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Lu Y, Rivera-Rodriguez A, Tay ZW, Hensley D, Fung KLB, Colson C, Saayujya C, Huynh Q, Kabuli L, Fellows B, Chandrasekharan P, Rinaldi C, Conolly S. Combining magnetic particle imaging and magnetic fluid hyperthermia for localized and image-guided treatment. Int J Hyperthermia 2021; 37:141-154. [PMID: 33426994 DOI: 10.1080/02656736.2020.1853252] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Magnetic fluid hyperthermia (MFH) has been widely investigated as a treatment tool for cancer and other diseases. However, focusing traditional MFH to a tumor deep in the body is not feasible because the in vivo wavelength of 300 kHz very low frequency (VLF) excitation fields is longer than 100 m. Recently we demonstrated that millimeter-precision localized heating can be achieved by combining magnetic particle imaging (MPI) with MFH. In principle, real-time MPI imaging can also guide the location and dosing of MFH treatments. Hence, the combination of MPI imaging plus real time localized MPI-MFH could soon permit closed-loop high-resolution hyperthermia treatment. In this review, we will discuss the fundamentals of localized MFH (e.g. physics and biosafety limitations), hardware implementation, MPI real-time guidance, and new research directions on MPI-MFH. We will also discuss how the scale up to human-sized MPI-MFH scanners could proceed.
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Affiliation(s)
- Yao Lu
- Department of Bioengineering, University of California Berkeley, Berkeley, CA, USA
| | - Angelie Rivera-Rodriguez
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Zhi Wei Tay
- Department of Bioengineering, University of California Berkeley, Berkeley, CA, USA
| | | | - K L Barry Fung
- Department of Bioengineering, University of California Berkeley, Berkeley, CA, USA
| | - Caylin Colson
- Department of Bioengineering, University of California Berkeley, Berkeley, CA, USA
| | - Chinmoy Saayujya
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - Quincy Huynh
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - Leyla Kabuli
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - Benjamin Fellows
- Department of Bioengineering, University of California Berkeley, Berkeley, CA, USA
| | | | - Carlos Rinaldi
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.,Department of Chemical Engineering, University of Florida, Gainesville, FL, USA
| | - Steven Conolly
- Department of Bioengineering, University of California Berkeley, Berkeley, CA, USA.,Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
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2
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Ananthan K, Yusuf GT, Kumar M. Intrahepatic and intra-abdominal splenosis: A case report and review of literature. World J Hepatol 2019; 11:773-779. [PMID: 31966909 PMCID: PMC6960294 DOI: 10.4254/wjh.v11.i12.773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/11/2019] [Accepted: 11/26/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Splenosis is defined as the process by which tissue from the spleen disseminates through the body and grows in an ectopic location following trauma or a splenectomy. Visceral sites of splenosis are rare.
CASE SUMMARY We report a case of intrahepatic splenosis in a 57-year-old man with a history of trauma over 40 years ago who initially presented with chest pain. Findings initially mimicked malignancy but a diagnosis of intrahepatic splenosis was confirmed using computed tomography and scintigraphy with technetium-99m heat-denatured red blood cells (Tc-99 DRBC).
CONCLUSION Scintigraphy with Tc-99 DRBC is a reliable technique to diagnose splenosis and should be performed before using more invasive procedures are carried out. Splenosis should be considered as a possible differential diagnosis for a hepatic nodule in any patient with a history of abdominal trauma, previous splenectomy or atypical radiological features on imaging.
