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Wei L, Wahyulaksana G, Te Lintel Hekkert M, Beurskens R, Boni E, Ramalli A, Noothout E, Duncker DJ, Tortoli P, van der Steen AFW, de Jong N, Verweij M, Vos HJ. High-Frame-Rate Volumetric Porcine Renal Vasculature Imaging. Ultrasound Med Biol 2023; 49:2476-2482. [PMID: 37704558 DOI: 10.1016/j.ultrasmedbio.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/02/2023] [Accepted: 08/08/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE The aim of this study was to assess the feasibility and imaging options of contrast-enhanced volumetric ultrasound kidney vasculature imaging in a porcine model using a prototype sparse spiral array. METHODS Transcutaneous freehand in vivo imaging of two healthy porcine kidneys was performed according to three protocols with different microbubble concentrations and transmission sequences. Combining high-frame-rate transmission sequences with our previously described spatial coherence beamformer, we determined the ability to produce detailed volumetric images of the vasculature. We also determined power, color and spectral Doppler, as well as super-resolved microvasculature in a volume. The results were compared against a clinical 2-D ultrasound machine. RESULTS Three-dimensional visualization of the kidney vasculature structure and blood flow was possible with our method. Good structural agreement was found between the visualized vasculature structure and the 2-D reference. Microvasculature patterns in the kidney cortex were visible with super-resolution processing. Blood flow velocity estimations were within a physiological range and pattern, also in agreement with the 2-D reference results. CONCLUSION Volumetric imaging of the kidney vasculature was possible using a prototype sparse spiral array. Reliable structural and temporal information could be extracted from these imaging results.
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Affiliation(s)
- Luxi Wei
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Geraldi Wahyulaksana
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Robert Beurskens
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Enrico Boni
- Department of Information Engineering, University of Florence, Florence, Italy
| | - Alessandro Ramalli
- Department of Information Engineering, University of Florence, Florence, Italy
| | - Emile Noothout
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Dirk J Duncker
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Piero Tortoli
- Department of Information Engineering, University of Florence, Florence, Italy
| | - Antonius F W van der Steen
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Nico de Jong
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Martin Verweij
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Hendrik J Vos
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
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Tang Y, Li X, Jiang Q, Zhai L. Diagnostic accuracy of multiparametric ultrasound in the diagnosis of prostate cancer: systematic review and meta-analysis. Insights Imaging 2023; 14:203. [PMID: 38001351 PMCID: PMC10673798 DOI: 10.1186/s13244-023-01543-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/15/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES Ultrasound (US) technology has recently made advances that have led to the development of modalities including elastography and contrast-enhanced ultrasound. The use of different US modalities in combination may increase the accuracy of PCa diagnosis. This study aims to assess the diagnostic accuracy of multiparametric ultrasound (mpUS) in the PCa diagnosis. METHODS Through September 2023, we searched through Cochrane CENTRAL, PubMed, Embase, Scopus, Web of Science, ClinicalTrial.gov, and Google Scholar for relevant studies. We used standard methods recommended for meta-analyses of diagnostic evaluation. We plot the SROC curve, which stands for summary receiver operating characteristic. To determine how confounding factors affected the results, meta-regression analysis was used. RESULTS Finally, 1004 patients from 8 studies that were included in this research were examined. The diagnostic odds ratio for PCa was 20 (95% confidence interval (CI), 8-49) and the pooled estimates of mpUS for diagnosis were as follows: sensitivity, 0.88 (95% CI, 0.81-0.93); specificity, 0.72 (95% CI, 0.59-0.83); positive predictive value, 0.75 (95% CI, 0.63-0.87); and negative predictive value, 0.82 (95% CI, 0.71-0.93). The area under the SROC curve was 0.89 (95% CI, 0.86-0.92). There was a significant heterogeneity among the studies (p < 0.01). According to meta-regression, both the sensitivity and specificity of mpUS in the diagnosis of clinically significant PCa (csPCa) were inferior to any PCa. CONCLUSION The diagnostic accuracy of mpUS in the diagnosis of PCa is moderate, but the accuracy in the diagnosis of csPCa is significantly lower than any PCa. More relevant research is needed in the future. CRITICAL RELEVANCE STATEMENT This study provides urologists and sonographers with useful data by summarizing the accuracy of multiparametric ultrasound in the detection of prostate cancer. KEY POINTS • Recent studies focused on the role of multiparametric ultrasound in the diagnosis of prostate cancer. • This meta-analysis revealed that multiparametric ultrasound has moderate diagnostic accuracy for prostate cancer. • The diagnostic accuracy of multiparametric ultrasound in the diagnosis of clinically significant prostate cancer is significantly lower than any prostate cancer.
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Affiliation(s)
- Yun Tang
- Department of Geriatric Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
- Longmen Hao Street Community Health Service Center, Nan'an District, Chongqing, 401336, China
| | - Xingsheng Li
- Department of Geriatric Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Qing Jiang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
| | - Lingyun Zhai
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
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Lima MG, Jussiani EI, Andrello AC, Zequi JAC, Kawabata EK. Potentialities of iodine-enhanced micro-CT imaging in the morphological study of adult Aedes (Stegomyia) aegypti (Linnaeus, 1762) mosquitoes. Micron 2023; 173:103518. [PMID: 37531794 DOI: 10.1016/j.micron.2023.103518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/19/2023] [Accepted: 07/19/2023] [Indexed: 08/04/2023]
Abstract
X-ray micro-computed tomography (CT) produces three-dimensional images of samples on a micrometer scale. This technique has several advantages, such as its nondestructive character and low measurement time, compared with other techniques. However, when applied to biological samples of soft tissue, the low attenuation and low effective contrast between structures pose difficulties in creating appropriate images for morphological studies. Diffusible iodine-based contrast-enhanced CT (DICE-CT), which uses iodine solutions to enhance contrast, is a viable alternative for addressing the aforementioned challenges. Given the variety of biological samples, an appropriate methodology must be adapted depending on the dimensions and morphological characteristics of the investigated object. A specimen that has not been morphologically studied by micro-CT and is of high sanitary importance is the adult Aedes aegypti mosquito. This study investigated the stage of iodine staining in the treatment of the A. aegypti mosquito to determine the most suitable staining time for the morphological study of this mosquito in adulthood. After determining the appropriate staining time, we discuss the potential of applying DICE-CT and methodology to mosquito studies. Seven A. aegypti females were treated using fixation steps with Bouin's solution, dehydration in a graded ethanol series, staining with iodine solution (1%), and washing in absolute ethanol. Only the staining step was different between samples. Each mosquito spent a varying amount of time (6-72 h) in the iodine solution (1%). For comparison, one of the mosquitoes was not stained. After treatment, the samples were scanned using the Bruker SkyScan 1172 micro-CT scanner. The reconstructed volumes and histograms were compared to determine the most suitable time. In addition, a quantitative analysis was performed based on a comparison of the attenuation profiles of the mosquito brains. Thereafter, the most suitable treatment process was selected, and two other samples were scanned after applying the selected process. Although fewer than 18 h was insufficient for an effective increase in attenuation and effective contrast, surpassing 24 h proved unnecessary and resulted in saturating the gray tones visualized through the histograms, leading to information loss. Therefore, a time of approximately 24 h was the most suitable staining time for studying adult A. aegypti. It was possible to isolate the organs of the digestive and reproductive systems of the mosquito stained for 24 h. Thus, micro-CT was confirmed to be an excellent technique in studies of individual structures of adult A. aegypti mosquitoes.
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Affiliation(s)
- Mateus Gruener Lima
- Applied Nuclear Physics Research Group, State University of Londrina, Rodovia Celso Garcia Cid/PR 445 Km 380, 86057-970 Londrina, Paraná, Brazil.
| | - Eduardo Inocente Jussiani
- Applied Nuclear Physics Research Group, State University of Londrina, Rodovia Celso Garcia Cid/PR 445 Km 380, 86057-970 Londrina, Paraná, Brazil
| | - Avacir Casanova Andrello
- Applied Nuclear Physics Research Group, State University of Londrina, Rodovia Celso Garcia Cid/PR 445 Km 380, 86057-970 Londrina, Paraná, Brazil
| | - João Antonio Cyrino Zequi
- Laboratory of Medical and General Entomology, State University of Londrina, Rodovia Celso Garcia Cid/PR 445 Km 380, 86057-970 Londrina, Paraná, Brazil
| | - Edson Kenji Kawabata
- Laboratory of Medical and General Entomology, State University of Londrina, Rodovia Celso Garcia Cid/PR 445 Km 380, 86057-970 Londrina, Paraná, Brazil
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Otsuka Y, Kamata K. A review of contrast-enhanced harmonic endoscopic ultrasonography for pancreatic solid tumors. J Med Ultrason (2001) 2023:10.1007/s10396-023-01346-3. [PMID: 37584780 DOI: 10.1007/s10396-023-01346-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/15/2023] [Indexed: 08/17/2023]
Abstract
Endoscopic ultrasonography (EUS) is superior to other imaging modalities in the detection of pancreatic masses, although differentiating the types of pancreatic masses detected on EUS remains challenging. However, the value of contrast-enhanced harmonic EUS (CH-EUS) using ultrasound contrast agents for this differentiation has been reported. CH-EUS plays a pivotal role in analysis of small lesions that can only be detected with EUS. Recently, CH-EUS was used for staging and/or determining the resectability of pancreatic cancer in several clinical trials. In addition, it is used to estimate the response of pancreatic cancer to chemotherapy and to determine the prognosis in cases of pancreatic cancer and pancreatic neuroendocrine neoplasms. It is also postulated that CH-EUS improves the diagnostic performance of endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) through complementary diagnoses using CH-EUS and EUS-FNAB, or CH-EUS-guided EUS-FNAB. Thus, CH-EUS has been employed for various qualitative diagnoses, including differentiation of pancreatic masses. Second-generation contrast agents such as Sonazoid are used clinically for ultrasound diagnostic imaging of liver and breast disease. The positioning of CH-EUS with Sonazoid as a test for the diagnosis of solid pancreatic tumors is an issue for further studies.
