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Chen AM, Harris JP, Tjoa T, Haidar Y, Armstrong WB. Refining Target Volume Coverage After Parotidectomy for Cutaneous Squamous Cell Carcinoma: Omission of the Cervical Neck From the Radiation Field. Adv Radiat Oncol 2024; 9:101306. [PMID: 38260235 PMCID: PMC10801645 DOI: 10.1016/j.adro.2023.101306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/25/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose For patients without pathologic evidence of cervical disease after neck dissection for cutaneous squamous cell carcinoma involving the parotid region, inclusion of the ipsilateral cervical neck in the postparotidectomy radiation volume is routinely performed. We report our experience with selective avoidance of the ipsilateral neck for patients undergoing postoperative radiation to the parotid bed. Methods and Materials From January 2014 to December 2023, a total of 30 consecutive patients underwent postoperative radiation after parotidectomy for cutaneous squamous cell carcinoma involving the parotid area. All patients had previously had a neck dissection confirming pathologic N0 disease. Treatment was delivered using intensity modulated radiation therapy to a median dose of 60 Gy (range, 56-66 Gy). The radiation target volumes included the parotid bed only, with deliberate avoidance of the ipsilateral cervical neck. The median pathologic tumor size of the parotid tumor was 3.3 cm (range, 0.2-9.4 cm). Final pathologic evaluation showed positive microscopic margins in 8 patients (27%), perineural invasion in 17 patients (57%), and facial nerve involvement in 6 patients (20%). Results There were no isolated nodal failures. One patient developed an ipsilateral neck recurrence approximately 8 months after completion of radiation therapy. This occurred 2 months subsequent to the development of local recurrence. The 5-year actuarial rates of local (parotid) control, neck control, and overall survival were 87%, 97%, and 76%, respectively. Conclusions Omission of the ipsilateral neck from the parotid volume does not compromise disease control for pathologically N0 patients undergoing postoperative radiation for cutaneous squamous cell carcinoma involving the parotid region. Practical implications are discussed.
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Affiliation(s)
| | | | - Tjoson Tjoa
- Otolaryngology, University of California, Irvine, Chao Family Comprehensive Cancer Center, Orange, California
| | - Yarah Haidar
- Otolaryngology, University of California, Irvine, Chao Family Comprehensive Cancer Center, Orange, California
| | - William B. Armstrong
- Otolaryngology, University of California, Irvine, Chao Family Comprehensive Cancer Center, Orange, California
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Abstract
Magnetic resonance (MR) imaging is a crucial tool for evaluation of the skull base, enabling characterization of complex anatomy by utilizing multiple image contrasts. Recent technical MR advances have greatly enhanced radiologists' capability to diagnose skull base pathology and help direct management. In this paper, we will summarize cutting-edge clinical and emerging research MR techniques for the skull base, including high-resolution, phase-contrast, diffusion, perfusion, vascular, zero echo-time, elastography, spectroscopy, chemical exchange saturation transfer, PET/MR, ultra-high-field, and 3D visualization. For each imaging technique, we provide a high-level summary of underlying technical principles accompanied by relevant literature review and clinical imaging examples.
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Affiliation(s)
- Claudia F Kirsch
- Division Chief, Neuroradiology, Professor of Neuroradiology and Otolaryngology, Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine at Northwell, North Shore University Hospital, Manhasset, NY
| | - Mai-Lan Ho
- Associate Professor of Radiology, Director of Research, Department of Radiology, Director, Advanced Neuroimaging Core, Chair, Asian Pacific American Network, Secretary, Association for Staff and Faculty Women, Nationwide Children's Hospital and The Ohio State University, Columbus, OH; Division Chief, Neuroradiology, Professor of Neuroradiology and Otolaryngology, Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine at Northwell, North Shore University Hospital, Manhasset, NY.
