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Xia S, Gowda P, Silva FD, Guirguis M, Ravi V, Xi Y, Chhabra A. Comparison between ZOOMit DWI and conventional DWI in the assessment of foot and ankle infection: a prospective study. Eur Radiol 2024; 34:3483-3492. [PMID: 37848770 DOI: 10.1007/s00330-023-10315-w] [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: 06/27/2023] [Revised: 08/16/2023] [Accepted: 08/23/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE The study aimed to compare ZOOMit diffusion-weighted imaging (DWI) MRI with conventional DWI MRI for visualizing small bones in the foot, soft tissue abscesses, and osteomyelitis. MATERIALS AND METHODS The cohort consisted of a consecutive series of patients with potential foot and ankle infections referred for MR imaging. Patients were imaged using both conventional and ZOOMit DWI in the same setting. Blinded reads were then conducted in separate settings and independent of known clinical diagnosis by two expert radiologists. The results from the reads were compared statistically using paired t-tests and with biopsy specimen analysis, both anatomopathological and microbiological. RESULTS There was improvement in fat suppression using ZOOMit sequence compared to conventional DWI (p = .001) with no significant difference in motion artifacts (p = .278). ZOOMit had a higher rate of concordance with pathology findings for osteomyelitis (72%, 31/43 cases) compared with conventional DWI (60%, 26/43 cases). ZOOMit also identified 46 additional small bones of the foot and ankle (405/596, 68.0%) than conventional DWI (359/596, 60.2%). Conventional DWI however exhibited a more negative contrast-to-noise ratio (CNR) than ZOOMit (p = 0.001). CONCLUSION ZOOMit DWI improves distal extremity proton diffusion assessment and helps visualize more bones in the foot, with less image distortion and improved fat saturation at the expense of reduced CNR. This makes it a viable option for assessing lower extremity infections. CLINICAL RELEVANCE STATEMENT This study highlights the novel utilization of ZOOMit diffusion-weighted imaging (DWI) for the assessment of lower extremity lesions compared to conventional DWI. KEY POINTS • Distal extremity diffusion-weighted imaging (DWI) is often limited. • ZOOMit DWI displayed improved fat suppression with less motion artifacts and better visualization of the lower extremity bones than conventional DWI. • ZOOMit shows decreased contrast-to-noise ratio than conventional DWI.
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Affiliation(s)
| | | | | | | | | | - Yin Xi
- UT Southwestern, Dallas, TX, USA
| | - Avneesh Chhabra
- UT Southwestern, Dallas, TX, USA.
- Radiology & Orthopedic Surgery, UT Southwestern, Dallas, TX, 75390-9178, USA.
- Johns Hopkins University, Baltimore, MD, USA.
- University of Dallas, Richardson, TX, USA.
- Walton Centre for Neuroscience, Liverpool, UK.
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2
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Debs P, Ahlawat S, Fayad LM. Bone tumors: state-of-the-art imaging. Skeletal Radiol 2024:10.1007/s00256-024-04621-7. [PMID: 38409548 DOI: 10.1007/s00256-024-04621-7] [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] [Received: 12/21/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/28/2024]
Abstract
Imaging plays a central role in the management of patients with bone tumors. A number of imaging modalities are available, with different techniques having unique applications that render their use advantageous for various clinical purposes. Coupled with detailed clinical assessment, radiological imaging can assist clinicians in reaching a proper diagnosis, determining appropriate management, evaluating response to treatment, and monitoring for tumor recurrence. Although radiography is still the initial imaging test of choice for a patient presenting with a suspected bone tumor, technological innovations in the last decades have advanced the role of other imaging modalities for assessing bone tumors, including advances in computed tomography, magnetic resonance imaging, scintigraphy, and hybrid imaging techniques that combine two existing modalities, providing clinicians with diverse tools for bone tumor imaging applications. Determining the most suitable modality to use for a particular application requires familiarity with the modality in question, its advancements, and its limitations. This review highlights the various imaging techniques currently available and emphasizes the latest developments in imaging, offering a framework that can help guide the imaging of patients with bone tumors.
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Affiliation(s)
- Patrick Debs
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA
| | - Shivani Ahlawat
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA
| | - Laura M Fayad
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
- Division of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, 601 North Caroline Street, JHOC 3014, Baltimore, MD, 21287, USA.
