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Krueger PC, Krämer M, Benkert T, Ertel S, Teichgräber U, Waginger M, Mentzel HJ, Glutig K. Whole-body diffusion magnetic resonance imaging with simultaneous multi-slice excitation in children and adolescents. Pediatr Radiol 2023; 53:1485-1496. [PMID: 36920515 PMCID: PMC10276081 DOI: 10.1007/s00247-023-05622-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Whole-body magnetic resonance imaging (WB-MRI) is an increasingly used guideline-based imaging modality for oncological and non-oncological pathologies during childhood and adolescence. While diffusion-weighted imaging (DWI), a part of WB-MRI, enhances image interpretation and improves sensitivity, it also requires the longest acquisition time during a typical WB-MRI scan protocol. Interleaved short tau inversion recovery (STIR) DWI with simultaneous multi-slice (SMS) acquisition is an effective way to speed up examinations. OBJECTIVE In this study of children and adolescents, we compared the acquisition time, image quality, signal-to-noise ratio (SNR) and apparent diffusion coefficient (ADC) values of an interleaved STIR SMS-DWI sequence with a standard non-accelerated DWI sequence for WB-MRI. MATERIALS AND METHODS Twenty children and adolescents (mean age: 13.9 years) who received two WB-MRI scans at a maximum interval of 18 months, consisting of either standard DWI or SMS-DWI MRI, respectively, were included. For quantitative evaluation, the signal-to-noise ratio (SNR) was determined for b800 images and ADC maps of seven anatomical regions. Image quality evaluation was independently performed by two experienced paediatric radiologists using a 5-point Likert scale. The measurement time per slice stack, pause between measurements including shim and total measurement time of DWI for standard DWI and SMS-DWI were extracted directly from the scan data. RESULTS When including the shim duration, the acquisition time for SMS-DWI was 43% faster than for standard DWI. Qualitatively, the scores of SMS-DWI were higher in six locations in the b800 images and four locations in the ADC maps. There was substantial agreement between both readers, with a Cohen's kappa of 0.75. Quantitatively, the SNR in the b800 images and the ADC maps did not differ significantly from one another. CONCLUSION Whole body-MRI with SMS-DWI provided equivalent image quality and reduced the acquisition time almost by half compared to the standard WB-DWI protocol.
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Affiliation(s)
- Paul-Christian Krueger
- Section Paediatric Radiology, Department of Radiology, Jena University Hospital, Am Klinikum 1, Jena, Germany
| | - Martin Krämer
- Department of Radiology, Jena University Hospital, Jena, Germany
| | - Thomas Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Sophia Ertel
- Section Paediatric Radiology, Department of Radiology, Jena University Hospital, Am Klinikum 1, Jena, Germany
| | - Ulf Teichgräber
- Department of Radiology, Jena University Hospital, Jena, Germany
| | - Matthias Waginger
- Section Paediatric Radiology, Department of Radiology, Jena University Hospital, Am Klinikum 1, Jena, Germany
| | - Hans-Joachim Mentzel
- Section Paediatric Radiology, Department of Radiology, Jena University Hospital, Am Klinikum 1, Jena, Germany
| | - Katja Glutig
- Section Paediatric Radiology, Department of Radiology, Jena University Hospital, Am Klinikum 1, Jena, Germany
- Clinic for Radiology – Focus Pediatric Radiology, University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1 – Building A1, Münster, Germany
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Herrmann J, Esser M, Brecht I, Tsiflikas I, Schäfer JF. [Whole-body MRI in cancer predisposition syndromes]. RADIOLOGIE (HEIDELBERG, GERMANY) 2022; 62:1017-1025. [PMID: 36098807 DOI: 10.1007/s00117-022-01067-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In recent decades, whole-body magnetic resonance imaging (WB-MRI) has become established as the modality of choice for the diagnosis, staging, and follow-up of oncological diseases as well as for the screening of cancer predisposition syndromes, such as Li-Fraumeni syndrome. METHODS As a comprehensive imaging modality without ionizing radiation, WB-MRI can be used repetitively and because of its excellent soft tissue contrast and high resolution provides early and precise detection of pathologies. This article discusses the technical requirements, some examination strategies and the clinical significance of typical findings of WB-MRI in patients with cancer predisposition syndromes.
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Affiliation(s)
- Judith Herrmann
- Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland.
| | - Michael Esser
- Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland
| | - Ines Brecht
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Ilias Tsiflikas
- Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland
| | - Jürgen F Schäfer
- Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland
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Kagatani J, Asakura T, Sekine K, Watanabe H, Kawada M, Ohkusu K, Koyama T. Clinical utility of whole body diffusion-weighted imaging in an immunocompetent adult with atypical cat scratch disease. J Infect Chemother 2022; 28:1558-1561. [PMID: 35921966 DOI: 10.1016/j.jiac.2022.07.013] [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] [Received: 05/03/2022] [Revised: 06/25/2022] [Accepted: 07/18/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Cat scratch disease (CSD) is an infectious disease caused by Bartonella henselae. CSD follows a typical course, characterized by regional lymphadenopathy. In atypical CSD, the lesions spread to systemic organs and can cause fever of unknown origin (FUO). A previous study showed the usefulness of whole-body magnetic resonance imaging (WB-MRI) with diffusion-weighted imaging (DWI) for limited areas in the diagnosis of FUO, but there are no studies on the clinical utility of whole-body DWI (WB-DWI). We herein report the case of an immunocompetent young man in whom contrast-enhanced CT-unidentifiable multiple liver abscess and osteomyelitis were successfully detected by WB-DWI. Follow-up with a liver biopsy helped confirm an atypical CSD diagnosis. CASE PRESENTATION A 23-year-old previously healthy man was admitted for a 19-day history of high fever despite 3-day treatment by azithromycin. His physical examination was unremarkable and contrast-enhanced CT showed only a low attenuated area in the right lobe of the liver, indicating a cyst. WB-DWI revealed multiple nodular lesions of hypo-diffusion in the liver, spine, and pelvic region. The biopsy specimens of the liver abscess showed no evidence of tuberculosis/malignancy and the polymerase chain reaction (PCR) test of liver abscess aspirate showed positive findings for Bartonellahenselae, confirming the diagnosis of CSD. He completed minocycline monotherapy for a total of 60 days without any deterioration. CONCLUSIONS WB-DWI can be useful for the diagnosis of atypical CSD with hepatic and bone involvement, which can cause FUO in young immunocompetent adults.
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Affiliation(s)
- Jin Kagatani
- Department of Internal Medicine, Saitama City Hospital, Saitama, Japan.
| | - Takanori Asakura
- Department of Pulmonary Medicine, Saitama City Hospital, Saitama, Japan; Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Katsutoshi Sekine
- Department of Internal Medicine, Saitama City Hospital, Saitama, Japan
| | - Hiromi Watanabe
- Department of Diagnostic Radiology, Saitama City Hospital, Saitama, Japan
| | - Miki Kawada
- Department of Infectious Diseases, Saitama City Hospital, Saitama, Japan
| | - Kiyofumi Ohkusu
- Department of Microbiology, Tokyo Medical University, Tokyo, Japan
| | - Takashi Koyama
- Department of Internal Medicine, Saitama City Hospital, Saitama, Japan
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Radbruch A, Paech D, Gassenmaier S, Luetkens J, Isaak A, Herrmann J, Othman A, Schäfer J, Nikolaou K. 1.5 vs 3 Tesla Magnetic Resonance Imaging: A Review of Favorite Clinical Applications for Both Field Strengths-Part 2. Invest Radiol 2021; 56:692-704. [PMID: 34417406 DOI: 10.1097/rli.0000000000000818] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
ABSTRACT The second part of this review deals with experiences in neuroradiological and pediatric examinations using modern magnetic resonance imaging systems with 1.5 T and 3 T, with special attention paid to experiences in pediatric cardiac imaging. In addition, whole-body examinations, which are widely used for diagnostic purposes in systemic diseases, are compared with respect to the image quality obtained in different body parts at both field strengths. A systematic overview of the technical differences at 1.5 T and 3 T has been presented in part 1 of this review, as well as several organ-based magnetic resonance imaging applications including musculoskeletal imaging, abdominal imaging, and prostate diagnostics.
