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Kohan A, Hanneman K, Mirshahvalad SA, Afaq A, Mallak N, Metser U, Veit-Haibach P. Current Applications of PET/MR: Part II: Clinical Applications II. Can Assoc Radiol J 2024:8465371241255904. [PMID: 38836428 DOI: 10.1177/08465371241255904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
Due to the major improvements in the hardware and image reconstruction algorithms, positron emission tomography/magnetic resonance imaging (PET/MR) is now a reliable state-of-the-art hybrid modality in medical practice. Currently, it can provide a broad range of advantages in preclinical and clinical imaging compared to single-modality imaging. In the second part of this review, we discussed the further clinical applications of PET/MR. In the chest, PET/MR has particular potential in the oncology setting, especially when utilizing ultrashort/zero echo time MR sequences. Furthermore, cardiac PET/MR can provide reliable information in evaluating myocardial inflammation, cardiac amyloidosis, myocardial perfusion, myocardial viability, atherosclerotic plaque, and cardiac masses. In gastrointestinal and hepato-pancreato-biliary malignancies, PET/MR is able to precisely detect metastases to the liver, being superior over the other imaging modalities. In genitourinary and gynaecology applications, PET/MR is a comprehensive diagnostic method, especially in prostate, endometrial, and cervical cancers. Its simultaneous acquisition has been shown to outperform other imaging techniques for the detection of pelvic nodal metastases and is also a reliable modality in radiation planning. Lastly, in haematologic malignancies, PET/MR can significantly enhance lymphoma diagnosis, particularly in detecting extra-nodal involvement. It can also comprehensively assess treatment-induced changes. Furthermore, PET/MR may soon become a routine in multiple myeloma management, being a one-stop shop for evaluating bone, bone marrow, and soft tissues.
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Affiliation(s)
- Andres Kohan
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Kate Hanneman
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Seyed Ali Mirshahvalad
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Asim Afaq
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nadine Mallak
- Department of Diagnostic Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Ur Metser
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Patrick Veit-Haibach
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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Aquino GJ, Mastrodicasa D, Alabed S, Abohashem S, Wen L, Gill RR, Bardo DME, Abbara S, Hanneman K. Radiology: Cardiothoracic Imaging Highlights 2023. Radiol Cardiothorac Imaging 2024; 6:e240020. [PMID: 38602468 PMCID: PMC11056755 DOI: 10.1148/ryct.240020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/15/2024] [Accepted: 02/28/2024] [Indexed: 04/12/2024]
Abstract
Radiology: Cardiothoracic Imaging publishes novel research and technical developments in cardiac, thoracic, and vascular imaging. The journal published many innovative studies during 2023 and achieved an impact factor for the first time since its inaugural issue in 2019, with an impact factor of 7.0. The current review article, led by the Radiology: Cardiothoracic Imaging trainee editorial board, highlights the most impactful articles published in the journal between November 2022 and October 2023. The review encompasses various aspects of coronary CT, photon-counting detector CT, PET/MRI, cardiac MRI, congenital heart disease, vascular imaging, thoracic imaging, artificial intelligence, and health services research. Key highlights include the potential for photon-counting detector CT to reduce contrast media volumes, utility of combined PET/MRI in the evaluation of cardiac sarcoidosis, the prognostic value of left atrial late gadolinium enhancement at MRI in predicting incident atrial fibrillation, the utility of an artificial intelligence tool to optimize detection of incidental pulmonary embolism, and standardization of medical terminology for cardiac CT. Ongoing research and future directions include evaluation of novel PET tracers for assessment of myocardial fibrosis, deployment of AI tools in clinical cardiovascular imaging workflows, and growing awareness of the need to improve environmental sustainability in imaging. Keywords: Coronary CT, Photon-counting Detector CT, PET/MRI, Cardiac MRI, Congenital Heart Disease, Vascular Imaging, Thoracic Imaging, Artificial Intelligence, Health Services Research © RSNA, 2024.