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3
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Requist MR, Mills MK, Carroll KL, Lenz AL. Quantitative Skeletal Imaging and Image-Based Modeling in Pediatric Orthopaedics. Curr Osteoporos Rep 2024; 22:44-55. [PMID: 38243151 DOI: 10.1007/s11914-023-00845-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 01/21/2024]
Abstract
PURPOSE OF REVIEW Musculoskeletal imaging serves a critical role in clinical care and orthopaedic research. Image-based modeling is also gaining traction as a useful tool in understanding skeletal morphology and mechanics. However, there are fewer studies on advanced imaging and modeling in pediatric populations. The purpose of this review is to provide an overview of recent literature on skeletal imaging modalities and modeling techniques with a special emphasis on current and future uses in pediatric research and clinical care. RECENT FINDINGS While many principles of imaging and 3D modeling are relevant across the lifespan, there are special considerations for pediatric musculoskeletal imaging and fewer studies of 3D skeletal modeling in pediatric populations. Improved understanding of bone morphology and growth during childhood in healthy and pathologic patients may provide new insight into the pathophysiology of pediatric-onset skeletal diseases and the biomechanics of bone development. Clinical translation of 3D modeling tools developed in orthopaedic research is limited by the requirement for manual image segmentation and the resources needed for segmentation, modeling, and analysis. This paper highlights the current and future uses of common musculoskeletal imaging modalities and 3D modeling techniques in pediatric orthopaedic clinical care and research.
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Affiliation(s)
- Melissa R Requist
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA
- Department of Biomedical Engineering, University of Utah, 36 S Wasatch Dr., Salt Lake City, UT, 84112, USA
| | - Megan K Mills
- Department of Radiology and Imaging Sciences, University of Utah, 30 N Mario Capecchi Dr. 2 South, Salt Lake City, UT, 84112, USA
| | - Kristen L Carroll
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA
- Shriners Hospital for Children, 1275 E Fairfax Rd, Salt Lake City, UT, 84103, USA
| | - Amy L Lenz
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
- Department of Biomedical Engineering, University of Utah, 36 S Wasatch Dr., Salt Lake City, UT, 84112, USA.
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4
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Setiawati R, Novariyanto B, Rahardjo P, Mustokoweni S, Guglielmi G. Characteristic of Apparent Diffusion Coefficient and Time Intensity Curve Analysis of Dynamic Contrast Enhanced MRI in Osteosarcoma Histopathologic Subtypes. Int J Med Sci 2023; 20:163-171. [PMID: 36794155 PMCID: PMC9925980 DOI: 10.7150/ijms.77906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/09/2022] [Indexed: 01/06/2023] Open
Abstract
Background: According to WHO criteria, osteosarcoma (OS) consists of various histopathological subtypes. Thus, contrast-enhanced MRI is a very useful modality in the diagnosis and evaluation of osteosarcoma. Magnetic resonance imaging with dynamic contrast enhancement (DCE-MRI) studies was used to determine the apparent diffusion coefficient (ADC) value and the slope of the time-intensity curve (TIC). This study aimed to determine the correlation between ADC and TIC analysis using %Slope and maximum enhancement (ME) of histopathological osteosarcoma subtypes. Methods: This was a retrospective study with observational analysis on OS patients. The obtained data were 43 samples. Moreover, the interpretation was conducted by placing three regions of interest (ROI) in determining ADC value. It was observed by two radiologist observers with more than 10 years of experience. In this case, as many as six obtained ROIs were averaged. The inter-observer agreement was evaluated by Kappa test. TIC curve was analyzed and slope value was obtained afterward. Through SPSS 21 software, the data was analyzed. Results: The mean of ADC values of OS was (1.031x10-3±0.31mm2/s), where the highest value was found in chondroblastic subtype (1.470 x10-3±0.31mm2/s). However, the mean of TIC %slope of OS was (45.3%/s), where the highest result was found in the osteoblastic subtype (70.8%/s) followed by small cell subtype (60.8%/s) and the mean of ME of OS was 100.55% with the highest values was in osteoblastic subtype 172.72% followed by chondroblastic subtype (144.92%). This study found a significant correlation between the mean of ADC value and the OS histopathologic results as well as the correlation between the mean of ADC value and ME. Conclusion: The various types of osteosarcoma have a characteristic of radiological appearances which may similar to some bone tumor entities. The analysis of ADC values and TIC curves using % slope and ME of osteosarcoma subtypes can improve the accuracy of diagnosis as well as the monitoring of the treatment response and the disease progression.