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Affiliation(s)
- Alexander Radbruch
- From the Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Bonn, Bonn
| | - Daniel Paech
- From the Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Bonn, Bonn
| | - Sebastian Gassenmaier
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Tübingen
| | - Julian Luetkens
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Alexander Isaak
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Judith Herrmann
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Tübingen
| | | | - Jürgen Schäfer
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Tübingen
| | - Konstantin Nikolaou
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Tübingen
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Tavakoli AA, Reichert M, Blank T, Dinter D, Weckbach S, Buchheidt D, Schoenberg SO, Attenberger U. Findings in whole body MRI and conventional imaging in patients with fever of unknown origin-a retrospective study. BMC Med Imaging 2020; 20:94. [PMID: 32767967 PMCID: PMC7412796 DOI: 10.1186/s12880-020-00493-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 07/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background To analyse the influence of whole body (wb)-MRI on patient management compared to routine diagnostic tests in patients with fever of unknown origin (FUO). Methods Twenty-four patients with FUO, defined as illness of more than three weeks with fever greater than 38.3 °C, underwent wb-MRI at a 1.5 T MR-system. The MR-protocol consisted of the following sequences: axial T1 VIBE, coronal T2-TIRM and a coronal echoplanar diffusion weighted sequence (overall acquisition time 29:39 min:s). Furthermore, laboratory findings, chest-x-ray, abdominal ultrasound, CT-scans and/or PET-CT scans were evaluated and compared to the wb-MRI findings in regard to treatment changes. Results Wb-MRI yielded a correct diagnosis in 70% of the patients. In 46% the inflammatory focus was exclusively detected by wb-MRI. Focus detection by wb-MRI led to a subsequent change of the clinical management in 92% of the patients. In 6 patients both a wb-MRI and a PET-CT were performed yielding the correct diagnosis in the same 4 of 6 patients for both imaging modalities. Conclusions Wb-MRI appears to be of value in the evaluation of FUO patients, allowing for optimized treatment by increasing diagnostic certainty. Due to its lack of nephrotoxicity and ionizing radiation it may be preferred over standard imaging techniques and PET-CT in the future. However, given the low number of patients in our trial, further prospective studies have to be performed to confirm our results.
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Affiliation(s)
- Anoshirwan Andrej Tavakoli
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany. .,Department of Radiology, German Cancer Research Center (Dkfz), Heidelberg, Germany.
| | - Miriam Reichert
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany
| | - Tanja Blank
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany
| | - Dietmar Dinter
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany.,Radiologie Schwetzingen, Schwetzingen, Germany
| | - Sabine Weckbach
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany.,Department of Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dieter Buchheidt
- Department of Hematology and Oncology, University Medical Center Mannheim, Mannheim, Germany
| | - Stefan Oswald Schoenberg
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany
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Schäfer JF, Granata C, von Kalle T, Kyncl M, Littooij AS, Di Paolo PL, Sefic Pasic I, Nievelstein RAJ. Whole-body magnetic resonance imaging in pediatric oncology - recommendations by the Oncology Task Force of the ESPR. Pediatr Radiol 2020; 50:1162-1174. [PMID: 32468287 PMCID: PMC7329776 DOI: 10.1007/s00247-020-04683-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/03/2020] [Accepted: 04/16/2020] [Indexed: 12/20/2022]
Abstract
The purpose of this recommendation of the Oncology Task Force of the European Society of Paediatric Radiology (ESPR) is to indicate reasonable applications of whole-body MRI in children with cancer and to address useful protocols to optimize workflow and diagnostic performance. Whole-body MRI as a radiation-free modality has been increasingly performed over the last two decades, and newer applications, as in screening of children with germ-line mutation cancer-related gene defects, are now widely accepted. We aim to provide a comprehensive outline of the diagnostic value for use in daily practice. Based on the results of our task force session in 2018 and the revision in 2019 during the ESPR meeting, we summarized our group's experiences in whole-body MRI. The lack of large evidence by clinical studies is challenging when focusing on a balanced view regarding the impact of whole-body MRI in pediatric oncology. Therefore, the final version of this recommendation was supported by the members of Oncology Task Force.
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Affiliation(s)
- Jürgen F Schäfer
- Division of Pediatric Radiology, Department of Radiology, University Hospital of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
| | - Claudio Granata
- Department of Paediatric Radiology, IRCCS materno infantile Burlo Garofolo, Trieste, Italy
| | - Thekla von Kalle
- Department of Pediatric Radiology, Olgahospital Klinikum Stuttgart, Stuttgart, Germany
| | - Martin Kyncl
- Department of Pediatric Radiology, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Annemieke S Littooij
- Department of Radiology & Nuclear Medicine, Princess Maxima Center for Pediatric Oncology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Irmina Sefic Pasic
- Radiology Clinic, Sarajevo School of Science and Technology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Rutger A J Nievelstein
- Department of Radiology & Nuclear Medicine, Princess Maxima Center for Pediatric Oncology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, The Netherlands
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Lorenzen J, Schenzer-Hoffmann E, Braun C, Lorenzen M, Anders S, Adam G, Püschel K. Todesursachenbestimmung mit verblindeter koronaler Ganzkörper-MRT im Vergleich zur rechtsmedizinischen Untersuchung. Rechtsmedizin (Berl) 2019. [DOI: 10.1007/s00194-019-0329-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Whole-Body Magnetic Resonance Imaging in the Oncology Setting: An Overview and Update on Recent Advances. J Comput Assist Tomogr 2018; 43:66-75. [PMID: 30015799 DOI: 10.1097/rct.0000000000000772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Whole-body magnetic resonance imaging is becoming an important tool in oncology as a nonirradiating imaging technique since recent technological advances allowed the incorporation of high-quality imaging in an adequate time. Moreover, the noninjection of radioisotope/intravenous contrast, low cost compared with traditional nuclear medicine techniques, and fast acquisition times are another distinct feature. Thus, the purpose of this article is to review the whole-body magnetic resonance imaging protocol and its main applications in the oncology setting.
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Carotti M, Galeazzi V, Catucci F, Zappia M, Arrigoni F, Barile A, Giovagnoni A. Clinical utility of eco-color-power Doppler ultrasonography and contrast enhanced magnetic resonance imaging for interpretation and quantification of joint synovitis: a review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:48-77. [PMID: 29350637 PMCID: PMC6179068 DOI: 10.23750/abm.v89i1-s.7010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 01/11/2018] [Indexed: 12/11/2022]
Abstract
With the introduction of new biologics such as anti-TNF-alpha antibodies and other therapies in the treatment of inflammatory arthritis, capable of halting joint destruction and functional disability, there are new pressures on diagnostic and prognostic imaging. Early demonstration of pre-erosive inflammatory features and monitoring of the long-term effects of treatment are becoming increasingly important. Early detection of synovitis offers advantages in terms of allowing early instigation of therapy and may allow the identification of those patients displaying more aggressive disease who might benefit from early intervention with expensive DMARD therapy. Advanced imaging techniques such as ultrasound (US) and magnetic resonance imaging (MRI) have focussed on the demonstration and quantification of synovitis and allow early diagnosis of inflammatory arthropathies such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Synovitis represents a potential surrogate measure of disease activity that can be monitored using either MRI or US; the techniques have, generally, focused on monitoring synovial volume or quality as assessed by its vascularity. However to achieve these goals, standardisation and validation of US and MRI are required to ensure accurate diagnosis, reproducibility and reliability. Each modality has different strengths and weaknesses and levels of validation. This article aims to increase the awareness of radiologists and rheumatologists about this field and to encourage them to participate and contribute to the ongoing development of these modalities. Without this collaboration, it is unlikely that these modalities will reach their full potential in the field of rheumatological imaging. This review is in two parts. The first part addresses the role of US and colour or power Doppler sonography (PDUS) in the detection and monitoring of synovitis in inflammatory arthropathies. The second part will look at advanced MR imaging and Dynamic contrast-enhanced MRI techniques and in particular how they are applied to the monitoring of the disease process.