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Tang M, Huang R, Chen J, Sheng M, Zhang Z, Xing J, Guo L, Li Y. Clinical value of high-resolution dynamic contrast-enhanced (DCE) MRI in diagnosis of cutaneous squamous cell carcinoma. Skin Res Technol 2020; 27:511-520. [PMID: 33141995 DOI: 10.1111/srt.12978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND While uncomplicated cases of skin squamous cell carcinoma (cSCC) can be treated with surgery topical therapy alone, more objective and non-invasive examination methods are needed to guide clinicians to make more detailed biopsy and surgical plans for lesions with atypical or subcutaneous growth. High-resolution magnetic resonance imaging (HR-MRI) is a novel skin imaging method. MATERIALS AND METHODS Prospective collection of 19 patients with clinically suspected cSCC. All patients underwent high-resolution DCE-MRI using a 70-mm microscopy coil before operation. The imaging features and results of surgical pathology were recorded. Ktrans , Kep , Ve values, and the time-signal curve (TIC) types were determined using DCE images. RESULTS 16 cases of cSCC, 3 cases of acanthoma. The subcutaneous invasion of all lesions was clearly displayed, of which 8 lesions invaded the subcutaneous fat layer, 5 invaded the muscle layer, 1 invaded the periosteum, 2 invaded the cap fascia, and the layer of all lesions invasion judged by HR-MR imaging was consistent with the postoperative pathology. The main manifestations of cSCC were ill-defined margin, obvious inhomogeneous enhancement, higher perfusion parameters value and type-III TIC, while acanthoma showed well-defined and type-I TIC. Some imaging findings (such as boundary, enhancement) and DCE perfusion parameters of the two groups overlap. CONCLUSION High-resolution DCE-MRI can fully and directly display the subcutaneous invasion of cSCC, and more work needs to be done to prove its value. Next, we will expand the sample size, and further explore its value in the differential diagnosis and prognosis evaluation of cSCC from acanthoma or other skin tumors.
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Affiliation(s)
- Mengxiao Tang
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Renjun Huang
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Jianhua Chen
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Meiying Sheng
- Department of Burn and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | | | - Jianming Xing
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Lingchuan Guo
- Department of Pathology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Yonggang Li
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China
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van Egmond SL, Vonck BM, Bluemink JJ, Pameijer FA, Dankbaar JW, Stegeman I, Philippens ME, van den Berg CA, Janssen LM, Terhaard CH. Clinical value of (dedicated) 3 Tesla and 7 Tesla MRI for cT1 glottic carcinoma: A feasibility study. Laryngoscope Investig Otolaryngol 2019; 4:95-101. [PMID: 30828625 PMCID: PMC6383319 DOI: 10.1002/lio2.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/26/2018] [Accepted: 12/10/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To assess the feasibility of the clinical use of 3 Tesla and 7 Tesla Magnetic Resonance Imaging for early (cT1) glottic carcinoma, including structural assessment of technical image quality and visibility of the tumor; and if feasible, to correlate MRI findings to routine diagnostics. METHODS Prospective feasibility study. Twenty patients with primary clinical T1 glottic carcinoma underwent both routine clinical staging and CT. In addition, a 3 T and 7 T MRI protocol, developed for small laryngeal lesions, was performed in a 4-point immobilization mask, using dedicated surface coils. Afterwards, routine endoscopic direct suspension laryngoscopy under general anaesthesia was performed. RESULTS Only 2 of 7 (29%) of 7 T MRI scans were rated as moderate to good technical image quality. After exclusion of three patients with only mild to moderate dysplasia at the time of MRI, 13 of 17 (76%) of 3 T MRIs were of adequate technical image quality. Tumor visualization was adequate in 8 of 13 (62%) of patients with invasive squamous cell carcinomas. With exclusion of the four MRIs with motion artefacts, the tumor and its boundaries could be adequately seen in 8 of 9 (89%) patients with squamous cell carcinoma versus only one in four (25%) of patients with carcinoma in situ lesions. CONCLUSIONS 7 Tesla MRI was considered not feasible. 3 Tesla MRI, with adequate patient selection, namely clinical exclusion of patients with a history of claustrophobia and inclusion of only histologically proven invasive squamous cell carcinoma, can be feasible. Especially with further improvement of MR image quality. LEVEL OF EVIDENCE 2B, prospective diagnostic study.