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Affiliation(s)
- Rosy Setiawati
- Radiology Department, Faculty of Medicine, Universitas Airlangga, Surabaya - Dr Soetomo General Academic Hospital Surabaya, Indonesia
| | - Bagus Novariyanto
- Radiology Department, Faculty of Medicine, Universitas Airlangga, Surabaya - Dr Soetomo General Academic Hospital Surabaya, Indonesia
| | - Paulus Rahardjo
- Radiology Department, Faculty of Medicine, Universitas Airlangga, Surabaya - Dr Soetomo General Academic Hospital Surabaya, Indonesia
| | - Sjahjenny Mustokoweni
- Department of Anatomical Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya - Dr Soetomo General Academic Hospital Surabaya, Indonesia, Indonesia
| | - Giuseppe Guglielmi
- Department of Radiology, School of Medicine, Foggia University, Foggia, Italy
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5
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Digma LA, Feng CH, Conlin CC, Rodríguez-Soto AE, Zhong AY, Hussain TS, Lui AJ, Batra K, Simon AB, Karunamuni R, Kuperman J, Rakow-Penner R, Hahn ME, Dale AM, Seibert TM. Correcting B 0 inhomogeneity-induced distortions in whole-body diffusion MRI of bone. Sci Rep 2022; 12:265. [PMID: 34997164 PMCID: PMC8741963 DOI: 10.1038/s41598-021-04467-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/23/2021] [Indexed: 01/05/2023] Open
Abstract
Diffusion-weighted magnetic resonance imaging (DWI) of the musculoskeletal system has various applications, including visualization of bone tumors. However, DWI acquired with echo-planar imaging is susceptible to distortions due to static magnetic field inhomogeneities. This study aimed to estimate spatial displacements of bone and to examine whether distortion corrected DWI images more accurately reflect underlying anatomy. Whole-body MRI data from 127 prostate cancer patients were analyzed. The reverse polarity gradient (RPG) technique was applied to DWI data to estimate voxel-level distortions and to produce a distortion corrected DWI dataset. First, an anatomic landmark analysis was conducted, in which corresponding vertebral landmarks on DWI and anatomic T2-weighted images were annotated. Changes in distance between DWI- and T2-defined landmarks (i.e., changes in error) after distortion correction were calculated. In secondary analyses, distortion estimates from RPG were used to assess spatial displacements of bone metastases. Lastly, changes in mutual information between DWI and T2-weighted images of bone metastases after distortion correction were calculated. Distortion correction reduced anatomic error of vertebral DWI up to 29 mm. Error reductions were consistent across subjects (Wilcoxon signed-rank p < 10-20). On average (± SD), participants' largest error reduction was 11.8 mm (± 3.6). Mean (95% CI) displacement of bone lesions was 6.0 mm (95% CI 5.0-7.2); maximum displacement was 17.1 mm. Corrected diffusion images were more similar to structural MRI, as evidenced by consistent increases in mutual information (Wilcoxon signed-rank p < 10-12). These findings support the use of distortion correction techniques to improve localization of bone on DWI.
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Affiliation(s)
- Leonardino A Digma
- Department of Radiation Medicine and Applied Sciences, School of Medicine, University of California San Diego, 9500 Gilman Drive, Mail Code 0861, La Jolla, CA, 92093-0861, USA
| | - Christine H Feng
- Department of Radiation Medicine and Applied Sciences, School of Medicine, University of California San Diego, 9500 Gilman Drive, Mail Code 0861, La Jolla, CA, 92093-0861, USA
| | - Christopher C Conlin
- Department of Radiology, School of Medicine, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Ana E Rodríguez-Soto
- Department of Radiology, School of Medicine, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Allison Y Zhong
- Department of Radiation Medicine and Applied Sciences, School of Medicine, University of California San Diego, 9500 Gilman Drive, Mail Code 0861, La Jolla, CA, 92093-0861, USA
| | - Troy S Hussain
- Department of Radiation Medicine and Applied Sciences, School of Medicine, University of California San Diego, 9500 Gilman Drive, Mail Code 0861, La Jolla, CA, 92093-0861, USA
| | - Asona J Lui