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Wu R, Suo ST, Wu LM, Yao QY, Gong HX, Xu JR. Assessment of chemotherapy response in non-Hodgkin lymphoma involving the neck utilizing diffusion kurtosis imaging: a preliminary study. Diagn Interv Radiol 2018; 23:245-249. [PMID: 28381389 DOI: 10.5152/dir.2017.16184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE We aimed to examine the utility of non-Gaussian diffusion kurtosis imaging (DKI) for assessment of chemotherapy response in patients with cervical (neck) non-Hodgkin lymphoma (NHL). METHODS Patients with cervical NHL underwent 3.0 T magnetic resonance imaging with maximal b value of 2000 s/mm2 at baseline and seven days after chemotherapy onset. Apparent diffusion coefficient (ADC) value and diffusion kurtosis imaging maps for diffusion coefficient (D) and kurtosis (K) were calculated. Based on clinical examination, laboratory screening, and PET/CTs, patients were classified as responders or nonresponders. RESULTS Twenty-six patients were enrolled. Among them, 24 patients were classified as responders and two as nonresponders. For responders, mean follow-up ADC and D increased significantly compared with baseline (ADC: 0.92±0.11 ×10-3 mm2/s vs. 0.68±0.11 ×10-3 mm2/s; D: 1.47±0.32 ×10-3 mm2/s vs. 0.98±0.21 ×10-3 mm2/s, P < 0.001 for both). Mean follow-up K decreased significantly compared with baseline (1.14±0.10 vs. 1.47±0.19, P < 0.001) for responders. Dratio showed significant positive correlation and high agreement with ADCratio (r = 0.776, P < 0.001). Likewise, Kratio showed significant negative correlation and high agreement with ADCratio (r = -0.658, P < 0.001). CONCLUSION The new DKI model may serve as a new biomarker for the evaluation of early chemotherapy response in NHL.
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Affiliation(s)
- Rui Wu
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Lee DH, Nam JK, Jung HS, Kim SJ, Chung MK, Park SW. Does T1- and diffusion-weighted magnetic resonance imaging give value-added than bone scintigraphy in the follow-up of vertebral metastasis of prostate cancer? Investig Clin Urol 2017; 58:324-330. [PMID: 28868503 PMCID: PMC5577328 DOI: 10.4111/icu.2017.58.5.324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 04/17/2017] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate the effectiveness of limited Magnetic Resonance (MR) images including T1- and diffusion-weighted image (DWI) for monitoring vertebral metastasis in patients with prostate cancer. MATERIALS AND METHODS From July 2014 to November 2016, patients diagnosed with spinal metastasis from prostate cancer using 99mTc bone scintigraphy were enrolled. Regardless of the primary local therapy, the changes in spinal metastasis were followed up using bone scan and biparametric MR (T1+DWI). All tests were followed up for more than 3 months. RESULTS Among the 14 follow-ups of 10 patients, 6 and 10 (including all progressed cases on bone scan) follow-ups were determined to show progressive disease using bone scan and biparametric MR, respectively. Otherwise, we could have predicted neurologic sequela earlier using biparametric MR. Examination time for biparametric MR was 15 minutes, and it was 4 hours for bone scan, respectively. CONCLUSIONS Although bone scan has been considered the standard test for bony metastasis in men with prostate cancer, limited MR including T1 and DWI has an additional benefit in monitoring spinal metastasis in patients who are already diagnosed as having spinal metastasis. The limited MR is more sensitive in detecting progressive disease. In addition, it can reduce neurologic complications caused by spinal metastasis.
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Affiliation(s)
- Dong Hoon Lee
- Department of Urology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Jong Kil Nam
- Department of Urology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Hee Suk Jung
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Seong Jang Kim
- Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Moon Kee Chung
- Department of Urology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Sung-Woo Park
- Department of Urology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Walker A, Liney G, Holloway L, Dowling J, Rivest-Henault D, Metcalfe P. Continuous table acquisition MRI for radiotherapy treatment planning: distortion assessment with a new extended 3D volumetric phantom. Med Phys 2015; 42:1982-91. [PMID: 25832089 DOI: 10.1118/1.4915920] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Accurate geometry is required for radiotherapy treatment planning (RTP). When considering the use of magnetic resonance imaging (MRI) for RTP, geometric distortions observed in the acquired images should be considered. While scanner technology and vendor supplied correction algorithms provide some correction, large distortions are still present in images, even when considering considerably smaller scan lengths than those typically acquired with CT in conventional RTP. This study investigates MRI acquisition with a moving table compared with static scans for potential geometric benefits for RTP. METHODS A full field of view (FOV) phantom (diameter 500 mm; length 513 mm) was developed for measuring geometric distortions in MR images over volumes pertinent to RTP. The phantom consisted of layers of refined plastic within which vitamin E capsules were inserted. The phantom was scanned on CT to provide the geometric gold standard and on MRI, with differences in capsule location determining the distortion. MRI images were acquired with two techniques. For the first method, standard static table acquisitions were considered. Both 2D and 3D acquisition techniques were investigated. With the second technique, images were acquired with a moving table. The same sequence was acquired with a static table and then with table speeds of 1.1 mm/s and 2 mm/s. All of the MR images acquired were registered to the CT dataset using a deformable B-spline registration with the resulting deformation fields providing the distortion information for each acquisition. RESULTS MR images acquired with the moving table enabled imaging of the whole phantom length while images acquired with a static table were only able to image 50%-70% of the phantom length of 513 mm. Maximum distortion values were reduced across a larger volume when imaging with a moving table. Increased table speed resulted in a larger contribution of distortion from gradient nonlinearities in the through-plane direction and an increased blurring of capsule images, resulting in an apparent capsule volume increase by up to 170% in extreme axial FOV regions. Blurring increased with table speed and in the central regions of the phantom, geometric distortion was less for static table acquisitions compared to a table speed of 2 mm/s over the same volume. Overall, the best geometric accuracy was achieved with a table speed of 1.1 mm/s. CONCLUSIONS The phantom designed enables full FOV imaging for distortion assessment for the purposes of RTP. MRI acquisition with a moving table extends the imaging volume in the z direction with reduced distortions which could be useful particularly if considering MR-only planning. If utilizing MR images to provide additional soft tissue information to the planning CT, standard acquisition sequences over a smaller volume would avoid introducing additional blurring or distortions from the through-plane table movement.
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Affiliation(s)
- Amy Walker
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia and Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Gary Liney
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia; Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; and South West Clinical School, University of New South Wales, Sydney, NSW 2170, Australia
| | - Lois Holloway
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia; Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; South West Clinical School, University of New South Wales, Sydney, NSW 2170, Australia; and Institute of Medical Physics, School of Physics, University of Sydney, Sydney, NSW 2006, Australia
| | - Jason Dowling
- Commonwealth Scientific and Industrial Research Organisation, Australian E-Health Research Centre, Herston, QLD 4029, Australia
| | - David Rivest-Henault
- Commonwealth Scientific and Industrial Research Organisation, Australian E-Health Research Centre, Herston, QLD 4029, Australia
| | - Peter Metcalfe
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia and Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
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Teixeira SR, Elias Junior J, Nogueira-Barbosa MH, Guimarães MD, Marchiori E, Santos MK. Whole-body magnetic resonance imaging in children: state of the art. Radiol Bras 2015; 48:111-20. [PMID: 25987752 PMCID: PMC4433302 DOI: 10.1590/0100-3984.2014.0005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 03/24/2014] [Indexed: 11/22/2022] Open
Abstract
Whole-body imaging in children was classically performed with radiography,
positron-emission tomography, either combined or not with computed tomography, the
latter with the disadvantage of exposure to ionizing radiation. Whole-body magnetic
resonance imaging (MRI), in association with the recently developed metabolic and
functional techniques such as diffusion-weighted imaging, has brought the advantage
of a comprehensive evaluation of pediatric patients without the risks inherent to
ionizing radiation usually present in other conventional imaging methods. It is a
rapid and sensitive method, particularly in pediatrics, for detecting and monitoring
multifocal lesions in the body as a whole. In pediatrics, it is utilized for both
oncologic and non-oncologic indications such as screening and diagnosis of tumors in
patients with genetic syndromes, evaluation of disease extent and staging, evaluation
of therapeutic response and post-therapy follow-up, evaluation of non neoplastic
diseases such as multifocal osteomyelitis, vascular malformations and syndromes
affecting multiple regions of the body. The present review was aimed at describing
the major indications of whole-body MRI in pediatrics added of technical
considerations.