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Affiliation(s)
- Kiruthika Ananthan
- GKT School of Medical Education, King’s College London, London WC2R 2LS, United Kingdom
| | - Gibran Timothy Yusuf
- Department of Radiology, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Kent BR6 8ND, United Kingdom
| | - Mayur Kumar
- Department of Gastroenterology, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Kent BR6 8ND, United Kingdom
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3
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Chu C, Liu G, Janowski M, Bulte JWM, Li S, Pearl M, Walczak P. Real-Time MRI Guidance for Reproducible Hyperosmolar Opening of the Blood-Brain Barrier in Mice. Front Neurol 2018; 9:921. [PMID: 30416485 PMCID: PMC6212512 DOI: 10.3389/fneur.2018.00921] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/10/2018] [Indexed: 12/29/2022] Open
Abstract
The blood-brain barrier (BBB) prevents effective delivery of most therapeutic agents to the brain. Intra-arterial (IA) infusion of hyperosmotic mannitol has been widely used to open the BBB and improve parenchymal targeting, but the extent of BBB disruption has varied widely with therapeutic outcomes often being unpredictable. In this work, we show that real-time MRI can enable fine-tuning of the infusion rate to adjust and predict effective and local brain perfusion in mice, and thereby can be allowed for achieving the targeted and localized BBB opening (BBBO). Both the reproducibility and safety are validated by MRI and histology. The reliable and reproducible BBBO we developed in mice will allow cost-effective studies on the biology of the BBB and drug delivery to the brain. In addition, the IA route for BBBO also permits subsequent IA delivery of a specific drug during the same procedure and obtains high targeting efficiency of the therapeutic agent in the targeted tissue, which has great potential for future clinical translation in neuro-oncology, regenerative medicine and other neurological applications.
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Affiliation(s)
- Chengyan Chu
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Cellular Imaging Section and Vascular Biology Program, Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Neurology Department, Dalian Municipal Central Hospital Affiliated with Dalian Medical University, Dalian, China
| | - Guanshu Liu
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.,F. M. Kirby Research Center, Kennedy Krieger Research Institute, Baltimore, MD, , United States
| | - Miroslaw Janowski
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Cellular Imaging Section and Vascular Biology Program, Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.,NeuroRepair Department, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.,Department of Neurosurgery, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Jeff W M Bulte
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Cellular Imaging Section and Vascular Biology Program, Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Shen Li
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Cellular Imaging Section and Vascular Biology Program, Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Neurology Department, Dalian Municipal Central Hospital Affiliated with Dalian Medical University, Dalian, China
| | - Monica Pearl
- Division of Interventional Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Piotr Walczak
- Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Cellular Imaging Section and Vascular Biology Program, Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Neurology and Neurosurgery, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland
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4
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Abstract
Gadolinium has been widely used as the contrast agent of choice for magnetic resonance imaging (MRI). However, gadolinium administration is not always desired due to its inherent enhancement properties and potential side effects (nephrogenic systemic fibrosis). This article reviews gadolinium alternatives, iron-, and manganese- based agents, and their current clinical usage for contrast-enhanced MRI examinations.
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5
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Arterialised hepatic nodules in the Fontan circulation: Hepatico-cardiac interactions. Int J Cardiol 2011; 151:268-72. [DOI: 10.1016/j.ijcard.2010.05.047] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2009] [Revised: 05/03/2010] [Accepted: 05/23/2010] [Indexed: 11/21/2022]
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6
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Buyukhatipoglu K, Clyne AM. Superparamagnetic iron oxide nanoparticles change endothelial cell morphology and mechanics via reactive oxygen species formation. J Biomed Mater Res A 2010; 96:186-95. [DOI: 10.1002/jbm.a.32972] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 09/07/2010] [Accepted: 09/09/2010] [Indexed: 12/16/2022]
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7
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Abstract
Technical advances in nanotechnology are creating novel classes of MRI contrast-enhancing agents. These nanomaterials offer much higher relaxivities than most current clinical contrast agents, which translates into greater MRI contrast enhancement. These nanoscale agents also have the potential to revolutionize in vivo applications of contrast-enhanced MRI since they offer the multiple advantages of low toxicities, extremely high relaxivities and cell internalization capabilities. In this review, we discuss three types of such contrast agents currently in use or under development for medical imaging: small particles of iron oxide, fullerenes encapsulating Gd3+ ions (gadofullerenes) and single-walled carbon nanotube nanocapsules encapsulating Gd3+ ion clusters (gadonanotubes). The latest developments and projected future applications of these nanotechnology-inspired contrast agents in the field of medical imaging are also discussed.
