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Burian E, Lenhart N, Greve T, Bodden J, Burian G, Palla B, Probst F, Probst M, Beer M, Folwaczny M, Schwarting J. Detection of caries lesions using a water-sensitive STIR sequence in dental MRI. Sci Rep 2024; 14:663. [PMID: 38182726 PMCID: PMC10770403 DOI: 10.1038/s41598-024-51151-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 01/01/2024] [Indexed: 01/07/2024] Open
Abstract
In clinical practice, diagnosis of suspected carious lesions is verified by using conventional dental radiography (DR), including panoramic radiography (OPT), bitewing imaging, and dental X-ray. The aim of this study was to evaluate the use of magnetic resonance imaging (MRI) for caries visualization. Fourteen patients with clinically suspected carious lesions, verified by standardized dental examination including DR and OPT, were imaged with 3D isotropic T2-weighted STIR (short tau inversion recovery) and T1 FFE Black bone sequences. Intensities of dental caries, hard tissue and pulp were measured and calculated as aSNR (apparent signal to noise ratio) and aHTMCNR (apparent hard tissue to muscle contrast to noise ratio) in both sequences. Imaging findings were then correlated to clinical examination results. In STIR as well as in T1 FFE black bone images, aSNR and aHTMCNR was significantly higher in carious lesions than in healthy hard tissue (p < 0.001). Using water-sensitive STIR sequence allowed for detecting significantly lower aSNR and aHTMCNR in carious teeth compared to healthy teeth (p = 0.01). The use of MRI for the detection of caries is a promising imaging technique that may complement clinical exams and traditional imaging.
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Affiliation(s)
- Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Ulm, Ulm, Germany.
- Department of Diagnostic and Interventional Neuroradiology, Kantonsspital Frauenfeld, Thurgau AG, Frauenfeld, Switzerland.
| | - Nicolas Lenhart
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Tobias Greve
- Department of Neurosurgery, University of Munich, Munich, Germany
| | - Jannis Bodden
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gintare Burian
- Department of Prosthodontics, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Benjamin Palla
- Department of Oral and Maxillofacial Surgery, University of Illinois, Chicago, Chicago, USA
| | - Florian Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital LMU Munich, 80337, Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Ulm, Ulm, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Julian Schwarting
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Alus O, El Homsi M, Golia Pernicka JS, Rodriguez L, Mazaheri Y, Kee Y, Petkovska I, Otazo R. Convolutional network denoising for acceleration of multi-shot diffusion MRI. Magn Reson Imaging 2024; 105:108-113. [PMID: 37820978 PMCID: PMC11138874 DOI: 10.1016/j.mri.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/04/2023] [Accepted: 10/07/2023] [Indexed: 10/13/2023]
Abstract
Multi-shot echo planar imaging is a promising technique to reduce geometric distortions and increase spatial resolution in diffusion-weighted MRI (DWI), at the expense of increased scan time. Moreover, performing DWI in the body requires multiple repetitions to obtain sufficient signal-to-noise ratio, which further increases the scan time. This work proposes to reduce the number of repetitions and perform denoising of high b-value images using a convolutional network denoising trained on single-shot DWI to accelerate the acquisition of multi-shot DWI. Convolutional network denoising is demonstrated to accelerate the acquisition of 2-shot DWI by a factor of 4 compared to the clinical standard on patients with rectal cancer. Image quality was evaluated using qualitative scores from expert body radiologists between accelerated and non-accelerated acquisition. Additionally, the effect of convolutional network denoising on each image quality score was analyzed using a Wilcoxon signed-rank test. Convolutional network denoising would enable to increase the number of shots without increasing scan time for significant geometric artifact reduction and spatial resolution increase.
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Affiliation(s)
- Or Alus
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maria El Homsi
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Lee Rodriguez
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yousef Mazaheri
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Youngwook Kee
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Iva Petkovska
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ricardo Otazo
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Dong Y, Koolstra K, Li Z, Riedel M, van Osch MJP, Börnert P. Structured low-rank reconstruction for navigator-free water/fat separated multi-shot diffusion-weighted EPI. Magn Reson Med 2024; 91:205-220. [PMID: 37753595 DOI: 10.1002/mrm.29848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/20/2023] [Accepted: 08/11/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE Multi-shot diffusion-weighted EPI allows an increase in image resolution and reduced geometric distortions and can be combined with chemical-shift encoding (Dixon) to separate water/fat signals. However, such approaches suffer from physiological motion-induced shot-to-shot phase variations. In this work, a structured low-rank-based navigator-free algorithm is proposed to address the challenge of simultaneously separating water/fat signals and correcting for physiological motion-induced shot-to-shot phase variations in multi-shot EPI-based diffusion-weighted MRI. THEORY AND METHODS We propose an iterative, model-based reconstruction pipeline that applies structured low-rank regularization to estimate and eliminate the shot-to-shot phase variations in a data-driven way, while separating water/fat images. The algorithm is tested in different anatomies, including head-neck, knee, brain, and prostate. The performance is validated in simulations and in-vivo experiments in comparison to existing approaches. RESULTS In-vivo experiments and simulations demonstrated the effectiveness of the proposed algorithm compared to extra-navigated and an alternative self-navigation approach. The proposed algorithm demonstrates the capability to reconstruct in the multi-shot/Dixon hybrid space domain under-sampled datasets, using the same number of acquired EPI shots compared to conventional fat-suppression techniques but eliminating fat signals through chemical-shift encoding. In addition, partial Fourier reconstruction can also be achieved by using the concept of virtual conjugate coils in conjunction with the proposed algorithm. CONCLUSION The proposed algorithm effectively eliminates the shot-to-shot phase variations and separates water/fat images, making it a promising solution for future DWI on different anatomies.
