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Jiang Z, Sun W, Xu D, Mei H, Yuan J, Song X, Ma C, Xu H. The feasibility of half-dose contrast-enhanced scanning of brain tumours at 5.0 T: a preliminary study. BMC Med Imaging 2024; 24:88. [PMID: 38615005 PMCID: PMC11016225 DOI: 10.1186/s12880-024-01270-z] [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: 09/27/2023] [Accepted: 04/05/2024] [Indexed: 04/15/2024] Open
Abstract
PURPOSE This study investigated and compared the effects of Gd enhancement on brain tumours with a half-dose of contrast medium at 5.0 T and with a full dose at 3.0 T. METHODS Twelve subjects diagnosed with brain tumours were included in this study and underwent MRI after contrast agent injection at 3.0 T (full dose) or 5.0 T (half dose) with a 3D T1-weighted gradient echo sequence. The postcontrast images were compared by two independent neuroradiologists in terms of the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and subjective image quality score on a ten-point Likert scale. Quantitative indices and subjective quality ratings were compared with paired Student's t tests, and interreader agreement was assessed with the intraclass correlation coefficient (ICC). RESULTS A total of 16 enhanced tumour lesions were detected. The SNR was significantly greater at 5.0 T than at 3.0 T in grey matter, white matter and enhanced lesions (p < 0.001). The CNR was also significantly greater at 5.0 T than at 3.0 T for grey matter/tumour lesions, white matter/tumour lesions, and grey matter/white matter (p < 0.001). Subjective evaluation revealed that the internal structure and outline of the tumour lesions were more clearly displayed with a half-dose at 5.0 T (Likert scale 8.1 ± 0.3 at 3.0 T, 8.9 ± 0.3 at 5.0 T, p < 0.001), and the effects of enhancement in the lesions were comparable to those with a full dose at 3.0 T (7.8 ± 0.3 at 3.0 T, 8.7 ± 0.4 at 5.0 T, p < 0.001). All subjective scores were good to excellent at both 5.0 T and 3.0 T. CONCLUSION Both quantitative and subjective evaluation parameters suggested that half-dose enhanced scanning via 5.0 T MRI might be feasible for meeting clinical diagnostic requirements, as the image quality remains optimal. Enhanced scanning at 5.0 T with a half-dose of contrast agents might benefit patients with conditions that require less intravenous contrast agent, such as renal dysfunction.
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Affiliation(s)
- Zhiyong Jiang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Medical Imaging Department, Shenzhen Ban'an Traditional Chinese Medicine Hospital Group, Shenzhen, China
| | - Wenbo Sun
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Dan Xu
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hao Mei
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | | | - Xiaopeng Song
- United Imaging Healthcare, Shanghai, China
- Wuhan Zhongke Industrial Research Institute, Wuhan, Hubei, China
| | - Chao Ma
- Department of Neurosurgery, Zhongnan Hospital, Wuhan, China.
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
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2
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Dekker HM, Stroomberg GJ, Van der Molen AJ, Prokop M. Review of strategies to reduce the contamination of the water environment by gadolinium-based contrast agents. Insights Imaging 2024; 15:62. [PMID: 38411847 PMCID: PMC10899148 DOI: 10.1186/s13244-024-01626-7] [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: 09/14/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024] Open
Abstract
Gadolinium-based contrast agents (GBCA) are essential for diagnostic MRI examinations. GBCA are only used in small quantities on a per-patient basis; however, the acquisition of contrast-enhanced MRI examinations worldwide results in the use of many thousands of litres of GBCA per year. Data shows that these GBCA are present in sewage water, surface water, and drinking water in many regions of the world. Therefore, there is growing concern regarding the environmental impact of GBCA because of their ubiquitous presence in the aquatic environment. To address the problem of GBCA in the water system as a whole, collaboration is necessary between all stakeholders, including the producers of GBCA, medical professionals and importantly, the consumers of drinking water, i.e. the patients. This paper aims to make healthcare professionals aware of the opportunity to take the lead in making informed decisions about the use of GBCA and provides an overview of the different options for action.In this paper, we first provide a summary on the metabolism and clinical use of GBCA, then the environmental fate and observations of GBCA, followed by measures to reduce the use of GBCA. The environmental impact of GBCA can be reduced by (1) measures focusing on the application of GBCA by means of weight-based contrast volume reduction, GBCA with higher relaxivity per mmol of Gd, contrast-enhancing sequences, and post-processing; and (2) measures that reduce the waste of GBCA, including the use of bulk packaging and collecting residues of GBCA at the point of application.Critical relevance statement This review aims to make healthcare professionals aware of the environmental impact of GBCA and the opportunity for them to take the lead in making informed decisions about GBCA use and the different options to reduce its environmental burden.Key points• Gadolinium-based contrast agents are found in sources of drinking water and constitute an environmental risk.• Radiologists have a wide spectrum of options to reduce GBCA use without compromising diagnostic quality.• Radiology can become more sustainable by adopting such measures in clinical practice.
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Affiliation(s)
- Helena M Dekker
- Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
| | - Gerard J Stroomberg
- RIWA-Rijn - Association of River Water Works, Groenendael 6, 3439 LV, Nieuwegein, The Netherlands
| | - Aart J Van der Molen
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Mathias Prokop
- Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
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Radbruch A, Paech D, Gassenmaier S, Luetkens J, Isaak A, Herrmann J, Othman A, Schäfer J, Nikolaou K. 1.5 vs 3 Tesla Magnetic Resonance Imaging: A Review of Favorite Clinical Applications for Both Field Strengths-Part 2. Invest Radiol 2021; 56:692-704. [PMID: 34417406 DOI: 10.1097/rli.0000000000000818] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
ABSTRACT The second part of this review deals with experiences in neuroradiological and pediatric examinations using modern magnetic resonance imaging systems with 1.5 T and 3 T, with special attention paid to experiences in pediatric cardiac imaging. In addition, whole-body examinations, which are widely used for diagnostic purposes in systemic diseases, are compared with respect to the image quality obtained in different body parts at both field strengths. A systematic overview of the technical differences at 1.5 T and 3 T has been presented in part 1 of this review, as well as several organ-based magnetic resonance imaging applications including musculoskeletal imaging, abdominal imaging, and prostate diagnostics.
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Affiliation(s)
- Alexander Radbruch
- From the Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Bonn, Bonn
| | - Daniel Paech
- From the Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Bonn, Bonn
| | - Sebastian Gassenmaier
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Tübingen
| | - Julian Luetkens
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Alexander Isaak
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Judith Herrmann
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Tübingen
| | | | - Jürgen Schäfer
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Tübingen
| | - Konstantin Nikolaou
- Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Tübingen
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4
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Kwon H, Kim JW, Park M, Kim JW, Kim M, Suh SH, Chang YS, Ahn SJ, Lee JM. Brain Metastases From Lung Adenocarcinoma May Preferentially Involve the Distal Middle Cerebral Artery Territory and Cerebellum. Front Oncol 2020; 10:1664. [PMID: 32984041 PMCID: PMC7484698 DOI: 10.3389/fonc.2020.01664] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/28/2020] [Indexed: 11/13/2022] Open
Abstract
Although whole-brain radiation therapy (WBRT) is the mainstay of treatment for brain metastases (BMs), the concept of saving eloquent cortical lesions has been promoted. If BMs from lung cancer are spatially biased to certain regions, this approach can be justified more. We evaluated whether BMs from lung cancer show a preference for certain brain regions and if their distribution pattern differs according to the histologic subtype of the primary lung cancer. In this retrospective study, 562 BMs in 80 patients were analyzed (107 BMs from small cell carcinoma, 432 from adenocarcinoma, and 23 from squamous cell carcinoma). Kernel density estimation was performed to investigate whether BM spatial patterns differed among lung cancer subtypes. Further, we explored more detailed subregions where BMs from adenocarcinomas occur frequently using one-way analysis of variance. Finally, we divided our cohort into those with fewer (≤10) and more (>10) BMs and evaluated whether this biased pattern was maintained across limited and extensive stages. For small cell carcinoma, BMs were biased to the cerebellum, but this did not reach statistical significance. For adenocarcinoma, BMs were found more frequently near the distal middle cerebral artery (MCA) territory and cerebellum than in other arterial territories (p < 0.01). The precentral and postcentral gyri were the most significant subregions within the distal anterior cerebral artery (ACA) and MCA territories (p < 0.01). Crus I and Lobule VI were significant regions within the cerebellum (p < 0.01). Regardless of the number of BMs, the affinity to the distal MCA territory and cerebellum was maintained. The present data confirm that BMs from lung adenocarcinoma may preferentially involve the distal MCA territory and cerebellum.
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Affiliation(s)
- Hyeokjin Kwon
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Jun Won Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Mina Park
- Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Jin Woo Kim
- Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Minseo Kim
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Sang Hyun Suh
- Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Yoon Soo Chang
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Sung Jun Ahn
- Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
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5
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Benzakoun J, Robert C, Legrand L, Pallud J, Meder JF, Oppenheim C, Dhermain F, Edjlali M. Anatomical and functional MR imaging to define tumoral boundaries and characterize lesions in neuro-oncology. Cancer Radiother 2020; 24:453-462. [PMID: 32278653 DOI: 10.1016/j.canrad.2020.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/04/2020] [Indexed: 12/19/2022]
Abstract
Neuroimaging and especially MRI has emerged as a necessary imaging modality to detect, measure, characterize and monitor brain tumours. Advanced MRI sequences such as perfusion MRI, diffusion MRI and spectroscopy as well as new post-processing techniques such as automatic segmentation of tumours and radiomics play a crucial role in characterization and follow up of brain tumours. The purpose of this review is to provide an overview on anatomical and functional MRI use for brain tumours boundaries determination and tumour characterization in the specific context of radiotherapy. The usefulness of anatomical and functional MRI on particular challenges posed by radiotherapy such as pseudo progression and pseudo esponse and new treatment strategies such as dose painting is also described.