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Affiliation(s)
| | | | - Samer Alabed
- From the Department of Radiology, SUNY Upstate Medical University,
750 E Adams St, Syracuse, NY, 13210 (G.J.A); Department of Radiology, University
of Washington School of Medicine, UW Medical Center Montlake, Seattle, Wash
(D.M.); Department of Radiology, OncoRad/Tumor Imaging Metrics Core (TIMC),
University of Washington School of Medicine, Seattle, Wash (D.M.); Division of
Clinical Medicine, School of Medicine and Population Health, University of
Sheffield, Sheffield, United Kingdom (S. Alabed); National Institute for Health
and Care Research, Sheffield Biomedical Research Centre, Sheffield, United
Kingdom (S. Alabed); Department of Radiology, Cardiovascular Imaging Research
Center, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
(S. Abohashem); Department of Radiology, Key Laboratory of Birth Defects and
Related Diseases of Women and Children, Ministry of Education, West China Second
University Hospital, Sichuan University, Sichuan, China (L.W.); Department of
Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston,
Mass (R.R.G.); Department of Medical Imaging, Ann & Robert H. Lurie
Children’s Hospital of Chicago, Chicago, Ill (D.M.E.B.); Department of
Radiology, UT Southwestern Medical Center, Dallas, Tex (S. Abbara); Department
of Medical Imaging, University Medical Imaging Toronto, University of Toronto,
Toronto, Ontario, Canada (K.H.); and Peter Munk Cardiac Centre, Toronto General
Hospital, University of Toronto, Toronto, Ontario, Canada (K.H.)
| | - Shady Abohashem
- From the Department of Radiology, SUNY Upstate Medical University,
750 E Adams St, Syracuse, NY, 13210 (G.J.A); Department of Radiology, University
of Washington School of Medicine, UW Medical Center Montlake, Seattle, Wash
(D.M.); Department of Radiology, OncoRad/Tumor Imaging Metrics Core (TIMC),
University of Washington School of Medicine, Seattle, Wash (D.M.); Division of
Clinical Medicine, School of Medicine and Population Health, University of
Sheffield, Sheffield, United Kingdom (S. Alabed); National Institute for Health
and Care Research, Sheffield Biomedical Research Centre, Sheffield, United
Kingdom (S. Alabed); Department of Radiology, Cardiovascular Imaging Research
Center, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
(S. Abohashem); Department of Radiology, Key Laboratory of Birth Defects and
Related Diseases of Women and Children, Ministry of Education, West China Second
University Hospital, Sichuan University, Sichuan, China (L.W.); Department of
Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston,
Mass (R.R.G.); Department of Medical Imaging, Ann & Robert H. Lurie
Children’s Hospital of Chicago, Chicago, Ill (D.M.E.B.); Department of
Radiology, UT Southwestern Medical Center, Dallas, Tex (S. Abbara); Department
of Medical Imaging, University Medical Imaging Toronto, University of Toronto,
Toronto, Ontario, Canada (K.H.); and Peter Munk Cardiac Centre, Toronto General
Hospital, University of Toronto, Toronto, Ontario, Canada (K.H.)
| | - Lingyi Wen
- From the Department of Radiology, SUNY Upstate Medical University,
750 E Adams St, Syracuse, NY, 13210 (G.J.A); Department of Radiology, University
of Washington School of Medicine, UW Medical Center Montlake, Seattle, Wash
(D.M.); Department of Radiology, OncoRad/Tumor Imaging Metrics Core (TIMC),
University of Washington School of Medicine, Seattle, Wash (D.M.); Division of
Clinical Medicine, School of Medicine and Population Health, University of
Sheffield, Sheffield, United Kingdom (S. Alabed); National Institute for Health
and Care Research, Sheffield Biomedical Research Centre, Sheffield, United
Kingdom (S. Alabed); Department of Radiology, Cardiovascular Imaging Research
Center, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
(S. Abohashem); Department of Radiology, Key Laboratory of Birth Defects and
Related Diseases of Women and Children, Ministry of Education, West China Second
University Hospital, Sichuan University, Sichuan, China (L.W.); Department of
Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston,
Mass (R.R.G.); Department of Medical Imaging, Ann & Robert H. Lurie
Children’s Hospital of Chicago, Chicago, Ill (D.M.E.B.); Department of
Radiology, UT Southwestern Medical Center, Dallas, Tex (S. Abbara); Department
of Medical Imaging, University Medical Imaging Toronto, University of Toronto,
Toronto, Ontario, Canada (K.H.); and Peter Munk Cardiac Centre, Toronto General
Hospital, University of Toronto, Toronto, Ontario, Canada (K.H.)