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9
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Ba-Ssalamah A, Uffmann M, Saini S, Bastati N, Herold C, Schima W. Clinical value of MRI liver-specific contrast agents: a tailored examination for a confident non-invasive diagnosis of focal liver lesions. Eur Radiol 2008; 19:342-57. [DOI: 10.1007/s00330-008-1172-x] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 07/13/2008] [Accepted: 08/11/2008] [Indexed: 12/27/2022]
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10
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Fat-Suppressed Dynamic and Delayed Gadolinium-Enhanced Volumetric Interpolated Breath-hold Magnetic Resonance Imaging of Cholangiocarcinoma. J Comput Assist Tomogr 2008; 32:178-84. [DOI: 10.1097/rct.0b013e31806bef8e] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Ba-Ssalamah A, Fakhrai N, Matzek WK, Herneth AM, Stadler A, Bastati N, Herold CJ, Schima W. Magnetic resonance imaging of liver malignancies. Top Magn Reson Imaging 2007; 18:445-455. [PMID: 18303402 DOI: 10.1097/rmr.0b013e3181614374] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The histological structure of the liver is complex, consisting of hepatocytes, biliary epithelium, and mesenchymal cells. From this large variety of cells, a broad spectrum of benign and malignant liver lesions in originate. An accurate diagnosis of these lesions is mandatory for choosing an appropriate therapeutic approach. With the recent developments in hardware and software, magnetic resonance imaging (MRI) has emerged as the method of choice in the diagnostic workup of focal liver lesions, in particular in the pretherapeutic stage. The introduction of high-field MRI at 3.0 T in the routine workup and the selective use of liver-specific contrast agents, including hepatobiliary and reticuloendothelial agents, have also strengthened the role of MRI in liver imaging. In this overview article, we will review the recent developments in 3.0-T MRI and MRI contrast agents in the diagnostic workup of the most common malignant liver tumors.
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Affiliation(s)
- Ahmed Ba-Ssalamah
- Department of Radiology, Medical University of Vienna, Vienna, Austria.
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12
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Caseiro-Alves F, Brito J, Araujo AE, Belo-Soares P, Rodrigues H, Cipriano A, Sousa D, Mathieu D. Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis. Eur Radiol 2007; 17:1544-54. [PMID: 17260159 DOI: 10.1007/s00330-006-0503-z] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2006] [Revised: 09/15/2006] [Accepted: 10/12/2006] [Indexed: 02/07/2023]
Abstract
Haemangiomas are common focal liver lesions, generally detected in the work-up of asymptomatic patients. From the pathological point of view, they can be classified as small (capillary) or large, with cavernous vascular spaces that may show thrombosis, calcifications and hyalinisation. The polymorphic imaging appearance of haemangiomas depends on their histological features and flow pattern. The widespread use of cross-sectional imaging has allowed an increased detection rate and a better characterisation of this benign tumour. Recent developments of ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) providing high spatial and temporal resolution, together with the use of new contrast agents and/or pulse sequences has broadened the spectrum of imaging findings, contributing to diagnostic refinement in difficult cases. The scope of the present article is to provide an overview of the range of appearances of haemangiomas, explored with recent cross-sectional imaging modalities, emphasising its atypical findings as explored by temporally resolved contrast-enhanced imaging.
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Affiliation(s)
- Filipe Caseiro-Alves
- Clínica Universitária de Imagiologia, Hospitais da Universidade de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, Portugal.
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13
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Gandhi SN, Brown MA, Wong JG, Aguirre DA, Sirlin CB. MR contrast agents for liver imaging: what, when, how. Radiographics 2006; 26:1621-36. [PMID: 17102040 DOI: 10.1148/rg.266065014] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The major classes of contrast agents currently used for magnetic resonance (MR) imaging of the liver include extracellular agents (eg, low-molecular-weight gadolinium chelates), reticuloendothelial agents (eg, ferumoxides), hepatobiliary agents (eg, mangafodipir), blood pool agents, and combined agents. Mechanisms of action, dosage, elimination, toxic effects, indications for use, and MR imaging technical considerations vary according to class. Gadolinium chelates are the most widely used. Ferumoxides are a useful adjunct for detection of hepatocellular carcinoma, particularly when used in combination with gadolinium to achieve improved lesion-to-liver contrast over that achievable with gadolinium alone. Mangafodipir is a prototype hepatobiliary agent that is taken up by lesions with functioning hepatocytes. It may be used for MR cholangiography as well as liver imaging. Although mangafodipir is no longer commercially available in the United States, it is currently marketed and used in Europe. Blood pool agents have not yet been approved for human use in the United States. However, a new combined MR contrast agent, gadobenate dimeglumine, recently was approved, and other agents are in various stages of development.