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Affiliation(s)
- Sylvia L. van Egmond
- Department of Otorhinolaryngology and Head & Neck SurgeryLeiden University Medical CenterLeidenThe Netherlands
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Bernard M.D. Vonck
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Johanna J. Bluemink
- Department of RadiotherapyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Frank A. Pameijer
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Jan Willem Dankbaar
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtThe Netherlands
- Rudolf Magnus Institute of NeuroscienceUniversity Medical Center UtrechtUtrechtThe Netherlands
| | | | | | - Luuk M. Janssen
- Department of Head and Neck Surgical OncologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Chris H. Terhaard
- Department of RadiotherapyUniversity Medical Center UtrechtUtrechtThe Netherlands
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Zhao Y, Yang B. Value of Visualization of the Intraparotid Facial Nerve and Parotid Duct Using a Micro Surface Coil and Three-Dimensional Reversed Fast Imaging With Steady-State Precession and Diffusion-Weighted Imaging Sequence. J Craniofac Surg 2018; 29:e754-e757. [PMID: 29927823 DOI: 10.1097/scs.0000000000004704] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To explore the value of micro surface coil combined with three-dimensional reversed fast imaging with steady-state precession and diffusion-weighted imaging (3D-PSIF-DWI) in displaying intraparotid facial nerves and parotid ducts. METHODS In total 24 healthy volunteers with no parotid disease underwent scanning of head and neck coil and 4-cm micro surface coil combined with 3D-PSIF-DWI prospectively. The obtained original images were processed through maximum intensity projection, multiplanar reconstruction, and curved planar reconstruction. The magnetic resonance imaging (MRI) signal characteristics of intraparotid structure, the subjective score of image quality, the signal intensity ratio (SIR) of facial nerve/parotid tissues (SIRN), and SIR of parotid duct/parotid tissues (SIRD) were calculated, and the displaying rates of the facial nerves and parotid ducts were observed. The Wilcoxon matched-sample signed rank sum test was used to compare the scores of head and neck coil and micro surface coil 3D-PSIF-DWI sequence images; paired-t test was used to compare SIRN and SIRD of the 2 groups; χ test was used to compare the displaying rate of the facial nerves and parotid ducts in the 2 groups. RESULTS In total 24 volunteers successfully underwent MRI scan of parotid glands. On 3D-PSIF-DWI images, the parotid gland showed slightly low signal intensity, muscle tissues showed intermediate intensity, while the vessels showed slightly high or equal intensity; the parotid segment of facial nerves was displayed as a tortuous line-like high intensity, and the parotid duct showed curved high intensity, lymph nodes showed kidney-shaped, oval, or spindle-shaped high intensity. The subjective scores for head and neck coil and small coil images were (2.2 ± 0.7) and (1.5 ± 0.3) respectively, with significant difference (Z = -2.714, P = 0.007), and image quality of micro surface coils was better than that of head and neck coil. The SIRNs of head and neck coil and micro surface coil images were 1.6 ± 0.5 and 2.2 ± 1.1 respectively; the SIRDs were 2.0 ± 0.6 and 2.8 ± 1.4 respectively, which showed significant differences (t = 3.440, 3.639 respectively, P value was 0.001, 0.001 respectively). All facial nerve trunks could be displayed by head and neck coils and micro surface coils. On head and neck coil images, 46 sides of temporofacial division, 47 sides of cervicofacial division, 21 sides of temporal branches, 22 sides of zygomatic branches, 29 sides of buccal branches, 30 sides of marginal mandibular branches, 32 sides of cervical branches, and 28 sides of the parotid duct could be displayed. On micro coil images, 48 sides of temporofacial division, 48 sides of cervicofacial division, 37 sides of temporal branches, 39 sides of zygomatic branches, 42 sides of buccal branches, 35 sides of marginal mandibular branches, 46 sides of cervical branches, and 28 sides of the parotid duct could be displayed. The display number of first branches of the intraparotid facial nerve by these 2 methods had no significant difference, the number of the secondary branches and parotid duct had significant differences. CONCLUSION Micro surface coil surpassed parotid MRI with 3D-PSIF-DWI sequence than neck coil, which can simultaneously clearly display the trunk and branches of the intraparotid facial nerves and parotid ducts.
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Affiliation(s)
- Yue Zhao
- CT/MR Room, Zhanjiang Central People's Hospital, Zhanjiang
| | - Bin Yang
- Department of Radiology, the First Affiliated Hospital of Dali University, Dali, China
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Obusez EC, Lowe M, Oh SH, Wang I, Jennifer Bullen, Ruggieri P, Hill V, Lockwood D, Emch T, Moon D, Loy G, Lee J, Kiczek M, Manoj Massand, Statsevych V, Stultz T, Jones SE. 7T MR of intracranial pathology: Preliminary observations and comparisons to 3T and 1.5T. Neuroimage 2018; 168:459-476. [DOI: 10.1016/j.neuroimage.2016.11.030] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 10/26/2016] [Accepted: 11/12/2016] [Indexed: 12/12/2022] Open
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Kroll T, May A, Wittekindt C, Kähling C, Sharma SJ, Howaldt HP, Klussmann JP, Streckbein P. Cone beam computed tomography (CBCT) sialography--an adjunct to salivary gland ultrasonography in the evaluation of recurrent salivary gland swelling. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:771-5. [PMID: 26548729 DOI: 10.1016/j.oooo.2015.09.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 02/14/2015] [Accepted: 09/02/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Cone beam computed tomography (CBCT) sialography could help improve the visualization of the ductal system of salivary glands. The aim of this retrospective investigation was to monitor the use of CBCT sialography for the diagnosis of pathologies within the intraglandular ductal system when ultrasonography was inconclusive. STUDY DESIGN Fourteen consecutive patients suffering from recurrent swelling of a major salivary gland were evaluated. In 12 patients (8 female; 4 male; average age 46 years), a radiopaque contrast agent could be injected into the ductal system, followed by a routine CBCT. Four blinded examiners evaluated the acquired data sets retrospectively. RESULTS CBCT revealed seven stenosis, two salivary stones, one complete duct atresia, one intraglandular duct ectasia, and one regular duct system. Three of the detected pathologies were strictly intraglandular. CONCLUSIONS CBCT sialography shows promise as a supplementary noninvasive diagnostic tool for the visualization of the intraglandular ductal system of the major human salivary glands. Controlled studies to further validate this method should be undertaken.