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Affiliation(s)
- J Benzakoun
- Radiology Department, GHU de Paris, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France; Imabrain, Institut de psychiatrie et neurosciences de Paris (IPNP), 102-108, rue de la Santé, 75014 Paris, France; Inserm, U1266, 102, rue de la Santé, 75013 Paris, France.
| | - C Robert
- Medical Physics Department, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Molecular Radiotherapy, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Inserm, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Paris-Sud University, Paris-Saclay University, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - L Legrand
- Radiology Department, GHU de Paris, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France; Imabrain, Institut de psychiatrie et neurosciences de Paris (IPNP), 102-108, rue de la Santé, 75014 Paris, France; Inserm, U1266, 102, rue de la Santé, 75013 Paris, France
| | - J Pallud
- Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France; Imabrain, Institut de psychiatrie et neurosciences de Paris (IPNP), 102-108, rue de la Santé, 75014 Paris, France; Inserm, U1266, 102, rue de la Santé, 75013 Paris, France; Neurosurgery Department, GHU de Paris, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France
| | - J-F Meder
- Radiology Department, GHU de Paris, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France; Imabrain, Institut de psychiatrie et neurosciences de Paris (IPNP), 102-108, rue de la Santé, 75014 Paris, France; Inserm, U1266, 102, rue de la Santé, 75013 Paris, France
| | - C Oppenheim
- Radiology Department, GHU de Paris, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France; Imabrain, Institut de psychiatrie et neurosciences de Paris (IPNP), 102-108, rue de la Santé, 75014 Paris, France; Inserm, U1266, 102, rue de la Santé, 75013 Paris, France
| | - F Dhermain
- Radiotherapy Department, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - M Edjlali
- Radiology Department, GHU de Paris, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Université de Paris, 85, boulevard Saint-Germain, 75006 Paris, France; Imabrain, Institut de psychiatrie et neurosciences de Paris (IPNP), 102-108, rue de la Santé, 75014 Paris, France; Inserm, U1266, 102, rue de la Santé, 75013 Paris, France
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6
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Danieli L, Riccitelli GC, Distefano D, Prodi E, Ventura E, Cianfoni A, Kaelin-Lang A, Reinert M, Pravatà E. Brain Tumor-Enhancement Visualization and Morphometric Assessment: A Comparison of MPRAGE, SPACE, and VIBE MRI Techniques. AJNR Am J Neuroradiol 2019; 40:1140-1148. [PMID: 31221635 DOI: 10.3174/ajnr.a6096] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/08/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE Postgadolinium MR imaging is crucial for brain tumor diagnosis and morphometric assessment. We compared brain tumor enhancement visualization and the "target" object morphometry obtained with the most commonly used 3D MR imaging technique, MPRAGE, with 2 other routinely available techniques: sampling perfection with application-optimized contrasts by using different flip angle evolutions (SPACE) and volumetric interpolated brain examination (VIBE). MATERIALS AND METHODS Fifty-four contrast-enhancing tumors (38 gliomas and 16 metastases) were assessed using MPRAGE, VIBE, and SPACE techniques randomly acquired after gadolinium-based contrast agent administration on a 3T scanner. Enhancement conspicuity was assessed quantitatively by calculating the contrast rate and contrast-to-noise ratio, and qualitatively, by consensus visual comparative ratings. The total enhancing tumor volume and between-sequence discrepancy in the margin delineation were assessed on the corresponding 3D target objects contoured with a computer-assisted software for neuronavigation. The Wilcoxon signed rank and Pearson χ2 nonparametric tests were used to investigate between-sequence discrepancies in the contrast rate, contrast-to-noise ratio, visual conspicuity ratings, tumor volume, and margin delineation estimates. Differences were also tested for 1D (Response Evaluation Criteria in Solid Tumors) and 2D (Response Assessment in Neuro-Oncology) measurements. RESULTS Compared with MPRAGE, both SPACE and VIBE obtained higher contrast rate, contrast-to-noise ratio, and visual conspicuity ratings in both gliomas and metastases (P range, <.001-.001). The between-sequence 3D target object margin discrepancy ranged between 3% and 19.9% of lesion tumor volume. Larger tumor volumes, 1D and 2D measurements were obtained with SPACE (P range, <.01-.007). CONCLUSIONS Superior conspicuity for brain tumor enhancement can be achieved using SPACE and VIBE techniques, compared with MPRAGE. Discrepancies were also detected when assessing target object size and morphology, with SPACE providing more accurate estimates.
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Affiliation(s)
- L Danieli
- From the Departments of Neuroradiology (L.D., D.D., E.P., E.V., A.C., E.P.)
| | - G C Riccitelli
- Neurology (G.C.R., A.K.-L.).,Neuroimaging Research Unit (G.C.R.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - D Distefano
- From the Departments of Neuroradiology (L.D., D.D., E.P., E.V., A.C., E.P.)
| | - E Prodi
- From the Departments of Neuroradiology (L.D., D.D., E.P., E.V., A.C., E.P.)
| | - E Ventura
- From the Departments of Neuroradiology (L.D., D.D., E.P., E.V., A.C., E.P.)
| | - A Cianfoni
- From the Departments of Neuroradiology (L.D., D.D., E.P., E.V., A.C., E.P.).,Departments of Neuroradiology (A.C.)
| | - A Kaelin-Lang
- Neurology (G.C.R., A.K.-L.).,Neurology (A.K.-L.), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Faculty of Biomedical Sciences (A.K.-L., M.R.), Università della Svizzera Italiana, Lugano, Switzerland
| | - M Reinert
- Neurosurgery (M.R.), Neurocenter of Southern Switzerland, Lugano, Switzerland.,Faculty of Biomedical Sciences (A.K.-L., M.R.), Università della Svizzera Italiana, Lugano, Switzerland
| | - E Pravatà
- From the Departments of Neuroradiology (L.D., D.D., E.P., E.V., A.C., E.P.)
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7
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Packer RA, Rossmeisl JH, Kent MS, Griffin JF, Mazcko C, LeBlanc AK. Consensus recommendations on standardized magnetic resonance imaging protocols for multicenter canine brain tumor clinical trials. Vet Radiol Ultrasound 2018. [PMID: 29522650 DOI: 10.1111/vru.12608] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The National Cancer Institute Comparative Brain Tumor Consortium, Patient Outcomes Working Group, propose a consensus document in support of standardized magnetic resonance imaging protocols for canine brain tumor clinical trials. The intent of this manuscript is to address the widely acknowledged need to ensure canine brain tumor imaging protocols are relevant and have sufficient equivalency to translate to human studies such that: (1) multi-institutional studies can be performed with minimal inter-institutional variation, and (2) imaging protocols are consistent with human consensus recommendations to permit reliable translation of imaging data to human clinical trials. Consensus recommendations include pre- and postcontrast three-dimensional T1-weighted images, T2-weighted turbo spin echo in all three planes, T2*-weighted gradient recalled echo, T2-weighted fluid attenuated inversion recovery, and diffusion weighted imaging/diffusion tensor imaging in transverse plane; field of view of ≤150 mm; slice thickness of ≤2 mm, matrix ≥ 256 for two-dimensional images, and 150 or 256 for three-dimensional images.
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Affiliation(s)
- Rebecca A Packer
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523-1678
| | - John H Rossmeisl
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, 24061
| | - Michael S Kent
- Department of Surgical and Radiological Sciences, University of California Davis, School of Veterinary Medicine, Davis, CA, 95616
| | - John F Griffin
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843
| | - Christina Mazcko
- Comparative Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892
| | - Amy K LeBlanc
- Comparative Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892
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8
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Laader A, Beiderwellen K, Kraff O, Maderwald S, Ladd ME, Forsting M, Umutlu L. Non-enhanced versus low-dose contrast-enhanced renal magnetic resonance angiography at 7 T: a feasibility study. Acta Radiol 2018; 59:296-304. [PMID: 28691526 DOI: 10.1177/0284185117718399] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Considering the currently reported association between a repetitive application and cumulative dosage of Gadolinium (Gd)-based contrast agents and Gd-deposition in brain tissue as well as the risk for the advent of nephrogenic systemic fibrosis (NSF), techniques allowing for a dose reduction become an important key aspect aside from non-enhanced magnetic resonance angiography (MRA) techniques. Thus, this study was focused on the reduction and/or complete omission of contrast agent for renal MRA at 7T. Purpose To evaluate the performance of time-of-flight MRA versus low-dose contrast-enhanced (CE) renal MRA at 7T. Material and Methods Ten healthy volunteers were examined on a 7T MR system comprising a TOF MRA and three-dimensional (3D) fast low angle shot spoiled gradient-echo sequence (FLASH) MRA after administration of one-quarter of clinical dose of gadobutrol. Qualitative image analysis was performed including overall image quality, artery delineation and presence of artifacts. Contrast ratio (CR), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the renal arteries were calculated. Results TOF MRA and low-CE MRA achieved comparable overall ratings, with slightly superior delineation of the main renal arteries in TOF MRA (TOF = 3.10 ± 0.75, low-CE = 2.95 ± 0.75). Segmental branches outside and inside the parenchyma were delineated significantly better on TOF MRA. Quantitative analysis demonstrated the superiority of TOF MRA, yielding higher scores for CR, SNR, and CNR. Conclusion The initial results of our study demonstrate the feasibility and comparable diagnostic performance of TOF and low-dose CE renal MRA at 7T.