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Affiliation(s)
- Yasuo Otsuka
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Ken Kamata
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.
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Wilsen CB, Patel MK, Douek ML, Masamed R, Dittmar KM, Lu DSK, Raman SS. Contrast-enhanced ultrasound for abdominal image-guided procedures. Abdom Radiol (NY) 2023; 48:1438-1453. [PMID: 36853392 DOI: 10.1007/s00261-023-03804-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
INTRODUCTION Since FDA approval for contrast-enhanced ultrasound (CEUS), clinical applications have increased to include diagnostic imaging of hepatic, renal, and other abdominal lesions. The modality has also demonstrated utility in certain image-guided procedures. Intravascular ultrasound contrast agents use microbubbles to improve visibility of solid tumors. Lesions not well seen on grayscale or Doppler ultrasound may become amenable to CEUS-guided biopsy or ablation. MATERIALS AND METHODS This pictorial essay provides eleven examples to illustrate the current use of CEUS in a variety of abdominal image-guided procedures. Hepatic, renal, peritoneal, and soft tissue cases are presented. CONCLUSION CEUS can improve visualization and targeting in abdominal image-guided procedures, without nephrotoxicity or radiation exposure.
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Affiliation(s)
- Craig B Wilsen
- UCLA Department of Radiological Sciences, University of California Los Angeles, David Geffen School of Medicine, 757 Westwood Plaza, Los Angeles, CA, 90095, USA.
| | - Maitraya K Patel
- UCLA Department of Radiological Sciences, University of California Los Angeles, David Geffen School of Medicine, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Michael L Douek
- UCLA Department of Radiological Sciences, University of California Los Angeles, David Geffen School of Medicine, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Rinat Masamed
- UCLA Department of Radiological Sciences, University of California Los Angeles, David Geffen School of Medicine, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | | | - David S K Lu
- UCLA Department of Radiological Sciences, University of California Los Angeles, David Geffen School of Medicine, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Steven S Raman
- UCLA Department of Radiological Sciences, University of California Los Angeles, David Geffen School of Medicine, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
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Chang GY, Fetzer DT, Porembka MR. Contrast-Enhanced Intraoperative Ultrasound of the Liver. Surg Oncol Clin N Am 2022; 31:707-719. [PMID: 36243503 DOI: 10.1016/j.soc.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Contrast-enhanced intraoperative ultrasound (CE-IOUS) is a relatively new but valuable tool that is increasingly used as an adjunct to computed tomography, MRI, and IOUS for patients undergoing liver surgery. CE-IOUS has an important role in 2 main settings: the discrimination of indeterminate lesions detected in cirrhotic livers by conventional IOUS and in the detection of colorectal liver metastasis that may be overlooked by other imaging modalities. The intraoperative nature of the imaging and interpretation allows for CE-IOUS to directly affect surgical decision-making that may importantly affect patient outcomes.
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Affiliation(s)
- Gloria Y Chang
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - David T Fetzer
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, E6-230-BF, Dallas, TX 75390-9316, USA
| | - Matthew R Porembka
- Division of Surgical Oncology, Department of Surgery, Dedman Family Scholar in Clinical Care, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, NB2.340, Dallas, TX 75390, USA.
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Golemati S, Cokkinos DD. Recent advances in vascular ultrasound imaging technology and their clinical implications. Ultrasonics 2022; 119:106599. [PMID: 34624584 DOI: 10.1016/j.ultras.2021.106599] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/26/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
In this paper recent advances in vascular ultrasound imaging technology are discussed, including three-dimensional ultrasound (3DUS), contrast-enhanced ultrasound (CEUS) and strain- (SE) and shear-wave-elastography (SWE). 3DUS imaging allows visualisation of the actual 3D anatomy and more recently of flow, and assessment of geometrical, morphological and mechanical features in the carotid artery and the aorta. CEUS involves the use of microbubble contrast agents to estimate sensitive blood flow and neovascularisation (formation of new microvessels). Recent developments include the implementation of computerised tools for automated analysis and quantification of CEUS images, and the possibility to measure blood flow velocity in the aorta. SE, which yields anatomical maps of tissue strain, is increasingly being used to investigate the vulnerability of the carotid plaque, but is also promising for the coronary artery and the aorta. SWE relies on the generation of a shear wave by remote acoustic palpation and its acquisition by ultrafast imaging, and is useful for measuring arterial stiffness. Such advances in vascular ultrasound technology, with appropriate validation in clinical trials, could positively change current management of patients with vascular disease, and improve stratification of cardiovascular risk.
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Affiliation(s)
- Spyretta Golemati
- Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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Ramirez-Suarez KI, Tierradentro-Garcia LO, Smith CL, Krishnamurthy G, Escobar FA, Otero HJ, Rapp JB, Dori Y, Biko DM. Dynamic contrast-enhanced magnetic resonance lymphangiography. Pediatr Radiol 2022; 52:285-94. [PMID: 33830292 DOI: 10.1007/s00247-021-05051-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/25/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
Lymphatic flow disorders include a broad spectrum of abnormalities that can originate in the lymphatic or the venous system. The development of these disorders is multifactorial and is most commonly associated with congenital heart diseases and palliative surgeries that these patients undergo. Central lymphatic disorders might be secondary to traumatic leaks, lymphatic overproduction, conduction abnormalities or lymphedema, and they can progress to perfusion anomalies. Several imaging modalities have been used to visualize the lymphatic system. However, the imaging of central lymphatic flow has always been challenging. Dynamic contrast-enhanced magnetic resonance lymphangiography (DCMRL) allows for visualization of central lymphatic flow disorders and has been recently applied for the assessment of plastic bronchitis, protein-losing enteropathy, chylothorax and chylopericardium, among other lymphatic disorders. The hepatic and mesenteric accesses are innovative and promising techniques for better identification and understanding of these abnormalities. The main objectives of this review are to discuss the physiology and anatomy of the lymphatic system and review the current uses of DCMRL in the diagnosis and management of lymphatic flow disorders.
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Rossmann T, Reissig LF, Pfisterer WK, Grisold W, Weninger WJ, Meng S. Angiosomes of the Ulnar Nerve at the Elbow: A Cadaver Trial Using Contrast-Enhanced Ultrasound. Ultrasound Med Biol 2021; 47:3393-3402. [PMID: 34479732 DOI: 10.1016/j.ultrasmedbio.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/12/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
Three major arteries supplying the ulnar nerve in the cubital tunnel are commonly known. However, their vascular territories (angiosomes) have not been described yet. Contrast-enhanced ultrasound was used to identify the angiosomes of posterior ulnar recurrent artery, inferior ulnar collateral artery and superior ulnar collateral artery in 20 fresh, non-frozen human body donors. The arteries were cannulated, and physiologic blood flow was simulated. Contrast agent was applied in each vessel in a randomized sequence, and the length of the contrast-enhancing ulnar nerve segment was measured by a radiologist blinded to the sequence. The angiosome of the posterior ulnar recurrent artery overlaps both other angiosomes. It fully covers the cubital tunnel in 63.6% of specimens. In addition, collateral flow via nerve and muscle branches of the arterial anastomotic network around the elbow (rete articulare cubiti) partly maintains the intra-neural blood flow in the absence of a vascular pedicle. The posterior ulnar recurrent artery is the dominant nutrient vessel of the ulnar nerve in the cubital tunnel. A potential watershed zone exists proximal to the Osborne ligament. Knowledge of these angiosomes may advance surgery of the ulnar nerve in the cubital tunnel.
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Affiliation(s)
- Tobias Rossmann
- Division of Anatomy, Medical University of Vienna, Vienna, Austria; Department of Neurosurgery, Neuromed Campus, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Lukas F Reissig
- Division of Anatomy, Medical University of Vienna, Vienna, Austria
| | | | - Wolfgang Grisold
- Neurology Consultancy Unit, Division of Anatomy, Medical University of Vienna, Vienna, Austria
| | | | - Stefan Meng
- Division of Anatomy, Medical University of Vienna, Vienna, Austria; Department of Radiology, Hanusch Hospital, Vienna, Austria.
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Agrawal A, Prakash A, Choudhury S, Mv M, Jain Y, Purandare N, Puranik A, Shah S, Rangarajan V. 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Postsurgical and Postprocedural Setting in Thorax and Abdominopelvic Malignancies: A Pictorial Essay (Part II). Indian J Nucl Med 2021; 36:319-326. [PMID: 34658561 PMCID: PMC8481839 DOI: 10.4103/ijnm.ijnm_223_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/14/2020] [Indexed: 11/22/2022] Open
Abstract
This pictorial essay depicts normal appearances, complications and residual or recurrent disease on fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) studies in the postsurgical and postprocedural setting, other than head and neck malignancy. Reading and reporting FDG PET/CT in this scenario is daunting due to the multiple confounding false positives seen during this period. This article which is the second part in this series will familiarize the readers with the normal appearance and pitfalls seen in FDG PET/CT studies in thoracic and abdominopelvic malignancies during the postoperative and postprocedural period so as to avoid misinterpretations.
