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Yildirim O, Peck KK, Saha A, Karimi S, Lis E. Dynamic Contrast Enhanced MR Perfusion and Diffusion-Weighted Imaging of Marrow-Replacing Disorders of the Spine: A Comprehensive Review. Radiol Clin North Am 2024; 62:287-302. [PMID: 38272621 DOI: 10.1016/j.rcl.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Significant advancements in cancer treatment have led to improved survival rates for patients, particularly in the context of spinal metastases. However, early detection and monitoring of treatment response remain crucial for optimizing patient outcomes. Although conventional imaging methods such as bone scan, PET, MR imaging, and computed tomography are commonly used for diagnosing and monitoring treatment, they present challenges in differential diagnoses and treatment response monitoring. This review article provides a comprehensive overview of the principles, applications, and practical uses of dynamic contrast-enhanced MR imaging and diffusion-weighted imaging in the assessment and monitoring of marrow-replacing disorders of the spine.
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Affiliation(s)
- Onur Yildirim
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
| | | | - Atin Saha
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Sasan Karimi
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Eric Lis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
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Ghasemi A, Ahlawat S, Fayad LM. Magnetic Resonance Imaging Biomarkers of Bone and Soft Tissue Tumors. Semin Musculoskelet Radiol 2024; 28:39-48. [PMID: 38330969 DOI: 10.1055/s-0043-1776433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Magnetic resonance imaging (MRI) is essential in the management of musculoskeletal (MSK) tumors. This review delves into the diverse MRI modalities, focusing on anatomical, functional, and metabolic sequences that provide essential biomarkers for tumor detection, characterization, disease extent determination, and assessment of treatment response. MRI's multimodal capabilities offer a range of biomarkers that enhance MSK tumor evaluation, aiding in better patient management.
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Affiliation(s)
- Ali Ghasemi
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Shivani Ahlawat
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Laura Marie Fayad
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, Maryland
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Albano D, Messina C, Gitto S, Chianca V, Sconfienza LM. Bone biopsies guided by augmented reality: a pilot study. Eur Radiol Exp 2023; 7:40. [PMID: 37468652 PMCID: PMC10356701 DOI: 10.1186/s41747-023-00353-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/09/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE To test the technical feasibility of an augmented reality (AR) navigation system to guide bone biopsies. METHODS We enrolled patients subjected to percutaneous computed tomography (CT)-guided bone biopsy using a novel AR navigation system. Data from prospectively enrolled patients (AR group) were compared with data obtained retrospectively from previous standard CT-guided bone biopsies (control group). We evaluated the following: procedure duration, number of CT passes, patient's radiation dose (dose-length product), complications, and specimen adequacy. Technical success was defined as the ability to complete the procedure as planned, reaching the target center. Technical efficacy was assessed evaluating specimen adequacy. RESULTS Eight patients (4 males) aged 58 ± 24 years (mean ± standard deviation) were enrolled in the AR group and compared with 8 controls (4 males) aged 60 ± 15 years. No complications were observed. Procedure duration, number of CT passes, and radiation dose were 22 ± 5 min, 4 (median) [4, 6 interquartile range] and 1,034 ± 672 mGy*cm for the AR group and 23 ± 5 min, 9 [7.75, 11.25], and 1,954 ± 993 mGy*cm for controls, respectively. No significant differences were observed for procedure duration (p = 0.878). Conversely, number of CT passes and radiation doses were significantly lower for the AR group (p < 0.001 and p = 0.021, respectively). Technical success and technical efficacy were 100% for both groups. CONCLUSIONS This AR navigation system is safe, feasible, and effective; it can decrease radiation exposure and number of CT passes during bone biopsies without increasing duration time. RELEVANCE STATEMENT This augmented reality (AR) navigation system is a safe and feasible guidance for bone biopsies; it may ensure a decrease in the number of CT passes and patient's radiation dose. KEY POINTS • This AR navigation system is a safe guidance for bone biopsies. • It ensures decrease of number of CT passes and patient's radiation exposure. • Procedure duration was similar to that of standard CT-guided biopsy. • Technical success was 100% as in all patients the target was reached. • Technical efficacy was 100% as the specimen was adequate in all patients.
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Affiliation(s)
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milan, 20161, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, 20122, Italy
| | - Salvatore Gitto
- IRCCS Istituto Ortopedico Galeazzi, Milan, 20161, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, 20122, Italy
| | - Vito Chianca
- Clinica Di Radiologia EOC IIMSI, Lugano, Switzerland
- Ospedale Evangelico Betania, Via Argine 604, Naples, 80147, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, 20161, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, 20122, Italy
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Koo JH, Lee J, Han K, Song HT, Ryu L, Lee YH. Preliminary study for prediction of benign vertebral compression fracture age by quantitative water fraction using modified Dixon sequences: an imaging biomarker of fracture age. LA RADIOLOGIA MEDICA 2023:10.1007/s11547-023-01662-1. [PMID: 37336859 DOI: 10.1007/s11547-023-01662-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE This study aimed to evaluate whether quantitative water fraction parameters could predict fracture age in patients with benign vertebral compression fractures (VCFs). METHODS A total of 38 thoracolumbar VCFs in 27 patients imaged using modified Dixon sequences for water fraction quantification on 3-T MRI were retrospectively reviewed. To calculate quantitative parameters, a radiologist independently measured the regions of interest in the bone marrow edema (BME) of the fractures. Furthermore, five features (BME, trabecular fracture line, condensation band, cortical or end plate fracture line, and paravertebral soft-tissue change) were analyzed. The fracture age was evaluated based on clear-onset symptoms and previously available images. A correlation analysis between the fracture age and water fraction was evaluated using a linear regression model, and a multivariable analysis of the dichotomized fracture age model was performed. RESULTS The water fraction ratio was the only significant factor and was negatively correlated with the fracture age of VCFs in multiple linear regression (p = 0.047), whereas the water fraction was not significantly correlated (p = 0.052). Water fraction and water fraction ratio were significant factors in differentiating the fracture age of 1 year in multiple logistic regression (odds ratio 0.894, p = 0.003 and odds ratio 0.986, p = 0.019, respectively). Using a cutoff of 0.524 for the water fraction, the area under the curve, sensitivity, and specificity were 0.857, 85.7%, and 87.1%, respectively. CONCLUSIONS Water fraction is a good imaging biomarker for the fracture healing process. The water fraction ratio of the compression fractures can be used to predict the fracture age of benign VCFs.
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Affiliation(s)
- Ja Ho Koo
- Department of Radiology, Research Institute of Radiological Science, and Center for Clinical Imaging Data Science (CCIDS), Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Joohee Lee
- Department of Radiology, Research Institute of Radiological Science, and Center for Clinical Imaging Data Science (CCIDS), Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Kyunghwa Han
- Department of Radiology, Research Institute of Radiological Science, and Center for Clinical Imaging Data Science (CCIDS), Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Ho-Taek Song
- Department of Radiology, Research Institute of Radiological Science, and Center for Clinical Imaging Data Science (CCIDS), Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Leeha Ryu
- Department of Biostatistics and Computing, Yonsei University Graduate School, Seoul, South Korea
| | - Young Han Lee
- Department of Radiology, Research Institute of Radiological Science, and Center for Clinical Imaging Data Science (CCIDS), Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea.
