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Gao T, Wei L, Jiang L, Ma S, Zhang W, Zhang Y, Wu F. Dose-Volume Parameters of Spared Magnetic Resonance Imaging-Defined Active Bone Marrow Predict Hematologic Toxicity in Pelvic Malignancies Patients Undergoing Radiotherapy: A Cohort Study. Technol Cancer Res Treat 2024; 23:15330338241255283. [PMID: 38752234 PMCID: PMC11102680 DOI: 10.1177/15330338241255283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024] Open
Abstract
Background: The objective of this investigation is to evaluate the superiority of dose-volume parameters relying on magnetic resonance imaging (MRI)-defined active bone marrow (ABM) over those based on total bone marrow (TBM) contoured via CT in the prediction of hematologic toxicity (HT) occurrence among patients with pelvic malignancies undergoing radiotherapy. Methods: The clinical data of 116 patients with pelvic malignancies treated with pelvic radiotherapy were analyzed retrospectively. The ABM areas on T1-weighted MRI were contoured. The statistical significance between TBM and ABM dose-volume measures was assessed through the utilization of either Student's t-test or Wilcoxon signed rank test. Logistic and linear regression models were employed to analyze the correlation between dose-volume parameters (V5-V50) and HT occurrence in pelvic ABM and TBM. Receiver operating characteristic (ROC) curves were used to compare predictors of HT2+. Results: There were significant differences in dosimetric parameters between ABM and TBM. Logistic regression analysis showed that ABM V5, ABM V10, ABM V15, ABM V20, and TBM V5 were significantly associated with the occurrence of HT2+ in pelvic malignancies. Linear regression analysis showed that ABM V5, ABM V10, and ABM V15 were significantly associated with white blood cell (WBC), absolute neutrophil count (ANC), hemoglobin (Hb), and lymphocyte (Lym) nadir. ABM V5, ABM V10, ABM V15, and ABM V30 were predictive of HT2+. Conclusions: More accurate prediction of HT in patients receiving pelvic radiotherapy may be achieved by relying on dose-volume parameters of MRI-based ABM. Further prospective studies are needed to confirm this.
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Affiliation(s)
- Ting Gao
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Liqun Wei
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Li Jiang
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Shanshan Ma
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Wei Zhang
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Yong Zhang
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Fang Wu
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
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Guariento A, Sharma P, Andronikou S. MRI features of spinal chronic recurrent multifocal osteomyelitis/chronic non-bacterial osteomyelitis in children. Pediatr Radiol 2023; 53:2092-2103. [PMID: 37204463 DOI: 10.1007/s00247-023-05688-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Spinal lesions in pediatric chronic recurrent multifocal osteomyelitis/chronic non-bacterial osteomyelitis (CRMO/CNO) can cause permanent sequelae; thus, early recognition of these is vital for management. OBJECTIVE To characterize the MR imaging features and patterns of pediatric spinal CRMO/CNO. MATERIALS AND METHODS This cross-section study received IRB approval. The first available MRI with documented spine involvement in children with CRMO/CNO was reviewed by a pediatric radiologist. Descriptive statistics were used to describe the characteristics of vertebral lesions, disc involvement, and soft tissue abnormality. RESULTS Forty-two patients were included (F:M, 30:12); median age was 10 years (range 4-17). At diagnosis, 34/42 (81%) had spine involvement. Kyphosis in 9/42 (21%) and scoliosis in 4/42 (9.5%) patients were present at the time of spinal disease recognition. Vertebral involvement was multifocal in 25/42 (59.5%). Disc involvement was found in 11/42 (26%) patients, commonly in the thoracic spine and often with adjacent vertebrae height loss. Posterior element abnormalities were present in 18/42 patients (43%) and soft tissue involvement in 7/42 (17%). One hundred nineteen vertebrae were affected, commonly the thoracic vertebrae (69/119; 58%). Vertebral body edema was focal in 77/119 (65%) and frequently superior (42/77; 54%). Sclerosis and endplate abnormality were present in 15/119 (13%) and 31/119 (26%) vertebrae, respectively. Height loss was present in 41/119 (34%). CONCLUSION Chronic non-bacterial osteomyelitis of spine is usually thoracic. Vertebral body edema is often focal at the superior vertebral body. Kyphosis and scoliosis occur in a quarter and vertebral height loss in a third of children at spinal disease recognition.