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Affiliation(s)
- Archi Agrawal
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, HBNI (Homi Bhabha National Institute), Parel, Mumbai, India
| | - Anjali Prakash
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, HBNI (Homi Bhabha National Institute), Parel, Mumbai, India
| | - Sayak Choudhury
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, HBNI (Homi Bhabha National Institute), Parel, Mumbai, India
| | - Manikandan Mv
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, HBNI (Homi Bhabha National Institute), Parel, Mumbai, India
| | - Yash Jain
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, HBNI (Homi Bhabha National Institute), Parel, Mumbai, India
| | - Nilendu Purandare
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, HBNI (Homi Bhabha National Institute), Parel, Mumbai, India
| | - Ameya Puranik
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, HBNI (Homi Bhabha National Institute), Parel, Mumbai, India
| | - Sneha Shah
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, HBNI (Homi Bhabha National Institute), Parel, Mumbai, India
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, HBNI (Homi Bhabha National Institute), Parel, Mumbai, India
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Ma X, Qiang J, Zhang G, Cai S, Ma F, Liu J. Evaluation of the Depth of Myometrial Invasion of Endometrial Carcinoma: Comparison of Orthogonal Pelvis-axial Contrast-enhanced and Uterus-axial Dynamic Contrast-enhanced MRI Protocols. Acad Radiol 2021; 29:e119-e127. [PMID: 34645571 DOI: 10.1016/j.acra.2021.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 11/01/2022]
Abstract
RATIONALE AND OBJECTIVES To compare the diagnostic performance of orthogonal pelvis-axial (OPA) contrast-enhanced (CE) and orthogonal uterus-axial (OUA) dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) protocols in assessing the depth of myometrial invasion (MI) of endometrial carcinoma (EC). MATERIALS AND METHODS Preoperative MRI of 398 consecutive EC patients (197 patients with OPA CE-MRI protocol and 201 patients with OUA DCE-MRI protocol) was analyzed. Two radiologists independently interpreted the depth of MI, with postoperative histopathology as the reference standard. The chi-square test, Fisher's exact test, and receiver operating characteristic curve analysis were used for diagnostic performance comparison. RESULTS OUA DCE-MRI showed a significantly larger area under the curve than OPA CE-MRI in detecting the presence of MI for radiologist 1 (0.71 versus 0.49, p < 0.05) but not for radiologist 2 or deep MI (all p > 0.05). Compared to OPA CE-MRI, OUA DCE-MRI significantly improved the diagnostic accuracy of non-MI and superficial MI (radiologist 1: 45.5% versus 0 and 88.7% versus 86.4%, p = 0.045 and 0.567, respectively; radiologist 2: 45.5% versus 12.5% and 88.7% versus 78.8%, p = 0.177 and 0.027, respectively) and of EC with adenomyosis/submucous myomas, cornual tumor, and antero-posterior diameter ≤ 10 mm (radiologist 1: 86.4% versus 71.4%, 91.2% versus 67.7%, and 90.1% versus 81.1%, p = 0.048, 0.018, and 0.081, respectively; radiologist 2: 86.4% versus 64.3%, 88.2% versus 64.5%, and 87.0% versus 71.6%, p = 0.006, 0.023, and 0.019, respectively). CONCLUSION The OUA DCE-MRI protocol was superior to the OPA CE-MRI protocol in assessing the depth of MI of EC.
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Agrawal A, Prakash A, Choudhury S, Manikandan MV, Jain Y, Purandare N, Puranik A, Shah S, Rangarajan V. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Postsurgical Setting in Head and Neck Cancers - A Pictorial Essay. Indian J Nucl Med 2021; 36:195-200. [PMID: 34385794 PMCID: PMC8320815 DOI: 10.4103/ijnm.ijnm_204_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 11/06/2022] Open
Abstract
This pictorial essay depicts normal appearances, complications, and findings of residual and/or recurrent disease on fluorodeoxyglucose positron emission tomography/computed tomography (18F- FDG PET/CT) studies in the postsurgical setting. Reading and reporting 18F- FDG PET/CT in the postoperative scenario is demanding due to the multiple false positives seen during this period. This article which contains two parts will familiarize the readers with the normal appearance and pitfalls seen in 18F- FDG PET/CT studies during the postoperative period so as to avoid misinterpretations. This pictorial will discuss 18F- FDG PET/CT in the postoperative scenario in head and neck cancers.
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Affiliation(s)
- Archi Agrawal
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Anjali Prakash
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sayak Choudhury
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - M V Manikandan
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Yash Jain
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Nilendu Purandare
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Ameya Puranik
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sneha Shah
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Shibutani K, Okada M, Tsukada J, Ibukuro K, Abe H, Matsumoto N, Midorikawa Y, Moriyama M, Takayama T. Predictive value of combined computed tomography volumetry and magnetic resonance elastography for major complications after liver resection. Abdom Radiol (NY) 2021; 46:3193-204. [PMID: 33683428 DOI: 10.1007/s00261-021-02991-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 02/01/2021] [Accepted: 02/11/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE To retrospectively compare the predictive value of computed tomography volumetry (CTV), magnetic resonance elastography (MRE) of the liver, and their combination for major complications after liver resection. METHODS We enrolled 108 consecutive patients who underwent anatomical liver resection for liver tumors and preoperative contrast-enhanced CT and MRE. The future liver remnant (FLR) ratio was calculated by CTV, while the liver stiffness measurement (LSM) was obtained by MRE. FLR ratio alone, LSM alone, and combined FLR ratio and LSM were evaluated to predict major complications (Clavien-Dindo grade ≥ IIIa). Univariate and multivariate analyses of hepatic biochemical parameters and imaging data were performed to identify predictors of major complications. Receiver operating characteristic analyses of FLR ratio, LSM, and their combination were performed, and the sensitivity and specificity were calculated. RESULTS Twenty-two (20.4%) of the 108 patients experienced major complications. According to multiple regression analysis, the FLR ratio (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.91-0.99, p = 0.040) and LSM (OR 1.72, 95% CI 1.01-2.94, p = 0.047) were independent predictors of major complications. The combined FLR ratio and LSM were predictive of major complications, with an area under the curve (AUC) of 0.818, sensitivity of 68.2%, and specificity of 84.9%. The AUC and specificity for combined FLR ratio and LSM were larger than those for FLR ratio (AUC: 0.711, specificity: 80.2%) and LSM (AUC: 0.793, specificity: 80.2%). CONCLUSION Combined CTV and MRE analysis can improve the AUC and specificity for predicting major complications after anatomical liver resection.
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14
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Verheggen ICM, Freeze WM, de Jong JJA, Jansen JFA, Postma AA, van Boxtel MPJ, Verhey FRJ, Backes WH. Application of contrast-enhanced magnetic resonance imaging in the assessment of blood-cerebrospinal fluid barrier integrity. Neurosci Biobehav Rev 2021; 127:171-183. [PMID: 33930471 DOI: 10.1016/j.neubiorev.2021.04.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/15/2021] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Abstract
VERHEGGEN, I.C.M., W. Freeze, J. de Jong, J. Jansen, A. Postma, M. van Boxtel, F. Verhey and W. Backes. The application of contrast-enhanced MRI in the assessment of blood-cerebrospinal fluid barrier integrity. Choroid plexus epithelial cells form a barrier that enables active, bidirectional exchange between the blood plasma and cerebrospinal fluid (CSF), known as the blood-CSF barrier (BCSFB). Through its involvement in CSF composition, the BCSFB maintains homeostasis in the central nervous system. While the relation between blood-brain barrier disruption, aging and neurodegeneration is extensively studied using contrast-enhanced MRI, applying this technique to investigate BCSFB disruption in age-related neurodegeneration has received little attention. This review provides an overview of the current status of contrast-enhanced MRI to assess BCSFB permeability. Post-contrast ventricular gadolinium enhancement has been used to indicate BCSFB permeability. Moreover, new techniques highly sensitive to low gadolinium concentrations in the CSF, for instance heavily T2-weighted imaging with cerebrospinal fluid suppression, seem promising. Also, attempts are made at using other contrast agents, such as manganese ions or very small superparamagnetic iron oxide particles, that seem to be cleared from the brain at the choroid plexus. Advancing and applying new developments such as these could progress the assessment of BCSFB integrity.
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Affiliation(s)
- Inge C M Verheggen
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands.
| | - Whitney M Freeze
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, P.O. Box 9600, 2300 RC Leiden, the Netherlands
| | - Joost J A de Jong
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands
| | - Jacobus F A Jansen
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands
| | - Alida A Postma
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands
| | - Martin P J van Boxtel
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - Frans R J Verhey
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - Walter H Backes
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands; School for Cardiovascular Diseases (CARIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
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15
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Ziegler M, Alfraeus J, Bustamante M, Good E, Engvall J, de Muinck E, Dyverfeldt P. Automated segmentation of the individual branches of the carotid arteries in contrast-enhanced MR angiography using DeepMedic. BMC Med Imaging 2021; 21:38. [PMID: 33639893 PMCID: PMC7912466 DOI: 10.1186/s12880-021-00568-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/15/2021] [Indexed: 11/24/2022] Open
Abstract
Background Non-invasive imaging is of interest for tracking the progression of atherosclerosis in the carotid bifurcation, and segmenting this region into its constituent branch arteries is necessary for analyses. The purpose of this study was to validate and demonstrate a method for segmenting the carotid bifurcation into the common, internal, and external carotid arteries (CCA, ICA, ECA) in contrast-enhanced MR angiography (CE-MRA) data. Methods A segmentation pipeline utilizing a convolutional neural network (DeepMedic) was tailored and trained for multi-class segmentation of the carotid arteries in CE-MRA data from the Swedish CardioPulmonsary bioImage Study (SCAPIS). Segmentation quality was quantitatively assessed using the Dice similarity coefficient (DSC), Matthews Correlation Coefficient (MCC), F2, F0.5, and True Positive Ratio (TPR). Segmentations were also assessed qualitatively, by three observers using visual inspection. Finally, geometric descriptions of the carotid bifurcations were generated for each subject to demonstrate the utility of the proposed segmentation method. Results Branch-level segmentations scored DSC = 0.80 ± 0.13, MCC = 0.80 ± 0.12, F2 = 0.82 ± 0.14, F0.5 = 0.78 ± 0.13, and TPR = 0.84 ± 0.16, on average in a testing cohort of 46 carotid bifurcations. Qualitatively, 61% of segmentations were judged to be usable for analyses without adjustments in a cohort of 336 carotid bifurcations without ground-truth. Carotid artery geometry showed wide variation within the whole cohort, with CCA diameter 8.6 ± 1.1 mm, ICA 7.5 ± 1.4 mm, ECA 5.7 ± 1.0 mm and bifurcation angle 41 ± 21°. Conclusion The proposed segmentation method automatically generates branch-level segmentations of the carotid arteries that are suitable for use in further analyses and help enable large-cohort investigations.