| | - Ritu R. Gill
- From the Department of Radiology, SUNY Upstate Medical University,
750 E Adams St, Syracuse, NY, 13210 (G.J.A); Department of Radiology, University
of Washington School of Medicine, UW Medical Center Montlake, Seattle, Wash
(D.M.); Department of Radiology, OncoRad/Tumor Imaging Metrics Core (TIMC),
University of Washington School of Medicine, Seattle, Wash (D.M.); Division of
Clinical Medicine, School of Medicine and Population Health, University of
Sheffield, Sheffield, United Kingdom (S. Alabed); National Institute for Health
and Care Research, Sheffield Biomedical Research Centre, Sheffield, United
Kingdom (S. Alabed); Department of Radiology, Cardiovascular Imaging Research
Center, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
(S. Abohashem); Department of Radiology, Key Laboratory of Birth Defects and
Related Diseases of Women and Children, Ministry of Education, West China Second
University Hospital, Sichuan University, Sichuan, China (L.W.); Department of
Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston,
Mass (R.R.G.); Department of Medical Imaging, Ann & Robert H. Lurie
Children’s Hospital of Chicago, Chicago, Ill (D.M.E.B.); Department of
Radiology, UT Southwestern Medical Center, Dallas, Tex (S. Abbara); Department
of Medical Imaging, University Medical Imaging Toronto, University of Toronto,
Toronto, Ontario, Canada (K.H.); and Peter Munk Cardiac Centre, Toronto General
Hospital, University of Toronto, Toronto, Ontario, Canada (K.H.)
| | - Dianna M. E. Bardo
- From the Department of Radiology, SUNY Upstate Medical University,
750 E Adams St, Syracuse, NY, 13210 (G.J.A); Department of Radiology, University
of Washington School of Medicine, UW Medical Center Montlake, Seattle, Wash
(D.M.); Department of Radiology, OncoRad/Tumor Imaging Metrics Core (TIMC),
University of Washington School of Medicine, Seattle, Wash (D.M.); Division of
Clinical Medicine, School of Medicine and Population Health, University of
Sheffield, Sheffield, United Kingdom (S. Alabed); National Institute for Health
and Care Research, Sheffield Biomedical Research Centre, Sheffield, United
Kingdom (S. Alabed); Department of Radiology, Cardiovascular Imaging Research
Center, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
(S. Abohashem); Department of Radiology, Key Laboratory of Birth Defects and
Related Diseases of Women and Children, Ministry of Education, West China Second
University Hospital, Sichuan University, Sichuan, China (L.W.); Department of
Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston,
Mass (R.R.G.); Department of Medical Imaging, Ann & Robert H. Lurie
Children’s Hospital of Chicago, Chicago, Ill (D.M.E.B.); Department of
Radiology, UT Southwestern Medical Center, Dallas, Tex (S. Abbara); Department
of Medical Imaging, University Medical Imaging Toronto, University of Toronto,
Toronto, Ontario, Canada (K.H.); and Peter Munk Cardiac Centre, Toronto General
Hospital, University of Toronto, Toronto, Ontario, Canada (K.H.)