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Affiliation(s)
- Yiming Dong
- C.J. Gorter MRI Center, Department of Radiology, LUMC, Leiden, The Netherlands
| | | | - Ziyu Li
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | | | - Peter Börnert
- C.J. Gorter MRI Center, Department of Radiology, LUMC, Leiden, The Netherlands
- Philips Research Hamburg, Hamburg, Germany
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Wang L, Li T, Cai J, Chang HC. Motion-resolved four-dimensional abdominal diffusion-weighted imaging using PROPELLER EPI (4D-DW-PROPELLER-EPI). Magn Reson Med 2023; 90:2454-2471. [PMID: 37486854 DOI: 10.1002/mrm.29802] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE To develop a distortion-free motion-resolved four-dimensional diffusion-weighted PROPELLER EPI (4D-DW-PROPELLER-EPI) technique for benefiting clinical abdominal radiotherapy (RT). METHODS An improved abdominal 4D-DWI technique based on 2D diffusion-weighted PROPELLER-EPI (2D-DW-PROPELLER-EPI), termed 4D-DW-PROPELLER-EPI, was proposed to improve the frame rate of repeated data acquisition and produce distortion-free 4D-DWI images. Since the radial or PROPELLER sampling with golden-angle rotation can achieve an efficient k-space coverage with a flexible time-resolved acquisition, the golden-angle multi-blade acquisition was used in the proposed 4D-DW-PROPELLER-EPI to improve the performance of data sorting. A new k-space and blade (K-B) amplitude binning method was developed for the proposed 4D-DW-PROPELLER-EPI to optimize the number of blades and the k-space uniformity before performing conventional PROPELLER-EPI reconstruction, by using two metrics to evaluate the adequacy of the acquired data. The proposed 4D-DW-PROPELLER-EPI was preliminarily evaluated in both simulation experiments and in vivo experiments with varying frame rates and different numbers of repeated acquisition. RESULTS The feasibility of achieving distortion-free 4D-DWI images by using the proposed 4D-DW-PROPELLER-EPI technique was demonstrated in both digital phantom and healthy subjects. Evaluation of the 4D completeness metrics shows that the K-B amplitude binning method could simultaneously improve the acquisition efficiency and data reconstruction performance for 4D-DW-PROPELLER-EPI. CONCLUSION 4D-DW-PROPELLER-EPI with K-B amplitude binning is an advanced technique that can provide distortion-free 4D-DWI images for resolving respiratory motion, and may benefit the application of image-guided abdominal RT.
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Affiliation(s)
- Lu Wang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Tian Li
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Jing Cai
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Hing-Chiu Chang
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Multi-Scale Medical Robotics Center, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Lakhman Y, Aherne EA, Jayaprakasam VS, Nougaret S, Reinhold C. Staging of Cervical Cancer: A Practical Approach Using MRI and FDG PET. AJR Am J Roentgenol 2023; 221:633-648. [PMID: 37459457 PMCID: PMC467038 DOI: 10.2214/ajr.23.29003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
This review provides a practical approach to the imaging evaluation of patients with cervical cancer (CC), from initial diagnosis to restaging of recurrence, focusing on MRI and FDG PET. The primary updates to the International Federation of Gynecology and Obstetrics (FIGO) CC staging system, as well as these updates' relevance to clinical management, are discussed. The recent literature investigating the role of MRI and FDG PET in CC staging and image-guided brachytherapy is summarized. The utility of MRI and FDG PET in response assessment and posttreatment surveillance is described. Important findings on MRI and FDG PET that interpreting radiologists should recognize and report are illustrated. The essential elements of structured reports during various phases of CC management are outlined. Special considerations, including the role of imaging in patients desiring fertility-sparing management, differentiation of CC and endometrial cancer, and unusual CC histologies, are also described. Finally, future research directions including PET/MRI, novel PET tracers, and artificial intelligence applications are highlighted.
