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Dyrberg E, Hendel HW, Løgager VB, Madsen C, Pedersen EM, Zerahn B, Thomsen HS. A prospective study determining and comparing the diagnostic accuracy of fluoride-PET/CT, choline-PET/CT, whole-body bone SPECT/CT and whole-body MRI for the detection of bone metastases in patients with prostate cancer. Eur J Hybrid Imaging 2018. [DOI: 10.1186/s41824-018-0038-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Dyrberg E, Hendel HW, Al-Farra G, Balding L, Løgager VB, Madsen C, Thomsen HS. A prospective study comparing whole-body skeletal X-ray survey with 18F-FDG-PET/CT, 18F-NaF-PET/CT and whole-body MRI in the detection of bone lesions in multiple myeloma patients. Acta Radiol Open 2017; 6:2058460117738809. [PMID: 29123920 PMCID: PMC5661685 DOI: 10.1177/2058460117738809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 09/25/2017] [Indexed: 11/29/2022] Open
Abstract
Background For decades, the most widely used imaging technique for myeloma bone lesions has been a whole-body skeletal X-ray survey (WBXR), but newer promising imaging techniques are evolving. Purpose To compare WBXR with the advanced imaging techniques 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT), 18F-sodium fluoride (NaF) PET/CT and whole-body magnetic resonance imaging (WB-MRI) in the detection of myeloma bone lesions. Material and Methods Fourteen patients with newly diagnosed multiple myeloma were prospectively enrolled. In addition to WBXR, all patients underwent FDG-PET/CT, NaF-PET/CT, and WB-MRI. Experienced specialists performed blinded readings based on predefined anatomical regions and diagnostic criteria. Results In a region-based analysis, a two-sided ANOVA test showed that the extent of detected skeletal disease depends on the scanning technique (P < 0.0001). Tukey’s multiple comparison test revealed that WB-MRI on average detects significantly more affected regions than WBXR (P < 0.005), FDG-PET/CT (P < 0.0001), and NaF-PET/CT (P < 0.05). In a patient-based analysis, a Cochran’s Q test showed that there are no significant differences in the proportion of patients with bone disease detected by the different scanning techniques (P = 0.23). Determination of intrareader variability resulted in Kappa coefficients corresponding to moderate (FDG-PET/CT) and substantial agreement (WB-MRI, WBXR, NaF-PET/CT). Conclusion WB-MRI detects on average significantly more body regions indicative of myeloma bone disease compared to WBXR, FDG-PET/CT, and NaF-PET/CT. The lack of significance in the patient-based analysis is most likely due to the small number of study participants.
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Affiliation(s)
- Eva Dyrberg
- Copenhagen University Hospital Herlev, Herlev, Denmark.,Copenhagen University Hospital Herlev, Herlev, Denmark
| | | | - Gina Al-Farra
- Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Lone Balding
- Copenhagen University Hospital Herlev, Herlev, Denmark
| | | | - Claus Madsen
- Copenhagen University Hospital Herlev, Herlev, Denmark
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Achiam MP, Løgager VB, Skjoldbye B, Møller JM, Lorenzen T, Rasmussen VL, Thomsen HS, Mollerup TH, Okholm C, Rosenberg J. Preoperative CT versus diffusion weighted magnetic resonance imaging of the liver in patients with rectal cancer; a prospective randomized trial. PeerJ 2016; 4:e1532. [PMID: 26793420 PMCID: PMC4715462 DOI: 10.7717/peerj.1532] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 12/03/2015] [Indexed: 12/13/2022] Open
Abstract
Introduction. Colorectal cancer is one of the most frequent cancers in the world and liver metastases are seen in up to 19% of patients with colorectal cancers. Detection of liver metastases is not only vital for sufficient treatment and survival, but also for a better estimation of prognosis. The aim of this study was to evaluate the feasibility of diffusion weighted MRI of the liver as part of a combined MR evaluation of patients with rectal cancers and compare it with the standard preoperative evaluation of the liver with CT. Methods. Consecutive patients diagnosed with rectal cancers were asked to participate in the study. Preoperative CT and diffusion weighted MR (DWMR) were compared to contrast enhanced laparoscopic ultrasound (CELUS). Results. A total of 35 patients were included, 15 patients in Group-1 having the standard CT evaluation of the liver and 20 patients in Group-2 having the standard CT evaluation of the liver and DWMR of the liver. Compared with CELUS, the per-patient sensitivity/specificity was 50/100% for CT, and for DWMR: 100/94% and 100/100% for Reader 1 and 2, respectively. The per-lesion sensitivity of CT and DWMR were 17% and 89%, respectively compared with CELUS. Furthermore, one patient had non-resectable metastases after DWMR despite being diagnosed with resectable metastases after CT. Another patient was diagnosed with multiple liver metastases during CELUS, despite a negative CT-scan. Discussion. DWMR is feasible for preoperative evaluation of liver metastases. The current standard preoperative evaluation with CT-scan results in disadvantages like missed metastases and futile operations. We recommend that patients with rectal cancer, who are scheduled for MR of the rectum, should have a DWMR of the liver performed at the same time.