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Kim Y, Lee SK, Kim JY, Kim JH. Pitfalls of Diffusion-Weighted Imaging: Clinical Utility of T2 Shine-through and T2 Black-out for Musculoskeletal Diseases. Diagnostics (Basel) 2023; 13:diagnostics13091647. [PMID: 37175036 PMCID: PMC10177815 DOI: 10.3390/diagnostics13091647] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/30/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
Diffusion-weighted imaging (DWI) with an apparent diffusion coefficient (ADC) value is a relatively new magnetic resonance imaging (MRI) sequence that provides functional information on the lesion by measuring the microscopic movement of water molecules. While numerous studies have evaluated the promising role of DWI in musculoskeletal radiology, most have focused on tumorous diseases related to cellularity. This review article aims to summarize DWI-acquisition techniques, considering pitfalls such as T2 shine-through and T2 black-out, and their usefulness in interpreting musculoskeletal diseases with imaging. DWI is based on the Brownian motion of water molecules within the tissue, achieved by applying diffusion-sensitizing gradients. Regardless of the cellularity of the lesion, several pitfalls must be considered when interpreting DWI with ADC values in musculoskeletal radiology. This review discusses the application of DWI in musculoskeletal diseases, including tumor and tumor mimickers, as well as non-tumorous diseases, with a focus on lesions demonstrating T2 shine-through and T2 black-out effects. Understanding these pitfalls of DWI can provide clinically useful information, increase diagnostic accuracy, and improve patient management when added to conventional MRI in musculoskeletal diseases.
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Affiliation(s)
- Yuri Kim
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Seul Ki Lee
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jee-Young Kim
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jun-Ho Kim
- Department of Orthopaedic Surgery, Center for Joint Diseases, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea
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Ong W, Zhu L, Tan YL, Teo EC, Tan JH, Kumar N, Vellayappan BA, Ooi BC, Quek ST, Makmur A, Hallinan JTPD. Application of Machine Learning for Differentiating Bone Malignancy on Imaging: A Systematic Review. Cancers (Basel) 2023; 15:cancers15061837. [PMID: 36980722 PMCID: PMC10047175 DOI: 10.3390/cancers15061837] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/07/2023] [Accepted: 03/16/2023] [Indexed: 03/22/2023] Open
Abstract
An accurate diagnosis of bone tumours on imaging is crucial for appropriate and successful treatment. The advent of Artificial intelligence (AI) and machine learning methods to characterize and assess bone tumours on various imaging modalities may assist in the diagnostic workflow. The purpose of this review article is to summarise the most recent evidence for AI techniques using imaging for differentiating benign from malignant lesions, the characterization of various malignant bone lesions, and their potential clinical application. A systematic search through electronic databases (PubMed, MEDLINE, Web of Science, and clinicaltrials.gov) was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 34 articles were retrieved from the databases and the key findings were compiled and summarised. A total of 34 articles reported the use of AI techniques to distinguish between benign vs. malignant bone lesions, of which 12 (35.3%) focused on radiographs, 12 (35.3%) on MRI, 5 (14.7%) on CT and 5 (14.7%) on PET/CT. The overall reported accuracy, sensitivity, and specificity of AI in distinguishing between benign vs. malignant bone lesions ranges from 0.44–0.99, 0.63–1.00, and 0.73–0.96, respectively, with AUCs of 0.73–0.96. In conclusion, the use of AI to discriminate bone lesions on imaging has achieved a relatively good performance in various imaging modalities, with high sensitivity, specificity, and accuracy for distinguishing between benign vs. malignant lesions in several cohort studies. However, further research is necessary to test the clinical performance of these algorithms before they can be facilitated and integrated into routine clinical practice.
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Affiliation(s)
- Wilson Ong
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
- Correspondence: ; Tel.: +65-67725207
| | - Lei Zhu
- Department of Computer Science, School of Computing, National University of Singapore, 13 Computing Drive, Singapore 117417, Singapore
| | - Yi Liang Tan
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
| | - Ee Chin Teo
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
| | - Jiong Hao Tan
- University Spine Centre, Department of Orthopaedic Surgery, National University Health System, 1E, Lower Kent Ridge Road, Singapore 119228, Singapore
| | - Naresh Kumar
- University Spine Centre, Department of Orthopaedic Surgery, National University Health System, 1E, Lower Kent Ridge Road, Singapore 119228, Singapore
| | - Balamurugan A. Vellayappan
- Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore
| | - Beng Chin Ooi
- Department of Computer Science, School of Computing, National University of Singapore, 13 Computing Drive, Singapore 117417, Singapore
| | - Swee Tian Quek
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
| | - Andrew Makmur
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
| | - James Thomas Patrick Decourcy Hallinan
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
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Allam KE, Abd Elkhalek YI, Hassan HGEMA, Emara MAE. Diffusion-weighted magnetic resonance imaging in differentiation between different vertebral lesions using ADC mapping as a quantitative assessment tool. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00827-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Diffusion-weighted imaging is one of the most useful clinical MRI techniques. Including this technique with other sequences used for routine spine scanning improves sensitivity and the capacity to characterize lesions. This study aims to evaluate the utility of apparent diffusion coefficient obtained from diffusion-weighted MR imaging in differentiating between benign and malignant vertebral lesions according to the optimal cutoff ADC value.
Results
This study included 30 patients at Ain Shams University hospitals; all of them were subjected to full clinical assessment and magnetic resonance imaging. Patients were classified into 4 groups: inflammatory lesions (12 cases) followed by malignant lesions (7 cases), then benign neoplastic lesions (6 cases), then traumatic lesions (3 cases) and osteoporosis (two cases). Inflammatory lesions revealed restricted diffusion. Benign neoplastic lesions/hemangioma showed low signal at DWIs due to free diffusion, while malignant/metastatic lesions showed restricted diffusion. Traumatic lesions showed restricted diffusion. The osteoporotic lesions showed iso- to hyper-intense signal at DWIs. The mean ADC value of the benign lesions was 1.8 ± 0.43 mm2/s, while metastatic tumors was 0.96 ± 0.5 × 10–3 mm2/s; however, overlapping values may be present.
Conclusions
Compared with benign tumors, malignant tumors have lower ADC values; nevertheless, some lesions, such as tuberculosis, have low ADC values that are like those of malignant tumors. Diffusion MRI and ADC values should always be analyzed in conjunction with standard MRI sequences as well as a thorough clinical history and examination.
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Zarad CA, Elmaaty AAA, Shanab WSA. Dixon chemical shift MR sequences for demonstrating of bone marrow vertebral metastasis. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00861-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This study aimed to investigate the diagnostic performance and clinical utility of different MR Dixon sequences in the characterization of vertebral metastasis in a patient with a history of malignant neoplasm and compare the results with 18-F FDG PET CT. Patients were subjected to MR imaging of the dorsal and lumbosacral spine (1.5 T MR machine) using conventional MR, T2 Dixon and T1 post-contrast Dixon.
Results
This study involved 40 patients (45% female and 55% male) with 161 metastatic lesions and median age 61.5 years. The sensitivities of T1 post-contrast water-only (WO), fat-only (FO) and opposed-phase (OP) Dixon for diagnosis of vertebral metastasis were 92.6%, 89.4% and 83.1%, respectively, while the sensitivity of T2 (WO, OP) Dixon was 78.3% with 100% specificity for both T1 and T2 Dixon. There were excellent positive clinical utilities of T1 post-contrast WO (0.925), FO (0.894) and OP (0.826) Dixon with the good positive clinical utility of T2 Dixon (0.783) for lesion finding. There were fair negative clinical utilities of T1 WO (0.636) and FO (0.553) Dixon with poor negative clinical utilities of T1 OP (0.429), T2 WO and OP (0.375) Dixon for lesion screening. 15% was the best in-phase/opposed-phase ratio for differentiation between metastatic and benign vertebral lesions.
Conclusions
MR Dixon techniques are sensitive and specific for the diagnosis of vertebral metastasis. T1 post-contrast and T2 Dixons have excellent and good positive clinical utilities for lesion finding with fair and poor negative clinical utilities for lesion screening, respectively.