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Affiliation(s)
- Tobias Kroll
- Department of Otorhinolaryngology, University Hospital Gießen, Justus Liebig University, Klinikstraße 33, Giessen, 35392, Germany.
| | - Andreas May
- Department of Cranio-Maxillo-Facial Surgery, University Hospital Gießen, Justus Liebig University, Klinikstraße 33, Giessen, 35392, Germany
| | - Claus Wittekindt
- Department of Otorhinolaryngology, University Hospital Gießen, Justus Liebig University, Klinikstraße 33, Giessen, 35392, Germany
| | - Christopher Kähling
- Department of Cranio-Maxillo-Facial Surgery, University Hospital Gießen, Justus Liebig University, Klinikstraße 33, Giessen, 35392, Germany
| | - Shachi Jenny Sharma
- Department of Otorhinolaryngology, University Hospital Gießen, Justus Liebig University, Klinikstraße 33, Giessen, 35392, Germany
| | - Hans-Peter Howaldt
- Department of Cranio-Maxillo-Facial Surgery, University Hospital Gießen, Justus Liebig University, Klinikstraße 33, Giessen, 35392, Germany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, University Hospital Gießen, Justus Liebig University, Klinikstraße 33, Giessen, 35392, Germany
| | - Philipp Streckbein
- Department of Cranio-Maxillo-Facial Surgery, University Hospital Gießen, Justus Liebig University, Klinikstraße 33, Giessen, 35392, Germany
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Abstract
HYPOTHESIS The implementation of 7.0 Tesla magnetic resonance imaging (MRI) for human use has the potential to further advance spatial resolution beyond that of 1.5T and 3T. This could result in potential advantages in the depiction of the membranous structures of the inner ear. BACKGROUND The inner ear is particularly challenging to visualize at 7T. Where the signal-to-noise ratio will scale linear with the field strength, the proximity of the inner ear to the cerebrospinal fluid, nerves, and bone can lead to susceptibility banding artifacts and signal loss at the interface between the inner ear and its surroundings. METHODS A human head specimen as well as 2 healthy volunteers underwent MRI at a 7 Tesla scanner. First aim was to scan with ultrahigh resolution, independent of scan duration. Second aim was to reduce scan duration. The final step was to develop a scanning protocol suitable for clinical practice, based on previous information from ex vivo imaging. RESULTS Both in and ex vivo, large objects like the cochlear basal turn, vestibule, and semicircular canals were visualized clearly. The nerves were depicted in more detail in vivo. The interscalar septum was visible in all images. A prolonged acquisition time ex vivo showed more detail of the scala tympani and vestibuli. However, the scala media was never visible, even with maximal resolution. CONCLUSION Although inhomogeneities remain present, maximum resolution scanning ex vivo as well as scanning in vivo at 7T MRI resulted in clear depiction of the major membranous structures of the inner ear.
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Kinner S, Maderwald S, Albert J, Parohl N, Corot C, Robert P, Baba HA, Barkhausen J. Discrimination of benign and malignant lymph nodes at 7.0T compared to 1.5T magnetic resonance imaging using ultrasmall particles of iron oxide: a feasibility preclinical study. Acad Radiol 2013; 20:1604-9. [PMID: 24200489 DOI: 10.1016/j.acra.2013.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 08/31/2013] [Accepted: 09/01/2013] [Indexed: 11/17/2022]
Abstract
RATIONALE AND OBJECTIVES To investigate the feasibility and performance of 7T magnetic resonance imaging compared to 1.5T imaging to discriminate benign (normal and inflammatory changed) from tumor-bearing lymph nodes in rabbits using ultrasmall particles of iron oxide (USPIO)-based contrast agents. MATERIALS AND METHODS Six New Zealand White rabbits were inoculated with either complete Freund's adjuvant cell suspension (n = 3) to induce reactively enlarged lymph nodes or with VX2 tumor cells to produce metastatic lymph nodes (n = 3). Image acquisition was performed before and 24 hours after bolus injection of an USPIO contrast agent at 1.5T and afterward at 7T using T1-weighted and T2*-weighted sequences. Sensitivities, specificities, and negative and positive predictive values for the detection of lymph node metastases were calculated for both field strengths with histopathology serving as reference standard. Sizes of lymph nodes with no, inflammatory, and malignant changes were compared using a Mann-Whitney U-test. RESULTS All 24 lymph nodes were detected at 1.5T as well as at 7T. At 1.5T, sensitivity amounted to 0.67, while specificity reached a value of 1. At the higher field strength (7T), imaging was able to reach sensitivity and specificity values of 1. No statistical differences were detected concerning lymph node sizes. CONCLUSIONS Magnetic resonance lymphography with USPIO contrast agents allows for differentiation of normal and reactively enlarged lymph nodes compared to metastatic nodes. First experiments at 7T show promising results compared to 1.5T, which have to be evaluated in further trials.