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Affiliation(s)
- Andressa Guariento
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Parth Sharma
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Savvas Andronikou
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Di Primio G, Boyd GJ, Fung CI, Hurrell C, Brahm GL, Bird JR, Co SJ, Kirkpatrick IDC. Recommendations for the Management of Incidental Musculoskeletal Findings on MRI and CT. Can Assoc Radiol J 2023; 74:514-525. [PMID: 36710521 DOI: 10.1177/08465371231152151] [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] [Indexed: 01/31/2023] Open
Abstract
The Canadian Association of Radiologists (CAR) Incidental Findings Working Group consists of both academic subspeciality and general radiologists tasked with either adapting American College of Radiology (ACR) guidelines to meet the needs of Canadian radiologists or authoring new guidelines where appropriate. In this case, entirely new guidelines to deal with incidental musculoskeletal findings that may be encountered on thoracoabdominal computed tomography or magnetic resonance imaging were drafted, focussing on which findings should prompt recommendations for further workup. These recommendations discuss how to deal with incidental marrow changes, focal bone lesions, abnormalities of the pubic symphysis and sacroiliac joints, fatty soft tissue masses, manifestations of renal osteodystrophy and finally discuss opportunistic osteoporosis evaluation.
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Affiliation(s)
- Gina Di Primio
- McMaster University, Hamilton, ON, Canada
- Department of Radiology, Oakville Trafalgar Memorial Hospital (Halton Health Care), Oakville, ON, Canada
| | - Gordon J Boyd
- Department of Radiology, Dalhousie University, Halifax, NS, Canada
| | - Christopher I Fung
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Casey Hurrell
- Canadian Association of Radiologists, Ottawa, ON, Canada
| | - Gary L Brahm
- Department of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Jeffery R Bird
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada
| | - Steven J Co
- University of British Columbia, Vancouver, BC, Canada
| | - Iain D C Kirkpatrick
- Department of Diagnostic Radiology, University of Manitoba, Winnipeg, MB, Canada
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Omorogbe E, Stormo J. Sonographic Detection of Hepatic Abscesses. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2022. [DOI: 10.1177/87564793221076760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hepatic abscesses are masses or lesions within the liver as a response to an infection manifesting into the liver. Hepatic abscess can be a result of other abdominal diseases, such as any biliary tract disease or appendicitis. Because of its inconsistent characteristics in many imaging modalities, its appearance can be mistaken for other pathologies like liver metastasis. With the use of one or more imaging modalities and an imaging-guided biopsy of the targeted lesion, hepatic abscess can be confirmed. The case presents multiple hepatic abscesses throughout the liver with similar imaging characteristics as that of metastasis. Computed tomography (CT), sonography, magnetic resonance imaging, and a biopsy were performed to successfully diagnose the hepatic abscesses.
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Affiliation(s)
- Etinosa Omorogbe
- Diagnostic Medical Ultrasound Program, University of Missouri-Columbia, MO, USA
| | - Janell Stormo
- Diagnostic Medical Ultrasound Program, University of Missouri-Columbia, MO, USA
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Mora-Bravo F, Muñoz J. Impaired Reconversion of Bone Marrow in Nuclear Magnetic Resonance in Patients with Chronic Renal Disease. Curr Med Imaging 2020; 17:1256-1261. [PMID: 33213332 DOI: 10.2174/1573405616999201118140832] [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: 06/04/2020] [Revised: 10/08/2020] [Accepted: 10/15/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Anemia is one of the main consequences of Chronic Kidney Disease (CKD), which causes a bone marrow response determined by Magnetic Resonance Imaging. OBJECTIVE The objective of this study was to identify Bone Marrow Reconversion (BMR) by nuclear magnetic resonance imaging in patients with CKD. METHODS A descriptive study was carried in "José Carrasco Arteaga" Hospital, Cuenca-Ecuador. Images of the femurs of patients diagnosed with CKD were acquired by magnetic resonance imaging. Several variables, including age, sex, CKD stage, anemia and BMR, were taken into account. Groups are analyzed according to the stages CKD with the Anova test and logistic regression is obtained for the BMR event with the study variables. RESULTS Two hundred sixteen patients were included in this analysis. Prevalences of Anemia were 2/40 (5%) in Group 1, 3/35 (8.6%) in group 2, 17/56 (30.4%) in group 3, 23/46 (50%) in group 4 and 25/39 (64.1%) in group 5, Anova P<0.0001. BMR in Group 1 was 12 cases (30%), in group 2: 4 cases (11.4%), in group 3: 18 cases (32.1%), in group 4: 13 cases (28.3%), and group 5: 17 cases (43.6%). P=0.51. Regression equation for BMR were significant with sex (male) OR 0.193 (CI95% 0.092-0.405) P<0.0001, CKD Stage 1 OR 0.195 (0.057-0.668) P=0.009, Stage 2 OR 0.082 (0.020-0.329). Other variables were not significant. CONCLUSION In this study, we describe that there is an impaired Reconversion of Bone Marrow in Nuclear Magnetic Resonance Imaging in Patients with Chronic Renal Disease in stages 3, 4 and 5, despite the progressive presence of anemia. The female sex is associated with the presence of bone marrow reconversion. No statistical dependence was observed between anemia and the reconversion of bone marrow.