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Affiliation(s)
- Michael P Achiam
- Department of Surgical Gastroenterology, Abdominal Centret, Rigshospitalet, University of Copenhagen , Copenhagen , Denmark
| | - Vibeke B Løgager
- Department of Radiology, Herlev Hospital, University of Copenhagen , Herlev , Denmark
| | - Bjørn Skjoldbye
- Department of Surgical Gastroenterology, Herlev Hospital, University of Copenhagen , Herlev , Denmark
| | - Jakob M Møller
- Department of Radiology, Herlev Hospital, University of Copenhagen , Herlev , Denmark
| | - Torben Lorenzen
- Department of Surgical Gastroenterology, Herlev Hospital, University of Copenhagen , Herlev , Denmark
| | - Vera L Rasmussen
- Department of Radiology, Herlev Hospital, University of Copenhagen , Herlev , Denmark
| | - Henrik S Thomsen
- Department of Radiology, Herlev Hospital, University of Copenhagen , Herlev , Denmark
| | - Talie H Mollerup
- Department of Surgical Gastroenterology, Herlev Hospital, University of Copenhagen , Herlev , Denmark
| | - Cecilie Okholm
- Department of Surgical Gastroenterology, Abdominal Centret, Rigshospitalet, University of Copenhagen , Copenhagen , Denmark
| | - Jacob Rosenberg
- Department of Surgical Gastroenterology, Herlev Hospital, University of Copenhagen , Herlev , Denmark
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Jesuratnam-Nielsen K, Løgager VB, Rezanavaz-Gheshlagh B, Munkholm P, Thomsen HS. Plain magnetic resonance imaging as an alternative in evaluating inflammation and bowel damage in inflammatory bowel disease--a prospective comparison with conventional magnetic resonance follow-through. Scand J Gastroenterol 2015; 50:519-27. [PMID: 25592192 DOI: 10.3109/00365521.2014.1003398] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To compare prospectively the diagnostic accuracy of magnetic resonance imaging (MRI) without use of contrast medium orally or intravenously (plain MRI) with magnetic resonance follow-through (MRFT) in patients with inflammatory bowel disease (IBD). MATERIAL AND METHODS Plain MRI was carried out in addition to MRFT, to which the patients were referred. All patients underwent both examinations on the same day. For the evaluation, the bowel was divided into nine segments. Two radiologists, blinded to clinical findings, evaluated bowel wall thickness, diffusion weighted imaging (DWI), and other inflammatory changes in each bowel segments. Further, hyperenhancement of the bowel was also evaluated in MRFT. RESULTS A total of 100 patients (40 males and 60 females; median age: 38.5; range: 19-90) were enrolled; 44 with Crohn's disease (CD), 25 with ulcerative colitis (UC), 24 with IBD unclassified (IBD-U), and 7 had other diagnosis. Sensitivity, specificity, and accuracy in CD ranged 50-86%, 93-94%, and 91-92% for wall thickening and 49-82%, 85-93%, and 84-89% for DWI, respectively. Sensitivity, specificity, and accuracy in UC range 0-40%, 87-100%, and 80-100% for wall thickening and 0-52%, 83-94% and 76-92% for DWI, respectively. The κ values for bowel wall thickening, DWI, and mural hyperenhancement were detected with fair agreement (κ = 0.26-0.39) at both MRI examinations, whereas only bowel wall thickening in MRFT were detected with moderate agreement (κ = 0.47) Conclusion. Plain MRI cannot currently replace MRFT in the workup of patients with IBD. Further research on plain MRI is needed to improve the protocol.