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Affiliation(s)
- Anja Laader
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- Erwin L Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | - Karsten Beiderwellen
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- Erwin L Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | - Oliver Kraff
- Erwin L Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | - Stefan Maderwald
- Erwin L Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | - Mark E Ladd
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- Erwin L Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Forsting
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- Erwin L Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
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Abstract
Magnetic resonance imaging (MRI) is the cornerstone for evaluating patients with brain masses such as primary and metastatic tumors. Important challenges in effectively detecting and diagnosing brain metastases and in accurately characterizing their subsequent response to treatment remain. These difficulties include discriminating metastases from potential mimics such as primary brain tumors and infection, detecting small metastases, and differentiating treatment response from tumor recurrence and progression. Optimal patient management could be benefited by improved and well-validated prognostic and predictive imaging markers, as well as early response markers to identify successful treatment prior to changes in tumor size. To address these fundamental needs, newer MRI techniques including diffusion and perfusion imaging, MR spectroscopy, and positron emission tomography (PET) tracers beyond traditionally used 18-fluorodeoxyglucose are the subject of extensive ongoing investigations, with several promising avenues of added value already identified. These newer techniques provide a wealth of physiologic and metabolic information that may supplement standard MR evaluation, by providing the ability to monitor and characterize cellularity, angiogenesis, perfusion, pH, hypoxia, metabolite concentrations, and other critical features of malignancy. This chapter reviews standard and advanced imaging of brain metastases provided by computed tomography, MRI, and amino acid PET, focusing on potential biomarkers that can serve as problem-solving tools in the clinical management of patients with brain metastases.
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Affiliation(s)
- Whitney B Pope
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States.
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10
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Ueda F, Okuda M, Aburano H, Yoshie Y, Matsui O, Gabata T. Cranial Pachymeningeal Involvement in POEMS Syndrome: Evaluation by Pre- and Post-contrast FLAIR and T 1-weighted Imaging. Magn Reson Med Sci 2017; 16:231-237. [PMID: 28003622 PMCID: PMC5600030 DOI: 10.2463/mrms.mp.2015-0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose: To evaluate the cranial pachymeningeal involvement of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes (POEMS) syndrome using pre- and post-contrast fluid-attenuated inversion recovery (FLAIR) and T1-weighted imaging (T1WI). Methods: The appearance of pachymeningeal involvement in nine cases of POEMS syndrome was evaluated using pre- and post-contrast FLAIR and T1WI. The degree of pachymeningeal thickening was graded as normal or abnormal using pre-contrast FLAIR. The degrees of contrast enhancement effect were evaluated based on pre- and post-contrast images, and recorded in each of three separate anatomical areas, i.e., the falx cerebri, cerebral convexity, and tentorium cerebelli. The degrees of contrast enhancement of pachymeninges were graded as not detected (ND), positive, or prominent on post-contrast FLAIR, and normal range (NR), positive, and prominent on post-contrast T1WI. Results: Pre-contrast FLAIR demonstrated 41% of pachymeningeal anatomical regions as areas of thickening. Post-contrast FLAIR did not detect any contrast enhancement on 26% of the regions but showed positive enhancement on 30% and prominent enhancement on 44%. Post-contrast T1WI showed normal range enhancement on 48%, positive enhancement on 11%, and prominent enhancement on 41% of the regions. Post-contrast FLAIR showed the highest percentage for detection of pachymeningeal abnormalities (74%). Conclusion: Post-contrast FLAIR may contribute to objective judgment in the evaluation of pachymeningeal involvement in POEMS syndrome.
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Affiliation(s)
- Fumiaki Ueda
- Department of Advanced Medical Imaging, Graduate School of Medical Science, Kanazawa University
| | - Miho Okuda
- Department of Radiology, Kanazawa University Hospital
| | | | - Yuichi Yoshie
- Department of Radiology, Kanazawa University Hospital
| | - Osamu Matsui
- Department of Advanced Medical Imaging, Graduate School of Medical Science, Kanazawa University
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Talaat Ali M, Fouad Osman M, Homos MD, Mohamed Nabil D. Role of 3-T diffusion-weighted magnetic resonance imaging in differentiation between benign and malignant hepatic lesions. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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12
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Beiderwellen K, Kraff O, Laader A, Maderwald S, Orzada S, Ladd ME, Forsting M, Lauenstein TC, Umutlu L. Contrast enhanced renal MR angiography at 7 Tesla: How much gadolinium do we need? Eur J Radiol 2016; 86:76-82. [PMID: 28027770 DOI: 10.1016/j.ejrad.2016.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 11/01/2016] [Accepted: 11/03/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To investigate whether a dose reduction of Gadobutrol for renal magnetic resonance angiography (MRA) at 7 Tesla (T) is feasible while preserving diagnostic image quality. METHODS Ten healthy volunteers were enrolled for a renal MRA on a 7T scanner. Fast low angle shot (FLASH) MRA data sets were obtained utilizing three different doses of Gadobutrol (0.1, 0.05 and 0.025mmol/kg body weight [BW]). Contrast ratios (CR) were measured in the aorta as well as in the intra- and extraparenchymal arteries compared to the psoas muscle. Qualitative analysis regarding the delineation of vessel structures was performed using a four-point-scale. RESULTS All doses of Gadobutrol allowed for a good delineation of the aorta and renal arteries. For the extra- and intraparenchymal segmental arteries higher values were observed for full and half dose in comparison to quarter dose. No significant difference was observed for full and half dose. A lower CR was observed for quarter compared to half dose (p<0.05) for the renal arteries. CONCLUSIONS While best results were observed for half and full dose, a dose reduction to 0.025mmol/kg BW is justifiable, maintaining a diagnostic image quality. This may be of high interest considering patients with renal impairment.
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Affiliation(s)
- Karsten Beiderwellen
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.
| | - Oliver Kraff
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.
| | - Anja Laader
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.
| | - Stefan Maderwald
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.
| | - Stephan Orzada
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.
| | - Mark E Ladd
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Michael Forsting
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.
| | - Thomas C Lauenstein
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.
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Hayashi M, Yamamoto M, Nishimura C, Satoh H. Do Recent Advances in MR Technologies Contribute to Better Gamma Knife Radiosurgery Treatment Results for Brain Metastases? Neuroradiol J 2016; 20:481-90. [DOI: 10.1177/197140090702000501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2007] [Accepted: 06/29/2007] [Indexed: 11/15/2022] Open
Abstract
The detection of intracerebral lesions has improved greatly with advancements in MR imaging, especially the greater sensitivity of the 1.5 Tesla unit versus the older 1.0 Tesla unit. We aimed to determine whether improvements in MR imaging have actually improved diagnostic capabilities and treatment outcomes in gamma knife radiosurgery (GKRS) for brain metastases (METs). Ours was a retrospective study of a consecutive series of 1179 patients (441 females, 738 males, mean age: 63 years, range: 19–92 years) with brain METs who underwent GKRS from 1998 to 2004. Our treatment policy was to irradiate all lesions visible on MR images during a single GKRS session. Mean and median tumor numbers were seven and three (range; 1–74). The 1179 patients were divided into two groups: a 1.0 T-group of 660 patients examined using a 1.0 Tesla MR unit before August, 2002, and a 1.5 T-group of 519 examined using a 1.5 Tesla MR unit after September 2002. In the 1.5 T-group, lesion volumes as small as 0.004 cc were detected with a 5 mm slice thickness. The corresponding lesion size was 0.013 cc in the 1.0 T-group. One or more lesions invisible on a 5 mm slice study were additionally detected on a 2 mm slice study in 47.8% of patients in the 1.0 T-group and 25.2% in the 1.5 T-group (p<.0001). The median survival time (MST) in the 1.5 T-group was significantly longer than that in the 1.0 T-group (8.4 vs. 6.3 months, p=.0004). Due to biases in patient numbers between the two groups, we analyzed subgroups with KPS of 80% or better, no neurological deficits, stable primary tumors, lung cancer, tumor numbers of four or less and tumor volumes of 10.0 cc or smaller. In every subgroup analysis, the MSTs of the 1.5-Tesla group were significantly longer than those of the 1.0-Tesla group. The prognosis of a cancer patient is undoubtedly influenced by multiple factors. Nevertheless, we conclude that application of the 1.5 Tesla MR unit has had a favorable impact on diagnosis and GKRS treatment results in patients with brain METs.
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Affiliation(s)
- M. Hayashi
- Department of Neurosurgery, Toho University Medical Center Ohashi Hospital, Japan
| | - M. Yamamoto
- Katsuta Hospital Mito GammaHouse; Ibaraki, Japan
| | - C. Nishimura
- Department of Medical Informatics, Toho University School of Medicine; Tokio, Japan
| | - H Satoh
- Katsuta Hospital Mito GammaHouse; Ibaraki, Japan
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14
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Khalifa J, Tensaouti F, Chaltiel L, Lotterie JA, Catalaa I, Sunyach MP, Ibarrola D, Noël G, Truc G, Walker P, Magné N, Charissoux M, Ken S, Peran P, Berry I, Moyal ECJ, Laprie A. Identification of a candidate biomarker from perfusion MRI to anticipate glioblastoma progression after chemoradiation. Eur Radiol 2016; 26:4194-4203. [PMID: 26843012 DOI: 10.1007/s00330-016-4234-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/13/2016] [Accepted: 01/20/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To identify relevant relative cerebral blood volume biomarkers from T2* dynamic-susceptibility contrast magnetic resonance imaging to anticipate glioblastoma progression after chemoradiation. METHODS Twenty-five patients from a prospective study with glioblastoma, primarily treated by chemoradiation, were included. According to the last follow-up MRI confirmed status, patients were divided into: relapse group (n = 13) and control group (n = 12). The time of last MR acquisition was tend; MR acquisitions performed at tend-2M, tend-4M and tend-6M (respectively 2, 4 and 6 months before tend) were analyzed to extract relevant variations among eleven perfusion biomarkers (B). These variations were assessed through R(B), as the absolute value of the ratio between ∆B from tend-4M to tend-2M and ∆B from tend-6M to tend-4M. The optimal cut-off for R(B) was determined using receiver-operating-characteristic curve analysis. RESULTS The fraction of hypoperfused tumor volume (F_hPg) was a relevant biomarker. A ratio R(F_hPg) ≥ 0.61 would have been able to anticipate relapse at the next follow-up with a sensitivity/specificity/accuracy of 92.3 %/63.6 %/79.2 %. High R(F_hPg) (≥0.61) was associated with more relapse at tend compared to low R(F_hPg) (75 % vs 12.5 %, p = 0.008). CONCLUSION Iterative analysis of F_hPg from consecutive examinations could provide surrogate markers to predict progression at the next follow-up. KEY POINTS • Related rCBV biomarkers from DSC were assessed to anticipate GBM progression. • Biomarkers were assessed through their patterns of variation during the follow-up. • The fraction of hypoperfused tumour volume (F_hP g ) seemed to be a relevant biomarker. • An innovative ratio R(F_hP g ) could be an early surrogate marker of relapse. • A significant time gain could be achieved in the management of GBM patients.