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Affiliation(s)
- Magnus Ziegler
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. .,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
| | - Jesper Alfraeus
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mariana Bustamante
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Elin Good
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Cardiology, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Jan Engvall
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Clinical Physiology, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ebo de Muinck
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Cardiology, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Petter Dyverfeldt
- Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
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16
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Gullberg Lidegran M, Gordon Murkes L, Andersson Lindholm J, Frenckner B. Optimizing Contrast-Enhanced Thoracoabdominal CT in Patients During Extracorporeal Membrane Oxygenation. Acad Radiol 2021; 28:58-67. [PMID: 32094031 DOI: 10.1016/j.acra.2020.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/16/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate the quality and value of contrast-enhanced (CE) chest- and abdominal computed tomography (CT) and CT angiography in neonates, children, and adults undergoing extracorporeal membrane oxygenation (ECMO) using a customized protocol for contrast delivery. MATERIALS AND METHODS All patients admitted for CE thoracic- and/or abdominal CT while on ECMO were prospectively included in the study. A protocol for contrast delivery adapted for the type of ECMO circulation, cannulation sites, anatomy of interest, and desired contrast phase was applied. Clinical information, ECMO and CT technique, including contrast administration strategy, was noted for each patient. Two radiologists separately evaluated the quality of the scan. The value of the examination was decided in consensus with the referring ECMO physician. RESULTS One hundred thirty CE thoracoabdominal scans were performed at 103 different occasions during the study time. Eighty-nine scans were performed during veno-arterial ECMO and 41 during veno-venous ECMO. In the majority, contrast was delivered to the oxygenator with preserved ECMO flow. A peripheral or central venous line with reduced flow was utilized in the remaining cases. Mean scan quality was graded 4.2 on a five-grade scale. In 56% of the examinations, the findings affected the immediate treatment of the patient. CONCLUSION High-quality CT and CT angiography can be achieved in ECMO patients of different ages and clinical issues considering the type of ECMO circulation, ECMO cannulation sites, preferred contrast phase and anatomy of interest. CT diagnoses affect the treatment of the patient.
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Affiliation(s)
- Marika Gullberg Lidegran
- Department of Pediatric Radiology, Karolinska University Hospital, Eugeniav. 23 C7:33, Stockholm SE-171 76, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
| | - Lena Gordon Murkes
- Department of Pediatric Radiology, Karolinska University Hospital, Eugeniav. 23 C7:33, Stockholm SE-171 76, Sweden
| | - Jonas Andersson Lindholm
- ECMO Centre, Karolinska University Hospital, Stockholm, Sweden; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Björn Frenckner
- Department of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Maecker HT, Wang W, Rosenberg-Hasson Y, Semelka RC, Hickey J, Koran LM. An initial investigation of serum cytokine levels in patients with gadolinium retention. Radiol Bras 2020; 53:306-313. [PMID: 33071374 PMCID: PMC7545733 DOI: 10.1590/0100-3984.2019.0075] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Objective To determine whether individuals with proposed gadolinium deposition disease (GDD) have elevated serum levels of pro-inflammatory and pro-fibrotic cytokines, and whether specific cytokines are correlated with certain symptoms. Materials and Methods Twenty-four participants recruited between May 2016 and June 2017 met GDD diagnostic criteria. The 64 control subjects provided serum samples before prophylactic flu vaccination. Serum cytokine levels were obtained with Luminex serum cytokine assay using eBiosciences/Affymetrix human 62-plex kits. Wilcoxon rank-sum tests were performed to assess the difference between the median fluorescence intensity values for the participants and the control group. Generalized linear models were built to evaluate the association between each cytokine of interest and selected participant symptoms. Results Serum levels of 14 cytokines, including nine pro-inflammatory cytokines, were statistically significantly elevated compared to controls (p ≤ 0.05). Hypotheses regarding pro-fibrotic cytokines and cytokine links to specific symptoms' intensity were not confirmed. Conclusion The statistically significantly elevated cytokines may be markers of susceptibility to GDD or agents of symptom induction. These findings suggest that individuals developing symptoms characteristic of GDD after a contrast-assisted magnetic resonance imaging should be studied to investigate whether gadolinium retention and elevated cytokines may be related to their symptoms.
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Affiliation(s)
| | - Weiqi Wang
- Stanford University Medical Center, Stanford, CA, USA
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18
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Zhao HW, Li J, Cao JZ, Lin J, Wang Z, Lv JY, Wei JH, Chen ZH, Yao HH, Pan YH, Gao ZL, Luo JH, Chen W, Shi L, Fang Y. Contrast-enhanced transrectal ultrasound can reduce collection of unnecessary biopsies when diagnosing prostate cancer and is predictive of biochemical recurrence following a radical prostatectomy in patients with localized prostate cancer. BMC Urol 2020; 20:100. [PMID: 32677927 PMCID: PMC7364623 DOI: 10.1186/s12894-020-00659-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 06/26/2020] [Indexed: 12/31/2022] Open
Abstract
Background To investigate the value of using contrast-enhanced transrectal ultrasound (CETRUS) to reduce unnecessary collection of biopsies during prostate cancer diagnosis and its utility in predicting biochemical recurrence in patients with localized prostate cancer. Methods This was a prospective study of suspected prostate cancer patients who were evaluated with CETRUS followed by a prostate biopsy. Prostate blood flow via CETRUS was graded using a 5-point scale. The relationship between CETRUS score and biopsy outcome was then analyzed for all patients; univariate and multi-variate analyses were used to determine the probable prognostic factors for biochemical recurrence in patients with localized prostate cancer that underwent a radical prostatectomy. Results A total of 347 patients were enrolled in the study. Prostate cancer was found in 164 patients. A significant positive correlation (r = 0.69, p < 0.001) was found between CETRUS scores and prostate cancer incidence. Using CETRUS scores ≥2 as the threshold for when to biopsy could have safely reduced the number of biopsies taken overall by 12.1% (42/347) and spared 23.0% (42/183) of patients from undergoing an unnecessary biopsy. 77 patients with localized prostate cancer underwent a radical prostatectomy. The median follow-up time was 30 months (range: 8–56 months) and 17 of these 77 patients exhibited biochemical recurrence during the follow-up period. 3-year biochemical recurrence-free survival rates were 86% for patients with low CETRUS scores (≤ 3) and 59% for patients with high scores (> 3; p = 0.015). Multivariate Cox regression analysis indicated that CETRUS score was an independent predictor of biochemical recurrence (HR: 7.02; 95% CI: 2.00–24.69; p = 0.002). Conclusions CETRUS scores may be a useful tool for reducing the collection unnecessary biopsy samples during prostate cancer diagnosis and are predictive of biochemical recurrence in patients with localized prostate cancer following a radical prostatectomy.
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Affiliation(s)
- Hong-Wei Zhao
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, 264000, Shandong, P. R. China.,Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, No.58 ZhongShan 2nd Road, Guangzhou, 510080, Guangdong, P. R. China
| | - Jian Li
- State Key Laboratory of Oncology in South China, Department of Ultrasound, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China
| | - Jia-Zheng Cao
- Department of Urology, Jiangmen Hospital, Sun Yat-Sen University, Jiangmen, 529000, Guangdong, P. R. China
| | - Juan Lin
- Department of Pediatrics, hird Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong, P. R. China
| | - Zhu Wang
- Department of Ultrasound, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China
| | - Jian-Yao Lv
- Department of Ultrasound, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China
| | - Jin-Huan Wei
- Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, No.58 ZhongShan 2nd Road, Guangzhou, 510080, Guangdong, P. R. China
| | - Zhen-Hua Chen
- Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, No.58 ZhongShan 2nd Road, Guangzhou, 510080, Guangdong, P. R. China
| | - Hao-Hua Yao
- Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, No.58 ZhongShan 2nd Road, Guangzhou, 510080, Guangdong, P. R. China
| | - Yi-Hui Pan
- Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, No.58 ZhongShan 2nd Road, Guangzhou, 510080, Guangdong, P. R. China
| | - Zhen-Li Gao
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, 264000, Shandong, P. R. China
| | - Jun-Hang Luo
- Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, No.58 ZhongShan 2nd Road, Guangzhou, 510080, Guangdong, P. R. China
| | - Wei Chen
- Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, No.58 ZhongShan 2nd Road, Guangzhou, 510080, Guangdong, P. R. China
| | - Lei Shi
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, 264000, Shandong, P. R. China.
| | - Yong Fang
- Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, No.58 ZhongShan 2nd Road, Guangzhou, 510080, Guangdong, P. R. China.
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Sun B, Chen Z, Duan Q, Xue Y, Chen L, Zhang Z, An J. A direct comparison of 3 T contrast-enhanced whole-heart coronary cardiovascular magnetic resonance angiography to dual-source computed tomography angiography for detection of coronary artery stenosis: a single-center experience. J Cardiovasc Magn Reson 2020; 22:40. [PMID: 32475355 PMCID: PMC7262765 DOI: 10.1186/s12968-020-00630-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 04/07/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In recent years, substantial advances have been made in noninvasive cardiac imaging, including cardiac computed tomography (CT) and cardiovascular magnetic resonance (CMR). The purpose of this study was to prospectively compare the diagnostic performance of contrast-enhanced whole heart coronary CMR angiography (CCMRA) to dual-source coronary CT angiography (CCTA) for the diagnosis of significant coronary stenoses (≥50%) in patients with known or suspected coronary artery disease (CAD) referred for conventional x-ray coronary angiography. METHODS Our objective was to directly compare the diagnostic accuracy of contrast-enhanced whole-heart CCMRA (CE-CCMRA) to dual-source CCTA (DS-CCTA) for the detection of CAD. We prospectively studied 57 symptomatic patients with suspected or known CAD who were scheduled for conventional x-ray coronary angiography. Significant CAD was defined as an x-ray defined diameter reduction of ≥50% in a coronary artery with a reference diameter of ≥1.5 mm. RESULTS CE-CCMRA and DS-CCTA were completed in 51 (89%) of 57 patients without complications. The acquisition times of CE-CCMRA and DS-CCTA, respectively, were 9.5 ± 3.1 min and 8.3 ± 1.4 s. On patient-based analysis, the sensitivity, specificity, positive and negative predictive value of CE-CCMRA and DS-CCTA were 93.5% versus 93.5%(P > 0.05), 85% versus 90%(P > 0.05), 90.6% versus 93.5%(P > 0.05), and 89.4% versus 90%(P > 0.05), respectively. The area under the curve (AUC) was 0.89 (95% CI: 0.79 to 0.99) for CE-CCMRA and 0.92 (95% CI: 0.83 to 1.00) for DS-CCTA. CONCLUSIONS DS-CCTA was found to be superior to CE-CCMRA in the diagnosis of significant coronary stenoses (≥50%) in patients with suspected or known CAD scheduled for conventional x-ray coronary angiography, owing to shorter scanning times and higher spatial resolution. However, CE-CCMRA and DS-CCTA have similar diagnostic accuracies.