- Department of Radiation Medicine and Applied Sciences, School of Medicine, University of California San Diego, 9500 Gilman Drive, Mail Code 0861, La Jolla, CA, 92093-0861, USA
| | - Kanha Batra
- Department of Electrical and Computer Engineering, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Aaron B Simon
- Department of Radiation Medicine and Applied Sciences, School of Medicine, University of California San Diego, 9500 Gilman Drive, Mail Code 0861, La Jolla, CA, 92093-0861, USA
| | - Roshan Karunamuni
- Department of Radiation Medicine and Applied Sciences, School of Medicine, University of California San Diego, 9500 Gilman Drive, Mail Code 0861, La Jolla, CA, 92093-0861, USA
| | - Joshua Kuperman
- Department of Radiology, School of Medicine, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Rebecca Rakow-Penner
- Department of Radiology, School of Medicine, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Michael E Hahn
- Department of Radiology, School of Medicine, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Anders M Dale
- Department of Radiology, School of Medicine, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Tyler M Seibert
- Department of Radiation Medicine and Applied Sciences, School of Medicine, University of California San Diego, 9500 Gilman Drive, Mail Code 0861, La Jolla, CA, 92093-0861, USA. .,Department of Radiology, School of Medicine, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA. .,Department of Bioengineering, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
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6
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Chaturvedi A. Pediatric skeletal diffusion-weighted magnetic resonance imaging, part 2: current and emerging applications. Pediatr Radiol 2021; 51:1575-1588. [PMID: 34018037 DOI: 10.1007/s00247-021-05028-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/07/2021] [Accepted: 02/17/2021] [Indexed: 01/07/2023]
Abstract
Diffusion-weighted imaging (DWI) complements the more established T1, fluid-sensitive and gadolinium-enhanced magnetic resonance pulse sequences used to assess several pediatric skeletal pathologies. There is optimism that the technique might not just be complementary but could serve as an alternative to gadolinium and radiopharmaceuticals for several indications. As a non-contrast, free-breathing and noninvasive technique, DWI is especially valuable in children and is readily incorporated into existing MRI protocols. The indications for skeletal DWI in children include distinguishing between benign and malignant skeletal processes, initial assessment and treatment response assessment for osseous sarcomas, and assessment of inflammatory arthropathies and femoral head ischemia, among others. A notable challenge of diffusion MRI is the dynamic nature of the growing pediatric skeleton. It is important to consider the child's age when placing DWI findings in context with potential marrow pathology. This review article summarizes the current and evolving applications of DWI for assessing the pediatric skeleton, rounding off the discussion with evolving directions for further research in this realm.
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Affiliation(s)
- Apeksha Chaturvedi
- Division of Pediatric Radiology, Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642, USA.
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7
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Chianca V, Albano D, Messina C, Vincenzo G, Rizzo S, Del Grande F, Sconfienza LM. An update in musculoskeletal tumors: from quantitative imaging to radiomics. Radiol Med 2021; 126:1095-1105. [PMID: 34009541 DOI: 10.1007/s11547-021-01368-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/02/2021] [Indexed: 02/08/2023]
Abstract
In the last two decades, relevant progress has been made in the diagnosis of musculoskeletal tumors due to the development of new imaging tools, such as diffusion-weighted imaging, diffusion kurtosis imaging, magnetic resonance spectroscopy, and diffusion tensor imaging. Another important role has been played by the development of artificial intelligence software based on complex algorithms, which employ computing power in the detection of specific tumor types. The aim of this article is to report the most advanced imaging techniques focusing on their advantages in clinical practice.