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Affiliation(s)
- Yulia Lakhman
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - Emily A Aherne
- Department of Radiology, Cork University Hospital, Cork, Ireland
| | - Vetri Sudar Jayaprakasam
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065
| | - Stephanie Nougaret
- Department of Radiology, Montpellier Cancer Institute, Montpellier, France
- Pinkcc Lab, IRCM, Montpellier, France
| | - Caroline Reinhold
- Department of Radiology, McGill University Health Centre, McGill University, Montreal, QC, Canada
- Augmented Intelligence & Precision Health Laboratory, Research Institute of McGill University Health Centre, Montreal, QC, Canada
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Yu Y, Song X, Zeng Z, Wang L, Zhang L, Zhao H, Zheng Z. Amide proton transfer weighted MRI in differential diagnosis of ovarian masses with cystic components: A preliminary study. Magn Reson Imaging 2023; 103:216-223. [PMID: 37517767 DOI: 10.1016/j.mri.2023.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/01/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate the performance of three-dimensional (3D) amide proton transfer-weighted (APTw) MRI in the differentiation between benign and malignant ovarian masses based on single-slice and all-slice analysis of cystic regions. MATERIALS AND METHODS Patients were consecutively recruited and underwent conventional pelvic MRI and APTw MRI. Two radiologists independently assessed ovarian masses blinded to the histopathological results. Three APTw SI values were generated from the cystic regions of the masses: (1) APTw SI of a single representative slice (RS); (2) average (AVE) of APTw SIs of all slices of the mass; (3) area-weighted (AW) average of APTw SIs of all slices of the mass. O-RADS MRI score of each mass was reported. Independent sample t-test and receiver operating characteristic (ROC) curve analysis were performed for comparison. Inter- and intra-observer reliability were assessed by the intraclass correlation coefficient (ICC) and quadratic kappa coefficient. RESULTS 46 ovarian masses were included for final analysis. The three APTw SI values were higher in cystic regions of malignant ovarian masses compared with benign lesions (p<0.0001). ROC curve analysis showed no significant difference in diagnostic performance among three APTw SI values and the O-RADS MRI score (AUC: RS-APTw SI, 0.930; AVE-APTw SI, 0.927; AW-APTw SI, 0.935; O-RADS score, 0.937). CONCLUSIONS APTw MRI may be used as a noninvasive tool for the differentiation of benign and malignant ovarian masses based on the analysis of the cystic regions.
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Affiliation(s)
- Yibei Yu
- Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 168 Litang Road, Changping District, Beijing 102218, China
| | - Xiaolei Song
- Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, 30 Shuangqing Road, Haidian District, Beijing 100084, China
| | - Zhen Zeng
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 168 Litang Road, Changping District, Beijing 102218, China
| | - Lixue Wang
- Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 168 Litang Road, Changping District, Beijing 102218, China
| | - Lei Zhang
- Department of Obstetrics and Gynecology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 168 Litang Road, Changping District, Beijing 102218, China
| | - Hongliang Zhao
- Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 168 Litang Road, Changping District, Beijing 102218, China
| | - Zhuozhao Zheng
- Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 168 Litang Road, Changping District, Beijing 102218, China.
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Shaterian Mohammadi H, Moazamian D, Athertya JS, Shin SH, Lo J, Suprana A, Malhi BS, Ma Y. Quantitative myelin water imaging using short TR adiabatic inversion recovery prepared echo-planar imaging (STAIR-EPI) sequence. FRONTIERS IN RADIOLOGY 2023; 3:1263491. [PMID: 37840897 PMCID: PMC10568074 DOI: 10.3389/fradi.2023.1263491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023]
Abstract
Introduction Numerous techniques for myelin water imaging (MWI) have been devised to specifically assess alterations in myelin. The biomarker employed to measure changes in myelin content is known as the myelin water fraction (MWF). The short TR adiabatic inversion recovery (STAIR) sequence has recently been identified as a highly effective method for calculating MWF. The purpose of this study is to develop a new clinical transitional myelin water imaging (MWI) technique that combines STAIR preparation and echo-planar imaging (EPI) (STAIR-EPI) sequence for data acquisition. Methods Myelin water (MW) in the brain has shorter T1 and T2 relaxation times than intracellular and extracellular water. In the proposed STAIR-EPI sequence, a short TR (e.g., ≤300 ms) together with an optimized inversion time enable robust long T1 water suppression with a wide range of T1 values [i.e., (600, 2,000) ms]. The EPI allows fast data acquisition of the remaining MW signals. Seven healthy volunteers and seven patients with multiple sclerosis (MS) were recruited and scanned in this study. The apparent myelin water fraction (aMWF), defined as the signal ratio of MW to total water, was measured in the lesions and normal-appearing white matter (NAWM) in MS patients and compared with those measured in the normal white matter (NWM) in healthy volunteers. Results As seen in the STAIR-EPI images acquired from MS patients, the MS lesions show lower signal intensities than NAWM do. The aMWF measurements for both MS lesions (3.6 ± 1.3%) and NAWM (8.6 ± 1.2%) in MS patients are significantly lower than NWM (10 ± 1.3%) in healthy volunteers (P < 0.001). Discussion The proposed STAIR-EPI technique, which can be implemented in MRI scanners from all vendors, is able to detect myelin loss in both MS lesions and NAWM in MS patients.