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Affiliation(s)
- Sonja Kinner
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany.
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Maas MC, Vos EK, Lagemaat MW, Bitz AK, Orzada S, Kobus T, Kraff O, Maderwald S, Ladd ME, Scheenen TWJ. Feasibility of T2 -weighted turbo spin echo imaging of the human prostate at 7 tesla. Magn Reson Med 2013; 71:1711-9. [PMID: 23798333 DOI: 10.1002/mrm.24818] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 04/03/2013] [Accepted: 05/02/2013] [Indexed: 11/09/2022]
Abstract
PURPOSE To demonstrate that high quality T2 -weighted (T2w) turbo spin-echo (TSE) imaging of the complete prostate can be achieved routinely and within safety limits at 7 T, using an external transceive body array coil only. METHODS Nine healthy volunteers and 12 prostate cancer patients were scanned on a 7 T whole-body system. Preparation consisted of B0 and radiofrequency shimming and localized flip angle calibration. T1 and T2 relaxation times were measured and used to define the T2w-TSE protocol. T2w imaging was performed using a TSE sequence (pulse repetition time/echo time 3000-3640/71 ms) with prolonged excitation and refocusing pulses to reduce specific absorption rate. RESULTS High quality T2w TSE imaging was performed in less than 2 min in all subjects. Tumors of patients with gold-standard tumor localization (MR-guided biopsy or prostatectomy) were well visualized on 7 T imaging (n = 3). The number of consecutive slices achievable within a 10-g averaged specific absorption rate limit of 10 W/kg was ≥28 in all subjects, sufficient for full prostate coverage with 3-mm slices in at least one direction. CONCLUSION High quality T2w TSE prostate imaging can be performed routinely and within specific absorption rate limits at 7 T with an external transceive body array.
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Affiliation(s)
- Marnix C Maas
- Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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Horsburgh A, Massoud TF. The salivary ducts of Wharton and Stenson: Analysis of normal variant sialographic morphometry and a historical review. Ann Anat 2013; 195:238-42. [DOI: 10.1016/j.aanat.2012.11.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 10/29/2012] [Accepted: 11/13/2012] [Indexed: 11/25/2022]
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Chu J, Zhou Z, Hong G, Guan J, Li S, Rao L, Meng Q, Yang Z. High-resolution MRI of the intraparotid facial nerve based on a microsurface coil and a 3D reversed fast imaging with steady-state precession DWI sequence at 3T. AJNR Am J Neuroradiol 2013; 34:1643-8. [PMID: 23578676 DOI: 10.3174/ajnr.a3472] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE 3D high-resolution MR imaging can provide reliable information for defining the exact relationships between the intraparotid facial nerve and adjacent structures. The purpose of this study was to explore the clinical value of using a surface coil combined with a 3D-PSIF-DWI sequence in intraparotid facial nerve imaging. MATERIALS AND METHODS Twenty-one healthy volunteers underwent intraparotid facial nerve scanning at 3T by using the 3D-PSIF-DWI sequence with both the surface coil and the head coil. Source images were processed with MIP and MPR to better delineate the intraparotid facial nerve and its branches. In addition, the SIR of the facial nerve and parotid gland was calculated. The number of facial nerve branches displayed by these 2 methods was calculated and compared. RESULTS The display rates of the main trunk, divisions (cervicofacial, temporofacial), and secondary branches of the intraparotid facial nerve were 100%, 97.6%, and 51.4% by head coil and 100%, 100%, and 83.8% by surface coil, respectively. The display rate of secondary branches of the intraparotid facial nerve by these 2 methods was significantly different (P < .05). The SIRs of the intraparotid facial nerve/parotid gland in these 2 methods were significantly different (P < .05) at 1.37 ± 1.06 and 1.89 ± 0.87, respectively. CONCLUSIONS The 3D-PSIF-DWI sequence combined with a surface coil can better delineate the intraparotid facial nerve and its divisions than when it is combined with a head coil, providing better image contrast and resolution. The proposed protocol offers a potentially useful noninvasive imaging sequence for intraparotid facial nerve imaging at 3T.