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Affiliation(s)
- Vito Chianca
- Clinica di Radiologia EOC IIMSI, Lugano, Switzerland. .,Ospedale Evangelico Betania, Napoli, Italy. .,Master in Oncologic Imaging, Diagnostic and Interventional Radiology Department of Translational Research, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.,Sezione di Scienze Radiologiche, Dipartimento Di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Palermo, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.,Dipartimento di Scienze Biomediche Per La Salute, Università degli Studi di Milano, Milano, Italy
| | | | | | | | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.,Dipartimento di Scienze Biomediche Per La Salute, Università degli Studi di Milano, Milano, Italy
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8
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Meyer HJ, Schneider I, Emmer A, Kornhuber M, Surov A. Associations between apparent diffusion coefficient values and histopathological tissue alterations in myopathies. Brain Behav 2020; 10:e01809. [PMID: 32860496 PMCID: PMC7667360 DOI: 10.1002/brb3.1809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Diffusion-weighted imaging (DWI) can reflect histopathologic changes in muscle disorders. The present study sought to elucidate possible associations between histopathology derived from muscle biopsies and DWI in myositis and other myopathies. METHODS Nineteen patients (10 women, 52.6%) with a mean age 51.43 ± 19 years were included in this retrospective study. Apparent diffusion coefficients (ADC) were evaluated with a histogram approach of the biopsied muscle. The histopathology analysis included the scoring systems proposed by Tateyama et al., Fanin et al., Allenbach et al. and immunhistochemical stainings for MHC, CD68, CD8, and CD4. RESULTS There was a tendency that skewness was lowered with increasing Tateyama score, but it did not reach statistical significance (p = .14). No statistical differences for the other scores were identified. There was a tendency that kurtosis was higher in MHC negative stained patient compared to positive patients, but statistically significance was not reached (p = .07). ADC histogram parameters did not correlate with CD68 and CD8 positive stained cells. There was a trend for skewness to correlate with the amount of CD4-positive cells (r = .57, p = .07). CONCLUSION The present study could not identify statistical significant associations between DWI and histopathology in muscle diseases based upon a small patient sample. Presumably, the investigated histopathology scores are more specific for certain disease aspects, whereas ADC values reflect the whole cellularity of the investigated muscle, which might cause the negative results.
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Affiliation(s)
- Hans-Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Ilka Schneider
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Alexander Emmer
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Malte Kornhuber
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Alexey Surov
- Department of Diagnostic and Interventional Radiology, University of Magdeburg, Magdeburg, Germany
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Sandberg JK, Young VA, Syed AB, Yuan J, Hu Y, Sandino C, Menini A, Hargreaves B, Vasanawala S. Near-Silent and Distortion-Free Diffusion MRI in Pediatric Musculoskeletal Disorders: Comparison With Echo Planar Imaging Diffusion. J Magn Reson Imaging 2020; 53:504-513. [PMID: 32815203 DOI: 10.1002/jmri.27330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diffusion-weighted imaging (DWI) is common for evaluating pediatric musculoskeletal lesions, but suffers from geometric distortion and intense acoustic noise. PURPOSE To investigate the performance of a near-silent and distortion-free DWI sequence (DW-SD) relative to standard echo-planar DWI (DW-EPI) in pediatric extremity MRI. STUDY TYPE Prospective validation study. SUBJECTS Thirty-nine children referred for extremity MRI. FIELD STRENGTH/SEQUENCE DW-EPI and DW-SD, based on a rotating ultrafast sequence modified with sinusoidal diffusion preparation gradients, at 3T. ASSESSMENT DW-SD image quality (Sanat ) was assessed from 0 (nondiagnostic) to 5 (outstanding) and comparative image quality (Scomp ) (from -2 = DW-EPI more delineated to +2 = DW-SD more delineated, 0 = same). ADC measured by DW-SD and DW-EPI were compared in bone marrow, muscle, and lesions. STATISTICAL TESTS Wilcoxon rank-sum test and confidence interval of proportions (CIOP) were calculated for Scomp , Student's t-test, coefficient of variation (COV), and Bland-Altman analysis for ADC values, and intraclass correlation coefficient (ICC) for interreader agreement. RESULTS DW-SD and DW-EPI ADC values for bone marrow, muscle, and lesions were not significantly different (P = 0.3, P = 0.2, and P = 0.27, respectively) and had an overall ADC COV of 14.8% (95% confidence interval: 12.3%, 16.9%) and no significant proportional bias on Bland-Altman analysis. Sanat CIOP was rated diagnostic or better (score of 3, 4, or 5) in 72-98% of cases for bone marrow, muscle, and soft tissues. DW-SD was equivalent to or preferred over DW-EPI in muscles and soft tissues, with CIOP 86-93% and 93%, respectively. Lesions were equally visualized on DW-SD and DW-EPI in 40-51%, with DW-SD preferred in 44-56% of cases. DW-SD was rated significantly better than DW-EPI across all comparative variables that included bone marrow, muscle, soft tissue, cartilage, and lesions (P < 0.05). Readers had moderate to near-perfect (ICC range = 0.45-0.85). DATA CONCLUSION DW-SD of the extremities provided similar ADC values and improved image quality compared with conventional DW-EPI. Level of Evidence 2 Technical Efficacy Stage 2 J. MAGN. RESON. IMAGING 2021;53:504-513.