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Affiliation(s)
| | | | | | | | | | | | | | - Yajun Ma
- Department of Radiology, University of California San Diego, San Diego, CA, United States
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Ota T, Tsuboyama T, Onishi H, Nakamoto A, Fukui H, Yano K, Honda T, Kiso K, Tatsumi M, Tomiyama N. Diagnostic accuracy of MRI for evaluating myometrial invasion in endometrial cancer: a comparison of MUSE-DWI, rFOV-DWI, and DCE-MRI. LA RADIOLOGIA MEDICA 2023:10.1007/s11547-023-01635-4. [PMID: 37120661 DOI: 10.1007/s11547-023-01635-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/20/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVES To compare the image quality of high-resolution diffusion-weighted imaging (DWI) using multiplexed sensitivity encoding (MUSE) versus reduced field-of-view (rFOV) techniques in endometrial cancer (EC) and to compare the diagnostic performance of these techniques with that of dynamic contrast-enhanced (DCE) MRI for assessing myometrial invasion of EC. METHODS MUSE-DWI and rFOV-DWI were obtained preoperatively in 58 women with EC. Three radiologists assessed the image quality of MUSE-DWI and rFOV-DWI. For 55 women who underwent DCE-MRI, the same radiologists assessed the superficial and deep myometrial invasion using MUSE-DWI, rFOV-DWI, and DCE-MRI. Qualitative scores were compared using the Wilcoxon signed-rank test. Receiver operating characteristic analysis was performed to compare the diagnostic performance. RESULTS Artifacts, sharpness, lesion conspicuity, and overall quality were significantly better with MUSE-DWI than with rFOV-DWI (p < 0.05). The area under the curve (AUC) of MUSE-DWI, rFOV-DWI, and DCE-MRI for the assessment of myometrial invasion were not significantly different except for significantly higher AUC of MUSE-DWI than that of DCE-MRI for superficial myometrial invasion (0.76 for MUSE-DWI and 0.64 for DCE-MRI, p = 0.049) and for deep myometrial invasion (0.92 for MUSE-DWI and 0.80 for DCE-MRI, p = 0.022) in one observer, and that of rFOV-DWI for deep myometrial invasion in another observer (0.96 for MUSE-DWI and 0.89 for rFOV-MRI, p = 0.048). CONCLUSION MUSE-DWI exhibits better image quality than rFOV-DWI. MUSE-DWI and rFOV-DWI shows almost equivalent diagnostic performance compared to DCE-MRI for assessing superficial and deep myometrial invasion in EC although MUSE-DWI may be helpful for some radiologists.
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Affiliation(s)
- Takashi Ota
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Takahiro Tsuboyama
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hiromitsu Onishi
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Atsushi Nakamoto
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hideyuki Fukui
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Keigo Yano
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Toru Honda
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kengo Kiso
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Mitsuaki Tatsumi
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Noriyuki Tomiyama
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
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Picone C, Fusco R, Tonerini M, Fanni SC, Neri E, Brunese MC, Grassi R, Danti G, Petrillo A, Scaglione M, Gandolfo N, Giovagnoni A, Barile A, Miele V, Granata C, Granata V. Dose Reduction Strategies for Pregnant Women in Emergency Settings. J Clin Med 2023; 12:jcm12051847. [PMID: 36902633 PMCID: PMC10003653 DOI: 10.3390/jcm12051847] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/11/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
In modern clinical practice, there is an increasing dependence on imaging techniques in several settings, and especially during emergencies. Consequently, there has been an increase in the frequency of imaging examinations and thus also an increased risk of radiation exposure. In this context, a critical phase is a woman's pregnancy management that requires a proper diagnostic assessment to reduce radiation risk to the fetus and mother. The risk is greatest during the first phases of pregnancy at the time of organogenesis. Therefore, the principles of radiation protection should guide the multidisciplinary team. Although diagnostic tools that do not employ ionizing radiation, such as ultrasound (US) and magnetic resonance imaging (MRI) should be preferred, in several settings as polytrauma, computed tomography (CT) nonetheless remains the examination to perform, beyond the fetus risk. In addition, protocol optimization, using dose-limiting protocols and avoiding multiple acquisitions, is a critical point that makes it possible to reduce risks. The purpose of this review is to provide a critical evaluation of emergency conditions, e.g., abdominal pain and trauma, considering the different diagnostic tools that should be used as study protocols in order to control the dose to the pregnant woman and fetus.