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Azad H, Ahmed A, Zafar I, Bhutta MR, Rabbani MA, KC HR. X-ray and MRI Correlation of Bone Tumors Using Histopathology As Gold Standard. Cureus 2022; 14:e27262. [PMID: 36039258 PMCID: PMC9403219 DOI: 10.7759/cureus.27262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Bone tumors are a common pathology of the musculoskeletal system being frequently encountered by clinicians. Radiological workup is a mainstay in the diagnostic workup of bone tumors. This study aimed to highlight the importance of plain radiography and MRI in the diagnosis of bone tumors keeping histopathology as a gold standard. It is a descriptive validation study conducted in the Radiology Department of Pakistan Institute of Medical Sciences Islamabad. Methodology The study included 92 patients with suspected bone lesions. After taking a complete history and receiving informed written consent. X-rays radiographs and magnetic resonance imaging were performed. X-ray radiograph and magnetic resonance imaging parameters were recorded and compared with the histopathology of lesions as a standard. Results The mean age of patients was 30.50 ± 8.95 years. Of 92 patients examined on X-ray, 51 (55.4%) had lytic lesions, 34 (37.0%) had sclerotic lesions, and seven (7.6 %) had mixed lesions. MRI revealed the location of the lesion. There were 25 (27.2%) bone lesions in diaphysis, 19 (20.7%) in metaphysis, nine (9.8%) at meta-diaphysis, and 32 (34.8 %) in the meta-epiphyseal region. These findings were later on confirmed with histopathological results. Conclusion MRI can differentiate soft-tissue components and periosteal reactions. An X-ray radiograph can provide information about bony matrix and calcifications within tumors. After analysis of imaging findings and histopathological results, it is concluded that these modalities can be used to diagnose bone tumors with high diagnostic accuracy.
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Yajun F, Limin T, Ruizhi Z, Qi X, Haisong C. Differentiation of microinfiltration and simple-edema areas in VX2 bone tumors by diffusion kurtosis imaging in animal experiments: a preliminary study. Acta Radiol 2022; 63:794-801. [PMID: 34000825 DOI: 10.1177/02841851211017519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Dual-energy computed tomography, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can be used to distinguish microinvasion areas of malignant bone tumors. However, reports of diffusion kurtosis imaging (DKI) to determine the extent of intramedullary infiltration are relatively rare. PURPOSE To assess the application value of MR-DKI in differentiating areas of microinfiltration and simple edema in rabbit bone VX2 tumor models. MATERIAL AND METHODS Conventional MRI and DKI were performed on 25 successfully constructed rabbit VX2 bone tumor models. We acquired a midline sagittal section of the tumor for hematoxylin and eosin staining. Using pathological findings as the gold standard and combining them with MRI data, strict point-to-point control was performed to delineate regions of interest (ROIs) in the microinfiltration and simple-edema areas of bone tumors for quantitative measurement of mean diffusivity (MD) and mean kurtosis (MK). MD and MK values between microinfiltration and simple-edema areas were compared using an independent sample t-test, and the diagnostic values were evaluated by receiver operating characteristic (ROC) curve analysis. RESULTS In comparison with the simple-edema area, the micro-infiltration area demonstrated significantly smaller MD values and larger MK values (P < 0.05), and MD showed a better area under the curve (AUC) than MK (AUC = 0.884 vs. AUC = 0.690) for distinguishing the microinfiltration area from the simple-edema area. The optimal cutoff MD value was 1108.5 mm2/s with a sensitivity of 84% and specificity of 84%. CONCLUSION DKI can distinguish the microinfiltration and simple-edema areas of malignant bone tumors in animal experiments.
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Affiliation(s)
- Fang Yajun
- Department of Radiology, the Affiliated Hospital of Qingdao University,Qingdao, China
| | - Tang Limin
- Department of Radiology, the Affiliated Hospital of Qingdao University,Qingdao, China
| | - Zhou Ruizhi
- Department of Radiology, the Affiliated Hospital of Qingdao University,Qingdao, China
| | - Xu Qi
- Department of Radiology, the Affiliated Hospital of Qingdao University,Qingdao, China
| | - Chen Haisong
- Department of Radiology, the Affiliated Hospital of Qingdao University,Qingdao, China
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Li J, Wang X, Li Y, Cao Q, Bu Y, Cao H, Wang X. Pathological Clinical Analysis and Imaging Manifestations for Spinal Bone Tumors Based on Cement Injection. Appl Bionics Biomech 2022; 2022:2105332. [PMID: 35510043 PMCID: PMC9061064 DOI: 10.1155/2022/2105332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 11/17/2022] Open
Abstract
In order to explore the imaging manifestations and pathological characteristics of spine tumors, this article explores the clinical diagnosis and treatment methods through multi-sample case analysis with the support of imaging, and proposes a targeted treatment method that uses a special PVP needle with a beveled puncture surface for puncture. Moreover, this article uses the supporting PVP syringe for bone cement injection, develops a health status questionnaire, and adopts a scoring method for comprehensive assessment. The purpose of this article is to show that through the combination of preoperative radiotherapy and postoperative bracing, bone cement injection to treat vertebral tumors can immediately obtain satisfactory pain relief. Finally, through case analysis and image performance, we can see that the method proposed in this article has a certain effect.
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Affiliation(s)
- Jie Li
- Department of Spine, Second Hospital of Tangshan, Tangshan, Hebei, China 063000
| | - Xu Wang
- Department of Spine, Second Hospital of Tangshan, Tangshan, Hebei, China 063000
| | - Yongmin Li
- Department of Spine, Second Hospital of Tangshan, Tangshan, Hebei, China 063000
| | - Qinhui Cao
- Department of Spine, Second Hospital of Tangshan, Tangshan, Hebei, China 063000
| | - Yi Bu
- Department of Spine, Second Hospital of Tangshan, Tangshan, Hebei, China 063000
| | - Hengcong Cao
- Department of Spine, Second Hospital of Tangshan, Tangshan, Hebei, China 063000
| | - Xiaoqiang Wang
- Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China 200000
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Diffusion-weighted MRI radiomics of spine bone tumors: feature stability and machine learning-based classification performance. Radiol Med 2022; 127:518-525. [PMID: 35320464 PMCID: PMC9098537 DOI: 10.1007/s11547-022-01468-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 02/11/2022] [Indexed: 10/29/2022]
Abstract
PURPOSE To evaluate stability and machine learning-based classification performance of radiomic features of spine bone tumors using diffusion- and T2-weighted magnetic resonance imaging (MRI). MATERIAL AND METHODS This retrospective study included 101 patients with histology-proven spine bone tumor (22 benign; 38 primary malignant; 41 metastatic). All tumor volumes were manually segmented on morphologic T2-weighted sequences. The same region of interest (ROI) was used to perform radiomic analysis on ADC map. A total of 1702 radiomic features was considered. Feature stability was assessed through small geometrical transformations of the ROIs mimicking multiple manual delineations. Intraclass correlation coefficient (ICC) quantified feature stability. Feature selection consisted of stability-based (ICC > 0.75) and significance-based selections (ranking features by decreasing Mann-Whitney p-value). Class balancing was performed to oversample the minority (i.e., benign) class. Selected features were used to train and test a support vector machine (SVM) to discriminate benign from malignant spine tumors using tenfold cross-validation. RESULTS A total of 76.4% radiomic features were stable. The quality metrics for the SVM were evaluated as a function of the number of selected features. The radiomic model with the best performance and the lowest number of features for classifying tumor types included 8 features. The metrics were 78% sensitivity, 68% specificity, 76% accuracy and AUC 0.78. CONCLUSION SVM classifiers based on radiomic features extracted from T2- and diffusion-weighted imaging with ADC map are promising for classification of spine bone tumors. Radiomic features of spine bone tumors show good reproducibility rates.