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Affiliation(s)
- J Khalifa
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France. .,Department of Radiation Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France.
| | - F Tensaouti
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France
| | - L Chaltiel
- Department of Biostatistics, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France
| | - J-A Lotterie
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Department of Nuclear Medicine, CHU Rangueil, 1 Avenue du Professeur Jean Poulhès, 31400, Toulouse, France
| | - I Catalaa
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Department of Radiology, CHU Rangueil, 1 Avenue du Professeur Jean Poulhès, 31400, Toulouse, France
| | - M P Sunyach
- Department of Radiation Oncology, Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon, France
| | - D Ibarrola
- CERMEP - Imagerie du Vivant, Lyon, France
| | - G Noël
- Department of Radiation Oncology, Centre Paul Strauss, EA 3430, University of Strasbourg, 3 rue de la Porte de l'Hôpital, 67065, Strasbourg, France
| | - G Truc
- Department of Radiation Oncology, Centre Georges-François Leclerc, 1 rue Professeur Marion, 21079, Dijon, France
| | - P Walker
- Laboratory of Electronics, Computer Science and Imaging (Le2I), UMR 6306 CNRS, University of Burgundy, Dijon, France
| | - N Magné
- Department of Radiation Oncology, Institut de cancérologie Lucien-Neuwirth, 108 bis, avenue Albert-Raimond, 42271, Saint-Priest-en-Jarez, France
| | - M Charissoux
- Department of Radiation Oncology, Institut du Cancer de Montpellier, 208 avenue des Apothicaires, parc Euromédecine, 34298, Montpellier cedex 5, France
| | - S Ken
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Department of Medical Physics, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France
| | - P Peran
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Université Toulouse III Paul Sabatier, UMR 1214, 31059, Toulouse, France
| | - I Berry
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Department of Nuclear Medicine, CHU Rangueil, 1 Avenue du Professeur Jean Poulhès, 31400, Toulouse, France.,Université Toulouse III Paul Sabatier, UMR 1214, 31059, Toulouse, France
| | - E Cohen-Jonathan Moyal
- Department of Radiation Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France.,Université Toulouse III Paul Sabatier, 31000, Toulouse, France.,INSERM U1037, Centre de Recherches contre le Cancer de Toulouse, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France
| | - A Laprie
- INSERM UMR 1214, TONIC (TOulouse NeuroImaging Centre), 31059, Toulouse, France.,Department of Radiation Oncology, Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse - Oncopôle, 1 avenue Irène-Joliot Curie, 31100, Toulouse, France.,Université Toulouse III Paul Sabatier, 31000, Toulouse, France
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15
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Lohrke J, Frenzel T, Endrikat J, Alves FC, Grist TM, Law M, Lee JM, Leiner T, Li KC, Nikolaou K, Prince MR, Schild HH, Weinreb JC, Yoshikawa K, Pietsch H. 25 Years of Contrast-Enhanced MRI: Developments, Current Challenges and Future Perspectives. Adv Ther 2016; 33:1-28. [PMID: 26809251 PMCID: PMC4735235 DOI: 10.1007/s12325-015-0275-4] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Indexed: 12/17/2022]
Abstract
UNLABELLED In 1988, the first contrast agent specifically designed for magnetic resonance imaging (MRI), gadopentetate dimeglumine (Magnevist(®)), became available for clinical use. Since then, a plethora of studies have investigated the potential of MRI contrast agents for diagnostic imaging across the body, including the central nervous system, heart and circulation, breast, lungs, the gastrointestinal, genitourinary, musculoskeletal and lymphatic systems, and even the skin. Today, after 25 years of contrast-enhanced (CE-) MRI in clinical practice, the utility of this diagnostic imaging modality has expanded beyond initial expectations to become an essential tool for disease diagnosis and management worldwide. CE-MRI continues to evolve, with new techniques, advanced technologies, and novel contrast agents bringing exciting opportunities for more sensitive, targeted imaging and improved patient management, along with associated clinical challenges. This review aims to provide an overview on the history of MRI and contrast media development, to highlight certain key advances in the clinical development of CE-MRI, to outline current technical trends and clinical challenges, and to suggest some important future perspectives. FUNDING Bayer HealthCare.
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Affiliation(s)
- Jessica Lohrke
- MR and CT Contrast Media Research, Bayer HealthCare, Berlin, Germany
| | - Thomas Frenzel
- MR and CT Contrast Media Research, Bayer HealthCare, Berlin, Germany
| | - Jan Endrikat
- Global Medical Affairs Radiology, Bayer HealthCare, Berlin, Germany
- Saarland University Hospital, Homburg, Germany
| | | | - Thomas M Grist
- Radiology, Medical Physics and Biomedical Engineering, University of Wisconsin, Madison, WI, USA
| | - Meng Law
- Radiology and Neurological Surgery, University of South California, Keck School of Medicine, USC University Hospital, Los Angeles, CA, USA
| | - Jeong Min Lee
- College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Tim Leiner
- Radiology, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Kun-Cheng Li
- Radiology, Xuan Wu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Konstantin Nikolaou
- Radiology, Ludwig-Maximilians University, University Hospitals, Munich, Germany
| | - Martin R Prince
- Radiology, Weill Cornell Medical College, New York, NY, USA
- Columbia College of Physicians and Surgeons, New York, NY, USA
| | | | | | - Kohki Yoshikawa
- Graduate Division of Medical Health Sciences, Graduate School of Komazawa University, Tokyo, Japan
| | - Hubertus Pietsch
- MR and CT Contrast Media Research, Bayer HealthCare, Berlin, Germany.
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16
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Chae MP, Hunter-Smith DJ, Rozen WM. Comparative analysis of fluorescent angiography, computed tomographic angiography and magnetic resonance angiography for planning autologous breast reconstruction. Gland Surg 2015; 4:164-78. [PMID: 26005648 DOI: 10.3978/j.issn.2227-684x.2015.03.06] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 03/18/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND The high incidence of breast cancer and growing number of breast cancer patients undergoing mastectomy has led to breast reconstruction becoming an important part of holistic treatment for these patients. In planning autologous reconstructions, preoperative assessment of donor site microvascular anatomy with advanced imaging modalities has assisted in the appropriate selection of flap donor site, individual perforators, and lead to an overall improvement in flap outcomes. In this review, we compare the accuracy of fluorescent angiography, computed tomographic angiography (CTA), and magnetic resonance angiography (MRA) and their impact on clinical outcomes. METHODS A review of the published English literature dating from 1950 to 2015 using databases, such as PubMed, Medline, Web of Science, and EMBASE was undertaken. RESULTS Fluorescent angiography is technically limited by its inability to evaluate deep-lying perforators and hence, it has a minimal role in the preoperative setting. However, it may be useful intraoperatively in evaluating microvascular anastomotic patency and the mastectomy skin perfusion. CTA is currently widely considered the standard, due to its high accuracy and reliability. Multiple studies have demonstrated its ability to improve clinical outcomes, such as operative length and flap complications. However, concerns surrounding exposure to radiation and nephrotoxic contrast agents exist. MRA has been explored, however despite recent advances, the image quality of MRA is considered inferior to CTA. CONCLUSIONS Preoperative imaging is an essential component in planning autologous breast reconstruction. Fluorescent angiography presents minimal role as a preoperative imaging modality, but may be a useful intraoperative adjunct to assess the anastomosis and the mastectomy skin perfusion. Currently, CTA is the gold standard preoperatively. MRA has a role, particularly for women of younger age, iodine allergy, and renal impairment.
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Affiliation(s)
- Michael P Chae
- 1 Department of Surgery, Monash University, Monash Medical Centre, Clayton, Victoria 3168, Australia ; 2 Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health, Frankston, Victoria 3199, Australia
| | - David J Hunter-Smith
- 1 Department of Surgery, Monash University, Monash Medical Centre, Clayton, Victoria 3168, Australia ; 2 Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health, Frankston, Victoria 3199, Australia
| | - Warren Matthew Rozen
- 1 Department of Surgery, Monash University, Monash Medical Centre, Clayton, Victoria 3168, Australia ; 2 Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health, Frankston, Victoria 3199, Australia
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18
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Tocchio S, Kline-Fath B, Kanal E, Schmithorst VJ, Panigrahy A. MRI evaluation and safety in the developing brain. Semin Perinatol 2015; 39:73-104. [PMID: 25743582 PMCID: PMC4380813 DOI: 10.1053/j.semperi.2015.01.002] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Magnetic resonance imaging (MRI) evaluation of the developing brain has dramatically increased over the last decade. Faster acquisitions and the development of advanced MRI sequences, such as magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), perfusion imaging, functional MR imaging (fMRI), and susceptibility-weighted imaging (SWI), as well as the use of higher magnetic field strengths has made MRI an invaluable tool for detailed evaluation of the developing brain. This article will provide an overview of the use and challenges associated with 1.5-T and 3-T static magnetic fields for evaluation of the developing brain. This review will also summarize the advantages, clinical challenges, and safety concerns specifically related to MRI in the fetus and newborn, including the implications of increased magnetic field strength, logistics related to transporting and monitoring of neonates during scanning, and sedation considerations, and a discussion of current technologies such as MRI conditional neonatal incubators and dedicated small-foot print neonatal intensive care unit (NICU) scanners.
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Affiliation(s)
- Shannon Tocchio
- Pediatric Imaging Research Center, Department of Radiology Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Beth Kline-Fath
- Department of Radiology Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Emanuel Kanal
- Director, Magnetic Resonance Services; Professor of Neuroradiology; Department of Radiology, University of Pittsburgh Medical Center (UPMC)
| | - Vincent J. Schmithorst
- Pediatric Imaging Research Center, Department of Radiology Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Ashok Panigrahy
- Pediatric Imaging Research Center, Department of Radiology Children׳s Hospital of Pittsburgh of UPMC, University of Pittsburgh Medical Center, Pittsburgh, PA.