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Affiliation(s)
- J Chu
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Somma F, Berritto D, Iacobellis F, Landi N, Cavaliere C, Corona M, Russo S, Di Mizio R, Rotondo A, Grassi R. 7T μMRI of mesenteric venous ischemia in a rat model: timing of the appearance of findings. Magn Reson Imaging 2012; 31:408-13. [PMID: 23102942 DOI: 10.1016/j.mri.2012.08.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 08/18/2012] [Accepted: 08/30/2012] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The aim of this study is to analyze the chronological development of macroscopic, microscopic and magnetic resonance imaging (MRI) findings in a rat model of Superior Mesenteric Venous (SMV) ligation, and to evaluate the role of MRI in the diagnosis of mesenteric venous thrombosis. METHODS Thirty adult Sprague-Dawley rats were used and divided in two different groups that underwent a different surgical model and a different monitoring of ischemic damage. Group I underwent macroscopical and histological observation; Group II underwent 7T μMRI evaluation and histological analysis. RESULTS The first alterations occurred 30 min after SMV ligation and progressively worsened until the eighth hour. The morphological and MRI findings showed the same course. CONCLUSIONS This study provides a systematic evaluation of early anatomopathological and MRI findings following the SMV ligation. MRI allows to identify the early pathological findings of venous mesenteric ischemia and allows to correlate those to the histopathological features. Our data suggest a relevant role of MRI in the diagnostic management of mesenteric venous thrombosis, allowing to non-invasively identify and characterize the histopathologic findings. So, thanks to these skills, its future application in early diagnosis of human mesenteric venous ischemia is supposable.
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Affiliation(s)
- Francesco Somma
- Institute of Radiology, Second University of Naples, Piazza Miraglia 2, Naples, Italy
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Grams AE, Kraff O, Kalkmann J, Orzada S, Maderwald S, Ladd ME, Forsting M, Gizewski ER. Magnetic Resonance Imaging of Cranial Nerves at 7 Tesla. Clin Neuroradiol 2012; 23:17-23. [DOI: 10.1007/s00062-012-0144-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 03/08/2012] [Indexed: 01/16/2023]
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Umutlu L, Forsting M, Ladd ME. Ultrahigh-field magnetic resonance imaging: the clinical potential for anatomy, pathogenesis, diagnosis and treatment planning in neck and spine disease. Neuroimaging Clin N Am 2012; 22:363-71, xii. [PMID: 22548937 DOI: 10.1016/j.nic.2012.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An increase of the magnetic field strength to ultrahigh-field yields advantageous as well as disadvantageous changes in physical effects. The beneficial increase in signal/noise ratio can be leveraged into higher spatiotemporal resolution, and an exacerbation of artifacts can impede ultrahigh-field imaging. With the successful introduction of intracranial and musculoskeletal imaging at 7 T, recent advances in coil design have created opportunities for further applications of ultrahigh-field magnetic resonance (MR) imaging in other parts of the body. Initial studies in 7 T neck and spine MR imaging have revealed promising insights and new challenges, demanding further research and methodological optimization.
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Affiliation(s)
- Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D-45122 Essen, Germany.
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Iacobellis F, Berritto D, Somma F, Cavaliere C, Corona M, Cozzolino S, Fulciniti F, Cappabianca S, Rotondo A, Grassi R. Magnetic resonance imaging: A new tool for diagnosis of acute ischemic colitis? World J Gastroenterol 2012; 18:1496-501. [PMID: 22509081 PMCID: PMC3319945 DOI: 10.3748/wjg.v18.i13.1496] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 07/07/2011] [Accepted: 07/14/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To define the evolution of ischemic lesions with 7T magnetic resonance imaging (7T-MRI) in an animal model of acute colonic ischemia.
METHODS: Adult Sprague-Dawley rats were divided into two groups. Group I underwent inferior mesenteric artery (IMA) ligation followed by macroscopic observations and histological analysis. In group II, 7T-MRI was performed before and after IMA ligation and followed by histological analysis.
RESULTS: Morphological alterations started to develop 1 h after IMA ligation, when pale areas became evident in the splenic flexure mesentery and progressively worsened up to 8 h thereafter, when the mesentery was less pale, and the splenic flexure loop appeared very dark. The 7T-MRI results reflected these alterations, showing a hyperintense signal in both the intraperitoneal space and the colonic loop wall 1 h after IMA ligation; the latter progressively increased to demonstrate a reduction in the colonic loop lumen at 6 h. Eight hours after IMA ligation, MRI showed a persistent colonic mural hyperintensity associated with a reduction in peritoneal free fluid. The 7T-MRI findings were correlated with histological alterations, varying from an attenuated epithelium with glandular apex lesions at 1 h to coagulative necrosis and loss of the surface epithelium detected 8 h after IMA ligation.