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Nouh M, Doweidar A, Khalil AME. Apparent diffusion coefficient (ADC): A potential in vivo biological surrogate of the incidentally discovered bone lesions at 3T MRI. Eur J Radiol Open 2021; 8:100386. [PMID: 34877369 PMCID: PMC8628214 DOI: 10.1016/j.ejro.2021.100386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/27/2021] [Accepted: 11/08/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To probe the potential of apparent diffusion coefficient (ADC) to rectify the incidentally detected bone lesion on MRI into benign or malignant lesions. MATERIALS AND METHODS We retrospectively recruited 44 patients (24 males and 20 females); with 52 bone lesions, who underwent diffusion weighted (DW) imaging using multiple b-values on 3 T MRI. ADC maps were derived and analyzed by two radiologists; blinded to the final diagnosis. The mean ADC values were used for statistical analyses. The diagnosis was deduced by histopathological confirmation; in 32 lesions and strict clinical and imaging follow-up for at least 12 months; in 20 lesions. RESULTS The mean ADC value (mean±SD) of all malignant tumors (including cartilaginous neoplasms) was [0.92 ± 0.40] × 10-3 mm2/s. This significantly differed from those of both primary benign tumors [1.14 ± 0.24] × 10-3 mm2/s, (p = 0.011), and all non-malignant lesions collectively [1.29 ± 0.44] × 10-3 mm2/s, (p < 0.001). Using mADC value of ≤ 1.1 × 10-3 mm2/s resulted in 86.1% sensitivity and 62.5% specificity for characterizing a lesion as a malignant. The inter-rater reliability was almost perfect (95% CI = 0.954-0.985). CONCLUSION ADC could be a non-invasive in-vivo surrogate that may be able to discern the incidentally discovered osseous lesions into benign and malignant pathologies and guide further diagnostic workup.
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Affiliation(s)
- M.R. Nouh
- Department of Radiology, Faculty of Medicine, Alexandria University, Egypt
| | - Ahmed Doweidar
- Department of Radiology, SWBH NHS TRUST, Birmingham, West Midlands B187QH, UK
| | - Abdullah Mohie-Eddin Khalil
- Department of Radiology and Clinical Imaging, El-Razi Hospital, Gamal Abd El-Nasser Street, Sulibakhat, 13001 Kuwait City, Kuwait
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14
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Single shot zonal oblique multislice SE-EPI diffusion-weighted imaging with low to ultra-high b-values for the differentiation of benign and malignant vertebral spinal fractures. Eur J Radiol Open 2021; 8:100377. [PMID: 34611530 PMCID: PMC8476351 DOI: 10.1016/j.ejro.2021.100377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/19/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose To investigate the diagnostic yield of low to ultra-high b-values for the differentiation of benign from malignant vertebral fractures using a state-of-the-art single-shot zonal-oblique-multislice spin-echo echo-planar diffusion-weighted imaging sequence (SShot ZOOM SE-EPI DWI). Materials and Methods 66 patients (34 malignant, 32 benign) were examined on 1.5 T MR scanners. ADC maps were generated from b-values of 0,400; 0,1000 and 0,2000s/mm2. ROIs were placed into the fracture of interest on ADC maps and trace images and into adjacent normal vertebral bodies on trace images. The ADC of fractures and the Signal-Intensity-Ratio (SIR) of fractures relative to normal vertebral bodies on trace images were considered quantitative metrics. The appearance of the fracture of interest was graded qualitatively as iso-, hypo-, or hyperintense relative to normal vertebrae. Results ADC achieved an area under the curve (AUC) of 0.785/0.698/0.592 for b = 0,400/0,1000/0,2000s/mm2 ADC maps respectively. SIR achieved an AUC of 0.841/0.919/0.917 for b = 400/1000/2000s/mm2 trace images respectively. In qualitative analyses, only b = 2000s/mm2 trace images were diagnostically valuable (sensitivity:1, specificity:0.794). Machine learning models incorporating all qualitative and quantitative metrics achieved an AUC of 0.95/0.98/0.98 for b-values of 400/1000/2000s/mm2 respectively. The model incorporating only qualitative metrics from b = 2000s/mm2 achieved an AUC of 0.97. Conclusion By using quantitative and qualitative metrics from SShot ZOOM SE-EPI DWI, benign and malignant vertebral fractures can be differentiated with high diagnostic accuracy. Importantly qualitative analysis of ultra-high b-value images may suffice for differentiation as well.
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Key Words
- ADC, Apparent Diffusion Coefficient
- AUC, Area Under the Curve
- DWI, Diffusion Weighted Imaging
- DXA, Dual Energy X-Ray Absorptiometry
- Diffusion magnetic resonance imaging
- FOV, Field of View
- MRI, Magnetic Resonance Imaging
- MShot, Multi Shot
- Magnetic resonance imaging
- PET-CT, Positron Emission Tomography – Computed Tomography
- ROC, Receiver Operating Characteristics
- SE-EPI, Spin Echo – Echo Planar Imaging
- SI, Signal Intensity
- SIR, Signal Intensity Ratio
- SShot, Single Shot
- STIR, Short Tau Inversion Recovery
- Spinal fractures
- T1w, T1-weighted
- T2w, T2-weighted
- TSE, Turbo Spin Echo
- Vertebral body
- ZOOM, Zonal Oblique Multislice
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15
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Albano D, Benenati M, Bruno A, Bruno F, Calandri M, Caruso D, Cozzi D, De Robertis R, Gentili F, Grazzini I, Micci G, Palmisano A, Pessina C, Scalise P, Vernuccio F, Barile A, Miele V, Grassi R, Messina C. Imaging side effects and complications of chemotherapy and radiation therapy: a pictorial review from head to toe. Insights Imaging 2021; 12:76. [PMID: 34114094 PMCID: PMC8192650 DOI: 10.1186/s13244-021-01017-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 05/18/2021] [Indexed: 02/08/2023] Open
Abstract
Newer biologic drugs and immunomodulatory agents, as well as more tolerated and effective radiation therapy schemes, have reduced treatment toxicity in oncology patients. However, although imaging assessment of tumor response is adapting to atypical responses like tumor flare, expected changes and complications of chemo/radiotherapy are still routinely encountered in post-treatment imaging examinations. Radiologists must be aware of old and newer therapeutic options and related side effects or complications to avoid a misinterpretation of imaging findings. Further, advancements in oncology research have increased life expectancy of patients as well as the frequency of long-term therapy-related side effects that once could not be observed. This pictorial will help radiologists tasked to detect therapy-related complications and to differentiate expected changes of normal tissues from tumor relapse.
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Affiliation(s)
- Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy. .,Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università Degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy. .,Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy.