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19
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Tselikas L, Souillard-Scemama R, Naggara O, Mellerio C, Varlet P, Dezamis E, Domont J, Dhermain F, Devaux B, Chrétien F, Meder JF, Pallud J, Oppenheim C. Imaging of gliomas at 1.5 and 3 Tesla - A comparative study. Neuro Oncol 2014; 17:895-900. [PMID: 25526734 DOI: 10.1093/neuonc/nou332] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 11/03/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Glioma follow-up is based on MRI parameters, which are correlated with survival. Although established criteria are used to evaluate tumor response, radiological markers may be confounded by differences in instrumentation including the magnetic field strength. We assessed whether MRIs obtained at 3 Tesla (T) and 1.5T provided similar information. METHODS We retrospectively compared imaging features of 30 consecutive patients with WHO grades II and III gliomas who underwent MRI at 1.5T and 3T within a month of each other, without any clinical changes during the same period. We compared lesion volumes on fluid attenuation inversion recovery (FLAIR), ratio of cerebral blood volume (rCBV) on perfusion-weighted imaging, contrast-to-noise ratio (CNR) on FLAIR, and on post-gadolinium 3D T1-weighted sequences between 1.5T and 3T using intraclass correlation coefficient (ICC). Concordance between observers within and between modalities was evaluated using weighted-kappa coefficient (wκ). RESULTS The mean ± SD delay between modalities (1.5T and 3T MRI) was 8.6 ± 5.6 days. Interobserver/intraobserver concordance for lesion volume was almost perfect for 1.5T (ICC = 0.96/0.97) and 3T (ICC = 0.99/0.98). Agreement between observers for contrast enhancement was excellent at 1.5T (wκ = 0.92) and 3T (wκ = 0.92). The tumor CNR was significantly higher for FLAIR at 1.5T (P < .001), but it was higher at 3T (P = .012) for contrast enhancement. Correlations between modalities for lesion volume (ICC = 0.97) and for rCBV values (ICC = 0.92) were almost perfect. CONCLUSIONS In the follow-up of WHO grades II and III gliomas, 1.5T and 3T provide similar MRI features, suggesting that monitoring could be performed on either a 1.5 or a 3T MR magnet.
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Affiliation(s)
- Lambros Tselikas
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Raphaëlle Souillard-Scemama
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Olivier Naggara
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Charles Mellerio
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Pascale Varlet
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Edouard Dezamis
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Julien Domont
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Frédéric Dhermain
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Bertrand Devaux
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Fabrice Chrétien
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Jean-François Meder
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Johan Pallud
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
| | - Catherine Oppenheim
- Neuroimaging Department, Centre Hospitalier Sainte-Anne, Paris, France (L.T., R.S.-S., O.N., C.M., J.-F.M., C.O.); Neurosurgery Department, Centre Hospitalier Sainte-Anne, Paris, France (E.D., B.D., J.P.); Neuropathology Department, Centre Hospitalier Sainte-Anne, Paris, France (P.V., F.C.); INSERM U 894 Centre Hospitalier Sainte-Anne, Paris, France (O.N., C.O.); Radiation Therapy and Physics Department, Gustave Roussy Institute, Villejuif, France (F.D.); Medical Oncology department, Gustave Roussy Institute, Villejuif, France (J.D.); Université Paris Descartes, Paris, France (O.N., P.V., F.C., J.-F.M., J.P., C.O.)
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Brain tumours at 7T MRI compared to 3T--contrast effect after half and full standard contrast agent dose: initial results. Eur Radiol 2014; 25:106-12. [PMID: 25194707 DOI: 10.1007/s00330-014-3351-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 06/05/2014] [Accepted: 07/16/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To compare the contrast agent effect of a full dose and half the dose of gadobenate dimeglumine in brain tumours at 7 Tesla (7 T) MR versus 3 Tesla (3T). METHODS Ten patients with primary brain tumours or metastases were examined. Signal intensities were assessed in the lesion and normal brain. Tumour-to-brain contrast and lesion enhancement were calculated. Additionally, two independent readers subjectively graded the image quality and artefacts. RESULTS The enhanced mean tumour-to-brain contrast and lesion enhancement were significantly higher at 7 T than at 3T for both half the dose (91.8 ± 45.8 vs. 43.9 ± 25.3 [p = 0.010], 128.1 ± 53.7 vs. 75.5 ± 32.4 [p = 0.004]) and the full dose (129.2 ± 50.9 vs. 66.6 ± 33.1 [p = 0.002], 165.4 ± 54.2 vs. 102.6 ± 45.4 [p = 0.004]). Differences between dosages at each field strength were also significant. Lesion enhancement was higher with half the dose at 7 T than with the full dose at 3T (p = .037), while the tumour-to-brain contrast was not significantly different. Subjectively, contrast enhancement, visibility, and lesion delineation were better at 7 T and with the full dose. All parameters were rated as good, at the least. CONCLUSION Half the routine contrast agent dose at 7 T provided higher lesion enhancement than the full dose at 3T which indicates the possibility of dose reduction at 7 T. KEY POINTS • The contrast effect of gadobenate dimeglumine was assessed at 7 T and 3T. • In brain tumours, contrast effect was higher at 7 T than at 3T. • Tumour-to-brain contrast at 7 T half dose and 3T full dose were comparable. • 7 T half dose lesion enhancement was higher than 3T full dose enhancement. • Our results indicate the possibility of contrast agent dose reduction at 7 T.
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Togao O, Hiwatashi A, Yamashita K, Kikuchi K, Yoshiura T, Honda H. Additional MR contrast dosage for radiologists' diagnostic performance in detecting brain metastases: a systematic observer study at 3 T. Jpn J Radiol 2014; 32:537-44. [PMID: 24957183 DOI: 10.1007/s11604-014-0342-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 06/05/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the diagnostic performance of a double-dose administration of gadolinium for brain metastases at 3 T in a systematic observer test. MATERIALS AND METHODS Postcontrast MR images of 39 patients (total 104 metastases) were obtained by 3D T1-weighted sequences with both standard and cumulative double dose contrast administration. An observer test involving 9 radiologists (5 board-certified radiologists and 4 residents) was performed, and their diagnostic performance with the two doses was compared by means of sensitivity, false-positives, reading time, and a figure-of-merit. RESULTS Compared to the standard dose, the double dose showed higher sensitivity (P < 0.0001), higher false-positive/case (P < 0.05), longer reading time (P < 0.05), and higher figure-of-merit (P < 0.0001). Particularly in small lesions (< 5 mm), sensitivity with the double dose (61.5%, P < 0.0001) was approximately twice as high as that with the standard dose (29.5%). Artifacts and blood vessels were the most common imaging findings resulting in false-positives. CONCLUSIONS The double dose improved detection for metastases smaller than 5 mm at 3 T and thus resulted in better diagnostic performance of radiologists. However, a higher dose might result in prolonged reading time and increased false-positives, presumably due to increased vessel signals and frequency of flow-related artifacts.
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Affiliation(s)
- Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan,
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22
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Nguyen HT, Jia G, Shah ZK, Pohar K, Mortazavi A, Zynger DL, Wei L, Yang X, Clark D, Knopp MV. Prediction of chemotherapeutic response in bladder cancer using K-means clustering of dynamic contrast-enhanced (DCE)-MRI pharmacokinetic parameters. J Magn Reson Imaging 2014; 41:1374-82. [PMID: 24943272 DOI: 10.1002/jmri.24663] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 05/01/2014] [Accepted: 05/02/2014] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To apply k-means clustering of two pharmacokinetic parameters derived from 3T dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to predict the chemotherapeutic response in bladder cancer at the mid-cycle timepoint. MATERIALS AND METHODS With the predetermined number of three clusters, k-means clustering was performed on nondimensionalized Amp and kep estimates of each bladder tumor. Three cluster volume fractions (VFs) were calculated for each tumor at baseline and mid-cycle. The changes of three cluster VFs from baseline to mid-cycle were correlated with the tumor's chemotherapeutic response. Receiver-operating-characteristics curve analysis was used to evaluate the performance of each cluster VF change as a biomarker of chemotherapeutic response in bladder cancer. RESULTS The k-means clustering partitioned each bladder tumor into cluster 1 (low kep and low Amp), cluster 2 (low kep and high Amp), cluster 3 (high kep and low Amp). The changes of all three cluster VFs were found to be associated with bladder tumor response to chemotherapy. The VF change of cluster 2 presented with the highest area-under-the-curve value (0.96) and the highest sensitivity/specificity/accuracy (96%/100%/97%) with a selected cutoff value. CONCLUSION The k-means clustering of the two DCE-MRI pharmacokinetic parameters can characterize the complex microcirculatory changes within a bladder tumor to enable early prediction of the tumor's chemotherapeutic response.