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Affiliation(s)
- Sara Reis Teixeira
- PhD, Attending Physician at Centro de Ciências das Imagens e Física Médica (CCIFM) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | - Jorge Elias Junior
- PhD, Associate Professor, Division of Radiology, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | - Marcello Henrique Nogueira-Barbosa
- PhD, Professor, Division of Radiology, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | - Marcos Duarte Guimarães
- PhD, Attending Physician at Hospital Heliópolis and A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Edson Marchiori
- PhD, Full Professor, Division of Radiology, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | - Marcel Koenigkam Santos
- PhD, Attending Physician at Centro de Ciências das Imagens e Física Médica (CCIFM) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
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Voit AM, Arnoldi AP, Douis H, Bleisteiner F, Jansson MK, Reiser MF, Weckbach S, Jansson AF. Whole-body Magnetic Resonance Imaging in Chronic Recurrent Multifocal Osteomyelitis: Clinical Longterm Assessment May Underestimate Activity. J Rheumatol 2015; 42:1455-62. [PMID: 25979713 DOI: 10.3899/jrheum.141026] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE (1) To examine how many patients have clinically and/or radiologically active chronic recurrent multifocal osteomyelitis (CRMO) ≥ 10 years after first onset of symptoms, and (2) to compare clinical and whole-body magnetic resonance imaging (WB-MRI) findings. METHODS Seventeen patients (82% women) who were diagnosed with childhood-onset CRMO at least 10 years (average 12) before reexamination were reevaluated. Patients completed a standardized questionnaire, and underwent clinical and laboratory investigation and WB-MRI. Clinical features were compared with imaging findings. RESULTS Five patients were found to be in clinical and radiological remission. One of these patients demonstrated 1 radiologically inactive lesion on WB-MRI. Four patients showed radiologically active lesions despite full clinical remission, 2 of them in 3 vertebral bodies. Spinal involvement in 6 patients (35%) caused vertebral compression fractures, vertebra plana, or vertebral hemifusion. Eight patients presented with ongoing clinical disease activity. When applying a CRMO activity score based on clinical and imaging findings, 2 patients were identified as having pain amplification. Overall, 22/55 known CRMO lesions were identified; 11 of them were radiologically active lesions. Additionally, 14 so far unknown clinically silent lesions were detected: 8 radiologically active lesions and 6 radiologically inactive lesions. CONCLUSION CRMO activity on longterm followup might have been underestimated. Our study demonstrates that clinical remission does not necessarily mean radiological remission. We therefore propose that all patients with CRMO, including patients in clinical remission, require longterm clinical followup and should undergo evaluation with WB-MRI on a regular basis until radiological remission or a steady state of disease is achieved.
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Affiliation(s)
- Agnes M Voit
- From the Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; Institute for Clinical Radiology, Ludwig Maximilians University of Munich, Munich; Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; and the Department of Radiology, Royal Orthopaedic Hospital, Birmingham, UK.A.M. Voit*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; A.P. Arnoldi*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; H. Douis, MD, Department of Radiology, Royal Orthopaedic Hospital; F. Bleisteiner, MD; M.K. Jansson, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; M.F. Reiser, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; S. Weckbach*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich, and Diagnostic and Interventional Radiology, University Hospital Heidelberg; A.F. Jansson*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University
| | - Andreas P Arnoldi
- From the Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; Institute for Clinical Radiology, Ludwig Maximilians University of Munich, Munich; Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; and the Department of Radiology, Royal Orthopaedic Hospital, Birmingham, UK.A.M. Voit*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; A.P. Arnoldi*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; H. Douis, MD, Department of Radiology, Royal Orthopaedic Hospital; F. Bleisteiner, MD; M.K. Jansson, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; M.F. Reiser, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; S. Weckbach*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich, and Diagnostic and Interventional Radiology, University Hospital Heidelberg; A.F. Jansson*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University
| | - Hassan Douis
- From the Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; Institute for Clinical Radiology, Ludwig Maximilians University of Munich, Munich; Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; and the Department of Radiology, Royal Orthopaedic Hospital, Birmingham, UK.A.M. Voit*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; A.P. Arnoldi*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; H. Douis, MD, Department of Radiology, Royal Orthopaedic Hospital; F. Bleisteiner, MD; M.K. Jansson, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; M.F. Reiser, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; S. Weckbach*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich, and Diagnostic and Interventional Radiology, University Hospital Heidelberg; A.F. Jansson*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University
| | - Felicitas Bleisteiner
- From the Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; Institute for Clinical Radiology, Ludwig Maximilians University of Munich, Munich; Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; and the Department of Radiology, Royal Orthopaedic Hospital, Birmingham, UK.A.M. Voit*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; A.P. Arnoldi*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; H. Douis, MD, Department of Radiology, Royal Orthopaedic Hospital; F. Bleisteiner, MD; M.K. Jansson, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; M.F. Reiser, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; S. Weckbach*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich, and Diagnostic and Interventional Radiology, University Hospital Heidelberg; A.F. Jansson*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University
| | - Moritz K Jansson
- From the Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; Institute for Clinical Radiology, Ludwig Maximilians University of Munich, Munich; Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; and the Department of Radiology, Royal Orthopaedic Hospital, Birmingham, UK.A.M. Voit*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; A.P. Arnoldi*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; H. Douis, MD, Department of Radiology, Royal Orthopaedic Hospital; F. Bleisteiner, MD; M.K. Jansson, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; M.F. Reiser, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; S. Weckbach*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich, and Diagnostic and Interventional Radiology, University Hospital Heidelberg; A.F. Jansson*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University
| | - Maximilian F Reiser
- From the Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; Institute for Clinical Radiology, Ludwig Maximilians University of Munich, Munich; Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; and the Department of Radiology, Royal Orthopaedic Hospital, Birmingham, UK.A.M. Voit*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; A.P. Arnoldi*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; H. Douis, MD, Department of Radiology, Royal Orthopaedic Hospital; F. Bleisteiner, MD; M.K. Jansson, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; M.F. Reiser, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; S. Weckbach*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich, and Diagnostic and Interventional Radiology, University Hospital Heidelberg; A.F. Jansson*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University
| | - Sabine Weckbach
- From the Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; Institute for Clinical Radiology, Ludwig Maximilians University of Munich, Munich; Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; and the Department of Radiology, Royal Orthopaedic Hospital, Birmingham, UK.A.M. Voit*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; A.P. Arnoldi*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; H. Douis, MD, Department of Radiology, Royal Orthopaedic Hospital; F. Bleisteiner, MD; M.K. Jansson, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; M.F. Reiser, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; S. Weckbach*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich, and Diagnostic and Interventional Radiology, University Hospital Heidelberg; A.F. Jansson*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University.