| | - Massimo Benenati
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy.,Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Bruno
- Diagnostic and Interventional Radiology Unit, Maggiore Hospital "C. A. Pizzardi", 40133, Bologna, Italy
| | - Federico Bruno
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy.,Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Marco Calandri
- Radiology Unit, A.O.U. San Luigi Gonzaga di Orbassano, Department of Oncology, University of Torino, 10043, Turin, Italy
| | - Damiano Caruso
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Diletta Cozzi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy.,Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Riccardo De Robertis
- U.O.C. Radiologia BT, Ospedale Civile Maggiore - Azienda Ospedaliera Universitaria Integrata Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Francesco Gentili
- Unit of Diagnostic Imaging, Department of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Irene Grazzini
- Department of Radiology, Section of Neuroradiology, San Donato Hospital, Arezzo, Italy
| | - Giuseppe Micci
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università Degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.,Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy
| | - Anna Palmisano
- Experimental Imaging Centre, Radiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, via Olgettina 58, 20132, Milan, Italy
| | - Carlotta Pessina
- Department of Radiology, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Paola Scalise
- Department of Diagnostic Imaging, Pisa University Hospital, Via Paradisa 2, 56124, Pisa, Italy
| | - Federica Vernuccio
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università Degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Roberto Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy.,Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138, Naples, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy
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16
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Whole-Body Magnetic Resonance Imaging: Current Role in Patients with Lymphoma. Diagnostics (Basel) 2021; 11:diagnostics11061007. [PMID: 34073062 PMCID: PMC8227037 DOI: 10.3390/diagnostics11061007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 12/13/2022] Open
Abstract
Imaging of lymphoma is based on the use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) and/or contrast-enhanced CT, but concerns have been raised regarding radiation exposure related to imaging scans in patients with cancer, and its association with increased risk of secondary tumors in patients with lymphoma has been established. To date, lymphoproliferative disorders are among the most common indications to perform whole-body magnetic resonance imaging (MRI). Whole-body MRI is superior to contrast-enhanced CT for staging the disease, also being less dependent on histology if compared to 18F-FDG-PET/CT. As well, it does not require exposure to ionizing radiation and could be used for the surveillance of lymphoma. The current role of whole-body MRI in the diagnostic workup in lymphoma is examined in the present review along with the diagnostic performance in staging, response assessment and surveillance of different lymphoma subtypes.
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17
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Chianca V, Albano D, Messina C, Vincenzo G, Rizzo S, Del Grande F, Sconfienza LM. An update in musculoskeletal tumors: from quantitative imaging to radiomics. Radiol Med 2021; 126:1095-1105. [PMID: 34009541 DOI: 10.1007/s11547-021-01368-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/02/2021] [Indexed: 02/08/2023]
Abstract
In the last two decades, relevant progress has been made in the diagnosis of musculoskeletal tumors due to the development of new imaging tools, such as diffusion-weighted imaging, diffusion kurtosis imaging, magnetic resonance spectroscopy, and diffusion tensor imaging. Another important role has been played by the development of artificial intelligence software based on complex algorithms, which employ computing power in the detection of specific tumor types. The aim of this article is to report the most advanced imaging techniques focusing on their advantages in clinical practice.
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Affiliation(s)
- Vito Chianca
- Clinica di Radiologia EOC IIMSI, Lugano, Switzerland. .,Ospedale Evangelico Betania, Napoli, Italy. .,Master in Oncologic Imaging, Diagnostic and Interventional Radiology Department of Translational Research, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.,Sezione di Scienze Radiologiche, Dipartimento Di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Palermo, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.,Dipartimento di Scienze Biomediche Per La Salute, Università degli Studi di Milano, Milano, Italy
| | | | | | | | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.,Dipartimento di Scienze Biomediche Per La Salute, Università degli Studi di Milano, Milano, Italy
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18
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Chianca V, Cuocolo R, Gitto S, Albano D, Merli I, Badalyan J, Cortese MC, Messina C, Luzzati A, Parafioriti A, Galbusera F, Brunetti A, Sconfienza LM. Radiomic Machine Learning Classifiers in Spine Bone Tumors: A Multi-Software, Multi-Scanner Study. Eur J Radiol 2021; 137:109586. [PMID: 33610852 DOI: 10.1016/j.ejrad.2021.109586] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 11/22/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Spinal lesion differential diagnosis remains challenging even in MRI. Radiomics and machine learning (ML) have proven useful even in absence of a standardized data mining pipeline. We aimed to assess ML diagnostic performance in spinal lesion differential diagnosis, employing radiomic data extracted by different software. METHODS Patients undergoing MRI for a vertebral lesion were retrospectively analyzed (n = 146, 67 males, 79 females; mean age 63 ± 16 years, range 8-89 years) and constituted the train (n = 100) and internal test cohorts (n = 46). Part of the latter had additional prior exams which constituted a multi-scanner, external test cohort (n = 35). Lesions were labeled as benign or malignant (2-label classification), and benign, primary malignant or metastases (3-label classification) for classification analyses. Features extracted via 3D Slicer heterogeneityCAD module (hCAD) and PyRadiomics were independently used to compare different combinations of feature selection methods and ML classifiers (n = 19). RESULTS In total, 90 and 1548 features were extracted by hCAD and PyRadiomics, respectively. The best feature selection method-ML algorithm combination was selected by 10 iterations of 10-fold cross-validation in the training data. For the 2-label classification ML obtained 94% accuracy in the internal test cohort, using hCAD data, and 86% in the external one. For the 3-label classification, PyRadiomics data allowed for 80% and 69% accuracy in the internal and external test sets, respectively. CONCLUSIONS MRI radiomics combined with ML may be useful in spinal lesion assessment. More robust pre-processing led to better consistency despite scanner and protocol heterogeneity.
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Affiliation(s)
- Vito Chianca
- Clinica di Radiologia EOC, Istituto di Imaging della Svizzera Italiana (IIMSI), Lugano, Switzerland; Ospedale Evangelico Betania, Napoli, Italy
| | - Renato Cuocolo
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli (")Federico II", Napoli, Italy; Laboratory of Augmented Reality for Health Monitoring (ARHeMLab), Dipartimento di Ingegneria Elettrica e delle Tecnologie dell'Informazione, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Salvatore Gitto
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy.
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy; Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Italy
| | - Ilaria Merli
- UOC Radiodiagnostica, Presidio San Carlo Borromeo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Julietta Badalyan
- International Medical School, University of Milan and Russian National Research Medical University, Milano, Italy
| | - Maria Cristina Cortese
- Istituto di Radiologia, Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore, Roma, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | | | | | | | - Arturo Brunetti
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli (")Federico II", Napoli, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
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19
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Review article: the current status of CT-guided needle biopsy of the spine. Skeletal Radiol 2021; 50:281-299. [PMID: 32815040 DOI: 10.1007/s00256-020-03584-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/12/2020] [Accepted: 08/12/2020] [Indexed: 02/02/2023]
Abstract
CT-guided percutaneous needle biopsy of the spine is a well-described technique for determining the nature of indeterminate vertebral lesions or establishing a diagnosis of spinal infection, the high diagnostic accuracy and the safety of the procedure having been extensively documented. The purpose of the current article is to review the literature to date on CT-guided spinal biopsy. Specifically, indications for spinal biopsy, techniques for optimising yield, detail of the approaches for various spinal levels which is dependent upon both the region within the spinal column and lesion location within the vertebra (body vs. neural arch), determinants of biopsy outcome and complications are covered. It is hoped that the review will be of particular benefit to junior radiologists who are required to perform this procedure.
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20
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Differentiating atypical hemangiomas and vertebral metastases: a field-of-view (FOV) and FOCUS intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:3187-3193. [PMID: 33078268 DOI: 10.1007/s00586-020-06632-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/15/2020] [Accepted: 10/07/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Some atypical vertebral hemangiomas (VHs) may mimic metastases on routine MRI and can result in misdiagnosis and ultimately to additional imaging, biopsy and unnecessary costs. The purpose of this study is to assess the utility of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) on account of field-of-view optimized and constrained undistorted single shot (FOCUS) in distinguishing atypical VHs and vertebral metastases. METHODS A total of 25 patients with vertebral metastases and 25 patients with atypical VHs were confirmed by clinical follow-up or pathology. IVIM-DWI imaging was performed at different b values (0, 30, 50, 100, 150, 200, 400, 600, 800, 1000 mm2/s). IVIM parameters [the true diffusion coefficient (D), pseudodiffusion coefficient (D*), standard apparent diffusion coefficient (ADC), and perfusion fraction (f)] were calculated and compared between two groups by using Student's t test. A receiver operating characteristic analysis was performed. RESULTS Quantitative analysis of standard ADC and D parameters showed significantly lower values in vertebral metastases when compared to atypical hemangiomas [ADC value: (0.70 ± 0.12) × 10-3 mm2/s vs (1.14 ± 0.28) × 10-3 mm2/s; D value: (0.47 ± 0.07) × 10-3 mm2/s vs (0.76 ± 0.14) × 10-3 mm2/s, all P < 0.01]. The sensitivity and specificity of D value were 93.8% and 92.3%, respectively. CONCLUSION The standard ADC value and D value may be used as an indicator to distinguish vertebral metastases from atypical VHs. FOCUS IVIM-derived parameters provide potential value in the quantitatively differentiating vertebral metastases from vertebral atypical hemangiomas.