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Affiliation(s)
- Huyen T Nguyen
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, Ohio State University, Columbus, Ohio, USA
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de Rotte AAJ, van der Kolk AG, Rutgers D, Zelissen PMJ, Visser F, Luijten PR, Hendrikse J. Feasibility of high-resolution pituitary MRI at 7.0 tesla. Eur Radiol 2014; 24:2005-11. [DOI: 10.1007/s00330-014-3230-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 04/22/2014] [Accepted: 05/08/2014] [Indexed: 11/28/2022]
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Brown R, Storey P, Geppert C, McGorty K, Leite APK, Babb J, Sodickson DK, Wiggins GC, Moy L. Breast MRI at 7 Tesla with a bilateral coil and robust fat suppression. J Magn Reson Imaging 2014; 39:540-9. [PMID: 24123517 PMCID: PMC3945054 DOI: 10.1002/jmri.24205] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 04/12/2013] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To develop a bilateral coil and fat suppressed T1-weighted sequence for 7 Tesla (T) breast MRI. MATERIALS AND METHODS A dual-solenoid coil and three-dimensional (3D) T1w gradient echo sequence with B1+ insensitive fat suppression (FS) were developed. T1w FS image quality was characterized through image uniformity and fat-water contrast measurements in 11 subjects. Signal-to-noise ratio (SNR) and flip angle maps were acquired to assess the coil performance. Bilateral contrast-enhanced and unilateral high resolution (0.6 mm isotropic, 6.5 min acquisition time) imaging highlighted the 7T SNR advantage. RESULTS Reliable and effective FS and high image quality was observed in all subjects at 7T, indicating that the custom coil and pulse sequence were insensitive to high-field obstacles such as variable tissue loading. 7T and 3T image uniformity was similar (P=0.24), indicating adequate 7T B1+ uniformity. High 7T SNR and fat-water contrast enabled 0.6 mm isotropic imaging and visualization of a high level of fibroglandular tissue detail. CONCLUSION 7T T1w FS bilateral breast imaging is feasible with a custom radiofrequency (RF) coil and pulse sequence. Similar image uniformity was achieved at 7T and 3T, despite different RF field behavior and variable coil-tissue interaction due to anatomic differences that might be expected to alter magnetic field patterns.
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Affiliation(s)
- Ryan Brown
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY, United States
| | - Pippa Storey
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY, United States
| | | | - KellyAnne McGorty
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY, United States
| | - Ana Paula Klautau Leite
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY, United States
| | - James Babb
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY, United States
| | - Daniel K. Sodickson
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY, United States
| | - Graham C. Wiggins
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY, United States
| | - Linda Moy
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY, United States
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Anzalone N, Essig M, Lee SK, Dörfler A, Ganslandt O, Combs SE, Picozzi P. Optimizing contrast-enhanced magnetic resonance imaging characterization of brain metastases: relevance to stereotactic radiosurgery. Neurosurgery 2013; 72:691-701. [PMID: 23381488 DOI: 10.1227/neu.0b013e3182889ddf] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Intracranial metastases are the most common form of intra-axial brain tumor. Management approaches to brain metastases include surgical resection, whole-brain radiotherapy, and stereotactic radiosurgery (SRS). The management approach that is selected is based typically on algorithms that incorporate the number, size, and location of lesions. SRS is the treatment of choice when metastases detected on imaging are few (maximum, 3-5) and/or of small size (≤30 mm) and offers the advantages of noninvasiveness and the ability to treat inaccessible lesions compared with surgical resection. Contrast-enhanced magnetic resonance imaging (MRI) is the standard imaging technique for determining the number, size, and location of metastatic lesions. In SRS, the capability of MRI to delineate lesion borders precisely in 3 dimensions helps reduce recurrence rates and minimize radiation necrosis in surrounding tissue. Optimization of the MRI protocol, including selection of the appropriate gadolinium-based contrast agent (GBCA), is paramount for accurate lesion imaging. GBCAs differ in their safety, tolerability, and efficacy because of their diverse physicochemical properties. Gadobutrol and gadobenate dimeglumine are high-relaxivity GBCAs that demonstrate superior efficacy for imaging metastatic lesions compared with other GBCAs, whereas gadobutrol additionally provides macrocyclic stability. This article reviews recent comparative trials of GBCAs and discusses their relevance for optimizing MRI protocols in the management of brain metastases, with particular relevance to SRS.
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Affiliation(s)
- Nicoletta Anzalone
- Department of Neuroradiology, Scientific Institute H. S. Raffaele, Milan, Italy.
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Breast MRI at 7 Tesla with a bilateral coil and T1-weighted acquisition with robust fat suppression: image evaluation and comparison with 3 Tesla. Eur Radiol 2013; 23:2969-78. [PMID: 23896763 DOI: 10.1007/s00330-013-2972-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 06/10/2013] [Accepted: 06/27/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To evaluate the image quality of T1-weighted fat-suppressed breast MRI at 7 T and to compare 7-T and 3-T images. METHODS Seventeen subjects were imaged using a 7-T bilateral transmit-receive coil and 3D gradient echo sequence with adiabatic inversion-based fat suppression (FS). Images were graded on a five-point scale and quantitatively assessed through signal-to-noise ratio (SNR), fibroglandular/fat contrast and signal uniformity measurements. RESULTS Image scores at 7 and 3 T were similar on standard-resolution images (1.1 × 1.1 × 1.1-1.6 mm(3)), indicating that high-quality breast imaging with clinical parameters can be performed at 7 T. The 7-T SNR advantage was underscored on 0.6-mm isotropic images, where image quality was significantly greater than at 3 T (4.2 versus 3.1, P ≤ 0.0001). Fibroglandular/fat contrast was more than two times higher at 7 T than at 3 T, owing to effective adiabatic inversion-based FS and the inherent 7-T signal advantage. Signal uniformity was comparable at 7 and 3 T (P < 0.05). Similar 7-T image quality was observed in all subjects, indicating robustness against anatomical variation. CONCLUSION The 7-T bilateral transmit-receive coil and adiabatic inversion-based FS technique produce image quality that is as good as or better than at 3 T. KEY POINTS • High image quality bilateral breast MRI is achievable with clinical parameters at 7 T. • 7-T high-resolution imaging improves delineation of subtle soft tissue structures. • Adiabatic-based fat suppression provides excellent fibroglandular/fat contrast at 7 T. • 7- and 3-T 3D T1-weighted gradient-echo images have similar signal uniformity. • The 7-T dual solenoid coil enables bilateral imaging without compromising uniformity.
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Essig M, Dinkel J, Gutierrez JE. Use of Contrast Media in Neuroimaging. Magn Reson Imaging Clin N Am 2012; 20:633-48. [DOI: 10.1016/j.mric.2012.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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A systematic review of the utility of 1.5 versus 3 Tesla magnetic resonance brain imaging in clinical practice and research. Eur Radiol 2012; 22:2295-303. [PMID: 22684343 DOI: 10.1007/s00330-012-2500-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 04/05/2012] [Accepted: 04/09/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE MRI at 3 T is said to be more accurate than 1.5 T MR, but costs and other practical differences mean that it is unclear which to use. METHODS We systematically reviewed studies comparing diagnostic accuracy at 3 T with 1.5 T. We searched MEDLINE, EMBASE and other sources from 1 January 2000 to 22 October 2010 for studies comparing diagnostic accuracy at 1.5 and 3 T in human neuroimaging. We extracted data on methodology, quality criteria, technical factors, subjects, signal-to-noise, diagnostic accuracy and errors according to QUADAS and STARD criteria. RESULTS Amongst 150 studies (4,500 subjects), most were tiny, compared old 1.5 T with new 3 T technology, and only 22 (15 %) described diagnostic accuracy. The 3 T images were often described as "crisper", but we found little evidence of improved diagnosis. Improvements were limited to research applications [functional MRI (fMRI), spectroscopy, automated lesion detection]. Theoretical doubling of the signal-to-noise ratio was not confirmed, mostly being 25 %. Artefacts were worse and acquisitions took slightly longer at 3 T. CONCLUSION Objective evidence to guide MRI purchasing decisions and routine diagnostic use is lacking. Rigorous evaluation accuracy and practicalities of diagnostic imaging technologies should be the routine, as for pharmacological interventions, to improve effectiveness of healthcare. KEY POINTS • Higher field strength MRI may improve image quality and diagnostic accuracy. • There are few direct comparisons of 1.5 and 3 T MRI. • Theoretical doubling of the signal-to-noise ratio in practice was only 25 %. • Objective evidence of improved routine clinical diagnosis is lacking. • Other aspects of technology improved images more than field strength.
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Dahmoush HM, Vossough A, Roberts TPL. Pediatric high-field magnetic resonance imaging. Neuroimaging Clin N Am 2012; 22:297-313, xi. [PMID: 22548934 DOI: 10.1016/j.nic.2012.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
High-field 3 T magnetic resonance (MR) imaging provides greater signal-to-noise ratio (SNR) compared with 1.5 T systems. Various MR imaging clinical applications in children can benefit from improvements resulting from this increased SNR. High-resolution imaging of the brain, arterial spin labeling perfusion imaging, diffusion imaging, MR spectroscopy, and imaging of small anatomic parts are some areas in which these improvements can increase our clinical diagnostic capabilities. However, challenges inherent to 3 T imaging become more relevant in children. The use of 3 T imaging in children has allowed better diagnostic efficacy in neuroimaging, but certain technique modifications may be required for optimal imaging.
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Affiliation(s)
- Hisham M Dahmoush
- Neuroradiology Section, Department of Radiology, Children's Hospital of Philadelphia, Wood 2115, 324 South 34th Street, Philadelphia, PA 19104, USA
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Kilsdonk ID, de Graaf WL, Barkhof F, Wattjes MP. Inflammation high-field magnetic resonance imaging. Neuroimaging Clin N Am 2012; 22:135-57, ix. [PMID: 22548925 DOI: 10.1016/j.nic.2012.02.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Multiple sclerosis (MS) is the most common inflammatory demyelinating disorder of the central nervous system (CNS). MS has been subject to high-field magnetic resonance (MR) imaging research to a great extent during the past years, and much data has been collected that might be helpful in the investigation of other inflammatory CNS disorders. This article reviews the value of high-field MR imaging in examining inflammatory MS abnormalities. Furthermore, possibilities and challenges for the future of high-field MR imaging in MS are discussed.
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Affiliation(s)
- Iris D Kilsdonk
- Department of Radiology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
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Chhabra A, Soldatos T, Chalian M, Carrino JA, Schon L. Current concepts review: 3T magnetic resonance imaging of the ankle and foot. Foot Ankle Int 2012; 33:164-71. [PMID: 22381350 DOI: 10.3113/fai.2012.0164] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Avneesh Chhabra
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Baltimore, MD 21287, USA.