| | - Annette F Jansson
- From the Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; Institute for Clinical Radiology, Ludwig Maximilians University of Munich, Munich; Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; and the Department of Radiology, Royal Orthopaedic Hospital, Birmingham, UK.A.M. Voit*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; A.P. Arnoldi*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; H. Douis, MD, Department of Radiology, Royal Orthopaedic Hospital; F. Bleisteiner, MD; M.K. Jansson, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University; M.F. Reiser, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich; S. Weckbach*, MD, Institute for Clinical Radiology, Ludwig Maximilians University of Munich, and Diagnostic and Interventional Radiology, University Hospital Heidelberg; A.F. Jansson*, MD, Department of Rheumatology and Immunology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University
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Tsuji K, Kishi S, Tsuchida T, Yamauchi T, Ikegaya S, Urasaki Y, Fujiwara Y, Ueda T, Okazawa H, Kimura H. Evaluation of staging and early response to chemotherapy with whole-body diffusion-weighted MRI in malignant lymphoma patients: A comparison with FDG-PET/CT. J Magn Reson Imaging 2014; 41:1601-7. [DOI: 10.1002/jmri.24714] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 07/13/2014] [Accepted: 07/15/2014] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kazunobu Tsuji
- Department of Radiology; University of Fukui Hospital; Fukui Japan
| | - Shinji Kishi
- Department of Hematology; University of Fukui Hospital; Fukui Japan
| | - Tatsuro Tsuchida
- Department of Radiology; University of Fukui Hospital; Fukui Japan
| | | | - Satoshi Ikegaya
- Department of Hematology; University of Fukui Hospital; Fukui Japan
| | | | | | - Takanori Ueda
- Department of Hematology; University of Fukui Hospital; Fukui Japan
| | - Hidehiko Okazawa
- Biomedical Imaging Research Center; University of Fukui; Fukui Japan
| | - Hirohiko Kimura
- Department of Radiology; University of Fukui Hospital; Fukui Japan
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Canale S, Vilcot L, Ammari S, Lemery M, Bidault F, Balleyguier C, Caramella C, Dromain C. Whole body MRI in paediatric oncology. Diagn Interv Imaging 2014; 95:541-50. [DOI: 10.1016/j.diii.2013.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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de Oliveira Schiavon JL, Lederman HM. Whole Body MRI and Diffusion Weighed Images in Pediatric Oncology: Lymphomas and Several Others Tumors. CURRENT RADIOLOGY REPORTS 2014. [DOI: 10.1007/s40134-014-0054-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Pilot Prospective Evaluation of 99mTc-MDP Scintigraphy, 18F NaF PET/CT, 18F FDG PET/CT and Whole-Body MRI for Detection of Skeletal Metastases. Clin Nucl Med 2013; 38:e290-6. [DOI: 10.1097/rlu.0b013e3182815f64] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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19
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Schraml C, Schwenzer NF, Sperling O, Aschoff P, Lichy MP, Müller M, Brendle C, Werner MK, Claussen CD, Pfannenberg C. Staging of neuroendocrine tumours: comparison of [⁶⁸Ga]DOTATOC multiphase PET/CT and whole-body MRI. Cancer Imaging 2013; 13:63-72. [PMID: 23466785 PMCID: PMC3589947 DOI: 10.1102/1470-7330.2013.0007] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: In patients with a neuroendocrine tumour (NET), the extent of disease strongly influences the outcome and multidisciplinary therapeutic management. Thus, systematic analysis of the diagnostic performance of the existing staging modalities is necessary. The aim of this study was to compare the diagnostic performance of 2 whole-body imaging modalities, [68Ga]DOTATOC positron emission tomography (PET)/computed tomography (CT) and magnetic resonance imaging (MRI) in patients with NET with regard to possible impact on treatment decisions. Materials and methods: [68Ga]DOTATOC-PET/CT and whole-body magnetic resonance imaging (wbMRI) were performed on 51 patients (25 females, 26 males, mean age 57 years) with histologically proven NET and suspicion of metastatic spread within a mean interval of 2.4 days (range 0–28 days). PET/CT was performed after intravenous administration of 150 MBq [68Ga]DOTATOC. The CT protocol comprised multiphase contrast-enhanced imaging. The MRI protocol consisted of standard sequences before and after intravenous contrast administration at 1.5 T. Each modality (PET, CT, PET/CT, wbMRI) was evaluated independently by 2 experienced readers. Consensus decision based on correlation of all imaging data, histologic and surgical findings and clinical follow-up was established as the standard of reference. Lesion-based and patient-based analysis was performed. Detection rates and accuracy were compared using the McNemar test. P values <0.05 were considered significant. The impact of whole-body imaging on the treatment decision was evaluated by the interdisciplinary tumour board of our institution. Results: 593 metastatic lesions were detected in 41 of 51 (80%) patients with NET (lung 54, liver 266, bone 131, lymph node 99, other 43). One hundred and twenty PET-negative lesions were detected by CT or MRI. Of all 593 lesions detected, PET identified 381 (64%) true-positive lesions, CT 482 (81%), PET/CT 545 (92%) and wbMRI 540 (91%). Comparison of lesion-based detection rates between PET/CT and wbMRI revealed significantly higher sensitivity of PET/CT for metastatic lymph nodes (100% vs 73%; P < 0.0001) and pulmonary lesions (100% vs 87%; P = 0.0233), whereas wbMRI had significantly higher detection rates for liver (99% vs 92%; P < 0.0001) and bone lesions (96% vs 82%; P < 0.0001). Of all 593 lesions, 22 were found only in PET, 11 only in CT and 47 only in wbMRI. The patient-based overall assessment of the metastatic status of the patient showed comparable sensitivity of PET/CT and MRI with slightly higher accuracy of PET/CT. Patient-based analysis of metastatic organ involvement revealed significantly higher accuracy of PET/CT for bone and lymph node metastases (100% vs 88%; P = 0.0412 and 98% vs 78%; P = 0.0044) and for the overall comparison (99% vs 89%; P < 0.0001). The imaging results influenced the treatment decision in 30 patients (59%) with comparable information from PET/CT and wbMRI in 30 patients, additional relevant information from PET/CT in 16 patients and from wbMRI in 7 patients. Conclusion: PET/CT and wbMRI showed comparable overall lesion-based detection rates for metastatic involvement in NET but significantly differed in organ-based detection rates with superiority of PET/CT for lymph node and pulmonary lesions and of wbMRI for liver and bone metastases. Patient-based analysis revealed superiority of PET/CT for NET staging. Individual treatment strategies benefit from complementary information from PET/CT and MRI.
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Affiliation(s)
- C Schraml
- University Department of Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany.
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Abstract
OBJECTIVE The aim of this study was to determine the sensitivity and specificity of postmortem whole-body MRI for typical injuries resulting from traumatic causes of death. MATERIALS AND METHODS Forty cases of accidental death were evaluated with postmortem whole-body MRI. Imaging was conducted according to a standard protocol, and each examination had an average duration of 90 minutes. The imaging findings were correlated with the autopsy findings, which served as the reference standard. RESULTS MRI showed the main pathologic process leading to death in 39 of the 40 cases. The sensitivity of postmortem MRI ranged from 100% (pneumothorax) to 40% (fractures of the upper extremities). In general, MRI had a high level of performance for depicting soft-tissue lesions, such as subcutaneous hematoma (e.g., galeal hematoma with a sensitivity 95%). The sensitivity of MRI was remarkably lower for lesions of the upper abdominal organs (liver, 80%; spleen, 50%; pancreas, 60%; kidneys, 66%). CONCLUSION Postmortem whole-body MRI had overall good performance for depicting traumatic findings in corpses and therefore may serve an important role as an adjunct to classic autopsy for the forensic examination of cases of traumatic cause of death. However, the reduced sensitivity of postmortem MRI for lacerations of the upper abdominal organs and the observed superimposition of antemortem findings and postmortem findings (e.g., in the pulmonary tissue) in this retrospective study suggest that whole-body postmortem MRI not be recommended as a replacement for classic autopsy.
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Padhani AR, Koh DM, Collins DJ. Whole-body diffusion-weighted MR imaging in cancer: current status and research directions. Radiology 2012; 261:700-18. [PMID: 22095994 DOI: 10.1148/radiol.11110474] [Citation(s) in RCA: 242] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Diffusion-weighted (DW) magnetic resonance (MR) imaging is emerging as a powerful clinical tool for directing the care of patients with cancer. Whole-body DW imaging is almost at the stage where it can enter widespread clinical investigations, because the technology is stable and protocols can be implemented for the majority of modern MR imaging systems. There is a continued need for further improvements in data acquisition and analysis and in display technologies. Priority areas for clinical research include clarification of histologic relationships between tissues of interest and DW MR imaging biomarkers at diagnosis and during therapy response. Because whole-body DW imaging excels at bone marrow assessments at diagnosis and for therapy response, it can potentially address a number of unmet clinical and pharmaceutical requirements. There are compelling needs to document and understand how common and novel treatments affect whole-body DW imaging results and to establish response criteria that can be tested in prospective clinical studies that incorporate measures of patient benefit.
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Affiliation(s)
- Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex HA6 2RN, England.
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22
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Chavhan GB, Babyn PS. Whole-Body MR Imaging in Children: Principles, Technique, Current Applications, and Future Directions. Radiographics 2011; 31:1757-72. [DOI: 10.1148/rg.316115523] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Koeppe S, Schäfer J. Magnetresonanztomographie der Lunge bei Kindern und Jugendlichen. Monatsschr Kinderheilkd 2011. [DOI: 10.1007/s00112-010-2328-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abdulqadhr G, Molin D, Åström G, Suurküla M, Johansson L, Hagberg H, Ahlström H. Whole-body diffusion-weighted imaging compared with FDG-PET/CT in staging of lymphoma patients. Acta Radiol 2011; 52:173-80. [PMID: 21498346 DOI: 10.1258/ar.2010.100246] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) has become increasingly valuable in lymph node imaging, yet the clinical utility of this technique in the staging of lymphoma has not been established. PURPOSE To compare whole-body DWI with FDG-PET/CT in the staging of lymphoma patients. MATERIAL AND METHODS Thirty-one patients, eight with Hodgkin lymphoma (HL) and 23 with non-Hodgkin's lymphoma (18 aggressive and five indolent) underwent both whole-body DWI, whole-body MRI (T1W and T2W-STIR) and FDG-PET/CT. Lesions on whole-body DWI were only considered positive if they correlated with lesions on T1W and T2W-STIR images. The staging given by each technique was compared, according to the Ann Arbor staging system. Differences in staging were solved using biopsy results, and clinical and CT follow-ups as standard of reference. RESULTS The staging was the same for DWI and FDG-PET/CT in 28 (90.3%) patients and different in three (9.7%). Of the 28 patients with the same staging, 11 had stage IV in both techniques and 17 had stages 0-III. No HL or aggressive non-Hodgkin's lymphoma patients had different staging. Three indolent small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) lymphoma had higher staging with DWI when compared with FDG-PET/CT. One small subcutaneous breast lymphoma was not seen but all other extranodal sites were detected by both techniques. CONCLUSION Whole-body DWI is a promising technique for staging of both (aggressive and indolent) non-Hodgkin's lymphoma and HL.