CONCLUSION: MRI may be used as a substitute for invasive procedures in diagnosing and grading acute ischemic colitis, allowing for the early identification of pathological findings.
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Abstract
Recent advances in diagnostic radiology are discussed on the basis of current publications in Investigative Radiology. Publications in the journal during 2009 and 2010 are reviewed, evaluating developments by modality and anatomic region. Technological advances continue to play a major role in the evolution and clinical practice of diagnostic radiology, and as such constitute a major publication focus. In the past 2 years, this includes advances in both magnetic resonance and computed tomography (in particular, the advent of dual energy computed tomography). An additional major focus of publications concerns contrast media, and in particular continuing research involving nephrogenic systemic fibrosis, its etiology, and differentiation of the gadolinium chelates on the basis of in vivo stability.
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Qin Y, Zhang J, Li P, Wang Y. 3D double-echo steady-state with water excitation MR imaging of the intraparotid facial nerve at 1.5T: a pilot study. AJNR Am J Neuroradiol 2011; 32:1167-72. [PMID: 21566007 DOI: 10.3174/ajnr.a2480] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The intraparotid facial nerve is difficult to delineate using conventional MR sequence. Our aim was to assess the value of 3D DESSWE MR imaging in depicting the normal anatomy of the intraparotid facial nerve. MATERIALS AND METHODS A 3D-DESSWE sequence was performed with optimum parameters in 18 healthy volunteers on a 1.5T MR imaging unit. The data obtained were reconstructed in relation to the course of the facial nerve by using the MPR and thin-section MIP programs. Images acquired were analyzed by 2 neuroradiologists. They made the initial evaluations independently but resolved inconsistencies by collaborative review and consensus agreement. The certainty of identifying the intraparotid facial nerve was scored and recorded on an arbitrary scale of 0-2. The lengths of the facial nerves were measured; CNRs of the facial nerves and parotid ducts were calculated. Statistical evaluation of the results was achieved by the 2-tailed Wilcoxon test, ANOVA, and a paired t test. RESULTS In all subjects, 3D DESSWE images provided a reliable definition of the normal facial nerve anatomy bilaterally. There were no significant differences between scores, lengths, and CNRs of bilateral facial nerves (P > .05). The intraparotid facial nerve, parotid ducts, and retromandibular vein showed high signal intensity while the surrounding soft tissue showed relatively low signal intensity. The signal intensity between the facial nerves and parotid ducts was significantly different (P < .01); but no differences could be obtained for the CNRs between the 2 structures (P > .05). CONCLUSIONS The 3D DESSWE sequence can display the intraparotid course of the normal facial nerve, including the relationship between the facial nerve and the parotid duct.
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Affiliation(s)
- Y Qin
- Department of Radiology, First Affiliated Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Umutlu L, Maderwald S, Kraff O, Theysohn JM, Kuemmel S, Hauth EA, Forsting M, Antoch G, Ladd ME, Quick HH, Lauenstein TC. Dynamic contrast-enhanced breast MRI at 7 Tesla utilizing a single-loop coil: a feasibility trial. Acad Radiol 2010; 17:1050-6. [PMID: 20599158 DOI: 10.1016/j.acra.2010.03.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 03/26/2010] [Accepted: 03/29/2010] [Indexed: 10/19/2022]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to assess the feasibility of dynamic contrast-enhanced ultra-high-field breast imaging at 7 Tesla. MATERIAL AND METHODS A total of 15 subjects, including 5 patients with histologically proven breast cancer, were examined on a 7 Tesla whole-body magnetic resonance imaging system using a unilateral linearly polarized single-loop coil. Subjects were placed in prone position on a biopsy support system, with the coil placed directly below the region of interest. The examination protocol included the following sequences: 1) T2-weighted turbo spin echo sequence; 2) six dynamic T1-weighted spoiled gradient-echo sequences; and 3) subtraction imaging. RESULTS Contrast-enhanced T1-weighted imaging at 7 Tesla could be obtained at high spatial resolution with short acquisition times, providing good image accuracy and a conclusively good delineation of small anatomical and pathological structures. T2-weighted imaging could be obtained with high spatial resolution at adequate acquisition times. Because of coil limitations, four high-field magnetic resonance examinations showed decreased diagnostic value. CONCLUSIONS This first scientific approach of dynamic contrast-enhanced breast magnetic resonance imaging at 7 Tesla demonstrates the complexity of ultra-high-field breast magnetic resonance imaging and countenances the implementation of further advanced bilateral coil concepts to circumvent current limitations from the coil and ultra-high-field magnetic strength.