| | - Suhny Abbara
- From the Department of Radiology, SUNY Upstate Medical University,
750 E Adams St, Syracuse, NY, 13210 (G.J.A); Department of Radiology, University
of Washington School of Medicine, UW Medical Center Montlake, Seattle, Wash
(D.M.); Department of Radiology, OncoRad/Tumor Imaging Metrics Core (TIMC),
University of Washington School of Medicine, Seattle, Wash (D.M.); Division of
Clinical Medicine, School of Medicine and Population Health, University of
Sheffield, Sheffield, United Kingdom (S. Alabed); National Institute for Health
and Care Research, Sheffield Biomedical Research Centre, Sheffield, United
Kingdom (S. Alabed); Department of Radiology, Cardiovascular Imaging Research
Center, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
(S. Abohashem); Department of Radiology, Key Laboratory of Birth Defects and
Related Diseases of Women and Children, Ministry of Education, West China Second
University Hospital, Sichuan University, Sichuan, China (L.W.); Department of
Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston,
Mass (R.R.G.); Department of Medical Imaging, Ann & Robert H. Lurie
Children’s Hospital of Chicago, Chicago, Ill (D.M.E.B.); Department of
Radiology, UT Southwestern Medical Center, Dallas, Tex (S. Abbara); Department
of Medical Imaging, University Medical Imaging Toronto, University of Toronto,
Toronto, Ontario, Canada (K.H.); and Peter Munk Cardiac Centre, Toronto General
Hospital, University of Toronto, Toronto, Ontario, Canada (K.H.)
| | - Kate Hanneman
- From the Department of Radiology, SUNY Upstate Medical University,
750 E Adams St, Syracuse, NY, 13210 (G.J.A); Department of Radiology, University
of Washington School of Medicine, UW Medical Center Montlake, Seattle, Wash
(D.M.); Department of Radiology, OncoRad/Tumor Imaging Metrics Core (TIMC),
University of Washington School of Medicine, Seattle, Wash (D.M.); Division of
Clinical Medicine, School of Medicine and Population Health, University of
Sheffield, Sheffield, United Kingdom (S. Alabed); National Institute for Health
and Care Research, Sheffield Biomedical Research Centre, Sheffield, United
Kingdom (S. Alabed); Department of Radiology, Cardiovascular Imaging Research
Center, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
(S. Abohashem); Department of Radiology, Key Laboratory of Birth Defects and
Related Diseases of Women and Children, Ministry of Education, West China Second
University Hospital, Sichuan University, Sichuan, China (L.W.); Department of
Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston,
Mass (R.R.G.); Department of Medical Imaging, Ann & Robert H. Lurie
Children’s Hospital of Chicago, Chicago, Ill (D.M.E.B.); Department of
Radiology, UT Southwestern Medical Center, Dallas, Tex (S. Abbara); Department
of Medical Imaging, University Medical Imaging Toronto, University of Toronto,
Toronto, Ontario, Canada (K.H.); and Peter Munk Cardiac Centre, Toronto General
Hospital, University of Toronto, Toronto, Ontario, Canada (K.H.)
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Sánchez Tijmes F, Marschner CA, de Matos JFRG, Urzua Fresno CM, Gutiérrez Chacoff JM, Thavendiranathan P, Fuss C, Hanneman K. Imaging Acute and Chronic Cardiac Complications of COVID-19 and after COVID-19 Vaccination. Radiographics 2023; 43:e230044. [PMID: 37616171 DOI: 10.1148/rg.230044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
COVID-19 is associated with acute and longer-term cardiovascular manifestations including myocardial injury, myopericarditis, stress-induced cardiomyopathy, myocardial infarction, and thromboembolic disease. Although the morbidity and mortality related to acute COVID-19 have decreased substantially, there is growing concern about the longer-term cardiovascular effects of the disease and postacute sequelae. Myocarditis has also been reported after messenger ribonucleic acid (mRNA)-based COVID-19 vaccination, with the highest risk among adolescent boys and young adult men. Noninvasive imaging including cardiac MRI has a key role in identifying the presence of cardiovascular disease, evaluating for potential mechanisms of injury, stratifying risk of future adverse cardiovascular events, and potentially guiding treatment in patients with suspected cardiovascular injury after COVID-19 and vaccination. Patterns of injury identified at cardiac MRI after COVID-19 include myocarditis and pericarditis, myocardial ischemia, and infarction. Myocardial edema and late gadolinium enhancement have been described months after the initial infection in a minority of patients with persistent cardiac symptoms after COVID-19. In patients with myocarditis after receiving a COVID-19 vaccination, the most common pattern of late gadolinium enhancement is subepicardial at the basal inferolateral wall, and patients tend to have milder imaging abnormalities compared with those from other causes of myocarditis. This article describes the role of multimodality cardiac imaging and imaging findings in patients with acute and longer-term cardiovascular manifestations of COVID-19 and in patients with myocarditis after receiving an mRNA-based COVID-19 vaccination. ©RSNA, 2023 Online supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center.