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Affiliation(s)
- Sunil N Gandhi
- Department of Radiology, UCSD Medical Center, 200 W Arbor Dr, San Diego, CA 92103, USA
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14
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Naganawa S, Kawai H, Fukatsu H, Sakurai Y, Aoki I, Miura S, Mimura T, Kanazawa H, Ishigaki T. Diffusion-weighted imaging of the liver: technical challenges and prospects for the future. Magn Reson Med Sci 2006; 4:175-86. [PMID: 16543702 DOI: 10.2463/mrms.4.175] [Citation(s) in RCA: 113] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Diffusion-weighted imaging (DWI) has recently been attempted in the abdominal region. We review diffusion-weighted images of the liver, especially from the technical point of view. We discuss selection of pulse sequence parameters, effects of anti-breathing motion technique, tips for measuring apparent diffusion coefficient (ADC), and utility of superparamagnetic iron oxide (SPIO), showing clinical cases, including those at 3T. Our current trial of new pulse sequencing, such as SPIO-mediated breath-holding black-blood fluid-attenuated inversion recovery (BH-BB-FLAIR), imaging is shown. Some prospects for the future in DWI of the liver are also stated.
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Affiliation(s)
- Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Japan.
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15
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Wersebe A, Wiskirchen J, Decker U, Schick F, Dietz K, Müller-Schimpfle M, Claussen CD, Pereira PL. Comparison of Gadolinium-BOPTA and Ferucarbotran-Enhanced Three-Dimensional T1-Weighted Dynamic Liver Magnetic Resonance Imaging in the Same Patient. Invest Radiol 2006; 41:264-71. [PMID: 16481909 DOI: 10.1097/01.rli.0000188359.72928.0f] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES We sought to compare signal changes using Ferucarbotran and gadobenate dimeglumine (Gd-BOPTA) in dynamic 3D T1-weighted (T1w) GRE imaging of the liver. MATERIAL AND METHODS Thirty patients were prospectively included in the study. All patients underwent 2 high-field magnetic resonance (MR) examinations: first with Gd-BOPTA (Gd) and then after a mean interval of 4 days with ferucarbotran (Feru). Dynamic MRI was obtained with a 3D T1w GRE sequence (TR 6.33, TE 2.31, flip angle 20 degrees ). Contrast enhanced scans were assessed before intravenous injection of the contrast agent (precontrast), and postcontrast during the arterial phase (30 seconds), portal venous phase (60 seconds), and equilibrium phase (120 seconds). The signal intensities (SIs) of liver, spleen, aorta, and portal vein were defined by region of interest measurements. Signal intensity changes (SICs) and percentage signal intensity change (PSIC) were calculated using the formulas SIC=(SI pre - SI post)/SI pre and PSIC=SIC x 100%. RESULTS Positive signal enhancement was observed after intravenous injection of Feru during all dynamic measurements, whereas the mean SI values were lower compared with Gd. During the portal venous phase the mean SI of Gd was up to a factor of 2.1 higher (portal vein). The widest difference of SIC was observed during the equilibrium phase for liver parenchyma (Gd, 1.03; Feru, 0.24). The dynamic signal courses were similar for liver, portal vein and aorta. Different signal courses were obtained for the spleen. CONCLUSIONS Feru-enhanced T1w dynamic images demonstrated significant signal increases for liver, vessels, and spleen but overall lower signal intensities than Gd-BOPTA. The dynamic signal courses of ferucarbotran were similar to that of Gd-BOPTA during ll perfusion phases except in the spleen. Thus, it may be possible to detect typical enhancement pattern of focal liver lesions with Feru-enhanced dynamic T1w MRI.
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Affiliation(s)
- Annika Wersebe
- Department of Diagnostic Radiology, University Hospital Tübingen, Germany.
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16
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Abstract
AIM: To investigate the role of SPECT/CT in the diagnosis of hepatic hemangiomas whose anatomical positions are not ideal, situated adjacent to the heart, the inferior cava, hepatic vessels or abdominal aorta, etc.