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Affiliation(s)
| | | | | | - Madis Suurküla
- Department of Nuclear Medicine, Uppsala University Hospital, Uppsala, Sweden
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Balliu E, Boada M, Peláez I, Vilanova J, Barceló-Vidal C, Rubio A, Galofré P, Castro A, Pedraza S. Comparative study of whole-body MRI and bone scintigraphy for the detection of bone metastases. Clin Radiol 2010; 65:989-96. [DOI: 10.1016/j.crad.2010.07.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Revised: 03/16/2010] [Accepted: 07/14/2010] [Indexed: 11/30/2022]
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Weckbach S, Michaely HJ, Stemmer A, Schoenberg SO, Dinter DJ. Comparison of a new whole-body continuous-table-movement protocol versus a standard whole-body MR protocol for the assessment of multiple myeloma. Eur Radiol 2010; 20:2907-16. [PMID: 20574630 DOI: 10.1007/s00330-010-1865-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 05/11/2010] [Accepted: 05/19/2010] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To evaluate a whole body (WB) continuous-table-movement (CTM) MR protocol for the assessment of multiple myeloma (MM) in comparison to a step-by-step WB protocol. METHODS Eighteen patients with MM were examined at 1.5T using a WB CTM protocol (axial T2-w fs BLADE, T1-w GRE sequence) and a step-by-step WB protocol including coronal/sagittal T1-w SE and STIR sequences as reference. Protocol time was assessed. Image quality, artefacts, liver/spleen assessability, and the ability to depict bone marrow lesions less than or greater than 1 cm as well as diffuse infiltration and soft tissue lesions were rated. Potential changes in the Durie and Salmon Plus stage and the detectability of complications were assessed. RESULTS Mean protocol time was 6:38 min (CTM) compared to 24:32 min (standard). Image quality was comparable. Artefacts were more prominent using the CTM protocol (P = 0.0039). Organ assessability was better using the CTM protocol (P < 0.001). Depiction of bone marrow and soft tissue lesions was identical without a staging shift. Vertebral fractures were not detected using the CTM protocol. CONCLUSIONS The new protocol allows a higher patient throughput and facilitates the depiction of extramedullary lesions. However, as long as vertebral fractures are not detectable, the protocol cannot be safely used for clinical routine without the acquisition of an additional sagittal sequence.
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Affiliation(s)
- S Weckbach
- Department of Clinical Radiology, University Hospital Munich-Grosshadern Campus, Marchioninistr. 15, 81377, Munich, Germany.
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Vilanova JC. [New advances on diagnostic imaging in spinal pathology]. ACTA ACUST UNITED AC 2010; 6:49-52. [PMID: 21794677 DOI: 10.1016/j.reuma.2008.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Accepted: 02/07/2008] [Indexed: 11/26/2022]
Abstract
In the past years, there has been a remarkable improvement on imaging technology. Magnetic resonance (MR) is the method of choice for detection, diagnosis and therapeutic management for many disorders of the spine. A variety of innovative new MR methods have been developed. These new techniques include molecular diffusion sequences, MR myelography, a complete study of the entire spine, kinematic MR imaging of the spine, whole body MR exam and the fusion of different imaging modalities. These new technological developments have the potential to profoundly impact and modify imaging interpretation to offer a more efficient diagnostic and work-up of patients suffering from spinal disease.
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Affiliation(s)
- Joan C Vilanova
- Departamento de Resonancia Magnética, Clínica Girona-Hospital Sta. Caterina, Girona, España
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Heusner T, Gölitz P, Hamami M, Eberhardt W, Esser S, Forsting M, Bockisch A, Antoch G. "One-stop-shop" staging: should we prefer FDG-PET/CT or MRI for the detection of bone metastases? Eur J Radiol 2009; 78:430-5. [PMID: 19945240 DOI: 10.1016/j.ejrad.2009.10.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Revised: 10/27/2009] [Accepted: 10/30/2009] [Indexed: 10/20/2022]
Abstract
AIM The aim of this study was to compare the diagnostic accuracy of fully diagnostic, contrast-enhanced whole-body FDG-PET/CT and whole-body MRI for detection of bone metastases in patients suffering from newly diagnosed non-small cell lung cancer and malignant melanoma. MATERIAL AND METHODS 109 consecutive non-small cell lung cancer (n=54) and malignant melanoma (n=55) patients underwent whole-body FDG-PET/CT and whole-body MRI for initial tumor staging. All images were evaluated by four experienced physicians (three radiologists, one nuclear medicine physician). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detection of bone metastases were determined for both modalities. Statistically significant differences between FDG-PET/CT and MRI were calculated with Fisher's Exact test (p<0.05). Clinical and imaging follow-up data with a mean follow-up time of 434 days served as the reference standard. RESULTS According to the reference standard 11 patients (10%) suffered from bone metastases. The sensitivity, specificity, PPV, NPV, and accuracy for the detection of osseous metastases was 45%, 99%, 83%, 94%, and 94% with whole-body FDG-PET/CT and 64%, 94%, 54%, 96%, and 91% with whole-body MRI. The difference was not statistically significant (p=0.6147). CONCLUSIONS FDG-PET/CT and MRI seem to be equally suitable for the detection of skeletal metastases in patients suffering from newly diagnosed non-small cell lung cancer and malignant melanoma. Both modalities go along with a substantial rate of false-negative findings requiring a close follow-up of patients who are staged free of bone metastases at initial staging.
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Affiliation(s)
- Till Heusner
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University at Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany
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Goo HW. Whole-body MRI of neuroblastoma. Eur J Radiol 2009; 75:306-14. [PMID: 19781884 DOI: 10.1016/j.ejrad.2009.09.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2009] [Revised: 09/04/2009] [Accepted: 09/07/2009] [Indexed: 01/22/2023]
Abstract
Whole-body MRI (WBMRI) is an emerging imaging method that has a great potential in pediatric oncologic imaging. It appears useful in staging and monitoring neuroblastoma although its clinical impact has not been thoroughly evaluated. Among various imaging techniques currently available for WBMRI, coronal and sagittal STIR imaging with a quadrature body coil at 1.5T MR system is recommended for a standard protocol. Nevertheless, further technical improvements are anticipated at 3.0T MR system and multi-channel surface coil system. Scan time of WBMRI is reasonably short ranging from 20 min to 60 min. In localized neuroblastoma, WBMRI may help in predicting surgical risks by evaluating image-defined risk factors accurately. In addition, WBMRI is quite useful in detecting distant metastasis, assessing initial treatment responses, and identifying tumor recurrence of neuroblastoma. We should understand limitations of WBMRI in the evaluation of lymph node involvement, in the differentiation between viable tumor and non-viable residual lesion, and in the detection of calcified lesion. Diffusion-weighted imaging may improve diagnostic accuracy of WBMRI. Complementary use of WBMRI and other metabolic imaging method such as MIBG scintigraphy or PET probably increases diagnostic accuracy and, subsequently, improves clinical outcome of children with neuroblastoma.
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Affiliation(s)
- Hyun Woo Goo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul 138-736, South Korea.