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Affiliation(s)
- Franklin Mora-Bravo
- Department of Internal Medicine, Faculty of Medicine, University of Cuenca, Cuenca, Ecuador
| | - Javier Muñoz
- Department of Radiology, Faculty of Medicine, University of Cuenca, Cuenca, Ecuador
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Kuncman Ł, Stawiski K, Masłowski M, Kucharz J, Fijuth J. Dose-volume parameters of MRI-based active bone marrow predict hematologic toxicity of chemoradiotherapy for rectal cancer. Strahlenther Onkol 2020; 196:998-1005. [PMID: 32621010 PMCID: PMC7653786 DOI: 10.1007/s00066-020-01659-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 06/13/2020] [Indexed: 01/22/2023]
Abstract
Purpose Magnetic resonance imaging (MRI) is routinely used for locoregional staging of rectal cancer and offers promise for the prediction of hematologic toxicity. The present study compares the clinical utility of MRI-based active bone marrow (BMact) delineation with that of CT-based bone marrow total (BMtot) delineation for predicting hematologic toxicity. Methods A prospective cohort study was performed. Eligible patients had stage II/III rectal cancer and qualified for preoperative chemoradiotherapy. The BMact areas on T1-weighted MRI were contoured. The impact of the dose–volume parameters of BMact/BMtot and clinical data on hematologic toxicity were assessed. Basic endpoints were the occurrence of grade 3/4 hematologic toxicity and peripheral blood parameters reaching a nadir. Linear regression models were generated for the nadirs and receiver operating characteristic (ROC) curves for the occurrence of grade 3/4 hematologic toxicity. Results Thirty-five patients were enrolled. Women presented higher dose–volume parameters of BMact, BMtot, and lymphocyte nadir (ALCnadir%) than men. Models for the prediction of ALCnadir% (V5-V20BMtot, V5-V30BMact) and platelet nadir (PLTnadir%; V5-V10BMtot, V5-V20BMact) were statistically significant. In the ROC curves, a baseline lymphocyte level of 1.81 × 103/ml was adopted as the cutoff for predicting grade 3/4 lymphopenia, with specificity of 77.8% and sensitivity of 73.1%. The multivariate linear regression model for ALCnadir% had R2 = 0.53, p = 0.038. In the tenth step of selection, V5BMact (p = 0.002) and gender (p = 0.019) remained. The multivariate linear regression model for PLTnadir% had R2 = 0.20, p = 0.34. In the sixth step of selection, V15BMact remained (p = 0.026). Conclusion The dose–volume parameters of BMact serve as better predictors of ALCnadir% and PLTnadir% than BMtot.