METHODS: The hepatic perfusion, blood pool, and fusion imaging were carried out using SPECT/CT in 54 patients, who were suspected for hepatic hemangiomas. When the anatomical positions were not ideal, the diagnosis was difficult by SPECT only. So the information of computed tomography (CT) was applied to help in diagnosing. The results were recorded as hemangiomas or not.
RESULTS: Of the 54 patients, 31 patients were diagnosed as suffering from hepatic hemangiomas. The anatomical positions of eight patients’ hepatic hemangiomas (25.81%) were not ideal. Among these lesions of the eight patients, three patients’ hepatic lesions were located near to the abdominal aorta, one to the heart, and four to the inferior cava. In addition, six abnormal radioactivity accumulation regions, adjacent to the heart and inferior cava, with the help of CT, were confirmed to be the imaging of inferior cava other than hepatic hemangiomas.
CONCLUSION: When the anatomical positions of hepatic hemangiomas are not good enough for diagnosis, the fusion imaging of SPECT/CT is a simple and efficient method for differential diagnosis.
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Affiliation(s)
- Jian-Guo Zheng
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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17
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Abstract
Imaging of the liver is undertaken for the detection and characterization of suspected primary or secondary neoplasms, prior to planning a surgery or chemotherapy pump placement, for assessing treatment response, for evaluating biliary pathology, and for screening for liver neoplasms in high-risk groups. In this article, we review the advantages and disadvantages of various imaging modalities in the evaluation of the liver and formulate guidelines for the imaging of common clinical indications. A brief review of imaging findings in focal and diffuse liver disease is also presented.
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Affiliation(s)
- Dushyant V Sahani
- Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, White 270, 55 Fruit Street, Boston, Massachusetts 02114, USA.
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18
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Xu HB, Kong XQ, Xiong Y, Feng GS. MRI features of regenerative and dysplastic nodules in cirrhotic liver. Shijie Huaren Xiaohua Zazhi 2004; 12:385-389. [DOI: 10.11569/wcjd.v12.i2.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To study MR features of the regenerative nodule (RN) and dysplastic nodule (DN) in the cirrhotic liver.
METHODS: MRI was performed in 26 cases of suspected cirrhotic liver with RN and DN. Additional enhanced MRI with administration of Gd-DTPA on T1WI was performed in 18 of 26 cases. Meanwhile in 10 of 18 both Gd-DTPA and SPIO (Feridex) enhancement were underwent one day apart. All patients were confirmed by aspiration biopsy or histopathology. MRI was compared to the pathological findings.
RESULTS: In 26 cases, there were 12 cases of regenerative nodules measuring 0.3-1cm in size, and 14 dysplastic nodules including 8 nodules measuring ≥1 cm and <3 cm in size, and 6 nodules measuring ≥3 cm. Their MR appearances were as followings: nodules with <1 cm in size showed isointensity on T1WI and hypointensity on T2WI, of which the intensity was as isointense as the surrounding hepatic parenchyma on enhanced MRI with administration of Gd-DTPA or SPIO. In 8 cases with nodules measuring 1-3 cm in size, 5 cases appeared hyperintense on T1WI and hypointense on T2WI as well as the enhancement as that of nodules with <1 cm in size; the other 3 cases appeared hypointense on T1WI and hyperintense on T2WI, and were enhanced after administration of Gd-DTPA but hyperintense on SPIO enhancing MRI, which indicated malignant transformation of dysplastic nodule into hepatocellular carcinoma (HCC) arising from hepatic nodule on histopathology. In 6 cases of nodules measuring >3 cm in size, 2 cases appeared hyperintense compared to the surrounding hepatic parenchyma on T1, T2WI and enhanced MRI, one of which was documented "nodule within a nodule" on T2WI. The 2 cases were demonstrated well-differentiated HCC. The other 4 cases showed hyperintense on T1WI, and hypointense on T2WI and enhanced MRI. Sometimes, normal vessels were seen to pass through the surface of macroregenerative nodule. Additionally, RN and DN had the same pattern of the time-signal intensity course as the normal surrounding hepatic parenchyma, but malignant transformation of DN appeared fast wash-in and wash-out.