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Affiliation(s)
- Carmine Picone
- Division of Radiology, “Instituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy
- Correspondence:
| | - Michele Tonerini
- Department of Emergency Radiology, University Hospital of Pisa, 56124 Pisa, Italy
| | - Salvatore Claudio Fanni
- Department of Translational Research, Academic Radiology, University of Pisa, 56124 Pisa, Italy
| | - Emanuele Neri
- Department of Translational Research, Academic Radiology, University of Pisa, 56124 Pisa, Italy
| | - Maria Chiara Brunese
- Diagnostic Imaging Section, Department of Medical and Surgical Sciences & Neurosciences, University of Molise, 86100 Campobasso, Italy
| | - Roberta Grassi
- Division of Radiology, “Università degli Studi della Campania Luigi Vanvitelli”, 81100 Naples, Italy
| | - Ginevra Danti
- Division of Radiology, Azienda Ospedaliera Universitaria Careggi, 50134 Florence, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122 Milan, Italy
| | - Antonella Petrillo
- Division of Radiology, “Instituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy
| | - Mariano Scaglione
- Department of Clinical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy
| | - Nicoletta Gandolfo
- Diagnostic Imaging Department, Villa Scassi Hospital-ASL 3, Corso Scassi 1, 16121 Genoa, Italy
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, Via Conca 71, 60126 Ancona, Italy
- Department of Radiology, University Hospital “Azienda Ospedaliera Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy
| | - Antonio Barile
- Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Vittorio Miele
- Division of Radiology, Azienda Ospedaliera Universitaria Careggi, 50134 Florence, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122 Milan, Italy
| | - Claudio Granata
- Department of Radiology, G. Gaslini Institute, IRCCS, 16147 Genova, Italy
| | - Vincenza Granata
- Division of Radiology, “Instituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy
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Carboxymethyl chitosan-assisted MnOx nanoparticles: Synthesis, characterization, detection and cartilage repair in early osteoarthritis. Carbohydr Polym 2022; 294:119821. [DOI: 10.1016/j.carbpol.2022.119821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 12/24/2022]
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11
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Wang YF, Ren Y, Zhu CF, Qian L, Yang Q, Deng WM, Zou LY, Liu Z, Luo DH. Optimising diffusion-weighted imaging of the thyroid gland using dedicated surface coil. Clin Radiol 2022; 77:e791-e798. [PMID: 36096939 DOI: 10.1016/j.crad.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/03/2022]
Abstract
AIM To assess the feasibility of applying field-of-view (FOV) optimised and constrained undistorted single-shot (FOCUS) diffusion-weighted imaging (DWI) in the thyroid gland by comparing its image quality with conventional DWI (C-DWI) qualitatively and quantitatively using a dedicated surface coil exclusively designed for the thyroid gland at 3 T magnetic resonance imaging (MRI). MATERIALS AND METHODS In this prospective study, 32 healthy volunteers who had undergone 3 T the thyroid gland MRI with FOCUS-DWI and C-DWI were enrolled. Two independent reviewers assessed the overall image quality, artefacts, sharpness, and geometric distortion based on a five-point Likert scale. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) were quantified for both sequences. Interobserver agreement, qualitative scores, and quantitative parameters were compared between two sequences. RESULTS Agreement between the two readers was good for FOCUS-DWI (κ = 0.714-0.778) and moderate to good for C-DWI (κ = 0.525-0.672) in qualitative image quality assessment. Qualitatively, image quality (overall image quality, artefacts, sharpness, and geometric distortion) was significantly better in FOCUS-DWI than that in the C-DWI (all p<0.05); however, quantitatively, FOCUS-DWI had significantly lower SNRs (p<0.001) and CNRs (p=0.012) compared with C-DWI. The ADC value on FOCUS-DWI was significantly higher than that on C-DWI (p<0.001). CONCLUSION FOCUS-DWI depicted the thyroid gland with significantly better image quality qualitatively and less ghost artefacts, but had significantly lower SNR and CNR quantitatively, compared with C-DWI, suggesting that both DWI sequences have advantages and could be chosen for different purposes.