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Gandrup KL, Løgager VB, Bretlau T, Nordling J, Thomsen HS. Diagnosis of bladder tumours in patients with macroscopic haematuria: A prospective comparison of split-bolus computed tomography urography, magnetic resonance urography and flexible cystoscopy. Scand J Urol 2014; 49:224-9. [DOI: 10.3109/21681805.2014.981203] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Nielsen YW, Eiberg JP, Løgager VB, Just S, Schroeder TV, Thomsen HS. Patient acceptance of whole-body magnetic resonance angiography: A prospective questionnaire study. Acta Radiol 2010; 51:277-83. [PMID: 20092370 DOI: 10.3109/02841850903482893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Whole-body magnetic resonance angiography (WB-MRA) is a noninvasive method for diagnosing the systemic distribution of atherosclerosis. Numerous studies have demonstrated the feasibility and diagnostic performance of WB-MRA, but no studies have investigated patient acceptance of this imaging method. PURPOSE To measure patient acceptance of WB-MRA compared to the gold standard, digital subtraction angiography (DSA), in patients with peripheral arterial disease (PAD). MATERIAL AND METHODS In a prospective design, 79 consecutive patients (51 male, mean age 67 years) with symptomatic PAD, scheduled to undergo both WB-MRA and DSA, were included. Patient acceptance of each imaging procedure was assessed with a postal questionnaire (13 questions). A five-point rank scale (1, no discomfort; 5, severe discomfort) was used to grade patient discomfort. RESULTS One patient was excluded from data analysis (did not undergo DSA). Of the remaining 78 patients, 69 completed the questionnaire (response rate 88%). Overall discomfort scores were higher in DSA compared to WB-MRA (mean 2.1 and 1.7, respectively; P = 0.06). In WB-MRA, overall discomfort was strongly correlated to feeling confined in the MRI system (R = 0.77, P< 0.001). In DSA, discomfort was strongly correlated to arterial puncture (R = 0.66, P< 0.001) and contrast injection (R= 0.65, P< 0.001). Injection of iodinated contrast agent at DSA was graded more uncomfortable than injection of gadolinium-based contrast agent at WB-MRA (mean 2.1 vs. 1.5, respectively; P<0.001). Sixty-two patients (90%) were willing to repeat WB-MRA, and 64 patients (93%) would repeat DSA if they needed another vascular examination. Forty-one patients preferred WB-MRA (60%), 12 patients preferred DSA (17%), and 16 patients had no preference (23%). Patient preference of WB-MRA over DSA was statistically significant (P< 0.001). CONCLUSION Patient acceptance of WB-MRA is superior to that of DSA in patients with PAD, with the majority of patients preferring WB-MRA.
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Affiliation(s)
| | - Jonas P. Eiberg
- Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke B. Løgager
- Department of Radiology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Sven Just
- Department of Radiology, Copenhagen University Hospital Gentofte, Gentofte, Denmark
| | - Torben V. Schroeder
- Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Surgery and Internal Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik S. Thomsen
- Department of Radiology, Copenhagen University Hospital Herlev, Herlev, Denmark
- Department of Diagnostic Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Thomsen HS, Johannesen HH, Løgager VB, Hansen RH. [Magnetic resonance imaging]. Ugeskr Laeger 2008; 170:3211. [PMID: 18940148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Juhl ZK, Løgager VB. [Subcutaneous cysticercosis and neurocysticercosis]. Ugeskr Laeger 2000; 162:6691-2. [PMID: 11188058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Two cases, one of subcutaneous cysticercosis and one of neurocysticercosis, are described--both in young women, who had been in Mexico and ex-Yugoslavia, respectively. Neurocysticercosis is the most common neuroparasitosis in the world (and probably the reason for 2/3 of the cases of epilepsy) and as travels to endemic areas and immigration are on the increase, general practitioners should have cysticercosis in mind when treating a patient with subcutaneous noduli or cerebral symptoms.
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Affiliation(s)
- Z K Juhl
- H:S Rigshospitalet, infektionsmedicinsk afdeling M og neuroradiologisk afsnit
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Løgager VB, Vestergaard A, Herrstedt J, Thomsen HS, Zedeler K, Dombernowsky P. The limited value of routine chest X-ray in the follow-up of stage II breast cancer. Eur J Cancer 1990; 26:553-5. [PMID: 2144738 DOI: 10.1016/0277-5379(90)90073-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In 280 patients with stage II breast cancer, chest X-ray was performed at 6 and 12 months and yearly thereafter to the 6th year or until recurrence, another cancer was detected, the patient refused further follow-up or died. Among 1289 scheduled chest X-rays, malignant changes were found in 20 patients, of which only 3 had pulmonary symptoms. In a further 14 patients malignant changes were suspected, but follow-up examinations could not prove malignancy. 26 patients presented within 12 months after the last scheduled X-ray with pulmonary symptoms and a work-up chest X-ray revealed malignant changes. Thus, in only 1.3% of the scheduled X-rays were unsuspected malignant changes diagnosed. Median survival of patients with malignant chest X-rays found at scheduled controls versus between scheduled controls did not differ significantly (P = 0.26). It is concluded that routine chest X-ray is not indicated in patients with stage II breast cancer.
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Affiliation(s)
- V B Løgager
- Department of Diagnostic Radiology, Herlev Hospital, University of Copenhagen, Denmark
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