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Affiliation(s)
- Jesse K Sandberg
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Victoria A Young
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Ali B Syed
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Jianmin Yuan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Yuxin Hu
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Christopher Sandino
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Anne Menini
- Application Science Lab, GE Healthcare, Menlo Park, California, USA
| | - Brian Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA
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10
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[Postoperative and posttherapeutic changes after primary bone tumors : What's important for radiologists?]. Radiologe 2017; 57:938-957. [PMID: 28986639 DOI: 10.1007/s00117-017-0304-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Posttreatment imaging of primary bone tumours represents a diagnostic challenge for radiologists. Depending on the primary bone tumour common radiological procedures, such as radiography, computed tomography (CT), and magnetic resonance imaging (MRI), are employed. Radiography and CT are particularly useful in benign bone tumours and in matrix-forming bone tumours. MRI comes into consideration with malignant tumour recurrence and tumoral soft tissue infiltration. Bone scintigraphy is of superior importance if a primarily multifocal manifestation of bone tumour or metastasizing tumour disease is suspected. Molecular imaging (FDG-PET and hybrid imaging, using CT) are gaining increasing importance in light of monitoring neoadjuvant chemotherapy and detecting recurrent tumour appearance. The current literature shows sensitivity and specificity values for recurrent detection of up to 92% and 93%. Diagnostic accuracy is as high as 95%, thus, exceeding accuracy values for CT (67%) and MRI (86%) by far. Likewise, this is also applicable for the assessment of the neoadjuvant chemotherapy. Moreover, PET-based modalities are able to establish prognostic statements using SUV-threshold values at baseline (especially for Ewing sarcomas). Advanced imaging techniques have made a great diagnostic step forward and have proven to be relevant and reproducible with respect to both relapse detection and treatment assessment. Furthermore, it is not clear whether a higher detection rate of early tumour recurrence will inevitably lead to better outcome and survival.
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11
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Bae WC, Ruangchaijatuporn T, Chung CB. New Techniques in MR Imaging of the Ankle and Foot. Magn Reson Imaging Clin N Am 2017; 25:211-225. [PMID: 27888849 DOI: 10.1016/j.mric.2016.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Foot and ankle disorders are common in everyday clinical practice. MR imaging is frequently required for diagnosis given the variety and complexity of foot and ankle anatomy. Although conventional MR imaging plays a significant role in diagnosis, contemporary management increasingly relies on advanced imaging for monitoring therapeutic response. There is an expanding need for identification of biomarkers for musculoskeletal tissues. Advanced imaging techniques capable of imaging these tissue substrates will be increasingly used in routine clinical practice. Radiologists should therefore become familiar with these innovative MR techniques. Many such techniques are already widely used in other organ systems.
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Affiliation(s)
- Won C Bae
- Radiology Service, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA 92161, USA; Department of Radiology, UCSD MSK Imaging Research Lab, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997, USA
| | - Thumanoon Ruangchaijatuporn
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchatewi, Bangkok 10400, Thailand
| | - Christine B Chung
- Radiology Service, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA 92161, USA; Department of Radiology, UCSD MSK Imaging Research Lab, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997, USA.
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Oei L, Koromani F, Rivadeneira F, Zillikens MC, Oei EHG. Quantitative imaging methods in osteoporosis. Quant Imaging Med Surg 2016; 6:680-698. [PMID: 28090446 DOI: 10.21037/qims.2016.12.13] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Osteoporosis is characterized by a decreased bone mass and quality resulting in an increased fracture risk. Quantitative imaging methods are critical in the diagnosis and follow-up of treatment effects in osteoporosis. Prior radiographic vertebral fractures and bone mineral density (BMD) as a quantitative parameter derived from dual-energy X-ray absorptiometry (DXA) are among the strongest known predictors of future osteoporotic fractures. Therefore, current clinical decision making relies heavily on accurate assessment of these imaging features. Further, novel quantitative techniques are being developed to appraise additional characteristics of osteoporosis including three-dimensional bone architecture with quantitative computed tomography (QCT). Dedicated high-resolution (HR) CT equipment is available to enhance image quality. At the other end of the spectrum, by utilizing post-processing techniques such as the trabecular bone score (TBS) information on three-dimensional architecture can be derived from DXA images. Further developments in magnetic resonance imaging (MRI) seem promising to not only capture bone micro-architecture but also characterize processes at the molecular level. This review provides an overview of various quantitative imaging techniques based on different radiological modalities utilized in clinical osteoporosis care and research.
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Affiliation(s)
- Ling Oei
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Fjorda Koromani
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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