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Affiliation(s)
- Bin Sun
- Department of Radiology, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, 350001, People's Republic of China
| | - Zhiyong Chen
- Department of Radiology, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, 350001, People's Republic of China.
| | - Qing Duan
- Department of Radiology, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, 350001, People's Republic of China
| | - Yunjing Xue
- Department of Radiology, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, 350001, People's Republic of China
| | - Lianglong Chen
- Department of Cardiology, Union Hospital, Fujian Medical University, Fuzhou, China
| | | | - Jing An
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
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Ključevšek D, Riccabona M, Ording Müller LS, Woźniak MM, Franchi-Abella S, Darge K, Mentzel HJ, Ntoulia A, Avni FE, Napolitano M, Lobo L, Littooij AS, Augdal TA, Bruno C, Damasio BM, Ibe D, Stafrace S, Petit P. Intracavitary contrast-enhanced ultrasonography in children: review with procedural recommendations and clinical applications from the European Society of Paediatric Radiology abdominal imaging task force. Pediatr Radiol 2020; 50:596-606. [PMID: 32055916 DOI: 10.1007/s00247-019-04611-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/03/2019] [Accepted: 12/30/2019] [Indexed: 12/18/2022]
Abstract
Contrast-enhanced ultrasonography (US) has become an important supplementary tool in many clinical applications in children. Contrast-enhanced voiding urosonography and intravenous US contrast agents have proved useful in routine clinical practice. Other applications of intracavitary contrast-enhanced US, particularly in children, have not been widely investigated but could serve as a practical and radiation-free problem-solver in several clinical settings. Intracavitary contrast-enhanced US is a real-time imaging modality similar to fluoroscopy with iodinated contrast agent. The US contrast agent solution is administered into physiological or non-physiological body cavities. There is no definitive list of established indications for intracavitary US contrast agent application. However, intracavitary contrast-enhanced US can be used for many clinical applications. It offers excellent real-time spatial resolution and allows for a more accurate delineation of the cavity anatomy, including the internal architecture of complex collections and possible communications within the cavity or with the surrounding structures through fistulous tracts. It can provide valuable information related to the insertion of catheters and tubes, and identify related complications such as confirming the position and patency of a catheter and identifying causes for drainage dysfunction or leakage. Patency of the ureter and biliary ducts can be evaluated, too. US contrast agent solution can be administered orally or a via nasogastric tube, or as an enema to evaluate the gastrointestinal tract. In this review we present potential clinical applications and procedural and dose recommendations regarding intracavitary contrast-enhanced ultrasonography.
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Affiliation(s)
- Damjana Ključevšek
- Department of Radiology, University Children's Hospital,, University Medical Center Ljubljana, Bohoričeva 20, 1000, Ljubljana, Slovenia.
| | - Michael Riccabona
- Department of Radiology, Division of Pediatric Radiology, University Hospital LKH Graz and Medical University Graz, Graz, Austria
| | - Lil-Sofie Ording Müller
- Division of Radiology and Nuclear Medicine, Department of Paediatric Radiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | - Stéphanie Franchi-Abella
- Service de Radiopédiatrie, Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France
| | - Kassa Darge
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hans-Joachim Mentzel
- Section of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology,, University Hospital Jena, Jena, Germany
| | | | - Fred Efraim Avni
- Department of Pediatric Radiology, Jeanne de Flandre Hospital,, Lille University Hospitals, Lille, France
| | - Marcello Napolitano
- Department of Pediatric Radiology and Neuroradiology,, V. Buzzi Children's Hospital, Milan, Italy
| | - Luisa Lobo
- Department of Radiology, Hospital de Santa Maria-CHLN, University Hospital, Lisbon, Portugal
| | - Annemieke Simone Littooij
- Princess Maxima Center for Pediatric Oncology,, Wilhelmina Children's Hospital Utrecht/UMCU, Utrecht, the Netherlands
| | | | - Costanza Bruno
- Radiology Institute, Department of Radiology, AOUI, Verona, Italy
| | | | - Donald Ibe
- Radiology Department, Silhouette Diagnostic Consultants,, Wuse 2, Abuja, Nigeria
| | - Samuel Stafrace
- Department of Diagnostic Imaging, Sidra Medicine, Doha, Qatar
| | - Philippe Petit
- Service d'Imagerie Pédiatrique et Prénatale, Hôpital Timone Enfants, Marseille, France
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Shakoor D, Demehri S, Roemer FW, Loeuille D, Felson DT, Guermazi A. Are contrast-enhanced and non-contrast MRI findings reflecting synovial inflammation in knee osteoarthritis: a meta-analysis of observational studies. Osteoarthritis Cartilage 2020; 28:126-136. [PMID: 31678664 DOI: 10.1016/j.joca.2019.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/30/2019] [Accepted: 10/14/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the correlation between knee synovitis assessed on contrast-enhanced (CE) and non-contrast enhanced (NCE) magnetic resonance imaging (MRI) with histology in patients with knee osteoarthritis. METHODS A comprehensive literature search was performed, and related articles published through July 2018 were extracted. Spearman correlation coefficients of MRI-based scores with histology reports were pooled using random effects model. To evaluate presence of publication bias, Egger test was performed. RESULTS Of 2377 identified records, eight studies consisting of 246 MRI exams were included. Two studies reported results of dynamic CE (DCE)-MRI examinations (81 knees) and two studies reported results of NCE-MRI. There were moderate positive correlations between CE-MRI scores and macroscopic (r = 0.53 (95% Confidence Interval (CI):0.37-0.66), P < 0.001) as well as microscopic (r = 0.56 (0.39-0.69), P < 0.001) histology. DCE-MRI were strongly correlated (r = 0.71 (0.58-0.80), P-value<0.001), with microscopic histology reports, while the correlation for NCE-MRI was low positive (r = 0.44 (0.20-0.63), P < 0.001). Meta-regression analysis showed that pooled correlation coefficients of DCE-MRI were significantly higher than CE-MRI (Slope = 0.29, SE = 0.13, P-value = 0.02). CE-MRI were also correlated with inflammatory infiltrate (r = 0.42), while the correlations for cell number of synovial lining (r = 0.27) and level of fibrosis (r = 0.29, P < 0.001) were very low. CONCLUSION Static and dynamic CE-MRI evaluation of knee synovitis were positively correlated with macroscopic and microscopic features of synovial membrane inflammation. Among the features of synovial tissue inflammation, CE-MRI scores correlated best with the inflammatory infiltrates of synovial tissue. Paucity of current evidence warrants further studies to assess performance of NCE-MRI on determining knee synovitis.
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Affiliation(s)
- D Shakoor
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC, Baltimore, MD, 21287, USA; Department of Internal Medicine, St Agnes Hospital, 900 Caton Avenue, Baltimore, MD, 21229, USA.
| | - S Demehri
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC, Baltimore, MD, 21287, USA
| | - F W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, 02118, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - D Loeuille
- Department of Rheumatology and INSERM, CIC-EC CIE6, University Hospital of Nancy, Epidemiology and Clinical Evaluation, 54500, Vandoeuvre-lès-Nancy, France
| | - D T Felson
- Clinical Epidemiology Research & Training Unit, Boston University School of Medicine, Boston, MA, 02118, USA
| | - A Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, 02118, USA
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Leithner D, Horvat JV, Marino MA, Bernard-Davila B, Jochelson MS, Ochoa-Albiztegui RE, Martinez DF, Morris EA, Thakur S, Pinker K. Radiomic signatures with contrast-enhanced magnetic resonance imaging for the assessment of breast cancer receptor status and molecular subtypes: initial results. Breast Cancer Res 2019; 21:106. [PMID: 31514736 PMCID: PMC6739929 DOI: 10.1186/s13058-019-1187-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 08/14/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND To evaluate the diagnostic performance of radiomic signatures extracted from contrast-enhanced magnetic resonance imaging (CE-MRI) for the assessment of breast cancer receptor status and molecular subtypes. METHODS One hundred and forty-three patients with biopsy-proven breast cancer who underwent CE-MRI at 3 T were included in this IRB-approved HIPAA-compliant retrospective study. The training dataset comprised 91 patients (luminal A, n = 49; luminal B, n = 8; HER2-enriched, n = 11; triple negative, n = 23), while the validation dataset comprised 52 patients from a second institution (luminal A, n = 17; luminal B, n = 17; triple negative, n = 18). Radiomic analysis of manually segmented tumors included calculation of features derived from the first-order histogram (HIS), co-occurrence matrix (COM), run-length matrix (RLM), absolute gradient (GRA), autoregressive model (ARM), discrete Haar wavelet transform (WAV), and lesion geometry (GEO). Fisher, probability of error and average correlation (POE + ACC), and mutual information coefficients were used for feature selection. Linear discriminant analysis followed by k-nearest neighbor classification (with leave-one-out cross-validation) was used for pairwise radiomic-based separation of receptor status and molecular subtypes. Histopathology served as the standard of reference. RESULTS In the training dataset, radiomic signatures yielded the following accuracies > 80%: luminal B vs. luminal A, 84.2% (mainly based on COM features); luminal B vs. triple negative, 83.9% (mainly based on GEO features); luminal B vs. all others, 89% (mainly based on COM features); and HER2-enriched vs. all others, 81.3% (mainly based on COM features). Radiomic signatures were successfully validated in the separate validation dataset for luminal A vs. luminal B (79.4%) and luminal B vs. triple negative (77.1%). CONCLUSIONS In this preliminary study, radiomic signatures with CE-MRI enable the assessment of breast cancer receptor status and molecular subtypes with high diagnostic accuracy. These results need to be confirmed in future larger studies.