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Affiliation(s)
- Y F Wang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - Y Ren
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - C F Zhu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - L Qian
- MR Research, GE Healthcare, Beijing, China
| | - Q Yang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - W M Deng
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - L Y Zou
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China
| | - Z Liu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China.
| | - D H Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China; Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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12
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Barlas BA, Bahadir CD, Kafali SG, Yilmaz U, Saritas EU. Sheared two-dimensional radiofrequency excitation for off-resonance robustness and fat suppression in reduced field-of-view imaging. Magn Reson Med 2022; 88:2504-2519. [PMID: 36000548 DOI: 10.1002/mrm.29416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/16/2022] [Accepted: 07/27/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Two-dimensional (2D) echo-planar radiofrequency (RF) pulses are widely used for reduced field-of-view (FOV) imaging in applications such as diffusion-weighted imaging. However, long pulse durations render the 2D RF pulses sensitive to off-resonance effects, causing local signal losses in reduced-FOV images. This work aims to achieve off-resonance robustness for 2D RF pulses via a sheared trajectory design. THEORY AND METHODS A sheared 2D RF pulse design is proposed to reduce pulse durations while covering identical excitation k-space extent as a standard 2D RF pulse. For a given shear angle, the number of sheared trajectory lines is minimized to obtain the shortest pulse duration, such that the excitation replicas are repositioned outside the slice stack to guarantee unlimited slice coverage. A target fat/water signal ratio of 5% is chosen to achieve robust fat suppression. RESULTS Simulations, imaging experiments on a custom head and neck phantom, and in vivo imaging experiments in the spinal cord at 3 T demonstrate that the sheared 2D RF design provides significant improvement in image quality while preserving profile sharpnesses. In regions with high off-resonance effects, the sheared 2D RF pulse improves the signal by more than 50% when compared to the standard 2D RF pulse. CONCLUSION The proposed sheared 2D RF design successfully reduces pulse durations, exhibiting significantly improved through-plane off-resonance robustness, while providing unlimited slice coverage and high fidelity fat suppression. This method will be especially beneficial in regions suffering from a variety of off-resonance effects, such as spinal cord and breast.
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Affiliation(s)
- Bahadir Alp Barlas
- Department of Electrical and Electronics Engineering, Bilkent University, Ankara, Turkey.,National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Cagla Deniz Bahadir
- Department of Electrical and Electronics Engineering, Bilkent University, Ankara, Turkey.,National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey.,Department of Biomedical Engineering, Cornell University, Ithaca, New York, USA
| | - Sevgi Gokce Kafali
- Department of Electrical and Electronics Engineering, Bilkent University, Ankara, Turkey.,National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey.,Department of Bioengineering, University of California Los Angeles, Los Angeles, California, USA
| | - Ugur Yilmaz
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Emine Ulku Saritas
- Department of Electrical and Electronics Engineering, Bilkent University, Ankara, Turkey.,National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey.,Neuroscience Graduate Program, Bilkent University, Ankara, Turkey
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13
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Diagnostic Value and Clinical Application of Diffusion-Weighted Magnetic Resonance Imaging for Female Pelvic Lesions. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:5868453. [PMID: 35833078 PMCID: PMC9236816 DOI: 10.1155/2022/5868453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/17/2022]
Abstract
Pelvic inflammatory disease refers to a group of infectious diseases of the female upper genital tract, often caused by ascending infection of vaginitis and cervicitis, causing endometritis, salpingitis, tubo-ovarian abscess, pelvic connective tissue inflammation, and/or pelvic peritonitis. PID is the most common and important infectious disease in nonpregnant women of childbearing age, and inflammation in multiple parts often coexists and affects each other. The functional MRI techniques currently used in pelvic floor muscle injury are magnetic resonance diffusion tensor imaging, T2 mapping, and magnetic resonance elastography. Diffusion tensor imaging is a new imaging and postprocessing technology developed on the basis of magnetic resonance diffusion-weighted imaging. Due to the lack of specificity of clinical symptoms, many subclinical patients are often not detected and diagnosed in time, so it is very difficult to accurately estimate the incidence of PID. This article retrospectively analyzed 72 patients with pelvic inflammatory disease confirmed by surgical pathology from February 2020 to 2022, who had undergone pelvic MRI examination before surgery, including 25 patients with chronic pelvic inflammation (hydrosalpinx), 25 patients with acute pelvic inflammation, and 47 cases (including 21 cases of hydrosalpinx, 19 cases of tubo-ovarian abscess, and 7 cases of pelvic abscess). The age range was 13 to 59 years old. The clinical data and MRI findings were analyzed, the ADC value of the cystic part of the lesion was measured, and the differences in age, maximum diameter of the lesion, thickness of the vessel wall/separation, and the ADC value of the cystic part of chronic and acute pelvic inflammation were compared. In this part of the cases, there were 25 cases of chronic pelvic inflammation and 47 cases of acute pelvic inflammation. The average ADC value of the cystic component of chronic inflammation was significantly higher than that of acute inflammation, which were (2.86 ± 0.20) × 10−3 mm2/s and (1.07 ± 0.38) ×10−3 mm2/s, respectively,
value <0.001.