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Affiliation(s)
- Łukasz Kuncman
- Department of Radiotherapy, Medical University of Lodz, Zakład Radioterapii, W.W.C.O.iT. im. M. Kopernika w Łodzi, Pabianicka 62 street, 93-513, Łódź, Poland. .,Department of External Beam Radiotherapy, Regional Cancer Center, Copernicus Memorial Hospital of Lodz, Zakład Teleradioterapii, Wojewódzkie W.W.C.O.iT. im. M. Kopernika w Łodzi, Pabianicka 62 street, 93-513, Łódź, Poland.
| | - Konrad Stawiski
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Zakład Biostatystyki i Medycyny Translacyjnej, Cenrum Mazowiecka 15 street, 92-215, Łódź, Poland
| | - Michał Masłowski
- Department of External Beam Radiotherapy, Regional Cancer Center, Copernicus Memorial Hospital of Lodz, Zakład Teleradioterapii, Wojewódzkie W.W.C.O.iT. im. M. Kopernika w Łodzi, Pabianicka 62 street, 93-513, Łódź, Poland
| | - Jakub Kucharz
- Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology Warsaw, Klinika Nowotworów Układu Moczowego, Centrum Onkologii-Instytut im. Marii Skłodowskiej-Curie ul. Roentgena 5, 02-781, Warszawa, Poland
| | - Jacek Fijuth
- Department of Radiotherapy, Medical University of Lodz, Zakład Radioterapii, W.W.C.O.iT. im. M. Kopernika w Łodzi, Pabianicka 62 street, 93-513, Łódź, Poland.,Department of External Beam Radiotherapy, Regional Cancer Center, Copernicus Memorial Hospital of Lodz, Zakład Teleradioterapii, Wojewódzkie W.W.C.O.iT. im. M. Kopernika w Łodzi, Pabianicka 62 street, 93-513, Łódź, Poland
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Zhao F, Shen J, Yu X, Zhou H, Lu Z, Yan S. Bone marrow reconversion mimicking pelvis metastases in a patient with rectal cancer: a pitfall on magnetic resonance images. Quant Imaging Med Surg 2018; 8:621-626. [PMID: 30140624 PMCID: PMC6081354 DOI: 10.21037/qims.2018.07.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/30/2018] [Indexed: 01/14/2023]
Affiliation(s)
- Feng Zhao
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Jiayan Shen
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Xiaokai Yu
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Hua Zhou
- Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Zhongjie Lu
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Senxiang Yan
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
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Romeo V, Cavaliere C, Sorrentino C, Ponsiglione A, Ugga L, Barbuto L, Verde F, Covello M. Clinical impact of coronal-STIR sequence in a routine lumbar spine MR imaging protocol to investigate low back pain. Medicine (Baltimore) 2018; 97:e10789. [PMID: 29879016 PMCID: PMC5999459 DOI: 10.1097/md.0000000000010789] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aim of this study is to assess the clinical impact of coronal short tau inversion recovery (STIR)-weighted magnetic resonance (MR) sequence, when acquired in a lumbar spine MR imaging protocol, in detecting significant extraspinal imaging findings in patients with low back pain (LBP).We retrospectively evaluated 931 lumbar spine MR examinations of patients with LBP. Extraspinal MR imaging findings were categorized as: probably related to LBP (Category 1), not related to LBP but with relevant implications on patient's care (Category 2), and not related to LBP without significant implications on patient's care (Category 3). For each MR imaging finding was also assessed if it was detectable or not on the conventional sagittal and axial acquisition planes.Of the 931 evaluated MR examinations, 60 (6.4%) showed additional extraspinal MR imaging findings, categorized as follows: 55% (33/60) probably related to LBP (Category 1), 22% (13/60) not related to LBP but with relevant implications on patient's care (Category 2), and 23% (14/60) not related to LBP and without significant implications on patient's care (Category 3). Among categories 1 and 2 (n = 46), the 72% (33/46) of imaging findings were detected only on coronal plane. Coronal-STIR sequence significantly changed patients' diagnostic work-flow in 3.5% (33/931) of cases.Coronal STIR sequence, acquired in a lumbar spine MR imaging protocol to investigate LBP, may aid radiologists in detecting additional extraspinal MR imaging findings that could be related to LBP, addressing to the most appropriate clinical management.
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Affiliation(s)
- Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples Federico II
| | | | | | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples Federico II
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples Federico II
| | - Luigi Barbuto
- Department of Advanced Biomedical Sciences, University of Naples Federico II
| | - Francesco Verde
- Department of Advanced Biomedical Sciences, University of Naples Federico II
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