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Affiliation(s)
- Doris Leithner
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, 7th Floor, New York, NY, 10065, USA.,Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Joao V Horvat
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, 7th Floor, New York, NY, 10065, USA
| | - Maria Adele Marino
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, 7th Floor, New York, NY, 10065, USA.,Department of Biomedical Sciences and Morphologic and Functional Imaging, University of Messina, Messina, Italy
| | - Blanca Bernard-Davila
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maxine S Jochelson
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, 7th Floor, New York, NY, 10065, USA
| | - R Elena Ochoa-Albiztegui
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, 7th Floor, New York, NY, 10065, USA
| | - Danny F Martinez
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, 7th Floor, New York, NY, 10065, USA
| | - Elizabeth A Morris
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, 7th Floor, New York, NY, 10065, USA
| | - Sunitha Thakur
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Katja Pinker
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, 300 E 66th St, 7th Floor, New York, NY, 10065, USA. .,Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University Vienna, Vienna, Austria.
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Abstract
BACKGROUND We investigated the frequency of blood-retina barrier impairment in optic neuritis (ON) using gadolinium leakage in ocular structures (GLOS), a novel imaging marker on contrast enhanced fluid attenuated inversion recovery images (FLAIR). METHODS In 12 patients with acute ON who underwent repeated MRI the presence of GLOS was noted on contrast-enhanced FLAIR. RESULTS Bilateral GLOS was observed in 4 (33.3%): in 3 symmetrical, and in 1 asymmetrical. In the latter GLOS was ipsilateral to the ON. CONCLUSIONS GLOS may be observed frequently in ON. Asymmetrical GLOS may be caused by a more local effect of ON.
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Affiliation(s)
- Alex Förster
- Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Johannes Böhme
- Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Christoph Groden
- Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Holger Wenz
- Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
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Su X, Kong X, Liu D, Kong X, Alwalid O, Wang J, Shu S, Zheng C. Multimodal magnetic resonance imaging of peripheral nerves: Establishment and validation of brachial and lumbosacral plexi measurements in 163 healthy subjects. Eur J Radiol 2019; 117:41-8. [PMID: 31307651 DOI: 10.1016/j.ejrad.2019.05.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/19/2019] [Accepted: 05/23/2019] [Indexed: 01/06/2023]
Abstract
PURPOSE This study aims to provide normal reference values for quantitative parameters for brachial and lumbosacral plexi on multimodal MRI. In addition, the parameter variations between the left and right sides, the individual nerve groups, genders and age groups were also evaluated. MATERIALS AND METHODS Multimodal MRI was evaluated in 163 healthy subjects, who were randomly divided into three groups: brachial plexus, lumbosacral plexus and diffusion tensor imaging groups. Nerve diameters, contrast ratios, T2 nerve-muscle signal ratios (nT2), fractional anisotropy (FA) values and apparent diffusion coefficients (ADC) were measured in both plexi. Parametric tests and Pearson correlation for normally distributed data, and non-parametric tests and Spearman correlation for non-normally distributed data were used. RESULTS There were no significant differences in parameters between the left and right sides. The diameters of the C7, L4-S1, sciatic, and femoral nerve roots were larger in men than in women (P < 0.05). The nT2 in the brachial and lumbosacral plexi and the contrast ratio in the lumbosacral plexus were significantly higher in the elderly. The diameter of the S1 nerve root was smaller in the elderly. There were no significant differences between the individual nerve groups in contrast ratios and in brachial plexus nT2. A gradual increase in the nT2 from the top to the bottom was observed in the L4-S1 nerve roots (P < 0.05). CONCLUSION This study provides multi-parameter normative data for the brachial and lumbosacral plexi while considering differences between the two sides, the individual nerves, genders, and the ages.
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25
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Lala SV, Strubel N, Nocera N, Bittman ME, Fefferman NR. Visualization of the normal appendix in children: feasibility of a single contrast-enhanced radial gradient recalled echo MRI sequence. Pediatr Radiol 2019; 49:770-776. [PMID: 30783687 DOI: 10.1007/s00247-019-04352-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 01/03/2019] [Accepted: 02/04/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) assessment for appendicitis is limited by exam time and patient cooperation. The radially sampled 3-dimensional (3-D) T1-weighted, gradient recalled echo sequence (radial GRE) is a free-breathing, motion robust sequence that may be useful in evaluating appendicitis in children. OBJECTIVE To compare the rate of detection of the normal appendix with contrast-enhanced radial GRE versus contrast-enhanced 3-D GRE and a multi-sequence study including contrast-enhanced radial GRE. MATERIALS AND METHODS This was a retrospective study of patients ages 7-18 years undergoing abdominal-pelvic contrast-enhanced MRI between Jan. 1, 2012, and April 1, 2016. Visualization of the appendix was assessed by consensus between two pediatric radiologists. The rate of detection of the appendix for each sequence and combination of sequences was compared using a McNemar test. RESULTS The rate of detection of the normal appendix on contrast-enhanced radial GRE was significantly higher than on contrast-enhanced 3-D GRE (76% vs. 57.3%, P=0.003). The rate of detection of the normal appendix with multi-sequence MRI including contrast-enhanced radial GRE was significantly higher than on contrast-enhanced 3-D GRE (81.3% vs. 57%, P<0.001). There was no significant difference between the rate of detection of the normal appendix on contrast-enhanced radial GRE alone and multi-sequence MRI including contrast-enhanced radial GRE (76% vs. 81.3%, P=0.267). CONCLUSION Contrast-enhanced radial GRE allows superior detection of the normal appendix compared to contrast-enhanced 3-D GRE. The rate of detection of the normal appendix on contrast-enhanced radial GRE alone is nearly as good as when the contrast-enhanced radial GRE is interpreted with additional sequences.
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Affiliation(s)
- Shailee V Lala
- Department of Radiology, New York University School of Medicine, 660 First Ave., New York, NY, 10016, USA.
| | - Naomi Strubel
- Department of Radiology, New York University School of Medicine, 660 First Ave., New York, NY, 10016, USA
| | - Nicole Nocera
- Department of Radiology, New York University School of Medicine, 660 First Ave., New York, NY, 10016, USA
| | - Mark E Bittman
- Department of Radiology, New York University School of Medicine, 660 First Ave., New York, NY, 10016, USA
| | - Nancy R Fefferman
- Department of Radiology, New York University School of Medicine, 660 First Ave., New York, NY, 10016, USA
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26
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Park C, Lee JW, Kim Y, Ahn S, Lee E, Kang Y, Kang HS. Diagnosis of spinal metastasis: are MR images without contrast medium application sufficient? Clin Imaging 2019; 55:165-173. [PMID: 30904626 DOI: 10.1016/j.clinimag.2019.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 02/18/2019] [Accepted: 03/05/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the usefulness of adding contrast-enhanced (CE) magnetic resonance imaging (MRI) to conventional MRI for evaluation of spinal metastases. MATERIALS AND METHODS One-hundred-and-two whole spine MR examinations, obtained for metastasis work-up within a 2-month period, from 65 men and 37 women (mean age, 64 years) with extra-spinal tumor, who also underwent CE-MRI, were retrospectively evaluated by three radiologists. The number of spine segments with bone marrow involvement was interpreted using a 3-point confidence scale (probable metastasis, equivocal, probably benign) during session 1 (conventional imaging) and session 2 (addition of CE-MRI to conventional imaging). The patients were assigned to 14 categories based on the changes in confidence rating between sessions 1 and 2; these were aggregated to four groups indicating the degree of usefulness of CE-MRI: definitely useful, equivocal, not useful, and presumed non-metastatic groups. Clinical information, metastatic bone type, the number of probably metastatic segments, and anatomical level and position were compared among the former three groups. RESULTS The readers assigned 39-53% of cases to the definitely useful group. The number of probably metastatic segments differed significantly among the three groups for all readers (p ≤ 0.046). Age, sex, primary cancer, metastatic bone type, and anatomical level and position were similar. CONCLUSION Adding CE-MRI to conventional MRI was useful for objectively detecting and characterizing spinal segments with metastases in 39-53% of cases. However, there were no clinical or radiological factors that could predict the usefulness of CE-MRI in evaluating spinal metastases, except for the number of metastatic segments.
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Affiliation(s)
- Chankue Park
- Department of Radiology, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsananam-do, Republic of Korea
| | - Joon Woo Lee
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
| | - Yongju Kim
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Soyeon Ahn
- Division of Statistics, Medical Research Collaborating Center, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Eugene Lee
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Yusuhn Kang
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Heung Sik Kang
- Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
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Abstract
Contrast-enhanced ultrasound imaging is a recently approved technique in the United States that uses a specific contrast agent, namely, microbubbles, consisting mainly of a gas core and a stabilized biological shell. These compounds allow for the visualization of small vascular beds and improve characterization of anatomic structures and lesions. They have a relatively safe profile and are primarily excreted through the lungs.
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Affiliation(s)
- David Hunt
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Javier Romero
- Department of Radiology, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
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28
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Pino-Lopez L, Wenz H, Böhme J, Maros M, Schlichtenbrede F, Groden C, Förster A. Contrast-enhanced fat-suppressed FLAIR for the characterization of leptomeningeal inflammation in optic neuritis. Mult Scler 2018; 25:792-800. [PMID: 29683029 DOI: 10.1177/1352458518770268] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Leptomeningeal contrast enhancement on fluid-attenuated inversion recovery (FLAIR) images has been reported in patients with multiple sclerosis and interpreted as a biomarker of inflammation. In this study, we sought to evaluate this phenomenon in patients with optic neuritis (ON). METHODS A total of 42 patients with suspected ON were included in this prospective study and underwent a dedicated study magnetic resonance imaging (MRI) protocol including native and contrast-enhanced fat-suppressed thin-section axial and coronal FLAIR images on an 1.5 T magnetic resonance (MR) system. RESULTS After diagnostic workup, 34 patients with final diagnosis of ON were analyzed in detail. On contrast-enhanced fat-suppressed FLAIR images, 25 (73.5%) patients with ON demonstrated perioptic leptomeningeal enhancement, and in 3 (8.8%) patients, this was even the only pathological MRI finding. In comparison, patients with perioptic leptomeningeal enhancement on contrast-enhanced fat-suppressed FLAIR images had a higher prevalence of additional hyperintense brain lesions ( p = 0.022) as well as cerebrospinal fluid (CSF)-specific oligoclonal bands ( p = 0.013) than patients without. CONCLUSION Perioptic leptomeningeal contrast enhancement on fat-suppressed FLAIR images is a novel marker in ON and possibly reflects a leptomeningeal inflammatory process preceding or accompanying ON. Thin-section contrast-enhanced fat-suppressed FLAIR images might be a useful addition in MRI protocols for patients with suspected ON.