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Affiliation(s)
- Felipe Sánchez Tijmes
- From the Department of Medical Imaging (F.S.T., C.A.M., J.F.R.G.d.M., C.M.U.F., P.T., K.H.) and the Division of Cardiology (P.T.), Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2; Department of Medical Imaging, Clinica Santa Maria, Universidad de los Andes, Santiago, Chile (F.S.T.); Department of Medical Imaging, Hospital Barros Luco, Universidad Mayor, Santiago, Chile (J.M.G.C.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (C.F.)
| | - Constantin A Marschner
- From the Department of Medical Imaging (F.S.T., C.A.M., J.F.R.G.d.M., C.M.U.F., P.T., K.H.) and the Division of Cardiology (P.T.), Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2; Department of Medical Imaging, Clinica Santa Maria, Universidad de los Andes, Santiago, Chile (F.S.T.); Department of Medical Imaging, Hospital Barros Luco, Universidad Mayor, Santiago, Chile (J.M.G.C.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (C.F.)
| | - Joao Francisco Ribeiro Gavina de Matos
- From the Department of Medical Imaging (F.S.T., C.A.M., J.F.R.G.d.M., C.M.U.F., P.T., K.H.) and the Division of Cardiology (P.T.), Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2; Department of Medical Imaging, Clinica Santa Maria, Universidad de los Andes, Santiago, Chile (F.S.T.); Department of Medical Imaging, Hospital Barros Luco, Universidad Mayor, Santiago, Chile (J.M.G.C.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (C.F.)
| | - Camila M Urzua Fresno
- From the Department of Medical Imaging (F.S.T., C.A.M., J.F.R.G.d.M., C.M.U.F., P.T., K.H.) and the Division of Cardiology (P.T.), Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2; Department of Medical Imaging, Clinica Santa Maria, Universidad de los Andes, Santiago, Chile (F.S.T.); Department of Medical Imaging, Hospital Barros Luco, Universidad Mayor, Santiago, Chile (J.M.G.C.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (C.F.)
| | - Jose Miguel Gutiérrez Chacoff
- From the Department of Medical Imaging (F.S.T., C.A.M., J.F.R.G.d.M., C.M.U.F., P.T., K.H.) and the Division of Cardiology (P.T.), Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2; Department of Medical Imaging, Clinica Santa Maria, Universidad de los Andes, Santiago, Chile (F.S.T.); Department of Medical Imaging, Hospital Barros Luco, Universidad Mayor, Santiago, Chile (J.M.G.C.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (C.F.)
| | - Paaladinesh Thavendiranathan
- From the Department of Medical Imaging (F.S.T., C.A.M., J.F.R.G.d.M., C.M.U.F., P.T., K.H.) and the Division of Cardiology (P.T.), Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2; Department of Medical Imaging, Clinica Santa Maria, Universidad de los Andes, Santiago, Chile (F.S.T.); Department of Medical Imaging, Hospital Barros Luco, Universidad Mayor, Santiago, Chile (J.M.G.C.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (C.F.)
| | - Cristina Fuss
- From the Department of Medical Imaging (F.S.T., C.A.M., J.F.R.G.d.M., C.M.U.F., P.T., K.H.) and the Division of Cardiology (P.T.), Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2; Department of Medical Imaging, Clinica Santa Maria, Universidad de los Andes, Santiago, Chile (F.S.T.); Department of Medical Imaging, Hospital Barros Luco, Universidad Mayor, Santiago, Chile (J.M.G.C.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (C.F.)
| | - Kate Hanneman
- From the Department of Medical Imaging (F.S.T., C.A.M., J.F.R.G.d.M., C.M.U.F., P.T., K.H.) and the Division of Cardiology (P.T.), Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2; Department of Medical Imaging, Clinica Santa Maria, Universidad de los Andes, Santiago, Chile (F.S.T.); Department of Medical Imaging, Hospital Barros Luco, Universidad Mayor, Santiago, Chile (J.M.G.C.); and Department of Diagnostic Radiology, Oregon Health and Science University, Portland, Ore (C.F.)
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