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21
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Berardo S, Sukhovei L, Andorno S, Carriero A, Stecco A. Quantitative bone marrow magnetic resonance imaging through apparent diffusion coefficient and fat fraction in multiple myeloma patients. Radiol Med 2020; 126:445-452. [PMID: 32812173 DOI: 10.1007/s11547-020-01258-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 08/10/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Quantitative bone marrow (BM) MR sequences, as DWI and CSI, were used to evaluate BM water-fat composition. The aim of the study was to assess the potential usefulness of fat fraction (FF) and ADC, calculated by CSI or DWI, in diagnosing and classifying myeloma (MM) patients according to their different BM infiltration patterns. METHODS The study group included 43 MM patients (19F; 24M; mean age 64 years), 15 asymptomatic, 15 symptomatic with diffuse BM infiltration and 13 symptomatic with focal lesions (FLs). The control group was made up of 15 healthy subjects (7F; 8M; mean age 64 years). MRI examinations consisted of sagittal T1w TSE on the spinal column, axial DWI (b 50-400-800 mm2/s) and coronal T2 Dixon, on the whole body. Mean ADC and FF were calculated placing 1 ROI on 6 vertebras and 2 ROIs on either the pelvis or FL. RESULTS ANOVA with Bonferroni's correction showed a significant difference in ADC values among the different groups of MM patients (P < 0.05), while FF was only significantly different between patients with diffuse infiltration and patients with FL (P = 0.002). ADC allowed distinguishing MM patients from normal BM patients with diffuse BM infiltration (cutoff value: 0.491 × 10-3 mm2/s; sensitivity 73%, specificity 80%). FF helped better discriminate healthy controls from normal BM patients (cutoff = 0.33, sensitivity 73%, specificity 92%) and patients with diffuse BM infiltration from those with FL (cutoff = 0.16, sensitivity 82%, specificity 92%). CONCLUSION ADC and FF are potentially useful parameter for the quantitative evaluation of BM infiltration in MM patients.
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Affiliation(s)
- Sara Berardo
- Department of Radiology, AOU Maggiore della Carità, Novara, Italy.
| | - Lidiia Sukhovei
- Department of Radiology, AOU Maggiore della Carità, Novara, Italy
| | - Silvano Andorno
- Department of Biomedical Statistics, AOU Maggiore della Carità, Novara, Italy
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22
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Onashvili N, Loria G, Gogichaishvili T, Mariamidze A, Sirbiladze M, Sainishvili N. Computed tomography guided radiofrequency ablation of multifocal osteoid osteoma. Radiol Case Rep 2020; 15:1275-1279. [PMID: 32577146 PMCID: PMC7305363 DOI: 10.1016/j.radcr.2020.05.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/23/2020] [Accepted: 05/24/2020] [Indexed: 11/05/2022] Open
Abstract
Osteoid osteoma is a benign osteoblastic tumor characterized mostly by presence of one nidus, butvery infrequentlyniduses can be multiple. Radiofrequency ablation is a well-established treatment method for this disease. We report a case of a 19-year-old male patient with bifocal osteoid osteoma which was partially missed on the initial magnetic resonance imaging and treated successfully with two sessions of radiofrequency ablation. Following the second session of ablation, the pain resolved immediately and the patient remains pain-free for 6 months since the procedure. Our case report underlines the fact that although very rare, multifocal osteoid osteomas do exist and its niduses can be obscured during the magnetic resonance imaging due to the edema. It emphasizes the role of the initial computed tomography evaluation.
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Affiliation(s)
- Nikoloz Onashvili
- Department of Interventional Radiology, Tbilisi Central Hospital 1, Konstantine Chachava St, Tbilisi 0159, Georgia
| | - George Loria
- Department of Orthopedic Surgery, Tbilisi Central Hospital, Georgia
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23
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Diffusion-Weighted Imaging in Oncology: An Update. Cancers (Basel) 2020; 12:cancers12061493. [PMID: 32521645 PMCID: PMC7352852 DOI: 10.3390/cancers12061493] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 02/06/2023] Open
Abstract
To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the "functional" information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment responses, and to identify residual or recurrent tumors in follow-up examinations. In this review, we provide an up-to-date overview on the application of DWI in oncology.
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24
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Cannavò L, Albano D, Messina C, Corazza A, Rapisarda S, Pozzi G, Di Bernardo A, Parafioriti A, Scotto G, Perrucchini G, Luzzati A, Sconfienza L. Accuracy of CT and MRI to assess resection margins in primary malignant bone tumours having histology as the reference standard. Clin Radiol 2019; 74:736.e13-736.e21. [DOI: 10.1016/j.crad.2019.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 05/23/2019] [Indexed: 11/25/2022]
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25
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Giambelluca D, Albano D, Giambelluca E, Bruno A, Panzuto F, Agrusa A, Di Buono G, Cannizzaro F, Gagliardo C, Midiri M, Lagalla R, Salvaggio G. Renal endometriosis mimicking complicated cysts of kidney: report of two cases. G Chir 2019; 38:250-255. [PMID: 29280706 DOI: 10.11138/gchir/2017.38.5.250] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Endometriosis is a common gynecologic disorder characterized by ectopic endometrial tissue growth outside the uterine cavity. Although usually occurring in pelvic organs, endometrial lesions may involve urinary tract. Renal endometriosis is extremely rare and it has only occasionally been reported in the past. We report two cases of patients with renal cystic lesions, incidentally found at imaging techniques during oncologic follow-up for gastric sarcoma and melanoma, initially misinterpreted as complicated haemorrhagic cysts and then histologically characterized as renal localizations of extragenital endometriosis.
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Mossa-Basha M, Gerszten PC, Myrehaug S, Mayr NA, Yuh WT, Jabehdar Maralani P, Sahgal A, Lo SS. Spinal metastasis: diagnosis, management and follow-up. Br J Radiol 2019; 92:20190211. [PMID: 31322920 DOI: 10.1259/bjr.20190211] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Spine metastatic disease is an increasingly common occurrence in cancer patients due to improved patient survival. Close proximity of the bony spinal column to the spinal cord limits many conventional treatments for metastatic disease. In the past decade, we have witnessed dramatic advancements in therapies, with improvements in surgical techniques and recent adoption of spine stereotactic radiotherapy techniques leading to improved patient outcomes. Multidisciplinary approaches to patient evaluation, treatment and follow-up are essential. Imaging plays an ever increasing role in disease detection, pre-treatment planning and assessment of patient outcomes. It is important for the radiologist to be familiar with imaging algorithms, best practices for surgery and/or radiotherapy and imaging findings in the post-treatment period that may indicate disease recurrence. In this review, we present a multidisciplinary discussion of spine metastases, with specific focus on pre-treatment imaging, planning, current treatment approaches, and post-treatment assessment.