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Affiliation(s)
- Luis Pino-Lopez
- Department of Ophthalmology, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
| | - Holger Wenz
- Department of Neuroradiology, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
| | - Johannes Böhme
- Department of Neuroradiology, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
| | - Máté Maros
- Department of Neuroradiology, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
| | - Frank Schlichtenbrede
- Department of Ophthalmology, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
| | - Christoph Groden
- Department of Neuroradiology, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
| | - Alex Förster
- Department of Neuroradiology, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
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29
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Abstract
Contrast-enhanced ultrasound (CEUS) is a safe, relatively inexpensive, and widely available imaging technique using dedicated imaging ultrasound sequences and FDA-approved contrast microbubbles that allow detection and characterization of malignant focal liver lesions with high diagnostic accuracy. CEUS provides dynamic real-time imaging with high spatial and temporal capability, allowing for unique contributions to the already established protocols for diagnosing focal liver lesions using CT and MR imaging. In patients with lesions indeterminate on CT and MRI, CEUS is a helpful problem-solving complementary tool that improves patient management. Furthermore, CEUS assists guidance of liver biopsies and local treatment. Variations of CEUS such as DCE-US and ultrasound molecular imaging are emerging for quantitative monitoring of treatment effects and possible earlier detection of cancer. In this review, basic principles of CEUS techniques and ultrasound contrast agents along with a description of the enhancement patterns of malignant liver lesions are summarized. Also, a discussion of the role of CEUS for treatment guidance and monitoring, intraoperative CEUS, and an outlook on emerging applications is provided.
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30
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Abstract
Endoscopic ultrasound (EUS) plays an important role as a diagnostic and therapeutic modality in gastroenterology. New developments have emerged, especially in the last decade, and are being introduced to endoscopists. The ability to readily visualize and access organs in the gastrointestinal tract has allowed endoscopists to perform new interventional procedures. EUS procedures have taken the place of conventional approaches for the treatment of various gastrointestinal diseases, including pancreatic cystic lesions. This article focuses on the advances and future of diagnostic and therapeutic EUS.
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Affiliation(s)
- Sahin Coban
- Department of Medicine, University of Massachusetts Medical School, 55 N Lake Avenue, Worcester, MA 01655, USA
| | - Omer Basar
- Pancreas Biliary Center, Gastrointestinal Unit, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
| | - William R Brugge
- Pancreas Biliary Center, Gastrointestinal Unit, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
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31
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Buijs SB, Barentsz MW, Smits MLJ, Gratama JWC, Spronk PE. Systematic review of the safety and efficacy of contrast injection via venous catheters for contrast-enhanced computed tomography. Eur J Radiol Open 2017; 4:118-122. [PMID: 29034281 PMCID: PMC5633350 DOI: 10.1016/j.ejro.2017.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 09/04/2017] [Accepted: 09/07/2017] [Indexed: 11/29/2022] Open
Abstract
In ICU patients, contrast injection via central venous catheters is a safe alternative to peripheral injection. Implementing a safety protocol before power injection via central venous catheters is advisable. The quality of scans varies and remains not sufficiently investigated in scans with higher flow rates.
Objective To examine the safety and efficacy of contrast injection through a central venous catheter (CVC) for contrast-enhanced computed tomography (CECT). Methods A systematic literature search was performed using PubMed. Studies were deemed eligible if they reported on the use of CVCs for contrast administration. Selected articles were assessed for their relevance and risk of bias. Articles with low relevance and high risk of bias or both were excluded. Data from included articles was extracted. Results Seven studies reported on the use of CVCs for contrast administration. Catheter rupture did not occur in any study. The incidence of dislocation ranged from 2.2-15.4%. Quality of scans was described in three studies, with less contrast enhancement of pulmonary arteries and the thoracic aorta in two studies, and average or above average quality in one study. Four other studies used higher flowrates, but did not report quality of scans. Conclusion Contrast injection via CVCs can be performed safely for CECT when using a strict protocol. Quality of scans depended on multiple factors like flow rate, indication of the scan, and cardiac output of the patient. In each patient, an individual evaluation whether to use the CVC as access for contrast media should be made, while bolus tracking may be mandatory in most cases.
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Affiliation(s)
- S B Buijs
- Department of Intensive care, Gelre Hospitals, Apeldoorn, The Netherlands
| | - M W Barentsz
- Department of Radiology, Gelre Hospitals, Apeldoorn, The Netherlands
| | - M L J Smits
- Department of Radiology, Gelre Hospitals, Apeldoorn, The Netherlands
| | - J W C Gratama
- Department of Radiology, Gelre Hospitals, Apeldoorn, The Netherlands
| | - P E Spronk
- Department of Intensive care, Gelre Hospitals, Apeldoorn, The Netherlands
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Seicean A, Mosteanu O, Seicean R. Maximizing the endosonography: The role of contrast harmonics, elastography and confocal endomicroscopy. World J Gastroenterol 2017; 23:25-41. [PMID: 28104978 PMCID: PMC5221284 DOI: 10.3748/wjg.v23.i1.25] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/17/2016] [Accepted: 12/08/2016] [Indexed: 02/07/2023] Open
Abstract
New technologies in endoscopic ultrasound (EUS) evaluation have been developed because of the need to improve the EUS and EUS-fine needle aspiration (EUS-FNA) diagnostic rate. This paper reviews the principle, indications, main literature results, limitations and future expectations for each of the methods presented. Contrast-enhanced harmonic EUS uses a low mechanical index and highlights slow-flow vascularization. This technique is useful for differentiating solid and cystic pancreatic lesions and assessing biliary neoplasms, submucosal neoplasms and lymph nodes. It is also useful for the discrimination of pancreatic masses based on their qualitative patterns; however, the quantitative assessment needs to be improved. The detection of small solid lesions is better, and the EUS-FNA guidance needs further research. The differentiation of cystic lesions of the pancreas and the identification of the associated malignancy features represent the main indications. Elastography is used to assess tissue hardness based on the measurement of elasticity. Despite its low negative predictive value, elastography might rule out the diagnosis of malignancy for pancreatic masses. Needle confocal laser endomicroscopy offers useful information about cystic lesions of the pancreas and is still under evaluation for use with solid pancreatic lesions of lymph nodes.
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33
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Jo KI, Kim SR, Choi JH, Kim KH, Jeon P. Contrast-enhanced angiographic cone-beam computed tomography without pre-diluted contrast medium. Neuroradiology 2015; 57:1121-6. [PMID: 26293128 DOI: 10.1007/s00234-015-1570-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 08/04/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Contrast-enhanced cone-beam computed tomography (CBCT) has been introduced and accepted as a useful technique to evaluate delicate vascular anatomy and neurovascular stents. Current protocol for CBCT requires quantitative dilution of contrast medium to obtain adequate quality images. Here, we introduce simple methods to obtain contrast-enhanced CBCT without quantitative contrast dilution. METHODS A simple experiment was performed to estimate the change in flow rate in the internal carotid artery during the procedure. Transcranial doppler (TCD) was used to evaluate the velocity change before and after catheterization and fluid infusion. In addition, 0.3 cm(3)/s (n = 3) and 0.2 cm(3)/s (n = 7) contrast infusions were injected and followed by saline flushes using a 300 mmHg pressure bag to evaluate neurovascular stent and host arteries. RESULTS Flow velocities changed -15 ± 6.8 % and +17 ± 5.5 % from baseline during catheterization and guiding catheter flushing with a 300 mmHg pressure bag, respectively. Evaluation of the stents and vascular structure was feasible using this technique in all patients. Quality assessment showed that the 0.2 cm(3)/s contrast infusion protocol was better for evaluating the stent and host artery. CONCLUSION Contrast-enhanced CBCT can be performed without quantitative contrast dilution. Adequate contrast dilution can be achieved with a small saline flush and normal blood flow.
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Affiliation(s)
- K I Jo
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea
| | - S R Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea
| | - J H Choi
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea
| | - K H Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea
| | - P Jeon
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
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Meng FS, Zhang ZH, Ji F. New endoscopic ultrasound techniques for digestive tract diseases: A comprehensive review. World J Gastroenterol 2015; 21:4809-4816. [PMID: 25944994 PMCID: PMC4408453 DOI: 10.3748/wjg.v21.i16.4809] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 01/14/2015] [Accepted: 03/12/2015] [Indexed: 02/06/2023] Open
Abstract
Endoscopic ultrasound (EUS) is one of the most important modalities for the diagnosis of digestive tract diseases. EUS has been evolving ever since it was introduced. New techniques such as elastography and contrast enhancement have emerged, increasing the accuracy, sensitivity and specificity of EUS for the diagnosis of digestive tract diseases including pancreatic masses and lymphadenopathy. EUS-elastography evaluates tissue elasticity and therefore, can be used to differentiate various lesions. Contrast-enhanced EUS can distinguish benign from malignant pancreatic lesions and lymphadenopathy using the intravenous injection of contrast agents. This review discusses the principles and types of these new techniques, as well as their clinical applications and limitations.