CONCLUSION: RN of cirrhosis has features on MRI that usually allow distinction from HCC but not always from DN. A helpful distinction between HCC and DN is that the latter is almost never hyperintense on T2WI. Additionally, the followings indicate malignant transformation of DN when DN appears a ring like enhancement after injection of Gd-DTPA, and fast wash-in and wash-out as well as hyperintensity on SPIO enhanced MRI.
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Abstract
The liver is the commonest site of distant metastasis of colorectal cancer and nearly half of the patients with colorectal cancer ultimately develop liver involved during the course of their diseases. Surgery is the only therapy that offers the possibility of cure for patients with hepatic metastatic diseases. Five-year survival rates after resection of all detectable liver metastases can be up to 40%. Unfortunately, only 25% of patients with colorectal liver metastases are candidates for liver resection, while the others are not amenable to surgical resection. Regional therapies such as radiofrequency ablation and cryotherapy may be offered to patients with isolated unresectable metastases but no extrahepatic diseases. Hepatic artery catheter chemotherapy and chemoembolization and portal vein embolization are often used for the patients with extensive liver metastases but without extrahepatic diseases, which are not suitable for regional ablation. For the patients with metastatic colorectal cancer beyond the liver, systemic chemotherapy is a more appropriate choice. Immunotherapy is also a good option when other therapies are used in combination to enhance the efficacy. Selective internal radiation therapy is a new radiation method which can be used in patients given other routine therapies without effects.
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Affiliation(s)
- Lian-Xin Liu
- Department of Surgery, First Clinical College, Harbin Medical University, No. 23 Youzheng Street, Nangang District, Harbin 150001, Heilongjiang Province, China.
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20
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Wu LF, Wang BZ, Feng JL, Cheng WR, Liu GR, Xu XH, Zheng ZC. Preoperative TN staging of esophageal cancer: Comparison of miniprobe ultrasonography, spiral CT and MRI. World J Gastroenterol 2003; 9:219-24. [PMID: 12532435 PMCID: PMC4611315 DOI: 10.3748/wjg.v9.i2.219] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIM: To evaluate the value of miniprobe sonography (MPS), spiral CT and MR imaging (MRI) in the tumor and regional lymph node staging of esophageal cancer.
METHODS: Eight-six patients (56 men and 30 women; age range of 39-73 years, mean 62 years) with esophageal carcinoma were staged preoperatively with imaging modalities. Of them, 81 (94%) had squamous cell carcinoma, 4 (5%) adenocarcinoma, and 1 (1%) adenoacanthoma. Eleven patients (12%) had malignancy of the upper one third, 41 (48%) of the mid-esophagus and 34 (40%) of the distal one third. Forty-one were examined by spiral CT in whom 13 were co-examined by MPS, and forty-five by MRI in whom 18 were also co-examined by MPS. These imaging results were compared with the findings of the histopathologic examination for resected specimens.
RESULTS: In staging the depth of tumor growth, MPS was significantly more accurate (84%) than spiral CT and MRI (68% and 60%, respectively, P < 0.05). The specificity and sensitivity were 82% and 85% for MPS; 60% and 69% for spiral CT; and 40% and 63% for MRI, respectively. In staging regional lymph nodes, spiral CT was more accurate (78%) than MPS and MRI (71% and 64%, respectively), but the difference was not statistically significant. The specificity and sensitivity were 79% and 77% for spiral CT; 75% and 68% for MPS; and 68% and 62% for MRI, respectively.
CONCLUSION: MPS is superior to spiral CT or MRI for T staging, especially in early esophageal cancer. However, the three modalities have the similar accuracy in N staging. Spiral CT or MRI is helpful for the detection of far-distance metastasis in esophageal cancer.
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Affiliation(s)
- Ling-Fei Wu
- Department of Gastroenterology, Second Affiliated Hospital, Shantou University Medical College, Shantou 515041, Guangdong Province China.
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21
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Current awareness in NMR in biomedicine. NMR IN BIOMEDICINE 2002; 15:367-374. [PMID: 12224543 DOI: 10.1002/nbm.750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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