.1/11.6 min (P = 0.001; Wilcoxon signed ranks test) and lasted for 17.7/28.2 min with greater inter-individual differences (P = 0.012; Brown-Forsythe test). The combined scheme resulted in a rapid onset after 65 s with effect duration of 31 min. CONCLUSION Anti-peristaltic effects on the small bowel are drug dependant, i.e., their onset is faster and more reliable when administering i.v. than i.m.. Combining i.v. GLU with i.m. HBB provides an early onset of effect, sustained spasmolysis and the highest degree of motility impairment. KEY POINTS • Anti-persitaltic agents are widely used before various diagnostic procedures of the abdomen. • The combination of iv-glucagon with im-hyoscine provides reliable spasmolysis with early onset. • Intravenous spasmolysis is more reliable compared to intramuscular administration. • Intravenous glucagon has a prolonged spasmolytic effect compared to intravenous hyoscine.
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Affiliation(s)
- Andreas Gutzeit
- Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland.
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BLADE acquisition method improves T2-weighted MR images of the female pelvis compared with a standard fast spin-echo sequence. Eur J Radiol 2011; 80:796-801. [DOI: 10.1016/j.ejrad.2010.08.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 07/27/2010] [Accepted: 08/02/2010] [Indexed: 11/23/2022]
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Effect of butylscopolamine on image quality in MRI of the prostate. Clin Radiol 2010; 65:460-4. [PMID: 20451013 DOI: 10.1016/j.crad.2010.02.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 02/05/2010] [Accepted: 02/14/2010] [Indexed: 11/21/2022]
Abstract
AIM To evaluate the impact of butylscopolamine on the quality of magnetic resonance imaging (MRI) images of the prostate. MATERIAL AND METHODS Eighty-two MRI examinations of the prostate were retrospectively analysed. MRI was performed with a combined endorectal/body phased-array coil including proton density-weighted (PD) sequence, T1-weighted turbo spin-echo (TSE)-sequence, and T2-weighted TSE-sequences. Forty milligrams of butylscopolamine was administered intramuscularly in 31 patients (im-group) and intravenously in 30 patients (iv-group). Twenty-one patients did not receive premedication with butylscopolamine (ø-group). Overall image quality, delineation of the bowel wall, and visualization of the prostate, neurovascular bundle, and pelvic lymph nodes were evaluated qualitatively using a five-point scale (from 1=excellent to 5=non-diagnostic/structure not discernible). Motion artefacts within the endorectal coil were quantified by baseline adjusted signal intensities inside the endorectal coil area. RESULTS Delineation of the bowel wall using the PD-sequence was significantly improved after both intramuscular and intravenous butylscopolamine administration (ø-group: 3.6+/-0.7; im-group: 2.9+/-0.7; iv-group: 2.9+/-0.7; p=0.001). However, there were no significant differences in motion artefacts measured within the endorectal coil (ø-group: 1.18+/-0.14; im-group: 1.15+/-0.11; iv-group: 1.12+/-0.06; p=0.39). There were also no significant differences in qualitative assessment of visualization of the prostate, neurovascular bundle, pelvic lymph nodes, and of overall image quality between the study groups. CONCLUSION : In conclusion, butylscopolamine had only a small effect on image quality and is not mandatory for MRI of the prostate.
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Rief M, Wagner M, Franiel T, Bresan V, Taupitz M, Klessen C, Hamm B, Asbach P. Detection of focal liver lesions in unenhanced and ferucarbotran-enhanced magnetic resonance imaging: a comparison of T2-weighted breath-hold and respiratory-triggered sequences. Magn Reson Imaging 2009; 27:1223-9. [DOI: 10.1016/j.mri.2009.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 02/02/2009] [Accepted: 05/06/2009] [Indexed: 11/17/2022]
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Samuels LA. Pharmacotherapy Update: Hyoscine Butylbromide in the Treatment of Abdominal Spasms. ACTA ACUST UNITED AC 2009. [DOI: 10.4137/cmt.s1134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abdominal pain is one of the most common reasons why people seek medical care, and is often due to spasm of intra-abdominal visceral organs. Hyoscine butylbromide (HBB) is a quaternary ammonium compound which blocks the action of acetylcholine at parasympathetic sites (both muscarinic and nicotinic receptors) in smooth muscle, and in secretory glands. It causes decreased motility of the gastrointestinal tract and the urogenital tracts, and is useful in the treatment of spasms in these regions. Side effects are common, but tend to be minor and self limiting. Evidence exists to support its use in the management of non-specific colicky abdominal pain (in adults and children); irritable bowel syndrome; labor and delivery; dysmenorrhea; as an adjunct in the therapy of late stage cancer patients with inoperable bowel malignancies; and to facilitate improved resolution in certain imaging techniques. It may also be useful in certain procedures, such as colonoscopy and sigmoidoscopy, and may be useful in the management of renal colic (although NSAIDs seem clinically superior). The role of HBB in the management of esophageal food obstruction is unclear at this time; further studies need to be done.
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Affiliation(s)
- Leslie A. Samuels
- Department of Obstetrics, Gynaecology and Child Health, University of the West Indies, Mona Campus, Kingston, Jamaica
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Froehlich JM, Daenzer M, von Weymarn C, Erturk SM, Zollikofer CL, Patak MA. Aperistaltic effect of hyoscine N-butylbromide versus glucagon on the small bowel assessed by magnetic resonance imaging. Eur Radiol 2009; 19:1387-93. [PMID: 19190916 DOI: 10.1007/s00330-008-1293-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2008] [Revised: 12/03/2008] [Accepted: 12/13/2008] [Indexed: 12/13/2022]
Abstract
The aim of this prospective study was to compare the intraindividual aperistaltic effect of 40 mg hyoscine N-butylbromide (HBB/Buscopan) with that of 1 mg glucagon on small bowel motility by using magnetic resonance imaging (MRI). Ten healthy volunteers underwent two separate 1.5-T MRI studies (HBB/glucagon) after a standardized oral preparation with an aqueous solution of Gd-DOTA and ispaghula (Metamucil). A 2D T1-w GRE sequence was acquired (TR 2.7 ms/TE 1.3 ms, temporal resolution 0.25 s) before and after intravenous (i.v.) drug administration and motility was followed over 1 h. On the resulting images the cross-sectional luminal diameters were assessed and plotted over time. Baseline motility frequency, onset of aperistalsis, duration of arrest, reappearance of motility and return to normal motility were analysed. Significant differences regarding reliability and duration of aperistalsis were observed. In the HBB group aperistalsis lasted a mean of 6.8 +/- 5.3 min compared with 18.3 +/- 7 min after glucagon (p < 0.0001). In 50% of cases HBB did not accomplish aperistalsis, whereas glucagon always succeeded (p = 0.05). There were no significant differences in terms of baseline and end frequencies for the onset of aperistalsis (22.2 +/- 37.5 s HBB/13.4 +/- 9.2 s glucagon, p = 0.1), nor for the return to normal motility. Arrest of small bowel motion is achieved more reliably and lasts significantly longer after i.v. administration of 1 mg glucagon compared with 40 mg HBB.
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