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van de Haar HJ, Burgmans S, Hofman PAM, Verhey FRJ, Jansen JFA, Backes WH. Blood-brain barrier impairment in dementia: current and future in vivo assessments. Neurosci Biobehav Rev 2014; 49:71-81. [PMID: 25524876 DOI: 10.1016/j.neubiorev.2014.11.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 10/20/2014] [Accepted: 11/21/2014] [Indexed: 01/14/2023]
Abstract
Increasing evidence indicates that blood-brain barrier (BBB) impairment may play a role in the pathophysiology of cognitive decline and dementia. In vivo imaging studies are needed to quantify and localize the BBB defects during life, contemplating the circulatory properties. We reviewed the literature for imaging studies investigating BBB impairment in patients suffering from dementia. After selection, 11 imaging studies were included, of which 6 used contrast-enhanced magnetic resonance imaging (MRI), 2 used contrast-enhanced computed tomography (CT), and 3 positron emission tomography (PET). Primarily the MRI studies hint at a subtle increasing permeability of the BBB, particularly in patients already exhibiting cerebrovascular pathology. More elaborate studies are required to provide convincing evidence on BBB impairment in patients with various stages of dementia with and without obvious cerebrovascular pathology. In the future, dynamic contrast enhanced MRI techniques and transport specific imaging using PET may further detail the research on the molecular nature of BBB defects.
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Affiliation(s)
- Harm J van de Haar
- School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands; Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University Medical Center, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands; Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Saartje Burgmans
- School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands; Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University Medical Center, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Paul A M Hofman
- School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands; Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Frans R J Verhey
- School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands; Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University Medical Center, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Jacobus F A Jansen
- School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands; Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Walter H Backes
- School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands; Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; CARIM School for Cardiovascular Disease, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands.
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Foley D, Browne JE, Zhuang X, Sheane B, O'Driscoll D, Cannon D, Sheehy N, Meaney JF, Fagan AJ. The utility of deformable image registration for small artery visualisation in contrast-enhanced whole body MR angiography. Phys Med 2014; 30:898-908. [PMID: 25182374 DOI: 10.1016/j.ejmp.2014.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 07/30/2014] [Accepted: 08/09/2014] [Indexed: 12/13/2022] Open
Abstract
PURPOSE An investigation was carried out into the effect of three image registration techniques on the diagnostic image quality of contrast-enhanced magnetic resonance angiography (CE-MRA) images. METHODS Whole-body CE-MRA data from the lower legs of 27 patients recruited onto a study of asymptomatic atherosclerosis were processed using three deformable image registration algorithms. The resultant diagnostic image quality was evaluated qualitatively in a clinical evaluation by four expert observers, and quantitatively by measuring contrast-to-noise ratios and volumes of blood vessels, and assessing the techniques' ability to correct for varying degrees of motion. RESULTS The first registration algorithm ('AIR') introduced significant stenosis-mimicking artefacts into the blood vessels' appearance, observed both qualitatively (clinical evaluation) and quantitatively (vessel volume measurements). The two other algorithms ('Slicer' and 'SEMI'), based on the normalised mutual information (NMI) concept and designed specifically to deal with variations in signal intensity as found in contrast-enhanced image data, did not suffer from this serious issue but were rather found to significantly improve the diagnostic image quality both qualitatively and quantitatively, and demonstrated a significantly improved ability to deal with the common problem of patient motion. CONCLUSIONS This work highlights both the significant benefits to be gained through the use of suitable registration algorithms and the deleterious effects of an inappropriate choice of algorithm for contrast-enhanced MRI data. The maximum benefit was found in the lower legs, where the small arterial vessel diameters and propensity for leg movement during image acquisitions posed considerable problems in making accurate diagnoses from the un-registered images.
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Affiliation(s)
- Daniel Foley
- National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital/School of Medicine, Trinity College Dublin, Ireland
| | - Jacinta E Browne
- Medical Ultrasound Physics Group, School of Physics/IEO & FOCAS Institutes, Dublin Institute of Technology, Kevin's Street, Dublin 8, Ireland
| | - Xiahai Zhuang
- Centre for Medical Image Computing, Department of Medical Physics and Bioengineering, University College London, UK; Shanghai Advanced Research Institute, Chinese Academy of Sciences, Shanghai, China
| | - Barry Sheane
- National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital/School of Medicine, Trinity College Dublin, Ireland
| | - Dearbhail O'Driscoll
- National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital/School of Medicine, Trinity College Dublin, Ireland
| | - Daniel Cannon
- National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital/School of Medicine, Trinity College Dublin, Ireland
| | - Niall Sheehy
- National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital/School of Medicine, Trinity College Dublin, Ireland
| | - James F Meaney
- National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital/School of Medicine, Trinity College Dublin, Ireland
| | - Andrew J Fagan
- National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital/School of Medicine, Trinity College Dublin, Ireland.
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Yoneyama T, Tateishi U, Endo I, Inoue T. Staging accuracy of pancreatic cancer: comparison between non- contrast-enhanced and contrast-enhanced PET/CT. Eur J Radiol 2014; 83:1734-9. [PMID: 25043494 DOI: 10.1016/j.ejrad.2014.04.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 04/19/2014] [Accepted: 04/24/2014] [Indexed: 01/02/2023]
Abstract
PURPOSE Our aim was to clarify the diagnostic impact of contrast-enhanced (CE) (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) for staging of pancreatic cancer compared to non-CE PET/CT. METHOD AND MATERIALS Between April 2006 and November 2009, a total of 95 patients (age range, 36-83 years [mean age, 67]) with primary pancreatic cancer underwent (18)F-FDG PET/CT examinations. Diagnostic accuracy was compared between non-CE PET/CT and CE PET/CT. Images were analyzed visually and quantitatively by two blinded reviewers. Reference standard was histological examination in 48 patients (51%) and/or confirmation of an obvious progression in number and/or size of the lesions on follow-up CT examinations in 47 patients (49%). RESULTS For T-staging, invasion of duodenum (n=20, 21%), mesentery (n=12, 13%), and retroperitoneum (n=13, 14%) was correctly diagnosed by both modalities. The ROC analyses revealed that the Az values of celiac artery (CA), common hepatic artery (CHA), splenic artery (SV), and superior mesenteric vein (SMV) invasion were significantly higher in the CE PET/CT group for both readers. Nodal metastasis was correctly diagnosed by CE PET/CT in 38 patients (88%) and by non-CE PET/CT in 45 patients (87%). Diagnostic accuracies of nodal metastasis in two modalities were similar. Using CE PET/CT, distant metastasis, scalene node metastasis, and peritoneal dissemination were correctly assigned in 39 patients (91%), while interpretation based on non-CE PET/CT revealed distant metastasis, scalene node metastasis, and peritoneal dissemination in 42 patients (81%). Diagnostic accuracy of distant metastasis, scalene node metastasis, and peritoneal dissemination with CE PET/CT was significantly higher than that of non-CE PET/CT (p<0.05). CONCLUSION CE PET/CT allows a more precise assessment of distant metastasis, scalene node metastasis, and peritoneal dissemination in patients with pancreatic cancer.
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Affiliation(s)
- Tomohiro Yoneyama
- Department of Radiology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Ukihide Tateishi
- Department of Radiology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
| | - Itaru Endo
- Department of Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Tomio Inoue
- Department of Radiology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
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Stenzel M, Mentzel HJ. Ultrasound elastography and contrast-enhanced ultrasound in infants, children and adolescents. Eur J Radiol 2014; 83:1560-9. [PMID: 25022978 DOI: 10.1016/j.ejrad.2014.06.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 06/19/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To describe prerequisites, use, and safety of ultrasound elastography and contrast-enhanced ultrasound in infants, children, and adolescents. METHOD This review deals with two latest developments in ultrasonography in children. The principle of strain elastography, transient elastography, and acoustic radiation force imaging is discussed, including limitations, and advantages of the different techniques in diagnosing focal and diffuse organ disease. The intravesical (contrast-enhanced voiding ultrasonography) and intravascular use of contrast-media to outline blood, and urinary flow is described, with special emphasis on indications, off-label use, and diagnostic gain. Examples of indications for performing the advanced ultrasound techniques are presented. SUMMARY AND CONCLUSION Latest developments in ultrasound machine engineering, and the availability of contrast-media that interact with ultrasound waves allow for assessment of tissue stiffness/elasticity properties, blood, and urinary flow. Thereby ultrasound is capable not only to depict morphology, but gives the additional information on organ, and focal lesion perfusion, and urinary flow dynamics. The information gap to other cross-sectional techniques such as magnetic resonance imaging, that make potential harmful sedation, and anaesthesia in the youngest children necessary, thereby gets closer.
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Lee TY, Cheon YK, Shim CS. Clinical role of contrast-enhanced harmonic endoscopic ultrasound in differentiating solid lesions of the pancreas: a single-center experience in Korea. Gut Liver 2013; 7:599-604. [PMID: 24073319 PMCID: PMC3782676 DOI: 10.5009/gnl.2013.7.5.599] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 11/02/2012] [Accepted: 11/03/2012] [Indexed: 11/07/2022] Open
Abstract
Background/Aims The differential diagnosis of pancreatic solid lesions remains challenging. The aim of this study was to investigate the accuracy of contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) in differentiating pancreatic cancer from benign lesions. Methods We prospectively evaluated 37 patients with pancreatic solid lesions. After intravenous injection of a contrast agent (SonoVue), CEH-EUS was performed using a radial echoendoscope. Pancreatic solid lesions were classified into three vascular patterns (hyperintense, isointense, and hypointense) on the basis of CEH-EUS imaging, and these patterns were compared to the histological diagnosis. Results The lesions were hypervascular (n=6), isovascular (n=3), or hypovascular (n=28). Histological diagnosis was confirmed by EUS-FNA in 26 patients (22 adenocarcinomas, two focal pancreatitis, one pancreatic neuroendocrine tumor [NET], and one pancreatic tuberculosis); by surgery in 10 patients (four adenocarcinomas, three pancreatic NETs, two invasive intraductal papillary mucinous neoplasms, and one acinar cell carcinoma); and by both methods in one patient. Among pancreatic carcinomas, 28 out of 30 lesions (93%) had persistent hypovascular signals in the early and late phase, which indicates a sensitivity and diagnostic accuracy of 93% and 92%, respectively for the diagnosis of pancreatic cancer. Conclusions CEH-EUS was useful for characterization of pancreatic solid masses with high sensitivity and accuracy.
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Affiliation(s)
- Tae Yoon Lee
- Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
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