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Affiliation(s)
| | - Peter C Gerszten
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, PA
| | - Sten Myrehaug
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON Canada
| | - Nina A Mayr
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - William Tc Yuh
- Department of Radiology, University of Washington, Seattle, WA
| | - Pejman Jabehdar Maralani
- Department of Medical Imaging, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Arjun Sahgal
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON Canada
| | - Simon S Lo
- Department of Radiation Oncology, University of Washington, Seattle, WA
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Cortese MC, Albano D, Messina C, Perrucchini G, Gallazzi E, Gallazzi MB, Daolio PA, Sconfienza LM. Multicentric, multifocal, and recurrent osteoid osteoma of the hip: first case report. BMC Musculoskelet Disord 2019; 20:171. [PMID: 30991974 PMCID: PMC6469211 DOI: 10.1186/s12891-019-2552-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 04/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoid osteoma is a benign bone-forming tumour, which very unfrequently has multifocal or multicentric presentation. We report the first known case of a multicentric, multifocal and recurrent osteoid osteoma treated using radiofrequency ablation. CASE PRESENTATION A 39-year-old man with two-year history of left hip pain was admitted at our Institution. The pain was more intense during the night and partially relieved by salicylates. Pelvis CT demonstrated two lytic lesions (8 and 7 mm, respectively) with surrounding sclerotic reactive bone, both with a central focal area of high attenuation, located in the femoral neck and along the anterior portion of the acetabulum, respectively. Both lesions had clinical and imaging findings consistent with multicentric osteoid osteoma. Thus, the two lesions were biopsied - with pathologic confirmation of osteoid osteoma - and treated using radiofrequency ablation. Hip pain decreased but did not disappear, actually increasing a few months after treatment. CT and MRI were performed showing a smaller lesion (5 mm) with the same imaging features, surrounded by marrow oedema, along the posterior column of the acetabulum. The lesion was considered suspicious for osteoid osteoma, overlooked on previous examinations. Therefore, a diagnosis of multicentric and multifocal osteoid osteoma was established. The new lesion was again treated with radiofrequency ablation with symptom disappearance. However, hip pain relapsed after 18 months, and CT and MRI showed an osteoid osteoma recurrence on the posterior column of the acetabulum, which was biopsied and successfully treated using radiofrequency ablation. CONCLUSIONS To our knowledge, this is the first reported case of multicentric, multifocal, recurrent osteoid osteoma. Our case report highlights the importance of considering a diagnosis of multifocal osteoid osteoma when dealing with multifocal lytic lesions of the bone and with pain persistence after treatment. It also emphasises the combined role of CT and MRI in this setting.
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Affiliation(s)
- Maria Cristina Cortese
- Istituto di Radiologia, F. Policlinico Gemelli - IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenico Albano
- Università degli Studi di Palermo, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Palermo, Italy
| | - Carmelo Messina
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | | | - Enrico Gallazzi
- Università degli Studi di Milano, Scuola di Specializzazione in Ortopedia, Milan, Italy
| | - Mauro Battista Gallazzi
- Struttura Complessa di Radiologia, Azienda Sociosanitaria Territoriale PINI-CTO, Milan, Italy
| | - Primo Andrea Daolio
- Struttura Complessa di Ortopedia Oncologica, Azienda Sociosanitaria Territoriale PINI-CTO, Milan, Italy
| | - Luca Maria Sconfienza
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
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Bruno F, Arrigoni F, Mariani S, Splendiani A, Di Cesare E, Masciocchi C, Barile A. Advanced magnetic resonance imaging (MRI) of soft tissue tumors: techniques and applications. Radiol Med 2019; 124:243-252. [PMID: 30949892 DOI: 10.1007/s11547-019-01035-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 03/29/2019] [Indexed: 12/20/2022]
Abstract
Imaging evaluation of soft tissue tumors is important for the diagnosis, staging, and follow-up. Magnetic resonance imaging (MRI) is the preferred imaging modality due to its multiplanarity and optimal tissue contrast resolution. However, standard morphological sequences are often not sufficient to characterize the exact nature of the lesion, addressing the patient to an invasive bioptic examination for the definitive diagnosis. The recent technological advances with the development of functional MRI modalities such as diffusion-weighted imaging, dynamic contrast-enhanced perfusion imaging, magnetic resonance spectroscopy, and diffusion tensor imaging with tractography have implemented the multiparametricity of MR to evaluate in a noninvasive manner the biochemical, structural, and metabolic features of tumor tissues. The purpose of this article is to review the state of the art of these advanced MRI techniques, with focus on their technique and clinical application.
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Affiliation(s)
- Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, S. Salvatore Hospital, University of L'Aquila, Vetoio Street, 1, 67100, L'Aquila, Italy
| | - Francesco Arrigoni
- Department of Biotechnology and Applied Clinical Sciences, S. Salvatore Hospital, University of L'Aquila, Vetoio Street, 1, 67100, L'Aquila, Italy
| | - Silvia Mariani
- Department of Biotechnology and Applied Clinical Sciences, S. Salvatore Hospital, University of L'Aquila, Vetoio Street, 1, 67100, L'Aquila, Italy
| | - Alessandra Splendiani
- Department of Biotechnology and Applied Clinical Sciences, S. Salvatore Hospital, University of L'Aquila, Vetoio Street, 1, 67100, L'Aquila, Italy
| | - Ernesto Di Cesare
- Department of Biotechnology and Applied Clinical Sciences, S. Salvatore Hospital, University of L'Aquila, Vetoio Street, 1, 67100, L'Aquila, Italy
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, S. Salvatore Hospital, University of L'Aquila, Vetoio Street, 1, 67100, L'Aquila, Italy
| | - Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, S. Salvatore Hospital, University of L'Aquila, Vetoio Street, 1, 67100, L'Aquila, Italy.
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Position paper on magnetic resonance imaging protocols in the musculoskeletal system (excluding the spine) by the Italian College of Musculoskeletal Radiology. Radiol Med 2019; 124:522-538. [DOI: 10.1007/s11547-019-00992-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 01/14/2019] [Indexed: 12/12/2022]
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Arrigoni F, Bruno F, Zugaro L, Splendiani A, Di Cesare E, Barile A, Masciocchi C. Role of interventional radiology in the management of musculoskeletal soft-tissue lesions. Radiol Med 2018; 124:253-258. [PMID: 29687209 DOI: 10.1007/s11547-018-0893-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/09/2018] [Indexed: 12/13/2022]
Abstract
The lesions of the soft tissues are rare and extremely heterogeneous; even if the surgical treatment is usually the standard therapy, the role of the interventional radiology (IR) in this field is growing up for multiple reasons. First, because the imaging alone usually is not able to ensure a definitive diagnosis, IR has a basic role in the staging: the percutaneous biopsy is infact an irreplaceable step. Moreover, biopsy is necessary not only for histologic evaluations but also for the biochemical and molecular studies. Furthermore, the proved safety and effectiveness of IR in a multiple oncologial applications prompt a wider use also in this field.