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Weber U, Maksymowych WP, Jurik AG, Pfirrmann CWA, Rufibach K, Kissling RO, Khan MA, Lambert RGW, Hodler J. Validation of whole-body against conventional magnetic resonance imaging for scoring acute inflammatory lesions in the sacroiliac joints of patients with spondylarthritis. ACTA ACUST UNITED AC 2009; 61:893-9. [DOI: 10.1002/art.24542] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Abstract
Among imaging techniques, magnetic resonance imaging (MRI) has evolved as the most robust technique for the detection, characterization, and staging of anorectal cancers. With its superior contrast resolution, multiplanar imaging capability, and nil radiation risk, it has become the standard preoperative imaging tool in rectal tumors. In this article we aim to outline the various types of anorectal cancers, highlight the complex anatomy of this region, and discuss the immensely useful role of MRI in the management of anorectal cancers. Existing limitations and future applications in this area will also be discussed. Because rectal adenocarcinomas constitute the majority of tumors in this region, we will be discussing the input of MRI in the management of this condition in greater detail. This will be followed by an overview of MRI in anal carcinoma and other less common anorectal neoplasms.
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Affiliation(s)
- Girish Raghunathan
- Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
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McMahon CJ, Smith MP. Magnetic resonance imaging in locoregional staging of rectal adenocarcinoma. Semin Ultrasound CT MR 2009; 29:433-53. [PMID: 19166041 DOI: 10.1053/j.sult.2008.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
A comprehensive overview of the current status of magnetic resonance imaging (MRI) in the locoregional assessment and management of rectal adenocarcinoma is presented. Staging systems for rectal cancer and treatment strategies in its management are discussed to give the reader the context that shapes MRI acquisition techniques and interpretation. Findings on MRI are detailed and their accuracy reviewed based on currently available evidence. Optimization of MRI acquisition and relevant pelvic anatomy are reviewed. A detailed description of our approach in interpreting MRI for locoregional staging of rectal cancer is given and future directions are also introduced.
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Affiliation(s)
- Colm J McMahon
- Department of Radiology, Beth israel Deaconess Medical Center, Boston, MA 02215, USA
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Baumann T, Ludwig U, Pache G, Fautz HP, Kotter E, Langer M, Schaefer O. Continuously moving table MRI with sliding multislice for rectal cancer staging: image quality and lesion detection. Eur J Radiol 2009; 73:579-87. [PMID: 19179029 DOI: 10.1016/j.ejrad.2008.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Revised: 10/04/2008] [Accepted: 12/10/2008] [Indexed: 12/27/2022]
Abstract
PURPOSE To determine image quality and lesion detection of sliding multislice (SMS), a recently developed moving table MRI technique, in patients with rectal cancer. MATERIALS AND METHODS Twenty-seven paired SMS (Avanto, Siemens Medical Solutions) and MDCT (Sensation 64, Siemens Medical Solutions) examinations of abdomen and pelvis were performed in patients with rectal cancer and compared for detection of liver, lymph node and bone metastases by two independent observers. A contrast-enhanced, fat saturated 2D gradient echo sequence (TE, 2.0 ms; TR, 102 ms; slice, 5 mm) was acquired with SMS and a standard contrast-enhanced protocol (100 ml @ 2.5 ml/s; slice, 5 mm) was used for abdominal MDCT. Standard of reference consisted of a consensus evaluation of SMS, MDCT, and all available follow-up examinations after a period of 6 months. Artifact burden and image quality of SMS was assessed in comparison to stationary gradient echo sequences obtained in an age-matched group of 27 patients. RESULTS Whereas SMS achieved a mean quality score of 3.65 (scale, 0-4) for the liver, representing very good diagnostic properties, strong breathing artifacts in the intestinal region were observed in 19 cases by both observers. The retroperitoneum still achieved a mean quality score of 3.52, although breathing artifacts were noted in 12 and 15 cases (observers 1 and 2, respectively). The sensitivities of SMS to detect hepatic metastases were 91.2% and 94.1% for both observers, respectively, compared to 98.5%/98.5% for MDCT. The sensitivities for lymph node metastases were 87.5%/81.3% for SMS compared to 78.1%/81.3% for MDCT. The sensitivities for bone metastases were 91.7%/100% for SMS compared to 8.3%/16.7% for MDCT. CONCLUSION With slightly reduced image quality in the intestinal region, SMS exhibits equal detection of lymph node and liver metastases compared to MDCT. SMS MRI proved to be superior to MDCT in detection of bone metastases.
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Affiliation(s)
- Tobias Baumann
- Department of Diagnostic Radiology, University Hospital Freiburg, Freiburg, Germany.
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Abstract
The recent wave of enthusiasm for image guidance in radiation therapy is largely due to the advent of on-line imaging devices. The current narrow definition of image-guided radiotherapy (IGRT), in fact, essentially connotes the use of near real-time imaging during treatment delivery to reduce uncertainties in target position and should therefore be termed IGRT-D. However, a broader (and more appropriate) context of image-guidance should include: (1) detection and diagnosis, (2) delineation of target and organs at risk, (3) determining biological attributes, (4) dose distribution design, (5) dose delivery assurance and (6) deciphering treatment response through imaging i.e. the 6 D's of IGRT. Strategies to advance these areas will be discussed.
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Lavayssière R, Cabée AE, Filmont JE. Positron Emission Tomography (PET) and breast cancer in clinical practice. Eur J Radiol 2008; 69:50-8. [PMID: 18814983 DOI: 10.1016/j.ejrad.2008.07.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Accepted: 07/28/2008] [Indexed: 10/21/2022]
Abstract
The landscape of oncologic practice has changed deeply during the past few years and there is now a need, through a multidisciplinary approach, for imaging to provide accurate evaluation of morphology and function and to guide treatment (Image Guided Therapy). Increasing emphasis has been put on Position Emission Tomography (PET) role in various cancers among clinicians [Juweid ME, Cheson BD. Positron-emission tomography and assessment of cancer therapy. N Engl J Med 2006;354:496-507; Koh DM, Cook GJR, Husband JE. New horizons in oncologic imaging. N Engl J Med 2003;348:25; Tafra L, positron emission tomography (PET) and mammography (PEM) for breast cancer: importance to surgeons. Ann Surg Oncol 2006;14(1):3-13] and patients despite a general context of healthcare expenditure limitation. Positron Emission Tomography has currently a limited role in breast cancer, but also general radiologists and specialists should be aware of these indications, especially when staging aggressive cancers and looking for recurrence. Currently, the hybrid systems associating PET and Computed Tomography (CT) and in the same device [Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology 2004;231:305-32; Blodgett TM, Meltzer CM, Townsend DW. PET/CT: form and function. Radiology 2007;242:360-85; von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: current applications and futures directions. Radiology 2006;238(2):405-22], or PET-CT, are more commonly used and the two techniques are adding their potentialities. Other techniques, MRI in particular, may also compete with PET in some instance and as far as ionizing radiations dose limitation is considered, some breast cancers becoming some form of a chronic disease. Breast cancer is a very complex, non-uniform, disease and molecular imaging at large may contribute to a better knowledge and to new drugs development. Ongoing research, Positron Emission Mammography (PEM) and new tracers, are likely to bring improvements in patient care [Kelloff GJ, Hoffman JM, Johnson B, et al. Progress and promise of FDG-PET Imaging for cancer patient management and oncologic drug development. Clin Cancer Res 2005;1(April (8)): 2005].
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Affiliation(s)
- Robert Lavayssière
- Centre d'Imagerie Paris-Nord, 1, avenue Charles Péguy, 95200 Sarcelles, France.
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Darge K, Jaramillo D, Siegel MJ. Whole-body MRI in children: current status and future applications. Eur J Radiol 2008; 68:289-98. [PMID: 18799279 DOI: 10.1016/j.ejrad.2008.05.018] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Accepted: 05/20/2008] [Indexed: 10/21/2022]
Abstract
Whole-body MRI (WBMRI) is a novel technique that makes imaging of the whole patient in a manner similar to scintigraphy or positron emission tomography (PET) possible. Unlike the latter two methods, it is without exposure to radiation and thus gaining increasing importance and application in pediatrics. With the introduction of a moving tabletop, sequential movement of the patient through the magnet has become possible with automatic direct realignment of the images after acquisition. The common scan plane is coronal with additional planes being added depending on the indication. WBMRI is targeted for maximum coverage of the body within the shortest possible time using the minimum number of sequences. The evaluation of the bone marrow has been the primary indication thus inversion recovery sequences like STIR or TIRM are mostly used with the T1-weighted sequence being added variably. For correct evaluation of the bone marrow in the pediatric age group understanding normal pattern of marrow transformation is essential. The primary role of WBMRI has been in oncology for the detection of tumor spread and also for the follow-up and evaluation of complications. The initial comparative studies of WBMRI with scintigraphy and PET in children have shown the high diagnostic potential of WBMRI. Emerging potential applications of WBMRI include the evaluation for osteonecrosis, chronic multifocal recurrent osteomyelitis, myopathies, and generalized vascular malformations. Future use of WBMRI may incorporate non-accidental trauma, virtual autopsy, body fat mapping and diffusion-weighted imaging.