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Hartung MP, Grist TM, François CJ. Magnetic resonance angiography: current status and future directions. J Cardiovasc Magn Reson 2011; 13:19. [PMID: 21388544 PMCID: PMC3060856 DOI: 10.1186/1532-429x-13-19] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 03/09/2011] [Indexed: 01/06/2023] Open
Abstract
With recent improvement in hardware and software techniques, magnetic resonance angiography (MRA) has undergone significant changes in technique and approach. The advent of 3.0 T magnets has allowed reduction in exogenous contrast dose without compromising overall image quality. The use of novel intravascular contrast agents substantially increases the image windows and decreases contrast dose. Additionally, the lower risk and cost in non-contrast enhanced (NCE) MRA has sparked renewed interest in these methods. This article discusses the current state of both contrast-enhanced (CE) and NCE-MRA. New CE-MRA methods take advantage of dose reduction at 3.0 T, novel contrast agents, and parallel imaging methods. The risks of gadolinium-based contrast media, and the NCE-MRA methods of time-of-flight, steady-state free precession, and phase contrast are discussed.
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Affiliation(s)
- Michael P Hartung
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - Thomas M Grist
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - Christopher J François
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
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Lang MJ, Kelly JJ, Sutherland GR. A Moveable 3-Tesla Intraoperative Magnetic Resonance Imaging System. Oper Neurosurg (Hagerstown) 2011; 68:168-79. [DOI: 10.1227/neu.0b013e3182045803] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
Based on success with a prototype 1.5T intraoperative magnetic resonance imaging (iMRI) system and the desire for increased signal-to-noise ratio, along with its relationship to image quality and advanced applications, a 3.0T system that uses the same novel moveable magnet configuration was developed.
OBJECTIVE:
To assess clinical applicability by prospectively applying the higher-field system to a neurosurgical cohort.
METHODS:
Upgrading to 3.0T required substantial modification of an existing iMRI-equipped operating room. The 1.5T magnet was replaced with a ceiling-mounted, moveable 3.0T magnet with a 70-cm working aperture. Local radiofrequency shielding was replaced with whole-room shielding. A new hydraulic operating table, high-performance gradients, and advanced image processing software were also installed. The new system was used as an adjunct to standard neurosurgical practice.
RESULTS:
The iMRI system upgrade required 6 months. Since completion, the 3.0T iMRI system has successfully guided neurosurgery in 120 patients without system failure in a patient-focused environment. Intraoperative image quality was superior to that obtained at 1.5T and enabled intraoperative acquisition of advanced imaging sequences, including tractography. Intraoperative imaging was found to modify surgery in a substantial number of patients.
CONCLUSION:
Implementation of an iMRI system based on a moveable 3.0T magnet is feasible. From clinical experience with 120 patients, iMRI at 3.0T is safe, reliable, and capable of directing image-guided surgery with exceptional image quality.
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Affiliation(s)
- Michael J. Lang
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - John J. Kelly
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Garnette R. Sutherland
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
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Dynamic Contrast-Enhanced Magnetic Resonance Imaging Evaluation of VX2 Carcinoma in a Rabbit Model. Invest Radiol 2010; 45:655-61. [DOI: 10.1097/rli.0b013e3181ed55b4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lee MH, Son EI. Comparison between Initial and Recent Surgical Outcome of 15-Year Series of Surgically Remediable Epilepsy. J Korean Neurosurg Soc 2010; 48:230-5. [PMID: 21082050 DOI: 10.3340/jkns.2010.48.3.230] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Revised: 07/18/2010] [Accepted: 09/17/2010] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The aim of this study is to compare the surgical outcome of the initial and recent surgical cases, during our 15-years experience, in terms of the surgical strategies and the prognostic factors for surgically remediable epilepsy. METHODS We retrospectively reviewed and compared the surgical outcomes between the initial 256 (Group I) and recent 139 (Group II) patients according to the time period of operation for a total of 518 consecutive epilepsy surgeries at our institution since 1992. The patients of the middle intermediate period, which were subjected to changed surgical strategies, were excluded. RESULTS The surgical outcome data from the initial and recent groups showed a much improved outcome for patients who underwent temporal lobe epilepsy (TLE) surgery over time. The number of patients with a good outcome (Engel class I-II) was much increased from 87.7% (178 TLE cases of Group I) to 94.8% (79 TLE cases of Group II) and this was statistically significant (p = 0.0324) on univariate analysis. Other remarkable changes were the decreased performance of intracranial invasive studies from 43.5% in Group I to 30.9% in Group II due to the advanced neuroimaging tools. The strip/grid ratio was reduced from 131/32 in Group I to 17/25 in Group II, because of a markedly reduced mesial TLE surgery and an increased extratemporal epilepsy surgery. CONCLUSION Our results show that surgical outcome of epilepsy surgery has improved over time and it has shown to be efficient to control medically intractable epilepsy. Appropriate patient selection, comprehensive preoperative assessments and more extensive resection are associated with good postoperative outcomes.
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Affiliation(s)
- Myoung-Hee Lee
- Department of Neurosurgery, Dongsan Epilepsy Center, Keimyung University School of Medicine, Daegu, Korea
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Portocarrero-Ortiz L, Bonifacio-Delgadillo D, Sotomayor-González A, Garcia-Marquez A, Lopez-Serna R. A modified protocol using half-dose gadolinium in dynamic 3-Tesla magnetic resonance imaging for detection of ACTH-secreting pituitary tumors. Pituitary 2010; 13:230-5. [PMID: 20182808 DOI: 10.1007/s11102-010-0222-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
UNLABELLED ACTH-secreting tumors represent 10% of functioning pituitary adenomas, and most of them are microadenomas. It is generally accepted that only half of these tumors are correctly identified with current magnetic resonance imaging (MRI) techniques. The objective of the paper is to report a method for detecting suspected ACTH-secreting pituitary tumors undetectable by conventional dynamic MRI using dynamic 3-Tesla MRI (3T MRI) and half-dose gadopentetate dimeglumine (0.05 mmol/Kg). Eight patients were included (5 men and 3 women) with a mean age of 29.12 years. Each of them had a confirmed diagnosis of Cushing disease and a negative dynamic MRI for microadenoma using full-dose gadopentetate dimeglumine. A second MRI was then performed using only half the usual dose of contrast material. Images from the second MRI where compared with the first study. Microadenomas were detected in 100% of the patients using a half dose of the contrast. All were recognized on the basis of the presence of a hypointense nodular lesion surrounded by normal contrast-enhanced tissue. Six patients were submitted to surgery, and the results were confirmed by immunohistochemistry in all of them. The remaining subject had a sinus sample catheterization coincident with the MRI results. CONCLUSION A half dose of dynamic resonance imaging contrast material increases the sensitivity of MRI detection of ACTH-secreting pituitary tumors.
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Affiliation(s)
- Lesly Portocarrero-Ortiz
- Department of Endocrinology, Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Insurgentes Sur 3877 Col. La Fama, Mexico City, 14269, Mexico.
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Kwee TC, Takahara T, Klomp DWJ, Luijten PR. Cancer imaging: novel concepts in clinical magnetic resonance imaging. J Intern Med 2010; 268:120-32. [PMID: 20497294 DOI: 10.1111/j.1365-2796.2010.02243.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Cancer is a major public health problem in the Western world. Imaging is of crucial importance in oncology, because it may reduce cancer-related morbidity and mortality. To improve tumour evaluation, there is a need for functional imaging modalities that go beyond gross assessment of anatomical abnormalities and allow visualization and quantification of biochemical processes in vivo. Magnetic resonance imaging (MRI) not only provides anatomical information, but also offers a wide range of functional sequences that may aid the evaluation of cancerous lesions. Furthermore, MRI provides the opportunity to guide and monitor anticancer therapies noninvasively. The aim of this review is to highlight some of the most promising developments of MRI in the functional assessment of cancer and the guidance and monitoring of (novel) anticancer therapies.
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Affiliation(s)
- T C Kwee
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
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Marin D, Husarik DB, Boll DT, Merkle EM. Abdominal magnetic resonance imaging at 3 T: oncological applications. Top Magn Reson Imaging 2010; 21:149-156. [PMID: 21847034 DOI: 10.1097/rmr.0b013e3181e8fb7a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The gain in signal-to-noise ratio at 3 T magnetic resonance (MR) imaging produces many benefits for abdominal imaging applications, including the capability to reduce acquisition times and/or improve spatial resolution for a variety of pulse sequences, the potential for broader application of parallel imaging techniques, and an increased sensitivity to gadolinium-based contrast media. These advances have the potential of improving the accuracy of MR imaging in the detection, staging, treatment planning, and follow-up of patients with abdominal tumors. At the same time, because certain high-field-strength-related drawbacks could not be compensated for, abdominal 3 T MR imaging should be clinically implemented with caution in some patients (eg, patients with massive ascites).