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14
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Liu Q, Xu Z, Zhao K, Hoge WS, Zhang X, Mei Y, Lu Q, Niendorf T, Feng Y. Diffusion-weighted magnetic resonance imaging in rat kidney using two-dimensional navigated, interleaved echo-planar imaging at 7.0 T. NMR IN BIOMEDICINE 2022; 35:e4652. [PMID: 34820933 DOI: 10.1002/nbm.4652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this study was to investigate the feasibility of two-dimensional (2D) navigated, interleaved multishot echo-planar imaging (EPI) to enhance kidney diffusion-weighted imaging (DWI) in rats at 7.0 T. Fully sampled interleaved four-shot EPI with 2D navigators was tailored for kidney DWI (Sprague-Dawley rats, n = 7) on a 7.0-T small bore preclinical scanner. The image quality of four-shot EPI was compared with T2 -weighted rapid acquisition with relaxation enhancement (RARE) (reference) and single-shot EPI (ss-EPI) without and with parallel imaging (PI). The contrast-to-noise ratio (CNR) was examined to assess the image quality for the EPI approaches. The Dice similarity coefficient and the Hausdorff distance were used for evaluation of image distortion. Mean diffusivity (MD) and fractional anisotropy (FA) were calculated for renal cortex and medulla for all DWI approaches. The corticomedullary difference of MD and FA were assessed by Wilcoxon signed-rank test. Four-shot EPI showed the highest CNR among the three EPI variants and lowest geometric distortion versus T2 -weighted RARE (mean Dice: 0.77 for ss-EPI without PI, 0.88 for ss-EPI with twofold undersampling, and 0.92 for four-shot EPI). The FA map derived from four-shot EPI clearly identified a highly anisotropic region corresponding to the inner stripe of the outer medulla. Four-shot EPI successfully discerned differences in both MD and FA between renal cortex and medulla. In conclusion, 2D navigated, interleaved multishot EPI facilitates high-quality rat kidney DWI with clearly depicted intralayer and interlayer structure and substantially reduced image distortion. This approach enables the anatomic integrity of DWI-MRI in small rodents and has the potential to benefit the characterization of renal microstructure in preclinical studies.
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Affiliation(s)
- Qiang Liu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Medical Image Processing & Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
- Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence & Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, China
| | - Zhongbiao Xu
- Department of Radiation Oncology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kaixuan Zhao
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Medical Image Processing & Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
- Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence & Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, China
| | - W Scott Hoge
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Xinyuan Zhang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Medical Image Processing & Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
- Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence & Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, China
| | - Yingjie Mei
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Medical Image Processing & Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
- Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence & Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, China
| | - Qiqi Lu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Medical Image Processing & Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
- Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence & Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, China
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Medical Image Processing & Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
- Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence & Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, China
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15
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Foda A, Kellner E, Gunawardana A, Gao X, Janz M, Kufner A, Khalil AA, Geran R, Mekle R, Fiebach JB, Galinovic I. Differentiation of Cerebral Neoplasms with Vessel Size Imaging (VSI). Clin Neuroradiol 2022; 32:239-248. [PMID: 34940899 PMCID: PMC8894153 DOI: 10.1007/s00062-021-01129-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Cerebral neoplasms of various histological origins may show comparable appearances on conventional Magnetic Resonance Imaging (MRI). Vessel size imaging (VSI) is an MRI technique that enables noninvasive assessment of microvasculature by providing quantitative estimates of microvessel size and density. In this study, we evaluated the potential of VSI to differentiate between brain tumor types based on their microvascular morphology. METHODS Using a clinical 3T MRI scanner, VSI was performed on 25 patients with cerebral neoplasms, 10 with glioblastoma multiforme (GBM), 8 with primary CNS lymphoma (PCNSL) and 7 with cerebral lung cancer metastasis (MLC). Following the postprocessing of VSI maps, mean vessel diameter (vessel size index, vsi) and microvessel density (Q) were compared across tumors, peritumoral areas, and healthy tissues. RESULTS The MLC tumors have larger and less dense microvasculature compared to PCNSLs in terms of vsi and Q (p = 0.0004 and p < 0.0001, respectively). GBM tumors have higher yet non-significantly different vsi values than PCNSLs (p = 0.065) and non-significant differences in Q. No statistically significant differences in vsi or Q were present between GBMs and MLCs. GBM tumor volume was positively correlated with vsi (r = 0.502, p = 0.0017) and negatively correlated with Q (r = -0.531, p = 0.0007). CONCLUSION Conventional MRI parameters are helpful in differentiating between PCNSLs, GBMs, and MLCs. Additionally incorporating VSI parameters into the diagnostic protocol could help in further differentiating between PCNSLs and metastases and potentially between PCNSLs and GBMs. Future studies in larger patient cohorts are required to establish diagnostic cut-off values for VSI.