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Affiliation(s)
- Francesco Arrigoni
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, S. Salvatore Hospital, Vetoio Street,1, 67100, L'Aquila, Italy
| | - Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, S. Salvatore Hospital, Vetoio Street,1, 67100, L'Aquila, Italy
| | - Luigi Zugaro
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, S. Salvatore Hospital, Vetoio Street,1, 67100, L'Aquila, Italy
| | - Alessandra Splendiani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, S. Salvatore Hospital, Vetoio Street,1, 67100, L'Aquila, Italy
| | - Ernesto Di Cesare
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, S. Salvatore Hospital, Vetoio Street,1, 67100, L'Aquila, Italy
| | - Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, S. Salvatore Hospital, Vetoio Street,1, 67100, L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, S. Salvatore Hospital, Vetoio Street,1, 67100, L'Aquila, Italy
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Albano D, Patti C, Matranga D, Lagalla R, Midiri M, Galia M. Whole-body diffusion-weighted MR and FDG-PET/CT in Hodgkin Lymphoma: Predictive role before treatment and early assessment after two courses of ABVD. Eur J Radiol 2018; 103:90-98. [PMID: 29803392 DOI: 10.1016/j.ejrad.2018.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/03/2018] [Accepted: 04/10/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate whether imaging features of pathologic lymph nodes on whole-body diffusion-weighted MR have a predictive role before treatment and may assess the response after two courses of chemotherapy in comparison to FDG-PET/CT in Hodgkin Lymphoma. MATERIALS AND METHODS We reviewed the whole-body MR and FDG-PET/CT performed on 41 patients with Hodgkin Lymphoma before and after two Doxorubicin-Bleomycin-Vinblastine-Dacarbazine (ABVD). Responder and non-responder lesions were identified on interim-FDG-PET/CT performed after two ABVD. We used Multivariate Generalized Estimating Equations model to assess statistical association between being-responder and baseline-Maximum Standard Uptake Value (SUVmax), baseline and interim-Apparent Diffusion Coefficient (ADC) and size, ADC and size changes during chemotherapy, site of disease, bulky, and stage. RESULTS 10/41 (24%) patients were positive on interim-FDG-PET/CT. The interim-FDG-PET/CT positivity was associated with worse cumulative survival rate at 24 months in comparison to interim-FDG-PET/CT negativity (P < .05); 3/10 patients with positive interim-FDG-PET/CT and 1/31 with negative interim-FDG-PET/CT experienced disease progression. Baseline-SUVmax was 11.18 ± 5.58 (3.1-28.0) and baseline-ADC was 0.70 ± 0.14 × 10-3 mm2/s (0.39-0.98). There was a significant difference between responder and non-responder lesions based on interim-ADC (1.83 ± 0.34 × 10-3 mm2/s vs. 1.01 ± 0.27 × 10-3 mm2/s;p <.001), interim-size (3.1 cm2 vs. 9.4 cm2;p = .009), and bulky (8.2% vs. 66.7%;p = .002). There was no significant difference between responder and non-responder lesions based on baseline-SUVmax (p = .713), baseline-ADC (p = .253), ADC changes (p = .058), size changes (p = .085), site (p = .209), stage (p = .290), baseline-size (p = .064). CONCLUSIONS Interim-ADC is helpful for identifying non-responder lesions, while size changes are not useful. Baseline-SUVmax and ADC have no predictive role. Bulky is the most useful imaging parameter to predict suboptimal response to chemotherapy.
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Affiliation(s)
- Domenico Albano
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
| | - Caterina Patti
- Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Viale Trabucco 180, 90146 Palermo, Italy.
| | - Domenica Matranga
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy.
| | - Roberto Lagalla
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
| | - Massimo Midiri
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
| | - Massimo Galia
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
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ADC as a useful diagnostic tool for differentiating benign and malignant vertebral bone marrow lesions and compression fractures: a systematic review and meta-analysis. Eur Radiol 2018; 28:2890-2902. [DOI: 10.1007/s00330-018-5330-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/10/2018] [Accepted: 01/12/2018] [Indexed: 12/14/2022]
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Messina C, Sconfienza LM, Guglielmi G. Highlights of the annual scientific meeting of the 24th congress of the European Society of Musculoskeletal Radiology (ESSR) 2017. Skeletal Radiol 2018; 47:1-3. [PMID: 28932885 DOI: 10.1007/s00256-017-2774-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/04/2017] [Accepted: 09/05/2017] [Indexed: 02/02/2023]
Abstract
This paper summarizes the main aspects of the 24th Annual Scientific Meeting of the European Society of Musculoskeletal Radiology (ESSR), which was hosted in Bari (Italy) in June 2017.
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Affiliation(s)
- Carmelo Messina
- Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Galeazzi 4, 20161, Milan, Italy
| | - Luca Maria Sconfienza
- Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Galeazzi 4, 20161, Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy.
- Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy.
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Chen H, Wu Z, Xu W, Pang J, Jia M, Dong C, Li X. Evaluating the Scope of Malignant Bone Tumor Using ADC Measurement on ADC Map. Technol Cancer Res Treat 2018; 18:1533033819853267. [PMID: 31122153 PMCID: PMC6535712 DOI: 10.1177/1533033819853267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It is very important for surgeons to know the accurate borders of malignant bone tumors before they can precisely resect the tumors. The objective of the study is to investigate the usefulness of apparent diffusion coefficient value for estimating the extent of malignant bone tumor. METHODS VX2 tumor fragments were implanted into the tibiae of 30 rabbits. After 4 weeks, magnetic resonance plain scans were performed and then tumor specimens were cut into sagittal sections and partitioned into histology slices for dot-to-dot comparisons with microscopic findings. The sizes of the tumors measured separately on specimen, conventional magnetic resonance imaging sequences, and diffusion-weighted imaging (by measuring apparent diffusion coefficient value on apparent diffusion coefficient mapping) were compared statistically with each other. RESULTS The mean tumor sizes measured on specimen and apparent diffusion coefficient mapping (by calculating apparent diffusion coefficient value) were 5.20 ± 0.89 cm and 5.31 ± 0.87 cm, respectively; there was no significant difference between the 2 ( P > .05). The tumor sizes measured on T1WI, T2WI, T2WI with fat suppression were 4.82 ± 0.87 cm, 5.58 ± 0.87 cm, 5.63 ± 0.85 cm, respectively, and these values were significantly different from that measured on specimen (5.20 ± 0.89 cm, P < .05). CONCLUSION The extent of the VX2 malignant bone tumor can be estimated accurately by measurement of apparent diffusion coefficient value.
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Affiliation(s)
- Haisong Chen
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zengjie Wu
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wenjian Xu
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
- Wenjian Xu, MD, PhD, Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China.
| | - Jing Pang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Meng Jia
- Department of Ultrasound, The Women and Children’s Hospital of Qingdao, Qingdao, China
| | - Cheng Dong
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaoli Li
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Chianca V, Albano D, Messina C, Cinnante CM, Triulzi FM, Sardanelli F, Sconfienza LM. Diffusion tensor imaging in the musculoskeletal and peripheral nerve systems: from experimental to clinical applications. Eur Radiol Exp 2017; 1:12. [PMID: 29708174 PMCID: PMC5909344 DOI: 10.1186/s41747-017-0018-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 08/01/2017] [Indexed: 12/14/2022] Open
Abstract
Magnetic resonance imaging (MRI) is a well-established imaging modality which is used in all districts of the musculoskeletal and peripheral nerve systems. More recently, initial studies have applied multiparametric MRI to evaluate quantitatively different aspects of musculoskeletal and peripheral nerve diseases, thus providing not only images but also numbers and clinical data. Besides 1H and 31P magnetic resonance spectroscopy, diffusion-weighted imaging (DWI) and blood oxygenation level-dependent imaging, diffusion tensor imaging (DTI) is a relatively new MRI-based technique relying on principles of DWI, which has traditionally been used mainly for evaluating the central nervous system to track fibre course. In the musculoskeletal and peripheral nerve systems, DTI has been mostly used in experimental settings, with still few indications in clinical practice. In this review, we describe the potential use of DTI to evaluate different musculoskeletal and peripheral nerve conditions, emphasising the translational aspects of this technique from the experimental to the clinical setting.
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Affiliation(s)
- Vito Chianca
- 1Department of Advanced Biomedical Sciences, Università Federico II, Via Pansini 5, 80131 11 Napoli, Italy
| | - Domenico Albano
- 2Department of Radiology, DIBIMED, Università di Palermo, Via del Vespro 127, 90127 Palermo, Italy
| | - Carmelo Messina
- 7Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milano, Italy
| | - Claudia Maria Cinnante
- 3Unit of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy
| | - Fabio Maria Triulzi
- 3Unit of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy.,5Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Francesco Sardanelli
- 4Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy.,6Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, 20122 Milano, Italy
| | - Luca Maria Sconfienza
- 6Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, 20122 Milano, Italy.,7Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milano, Italy
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