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Affiliation(s)
- Daniele Marin
- Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
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Brain MRI With Single-Dose (0.1 mmol/kg) Gadobutrol at 1.5 T and 3 T: Comparison With 0.15 mmol/kg Gadoterate Meglumine. AJR Am J Roentgenol 2010; 194:1337-42. [DOI: 10.2214/ajr.09.3427] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Placantonakis DG, Shariff S, Lafaille F, Labar D, Harden C, Hosain S, Kandula P, Schaul N, Kolesnik D, Schwartz TH. Bilateral intracranial electrodes for lateralizing intractable epilepsy: efficacy, risk, and outcome. Neurosurgery 2010; 66:274-83. [PMID: 20087126 DOI: 10.1227/01.neu.0000363184.43723.94] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Medically refractory epilepsy is amenable to neurosurgical intervention if the epileptogenic focus is accurately localized. If the scalp video-electroencephalography (EEG) and magnetic resonance imaging are nonlateralizing, yet a single focus is suspected, video-EEG monitoring with bilateral intracranial electrode placement is helpful to lateralize the ictal onset zone. We describe the indications, risks, and utility of such bilateral surveys at our institution. METHODS We retrospectively reviewed 26 patients with medically refractory seizures who were treated over a 5-year period and underwent bilateral placement of intracranial electrodes. Subdural strips were used in all cases, and additional stereotactic implantation of depth electrodes into mesial temporal lobes occurred in 50%. The mean patient age was 37.7 years, and 65.4% of patients were male. RESULTS The most common indication for bilateral invasive monitoring was bilateral ictal onsets on surface video-EEG (76.9%), followed by frequent interictal spikes contralateral to a single ictal focus (7.7%). Intracranial monitoring lasted an average of 8.2 days, with ictal events recorded in all cases. Ten patients (38.5%) subsequently underwent more extensive unilateral monitoring via implantation of subdural and depth electrodes through a craniotomy. A therapeutic procedure was performed in 17 patients (65.4%), whereas 1 patient underwent a palliative corpus callosotomy (3.8%). Nine patients underwent a resection without unilateral invasive mapping. Reasons for no therapeutic surgery (n = 8) included multifocal onsets, failing the Wada test, refusal of further treatment, and negative intraoperative electrocorticogram. There was 1 surgical complication, involving a retained electrode fragment that was removed in a separate minor procedure. Of the 26 patients, 15 (57.7%) are now seizure-free or have seizure disorders that have substantially improved (modified Engel classes I and II). Of the 17 patients who underwent a potentially curative surgery, 13 (76.5%) were Engel classes I and II. CONCLUSION Bilateral placement of subdural strip and depth electrodes for epilepsy monitoring in patients with nonlateralizing scalp EEG and/or discordant imaging studies but clinical suspicion for focal seizure origin is both safe and effective. Given the safety and efficacy of this procedure, epileptologists should have a low threshold to consider bilateral implants for suitable patients.
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Affiliation(s)
- Dimitris G Placantonakis
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York 10065, USA
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Kakite S, Fujii S, Kurosaki M, Kanasaki Y, Matsusue E, Kaminou T, Ogawa T. Three-dimensional gradient echo versus spin echo sequence in contrast-enhanced imaging of the pituitary gland at 3T. Eur J Radiol 2010; 79:108-12. [PMID: 20116954 DOI: 10.1016/j.ejrad.2009.12.036] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Accepted: 12/30/2009] [Indexed: 10/19/2022]
Abstract
INTRODUCTION To clarify whether a three-dimensional-gradient echo (3D-GRE) or spin echo (SE) sequence is more useful for evaluating sellar lesions on contrast-enhanced T1-weighted MR imaging at 3.0Tesla (T). METHODS We retrospectively assessed contrast-enhanced T1-weighted images using 3D-GRE and SE sequences at 3.0T obtained from 33 consecutive patients with clinically suspected sellar lesions. Two experienced neuroradiologists evaluated the images qualitatively in terms of the following criteria: boundary edge of the cavernous sinus and pituitary gland, border of sellar lesions, delineation of the optic nerve and cranial nerves within the cavernous sinus, susceptibility and flow artifacts, and overall image quality. RESULTS At 3.0T, 3D-GRE provided significantly better images than the SE sequence in terms of the border of sellar lesions, delineation of cranial nerves, and overall image quality; there was no significant difference regarding the boundary edge of the cavernous sinus and pituitary gland. In addition, the 3D-GRE sequence showed fewer pulsation artifacts but more susceptibility artifacts. CONCLUSION Our results indicate that 3D-GRE is the more suitable sequence for evaluating sellar lesions on contrast-enhanced T1-weighted imaging at 3.0T.
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Affiliation(s)
- Suguru Kakite
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago 683-8503, Japan.
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Waugh SA, Ramkumar PG, Gandy SJ, Nicholas RS, Martin P, Belch JJF, Struthers AD, Houston JG. Optimization of the contrast dose and injection rates in whole-body MR angiography at 3.0T. J Magn Reson Imaging 2010; 30:1059-67. [PMID: 19856438 DOI: 10.1002/jmri.21930] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To optimize the contrast agent dose and delivery rate used in a novel whole-body magnetic resonance angiography (MRA) protocol using a 3.0T MR scanner. MATERIALS AND METHODS Six groups of 20 consenting volunteers underwent whole-body MRA, with each group receiving a different contrast dose and contrast delivery rate. The arterial tree was divided into 16 segments and the image quality at each of the anatomical locations, covering the whole body, was assessed. Qualitative analysis was carried out using a scoring assessment of image quality, and quantitative assessments were performed by measuring contrast-to-noise (CNR) and a signal-to-noise (SNR) index. RESULTS Reducing the contrast dose from 40 mL to 25 mL was found to significantly increase the CNR in several vessels of interest in the arterial tree. There was also a significant increase in the qualitative image quality score (P < 0.001). CONCLUSION This study demonstrates that reducing the contrast dose at 3.0T can result in an increase in the CNR in the vessels of interest without significantly affecting the SNR.
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Affiliation(s)
- Shelley A Waugh
- Department of Medical Physics, Ninewells Hospital, NHS Tayside, Dundee, UK.
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Seo HS. High field strength magnetic resonance imaging of brain lesion. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2010. [DOI: 10.5124/jkma.2010.53.12.1086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hyung Suk Seo
- Department of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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Rha SE. High field strength magnetic resonance imaging of abdominal diseases. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2010. [DOI: 10.5124/jkma.2010.53.12.1065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sung Eun Rha
- Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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van Rooden S, Maat-Schieman MLC, Nabuurs RJA, van der Weerd L, van Duijn S, van Duinen SG, Natté R, van Buchem MA, van der Grond J. Cerebral Amyloidosis: Postmortem Detection with Human 7.0-T MR Imaging System. Radiology 2009; 253:788-96. [DOI: 10.1148/radiol.2533090490] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Erturk SM, Alberich-Bayarri A, Herrmann KA, Marti-Bonmati L, Ros PR. Use of 3.0-T MR Imaging for Evaluation of the Abdomen. Radiographics 2009; 29:1547-63. [DOI: 10.1148/rg.296095516] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chavhan GB, Babyn PS, Singh M, Vidarsson L, Shroff M. MR Imaging at 3.0 T in Children: Technical Differences, Safety Issues, and Initial Experience. Radiographics 2009; 29:1451-66. [DOI: 10.1148/rg.295095041] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Sutter R, Heilmaier C, Lutz AM, Weishaupt D, Seifert B, Willmann JK. MR angiography with parallel acquisition for assessment of the visceral arteries: comparison with conventional MR angiography and 64-detector-row computed tomography. Eur Radiol 2009; 19:2679-88. [PMID: 19526242 DOI: 10.1007/s00330-009-1473-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 04/01/2009] [Accepted: 04/24/2009] [Indexed: 12/31/2022]
Abstract
The purpose of the study was to retrospectively compare three-dimensional gadolinium-enhanced magnetic resonance angiography (conventional MRA) with MRA accelerated by a parallel acquisition technique (fast MRA) for the assessment of visceral arteries, using 64-detector-row computed tomography angiography (MDCTA) as the reference standard. Eighteen patients underwent fast MRA (imaging time 17 s), conventional MRA (29 s) and MDCTA of the abdomen and pelvis. Two independent readers assessed subjective image quality and the presence of arterial stenosis. Data were analysed on per-patient and per-segment bases. Fast MRA yielded better subjective image quality in all segments compared with conventional MRA (P = 0.012 for reader 1, P = 0.055 for reader 2) because of fewer motion-induced artefacts. Sensitivity and specificity of fast MRA for the detection of arterial stenosis were 100% for both readers. Sensitivity of conventional MRA was 89% for both readers, and specificity was 100% (reader 1) and 99% (reader 2). Differences in sensitivity between the two types of MRA were not significant for either reader. Interobserver agreement for the detection of arterial stenosis was excellent for fast (kappa = 1.00) and good for conventional MRA (kappa = 0.76). Thus, subjective image quality of visceral arteries remains good on fast MRA compared with conventional MRA, and the two techniques do not differ substantially in the grading of arterial stenosis, despite the markedly reduced acquisition time of fast MRA.
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Affiliation(s)
- Reto Sutter
- Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
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Rumboldt Z, Rowley HA, Steinberg F, Maldjian JA, Ruscalleda J, Gustafsson L, Bastianello S. Multicenter, double-blind, randomized, intra-individual crossover comparison of gadobenate dimeglumine and gadopentetate dimeglumine in MRI of brain tumors at 3 tesla. J Magn Reson Imaging 2009; 29:760-7. [PMID: 19306364 DOI: 10.1002/jmri.21695] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To prospectively compare 0.1 mmol/kg doses of gadobenate dimeglumine and gadopentetate dimeglumine for contrast-enhanced MRI of brain lesions at 3 Tesla (T). MATERIALS AND METHODS Forty-six randomized patients underwent a first examination with gadobenate dimeglumine (n = 23) or gadopentetate dimeglumine (n = 23) and then, after 2-7 days, a second examination with the other agent. Contrast administration (volume, rate), sequence parameters (T1wSE; T1wGRE), and interval between injection and image acquisition were identical for examinations in each patient. Three blinded neuroradiologists evaluated images qualitatively (lesion delineation, lesion enhancement, global preference) and quantitatively (lesion-to-brain ratio [LBR], contrast-to-noise ratio [CNR], % lesion enhancement). Differences were assessed using Wilcoxon's signed-rank test. Reader agreement was determined using kappa (kappa) statistics. RESULTS There were no demographic differences between groups. The three readers preferred gadobenate dimeglumine globally in 22 (53.7%), 21 (51.2%), and 27 (65.9%) patients, respectively, compared with 0, 1, and 0 patients for gadopentetate dimeglumine. Similar significant (P < 0.001) preference was expressed for lesion border delineation and enhancement. Reader agreement was consistently good (kappa = 0.48-0.64). Significantly (P < 0.05) higher LBR (+43.5- 61.2%), CNR (+51.3-147.6%), and % lesion enhancement (+45.9-49.5%) was noted with gadobenate dimeglumine. CONCLUSION Brain lesion depiction at 3T is significantly improved with 0.1 mmol/kg gadobenate dimeglumine.
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Affiliation(s)
- Zoran Rumboldt
- Medical University of South Carolina, Department of Radiology, Charleston, SC, USA.
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