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Affiliation(s)
- Asmaa Foda
- International Graduate Program Medical Neurosciences, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Elias Kellner
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Freiburg, Germany
| | - Asanka Gunawardana
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
| | - Xiang Gao
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Freiburg, Germany
| | - Martin Janz
- Department of Hematology, Oncology and Cancer Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Kufner
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ahmed A Khalil
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Berlin, Germany
| | - Rohat Geran
- Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ralf Mekle
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jochen B Fiebach
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ivana Galinovic
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
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16
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Kwee TC, Kwee RM. Workload of diagnostic radiologists in the foreseeable future based on recent scientific advances: growth expectations and role of artificial intelligence. Insights Imaging 2021; 12:88. [PMID: 34185175 PMCID: PMC8241957 DOI: 10.1186/s13244-021-01031-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/08/2021] [Indexed: 12/13/2022] Open
Abstract
Objective To determine the anticipated contribution of recently published medical imaging literature, including artificial intelligence (AI), on the workload of diagnostic radiologists. Methods This study included a random sample of 440 medical imaging studies published in 2019. The direct contribution of each study to patient care and its effect on the workload of diagnostic radiologists (i.e., number of examinations performed per time unit) was assessed. Separate analyses were done for an academic tertiary care center and a non-academic general teaching hospital. Results In the academic tertiary care center setting, 65.0% (286/440) of studies could directly contribute to patient care, of which 48.3% (138/286) would increase workload, 46.2% (132/286) would not change workload, 4.5% (13/286) would decrease workload, and 1.0% (3/286) had an unclear effect on workload. In the non-academic general teaching hospital setting, 63.0% (277/240) of studies could directly contribute to patient care, of which 48.7% (135/277) would increase workload, 46.2% (128/277) would not change workload, 4.3% (12/277) would decrease workload, and 0.7% (2/277) had an unclear effect on workload. Studies with AI as primary research area were significantly associated with an increased workload (p < 0.001), with an odds ratio (OR) of 10.64 (95% confidence interval (CI) 3.25–34.80) in the academic tertiary care center setting and an OR of 10.45 (95% CI 3.19–34.21) in the non-academic general teaching hospital setting. Conclusions Recently published medical imaging studies often add value to radiological patient care. However, they likely increase the overall workload of diagnostic radiologists, and this particularly applies to AI studies. Supplementary Information The online version contains supplementary material available at 10.1186/s13244-021-01031-4.
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Affiliation(s)
- Thomas C Kwee
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Robert M Kwee
- Department of Radiology, Zuyderland Medical Center, Heerlen, Sittard-Geleen, The Netherlands
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17
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Chen M, Feng C, Wang Q, Li J, Wu S, Hu D, Deng B, Li Z. Comparison of reduced field-of-view diffusion-weighted imaging (DWI) and conventional DWI techniques in the assessment of Cervical carcinoma at 3.0T: Image quality and FIGO staging. Eur J Radiol 2021; 137:109557. [PMID: 33549900 DOI: 10.1016/j.ejrad.2021.109557] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/06/2021] [Accepted: 01/18/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate imaging quality (IQ) and International Federation of Gynecology and Obstetrics (FIGO) staging of reduced field-of-view (r-FOV) diffusion-weighted imaging (DWI) in cervical carcinoma (CC). MATERIALS AND METHODS Sixty patients with pathologically proven CC who underwent both pre-treatment r-FOV DWI and full field-of-view (f-FOV) DWI on a 3.0T MRI scanner were retrospectively reviewed. The subjective qualitative image scores were compared using the Wilcoxon signed-rank test. Objective quality values and apparent diffusion coefficient (ADC) were estimated by paired t-test or Wilcoxon signed-rank test for the two DWI sequences according to Normality test. Spearman rank correlation analysis was used to evaluate the relationship between pathological results and mean ADC value. RESULTS The subjective IQ scores for r-FOV DWI were significantly higher than those for f-FOV DWI (P < 0.001). Similarly, the contrast-to-noise (CNR) value of r-FOV DWI was superior to that of f-FOV DWI (10.30 ± 3.676, 8.91 ± 3.008, P = 0.021). However, the signal-to-noise ratio (SNR) value of r-FOV DWI was considerably lower than that of f-FOV DWI (27.80 ± 6.056, 33.67 ± 7.833, P<0.001). No significant difference was found between mean ADC values of f-FOV DWI and r-FOV DWI. There was a significant tendency for a negative correlation between the ADC values and FIGO stages of CC for both two sequences (r=-0. 436, P<0.01; r=-0.470, P<0.01, respectively). CONCLUSIONS The rFOV DWI sequence provided significantly better IQ and lesion conspicuity than the fFOV DWI sequence. In addition, rFOV sequences can be used in evaluation of FIGO staging of cervical cancer.
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Affiliation(s)
- Mingzhen Chen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Cui Feng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Qiuxia Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Jiali Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Sisi Wu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Daoyu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Baodi Deng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
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