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Affiliation(s)
- Kassa Darge
- Department of Radiology, Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd., Philadelphia, PA 19104, USA.
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Vilanova JC, Barceló J. Diffusion-weighted whole-body MR screening. Eur J Radiol 2008; 67:440-7. [DOI: 10.1016/j.ejrad.2008.02.040] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Accepted: 02/27/2008] [Indexed: 11/15/2022]
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Plathow C, Walz M, Lichy MP, Aschoff P, Pfannenberg C, Bock H, Eschmann SM, Claussen CD, Schlemmer HP. [Cost considerations for whole-body MRI and PET/CT as part of oncologic staging]. Radiologe 2008; 48:384-96. [PMID: 17891370 DOI: 10.1007/s00117-007-1547-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to evaluate and discuss economic aspects of whole-body MRI and PET/CT in oncologic staging. Considerations from the perspective of the health care system, the radiologist, and the patients are presented. MATERIALS AND METHODS Costs of both whole-body techniques are compared with the conventional radiologic diagnostic recommendations of the AWFM (Arbeitsgemeinschaft Wissenschaftlich Medizinischer Fachgesellschaften) in oncologic staging of the five most frequent tumor entities. Temporal and monetary aspects are calculated. Invasive, endoscopic, and endosonographic techniques are regarded as essential and cannot be replaced by other techniques. Thus only the minimal potential for cost reduction is quantified. RESULTS In the German system there is no cipher to correctly balance whole-body MRI and PET/CT. Using the frequently applied ciphers 5700-5730 and 5378, 5489 (factor 1.0) total costs were 440.45 euros, and adding the cipher for additional series 545.37 euros (60 min examination time) for whole-body MRI and 774.74 euros (879.66 euros) (60/90 min examination time) for whole-body PET/CT. Using the common factor 1.8 costs were 981.66 and 1583.38 euros. On the basis of a simple full cost analysis total costs of whole-body PET/CT were higher than of whole-body MRI by a factor of about 2.0 (about 1123 vs 575 euros). There were substantial monetary and temporal differences between tumor entities. In extended bronchial carcinoma 375.32 euros and 55 min can be saved using whole-body MRI in comparison to conventional recommended techniques and using whole-body PET/CT 88.14 euros and 45 min. In tumor entities of lower stages with thus less essential radiologic diagnostics the potential for cost reduction is substantially lower. CONCLUSION Whole-body imaging techniques make it possible to reduce the number of necessary separate radiologic examinations and thus time in oncologic staging. A substantial reduction of health care costs seems to be possible in many tumor entities but differences between different tumor entities are decisive.
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Affiliation(s)
- C Plathow
- Abteilung Diagnostische Radiologie, Eberhardt-Karls-Universität Tübingen, Tübingen.
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Börnert P, Aldefeld B. Principles of whole-body continuously-moving-table MRI. J Magn Reson Imaging 2008; 28:1-12. [DOI: 10.1002/jmri.21339] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Pichler BJ, Wehrl HF, Judenhofer MS. Latest Advances in Molecular Imaging Instrumentation. J Nucl Med 2008; 49 Suppl 2:5S-23S. [PMID: 18523063 DOI: 10.2967/jnumed.108.045880] [Citation(s) in RCA: 166] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Bernd J Pichler
- Laboratory for Preclinical Imaging and Imaging Technology of the Werner Siemens Foundation, Department of Radiology, Eberhard Karls University Tübingen, Tübingen, Germany.
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Machann J, Schlemmer HP, Schick F. Technical challenges and opportunities of whole-body magnetic resonance imaging at 3T. Phys Med 2008; 24:63-70. [DOI: 10.1016/j.ejmp.2008.01.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2007] [Revised: 01/09/2008] [Accepted: 01/15/2008] [Indexed: 11/25/2022] Open
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Positron Emission Tomography/Computed Tomography and Whole-Body Magnetic Resonance Imaging in Staging of Advanced Nonsmall Cell Lung Cancer???Initial Results. Invest Radiol 2008; 43:290-7. [DOI: 10.1097/rli.0b013e318163273a] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Staging of colon cancer: whole-body MRI vs. whole-body PET-CT—initial clinical experience. ACTA ACUST UNITED AC 2008; 33:676-88. [DOI: 10.1007/s00261-007-9347-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Efficient whole-body MRI interpretation: evaluation of a dedicated software prototype. J Digit Imaging 2008; 21 Suppl 1:S50-8. [PMID: 18266034 DOI: 10.1007/s10278-008-9107-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Revised: 12/14/2007] [Accepted: 01/15/2008] [Indexed: 10/22/2022] Open
Abstract
The study investigates the performance of a dedicated whole-body magnetic resonance imaging (MRI) interpretation software with regard to diagnostic efficiency using quantitative and qualitative parameters. Forty-eight oncologic patients underwent whole-body computed tomography (WB-CT) and whole-body magnetic resonance imaging (WB-MRI). In a quantitative analysis, the times needed for interpretation of the CT and MRI datasets were measured. The MRI studies were read using a standard workstation and the whole-body MRI interpretation software, respectively. In the qualitative analysis, the numbers of metastases were separately recorded for 13 organ systems, again interpreting the MRI images on the standard workstation and with the dedicated software. Moreover, user friendliness and system usability were evaluated using a standardized questionnaire. Use of the whole-body MRI interpretation software significantly reduced the MRI interpretation time compared with the standard workstation. There was no significant difference between interpretation time of WB-CT and interpretation time of WB-MRI using the dedicated software. Comparison with WB-CT as the reference method demonstrated no significant difference between the whole-body MRI interpretation software prototype and the standard interpretation software in the number of metastases detected. In conclusion, the use of the dedicated whole-body reading software improves the interpretation process of WB-MRI studies with respect to time efficiency and system usability.
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Sommer G, Schaefer AO, Baumann T, Ludwig UA, Fautz HP. Sliding multislice MRI for abdominal staging of patients with pelvic malignancies: A pilot study. J Magn Reson Imaging 2008; 27:666-72. [DOI: 10.1002/jmri.21279] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Abstract
Endorectal-US is the most suitable imaging technique in the initial staging of rectal cancer and it is mostly accurate in evaluating early stages and in demonstrating the perirectal spread of cancer tissue. CT is not able to demonstrate the layers of the rectal wall and its accuracy in demonstrating the invasion of muscolaris propria and perirectal fat is lower than other techniques, so its use in local staging is not recommended. MRI is mostly accurate in evaluating the mesorectum and the mesorectal fascia which are considered the most relevant prognostic factors for local recurrence. Lymph node evaluation is a challenge for every imaging techniques since lymph node size is not a reliable criterion for diagnosing metastatic involvement. Nuclear medicine has a remarkable role in the work-up of rectal cancer and in the next future the combination of FDG PET in conjunction with a dedicated contrast enhanced CT protocols could become a single-step staging procedure.
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Affiliation(s)
- Pietro Torricelli
- Department of Radiology, University of Modena and Reggio-Emilia, Italy.
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Schaefer O, Langer M. Detection of recurrent rectal cancer with CT, MRI and PET/CT. Eur Radiol 2007; 17:2044-54. [PMID: 17404742 DOI: 10.1007/s00330-007-0613-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Revised: 02/07/2007] [Accepted: 02/09/2007] [Indexed: 02/08/2023]
Abstract
Computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) all have the potential to directly visualize local and distant relapse of colorectal cancer (CRC). Nevertheless, the role of diagnostic imaging for routine follow-up of CRC patients remains controversial. Although MRI and PET have advantages over CT in the detection of local recurrence, until now only a few surveillance programs recommend the use of annual CT for routine follow-up. The objective of this review is to elucidate the current status of diagnostic imaging for the detection of recurrent rectal cancer based on the recent literature and our own experience. Furthermore, an insight into contemporary surveillance programs and an outlook concerning a novel technical approach to moving-table MRI at 1.5 Tesla for staging purposes are given.
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Affiliation(s)
- O Schaefer
- Department of Diagnostic Radiology, University Hospital Feiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
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