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7.0 Tesla MRI: the "field of dreams"? Acad Radiol 2010; 17:407-9. [PMID: 20207312 DOI: 10.1016/j.acra.2009.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 12/18/2009] [Accepted: 12/18/2009] [Indexed: 11/20/2022]
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Abstract
OBJECTIVE To develop a transmit/receive radiofrequency (RF) array for MR imaging of the human spine at 7 T. The prototype is characterized in simulations and bench measurements, and the feasibility of high-resolution spinal cord imaging at 7 T is demonstrated in in vivo images of volunteers. MATERIALS AND METHODS The RF phased array consists of 8 overlapping surface loop coils with a dimension of 12 cm x 12 cm each. Bench measurements were obtained with a phantom made of body-simulating liquid and assessed with a network analyzer. For safety validation, numerical computations of the RF field distribution and the corresponding specific absorption rate were performed on the basis of 3 different human body models. In vivo images of 3 volunteers (2 with a documented scoliosis) were acquired using a 3D-FLASH sequence with a high spatial resolution of 0.57 mm isotropic. RESULTS The 7 T transmit/receive RF coil could be easily integrated into the patient table for examinations of the cervicothoracic or thoracolumbosacral spine. Comparable results were found for all 3 numerical calculations using different human body models. Measurements of the g-factor indicated good image quality for parallel imaging acceleration factors up to 2.7 along the head-feet direction, which could be validated in the in vivo images. The in vivo images demonstrated very fine anatomic features such as the longitudinal ligaments or the venous drainage through the vertebral bodies. A largely homogeneous excitation over an extensive field-of-view of 40 cm could be obtained. CONCLUSIONS These early results indicate that a multichannel transmit/receive phased array RF coil can be used for in vivo spine imaging at 7 T, thereby rendering high-resolution spine imaging a promising new application in 7 T clinical research.
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NAGANAWA S, ISHIHARA S, SATAKE H, KAWAI H, SONE M, NAKASHIMA T. Simultaneous Three-dimensional Visualization of the Intra-parotid Facial Nerve and Parotid Duct using a Three-dimensional Reversed FISP Sequence with Diffusion Weighting. Magn Reson Med Sci 2010; 9:153-8. [DOI: 10.2463/mrms.9.153] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Fitzgerald TN, Muto A, Fancher TT, Brown PB, Martin KA, Muhs BE, Rothman DL, Constable RT, Sampath S, Dardik A. Surgically implantable magnetic resonance angiography coils improve resolution to allow visualization of blood flow dynamics. Ann Vasc Surg 2009; 24:242-53. [PMID: 20036497 DOI: 10.1016/j.avsg.2009.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2009] [Revised: 08/28/2009] [Accepted: 10/23/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Magnetic resonance angiography (MRA) is clinically useful but of limited applicability to small animal models due to poor signal resolution, with typical voxel sizes of 1 mm(3) that are insufficient to analyze vessels of diameter <1 mm. We determined whether surgically implantable, extravascular MRA coils increase signal resolution adequately to examine blood flow dynamics METHODS A custom MRA coil was surgically implanted near the carotid artery of a New Zealand White rabbit. A stenosis was created in the carotid artery to induce complicated, non-laminar flow. Phase contrast images were obtained on multiple axial planes with 3T MRA and through-plane velocity profiles were calculated under laminar and complicated flow conditions. These velocity profiles were fit to a laminar flow model using ordinary least squares in order to quantify the degree of flow complication (Matlab). Flow was also measured with a Doppler flow probe; vessel diameters and flow velocities were compared with duplex ultrasound RESULTS Carotid artery blood flow was 24.7 +/- 2.6 ml/min prior to stenosis creation and reduced to 12.0 +/- 1.7 ml/min following injury (n=3). An MRA voxel size of 0.1 x 0.1 x 5 mm was achieved. The control carotid artery diameter was 1.9 +/- 0.1 mm, and cross-sectional images containing 318 +/- 22 voxels were acquired (n=26). Velocity profiles resembled laminar flow proximal to the stenosis, and then became more complicated just proximal and distal to the stenosis. Laminar flow conditions returned downstream of the stenosis CONCLUSION Implantable, extra-vascular coils enable small MRA voxel sizes to reproducibly calculate complex velocity profiles under both laminar and complicated flow in a small animal model. This technique may be applied to study blood flow dynamics of vessel remodeling and atherogenesis.
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Affiliation(s)
- Tamara N Fitzgerald
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
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